Tanaffos Respiration Journal
Volume:12 Issue: 1, Winter 2013

The increasing prevalence of TB drug resistant strains in absence of recent transmission evidence, highlights the need for an improved control program, coupled with a need to improve detection rate and early diagnosis. IS6110-RFLP is a means of genotyping TB clinical samples. In this study IS6110- RFLP was used for specification and quick tracking of TB infection source, transmission and reactivation of infection, in Iran. This study was carried out on 258 TB patients from Tehran, Mashhad, Isfahan, Shiraz and Ahwaz. DNA from positive cultures was extracted and digested by PVUII restriction enzyme. The digested sequences were separated based on the size on agar gel and then southern Blot was transferred on the membrane. IS6110 probe was marked by HRD and hybridized to the target parts along genome. Sixty-one strains (24%) showed similar patterns (Recent transmission) and 197 strains (76%) showed different IS6110 patterns (Reactivation). Average number of IS6110 copies was between 10-11 bands. Frequency of IS6110 similar pattern was 11.46 in Afghan immigrants and 10.68 in Iranians. High diversity of IS6110, indicates that 76% of the patients have been infected through reactivation by different sources, while 24% have been infected due to recent transmission. Observing different antibiogram patterns in patients infected with the same strain indicated vast transmission of a single strain in the society. A susceptible strain can be changed into mono drug resistant and MDR strain in the transition period.

Several studies have been carried out to evaluate the effects of dialysis on pulmonary function tests (PFT). Dialysis procedure may reduce lung volumes and capacities or cause hypoxia; however, to the best of our knowledge, there is no previous study evaluating the effects of membrane type (high flux vs. low flux) on PFT in these patients. The aim of this study was the evaluation of this relationship. In this cross-sectional study, 43 hemodialysis patients without pulmonary disease were enrolled. In these patients dialysis was conducted by low- and high-flux membranes and before and after the procedure, spirometry was done and the results were evaluated by t-test and chi square test. The mean age of patients was 56.34 years. Twenty-three of them were female (53.5%). Type of membrane (high flux vs. low flux) had no effect on spirometry results of patients despite the significant decrease in the body weight during the dialysis session. High flux membrane had no advantage over low flux membrane in terms of improvement in spirometry findings; thus, we could not offer these expensive membranes for this purpose.

The burden of chronic obstructive pulmonary disease (COPD) is quite high and its prevalence is increasing. We aimed to evaluate the correlation of COPD severity according to the American Thoracic Society (ATS) criteria with spirometric measurements in patients admitted to the emergency ward.

In this cross-sectional descriptive study, 50 randomly selected patients with COPD admitted to the emergency ward in a tertiary care center were evaluated. The COPD severity according to the ATS criteria was measured and its association with spirometric findings was evaluated. The statistical analysis was performed by SPSS software and the Kendall's tau-b correlation test.

The mean age (±standard deviation) was 64.3 ± 11.3 years. Twelve percent were females and 88 percent were males. The COPD severity, according to the ATS criteria, was mild in 16%, moderate in 48%, severe in 32% and very severe in four percent. There was a statistically significant correlation between total lung capacity (TLC) and COPD severity (P=0.013, r=275). Besides, there was a statistically significant correlation between functional residual capacity (FRC) and COPD severity (P=0.022, r=255). Age, sex, and the other spirometric findings especially FEV1 and FVC had no association with COPD severity (P > 0.05).

According to the obtained results, it is concluded that determining the COPD severity according to the ATS criteria may help the physicians to estimate the patient's prognosis and therapeutic planning. However, the spirometric measurements may not be replaced by ATS criteria.

