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INTRODUCTION: Cystic fibrosis (CF) patients frequently experience gut microbiota dysbiosis. Probiotic supplementation is a potential therapeutic approach to modify gut microbiota and improve CF management through the gut–lung axis. The aim of this study was to investigate the effect of Lactobacillus reuteri supplementation on pulmonary function test, respiratory symptoms and growth in CF patients. METHODS: A randomized, placebo‐controlled clinical trial was carried out on 40 children with CF aged from 6 to 20 years. Participants were designated to receive either L. reuteri or placebo daily for 4 months. Pulmonary function tests, weight, height and body mass index (BMI) z‐scores were measured pre and post treatment. RESULTS: The median baseline BMI of the patients was 16.28 kg m−2. A significant change in the probiotic group's BMI z‐score after the study period was observed (P = 0.034) but not for weight and height z‐scores (P > 0.05). After treatment, Pseudomonas aeruginosa grew in sputum cultures of seven in the placebo and one patient in the intervention group (P = 0.03) while at baseline it grew in the sputum of four patients in each group. There was no significant difference in forced expiratory volume in the first second, forced expiratory flow at 25–75% or forced vital capacity change between the two groups after the treatment period (P > 0.05). Additionally, no significant differences were found in pulmonary exacerbations, hospitalization frequencies or COVID‐19 infection between the two groups during the study (P > 0.05). CONCLUSION: The results suggest that L. reuteri supplementation may impact the growth of severely malnourished CF patients. Furthermore, it may be concluded that this strain might reduce P. aeruginosa in the sputum culture of CF patients. © 2024 Society of Chemical Industry. [ABSTRACT FROM AUTHOR]

Probiotics positively influence age-related macular degeneration (ARMD) given their propensity to attenuate oxidative and inflammatory stress. We addressed the impact of probiotics on metabolic profiles, clinical indices, inflammatory and oxidative stress parameters in ARMD patients. We performed a randomized, double-blind, placebo-controlled trial analyzing 57 subjects with ARMD aged between 50 and 85 years. Subjects were randomized into two groups, and received daily for 8 weeks either probiotic capsule or placebo. Fasting blood samples were obtained at baseline and after the 8-week intervention for the determination of metabolic profiles and oxidative stress biomarkers. After the 8-week intervention, compared with the placebo, probiotic supplementation significantly increased means HDL-cholesterol (Probiotic group: +3.86±4.42 vs. Placebo group: −0.55±4.93 mg/dL, P =.001), plasma total antioxidant capacity (TAC) (Probiotic group: +77.43±168.30 vs. Placebo group: −23.12±169.22 mmol/L, P =.02) and significantly decreased malondialdehyde (MDA) levels (Probiotic group: −0.18±0.46 vs. Placebo group: +0.18±0.25 µmol/L, P =.001). There was no significant effect of probiotic administration on other metabolic profiles and clinical symptoms. Overall, an eight-week probiotic administration among ARMD patients had beneficial effects on TAC, MDA and HDL-cholesterol levels; however, it did not affect clinical signs and other metabolic profiles. [ABSTRACT FROM AUTHOR]

Background: Chronic obstructive pulmonary disease (COPD) is one of the most common pulmonary diseases. The current therapeutic outcomes are not satisfactory and may cause adverse events such as cardiovascular complications. In this study, we aimed to discuss some effective medicinal herbs for the management of COPD. Materials and Methods: In this review, we looked for effective medicinal herbs for productive cough with thick and sticky mucus in Persian medicine sources such as Qanoon fi al-Teb, Exir Azam, and Zakhire Kharazmshahi. Then, to find relevant evidence about them, the data sources (PubMed and Google Scholar) were searched in the English language without time restriction from inception up to March 2022. Results: We found that Zataria multiflora, Thymus vulgaris L, Glycyrrhiza glabra L., Crocus sativus L., Nepeta bracteata Benth., and Hyssopus officinalis have beneficial effects on COPD due to their properties including anti-inflammatory and antioxidant activity. In addition, considering asthma COPD overlap (ACO), medicinal herbs including Cordia myxa, Adiantum capillus-veneris, Cinnamomum verum, Viola odorata, Borago officinalis, Linum usitatissimum and Vitis viniferia L. were found to have useful effects on asthma. Conclusion: Considering the mentioned beneficial mechanisms of action of these medicinal herbs, they could be used as a complementary therapy in COPD and asthma. However, more experimental and clinical research should be done to confirm their clinical effects. [ABSTRACT FROM AUTHOR]

Background: Pulmonary artery sling is a rare condition in which the left pulmonary artery anomalously originates from a normally positioned right pulmonary artery. The left pulmonary artery arises anterior to the right main bronchus, courses between the trachea and esophagus then enters the left hilum. Respiratory symptoms such as wheezing, stridor, cough, and dysphasia are common in this anomaly. Case presentation: We describe a 16-month-old male infant presenting recurrent cough, stridor, and wheezing from early infancy. He underwent computed tomography angiography, bronchoscopy, and transthoracic echocardiography, confirming the left pulmonary artery sling diagnosis. Surgical correction of pulmonary artery sling was successfully performed as a new anastomosis between the main pulmonary artery and the left pulmonary artery, as well as tracheoplasty. The infant was discharged without any complications. Follow-up after two years revealed no respiratory symptoms and feeding difficulty. Conclusion: In the presence of chronic cough, stridor, recurrent wheezing, and other prolonged respiratory symptoms, investigation for possible detection of pulmonary artery sling is recommended. [ABSTRACT FROM AUTHOR]

