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Journal of Cardio-Thoracic Medicine
  [2 followers]  Follow
    
  This is an Open Access Journal Open Access journal
   ISSN (Print) 2345-2447 - ISSN (Online) 2322-5750
   Published by Mashhad University of Medical Sciences Homepage  [12 journals]
  • Evaluation of Superiority of FEV1/VC Over FEV1/FVC for Classification of
           Pulmonary Disorders

    • Abstract: Introduction: Forced expiratory value in one score  (FEV1)/ Forced vital capacity (FVC) was used in classical literature for primary classifications of pulmonary disorders. American Thoracic Society/ European Respiratory Society guidelines recommended using FEV1/VC instead of FEV1/FVC.The aim of study was determination of the extent of superiority of FEV1/VC over the FEV1/FVC. Materials and Methods: Two hundred seven subjects whom suffered from different pulmonary disorders were evaluated by standard spirometry, lung volume and Carbon mono-oxide lung diffusion capacity (DLCO). Accuracy of FEV1/VC and FEV1/FVC for diagnosing lung disease was compared by area under the ROC curve, sensitivity and specificity analysis including Kraemer efficiency and likelihood ration methods. Gold standards were diagnosis confirmed by over-all clinical and para-clinical judgment. Results: Primary classification of FEV1/FVC and FEV1/VC according to gold standards showed that FEV1/FVC detected obstructive and restrictive lung disease better than FEV1/VC. FEV1/FVC was able to detect the obstructive and restrictive lung disease correctly in 61% and 34% and FEV1/VC in 56% and 33% respectively. FEV1/FVC showed 100% agreement with forced expiratory flow (FEF)=25-75%,   and Maximum expiratory flow (MEF)=50% but this agreement for FEV1/VC was 95-96%. Accuracy assessments revealed the superiority of FEV/FVC in the likelihood ratio method. Also, based on the ROC curve and Kraemer’s coefficient, more accurate results were obtained by FEV1/FVC, compared to FEV1/VC. Conclusion: FEV1/FVC showed marginally higher accuracy for detecting lung disease than FEV1/VC.
      PubDate: Sat, 31 Oct 2015 20:30:00 +010
       
  • The Correlation Between the Six Minute Walk Test and Spirometric
           Parameters in Patients with ...

    • Abstract: Introduction: Systemic Lupus Erythematosus (SLE) is an autoimmune disease affect nearly every organ system. Pulmonary involvement, which is a common manifestation of SLE, can remain undiagnosed if asymptomatic. This study aimed to evaluate the efficiency of spirometric findings in early detection of silent pulmonary involvement and examine its correlation with the six minute walk test in SLE patients. Materials and Methods: In this cross-sectional study fifty patients, who met the American College of Rheumatology criteria for SLE, were recruited from the outpatient rheumatology clinic at the Imam Reza Hospital of Mashhad between July 2013 and September 2014. First, a checklist including demographic information and previous medical documents was completed. Then, spirometry and 6MWT was performed to evaluate subclinical pulmonary involvement and assess patients’ exercise capacity. Results: Based on the results of pulmonary function tests, patients were divided into two groups. A total of 40 patients with normal pattern were placed in one group and 10 patients with restrictive pattern in the other. The difference between SLE patients with and without abnormal spirometry were statistically significant in regard to anti-RNP positivity but total distance walked in six minute, was not significantly different between two groups (p=0.356). Additionally, there were no significant correlations between 6MWD and FVC in SLE patients in the either group as determined by Pearson’s correlation coefficient testing. (R=0.439,P=0.205 in SLE patients with normal spirometry and R=0.191,P=0.237 in those with abnormal pattern) Conclusion: Considering the impact of anti-U1RNP positivity with restrictive pattern on spirometry, it can be deemed as a pulmonary involvement predictor in SLE patients. However, lack of correlation between 6MWT and spirometric parameters is suggestive of restrictive lung involvement, which in turn, demonstrates a multifactorial basis for limited exercise capacity in patients with SLE. Thus, the application of the 6MWT as a measure of pulmonary function is called into question.
      PubDate: Sat, 31 Oct 2015 20:30:00 +010
       
  • Clinical Profile of Suspected and Confirmed H1N1 Influenza Infection in
           Patients admitted at a ...

    • Abstract: Introduction: This study aimed to evaluate the clinical profile and outcomes of adult patients screened and diagnosed with H1N1 influenza infection at a tertiary care hospital in India. Materials and Methods: This retrospective  study was conducted on all adult patients suspected of H1N1 influenza admitted at a teaching hospital during the epidemic period of January-March 2015. Patients were screened and classified into three categories of A, B, and C based on international guidelines. Home confinement was recommended for patients in category A, and subjects in category B received treatment with Oseltamivir capsules. In addition, patients in category C received inpatient treatment with oseltamivir capsules. Results: In total, 695 patients were screened for H1N1 influenza infection during the epidemic, out of whom 380 patients (54.6%) were in category A, 264 (37.9%) were in category B, and 51 (7.3%) were in category C. Throat swabs were collected and examined for 192 ( 27.6%) patients, and 59 ( 8.4%) cases were positive for H1N1 infection. Conclusion: According to the results of this study, close vigilance over the symptoms of patients infected with H1N1 influenza is more important than treatment and screening of suspicious cases during the epidemics of this infection. This is a retrospective cross sectional study. Hence, there were no comparative controls. The limitation of this study is,  thus the lack of control.
      PubDate: Sat, 31 Oct 2015 20:30:00 +010
       
