Mutual Effects of Coincident Chronic Renal Failure and Chronic Obstructive Pulmonary Disease.

Background: The current study tried to assess the effects of CKD on the severity and outcome of COPD in a population of patients who referred to our tertiary center in Tehran through a 3-year time section. Materials and Methods: Through a retrospective cross-sectional design, the current study tried to assess the effects of chronic kidney disease (CKD) on the health situation and some spirometric and para-clinical parameters as well as their outcomes in patients who had been hospitalized for COPD. The participants had already COPD and we separate them into two groups with or without CKD. Results: Regarding the outcome of hospitalizations, 94% of the COPD and 77.9% of the COPD+CKD group were discharged in good health condition while 6% and 22.1% deceased, respectively. This shows significantly higher death rate in the latter group and the findings obtained the odds ratio of 4.5 for CKD to raise this rate. Conclusion: The current study could suggest an absolute relationship between CKD and COPD in terms of respiratory and blood parameters as well as the mutual effects of the diseases on the outcome of each.

Cardiopulmonary Exercise Test Parameters among Dialysis Patients with End-Stage Renal Disease.

Background: The current study aimed to assess some parameters of the cardiopulmonary exercise test (CPET) among end-stage renal disease patients who underwent dialysis. The ultimate goal is to improve disease management to achieve optimal quality of life and exercise capacity in this group of patients. Materials and Methods: Through a cross-sectional design, the current study enrolled 46 dialysis patients by simple sampling between Jan 2019 and Jan 2020. Some CPET parameters such as AT, VO2, VO2/kg, SPO2, minute ventilation CO2 production/O2 consumption ratios (VE/VCO2 and VE/VO2, respectively), O2 pulse, heart rate reserve (HRR), breathing reserve (BR) and end-tidal carbon dioxide pressure (PETCO2) were focused. Results: Although a limited sample size, the current study showed that VO2/Kg, VE/VCO2, PETCO2, and SPO2 are the main parameters affected by dialysis as expected. Conclusion: The current study suggests using cardiopulmonary rehabilitation for all chronic medical conditions such as chronic kidney disease and end-stage renal disease that increase the rate of metabolic acidosis.

Inflammatory Serum Biomarker Pattern in Emphysema and Chronic Bronchitis Phenotypes of Acute Exacerbation of Chronic Obstructive Pulmonary Disease.

Background: COPD exacerbation is characterized by both airway and systemic inflammation. The present study aimed to investigate the relationship between serum levels of some inflammatory biomarkers and the phenotypes of COPD exacerbation. Materials and Methods: This study includes known COPD patients, presenting to a hospital with acute exacerbation of COPD. Serum levels of CRP, ESR, CBC, TNF-α, IL-8, and IL-6 were measured at the time of admission. According to the previously done HRCT, the patients were divided into two groups including emphysema and chronic bronchitis. Levels of serum biomarkers were compared in the two groups. The relationships between biomarkers and duration of hospitalization were assessed too. Results: Comparison of quantitative CRP levels, WBC, and platelet counts did not show a statistically significant difference between emphysema and chronic bronchitis but it was significantly higher than control subjects. Although not statistically significant, ESR level was higher in emphysema. TNF-alpha was 6.0±1.5 ng / ml and 1.5 ng / ml in the emphysema and chronic bronchitis groups, respectively. TNF-α had no significant difference compared to the groups. Although higher than the control group, IL-6 and IL-8 did not show significant differences between emphysema and chronic bronchitis. The two groups did not statistically differ in terms of hospital stay but patients with higher serum TNF-α tended to have longer hospitalization and ICU admission. Conclusion: The present study showed predictably higher inflammatory biomarkers in COPD exacerbation but no significant difference between the two phenotypes of COPD and these two entities could not be discriminated based on inflammatory bio-factors.

Photobiomodulation Improves Serum Cytokine Response in Mild to Moderate COVID-19: The First Randomized, Double-Blind, Placebo Controlled, Pilot Study.

