National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran TANAFFOS (Respiration) 1735-0344 24 4 2025 10 01 Shelter Challenges for Asthma Patients during Disasters: Experiences and Solutions 309 311 741059 EN Ameneh Marzban Department of Health in Disasters and Emergencies, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran 0000-0002-8111-3319 Journal Article 2025 02 25 Dear Editor, Natural disasters such as hurricanes, earthquakes, and floods can have devastating effects on entire communities (1). While the immediate focus often lies on providing shelter, food, and emergency medical care, the unique challenges faced by individuals with chronic conditions, such as asthma, often remain underappreciated (2). It is vital to address these challenges to ensure comprehensive disaster response and mitigate adverse health outcomes for asthma patients (3). Additionally, establishing clear guidelines for managing chronic respiratory conditions in disaster situations is essential. In the absence of existing guidelines, developing one should be advised. In this letter, I aim to highlight the specific challenges faced by asthma patients in emergency shelters during disasters, share experiences from past events, and propose practical solutions to improve care for this vulnerable population. Challenges Faced by Asthma Patients in Emergency Shelters 1. Exposure to Triggers Emergency shelters, often hastily set up, may not be equipped to maintain indoor air quality (4). The presence of dust, mold, and other allergens can exacerbate asthma symptoms. Moreover, continuous exposure to polluted air worsens symptoms, making it necessary to establish designated safe areas with improved air quality and access to medical care. Overcrowding and limited ventilation further increase the risk of exposure to respiratory infections, compromising the health of asthma patients (5). 2. Limited Access to Medications During disasters, access to asthma medications such as inhalers and nebulizers can be severely disrupted. Supply chain interruptions, loss of personal belongings, and the prioritization of immediate life-saving interventions often result in a shortage of essential medications for asthma patients (6). Efforts should be made to improve communication channels for timely medication delivery and ensure emergency shelters maintain a sufficient stockpile of respiratory medications. 3. Stress and Anxiety The psychological impact of disasters can significantly affect asthma patients. High levels of stress and anxiety can trigger or worsen asthma symptoms. Providing psychological support, including mental health counseling and stress management programs, can help mitigate this issue. The unfamiliar environment of shelters, separation from loved ones, and uncertainty about the future contribute to heightened stress levels, making asthma management even more challenging (7). 4. Inadequate Medical Support Emergency shelters may lack adequate medical personnel trained in asthma management. The focus on acute medical care often means that chronic conditions like asthma do not receive the attention they need. Integrating healthcare professionals who specialize in chronic respiratory diseases into disaster response teams can significantly improve patient outcomes. Without proper intervention, patients may suffer from poorly managed symptoms and an increased risk of severe asthma attacks (8). Experiences from Past Disasters 1. Hurricane Katrina (2005): The aftermath of Hurricane Katrina saw thousands of people displaced and living in emergency shelters. Asthma patients reported increased symptoms due to poor air quality and lack of access to medications. Many patients had to rely on the limited medical supplies available in shelters, often receiving suboptimal care for their condition (6). 2. California Wildfires (2018): During the California wildfires, emergency shelters were set up to accommodate evacuees. The smoke from the fires significantly impacted air quality, both outdoors and within shelters. Asthma patients experienced severe symptoms due to the smoke and had limited access to their medications. Portable air filtration units were eventually introduced to improve indoor air quality, underscoring the importance of proactive air quality measures (3). 3. Puerto Rico Earthquake (2020): The earthquake in Puerto Rico resulted in many people seeking refuge in emergency shelters. Reports indicated that asthma patients struggled with limited availability of medical support and essential medications. Special arrangements should be made to quickly triage and transport patients with severe asthma attacks to safer environments with better air quality (9). Proposed Solutions 1. Enhanced Preparedness and Planning Disaster preparedness plans must include provisions for managing chronic conditions like asthma (9). This involves pre-positioning asthma medications and medical supplies in emergency shelters, creating stockpiles to meet patient needs, and ensuring collaboration with local pharmacies and healthcare providers to maintain an uninterrupted supply chain for essential medications (5, 8). 2. Improving Shelter Air Quality Measures should ensure emergency shelters maintain high-quality indoor air to reduce asthma triggers (6). This includes regular cleaning to minimize dust and mold, ensuring adequate ventilation, using portable air filtration units when needed, and establishing designated areas for asthma patients with enhanced air-quality control (3, 6, 9). 3. Training and Education Shelter staff and volunteers should be trained in early detection of asthma exacerbations, triage protocols for severe cases, and proper medication administration. Additionally, educating asthma patients on self-management techniques during disasters, including recognizing triggers, using inhalers correctly, and maintaining medication schedules, is crucial (2, 5). 4. Psychological Support Addressing the psychological impact of disasters is essential for asthma patients (7). Providing access to mental health support, such as counseling, stress management programs, and community support networks, can help reduce anxiety and improve overall asthma control (9). Integrating psychological support into disaster response plans will enhance the well-being of asthma patients during crises (6). 5. Telemedicine and Remote Monitoring Leveraging technology, such as telemedicine and remote monitoring, can significantly enhance asthma management during disasters (9). Telemedicine consultations with healthcare providers ensure timely medical advice and enable adjustments to treatment plans. Remote monitoring devices track asthma symptoms in real-time, providing healthcare teams with crucial data to intervene proactively (5). CONCLUSION The challenges faced by asthma patients in emergency shelters during disasters are significant but manageable with proactive planning. By incorporating guidelines for asthma management into disaster preparedness, improving shelter air quality, providing training and education, offering psychological support, and utilizing technology, we can ensure better care for this vulnerable population. Establishing a dedicated system for triage and early transportation of asthma patients to safer environments is also critical. Prioritizing asthma care in disaster response efforts will ultimately enhance the health and well-being of affected individuals.