  • Clinical and Para-Clinical Presentations of Endobronchial Tuberculosis

    • Abstract: Introdution: Tuberculosis (TB), with different types of respiratory tract involvements, has a high rate of mortality all around the world. Endobronchial involvement, which is a slightly common tuberculous infection, requires special attention due to its severe complications such as bronchostenosis. Aim of study of this study was describes, one type of pulmonary tuberculosis with less diagnosed and delayed treatment. High suspicious needs to diagnose and may be need bronchoscopy for confirmed the diagnosis. It can be associated with sever complication and early diagnosis and treatment are necessary for prevention of adverse effect.   Materials and Methods: This retrospective study was conducted in a teaching hospital during 2005-2010. Patients diagnosed with endobronchial tuberculosis through bronchoscopic biopsy were included in the study. Diagnosis was confirmed by observation of caseous necrosis, bronchial lavage fluid or positive acid-fast staining in tissue samples obtained through bronchial biopsy. Moreover, demographic information, endobronchial view, lab tests, as well as clinical and radiographic findings were reviewed and evaluated retrospectively. Results: A total of 20 cases were confirmed with endobronchial tuberculosis, 75% of whom were female with the mean age of 60 years. The results showed that the most common clinical symptom was cough (80%), the most common finding in the chest X-ray was consolidation (75%), and the most common bronchoscopic feature was anthracosis (55%). Conclusion: TB is still a major concern, particularly in the developing countries. Thus, in order for early diagnosis and prevention of this disease, we need to pay meticulous attention to its clinical manifestations and bronchoscopic features.
      PubDate: Sat, 31 Oct 2015 20:30:00 +010
       
  • Does Airway Pressure Release Ventilation Mode Make Difference in
           Cardiopulmonary Function of ...

    • Abstract: Introduction: Tuberculosis (TB), with different types of respiratory tract involvements, has a high rate of mortality all around the world. Endobronchial involvement, which is a slightly common tuberculous infection, requires special attention due to its severe complications such as bronchostenosis. Aim of study of this study was describes, one type of pulmonary tuberculosis with less diagnosed and delayed treatment. High suspicious needs to diagnose and may be need bronchoscopy for confirmed the diagnosis. It can be associated with sever complication and early diagnosis and treatment are necessary for prevention of adverse effect. Materials and Methods: This retrospective study was conducted in a teaching hospital during 2005-2010. Patients diagnosed with endobronchial tuberculosis through bronchoscopic biopsy were included in the study. Diagnosis was confirmed by observation of caseous necrosis, bronchial lavage fluid or positive acid-fast staining in tissue samples obtained through bronchial biopsy. Moreover, demographic information, endobronchial view, lab tests, as well as clinical and radiographic findings were reviewed and evaluated retrospectively. Results: A total of 20 cases were confirmed with endobronchial tuberculosis, 75% of whom were female with the mean age of 60 years. The results showed that the most common clinical symptom was cough (80%), the most common finding in the chest X-ray was consolidation (75%), and the most common bronchoscopic feature was anthracosis (55%). Conclusion: TB is still a major concern, particularly in the developing countries. Thus, in order for early diagnosis and prevention of this disease, we need to pay meticulous attention to its clinical manifestations and bronchoscopic features.
      PubDate: Sat, 31 Oct 2015 20:30:00 +010
       
  • An Investigation of the Effects of Aerobic Exercise on Serum Brain
           Natriuretic Peptide and ...

    • PubDate: Sat, 31 Oct 2015 20:30:00 +010
       
  • Right Atrium Laceration with Pericardial Tamponade: A Rare Presentation of
           Blunt Cardiac Trauma

    • Abstract: Cardiac laceration from blunt thoracic trauma is not a common presentation. The rate of mortality due to this injury is very high since it is not diagnosed and treated immediately. In this study, we present the case of a 65-year-old man with blunt cardiac trauma, causing right atrial rupture and pericardial tamponade. Successful management of this patient was firstly done with initial pericardiocentesis. Then, the patient was immediately transferred to the operating room for tamponade relief and cardiac wall repair. We recommend that cardiac surgeon have  an important suspicious for cardiac involvement in Blunt chest wall trauma
      PubDate: Sat, 31 Oct 2015 20:30:00 +010
       
  • Cardiac Rhabdomyomas and Congenital Hypothyroidism: A Coincidence or
           Hamartia

    • Abstract: Cardiac rhabdomyomas are the most common primary cardiac tumors in children. These tumors are generally asymptomatic, although they may be associated with neonatal tuberous sclerosis complex. Despite the fact that thyroid dysfunction rarely occurs in tuberous sclerosis, papillary adenomas (hamartomas) of the thyroid gland have been reported in a number of autopsies. Herein, we present the case of an infant with tuberous sclerosis, congenital hypothyroidism and multiple cardiac rhabdomyomas, leading to atrioventricular node dysfunction. Considering the rarity of this co-occurrence, we decided to report the present case. The co-occurrence of these two disorders in one patient may be a mere coincidence or related to hamartoma of the thyroid gland as a consequence of tuberous sclerosis gene products.
      PubDate: Sat, 31 Oct 2015 20:30:00 +010
       
 
 
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