journal of cardio-thoracic medicine最新文献

{"title":"Investigation serum procalcitonin in patients with exacerbation of obstructive pulmonary disease","authors":"Mina Delghandi, F. Rezaeetalab, F. Ebrahimzadeh, M. Najafi","doi":"10.22038/JCTM.2020.50524.1289","DOIUrl":"https://doi.org/10.22038/JCTM.2020.50524.1289","url":null,"abstract":"Introduction: Chronic obstructive pulmonary disease (COPD) is a disease of chronic diffuse irreversible airflow obstruction. Due to the relatively high prevalence of the disease, paying attention to the treatment of these patients helps a lot in controlling the disease and reducing its cost. This study aimed to investigate the presence of serum procalcitonin in patients with an acute attack of COPD. Methods & Materials: This cross-sectional study was performed on 65 patients with an acute COPD attack in Imam Reza Hospital in 2019 by the convenience sampling method. Three ccs of blood samples were taken from patients to check serum procalcitonin levels from hospitalization to 24 hours after that. Patients with an acute COPD attack were selected based on American thoracic society criteria. Also, demographic information such as age, sex, hospitalization time, and duration of the disease was recorded. Patient complaints, disease exacerbation, and type of ventilation were recorded. Data were analyzed with SPSS software (version 16). Man-Whitney and Kruskal Wallis tests were used to analyze the data. The significance level was Results: According to data, 65 patients (36 men and 29 women) were examined and the mean age of the patients was 66.72 (±12.65) years. Dyspnea was the most common complaint in patients. Serum procalcitonin levels were higher in patients with invasive ventilation (P = 0.007). Also, serum procalcitonin levels were lower in patients with non-invasive ventilation (P = 0.008). Besides, serum procalcitonin levels increase with increasing disease exacerbation from mild to moderate (P <0.001). According to the results of the post hoc test, there was a significant difference between mild and severe (P <0.001) and moderate and severe groups (P <0.001). There is also a significant correlation between procalcitonin serum levels and Exacerbation (R=0.6, P <0.001) and age (R=0.2, P = 0.01). serum procalcitonin levels were higher in patients with the use of invasive ventilation Conclusion: According to the results, serum procalcitonin levels are associated with acute COPD attacks. Measurement of procalcitonin levels in patients with acute COPD attacks can help diagnose and perform timely care.","PeriodicalId":131413,"journal":{"name":"journal of cardio-thoracic medicine","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121044030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posterolateral thoracotomy Approach for an Ectopic Mediastinum Thymoma: A Case Report","authors":"N. Razafimanjato, G. O. Tsiambanizafy, T. Ravelomihary, A. Rajaonera, H. Rakotovao","doi":"10.22038/JCTM.2020.48733.1274","DOIUrl":"https://doi.org/10.22038/JCTM.2020.48733.1274","url":null,"abstract":"Thymic epithelial neoplasms are commonly aetiology of the anterior mediastinum masses in adults. It represents 20–30% of all mediastinal tumours in adults. Ectopic thymomas usually affect the neck, mediastinal compartments, lung, and pleura, arising from aberrant thymic tissue. For giant thymoma, there is still no consensus on the surgical approach.  We herein report a patient with a giant thymoma that was successfully resected through a large right posterolateral thoracotomy. We report a rare case of a giant thymoma in the posterior mediastinal. Our patient underwent a conventional posterolateral thoracotomy to remove the mass. This latter was histologically diagnosed as a WHO classification type AB thymoma and Masaoka stage I. The choice of surgical approach of mediastinal tumor is based on the tumour topography, the assessment of tumour extension and extirpation, the surgeon's experience and clinical symptomatology. A multidisciplinary approach is mandatory to achieve good results.","PeriodicalId":131413,"journal":{"name":"journal of cardio-thoracic medicine","volume":"63 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114866486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mediastinal epidermoid cyst in an old man with recurrent pneumonia: A case report","authors":"Alireza Omranzadeh, Seyed Morteza Hoseini Jebeli, A. Ghodsi, M. M. Rashed","doi":"10.22038/JCTM.2020.50173.1282","DOIUrl":"https://doi.org/10.22038/JCTM.2020.50173.1282","url":null,"abstract":"Mediastinal epidermoid cyst is a rare condition that is considered as a congenital disorder. Various manifestations from asymptomatic cases to serious symptoms may be found in these patients. However, some cases may be diagnosed incidentally. Here, we report an old man with recurrent pneumonia who demonstrated symptoms