Journal of Cardiovascular and Thoracic Research
Volume:2 Issue: 3, Aug 2010

Previous studies suggest a protective role of the essential trace elements against cardiovascular disease, whereas wistful epidemiological data remains controversial. We aimed to investigate the serum concentration of zinc (Zn) and copper (Cu) in patients presented with acute coronary syndrome (ACS) considering status of cigarette smoking. Baseline Zn and Cu concentrations were measured in 100 individuals [50 with unstable angina (UA) and 50 with acute myocardial infarction (AMI)]; then these parameters were compared with normal reference values. Current smoking status of patients in each group was analyzed considering values of serum trace elements concentration. In those patients who were admitted with ACS, mean serum Zn (62.1±13.4 µg/dL) and Cu (66.5±14.1 µg/dL) levels were lower compared to normal reference values (p < 0.001). No significant differences were observed between AMI and UA patients in serum Zn (59.6±12.9 vs. 65.7±14.2 µg/dL; p=0.28) and Cu (64.9±13.3 vs. 68.1±15.0 µg/dL; p=0.79) levels. Also there were not any statistically significant differences in Cu and Zn levels between smoker and non-smoker patients in each study group (p values> 0.05). Lower Zn and Cu serum concentration was found in patients with ACS but these relatively low levels are not significantly different between AMI and UA patients. Also, it seems that cigarette smoking dose not considerably affect serum levels of Zn or Cu in ACS patients

The high mortality rate of myocardial infarction (MI) before admission to hospital, particularly at younger ages, is a major health challenge. In fact 90% of MI deaths among patients < 55 years occur before arrival at hospital. This study sought to examine the association between methods of transfer with MI-related outcomes. The study was conducted among patients admitted to Taleghani Teaching Hospital (Urmia, Iran) with chest pain and symptoms of early MI. These patients were studied for endpoints including treatment (thrombolytics) and survival. Information was collected using a previously developed and validated questionnaire. Data analysis was performed by examining frequency, means and standard deviations for a range of variables. We estimated the association between method of transfer and outcome using paired t-test and one way ANOVA. Among 274 eligible patients with admissions for MI, 41 (15%) were transferred by ambulances using emergency telephone hotlines while the remainder used alternative means. Among those not using ambulance services, 143 were not aware of the existence of those services and 76 did not believe they were experiencing MI. 48.5% of all patients received thrombolytic (streptokinase) therapy. Patients arriving by ambulance were significantly more likely to receive thrombolytic therapy than other patients (p-value =0.001), although there was no significant difference in mortality between the groups (p-value =0.88). This hospital-based study from Iran has identified lack of knowledge about emergency ambulance services as well as lack of awareness about symptoms of heart attack to be major barriers to using available facilities.

Staphylococcus aurous has been known as one of the most common nosocomial pathogens which include as much as %30 to %50 of general population. Regarding to the presence of carrier staff can be considered as one of the infection source; remarking of carrier for prevention purposes is important. In a cross-sectional study we determined the prevalence of staphylococcus aurous carriage among 113 edical staff of Madani Heart Hospital, Tabriz (Iran) 28/08/2009 to 28/09/2009 on (Physicians, nurses, technicians, secretaries, the administrative personnel and services), including surgical wards, laboratory, ICU and CCU. In this study, 113 participants comprised of 60 males (53%) and 53 females (47%), and their mean age of participants in this study was 34.8 years (20-55). Sampling was carried out from nasal of employees. Samples were place on blood agar and mannitol salt agar; suspected colonies have been cultured and identified by catalase, coagulase and DNAase. Generally, of 113 people who entered the study, 30 person (26.5%) had positive cultures and 82 (72.6%) had a negative culture. The incidence of staphylococcus aureus carriage was more in men than women 57% vs. 43% (p<0.05). In this study staphylococcous areous carriage incidence in Tabriz heart centre (Madani hospital) was 50 % to 80% lower than our estimation, unexpectedly.

