Showing 45 results for Fusion
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Volume 59, Issue 5 (9-2001)
Abstract
Hypotention is hazardous for fetus and mother under spinal anesthesia in cesarean section. Prophylactic effect of crystalloid preload and ephedrine infusion were compared in preventing of hypotention in these patients. From the cases, 44 women candidate for elective cesarean section were randomly divided in two groups. In first group, 15 ml per kg Ringer infused before spinal anesthesia. In the second group, Ephedrine infusion 0.25 mg/kg/3 min started immediately after spinal. During the section, BP was more stable in second group than the first group. Therefore ephedrine infusion seems to be more effective in controlling of BP in these patients.
Anyamanesh S, Faghihi M, Kadkhodaei M,
Volume 61, Issue 2 (5-2003)
Abstract
During kidney and other organ transplantation, the organ to be transplanted, must inevitably remain out of the body with little or no blood perfusion at all for a long period of time (ischemia). These events have been suggested to cause the formation of oxygen- derived free radicals (OFR). Reperfusion (reintroduction of blood flow) will further exacerbate the initial damage caused by the ischemic insult and may result in the production of free radicals. The aim of this study was to investigate whether induction of brief periods of renal artery occlusion (ischemic preconditioning, IPC) can provide protection from the effects of a subsequent period of ischemia and reperfusion (IR) in the rat kidney.
Materials and Methods: In this regard, 28 white, male rats were randomly and equally divided into four groups: Control (sham- operated), IPC alone, IR alone (30 min ischemia followed by 10 min reperfusion), and IPC- IR. Preconditioning involved the sequential clamping of the right renal artery for 5 min and declamping for 5 min for a total of 3 cycles. To demonstrate the effectiveness of IPC regimen, vitamin E as an endogenous antioxidant and an index of lipid peroxidation was measured by HPLC after its extraction from right renal venous plasma and right renal tissue.
Results: Results of this study showed that the amount of vitamin E of renal tissue and venous plasma in the IR group had a significant decrease when compared to the control group (P< 0.0001). Whereas the amount of this vitamin in both renal tissue and venous plasma of the IPC- IR group was significantly higher than that in the IR group (P< 0.0001), but did not show any significant difference with the control group.
Conclusion: In this study, preconditioning method prevented the reduction of the endogenous antioxidant (Vit. E) in encountering the following sustained ischemic insult. Therefore, we suggest that ischemic preconditioning can be used to protect the Vit. E level of kidney from its subsequent decrease by ischemia and reperfusion.
Sharifi A M, Heshmatian B, Karimiam S M, Akbarloo N,
Volume 61, Issue 3 (6-2003)
Abstract
Essential hypertension is one of the risk factors of cardiovascular diseases. Hypertension etiology is not completely known, it seems that rennin-Angiotensin system has an important role in its etiology, Thus better recognition of this system and its activity changes or vascular reaction changes to different parts of this system during progressive hypertension can be more effective in better recognition of the disease progress and treatment.
Materials and Methods: In this study responsiveness of mesenteric vessels of Goldblatt two kidney- one clip (2k-lc) renovascular hypertensive rats to angiotensin / and II with and with out captopril during a time of two , four , six and eight weeks after hypertension induction was investigated and compared with control and surgical sham groups.
Results: This study shows that vascular responsiveness to angiotensin // in animals that passed four weeks of their hypertension , (p< 0.05) and in the sixth and eight week of post induction hypertension (p< 0.01 and p< 0.001) has a significant different with both sham and control groups. Also it has been observed that an increased reaction to angiotensin II with an increased significant rate of arterial hypertension in hypertensive group. In the other hand in spite of inhibition of angiotensin converting enzyme by captopril in animals that have been eight weeks hypertension , on the contrary to other groups reactive to angiotensin /.
Conclusion: Results of this study show that vessels reaction to angiotensin /and II increased due to six to eight weeks post induction renal hypertension. Captopril does not inhibite mesenteric vessels reaction to Angiotensin / in hypertensive Rats after eight weeks. Try to completely inhibit production of angiotensin II maybe a hopful way in controlling essential hypertension.
