effects of chronicity on high resolution computed tomography findings in asthma

Remodeling is the late result of chronic inflammation in untreated asthma. Remodeling causes resistance to classic asthma therapy, but the time required for this change has not been confirmed, yet. High resolution computed tomography [HRCT] is the only noninva sive method to confirm the structural change in the bronchial wall. The objective of this study was to evaluate the frequency of remodeling in chronic asthma as well as determine the proposed time required for developing remodeling. Non smoker asthmatic patients with more than one year of duration who referred to the sub specialty clinic of pulmonary participated in our study. History, physical examination and spirometric evaluation were done. Diagnosis of asthma was confirmed according to GINA guidelines. CT scan of the lungs was performed in a deep inspiration using Phillips Spiral Multi Slice [1.5 mm thickening]. The images were evaluated by two radiologists. The main group was divided in two groups: The patients with more than 5 years of duration of the disease, and those who had been infected with the disease for less than 5 years. The results were then compared with each other. Seventy four subjects participated in this study [40 females, 34 males]. In asthmatic patients with a history of more than 5 years, the mean of age was 51 15.5 years. This group showed no significant difference from the other group with a duration of lower than 5 years [mean age: 45 18.26 years]. The most frequent clinical disorder in both groups was found to be dyspnea [98/6%]. The symptoms found in the subjects with abnormal HRCT were ranking from the most to the least frequent as: bronchial dilation [22, 30%], mosaic pattern [12, 16%]; both bronchial wall thickening and modularity pattern [11, 15%], and emphysema [9, 12%]. HRCT findings were normal in 32% of subjects. Diagnostic criteria of remodeling in subjects with duration of 1-5 years were not significantly different from those in the subjects who were infected for over 5 years. Bronchial dilation and thickening of bronchus are the best criteria for diagnosing remodeling, but remodeling may occur earlier than the expected time

effects of pregnancy: induced hypertension on umbilical artery blood flow in the third trirnester

Doppler ultrasound of umbilical vessels is a method of evaluating fetoplacental blood flow which is very important in high risk pregnancies and can predict both the duration of maternal hospitalization and fetal mortality rates in IUGR. Pregnancy induced hypertension is one of the most important causes of high-risk pregnancies. In this study, the rate of blood flow through umbilical artery as well as its degree of resistance were measured, using Doppler ultrasound in the patients with pregnancy induced hypertension. This is a cross-sectional study which was carried out on 35 pregnant women with pregnancy induced hypertension in the year of 2004. All of the cases were studied during their third trimester. 61 pregnant women in their third trimester were selected as the control group. They all had normal blood pressure. Doppler ultrasound of umbilical artery was performed for both the case and the control groups. Then, Peak Systolic Velocity [PSV], End Diastolic Velocity [EDV] and mean velocity were measured, based of which Resistive Index [RI], Pulsatility Index [PI] and Systolic to Diastolic ratio [S/D ratio] were calculated. Finally the statistical analysis was performed on the obtained recorded data, using SPSS software. The results indicate a measure of 0.77 for RI; 1.39 for PT and 4.88 for S/D ratio in the case group while in the control group, such measurements were calculated as 0.64; 1.08 and 2.97, respectively. As a whole, the comparison of the mean values of the mentioned indices revealed a significant difference between the two groups [P<0.01]. The case group were significantly rated higher in terms of the above mentioned indices. In patients with pregnancy induced hypertension without having other risk factors [such as diabetes, mellitus and IUGR], Doppler ultrasound should be used for evaluating the degree of fetoplacental blood flow in order to decrease the risk of pregnancy complications