With attention to association of right atrial pressure to renal venous hypertension, we try to review renal function indices changing due to congenital heart disease as base of right atrial pressure and cyanosis condition. Forty five children without preexisting renal disease, diagnosed as pulmonary hypertension due to congenital heart disease with or without cyanosis entered to this study,their renal function indices besides to their right atrial pressure measured by angiographic documents. The effects of right atrial pressure and cyanosis on renal function indices evaluated by appropriate statistical methods. Right atrial pressure is not a common problem but it is more frequent in cyanotic than acyanotic patients. In addition significant proteinuria occurs in cyanotic patients with high right atrial pressure (above 5 mmHg). There is not any difference between renal function as glomerular filtration rate or creatinine in either groups of cyantic or acyanotic with a high or normal right atrial pressure. In cyanotic congenital heart disease patients who have pulmonary hypertension measuring of right atrial pressure seems essential; in high risk group including those with high right atrial pressure and cyanosis, significant proteinuria may happen in up to 30% of cases independent of age or gender. J Cardiovasc Thorac Res 2010

Mental situation of patients with cardiac surgery operation could be effective in recovery of them. The main target of recent study is to check out mental health situation according to delirium and cardiac surgery patients so as to assist them. 328 patients in Shahid Madani Hospital were examined by available sampling via questionnaire MMPI. Data were statistics analyzed. The results of study indicated that %14 patients on MMPI are sustainable which in cardiac operation %5 in miscellaneous surgery group and %4 in coronary one and %3 in valve operation group and %1.5 in congenital group, as well the number of damaged patients were much more in women. The results determined MA scale in level (p=/000) of pT (p=/01) and pd (p=/01) and Sc (p=/02) as well as PA (p=/02) in delirium ones are meaningful. The features are compatible with Shelly’s research studies as well Finland, Brazil, and Poland. With regard to %14 patients are damaged by MMPI, psychic and psychological complementary treatment is requested for cardiac patients.

The aim of the present study was to compare the hemodynamic changes of intravenous ondansetron and metoclopramide for prevention of post-operative nausea and vomiting in patients undergoing strabism surgery under general anesthesia. This is a randomized double blind clinical trial performed on 96 patients with average age of 6-12y/o, ASA (American Society of Anesthesiologists) physical status I and II candidated for strabism surgery with general anesthesia between the years 2009 till July 2010. After the hospital's Ethic Committe approval, the study was conducted in Tabriz University of Medical Sciences, Tabriz, IRAN. The patients were randomized into two groups, ondansetron (n=48) and metoclopramide (n=48). In this study ondansetron 50g/kg and metoclopramide 150g/kg administered intravenously five minutes before induction of general anesthesia after routine monitoring. Systolic and diastolic blood pressure and heart rate were measured as hemodynamic variables in both groups. In recovery room Aldrete scoring system employed as the patient's discharge criteria. Incidence and severity of post-operative nausea and vomiting documented in recovery room and in different times in surgical ward by using a specified scoring system and getting information from patients and their caregivers. There were not significant differences between two groups in demographics, hemodynamic parameters and anesthesia length. There was not also significant difference about the incidence and severity of nausea and vomiting between two groups. It is concluded that preoperative administration of both ondansetron and metoclopramide can decrease frequency and also intensity of post-operative nausea and vomiting without having significant difference and prominent complication

We describe a 70-year-old man who presented to our emergency department with worsening shortness of breath. His chest roentgenogram showed pulmonary congestion and his condition improved with heart failure treatment yet a repeat chest roentgenogram revealed an abnormality which had remained unnoticed in his first chest x-ray due to the underlying congestion in lung fields. Descending aorta was dilated and very prominent. Further work-up showed a type B dissection which seemed to be chronic. Considering the chronicity of the condition, the fact that it was actually asymptomatic and the patient’s fragile condition we decided not to proceed with surgery.

An 18-year-old otherwise healthy male presented with palpitation and dizziness following a football match. His blood pressure and heart rate was 90/70 mmHg and 200 beats per minute, respectively. Electrocardiogram (ECG) on admission showed a wide QRS tachycardia with typical AV dissociation and left bundle branch block pattern (Figure 1). Lidocaine and then amiodarone were administered but the arrhythmia persisted. Considering the refractoriness of the rhythm synchronized DC shock was applied to convert the rhythm. Post conversion ECG had sinus rhythm, right axis deviation, Q wave and T wave inversion in inferior leads and T wave inversion in leads V1-V3 with a typical epsilon wave (Figure 2). Chest radiography showed RV enlargement (Figure 3) and right ventricular (RV) enlargement with free wall thinning was evident on echocardiography (Figure 4). A diagnosis of arrhythmogenic RV dysplasia (ARVD) was made and an implantable cardioverter defibrillator (ICD) was implanted. Screening of his family members showed RV enlargement in one of his sisters.