Maryam Ahmadipour, Marzieh Lashkari, Mehdi Ahmadinejad
{"title":"Comparison of Morbidity, Mortality, and Costs of VAP Patients with Non-VAP Patients in the Tertiary Referral Hospital of Kerman, Iran.","authors":"Maryam Ahmadipour, Marzieh Lashkari, Mehdi Ahmadinejad","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Ventilator-associated pneumonia is the most common type of nosocomial infection in ICUs. Hence, this study shall focus on the morbidity, mortality, and costs associated with this infection among ICU patients.</p><p><strong>Materials and methods: </strong>The current research is a prospective descriptive-analytical study. The study population included patients admitted to the Tertiary Referral Hospital of Kerman University of Medical Sciences who were enrolled in the study according to inclusion criteria and demographic characteristics data, length of stay in ICU and general wards, and direct and indirect medical expenses such as unemployment and rehabilitation cost, etc.</p><p><strong>Results: </strong>Nine of the 144 patients studied died. (4 in the Ventilator-Associated Pneumonia (VAP) group and 5 in the non-VAP group). Among them, the prevalence of <i>Acinetobacter Baumannii</i> was significantly higher than other bacteria (P-Value=0.001). The duration of hospitalization in the ICU (18±9 vs. 9.5±6 days) and recovery time (21.6±9 9.6 vs. 13.2±7 days) were higher in the VAP group (P-Value<0.05). Moreover, the duration of hospitalization in the general ward was 15.4±8 days in the VAP group and 10.6±6 days in the non-VAP group (P-Value<0.05). The cost of treatment in the VAP group ($7952.28) was significantly higher than in the non-infected group ($4400.98). The average rehabilitation cost in the VAP group was $2571.42 and in the non-affected group was $1530.88. The financial loss due to the delay in work starting was $482 in the non-VAP group which was significantly less than the VAP group ($792).</p><p><strong>Conclusion: </strong>Having VAP can significantly increase mortality, length of stay in the ICU as well as increase direct and indirect costs for patients.</p>","PeriodicalId":22247,"journal":{"name":"Tanaffos","volume":"22 1","pages":"61-69"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10618589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71427072","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}
Abbas Yousefi-Koma, Farahnaz Aghahosseini, Hannaneh Yousefi-Koma, Alireza Roohizadeh, Mojgan Panahmoghaddam
{"title":"F-18 FDG PET/CT as a One-Stop Shop Imaging Modality for Assessment of Neurologic and Pulmonary Manifestations of COVID-19.","authors":"Abbas Yousefi-Koma, Farahnaz Aghahosseini, Hannaneh Yousefi-Koma, Alireza Roohizadeh, Mojgan Panahmoghaddam","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Neurologic manifestations are now being increasingly encountered in patients who are admitted for respiratory symptoms of COVID-19. A 67-year-old male with a recent history of Wernicke's aphasia was referred to the nuclear medicine department for risk stratification of malignancy in pulmonary nodule by 18F-FDG PET-CT scan. PET-CT revealed decreased metabolic activity in the left temporoparietal lobe of the brain consistent with recent CVA and excluded malignancy in the pulmonary nodule with low-grade metabolic activity. Incidentally noted, new bilateral pulmonary hypermetabolic ground glass opacities rising suspicious for covid-19 infection which was confirmed by PCR of nasopharyngeal mucosa sample. These findings highlight the value of 18FFDG PET-CT in the assessment of COVID-19 infection especially in non-pulmonary presentations like early neurologic manifestation.</p>","PeriodicalId":22247,"journal":{"name":"Tanaffos","volume":"22 1","pages":"172-175"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10618579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71427077","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}
Maral Moafi, Mohammad Javad Ebrahimi, Firouze Hatami, Farid Javandoust Gharehbagh, Arman Ahmadzadeh, Mohammad Mehdi Emam, Alireza Rajaei, Davood Mansouri, Ilad Alavi Darazam