Radmehr H, Mirkhani S H, Sanatkar Far M, Soltatii Nia H, Emami S A, Ghorbandaei Pour I, Abolghasemi, Taghavi M, Moameni F,
Volume 61, Issue 6 (9-2003)
Abstract
Preoperative autologous blood donation is commonly used to reduce exposure to homologous blood transfusions among patients undergoing elective cardiac surgery. The aim of this study was to evaluate the effect of autologous transfusion on patients' hematocryte value, intra and postoperative blood loss, hospitalization time, the development of infective complications and other factors.
Materials and Methods: Between June 2001 to April 2002, 208 patients were underwent cardiac surgery in cardiac surgery ward in Imam Khomeini Medical Center. One or more blood units donate from 104 Patients before cardiopulmonary bypass and heparin injection, and transfused to them after CPB and Protamin injection (autologous Group, group 1). 104 patients underwent cardiac surgery routinely (control group, group 2).
Results: Mean of age was 55.9±8.6 in group 1 and 56.6±9.3 in group 2 (P=NS). 73 male and 31 females were in group 1 and 79 males and 25 females were in group 2 (P=NS). Smoking, familial history, hyperlipidemia, diabetes mellitus, renal failure, hypertension, stroke, and history of myocardial infarction was similar in two groups.
Severity of angina, urgency operation, number vessels disease, duration of cardiopulmonary bypass, duration of aortic cross clamp time, use of internal thoracic artery graft, and number of grafts was similar in both groups. Mean of bleeding post operation was 548 cc in group 1 and 803 cc in-group 2 (P=0.003). Bleeding that need to operation was 1.8% in group 1 and 8.6% in group 2 (P=0.002). Wound infection, mediastinitis, renal failure, ventilatory prolonged, stroke, need to Intra-aortic Balloon Pump (IABP), intraoperative bleeding, and hospital stay was similar in both groups. Mean of extubationt time was 10.2 hours in group 1 and 14.8 hours in group 2 (P=0.001).
Conclusion: Preoperative and intra-operative donations are safe and continue to contribute uniquely to blood conservation, providing important options in comprehensive blood conservation programs in current pediatric open-heart surgery.
Mehr Aein A, Davoodi S, Madani Givi M,
Volume 61, Issue 6 (9-2003)
Abstract
The aim of this study was to compare the effects of intraoperative autotransfusion and tranexamic acid on post-operative bleeding and need for allogeneic transfusion.
Materials and Methods: In a prospective, randomized study, 200 patients undergoing CABG allocated into two groups:
□ AT group = 100 patients received 1-2 units (300-450cc) autologous blood after termination of CPB D TX group = 100 patients received tranexamic acid, 15mg/kg before the injection of heparin and 15mg/kg after protamin injection Postoperative bleeding, transfusions, complications, ICU stay and hospital stay were recorded.
Results: The postoperative bleeding was lower in TX group (600 ml) than in AT group (1100 ml) (P <0.001). The rates of transfused patients in AT and TX groups were 72% and 65%. Patients in the AT group received more whole blood (2.82 units per patient vs. 1.93 units in TX group) (P<0.01). The numbers of FFP units administered per patient in AT and TX groups were 3.08 and 2.38 (P <0.01). In TX group, ICU stays and hospital stays were 0.8, 5.4 days (vs. 1.2s, 6.7days in AT group). In AT group, there were 2 transient renal dysfunctions and two re-operations. There was no difference between all groups regarding to neurological dysfunction and coagulopathy. There is no hospital mortality in all groups.
Conclusion: Tranexamic acid in comparison with intra-operative autotransfusion effectively reduces postoperative complications and allogeneic transfusions in CABG. In addition this technique due to shorter ICU and hospital stay is cost- effective.
Z Ahmadinejad, Sh Phyroosbakhsh, Z.n Hatmy, B Bagherian, H Sabery, M Bahador, M Nikzad, M Jamali Zavare, A Hadady, M Hajiabdolbaghi, M Mohraz, M. Rasolinejad, A Soudbakhsh, A Yalda,
Volume 64, Issue 2 (4-2006)
Abstract
Background and Aim: Tuberculous pleural effusion occurs in 30% of patients with tuberculosis (TB). Rapid diagnosis of a tuberculous pleural effusion would greatly facilitate the management of many patients. The purpose of this study was to determine sensitivity, specificity, and predictive values of clinical, laboratory, radiographic findings in patients with tuberculous pleural effusion.
