Does downhill walking on treadmill improve physical status and quality of life of a patient with COPD?

Introduction: Chronic obstructive pulmonary disease (COPD) is accompanied by several extra-pulmonary consequences, such as skeletal muscle weakness and atrophy which will have a negative impact on daily life in patients and lead to their debilitation; therefore, when treating COPD patients, protocols should be taken into account to improve function and quality of life (QoL). Case Presentation: The case was a 71- year-old woman suffering from chronic bronchitis and bronchiectasis for 30 years that has been faced with increased musculoskeletal disorders in recent months. The case was managed by downhill treadmill walking for four months with the aim of improving her functional ability and QoL. Functional tests, thigh girth measurement and St. george�s respiratory questionnaire (SGRQ) were used to assess the physical status and QoL of the patient. The outcomes measures confirmed the improvement of the studied case. The improvements continued three months after the beginning of the treatment. Conclusions: The eccentric exercise therapy in the form of downhill walking had positive effects on functions and QoL of studied case, especially had an augmenting effect on the thigh muscles size. © 2015, Sports Medicine Research Center

Distribution of KRAS, DDR2, and TP53 gene mutations in lung cancer: An analysis of Iranian patients

Purpose Lung cancer is the deadliest known cancer in the world, with the highest number of mutations in proto-oncogenes and tumor suppressor genes. Therefore, this study was conducted to determine the status of hotspot regions in DDR2 and KRAS genes for the first time, as well as in TP53 gene, in lung cancer patients within the Iranian population. Experimental design The mutations in exon 2 of KRAS, exon 18 of DDR2, and exons 5�6 of TP53 genes were screened in lung cancer samples, including non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) using PCR and sequencing techniques. Results Analysis of the KRAS gene showed only a G12C variation in one large cell carcinoma (LCC) patient, whereas variants were not found in adenocarcinoma (ADC) and squamous cell carcinoma (SCC) cases. The Q808H variation in the DDR2 gene was detected in one SCC sample, while no variant was seen in the ADC and LCC subtypes. Variations in the TP53 gene were seen in all NSCLC subtypes, including six ADC (13.63), seven SCC (15.9) and two LCC (4.54). Forty-eight variants were found in the TP53 gene. Of these, 15 variants were found in coding regions V147A, V157F, Q167Q, D186G, H193R, T211T, F212L and P222P, 33 variants in intronic regions rs1625895 (HGVS: c.672+62A>G), rs766856111 (HGVS: c.672+6G>A) and two new variants (c.560-12A>G and c.672+86T>C). Conclusions In conclusion, KRAS, DDR2, and TP53 variants were detected in 2, 2.17 and 79.54 of all cases, respectively. The frequency of DDR2 mutation is nearly close to other studies, while KRAS and TP53 mutation frequencies are lower and higher than other populations, respectively. Three new putative pathogenic variants, for the first time, have been detected © 2018 Fathi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

Arterial blood gas and spirometry parameters affect the length of stay in hospitalized asthmatic patients

Background: Asthma is a common condition in general medical practice, and it accounts for about 1 of all ambulatory hospital visits. Nowadays, hospitalization rates for asthma have actually been increased in some demographic subgroups despite recent advances in treatment. Understanding the underlying factors that contribute to hospitalization and especially duration of the hospitalization of asthmatics could help elucidate the recent rise in morbidity and also reduce the high demand on health care systems of the disease. The aim of this study was to evaluate factors affecting the duration of hospitalization for Iranian patients with asthma. Methods: This study was conducted on 55 asthmatic patients (diagnosis of asthma was in accordance with the criteria of the American Thoracic Society). The study was performed on patients hospitalized in Rasoul-e- Akram hospital in Tehran, Iran during the period 2005-2006. During hospitalization, the patients' most common complaints were recorded as the symptoms and signs of the medical condition, results of physical examinations, spirometry, arterial blood gas analysis (ABG), and ICU admission. Results: There were 18(32.7) male and 37(67.3) female patients with a mean age of 54.96 (SD=17.54) years. The mean duration of hospitalization was 8.31(SD=4.69) days that ranged between 2 and 23 days. The mean baseline arterial PH (p=0.039, RPearso = -0.362), baseline arterial HCO3 (p=0.042, RPearson = 0.361), changes of FEV1 after bronchodilator (p=0.041, RPearson = -0.363) and patient's age (p=0.002, RPearson=0.0433) were determined as factors affecting duration of hospitalization. Conclusion: Our results showed that more attention needs to be given to the findings of arterial blood gas and spirometry which can potentially affect the duration of hospitalization of asthmatic patients

The prevalence of right to left shunt in chronic obstructive pulmonary disease patients with increased pulmonary hypertension