{"title":"Lupus Anticoagulant Is Associated with Critical Cases and High Mortality in COVID-19: A Literature Review.","authors":"Maral Moafi, Mohammad Javad Ebrahimi, Firouze Hatami, Farid Javandoust Gharehbagh, Arman Ahmadzadeh, Mohammad Mehdi Emam, Alireza Rajaei, Davood Mansouri, Ilad Alavi Darazam","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>In severe COVID-19 cases, a hypercoagulable state may occur. Antiphospholipid syndrome-related auto-antibodies (APSRAs) contribute to coagulopathy, but their role in COVID- 19 remains unclear. We aimed to investigate the prevalence of positive APSRAs and their effect on clinical outcomes in confirmed COVID-19 patients.</p><p><strong>Materials and methods: </strong>In this cross-sectional study, severe hospitalized COVID-19 cases were enrolled. Demographic and clinical data were obtained from the day of admission. APSRAs including IgG and/or IgM anticardiolipin (aCL) and anti-β2-glycoprotein1 (anti-β2GP1) as well as lupus anticoagulant (LAC) were measured.</p><p><strong>Results: </strong>In this study, 54 severe COVID-19 cases with positive RT-PCR and chest CT scans were recruited. Positive APSRAs were found in 7 (12.9%) patients. Positive LAC was a more prevalent marker as compared to other tests (11.1%). The prevalence of positive aCL (IgM or IgG) and anti-ß2 GPI (IgM or IgG) was 1.8% (in an elderly woman). Lower oxygen saturation was found in the positive APSRAs group as opposed to the negative APSRAs group (70.3±9 vs. 84.8±9.7%). The mortality rate in the positive APSRAs group was significantly higher relative to the negative APSRAs group (83.3% vs. 27.1%; P-value: 0.01). Likewise, the mechanical ventilation requirement in the positive group was also higher (50% vs. 27.1%, P-value: 0.28).</p><p><strong>Conclusion: </strong>This study indicated that LAC might be associated with critical cases and high mortality of COVID-19. Nonetheless, the mortality was not related to macrothrombotic incidence.</p>","PeriodicalId":22247,"journal":{"name":"Tanaffos","volume":"22 1","pages":"53-60"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10618584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71427080","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}
Maryam Ziaei, Meysam Sabaghzade, Mehdi Galavi, Ali Abdolrazaghnejad
{"title":"Relationship of Mean Platelet Volume (MPV) and Mean Corpuscular Volume (MCV) with the Outcome of Patients with Acute Exacerbation of COPD.","authors":"Maryam Ziaei, Meysam Sabaghzade, Mehdi Galavi, Ali Abdolrazaghnejad","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Mean platelet volume (MPV) reflects the platelet production rate and stimulation, while mean corpuscular volume (MCV) represents the average size of red blood cells. Considering the possibility of the relationship between red cell index changes and different severities of chronic obstructive pulmonary disease (COPD) as well as the uncertainty of the available results in this regard, the present study aimed at evaluating the relationship between MPV and MCV in the outcome of patients with acute exacerbation of COPD (AECOPD).</p><p><strong>Materials and methods: </strong>In this cross-sectional analytical study, 150 patients with AECOPD that referred to the emergency department (ED) were included in the study. The severity of the disease was recorded using the GOLD classification, and the MPV and the MCV were evaluated based on the reference range of kits in the laboratory. Then, the data were analyzed using SPSS software.</p><p><strong>Results: </strong>The mean MPV and MCV were 9.7±8.3 and 85.9±11.5, respectively, and had no significant difference in different severities of COPD(P>0.05). Moreover, although MCV in survivals with a mean of 88.81±6.47 was higher than that of non-survivals with a mean of 85.77±11.73, and MPV in the non-survivals with a mean of 8.53±9.74 was higher than that of survivals with the mean of 8.86±0.92, this difference was not statistically significant (P>0.05).</p><p><strong>Conclusion: </strong>Overall, the results of this study showed that the mean MPV and MCV did not have any significant relationship with AECOPD and patient outcome.</p>","PeriodicalId":22247,"journal":{"name":"Tanaffos","volume":"22 1","pages":"136-142"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10618581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71427084","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}
Biljana Lazovic, Radmila Dmitrovic, Isidora Simonovic, Antonio M Esquinas
{"title":"Cytokine Release Syndrome (CRS) in Severe COVID-19 Patients: Two Controversial and Interesting Case Reports and Literature Review.","authors":"Biljana Lazovic, Radmila Dmitrovic, Isidora Simonovic, Antonio M Esquinas","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Cytokine release syndrome (CRS) represents a potentially life-threatening and systematic inflammatory response where it is noted an increase of secretion of proinflammatory cytokines from lymphocytes, myeloid cells like macrophages, dendritic cells, and monocytes. This syndrome is characteristic of some conditions such as viral infections, administration of antibody-based therapy, auto immune disease, and immunotherapy, especially in severe COVID-19 patients.