National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran TANAFFOS (Respiration) 1735-0344 24 1 2025 01 01 New Insights into Pulmonary Arterial Hypertension Treatment with Non-Coding RNAs: What is the Best Option, microRNAs or Small-Interfering RNAs? 1 5 733700 EN Hannaneh Yousefi-Koma Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0001-7498-301X Babak Sharif-Kashani Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0002-3400-489X Abdolreza Mohammadnia Chronic Respiratory Diseases Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0001-9662-7462 Mahdi Ahmadinia Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran Shadi Shafaghi Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0002-9960-8854 Journal Article 2024 12 01 Pulmonary arterial hypertension is a devastating disease that can lead to other serious comorbidities. Heart failure is a major problem in patients with pulmonary arterial hypertension. It usually begins with right-sided heart failure, but in severe or uncontrolled cases, it can progress to left-sided heart failure. Currently, available treatment options do not have desirable effects. Therefore, considering a new treatment strategy is a cardiology priority. Non-coding RNAs, including small interfering RNA and microRNA, are valuable treatment options to study. Several non-coding RNAs have been studied and even approved for treatment in other hard-to-treat diseases. However, deciding which to choose can be complex. That is because these non-coding RNAs can have multiple interaction processes. Therefore, a thorough understanding of pulmonary arterial hypertension's pathological pathways and our target non-coding RNA interaction pathways is crucial. Here, we discuss the potential benefits and harms of these options in treating patients with pulmonary arterial hypertension.

https://www.tanaffosjournal.ir/article_733700_0931e083057e73aac136e95231dde25d.pdf

National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran TANAFFOS (Respiration) 1735-0344 24 1 2025 01 01 Pulmonary Artery Diameter During Pregnancy 6 8 733702 EN Seyed Hamed Jafari Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran 0000-0001-5364-2566 Mohammad Javad Fallahi Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran 0000-0002-8562-5637 Behnam Dalfardi Clinical Research Development, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran 0000-0003-4547-0965 Journal Article 2024 03 08 https://www.tanaffosjournal.ir/article_733702_680db7348bf76b4133ccede126d0245d.pdf

National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran TANAFFOS (Respiration) 1735-0344 24 1 2025 01 01 COVID-19: A Systematic Review of Metabolomics Data and Predicting Potential Biomarkers Based on Pathway Analysis 9 29 733705 EN Nasrin Amiri-Dashatan Zanjan Metabolic Diseases Research Center, Zanjan University of Medical Sciences, Zanjan, Iran 0000-0003-4259-8218 Mehdi Koushki Department of Clinical Biochemistry, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran 0000-0003-0071-3505 Negin Parsamanesh Zanjan Metabolic Diseases Research Center, Zanjan University of Medical Sciences, Zanjan, Iran 0000-0002-1925-9165 Nayebali Ahmadi Proteomics Research Center, Department of Medical Laboratory Sciences, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0003-2243-8276 Hossein Chiti Zanjan Metabolic Diseases Research Center, Zanjan University of Medical Sciences, Zanjan, Iran 0000-0003-1847-7774 Mitra Rezaei Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0003-1466-8645 Zahra Razzaghi Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0003-2112-5534 Reza Robati Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 0000-0002-7947-8642 Journal Article 2023 08 15 The COVID-19 pandemic is a worldwide disaster in medicine, public health, and the economy. Many details of COVID-19 are currently unknown. This study aims to offer dysregulated metabolic profiles as potential biomarkers for SARS-CoV-2 infection by analyzing identified COVID-19 metabolites. We searched PubMed, Web of Science, EMBASE, and Scopus for metabolomics studies on COVID-19 patients. Studies investigating COVID-19 metabolite changes and utilizing mass spectrometry-based techniques are included. Two reviewers separately retrieved pertinent data for each selected publication. Differences of opinion among the reviewers were settled via conversation, and a final judgment was obtained. The online MetaboAnalyst 3.0 was used to conduct the pathway analysis of COVID-19. This study comprised 31 investigations with QUADOMICS quality evaluation. We isolated modified metabolites that have been found in at least three other investigations. The metabolomics data in response to SARS-CoV-2 alter at the metabolite expression level, leading to dysregulation of major metabolic pathways, including carbohydrates, amino acids, and lipids associated with COVID-19. The pathway analysis of metabolic reprogramming across different biological samples demonstrated a significant role in amino acid metabolism, including phenylalanine, tyrosine, and tryptophan production, in the severity of COVID-19. This review showed dysregulated metabolic profiling for identifying individuals with high severity of COVID-19. These results provide an understanding of metabolic pathways and how dysregulated metabolic profiling reflects the severity of COVID-19 in the general population. The high frequency of changed metabolites might be used as COVID-19 biomarkers for early detection, and significant metabolic routes could reveal new information about pathogenesis and lead to potential treatment targets.

