Waist Circumference and Spirometric Measurements in Chronic Obstructive Pulmonary Disease

OBJECTIVES: The aim of this study was to evaluate whether the waist circumference of patients with chronic obstructive pulmonary disease (COPD), had an impact on lung function. METHODS: There were 180 patients with COPD recruited into this prospective cross-sectional study. The age, weight, body mass index and waist circumference (WC) were measured. Spirometry parameters including forced vital capacity (FVC), and forced expiratory volume in the first second (FEV1), were measured and FEV1/FVC calculated. RESULTS: The mean FEV1/FVC in both normal weight and overweight patients, did not statistically significantly correlate with WC. The COPD assessment test, positively correlated with WC ( p = 0.031). A positive correlation with body mass index ( p < 0.001), smoking ( p = 0.027), and global initiative for chronic obstructive lung disease score ( p = 0.009), were observed to positively associate with WC. WC, age, C-reactive protein, duration of disease, and gender (male), were observed to be statistically significant risk factors for the severity of COPD. CONCLUSION: WC was not observed to impact upon lung function in this study but it was a predictive factor for COPD severity in patients.

effect of family-centered psycho-education on mental health and quality of life of families of adolescents with bipolar mood disorder: a randomized controlled clinical trial

Background: bipolar Mood Disorder [BMD] is a type of mood disorder which is associated with various disabilities. The family members of the patients with BMD experience many difficulties and pressures during the periods of treatment, rehabilitation and recovery and their quality of life [QOL] is threatened. In the present study, we aimed to evaluate the effect of family-centered education on mental health and QOL of families with adolescents suffering from BMD

Methods: in this randomized controlled clinical trial performed on 40 families which were mostly mothers of the adolescents with BMD referred to the psychiatric clinics affiliated to Shiraz University of Medical Sciences during 2012-13.They were randomly assigned to intervention and control groups

Results: the results of single factor multivariate ANOVA/single-factor multivariate analysis of variance and Bonferroni post hoc tests showed that the interaction between the variables of group and time was significant [P<0.001]. The mean of QOL and mental health scores increased in the intervention group, but it decreased in the control group at three measurement time points

Conclusion: the study findings confirmed the effectiveness of family-centered psychoeducation program on Mental Health and Quality of life of the families of adolescents with Bipolar Mood Disorder

ACE genetic variability and response to fluoxetine: lack of association in depressed patients

Evidences suggest that besides the neurotransmitters contributing to the development of depression, renin-angiotensin system [RAS] may also have a substantial role. Certain polymorphisms of RAS are associated with over activity of RAS and depression. Considering that antidepressants reduce the actions of angiotensin II, the main product of RAS, this may come into mind that genetic polymorphisms of the mentioned system may affect the outcome of therapy in depressed patients. In the present study, 100 newly diagnosed depressed patients, according to DSM-IV criteria, were treated with 20 mg of fluoxetine for 8-12 weeks. Patients were categorized into responsive and non-responsive groups according to 50% reduction in symptoms. Genotype frequencies of angiotensin-converting enzyme [ACE] gene [ACE [I/D, A-240T and A2350G]] were then determined in DNAs extracted from venous blood of the patients using polymerase chain reaction-restriction fragment length polymorphism [PCR- RFLP] and PCR. Results indicate that polymorphisms studied and their haplotypes were not associated with better response to fluoxetine. However, a strong association between age and treatment in depressed Iranian patients was observed [P=0.001]. In conclusion, unlike previous reports, this study does not support the hypothesis of special genotypes of RAS contributing to a better response to antidepressants in depressed patients

Executive functions among traumatic injury patients: comparison of normal individuals and those with attention deficit hyperactivity disorder

Objectives: To describe the executive function of patients with traumatic injury admitted to Rajaei hospital, Shiraz, Iran and to compare the executive function between normal individuals and those with Attention Deficit Hyperactivity Disorder [ADHD]