</p><p><strong>Case reports: </strong>We presented two cases of COVID-19 patients in which the clinical picture significantly deteriorated during hospitalization, where the value of CRP, ferritin, LDH, and IL-6 dramatically increased, especially values of IL-6 were recorded over 2000. We treated them with third-generation cephalosporins, carbapenems, glycopeptides, metronidazole, anti-IL-6 inhibitor, low molecular weight heparin (LMWH), glucocorticoids, immunoglobulins (IVIG), and vitamins. Both patients were successfully treated and were discharged from the hospital with a recommendation for oral anticoagulant therapy.</p><p><strong>Conclusion: </strong>CRS is a complex syndrome. In the future, it is necessary to educate doctors about this syndrome, as well as to develop drugs whose goal would be to reduce the inflammatory response in already developed diseases.</p>","PeriodicalId":22247,"journal":{"name":"Tanaffos","volume":"22 1","pages":"167-171"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10618577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71427074","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}
Ghamartaj Khanbabaee, Ali Ahani Azari, Negarin Seyyedirad, Lobat Shahkar
{"title":"Combination of Serologic Tests and Sputum Culture Results as the Best Diagnostic Method of <i>Pseudomonas aeruginosa</i> Infection in Cystic Fibrosis Patients.","authors":"Ghamartaj Khanbabaee, Ali Ahani Azari, Negarin Seyyedirad, Lobat Shahkar","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>One of the most common reasons for mortality in patients with cystic fibrosis (CF) is lung infections, among which <i>Pseudomonas aeruginosa</i> (<i>Pa</i>) infection has the largest share. Diagnosis of <i>Pa</i> can be assessed by various methods such as sputum culture results and IgG antibody level via measuring the specific anti-<i>Pa</i> antibodies. This study aimed to select the best predictive technique in the diagnosis of <i>Pa</i> in CF patients through spirometry, sputum culture, and serum IgG antibody levels.</p><p><strong>Materials and methods: </strong>In this cross-sectional study, blood and sputum or pharyngeal samples were taken from 68 patients with cystic fibrosis. Because spirometry was not possible in all patients, 34 patients could do the spirometry. The samples were studied concerning <i>Pa</i> infection. The data including variables such as age, sex, and spirometry results were obtained. Then, in the serologic method, 3 serum-specific antibody levels were determined by enzyme-linked immune sorbent assay (ELISA).</p><p><strong>Results: </strong>The average age of children was 7.4 ± 5.6 (ranging from 0.5 to 23) years. Generally, the percentage of <i>Pa</i> infection increased in CF patients with higher ages. A statistically direct significant relationship was observed between the concentration of serum IgG antibodies in patients with CF and <i>Pa</i>-positive sputum culture results (p<0.05).</p><p><strong>Conclusion: </strong>Serum IgG antibodies against specific <i>Pa</i> antigens could be a diagnostic method against <i>Pa</i> infection, especially in patients who cannot expectorate. However, because of the positive and negative predictive value of both serum IgG antibody levels and the results of the sputum culture, we suggested that utilizing the combination of these methods could be beneficial in earlier diagnosis of <i>Pa</i>.</p>","PeriodicalId":22247,"journal":{"name":"Tanaffos","volume":"22 1","pages":"152-159"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10618574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71427062","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":"Plant-Derived Antioxidants for Management of COVID-19: A Comprehensive Review of Molecular Mechanisms.","authors":"Tahmineh Mokhtari, Maryam Azizi, Fatemeh Sheikhbahaei, Hooman Sharifi, Makan Sadr","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We aimed to review the literature to introduce some effective plant-derived antioxidants to prevent and treat COVID-19. Natural products from plants are excellent sources to be used for such discoveries. Among different plant-derived bioactive substances, components including luteolin, quercetin, glycyrrhizin, andrographolide, patchouli alcohol, baicalin, and baicalein were investigated for several viral infections as well as SARS-COV-2. The mechanisms of effects detected for these agents were related to their antiviral activity through inhibition of viral entry and/or suppuration of virus function. Also, the majority of components exert anti-inflammatory effects and reduce the cytokine storm induced by virus infection. The data from different studies confirmed that these agents may play a critical role against SARS-COVID-2 via direct (antiviral activity) and indirect (antioxidant and anti-inflammatory) mechanisms, suggesting that natural products are a potential option for management of patients with COVID-19 due to the lower side effects and high efficiency.