National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranTANAFFOS (Respiration)1735-034420320210701Late Post-Coronavirus Disease 2019 Inflammatory Syndrome: A Case Experience with Tocilizumab188191251185ENPayamTabarsiClinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IranGolnazAfzalDepartment of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, IranRahaEskandariChronic Respiratory Diseases Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, IranFarzanehDastanDepartment of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, IranChronic Respiratory Diseases Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, IranJournal Article20220316https://www.tanaffosjournal.ir/article_251185_8914cc5dc5cab89a7503780cd81b7421.pdfNational Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranTANAFFOS (Respiration)1735-034420320210701NRITLD Protocol for the Management of Outpatient Cases of COVID-19192196251186ENMitraRezaeiClinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranHamidrezaJamaatiChronic Respiratory Disease Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, IranPayamTabarsiClinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranAfshinMoniriClinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranMajidMarjaniClinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran0000-0003-1466-8645Ali AkbarVelayatiClinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranJournal Article20220316Despite the fact that about two years have passed since the onset of the COVID-19 pandemic, there is still no curative treatment for the disease. Most cases of COVID-19 have mild or moderate illness and do not require hospitalization.
This guideline released by the National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Masih Daneshvari Hospital COVID-19 Expert Group to provide a treatment guide for outpatient management of COVID-19.https://www.tanaffosjournal.ir/article_251186_192b9180ee7f1014aabd2be0d3d64694.pdfNational Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranTANAFFOS (Respiration)1735-034420320210701The Common miRNAs between Tuberculosis and Non-Small Cell Lung Cancer: A Critical Review197208251187ENMojganSheikhpourDepartment of Mycobacteriology and Pulmonary Research, Microbiology Research Center, Pasteur Institute of Iran, Tehran, IranMicrobiology Research Center, Pasteur Institute of Iran, Tehran, IranHanieAbolfathiDepartment of Mycobacteriology and Pulmonary Research, Pasteur Institute of Iran, Tehran, IranMortezaKarimipoorDepartment of Molecular Medicine, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, IranAbolfazlMovafaghDepartment of Medical Genetics, Cancer Research Center, Shohada Hospital , School of Medicine, Shahid Beheshti University of Medical Science, Tehran, IranMahbubehShahsavaniDepartment of Genetics & Biotechnology, School of Biological Science, Varamin-Pishva Branch, Islamic Azad University, Varamin, IranJournal Article20220316Tuberculosis (TB) and non-small cell lung cancer (NSCLC) are two major contributors to mortality and morbidity worldwide. In this regard, TB and NSCLC have similar symptoms, and TB has symptoms that are identical to malignancy; therefore, sometimes it is mistakenly diagnosed as lung cancer. Moreover, patients with active pulmonary TB are at a higher risk of dying due to lung cancer. In addition, several signaling pathways involved in TB and NSCLC have been identified. Also, the miRNAs are biological molecules shown to play essential roles in the above-mentioned diseases through targeting the signaling pathways’ genes. Most of the pathways affected by miRNAs are immune responses such as autophagy and apoptosis in TB and NSCLC, respectively. Several studies have separately investigated the expression of miRNAs profile in patients with NSCLC and infectious TB. In this critical review, we attempted to gather common miRNAs between TB and NSCLC and to explain the involved-pathways, which are affected by miRNAs in both TB and NSCLC. Results of this critical review show that the expressions of miR-155, miR-146a, miR-125b, miR-30a, miR-29a, and miR-Let7 have significantly changed in TB and NSCLC. The data suggest that miRNAs expression may provide a new method for screening or differential diagnosis of NSCLC and TB.https://www.tanaffosjournal.ir/article_251187_e72ea66931ab8a2bbc8168b6be8ef648.pdfNational Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranTANAFFOS (Respiration)1735-034420320210701Telemedicine Services in Chronic Obstructive Pulmonary Disease: A Systematic Review of Patients’ Adherence209220251188ENAzamSabahiDepartment of Health Information Technology, Ferdows School of Health and Allied Medical Sciences, Birjand University of Medical Sciences, South Khorasan, Iran0000-0002-9040-8813AzamossadatHosseiniDepartment of Health Information Technology and Management, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IranHasanEmamiDepartment of Health Information Technology and Management, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IranSohrabAlmasiDepartment of Health Information Technology and Management, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran0000-0003-0707-8399Journal Article20220316<strong>Background: </strong>The current systematic review aimed to determine the effect of telemedicine services on adherence in patients with chronic obstructive pulmonary disease (COPD) and to describe the type of adherence and applied devices and modules.