https://www.tanaffosjournal.ir/article_733705_76db7fb2a8202484b0263d55d9e60270.pdf

National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran TANAFFOS (Respiration) 1735-0344 24 1 2025 01 01 Evaluation of E-Cigarette Effects on Gene Expression Profile of Human Bronchial Epithelial Cells: A System Biology Approach 30 35 733707 EN Nayebali Ahmadi Proteomics Research Center, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0001-7730-3040 Mona Zamanian Azodi Proteomics Research Center, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0003-1894-5021 Mohammad Rostami Nejad Celiac Disease and Gluten Related Disorders Research Center, Research Institute for Gastroenterology and Liver Disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0003-2495-1831 Mitra Rezaei Clinical Tuberculosis and Epidemiology Research Center. National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0002-7242-5839 Reza M Robati Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0002-7947-8642 Fatemeh Bandarian Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran 0000-0003-0359-3043 Farideh Razi Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran 0000-0003-2350-9574 Zahra Razzaghi Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0003-2112-5534 Babak Arjmand Cell Therapy and Regenerative Medicine Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran Iranian Cancer Control Center (MACSA), Tehran, Iran 0000-0001-5001-5006 Mostafa Rezaei-Tavirani Proteomics Research Center, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0003-1767-7475 Journal Article 2024 01 20 Background: Electronic cigarettes produce aerosols that contain flavoring agents and nicotine, a drug that can lead to dependence, which users inhale. The widespread use of e-cigarettes has prompted research projects to investigate the safety or risks of e-cigarette smoke on human health. The present study aims to discover details of the e-cigarette smoke effect on the gene expression profile of human bronchial epithelial cells (HBECs) via network analysis. Materials and Methods: Data of GSE118431(GPL16791) from Gene Expression Omnibus (GEO) were extracted and pre-evaluated by GEO2R program. The differentially expressed genes (DEGs) were analyzed via protein-protein interaction PPI analysis, and the critical DEGs were introduced. Results: A total of 192 significant DEGs among the 17058 targeted genes were selected for PPI network analysis. The 177 recognized genes were interacted to construct a network. Six DEGs were common between the hubs and bottlenecks of the network. Conclusion: E-cigarettes target IL1B, PTGS2, SOD2, NFKBIA, TXNRD1, and DUSP1, the critical genes that are associated with progression of inflammation, cell proliferation and cell invasion in cancer, chromatin condensation, DNA fragmentation, and cell death.

https://www.tanaffosjournal.ir/article_733707_c62272f22e76288415c25478c3259826.pdf