</p>","PeriodicalId":22247,"journal":{"name":"Tanaffos","volume":"22 1","pages":"27-39"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10618592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71427082","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":"Effect of Pneumococcal Conjugate 13 Valent and Polysaccharide 23 Valent Vaccination on Anti-Pneumococcal Antibody Titer of Hemodialysis Patients: A Randomized Clinical Trial.","authors":"Shima Shahi, Sasan Tavana, Amirhesam Alirezaei, Leila Sayadi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Pneumococcal infections are a life- threatening disease in hemodialysis patients and vaccination against pneumococcus is an effective prevention. The current study aims to evaluate the immune response and maintenance of the anti-pneumococcal antibody titer in hemodialysis patients to the 23 valent pneumococcal polysaccharide vaccine alone and 13 valent conjugated with 23 valent polysaccharide vaccine.</p><p><strong>Materials and methods: </strong>This study is a randomized clinical trial that was performed at Loghman Hakim Hospital in Tehran, Iran in 2017. A total of 70 patients undergoing hemodialysis were randomly assigned to intervention (22 patients) and control (23 patients). In the control group, only one dose of the PPSV23 vaccine while patients in the intervention group were injected initially with PCV13, and then after at least 8 weeks PPSV23 vaccine. The outcome of this study is first and sixth-month antibody titer after injection of the PPSV23 vaccine.</p><p><strong>Results: </strong>The obtained result showed no significant difference between the two groups in the first month and sixth months. The results indicate that both the intervention group (treated with PCV13+PPSV23) and the control group (treated with PPSV23 only) experienced a significant impact from the first to the sixth month. Additionally, there was a noticeable effect on the levels of anti pneumococcal antibodies during the first to sixth month between the intervention and control groups. In addition, the difference between the antibody titer of the first month and the sixth month was not significant in the two groups.</p><p><strong>Conclusion: </strong>The anti-pneumococcal antibody titer in hemodialysis patients does not show a clear difference after two vaccine injections and one vaccination.</p>","PeriodicalId":22247,"journal":{"name":"Tanaffos","volume":"22 1","pages":"143-151"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10618593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71432176","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":"A Comprehensive Study on the Correlation of Treatment, Diagnosis and Epidemiology of Tuberculosis and Lung Cancer.","authors":"Mojgan Sheikhpour, Seyedeh Nasim Mirbahari, Makan Sadr, Mobina Maleki, Mohadeseh Arabi, Hanie Abolfathi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The correlation between tuberculosis (TB) and lung cancer (LC) in diagnosis, epidemiology, and treatment is still unclear. Based on different cohort and retrospective studies, this correlation could be justified by immune weakness because of exposure to TB which may increase the risk of LC. In this study, we tried to exhibit a prominent connection between TB and LC. The diagnosis and treatment of patients with concomitant TB and LC differ from patients with only one of the diseases. In this review, it was well clarified that the most practical diagnostic method for LC is chest tomography, biopsy, and histopathology, and for pulmonary TB sputum microscopic examination, Autofluorescence bronchoscopy (AFB), culture, and PCR. Also, immunological methods can be a good alternative for differential diagnosis. Most epidemiological studies were about concomitant TB and LC in TB-endemic areas, especially in the Middle East. The most suggested methods for definite treatment of LC are chemotherapy, radiotherapy, and surgery while for TB, a long course of anti-TB therapy can be used. Moreover, immunotherapy is considered a good treatment for lung cancer if the interferon-gamma release assay (IGRA) is negative.</p>","PeriodicalId":22247,"journal":{"name":"Tanaffos","volume":"22 1","pages":"7-18"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10618578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71427059","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}