Materials and Methods: The cross sectional study was performed between august 2002 and March 2004 at a referral teaching hospital. Major clinical, laboratory, and radiographic findings were evaluated in 88 cases of pleural effusion, 33 with confirmed TB pleural effusion (TBPE) and 55 with a diagnosis other than TB (NTBPE).
Results: The sensitivity of culture of pleural effusion and tissue were 3% and 9.1% respectively. The mean of adenosine deaminase (ADA) values in TBPE was 36.7 U/L (±18.72), and the mean in the NTBPE was 28.2 U/L (±17.0). Both the sensitivity and specificity of ADA estimation in diagnosing tuberculosis were 55%. The sensitivity of PCR was 3% with specificity of 12.7% (positive predictive value, 50% negative predictive value, 70%). Younger age (p<0.024), positive history of exposure to TB patient (p<0.02), and the combination of fever, weight loss and sweating (p<0.01), were associated with tuberculous pleural effusion. There were also significant association between Positive sputum smear (p<0.001), positive sputum culture (p<0.006), positive pleural biopsy (p<0.001), pleural LDH>200 (p<0.005), pleural lymphocytes>50% (p<0.015) and TBPE.
Conclusions: In our region with a high incidence of tuberculosis, the most frequent cause of exudative pleural effusion is tuberculosis. We suggest that the diagnostic planning of pleural effusion should be determined in each region with a view to the adoption of regionally optimized diagnostic and therapeutic facilities.
P. Pasbakhsh, S. Saeednia, F. Abolhasani, M. Noori, M. Maphi, K. Mehran Nia, A Sobhani,
Volume 64, Issue 6 (8-2006)
Abstract
Background: The aim of this study was to determine the level of lipid peroxidation and tissue protein after superior mesenteric artery occlusion tissue damage. The effect of melatonin as anti oxidant and free radical scavenger in prevention of tissue damage, were also evaluated.
Methods: Thity six young male Wisatr-Albino rats (weight: 80-120 gr), were divided equally in 6 group with different concentrations of melatonin (10,20,30 mg/kg) treatment. Group 1was control, group 2 the sham that surgical process was applied until superior mesenteric artery dissection and received vehicle solution only in equally volume by intra muscular route. Group 3 was ischemia- reperfusion (I/R), group 4 was I/R plus melatonin 10 mg/kg, group 5 I/R plus melatonin 20 mg/kg and finally group 6 I/R plus melatonin 30 mg/kg. After laparatomy, a microvascular atraumatic clip was placed across the superior mesenteric artery under general anaesthesia and itbremoved after ischemia for 30 minutes. The first dose of melatonin was applied just beforereperfusion, second dose, after reperfusion and third dose on the second day .On third day rats were killed and their bowels were removed. The level of tissue melandialdehyde (MDA) as index of lipid peroxidation and tissue protein was determined.
Results: The level of tissue MDA were significantly lower in group 4, 5, 6 than group 3 (p<0.05). Tissue protein levels were significantly upper in group 4 than group 3. (p<0.001). There was no significant difference tissue protein level in group 5, 6 than group 3(p>0, 05).
Conclusion: These results suggest that melatonin 10 mg/kg has antioxidant effect in prevention of inducing tissue damage during SMA occlusion in rat intestine.
Behtash H, Ganjavian M, Shahre Babaki B, Fereshtehnejad S.m, Akbarnia B,
Volume 64, Issue 10 (10-2006)
Abstract
Background: The currently accepted treatment of scoliosis are bracing and surgery. Two-stage anterior and posterior spinal fusion is used to correct scoliosis. It seems that the application of a longitudinal force to the axis of the spinal column as a means of stabilizing by halo traction, may increase the correction of the curve. The aim of this study was to evaluate the effect of halo traction used between the two stages of corrective surgery, anterior and posterior spinal fusion, on the correction of scoliosis curvature.
Methods: In this randomized clinical trial twelve scoliotic patients, aged from 12-19 years old, were treated by two-stage anterior spinal release and fusion (ASF) and posterior spinal fusion (PSF). The patients were divided in two groups: 6 scoliotic patients without any traction between ASF and PSF surgeries (group A), and 6 scoliotic patients were undergone halo traction for one week between ASF and PSF surgeries (group B). Major curve angle was measured before surgery, one week after ASF and one year after PSF surgeries. Data were collected and analyzed using SPSS v.13.5.
