[ effect of trinitroglycerine injection on angiographic complications]

Currently the ischemic heart disease [IHD] is common worldwide. Coronary angiography is gold standard for detecting coronary artery disease. Death, myocardial infarction, nausea, coronary vessels spasm, chest pain, bradyarrhythmia, hypotension, and hypertension are among the common complications occurring following angiography. The aim of this study was to investigate the effect of simultaneous administration of trinitroglycerine [TNG] and the contrast agent on early complications of angiography. This was a clinical trial carried out in Isfahan Shahid Chamran Hospital in 2005. Patients were randomly allocated to two intervention [n=111] and placebo [n=112] groups. Nausea, coronary vessels spasm, chest pain, bradyarhythmia, and systolic and diastolic blood pressure in both intervention [TNG plus contrast agent] and placebo [distilled water plus contrast agent] groups were investigated during and after angiography. The mean age in intervention and placebo groups were 59.93 +/- 9.14 and 59.37 +/- 10.12 years, respectively. Also, sex distribution showed no significant difference. Between TNG group and placebo group we had considering the nausea [4.5% vs 6.2%], coronary vessels spasm [0.9% vs 5.4%], chest pain [1.8% vs 6.3%], and bradyarrythmia [7.1% vs 7.1%] respectively, that had not any significant lower in TNG group compared to placebo group [p=0.001]. Based on data obtained in the present study, except for blood pressure no benefit in simultaneous administration of TNG and the contrast agent on early complication of angiography was demonstrated. Further investigations using different dose, time tables and also selection of high risk patients are recommended. Furthermore, the late complications and mortality as well as the cost-effectiveness are the subjects deserving more attention

Breathing pattern, respiratory center activity respiratory muscle function in schistosomal cor pulmonale: Relation to pulmonary hemodynamics

Breathing pattern, respiratory activity and respiratory muscle function were studied in 25 patients with schistosomal cor pulmonale, with mean pulmonary artery pressure [MPAP] of 47.4 +/- 21.2 mmHg, cardiac index 3.2 +/- 0.5 L/min/m2 and pulmonary vascular resistance [PVR] 7.4 +/- 4.4 units. The pattern of breathing showed near normal tidal volume, increased respiratory frequency, minute ventilation, mean inspiratory flow and decreased inspiratory duty cycle. Respiratory center activity, as measured by the mouth occlusion pressure P 0.1, was increased and demonstrated significant positive correlation with the mean pulmonary artery pressure. Data of the present study also revealed that schistosomal cor pulmonale patients have respiratory muscle weakness as evidenced by a reduction in the maximal inspiratory and expiratory pressure, while diaphragmatic function was found to be preserved. The respiratory muscle strength [PI max and PE max] revealed strong negative correlation with MPAP and PVR. Inclusion schistosomal cor pulmonary patients exhibit disturbed breathing pattern and respiratory muscle performance. The study of these parameters should be included in evaluating ventilatory function in such patients, since it reflects changes in pulmonary hemodynamics

Assessment of secretory IgA and neutrophil cell function in chronic obstructive pulmonary disease

This study was performed on twenty male patients having chronic obstructive pulmonary disease [COPD] and ten male normal subjects taken as controls. All of them were subjected to bronchoalveolar lavage [BAL] for the determination of protein [total and electrophoresis] total Leucocytic count, alveolar macrophages, lymphocytes, neutrophil cell functions using nitro blue tetrazolium dye [NBT] test and secretory of IgA. There was an increase in the total proteins and globulin as well as in the absolute number of macrophages, neutrophils and lymphocytes compared to the control group. There was increased NBT reduction, i.e. stimulation of neutrophil phagocytosis, also there was significant increase of SIgA compared to the control group. This means that cellular immune response as a defense lung mechanism is stimulated

Study of the humeral immune response in the serum and bronchoalveolar lavage in patients with bronchogenic carcinoma

This work included 20 patients with unilateral bronchogenic carcinoma with aim of assessing immunoglobulins G, A and M in both serum and bronchoalveolar lavage [BAL] in the tumor bearing side and the normal side. Protein content of the lavage fluid in both normal and tumor bearing side was increased as compared to controls. There was no significant difference between protein content of the normal side and the tumor bearing side. Immunoglobulins G and A were significantly increased in lavage fluid of the diseased side as compared to normal side. Immunoglobulin M was not detected in all the lavage samples. Serum IgS increased as compared to control. These increases suggest that a local response possibly of and immune nature is present by which the host recognizes and reacts against neoplasm

Haemodynamic response to intrapulmonary verapamil in bilharzial cor-pulmonale

Eleven patients with bilharzial cor pulmonale were subjected to right sided cardiac catheterization for the determination of pulmonary artery pressure [PAP], pulmonary vascular resistance [PVR], and cardiac output before and 5 minutes after intrapulmonary administration of 5 mg verapamil. This was accompanied by slight reduction of PAP, PVR, with a subsequent slight increase in cardiac output. Such effects resulting from the vasodilator properties of verapamil point to the presence of a potentially reversible vasospastic element in bilharzial cor pulmonale. However, the chronic effects as well as the clinical application of Ca channel blockers in such cases have to be evaluated

Tuberculin sensitivity in BCG vaccinated children

This work has been carried out in order to evaluate the waning of tuberculin sensitivity after BCG vaccination in three age groups: 2 years, 6 years and 10 years. Each group included 1000 children. The study revealed an unexpected high figure of negative reaction in all groups, denoting early waning of tuberculin sensitivity with maximum waning at age of 2 years, with a slow progression. It was recommended to boost primary vaccination during early infancy by revaccination earlier than the present policy of giving the vaccine at the age of 6

Respiratory muscles and pulmonary functions in muscle dystrophy

Respiratory muscle function was assessed in 15 patients with muscle dystrophy, the relationship between respiratory muscle efficiency, pulmonary functions and gaseous exchange has been identified. These patients were subjected to routine pulmonary function test, arterial blood gases and to specific respiratory muscle function test including maximal inspiratory pressure, PI max, maximal expiratory pressure PE max, respiratory muscle strength RMS, trans diaphragmatic pressure difference PDi and vital capacity in upright and supine position delta VC. Data of this work revealed reduction in all of the respiratory muscle function tests, increased difference in the vital capacity between upright and supine position and decrease in transdiaphragmatic pressure difference, which all reflect respiratory muscle weakness. Reduction in respiratory muscle efficiency produces a restrictive pattern of pulmonary function with reduction in the vital capacity and maximal voluntary ventilation which are highly dependent on RMS. Arterial blood gases revealed hypoxia and hypercapnia, this change reflects alveolar hypoventilation secondary to respiratory muscle weakness. It might be anticipated that decrements in VC, MVV, PaO2, would relate directly to the degree of respiratory muscle weakness. Objective measurement of respiratory functions are essential in the management of these patients and the most valuable are essential in the management of these patients and the most valuable are serial measurements of vital capacity and arterial carbon dioxide tension