ORIGINAL_ARTICLE
Changes in Body Fluid Composition Before and Early after Renal Transplantation and comparing it with Normal Persons
Introduction In this study we evaluated the body composition before and two weeks after kidney transplantation and compared it with the healthy people by BIA. Materials and Methods A total of 23 progressive renal failure patients who attended the transplantation were recruited for this study. The control group included 27 graft donors .Patients were checked one day before hemodialysis and a day before transplantation, by BIA. After transplantation, body composition was assessed between days 1-7 and on the 14th day of post transplantation. The control group included 27 graft donors. Result The comparison of body composition between two groups (donors and recipients) showed significant changes before hemodialysis and after transplantation, and TBW% decreased from the 7th day post transplantation. The Main cause of low level of TBW% was the decrease in ECW% and ECW/ICW from the beginning of 2nd week after transplantation. Just TBW% in normal males was different from that it normal females but in recipients there was no difference between males and females. Conclusion The body composition takes a long time to reach to the normal level and two weeks after transplantation some agents are probably responsible for intense changes of body composition including drugs and mild prerenal azotemia specially on the 2nd week after transplantation.
https://mjms.mums.ac.ir/article_5321_552add65f88330af12023f178dda79cf.pdf
2011-09-23
131
136
10.22038/mjms.2011.5321
Body composition
Bioelectrical Impedance Analysis
Renaltransplantation
Farzaneh
Sharifipour
roya.sadeghniya@yahoo.com
1
Associate professor of Nephrology, Mashhad University of Medical Sciences, Mashhad, Iran
AUTHOR
Masih
Naghibi
naghibim@mums.ac.ir
2
Professor of Endocrinology, Mashhad University of Medical Sciences, Mashhad, Iran
AUTHOR
Masoud
Mohebi
3
Resident of Internal Medicine,Mashhad University of Medical Sciences, Mashhad, Iran
AUTHOR
Abbassali
Zeraati
zeraaty@mums.ac.ir
4
Associate professor of Nephrology, Mashhad University of Medical Sciences, Mashhad, Iran
LEAD_AUTHOR
Maryam
Hami
hamim@mums.ac.ir
5
Associate professor of Nephrology, Mashhad University of Medical Sciences, Mashhad, Iran
AUTHOR
Boshra
Hasanzamani
6
Nephrologist,Mashhad University of Medical Sciences, Mashhad, Iran
AUTHOR
Farnaz
Kalani Mogaddam
7
General MD, Mashhad, Iran
AUTHOR
1- Bary GB. Determining body composition in adults. Available from www. Up to Date.com, Accessed Jun, 20, 2009
1
2- El Haggan W, Vendrely B, Chauveau P, Barthe N, Castaing F, Berger F, et al. Early evolution of nutritional status
2
and body composition after kidney transplantation. Am J Kidney 2002; 40:629.
3
3- van den Ham ECH, Kooman JP, Christiaans MHL, van Hooff JP, et al. Relation between steroid dose, body
4
composition and physical activity in renal transplant patients. Transplantation 2000; 69:1591.
5
4- Van der kooy K, Seidell J. Techniques for the measurement of visceral fat: a practical guide. Int J Obes Relat Metab
6
Disord 1993; 17:187-196.
7
5- Coroas A, De oliviera J, Sampaio S, Borges C, Tavares I, Pestana M, et al.postrenal transplantation body
8
composition:different evolution depending on gender. J Ren Nutr 2007; 17:151-156.
9
6- Coroas A, De oliviera J, Sampaio S, Borges C, Tavares I, Pestana M, et al. Bioimpedance analysis highlights changes in
10
body composition at the early stages of impairment of kidney transplant function. J Ren Nutr 2004; 14:157-163.
11
7-Wang H, Boey L, Morad Z. Body composition by bioelectrical Impedence Analysis in renal transplant
12
recipients.Transplant Proc 2004; 36: 2186-2187.
13
ORIGINAL_ARTICLE
ارزیابی نسبت بیلیروبین به آلبومین ه ب عنوان معیار انجام تعویض خون در نوزادان با زردی شدید مرکز تحقیقات بیماری های غیر واگیر کودکان - دانشگاه علوم پزشکی بابل
Introduction Total Serum Bilirubin level (TSB) has been the gold standard indicator for exchange transfusion (ET) in the neonates for many years. This study was designed to assess the bilirubin/albumin (B/A) ratio as an indicator for ET in comparison with TSB. Materials and Methods In the NICU and newborn services at Amirkola Children's Hospital (ACH) in the north of Iran, 90 neonates in 3 groups were selected. The first group was 30 neonates who required exchange transfusion (ET), because of severe hyperbilirubinemia (HB) based on the TSB according to the ACH protocol .The second group was 30 neonates, treated with phototherapy due to pathologic HB and the Other 30 neonates had only physiologic neonatal jaundice. Blood samples were checked for serum bilirubin, albumin and B/A ratio in addition to the routine lab tests for HB. Sensitivity, specificity, negative predictive value, positive predictive value, and relative risk were assessed for B/A ratio as a determinant to do ET. Results The mean±SD of B/A ratio was 6.0847±0.9870 in blood exchange group, 4.1680±0.5480 in phototherapy group and 1.7677±0.5061 in healthy neonate group. “Cut off level” of B/A ratio calculated to do ET was 4.50.The B/A ratio of 4.5 has a “positive predictive value” of 75% and a “negative predictive value” of 100%. Conclusion A B/A ratio equal to 4.5 among newborns Who required exchange transfusion has a high value as a criterion to do ET, although further study is required to recommend it alone in clinical practice. So we recommend doing B/A ratio in accompaniment with TSB as an adjunctive test.
https://mjms.mums.ac.ir/article_5322_9d32ea60b6e5f4ed86fe147ecc4b6dd3.pdf
2011-09-23
137
142
10.22038/mjms.2011.5322
Bilirubin-albumin ratio
Exchange transfusion
Neonatal Jaundice
Mousa
Ahmadpour-kacho
mousa_ahmadpour@hotmail.com
1
Associate professor of Pediatrics, Babol University of Medical Sciences, Babol, Iran
LEAD_AUTHOR
Yadollah
Zahedpasha
2
Professor of Pediatrics, Babol University of Medical Sciences, Babol, Iran
AUTHOR
Siamak
Peydayesh
3
Resident of Pediatrics, Babol University of Medical Sciences, Babol, Iran
AUTHOR
Aazamossat
Mazloomi
4
BSc in nurse, Babol University of Medical Sciences, Babol, Iran
AUTHOR
1- American Academy of Pediatrics, Provisional Committee for Quality Improvement and Subcommittee on
1
Hyperbilirubinemia. Practice parameter: management of hyperbilirubinemia in the healthy term newborn. Pediatrics
2
1994; 94:558–562.
3
2- Dennery PA, Seidman DS, Stevenson DK. Neonatal hyperbilirubinemia. N Engl J Med 2001; 344:581-590.
4
3- Ahlfors CE, Herbsman O. Unbound Bilirubin in a Term Newborn with Kernicterus. Pediatrics 2003; 111:1110-1112.
5
4- Khosravi N, Samaei H, Mojdehi Azar K. Serum Albumin level in full term neonates in Shahid Akbar Abadi
6
Hospital. J Iran Univ Med Sci 2001; 23:17-15.
7
5- Rosenthal P. Assessing liver function and hyperbilirubinemia in the newborn, National Academy of Clinical
8
Biochemistry. Clin Chem 1997; 43:228.
