Idiopathic great saphenous phlebosclerosis

Arterial sclerosis has been extensively described but reports on venous sclerosis are very sparse. Phlebosclerosis refers to the thickening and hardening of the venous wall. Despite its morphological similarities with arteriosclerosis and potential morbid consequences, phlebosclerosis has gained only little attention. We report a 72 year old male with paralysis and atrophy of the right leg due to childhood poliomyelitis who was referred for coronary artery bypass surgery. The great saphenous vein, harvested from the left leg, showed a hardened cord-like obliterated vein. Surprisingly, harvested veins from the atrophic limb were normal and successfully used for grafting

[Organizational and health care process management with use of information technology]

Hospital with different departments and information processing plans and also professional healthcare staff from different fields, need inter and intra- organizational communication. In addition, treatment method of every patient is unique. Healthcare organizations faced with coordination challenges and they do not apply workflow management technologies yet. To identify current challenges in healthcare, it is necessary that organizational process be separated of care process. Managing organizational process includes identify rules and definite relation of every section with others. In this regard, it seemed that use of work flow management system [WFMS] is the suitable method. Managing care process is done by evidence-based medicine [EBM] and clinical guidelines. Although, organizational process relies on static models of patient care process based on medical knowledge that is evolutes so fast. Health care information systems, such as HIS, have to support of organizational and treatment process separately. Overall, goal of applying information technology [IT] in support of clinical process is not just control of healthcare period, though it is used to reduce workload and promote decision-making. In this article, method of managing workflow for organizational and care process was studied separately and suitable information technology tools for supporting each process with mention of examples has presented

Results of surgical treatment of coarctation of the thoracic aorta at Madani Heart Hospital: a ten year experience

To make a review of the immediate results of coarcation of the aorta [CoAo] operation between March 1993 and October 2003 at madani Heart center Tabriz Iran. The following data were investigated age at the time of surgery, gender, symptoms. Clinical and Paraclinical findings, associated cardiac lesions, and type of surgical technique, and immediate surgical outcome, particularly focusing on the presence of hypertension. Fifty three patents underwent surgical repair of CoAo. Enrolled patients had an age between 12 months to 49 years [mean 17 years], and 30 [56.6%] were male. Twenty five [47%] patients were asymptomatic. The most common presenting symptoms were palpitation [45%] and dyspnea on exertion early fatigue [41%]. The most common signs were a systolic murmur [96%], and weak lower limb pulses [86%]. In electrocardiogram, 96% had signs of LV hypertrophy. The chest-X-ray was normal in only 54%. The location of coarctation was post-ductal in 78% and pre-ductal in the rest. The associated defects were present in 30 [56.6% patients, most common being patent ductus arteriosus [26.4%] and aortic valve disease [22.4%]. Among the various surgical techniques employed end-to-end anastomosis was used in 26 [49%] and Dacron patch aortoplasty in 23 patients [43.3%]. During discharge BP was reduced in 75% and unchanged in 25% with respect to preoperative values. Fifteen percent of patients had some complications and one death was observed in the immediate postoperative period. There is a high rate of associated cardiac with CoAo and despite a delayed diagnosis in our region corrective surgery has a relatively good short term outcome with low morbidity and mortality

Survey of operative outcome for aortic dissection

To survey the results of operative outcome for aortic dissection. A retrospective study on 46 patients, admitted for operation in Shahid Madani Heart Hospital in Tabriz, Iran from 1994-2003. A questionnaire was used for collecting data. Statistical analysis was performed and was carried out through a descriptive statistical methods. We included 30 males [65%] and 16 females [35%]. Seven [15.2%] died in the operating room before surgery, while 39 patients [59% male and 41% female] underwent surgery. The mean age of patients was 48.9 +/- 2.3 years old. Pre-operative diagnosis was carried out by transesophageal echocardiography and angiography. All patients were operated in an emergency situation. In 42% of patients aortic valve replacement [AVR] with ascending aorta was replaced. In 24% only the ascending aorta was replaced, and in 10% the aortic valve was repaired with acute aortic dissection. In 10% of patients, the ascending aorta with aortic arch was replaced. Four patients [14%] had distal aortic dissection and replacement. Major complications were hemorrhage [31%] and respiratory failure [13.8%]. A total of 20.7% died in hospital, and only 21 patients [45.5%] could be followed for 10 years. Acute aortic dissection is a fatal disease. With early diagnosis and surgical intervention, we can save approximately 75% of patients with very good functional class and survival in the mid term