of respiratory distress and chest pain. The high resolution computed tomography (HRCT) and subsequent magnetic resonance imaging (MRI) showed a hypodense mass with internal calcification. CT-scan guided transthoracic needle biopsy confirmed diagnosis of mediastinal epidermoid cyst. The mass was resected through open surgery and patient’s symptoms were subsided.","PeriodicalId":131413,"journal":{"name":"journal of cardio-thoracic medicine","volume":"222 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115532349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Impact of Thrombolysis in Myocardial Infarction Risk Index on Hospitalization Mortality of Patient with Acute Pulmonary Embolism","authors":"A. Separham, B. Sohrabi, Javad Mohammadalizadeh","doi":"10.22038/JCTM.2020.49497.1277","DOIUrl":"https://doi.org/10.22038/JCTM.2020.49497.1277","url":null,"abstract":"Introduction: Acute pulmonary embolism (PE) is one of the deadly cardiovascular diseases. One of the indexes proposed in these patients for risk stratification is the Thrombolysis in Myocardial Infarction (TIMI) risk index (TRI), which includes three parameters of systolic blood pressure, age, and heart rate. This study aimed to evaluate the predictive value of TRI on in-hospital and 30-day mortality of PE patients. Materials and Methods: This cross-sectional study included 345 patients who were diagnosed with acute PE in Madani Heart Center from January 2012 to January 2017. Demographic characteristics, hemodynamic findings upon first admission, type of treatment (i.e., thrombolytic, anticoagulant, or surgery), as well as in-hospital and 30-day outcomes were recorded for all patients. The TRI and simplified Pulmonary Embolism Severity Index (PESI) were calculated for all patients. Results: The overall and in-hospital mortality rates were 8.7% and 8.1%, respectively. The mortality group were significantly older and had significantly higher heart rates, cardiac troponin levels, simplified PESI scores, and TRI followed by lower systolic blood pressure and O2 saturation. Moreover, the TRI obtained specificity, sensitivity, positive, and negative predictive values of 98.78%, 25.25%, 89.29%, and 76.66%, respectively, using receiver operating characteristic curves and a cut-off value of 36.73. Using the multiple logistic regression analysis we found that TRI>36.73, older age, higher heart rate and lower SBP could predict 30-day mortality.   Conclusion: Theresults showed that the risk of in-hospital mortality is higher with an increase in TRI. Furthermore, despite the high specificity, lower sensitivity limits its utility.","PeriodicalId":131413,"journal":{"name":"journal of cardio-thoracic medicine","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133183786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Co- infectious Cytomegalovirus and Pneumocystis Jiroveci Pneumonia in a Polyarteritis Nodosa Patient: A Case Report","authors":"F. Sharafi, Mahnaz Mozdourian, F. Rezaeetalab","doi":"10.22038/JCTM.2020.50210.1283","DOIUrl":"https://doi.org/10.22038/JCTM.2020.50210.1283","url":null,"abstract":"Our report discusses a patient diagnosed with PAN since 3 years ago. He presented with fever, chills and nonproductive cough. He was a long time receiver of immunosuppressant drugs for his underlying condition. Upon examination he was febrile, had cushingoid appearance and cackles in both lungs. Lung CT scan showed opacities in right upper lobe lung and multiple bilateral nodules and ground glass opacity along with mild thickening of pleura. A bronchoscopy was ordered to asses PCP, and without hesitation empirical therapy was started. However, his clinical condition did not improve as expected. At this time, suspecting another infection at play, a PCR and BAL specimen was ordered for CMV. After receiving the result of BAL analysis, our suspicion was confirmed for both PCP and CMV pneumonia. CMV is an important opportunistic infection in immunocompromised individuals. This case highlights this importance in immunocompromising conditions. In this setting, presence of respiratory signs and symptoms point out to PCP as the first differential diagnosis; but at the same time it’s crucial for clinicians to consider the possibility of CMV as a co-infective agent.","PeriodicalId":131413,"journal":{"name":"journal of cardio-thoracic medicine","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123972011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Off-Pump Versus On-Pump Coronary Artery Bypass Graft Surgery, prospective cohort study","authors":"Mohammad Abbassi Teshnisi, G. Safarpoor, Atefeh Ghorbanzadeh, M. Akbari, Kayhan Mizani, Mahsa Moallemi, Omid Javdanfar, Aliasghar Moeinipour","doi":"10.22038/JCTM.2020.50378.1285","DOIUrl":"https://doi.org/10.22038/JCTM.2020.50378.1285","url":null,"abstract":"Introduction: Coronary artery bypass grafting is a surgical operation that bypasses atherosclerotic coronary vessels and restores blood flow to the ischemic zone of hearts. And two different conventional methods are ON-pump CABG, and Off-pump CABG.  