<strong>Materials and Methods: </strong>We reviewed PubMed, Scopus, Web of Science, and Embase databases to identify relevant studies from the time of inception of these databases to March 10, 2019, using three groups of keywords. The first group comprised words describing COPD, the second group included words describing types of telemedicine interventions, and the third group contained words describing adherence. The reference list of identified articles was also hand-searched to retrieve possibly relevant articles.
<strong>Results: </strong>In total 21 articles were included, in which 13 reported a positive effect for telemedicine on patients’ adherence. Adherence to treatment was classified under six categories. The highest frequency belongs to the adherence to performing exercises and participation in training sessions, using the system, using devices, measuring (like blood pressure, oxygen saturation, heart rate, weight, temperature, sputum volume) and reporting symptoms and the results of measurements, completing tasks, and medication.
<strong>Conclusion:</strong> This study demonstrated the effectiveness of telemedicine services on adherence to treatment plans in patients with COPD. The following factors contribute to the effectiveness of telemedicine services: patient support by healthcare professionals and easy access to them, uninterrupted execution of telemedicine programs, follow-up and supervision of providers, creating and maintaining motivation in patients, and provision of different self-management modules.https://www.tanaffosjournal.ir/article_251188_cf2c2d898f1e95aae8c6e4a7a4bed943.pdfNational Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranTANAFFOS (Respiration)1735-034420320210701Value of Cancer Ratio plus and Cancer Ratio Formulation in Distinguishing Malignant Pleural Effusion from Tuberculosis and Parapneumonic Effusion221231251189ENMineGayafDepartment of Chest Diseases, Health Sciences University İzmir Dr. Suat Seren Chest Diseases and Chest Surgery Training and Research Hospital, İzmir, TurkeyCeydaAnarDepartment of Chest Diseases, Health Sciences University İzmir Dr. Suat Seren Chest Diseases and Chest Surgery Training and Research Hospital, İzmir, Turkey0000-0002-3922-5800MustafaCanbazDepartment of Chest Diseases, Health Sciences University İzmir Dr. Suat Seren Chest Diseases and Chest Surgery Training and Research Hospital, İzmir, TurkeyDursunTatarDepartment of Chest Diseases, Health Sciences University İzmir Dr. Suat Seren Chest Diseases and Chest Surgery Training and Research Hospital, İzmir, TurkeyFilizGüldavalDepartment of Chest Diseases, Health Sciences University İzmir Dr. Suat Seren Chest Diseases and Chest Surgery Training and Research Hospital, İzmir, TurkeyJournal Article20220316<strong>Background: </strong>The aim of our study is to determine the clinical availability accessibility of cancer ratio and cancer ratio plus formulations, previously validated and reported to have clinical value in distinguishing malignant pleural effusion from tuberculosis pleurisy and parapneumonic effusion.
<strong>Materials and Methods:</strong> Retrospective study of patients hospitalized with Malignant Pleural Effusion (MPE), tuberculosis (TPE) and pararapneumonic effusion (PPE) between 2009 and 2018.
<strong>Results: </strong>Totally 232 patients, 101(43.5 %) having MPE, 86 (37.1 %) having PPE and 45 (19.4 %) TPE were examined. When compared with each other, ‘’serum LDH / PS Lymphocyte %’’, ‘’Cancer ratıo’’ and ‘’Cancer ratıo plus’’ values were statistically different between the groups (p = 0.021, p <0.001 and p = 0.015, respectively). In multivariate logistic regression analysis, cancer ratio, serum LDH: pleural fluid lymphocyte count ratio was in positive correlation with MPE. The sensitivity and specificity of ‘’cancer ratio’’, “cancer ratio plus” and ‘’ratio of serum LDH: pleural fluid lymphocyte count’’ were 84.2 % (95% CI 75.6– 90.7) and 52.7 (95% CI 43.8– 61.5), and 82.2 % (95% CI 73.3– 89.1) and 45.8 (95%CI 37.1– 54.7), 53.5% (95% CI 43.3– 63.5) and 67.2% (95% CI 0.68–0.94) at the cut-off level of >14.25, >28.7, and >636, respectively. When considering only MPE and TPE patients, the specificity of cancer ratıo and cancer ratıo plus increased.
