Evaluation and comparison of body mass index and albumin level in patients with active tuberculosis and latent tuberculosis infection

Introduction: Limited data are available on the relationship between nutritional status and tuberculosis. The aim of this study was to evaluate and compare the body mass index [BMI] and serum albumin level in patients with active tuberculosis [ATB] and latent tuberculosis [LTB]

Materials and Methods: A cross-sectional study was conducted on 17 patients newly diagnosed with pulmonary TB who were referred in Iran, during September 2011 to March 2012 and 17 latent tuberculosis infection individuals. Standard method was performed to collect an early morning fasting blood sample for albumin [by the bromocresolgreen method]. Also [BMI] was calculated as body weight divided by height squared [kg/m2]

Results: One-sample Kolmogorov-Smirnov test was used to check normal distribution data The mean +/- Standard deviation[SD] for albumin in the patients and controls were 3.62 +/- 0/56 and 4.68 +/- 0.25, respectively. BMI in the patients and controls were 19.46 +/- 2.79 and 25.4 +/- 3.46, respectively. The serum albumin level was significantly lower in the patient group, compared to the control group [P<0.001].BMI was significantly lower in the patient group, compared to the control group [P<0.001]

Conclusion: Our findings demonstrated that BMI and serum Albumin were significantly lower in the active tuberculosis patients than latent tuberculosis groups

diagnostic values of protein to lactate dehydrogenase ratio in serum and pleural fluid in exudate pleural effusions

Different etiologies of pleural effusion are diagnosed based on serum and plural fluid characteristics. The aim of this study was to assess and compare the serum and pleural fluid protein to lactate dehyrogenase [Pr/LDH] ratio in exudative pleural effusions. This study was conducted on 60 patients with exudative pleural effusion including: 20 cases with parapneumonic, 20 cases with Tuberculosis [TB], and 20 cases with malignancy. The serum and pleural Pr/LDH were measured and compared among 3 groups. The mean age of the patients was 55 +/- 19SD [years] and male to female ratio was 36/24. There was no statistically significant difference in mean age of the patients among 3 groups [p=0.08]. There were statistically significant differences in serum and pleural Pr. /LDH ratios among groups [p=0.04 and p= 0.1, respectively]. Additionally the comparisons of serum and pleural Pr. /LDH ratios between malignancy and tuberculosis groups were significant [p=0.02 and p=0.001, respectively]. The serum and pleural Pr. /LDH ratios were higher in TB group. The results of our study showed that serum and pleural Pr. /LDH ratio can be used in differentiating the etiology of exudative pleural effusion, but needs to be confirmed by larger study

Pattern of pulmonary function test abnormalities in anthracofibrosis of the lungs

The objective of this study was to discuss the spirometric characteristics of anthracofibrosis which is a from of bronchial anthracosis associated with deformity. Forty anthracofibrosis subjects who were diagnosed with bronchoscopy were enrolled in this prospective study. Static and dynamic spirometry plus lung volumes and diffusion capacity were measured in this group and compared to a healthy control group. Dyspnea [95%], cough [86%] and wheezing [68%] were the most frequent clinical findings. Spirometry showed significant decrease in all parameters including VC [FVC], FEV1, FEV1/FVC, FEF25-75 and FEF25-75 /FVC. The low value of FEV1/FVC and FEF25-75 and the increment of RV were in favor of obstructive patterns in 95% of subjects. Improving the obstruction with bronchodilator was not significant and diffusion capacity was mostly normal. Anthracofibrosis should be added to the list of chronic obstructive pulmonary diseases

[Evaluation of gamma-interferon in diagnosis of tuberculosis pleurisy]

Differential diagnosis between Tuberculosis pleurisy and Non Tuberculoses pleural effusion can be sometimes difficult and needs invasive diagnostic methods. In recent years, several biological markers have been found to be diagnostic markers of Tuberculosis pleurisy. The aim of this study was assessment of the value of Gamma-Interferon in the diagnosis of TB pleurisy. We studied 70 patients with pleural effusion who had been admitted to Ghaem hospital, Mashhad University of Medical Sciences, Mashhad, Iran. Interferon gamma level was measured by "ELISA' method. The diagnosis of tuberculosis was based on microbiologic study of pleural fluid plus pleural biopsy. Altogether Twenty patients had tuberculosis pleurisy [44.44%], 21 patients had malignant pleural effusion [46.67%] and 4 patients had pleural effusion with various non TB non malignant etiologies [8.9%]. The sensitivity, specificity of Gamma-Interferon in TB pleurisy were 60% and 96% respectively. INF gamma is a valuable indicative marker for diagnosis of tuberculosis pleurisies' but we should consider situations with high level of INF gamma without any evidence of TB and also Tuberculosis pleurisy patients with INF gamma level lower than diagnostic threshold