Results: The mean baseline curve angles were 90° (SD=18.70) and 94.17°(SD=28.18) in groups A and B, respectively. Whereas, the mean final curve angles (one year after PSF) were 51.17°(SD=29.59) and 39.17°(23.11) in groups A and B, respectively. Final angle improvement was 46.58% (SD=20.31) in patients without traction and 61.32% (SD=14.02) in patients with halo traction. The major curve angles showed significantly better correction in patients with traction one week after ASF [38.67°(SD=7.86) vs. 25°(SD=6.28), P=0.012]. This difference persisted at the end of the first year after operation. [55°(SD=8.94) vs. 38.83°(SD=11.65), P=0.022].
Conclusion: Application of halo traction between ASF and PSF surgeries may lead to better improvement of the scoliotic curvature and short time application of halo traction decreases possible complications.
Hadadi A, Rasoulinejad M, Maleki Z, Mojtahedzadeh M, Younesian M, Ahmadi S.a, Bagherian H,
Volume 65, Issue 4 (7-2007)
Abstract
Background: The object of this study was to investigate the antimicrobial resistance pattern among common nosocomial Gram-negative bacilli isolated from patients with nosocomial infections.
Methods: From June 2004 to December 2005, 380 isolates of common Gram-negative bacilli (Klebsiella, Pseudomonas, Acinetobacter and E. coli) from 270 patients with nosocomial infections in Sina and Imam Hospitals, Tehran, Iran, were evaluated for susceptibility to Imipenem, Cefepime, Ciprofloxacine, Ceftriaxone and Ceftazidime by Disc diffusion and E-test methods.
Results: The most frequent pathogens isolated were Klebsiella spp. (40%), followed by Pseudomonas (28%), Acinetobacter spp. (20%) and E. coli (12%). The most active antibiotic was imipenem (84%). 26% of all isolates were sensitive to Cefepime, 26% to Ciprofloxacin, 20% to Ceftazidime and 10% to Ceftrixone. The susceptibility rates of Klebsiella to Imipenem, cefepime, ciprofloxacin, Ceftazidime and Ceftriaxone were 91, 25, 21, 13 and 7 percent, respectively and 91, 19, 17, 21 and 21 percent, respectively, for E. coli. Among Acineto- bacter spp., the susceptibility rate was 77% for Imipenem and 21% for Ciprofloxacin. Among Pseudomonas spp., 75% of isolates were susceptible to Imipenem and 39% to Ciprofloxacin. The comparison of the resistance status of microorganisms by both Disc diffusion and E-test methods showed a clinically noticeable agreement between these two tests.
Conclusions: Since antibiotic resistance among Gram-negative bacilli has increased, enforcement of policy regarding proper antibiotic use is urgently needed in order to delay the development of resistance. Although it is widely accepted that E-test is more accurate in determining the resistance of microorganisms, our study showed that the Disc diffusion test will give the same results in most occasions and is therefore still considered useful in clinical practice.
Behtash H, Ameri E, Ganjavian M.s, Kabirian Dehkordi N, Fereshtehnejad S.m, Akbarnia B,
Volume 65, Issue 8 (11-2007)
Abstract
Background: Congenital scoliosis is a developmental disorder defined as a lateral curvature of the spine. Its progressive trend and complications, such as cosmetic problems, pain and pulmonary symptoms, have put scoliosis as an important skeletal deformity that should be corrected. One of the currently accepted methods of treatment is posterior spinal fusion (PSF) that may be performed with or without instrumentation. However, the use of implants in conjunction with PSF in congenital spine deformity has been debated over the past three decades primarily because of increased risk of neurological deficit and implant displacement. The aim of this study was to compare short-term and long-term outcomes of spinal fusion with and without posterior instrumentation in congenital scoliosis.
Methods: In this historical cohort study, 41 patients with congenital scoliosis were recruited. All patients underwent PSF surgery between 1977 and 1996. They were divided into two groups according to the use of instrumentation: 22 congenital scoliotic patients who were treated by PSF without any instrumentation (group A), and 19 instrumented PSF patients (group B). Instrumentation was mostly performed using the Harrington rod. The major curve angle was measured before surgery, two weeks and one year after PSF surgery and at the end of the follow-up period.
