محمدکاظم طرزمنی

The prevalence of chronic kidney disease (CKD) is increasing every year, which increases the risk of cardiovascular disease and even death. In Cardiorenal syndrome type 2 (CRS2), chronic cardiac dysfunction causes renal dysfunction. The aim of this study was to evaluate Doppler ultrasound of renal veins, calculate venous impedance index (VII) and determine their associations with the prognosis of CRS2 syndrome in patients with a history of chronic heart disease and CKD with a good forward function.

In this descriptive-analytical study, 49 patients referred to Imam Reza Hospital in Tabriz with heart failure and renal dysfunction were selected. Renal status, VII and ejection fraction (EF) were evaluated.

Mean age of the patients was 61.83±12.39 years, 42.9% of which were women and 57.1% were men. The durations of heart and renal failure were 33.16 ± 13.8 and 11.76±5.1 months, respectively. Significant associations were found between VII and EF of the right and left kidneys (P=0.01 and P =0.03, respectively). But there was no statistically significant relationship between renal function and EF (P =0.54). With increasing edema rate, both VII and EF were decreased; however, these associations were not statistically significant (P >0.05).

According to the results, significant associations were found between VII and EF of right and left kidneys, however, no statistically significant correlations were observed between edema and VII mean and EF.

Dense breasts are considered as limitation for the sensitivity of mammography. This study evaluates the role of adjunctive breast ultrasound screening in women with dense mammograms.

A cross-sectional study was performed in Tabriz AL Zahra hospital during a year (1394-1395). Asymptomatic women who referred for screening which shows dense breasts (ACR III OR IV) underwent ultrasonography screening for breast cancer. Mammography and sonography assessment were performed and categorized based on as BIRADS CATEGORY system. The final results of mammography BIRADS CATEGORY and sonography BIRADS CATEGORY were compared.

Three hundred and thirty women with mean age of 47.6 years were enrolled into the study. According to the report of mammography, 65, 161, 102 and 2 reports were categorized in BIRADS CATEGORY 0, 1, 2 and 4, respectively. The sonography reports were similar to mammography in BIRADS CATEGORY 1 and 2. Among 65 lesions with BIRADS CATEGORY 0, 10 were suspected as malignant with sonography. The biopsy of the suspicious lesions showed the malignancy in 30% of them.

This study reveals the values of sonography screening in detecting early stage of breast cancer in mammograms with BIRADS category 0 lesions in women with dense breasts. A larger long-term study is, however, needed to assess its feasibility and impact on breast cancer prognosis.

Right ventricle failure and massive pulmonary artery occlusion are the main causes of mortality in patients with acute pulmonary embolism. Although pulmonary CT angiography could be helpful in these patients there are some controversies. In current study we want to investigate correlation between pulmonary artery obstruction score and right ventricular dysfunction with mortality rate in patients with acute pulmonary embolism.

Pulmonary CT angiography of 76 patients with acute pulmonary embolism and no previous comorbidity were reviewed at this prospective study. Maximum short axis dimensions of the right ventricle (RVD) and the left ventricle (LVD) and their ratio were measured. The pulmonary artery obstruction score (PAOS) was determined according to Qanadli. At the end the correlation between these findings and mortality at first 60 days were evaluated.

The 60-days mortality rate was 19.7%. The expired and survived groups were comparable for PAOS, whereas both the median age and RVD/LVD ratio were significantly higher in the first group. In multivariate analysis, however, age was the only significant, independent predictor of 60-day mortality (p=0.02).

Without pre-existing morbidities, neither the RVD/LVD ratio nor PAOS is not an independent predictor of mortality in hemodynamically stable patients with acute PE.