Mashhad University of Medical SciencesJournal of Cardio-Thoracic Medicine2345-24476320180901Cardiac Complication Following Subarachnoid Hemorrhage3133181137510.22038/jctm.2018.32692.1170ENMahmoud ShabestariCardiologist,Cardiac Department, Mashhad University of Medical Sciences, Mashhad, Iran0000-0002-0051-9756Raphael BlancNeuroradiologist, Interventional Neuroradiology Department, Hospital of Rothschild Roundation, Paris 75019, FranceHumain BaharvahdatEndovascular Neurosurgeon, Department of Neurosurgery, Ghaem Hospital, Mashhad University of Medical Sciences,Mashhad,Iran0000-0002-1154-8843Hamzeh DehganizadehNeurosurgeon, Department of Neurosurgery, Ghaem Hospital, Mashhad University of Medical Sciences,MashhadMichel PiotinNeuroradiologist, Interventional Neuroradiology Department, Hospital of Rothschild Roundation, Paris 75019, FranceJournal Article20180614Besides its severe neurological injuries, spontaneous subarachnoid hemorrhage (SAH) commonly causes cardiac complications. These complications could include three different aspects of cardiac diseases, that is, electrocardiographic abnormalities, myocardial injuries, and left ventricular dysfunction. These complications not only may lead to misdiagnosis of SAH as myocardial infarction, but also it may complicate the management of SAH. In this review, we described all cardiac complications during SAH and explained the appropriate monitoring and management of these problemsMashhad University of Medical SciencesJournal of Cardio-Thoracic Medicine2345-24476320180901Responses of Muscle Mitochondrial Function to Physical Activity: A Literature Review3193281137610.22038/jctm.2018.32946.1171ENKeyvan HejaziPhysiologist, Department of Exercise and Sport Physiology, Faculty of Sport Sciences, Toos Institute of Higher Education, Mashhad, Iran0000-0002-4590-8018Journal Article20180624Skeletal muscles play an active role in regulating the metabolic homeostasis through their ability for relating to adipose tissue and endocrine hormones. Contraction of the skeletal muscle leads to increased release of several myokines, such as irisin, which is able to interact with the adipose tissue. Physical activity promotes the irisin mechanism by augmenting the peroxisomes (PGC1-α) in the skeletal muscle. Afterwards, an elevation occurs in the membrane protein of fibronectin type III domain-containing protein 5 (FNDC5) in muscle, ultimately resulting in production of irisin. The expression of irisin and FNDC5 converts white adipose into the brown type and increases energy consumption by the whole body hindering obesity and diabetes. The effects of regular exercise training on preventing obesity, diabetes, and the related complications, as well as improving health have already been proven. However, the point is that these beneficial effects are due to the cellular-molecular mechanisms, which are still under discussion.<br /> In this review, we searched the online databases, including scientific information database (SID), Google Scholar, PubMed, Science Direct, and Scopus. The following keywords were used: training, physical activity, myokine, adipose tissue, PRDM16, PGC-1α, PPARγ, SIRT1, FGF21, bone morphogenetic protein, neurugolin, VEGF, and IL-15. All the articles, including research studies, review articles, descriptive and analytical studies, in addition to cross-sectional researches published during 1998-2017 were reviewed.<br /> According to the obtained results, it seems that expression of irisin and FNDC5 converts the white adipose into brown adipose resulting in increased energy consumption. It has been proven in the literature that regular exercise training prevents obesity, diabetes, and the related complications, as well as improving health.Mashhad University of Medical SciencesJournal of Cardio-Thoracic Medicine2345-24476320180901The Critical-Care Pain Observation Tool: A useful tool for pain assessment in intensive care units3293311137410.22038/jctm.2018.32648.1169ENReza BasiriPulmonologist, Lung Disease Research Center, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranMohaddeseh GhelichliResident of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.0000-0002-8839-4774Shahrzad M LariPulmonologist, Lung Diseases Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Sepide HejaziPulmonologist, Lung Diseases Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.0000-0003-0230-5898Ali Vahidi RadResident of Surgery, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Journal Article20180611Pain is a major concern in all intensive care units (ICUs). The proper assessment and management of pain is one of the main goals of patient care in ICUs. Improper evaluation of pain and its over or under treatment can cause significant problems in the process of patient management in ICU. Since most ICU patients are unable to