9
6- American Academy of Pediatrics Subcommittee on Hyperbilirubinemia. Management of Hyperbilirubinemia in the
10
Newborn Infant 35 or More Weeks of Gestation. Pediatrics 2004; 114:1138.
11
7- Ahlfors CE. Criteria for exchange transfusion in jaundiced newborns. Pediatrics 1994; 93:488-494.
12
8- Buchanan N, Moodley GP, Strickwold B, Eyberg C, Rothberg AD. A laboratory investigation into bilirubin binding
13
in neonates. S Afr Med J 1977; 51:197-199.
14
9- Funato M, Tamai H, Shimada S, Nakamura H, Vigintiphobia. Unbound Bilirubin, and Auditory Brainstem
15
Responses. Pediatric 1994; 93:50-53.
16
10- Hulzebos CV, van Imhoff DE, Bos AF, Ahlfors CE, Verkade HJ, Dijk PH. Usefulness of the bilirubin/albumin ratio for
17
predicting bilirubin-induced neurotoxicity in premature infants. Arch Dis Child Fetal Neonatal Ed 2008; 93:F384-388.
18
11- Behjati Ardakani Sh, Ghobadi Dana V, Ziaee V, Haghi Ashtiani MT, Esmaeeli Djavid G, Alijani M, et al.
19
Bilirubin/Albumin ratio for predicting acute Bilirubin-induced neurologic dysfunction. Iran J pediatr 2011; 21: 28-32.
20
12- Amin SB, Ahlfors C, Orlando MS, Dalzell LE, Merle KS, Guillet R. Bilirubin and serial auditory brainstem
21
responses in premature infants. Pediatrics 2001; 107:664-670.
22
13- Robertson AF, Karp WB, Brodersen R. Comparison of the bilirubin concentration and the bilirubin/albumin ration
23
with the bilirubin-binding ability in neonatal serum. J Pediatr 1998; 132:343-344.
24
ORIGINAL_ARTICLE
Assessment of Relation of Hospital and Short and Term (30 days) Mortality of STEMI Patients with Angiographic Parameters and its Contributing Factors
Introduction Myocardial infarction is one of the most common causes of hospitalization and mortality in human societies. Several researches have performed to identify various risk factors for cardiovascular disease progression and improve treatment methods, medications and therapeutic interventions to minimize mortality. In this study, we have assessed the relation between angiographic findings of patients having myocardial infarction with ST segment elevation and mortality during the hospital course and one month follow up. Materials and Methods A total of 156 patients with STEMI Who referred to Imam Reza hospital with the definition of more than 2mm elevation of ST segment in precordial leads and more than 1mm in limb leads also with elevation in cardiac biomarkers were enrolled in this study. Patients’ history obtained and the angiography was carefully reviewed by a cardiologist and variables were recorded. Death of patients during hospitalization and a month after discharge was also recorded. Results There was a significant relationship between angiography performance and the presence of thrombus and location of involved vessel, hypotension at presentation, killip class, and tachycardia, hypertension with hospital mortality. Age and calcification were independent factors for one month mortality. In-hospital mortality was 10.3% and one month mortality was 4.3%. Conclusion Age and some angiographic factors including the existence of thrombus and anterior wall involvement were significantly correlated with mortality after myocardial infarction.
https://mjms.mums.ac.ir/article_5323_eb1a24cb1327abf52dbd47ae8a6e2ddf.pdf
2011-09-23
143
149
10.22038/mjms.2011.5323
Angiography
Myocardial infarction
Mortality
Ali Asghar
Dadgar
1
Professor of cardiology, Mashhad University of Medical Sciences, Mashhad, Iran
AUTHOR
Mohammad
Tayeby
tayyebim@mums.ac.com
2
Assistant Professor of Cardiology, Mashhad University of Medical Sciences, Mashhad, Iran
AUTHOR
Amirhossein
Shakiba Herfeh
3
Cardiologist, Mashhad Iran
LEAD_AUTHOR
Mahsa
Hassanzadeh Bashtian
4
MSc in Statistics, Mashhad Iran
AUTHOR
1- National Institutes of Health. Morbidity and Mortality: 2004 Chart Book on Cardiovascular, Lung and Blood
1
Diseases. Bethesda: US Department on Heart and Human Services, Public Health Service; 2004.
2
2- Sans S, Kesteloot H, Kromhout D. The burden of cardiovascular diseases mortality in Europe. Task Force of the
3
European Society of Cardiology on Cardiovascular Mortality and Morbidity Statistics in Europe. Eur Heart J 1997;
4
18:1231–1248.
5
3- Fox KA, Cokkinos DV, Deckers J, Keil U, Maggioni A, Steg G. The ENACT study: a pan-European survey of acute
6
coronary syndromes. European Network for Acute Coronary Treatment. Eur Heart J 2000; 21:1440–1449.
7
4- WHO MONICA Project Principal Investigators. The World Health Organization MONICA Project (monitoring
8
trends and determinants in cardiovascular disease): a major international collaboration. J Clin Epidemiol 1988; 41:105–
9
5- Gurjeva OS, Bukhman G, Murphy S, Cannon CP. Treatment and outcomes of eastern Europeans with coronary
10
syndromes in OPUS-TIMI 16. Int J Cardiol 2005; 100:1-7.
11
6- Kramer JM, Newby LK, Chang WC, Simes RJ, Van de Werf F, Granger CB, et al. International variation in the use
12
of vidence-based medicines for acute coronary syndromes. Eur Heart J 2003; 24:33-41.
13
7- Ganz P, Ganz W editors. Coronary blood flow and myocardial Ischemia. In: Braunwald E, Zipes P, Libby P, Bonow
14
O. Braunwald Heart Disease. 8th ed. Philadelphia: W.B. Saunders; 2008. Vol. 2.p.1103-1129.
15
8- Antmon EM, Braunwald E. Acute myocardial Infarction. In: Braunwald E, Zipes P, libby P, Bonow O, Braunwald
16
Heart Disease. 8th ed. Philadelphia: W.B. Saunders; 2008. Vol 2.p.1141-1167.
17
9- Popma J, Kuntz R, Baim D. Percotaneus coronary and intervention. In: Braunwald E, Zipes DP, Libby P. Heart
18
Disease: A textbook of cardiovascular medicine. 8th ed. Philadelphia: W.B. Saunders; 2008.p.1367-85.
19
10-Tatu-Chitoiu G, Cinteza M, Dorobantu M, Udeanu M, Manfrini O, Pizzi C, et al. In-hospital case fatality rates for
20
acute myocardial infarction in Romania. CMAJ 2009; 180:1207-1213.
21
11- Koeth O, Bauer T, Wienbergen H, Gitt AK, Juenger C, Zeymer U, et al. Maximal Individual Therapy in Acute
22
Myocardial Infarction Plus (MITRA Plus) Study Group. Angioplasty within 24 h after thrombolysis in patients with
23
acute ST-elevation myocardial infarction: current use, predictors and outcome. Results of the MITRA plus registry. Clin
24
Res Cardiol 2009; 98:107-113.