<strong>Conclusion:</strong> The cancer ratio plus rate ( the ratio of ‘’cancer ratio’’formulation to the percentage of differential pleural lymphocyte count ) was almost the same as the cancer ratio in separating the malignant pleural effusion from the TPE and PPE, while it has better specificity only in differentiating malignant effusions from tuberculosis effusions.https://www.tanaffosjournal.ir/article_251189_af4bc53b7545caaf2f34c4e90d34b4fc.pdfNational Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranTANAFFOS (Respiration)1735-034420320210701Predicting Severity of Novel Coronavirus (COVID-19) Pneumonia based upon Admission Clinical, Laboratory, and Imaging Findings232239251190ENLidaGhafuriDepartment of Radiology, Tabriz University of Medical Sciences, Tabriz, Iran, 2 Department of Internal Medicine, Tabriz University of Medical Sciences, Tabriz, IranArezouHamzehzadeh AlamdariDepartment of Internal Medicine, Tabriz University of Medical Sciences, Tabriz, IranShahramRoustaeiDepartment of Surgery, Tehran University of Medical Sciences, Tehran, IranArefehGolshani BeheshtiDepartment of Public Health, Tabriz University of Medical Sciences, Tabriz, IranAliNayerpourDepartment of Public Health, Tabriz University of Medical Sciences, Tabriz, IranJournal Article20220316<strong>Background:</strong> The purpose of this study was to investigate the prognostic factors in hospitalized COVID-19 pneumonia patients according to the baseline clinical, laboratory, and imaging manifestations.
<strong>Materials and Methods: </strong>In this retrospective study on the SARS-CoV-2 laboratory-confirmed cases, clinical and laboratory data were collected from 156 hospitalized patients during August to October, 2020. Baseline chest CT was assessed, and the CT severity score was then calculated. Data were compared between the two groups of patients with moderate and severe/critical conditions.
<strong>Results: </strong>Of the 156 participants with the age range of 25-95 years (56.87±16.88), 70 and 86 patients were in the moderate and severe/critical groups, respectively. Most patients had typical imaging features on chest CT. Compared to the moderate group, the severe/critical group were older and were mainly suffering from underlying comorbidities. The rate of confusion on admission (P=0.008) and pulse rate≥100 (p=0.04) were significantly higher in the severe/critical group. According to the CT manifestations, consolidation, central and diffuse peripheral and central distribution, patchy/segmental morphology, crazy paving pattern, pleural effusion, aorta, and coronary artery calcification were more likely to emerge in the severe/critical group (p<0.05). In contrast, round/nodular morphology mainly appeared in the moderate group (p= 0.002). The chest CT severity scores were 10.24±7.91 and 6.13±4.42 in the severe/critical and moderate groups, respectively, indicating statistically significant values.
<strong>Conclusion:</strong> The clinical, laboratory, and chest CT findings can be used for the prognosis of COVID-19 pneumonia. Predicting the outcomes for the patients on admission can play a critical role in decision making.https://www.tanaffosjournal.ir/article_251190_954dd9305896cb008eb100d3d7b780fc.pdfNational Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranTANAFFOS (Respiration)1735-034420320210701Investigating the Ventilation System of an Intensive Care Unit in the COVID-19 Crisis: A Study in a Hospital of Tehran, Iran240245251191ENZahraMoradpourDepartment of Occupational Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, IranGhasemHesamDepartment of Occupational Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, IranMehrdadHelmi_KohnehshahriDepartment of Occupational Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, IranFarahBokharaei-SalimDepartment of Virology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, IranMostafaPouyakianDepartment of Occupational Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, IranRezvanZendehdelDepartment of Occupational Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, IranJournal Article20220316<strong>Background:</strong> Ventilation system besides other prevention strategies such as surface disinfecting and personal protective equipment (PPE) decrease the risk of coronavirus disease 2019 (COVID-19) infection. This study aimed to examine the ventilation system of an intensive care unit (ICU) in a hospital in Tehran, Iran to evaluate the potency of heating, ventilation, and air conditioning system (HVAC) for COVID-19 spread.
<strong>Materials and Methods:</strong> Contamination of air turnover caves was evaluated in supplier diffuser and extractor grills of negative pressure HVAC by ten samples. Severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) in the samples was evaluated by the real time reverse transcription-polymerase chain reaction (PCR). Moreover, air conditioning and sick building syndrome (SBS) was assessed according to MM040EA questioning from health care workers.