https://www.tanaffosjournal.ir/article_741059_142bdbde818c1f3a120e014baf6bd8ac.pdf

National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran TANAFFOS (Respiration) 1735-0344 24 4 2025 10 01 COPD and Bronchiectasis Overlap: Coincidence or Phenotype? 312 320 741060 EN Elissavet Kosti Laboratory of Human Pathophysiology, Department of Nursing, University of Thessaly, Larissa. Greece Ourania S. Kotsiou Laboratory of Human Pathophysiology, Department of Nursing, University of Thessaly, Larissa. Greece 0000-0001-5219-6971 Journal Article 2024 11 27 The coexistence of chronic obstructive pulmonary disease (COPD) and bronchiectasis is increasingly recognized as a distinct clinical phenotype that presents unique diagnostic and therapeutic challenges. This overlap syndrome is characterized by heightened airway inflammation, frequent bacterial colonization, and a greater burden of respiratory symptoms, leading to poorer clinical outcomes. In this review, we explore the pathophysiological mechanisms underlying COPD-bronchiectasis overlap, emphasizing the role of chronic infection, impaired mucociliary clearance, and structural lung damage in driving disease progression. Bronchiectasis in COPD patients is associated with increased airflow obstruction, higher exacerbation rates, and greater disease severity compared to COPD alone. The shared pathophysiology includes chronic inflammation, often initiated by cigarette smoke or other environmental pollutants, and recurrent infections, especially with pathogens like Pseudomonas aeruginosa. These infections create a vicious cycle of inflammation and bronchial wall damage, resulting in airway dilation and impaired lung function. Diagnosing bronchiectasis in COPD patients remains challenging due to overlapping symptoms. High-resolution computed tomography (HRCT) is essential for identifying bronchial abnormalities, while spirometry confirms obstructive patterns. This review also highlights the need for tailored therapeutic strategies, including aggressive management of infections, use of long-acting bronchodilators, and cautious application of inhaled corticosteroids, which may exacerbate inflammation in patients with bronchiectasis. By recognizing COPD-bronchiectasis overlap as a distinct phenotype, we aim to improve clinical outcomes through a more personalized and comprehensive approach to diagnosis and treatment, ultimately enhancing patient quality of life.

https://www.tanaffosjournal.ir/article_741060_8265ed3ee751f874cc5319ac2444a53a.pdf