Background: One of the important etiologies for cryptogenic stroke is paradoxical embolization secondary to Patent Foramen Ovale (PFO). Foramen ovale can secondarily reopen due to Pulmonary Arterial Hypertension (PAH) which is common among the older age. PAH is known as a frequent and life threatening complication of COPD. The aim of this study was to determine the prevalence of PFO between COPD patients with PAH and compare it with the ratio of PFO in non PAH COPD patients by Valsalva Maneuver (VM) following the TCD test. Methods: This study was performed on 55 patients with COPD exacerbation who were admitted to Rasul-Akram Hospital in Tehran, Iran. The patients with high PAH were considered as the case group and the others without PAH were the control group. All patients underwent Trascranial Doppler (TCD) to detect intracardiac right-to-left shut (RLS) related by PFO. The data were collected and analyzed. Results: In the case group, among 45 patients 25 (55.5) males and 20 (44.5) females] with the mean age of 64.68±10.73 years, 31 (68.8) subjects had PFO. In 10 control patients whose PAP were normal during TTE, we detected PFO in 2 (20) patients during VM (p<0.001). There was a significant correlation with the number of microembolic signals (MES) and the increase in PAP (p=0.019). Conclusion: Right to left shunting was significantly more frequent in COPD patients with high PAP. High pulmonary pressure had a cardinal role in increasing the prevalence of RLS among these patients

CovidCTNet: an open-source deep learning approach to diagnose covid-19 using small cohort of CT images

Coronavirus disease 2019 (Covid-19) is highly contagious with limited treatment options. Early and accurate diagnosis of Covid-19 is crucial in reducing the spread of the disease and its accompanied mortality. Currently, detection by reverse transcriptase-polymerase chain reaction (RT-PCR) is the gold standard of outpatient and inpatient detection of Covid-19. RT-PCR is a rapid method; however, its accuracy in detection is only ~70�75. Another approved strategy is computed tomography (CT) imaging. CT imaging has a much higher sensitivity of ~80�98, but similar accuracy of 70. To enhance the accuracy of CT imaging detection, we developed an open-source framework, CovidCTNet, composed of a set of deep learning algorithms that accurately differentiates Covid-19 from community-acquired pneumonia (CAP) and other lung diseases. CovidCTNet increases the accuracy of CT imaging detection to 95 compared to radiologists (70). CovidCTNet is designed to work with heterogeneous and small sample sizes independent of the CT imaging hardware. To facilitate the detection of Covid-19 globally and assist radiologists and physicians in the screening process, we are releasing all algorithms and model parameter details as open-source. Open-source sharing of CovidCTNet enables developers to rapidly improve and optimize services while preserving user privacy and data ownership. © 2021, The Author(s)

Serum magnesium level impact on the outcome of patients admitted to the intensive care unit

Background: Magnesium deficiency is a common, yet under-diagnosed problem in the intensive Care Unit (ICU). Our aim was to determine the prevalence of abnormalities in serum magnesium concentrations in critically ill patients upon admission to the ICU. The association of serum magnesium level with prognosis was also studied. Materials and Methods: This historical cohort study was conducted in the medical ICU of Hazrat-e-Rasool Hospital and 273 critically ill patients were enrolled in this study during a one-year period. Binary logistic regression analyses were performed to identify significant independent risk factors of mortality in the ICU. Results: The mortality rate was 53.8 in the understudy subjects. One-hundred forty-seven subjects (53.8) had normal serum magnesium levels, whereas, 126 subjects (46.2) had abnormal values (hyper- or hypomagnesemia). Patients with lower total serum magnesium level had longer length of mechanical ventilation and ICU stay. The mortality rate was higher in patients who had abnormal magnesium levels. Age, serum Mg and mechanical ventilation were three risk factors that independently predicted probability of mortality in the ICU patients. Conclusion: Monitoring of serum magnesium levels may have prognostic, and perhaps therapeutic, implications and physicians should be alert to the high incidence of magnesium deficiency in critically ill patients. © 2010 NRITLD, National Research Institute of Tuberculosis and Lung Disease, Iran

Chitosan-alginate nano-carrier for transdermal delivery of pirfenidone in idiopathic pulmonary fibrosis