National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran TANAFFOS (Respiration) 1735-0344 24 1 2025 01 01 Visualization and Analysis of the Role of an Inflated Tracheostomy Tube Cuff in the Human: A Preliminary Study 36 43 733711 EN Makoto Miyamoto Department of Otolaryngology-Head and Neck Surgery, Korin University School of Medicine, 6-20-2, Shinkawa, Mitaka, Tokyo 181-8611, Japan Department of Otorhinolaryngology, ISEIKAI International General Hospital, 4-14, Minami-oogimachi, Kitaku, Osaka-shi, Osaka 530-0052, Japan 0000-0003-0826-6121 Takahiro Arai Department of Radiology, Kyorin University School of Medicine, 6-20-2, Shinkawa, Mitaka, Tokyo 181-8611, Japan Hideki Nakagawa Department of Otolaryngology-Head and Neck Surgery, Korin University School of Medicine, 6-20-2, Shinkawa, Mitaka, Tokyo 181-8611, Japan Koichiro Saito Department of Otolaryngology-Head and Neck Surgery, Korin University School of Medicine, 6-20-2, Shinkawa, Mitaka, Tokyo 181-8611, Japan Journal Article 2023 12 28 Background: This study aimed to reconstruct ultra-high-resolution computed tomography (CT) and three-dimensional CT images of tracheostomy tubes, including the shaft, flange, inflation line, and cuff, with a particular focus on examining the degree and fold formation of the inflated tracheostomy tube cuffs within the human trachea. Materials and Methods: All ten patients were inserted with a cuffed tracheostomy tube, and the cuff pressure was maintained at approximately 25 cmH2O intra-cuff pressure using a pressure gauge. The levels of the inserted tracheostomy tube, the degree of inflation of the tracheostomy tube cuffs, the folds of the cuff, and the location of the distal tip of the tracheostomy tube. Results: In this study, the pressure of the tracheostomy tube cuff was managed at an intracuff pressure; however, the degree of inflation of the tracheostomy tube cuffs and the form of the cuff folds inserted into the human trachea differed in each case. The distance between the skin and the tracheal anterior wall and the BMI value were associated with the inflation of the tracheostomy tube cuffs. Conclusion: In cases with distances greater than 25 mm between the skin and the tracheal anterior wall, we think it may be better to use other methods, such as tracheal fenestration, rather than simple tracheostomy. Examination of the size of the tracheostomy tube inserted into the human trachea, the degree of inflation of the tracheostomy tube cuff, and the position of the distal tip of the tracheostomy tube may help in the selection of an appropriate tracheostomy tube clinically.

https://www.tanaffosjournal.ir/article_733711_36f311901e81069fafdefa5afb3b30c8.pdf

National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran TANAFFOS (Respiration) 1735-0344 24 1 2025 01 01 Diagnostic Accuracy of Interleukin 27 for the Diagnosis of Pleural Tuberculosis 44 50 733712 EN Majid Marjani Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0003-1466-8645 Amir Reza Aghebatkheyri Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran Neda Dalil Roofchayee Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran Department of Microbiology and Immunology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA Alireza Eslaminejad Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0002-8788-4544 Mojdeh Azimi Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran Alireza Eskandari Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran Atefeh Abedini Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0002-4262-9873 Makan Sadr Virology Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0002-8781-8176 Seyed Mohammad Poorhosseini Department of Genetics, Faculty of Advanced Science and Technology, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran Mitra Rezaei Virology Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran Department of Pathology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0003-1466-8645 Esmaeil Mortaz Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran Journal Article 1970 01 01 Background: Pleural tuberculosis (TB) is one of the most common forms of extra-pulmonary TB. Since diagnosis is challenging through microbiological tests, discovering new diagnostic techniques with higher accuracy could help us improve early detection and lead to better outcomes. This study aims to investigate the sensitivity and specificity of interleukin 27 (IL27) as a diagnostic test for pleural Tuberculosis. Materials and Methods: The current study was conducted on 121 adult patients admitted to Masih Daneshvari Hospital due to pleural effusion with an unknown cause. 36 cases had transudative, and 85 cases had exudative pleural effusions. Among them, TB (33.1%) and malignant pleurisy (23.1%) were the most common causes. In addition to routine studies for pleural effusion workups, pleural interleukin-27 concentrations were measured by ELISA and compared between groups of TB-affected patients and those without TB. Results: We found that the value 679 pg/ml was the most appropriate cut-off threshold for interleukin 27 in pleural fluid with 95% sensitivity, 69% specificity, 94% negative predictive value, and 73% positive predictive value (P value<0.001) for diagnosis of TB pleurisy. ADA levels were not significantly different between TB and non-TB cases. Conclusion: Compared to other groups, interleukin 27 levels in patients with a final diagnosis of TB-pleurisy were significantly higher, indicating the significant value of this interleukin as a diagnostic biomarker.