Results: The mean baseline curve angles were 66.3° and 69.1° in groups A and B, respectively. The mean Cobb angles one year after PSF were 43.1° and 38.4° in groups A and B, respectively. The mean follow-up period was 8 years (SD=3) and, at the end of this period, the final Cobb angles were 47.3° and 39.4° in groups A and B, respectively. Therefore, the final angle correction was 28.7% in patients without instrumentation and 43% in patients with instrumentation. The mean loss of correction was 5.5% and 4.3% in groups A and B, respectively. The final curve angles was significantly more corrected for those patients in whom instrumentation was used than those without instrumentation (p<0.05).
Conclusion: The treatment of congenital scoliosis can be very challenging despite the benefits of modern surgeries and instrumentation methods. The results of our study demonstrate that the application of an implant with PSF surgery may lead to increased improvement of the scoliotic curvature in the short-term and long-term periods, as well as a decrease in the loss of correction and the rate of reoperation. In addition, the low incidence of complications in our study indicates the safety of the posterior instrumentation for the treatment of congenital scoliosis.
Sadeghian S, Sheikhvatan M, Hakki Kazazi E, Rouzkari M, Sheikhfathollahi M,
Volume 65, Issue 12 (3-2008)
Abstract
Background: The most common methods for screening of patients with probable ischemic heart disease are stress test and in special conditions are perfusion scan, so that their positive results was important indication of coronary angiography. Although, predictive value of perfusion scan has been considered, with regard to the impact of technical and specialized factors and according to the spread of this technique that has wrongly replaced the stress test, it is necessary to compare predictive value of this method with stress test in our country.
Methods: In a cross-sectional study, patients referred to Tehran Heart Center from all centers of country between January 2004 and January 2005 for coronary angiography was included. Demographic characteristics of patients were collected by interview and clinical tests and analyzed in two genders. Then, positive predictive value (PPV) of both techniques was calculated and compared.
Results: The total number of positive perfusion scan and stress test were 2178 and 2581, respectively. It was not significant difference between PPV of perfusion scan and stress test in men (86.9% vs 86.6%, P=0.814). PPV of perfusion scan was higher than stress test only in women more than 60 years old (P=0.0002).
Conclusions: According to the results of this study and with regard to high cost of perfusion scan, it seems that in case the possibility of stress test, the use of perfusion scan had no advantages with the condition of our scan centers and especially in women, predictive value of these techniques were similar. However, it is necessary to consider the causes of this unusual finding according to the role of drugs, instruments, and specialists in the future.
Rahimi Sharbaf F, Mirzaei F, Kaveh M,
Volume 66, Issue 6 (9-2008)
Abstract
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Background: The
prevalence of Rh alloimmunization has decreased following the use of anti-D
immunoglobulin. With serial amniocentesis, Doppler sonography of the middle
cerebral artery and treatment of anemia with intrauterine blood transfusion, perinatal
mortality has declined. However, Rh alloimmunization in twin pregnancies poses
a diagnostic and therapeutic challenge.
Case report: We are reporting,
for the first time in Iran, the successful treatment of severe Rh
alloimmunization in a dichorionic- diamnionic twin pregnancy leading to the
live births of both neonates. Before treatment, the fetal hemoglobin levels
were 3.1g/dL and 3.9g/dL, with ascites in both fetuses. The fetuses were
treated with several IUTs.
Results: After treatment, the neonates were
delivered, weighing 2200 and 2300g, with good Apgar scores, at a gestational
age of 34 weeks.
Conclusion: 10%
of population in Iran is Rh-negative, although Prophylaxis for Rh
alloimmunization is universal, as other part of the world it cannot irrigated.
For the best management of these cases, we need a well-equipped referral
center.
Behtash H, Ameri E, Mobini B, Omidi Kashani F, Tabatabaii Sm,
Volume 66, Issue 11 (2-2009)
Abstract
Background: Degenerative spondylolisthesis is a common disease of the lumbar spine especially in older ones. The disease represents a challenge to the treating physician. At present, for those patients that deteriorate clinically, there are many proposed algorithms for the surgical treatment. This before and after study was undertaken to assess the surgical results of decompression and instrumented posterolateral fusion in these patients.
