Farzaneh Akbari; Mina Delghandi; Fariba Rezaeetalab
Abstract
Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. One of the most important events in the course of COPD is acute exacerbation. Acute exacerbation of COPD (AECOPD) is characterized by the aggravation of dyspnea, cough, and sputum. Chronic obstructive pulmonary ...
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Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. One of the most important events in the course of COPD is acute exacerbation. Acute exacerbation of COPD (AECOPD) is characterized by the aggravation of dyspnea, cough, and sputum. Chronic obstructive pulmonary disease exacerbation leads to respiratory failure, hospitalization, morbidity, and mortality. During and after the COPD attack, lung function dramatically decreased. Bacterial pneumonia is an important and serious risk factor for AECOPD. However, there are other inflammatory and non-inflammatory causes of AECOPD. Antibiotic treatment is usually challenging in AECOPD. Procalcitonin is a non-hormone active protein and precursor to calcitonin that consists of 116 amino acids, and 13 kDa weight is produced by the neuroendocrine cells of the thyroid gland. However, procalcitonin is secreted in septic shock, metastatic cancers, bacterial and fungal infections; therefore, serum procalcitonin is increased in bacterial pneumonia of AECOPD. Some studies recommended procalcitonin serum measurement as a guide for antibiotic initiation in AECOPD.
Fariba Rezaeetalab; Mahnaz Mozdourian
Abstract
Wilson’s disease is a rare genetic disorder, which is associated with clinical manifestations such as liver dysfunction, psychological and neurological issues, and specific laboratory findings demonstrating the increased urinary excretion of copper and copper accumulation in the body. Wilson’s ...
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Wilson’s disease is a rare genetic disorder, which is associated with clinical manifestations such as liver dysfunction, psychological and neurological issues, and specific laboratory findings demonstrating the increased urinary excretion of copper and copper accumulation in the body. Wilson’s disease is occasionally presented by atypical features, which delay the diagnosis of this rare disorder. This study aimed to describe the case of a patient with pulmonary and portal hypertension as a primary manifestation of Wilson’s disease. A young male patient was admitted to the emergency department due to the deterioration of respiratory symptoms and overall weakness. The patient had a history of dyspnea and fatigue, which was diagnosed as idiopathic pulmonary hypertension. In the previous admission, the liver function test of the patient was not disrupted, and serum/urinary copper and ceruloplasmin levels were normal. In the current admission, the patient had elevated bilirubin and enzyme levels, as well as abnormal copper and ceruloplasmin levels. Moreover, portal hypertensive gastropathy and Kayser-Fleischer ring were detected in further investigations, confirming the diagnosis of Wilson’s disease. To the best of our knowledge, this was the first report on Wilson’s disease initially presented with pulmonary and portal hypertension.
Fariba Rezaeetalab; Fariborz RezaeiTalab
Abstract
Restless legs syndrome (RLS) is a common chronic sensory motor disorder that prevents initiation and/or sleep staying. Patients with this syndrome have uncomfortable sensations in their legs (and sometimes arms or other parts of the body), with moving their legs to relieve this sensations. The symptoms ...
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Restless legs syndrome (RLS) is a common chronic sensory motor disorder that prevents initiation and/or sleep staying. Patients with this syndrome have uncomfortable sensations in their legs (and sometimes arms or other parts of the body), with moving their legs to relieve this sensations. The symptoms of RLS are usually worse in the evening and at night. The diagnosis of RLS is primarily based on clinical evaluation and clinical history of the patient. International restless leg syndrome group study (IRLSSG) evaluates the symptoms and severity of RLS. RLS can be divided into two groups of primary and secondary. Iron deficiency, Parkinson’s disease, kidney failure, diabetes, peripheral neuropathy, and pregnancy may cause RLS. Antinausea, antipsychotic drugs, some antidepressants, and antihistamines may also worsen the symptoms. RLS is also observed in chronic obstructive pulmonary disease (COPD), which makes the outcomes worse. COPD is a main preventable health problem that can lead to morbidity and mortality. Thus, RLS in COPD causes excessive daytime hypersomnolence, fatigue, poor quality of life, disability and neuropsychological complications such as social isolation, frequent daytime headaches, anxiety and depression.