Journal of Research in Medical Sciences
Volume:26 Issue: 4, May 2021

The new coronavirus outbreak quickly filled hospital beds and stunned the world. Intensive care is required for 5% of patients, and the mortality rate for critically ill patients is 49%. The “cytokine storm” is considered as the main cause of pathogenesis for coronavirus disease‑19 (COVID-19)‑related respiratory failure, hemoperfusion may be a modality for treatment of disease.

Thirty-seven an patients with positive real‑time polymerase chain reaction for SARStions2 in an upper respiratory tract sample or typical chest computed tomography lesion were eligible for this case–control study. Patients meeting the criteria for hemoperfusion including clinical and laboratory indices, were evaluated for outcomes such as hospitalization length and mortality. Patients were divided into three groups, i.e., patients who received hemoperfusion without a need for mechanical ventilation (MV), patients who received hemoperfusion before MV, and patients who received hemoperfusion after MV.

Among 37 patients with COVID-19 respiratory failure, 32% were female with a mean age of 55.54 (standard deviation 14.1) years. There was no statistically significant difference between the three groups in terms of length of hospital stay and intensive care unit (ICU) stay (P-tayns: 0.593 and 0.243, respectively, confidence interval [CI]: 95%). Heart rate, respiratory rate, PaO2 /FIO2 , high‑sensitivity C‑reactive protein, and ferritin significantly improved after the application of hemoperfusion in all groups (P < 0.05, CI: 95%).

It seems that applying hemoperfusion in the inflammatory phase of the disease, especially before the intubation, reduce the need for MV. However, hemoperfusion does not have any impacts on the duration of hospital and ICU stay.

Bronchopulmonary dysplasia (BPD) remains a major problem in preterm infants that occurs in up to 50% of preterm infants. The inflammation plays an important role in its pathogenesis. This study was conducted to evaluate the efficacy intratracheal budesonide administration in combination with surfactant in the prevention of BPD in preterm infants.

In a randomized controlled clinical trial, 128 preterm infants with gestation age <30 weeks and birth weight <1250 g who had respiratory distress syndrome (RDS) and need surfactant replacement therapy were studied. They randomly allocated into two groups, surfactant group (n = 64) and surfactant + budesonide group (n = 64). Patients were followed till discharge for the primary outcome which was BPD.

The mean gestation age and birth weight of studied neonates were 28.3 ± 1.6 weeks and 1072 ± 180 g, respectively. BPD was occurred in 20 (31.3%) neonates in surfactant + budesonide group and 38 (59.4%) patients in surfactant group, P = 0.02. Respiratory support was needed in two groups similarly, but the mean duration of respiratory support was significantly longer in surfactant group in comparison with surfactant + budesonide group (mechanical ventilation 2.8 ± 0.6 vs. 0.8 ± 0.1 days, P = 0.006, nasal continuous positive airway pressure 5.2 ± 3.0 vs. 4.0 ± 3.5 days, P = 0.04 and high flow nasal cannula 7.7 ± 0.9 vs. 4.1 ± 0.5 days, P = 0.001).

Based on our findings, the use of budesonide in addition to surfactant for rescue therapy of RDS significantly decreases the incidence of BPD and duration of respiratory support. Future studies are recommended with a large number of patients before routine administration of surfactant and budesonide combination.

Promoting quality of life (QoL) in patients with bronchiectasis, as a chronic disease, is a part of therapeutic principles. This study aimed to investigate QoL and its determinants in patients with noncystic fibrosis (CF) bronchiectasis.

This cross‑sectional study was conducted on 62 patients (38.7% male, mean age: 44) with non‑CF bronchiectasis and involvement of ≥2 lobes in Qazvin, Iran. QoL was evaluated using the St. George’s Respiratory Questionnaire (SGRQ). The relationships of QoL subscales with clinical (cough, dyspnea, and sputum volume) and paraclinical (spirometry, computerized tomography scan, sputum microbiology, and 6‑min walk test [6‑MWT]) were assessed using Pearson’s correlation coefficient and multiple linear regression analyses.

The mean SGRQ total score was 53.1 (standard deviation 19.8) out of 100. The level of dyspnea (r = 0.543, P < 0.001), cough (r = −0.594, P < 0.001), 6‑MWT (r = −0.520, P < 0.001), sputum volume (r = 0.423, P = 0.002), and number of exacerbations (r = 0.446, P = 0.009) had significant correlation with SGRQ total score. In multiple regression analysis, forced expiratory volume in 1 s was an independent predictor of the symptom (β = −0.22, P = 0.048) and activity (β = −0.43, P = 0.03) subscales, whereas cough was an independent predictor of the symptom subscale (β = −2.1, P = 0.002).

In patients with non‑CF bronchiectasis, the extent of lung impairment has a lower effect on the QoL than clinical symptoms. It seems that the QoL can be improved through the proper treatment of clinical symptoms and rehabilitation for promoting 6‑MWT.

Reducing and maintaining body weight has become more important than ever as obesity is becoming increasingly common worldwide. This study was aimed to investigate the effects of diets with different protein contents administered to obese women on anthropometric measurements, inflammatory markers, and cardiometabolic risk factors.

