Journal of Vessels and Circulation
Volume:1 Issue: 4, Autumn 2020

Cerebral Venous sinus Thrombosis (CVST) is a rare cerebrovascular accident with a vatiety of clinical symptoms. As there is evidence of a higher rate of CVST in Iran, we aimed to investigate the frequency of CVST, its predisposing factors, and 1-year prognosis in Qom Province, Iran.

We performed a cross-sectional study from 2018 to 2020 in Beheshti Hospital, Qom City, Iran. We reviewed the clinical and para-clinical records of the patients by a checklist. Follow-up visits were performed at 12 months to evaluate the CVST recurrence, the neurological status according to modified Ranking Score (mRS), and persistence of neurological complaints. Eventually, we used SPSS version 22 to analyze the obtained data.

We identified 57 cases of definite CVST, which accounted for 2.5% of all cerebrovascular accidents in this period. We revealed a higher incidence of CVST among the women (68.4%). The use of oral contraceptives, pregnancy, and postpartum status were considered the main risk factors (n=32/39). We also revealed evidence of inherited coagulopathy in 14.03% of our patients, mainly due to protein S deficiency (n=5). The superior sagittal sinus was the main involved sinus (68.42%) associated with other sinus thromboses in 22% of all cases. We also showed a significant short-term and long-term recovery of the disease with a mean mRS score of 1.22 at discharge and 1.12 at a 1-year follow-up.

Oral contraceptives and fasting could contribute to developing CVST. We also revealed a favorable outcome following urgent treatment.

Central vein access is a common procedure in infants and neonates. In this regard, cutdown is a common central venous access technique. However, it is associated with complications, including catheter occlusion, infection, and spontaneous withdrawal. Catheter occlusion is a common complication of the cutdown procedure and causes catheter dysfunction and subsequent catheter removal. In this study, we compared the effect of heparin lock with Taurolock on the maintenance of central vein catheter potency placed in the greater saphenous vein at the saphenofemoral junction and their subsequent complications.

The children admitted to the pediatric hospital who required central vein access between December 2015 and July 2019 were recruited. There were two groups of patients. The first group received 0.5 mL Taurolock solution. The solution contains (cyclo)-taurolidine, heparin 500 IU/mL, and citrate (4%) before the catheter gets locked (Taurolock group). Another group received 0.5 mL heparin (contains 500 IU/mL heparin) before the catheter lock (heparin lock group). After the treatment period, the average duration of catheter usage and heparin-induced bleeding complications were evaluated.

The average duration of catheter function was 13.4 days and 9.3 days in the Taurolock group, and the heparin lock group, respectively. The coagulation tests were performed on 179 patients (33.9%) during hospitalization, no heparin-induced coagulopathies were reported.

Using Taurolock after catheter use could significantly reduce catheter occlusion and increase the duration of catheter function. Taurolock reduces costs, prevents delays in treatment, and decreases pain sensation and discomfort in patients.

Exposure to microgravity conditions is associated with changes in the cardiovascular system. Physical activities are employed to reduce deleterious physiologic effects of long-duration microgravity exposure. The purpose of the current study was to evaluate the effect of endurance training on serum levels of Vascular Endothelial Growth Factor (VEGF) under simulated microgravity condition.

A total of 42 male Wistar rats were randomly selected and divided into five groups of SST (suspension and suspension training, n=10), SET (suspension and endurance training, n=6), S (suspension without training, n=10), ET (endurance training, n=6), and C (control, n=10). Serum VEGF levels were measured by ELISA kit before and after training. Oneway ANOVA with a Bonferroni post hoc analysis was employed to test the research hypothesis.

Our results showed that six weeks of endurance training in simulated microgravity increased serum VEGF levels in the SST group compared to the S and control groups (P≤0.001), while six weeks resting in simulated microgravity condition did not significantly affect serum levels of VEGF (P>0.999).

Endurance training in simulated microgravity could affect VEGF and angiogenesis. In addition, endurance training in simulated weightlessness condition could be effective in rehabilitating patients with cardiovascular diseases.

Cardiovascular disease, especially myocardial infarction, is one of the common causes of death, disability, and productivity reduction globally, which is also rising in Iran. This study evaluated the share of modifiable and non-modifiable risk factors in myocardial infarction in the Iranian population.

A descriptive-analytic and retrospective study was conducted on 361 patients with myocardial infarction in Alborz, Iran, in 2015-2019. Data collection was done by reviewing records of patients diagnosed with myocardial infarction with ECG changes or increased cardiac enzymes (CPK-MB, Troponin I). Then required information was extracted, and intended data were analyzed with descriptive and inferential statistics by the SPSS software.

Among the subjects in the study, 71/1% were male, and 28/9% were female. The majority of samples were between the ages of 60 to 71(33/8%), and the least of them were under 30 years old (1/7%). 82.68% of the samples had a positive family history. The most common modifiable risk factors of myocardial infarction in this study were first Hypertension (42/4%), then Diabetes (31/6%), smoking (32/04%), and Hyperlipidemia (15%). Hypertension was significantly associated with gender, age, and diabetes, and Hyperlipidemia is also positively associated with diabetes and Hypertension.

