Therapeutic effects of successful angioplasty on the aorta and lower limb arteries on the healing of chronic ischemic wounds

Background: Chronic wounds are a serious problem for the patient and can increase the socioeconomic burden on the healthcare system and community. This study aimed at investigating the effect of angioplasty on chronic ischemic wound healing

Methods: This study was conducted in Sina Hospital, affiliated to Tehran University of Medical Sciences. Thirty-eight patients with chronic ischemic wounds and a suspicion of the narrowing or blockage of arteries underwent peripheral angiography. Arteries under angioplasty in different patients comprised the aorta and the iliac, superficial femoral, popliteal, and tibial arteries. The patients were evaluated in terms of wound healing in weekly and monthly visits. Wound healing was measured based on the Bates-Jensen criteria

Results: The patients were followed up at a median of 4.5 months. The mean age of the patients was 61.1 +/- 7.5 years. Of 38 patients, 12 [31.6%] were female. The involvement of arteries on angiography consisted of 16 [42.2%] cases of total occlusion and 22 [57.8%] cases of stenosis. Following angioplasty, the level of the narrowing of arteries and the wound score showed a significant reduction in all the patients [p value < 0.001]. Wound healing was observed in 29 [76.3%] patients. Hematoma, pseudoaneurysm, and thrombosis comprised the complications. No significant differences were observed in terms of age, gender, and history of risk factors between the 2 groups of wound healing and nonhealing. The wound evaluation scores before [p value = 0.044] and after [p value < 0.001] angioplasty were lower in the wound healing group than in the nonhealing group

Conclusion: Angioplasty of the aorta and lower limb arteries improved the healing of chronic ischemic wounds in our patients

Non-hodgkin's lymphoma presenting as constrictive pericarditis: a rare case report

Constrictive pericarditis [CP] is an uncommon post inflammatory disorder. It is described as pericardial thickening, myocardial constriction, and impaired diastolic filling. The most common etiologies are idiopathy, mediastinal radiotherapy, and prior cardiac surgery. Less common etiologies include viral infections, collagen vascular disorders, renal failure, sarcoidosis, tuberculosis, and blunt chest trauma. CP can less commonly be caused by malignancy. We report a very rare case of non-Hodgkin's lymphoma [NHL] presenting twice with attacks of decompensated heart failure. Echocardiography revealed that CP was responsible for the patient's symptoms as the first manifestation of NHL. Chest computed tomography scan and biopsy findings were compatible with the diagnosis of NHL. The patient received R-CHOP [cyclophosphamide, hydroxydaunorubicin, Oncovin®, and prednisone or prednisolone, combined with the monoclonal antibody rituximab] chemotherapy. Three months later, there was significant improvement in the patient's symptoms and considerable decrease in pericardial thickness

evaluation of pulmonary function tests in patients with polycystic ovary syndrome

Introduction: Recently a relation between female sex hormones and severity of asthma symptoms has been proposed. As a common endocrine dysfunction, polycystic ovary syndrome [PCOS] could significantly influence the level of sex hormones in PCOS patients. Regarding the possible role of sex hormones in airway physiology, the present study was conducted to survey the effects of PCOS on pulmonary function test parameters

Materials and Methods: In this cross-sectional study 30 recently diagnosed patients with PCOS without history of pulmonary disease were enrolled and 20 healthy women were considered as the control group according to their age, weight, and height. The patients and the controls underwent body plethysmography to measure pulmonary function tests

Results: The mean age of the patients and the controls were 29.43 +/- 7.8 and 30.0 +/- 7.6 years respectively. There were no statistically significant differences in all pulmonary function test parameters between the patients and the controls [p>0.05]. After dividing the patients into 2 groups based on their body mass index [BMI], BMI<25 and BMI>/=25, we found statistically significant differences only in expiratory reserve volume [ERV] and thoracic gas volume [p=0.01 and p=0.01, respectively].Moreover there was statistically moderate inverse correlation between BMI and ERV [r=-0.5, p=0.03]

Conclusion: Our results showed that pulmonary function test parameters are not different in PCOS patients comparing to healthy women. Only the deleterious effects of high BMI on pulmonary function can be occurred in these patients

Cabergoline Effect on Blood Sugar in Type 2 Diabetic Patients with Oral Agent Failure

Ergot-derived dopamine D2 receptor agonists are the usual treatment of hyperprolactinemia and Parkinson’s disease and recently bromocriptine has been approved for the treatment of type 2 diabetes. The aim of this study was the evaluation of short-term effect of cabergoline in poorly controlled diabetic patients with oral agent failure who refused insulin therapy. Methods: This study was performed in 17 overweight women and men with type 2 diabetes with persistent hyperglycemia in spite of treatment with maximum dose of sulfonylurea, metformin and pioglitazone. 10 patients (group I) randomized to be treated with cabergoline 0.5 mg weekly for 3 months and 7 patients (group II) with placebo. Fasting and postprandial plasma glucose concentration and HbA1c measured in beginning and end of the study. Results: FBS decreased from 210.70± 21.29 to 144.90± 26.56 mg/dl in cabergoline group whereas it decreased in placebo group insignificantly. Postprandial blood glucose decreased from 264.2±28 mg/dl to 203.6±34.34 mg/dl in cabergoline group whereas it increased in placebo group insignificantly.HbA1c decreased in cabergoline group from 8.48±0.44 to 7.7±0.11 whereas in control group it increased insignificantly from 8.7±0.33 to 8.8±0.16. Conclusion: Cabergoline improves glycemic control in type 2 diabetic patients with oral agent failure. It reduces both fasting and postprandial plasma glucose levels and causes 0.45–1.11 reduction in HbA1c.

Association of HTLV-I with autoimmune thyroiditis in patients with myelopathy/tropical spastic paraparesis and in HTLV-I carriers

There are some reports about the association of autoimmune thyroid diseases with human T cell leukemia virus type I [HTLV-I] infection. The objective of this study was to estimate the seroprevalence rates of anti-thyroid antibodies in HTLV-I carriers and HTLV-I associated myelopathy/tropical spastic paraparesis [HAM/TSP] patients in Mashhad, north east of Iran, to determine any association between HTLV-I infection and Hashimoto's thyroiditis [HT. A total of 46 HTLV-I infected patients [24 patients with HAM/TSP and 22 asymptomatic carriers] and 40 HTLV-I seronegative healthy individuals were screened for the presence of thyroid autoantibodies. The diagnosis of HT was based on the presence of positive thyroid autoantibodies [Anti thyroid peroxidase and/or Anti thyroglobulin] and at least one of two additional criteria [hypothyroidism and/or goiter]. Analysis of data was done, using Fisher-Exact test by statistical software SPSS version 13.0. A P value below 0.05 was considered statistically significant. Positivity for thyroid autoantibodies was found in 14 [63.6%] of 22 asymptomatic carriers, 6 [25%] of 24 patients with HAM/TSP and 3 [7.5%] of 40 HTLV-I seronegative healthy individuals. HT found in 45.4% of asymptomatic carriers, 25% of HAM/TSP patients and 5% of seronegative healthy individuals. This study demonstrates a high prevalence of HT in the HAM/TSP patients and the HTLV-I carriers in Mashhad. Our findings suggest an association between HTLV-I infection and HT in our region