ABSTRACT
The concomitant occurrence of acute type B aortic dissection (TBAD) and acute pulmonary embolism (PE) is a rare but challenging condition. Although anticoagulation therapy is essential in the treatment of PE, it may increase the risk of aortic rupture and bleeding complications. We herein describe a patient with acute TBAD complicated by PE, which was successfully treated with early thoracic endovascular aortic repair (TEVAR) followed by anticoagulation. The present case report demonstrates that early TEVAR not only treats the aortic pathology but also allows the safe initiation of anticoagulation therapy.
ABSTRACT
Diabetes mellitus as a chronic disease is associated with complications and stress. Empowerment as a coping index in health issues can be helpful among diabetic patients. In this study, we aimed to determine empowerment and adoption of self-management behaviors and its related factors among type 2 diabetic patients referring to hospitals affiliated to Tehran University of Medical Sciences during 2010. This study was a cross-sectional research conducted during a 9 months period [2010-2011]. A total of 688 samples were selected by random sampling. A questionnaire consisting of three parts including socio-demographic and health related data, diabetes empowerment scale [28 items], and diabetes self- management instrument [35 items] was used. Collected data was analyzed by SPSS software version 18 with using parametric and nonparametric tests. Response rate was 100%. Mean age of participants was 54.41 +/- 8.22 [Mean +/- SD]. Study findings showed that empowerment had significant relation between level of education [p=0.006] and age [p=0.009]. Self- management and some variables such as age [p<0.001], level of education [p<0.001], marital status [p=0.04] and disease duration [p=0.004] had significant relationship. Also, Pearson correlation coefficient showed that empowerment had reverse and linear relation with adoption of self-management behaviors among type 2 diabetic patients. Thus, by increasing empowerment score, adoption of self-management behaviors is increased [r = 0.28, p<0.001]. Regarding to relation between empowerment and adoption of self-management behaviors, focusing on planning empowerment based interventions has been more highlighted. It seems these strategies can be helpful in decreasing complications and mortality.
ABSTRACT
Percutaneous balloon mitral valvotomy [BMV] has been accepted as an alternative to surgical mitral commissurotomy in the treatment of patients with symptomatic rheumatic mitral stenosis. Despite the worldwide use of the BMV technique, no studies have been hitherto designed to assess the outcome of the patients undergoing BMV in Iran. The present study reports the outcome of 3138 BMV procedures at Shaheed Rajaei Cardiovascular, Medical and Research Center during a 15-year time period. A total of 2531 patients underwent 3138 BMV procedures at Shaheed Rajaei Cardiovascular, Medical and Research Center between 1992 and 2006. Seventy-three percent [2278] of the cases were followed for 48 +/- 41 months. Recurrent stenosis in 802 [25.8%], mitral valve replacement [MVR] in 213 [6.9%], immediate good result in 3110 [99.1%], and successful outcome in 2000 [72.9%] cases were the outcome of the BMV procedures in the current study. Concordant to the similar studies, we concluded that BMV produces a good clinical outcome in a high percentage of patients. The recent study demonstrated that the successful outcome of BMV was multi factorial and the selection of patients with rheumatic mitral stenosis is recommended to be based on both anatomic and clinical characteristics of the individuals. The procedure-related variables must also be considered in order to predict the outcome
ABSTRACT
Patients with QRS fragmentation following myocardial infarction [MI] are at greater risk of cardiac death. Transthoracic echocardiography [TTE] can be used as a method for evaluating the coronary sinus blood flow [CSBF] and coronary sinus velocity time integral [CSVTI]. The present study reports measurement of CSBF and CSVTI by TTE in 100 acute anterior MI cases, half of them with fragmented QRS. Our study included 100 patients with acute anterior MI in whom CSBF and CSVTI were measured by the use of TTE. Fifty of all the patients had fragmented QRS complex and 50 patients were without fragmented QRS complex, while there was no difference in terms of LVEF in both groups of study. CSBF [303 +/- 126 ml/min vs. 258 +/- 121 ml/min; p-0.001] and CSVTI [14.45 +/- 2.85 ml vs. 10.85 +/- 2.69 ml; p=0.003] were significantly lower in the acute anterior MI patients with fragmented QRS in comparison with the patients with acute anterior MI without fragmented QRS. We conclude that CSBF and CSVTI can be measured by TTE in acute MI patients and these variables are reduced in acute anterior MI patients with fragmented QRS
ABSTRACT
We present two women who lived in a rural community. The presence of a semi-solid mass, a hydatid cyst or tumor, in the heart was diagnosed by echocardiography, computed tomography, and Magnetic Resonance Imaging. The hydatid cyst was seen during surgery. Pathological examination confirmed an infected hydatid cyst