Methods: This was a case control study being performed during a 6-month period during spring and summer of 2013 in Shiraz level I trauma center. We included all patients admitted during the study period with impression of traumatic injury with or without adult ADHD. The patients' demographic factors were assessed through self-report questionnaire and executive functions by Wisconsin Card Sort Test [WCST] and Tower of London [TOL]. Results were compared between normal individuals and those with ADHD

Results: Among 60 patients evaluated during the study period, with impression of traumatic injury, 29 fulfilled adult ADHD criteria and 31 were normal. The mean age of ADHD patients was 27.16 +/- 5.6 years and that of normal individuals was 26 +/- 3.4 years [p=0.330]. There were no significant differences between two study groups regarding IQ [p=0.191] and education [p=0.396]. Patients with ADHD had significantly poorer mean in executive functions in different parts of the test scoring system when compared to normal individuals

Conclusion: ADHD patients with traumatic injury had poor executive function compared to normal individuals. This might lead to poor inhibition, shifting and problem solving in this population

Effectiveness of cognitive-behavioral therapy in decreasing suicidal ideation and hopelessness of the adolescents with previous suicidal attempts

To evaluate the effectiveness of a Cognitive-Behavioral therapy [CBT] for suicide prevention in decreasing suicidal ideation and hopelessness in a sample of depressed 12 to 18 year-old adolescents who had at least one previous suicidal attempt. In a clinical trial, 30 depressed adolescents who attempted suicide in the recent 3 months were selected using simple sampling method and divided randomly into intervention and wait-list control groups. Both groups received psychiatric interventions as routine. The intervention group received a 12 session [once a week] of CBT program according to the package developed by Stanley et al, including psychoeducational interventions and individual and family skills training modules. All of the patients were evaluated by Scale for Suicidal Ideation, Beck's hopelessness Inventory, and Beck's Depression Inventory before the intervention and after 12 weeks. There were significant differences between the two groups regarding the scores of the above mentioned scales after 12 weeks. Fifty-four to 77 percent decreases in the mean scores of the used scales were observed in the invention group. There were no significant changes in the scores of the control wait-list group. The differences between pre- and post-intervention scores in the intervention group were significant. CBT is an effective method in reducing suicidal ideation and hopelessness in the depressed adolescents with previous suicidal attempts

Stiff man syndrome with invasive thymic carcinoma

Stiff man syndrome is a rare disease characterized by painful chronic spasms in the muscle and skeletal system. This syndrome is an autoimmune neurologic disorder which is associated with thymoma. We treated a 32-year-old male patient with a type C thymoma [based on the World Health Organization classification] who had stiff man syndrome. The patient underwent an extended thymectomy which brought about alleviation of his symptoms

Situation of medical sciences in 50 top countries from 1996 to 2010-based on quality and quantity of publications

In research outputs both quality and quantity are of critical value and evaluation of both aspects is required for best evaluation. Several studies have worked on single or two-dimensional methods that provide the assessment of quality, quantity or both simultaneously in different branches of sciences, but none of them have played a role in a particular area of medicine. This study has been conducted to compare countries worldwide in the field of medical researches. Measuring both quality and quantity of researches is performed separately. In order to evaluate countries from both aspects of quantity and quality of research outputs, a modified form of the citation per publication [CPPm] and publication per population [PPPm] were used to make these indices comparable through different years and nations by normalizing the values according to the world average standards. When countries are ranked by CPPm, Iceland ranks the 1[st] with the score of 1.98, Faroe Islands and Gambia rank the 2[nd] and the 3[rd] with scores of 1.84 and 1.63, respectively. In PPPm Switzerland, Sweden and Denmark ranked the top three with scores of 13.34, 11.67 and 10.32, respectively. Iran ranked 71 in CPPm and 141 in PPPm. Ranking countries makes it possible to identify countries which have performed better in research outcomes by means of quality and quantity; thus, reforming policies can be taken into action to lower the waste of money, higher quality and quantity of outputs while providing helpful tip[s] for institutions to improve