<strong>Results:</strong> In the health care workers, respiratory effects were more prevalent compared to other signs. Despite suitable air conditioning, this study highlighted carrier potency of ICU workers for SARS-COV-2.
<strong>Conclusion:</strong> According to our results, although the HVAC of ICU ward had an appropriate air movement, it was not safe enough for health care workers.https://www.tanaffosjournal.ir/article_251191_a253f92323f73a2c3a5382f5230903fe.pdfNational Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranTANAFFOS (Respiration)1735-034420320210701Descriptive Analysis of COVID-19 among Health Care Workers in a Tertiary Center in Iran246252251192ENShahnazSaliInfectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran0000-0001-8494-0611MitraRezaeiClinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranVirology Research Center, National Research Institute of Tuberculosis and Lung diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranMajidMarjaniClinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran0000-0003-1466-8645ShabnamTehraniInfectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IranAmirmohammadAbdolmohammadzadehSchool of Medicine, Iran University of Medical Sciences, Tehran, Iran,AmiraliSoheiliStudent Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IranDavoodYadegaryniaInfectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IranSaraAbolghasemiInfectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IranJournal Article20220316<strong>Background: </strong>Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) spread widely all around the world and has infected too many healthcare workers (HCWs) as the pioneers combating coronavirus disease 2019 (COVID-19). This study aims to evaluate the symptoms and outcome of medical staff from a tertiary hospital in Tehran, Iran.<br /><strong>Materials and Methods: </strong>The diagnoses of 29 HCWs presenting COVID-19 symptoms were confirmed by molecular and imaging studies. Epidemiologic and disease-related data were collected via phone calls and filling a questionnaire and then analyzed descriptively.<br /><strong>Results: </strong>Eighteen (62.1%) of the affected HCWs were males. The mean age of them was 41.86 years with a lower average (38.27) for females than males. Nurses comprised 41.4% of our population. Only 2 (6.9%) patients were admitted to the respiratory care unit (RCU) (), marked as critical patients. The most presented symptoms were fever (79.3%) and dyspnea (79.3%). Overall, 55.2% of them had a longer exposure time (more than a week), which was more frequent in men than women.<br /><strong>Conclusion: </strong>Fever was the most prevalent symptom among the study group. Even though the clinical features of COVID-19 among HCWs cannot be copiously determined by this study, it highlights the requirement for comparative studies to illustrate differences among HCWs and the general population. There might be an association between the duration of the exposure and the risk of the infection in men.https://www.tanaffosjournal.ir/article_251192_aa07b4767cc017a03f4d3f9c692f66a0.pdfNational Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranTANAFFOS (Respiration)1735-034420320210701Age-Dependent Clinical Features and Prognosis of COVID-19 Patients253260251193ENRaminSamiDepartment of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranMaryamKarbasiInternal Medicine Ward, Qazvin University of Medical Sciences, Qazvin, Iran, 3 Department of Radiology, Isfahan University of Medical Sciences, Isfahan, IranSomayehHaji AhmadiDepartment of Radiology, Isfahan University of Medical Sciences, Isfahan, IranMarjanMansourianPediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, IranMehrnegarDehghanSchool of Medicine, Isfahan University of Medical Sciences, Isfahan, IranNilufarKhademiSchool of Medicine, Isfahan University of Medical Sciences, Isfahan, IranMohammad JavadEslamiSchool of Medicine, Isfahan University of Medical Sciences, Isfahan, IranKhojastehGhasemiPediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, IranJournal Article20220316<strong>Background: </strong>The clinical and paraclinical symptoms of COVID-19 differ across age groups. This study investigated the differences between these parameters and their outcomes in young, middle-aged, and elderly patients admitted to a COVID-19 referral center.<br /><strong>Materials and Methods: </strong>This retrospective study encompassed patients with COVID-19 hospitalized at Khorshid Hospital (Isfahan, Iran) during February 23 to April 30, 2020. The patients' predisposing conditions, clinical and paraclinical findings, and outcomes were compared among three young, middle-aged, and elderly groups.