National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran TANAFFOS (Respiration) 1735-0344 24 4 2025 10 01 Galactooligosaccharides Suppress the Development of Biofilm in the Presence of Blood Polymorphonuclear Cells of Non-Small Cell Lung Cancer (NSCLC) Patients: A Pilot Study 321 329 741061 EN Masoumeh Nomani Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases(NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran Babak Salimi Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases(NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0002-5541-8434 Mohammad Varahtam Mycobacteriology Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0002-8033-1867 Hamidreza Jamaati Chronic Respiratory Diseases Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0002-5402-1531 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 Chronic Respiratory Diseases Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran Department of Immunology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Respiratory Immunology Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran Journal Article 2025 05 10 Background: Bacterial biofilms pose a significant healthcare challenge due to their robust resistance to antibiotics and their involvement in various diseases, including cancer and infectious conditions. Biofilms hinder the antimicrobial activity of polymorphonuclear leukocytes (PMNs) by restricting their penetration through the extracellular matrix. With the rise of antimicrobial resistance, non-antibiotic strategies are gaining attention. Galacto-oligosaccharides (GOS) have been investigated for their potential to inhibit bacterial growth. This study investigates the impact of GOS on the biofilm development of GFP-labelled Staphylococcus aureus (GFP-SA) and Pseudomonas aeruginosa (GFP-PA) in the presence of blood PMNs from patients with non-small-cell lung cancer (NSCLC) and healthy controls. Materials and Methods: Bacterial biofilms were investigated in the presence or absence of PMNs isolated from the blood of 12 NSCLC patients and 3 healthy controls (HC), with the inclusion of GOS. These PMNs were incubated with GFP-SA or GFP-PA biofilms and exposed to various concentrations of GOS (2.5%, 5%, 10%, 15%, and 20%) for 24 hours in a microplate setting. The progress of bacterial biofilm was quantified using the crystal violet assay. Results: GOS itself, with bacteria at high concentrations (10%, 15%, and 20%), suppressed biofilm formation. PMNs of NSCLC patients show higher biofilm formation than in the absence of PMNs. Conclusion: Based on our findings, PMNs in NSCLC patients may disrupt the natural balance of bacteria in the lungs, potentially leading to an overgrowth of biofilm-forming bacteria. GOS are known to influence immune function and may improve the ability of PMNs to fight infections. Consequently, it is proposed that GOS could enhance the ability of PMNs to phagocytose bacterial biofilms and counteract the negative effects of cancerous PMNs on biofilm formation. However, further research is needed to confirm whether GOS can effectively manage bacterial biofilms in lung cancer patients.

https://www.tanaffosjournal.ir/article_741061_99e3cb9535ac9160cf23d4a6490dbeab.pdf

National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran TANAFFOS (Respiration) 1735-0344 24 4 2025 10 01 Predicting COPD Severity by Red Cell Distribution Width as a Potential Marker 330 337 741062 EN Fateme Mohammadzade Department Of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Mohammad Yousefi Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran AmirAli Moodi Ghalibaf Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran 0000-0002-3892-5047 Mostafa Kamandi Department Of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Farid Poursadegh Lung Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. 0009-0000-7238-5542 Fariba Rezaeetalab Lung Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. 0000-0003-3836-0944 Sepideh Hejazi Lung Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. 0000-0002-2723-1699 Mahnaz Mozdourian Lung Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. 0000-0002-1692-4510 Journal Article 2024 05 20 Background: Chronic obstructive pulmonary disease (COPD) is a condition of the lower airways and lungs with stable inflammation and alterations in the structure of small airways. There are some biomarkers linked to acute exacerbations of COPD (AECOPD). Red cell distribution width (RDW) is one of these biomarkers. To investigate the correlation between RDW and the severity of COPD, and to assess its relationship with the stage of airway obstruction in spirometry among COPD patients. Materials and Methods: In an 18-month retrospective study, a total of 255 participants were enrolled, including 170 patients with COPD (85 with stable COPD and 85 with acute exacerbations of COPD) and 85 age- and sex-matched healthy individuals. Demographic factors and blood laboratory tests were conducted for each group. The COPD groups had their COPD severity, spirometry parameters, and inflammation indices recorded and then compared. Results: RDW levels are increased in COPD patients (p˂0.001). However, no statistically significant relationships between RDW values and CAT scores or mMRC grades were observed. Our analysis revealed that spirometry parameters and RDW levels are negatively correlated (p˂0.05). Additionally, the RDW parameter has a positive and significant correlation with PCO2 and a negative and significant relationship with pH (p˂0.05), while no significant correlation exists between the RDW parameter and PHCO3. Conclusion: Our findings indicate that RDW could serve as a potential predictor of COPD conditions, especially in spirometry parameters

https://www.tanaffosjournal.ir/article_741062_e5627ef8e22cff75ec7735394a4dceaa.pdf