Myocardial infarction is common in men and patients with Hypertension in the Iranian population. High blood pressure is also associated with gender, age, and diabetes. The prevalence of both modifiable and non-modifiable risk factors and coronary artery occlusion increases with increasing age. Therefore, training a healthy lifestyle and controlling modifiable risk factors from an early age can significantly prevent various cardiovascular diseases in the future.

Hypertension is among the most well-recognized controllable risk factors for cardiovascular diseases. Thus, the current study aimed to determine the prevalence of hypertension and its associated cardiovascular disease-induced mortality in the middle-aged and elderly populations.

This cross-sectional study examined 722836 middle-aged and elderly subjects of Qom Province, Iran (approximately 15% of the total population, aged >30 years) referring to comprehensive healthcare service centers from 2017 to 2019. In this study, due to the adjusted risk ratio, the share of mortality due to cardiovascular diseases attributed to hypertension was estimated indirectly.

The prevalence of hypertension in the study population was reported to be 16.2%, i.e., estimated as 10% among the middle-aged and 42% among the elderly. The obtained data suggested that in patients with hypertension, the process of controlling and monitoring blood pressure in women, compared to men; the elderly, compared to middle-aged; and villagers, compared to urbanites, had a more favorable trend based on relevant protocols (P<0.001). Additionally, 4.9% and 29% of deaths due to cardiovascular diseases in individuals aged >30 and >60 years were attributed to hypertension, respectively.

The present research findings supported the considerable contribution of hypertension to hypertension-related mortality in cardiovascular diseases cases in Qom Province. Hypertension is a controllable risk factor; considering limited health resources, it is recommended that educational interventions be planned by health policymakers in the target populations to reduce mortality due to this disease

In December 2019, COVID-19 caused by the SARS-CoV-2 appeared in China and then spread to many countries. Like many other medical conditions, infection with SARS CoV-2 would cause complications during pregnancy and severe illness in pregnant women.

Case Report: 

We reported a premature neonate (31 weeks gestational age, weight 1700 g) with subclinical myocarditis born to a mother with COVID-19. Her mother had no symptoms and confirmed infection with SARS CoV-2 during pregnancy. Four days after delivery, the mother was diagnosed with COVID-19 infection. The neonate had positive C-Reactive Protein (CRP), elevated cardiac enzymes, and lymphopenia but negative real-time Polymerase Chain Reaction assays (real-time PCR). Her subclinical myocarditis was treated with Intravenous Immunoglobulin (IVIG) and inotrope. We did not use antiviral therapy in medical treatment. The neonate was discharged 3 weeks after admission with normal cardiac biomarkers enzyme levels and cardiac function in echocardiography. Her follow-up chest x-ray after two weeks was also normal.

It seems that subclinical myocarditis can be a complication of COVID-19 in neonates, and this infection could also cause preterm labor in infected pregnant women. Since clinical data on COVID-19 in newborns are still very limited, it is essential to check all the potential complications for pregnant women and their newborns, including cardiac complications.

Delayed Post-Hypoxic Leukoencephalopathy (DPHL) is a demyelinating syndrome that typically occurs in the form of progressive acute encephalopathy from a few days to weeks after apparent recovery from a coma due to prolonged cerebral hypoxia.

Case Report:

In this article, we present a disease case that developed spastic weakness of the lower extremities 3 months after hypoxic coma. The reported patient was eventually treated following a diagnosis of DPHL. A 28-year-old patient presented with a history of hypoxic coma following methadone overdose 3 months prior to referral with progressive lower limb weakness. Neurological examination presented weakness of 4.5 lower limbs with hyperreflexia, clonus, and Babinski reflex. Imaging data indicated a broad symmetrical involvement of the logical hemisphere white matter with delayed leukoencephalopathy after hypoxia. Furthermore, all the tests requested for the patient provided data in the healthy range.

DPHL is a unique clinical syndrome that requires high diagnostic suspicion along with additional laboratory and imaging findings. An essential point in the present report is the presentation of the spastic weakness of the lower extremities as a rare manifestation of DPHL

Patients with heart failure encounter numerous problems. The current study aimed to explore the effects of Johnson’s behavioral system model (JBSM) on the care of patients with heart failure, considering all aspects of their behaviors.

This case report study was performed in 2020 in a hospital affiliated with Qom University of Medical Sciences, Qom City, Iran. A patient with coronavirus disease 2019 (COVID-19) was examined and received JBSM. Based on the assessment form of JBSM, the relevant interviews and evaluations of subsystems were performed. The required data were collected using JBSM’s assessment checklist by observing, interviewing, and conducting physical examinations. Data sources included the client and her medical records, physicians, and nurses. The researcher followed up the patient for two months. In total, three face-to-face interviews were conducted with the patient. After the patient was discharged from the hospital, her condition was followed up via phone calls.

The patient presented unstable behaviors concerning aggressive protective, ingestive, eliminative, and sexual subsystems. After performing nursing care according to JBSM, her erratic behaviors decreased. Applying nursing models in the patient care process can alleviate unstable behaviors and promote sustainable behaviors in patients with heart failure.