LPS-responsive beige-like anchor protein (LRBA) deficiency is a monogenic primary immunodeficiency characterized by a heterogeneous spectrum of clinical manifestations associated with immune dysregulation. In this study, we reported clinical, immunologic, and genetic evaluation of two Iranian patients from unrelated families, both suffering from recurrent respiratory tract infections, failure to thrive, interstitial lung disease, autoimmune cytopenia, and hypogammaglobulinemia. Pulmonary abscess in one patient and persistent enteropathy in another were also observed. Further investigations revealed causative mutations in the exon (c.2166_2766del) and intron (c.4730–3 T > G) of the LRBA gene. These results may provide further elucidation of the clinical phenotypes and responsible genetic factors of LRBA deficiency. [ABSTRACT FROM AUTHOR]

Asthma is the most common chronic illness in children and is a major reason for pediatric emergency department visits. Beta-2 agonists are considered the most effective drugs for immediate relief in the symptoms. This study aimed to compare the effectiveness of salbutamol delivered via jet nebulizer with a metered-dose inhaler (MDI) plus a spacer for asthma exacerbation in the pediatric emergency departments. The study was a randomized control, parallel-group design in children with age ranging from 6 months to 14 years, presenting in the emergency department with an acute asthma attack. A total of 116 patients were recruited for the study. Sixty-two patients were enrolled in the MDI/spacer group, and 54 patients were in the nebulizer group. Patients were assessed at baseline (0 min) and 15, 30, 45 and 60 min after commencement of the nebulizer and MDI/spacer. The response of each group to treatment was compared. The parents were counseled for their child enrolment in the study, which was approved by the Human Ethics Committee of Shahid Beheshti University of Medical Sciences. Ethic code was IR.SBMU.SM.REC.1394.19. The patients in both treatment groups demonstrated statistically noticeable improvement in clinical scores at all study assessment periods. Results revealed that salbutamol via MDI/spacer was as effective as salbutamol nebulization during the treatment of asthma exacerbations. Salbutamol MDI/spacer is equally efficacious when compared to nebulization. Therefore, because Salbutamol MDI/spacer is more user-friendly and affordable, it is preferable to be used in emergency departments. [ABSTRACT FROM AUTHOR]

Severe combined immunodeficiency syndrome (SCID) is a life-threatening condition leading to early infant death as a result of severe infection, due to impaired cellular and humoral immune systems. Various forms of SCID are classified based on the presence or absence of T cells, B cells and natural killer cells. Patients usually present with recurrent infections and failure to thrive. Definitive treatment is hematopoietic stem cell transplantation. To achieve the best outcome, it should be performed prior to the development of severe infection. In This study, we described 10 patients (6 male and 4 female) with SCID who were admitted to Mofid Children Hospital, Tehran, Iran, from 2006 to 2013. We reviewed patients' clinical manifestation, laboratory data, family history and outcome. The mean age at the time of diagnosis was 131.8 days. One patient had non-consanguineous parents. Seven patients received BCG vaccine before the diagnosis of SCID, three of them showed disseminated BCG infection. One patient presented with invasive pulmonary aspergillosis. Flow cytometric analysis showed T⁻B⁺NK⁻ in three patients, T⁻B⁻NK⁺ in five patients, T⁻B⁻NK⁻ in one patient, and T⁻B⁺NK⁺ in one patient. This study highlights the importance of early diagnosis and patient referral before the occurrence of serious infection. [ABSTRACT FROM AUTHOR]

Background: The current study aims to understand the risk factors of multiple suicide attempts in Iran. Method: A cross-sectional study was administered to four hundred Iranian males and females who came to the Loghmon Hakim Medical Poison Centre of Shahid Beheshti University of Medical Sciences, after multiple fatal suicide attempts. With "The Risk Factors of Suicide Questionnaire (RFSQ), a Logistic Regression Analysis was used to classify the risk factors of multiple suicide attempts. Results: The participants were young, poor, and single, but were educated. This study clarifies the risk factors of suicide between both genders, based on 1) Previously attempted suicide, 2) The number of times suicide attempted (from three to as many as 18 times), 3) History of Mental illnesses, 4) Suicide ideation, 5) Mental illnesses in family, 6) Age, 7) Economical condition, 8) Single status, and 9) Substance abuse. The poor economical condition and single states had an important role among males in this study. Conclusion: The results have shown that psychologists and psychiatrists deal with some patients who really have mental illnesses. However, personal and social factors must be considered as serious problems. As a Muslim country, Iran should have addressed this issue more seriously and take preventive strategies, as suicide is forbidden in Islam and terrible loss for society. [ABSTRACT FROM AUTHOR]

Neuromuscular diseases (NMDs) affect muscle function directly or indirectly by affecting nerves or neuromuscular junctions. One of the leading causes of death in patients with NMD is respiratory muscle weakness (RMW). Respiratory involvement in patients with NMD can manifest widely, from mild failure that may initially affect only sleep to severe failure that can be life-threatening. Care approaches include arranged and precise clinical follow-ups of signs of sleep-disordered breathing, daytime hypoventilation, coughing, and swallowing disturbances . This manuscript will review the mechanisms and abnormalities of respiratory function in patients with NMD and help optimize NMD management., Competing Interests: The authors declare no conflicts of interest.