Molecular detection and genotype identification of Acanthamoeba species from bronchoalveolar lavage of patients with pulmonary symptoms suspected of cancer.

Acanthamoeba spp. are the most common free-living amoeba worldwide, inducing life-threatening diseases such as Granulomatous Amoebic Encephalitis, pulmonary infection, and amoebic keratitis. This study aimed to identify the FLA and Acanthamoeba genotypes in patients with pulmonary symptoms suspected of cancer in Kashan's hospitals, Kashan, Iran. This cross-sectional study was conducted on 97 bronchoalveolar lavage samples of patients with respiratory symptoms suspected of lung cancer, who were admitted to the Shahid Beheshti Hospital of Kashan from 2019 to 2020. The samples were cultured onto 1.5% non-nutrient agar enriched with killed Escherichia coli and examined for the presence of FLA. Following amoeba isolation and DNA extraction, Acanthamoeba spp. were determined by Polymerase Chain Reaction using JDP1 and JDP2 primers, which amplified a 490 bp fragment from the 18 S rDNA gene. Eighteen Acanthamoeba isolates were sequenced, and the genotypes were identified. The prevalence of FLA and Acanthamoeba and the relationship between symptoms and demographic variables were analyzed with SPSS Software version 16. The prevalence rates of FLA and Acanthamoeba in the BAL samples was 86.6% and 73.2%, respectively. All Acanthamoeba isolates belonged to the T4 genotype. The most symptoms among Acanthamoeba-positive patients were dyspnea and cough; however, their difference was not statistically significant. The findings indicated the high prevalence of FLA and Acanthamoeba in BAL in the population suspected of cancer in Kashan. Since the T4 genotype is a pathogenic genotype of Acanthamoeba, training health and improving sanitation levels would help to prevent infection.

Combination adjunctive nebulized furosemide and salbutamol versus single agent therapy in COPD patients: A randomized controlled trial.

BACKGROUND: COPD patients often require multiple therapies to enhance their lung function and reduce their symptoms in exacerbations. This study aimed to investigate the relative effects of combination adjunctive nebulized furosemide and salbutamol therapy versus single agent treatment in COPD patients. METHODS: Sixty-nine COPD patients were randomly divided into two groups. The first group (G1, 34 cases) received salbutamol in their first episode. The second group (G2, 35 cases) received furosemide in their first episode. Spirometry indices (FEV1, FVC, and FEV1/FVC), mMRC and BORG (COPD assessment) were assessed and recorded for all patients.To study the efficacy of combination adjunctive therapy, in 2nd episodes, the nebulized furosemide was added to nebulized salbutamol in the G1, and nebulized salbutamol was added to nebulized furosemide in G2. The aforementioned indices were then re-assessed. RESULTS: The mean age was (64.92 ± 11.71 years, 55% males. The use of nebulized furosemide and salbutamol as single agents slightly improved the spirometeric parameters, but it was not noteworthy compared to the significant improvement of the FEV1, FVC, FEV1/FVC, mMRC, and Borg parameters with combination therapy (p-value< 0.001). In the first episode, there was no difference in spirometeric indices, between groups (p-value > 0.1), so furosemide is considered as effective as nebulized salbutamol. Also, the results of sequential drugs administration, in the two groups was similar. CONCLUSION: Conjunction of nebulized furosemide and salbutamol is more effective than single therapy and can be considered as preferred drug regimen without any reported side effect in the treatment of COPD.

Primary composite lymphoma of the lung: a case report.

Herein, we report a rare case of primary lung lymphoma in a 61 year-old woman with a history of 6-month nonspecific symptoms like dry cough, fever, chills and weight loss. She was admitted to a hospital and received broad-spectrum antibiotics but discharged without full recovery. In her second hospital admission, a bronchoscopic evaluation and transbronchial biopsy were performed, which were not diagnostic. Finally, an open lung biopsy was done. Immunohistochemical (IHC) staining of the specimen suggested pulmonary Hodgkin lymphoma. Because of disease recurrence, a second bronchoscopy was performed and endobronchial biopsy revealed transformation to anaplastic lymphoma. In the second recurrence, we decided to reevaluate the last biopsy specimens in greater details. Finally, after conduction of several staining patterns, the diagnosis of primary composite lymphoma of the lung was made.

YKL-40 in Asthma and its correlation with different clinical parameters.

It has been suggested that elevated serum level of YKL-40 could be a marker for asthma and its severity. Along with few published studies, we investigated its correlation with asthma and its severity as well as spirometric indices.114 patients with asthma and 114 healthy controls underwent the assessment of serum level of YKL-40 (by ELISA) and spirometric indices. Pearson's coefficient determined the correlation between the variables and multivariate linear regression analysis was used for adjusting the effect of different probable confounding factors.Serum levels of YKL-40 were significantly higher in the asthmatic patients compared to those in healthy people (p<0.001). We also found a significant correlation between YKL-40 serum level and spirometric indices even after adjusting the effects of other variables.We report for the first time in an Iranian population that YKL-40 may be a good diagnostic marker of asthma in serum.