<br /><strong>Results: </strong>Of the 1185 hospitalized patients with suspected COVID-19, 1065 were discharged or died at the end of the study. Among these 1065 patients, 654 patients with the mean age of 57.7 years had positive PCR results or typical CT scans and were included in the study, of whom 77 (11.8%), 353 (54%), and 234 (34.2%) patients were assigned into the young, middle-aged, and elderly groups, respectively. There was no statistically significant difference among the three groups regarding the prevalence of clinical symptoms. Moreover, CRP, ESR, WBC, BUN, Cr, and lymphocytes were higher in the elderly group. The ground-glass opacity (GGO) (24.1%), GGO-consolidation (27.4%), and consolidation (10.3%) were the most common CT scan findings in the young, middle-aged, and elderly groups, respectively. Fifty-three patients (8.1%) died, and the mortality rates were 10.36%, 7.27%, and 3.8% in the elderly, middle-aged, and young groups, respectively.<br /><strong>Conclusion: </strong>COVID 19 symptoms do not depend on age; however, paraclinical findings differ across young, middle-aged, and elderly patients.https://www.tanaffosjournal.ir/article_251193_0a4e8c63cc8b78a4447dfc8a64922f26.pdfNational Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranTANAFFOS (Respiration)1735-034420320210701Three Consecutive Episodes of Thunderstorm Asthma in Ahvaz, Iran: the Possible Role of Conocarpus Pollen261267251194ENEsmaeilIdaniDepartment of Internal Medicine, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IranDepartment of Internal Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IranMaryamDastoorpoorDepartment of Biostatistics and Epidemiology, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IranGholamrezaGoudarziDepartment of Environmental Health, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IranMaryamHaddadzadeh ShoushtariDepartment of Internal Medicine, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IranHaniehRajiDepartment of Internal Medicine, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IranJournal Article20220316<strong>Background: </strong>The aim of this study is to evaluate the clinical pattern of thunderstorm asthma (TA) and the possible environmental hypotheses involved in the escalation of these epidemics.
<strong>Materials and Methods: </strong>This retrospective descriptive study examined patients with respiratory problems referred to the clinics and emergency departments in Ahvaz, Iran during 2013-2016 periods following the first episodes of rainfall in autumn. The seasonal profile of airborne pollens and fungal spores in Ahvaz were characterized and clinical and spirometry findings of 443 patients were evaluated.
<strong>Results:</strong> Of 56,000 people referred to the emergency department due to respiratory problems associated with the first rainfall in Khuzestan province, 91.4% displayed asthma-like symptoms and 71.3% had a history of allergic rhinitis. According to the results of spirometry test 38%, 52.9%, and 9.1% of patients had normal, obstructive, and restrictive patterns, respectively. Our results highlight the importance of allergic rhinitis as risk factors of TA epidemics. In terms of pollen, seasonal pollen integral was much higher in autumn than in winter.
<strong>Conclusion:</strong> Our results highlight the importance of seasonal allergy and rhinitis as risk factors for thunderstorm asthma epidemics.https://www.tanaffosjournal.ir/article_251194_3ecf9cad9a60652fcc8c09dfaef4c033.pdfNational Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranTANAFFOS (Respiration)1735-034420320210701Comparison of Chronic Obstructive Pulmonary Diseases Induced by Wood Smoke and Tobacco Smoke268276251196ENFatemehAghaeimeybodiDepartment of Internal Medicine, Division of Pulmonology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran0000-0002-5132-2494GolnazSamadzadehShahid Sadoughi University of Medical Sciences, Yazd, IranZahraHaji SafariShahid Sadoughi University of Medical Sciences, Yazd, IranSinaNouriShahid Sadoughi University of Medical Sciences, Yazd, IranHamid RezaTalebiShahid Sadoughi University of Medical Sciences, Yazd, IranSeyed HosseinShahcheraghiInfectious Diseases Research Center, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, IranJournal Article20220316<strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is a progressive airflow limitation and decline in lung function. Although tobacco smoke is the leading risk factor for COPD, air contamination by wood-burning smoke is also of great concern. About half of the world's populations, especially in developing countries such as Iran, exploit this energy source for cooking and heating. It is remained unknown if COPD induced by wood smoke from baking bread (COPD-B) and COPD induced by tobacco smoke (COPD-S) have different symptoms and clinical presentations. To fill this gap, the present study was to describe such differences.