25
12- Greig D, Corbalán R, Castro P, Campos P, Lamich R, Yovaniniz P. [Mortality of patients with ST-elevation acute
26
myocardial infarction treated with primary angioplasty or thrombolysis]. Rev Med Chil 2008; 136:1098-106. Epub
27
2008 Nov 12.
28
ORIGINAL_ARTICLE
Effect of Thoracic Epidural Anesthesia on Oxygen Saturation During one-lung Ventilation in Pulmonary Resection Surgery
Introduction The perfusion in the nonventilated, operative lung during one-lung ventilation (OLV) in patients undergoing thoracic surgery increases intrapulmonary shunt and decreases systemic arterial oxygenation. The anesthesia with OLV may affect oxygenation. The aim of this study was comparing the effect of total intravenous anesthesia (TIVA) and thoracic epidural anesthesia (TEA) combined with TIVA on saturation of oxygen during OLV in patients undergoing pulmonary resection. Materials and Methods In a randomized double-blind clinical trial, 60 patients undergoing elective pulmonary resection were Divided in to two groups .The intervention group received TEA (bupivacaine 0.25%) plus TIVA (propofol+remifentanil) while the control group received TEA (saline) plus TIVA.The hemodynamic parameters, Aldrete score and possible complications were compared between the two groups, within the study period . Results The change of hemodynamic parameters, as well as SaO2, PaO2 and ETCO2 within the study period was not significantly different between the two groups. The mean Aldrete score was comparable between the two groups upon entering recovery and after getting discharged from there. During the recovery stay, frequency of patients with pain and shivering was significantly higher in the group with sole TIVA. There was no significant difference in nausea and hypotension between the two groups. Conclusion TEA plus TIVA does not have a significant effect on O2 saturation in OLV in patients comparing with sole TIVA. However, this combination significantly decreases the post-operative pain and shivering and so may be recommended.
https://mjms.mums.ac.ir/article_5324_6b0557a7eb13aad192d2f1764b502ce5.pdf
2011-09-23
150
158
10.22038/mjms.2011.5324
Epidural Anesthesia
Intravenous Anesthesia
One Lung Ventilation
Oximetry
Hamzeh
Hosseinzadeh
hamzeh1338@yahoo.com
1
Associate Professor of Anesthesiology, Tabriz University of Medical Sciences, Tabriz, Iran
AUTHOR
Davoud
Aghamohamadi
2
Assistant Professor of Anesthesiology, Tabriz University of Medical Sciences, Tabriz, Iran
AUTHOR
Khosro
Kolahdouzan
kkolahdouzan@yahoo.com
3
Instructor of Anesthesiology,Tabriz University of Para Medical Sciences,Tabriz ,Iran
LEAD_AUTHOR
Parisa
Hosseinzadeh
4
Student of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
AUTHOR
Rasool
Azarfarin
5
Associate Professor of Anesthesiology, Tabriz University of Medical Sciences, Tabriz, Iran
AUTHOR
Afshin
Iranpor
6
Anesthesiologyst, Tabriz, Iran
AUTHOR
Samad
Golzari
7
Resident of anesthesiology, Tabriz, Iran
AUTHOR
1- Ishikawa S, Makita K, Nakazawa K, Amaha K. Continuous intraarterial blood gas monitoring during
1
oesophagectomy. Can J Anaesth 1998; 45:273-276.
2
2- Slinger P, Scott WAC. Arterial oxygenation during OLV:a comparison of enflurane and isoflurane. Anesthesiology
3
2005; 82:940-946.
4
3- Abe K, Shimizu T, Takashina M, Yoshiya. The effects of propofol, isoflurane and sevoflurane on oxygenation and
5
shunt fraction during OLV. Anesth Analg 1998; 87:1164-1169.
6
4- Kellow NH, Scott AD, White SA, Feneck RO. Comparison of the effects of propofol and isoflurane anaesthesia
7
on right ventricular function and shunt fraction during thoracic surgery. Br J Anaesth 1995; 75:578-582.
8
5- Benumof JL, Wahrenbrock EA. Blunted hypoxic pulmonary vasoconstriction by increased lung vascular pressures.
9
J Appl Physiol 1975; 38:846-850.
10
6- Lejeune P, Brimioulle S, Leeman M, Hallemans R, Melot C, Naeije R. Enhancement of hypoxic pulmonary
11
vasoconstriction by metabolic acidosis in dogs. Anesthesiology 1990; 73:256-264.
12
7- Brimioulle S, Lejeune P, Vachiery JL, Leeman M, Melot C, NaeijeR. Effects of acidosis and alkalosis on hypoxic
13
pulmonary vasoconstriction in dogs. Am J Physiol 1990; 258:H347-353.
14
8- Benumof JL. Anesthesia for Thoracic Surgery, 2nd ed. Philadelphia: WB Saunders; 1995.p.123-151.
15
9- Garutti I, Quintana B, Olmedilla L, Cruz A, Barranco M, Garcia de Lucas E. Arterial oxygenation during one-lung
16
ventilation: combined versus general anesthesia. Anesth Analg 1999; 88:494-499.
17
10- Pagel PS, John JL, Damask MC. Desflurane and isoflurane produce similar alterations in systemic and pulmonary
18
hemodynamics and arterial oxygenation in patients undergoing onelung ventilation during thoracotomy. Anesth Analg
19
1998; 87:800–807.
20
11- Spies C, Zaune U, Pauli G, Martin E. Comparison of enflurane and propofol during thoracic surgery. Anaesthesist
21
1991; 40:14–18.
22
12- Mohamed AK, Ahmed AA, Abul-Fotouh FM, Youssef IA. Total Intravenous versus Inhalational Anesthesia for One
23
Lung Ventilation during thoracic surgery. J Med Pak 2002; 2:342-348.
24
13- Oremus K, Safaric Z. The role of epidural anesthesia and analgesia in surgical practice. Ann Surg 2004; 240:561-562.
25
14- Senturk M. Acute and choronic pain after thoracotomies. Curr Opin Anaesthesiolo 2005; 18:1-4.
26
15- Ishibe Y, Shiokawa Y, Umeda T, Uno H, Nakamura M, Izumi T. The effect of thoracic epidural anesthesia on
27
hypoxic pulmonary vasoconstriction in dogs: an analysis of the pressure-flow curve. Anesth Analg 1996; 82:1049-1055.
28
16- Van Keer L, Van Aken H, Vandermeersch E, Vermaut G. Propofol does not inhibit HPV in humans. J Clin Anesth
29
1989; 1:284–288.
30
17- Von Dossow V. Thoracic epidural anesthesia combined with general anesthesia: the preferred anesthetic technique
31
for Thoracic Surgery. Anesth Analg 2001; 92:848–854.
32
18- Casati A, Mascotto G, Iemi K, Nzepa-Batonga J, De Luca M. Epidural block does not worsen oxygenation during onelung
33
ventilation for lung resections under isoflurane/nitrous oxide anaesthesia. Eur J Anaesthesiolol 2005; 22:363-368.
34
19- Slinge r RCW, Lenis S. A comparison of the effects of propofol-alfentanil versus isoflurane anesthesia on arterial
35
oxygenation during one-lung ventilation. J Cardiothoracic Vasc Anesthesia 2005; 10:860-863.
36
20- Ozcan PE. Effects of thoracic epidural anaesthesia on pulmonary venous and oxygenation during one-lung
37
ventilation. Acta Anaesthesiol Scand 2007; 51:1117-1122.
38
21- Chow MY, Goh MH, Boey SK, Thirugnanam A, Ip-Yam PC. The effects of remifentanil and thoracic epidural on
39
oxygenation and pulmonary shunt fraction during one-lung ventilation. J Cardiothorac Vasc Anesth 2003; 17:69-72.
40
22- Garutti I, Cruz P, Olmedilla L, Barrio JM, Cruz A, Fernandez C, et al. Effects of thoracic epidural meperidine on
41
arterial oxygenation during one-lung ventilation in thoracic surgery. J Cardiothorac Vasc Anesth 2003; 17:302-305.
