Itraconazole Improved Bronchial Wall Thickness in Severe Persistent Asthma: A Double-blind Placebo-controlled Randomized Clinical Trial.

The purpose of this study was to evaluate the effect of 8 months of treatment with itraconazole on airway wall thickness in patients with severe persistent asthma. It was a double-blind, randomized, placebo-controlled clinical trial (IRCT20091111002695N9). Seventy-five subjects with severe persistent asthma received itraconazole (100 mg), prednisolone (5 mg), or placebo twice a day for eight months in three treatment groups (n=25 in each group). The primary objective was to improve the right upper lobe apical segmental bronchus (RB1) wall thickness percentage measured by high-resolution computed tomography scan of the lungs. Other morphometric measurements of RB1, asthma control test (ACT) score, presence of wheezing, dyspnea severity, rate of asthma exacerbation, fractional exhaled nitric oxide (FeNO), and expiratory volume in 1 second (FEV1) were set as the secondary outcomes. Wall thickness percentage reduced significantly from 46% to 43.7% from pre- to post-treatment in the itraconazole-treated subjects. Similarly, lumen area and radius increased significantly in both the prednisolone and itraconazole groups. Itraconazole led to a significant improvement in wheezing, dyspnea severity, FEV1, ACT score, and FeNO. Although prednisolone was also effective in improving pulmonary function tests and ACT scores, it was associated with significantly more side effects than itraconazole. Long-term treatment with itraconazole resulted in a significant reduction in bronchial wall thickness and improvements in clinical findings and pulmonary function tests. Thus, itraconazole could be a helpful add-on treatment option for severe persistent asthma patients to achieve better disease control.

Evaluation of Serum Selenium and Copper Levels with Inflammatory Cytokines and Indices of Oxidative Stress in Type 2 Diabetes.

Type 2 diabetes mellitus (T2DM) is a metabolic and multifactorial disease in which inflammatory markers, oxidative stress, and certain trace elements seem to have an essential role. This study investigated the relationship between serum selenium and copper level with inflammatory cytokines and oxidative stress in T2DM.In this case-control study, 30 patients with T2DM and 30 healthy individuals were selected. Serum levels of copper and selenium were measured by atomic absorption spectrometry, and TNF-α and IL-6 and oxidative stress markers were measured by ELISA. The SPSS v.22 was used for data analysis and the significance level is less than 5%.The mean age of patients was 52.9 ± 10.4 years, and the control group was 48.5 ± 10.4 years. In this study, 53.3% were female, and 46.7% were male. The levels of BMI (p = 0.002), systolic pressure (p = 0.034), insulin, selenium, malondialdehyde, and glutathione peroxidase (p = 0.0001; each), insulin resistance, copper, and superoxide dismutase, IL6, and TNF-α (p = 0.001; each) in T2DM were significantly higher than the control group. While levels of lipid profile, uric acid, creatinine, and diastolic pressure were not significantly different between the two groups. Selenium and copper are related to insulin resistance, and their increasing levels are associated with increased levels of markers of oxidative stress and inflammatory cytokines (p < 0.05).Increased levels of copper and selenium are associated with T2DM and this increase is also associated with increased levels of TNF-α, IL-6, and oxidative stress in T2DM. Therefore, controlling these markers can lead us to control this disease better.

Investigation of serum level relationship anti-glutamic acid decarboxylase antibody and inflammatory cytokines (IL1-ß, IL-6) with vitamins D in type 2 diabetes.