Giant mediastinal thymolipoma in 35-year-old women

The patient was 35-year-old women with a six month history of difficulty breathing and chest pain. An anterior-posterior chest radiograph revealed a widened mediastinum with small lung volumes. During his diagnostic evaluation, a computed tomographic scan was performed and with huge mass in the anterior mediastinum with extension to the left and right side of pleural space. With postero-lateral thoracotomy the huge mass was resected. The patient discharged with good condition

Respiratory findings in dental laboratory technicians in Rasht [north of Iran]

There are several occupations that can expose people to some air pollutants. Dental technicians are exposed to inorganic dust and chemical vapors when making dental prosthesis that can put them at risk for respiratory problems. This study was performed to assess respiratory dysfunction in a group of dental technicians. This was a cross-sectional study designed to ascertain the prevalence of respiratory disorders in dental laboratory technicians in Rasht, a city located in north of Iran. A Structured questionnaire was adapted according to the European Community Respiratory Health Survey questionnaire and used to elicit information regarding sociodemographic characteristics and medical status of the study participants. The ventilation status, protective measures and direct exposure to materials in the laboratories were directly observed by the observers and subjects underwent respiratory tests and chest x-ray. The mean age of dental technicians was 31.31 yrs [range 18-56 years] and 83% were males with a mean dental work experience of 9.04 years. In 54.8% of cases, the work environment did not have air conditioning system. The most common signs and symptoms were cough [38.1%] and wheezing [16.7%]. There was a significant correlation between smoking and respiratory signs. Restrictive airway pattern and air trapping were two prevalent findings which were observed in 85.7% and 33.3% of the subjects. Cigarette smoking had a negative effect on FEV1, FEF[25%-75%], and TLC causing a significant reduction in all three parameters [p<0.05]. The most prevalent finding was interstitial opacity which was observed in 10 individuals [23.8%]. This finding was not significantly associated with age, gender, cigarette smoking, or daily work hours. However, there was a significant statistical association between work experience and interstitial opacity. The prevalence of respiratory dysfunction and chest x-ray findings were high as in several similar studies. In order to reduce the hazards of respiratory disorders in risky occupations and provide dental workers with technical preventive measures, a more comprehensive study should be conducted throughout the country and further evaluations through biopsy and CT-scan need to be performed in suspicious cases when necessary

Frequency of psychological disorders amongst children in Urban Areas of Tehran

To evaluate the frequency of different psychiatric disorders among 7 to 12 years old children in urban areas of Tehran. A sample of 799 children [6 to 11 years old] were selected from 250 clusters of the entire 22 municipality areas of Tehran using a multistage sampling method from 250 clusters from the entire 22 municipality areas of Tehran.. After responding to a Persian version of the Strengths and Difficulties Questionnaire [SDQ] parent-report form, the Persian version of Kiddie Schedule for Affective Disorders and Schizophrenia - Present and Lifetime [K-SADS-PL] was administered to 241 children and their families. The frequency of child psychological disorders was determined using the results of K-SADS-PL. The overall frequency of any psychological disorders in the sample of children was 17.9 percent. Among the interviewed children childrenwho were interviewed, the most prevalent diagnoses were Attention-Deficit/Hyperactivity Disorder [ADHD] [8.6 percent] 8.6%, Oppositional Defiant Disorder [ODD] [7.3 percent] 7.3%, and separation anxiety disorder [SAD] [5.9 percent] 5.9%. There were not any statistically significant differences between sexes in the frequency of psychological disorders except enuresis that was more frequent in the boys and anorexia nervosa that was observed more frequently in the girls. Higher frequency of ADHD and ODD and SAD among the studied children warrants more specific evaluation of frequency and possible causes of these high frequency rates. The frequency of psychological disorders in the studied children was comparable to the that of other studies

Effect of slow release pentoxifylline and captopril on delayed pulmonary complications of mustard gas in animal models

