Overuse and underuse of pulmonary CT angiography in patients with suspected pulmonary embolism

Background: The aim of the present study was to evaluate the utilization and diagnostic yields of CT pulmonary angiography (CTPA)using the Revised Geneva score and Wells' criteria, in patients with suspected pulmonary embolism (PE). Methods: One hundred and twelve adult patients underwent CTPA for suspected PE were participated in this study. The outcome was positive or negative CTPA for PE. Revised Geneva and Wells' scores were calculated. The relationship between the results obtained from these two scores and the available risk factors were compared. Descriptive analysis such as frequency and mean as well as analytical statistics including chi-square were done. The data analysis was performed using SPSS (v. 22). Results: In this study, according to the Wells' criteria calculated for the patients, 33.9 of the patients had low clinical, 56.3 intermediate and 9.8 high clinical probability. Among the 11 high clinical patients, 9(81.8) were CTPA positive. Based on the revised Geneva score, 65 patients (58) had low clinical, 36 (32.1) intermediate and 11(9.8) high clinical probability. Among the 11 high clinical patients, 8 were CTPA positive. Positive predictive value of the low clinical patients based on Wells' criteria and the revised Geneva score was 18.4 and 30.8, respectively. Also, positive predictive value for high clinical probability of Wells' criteria and the revised Geneva score was 81.8 and 72.8 respectively. Conclusion: Under/overuse of CTPA in diagnosing PTE is a common problem especially in university hospitals. It is possible to avoid unnecessary CTPA requests using scholarly investigations and more accurate clinical risk assessments. © Iran University of Medical Sciences

Overuse and underuse of pulmonary CT angiography in patients with suspected pulmonary embolism

Background: The aim of the present study was to evaluate the utilization and diagnostic yields of CT pulmonary angiography (CTPA)using the Revised Geneva score and Wells' criteria, in patients with suspected pulmonary embolism (PE). Methods: One hundred and twelve adult patients underwent CTPA for suspected PE were participated in this study. The outcome was positive or negative CTPA for PE. Revised Geneva and Wells' scores were calculated. The relationship between the results obtained from these two scores and the available risk factors were compared. Descriptive analysis such as frequency and mean as well as analytical statistics including chi-square were done. The data analysis was performed using SPSS (v. 22). Results: In this study, according to the Wells' criteria calculated for the patients, 33.9 of the patients had low clinical, 56.3 intermediate and 9.8 high clinical probability. Among the 11 high clinical patients, 9(81.8) were CTPA positive. Based on the revised Geneva score, 65 patients (58) had low clinical, 36 (32.1) intermediate and 11(9.8) high clinical probability. Among the 11 high clinical patients, 8 were CTPA positive. Positive predictive value of the low clinical patients based on Wells' criteria and the revised Geneva score was 18.4 and 30.8, respectively. Also, positive predictive value for high clinical probability of Wells' criteria and the revised Geneva score was 81.8 and 72.8 respectively. Conclusion: Under/overuse of CTPA in diagnosing PTE is a common problem especially in university hospitals. It is possible to avoid unnecessary CTPA requests using scholarly investigations and more accurate clinical risk assessments. © Iran University of Medical Sciences

Gelatinases Increase in Bleomycin-induced Systemic Sclerosis Mouse Model

Systemic sclerosis is a fibrotic autoimmune disease in which aberrant remodeling of the extracellular matrix in organs disturbs their functionalities. The aim of this study was to investigate the expression of gelatinases on systemic sclerosis. Consequently, a mouse model of systemic sclerosis was employed and the gelatinolytic activity of gelatinases was evaluated on the fibrotic tissues of this model. Two groups of ten mice were considered in this work: a group of systemic sclerosis model and control group. For the generation of systemic sclerosis model, mice received bleomycin, while the control group was subjected to phosphate buffered saline (PBS) reception. Mice were tested for fibrosis by using trichrome staining, hydroxyproline measurement and α-SMA detection in tissue sections. Additionally, the gelatinolytic activity of matrix metalloproteinase 2 and matrix metalloproteinase 9 were measured using gelatin zymography in lungs and skin tissue homogenates. The obtained results indicated that subcutaneous injection of bleomycin-induced fibrosis in skin and lung tissues of mice. Pro and active forms of matrix methaloproteinase 9 were increased in fibrotic lung tissues (p<0.05 and p<0.01, respectively), while, the gelatinolytic activity of MMP2 was unaffected in these tissues. Additionally, in skin tissues of bleomycin-treated animals, both pro and active forms of MMP9 and MMP2 were increased (p<0.05). Pro and active forms of gelatinases increase differently in skin and lung tissues of bleomycin-induced scleroderma

The role of progesterone in cellular apoptosis of skin and lung in a bleomycin-injured mouse model

