{"title":"Diagnostic Accuracy of Interleukin 27 for the Diagnosis of Pleural Tuberculosis.","authors":"Majid Marjani, Amir Reza Aghebatkheyri, Neda Dalil Roofchayee, Alireza Eslaminejad, Mojdeh Azimi, Alireza Eskandari, Atefeh Abedin, Makan Sadr, Seyed Mohammad Poorhosseini, Mitra Rezaei, Esmaeil Mortaz","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Pleural tuberculosis (TB) is one of the most common forms of extra-pulmonary TB. Since diagnosis is challenging through microbiological tests, discovering new diagnostic techniques with higher accuracy could help us improve early detection and lead to better outcomes. This study aims to investigate the sensitivity and specificity of interleukin 27 (IL27) as a diagnostic test for pleural Tuberculosis.</p><p><strong>Materials and methods: </strong>The current study was conducted on 121 adult patients admitted to Masih Daneshvari Ho spital due to pleural effusion with an unknown cause. 36 cases had transudative, and 85 cases had exudative pleural effusions. Among them, TB (33.1%) and malignant pleurisy (23.1%) were the most common causes. In addition to routine studies for pleural effusion workups, pleural interleukin-27 concentrations were measured by ELISA and compared between groups of TB-affected patients and those without TB<b>.</b></p><p><strong>Results: </strong>We found that the value 679 pg/ml was the most appropriate cut-off threshold for interleukin 27 in pleural fluid with 95% sensitivity, 69% specificity, 94% negative predictive value, and 73% positive predictive value (P value<0.001) for diagnosis of TB pleurisy. ADA levels were not significantly different between TB and non-TB cases.</p><p><strong>Conclusion: </strong>Compared to other groups, interleukin 27 levels in patients with a final diagnosis of TB-pleurisy were significantly higher, indicating the significant value of this interleukin as a diagnostic biomarker.</p>","PeriodicalId":22247,"journal":{"name":"Tanaffos","volume":"24 1","pages":"44-50"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13101919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147781851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Use of Flexible Bronchoscope for Diagnostic Medical Thoracoscopy in a Resource-Limited Setting: A Retrospective Study.","authors":"Rajnish Kaushik, Roopali Dahiya, Aditya Chaudhary, Pawan Kumar Singh, Aman Ahuja, Dhruva Chaudhry, Geetika Arya","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Exudative pleural effusion (ePE) is a common presentation in pulmonology clinics. Pleural biopsy is indicated for identifying the etiology in undiagnosed ePE, especially those with low adenosine deaminase levels. Access to rigid and semi-rigid medical thoracoscopy is scarce and heterogeneous in a resource-limited country like India. In such circumstances, using a flexible bronchoscope via an intercostal chest tube for visualization of the parietal pleura and pleural biopsy offers a way out.</p><p><strong>Materials and methods: </strong>In this retrospective study, we have presented our experience of such practice on 25 cases. Mean age was 52.4±1 years. Adhesions were present in 40% of the subjects.</p><p><strong>Results: </strong>The most common finding was the presence of nodules. On average, 6.8 passes were taken with a maximum of 10. In 32% cases, only tiny tissue was obtained, hence requiring multiple passes. Large tissue could be obtained in 44% of the subjects. The mean duration of the procedure was 35.6±9.0 minutes. Tissue diagnosis was established in 80% with the most common being malignancy (48%), followed by tuberculosis (20%). In 3 cases, the final diagnosis was made by exclusion. No major complications were recorded.</p><p><strong>Conclusions: </strong>In conclusion, medical thoracoscopy using a flexible video bronchoscope via intercostal chest tube was a feasible alternative for the diagnosis of ePE effusion in resource-limited settings.