https://www.tanaffosjournal.ir/article_733712_8b2d19ffacd887ead849a97efef848f3.pdf

National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran TANAFFOS (Respiration) 1735-0344 24 1 2025 01 01 The Impact of MELD, PESI, PSI, and DIC Scores on Predicting Pulmonary Thromboembolism and Mortality Rate in COVID-19 Pneumonia 51 61 733719 EN Gülçehre Oğuztürk Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery, University of Health Sciences, Department of Chest Diseases, Istanbul, Turkey 0000-0001-9531-4448 Ekrem Cengiz Seyhan Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery, University of Health Sciences, Department of Chest Diseases, Istanbul, Turkey 0000-0001-6639-2797 Journal Article 1970 01 01 Background: Multiple studies have reported an increased incidence of thrombosis in patients with COVID-19 pneumonia, contributing to higher mortality rates. This study aimed to investigate the ability of disease severity scores, the Pneumonia Severity Index (PSI), Pulmonary Embolism Severity Index (PESI), Disseminated Intravascular Coagulation (DIC), and End-Stage Liver Disease Model (MELD), to predict embolism and embolism-related mortality in patients with COVID-19 pneumonia. Materials and Methods: In this retrospective study, demographic data, comorbidities, hospitalization dates, length of stay in the intensive care unit, percentage of CT radiological involvement, presence of embolism, and biochemical and hematological test results of the patients were recorded. PSI, PESI, DIC, and MELD scores were calculated within the first 24 hours of hospitalization. Results: A total of 158 patients (82 males, 76 females) with a mean age of 53.47± 12.49 years were included. Embolism was detected in 24 cases (15%), and the mortality rate was 11% (18 cases) across all cases. The optimal threshold values for predicting mortality were 63 for PESI and 76 for PSI (AUC values of 0.802 and 0.747). The optimal threshold value for detecting pulmonary embolism was 4 for DIC (AUC: 0.740). In the univariate analysis, variables with a p-value less than 0.1 included radiological score, age, DIC, troponin levels, and D-dimer levels. The subsequent multivariate analysis indicated that both the DIC score (p = 0.047) and the radiological score (p = 0.043) were independently associated with pulmonary embolism. In another univariate analysis, the variables with a p-value less than 0.1 included age, radiological score, the presence of comorbidities, procalcitonin, CRP, troponin, PSI, and PESI score. The follow-up multivariate analysis suggested that the PESI score (p = 0.018) and PSI (p = 0.021) were independently linked to hospital mortality. Conclusion: The PESI score was found to be a significant predictor of mortality, while the DIC score was found to be a significant predictor of pulmonary embolism in patients with COVID-19 pneumonia.

https://www.tanaffosjournal.ir/article_733719_097ce0fddab698a6fdc4158a730a6af3.pdf