42
23- Bjertnaes L, Hauge A, Kriz M. Hypoxia-induced pulmonary vasoconstriction: Effects of fentanyl following
43
different routes of administration. Acta Anaesthesiol Scand 1980;24:53-57.
44
24- Judson WE, Hollander W, Arrowwood JG. Studies on the pulmonary circulation effects of anoxia, exercise and
45
hexamethonium in patients with and without thoracic sympathetic denervation. Clin Sci 1954; 33:946-947.
46
25- Jung SM, Cho CK, Kim YJ, Cho HM, Kim CW, Kwon HU, et al. The effect of thoracic epidural anesthesia on
47
pulmonary shunt fraction and arterial oxygenation during one-lung ventilation. J Cardiothorac Vasc Anesth 2010; 24: 456-
48
26- Lodato RF, Michael JR, Murray PA. Absence of neural modulation of hypoxic pulmonary vasoconstriction in
49
conscious dogs. J Appl Physiol 1988; 65:1481-1487.
50
27- Naeije R, Lejeune P, Leeman M. Pulmonary vascular responses to surgical chemodenervation and chemical
51
sympathectomy in dogs. J Appl Physiol 1989; 66:42-50.
52
28-Robin ED, Theodore J, Burke CM. Hypoxic pulmonary vasoconstriction persists in the human transplanted lung.
53
Clin Sci Lond 1987; 72:283-287.
54
29-Guenoun T, Journois D, Silleran-Chassany J, Frappier J, D'attellis N, Salem A, et al. Prediction of arterial oxygen
55
tension during one-lung ventilation: analysis of preoperative and intraoperative variables. J Cardiothorac Vasc Anesth
56
2002; 16:199-203.
57
30-Xu Y, Tan Z, Wang S, Shao H, Zhu X. Effect of thoracic epidural anesthesia with different concentrations of
58
ropivacaine on arterial oxygenation during one-lung ventilation. Anesthesiology 2010; 112:1146-1154.
59
31-Rodgers A, Walker N, Schug S. Reduction of postoperative mortality and morbidity with epidural or spinal
60
anaesthesia: Results from overview of randomised trials. BMJ 2000; 321:1493-1497.
61
32-Ballantyne JC, Carr DB, deFerranti S. The comparative effects of postoperative analgesic therapies on pulmonary
62
outcome: Cumulative meta-analyses of randomized, controlled trials. Anesth Analg 1998; 86:598-612.
63
ORIGINAL_ARTICLE
Diagnostic Value of Standard 12 Lead Electrocardiography in Acute RV Myocardial Infarction
Research Center of Cardiology- Birjand University of Medical Science
Introduction Right ventricular infarction (RVMI) is associated with increased morbidity and mortality in patients with acute inferior myocardial infarction (MI). Although, electrocardiography is probably the most useful, simple, and objective tool for the diagnosis of acute MI, there are no well-defined criteria in the standard 12-lead electrocardiogram to properly identify RVMI in patients with acute inferior MI. The aim of this study was to evaluate the value of ST-segment changes in 12-lead in diagnosing RVMI in patients with acute inferior MI. Materials and Methods A total of One hundred sixty seven patients, hospitalized with acute inferior MI, were included in this study. The diagnosis of acute inferior MI was based on the clinical history and the appearance of ST-segment elevation (STE) ³1 mm in at least two of the leads (leads II, III, aVF). RVMI was defined by STE³1 mm in lead V4R during the first 12 hours after the beginning of the symptoms. Then the patients were divided into two groups (RVMI + and -) and ST-segment changes were compared between the two groups. Results The Ninety patients (51.1%) had RVMI according to lead V4R. ST-segment change ³1mm was seen in I, III, aVL, and in aVF; also ST-segment depression ³2mm in I+aVL and STE³1 mm in lead III greater than lead II (III>II) was significantly different between the two groups. The high sensitivity-specificity was seen in lead I: 86%-72%; lead aVL: 96%-26%; I+aVL: 84%-71%; and III>II: 82%-74%. Conclusion More than 1 mm ST-segment depression in lead I, STE in III>II and ST-segment depression³2 mm in I+aVL are possible to identify RVMI in patients with acute inferior MI.
https://mjms.mums.ac.ir/article_5325_953e66f8f8a3cb1a98d5c07771b3bd30.pdf
2011-09-23
159
165
10.22038/mjms.2011.5325
Acute Inferior Myocardial Infarction
Electrocardiography
Right Ventricular Infarction
Sensitivity and Specificity
Toba
kazemi
1
Associated professor of cardiology, Birjand university of Medical science, Birjand, Iran
AUTHOR
Homa
Falsoleiman
2
Associated professor of cardiology, Mashhad University of Medical science Mashhad, Iran
LEAD_AUTHOR
Sara
Rozmina
3
Eneral practitioner, Birjand, Iran
AUTHOR
1- Hamon M, Agostini D, Le Page O, Riddell JW. Prognostic impact of right ventricular involvement in patients with acute
1
myocardial infarction: meta-analysis. Crit Care Med 2008; 36:2023-2033.
2
2- Mehta SR, Eikelboom JW, Natarajan MK, Diaz R, Yi C, Gibbons RJ, Yusuf S. Impact of right ventricular involvement on
3
mortality and morbidity in patients with inferior myocardial infarction. J Am Coll Cardiol 2001; 37:37-43.
4
3- Pereira AC, Franken RA, Sprovieri SR, Golin V. Impact on hospital mortality and morbidity of right ventricular
5
involvement among patients with acute left ventricular infarction. Sao Paulo Med J 2006; 124:186-191.
6
4- Saw J, Davies C, Fung A, Spinelli JJ, Jue J. Value of ST elevation in lead III greater than lead II in inferior wall acute
7
myocardial infarction for predicting in-hospital mortality and diagnosing right ventricular infarction. Am J Cardiol 2001;
8
87:448-450.
9
5- Zornoff LA, Skali H, Pfeffer MA, St John Sutton M, Rouleau JL, Lamas GA , et al. Right ventricular dysfunction and risk
10
of heart failure and mortality after myocardial infarction. J Am Coll Cardiol 2002; 39:1450-1455.
11
6- Carter T, Ellis K. Right-ventricular infarction. Crit Care Nurse 2005; 25:52-54, 56-58, 60-52.
12
7- Zehender M, Kasper W, Kauder E, Schö nthaler M, Geibel A, Olschewski M ,et al. Right ventricular infarction as an
13
independent predictor of prognosis after acute inferior myocardial infarction. N Engl J Med 1993; 328:981-988.
14
8- Navarro C, Owens C, Riddell J, McClelland A, Anderson JM, Escalona O, et al. The use of calculated epicardial
15
potentials improves significantly the sensitivity of a diagnostic algorithm in the detection of acute myocardial infarction. J
16
Electrocardiol 2003; 36:127-132.
17
9- Pahlm-Webb U, Pahlm O, Sadanandan S, Selvester RH, Wagner GS. A new method for using the direction of STsegment
18
deviation to localize the site of acute coronary occlusion: the 24-view standard electrocardiogram. Am J Med 2002;
19
113:75-78.
20
10- Lux RL, Kornreich F. Crossroads in electrocardiographic lead development: a roadmap to the future of
21
electrocardiographic leads in clinical electrocardiography. J Electrocardiol 2008; 41:183-186.