<strong>Materials and Methods: </strong>This retrospective cohort study was performed in Afshar COPD clinics affiliated with the Shahid Sadoughi University of Medical Sciences, Yazd, Iran. The clinical records of 231 patients with the COPD diagnosis were reviewed. After considering inclusion and exclusion criteria, 91 patients (46 with COPD-B and 45 with COPD-S) underwent physical examination and para-clinical assessments (i.e., respiratory function tests, Chest X-ray, and quality of life test).
<strong>Results:</strong> The COPD-B patients were mainly women at older age and had higher FEV<sub>1</sub>/FVC and FEF-75; however, they had fewer post-bronchodilator positive responses to FEV<sub>1</sub> (suggesting a restriction pattern) and sputum production, compared to the COPD-S patients. Regarding the other parameters, there were no statistically significant differences between the two groups.
<strong>Conclusion:</strong> This was the first study evaluating and revealing some differences in the clinical and paraclinical characteristics of the COPD-B patients (with prolonged exposure to wood smoke from bread baking; >100 hours per year, for at least 10 years) and COPD-S patients (>10 packs per year of exposure to tobacco smoke).https://www.tanaffosjournal.ir/article_251196_dbb467403d679d39e079ffe5ab8eccc9.pdfNational Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranTANAFFOS (Respiration)1735-034420320210701Challenges in Longitudinal Spirometry Data in Occupational Medicine: Spirometry Indices during Five Consecutive Years and its Causative Factors277283251197ENMirsaeedAttarchiInflammatory Lung Disease Research Center, Guilan University of Medical Sciences, Rasht, IranTaranehYazdanparastCenter for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, IranSimaMohtashamOccupational Medicine Department, School of Medicine, Iran University of Medical Sciences, Tehran, IranAzarBarzegarChronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranMahdiMohagheghianChronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranSeyed MohammadSeyedmehdiChronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran0000-0002-2777-5864PegahSalimi PormehrChronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranNeginTalaeeChronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranHamidrezaJamaatiChronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranJournal Article20220316<strong>Background: </strong>Respiratory illnesses caused by occupational exposure have the most negative effects on the workers’ health status in workplaces. In occupations with a high likelihood of labor-induced pulmonary diseases, a periodic spirometry test is usually used to monitor occupational lung function and prevent occupational respiratory diseases. Monitoring workers exposed to occupational pulmonary diseases is widely done using forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) for early diagnosis of obstructive pulmonary and lung diseases. We assessed the usefulness of longitudinal data of periodic spirometry tests in a sulfate production industry.<br /><strong>Materials and Methods: </strong>In this longitudinal study, 212 individuals working in a sulfate production industry near Tehran were examined. Demographic data and information, such as FEV1, FVC, FEV1%, FVC%, and FEV1 / FVC ratio were obtained from 2009 to 2013. Data were analyzed using the SPSS software version 21. The one-way analysis of variance (ANOVA) and repeated measures ANOVA for data analysis.<br /><strong>Results: </strong>The results showed that the variation of the spirometry parameters over 5 years was significant. The factors studied not only decreased in some years but also increased in comparison with the previous year. Also, the average FEV1 and FVC and also FEV1 / FVC significantly was different at different time points [F(2.864, 590.029)= 27.269, P < .0001], [F(2.910, 599.546)= 38.239, P < .0001], and [F(3.257, 671.019)= 13.351, P < .0001].<br /><strong>Conclusion: </strong>The best spirometry tests, not only acceptable tests, are important in longitudinal spirometry evaluations. There is no systematic supervision on spirometry tests in Iran and the results of this study reflect a serious need for such supervision.https://www.tanaffosjournal.ir/article_251197_6dbb78f709419587abf35f1b570e753c.pdfNational Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranTANAFFOS (Respiration)1735-034420320210701Paradoxical Reaction to Hypnotics in Intensive Care Unit284286251198ENNicolasMottardDepartment of Anesthesiology and Critical Care, Clinique de la Sauvegarde, Ramsay Santé, Lyon, FranceGuillaumeBoulayDepartment of Anesthesiology and Critical Care, Clinique de la Sauvegarde, Ramsay Santé, Lyon, FranceEtienneHautinDepartment of Anesthesiology and Critical Care, Clinique de la Sauvegarde, Ramsay Santé, Lyon, FranceJournal Article20220316<strong>Background:</strong> Paradoxical reactions (PR) to benzodiazepines are well-known, but PR can also follow sedation by propofol, although this has been reported only in the context of operating room anesthesia. We report a rare case of paradoxical excitement induced by midazolam and propofol.