National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran TANAFFOS (Respiration) 1735-0344 24 4 2025 10 01 Oxidative Stress Mediates Cross-Talk between the Thioredoxin System and NLRP3 Inflammasome in Patients with COVID-19 338 352 741063 EN Rajab Mardani Department of Clinical Biochemistry, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran 0000-0001-7730-3040 Seyed Davood Mosavinasab National Reference Laboratory, Department of Arboviruses and Viral Hemorrhagic Fevers, Pasteur Institute of Iran, Tehran, Iran Heidar Tavilani Department of Clinical Biochemistry, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran Jamshid Karimi Department of Clinical Biochemistry, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran Jalal Poorolajal Department of Epidemiology, School of Health, Hamadan University of Medical Sciences, Hamadan, Iran Iraj Khodadadi Department of Clinical Biochemistry, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran Nutrition Health Research Centre, Hamadan University of Medical Sciences, Hamadan-Iran 0000-0001-9048-4528 Journal Article 2024 10 08 Background: COVID-19 is known as a fatal respiratory disease with an inflammatory basis. Imbalance of the thioredoxin system in peripheral blood mononuclear cells (PBMCs) may cause NLRP3 inflammasome activation and interleukin-1β production. Materials and Methods: Forty patients with COVID-19 and forty healthy individuals were included in this case-control study. All participants had previously received two doses of the coronavirus vaccine. PBMCs were isolated, and the expression of thioredoxin-interacting protein (TXNIP), thioredoxin-1 (TRX-1), NLRP3, caspase-1, and IL-1β genes was determined. Protein levels of TXNIP, NLRP3, and IL-1β were measured. Moreover, to confirm the involvement of oxidative stress in evoking inflammation in COVID-19, PBMCs were isolated from three independent healthy subjects, cultured in vitro, and infected with the SARS-CoV-2 virus in the presence or absence of vitamin C. Reactive oxygen species (ROS) and IL-1β levels were determined in cultured PBMCs. Results: Oxidative stress was higher in COVID-19 patients. The mRNA expression and protein levels of TXNIP, NLRP3, and IL-1β were significantly higher in PBMCs of COVID-19 patients compared with the control group, whereas the expression of TRX-1 was found to be lower in patients. The enhancement in ROS, TXNIP protein, and NLRP3 gene expression levels was positively associated with increased IL-1β. Conclusion: The concurrent elevation of ROS, TXNIP, NLRP3, and IL-1β suggests the potential role of the thioredoxin system in activating the NLRP3 inflammasome and generating inflammatory IL-1β in patients with COVID-19. In addition, vitamin C, as an adjunct therapeutic agent, beneficially suppressed oxidative stress and inflammation in infected PBMCs.

https://www.tanaffosjournal.ir/article_741063_3cf3c09a0fc1df641c8fb4e6b2dfbf40.pdf