Methods: The study population consisted of 23 patients who had undergone no prior surgery for degenerative spondylolisthesis on the lumbar spine. These patients were treated by decompression, bilateral posterolateral fusion, and segmental (pedicle screw) instrumentation with mean follow-up of 29 months (range, 13-73 months). Finally, The clinical results were evaluated for all patients by means of an Oswestry Disability Index (ODI) version 2.1, the Henderson's functional capacity, and persistence of leg symptoms, low back pain or claudication. Mann-Whitney and Chi-Square tests were used to assess the average values and comparison, respectively.
Results: Henderson's functional capacity at the last visit session was excellent in 14 (60.9%), good in 7 (30.4%), fair in 2 (8.7%) cases. ODI decreased from 72.2% (50-88%) preoperatively to 14.4% (0-54%) at the latest follow-up visit. A history of leg pain or claudication was correlated significantly with the amount of decline in ODI score and Henderson's functional capacity (p<0.05).
Conclusion: In spite of limited number of our patients, decompressive surgery plus instrumented posterolateral fusion is a safe, reliable, and satisfactory procedure for treating degenerative lumbar spondylolisthesis. This procedure may be done when conservative treatment was failed and psychological problems can be ruled out.
Rahimi Sharbaf F, Mirzaie F, Izadi Mood N,
Volume 67, Issue 3 (6-2009)
Abstract
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Background: Acardiac twin is a
rare complication affecting monozygotic twins and is related to the twin
reversed atrial perfusion sequence (TRAP). The TRAP sequence involves a pump twin perfusing a recipient twin
through vascular anastomosis. Here, we report two cases with different
presentations of acardiac twin.
Case report: The first acardiac
twin was composed of a healthy fetus and a fetus with proximal of trunk, pelvic
and lower limbs without head, neck and arms (acardia acephalus- classic form).
The pregnancy was followed with ultrasonography and pregnancy terminated at 29 weeks, because there
was abnormal doppler of ductus venosus and non-reassuring NST in pump twin. The second
acardiac twin first time was diagnosed at a rotine ultrasonography at 26 weeks gestation as a
healthy fetus and an acardia fetus with a hypoplastic lower limb and intestine
like organ (amorphic mass). The pregnancy following, normal infant was born with
a sac with some loops of the intestine at term. Each two cases were diagnosed
at 26 week and each was
delivered healthy pump twin.
Conclusion: Acardiac twin has different presentation and here
we presented two end of acardia twin presentation with different management and
outcome.
Kadkhodaee M, Golab F, Zahmatkesh M, Ghaznavi R, Hedayati M, Arab Ha, Soleimani M,
Volume 67, Issue 7 (10-2009)
Abstract
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Background: The effect of ischemia/reperfusion (I/R) injury on kidney has
been under investigation for many years. But the changes in liver function and
oxidative stress status in renal I/R injury is not well known. Recent studies
suggest a crosstalk between liver and kidneys. The aim of the present study was
to assess liver changes after induction of various degrees of renal I/R injury.
Methods: This is an
experimental study conducted on 20
male rats that were obtained from animal house of Physiology Department. Twenty
male rats were subjected to either sham operation or ischemia (30, 45 and 60 min) followed by 60 min reperfusion
periods. Blood samples were drawn post-operatively and plasma creatinine, BUN, ALT and AST were measured.
Hepatic glutathione (GSH) and FRAP (ferric reducing antioxidant power) levels and the concentration
of IL-10 and tumor necrosis
factor (TNF) -alpha were
evaluated.
Results: Both 45 and 60 min ischemia
followed by 1h reperfusion periods
resulted in significant increases in plasma creatinine (11.1±1.7mg/dl and 1.24±0.07mg/dl vs 0.55±0.15mg/dl, p<0.05) and BUN (34±3.85mg/dl and 35.0±2.81mg/dl vs 23.75±1.1mg/dl, p<0.05). These rats
showed a significant decrease in liver GSH as well as significant increase in TNF-a & IL-10 concentrations.
Conclusion: Renal ischemia causes
changes in liver function and oxidative stress status. A minimum of 45 min ischemia is needed to
study the effects of renal injury on liver as a remote affected organ.