<strong>Case presentation:</strong> A 78-year-old patient presented with multiorgan failure secondary to infectious pneumopathy. During intensive care unit (ICU) stay, he experienced 2 episodes of ventilator-acquired pneumonia and 1 of acute kidney failure requiring renal replacement therapy. Throughout the stay, he showed restlessness, uncontrollable muscle spasms and stiffness without any neurological focus. Paradoxical reaction to midazolam and to propofol was diagnosed; difficult withdrawal was followed by favorable progression.
<strong>Conclusion:</strong> PR in the ICU context is exceptional. The present case is unique, with severe PR not only to midazolam but also to propofol. This etiology, with difficult withdrawal, should be considered after ruling out all classical etiologies for refractory agitation.https://www.tanaffosjournal.ir/article_251198_f11d757917bfa21508e4d886c4c65974.pdfNational Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranTANAFFOS (Respiration)1735-034420320210701Curable Syncope in Primary Pulmonary Hypertension with Novel Atrial Flow Regulator287290251199ENBabakSharif-KashaniTobacco Prevention and Control Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranAlirezaSeratiLung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranShadiShafaghiLung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran0000-0002-9960-8854NedaBehzadniaLung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran0000-0001-8963-4285FarahNaghashzadehLung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranMohammad SadeghKeshmiriLung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranMaedehMoradiLung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranJournal Article20220316Pulmonary artery hypertension (PAH) occurs when mean pulmonary artery pressure (PAP) is higher than 25 mmHg in rest or 30 mmHg during activity. Idiopathic pulmonary artery hypertension (IPAH) is defined as PAH without a definite reason. The IPAH is a rare disease with a high mortality rate if left untreated. To date, there has been no definite cure for this entity, and most treatments are for symptom relief or improvement in the quality of life. For many years, decompressing the right heart through a hole in the interatrial septum has been advised to alleviate some of their symptoms, specifically syncope. Atrial flow regulator (AFR) is a device to make an iatrogenic interatrial hole and finally a unidirectional shunt. It has been used for some PAH patients for symptom relief. Herein, we report a 36-year-old female case with diagnosed IPAH for 6 years. In the last 3 years, the case had frequent syncope with shortening intervals. The AFR was implanted for her without any complications. Then, within 6 months of follow-up, she had only one syncope episode. A significant change was observed in her 6-minute walk and PAP.https://www.tanaffosjournal.ir/article_251199_dbaa55ee1d30d26b6910edcdbbb3321a.pdfNational Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranTANAFFOS (Respiration)1735-034420320210701Ectopic Intrathoracic Kidney Associated with Ipsilateral Ectopic Spleen and Diaphragmatic Hernia in a Pediatric Patient: A Case Report291293251200ENMitraNaseriDepartment of Pediatric Nephrology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranSeyyedeh FatemehGhalibafanFaculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranSeyed AliAlamdaranDepartment of Pediatric Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranJournal Article20220316<strong>Background: </strong>Intrathoracic kidney is the rarest form of an ectopic kidney that is usually accompanied by left congenital diaphragmatic hernia (CDH) (Bochdalek hernia), the association of which with other anomalies is rare.
<strong>Case Presentation:</strong> Herein, we describe a case with a diagnosis of an intrathoracic kidney associated with the ectopic spleen and diaphragmatic hernia diagnosed during imaging studies for urinary tract infections (UTIs). This study reports an 11-month-old male case with a history of CDH and several episodes of UTIs. A kidney ultrasound revealed that the left kidney and spleen were located in the thoracic cavity. Despite intrathoracic lying of the left kidney, there was no vesicoureteral reflux. Technetium-99m dimercaptosuccinic acid scan reported a highly positioned left kidney.
<strong>Conclusion:</strong> With the consideration of a pediatric literature review among patients with intrathoracic ectopic kidney, our case was special and notable since it was the first neonate who had an association of intrathoracic spleen and kidney in the same side with a delayed diagnosis. The main point of this case was that radiologists should consider thoracic kidney a differential diagnosis of unilateral renal agenesis when there is a history of diaphragmatic hernia.https://www.tanaffosjournal.ir/article_251200_bfb3206155832047330e55a331d6734e.pdf