Anemia in COPD patients and its relation to serum levels of erythropoietin

Although chronic obstructive pulmonary disease [COPD] is traditionally associated with polycythemia, its systemic inflammatory components can interfere with erythropoietin and result in anemia of chronic disease. We assessed the frequency of anemia and its relation to serum erythropoietin [EPO] levels and severity of the disease in a group of COPD patients. Eighty patients with the mean age of 66.48 +/- 11.55 years and mean forced expiratory volume in first second [FEV1] of 45.14 +/- 16.88% predicted were enrolled in this study. Severity of the disease was defined according to the global initiative for chronic obstructive lung disease [GOLD] guidelines. Hemoglobin and erythropoietin levels were assessed in all patients. Anemia of chronic disease was present in 13 of 80 patients [16%]. The mean serum levels of EPO were 59 +/- 203 [SD] micro/l and 70.3 +/- 255 [SD] micro/l in anemic and nonanemic COPD patients, respectively. There was no significant difference between the two groups [p=0.13]. A significant correlation was seen between hemoglobin and serum EPO in all COPD and nonanemic patients [r = - 0.86, p < 0.001 and r = - 0.28, p = 0.02]. No significant correlation was seen between hemoglobin and serum erythropoietin levels in the anemic group [r = 0.07, p = 0.82]. This study showed that anemia occurred relatively frequently in COPD patients. In addition to erythropoietin resistance, other factors are probably involved in the pathogenesis of anemia in these patients

Pulmonary tuberculosis in the elderly

Despite the increased rate of tuberculosis [TB] in the elderly, few publications have presented the clinical characteristics of TB in this specific age group in our country. This study aimed to compare the clinical features, predisposing factors and imaging findings of pulmonary TB in the elderly and in young adults, and to determine if any difference exists between the two groups. We retrospectively reviewed the records of all patients with the diagnosis of pulmonary TB at Ghaem Hospital and outpatient clinics during a 6-year period. Ninety-five patients were studied and divided into two groups, 33 patients were in the young group [mean age, 29.3 yrs.] and 40 patients in the elderly group [mean age, 69.6 yrs.]. Patients aged 46-64 were excluded from the study. Predisposing factors were more prevalent in the elderly who had a significantly higher frequency of chronic obstructive pulmonary disease, ischemic heart disease, congestive heart failure, malignancy and diabetes mellitus. Pregnancy and postpartum status were the predisposing conditions in young females. The classic symptoms and signs of TB were noted in a higher proportion of the younger group. Fever [78% vs. 57.5%], and weight loss[94% vs. 80%] were significantly higher [p<0.05],while night sweats[24% vs. 22.5%],cough [100% vs. 92.5%] and hemoptysis[30% vs. 15%], were seen more in the younger group but with no significant differences .Lower lung infiltrates were higher in the elderly; whereas, cavitation was seen significantly more in the young age group[63% vs. 25%, p<0.05]. To prevent delay in diagnosis and treatment, TB should be considered among the differential diagnosis of any type of pulmonary infiltrates seen in the elderly, even when the clinical presentation is atypical

[Evaluation of body mass index and albumin in pts with COPD]

Chronic obstructive pulmonary disease [COPD] is characterized by chronic inflammation and progressive development of airflow limitation. Recently besides the typical pulmonary pathology of COPD, several effects occuring outside the lungs, for example weight loss and malnutrition have been described the so called systemic effects of COPD. In this study we evaluated body mass index [BMI], serum albumin and their relationship with pulmonary function. This descriptive study performed on 42 patients, referring to Ghaem Hospital Mashhad University of Medical Sciences, Mashhad, Iran at 2005, with the mean age of 62.82 +/- 10.54 years and the mean forced expiratory volume in the first second [FEV1] [1,38 +/- 0.76 lit.]. This study was approved by the local ethics. Severity of disease was defined by global initiative for chronic lung disease [GOLD] guideline. BMI and serum albumin were measured. BMI was lower than normal in 9.5% of patients. There was a significant negative correlation between the severity of disease and BMI [p=0.004, r= - 0.43]. Furthermore the correlation between the severity of disease and serum albumin was significantly negative [p= 0.02, r= - 0.35]. The results of this study indicate that BMI and serum albumin decreased as the severity of disease increased. Therefore, the nutritional status is closely linked to the severity of COPD