22
11- Zalenski RJ, Rydman RJ, Sloan EP, Hahn KH, Cooke D, Fagan J , et al. Value of posterior and right ventricular leads in
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comparison to the standard 12-lead electrocardiogram in evaluation of ST-segment elevation in suspected acute myocardial
24
infarction. Am J Cardiol 1997; 79:1579-1585.
25
12- Hoffman I. Diagnosis of acute right ventricular infarction. J Electrocardiol 2009; 42:226-227.
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13- Nair R, Glancy DL. ECG discrimination between right and left circumflex coronary arterial occlusion in patients with
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acute inferior myocardial infarction: value of old criteria and use of lead aVR. Chest 2002; 122:134-139.
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14- Moye S, Carney MF, Holstege C, Mattu A, Brady WJ. The electrocardiogram in right ventricular myocardial infarction.
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Am J Emerg Med 2005; 23:793-799.
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Cardiol 1974; 33:209-214.
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16- Kinch JW, Ryan TJ. Right ventricular infarction. N Engl J Med 1994; 330:1211-1217.
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17- Lopez-Sendon J, Coma-Canella I, Alcasena S, Seoane J, Gamallo C. Electrocardiographic findings in acute right
34
ventricular infarction: sensitivity and specificity of electrocardiographic alterations in right precordial leads V4R, V3R, V1,
35
V2, and V3. J Am Coll Cardiol 1985; 6:1273-1279.
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18- Hsiao SH, Chiou KR, Huang WC, Cheng CC, Kuo FY, Lin KL, et al. Right ventricular infarction and tissue Doppler
37
imaging – insights from acute inferior myocardial infarction after primary coronary intervention. Circ J 2010; 74:2173-2180.
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19- Jensen CJ, Jochims M, Hunold P, Sabin GV, Schlosser T, Bruder O. Right ventricular involvement in acute left
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ventricular myocardial infarction: prognostic implications of MRI findings. AJR Am J Roentgenol 2010; 194:592-598.
40
20- Robalino BD, Whitlow PL, Underwood DA, Salcedo EE. Electrocardiographic manifestations of right ventricular
41
infarction. Am Heart J 1989; 118:138-144.
42
21- Tsuka Y, Sugiura T, Hatada K, Nakamura S, Yuasa F, Iwasaka T. Clinical significance of ST-segment elevation in lead
43
V1 in patients with acute inferior wall Q-wave myocardial infarction. Am Heart J 2001; 141:615-620.
44
22- Turhan H, Yilmaz MB, Yetkin E, Atak R, Biyikoglu SF, Senen K, et al. Diagnostic value of aVL derivation for right
45
ventricular involvement in patients with acute inferior myocardial infarction. Ann Noninvasive Electrocardiol 2003; 8:185-
46
23- Somers MP, Brady WJ, Bateman DC, Mattu A, Perron AD. Additional electrocardiographic leads in the ED chest pain
47
patient: right ventricular and posterior leads. Am J Emerg Med 2003; 21:563-573.
48
24- Turkoglu S, Erden M, Ozdemir M. Isolated right ventricular infarction due to occlusion of the right ventricular branch in
49
the absence of percutaneous coronary intervention. Can J Cardiol 2008; 24:793-794.
50
25- Kukla P, Dudek D, Rakowski T, Dziewierz A, Mielecki W, Szczuka K, et al. Inferior wall myocardial infarction with or
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without right ventricular involvement--treatment and in-hospital course. Kardiol Pol 2006; 64:583-8; discussion 589-90.
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26- Shiraki H, Yokozuka H, Negishi K, Inoue S, Takahashi T, Chino M, et al. Acute impact of right ventricular infarction on
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early hemodynamic course after inferior myocardial infarction. Circ J 2010; 74:148-155.
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27-Ginghina C, Caloianu GA, Serban M, Dragomir D. Right ventricular myocardial infarction and pulmonary embolism
55
differential diagnosis – a challenge for the clinician. J Med Life 2010; 3:242-253.
56
ORIGINAL_ARTICLE
A Survey of Early Oral Feeding in Intestinal Anastomosis in Children Admitted in Tabriz Children Hospital
Child Health Research Center- Tabriz University of Medical Sciences
Introduction Early feeding improves the outcome of patients with trauma and burns, although, few studies have examined its use after gastrointestinal (GI) anastomosis. A randomized controlled trail that compared an early regular diet with the conventional postoperative dietary management to determine GI complications and mortality after major GI anastomosis was conducted. The secondary purpose of this trial was to evaluate the incidence of postoperative ileus after major GI anastomosis with early feeding in comparison with the conventional diet. The purpose of this study was to compare early feeding with traditional postoperative dietary management for improvment of postoperative gastrointestinal (GI) symptoms. Materials and Methods We conducted a prospective randomized controlled study. This was a study of 80 patients who were randomly allocated to early feeding beginning with liquid diet, 3 days postoperative, whereas those in the traditional feeding group were given a regular diet with normal bowel sounds. Results The incidence of postoperative ileus did not differ between the two groups. However, there was no significant difference in the rate of intraoperative complications such as, leakage of anastomosis, mesenteric embolus, wound infection, and wound dehiscence between the groups. Also, there were no Considerable Variation in mortality between the two groups. There was noticeable contracst in time of bedridden between the two groups (p<0.001). Conclusion Early feeding in GI anastomosis seems to be safe, well tolerated, and was not associated with increased postoperative GI complaints including ileus and postoperative complications such as wound dehiscence, infection, leakage, anastomosis, and mortality.
https://mjms.mums.ac.ir/article_5326_88f13f09bad2f08c1e5b1d396d256bff.pdf
2011-09-23
166
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10.22038/mjms.2011.5326
Digestive imposition
Early feeding
Gastrointestinal anastomosis
Saeed
Aslan Abadi
1
Professor of pediatrics Surgery, Tabriz University of Medical Sciences, Tabriz, Iran
AUTHOR
Davud
Badbarin
2
Assistant professor ofpediatrics Surgery, Tabriz University of Medical Sciences, Tabriz, Iran
AUTHOR
Asghar
Esmailzadeh
3
Assistant of General Surgery, Tabriz University of Medical Sciences, Tabriz, Iran
AUTHOR
Navid
Elmdust salimi
4
General M.D, Tabriz, Iran
LEAD_AUTHOR
1- Royal Infrmar. Intestinal anastomosis. Br Med J 2006; 28:1002-1003.
1
2- Inomata T, Ninomya H, Nagai T. A simple method of intestinal anastomosis in rat. EXP Anim 2005; 54:117-122.
2
3- Ashkkanani F, Krukowski Z. Intestinal anastomosis. The medicine publishing company 1td. Surg Wound Heal 2006;
3
23:104-107.
4
4- Lewis S, Egger M, Topic S. Early feeding versus “nil by mouth” after gastrointestinal surgery. BMJ 2001; 32:1-5.
5
5- Danak A, Schwartz S, Brunicardi F. Schwart’s principle of surgery, 8th edition. Blackwell Sci 2005; 12:942-947.
6
6- Bohm B, Yahav D, Bishara J, Pitlik S, Leibovici L.Tolerance of early oral feeding operation of the lower
7
gastrointestinal tract: systematic review and meta-analysis of randomised controlled trials. BMJ Pub 2005; 74:955-962.
8
7- Fanaie SA, Ziaee A. Safety of early oral feeding after gastrointestinal anastomosis: a randomized clinical trial.
9
Surgery 2005; 67:165-168.
