Interleukin-6 and airflow limitation in chemical warfare patients with chronic obstructive pulmonary disease

Objectives: Chronic obstructive pulmonary disease (COPD) is one of the main late complications of sulfur mustard poisoning. The aim of this study was to evaluate serum levels of interleukin (IL)-6 in war veterans with pulmonary complications of sulfur mustard poisoning and their correlation with severity of airways disease. Methods: Fifty consecutive patients with sulfur mustard poisoning and stable COPD, and of mean age 46.3 ± 9.18 years were enrolled in this study. Thirty healthy men were selected as controls and matched to cases by age and body mass index. Spirometry, arterial blood gas, six-minute walk test, BODE (body mass index, obstruction, dyspnea, and exercise capacity), and St George’s Respiratory Questionnaire about quality of life were evaluated. Serum IL-6 was measured in both patient and control groups. Results: Fifty-four percent of patients had moderate COPD. Mean serum IL-6 levels were 15.01 ± standard deviation (SD) 0.61 pg/dL and 4.59 ± 3.40 pg/dL in the case and control groups, respectively (P = 0.03). There was a significant correlation between IL-6 levels and Global Initiative for Chronic Obstructive Lung Disease stage (r = 0.25, P = 0.04) and between IL-6 and BODE index (r = 0.38, P = 0.01). There was also a significant negative correlation between serum IL-6 and forced expiratory volume in one second (FEV1, r = −0.36, P = 0.016). Conclusion: Our findings suggest that serum IL-6 is increased in patients with sulfur mustard poisoning and COPD, and may have a direct association with airflow limitation

Highly sensitive C-reactive protein levels in Iranian patients with pulmonary complication of sulfur mustard poisoning and its correlation with severity of airway diseases

Background: Sulfur mustard (SM) is a chemical warfare agent that can cause serious pulmonary complications. This study was designed to determine serum highly sensitive C-reactive protein (hs-CRP) and evaluate its correlation with lung function parameters in patients with chronic obstructive pulmonary disease (COPD) due to SM poisoning. Methods: Fifty consecutive SM patients with stable COPD and a mean age 46.3 + 9.18 years were enrolled in this cross sectional study. Thirty healthymen were selected as controls. Lung function parameters were evaluated. Serum hs-CRP by immunoturbidometry assay was measured in both the patients and controls. Results: In the case group, the mean forced expiratory volume in one second (FEV1) was 2.14 + 0.76 L (58.98%+17.51% predicted). The mean serum hs-CRP was 9.4+6.78 SD and 3.9+1.92 SDmg/L in the cases and controls, respectively, with significant statistical differences (p < .001). There was negative correlation between the serum hs-CRP and FEV1 levels (p ¼ .01). The serum hs-CRP levels were also correlated with Global Initiative for ChronicObstructive Lung disease (GOLD) stages (r ¼ .45, p < .001). Conclusions:Our findings suggest that the serum hs-CRP level is increased in SM patients with COPD and may have a direct correlation with disease severity. It may then be used as a marker for the severity of COPD in patients with SM poisoning

The Concurrent Validity of Using Simulated Patient and Real Patient in Communication Skills Assessment of Medical Students

Background & Objective: Communication skills assessment requires the use of valid instruments. The present study has done to investigate concurrent validity of the simulated patient meaning relationship between test results by the simulated or real patient and possibility to generalize the results by simulated patient and in simulated environment for real patient and in bedside. Methods: In this correlation study, 32 medical externships were enrolled by purposive sampling method. The students were divided randomly into two equal and homogeneous groups. Using crossover design, first group were assessed by real patient initially and then, simulated patient and second group, were measured conversely. Communication skills assessment was done using a checklist retrieved from Calgary-Cambridge interview skills checklist. The data were analyzed using descriptive and analytical statistics. Results: In first assessment, comparing scores by simulated and real patient in first group, second group and total students showed significant differences. In second assessment between two groups, the statistics results was not significant with very minor differences (P = 0.064). There were positive correlation between scores of total students by simulated and real patient (r = 0.63). Conclusion: According to the results, communication skills of each student in simulated position cannot be generalized to real situation and cannot be claimed that simulated patient can be used instead of real patient. Keywords Communication skills Assessment Concurrent validity Simulated patient Real patien