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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  [14 journals]
  • Efficacy of Intraoperative, Single-Bolus Corticosteroid Dose to Prevent
           Postoperative ...

    • Abstract: Introduction: Esophageal cancer is among the most common malignancies. Hospital mortality in the past decade reduced; but its morbidity is still high. Pulmonary complications are the most common complications after esophageal resection. In this study we examined the effect of steroids administration during surgery to reduce postoperative morbidity with a focus on respiratory complications.Material and Methods: Patients with esophageal cancer who underwent transhiatal esophagectomy, randomly divided into two groups to thirty patients: The intervention group (received 125mg methylprednisolone sodium succinate). After surgery, patients admitted in the ICU for a day. Oral feeding initiated on day 7th and patients discharged home on the day 8th or 9th.Postoperative complications included anastomotic fistula, wound infection in the neck and abdomen and pulmonary complications. We analyzed pulmonary complications included pneumonia, Acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) occurred before the seventh day. The leukocyte counts and CRP levels measured on the 2nd and 7th days after surgery.Results: 60 patients enrolled in the study. Incidence of ARDS, ALI and pneumonia in the control group was 3, 5 and 2 and in steroid group 1, 1 and 1 respectively. CRP levels and blood leukocyte count was similar in two groups on the second day but seventh day values and difference between the two levels between the second and seventh days were significantly different between the two groups (p<0.001).Conclusion: Intraoperative single dose corticosteroids are effective in preventing pulmonary complications after transhiatal esophagectomy. Methylprednisolone reduced the increase in CRP levels after surgery and decreased blood leukocyte count more in postoperative period.
      PubDate: Wed, 28 Feb 2018 20:30:00 +010
       
  • Relationship between Neutrophil-to-lymphocyte Ratio and the Severity of
           Coronary Artery Disease ...

    • Abstract: Introduction: Neutrophil-to-lymphocyte ratio (NLR) is considered as an independent predictor of long-term prognosis in the individual patients with coronary artery disease (CAD). This study sought to assess the relationship between NLR and CAD severity in Iranian patients undergoing cardiac catheterization.Material and Methods: This prospective study was conducted on 500 patients with acute coronary syndrome (ACS) presented to Shahid Beheshti Hospital, Qom, Iran, for admission and underwent cardiac catheterization between March 2015 and May 2017. The patients were assigned into three groups of high NLR (more than 3), intermediate NLR (between 2 and 3), and low NLR (less than 2). Then the CAD severity and its relationship with NLR were assessed.Results: According to the results, there was a significant difference between the groups in terms of CAD severity (P<0.001), and high NLR was independently associated with more severe CAD.Conclusion: Given the results of this study, high NLR was associated with CAD severity.
      PubDate: Wed, 28 Feb 2018 20:30:00 +010
       
  • Indication of Flexible Fiberoptic Bronchoscopy and the Histopathological
           Examination in 500 Patients

    • Abstract: Introduction: The importance of flexible fiberoptic bronchoscopy (FFB) for diagnosis of pulmonary diseases is well known. The aim of this study was to evaluate the indications of 500 FFBs performed in Imam Reza hospital, Mashhad, Iran as well as examination of the histopathological and radiological findings.Material and Methods: This was a retrospective analysis of the medical records and chest radiologic examinations of 500 patients who had undergone FFB using Olympus BFP20 instrument by local anesthesia in, Mashhad, Iran.  The indications for procedures, demographic data, and clinical symptoms were recorded and analyzed in addition to radiological and histopathological findings.Results: The most common indication for FFB was found to be bronchogenic carcinoma (n=20), followed by tuberculosis (TB; n=16), sarcoidosis (n=2), and hydatid cyst (n=2). A total of 70 anthracosis cases were reported to be accompanied with other pulmonary disorders and findings such as chronic granulomatous bronchitis suspicious of TB (n=16), squamous cell carcinoma (SCC; n=5), non-specific macrophage cells in cytology (n=19), anthracotic pigment with no risk of lung cancer (n=20), anthracofibrosis (n=4), severe anthracotic pigment with undetectable mucus layer (n=2), anthracotic pigment with non-specific inflammation (n=1), mild squamous metaplasia (n=1), and chronic bronchitis with mild squamous metaplasia (n=2). Lung cancer showed higher frequency in women and patients in the sixth and seventh decades of their lives and was associated with smoking. It is worthy to note that SCC was the most prevalent cancer among the smokers. Twenty cases were diagnosed as bronchogenic carcinoma by clinical findings, eighteen of which also being confirmed by the histological examinations. Moreover, two cases of sarcoidosis diagnosis using FFB were approved by biopsy. Out of 297 bronchial biopsies, the most common indication for FFB were airway collapse and unknown pulmonary opacity.Conclusion: Considering the important role of FFB in the diagnosis of pulmonary diseases, especially cancers, it seems that various diagnostic measures should be taken into consideration before disease progression. According to our evaluations, patient screening by the family physicians is recommended for the patients with cancer or TB as the two most prevalent diseases in our study.
      PubDate: Wed, 28 Feb 2018 20:30:00 +010
       
  • The evaluation of e-health adoption by Iranian citizens

    • Abstract: The advances in the diagnosis and management of diseases, especially chronic conditions, necessitates the development of health care systems and are time-consuming. The introduction of e-health system as an efficient tool for the management and care of patients in the recent decades has resulted in a significant success in this regard. However, the implementation of this system accompanies with some challenges in some countries, such as Iran. Regarding this, the present review aimed to discuss the definition of e-health and the barriers of applying this system.
      PubDate: Wed, 28 Feb 2018 20:30:00 +010
       
  • Seven-Year Survival of a Patient with Primary Tracheal Squamous Cell
           Carcinoma after Surgery: A ...