10
8- Nascimento JE, Viciana P, Colmenero J, Pachon J. Early feeding after intestinal anastomosis. Rev Assoc Med Bras
11
2004; 48:348-352.
12
9- Stewart BT, Sonmez E, Tevfik MR, But AD. Early feeding after intestinal .Infect Dis 2006; 72:817-820.
13
10- Petrellu NJ, Rahmi K, Durak A, Yildiz O, Aygen B, Sumerkan B. Early feeding after intestinal: analysis of factors
14
that may predict failure. Ann Surg Oncol 2001; 8:796-800.
15
11- Sagar S, Harland P, Shields R. Early postoperative feeding with elemental diet. BMJ 2003;23:293-295.
16
12- Schroeder D, Gillanders L,Mahr K, Hill GL. Effects of immediate postop- erative enteral nutrition on body
17
composition, muscle function, and wound healing. J Parenter Enteral Nutr 1991;15:76-83.
18
13- Binderow SR, Cohen SM,Wexner SD, Nogueras JJ. Must early postoperative oral intake be limited laparoscopy.
19
Dis Colon Rectum 1994; 37:584-589.
20
14- Sanjay MS, Rajesh MS, Rahul MS, Nisha MD. Early enteral nutrition following gastrointestinal anastomosis. Ann
21
Surg 2008; 222:73-77.
22
15-Carr CS, Ling KD, Boulos P, Singer M. Randomised trial of safety and efficacy of immediate postoperative enteral
23
feeding in patients undergoing gastrointestinal resection. BMJ 1996; 312:869-871.Early feeding, Gastrointestinal
24
anastomosis, digestive 312(4),869-71.
25
ORIGINAL_ARTICLE
The Result of Transrectal Ultrasound Guided 10-14 Cores Biopsies of the Prostate
Introduction The diagnostic tool in prostate cancer is prostate biopsy but recently classic biopsy has low efficacy. In recent years, trans-rectal ultrasound guided prostate biopsy is a standard method in prostate cancer diagnosis. In the present study, we report our experience about ultrasound guided 10-14 core prostate biopsies at a hospital in Mashhad. Materials and Methods The study included 196 men with PSA values of ≥10 ng/ml or 10 ng/ml ≥PSA level ≥4 ng/ml and Free PSA/ Total PSA ratio was less than 20%. These patients underwent transrectal ultrasound (TRUS)-guided 10-14 core prostate biopsy. Results Of the 196 patients, cancer in 73 patients (37.2%), intraepithelial neoplasia in 14 patients (7.1%) and benign prostatic hyperplasia in 108 patients (55.1%) were diagnosed. Transrectal ultrasound guided 10-14 core prostate biopsy diagnosed prostatic cancer in 25% of 14 patients who had no prostatic cancer with traditional biopsy. There were non significant associations between age and total and free PSA. There was a non significant correlation between the free PSA and Gleason score, but there was a significant correlation between the Gleason score and total PSA. Conclusion This study shows that the TRUS-guided 10-14 core biopsies yield a better prostate cancer detection rate than the classic biopsy.
https://mjms.mums.ac.ir/article_5327_a43b76f4180f97d25e0ec7994601a740.pdf
2011-09-23
172
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10.22038/mjms.2011.5327
Biopsy
Gleason score
Prostate specific antigen
Prostate
Reza
Mahdavi
mahdavir@mums.ac.ir
1
Professor of Urology, Mashhad University of medical Science Mashhad, Iran
LEAD_AUTHOR
Keyvan
Aghamohammadpour
2
Resident of Urology,Mashhad University of Medical Sciences,Mashhad, Iran
AUTHOR
Mohammad Hadi
Shakibi
3
Urologist, Mashhad, Iran
AUTHOR
1- Tobias-Machado M, Verotti MY, Arago AY, Rodrigues AO, Borelli M, Wroklawski ER. Prospective randomized
1
controlled trial comparing three different ways of anesthesia in transrectal ultrasound-guided prostate biopsy. Int Braz J
2
Urol 2006; 32:172-179.
3
2- Kariotis I, Philippou P, Volanis D, Serafetinides E, Delakas D. Safety of ultrasound-guided transrectal extended
4
prostate biopsy in patients receiving low-dose aspirin. Int Braz J Urol 2010; 36:308-316.
5
3- Bulbol MA, Hout R, Shaar A, Madi A. The distribution of non malignant conditions in patients referred for prostate
6
biopsy. A J Urol 2000; 4; 45-47.
7
4- Galetti TP, Dalmoro F, Bulbol MA, Hout R, Shaar A, Madi A. The distribution of non malignant conditions in
8
patients referred for prostate biopsy. A J Urol 2004; 4:45-47
9
5- Eisenberg ML, Davies BJ, Cooperberg MR, Cowan JE, Carroll PR. Prognostic Implications of an Undetectable
10
Ultrasensitive Prostate-Specific Antigen Level after Radical Prostatectomy. Eur Urol 2010; 57:622-630
11
6- Rigatti P, Schulman C. Transrectal ultrasound prostatic biopsy in the PSA Era :introduction. Eur Urol supp 2002;
12
7-Allen EA, Kahane H, Epstein JI. Repeat biopsy strategies for men with atypical diagnoses on initial prostate needle
13
biopsy. Urology 1998; 52:803.
14
8- Babaian RJ. Extended field prostate biopsy enhances cancer detection. Urology 2000; 55:45.
15
9- Carter HB, Hamper UM, Sheth S, Sanders RC, Epstein JI, Walsh PC. Evaluation of transrectal ultrasound in the early
16
detection of prostate cancer. J Urol 1989; 142:1008-10010.
17
10- Chang JJ, Shinohara K, Hovey RM, Montgomery C, Presti JC Jr. Prospective evaluation of systematic sextant
18
transition zone biopsies in large prostates for cancer detection. Urology 1998; 52:89-93.
19
11- Cho JM, Woo S, Lee K, Yoon K, Keun T. Safety and efficacy of combind transrectal ultrasound-guided prostate
20
biopsy and transurethralressection of the prostste. Korean J Urol 2010; 51:101-105.
21
12- Montironi R, Mazzucchelli R, Scattoni V, Bostwick DG. Pathological findings in TRUS prostatic biopsy
22
diagnostic,prognostic and therapeutic importance. Eur Uro Supp 2002; 2:60-75
23
13- Dyavan B, Remiz M, Marberger M. When and how aprostatic re-biopsy should be performed? Eur Uro Supp 2002;
24
14- Moreno Alarcó n C, Ló pez González PA, Ló pez Cubillana P, Doñ ate Iñ íguez G, Ruiz Morcillo JC, Olarte Barragán
25
EH, et al. Morbidity and risk factors of transrectal prostate biopsy. Actas Urol Esp 2010; 34:531-536.
26
15- Breslin JA, Turner BI, Faber RB, Rhamy RK. Anaerobic infection as a consequence of transrectal prostatic
27
biopsy. J Urol 1978; 120:502-503.
28
16- Brown RW, Warner JJ, Turner BI, Harris LF, Alford RH. Bacteremia and bacteruria after transrectal prostatic
29
biopsy. Urology 1981; 18:145-148.