communicate correctly with the ICU team and explain their level of pain, pain assessment can be challenging. Thus, several assessment tools for the evaluation of pain were developed, few of which were validated. Critical Care Pain Observation Tool is a valid and reliable instrument for pain assessment in different ICUs.Mashhad University of Medical SciencesJournal of Cardio-Thoracic Medicine2345-24476320180901Consequences of coronary artery bypass grafting in smokers and addicts3323371137210.22038/jctm.2018.32590.1168ENBehrouz MottahediCardiovascular Surgeon, Faculty of Medicine, Mashhad University Of Medical Sciences, Mashhad, Iran.0000-0003-0868-4366Majid GhodsiCardiovascular Surgeon, Faculty of Medicine ,Department Of Cardiovascular Surgery, Faculty Of Medicine, Mashhad University Of Medical Sciences, Mashhad, IranBita ZargaranStudent Research Committee, Faculty of Medicine, Islamic Azad University, Mashhad Branch, Mashhad, Iran.Saeedeh Hajebi KhanikiMsc Student Of Biostatistics, Social Determinants Of Health Research Center, Mashhad University Of Medical Sciences, Mashhad, Iran.0000-0001-7041-3802Mahnaz KomeilipourStudent Research Committee, Faculty of Medicine, Islamic Azad University, Mashhad Branch, Mashhad, Iran.Mahdi KahromCardio Surgeon, Department of Cardiovascular Surgery, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran0000-0002-0917-4547Journal Article20180611<strong>Introduction</strong>: The most common cardiac disease is coronary artery disease (CAD) in the world. Coronary artery bypass grafting (CABG) is implemented through two standard surgical techniques, namely off-pump beating-heart CABG (OPCABG) and on-pump CABG (ONCABG). The CABG results in various levels of morbidity, especially in smokers and addicts, who have a lower pain threshold. Regarding this, the aim of this study was to clarify several aspects of the consequences of CABG, especially in smokers and addicts.<br /> Materials and Methods:<br /> This cross-sectional study was conducted on 125 CABG candidates referring to the Cardiac Department of Ghaem Hospital in Mashhad, Iran, within 2014-2015. The patients underwent either OPCAB or ONCABG. The recorded data included the type and dosage of intra- and post-operative opioids used for the induction and maintenance of anaesthesia, as well as the volume of packed red blood cells, fresh frozen plasma, and platelet. Data analysed using IBM SPSS 19.0 and p-value less than 0.05 considered statistically significant.<br /> <strong>Result</strong>: According to the results, the mean age of the patients were 59.4±9.8 years. Out of the 125 participants, 89 and 36 patients underwent ONCABG and OPCABG, 71.9% and 58.3% of whom were male, respectively. The sufentanil dose administered for the induction of anaesthesia was 9.9±2.7 cc in the smokers, which was significantly higher in comparison to the dose (7.3±2.1 cc) used for the non-smokers (P=0.015). Furthermore, the mean doses of dobutamine used for the addicted and non-addiced patients were 4.4±1.8 and 5.5±2.2 cc, respectively, which was significantly different between the two groups (P=0.037).<br /> <strong>Conclusion</strong>: The ONCABG is a common surgical technique, which is used in patients with a more coronary vessel involvement. This study has demonstrated that although the same opioid anaesthetic drugs were used for the smokers and addicted patient, the dose of administered sufentanil was significant different between smokers and non-smokers.Mashhad University of Medical SciencesJournal of Cardio-Thoracic Medicine2345-24476320180901Is Subclinical Thyroid Dysfunction Associated With with Coronary Heart Disease?3383431137710.22038/jctm.2018.33242.1172ENElaheh BarghchiInternal Medicine, Department of Endocrinology, University of Medical Sciences, Mashhad, Iran.0000-0002-1656-6880Fereidoun AziziEndocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IranJournal Article20180708<strong>Introduction</strong>: Previous cohort studies reported contradictory data on the association between subclinical thyroid dysfunction and coronary heart disease (CHD). Regarding this, the present study was conducted to illuminate this relationship.<br /> <strong>Materials and Methods</strong>: For the purpose of the study, 3,066 participants employed in a study conducted by Azizi et al. aged ≥ 20 years were subjected to thyroid function tests every 3 years over a mean follow-up of 10 years. After the exclusion of the subjects with CHD and those consumed thyroid, anti-thyroid, or corticosteroid preparations, 2,144 subjects remained for analysis and followed up for CHD events in the next 10 years.<br /> <strong>Results:</strong> At the baseline, 1929, 139, and 76 subjects had euthyroid, subclinical hyperthyroid, and subclinical hypothyroid, respectively. No CHD event occurred in the subclinical hypothyroid group. After the adjustment of all confounders, the subclinical hyperthyroid group had the hazard ratio of 1.01 for CHD with a 95% confidence interval of 0.36-2.85.