    • Abstract: The primary tracheal cancers are very rare, and squamous cell carcinoma is its most common form, especially in smokers. Due to the late presentation of symptoms, these tumors are usually diagnosed too late, and thus, they have poor survival. The gold standard protocol for these cancers is surgical excision and adjuvant radiotherapy. Primary radiotherapy is applied for the advanced and inoperable patients.In this study, we present the case of a 78-year-old woman with a history of heavy smoking, coughing, and dyspnea for a long time. During the diagnostic evaluations, bronchoscopy was carried out and a vegetated tumor was observed about 5 cm below the vocal cords. The patient was referred to the Department of Cardiothoracic Surgery, Ghaem Hospital of Mashhad University of Medical Sciences, Iran, for surgical management. The tumor was removed with rigid bronchoscopy, and her dyspnea temporarily improved. The pathology report indicated that the patient was suffering from squamous carcinoma. Therefore, she required reoperation to excise the invaded trachea with a tumor-free margin. Ultimately, considering no marginal involvement, lymphatic metastasis, or distant metastasis, the patient was discharged and referred to receive additional oncological treatments with the recommendation of annual surveillance bronchoscopy. Seven years after the operation, the patient is still alive and healthy without any local recurrence or metastasis at the age of 82.
      PubDate: Wed, 28 Feb 2018 20:30:00 +010
       
  • Pulmonary Nodular Lymphoid Hyperplasia: A Rare Case Mimicking Malignancy

    • Abstract: Pulmonary nodular lymphoid hyperplasia (PNLH) is a reactive lymphoid proliferation manifesting as multiple solitary nodules or localized infiltrates in the lungs. It is a type of benign lymphoproliferative disease that can affect the lungs. We present the case of a 41-year-old female patient with respiratory symptoms such as productive cough, left chest pain, and dyspnea. Imaging findings revealed two lesions with lobulated contour in the left upper lobe apicoposterior segment and left lower lobe superior segment. After examining the minimally invasive diagnostic methods, this rare PNLH case mimicking malignancy was both diagnosed and treated by surgery. Further studies including more patients and longer follow-ups are needed for this rare disease.
      PubDate: Wed, 28 Feb 2018 20:30:00 +010
       
  • Primary Hydatid Disease of the Chest Wall Presenting as a Chest Wall Tumor

    • Abstract: Hydatid cyst is a parasitic disease that is endemic in Mediterranean areas, South America, North Africa, Australia, and Iran. Although the liver and lung are the most common involved organs, but the other organs in human body also can be involved by hydatid cyst. Chest wall involvement by hydatid cyst is a rare condition, which may be misdiagnosed as chest wall tumor in the endemic areas. Herein, we presented a case of primary chest wall hydatid cyst mimicking chest wall tumor.
      PubDate: Wed, 28 Feb 2018 20:30:00 +010
       
  • Cystic Lung Disease in a Young man

    • Abstract: A 32-year-old man was admitted in the Emergency Department with acute dyspnea secondary to spontaneous pneumothorax. He had history of spontaneous pneumothorax 2 years ago.He was active cigarette smoker (10 pack/year). The family history was unremarkable for lung diseases. Additionally, he had no systemic complaints.The lung HRCT revealed multiple bizarre-shaped cysts distributed in both lungs with more severe involvement of upper and middle parts (Figure 1).Since the HRCT findings were characteristic and he was smoker, the diagnosis of pulmonary langerhans cell histiocytosis (PLCH) was proposed. Small chest tube was inserted in left side and after 5 days it was easily removed.He was recommended to quit smoking and close follow-up.
      PubDate: Wed, 28 Feb 2018 20:30:00 +010
       
  • The Relationship Between Diabetes Mellitus and Pulmonary Diseases: A
           Systematic Review

    • Abstract: In this study, we aimed to review the relationship between pulmonary diseases and diabetes and to identify the most common pulmonary diseases presenting with diabetes during 2000-2016. The incidence of pulmonary diseases has reported among diabetic patients while TB was reported to have a higher rate when compared to other pulmonary disorder in diabetic patients. While the incidence of TB is mostly reported in patients with human immunodeficiency virus infection and diabetes, there are few studies had done based on the relationship of diabetes mellitus and tuberculosis, and there is no specific recommendation on the association between diabetes mellitus and tuberculosis in the World Health Organization program as well. Screening of tuberculosis patients for diabetes mellitus is essential for improving care services, especially in tuberculosis patients with concomitant diabetes mellitus. Therefore, conducting further studies on these two disorders is recommended, particularly in places where the incidence of diabetes is increasing rapidly, and tuberculosis remains endemic.
      PubDate: Wed, 28 Feb 2018 20:30:00 +010
       
 
 
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