30
17- Hori S, Sengupta A, Joannides A, Balogun-Ojuri B, Tilley R, McLoughlin J. Changing antibiotic prophylaxis for
31
transrectal ultrasound-guided prostate biopsies: are we putting our patients at risk? BJU Int 2010 [Epub ahead of print]
32
ORIGINAL_ARTICLE
The Study on Fungal Colonization of Respiratory Tract in Patients Admitted to Intensive Care Units of Sari and Babol hospitals
Introduction Fungi are considered as a life threatening in immunocompromised patients and respiratory tract is the main involvement location. Critically ill patients who are admitted to intensive care units (ICU) may also be susceptible to these infections, because of their conditions. Fungal colonization in respiratory tract maybe consider as a probable source for infection. Therefore, in the present study we evaluatedfungal flora of respiratory tract in patients admitted to ICU. Materials and Methods Bronchoalveolar lavage samples were collected by bronchoscope from 45 patients with underlying predisposing conditions for invasive fungal infection twice a week. Samples were homogenated by pancreatin for performance of direct microscopic examination and cultured on Sabouraud’s dextrose agar. The grown fungi on culture media were identified by standard mycological procedures. Results The main underlying predisposing conditions were COPD (22.2%), hematologic malignancy (20.3%) and prolonged stay in the ICU (16.9%). The mean length of ICU stay was 19.6 days. Overall, 80 samples had positive result in direct examination (76.2%) and culture (71.2%), respectively. The most frequent isolated fungi were Candida (64.7%), Aspergillus (19.3%) and Penicillium (7.9%). Among Candida and Aspergillus species, C. albicans and A. flavus were most common. In 48.4% of patients, similar fungal species were isolated in both sampling times. Conclusion The results of our study showed that the ICU patients were susceptible to fungal resistant colonization especially Candida and Aspergillus as two life threatening fungal agents. So we emphasize the control procedures to reduce the fungal infection possibility among ICU patients.
https://mjms.mums.ac.ir/article_5328_2a00f168634626cee224e756a9f969ed.pdf
2011-09-23
177
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10.22038/mjms.2011.5328
Fungal colonization
Intensive Care Units
Respiratory tract
Sadegh
Khodavaisy
1
MSc inMedical mycology, Sanndaj University of Medical Science,Sanndaj, Iran
AUTHOR
Masoud
Alialy
2
Assistant Professor of Pulmonary, Sari University of Medical Science,Sari, Iran
AUTHOR
Saeed
Mahdavi Omran
3
Assistant Professor of Medical mycology,Babol University of Medical sciences,Babol, Iran
AUTHOR
Mohammad Reza
Habibi
4
Assistant Professor of Anesthesiologyt, Sari University of Medical Science,Sari, Iran
AUTHOR
Parviz
Amri
5
Assistant Professor of Anesthesiology, Babol University of Medical sciences,Babol, Iran
AUTHOR
Mahmoud
Monadi
6
Assistant Professor of Pulmonary, Babol University of Medical sciences,Babol, Iran
AUTHOR
Mohammad Taghi
Hedayati
hedayaty2001@yahoo.co.uk
7
Professor of Medical mycology, Sari University of Medical Science,Sari, Iran
LEAD_AUTHOR
1- Lockhart SR, Diekemas DJ, Pfaller MA. The epidemiology of fungal infections. In: Anaissie EJ, McGinnis MR,
1
Pfaller MA. Clinical Mycology. 2nd ed. Churchill-Livingstone, Elsevier; 2009.p.1-14.
2
2- Shoham S, Marwaha S. Invasive Fungal Infections in the ICU. J Intensive Care Med 2010; 25:78-92.
3
3- Zilberberg M, Andrew F. Fungal infections in the ICU. Infect Dis Clin North Am 2009; 23:625–642.
4
4- Pfaller M, Diekema D. Epidemiology of invasive mycoses in North America. Crit Rev Microbiol 2010; 36:1–53.
5
5- Wisplinghof H, Bischof T, Tallent SM, Seifert H, Wenzel R, Edmond MB. Nosocomial bloodstream infections in
6
US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study. Clin Infect Dis 2004; 39:309–
7
6- Pappas PG. Invasive candidiasis. Infect Dis Clin North Am 2006; 20:485-506.
8
7- Bliss JM, Basavegowda KP, Watson WJ, Sheikh AU, Ryan RM. Vertical and horizontal transmission of Candida
9
albicans in very low birth weight infants using DNA fingerprinting techniques. Pediatr Infect Dis J 2008; 27:231-235.
10
8- Polderman KH, Girbes J. Central venous catheter use, part 2: infectious complications. Intensive Care Med 2002;
11
28:18–28.
12
9- Rolston KV. The spectrum of pulmonary infections in cancer patients. Curr Opin Oncol 2001; 13:218-223.
13
10- Randhawa HS. Respiratory and systemic mycoses: an overview. Indian J Chest Dis Allied Sci 2000; 42:207-219.
14
11- Koenraad H, Vandewoud E. Aspergillosis in the ICU -The new 21st century problem? Med Mycol 2006; 44:71-76.
15
12- Ascioglu S, Rex JH, dePauw B. Defining opportunistic invasive fungal infections in immunocompromised patients
16
with cancer and hematopoietic stem cell transplants: an international consensus. Clin Infect Dis 2002; 34:7–14.
17
13- Warris A, Verweij PE. Clinical implications of environmental sources for Aspergillus. Med Mycol 2005; 43:59–65.
18
14- Meersseman W, Vandecasteele SJ, Wilmer A, Verbeken E, Peetermans WE. Invasive aspergillosis in critically ill
19
patients without malignancy. Am J Respir Crit Care Med 2004; 170:621–625.
20
15- Meersseman W, Lagrou K, Johan M. Invasive Aspergillosis in the Intensive Care Unit Aspergillosis in the ICU.
21
Intensive Care Med 2007; 45:205-215.
22
16- Bulpa PA, Dive AM, Garrino MG, Delos MA, Gonzalez MR, Evrard PA, et al. Chronic obstructive pulmonary
23
disease patients with invasive pulmonary aspergillosis: benefits of intensive care? Intensive Care Med 2001; 27:59–67.
24
17- Vandewoude K, Colardyn F, Verschraegen G. Clinical relevance of positive Aspergillus cultures in respiratory tract
25
secretions in ICU patients. Critical Care 2005; 10:2-10.
26
18- Leroy O, Gangneux JP, Montravers P, Mira JP, Gouin F, Sollet JP, et al. AmarCand Study Group. Epidemiology,
27
management, and risk factors for death of invasive Candida infections in critical care: a multicenter, prospective,
28
observational study in France (2005-2006). Crit Care Med 2009; 37:1612-1618.
29
19- Debasis B, Sonal A, Girish S, Jagdish. Fungal colonization in patients with chronic respiratory diseases from
30
Himalayan region of India. Ann Clin Microbiol Antimicrob 2010; 9:28-35.
31
20- Keith P, Marin K, Michael D. Culturing bronchial washings obtained during bronchoscopy fails to add diagnostic
32
utility to culturing the bronchoalveolar lavage fluid alone. Diagn Microbiol Infect Dis 2002; 43:99–105.
33
21- Park SY, Kim SH, Choi SH, Sung H, Kim MN, Woo JH, et al. Clinical and radiological features of invasive
34
pulmonary aspergillosis in transplant recipients and neutropenic patients. Transpl Infect Dis 2010; 135:15-25.
35
22- Tarrand JJ, Lichterfeld M, Warraich I, Luna M, Han XY, May GS, et al. Diagnosis of invasive septate mold
36
infections: a correlation of microbiological culture and histologic or cytologic examination. Am J Clin Pathol 2003;
37
119:854–858.
38
23- Vandewoude KH, Blot SI, Benoit D, Colardyn F, Vogelaers D. Invasive aspergillosis in critically ill patients:
39
attributable mortality and excesses in length of ICU stay and ventilator dependence. J Hosp Infect 2004; 56:269–276.