</p>","PeriodicalId":22247,"journal":{"name":"Tanaffos","volume":"24 1","pages":"69-77"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13098002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147781840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Long COVID in Patients with Multiple Sclerosis Treated with Rituximab: A Report of Two Cases.","authors":"Payam Tabarsi, Abdolreza Mohamadnia, Pardis Shahabinejad, Sara Haseli, Elham Askari, Naghmeh Bahrami, Shadi Shafaghi, Maryam Hajimoradi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>COVID-19 symptoms may persist for more than 12 weeks in some infected patients, a condition described as long COVID-19 in these cases. These patients have symptoms attributed to impairment of multiple organs. Scientists have discovered the lengthy COVID-19 etiology, risk factors, and treatments. It has been observed that immunosuppression may prolong COVID-19 symptoms. Patients with multiple sclerosis (pwMS) are generally treated with disease-modifying treatments, which suppress the immune system and predispose patients to infections like COVID-19. Also, these drugs may increase not only the morbidity and mortality of infection but also the risk of developing long COVID-19 in these patients. We have described two cases of multiple sclerosis patients who were diagnosed with long COVID-19. Both patients were under treatment with rituximab, so we discussed treatment choices and strategies for pwMS patients under rituximab who had symptoms of long COVID. Our data would further add to the information on managing long COVID-19 in pwMS under treatment with rituximab.</p>","PeriodicalId":22247,"journal":{"name":"Tanaffos","volume":"24 1","pages":"106-110"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13098001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147781812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Evaluation of E-Cigarette Effects on Gene Expression Profile of Human Bronchial Epithelial Cells: A System Biology Approach.","authors":"Nayebali Ahmadi, Mona Zamanian Azodi, Mohammad Rostami Nejad, Mitra Rezaei, Reza Robati, Fatemeh Bandarian, Farideh Razi, Zahra Razzaghi, Babak Arjmand, Mostafa Rezaei-Tavirani","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Electronic cigarettes produce aerosols that contain flavoring agents and nicotine, a drug that can lead to dependence, which users inhale. The widespread use of e-cigarettes has prompted research projects to investigate the safety or risks of e-cigarette smoke on human health. The present study aims to discover details of the e-cigarette smoke effect on the gene expression profile of human bronchial epithelial cells (HBECs) via network analysis.</p><p><strong>Materials and methods: </strong>Data of GSE118431(GPL16791) from Gene Expression Omnibus (GEO) were extracted and pre-evaluated by GEO2R program. The differentially expressed genes (DEGs) were analyzed via protein-protein interaction PPI analysis, and the critical DEGs were introduced.</p><p><strong>Results: </strong>A total of 192 significant DEGs among the 17058 targeted genes were selected for PPI network analysis. The 177 recognized genes were interacted to construct a network. Six DEGs were common between the hubs and bottlenecks of the network.</p><p><strong>Conclusion: </strong>E-cigarettes target IL1B, PTGS2, SOD2, NFKBIA, TXNRD1, and DUSP1, the critical genes that are associated with progression of inflammation, cell proliferation and cell invasion in cancer, chromatin condensation, DNA fragmentation, and cell death.</p>","PeriodicalId":22247,"journal":{"name":"Tanaffos","volume":"24 1","pages":"30-35"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147781820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Visualization and Analysis of the Role of an Inflated Tracheostomy Tube Cuff in the Human: A Preliminary Study.","authors":"Makoto Miyamoto, Takahiro Arai, Hideki Nakagawa, Koichiro Saito","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to reconstruct ultra-high-resolution computed tomography (CT) and three-dimensional CT images of tracheostomy tubes, including the shaft, flange, inflation line, and cuff, with a particular focus on examining the degree and fold formation of the inflated tracheostomy tube cuffs within the human trachea.</p><p><strong>Materials and methods: </strong>All ten patients were inserted with a cuffed tracheostomy tube, and the cuff pressure was maintained at approximately 25 cmH<sub>2</sub>O intra-cuff pressure using a pressure gauge. The levels of the inserted tracheostomy tube, the degree of inflation of the tracheostomy tube cuffs, the folds of the cuff, and the location of the distal tip of the tracheostomy tube.</p><p><strong>Results: </strong>In this study, the pressure of the tracheostomy tube cuff was managed at an intracuff pressure; however, the degree of inflation of the tracheostomy tube cuffs and the form of the cuff folds inserted into the human trachea differed in each case. The distance between the skin and the tracheal anterior wall and the BMI value were associated with the inflation of the tracheostomy tube cuffs.