ABSTRACT
Tuberculosis is considered a major cause of morbidity and mortality worldwide. According to the WHO report 9.4 million individuals were suffering from active TB in 2009 [1]. Diagnostic methods for active pulmonary TB include: clinical suspicion, tuberculin skin test, acid fast bacilli stain, cultures for maycobacterium, and in recent years NNA [nucleid acid amplification]. An ideal test for pulmonary active tuberculosis should be easily performed with rapid results, it should have high sensitivity and specificity, low cost,technically easy to operate and reproducible results in a variety of settings, have the possibility of drug-susceptibility testing and could distinguish Mycobacterium tuberculosis from other mycobacteria. Direct smear sputum microscopy is the primary method for diagnosing pulmonary tuberculosis but it lacks enough sensitivity and only about 44% of all new cases are detected by this method [2]. Culture technique is still seen as the gold standard for active TB. Although, the sensitivity and specificity of culture is high, this method is slow and time consuming and needs special laboratory equipments [3,4,5]. It not only provides the detection of various mycobacterial species but also the examination of drug sensitivity. It also provides the examination of genotype for epidemiological purposes if needed. Nucleic acid amplification tests [NAATs] can be performed in one day. But NAAT are not [fully] standardized and the diagnostic accuracy is highly heterogeneous, and need experienced personnel and expensive equipments
ABSTRACT
Pulmonary embolism is a prevalent and fatal pulmonary disease. In this study, the relationships between serum highly sensitive [hs] troponin T levels and findings of ECG, colour doppler sonography of lower extremity veins venous [CDS LEV] and also arterial blood gas [ABG] in normotensive patients with acute pulmonary embolism were investigated. A cross sectional study was carried out on 33 patients with acute pulmonary embolism who were hospitalized in Emam Khomeini Hospital, Tehran University of Medical Sciences between 2009 and 2010 [mean age, 49.3; 18 male and 15 female]. [18 patients had with a normal hs-troponin T, lower than 14 pg/ml, and 15 patients had with elevated hs-troponin T.]with acute pulmonary embolism [mean age, 49.3; 18 male and 15 female] who were hospitalized in Emam Khomeini Hospital, Tehran University of Medical Sciences between 2009 and 2010 Serum hs-troponin T level was measured by ELISA highly sensitive method. The prevalence of T invert and S1Q3T3 patterns and also thrombosis in lower extremity deep venous were significantly higher in patients with elevated hs-troponin T. In addition, PCO2 and HCO3- levels were significantly lower in patients with elevated hs-troponin T levels. According to the results of the study, it seems that the elevated hs-troponin T accompanies with ECG and ABG findings and also with thrombosis in lower extremity deep venous prevalence in patients with acute pulmonary embolism
ABSTRACT
Pulmonary embolism is a prevalent and fatal pulmonary disease. In this study, the relationships of clinical and echocardiographic findings with serum troponin T level in patients diagnosed as having acute pulmonary embolism with normal pulmonary artery systolic pressure were investigated. A cross sectional study was carried out on 33 patients [18 with normal troponin T, lower than 14 pg/ml and 15 with elevated troponin T] with acute pulmonary embolism [mean age, 49.3; 18 male and 15 female], who hospitalized in Emam Khomeini Hospital, Tehran University of Medical Sciences between 2009 and 2010. Clinical and echocardiographic findings were analyzed by using x2, Exact Fisher's test and student's t-test. Serum troponin T level was measured by ELISA highly sensitive method. The prevalence of dysfunction, hypokinesia and dilatation of right ventricle, and also pulmonary hypertension in echocardiographic findings and right ventricular S3 sound in clinical finding was significantly higher in patients with elevated troponin T McConnell's sign, loud P2 sound, elevated jugular venous pulse and lowered left ventricular ejection fraction were higher in elevated troponin T patients, but there were not significant. According to results of the study, it seems that the elevated troponin T accompanies with right ventricular dysfunction signs in patients with acute pulmonary embolism
Subject(s)
Humans , Male , Female , Pulmonary Embolism , Acute Disease , Echocardiography , Cross-Sectional Studies , Enzyme-Linked Immunosorbent Assay , Ventricular Dysfunction, RightABSTRACT
Background: Tissue diagnosis of anterior mediastinal tumors is very important for making correct therapeutic decision. To evaluate the value of performing percutaneous core needle biopsy in these tumors, we decided to perform this study
Materials and Methods: CT guided core needle biopsy was performed in 17 patients with anterior mediastinal tumor during an18-month period. The biopsy specimens were sent for histopathological study, and if the result was not definite, immunohistochemical studies were performed
Results: Percutaneous core needle biopsy provided adequate material in 15 from 17 cases. Of these 17 patients, 15 were diagnosed correctly by percutaneous core needle biopsy whereas 2 were not diagnosed definitely [one was "spindle cell tumor" and another one was "suggestive for lymphoma"]. The procedure was technically successful in 15 cases, and no complications occurred
Conclusion: CT-guided core needle biopsy of the anterior mediastinal tumors may be a safe, cost-effective and reliable method which can provide a precise diagnosis in the majority of mediastinal tumors and may obviate the need for anterior mediastinotomy or exploratory thoracotomy in cases which are medically treatable or non-resectable