Hadadi A, Moradmand Badie S, Roham M, Rasulinejad M, Mirzai N,
Volume 67, Issue 8 (11-2009)
Abstract
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Background: One of the clinical manifestations of Human Immunodeficiency Virus (HIV)
infected patients is cardiovascular disorder. The aim of this study was to
evaluate the prevalence of cardiovascular disorders in HIV
infected patients for the beginning treatment of these patients and reducing
mortality and morbidity in these patients.
Methods: This cross-sectional study was performed on 134 HIV
infected patients who referred to Imam Khomeini hospital, Tehran University of
Medical sciences, Tehran Iran during years 2007-2008.
Demographic characteristics, history of smoking and opium addiction,
antiretroviral therapy, class of drugs and duration of consumption were
recorded. After completion of physical examination, electrocardiography and
echocardiography studies were done.
Results: In this study 98(73.1%) patients were male.
The mean age of the patients was 36.5±10.3
years. The mean of the CD4 number were 296±181. Injection drug users were 54.4%
of the study patients. Cardiovascular disorders were found in 84(62.7%)
patients. Among patients with heart diseases, 75%
were male. The most Electrocardiographic change was the axis deviation of the
heart found in 32(23.7%) patients.
Pericardial effusion and LVEF<50% were
noted in 7(5.2%) and 23(17.2%)
patients respectively. The involvement of the mitral valve
in 59(44%), tricuspid valve in 21(15.7%)
and aortic valve in 6(4.5%) patients were
noted. Myocardial dysfunctions existed in 10(7.4%)
patients.
Conclusions: Our results showed a high prevalence of cardiovascular disorder in HIV
infected patients. We recommend the evaluation of the cardiovascular
system in all HIV infected patients
even if they are symptom free.
Forouzan Nia Skh, Hadadzadeh M, Mirhosseini Sj, Hosseini H, Abdollahi Mh, Forat Yazdi M, Rasti M, Dehghanizadeh H, Ghoreishian Sm,
Volume 68, Issue 9 (12-2010)
Abstract
Background: One of the most important components of coronary
artery bypass graft surgery is need for blood transfusion that increases
morbidity and mortality. The aim of this study was to evaluate the factors
affecting the need for blood transfusion during off pump coronary artery bypass
(OPCAB)
surgery.
Methods: In
this descriptive case control study 923
patients who had undergone OPCAB at Afshar Hospital in Yazd,
Iran, from July 2008 to January 2010
were evaluated. The data was gathered from their records and was analyzed.
Results: 54% of
male and 79% of female patient need
blood transfusion. Mean age in patients needed transfusion was 61.58±11.11
years and in other group was 60.27±10.98
years of the patients that needed transfusion (p= 0.08). 563
(61%) of the patients needed transfusion with the
average of two units. The need for blood transfusion was higher in female
gender (p< 0.0001),
low hematocrit (p< 0.0001),
diabetes (p< 0.001),
hypertension (p< 0.025)
and multiple grafts (p< 0.027).
There were no significant differences in preoperative hemostasis tests,
affection to hyperlipidemia, CVA or
renal failure, antiplatelet drug administration and the application of left internal
mammary artery between the transfusion and non transfusion groups.
Conclusion: In this study preoperative
hematocrit was most important risk factor in transfusion in patients that
underwent OPCAB. Female gender, preoperative
low hematocrit, multiple grafts, diabetes and hypertension increased the rate
of blood transfusion. According to the high prevalence of blood transfusion in OPCAB, considering factors that
affect the transfusion rate is essential.
Khansari M, Imani A, Faghihi M, Aali Anvari M, Moghimian M, Sadeghipour Roodsari Hr,
Volume 69, Issue 11 (2-2012)
Abstract
Background: Creatine kinase is a cardiac biomarker that is used for the assessment of ischemic injuries and myocardial infarction. The present study was designed to evaluate effects of oxytocin administration during ischemia and reperfusion periods on CK-MB levels in the coronary effluent of isolated rat heart and the possible role of oxytocin receptor, nitric oxide (NO), prostacyclin and mitochondrial ATP-dependent potassium channels in this regard.