National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran TANAFFOS (Respiration) 1735-0344 24 4 2025 10 01 Can the Eosinophil-to-Platelet Ratio Predict Chronic Obstructive Pulmonary Disease Exacerbations and Length of Hospital Stay? 353 363 741065 EN Sina Homaee Department of Internal Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0002-4389-3705 Reyhaneh Toluei Department of Internal Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0009-0007-0798-8380 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 Azadeh Moradkhani Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0002-6872-3577 Niloufar Taherpour Department of Epidemiology, School of Public Health & Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0002-8336-0671 Farnaz Saberian Department of Internal Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0002-6019-7197 Journal Article 2025 07 12 Background: An acute exacerbation of chronic obstructive pulmonary disease is a severe condition that escalates the burden on patients and the healthcare system. This study aimed to evaluate the prognostic value of the eosinophil-to-platelet ratio (EPR) in predicting COPD exacerbations and hospital admissions, with these outcomes also assessed as secondary endpoints. Materials and Methods: This cohort study was conducted from 2023 to 2025 at Masih Daneshvari Educational Hospital in Tehran, Iran, among patients with confirmed COPD exacerbation. Participants were assessed during the recovery phase after management of the acute exacerbation. Collected clinical data included the history and frequency of exacerbations in the preceding 12 months; blood test results at discharge; 90-day mortality; hospital readmission; ICU admission; and corticosteroid use within 12 months post-discharge. Data were analyzed using STATA version 17. Results: This study evaluated 249 individuals with COPD exacerbation, with a mean age of 65.66±9.17 years. In individuals with EPR≤1, the risk of experiencing more COPD exacerbations was 17% higher than in those with EPR>1 (adjusted RR=1.17, 95% CI=0.92 –1.49, P=0.195). These results were not statistically significant. In addition, in patients with EPR≤1, the risk of having a higher number of hospitalization days was 16% lower compared to those with EPR>1 (adjusted RR=0.84, 95% CI=0.72–0.98, P=0.036). EPR was not associated with ICU admission and the need for systemic corticosteroids. Conclusion: The association between lower EPR values and a higher number of exacerbations, as well as shorter hospital stays, suggests that EPR could reflect distinct exacerbation phenotypes or patterns of disease activity.

https://www.tanaffosjournal.ir/article_741065_88b1b23c3df1b569527e154e46da4914.pdf

National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran TANAFFOS (Respiration) 1735-0344 24 4 2025 10 01 Characteristics of Bacterial Isolates from Patients with Ventilator-Associated Pneumonia and the Hospital Environment in Urmia, Iran 364 374 741066 EN Mahdieh Delfi Cellular and Molecular Medicine Research Institute, Urmia University of Medical Sciences, Urmia, Iran Department of Microbiology and Virology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran 0000-0002-1554-8808 Masome Rabieepour School of Medicine, Urmia University of Medical Sciences, Urmia, Iran Vajihe Sadat Nikbin Department of Bacteriology, Pasteur Institute of Iran, Tehran, Iran Saber Yousefi Cellular and Molecular Medicine Research Institute, Urmia University of Medical Sciences, Urmia, Iran Department of Microbiology and Virology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran 0000-0002-5314-3860 Journal Article 2024 08 05 Background: Ventilator-associated pneumonia is a nosocomial infection involving hospitalized patients using mechanical ventilation. The endotracheal tube is a place for colonizing microbial populations and subsequent biofilm formation, leading to relative drug resistance. Also, the hospital environment may worsen the infection. This study aims to identify the microbial cause of the infection and evaluate its characteristics. Materials and Methods: Sampling was done using endotracheal tube suction among hospitalized patients and from different places in intensive care units in selected hospitals in Urmia, Iran. All specimens were identified by microbial and biochemical tests. Then, the antibiotic susceptibility tests were performed using disk diffusion and minimum inhibitory and bacteriocidal concentrations for selected antibiotics. Finally, the biofilm formation rates of all isolates were evaluated. Results: The majority of clinical bacterial isolates were Gram-negative bacilli, including A. baumannii. Bacillus spp. and Staphylococcus aureus were the most isolated bacteria from environmental samples. The antibiotic susceptibility testing results showed that most Gram-negative bacilli were resistant to common antibiotics and were extensively-drug resistant. The intermediate rate was higher than resistance to colistin, but evidence showed the efficiency of colistin against Gram-negative bacilli. Most of the isolates were strong biofilm producers, and this was correlated with the extensively drug-resistant pattern of bacteria. Conclusion: The evidence shows that Ventilator-associated pneumonia is a critical infection. According to the findings, there is a high rate of biofilm formation and consequent drug resistance among bacterial causes of Ventilator-associated pneumonia, which needs new insights for preventing and controlling this healthcare problem.

https://www.tanaffosjournal.ir/article_741066_595a737e62b5e0413f9fd4021a5dd348.pdf

