Background: Cystic fibrosis (CF) is a multisystem disease presenting different manifestations, including the involvement of the respiratory and gastrointestinal tract. Patients may be at risk for micronutrient depletion, particularly during illness and infection. However, the relationship between micronutrient depletion and pulmonary involvement is not established well. Objectives: This study aimed to determine the relationship between serum levels of calcium, phosphorus, magnesium, zinc, copper, selenium, and vitamin D with the severity of pulmonary involvement in patients with CF. Methods: This cross-sectional study was performed on 84 patients with CF referred to Mofid Children’s Hospital, Tehran, Iran, in 2017. The collected data included demographic and anthropometric information. Laboratory evaluations included magnesium, copper, zinc, selenium, complete blood cell count (CBC), and vitamin D levels. The severity of pulmonary involvement was determined based on the Brasfield scoring system (BSS). Pearson correlation coefficient, t test, χ2 test, or Fisher exact test was used for analyses. Results: The mean age of the children was 6.8 ± 3.5 years, and 36 patients (43%) were female. Based on the z score, 53 patients (63%) were malnourished. The severity of pulmonary involvement was mild in 25 patients (30%), moderate in 39 patients (46%), and severe in 20 patients (24%). The percentages of deficiency related to vitamin D, zinc, copper, and selenium were 56%, 38%, 32.1%, and 21.4%, respectively. Among trace elements, there was a statistically significant relationship between the severity of pulmonary involvement according to BSS and serum copper (P = 0.007 and r = -0.229) and selenium deficiency (P < 0.001 and r = -0.418). There was a significant relationship between malnutrition and vitamin D deficiency in patients (P = 0.034, r = 0.231). Conclusions: Serum copper concentration might affect respiratory function in CF patients. Selenium supplements should be added to patients’ diets. However, further interventional studies are required to investigate the possible causal relationships.
Background: COVID-19, a novel pneumonia associated with the 2019 coronavirus infected pneumonia suddenly broke out in the world. The aim of this study is to analyze and summarize the clinical characteristics of pediatric patients with COVID‐19. Patients and method: Twenty-one patients confirmed by clinical and laboratory findings from 20 February to 19 April, 2020 in North of Iran were included. Demography information, clinical, laboratory and radiological findings, and treatment strategies of patients were evaluated. All statistical analyses were performed using SPSS version 13.0 software. Results: Body temperature was ≥38ºC in 11(52.4%) patients. Eleven (52/3%) patients had tachypnea and 4(19%) of them developed tachycardia. Six (30%) of patients suffered from a decrease in white blood cells. Also a decrease in creatine phosphokinase level was seen in 1(33%) of patients. Nine CT scans (42.85%) demonstrated a halo sign. Seven patients’ (33.33%) CT scans showed a patchy infiltration. Nine (42.85%) CT scans had bilateral crazy-paving pattern. 38.1% of patients were treated with chloroquine and oseltamivir. Four (19.04%) patients died and 17(80.95%) patients were discharged from the hospital. One of the patients who died suffered from acute respiratory distress syndrome. Conclusion: We found out that pediatrics, especially boys are more susceptible to COVID‐19 and it is more common in school-age and toddlers. Manifestations are milder than adults and severe cases associated with underlying disease. The effectiveness of medications used in the treatment of this disease need further study.
Introduction. COVID-19 infection which is a novel pneumonia associated with coronavirus suddenly broke out in the world. The aim of this study is to analyze and summarize the clinical characteristics of pediatric patients who were hospitalized in a referral pediatric hospital because of COVID-19 infection. Materials and Methods. Twenty-one COVID-19 infection cases confirmed by clinical and laboratory findings who were hospitalized in our center from 20 February to 19 April 2020 were included. Demography information, clinical, laboratory, and radiological findings, and treatment strategies of patients were evaluated. Results. The mean age was 91.5 ± 68.38 months (1-225), and there were 12 (57.1%) boys and 9 (42.9%) girls. Fever ≥ 38 ° C was detected in 11 (52.4%) patients. Eleven (52.3%) patients had tachypnea, and 4 (19%) of them developed tachycardia. Nine CT scans (42.85%) demonstrated a halo sign, and patchy infiltration was seen in CT scan of 7 patients (33.33%). Furthermore, bilateral crazy-paving pattern was seen in CT scan of nine (42.85%) patients. We prescribed chloroquine in 8 (38.1%), oseltamivir in 8 (38.1%), Kaletra in 6 (28.6%), and Ribavirin in 1 (4.8%) of patients. Finally, four (19.04%) patients expired which one of them suffered from ARDS. Conclusions. We found out that boys might develop more severe cases of COVID-19, and this could be more common in school age. Manifestations might be milder than adults, and the most severe cases might be associated with underlying diseases. Also, the effectiveness of drugs in the treatment of this disease needs further study.
Purpose: Methamphetamine is a powerful, highly addictive stimulant which affects the central nervous system. Here we evaluated the efficacy of modafinil for the treatment of patients with MA dependence.Methods: A randomized parallel controlled trial study was designed to compare the effectiveness of take-home, self-administered modafinil treatment in the intervention and the controlled group in three months. The primary outcome measurements were severity and duration of craving, and self-reported methamphetamine consumption, which was confirmed by urine drug test.Results: The relapse rate in the intervention group was 40%, and the controlled group was 75%, indicating a decrease in relapse rate of MA in the intervention group. During the three months, the severity and the duration of the drug abuse craving in the intervention group were less than thecontrolled group. Patients in the intervention group experienced an increase in the retention rate and a decrease in the slip rate.Conclusion: The use of modafinil is not only effective on craving and relapse reduction, but also changes urine drug screens of patients with MA dependence to negative. The modafinil is safely indicated as an absolutely effective medication to reduce withdrawal symptoms and the craving ofpatients with MA dependence. Keywords: Modafinil, Methamphetamine dependence, Effectiveness, Clinical trial
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