[ factors relevant to the onset of vascular complications after coronary intervention in Shahid Rajaei cardiovascular Center in Tehran, Iran]

Vascular complications, as the most common complications of diagnostic catheterization and percutaneous coronary intervention [PCI], are important factors in the morbidity of patients undergoing such procedures; thus, this study was done to evaluate the prevalence of these complications and their related factors. This is a descriptive study composed of 2097 consecutive patients who underwent percutaneous coronary intervention in Shahid Rajaei Cardiovascular Center in Tehran, Iran from January 2008 to January 2009. Occurrence of vascular complications in course of hospitalization and the related factors leading to the complications were investigated. Out of 2097 patients, 1544 [73.6%] were male and 553 [26.4%] were female, and the mean age of the participants was 57 +/- 10 years. Vascular complications from the time of PCI to the time discharge were observed in 19 [0.9%] patients. The other complications included: hematoma in 10 cases [52.6%], pseudoaneurysm in five cases [26.3%], retroperitoneal hemorrhage and arteriovenous fistula in 2 [10.5%] patients each. The complications were significantly more common in female patients [P=0.003], in patients with a history of hypertension [P=0.02], people of shorter stature [P=0.004], and being on gp IIIa/IIb inhibitors [P=0.003]. The rate of vascular complications post-percutaneous coronary interventions is low and it is considered to be a good treatment option for patients with coronary stenosis; provided that sufficient compression is applied on the vascular access point in the right time after removal of the arterial sheath. PCI is of fewer vascular complications, especially in female patients, history of hypertension, and higher anticoagulant concentrations

Spirometry parameters in patients undergoing hemodialysis with bicarbonate and acetate dialysates

End-stage renal disease causes impairment of all body organs including the heart and the lung. The main problems in the afflicted patients are pulmonary edema due to increased permeability of the capillaries, intravascular and interstitial volume overload, hypertension, and congestive heart failure. These changes cause altered physiologic and mechanical function of the lungs and subsequently increase in airway resistance. We aimed to study the impact of hemodialysis on spirometry parameters. In a cross-sectional study performed on 41 patients on maintenance hemodialysis, spirometry was done before and after the dialysis session. The patients were on either acetate or bicarbonate hemodialysis with the same method, dialysis machine, and duration of dialysis. Alterations in spirometry parameters including forced expiratory volume in the first second [FEV1], forced vital capacity [FVC], FEV1/FVC ratio, and maximal midexpiratory flow rate were determined and their relation with serum electrolytes, serum creatinine, blood urea nitrogen, and hemoglobin were analyzed. Twenty-nine patients undergoing dialysis with bicarbonate dialysate and 21 on dialysis with acetate were compared. Improvement in spirometry parameters was only significant in patients undergoing dialysis with bicarbonate dialysate. All spirometry parameters showed significant increases in the bicarbonate group except for the FEV1/FVC ratio. Furthermore, significant increase in these parameters was only prominent in the men. Postdialysis weight reduction and laboratory indexes had no significant correlation with improvement of spirometry parameters. Dialysis with bicarbonate dialysate causes significant improvement in spirometry parameters in men on maintenance dialysis. This effect might be independent of the effect of removing the volume overload by dialysis