National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran TANAFFOS (Respiration) 1735-0344 24 4 2025 10 01 Genetic Variants in Inflammatory Response Genes and Lung Cancer Risk: A Case-Control Study 375 383 741067 EN Adnan Khosravi Research Center of Thoracic Oncology (RCTO), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0001-6813-4847 Sharareh Seifi Research Center of Thoracic Oncology (RCTO), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0002-1340-0949 Babak D Salimi Research Center of Thoracic Oncology (RCTO), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0002-5541-8434 Maryam Mabani Research Center of Thoracic Oncology (RCTO), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran Patsa Rostami Research Center of Thoracic Oncology (RCTO), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran Masoumeh Nomani Research Center of Thoracic Oncology (RCTO), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran Shima Seif Mycobacteriology Research Center (MRS), NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran Hoda Dezhkhi Mycobacteriology Research Center (MRS), NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran Seyedeh Faezeh Sadatkiaei Research Center of Thoracic Oncology (RCTO), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran Journal Article 2024 12 04 Background: Lung cancer, a leading cause of cancer-related mortality, is influenced by both environmental and genetic factors. Chronic inflammation is recognized as a key driver of tumorigenesis. This study investigates the role of genetic variations in three inflammatory response genes in modulating lung cancer susceptibility. By examining the frequencies of specific polymorphisms in lung cancer patients and healthy controls, we aim to identify potential genetic markers for increased risk. Materials and Methods: We conducted a case-control study comparing the frequencies of 5 inflammatory response gene polymorphisms (TNF-α-308, TNF-α-238, IFN-γ-2109, IL-10-819, and IL-10-1082) in 62 patients with lung cancer and 78 controls. DNA samples were genotyped using PCR-based methods, and statistical analyses were performed to assess the associations between polymorphisms and lung cancer risk. Results: This study is the first to comprehensively analyze five key inflammatory response gene polymorphisms (TNF-α-308, TNF-α-238, IFN-γ-2109, IL-10-819, and IL-10-1082) in lung cancer patients. Our findings reveal significant associations between four of these polymorphisms and lung cancer risk. Conclusion: This study provides novel insights into the genetic basis of lung cancer susceptibility, highlighting the potential role of inflammatory response gene polymorphisms as biomarkers for risk assessment. Future research should develop deeper into the underlying biological mechanisms through which these genetic variants influence lung cancer development. By elucidating these pathways, we may identify novel therapeutic targets and develop personalized prevention and treatment strategies.

https://www.tanaffosjournal.ir/article_741067_47ad77a6f2270f49f736b7dbed7dc3f8.pdf

National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran TANAFFOS (Respiration) 1735-0344 24 4 2025 10 01 Comparative Analysis of Clinical, Laboratory, and Imaging Profiles in Tuberculosis Patients Pre- and Post-COVID-19 Pandemic 384 389 741069 EN Roya Alavi-Naini Department of Infectious Disease, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran. Infectious Diseases and Tropical Medicine Research Center, Resistant Tuberculosis Institute, Zahedan University of Medical Sciences, Zahedan, Iran Ilia Mirzaei Student Research Committee, Zahedan University of Medical Sciences, Zahedan, Iran 0000-0002-0235-3833 Mohammad Ali Zeinali Moghadam Department of Infectious Disease, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran Abolfazl Parsi-Moud Student Research Committee, Zahedan University of Medical Sciences, Zahedan, Iran 0000-0001-8156-2379 Journal Article 2024 03 06 Background: While the COVID-19 pandemic has understandably dominated global attention, Tuberculosis (TB) remains a persistent and formidable global health threat. Acknowledging the impact of COVID-19 on immune function and the decreased referrals of TB patients to medical clinics during the pandemic, we sought to assess the clinical and paraclinical characteristics of TB patients in two distinct periods: pre-pandemic and pandemic periods. Materials and Methods: We retrospectively identified 105 TB patients from the year preceding the pandemic and, during the pandemic, selected 72 TB patients with a positive history of COVID-19. A comprehensive analysis of various features, including age, gender, fever, cough, hemoptysis, and different imaging and laboratory parameters, was conducted and compared between the two groups. Results: Post-pandemic TB patients exhibited a higher prevalence of hemoptysis, chest pain, and elevated erythrocyte sedimentation rate (ESR) levels, with P-values of 0.014, 0.006, and <0.001, respectively. Furthermore, our findings indicated an increased incidence of bilateral imaging features in COVID-19 TB patients (P= 0.02). Conclusion: Given the potential effects of COVID-19 on immune function and the diagnostic challenges posed by overlapping clinical manifestations, clinicians should maintain a high index of suspicion for tuberculosis (TB) in patients with COVID-19, particularly those presenting with atypical or complex symptoms.