Altogether, the efficacy and safety of these two types of surgical procedures are still under debate. In this study, we aim to compare the efficacy, safety, and cost-effectiveness of these two different methods in admitted patients to Imam Reza Hospital in Mashhad in Iran during 2006 to 2016. Materials and Method: In this prospective cohort study, 533 patients who underwent CABG in Imam Reza hospital in Mashhad during 2006 to 2016 were identified. The data was collected using hospital records including demographic data, chief complaint, history of previous disease, ejection fraction, number of graft, blood transfusion, time of anesthesia, time of surgery, days of hospitalization, days of ICU stay, needs for reoperation, post-operative complication, expenses of hospitalization. Results: Of 533 patients were 347 patients of whom male. The mean age was 59.53±10.21 and the mean BMI was 26.38±5.4. The most common chief complaint of the patients was chest pain. 38 patients of 533 cases underwent on-pump surgery and 495 underwent off-pump technique. There were no significant differences for age, and gender. The prevalence of HTN, diabetes, MI, and hyperlipidemia had no differences among two groups. Renal failure was more common in on-pump group; whereas, pulmonary disease was more common in off-pump group. On-pump surgery required significantly longer hospitalization and ICU care. Also needs for reoperation was more common among on-pump surgery. Total expenses were significantly higher in on-pump group.10.5% of those who underwent on-pump surgery died after surgery. This rate was only 3.1% among off-pump group. Conclusion: In this study we showed that, the patients who underwent on-pump surgery, required longer hospitalization, and ICU care. Total expenses were significantly higher in on-pump group. In addition, the mortality rate of on-pump group was significantly higher than the off-pump group. Also needs for reoperation was more common among on-pump surgery. Altogether, it seems that off-pump surgery is safer with low expenses than on-pump CABG.","PeriodicalId":131413,"journal":{"name":"journal of cardio-thoracic medicine","volume":"151 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131052464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aortic Valve replacement with Reduction Aortoplasty with Mesh Prosthesis in 75 years old with Sever aortic Regurgitation with Aortic Aneurysm","authors":"Hamid Hoseinikhah, Mohammad Abbassi Teshnisi, Omid Javdanfar, Aliasghar Moeinipour","doi":"10.22038/JCTM.2020.50626.1288","DOIUrl":"https://doi.org/10.22038/JCTM.2020.50626.1288","url":null,"abstract":"Although classic and standard procedure for patients with ascending Aorta aneurysm with Sever aortic Regurgitation is Bentall surgery but in some selected cases this complex surgery was not performed with different reason like advanced age and coexisting comorbidity involving renal and hepatic and lung Function. In our cases 75 years old man with chronic renal failure ( Cr= 3.2 ) who was known case of sever aortic Regurgitation and Ascending Aortic Aneurysm with 5.5 diameter.replacement of Aortic Valve with Biologic Prosthesis Aortic Valve and Reduction Aortoplasty with Mesh prosthesis was done successfully with good result with early follow up.","PeriodicalId":131413,"journal":{"name":"journal of cardio-thoracic medicine","volume":"52 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132870060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Clinical background and yield of chest tube thoracotomy in hydropneumothorax , a pulmonologist point of view.","authors":"M. Devraj, Deepali R Gaikwad","doi":"10.22038/JCTM.2020.48907.1275","DOIUrl":"https://doi.org/10.22038/JCTM.2020.48907.1275","url":null,"abstract":"Introduction: The enlightenment of Hydro-pneumothorax arrived in former times of primitive Greece. It is a term which explains simultaneous existence of both free air and fluid (i.e., pneumothorax and hydrothorax) in the pleural space.The goal was to contribute and update the knowledge of clinical aspect as well as yield of diagnostic modalities in handling the cases of Hydropneumothorax. Materials and Methods: Diagnosed cases of hydropneumothorax from casualty and routine OPD are considered. Detail of clinical background entered. Patients were subjected for analysis of sputum, blood and pleural fluid. Radiological investigation was done. Patients underwent tube thoracotomy procedure and observed till resolution.  Results: Total 97 subjects had participated. Among them 76(78.35%) were men and 21 (21.64%) women. 91(93.85%) subjects had shortness of breath.  