مجله دانشکده پزشکی اصفهان
پیاپی 204 (هفته دوم آبان 1391)

After reading this tutorial, the learner should know the following: 1.define chronic stable angina2.differentiate between acute coronary syndromes and chronic stable angina3.identify methods to diagnose and evaluate chronic stable angina4.identify pharmaceutical treatments of chronic stable angina5.identify pharmaceutical therapies to improve chronic stable angina prognosis 6.provide necessary recommendations for patients suffering from chronic stable angina7.follow up the patients with chronic stable angina

Dopamine (DA) is a neurotransmitter with an important role in regulating brain processes involved in movement. Serotonin is a brain chemical that helps the transmission of messages throughout the nervous system. This neurotransmitter performs many functions including mood, appetite, and the sleep/wake cycle regulations. Previous studies have demonstrated that exercise increases brain serotonin and dopamine function in humans. Therefore, it has recently been suggested as an alternative to treat drug addiction. This study aimed to assess the effects of an eight-week aerobic exercise program on the concentration of DA and serotonin in addicted women in the central prison of Isfahan (Iran). Thirty addicted women in the central prison of Isfahan (mean age: 32.6 ± 8.0 years) were randomly divided into two groups of aerobic exercise training (n = 15) and control (n = 15). The aerobic training group performed a supervised 60-minute aerobic exercise training session three times a week for eight weeks. The control group was only followed-up without any effective physical activity. Blood samples of the subjects were tested both at baseline and after eight weeks. Data was analyzed by SPSS16. After eight weeks, the aerobic training group demonstrated significant improvements in serotonin and DA levels compared to the baseline values (P < 0.01). Significant differences were also observed between the two groups in serotonin and DA levels after eight weeks (P ≤ 0.05). It can be concluded that aerobic training program is an effective intervention in addicted women.

The aim of this study was to investigate the sensitivity and specificity of procalcitonin and C-reactive protein in the diagnosis of febrile neutropenic patients in Seyed-Alshohada Hospital (Isfahan, Iran) during 2010-11. This analytic cross-sectional study included all febrile neutropenic patients (n = 64) who were admitted in Seyed-Alshohada Hospital during 2010-11. Sex, age, admission time, and duration of fever before taking antibiotics were collected. Patients were then divided to groups with and without severe infection. The mean levels of procalcitonin in the groups with and without severe infection were 28.65 ± 2.68 and 2.48 ± 0.66 ng/ml, respectively (P < 0.001). The mean levels of C-reactive protein in the groups with and without severe infection were 159.48 ± 9.73 and 126.17 ± 10.63 mg/L, respectively (P = 0.015). Using receiver operating characteristic (ROC) curves, sensitivity and specificity of procalcitonin were determined as 92.5% and 97.3%, respectively. The corresponding values for C-reactive protein were 70.5% and 42.1%. Procalcitonin can be considered as a predictor and diagnostic marker for diagnosis of severe infectious disease. It can also differentiate severe and non-severe disease in febrile neutropenic patients. Nevertheless, clinical signs and symptoms of the disease should also be considered.

Listeria monocytogenes is an important psychrotrophic foodborne pathogen which may exist in milk and dairy products. The bacterium causes listeriosis with severe clinical consequences such as meningitis, septicemia and abortion. Therefore, contamination of food stuff implies a significant health risk for human. There are a minimum data on raw milk contamination of Listeria species In Iran. Thus, the objective of this study was to assess the prevalence of Listeria spp. in raw milk in Isfahan, Iran. A total of 91 samples of raw milk were examined for the presence of Listeria spp. using a two-step selective enrichment recommended by USDA. All isolates were subjected to standard biochemical test. L. monocytogenes strains were further confirmed by PCR amplification. Of the 91 raw milk samples collected, Listeria species were isolated on five (%5.49) samples. Four (%4.39) of these five isolates identified as L. monocytogenes and one (%1.09) as L. seeligeri. All strains of L. monocytogenes identified by biochemical tests, were also confirmed by PCR. The study shows the prevalence of L. monocytogenes in raw milk sold in the market. Consumption of raw milk with mild heat treatment or its usage in traditional dishes is a common practice in Iran. Therefore, the lack of appropriate control measures could pose serious health problems. The lack of knowledge on the risks of listeriosis transmission indicating the need of implementation of food safety education program. In addition, the Iranian food safety authorities urgently should set up an effective standard to screen all susceptible food for the presence of Listeria.

Contrast-induced nephropathy (CIN) is a serious complication following contrast-based imaging methods, e.g. receiving iodixanol. Statins have been postulated to prevent CIN via various mechanisms. However, there have been conflicting reports on the use of statins for prevention of CIN. The aim of this study was to assess the effectiveness of simvastatin in the prevention of CIN.

A total number of 194 patients were randomly allocated to groups of control and statin-treated patients (n = 97 in both groups). The two groups received the same dose of iodixanol. The control group received normal saline before and after angiography and statin-treated patients received simvastatin (80 mg/day) and normal saline before and after angiography. Serum creatinine levels were measured before angiography and two consecutive days after the procedure. Glomerular filtration rate (GFR) was calculated on the second and third days. The values were then statistically analyzed.

There were no differences between the two groups in the first 24 hours after the procedure. However, after 48 hours, GFR values were significantly higher in the statin-treated group (P = 0.002).

Prophylactic administration of statins along with hydration may be associated with less contrast-induced nephropathy.