IFN-gamma +874 and IL-4 -590 polymorphisms and asthma susceptibility in North West of Iran

Recent studies have documented an association between some cytokines' gene polymorphisms and chronic inflammation of the respiratory tract which leads to asthma susceptibility. This study was conducted to investigate if there were any differences in IFN-gamma +874 [A/T] and IL-4 -590 [C/T] single nucleotide variations in asthmatic patients compared to normal controls among West Azerbaijani population. IFN-gamma +874 [A/T] and IL-4 -590 [C/T] polymorphisms were amplified by ASO-PCR and RFLP-PCR from genomic DNA of 173 individuals including 64 asthmatic patients and 109 control subjects from West Azerbaijani population. The allele or genotype frequencies of IFN-gamma+874 A/T in patients were not different from those of controls [p>0.05]. The differences between allelic or genotypic frequencies of IL-4 -590 C/T in patients and controls were not statistically significant [p>0.05]. These findings showed that IL-4 -590 [C/T] and IFN-gamma+874 [A/T] polymorphisms were not associated with asthma susceptibility

Late onset dysphagia secondary to post-pneumonectomy syndrome, a rare complication

Postpneumonectomy syndrome reflects extrinsic compression of the distal trachea and main stem bronchus due to shifting of the mediastinum and hyperinflation of the remaining lung. The syndrome is characterized by development of progressive dyspnea, cough, inspiratory stridor, and recurrent pneumonia in patients at least 6 months after surgery. We report a case of late onset dysphagia secondary to post-pneumonectomy syndrome, nine years after right pneumonectomy. It is a rare complication and there are only two similar reports in the literature

Tumor-to-tumor metastases from lung carcinoma to soft tissue fibrous histiocytoma

Tumor-to-tumor metastases are uncommon. Lung cancer is the most frequent donor tumor while renal cell carcinoma is the most common malignant, and meningioma the most common benign recipient of metastases. Other reported host benign lesions include thyroid adenoma, adrenocortical adenoma, ovarian cystoma, and hepatic cavernous angioma. A 41-year-old male smoker presented with a mass in the right axillary's fossa, cough and weight loss. Chest x-ray showed left lung collapse. Fiberoptic bronchoscopy showed vegetation in the left main bronchus and biopsy revealed adenocarcinoma. Biopsy of the right axillary mass showed benign fibrous histiocytoma [BFH] with metastasis from adenocarcinoma. To our knowledge, this report represents the first case of tumor-to-tumor metastasis to BFH

Smoking and asthma symptoms among university students

The prevalence of asthma is known to be increasing especially in developed countries. Most studies assessing the prevalence of asthma in adults have used the "European Community Respiratory Health Survey" [ECRHS] protocol. The aims of this study were to determine the prevalence of asthma, asthma-like symptoms and smoking as well as the correlation of asthma symptoms and smoking among Urmia medical university students. An ECRHS questionnaire with additional questions about absence from class because of wheezing and/or dyspnea and smoking was filled for them. One thousand five-hundred students with the mean age of 20.8 +/- 3.5 years filled out the questionnaires. Among them, 17.1% of males and 2.3% of females were current smokers. The most prevalent symptoms during the last 12 months were wheezing [19.7%], resting breathlessness [10.2%], exercise-induced cough [16.5%], and asthma attacks [3.1%]. Asthma symptoms were strongly related to smoking [for all variables p < 0.001] but were not related to sex [p > 0.05], 5.4% had a history of absence from class because of wheezing or dyspnea. We found a relatively high prevalence of wheezing among young adult university students. Our findings suggest that cigarette smoking is common among young university students with asthma symptoms. Adequate public health measures are needed to prevent smoking among Iranian young adults, and medical students should be better educated with regard to asthma and the risks of smoking

Agreement between written and video asthma symptoms questionnaires in school children in Urmia, Iran

The prevalence of asthma remains difficult to determine with precision with no absolute or gold standard for diagnosis. International Study of Asthma and Allergies in Childhood [ISAAC] developed video questionnaire for epidemiological studies with less reliance on understanding written asthma questionnaire. The aim of this research was to determine the agreement between the ISAAC written and video questionnaires [AVQ3.0] on respiratory symptoms and reported asthma. We studied 3000 children aged 13-14 years in Urmia, Iran who completed sequentially the ISAAC written and video questionnaires [AVQ3.0] at school. The agreement between responses to the two questionnaires for reported wheeze ever, current wheeze, wheeze on exercise, and nocturnal wheeze [the latter three questions relating to symptoms in the previous 12 months], and to any combination of the latter three questions was examined by using concordance and kappa coefficients as measures of agreement. The prevalence of wheeze ever, current wheeze, wheeze on exercise, and nocturnal wheeze were significantly lower based on responses to the video questionnaire compared to the written questionnaire. Although concordance between video and written questionnaires was high [75% to 93%] for related questions, agreement measured by the kappa statistic for each question was only poor i.e. 0.22, 0.21, 0.13 for resting wheeze, exercise induced wheeze, and nocturnal wheeze respectively. We conclude that the video questionnaire yields lower reported prevalence rates for asthma symptoms, and that there is poor agreement between responses to the two questionnaires in Iranian children

Thromboprophylaxis practice in teaching hospital settings

Venous thromboembolism [VTE] is known to be a major cause of morbidity and mortality among hospitalized patients. The American College of Chest Physicians [ACCP] published their seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy in 2004, with recommendations for venous thromboembolism prophylaxis. Despite these recommendations, appropriate thrompoprophylaxis is underused. This study was performed to examine the frequency and adequacy of thromboprophylaxis in hospitalized patients in three primary-tertiary teaching hospitals in Urmia, Iran. We carried out a cross-sectional prospective study on 436 patients hospitalized in three teaching hospitals in Urmia, Iran. Information was obtained from medical-nursing records and patient observation and was compared with the recommended guidelines of the ACCP. The appropriateness of diagnoses was not evaluated. Of 436 patients, 352 subjects required thromboprophylaxis and the total proportion of them who underwent some form of thromboprophylaxis was 16.7% with only 9.9% receiving ACCP recommended prophylaxis. Prophylaxis rate was: 29.7% in medical wards, 27.8% in ICU, 11.0% in surgical wards overall and14.7% postoperatively. Low dose heparin was the most common type of prophylaxis. Despite the widely disseminated, evidence-based recommendations, venous thromboembolism prophylaxis is underused in our hospitals. It is more commonly neglected in our hospitals than those in Western countries. We think that in most other developing countries, this condition is similar. Therefore, the consensus statements alone are insufficient to ensure the routine use of prophylactic strategies in clinical practice. In addition to the statements, other strategies are required to solve the problem

Epithelioid hemangioendothelioma: a case with large solitary pulmonary mass and hypertrophic osteoarthropathy

We describe a case of pulmonary epithelioid hemangioendothelioma [PEH], previously known as intravascular bronchoalveolar tumor, in a 48-year-old woman with an initial diagnosis made by CT-guided transthoracic needle biopsy. This is a rare disease, with approximately 50 cases described in the literature. To our knowledge, this has not been previously described in the English-language literature. This tumor can affect multiple organs. PEH is usually multifocal or small sized; hypertrophic osteoarthropathy is uncommon. This patient presented with hypertrophic osteoarthropathy and large solitary pulmonary mass, rare presentations of this uncommon tumor