Background: Various factors are involved in the development and progression of diabetes mellitus, from cytokines and autoimmune destruction of pancreatic beta cells to vitamin D.This study aimed to investigate the association of serum levels of anti-glutamic acid decarboxylase (anti-GAD) and inflammatory cytokines with vitamin D in type 2 diabetes (T2D). Methods: This case-control study was performed on 30 patients with T2D and 30 healthy individuals in Mashhad hospitals in 2020. Lipid profile, creatinine, uric acid, FBS, HbA1c, and blood pressure were recorded. All study variables were measured, particularly serum vitamin D, anti-GAD, and inflammatory cytokine levels in diabetic patients, and the data were compared to those from healthy subjects by performing an appropriate statistical analysis. Results: Diabetic patients with a mean age of 52.9 ± 10.4 years, including 16 women and healthy individuals with a mean age of 48.5 ± 10.4 years, including 16 women, were studied. BMI level (P = 0.002), systolic blood pressure (P = 0.034), HbA1c, insulin, IL-6, IL1-ß, anti-GAD levels, and insulin resistance in diabetic patients were significantly higher than the control group (P = 0.001). The vitamin D level in the control group was significantly higher than in the case group (P = 0.0001). The results showed a significant direct relationship between IL-6, IL-1ß, and anti-GAD with HbA1c, FBS, insulin, and insulin resistance. However, there was a significant inverse relationship between IL-6, IL-1ß, and anti-GAD with vitamin D. Conclusions: Inflammatory cytokines and anti-GAD and vitamin D are associated with diabetes, and thus controlling these factors can help improve T2D.

Quality of Life and General Health in Pregnant Women Conceived with Assisted Reproductive Technology: A Case-Control Study.

BACKGROUND: Infertility affects different aspects of life including the quality of life (QOL) in infertile couples. Many infertile couples conceive via using assisted reproductive technology (ART). However, the effect of pregnancy and childbearing on QOL is not known in these couples. This study aimed to evaluate QOL and general health during pregnancy and after successful treatment of infertility, in women conceived with ART. MATERIALS AND METHODS: In this case-control study, QOL and general heath were evaluated in 40 women conceived with ART and 40 women who conceived spontaneously and served as the control group. WHO quality of life- BREF (WHOQOL-BREF) inventory was used to evaluate QOL and General Health Questionnaire-28 (GHQ-28) was applied to evaluate general health. These two questionnaires were completed in the first and second trimester of pregnancy and results were compared between the two groups. RESULTS: Mean age of women was 29.4 ± 4.4 and 29.6 ± 5 years in ART and control group, respectively. QOL in women conceived with ART was similar to QOL in the control group in the first and second trimester of pregnancy while general health score (distress level) in women conceived with ART was significantly higher than that of the control group in both trimesters. Although distress level decreased in the second trimester in ART group, but yet, it was higher than that recorded for the control group. CONCLUSION: After pregnancy, QOL in women conceived with ART is similar to women conceived spontaneously. However, these women experience higher distress level in the first and second trimester of pregnancy compared to women conceived spontaneously.

Association of meteorological factors and seasonality with preeclampsia: a 5-year study in northeast of Iran.

BACKGROUND: Preeclampsia is one of the common causes of maternal and fetal mortality, and an important problem of pregnancy. This disorder can cause intracranial hemorrhage, intravascular coagulation, pulmonary edema, liver and renal failures and placental abruption. OBJECTIVE: To evaluate the effects of seasonal and monthly changes of weather, humidity and temperature on the incidence rate of preeclampsia according to the conception and delivery times. MATERIALS AND METHODS: Retrospective analysis of hospital records of 20,520 consecutive singleton live birth pregnancies of 20-42 weeks of gestation during 2002-2008 was performed. After including preeclamptic cases, on the basis of American College of obstetricians and gynecologists (ACOG) criteria, gestational age and time of conception was estimated and the mean relative temperature and humidity of each month was derived from monthly climatological data collection of IRAN METEOROLOGICAL ORGANIZATION (IRIMO) between 22 June 2002 and 19 March 2008 (68 months). Statistics of each month's births were registered separately. RESULTS: Mean maternal age of 262 qualified singleton pregnant women with preeclampsia out of 20,520 deliveries were 26.48 years old and 85.9% of deliveries were done by cesarean section method. Based on time of conception, the highest prevalence was detected in summer, especially in September (11.06875%) and August (10.3053%) and the lowest prevalence was found in winter and early spring, especially in January (5.7552%) and April (5.7252%). CONCLUSION: Seasonal (monthly) variations of the weather (humidity and temperature) have a significant impression on preeclampsia prevalence.