40
24- Meersseman W, Lagrou K, Wilmer A, Johan M. Galactomannan in Bronchoalveolar Lavage Fluid A Tool for
41
Diagnosing Aspergillosis in Intensive Care Unit Patients. Am J Respir Crit Care Med 2008; 177:27-34.
42
25- Clancy C, Jaber R, Leather H, Wingard J. Bronchoalveolar lavage galactomannan in the diagnosis of invasive
43
pulmonary aspergillosis among solid organ transplant recipients. J Clin Microbiol 2007; 45:1759-1763.
44
26- Garnacho MJ, Amaya VR, Ortiz LC, Leon C, Alvarez LF, Nolla SJ, et al. Isolation of Aspergillus spp. from the
45
respiratory tract in critically ill patients: risk factors, clinical presentation and outcome. Critical Care 2005; 9:191–199.
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27- Maertens J, Theunissen K, Lodewyck T, Lagrou K. Advances in the serological diagnosis of invasive Aspergillus
47
infections in patients with haematological disorders. Mycoses 2007; 50:2–17.
48
30. Hope WW, Walsh TJ, Denning DW. Laboratory diagnosis of invasive aspergillosis. Lancet Infect Dis 2005; 5:609-
49
28- Hedayati MT, Mayahi S, Movahedi M, Shokohi T. A Study on fungal flora of tap water as a potential reservoir of
50
fungi in hospitals from Sari city, Iran. J Mycol Méd (In press).
51
29- Hedayati MT, Bahoosh M, Kasiri A, Ghasemi M, Motahhari J, Pormosa R. Prevalence of fungal rhinosinusitis
52
among patients with chronic rhinosinusitis from Iran. J Mycol Méd 2010; 20:298-303.
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30- Badiee P, Kordbacheh P, Alborzi A, Ramzi M, Shakiba E. Molecular detection of invasive aspergillosis in
54
hematologic malignancies. Infection 2008; 36:580-584.
55
31- Badiee P, Kordbacheh P, Alborzi A, Malekhoseini S, Ramzi M, Mirhendi H, et al. Study on invasive fungal
56
infections in immunocompromised patients to present a suitable early diagnostic procedure. Int J Infect Dis 2009; 13:
57
97-102.
58
ORIGINAL_ARTICLE
A Case Report of Nodular Regenerative Hyperplasia of the Liver and Coeliac Disease
Introduction Coeliac disease (CD) is an autoimmune enteropathy triggered by gluten. Several hepatic disorders have been described in association with coeliac disease. Nodular regenerative hyperplasia (NRH) of the liver is a rare disorder and is a cause of non-cirrhotic portal hypertension. [ Case report A 22 y/o lady presented with portal hypertension, after all causes of chronic liver disease ruled out we checked for coeliac and it was positive. Liver biopsy was done and was compatible with nodular regenerative hyperplasia (NRH) of the liver. Conclusion As far as we know this is one of the rare cases of nodular regenerative hyperplasia of the liver in a patient with coeliac. Only three cases have been reported until now and seems we should think about coeliac in any patient suffering from chronic liver disease with unknown cause.
https://mjms.mums.ac.ir/article_5329_a72f8bac27dbb1642c10c685aac1acb8.pdf
2011-09-23
185
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10.22038/mjms.2011.5329
Coeliac disease
Liver disease
Nodular regenerative hyperplasia
Azita
Ganji
ganjia@mums.ac.ir
1
Gastroenrologist and Hepatologist,Mashhad University of Medical Sciences, Mashhad, Iran
LEAD_AUTHOR
Abbas
Esmaeilzadeh
esmaeelzadea@mums.ac.ir
2
Assistant ProfessorofGastroenrology and Hepatology,Mashhad University of Medical Sciences, Mashhad, Iran
AUTHOR
Kamran
Ghafarzadegan
3
APCP-Pathologist,Mashhad, Iran
AUTHOR
Ali
Mokhtarifar
mokhtarifara@mums.ac.ir
4
Assistant ProfessorofGastroenrology and Hepatology,Mashhad University of Medical Sciences, Mashhad, Iran
AUTHOR
1- Barbero Villares A ,Moreno Monteagudo JA ,Moreno Borque, Moreno Otero R. Hepatic involvement in coeliac
1
disease .Gastroenterol Hepatol 2008; 31:25-28.
2
2- Rubio-Tapia A, Murray JA . The liver in celiac disease .Hepatol 2007; 46:1650-1658.
3
3- Volta,Pathogenesis and clinical significance of liver injury in coeliac disease. Clin Rev Allergy Immunol 2009 ;36:62-70.
4
4- Ziol M ,Poirel H ,Kountchou GN, Boyer O, Mohand D, Mouthon L, et al. intrasinusoidal cytotoxic CD8 Tcells in
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Nodular regenerative hyperplasia of the liver. Hum Pathol 2004; 35:1241-1251.
6
5- Maggiore G, Caprai S. Liver involvement in coeliac disease. Indian J Pediatr 2006; 73:809-811.
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6- Wanless IR. Micronodular transformation (nodular regenerative hyperplasia) of the liver: a report of 64 cases among
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2,500 autopsies and a new classification of benign hepatocellular nodules. Hepatology 1990; 11:787–797.
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7- Perez Ruiz F , Orte Martinez FJ, Zea Mendoza AC, Ruiz del Arbol L, Moreno Caparros A.
10
Nodular regenerative hyperplasia of the liver in rheumatic diseases: report of seven cases and review of the literature.
11
Semin Arthritis Rheum 1991; 21:47–54.
12
8- Austin A, Campbell E, Lane P, Elias E .Nodular regenerative hyperplasia of the liver and coeliac disease: potential
13
role of IgA anticardiolipin antibody. Gut 2004; 53:1032-1034.
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9- Al Mukhaizeem KA, Rosenberg A , Sherker AH. Nodular regenerative hyperplasia of the liver:an under-recognized
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cause of portal hypertension in hematological disorders. Am J Hematol 2004; 75:225-230.
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10- Ibarrola C, Colina F. Clinicopathological feathers of nine cases of non-cirrhotic portal hypertension; current
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definitions and criteria are inadequate .Histopathology 2003; 42:251-264.
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11- Reshamwala PA, Kleiner DE, Heller T. Nodular regenerative hyperplasia: not all nodules are created equal.
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Hepatology 2006; 44:7-14.
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12- Hillaire S, Bonte E , Denninger MH, Casadevall N, Cadranel JF, Lebrec D, et al. Idiopathic non-cirrhotic
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intrahepatic portal hypertension in the west: a re-evaluation in 28 patients .Gut 2002; 51:275-280.
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13- Sollid LM. Coeliac disease: dissecting a complex inflammatory disorder. Nat Rev Immunol 2002; 2:647–655.
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14- Moss SF, Attia L, Scholes JV, Walters JR, Holt PR. Increased small intestinal apoptosis in coeliac disease. Gut
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1996; 39:811–817.
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15- Biecker E ,Trebicka J ,Fischer Hp , Sauerbruch T, Lammert F.Portal hypertention and nodular regenerative
26
hyperplasia in a patients with coeliac disease . Z Gatroentrol 2006; 44:395-398.
27
16- Clein R,Goller S, BianchiL. Nodular regenerative hyperplasia of the liver a manifestation of organ specific
28
antiphospholipid syndrome? Immunobiology 2003; 207:51-57.
29