https://www.tanaffosjournal.ir/article_741069_9ea5ce82c2473ee4e05ee1c138b46edb.pdf

National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran TANAFFOS (Respiration) 1735-0344 24 4 2025 10 01 Association between Telomere Length and Idiopathic Pulmonary Fibrosis: A Case-Control Study 390 398 741070 EN 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 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 Seyed Alireza Nadji Virology Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran Makan Sadr Virology Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0002-8781-8176 Hooman Sharifi Tobacco Prevention and Control Research Center, NRITLD, Shahid Beheshti University of Medical Sciences ,Tehran, Iran 0000-0001-6448-046X Reyhaneh Dehghani School of Medicine, TeMS.C., Islamic Azad University, Tehran, Iran Mobina Zargar School of Medicine, TeMS.C., Islamic Azad University, Tehran, Iran Mohsen Sadeghi Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran Inflammatory Lung Disease Research Center, Department of Internal Medicine, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran Journal Article https://www.tanaffosjournal.ir/article_741070_e7f7a2fcdb9caec79427ac396caf8c2e.pdf

National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran TANAFFOS (Respiration) 1735-0344 24 4 2025 10 01 A Rare Mechanism of Hypoxemia: A Case Report 399 403 741071 EN Maria Laura Vega Pittao Respiratory and Critical Care Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy Alma Mater Studiorum, Department of Medicine and Surgical Sciences (DIMEC), University of Bologna, Italy 0000-0002-8317-6364 Davide Femia Alma Mater Studiorum, Department of Medicine and Surgical Sciences (DIMEC), University of Bologna, Italy Marco Carpano Respiratory and Critical Care Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy Alma Mater Studiorum, Department of Medicine and Surgical Sciences (DIMEC), University of Bologna, Italy Massimiliano Polastri Department of Continuity of Care and Integration, Physical Medicine and Rehabilitation, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy 0000-0001-8548-0813 Vito Catalanotti Respiratory and Critical Care Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy 0000-0001-9871-9475 Manuel Lucchin Alma Mater Studiorum, Department of Medicine and Surgical Sciences (DIMEC), University of Bologna, Italy Chiara Folchi Vici D’Arcevia Alma Mater Studiorum, Department of Medicine and Surgical Sciences (DIMEC), University of Bologna, Italy Anna Gabriela Lisowska Alma Mater Studiorum, Department of Medicine and Surgical Sciences (DIMEC), University of Bologna, Italy Lara Pisani Respiratory and Critical Care Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy Alma Mater Studiorum, Department of Medicine and Surgical Sciences (DIMEC), University of Bologna, Italy 0000-0001-9224-8158 Journal Article 2024 06 07 The leading causes of hypoxemia and acute respiratory failure commonly observed in the intensive care unit setting are ventilator/perfusion mismatch and intrapulmonary shunt. The main objective of the current report was to describe the treatment and the diagnostic procedures in a patient with methemoglobinemia. A 66-year-old woman arrived at the emergency department after suddenly losing coordination while walking and reported having experienced increased cough and sputum in the previous days. The patient, a current smoker with 35 pack–years, had comorbidities and chronic obstructive pulmonary disease, requiring long-term oxygen therapy. Extensive laboratory analyses revealed elevated methemoglobin (MetHb) levels, increasing from 10% upon admission to 25% of total hemoglobin (Hb), and the onset of post-surgical anemia (Hb 9.6 g/dL). In the present case, the hypoxemia was caused by an increase in MetHb levels, in addition to anemia due to surgical intervention and overhydration. Antibiotic and diuretic therapy for treating infection and right heart failure was effective, leading to a favorable postoperative course.

https://www.tanaffosjournal.ir/article_741071_6c7e9447a831149971e2188eaf77c52c.pdf