</p><p><strong>Conclusion: </strong>In cases with distances greater than 25 mm between the skin and the tracheal anterior wall, we think it may be better to use other methods, such as tracheal fenestration, rather than simple tracheostomy. Examination of the size of the tracheostomy tube inserted into the human trachea, the degree of inflation of the tracheostomy tube cuff, and the position of the distal tip of the tracheostomy tube may help in the selection of an appropriate tracheostomy tube clinically.</p>","PeriodicalId":22247,"journal":{"name":"Tanaffos","volume":"24 1","pages":"36-43"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147781797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"New Insights into Pulmonary Arterial Hypertension Treatment with Non-Coding RNAs: What is the Best Option, microRNAs or Small-Interfering RNAs?","authors":"Hannaneh Yousefi-Koma, Babak Sharif-Kashani, Abdolreza Mohammadnia, Mahdi Ahmadinia, Shadi Shafaghi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Pulmonary arterial hypertension is a devastating disease that can lead to other serious comorbidities. Heart failure is a major problem in patients with pulmonary arterial hypertension. It usually begins with right-sided heart failure, but in severe or uncontrolled cases, it can progress to left-sided heart failure. Currently, available treatment options do not have desirable effects. Therefore, considering a new treatment strategy is a cardiology priority. Non-coding RNAs, including small interfering RNA and microRNA, are valuable treatment options to study. Several non-coding RNAs have been studied and even approved for treatment in other hard-to-treat diseases. However, deciding which to choose can be complex. That is because these non-coding RNAs can have multiple interaction processes. Therefore, a thorough understanding of pulmonary arterial hypertension's pathological pathways and our target non-coding RNA interaction pathways is crucial. Here, we discuss the potential benefits and harms of these options in treating patients with pulmonary arterial hypertension.</p>","PeriodicalId":22247,"journal":{"name":"Tanaffos","volume":"24 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147781817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comparison of IOS and Body Plethysmography Findings in Patients with Interstitial Lung Disease.","authors":"Sanaz Soleimani, Jalal Heshmatnia, Mohsen Sadeghi, Alireza Eslaminejad","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>In patients with ILD, the static expiratory pressure-volume curve of the lung is generally shifted downward and to the right, and spirometry results reveal reduced vital capacity. However, decreased vital capacity may occur even in patients with obstructive lung diseases and in other situations, such as chest wall restriction, lung resection, inspiratory muscle weakness, or poor cooperation with spirometry. In addition, spirometry is sometimes difficult to perform with elderly, cognitively impaired patients or with severe respiratory distress. IOS is a simple, non-invasiv e method requiring only passive patient cooperation that allows for the evaluation of lung function through the measurement of both airway resistance and airway reactance. This study aims to assess the role of IOS in the evaluation of cases of interstitial lung diseases.</p><p><strong>Materials and methods: </strong>This study included 53 patients with interstitial lung diseases of different causes. Pulmonary function test by spirometry was done to measure FEV1, FVC, FEV1/FVC, MEF25-75, and pulmonary function test by impulse oscillometry (IOS). We measured R5, R20, X5, RF.</p><p><strong>Results: </strong>Examining the indicators evaluated based on IOS shows that the numerical values of R5 have not increased significantly. Regarding R20 and R5-R20, exhalation values are more than two, and as a result, the interval (expinsp) is a positive number. The values of X5, AX, and Fres increased as expected (213%).</p><p><strong>Conclusion: </strong>X5 was lower in patients with ILD, indicating a restrictive pattern. Conversely, there is a negative correlation between X5 and FVC. Based on the numerical values of R5 and R20, it can be inferred that patients experience small airway obstruction.