Pirfenidone (PFD) is one of the pyridine family components with anti-inflammatory, antifibrotic effects and US FDA approved for the treatment of idiopathic pulmonary fibrosis (IPF). Presently, PFD is administered orally and this has setbacks. Hence, it is important to eliminate the pharmacotherapeutic limitations of PFD. This research was carried out to study the possibility of transdermal delivery of PFD using chitosan-sodium alginate nanogel carriers. In order to synthesize chitosan-sodium alginate nanoparticles loaded with PFD, the pre-gelation method was used. Scanning electron microscopy (SEM), transmission electron microscopy (TEM), dynamic light scattering (DLS), and Fourier-transform infrared spectroscopy (FTIR) analyses were used for the characterization. Drug encapsulation and release manner were studied using UV spectroscopy. Ex vivo permeation examinations were performed using Franz diffusion cell and fluorescence microscopy. The results showed that nanoparticles having spherical morphology and size in the range of 80 nm were obtained. In vitro drug release profile represents sustained release during 24 h, while 50 and 94 are the loading capacity and efficiency, respectively. Also, the skin penetration of PFD loaded in nanoparticles was significantly increased as compared to PFD solution. The obtained results showed that synthesized nanoparticles can be considered as promising carriers for PFD delivery. © 201

Helicobacter pylori in patients suffering from pulmonary disease

Background: Recently, research of indirect evidence suggested a possible association between Helicobacter pylori and pulmonary disease. This study aimed to determine if H. pylori could be detected in endobronchial specimens collected from patients undergoing bronchoscopy. Materials and Methods: This prospective study was conducted on 34 consecutive patients with any type of lung disease undergoing bronchoscopy in which biopsy was required for their diagnosis. A written informed consent was obtained from all participants. Three bronchial mucosa biopsy samples were obtained using fenestrated biopsy forceps. One sample was used to determine urease activity, the second one for histopathological examination, and the third one for diagnosis. All subjects were fully informed regarding the gastroesophageal reflux disorder (GERD) Questionnaire. Results: There were 34 patients with pulmonary diseases (12 males and 22 females, mean age 58.2±18.2 years) out of which, 11 (32.4) had GERD. No significant difference was found between the histopathological assay and GERD. Conclusion: Our study found no direct evidence supporting the theory that H. pylori may cause pulmonary disease and no relation with GERD was detected. However, a possible indirect role could not be excluded. Further studies in patients with GERD and lung disease may reveal a potential pathogenic link between H. pylori and pulmonary disease. © 2011 NRITLD, National Research Institute of Tuberculosis and Lung Disease, Iran

Microextraction on a screw for determination of trace amounts of hexanal and heptanal as lung cancer biomarkers

Solid phase microextraction on a screw was utilized for the extraction of hexanal and heptanal as lung cancer biomarkers from urine samples. Reduced graphene oxide (rGO) was coated on the surface of a stainless-steel set screw by electrophoretic deposition method. The screw was located inside a glass cover, and the created channel acted as the sample solution flow pass. A 5 mL glass syringe was connected to a syringe pump to direct the sample and the eluent through the channel. The extraction procedure was followed by gas chromatography/mass spectrometry (GC/MS) for separation and determination of the extracted aldehydes. The effective parameters on the extraction efficiencies of the analytes were identified and optimized. Under the optimal extraction conditions, the extraction time was as short as 10 min. The calibration curves indicated good linearity (R2 &gt; 0.97) within the concentration range of 1.0�50 μg L�1. The obtained limits of detection (LODs) for hexanal and heptanal were down to 0.4 and 0.3 μg L�1, respectively. Considering the repeatability, simplicity, and eco-friendliness of this simple extraction method, it can be efficiently used for preconcentration of aldehydes in different samples. © 2020 Elsevier B.V

Occupational exposure of health care personnel to SARS-CoV-2 particles in the intensive care unit of Tehran hospital

The outbreak of SARS-CoV-2 (COVID-19) has attracted much attention to study its possible presence and airborne transmission. The possibility of COVID-19 airborne transmission in indoor environments is debatable. The present study examined the concentration of viral RNA-containing particles produced directly or indirectly by breathing or coughing of confirmed COVID-19 patients or by carriers without symptoms. Some studies do not accept this method of transmission (COVID-19 airborne transmission). The present study aimed to measure the possible exposure of health care personnel to SARS-CoV-2 particles that may have been suspended in the air to respond to the hypothesis of COVID-19 airborne transmission. Airborne particle sampling was performed using impingement method based on NIOSH (chapter BA) and ASHRAE. Selection of sampling sections was in line with the WHO guidelines. The samples were analyzed using RT-PCR technique. Based on the given results, airborne particles of COVID-19 may present in the air and affect the health of hospital personnel. In fact, the analysis of gene expression in ambient conditions and thereby aerosol transmission of SARS-CoV-2 through air is possible and may lead to occupational exposure of health care personnel. Furthermore, it was found that airborne emission of COVID-19 through the breathing zone of patients, particularly in ICU wards with confirmed cases of COVID-19, may be higher than in other ICU wards. Also, the demonstrated results showed that there is a possibility of reaerosolization (reintroduction) of previously airborne SARS-CoV-2 particles into the atmosphere due to health care personnel frequently walking between different wards and stations of ICU. © 2021, The Author(s)