فهرست مطالب

Cardio -Thoracic Medicine - Volume:6 Issue: 3, Summer 2018

Journal of Cardio -Thoracic Medicine
Volume:6 Issue: 3, Summer 2018

  • تاریخ انتشار: 1397/06/10
  • تعداد عناوین: 8
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  • Mahmoud Shabestari, Raphael Blanc, Humain Baharvahdat *, Hamzeh Dehganizadeh, Michel Piotin Pages 313-318
    Besides its severe neurological injuries, spontaneous subarachnoid hemorrhage (SAH) commonly causes cardiac complications. These complications could include three different aspects of cardiac diseases, that is, electrocardiographic abnormalities, myocardial injuries, and left ventricular dysfunction. These complications not only may lead to misdiagnosis of SAH as myocardial infarction, but also it may complicate the management of SAH. In this review, we described all cardiac complications during SAH and explained the appropriate monitoring and management of these problems.
    Keywords: Arrhythmia, Aneurysm, Subarachnoid Hemorrhage, Left Ventricular Dysfunction, Cardiomyopathy
  • Keyvan Hejazi * Pages 319-328
    Skeletal muscles play an active role in regulating the metabolic homeostasis through their ability for relating to adipose tissue and endocrine hormones. Contraction of the skeletal muscle leads to increased release of several myokines, such as irisin, which is able to interact with the adipose tissue. Physical activity promotes the irisin mechanism by augmenting the peroxisomes (PGC1-α) in the skeletal muscle. Afterwards, an elevation occurs in the membrane protein of fibronectin type III domain-containing protein 5 (FNDC5) in muscle, ultimately resulting in production of irisin. The expression of irisin and FNDC5 converts white adipose into the brown type and increases energy consumption by the whole body hindering obesity and diabetes. The effects of regular exercise training on preventing obesity, diabetes, and the related complications, as well as improving health have already been proven. However, the point is that these beneficial effects are due to the cellular-molecular mechanisms, which are still under discussion.
    In this review, we searched the online databases, including scientific information database (SID), Google Scholar, PubMed, Science Direct, and Scopus. The following keywords were used: training, physical activity, myokine, adipose tissue, PRDM16, PGC-1α, PPARγ, SIRT1, FGF21, bone morphogenetic protein, neurugolin, VEGF, and IL-15. All the articles, including research studies, review articles, descriptive and analytical studies, in addition to cross-sectional researches published during 1998-2017 were reviewed.
    According to the obtained results, it seems that expression of irisin and FNDC5 converts the white adipose into brown adipose resulting in increased energy consumption. It has been proven in the literature that regular exercise training prevents obesity, diabetes, and the related complications, as well as improving health.
    Keywords: Adipose Tissue, Myokine, PGC-1? Training
  • Reza Basiri, Mohaddeseh Ghelichli *, Shahrzad M. Lari, Sepide Hejazi, Ali Vahidi Rad Pages 329-331
    Pain is a major concern in all intensive care units (ICUs). The proper assessment and management of pain is one of the main goals of patient care in ICUs. Improper evaluation of pain and its over or under treatment can cause significant problems in the process of patient management in ICU. Since most ICU patients are unable to communicate correctly with the ICU team and explain their level of pain, pain assessment can be challenging. Thus, several assessment tools for the evaluation of pain were developed, few of which were validated. Critical Care Pain Observation Tool is a valid and reliable instrument for pain assessment in different ICUs.
    Keywords: CPOT, ICU, Pain
  • Behrouz Mottahedi, Majid Ghodsi, Bita Zargaran, Saeedeh Hajebi Khaniki, Mahnaz Komeilipour, Mahdi Kahrom* Pages 332-337
    Introduction
    The most common cardiac disease is coronary artery disease (CAD) in the world. Coronary artery bypass grafting (CABG) is implemented through two standard surgical techniques, namely off-pump beating-heart CABG (OPCABG) and on-pump CABG (ONCABG). The CABG results in various levels of morbidity, especially in smokers and addicts, who have a lower pain threshold. Regarding this, the aim of this study was to clarify several aspects of the consequences of CABG, especially in smokers and addicts.
    Materials And Methods
    This cross-sectional study was conducted on 125 CABG candidates referring to the Cardiac Department of Ghaem Hospital in Mashhad, Iran, within 2014-2015. The patients underwent either OPCAB or ONCABG. The recorded data included the type and dosage of intra- and post-operative opioids used for the induction and maintenance of anaesthesia, as well as the volume of packed red blood cells, fresh frozen plasma, and platelet. Data analysed using IBM SPSS 19.0 and p-value less than 0.05 considered statistically significant.
    Result
    According to the results, the mean age of the patients were 59.4±9.8 years. Out of the 125 participants, 89 and 36 patients underwent ONCABG and OPCABG, 71.9% and 58.3% of whom were male, respectively. The sufentanil dose administered for the induction of anaesthesia was 9.9±2.7 cc in the smokers, which was significantly higher in comparison to the dose (7.3±2.1 cc) used for the non-smokers (P=0.015). Furthermore, the mean doses of dobutamine used for the addicted and non-addiced patients were 4.4±1.8 and 5.5±2.2 cc, respectively, which was significantly different between the two groups (P=0.037).