34 subjects (35.05%) had tuberculosis in the past.  Sputum smear AFB was positive in 19 subjects (19.58%). Plural fluid GeneXpert MTB was detected in 11 subjects (11.34 %) and MGIT Culture positive in 23(23.71%) subjects. Plural fluid gram stain culture was conclusive in 24 (24.74%) subjects. Pleural fluid ADA was raised in 74 (76.28%) subjects. Hypoxemia was observed in 46 (47.42%). In 38 (39.19%) cases chest tube was removed between 31 to 60 days.  Conclusion: Tuberculosis turns up as the most common aetiology of hydropneumothorax and duration required for resolution is uncertain. Evaluation of pleural fluid (cytology, microbiological culture, biochemical measure) and Computed tomography were essential to reach aetiology of condition. Chest tube thoracotomy remains most practiced modality of treatment in hydropneumothorax. However advanced techniques have promising outcome and it’s an opportunity to research further.","PeriodicalId":131413,"journal":{"name":"journal of cardio-thoracic medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115337015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac arrhythmia due to ledipasvir/sofosbuvir Iranian counterpart, commercially named as Ledibiox: A case report","authors":"Alireza Heidari Bakavoli, A. Ghodsi, Alireza Omranzadeh, M. Bijari, S. Hosseini","doi":"10.22038/JCTM.2020.48728.1273","DOIUrl":"https://doi.org/10.22038/JCTM.2020.48728.1273","url":null,"abstract":"Sofosbuvir is an antiviral drug that entirely revolutionized the treatment of hepatitis C. This drug has an Iranian commercial brand, which is known as Ledibiox. Several adverse events have been reported with this drug, including syncope, pancolitis, and exacerbated pulmonary arterial hypertension; however, arrhythmia rarely has been described through the literature. Here, we report a 40-year-old Caucasian man who presented with chest pain, tachycardia, blurred vision, and severe headache; whose electrocardiography showed an atrial tachycardia along with a block. It seems that Sofosbuvir toxicity can cause arrhythmia, and the drug prescription should be halted in this situation.","PeriodicalId":131413,"journal":{"name":"journal of cardio-thoracic medicine","volume":"69 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124023247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Left Atrial Strain Parameter in Coronary Artery Stenosis: A New Tool to Predict LCX Stenosis","authors":"H. Poorzand, Masoomeh Alvandi Azari, A. Eshraghi, Hedieh Alimi, L. Bigdelu, M. Emadzadeh","doi":"10.22038/JCTM.2020.49964.1280","DOIUrl":"https://doi.org/10.22038/JCTM.2020.49964.1280","url":null,"abstract":"Introduction: Speckle tracking echocardiography (STE) based on frame-to-frame tracking of acoustic speckles is a novel angle-independent method, used for evaluating myocardial deformation and recently to assess left atrium (LA) function.Aim: To the best of our knowledge, there is no investigation evaluating the predictor role of LA strain parameters in detection of coronary artery stenosis in ischemic heart disease. In this study, we assessed this parameter for predicting the culprit artery in patients underwent selective coronary angiography (SCA) in Mashhad, Iran. Patients and Methods: This was a case-control study, which was performed in Imam Reza and Quaem Hospitals in Mashhad, Iran between 2017 and 2018 in patients referred for SCA. Subjects with two or three- vessel diseases were excluded .Sixty-five cases were included in the study and divided into four groups according to the vessel involved : Group (1): normal coronary artery subjects (n=36); group (2): patients with left anterior descending (LAD) artery stenosis (n=12); group (3): patients with left circumflex artery (LCX) stenosis (n= 7) and group 4: patients with right coronary artery (RCA) stenosis (n=10). Patients underwent routine TTE and Speckle Tracking Imaging.Results: The mean age of participants was 56.72± 10.69 years old. The male/female ratio was 0.96. Mean absolute value of LA strain was 24.74% in normal subjects, while in groups with stenotic coronary artery disease, less values were defined as 18.63%, 16.03% and 19.05%, respectively (p value=0.05). The amounts of left ventricle end systolic volume (LVESV), LV global longitudinal strain (GLS) and Em of septal annulus were significantly different between normal group and those with LCX stenosis. Among different echocardiographic parameters, LA strain, LVESV and Em of septal annulus were defined as predictors of LCX occlusion with regression analysis. Conclusion: LA strain in subjects with coronary artery stenosis was lower than the strain in normal group and could predict isolated LCX occlusion.","PeriodicalId":131413,"journal":{"name":"journal of cardio-thoracic medicine","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133648025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}