This randomized controlled trial was conducted with sixty volunteering obese women aged between 20 and 45 years. The subjects were divided into two groups in equal numbers. The high‑protein (HP) group (n = 30) was administered an iso‑caloric HP diet (25% protein, 30% fat, and 45% carbohydrate), and the control group (n = 30) an isocaloric low‑protein diet (15% protein, 30% fat, and 55% carbohydrate), and both groups were followed up for 8 weeks. The subjects’ descriptive data, anthropometric measurements, homeostatic model assessment‑insulin resistance (HOMA‑IR), lipid profiles, and high‑sensitive C‑reactive protein (hs‑CRP), tumor necrosis factor‑alpha (TNF‑α), and interleukin‑6 (IL‑6) levels were analyzed.

There was no significant difference at baseline (except for low‑density lipoprotein cholesterol [LDL‑C]), and end‑of‑study (except for IL‑6, systolic blood pressure [SBP], and diastolic blood pressure) values of parameters between the two groups; after adjusted for baseline measurements, a significant difference was observed between the groups for body weight, body mass index, waist circumference, HOMA‑IR, LDL‑C, hs‑CRP, TNF‑α, IL‑6, and SBP (P = 0.004, P = 0.001, P = 0.003, P = 0.029, P = 0.004, P = 0.016, P = 0.004, P = 0.010, and P = 0.000, respectively) and were greater in the HP group than in the control group (P < 0.05).

The HP diet was effective on improvement in HOMA‑IR, SBP, LDL‑C, hs‑CRP, TNF‑α, IL‑6, and resulted in body weight loss.

The purpose of this study was to evaluate of the study the role of LBW on EH in children and by studying the existing published literature.

A comprehensive literature search for original studies was conducted in Clarivate Analytics Web of Science, PubMed, Scopus, and Embase until July 2019. The search used all of the main keywords and its synonyms include essential hypertension, primary hypertension, essential arterial hypertension, idiopathic hypertension, spontaneous hypertension; child, childhood, children, pediatric, pediatrics, infant, infancy, newborn, neonatal, adolescence, teenagers; and BW, newborn weight, neonatal weight, BW.

Twelve articles were eligible for the final evaluation. Due to the difference among studies in the report, studies were divided into two-part. The first part, articles were reported in the LBW and NBW groups (interested outcome were SBP and DBP), and the second part was composed as the EH and NR groups (interested outcome were LBW and NBW). In the first part, SMD for SBP was -1.09 with 95% CI (-1.91,-0.26), and was statistically significant (Z=2.58, P=0.010). As well, SMD for DBP was -0.68 with 95% CI (-1.32,-0.05) statistically significant (Z=2.10, P=0.036). In the second part, SMD for SBP was 0.77 with 95% CI (-0.85, 2.39), and was statistically significant (Z=0.93, P=0.352). Subgroup analysis was performed on the pre-term and full- term babies. SMD for SBP was -0.08 with 95% CI (-0.51, 0.35) in the pre-term, and the full-term was -2.07 with 95% CI (-3.47, -0.67). As well, SMD for DBP was -0.02 with 95% CI (-0.20, 0.17) in the preterm, and the term was -1.35 with 95% CI (-1.57, -1.13).

Although findings of the correlation between BW and EHTN have conflicted. To our knowledge, this is the first report that attempts to a conclusion.

The high prevalence rate in conjunction with the long latency period made prostate cancer (PCa) an attractive and reasonable candidate for preventive measures. So far, several dietary and nutritional interventions have been implemented and studied with the aim of preventing the development or delaying the progression of PCa. Calorie restriction accompanied by weight loss has been shown to be associated with decreased likelihood of aggressive PCa. Supplements have played a major role in nutritional interventions. While genistein and lycopene seemed promising as preventive agents, minerals such as zinc and selenium were shown to be devoid of protective effects. The role of vitamins has been widely studied, with special emphasis on vitamins with antioxidant properties. Data related to Vitamin A and Vitamin C were rather controversial and positive effects were of insignificant magnitude. Vitamin E was associated with a decreased risk of PCa in high‑risk groups like smokers. However, when it comes to Vitamin D, the serum levels might affect the risk of PCa. While deficiency of this vitamin was associated with increased risk, high serum levels imposed the risk of aggressive disease. Despite the seemingly promising effects of dietary measures on PCa, no firm recommendation could be made due to the limitations of the studies and evidence. However, the majority of these advices could be followed by the patients with the intent of living a healthy lifestyle.

We report an extremely rare case of multifocal bone disorder in a 3.5‑year‑old boy who appeared for left forearm and arm pain and multiple periods of fever with an unusual presentation of lymphoma/leukemia and highlight diagnostic challenges leading to a misdiagnosis, which was then diagnosed and treated for chronic recurrent multifocal osteomyelitis (CRMO). Based on a left arm biopsy and whole‑body scans, he was eventually diagnosed with CRMO. Taken together, in this case, we noticed a notable amelioration after a 5‑month treatment with nonsteroidal anti‑inflammatory drugs on multiple bone pains.

COVID‑19 outbreak has become a global health concern due to challenges in treatment and high mortality rate; therefore, its therapeutic approaches play an important role in reducing the mortality rate and resolving this concern. Different therapies have been introduced, including interferon beta‑1a and purification methods, for instance, plasmapheresis. In this article, we reported a child with severe COVID‑19 who fully recovered after receiving plasmapheresis and interferon beta‑1a.