ABSTRACT
The most common treatment for asthma is transferring the drug into the lungs by inhaler devices. Besides, correct use of inhaled medication is required for effectiveness of pharmacotherapy. Thus, it is necessary to train the patients how to use Metered Dose Inhaler [MDI]. This study aimed to determine the effect of training about MDI usage with or without spacer on maximum expiratory flow rate and inhaler usage skills in asthmatic patients. This randomized clinical trial was conducted on 90 asthmatic patients who were randomly divided into inhalation technique group with spacer, inhalation technique group without spacer, and a control group. Then, the Peak Expiratory Flow Rate [PEFR] was measured using a peak flow meter, as a basic test. In addition, the patients' functional skills of inhalation technique were assessed using two checklists. Afterwards, 3 sessions of training were arranged for both groups. PEFR and the ability to use the MDI were evaluated immediately and 1 month after the intervention. Finally, the data were entered into the SPSS statistical software [v. 18] and analyzed using independent t-test and repeated measures ANOVA. After the intervention, MDI usage skills improved in the two intervention groups compared to the control group [P<0.001]. In addition, a significant difference was found between the intervention groups and the control group regarding the mean of PEFR after the intervention [P<0.001]. However, no significant difference was observed between the two intervention groups [P=0.556]. According to the results, providing appropriate training for asthmatic patients increased MDI usage skills, and both methods of inhalation [with or without spacer] could improve the PEFR among the patients
Subject(s)
Humans , Male , Female , Metered Dose Inhalers , Peak Expiratory Flow Rate , Inhalation , Nebulizers and Vaporizers , Inhalation SpacersABSTRACT
Background: An association between lung cancer and chemokines has been advocated in the recent years. This study aims at investigating the association between lung cancer and 16C/A single nucleotide polymorphism [SNP] [rs. 4359426] in C-C motif chemokine 22 [CCL22] as well as C1014T SNP [rs. 2228428] in C-C chemokine receptor type 4 [CCR4], which serves as the receptor for CCL22
Methods: Genotyping was performed in 148 lung cancer patients and 148 normal controls using Polymerase Chain Reaction- Restriction-Fragment Length Polymorphism [PCR-RFLP]. The data were verified by direct automated sequencing
Results: Frequencies of CC, CA and AA genotypes of 16C/A SNP in CCL22 gene were 112 [75.7%], 33 [22.3%] and 3 [2.0%] in patients, and 119 [80.4%], 24 [16.2%] and 5 [3.4%] in controls respectively. No significant differences were observed in genotype frequencies at this position between cases and controls [P=0.34]. Moreover, there was no significant association between CCL22 polymorphism and types of lung cancer in patients. The distribution of CC, CT and TT genotypes of C1014T SNP in CCR4 gene, was 76 [51.4%], 60 [40.5%] and 12 [8.1%] in patients, and 80 [54.1%], 49 [33.1%] and 19 [12.8%] in controls respectively. No statistically significant differences were observed in genotypes frequencies of CCR4 gene between patients and controls [P=0.24]. The genotype inherited by patients observed not to be associated with the type of lung cancer [P>0.05]
Conclusion: Results reveal that CCL22 gene polymorphism at position 16C/A and CCR4 gene polymorphism at position C1014T, appear not to be associated with susceptibility to lung cancer
ABSTRACT
Background: It was hypothesized that the use of Pentoxifylline would increase arterial O2 saturation and increase exercise tolerance in patients with Chronic Obstructive Pulmonary Disease [COPD]
Methods: We tested this hypothesis in 23 patients with COPD and pulmonary hypertension. Patients were randomized to receive Pentoxifylline or placebo, each for a 12-week period, in a prospective, double-blind study to assess the effects of Pentoxifylline on oxygen saturation and exercise tolerance via pulse oximetry and the 6-Minute Walk Test [6MWT]
Results: At the end of the 12 weeks, the six-minute walk distance rose from 351.9 +/- 65 meters to 393 +/- 67 meters in the Pentoxifylline group [10 patients] and increased from 328 +/- 79 meters to 353 +/- 66 meters in the placebo group [10 patients] [P=0.142]. Resting oxygen saturation by pulse oximetry changed from 87 +/- 4% to 85 +/- 14% in the Pentoxifylline group and from 88 +/- 3% to 88 +/- 2% in the placebo group [P=0.676]. There were no significant changes in dyspnea severity index and heart rate before and after the 6MWT
Conclusion: Pentoxifylline does not seem to improve exercise capacity and dyspnea in patients with severe and very severe COPD Trial Registration Number: IRCT201202018889N1
ABSTRACT
The alteration of Thl and Th2 cytokine levels is the subject of controversy in pleural effusions caused by malignancy, a situation that favors a Th2 immune response. To examine the different levels of IL-4 and IL-10 [Th2 cytokines], and IL-2 and interferon-y [IFN-gamma] [Thl cytokines] in malignant and non-malignant pleural effusions. The cytokine levels in pleural fluid of 62 patients with malignant pleural effusion [44 with lung cancer and 18 with extrathoracic tumors], 8 with tuberculous and 8 with congestive heart failure pleural effusion were analysed using enzyme-linked immunosorbent assays. IL-2 was below the detectable concentration of the assay. A significant decrease in IFN-gamma level was observed in malignant but not in congestive heart failure cases compared to tuberculous cases. IL-10 levels were higher in malignant and tuberculous pleural effusions than in congestive heart failure pleural effusions, however, this difference did not reach the significant level. IL-4 levels were also increased non-significantly in lung cancer pleural effusions compared to the other groups. Our results show a wide variation in IL-4, IL-10, and IFN-gamma levels in malignant pleural effusions, a pattern which was not convincing enough to differentiate the cause of effusion
ABSTRACT
A 40 year old female presented with a history of cough for 1.5 years and diarrhea for 5 days. She further had a history of pinkish discoloration of skin and red-crusted papules on the anterior and posterior parts of the trunk. Chest X-ray and chest CT-Scan revealed focal nodular densities in lung besides an anterior mediastinal mass. The mediastinal mass was surgically removed and the pathologic diagnosis was a lymphocytic type of thymoma [Fig. 1]. Laboratory data showed low albumin [2.9 gr/dl], high alkaline phosphatase [1448 units/1], high SCOT and SGPT [107 units/1 and 128 units/1, respectively] with total billirubin of 1.38 [mg/dl], direct billirubin of 0.52 [mg/dl] and yGt: 440 [Normal < 40]. Other positive findings included ANA: 1/640 speckled pattern, low hemoglobin: 9.1 [g/dl], mild eosinophilia [595/mm[3]] and positive occult blood in stool, with normal WBC, BUN, Na, K, Ca, PO4 and uric acid. Serum immunoelectrophoresis, abdominal sonography, fine needle aspiration of liver and endoscopic retrograde cholongiography were all normal. The report of skin biopsy indicated a lichen planus bolus type lesion. Colonoscopy detected points of inflammation with thick mucosa and biopsy was in favor of ulcerative colitis. Due to severe photophobia, she had previously consulted with an ophthalmologist revealing keratoconjuctivits sicca due to dry eye. Four months later, she was expired due to severe pneumonia and sepsis