Risk-scoring model to predict one-year major adverse cardiac events after percutaneous coronary intervention

Background: The aim of the present study was to develop a scoring system for predicting 1-year major adverse cardiac events [MACE], including mortality, target vessel or target lesion revascularization, coronary artery bypass graft surgery, and non-fatal myocardial infarction after percutaneous coronary intervention [PCI]

Methods: The data were extracted from a single center PCI registry. The score was created based on the clinical, procedural, and laboratory characteristics of 8206 patients who underwent PCI between April 2004 and October 2009. Consecutive patients undergoing PCI between November 2009 and February 2011 [n= 2875] were included as a validation data set

Results: Diabetes mellitus, increase in the creatinine level, decrease in the left ventricular ejection fraction, presentation with the acute coronary syndrome, number of diseased vessels, primary PCI, PCI on the left anterior descending artery and saphenous vein graft, and stent type and diameter were identified as the predictors of the outcome and used to develop the score [R[²] = 0.795]. The models had adequate goodness of fit [Hosmer-Lemeshow statistic; p value = 0.601] and acceptable ability of discrimination [c-statistics = 0.63]. The score categorized the individual patients as low-, moderate-, and high-risk for the occurrence of MACE. The validation of the model indicated a good agreement between the observed and expected risks

Conclusion: An individual risk-scoring system based on both clinical and procedural variables can be used conveniently to predict 1-year MACE after PCI. Risk classification based on this score can assist physicians in decision-making and postprocedural health care

association between completed suicides and season of the year in an Iranian population

The main objective of the present study was to determine the association between completed suicides and season of the year in Iran during 2006-2010. Data on completed suicides were collected by questionnaires field out by the family members of the victims in Legal Medicine Centers throughout the country over the period from 2006 to 2010. The maximum number of completed suicides [380] was observed in August, while the minimum number [231] was reported in February. Season-wise, completed suicides were most prevalent in summer [1040], whereas least prevalent in winter [726]. Mean [SD] age of individuals having committed suicide was 31.5 [14.6] years. This value did not change significantly in different seasons [P=0.051]; nor, was a statistically significant difference observed in the educational level and the reason for suicide across different seasons of the year. Self-immolation and toxic poisoning were found to be significantly less common in autumn and winter [P<0.05], respectively. The number of completed suicides was higher in warm seasons. Season of the year had significant relationships with gender as well the method of suicide, while no significant association was observed for age, level of education, and reason for suicide

Six year trend in cataract surgical techniques in Iran

To determine the cataract surgery techniques performed in Iran from 2000 to 2005. Materials and Methods- This study was part of the Iranian Cataract Surgery Survey [ICSS] which was a retrospective cross-sectional study. All major ocular surgery units and 10% of randomly selected minor units throughout Iran were included. Excluding the 2 week Iranian New Year holiday, 1 week per season between 2000 and 2005 [a total of 24 weeks] was selected for each center, and data on all cataract surgeries performed during these weeks were collected by reviewing patient records. The ANOVA repeated measure test was performed to determine longitudinal changes with a P<0.05 denoting statistical significance. Phacoemulsification with intraocular lens [IOL] implantation has become the surgical method of choice in Iran, increasing from less than 7% in 2000 to 57% in 2005 [P<0.000l]. Extracapsular cataract extraction showed a reverse trend compared to phacoemulsification, decreasing from greater than 91% in 2000 to 41% in 2005 [P<0.000l]. Intracapsular cataract extraction and lensectomy were rarely performed without significant changes over time [P>0.05] Phacoemulsification with IOL implantation has become the preferred cataract surgery method in Iran during recent years

Vascular endothelial growth factor in bronchoalveolar lavage fluid in sulfur mustard exposed lung patients

To determine the levels of vascular endothelial growth factor isoform consisting of 165 amino acids [VEGF165] in Bronchoalveolar Lavage fluid from Mustard Exposed Patients. Bronchoscopy with Bronchoalveolar Lavage was performed on sulphur mustard exposed patients. A total of 39 patients with documented exposure to Sulfur Mustard during the Iran-Iraq war participated in this study, of which 38 patients were males and one patient was female. The mean +/- SD age of patients was 41 +/- 6.6 years. The mean time after exposure to sulfure mustard was 19 +/- 1.7 years. Eighteen patients had concomitant war injuries but they were not related to the respiratory system. While twenty-two patients had a history of submassive persistent hemoptysis. There was no case with massive hemoptysis. Most of the patients had small airway obstruction [FEV1/FVC% = 78.14 +/- 9.76 and FEV% = 82.79 +/- 18.23]. Twenty-three patients had significant air trapping in the chest. High Resolution Computed Tomography was compatible with BOS. VEGF 165 concentrations in BALF were 36.87 +/- 34.68 pg/ml. When corrected to total protein of Bronchoalveolar Lavage Fluid [BALF] it was 0.76 +/- 0.70 pg/mg. BALF of VEGF did not correlate with hemoptysis or air trapping in chest HRCT. Thus, there was also no correlation between level of VEGF165 in BALF and any of PFT indexes [FVC, FEV1, MMEF or PEF]. Although VEGF is one of the cytokines which has an important role in chronic pulmonary disorders, it seems that it has no essential role in the severity of Mustard Lung Disease

Pulmonary function test trend in adult bronchiolitis obliterans

Some histopathologic patterns of bronchiolar disease may be relatively unique to a specific clinical entity, such as respiratory bronchiolitis caused by cigarette smoking and toxic fumes i.e. sulfur mustard [SM]. The aim of this study was to determine the trend of pulmonary function indices in SM-exposed patients with the diagnosis of bronchiolitis obliterans. In this retrospective cohort study, 407 cases were evaluated. Patients were divided into 4 groups according to the time period from performing PFT: 1-3, 4-6, 7-10 and more than 10 years. The amounts of these changes amongst four PFT interval groups were compared by analysis of variance test. In addition, we used linear regression analysis to create a linear model of changes for each PFT index. The following equations imply a correlation between decrease in PFT indices and interval between the two tests plus index value of baseline PFT. 1: [FVC%]= -2.23 - [0.76 T]-[0.23 FVC1%], 2: [FEV1%]= -1.43 - [0.95 T]-[0.10 FEV11%], 3: [PEF%]= -0.91 - [1.07 T]-[0.14 PEF1%]. Better understanding of the nature of bronchiolitis obliterans, helps improve the treatment of this disease. Our study suggests a pattern of decline in pulmonary function indices directly proportional to the percentage of each index in the baseline PFT which was apparent during a 10-year observation period