National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran TANAFFOS (Respiration) 1735-0344 24 4 2025 10 01 Pericardiocentesis in Massive Pericardial Effusion in the Setting of Pulmonary Hypertension: Is It Beneficial? 404 407 741072 EN Ahmad Mirdamadi Department of Cardiology, Najafabad Branch, Islamic Azad University, Najafabad, Isfahan, Iran Mahsa Hashemirad Faculty of Medicine, Islamic Azad University, Najafabad Branch, Isfahan, Iran Shakiba Seifi Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0001-8759-5817 Journal Article 2024 12 21 Background: A serious complication of pulmonary hypertension (PH) is pericardial effusion (PE), which can significantly increase the mortality rate of affected patients. While managing this condition is critical, there is ongoing debate regarding the best therapeutic approaches. Although pericardiocentesis is mostly indicated in patients with cardiac tamponade, it may inadvertently increase mortality in the context of PH. Case Presentation: This case series reports on three patients who experienced PE associated with PH. Each patient received a different treatment, resulting in varying outcomes. One patient, unfortunately, died within 24 hours after undergoing pericardiocentesis. In contrast, the other two patients did not receive the procedure; instead, they were treated with medication. One of them has shown significant improvement after receiving more aggressive medical treatment. Both are alive with unremarkable limitations. Conclusion: The coexistence of pulmonary hypertension and massive pericardial effusion presents a complex challenge for management decisions. An effective approach requires a multidisciplinary strategy to optimize patient outcomes. While pericardiocentesis is essential in cases of massive pericardial effusion, it should be reconsidered if the underlying cause is pulmonary hypertension.

https://www.tanaffosjournal.ir/article_741072_6871ffecb5f4660d20b335056c6c45eb.pdf

National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran TANAFFOS (Respiration) 1735-0344 24 4 2025 10 01 Pulmonary Nodules and Lymphadenopathy in a Patient with Advanced HIV Infection 408 410 741073 EN 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 0009-0007-4664-1953 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 Babak Salimi Research Center of Thoracic Oncology (RCTO), NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0002-5541-8434 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 Journal Article 2026 06 03 WHAT IS YOUR DIAGNOSIS? A 28-year-old woman was admitted with a two-month history of dysphagia and a two-week history of non-massive hemoptysis. She had been diagnosed with human immunodeficiency virus (HIV) infection five years earlier and was receiving antiretroviral therapy, although adherence was poor. On admission, she was afebrile and hemodynamically stable. Physical examination revealed multiple violaceous cutaneous plaques on the trunk and extremities. Lung examination was unremarkable. Multiple bilateral, non-tender, mobile cervical lymph nodes were palpable. On abdominal examination, the splenic edge was palpable below the left costal margin. Laboratory studies demonstrated pancytopenia, with a white blood cell count of 2.46 × 10⁹/L (absolute neutrophil count, 1.96 × 10⁹/L), hemoglobin of 10.6 g/dL, and platelet count of 44 × 10⁹/L. The erythrocyte sedimentation rate was 52 mm/h. Her HIV viral load was 1895 copies/mL, and the CD4+ T-lymphocyte count was 7 cells/µL. Contrast-enhanced CT of the neck demonstrated multiple bilateral cervical and supraclavicular lymphadenopathies, the largest measuring approximately 125 × 90 mm, associated with contour deformity and luminal narrowing of the oropharynx. Endoscopic evaluation revealed an erythematous lesion on the mucosal surface of the left nasal cavity; however, further evaluation of the nasopharynx was not feasible because of significant upper airway obstruction. Contrast-enhanced CT of the chest revealed multiple bilateral pulmonary nodules with mediastinal, hilar, and axillary lymphadenopathies (Figure 1). CT of the abdomen demonstrated mild hepatosplenomegaly. Given the presence of pancytopenia and generalized lymphadenopathy, both infectious and hematologic etiologies were considered. Sputum smear examination for acid-fast bacilli and Mycobacterium tuberculosis GeneXpert testing were negative. Bone marrow examination and an excisional biopsy of a cervical lymph node were subsequently performed for diagnostic evaluation. Histopathologic findings from the lymph node biopsy are shown in Figure 2. https://www.tanaffosjournal.ir/article_741073_7c997fb615e0a6fb957aed1823079809.pdf