National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran TANAFFOS (Respiration) 1735-0344 24 1 2025 01 01 Comparison between Levofloxacin and Azithromycin in Short-term Spirometry and Oxygen Saturation Indices in Patients with Exacerbated Bronchiectasis: A Randomized Double-blind Clinical Trial 62 68 733721 EN Maryam Hajimirghasemi Department of Respiratory, Faculty of Medicine, Shahroud University of Medical Science, Shahroud, Iran 0000-0001-6510-129X Mahdi Behi Department of Pharmacology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0001-5574-2181 Hoofer Rafiei Department of Nephrology, Faculty of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran 0000-0002-3238-2280 Mohammad Bagher Sohrabi Faculty of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran 0000-0001-8953-433X Babak Gholamine Department of Pharmacology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0002-7494-988X Mahsa Forghani Department of Internal medicine, Faculty of Medicine, Shahroud University of Medical Science, Shahroud, Iran 0000-0002-3238-2280 Journal Article 2023 07 09 Background: Bronchiectasis is a chronic pulmonary disease characterized by abnormal and permanent dilatation of the airways in the lung. This study was conducted to compare the effect of levofloxacin with azithromycin in improving the lung function of these patients. Materials and Methods: In this parallel double-blinded randomized clinical trial, 72 patients with exacerbated bronchiectasis were included and randomly divided into two intervention groups. One group was treated with levofloxacin (500 mg daily for two weeks at first and then 250 mg daily in the next four weeks), and the other group with azithromycin (500 mg daily in the first two weeks and then with a dose of 250 mg daily for the next four weeks) for 6 weeks. The pulmonary function tests were performed and analyzed at the beginning of the study, two, four, and six weeks after the intervention. Results: The mean expiratory volume in the first second (FEV1) and the percentage of oxygen saturation (O2Sat) in the levofloxacin group and the azithromycin group were not significantly different at the beginning of the study. Importantly, six weeks after the initiation, the mean FEV1 (61.02±8.54% vs. 56.88±7.13%, p=0.029) and O2Sat (91.00±1.72% vs. 85.44±1.77%, p=0.001) in the levofloxacin group were significantly higher than those in the azithromycin group. Conclusion: The present study showed that the favorable effect of six-week therapy with levofloxacin compared to azithromycin can significantly increase the pulmonary values of FEV1 and O2Sat in patients with exacerbated bronchiectasis.

https://www.tanaffosjournal.ir/article_733721_81e5c6392e2feb14ddc49235f62ea737.pdf

National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran TANAFFOS (Respiration) 1735-0344 24 1 2025 01 01 The Use of Flexible Bronchoscope for Diagnostic Medical Thoracoscopy in a Resource-Limited Setting: A Retrospective Study 69 77 733722 EN Rajnish Kaushil Department of Pulmonary Medicine, VMMC and Safdarjung Hospital, New Delhi, India 0009-0008-3985-4659 Roopali Dahiya Department of Medicine, Dr RML PGIMER, New Delhi, India 0009-0005-6178-9345 Aditya Chaudhry Department of Medicine, KCGMC, Karnal, India 0000-0003-1110-4641 Pawan Kumar Singh Department of Pulmonary and Critical Care Medicine, Pt B.D. Sharma PGIMS, Rohtak 0000-0002-3212-9875 Aman K Ahuja Department of Pulmonary and Critical Care Medicine, Pt B.D. Sharma PGIMS, Rohtak, India 0000-0003-0307-3427 Dhruva Chaudhry Department of Pulmonary and Critical Care Medicine, Pt B.D. Sharma PGIMS, Rohtak, India 0000-0001-5138-2908 Geetika Arya Department of Anatomy, Pt B.D. Sharma PGIMS, Rohtak 0009-0005-3283-7627 Journal Article 2023 11 15 Background: Exudative pleural effusion (ePE) is a common presentation in pulmonology clinics. Pleural biopsy is indicated for identifying the etiology in undiagnosed ePE, especially those with low adenosine-deaminase levels. Access to rigid and semi-rigid medical thoracoscopy is scarce and heterogeneous in a resource-limited country like India. In such circumstances, using a flexible bronchoscope via an intercostal chest tube for visualization of the parietal pleura and pleural biopsy offers a way out. Materials and Methods: In this retrospective study, we have presented our experience of such practice on 25 cases. Mean age was 52.4±1 years. Adhesions were present in 40% of the subjects. Results: The most common finding was the presence of nodules. On average, 6.8 passes were taken with a maximum of 10. In 32% cases, only tiny tissue was obtained, hence requiring multiple passes. Large tissue could be obtained in 44% of the subjects. The mean duration of the procedure was 35.6±9.0 minutes. Tissue diagnosis was established in 80% with the most common being malignancy (48%), followed by tuberculosis (20%). In 3 cases, the final diagnosis was made by exclusion. No major complications were recorded. Conclusions: In conclusion, medical thoracoscopy using a flexible video bronchoscope via intercostal chest tube was a feasible alternative for the diagnosis of ePE effusion in resource-limited settings.