Overweight and obese children are at increased risk of a wide range of health conditions including respiratory diseases. In addition, inactivity can decrease pulmonary function. This study assessed the effect of obesity and inactivity on pulmonary function impairment in adolescents. This study was conducted on 80 adolescents. Subjects were divided into two groups. Group I included 40 untrained (VO2max= 29.30±4.20) fat adolescents (UO). Group II included 40 healthy trained (VO2max= 58.11±2.23) normal weight adolescents (TN). Body mass index (BMI), body fat percentage and waist to hip ratio (WHR) were calculated and pulmonary function tests were carried out according to the standard protocols. Data were analyzed using student’s “t” test and Pearson’s correlation coefficient. UO had significantly lower pulmonary function values than the TN group. They also showed lower FEV1/FVC ratio when compared to TN group (P<0.05). In UO group, BMI, body fat percentage and WHR had a significant negative correlation with pulmonary function whereas in TN group only BMI had significant negative correlation with pulmonary function. A significant decrease in FEV1 was observed in the two groups, which led to a decrease in FEV1/FVC% after the exercise compared to before. Thus, exercise test induced airway resistance in both groups. untrained obese adolescents have more respiratory symptoms than their normal weight trained peers, and these factors are recommended to be used as a predictor of pulmonary function in assessment of obese children in epidemiological studies. In addition, obesity and inactivity can surcharge pulmonary function abnormalities in adolescents.

Laryngoscopy and intubation incur hemodynamic changes like increase in heart rate, arterial blood pressure, pulmonary artery pressure, wedge capillary pressure and arrhythmias. Anesthesiologists are continually in search of ways to alleviate such complications. Several medicinal methods have been suggested that serve the purpose including the administration of intravenous magnesium sulfate to minimize these unfavorable responses. This study compares the effects of intravenous administration of lidocaine and magnesium sulfate on unwanted hemodynamic responses following laryngoscopy and intubation in elective surgery candidates. This randomized double-blind clinical trial was conducted on 60 ASA-I and ASA-II candidates who received 60 mg/kg (based on Lean Body Mass) magnesium sulfate or lidocaine randomly before intubation. Values of systolic and diastolic blood pressures, mean arterial pressure, and heart rate were recorded for both groups during the 5 minutes following administration, and compared with baseline values. In both groups, systolic blood pressure increased compared to the baseline value. However, there was a significant difference between the two groups as this increase occurred within the first 3 minutes in the lidocaine group, while within the first minute in the magnesium sulfate group. The increase in diastolic blood pressure was not significant. But there was a significant difference in the mean arterial pressure increase between the two groups since in the magnesium sulfate group this increase occurred in the first minute whereas in the lidocaine group it occurred during the first two minutes. There was no significant difference in the heart rates after intubation between the two groups. Magnesium sulfate is more effective than lidocaine in controlling hemodynamics, although it may increase the heart rate.

Lung transplantation is considered the ultimate treatment for some patients, but due to the specific condition of patients undergoing it, follow up is a major concern. The aim of this study was to evaluate the role of home spirometry in follow up of lung transplant recipients and early detection of complications in these patients. A PC-based portable spirometry set was used to evaluate the well being of two lung transplant recipients on a regular daily basis for a 6-month period. Patient satisfaction and compliance, and device sensitivity in detecting complications were evaluated. Results of follow up were compared with 2 matched control patients. Patient adherence to home spirometry was 80% in one and 61% in the other patient and both patients were satisfied with the method, although this satisfaction declined towards the end of the study period. The main reason for low adherence was insufficient internet access. This method succeeded in early detection of infectious complications. Home spirometry seems to be a reliable method for follow up of lung transplant recipients, but further studies in a larger group of patients is recommended.

We report a 9-year old girl with an unusual presentation of granulomatosis with polyangiitis in association with Marfan phenotype. The patient presented with recurrent sinusitis, epistaxis, hearing loss and hyperplastic gingivitis, without any signs or symptoms of major organ involvement.

Hydatid cyst of the heart is an uncommon presentation of hydatidosis. We present a case of pericardial hydatid cyst in pericardial oblique sinus with extension to posterior wall of left atrium (LA), occluding all pulmonary vein ostia in a 35 year-old female with progressive dyspnea and severe orthopnea.