Background: Because the major event in COVID-19 is the release of pre- and inflammatory cytokines, finding a reliable therapeutic strategy to inhibit this release, help patients manage organ damage and avoid ICU admission or severe disease progression is of paramount importance. Photobiomodulation (PBM), based on numerous studies, may help in this regard, and the present study sought to evaluate the effects of said technology on cytokine reduction. Methods: This study was conducted in the 2nd half of 2021. The current study included 52 mild-to-moderately ill COVID-19, hospitalized patients. They were divided in two groups: a Placebo group and a PBM group, treated with PBM (620-635 nm light via 8 LEDs that provide an energy density of 45.40 J/cm2 and a power density of 0.12 W/cm2), twice daily for three days, along with classical approved treatment. 28 patients were in Placebo group and 24 in PBM group. In both groups, blood samples were taken four times in three days and serum IL-6, IL-8, IL-10, and TNF-α levels were determined. Results: During the study period, in PBM group, there was a significant decrease in serum levels of IL-6 (-82.5% +/- 4, P<0.001), IL-8 (-54.4% ± 8, P<0.001), and TNF-α (-82.4% ± 8, P<0.001), although we did not detect a significant change in IL-10 during the study. The IL-6/IL-10 Ratio also improved in PBM group. The Placebo group showed no decrease or even an increase in these parameters. There were no reported complications or sequelae due to PBM therapy throughout the study. Conclusion: The major cytokines in COVID-19 pathophysiology, including IL-6, IL-8, and TNF-α, responded positively to PBM therapy and opened a new window for inhibiting and managing a cytokine storm within only 3-10 days.

Depression while on the lung transplantation waiting list.

BACKGROUND: Patients inflicted with severe illnesses are prone to depression, which tends to intensify the burden of the disease. Those awaiting organ transplantation cannot help but feel that they may not be fortunate enough to breathe through a new lung. Such sense of doom along with constraints imposed by the illness increases the likelihood of depression. We sought to investigate the presence of depression in a group of patients on the lung transplantation waiting list in Iran.
MATERIAL/METHODS: This cross-sectional study, conducted between August and September 2007, recruited 64 candidates from a single lung transplantation clinic. The Beck Depression Inventory was employed to identify the presence and severity of depression. This 21-item questionnaire has a total score ranging from 0 to 63, with higher scores denoting more severe depressive symptoms. In an Iranian population, scores from 0 to 15 signify no problem, while scores from 16 to 30 indicate mild, 31 to 46 moderate, and 47 to 63 severe depression.
RESULTS: The patient population was composed of 70.3% men and 29.7% women at a mean age of 36.6+/-13.6 years. 40.6% were single and 59.4% were married. Whereas 43.8% had no abnormal depressive symptoms, 37.5% had mild and 18.7% had moderate symptoms.
CONCLUSIONS: More than half of the patients on the lung transplantation waiting list had a degree of depression. Given the risk of non-compliance with treatment in depressives, it is advisable that lung transplantation candidates be screened for depression and diagnosed cases be referred for the treatment of depression.

Health status of the patients before lung transplantation: a report from Iran.

BACKGROUND: Breathing is essential for living. When someone is a lung transplantation candidate, it could be imagined that the breathing difficulties that he/she is experiencing has a great impact on his/her health status. MATERIAL/METHODS: We asked all the patients on the lung transplantation waiting list at Masih Daneshvari Hospital to complete the validated Iranian version of Global Health Questionnaire (GHQ). It was the 28-item version of the questionnaire with scores ranging from 0 to 84. Patients filled the questionnaire while on routine out-patients visits. The higher scores represent greater distress. RESULTS: Seventy patients were requested to participate in the present study out of which 64 filled the questionnaire completely. Mean +/-SD (min-max) scores of the questionnaire subscales were as follows: somatic symptoms =8.2+/-4.2; anxiety =8.1+/-4.9; 8-14, depression =4+/-4.2; social dysfunction =10.4+/-4 and the overall score =30.6+/-9.5. There was no significant difference in the subscales of the questionnaire based on gender and disease type. Higher age was associated with less social dysfunction (r=-273, p=0.023). Higher level of prednisolone consumption and lower hemoglobin were associated with poorer somatic status (r=0.644, p=0.033; r=-0.410, 0.030 respectively). CONCLUSIONS: Our findings indicate that lung transplantation candidates have extremely poor health state. It seems that pulmonary problems and activity limitations put more pressure on younger patients and causes social difficulties.