[Assessment of cardiac troponin I in patients with pulmonary emboli and its relationship with right ventricular dysfunction]

Right ventricular dysfunction is common in major pulmonary embolisms. The purpose of this study was to evaluate the prevalence and diagnostic utility of cardiac troponin I and also to identify patients with RV dysfunction in pulmonary embolism. This study was conducted on 42 patients with pulmonary embolism in Ekbatan Hospital, in Hamedan city. Data from history, echocardiogram, and lung perfusion scan was obtained from medical records. Blood samples were obtained immediately after pulmonary embolism was diagnosed. Cardiac troponin was measured using chromatographic assay. Two patients [4.8%] had positive troponin I [>/= 0.5 microg/l], and 40 patients [95.2%] had negative troponin I [< 0.5 microg/l]. RV dysfunction was detected in 16 patients [38%]. RV dysfunction was detected in 1 of positive troponin I patients and 15 with negative troponin I [37.5%]. No significant relationship was found between RV dysfunction and troponin I level [p>0.05]. Our data demonstrates that troponin I measurement is not able to distinguish specifically between coronary and non- coronary causes of chest pain

E-selectin S128R polymorphism leads to severe asthma

The E-selectin mediates the interaction of activated endothelial cells with leukocytes and plays a fundamental role in the pathogenesis of asthma. It has been suggested that an S/R [Serine128 Arginine] polymorphism of E-selectin alters ligand binding function. Our purpose in this study was to determine whether this Serine128 Arginine polymorphism influences the risk of asthma and also to analyze the possible correlation of disease severity in Iranian patients with polymorphism of E-selectin. We studied human E-selectin gene polymorphism in 172 asthmatic patients and 173 healthy volunteers by polymerase chain reaction-restriction fragment length polymorphism [PCR-RFLP]. To determine the severity of the asthma's situation, a questionnaire was prepared requesting the following information: age, sex, clinical signs and symptoms and past medical history. After the participants filled in the questionnaire, all active or ex-smoker patients were excluded. A trained observer assessed airway reversibility, peak flowmetry and spirometry in asthmatic patients. We found increased serum levels of soluble E-selectin [sE-selectin] in asthmatic patients compared with healthy subjects [P <0.0001]. Frequencies of the SS, SR, and RR genotypes were found as 66.3%, 31.4%, and 2.3% in the patients and 91.9%, 8.1%, and 0.0% in control subjects, respectively. The 128 Arg allele was more prevalent in patients than controls [OR 5.78; 95% CI, 3.07-10.86, P<0.0001]. However, in this study the polymorphism was not associated with circulating sE-selectin levels. We found a direct correlation between the level of sE-selectin and the severity of asthma [P=0.001]. On the other hand, there was a close relation between 128 Arginine carriage and disease severity [P<0.0001]. These results suggest that the Ser 128 Arg polymorphism of the E-selectin gene is a genetic factor that may be associated with the severity of asthma

efficacy of interferon-alpha in the treatment of multidrug resistant tuberculosis

Tuberculosis is a major cause of infectious disease modality all over the world. Multidrug resistant tuberculosis [MDR-TB] is a major problem in the management of tuberculosis. With recent advances in understanding the immunopathogenesis of tuberculosis, the use of various cytokine therapies has been suggested. The objective of this study was to evaluate the efficacy of parenteral INF-alpha for treating MDR-TB patients. To conduct the study, 12 MDR- TB patients hospitalised in the clinical mycobacteriology ward of Massih Daneshvari hospital were selected randomly between October 2000 and March 2001. All had chest involvement in radiography, so they were smear and culture positive on two occasions. All had at least resistance to isoniazid and rifampin in antibio gram. They were divided in two groups. One group received INF-alpha; [3,000, 000U, three times a week, subcutaneously] in addition to anti-TB drugs, and the other group received only anti -TB medications as control group. Results indicate that the mean [ +/- SD] degree of sputum smear positivity at the beginning of therapy was 2.4 +/- 0.89 in the case group and 2 +/- 0.89 in the control group which showed no significant difference [p 0.132]. Also, at the beginning of our study, there was no significant difference in the degree of sputum culture positivity between the two groups. At the end of the 8th week, all cases became smear and culture negative, but all control subjects remained smear and culture positive [p= 0.017]. At the end of the 6th month; however, only two cases remained smear negative, one remained culture negative and the rest became positive. All control subjects had positive culture results [p 0.693]. We conclude that cytokines have at least temporary effect on disease remission and can be used as adjunctive therapy