https://www.tanaffosjournal.ir/article_733722_e7707d194f997a5dbc14c9e468cb4ece.pdf

National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran TANAFFOS (Respiration) 1735-0344 24 1 2025 01 01 The Effect of Intermittent Use of Oxygen Therapy via High-Flow Nasal Cannula Alternating with Noninvasive Ventilation on Critically Ill Patients 78 87 733723 EN Seyed Mohammadreza Hashemian Chronic Respiratory Diseases Research Center (CRDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0002-0768-9168 Hamidreza Jamaati Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. 0000-0002-5402-1531 Navid Shafigh Department of Anesthesiology and Critical Care Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 0000-0002-1314-296X Sara Salarian Department of Anesthesiology and Critical Care, Critical Care Quality Improvement Research Center, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0002-4544-8883 Alireza Shakeri Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0001-8095-7168 Mohammad Gharehbeglou Department of Anesthesiology and Critical Care Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0002-6925-7934 Jamshid Ordoni Avval Department of Anesthesiology and Critical Care Medicine, School of Medicine, Zahedan University of Medical Science, Zahedan, Iran 0000-0003-4675-2761 Journal Article 2024 04 19 Background: Despite limited research on high-flow nasal cannula (HFNC) alternating with noninvasive ventilation (NIV), this study investigates its effect on intensive care unit (ICU) patients. Materials and Methods: This clinical trial study at Masih Deneshvari Hospital (Tehran) compared NIV vs. alternating NIV with HFNC for ICU patients. It assessed intubation, mortality, and vitals. Patients were informed, and nurses were trained for optimal care. Daily follow-up ensured data collection. Results: The mean age of the patients was 66.3±19.7 years, which was 67.1±14.8 years in the NIV group and 65.5±14.9 years in the HFNC+NIV group, respectively. The distribution of patients in terms of APACHE and symptoms showed no significant difference (P=0.453). The mean HR in the two groups, NIV and HFNC+NIV, before the study was 113.30±5.25 and 112.43±5.80, respectively. At the end of the study, it was 94.78±17.53 and 94.48±17.47, respectively, with no significant difference found between the two groups. The mean RR before the beginning of this study was not significantly different between the two groups, while it was 16.61±4.23 and 17.91±1.78 in the NIV and HFNC+NIV groups, respectively, at the end of the study (P=0.043). PO2 created a greater distinction between the two groups based on the decision tree analysis, where the NIV group was more likely to have values of PO2<70. Conclusion: Based on the findings presented in our study, no difference was found between the use of NIV and NIV + HFNC, but HFNC + NIV was a more tolerable technique for patients.

https://www.tanaffosjournal.ir/article_733723_0fbe54a2e8a983ab3f953002c8cb248c.pdf