</p>","PeriodicalId":22247,"journal":{"name":"Tanaffos","volume":"24 1","pages":"88-96"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13098000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147781783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Invasive Pulmonary Aspergillosis and Tuberculosis after COVID-19.","authors":"Mahshid Talebi-Taher, Seyed-Ali Javad-Moosavi, Shirin Ahmadalipour, Masoud Bahrami, Maryam Sarkheil, Arash Javad-Moosavi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary tuberculosis (TB) and invasive aspergillosis are distinct infectious diseases that rarely coexist in the same patient. The concurrent occurrence of these infections presents diagnostic and therapeutic challenges, resulting in complex clinical presentations and potentially adverse outcomes. We present a case report highlighting the diagnostic process, management strategies, and pertinent literature regarding the simultaneous occurrence of pulmonary TB and aspergillosis in a patient following COVID-19 infection.</p><p><strong>Case presentation: </strong>A 55-year-old male with a history of occupational exposure as a farmer and welder presented with a complex medical condition. He had a previous COVID-19 infection and was hospitalized for three weeks, receiving appropriate treatment. Subsequently, he developed dyspnea and bilateral pleural effusion and underwent treatment with broad-spectrum antibiotics. Further investigations revealed consolidation in the left upper lobe, and biopsy confirmed the presence of Aspergillus species. The patient received voriconazole treatment for several months, but minimal improvement was observed. Recurrent hemoptysis prom pted bronchoscopy, which showed positive results for acid-fast bacilli smear and TB PCR testing, indicating concomitant pulmonary TB. Anti-tuberculosis treatment was initiated alongside ongoing management for aspergillosis.</p><p><strong>Conclusion: </strong>This case report ill ustrates the diagnostic and therapeutic complexities associated with the simultaneous occurrence of pulmonary TB and aspergillosis in a patient following COVID-19 infection. Clinicians should maintain a high index of suspicion for dual infections in similar clinical scenarios. Prompt recognition, accurate diagnosis, and individualized treatment strategies are crucial for optimal patient management. Further research is warranted to enhance our understanding of this unique clinical entity and improve patient outcomes.</p>","PeriodicalId":22247,"journal":{"name":"Tanaffos","volume":"24 1","pages":"102-105"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147781792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Seyed Mohammadreza Hashemian, Hamidreza Jamaati, Navid Shafigh, Sara Salarian, Alireza Shakeri, Mohammad Gharehbeglou, Jamshid Ordoni Avval
{"title":"The Effect of Intermittent Use of Oxygen Therapy via High-Flow Nasal Cannula Alternating with Noninvasive Ventilation on Critically Ill Patients.","authors":"Seyed Mohammadreza Hashemian, Hamidreza Jamaati, Navid Shafigh, Sara Salarian, Alireza Shakeri, Mohammad Gharehbeglou, Jamshid Ordoni Avval","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Despite limited research on high-flow nasal cannula (HFNC) alternating with noninvasive ventilation (NIV), this study investigates its effect on intensive care unit (ICU) patients.</p><p><strong>Materials and methods: </strong>This clinical trial study at Masih Deneshvari Hospital (Tehran) compared NIV vs. alternating NIV with HFNC for ICU patients. It assessed intubation, mortality, and vitals. Patients were informed, and nurses were trained for optimal care. Daily follow-up ensured data collection.</p><p><strong>Results: </strong>The mean age of the patients was 66.3±19.7 years, which was 67.1±14.8 years in the NIV group and 65.5±14.9 years in the HFNC+NIV group, respectively. The distribution of patients in terms of APACHE and symptoms showed no significant difference (P=0.453). The mean HR in the two groups, NIV and HFNC+NIV, before the study was 113.30±5.25 and 112.43±5.80, respectively. At the end of the study, it was 94.78±17.53 and 94.48±17.47, respectively, with no significant difference found between the two groups. The mean RR before the beginning of this study was not significantly different between the two groups, while it was 16.61±4.23 and 17.91±1.78 in the NIV and HFNC+NIV groups, respectively, at the end of the study (P=0.043). PO<sub>2</sub> created a greater distinction between the two groups based on the decision tree analysis, where the NIV group was more likely to have values of PO<sub>2</sub><70.</p><p><strong>Conclusion: </strong>Based on the findings presented in our study, no difference was found between the use of NIV and NIV + HFNC, but HFNC + NIV was a more tolerable technique for patients.</p>","PeriodicalId":22247,"journal":{"name":"Tanaffos","volume":"24 1","pages":"78-87"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13101918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147781805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}