Clinical risk factors and bronchoscopic features of invasive aspergillosis in Intensive Care Unit patients

Introduction. Invasive aspergillosis (IA) is an important cause of morbidity and mortality in immunocompromised patients. During recent years, a rising incidence of IA in Intensive Care Unit (ICU) patients has been reported. The patterns of IA related infection may differ according to the type of underlying disease. Unfortunately little is known about the characteristics of IA in ICU patients. In the present study we assessed IA related clinical and bronchoscopy findings in ICU patients. Materials and methods. This study was performed at the ICU units in Sari and Babul, Mazandaran from August 2009 through September 2010. We analysed 43 ICU patients with underlying predisposing conditions for IA. Bronchoalveolar lavage (BAL) samples were collected by bronchoscope twice a weekly. The samples were analyzed by direct microscopic examination, cul- ture and non-culture based diagnostic methods. Patients were assigned a probable or possible diagnosis of IA according to the consensus definition of the EORTC/MSG. Results. Out of 43 suspected patients to IA, 13 (36.1%) cases showed IA. According to criteria presented by EORTC/MSG, they were categorized as: 4 cases (30.8%) of possible IA and 9 (69.2%) of probable IA. The observed mortality was 69.2%. The main underlying predisposing conditions were neutropenia, hematologic malignancy, and COPD. The macroscopic finding in bronchoscopy included of Prulent secretion (46.6%), Mucosal bleeding (30.7%), Mucosal erythema (23%), Trachobronchomalasia (15.3%). Conclusion. The diagnosis of IA in patients with critical illness in ICU is even more difficult. The clinical diagnostic process is often dependent on indirect circumstantial data enhancing the proba- bility of IA. Bronchoscopy with inspection of the tracheobronchial tree, sampling of deep airway secretions and BAL can be helpful

First Molecular Diagnosis of Lophomoniasis: the End of a Controversial Story

Introduction: We report a case of lophomoniasis in an immunocompetent patient with acute paranasal sinusitis from the north of Iran whose disease was diagnosed by both microscopic and molecular methods. Case Presentation: The patient, a 40-year-old woman, suffered from upper respiratory infection, was referred to the Iranian National Registry Center for Lophomoniasis (INRCL) at the Mazandaran University of Medical Sciences, Sari, Iran, for diagnosis. A direct wet mount of nasal discharge revealed the flagellate protozoa morphologically identified Lophomonas blattarum. Moreover, through a specific polymerase chain reaction (PCR) of nasal discharge, a 214-bp band was observed, confirming the genus Lophomonas spp. The patient was treated successfully with metronidazole 500 mg t.i.d for 1 week. Conclusion: To the best of our knowledge, this is the first molecular detection of lophomoniasis in the literature. According to our preliminary study, a reliable PCR test is available now for detecting the Lophomonas parasite. © 2019, Witold Stefa�ski Institute of Parasitology, Polish Academy of Sciences

Morphological and Molecular Identification of Emerged Lophomonas blattarum Infection in Mazandaran Province, Northern Iran: First Registry-Based Study

Background: In the last decade, several cases of bronchopulmonary lophomoniasis (BPL) have been recorded. Little information is available about epidemiological aspects on Lophomonas infection among BPL patients. The present study was aimed to investigate the prevalence of Lophomonas spp. infection in patients who were referred to the Iranian National Registry Center for Lophomoniasis (INRCL), using morphological and molecular tests. Subjects and Methods: We examined patients enrolled in the INRCL from 2017 to 2019 at the Mazandaran University of Medical Sciences, northern Iran. All bronchoalveolar lavage fluid (BALF) and two nasal discharges of the patients were examined by both microscopic and small-subunit ribosomal RNA (SSU rRNA) PCR methods. To confirm the species of Lophomonas, two positive samples were sequenced. Results: In this study, 321 specimens (including 319 BALF and 2 nasal discharges) were microscopically examined. Lophomonas spp. was found in 45(14) (n = 44 BAL; n = 1 nasal discharge). The mean age of infected patients was 54.9 ± 17.1 years. The following morphological characteristics were observed in both fresh and Papanicolaou-stained smears to identify Lophomonas spp. All microscopically positive specimens were confirmed with genus-specific PCR technique. The obtained sequences were deposited in Gen Bank under the accession numbers (MN243135-36). The BLAST analysis of our two sequences with the only available sequence in the Gen Bank of the Thailand strain of L. blattarum, showed identity of 99�100 and 98.51, respectively. Conclusion: To the best of our knowledge, this is the first registry-based study regarding lophomoniasis worldwide. According to our study, the conventional PCR test is an available and reliable tool for confirming the Lophomonas parasite in clinical samples. Moreover, the results confirmed that L. blattarum is circulating at least in our region. © 2021, Witold Stefa�ski Institute of Parasitology, Polish Academy of Sciences

Oxidative Stress In Asthma

Asthma is a chronic inflammatory lung disease that results in airflow limitation, hyperreactivity, and airway remodeling. There is strong evidence that an imbalance between the reducing and oxidizing systems favoring a more oxidative state is present in asthma. Endogenous and exogenous reactive oxygen species, such as superoxide anion, hydroxyl radical, hypohalite radical, and hydrogen peroxide, and reactive nitrogen species, such as nitric oxide, peroxynitrite, and nitrite, play a major role in the airway inflammation and are determinants of asthma severity. Asthma is also associated with decreased antioxidant defenses, such as superoxide dismutase, catalase, and glutathione. In this review, we will summarize the current knowledge and discuss the current and future strategies for the modulation of oxidative stress in asthma.PubMe