National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran TANAFFOS (Respiration) 1735-0344 24 1 2025 01 01 Comparison of IOS and Body Plethysmography Findings in Patients with Interstitial Lung Disease 88 96 733724 EN Sanaz Soleimani Department of Pulmonology, Shahid Beheshti University of Medical Sciences, Shohada-ye-Tajrish Hospital, Tehran, Iran 0000-0001-6842-8466 Jalal Heshmatnia Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0003-2966-4380 Mohsen Sadeghi Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran Alireza Eslaminejad Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0002-8788-4544 Journal Article 1970 01 01 Background: In patients with ILD, the static expiratory pressure-volume curve of the lung is generally shifted downward and to the right, and spirometry results reveal reduced vital capacity. However, decreased vital capacity may occur even in patients with obstructive lung diseases and in other situations, such as chest wall restriction, lung resection, inspiratory muscle weakness, or poor cooperation with spirometry. In addition, spirometry is sometimes difficult to perform with elderly, cognitively impaired patients or with severe respiratory distress. IOS is a simple, non-invasive method requiring only passive patient cooperation that allows for the evaluation of lung function through the measurement of both airway resistance and airway reactance. This study aims to assess the role of IOS in the evaluation of cases of interstitial lung diseases. Materials and Methods: This study included 53 patients with interstitial lung diseases of different causes. Pulmonary function test by spirometry was done to measure FEV1, FVC, FEV1/FVC, MEF25-75, and pulmonary function test by impulse oscillometry (IOS). We measured R5, R20, X5, RF. Results: Examining the indicators evaluated based on IOS shows that the numerical values of R5 have not increased significantly. Regarding R20 and R5- R20, exhalation values are more than two, and as a result, the interval (exp-insp) is a positive number. The values of X5, AX, and Fres increased as expected (213%). Conclusion: X5 was lower in patients with ILD, indicating a restrictive pattern. Conversely, there is a negative correlation between X5 and FVC. Based on the numerical values of R5 and R20, it can be inferred that patients experience small airway obstruction.

https://www.tanaffosjournal.ir/article_733724_5b43707d2dce3116f8234510c608ad0e.pdf

National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran TANAFFOS (Respiration) 1735-0344 24 1 2025 01 01 The Effect of Acu-TENS Current on Shortness of Breath and Lung Function Indicators in Patients with COPD 97 101 733725 EN Amir Hasan Saberi Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0001-7353-1222 Mohsen Abedi Pulmonary Rehabilitation Research Center (PRRC), National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran Mehdi Rezaee Department of Orthotics and Prosthetics, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0002-8207-1982 Mobina Khosravi Department of Orthotics and Prosthetics, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran Physiotherapy Research Center, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0003-2947-0834 Hasan Shamsi Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran Azadeh Khosravi Health Service Management, Department of Health Service Management Faculty of Management, South Tehran Branch, Islamic Azad University, Tehran, Iran. Mohammad Mohsen Roostayi Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran Physiotherapy Research Center, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0002-5866-6505 Journal Article 2023 09 03 Background: The use of Acu-TENS is one of the physiotherapy methods to reduce shortness of breath and improve the quality of life of patients with chronic obstructive pulmonary disease (COPD). This study was conducted to evaluate the effectiveness of this method in respiratory parameters and the quality of life of patients with moderate to severe COPD. Materials and Methods: The present study was a controlled clinical trial on 40 patients with COPD. Patients with moderate to severe COPD were randomly divided into two treatment groups. Exercise therapy was used in one group, and Acu-TENS (12 sessions over three weeks, Burst TENS (Frequency: 2 Hz; pulse duration: 200 ms, time: 45 minutes)) was used in the other group. Shortness of breath was evaluated using the Borg criteria, functional capacity was assessed using the six-minute walking test, quality of life was evaluated using the St. George questionnaire, and respiratory parameters were measured using a spirometer and COPD Assessment Test (CAT) questionnaire. Results: According to the results, after 12 treatment sessions, a significant difference was observed in FVC, FEV1, activity, CAT, and impact domains of St George's questionnaire. In contrast, other variables had no significant difference between the control and the intervention groups. Conclusion: Using Acu-TENS three times a week and for 12 sessions can play a significant role in the respiratory function of moderate to severe COPD patients. Also, this method is effective in reducing shortness of breath and improving the quality of life of these patients.

https://www.tanaffosjournal.ir/article_733725_5398120c214bb033c5ebf4338a9bd0bc.pdf