Frequency of tuberculosis in anthracosis of the lung: a systematic review.

INTRODUCTION: Anthracosis of the lung is the blackening of bronchial tissues which can lead to chronic bronchial obstruction. Many studies have shown association of bronchial anthracosis and tuberculosis. The aim of this study was accumulation of scattered studies and getting the definite conclusion about the association between anthracosis and tuberculosis. MATHERIALS AND METHODS: We conducted a systematic search that included studies with sufficient information about the frequency of tuberculosis in anthracosis (anthracofibrosis) patients and non-anthracotic control group. Moreover, tuberculosis should be confirmed by microbiologic (smear or culture) or histopathological methods. RESULTS: Twelve studies (eight studies on anthracofibrosis and four studies on anthracosis as a general term) comprising of 6280 patients was entered into our meta-analysis. The frequency of tuberculosis in all anthracosis patients was 22.5 % (32.3 % for anthracofibrosis and 16.6 % for anthracosis), which was significantly higher than the control group. Determination of risk showed that the cumulated odds ratio of tuberculosis in all studies of anthracosis was 3.16 (95 % CI = 2.49 - 6.85), which revealed significantly higher risk than the control group. The analysis of the subgroups showed that the cumulated odds ratio of tuberculosis in subgroups of anthracofibrosis (3.28; 95 % CI = 2.16 - 9.12) was significantly higher than anthracosis as a general term (2.85; 95 % CI = 1.73 - 6.61). DISCUSSION: The association of tuberculosis with all types of anthracosis of the lung was confirmed and a proper mechanism should be defined.

A randomized trial of ovulation induction with two different doses of Letrozole in women with PCOS.

OBJECTIVE: To compare the effects of either a 5 or 7.5 mg daily dose of Letrozole in PCOS women undergoing ovulation induction and timed intercourse. DESIGN: Prospective randomized trial. SETTING: Academic infertility care center. PATIENTS: Sixty-seven PCOS patients with infertility. INTERVENTIONS: Patients were randomly divided into two groups and treated with either 5 mg/day (30 patients, group 1) or 7.5 mg/day (37 patients, group 2) Letrozole for 5 days starting from day 3 of the menstrual cycle. When the leading follicle reached 18 mm in diameter, ovulation was triggered by an injection of HCG and timed intercourse was advised thereafter. MAIN OUTCOME MEASURES: The primary outcome measures were the number of follicles and days to reach mature follicle and the secondary endpoints were endometrial thickness, day 7 testosterone level, ovulation and pregnancy rates. RESULTS: The mean age, BMI, duration of infertility and basal hormone levels in both groups were similar. There was no significant difference in the endometrial thickness (7.87 ± 1.67 vs 7.16 ± 2.04), the number of intermediate (0.83 ± 0.75 vs 0.62 ± 0.76) and mature follicles (1.13 ± 1.11 vs 1.22 ± 1.03) on days 12-14 between group 1 and 2, respectively. The days to reach mature follicle were similar in both groups (12.8 ± 1.36 vs 12.6 ± 1.22). Also there was no significant difference in the day 7 testosterone level and day 21 progesterone level between the two. Ovulation occurred in 90 and 89.2% of patients in group 1 and 2, respectively without a statistically significant difference. The pregnancy rate per first ovulatory cycle was 25.8% in group 1 and 21.2% in group 2 without significant difference. No OHSS was observed in either group. CONCLUSION(S): The results of this study did not show any advantage to the use of 7.5 mg/day over 5 mg/day dose of Letrozole as the first line treatment for induction of ovulation in women with PCOS.