Methods: Male wistar rats (n=8) were anesthetized with sodium thiopental and their hearts were transferred to a Langendorff perfusion apparatus. All animals were randomly divided into nine groups as follow in the ischemia-reperfusion group, hearts underwent 30 min of regional ischemia followed by 120 min of reperfusion. In oxytocin group, hearts were perfused with oxytocin 5 min after ischemia induction for 25 min. In other groups, 35 min prior to oxytocin perfusion, atosiban (a non-specific oxytocin receptor blocker), L-NAME (an NO synthase inhibitor), indomethacin (a non-specific cyclooxygenase blocker) and 5-HD (a specific mKATP channel blocker) were perfused for 10 min. In all groups, we measured CK-MB levels in the coronary effluent at the end of reperfusion. Moreover, coronary flow (mL/min) was measured at baseline, during ischemia period and 60 and 120 min after reperfusion.
Results: Oxytocin administration significantly reduced CK-MB level in oxytocin group as compared to ischemia-reperfusion group. Administration of atosiban, L-NAME, indomethacin and 5-HD prior to oxytocin perfusion abolished the effects of oxytocin on CK-MB levels.
Conclusion: Administration of oxytocin during ischemia and reperfusion periods deceased CK-MB levels but infusion of atosiban, L-NAME, 5-HD and indomethacin inhibited oxytocin from exerting its effects.
Gholampour F, Javadifar Ts, Karimi S, Eslam-Zadeh T, Owji Sm,
Volume 70, Issue 1 (4-2012)
Abstract
Background: Ischemia/reperfusion induced acute renal failure causes excretory functional disorders of nephrons. Ischemia/reperfusion injury is accompanied by generation of reactive oxygen species that leads to dysfunction, injury, and death of renal cells. Antioxidants of plant origin minimize the harmful effects of reactive oxygen species. The aim of this study was to determine the possible therapeutic potentials of Rosa canina L. in preventing renal functional disturbances during the post-ischemic reperfusion period.
Methods: In this experimental study undertaken for evaluating renal excretory function in 30 male Wistar rats, renal ischemia was induced by occluding both renal arteries for 45 min, followed by 24 h of reperfusion. The rats received 2 ml of tap water or a hydroalcoholic extract of Rosa canina (500 mg/kg) orally for 7 days before induction of ischemia. In plasma samples, creatinine and urea nitrogen levels were measured, and in renal tissue samples, red blood cells were counted. The data were analyzed using ANOVA and Duncan tests.
Results: Renal ischemia for 45 minutes increased plasma levels of creatinine (P<0.001) and nitrogen urea (P<0.01) while reducing red blood cell counts in renal glomeruli (P<0.001). Rosa canina administration diminished the increase in creatinine (P<0.001) and nitrogen urea concentrations (P<0.01), and prevented reductions in red blood cell counts in renal glomeruli (P<0.001).
Conclusion: Rosa canina seems to be useful as a preventive agent against renal damages induced by ischemia/reperfusion injuries in rats.
Kadkhodaee M, Khastar H, Seifi B, Najafi A, Delavari F,
Volume 70, Issue 2 (5-2012)
Abstract
Background: In a recent study, we were able to demonstrate a role for leukocyte transfer in the induction of liver damage in recipient mice after induction of IR (60 min of bilateral renal artery occlusion and 3 hrs reperfusion) injury in donors. The present study investigates the role of leukocyte transfer in the induction of kidney damage in recipient mice after induction of renal IR injury in donors.
Methods: Mice were divided into two sham and renal IR groups. After anesthesia, leukocytes were isolated from blood and were transferred to the two recipient groups: the intact recipient mice received leukocytes from the sham donor group (Sham recipient) and the intact recipient mice that received leukocytes from IR donor group (IR recipient). After 24 hrs, the recipient mice were anesthetized and blood samples and renal tissues were collected.
Results: Renal malondialdehyde (MDA) increased and glutathione and superoxide dismutase (SOD) decreased significantly in IR recipient group in comparison to sham recipient group. Although renal function tests, including BUN and plasma creatinine were significantly different between IR donor and sham donor groups, but they were not significantly different in two recipient groups. Renal tissues in IR donor group showed extensive damage compared to sham group, but in IR recipients' kidneys, they were different from IR donor tissues despite being different from their respective sham group.
Conclusion: These findings are suggestive of implication of leukocytes in renal tissue damage and oxidative stress after renal IR injury.