National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran TANAFFOS (Respiration) 1735-0344 24 1 2025 01 01 Invasive Pulmonary Aspergillosis and Tuberculosis after COVID-19 102 105 733726 EN Mahshid Talebi-Taher Antimicrobial Resistance Research Center, Institute of Immunology and Infectious Diseases, School of Medicine, Iran University of Medical Sciences, Tehran, Iran 0000-0002-3133-7859 Seyed- Ali Javad-Moosavi Department of Internal Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran 0000-0001-6870-4029 Shirin Ahmadalipour Department of Internal Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran 0009-0003-6402-1329 Masoud Bahrami School of Medicine, Iran University of Medical Sciences, Tehran, Iran 0009-0009-8892-0525 Maryam Sarkheil Department of Infectious Diseases, School of Medicine, Iran university of Medical Sciences, Tehran, Iran. 0009-0005-6099-4742 Arash Javad-Moosavi Department of Internal Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran 0009-0002-7438-664x Journal Article 2023 11 23 Background: Pulmonary tuberculosis (TB) and invasive aspergillosis are distinct infectious diseases that rarely coexist in the same patient. The concurrent occurrence of these infections presents diagnostic and therapeutic challenges, resulting in complex clinical presentations and potentially adverse outcomes. We present a case report highlighting the diagnostic process, management strategies, and pertinent literature regarding the simultaneous occurrence of pulmonary TB and aspergillosis in a patient following COVID-19 infection. Case Presentation: A 55-year-old male with a history of occupational exposure as a farmer and welder presented with a complex medical condition. He had a previous COVID-19 infection and was hospitalized for three weeks, receiving appropriate treatment. Subsequently, he developed dyspnea and bilateral pleural effusion and underwent treatment with broad-spectrum antibiotics. Further investigations revealed consolidation in the left upper lobe, and biopsy confirmed the presence of Aspergillus species. The patient received voriconazole treatment for several months, but minimal improvement was observed. Recurrent hemoptysis prompted bronchoscopy, which showed positive results for acid-fast bacilli smear and TB PCR testing, indicating concomitant pulmonary TB. Anti-tuberculosis treatment was initiated alongside ongoing management for aspergillosis. Conclusion: This case report illustrates the diagnostic and therapeutic complexities associated with the simultaneous occurrence of pulmonary TB and aspergillosis in a patient following COVID-19 infection. Clinicians should maintain a high index of suspicion for dual infections in similar clinical scenarios. Prompt recognition, accurate diagnosis, and individualized treatment strategies are crucial for optimal patient management. Further research is warranted to enhance our understanding of this unique clinical entity and improve patient outcomes.

https://www.tanaffosjournal.ir/article_733726_ea3bace49bb4f935a94d855d79ed1bdc.pdf

National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran TANAFFOS (Respiration) 1735-0344 24 1 2025 01 01 Long COVID in Patients with Multiple Sclerosis Treated with Rituximab: A Report of Two Cases 106 110 733727 EN Payam Tabarsi Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0002-8932-5420 Abdolreza Mohamadnia Chronic Respiratory Diseases Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0001-9662-7462 Pardis Shahabinejad School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Sara Haseli Chronic Respiratory Diseases Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran Elham Askari Chronic Respiratory Diseases Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran Naghmeh Bahrami Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran, Craniomaxillofacial Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Shadi Shafaghi Lung Transplantation Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0002-9960-8854 Maryam Hajimoradi Lung Transplantation Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran Journal Article 2024 07 31 COVID-19 symptoms may persist for more than 12 weeks in some infected patients, a condition described as long COVID-19 in these cases. These patients have symptoms attributed to impairment of multiple organs. Scientists have discovered the lengthy COVID-19 etiology, risk factors, and treatments. It has been observed that immunosuppression may prolong COVID-19 symptoms. Patients with multiple sclerosis (pwMS) are generally treated with disease-modifying treatments, which suppress the immune system and predispose patients to infections like COVID-19. Also, these drugs may increase not only the morbidity and mortality of infection but also the risk of developing long COVID-19 in these patients. We have described two cases of multiple sclerosis patients who were diagnosed with long COVID-19. Both patients were under treatment with rituximab, so we discussed treatment choices and strategies for pwMS patients under rituximab who had symptoms of long COVID. Our data would further add to the information on managing long COVID-19 in pwMS under treatment with rituximab.

https://www.tanaffosjournal.ir/article_733727_ee80dfcf60fcd13c3b124ecad2d11639.pdf