NAFAS JOURNAL
Year:2015 | Volume:2 | Issue:1|Papers Count:6

IL-17 family is a subset of cytokines that participates in both acute and chronic inflammatory response. IL-17 is an important link between dependent adaptive immune T-cell and innate immune system, especially an inflammatory component in innate immune response. The ability of IL-17 in neutrophils chemotaxis is responsible for the central role of Th17 in adaptive immune reactions, which in them neutrophil inflammation is a prominent feature. A large accumulation of neutrophils in airways is the salient features of some pathological conditions such as bronchial asthma and chronic obstructive pulmonary diseases (COPD). IL-17A and IL-17F have many common functions, which are necessary for recruitment and activation of neutrophils, in chemokine induction. Solely, IL-17A is a weak activator of NFkB, however, it is a powerful cytokine in collaboration with other cytokines such as TNF-a, so it can lead to the initiation and development of the pro-inflammatory responses.

Inhalers are one of the most important medicines in respiratory illness. According to the studies, most of the patients could not handle them correctly; hence, the current study designed to determine what factors are effective on correct handle of inhalers.During April to September 2011, all of the male COPD patients who were admitted to the internal medicine ward of an academic hospital have been selected sequentially. The inclusion criteria were age over 18 and independent use of spray. Inhaler handling was observed and assessed by the pre-defined checklist. Using SPSS Ver.13, the data were analyzed by the descriptive, and analytical statistical methods like ANOVA, Pearson’s correlation coefficient and multiple linear regression.The analysis showed that only 13% (n=15) of all of 116 participants used their inhalers completely correct. The studied factors of age (p<.05, r=.47), education (p<.05, r=.53) and history of inhaler usage (p<.05, r=.52) were only able to explain 8, 12 and 16 percent of correct handling of inhaler variances, respectively.It seems that correct training of the patients who use inhalers, is vital in every medical and/or health system. Based on the findings, it would be wise to teach and train the inhaler users, according to their backgrounds like age, education and history of the inhaler usage.

There is an association between opioid addiction and dysfunction of various body organs, especially lungs. This study was aimed to determine the effect of sub-maximal aerobic training on pulmonary function tests in addicts.As a quasi–experimental with pre- and post-test designed study, 20 addicted male (20-33 years old) participated in. The participants were divided into exercise-drug supplement (n=10) and drug supplement (n=10) groups. In first group, the subjects consumed 10 milligrams Methadone daily and performed exercise training with 70-75 percent of VO2max as a sub-maximal intensity for twenty sessions. In second group, the participants only consumed 10 milligrams Methadone daily. By the end of study interventions, the pulmonary function indices in subjects were assessed. Finally, data analysis was performed by Stata software.The statistical analysis showed that the pulmonary function tests such as FEV1/FVC, FEV1, PEF, FEF25, FEF25-75, FEF50 and FEF75 were significantly increased in exercise-drug supplement group (p<0.05). In addition, the rate of FEV1/FVC were significantly increased in drug supplement group (p<0.05). Moreover, serum levels of CC16 were significantly decreased in exercise-drug supplement group (P=0.029, t9=2.591).The study results showed that in comparison to only drug supplement, the drug plus exercise supplement is more appropriate for the improvement of pulmonary function in addict subjects. However, further researches are need to confirm the results.

Both of chronic obstructive pulmonary disease (COPD) and consumption of opium/opiates have harmful effects on breathing. During the day, it may decrease oxygen level and increase carbon dioxide level in blood while may cause sleep disordered breathing in nights. Sleep disordered breathing includes obstructive sleep apnea, central apnea, hypopnea, ataxic breathing, hypoventilation and hypoxia. The previous studies have emphasized on considerable respiratory disorders of COPD patients and opioid abusers, separately. However, according to our knowledge, there is no or rare studies on the simultaneous effects of these two conditions on sleep breathing disorders.The current study tried to compare sleep breathing patterns in 31 COPD patients with (14 persons) and without (17 persons) opioid use. Data gathering and polysomnography of the participants were carried out to determine any disturbances in sleep respiratory patterns and consequently the findings were compared between the groups statistically.The results showed that obstructive sleep apnea (AHI>15/h) was 71% among the opioid users, significantly different from non-opioid users (76%).Central sleep apnea (CSA) was significantly higher in opioid users, while the mean was lower than 5 per hour. The other parameters had no significant difference.Long term usage of opioids may affect sleep breath patterns and cause higher CSA. It doesn’t make any significant alteration in blood oxygen and carbon dioxide levels in day time.

It has already been recognized that stress evokes asthma exacerbation; however, the mechanism of short-term stress effect on pulmonary function is not clear. On the other hand, there is dysfunction in asthmatic autonomous nerve system. This study aimed to observe the impact of short-term stress on airway constriction and autonomous nerve system dysfunction in patients with controlled atopic asthma. We recorded respiration and heart rate during resting conditions and a short-term stressor (Stroop test) in women with controlled atopic asthma and healthy controls. Pulmonary function parameters were measured using spirometer before and after stress. The exposure to stress significantly decreased FVC, FEV1 and PEF in asthmatic patients, whereas FEV1/FVC level remained unchanged. In contrast to patients with asthma, healthy participants showed significant increases in respiratory rate, heart rate variability, and SD1/SD2 (An index of autonomic balance) during stress. The pulmonary function had been inversely correlated with heart rate variability, and autonomic impairment. We conclude that autonomic impairment might be the potential mechanisms of exacerbation in asthmatic people after short-term stress.

Massive hemoptysis is defined as hemoptysis exceeding 100 ml over a 24 hour period. It is often a sign of an important underlying disease that may be life-threatening due to asphyxiation.The present retrospective study consisted of 126 consecutive patients who had been referred to Dr. Masih Daneshvari Hospital because of massive hemoptysis from lower airways during 6 years.Mean volume of hemoptysis was 228.7±132 ml. Etiology of hemoptysis were tuberculosis (n=31, 25%), bronchiectasis and chronic bronchitis (n=40, 31.7%), hydatid cyst (n=8, 6.3%), lung cancer (n=8, 63%), pulmonary hypertension (n=8, 63%), anthracosis (n=7, 5.5%), pneumonia (n=5, 3.9%), unknown (n=19, 15%). Bleeding is ceased in 86 (68%) patients with cold saline and adrenaline (1/10000) during rigid and fiberoptic bronchoscopy. Embolization had been done in 2 cases in addition to other procedures. Operation was also conducted in 27 patients and mortality was occurred in 13 (10%) patients (7 cases during surgery, 1 case in emergency unit, and 5 cases in ward).Based on the evidences from this study, bronchiectasis, chronic bronchitis and tuberculosis were the most prevalent cause of massive bleeding in this center. This volume of bleeding (228 ml) can be often controlled by cold saline washing during bronchoscopy. However, this volume of hemoptysis can lead to high mortality rates (10%) and complication during surgery.