ABSTRACT
BACKGROUND Familial Mediterranean fever (FMF) is an autosomal recessive disorder characterized by sporadic, paroxysmal attacks of fever and serosal inflammation. Although the disease usually begins before the age of 20 years, we aimed to evaluate the demography, clinical features and treatment outcome of familial Mediterranean fever in Iranian adult patients above 20 years old. METHODS In this cross-sectional study, adult patients (first attack at the age of >20 years) with a diagnosis of FMF who referred to the gastroenterology and rheumatology Clinics of Ardebil University of Medical Science (situated in north west of Iran) over the period of 2004-2009 were enrolled. FMF diagnosis was based on clinical criteria. RESULTS Forty four FMF patients (30 male and 14 female) with the mean [± Standard Deviation (SD)] age of first attack of 29 ± 7.8 years were enrolled. Abdominal pain (95.5%) and fever (91%) were the most common clinical findings. All of the patients had satisfactorily responded to therapy. Response was complete in 76.7% and partial in 23.3% of the patients. There was no clinical or laboratory evidence of amyloidosis at the time of diagnosis or during follow-up. CONCLUSION Our findings demonstrated that adult-onset FMF in Iran has different characteristics (more common in males, lesser prevalence of arthritis and erysipelas-like erythema, less delay in diagnosis) and treatment outcome (favorable response even to low-dose colchicine) in comparison with the previous data on early onset patients.
ABSTRACT
This study in the Islamic Republic of Iran aimed to determine whether metoclopramide can prevent nosocomial pneumonia in the intensive care unit (ICU). Of 220 patients admitted to the surgical ICU who had a nasogastric tube for more than 24 hours, 68 case patients received oral metoclopramide (10 mg every 8 hours) and 152 control patients did not. Similar proportions of cases and controls developed nosocomial pneumonia (33.8% versus 33.6%). Endotracheal intubation was a risk factor for nosocomial pneumonia (odds ratio 7.70). There were no significant differences between groups in mortality rate or time of onset of nosocomial pneumonia. Metoclopramide appears to have no effect on the development of nosocomial pneumonia with nasogastric feeding.
Subject(s)
Antiemetics/therapeutic use , Cross Infection/prevention & control , Enteral Nutrition/adverse effects , Intubation, Gastrointestinal/adverse effects , Metoclopramide/therapeutic use , Pneumonia, Aspiration/prevention & control , Administration, Oral , Adult , Antiemetics/pharmacology , Chi-Square Distribution , Critical Care , Cross Infection/epidemiology , Cross Infection/etiology , Double-Blind Method , Female , Humans , Incidence , Intubation, Intratracheal/adverse effects , Iran/epidemiology , Logistic Models , Male , Metoclopramide/pharmacology , Middle Aged , Pneumonia, Aspiration/epidemiology , Pneumonia, Aspiration/etiology , Risk Factors , Time Factors , Treatment OutcomeABSTRACT
This study in the Islamic Republic of Iran aimed to determine whether metoclopramide can prevent nosocomial pneumonia in the intensive care unit [ICU]. Of 220 patients admitted to the surgical ICU who had a nasogastric tube for more than 24 hours, 68 case patients received oral metoclopramide [10 mg every 8 hours] and 152 control patients did not. Similar proportions of cases and controls developed nosocomial pneumonia [33.8% versus 33.6%]. Endotracheal intubation was a risk factor for nosocomial pneumonia [odds ratio 7.70]. There were no significant differences between groups in mortality rate or time of onset of nosocomial pneumonia. Metoclopramide appears to have no effect on the development of nosocomial pneumonia with nasogastric feeding