Systemic sclerosis is a female predominant, a fibrotic autoimmune disease in which disturbance in tissue homeostasis and cell turnover including cell apoptosis are central events in pathogenesis. Sex hormones are known as the important players in sexual dimorphism of autoimmune diseases and in tissue homeostasis. Progesterone influences autoimmune disease via its immunomodulatory effect or by its direct action on parenchymal cell function. On the other hand, this hormone impacts tissue homeostasis by acting on cell apoptosis in a different situation. The objective of this study was to examine the effect of progesterone on cellular apoptosis of skin and lung tissues in a mouse model of scleroderma. Four group of mice were involved in this study with 10 mice in each. The fibrotic model was induced by daily subcutaneous injection of bleomycin for 28 days. One week after initiation of fibrosis induction, mice received subcutaneous progesterone alone or with bleomycin for 21 days. Control group received only Phosphate buffered saline PBS. After 28 days, under lethal anesthesia skin and lung tissues were harvested for histological assessment and hydroxyproline measurement. Apoptosis in tissue sections was detected by TUNEL assay technique. Bleomycin administration induced fibrosis in skin and lung tissues. Severe apoptosis was seen in skin and lung tissues of the bleomycin-treated group (p0.05) or in the lung (p>0.05) did not alter apoptosis in bleomycin-treated animals. Our data confirm the role of apoptosis in the pathogenesis of fibrosis in this model; however, progesterone does not affect cellular apoptosis in skin and lung tissues of bleomycin-injured animals. Copyright© February 2019, Iran J Allergy Asthma Immunol. All rights reserved

Protective and anti-inflammatory effect of selenium nano-particles against bleomycin-induced pulmonary injury in male rats

Pulmonary fibrosis (PF) is an interstitial lung disease, in which the exact pathologic mechanisms are not fully understood. Drug trials for the treatment of PF have shown disappointing results and controversial. Recently, selenium nanoparticles (SeNPs) have received great attention for potential use in treatments, due to high bioactivity features and lower toxicity. This study evaluated the protective effect of SeNPs against pulmonary injury induced by bleomycin (single dose, 4 mg/kg, intratracheal) in male rats in early and late phases of the disease. The rats were treated with SeNPs by intraperitoneal injection (0.5 mg SeNP/kg) for five consecutive days in the early phase (a day after injection of bleomycin) and late phase (a week after injection of bleomycin). The results showed that injection of SeNPs in the early phase improved the degree of alveolitis and inflammation and lung structure damage. Also, led to significant decreases in density of transforming growth factor- β1 (TGF-β1) in the lung and tumor necrosis factor-α (TNF-α) levels in the serum and lung homogenates compared with bleomycin-administrated group. Notably, treatment with the SeNP during the late phase did not show any ameliorative effects. Thus, the data suggest that SeNP has a protective effect against bleomycin-induced pulmonary injury in rats in the early phase of the disease. This might mean that SeNPs may be a new therapeutic agent for the improvement of this disease in the early phases. © 2019 Informa UK Limited, trading as Taylor & Francis Group

Protective and anti-inflammatory effect of selenium nano-particles against bleomycin-induced pulmonary injury in male rats

Pulmonary fibrosis (PF) is an interstitial lung disease, in which the exact pathologic mechanisms are not fully understood. Drug trials for the treatment of PF have shown disappointing results and controversial. Recently, selenium nanoparticles (SeNPs) have received great attention for potential use in treatments, due to high bioactivity features and lower toxicity. This study evaluated the protective effect of SeNPs against pulmonary injury induced by bleomycin (single dose, 4 mg/kg, intratracheal) in male rats in early and late phases of the disease. The rats were treated with SeNPs by intraperitoneal injection (0.5 mg SeNP/kg) for five consecutive days in the early phase (a day after injection of bleomycin) and late phase (a week after injection of bleomycin). The results showed that injection of SeNPs in the early phase improved the degree of alveolitis and inflammation and lung structure damage. Also, led to significant decreases in density of transforming growth factor- β1 (TGF-β1) in the lung and tumor necrosis factor-α (TNF-α) levels in the serum and lung homogenates compared with bleomycin-administrated group. Notably, treatment with the SeNP during the late phase did not show any ameliorative effects. Thus, the data suggest that SeNP has a protective effect against bleomycin-induced pulmonary injury in rats in the early phase of the disease. This might mean that SeNPs may be a new therapeutic agent for the improvement of this disease in the early phases. © 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group

Effect of eight-week aerobic, resistive, and interval exercise routines on respiratory parameters in non-athlete women

Background: There are not many studies about the effects of physical activity on pulmonary function in normal population. However, it seems that strengthening and persevering respiratory muscles is an effective technique for improving pulmonary function. Objective: The purpose of this study was to evaluate and compare the effects of eight-week aerobic, resistance, and interval exercise routines on respiratory parameters in non-athlete women. Materials and Methods: Thirty-six non-athlete women between 18-25 years old participated in this prospective quasi-experimental trial. The subjects were randomly divided into three groups (aerobic, resistance and interval exercise, 12 in each group). Each group exercised three times a week for a total of eight weeks (24 sessions in total). Pulmonary function tests (PFT), including tidal volume (VT), inspiratory reserve volume (IRV), expiratory reserve volume (ERV), inspiratory capacity (IC), vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in the first seconds (FEV1), the ratio of FEV1/FVC, peak inspiratory flow (PIF), and forced expiratory flow (FEF 25-75) were recorded before and after the implementation of the exercise program for all participants. Data were analyzed using paired t-test and one-way ANOVA. Results: The mean age of participants was 20.17 ± 2.13. The results of the paired T-test indicated that VC significantly increased in the group assigned to aerobic exercise (P = 0.028), while IC (P = 0.012) and PIF (P = 0.019) significantly increased in the group assigned to interval training. Conclusion: Our results showed that interval and aerobic exercise routines could improve pulmonary functions and aerobic and interval training can be used to increase VC, IC, PIF, in non-athlete women. © 2016 NRITLD, National Research Institute of Tuberculosis and Lung Disease, Iran