Genetic profile variation in vaccine strains and clinical isolates of bordetella pertussis recovered from Iranian patients

Re-emergence of pertussis has been reported in Iran despite a high rate of vaccination coverage. Low efficacy of the vaccine might be due to the genetic divergence between Clinical versus vaccine strains. In the current study, the genetic profiles of Clinical isolates and vaccine strains of Bordetella pertussis [B. pertussis] were assessed by using Pulsed Field Gel Electrophoresis [PFGE]. Following phenotypic and molecular identification of isolates, XbaIdigested genomic DNA of 5 Clinical isolates, 2 vaccine strains and a Tohama I strain were analyzed by PFGE along with B. parapertussis as a control. Seven distinct PFGE profiles were found among all examined isolates/strains. In 5 Clinical isolates, 4 profiles were identified whereas the vaccine strains displayed 2 distinct profiles. The reference strain, Tohama I had a distinct profile. Vaccine and Clinical profiles had low similarity, with relatedness of approximately 40%. The genetic profiles of B. pertussis were different between circulating isolates and vaccine strains used in the national vaccination programs. Since new genetic profiles of B. pertussis can be disseminated periodically, the profiles of isolates circulating in the population should be monitored over the course of the re-emergence

Relationship between serum levels of testosterone and the severity of chronic obstructive pulmonary disease

This cross-sectional study aimed to investigate the relationship between the levels of serum testosterone and the severity of chronic obstructive pulmonary disease [COPD]. Using GOLD criteria, 140 male patients with COPD were categorized into mild, moderate, severe and very severe COPD groups of 35 each. Then, serum levels of testosterone, prolactin and LH of patients were compared and the data were analyzed using SPSS version 18 software. Average age of patients was 67.4 +/- 10.1 years [range 41 to 90 years]. The prevalence of the secondary hypogonadism was 58.6%. It was shown that the level of serum testosterone was directly correlated with the severity of COPD [P= 0.04]. This study found that the prevalence of the secondary hypogonadism in COPD patients was high. The forced expiratory volume in 1 second [FEV1] was correlated with the level of serum testosterone. Further investigations are required to better evaluate the pathology and treatment of secondary hypogonadism in COPD patients

[Anthropometric indices, fat-free mass index and their relationship with pulmonary function in COPD patients]

Loss of body weight and depletion of muscle mass are common nutritional problems in Chronic Obstructive Pulmonary Disease [COPD] patients. They are associated with increase disability, reduction of respiratory and skeletal muscle mass and strength, and these exert destructive effects on pulmonary function and quality of life in COPD patients. The aim of the current study was to assess the anthropometric indices and Fat-Free Mass Index and their relationship with pulmonary function in COPD patients in Hazrat Rasool Akram hospital in Tehran. This cross sectional study comprised 63 stable COPD patients, with a mean age [SD] of 67.6 [9.4] years in disease stages 2 to 4. In this study, assessment of anthropometric indices included BMI [Body Mass Index], TSF [Triceps Skinfold Thickness], MAMC [Mid Arm Muscle Circumference] and FFMI [Fat-Free Mass Index] analyzed by bioelectric impedance categorized by percentiles according to the severity of disease. Also spirometry for measuring FEV1, FVC, FEV1/ FVC, VC was performed on all participating COPD patients. Fisher's Exact Test was used for assessing relation between anthropometric indices and FFMI with stages of disease. Assessment of relationship between anthropometric indices, FFMI and respiratory factors was performed using Pearson's Correlation Coefficient test. SPSS V.12 was used for data analysis. Reduction of weight, depletion of fat mass and fat-free mass was observed in different disease stages. Reduction of body mass index, and depletion of muscle mass showed a significant increase as the disease progressed, MAMC [P=0/02] and BMI [P=0/04]. After assessing relationship between anthropometric indices and FFMI with respiratory factors, results showed significant relationship between BMI [P=0.02, r = 0.2] and MAMC [P=0.03, r = 0.2] with FEV1. Reduction of weight, depletion of muscle and fat mass were observed in many patients along with an increase in the severity of the disease. In regard to these results, measurement of anthropometric indices in addition to BMI in routine evaluation of COPD patients, provide more information about nutritional abnormalities and alterations in body composition usually occurs in COPD patients

Helicobacter pylori in patients suffering from pulmonary disease

Recently, research of indirect evidence suggested a possible association between Helicobacter pylori and pulmonary disease. This study aimed to determine if H. pylori could be detected in endobronchial specimens collected from patients undergoing bronchoscopy. This prospective study was conducted on 34 consecutive patients with any type of lung disease undergoing bronchoscopy in which biopsy was required for their diagnosis. A written informed consent was obtained from all participants. Three bronchial mucosa biopsy samples were obtained using fenestrated biopsy forceps. One sample was used to determine urease activity, the second one for histopathological examination, and the third one for diagnosis. All subjects were fully informed regarding the gastroesophageal reflux disorder [GERD] Questionnaire. There were 34 patients with pulmonary diseases [12 males and 22 females, mean age 58.2 +/- 18.2 years] out of which, 11 [32.4%] had GERD. No significant difference was found between the histopathological assay and GERD. Our study found no direct evidence supporting the theory that H. pylori may cause pulmonary disease and no relation with GERD was detected. However, a possible indirect role could not be excluded. Further studies in patients with GERD and lung disease may reveal a potential pathogenic link between H. pylori and pulmonary disease

Serum magnesium level impact on the outcome of patients admitted to the intensive care unit

Magnesium deficiency is a common, yet under-diagnosed problem in the intensive Care Unit [ICU]. Our aim was to determine the prevalence of abnormalities in serum magnesium concentrations in critically ill patients upon admission to the ICU. The association of serum magnesium level with prognosis was also studied. This historical cohort study was conducted in the medical ICU of Hazrat-e-Rasool Hospital and 273 critically ill patients were enrolled in this study during a one-year period. Binary logistic regression analyses were performed to identify significant independent risk factors of mortality in the ICU. The mortality rate was 53.8% in the understudy subjects. One-hundred forty-seven subjects [53.8%] had normal serum magnesium levels, whereas, 126 subjects [46.2%] had abnormal values [hyper- or hypomagnesemia]. Patients with lower total serum magnesium level had longer length of mechanical ventilation and ICU stay. The mortality rate was higher in patients who had abnormal magnesium levels. Age, serum Mg and mechanical ventilation were three risk factors that independently predicted probability of mortality in the ICU patients. Monitoring of serum magnesium levels may have prognostic, and perhaps therapeutic, implications and physicians should be alert to the high incidence of magnesium deficiency in critically ill patients