Considering the effect of pentoxifylline on the immune system and reducing oxidative stress and also the anti-oxidative properties of captopril, these drugs are indicated for prevention and treatment of delayed pulmonary complications due to exposure to sulfur mustard [SM]. Therefore, we decided to study the effect of slow release pentoxifylline and captopril on SM-induced delayed pulmonary complications in animal models. Pentoxifylline and captopril were administered for two weeks to mice exposed to sulfur mustard. Biochemical and pathological analyses included: hydroxyproline assay, alveolar space percentage and severity of inflammatory cell infiltration. The results were compared between groups using ANOVA statistical test. Hydroxyproline content of the lungs was significantly lower in the negative control group in comparison to positive control, captopril intervention and pentoxifylline intervention groups. There was no significant difference between groups in image analysis figures. However, there was a significant difference in extent of fibrosis, inflammation, and lymphocyte and PMN percentage between different groups. Pentoxifylline only resulted in decreased pulmonary inflammation without any effects on other indices. On the other hand, increase in hydroxyproline content of the lung in the captopril group compared to controls showed that captopril had accelerated the process of fibrosis. Hence, more research is recommended to study the effect of captopril on pulmonary fibrosis

Castleman's disease in a 35 year-old woman with a giant mediastinal mass

The patient was a 35 year-old woman with a 10-month history of breathing difficulty, cough and chest pain. An anterior-posterior chest radiograph revealed opacification of the right hemithorax with reduced right lung volumes. As part of diagnostic evaluation, a computed tomography [CT] scan was performed which showed a huge mass in the right anterior mediastinum with extension to the right side of the pleural space. It was resected through postero-lateral thoracotomy. The patient was discharged in a good condition. The pathology report showed hyaline vascular variant of Castleman's disease

Bcl-2 protein expression in pulmonary specimens of sulfur mustard victims

Considering the role of sulfur mustard gas in development of acute and chronic pulmonary complications and the role of some genes including Bcl-2 in pulmonary fibrosis, we decided to study Bcl-2 gene expression in lung biopsy specimens of victims in comparison with normal lung. Lung biopsy specimens were taken from 13 sulfur mustard [SM] victims with pulmonary complication and were stained by Hematoxylin and Eosin [H and E] and avidin-biotin methods. We used normal lung blocks from forensic medicine as the normal group. These blocks were treated and stained with the same procedure as the case group. Both groups' blocks were studied by a pathologist simultaneously. The percentage of macrophages in sulfur mustard victims' specimens was significantly lower than that of the control group. There was also a significant increase in lymphocytes of victims in comparison with the normal group. Neutrophil percentage and Bcl-2 protein in these cells showed no significant difference between the two groups. Bcl-2 protein in fibroblasts and epithelial cells of sulfur mustard victims was significantly higher than the control group. According to the results of this study in comparison with the results of patients with idiopathic pulmonary fibrosis [IPF], pulmonary fibrosis can be confirmed as one of the late complications of SM victims. According to these results, upregulation of Bcl-2 protein and subsequent alveolar epithelial cell hyperplasia and proliferation of fibroblasts may be a mechanism for pulmonary fibrosis induced by mustard gas. It could be important for developing new strategies for the treatment of fatal complications of this chemical warfare

Effect of fluid temperature in intravenous fluid resuscitation of hemorrhagic shock

Treatment of hemorrhagic shock is the major problem in emergency surgery. Fluid therapy is one of the first steps but, the conflict has been over the temperature used for the fluid injected to the patient. The aim of this study was to determine the effect of fluid temperature in intravenous fluid resuscitation of hemorrhagic shock. In this experimental study, 3 groups of 10 rabbits underwent hemorrhagic shock class III [mean arterial pressure = 40 mmHg] by catheter on femoral artery. Within 25 minutes, ringer lactate solutes with controlled temperaturesof 15°C, 25°C and 37°C were injected through femoral venous line. They were followed for 72 hours. In the lowest, middle and the highest fluid temperature group, mortality rate was 90%, 10% and 40%, respectively. Statistically significant difference was seen between the 15°C and 25°C resuscitation groups [P < 0.001]. Our findings showed possible benefit of room temperature as the optimal fluid temperature for fluid resuscitation in hemorrhagic shock