    Conclusion
    The ONCABG is a common surgical technique, which is used in patients with a more coronary vessel involvement. This study has demonstrated that although the same opioid anaesthetic drugs were used for the smokers and addicted patient, the dose of administered sufentanil was significant different between smokers and non-smokers.
    Keywords: Coronary Artery Bypass, Smoker, Outcome, Opium
  • Elaheh Barghchi *, Fereidoun Azizi Pages 338-343
    Introduction
    Previous cohort studies reported contradictory data on the association between subclinical thyroid dysfunction and coronary heart disease (CHD). Regarding this, the present study was conducted to illuminate this relationship.
    Materials And Methods
    For the purpose of the study, 3,066 participants employed in a study conducted by Azizi et al. aged ≥ 20 years were subjected to thyroid function tests every 3 years over a mean follow-up of 10 years. After the exclusion of the subjects with CHD and those consumed thyroid, anti-thyroid, or corticosteroid preparations, 2,144 subjects remained for analysis and followed up for CHD events in the next 10 years.
    Results
    At the baseline, 1929, 139, and 76 subjects had euthyroid, subclinical hyperthyroid, and subclinical hypothyroid, respectively. No CHD event occurred in the subclinical hypothyroid group. After the adjustment of all confounders, the subclinical hyperthyroid group had the hazard ratio of 1.01 for CHD with a 95% confidence interval of 0.36-2.85.
    Conclusions
    The 10 year follow-up of subjects with subclinical thyroid disease revealed no relationship between CHD and subclinical thyroid disorders.
    Keywords: Coronary Heart Disease, Cardiovascular Mortality, Subclinical Thyroid Disorders
  • Satish Das, Chandan Ray Mohapatra *, Ashish Badkhal, Sudhir Dhande, Pankaj Pohekar, Ambrish Khatod Pages 344-349
    Introduction
    Cardiac myxoma is a benign and rare tumor, which can present with a grim phenomenon if the presentation is late or the diagnosis and surgery are delayed. The purpose of this study was to share our institutional experience of cardiac myxoma.
    Material and
    Methods
    This retrospective study was conducted to evaluate patients undergoing procedures at a single tertiary care centre for the treatment of cardiac myxoma during January, 2007 to December, 2017. Preoperative diagnosis was made by assessing clinical presentation and doing echocardiography. Complete tumor excision was performed, and all the patients were followed up for recurrence and complications.
    Results
    A total of 45 cases of cardiac myxoma (13 males and 32 females) with the mean age of 37.5 years old (ranged between 16 and 60 years old) were operated over the period of 10 years. Cardiac myxoma constituted about 0.69% of all cardiac cases operated at our institute. Out of all the subjects, 41, 3, and 1 cases had left atrial, right atrial, and right ventricular involvements, respectively. Additionally, 43 patients (95%) survived the surgery, one recurrence was observed during the follow-up period.
    Conclusion
    Cardiac myxoma is the most common cardiac tumor account for very small percentage of patients with heart disease. Early clinical suspicion and the use of imaging modalities are key to early diagnosis of this condition. Although these tumors have a risk for severe cardiac and systemic symptoms, referral to experienced centers for prompt surgical resection under cardiopulmonary bypass provides excellent early and long-term results.
    Keywords: Atrial Myxoma, Cardiac Myxoma, Cardiac Tumour
  • Shekhar Gangadhar Kadam, Susheel Bindroo, Jithin Krishnan, Hina Jayantilal Shah *, Vikram Ramchandra Lele, Ganapathi Bhat Pages 350-354
    Giant cell tumour (GCT) is a benign, locally aggressive tumour of the bone that accounts for 5% of primary bone tumours and 21% of benign bone tumours. This tumour more commonly presents as a single (solitary) lesion; however, it may appear with multiple (multicentric) lesions in less than 1% of the cases. According to the literature, 1-9% of solitary GCTs metastasizes to the lung, more commonly in cases with local recurrence. There are limited case reports on multicentric GCT (MCGCT) in the literature. The MCGCT can be synchronous or metachronous depending upon the time interval between the two lesions. Herein, we presented a very rare case of metachronous MCGCT with benign lung metastasis in form of a huge lung mass.
    Keywords: Multicentric, Giant cell tumor, Metastasis, Metachronous, Lung mass, PET-CT
  • Asal Yadollahi, Aliasghar Moeinipour, Hamid Hoseinikhah, Javad Ramezani * Pages 355-359
    We report the case of a 23-year-old woman who died due to endograft stenosis 20 months after thoracic endovascular aortic repair. The patient presented with the pseudocoarctation syndrome. Although angioplasty of stenosis endograft was successfully performed, severe metabolic complications were lethal.
    Keywords: Angioplasty, Endograft Obstraction, Thoracic Endovascular Aortic Repair, Thoracic Aortic Psudoaneurysm