<br /> <strong>Conclusions: </strong>The 10 year follow-up of subjects with subclinical thyroid disease revealed no relationship between CHD and subclinical thyroid disorders.Mashhad University of Medical SciencesJournal of Cardio-Thoracic Medicine2345-24476320180901Cardiac Myxoma, a Rare But Most Common Encountered Cardiac Tumor: A Single Center Experience3443491137110.22038/jctm.2018.32303.1166ENSatish DasCardiovascular and Thoracic Surgeon, Department of Cardiovascular & Thoracic Surgery, Government medical college & Super speciality Hospital, Nagpur 440009 , Maharashtra, India.0000-0001-9920-2013Chandan Ray MohapatraCardiovascular and Thoracic Surgeon, Department of Cardiovascular & Thoracic Surgery, Government medical college & Super speciality Hospital, Nagpur 440009 , Maharashtra, India.0000-0002-3163-6488Ashish BadkhalCardiovascular and Thoracic Surgeon, Department of Cardiovascular & Thoracic Surgery, Government medical college & Super speciality Hospital, Nagpur 440009 , Maharashtra, India.Sudhir DhandeCardiovascular and Thoracic Surgeon, Department of Cardiovascular & Thoracic Surgery, Government medical college & Super speciality Hospital, Nagpur 440009 , Maharashtra, India.Pankaj PohekarCardiovascular and Thoracic Surgeon, Department of Cardiovascular & Thoracic Surgery, Government medical college & Super speciality Hospital, Nagpur 440009 , Maharashtra, India.Ambrish KhatodCardiovascular and Thoracic Surgeon, Department of Cardiovascular & Thoracic Surgery, Government medical college & Super speciality Hospital, Nagpur 440009 , Maharashtra, India.Journal Article20180528<strong>Introduction:</strong> Cardiac myxoma is a benign and rare tumor, which can present with a grim phenomenon if the presentation is late or the diagnosis and surgery are delayed. The purpose of this study was to share our institutional experience of cardiac myxoma.<br /> <strong>Material and Methods</strong>: This retrospective study was conducted to evaluate patients undergoing procedures at a single tertiary care centre for the treatment of cardiac myxoma during January, 2007 to December, 2017. Preoperative diagnosis was made by assessing clinical presentation and doing echocardiography. Complete tumor excision was performed, and all the patients were followed up for recurrence and complications.<br /> <strong>Results:</strong> A total of 45 cases of cardiac myxoma (13 males and 32 females) with the mean age of 37.5 years old (ranged between 16 and 60 years old) were operated over the period of 10 years. Cardiac myxoma constituted about 0.69% of all cardiac cases operated at our institute. Out of all the subjects, 41, 3, and 1 cases had left atrial, right atrial, and right ventricular involvements, respectively. Additionally, 43 patients (95%) survived the surgery, one recurrence was observed during the follow-up period.<br /> <strong>Conclusion:</strong> Cardiac myxoma is the most common cardiac tumor account for very small percentage of patients with heart disease. Early clinical suspicion and the use of imaging modalities are key to early diagnosis of this condition. Although these tumors have a risk for severe cardiac and systemic symptoms, referral to experienced centers for prompt surgical resection under cardiopulmonary bypass provides excellent early and long-term results.Mashhad University of Medical SciencesJournal of Cardio-Thoracic Medicine2345-24476320180901A very rare case of metachronous multicentric giant cell tumor of bone with benign lung metastasis in form of a very large mass lesion3503541137310.22038/jctm.2018.32639.1167ENShekhar Gangadhar KadamRespiratory Medicine, Department Of Respiratory Medicine, Jaslok Hospital And Research Center, Edarm (Ers),Idccm, Fnab, Edic, Fccp0000-0002-7199-4167Susheel BindrooRespiratory Medicine, Department Of Respiratory Medicine, Jaslok Hospital And Research Center, IndiaJithin KrishnanRespiratory Medicine, Department Of Respiratory Medicine, Jaslok Hospital And Research Center, IndiaHina Jayantilal ShahNuclear Medicine, Department Of Nuclear Medicine, Jaslok Hospital And Research Centre, IndiaVikram Ramchandra LeleNuclear Medicine, Department Of Nuclear Medicine, Jaslok Hospital And Research Center, IndiaGanapathi BhatOncologist, Department of Medical Oncology,Jaslok Hospital And Research Center, IndiaJournal Article20180610Giant cell tumour (GCT) is a benign, locally aggressive tumour of the bone that accounts for 5% of primary bone tumours and 21% of benign bone tumours. This tumour more commonly presents as a single (solitary) lesion; however, it may appear with multiple (multicentric) lesions in less than 1% of the cases. According to the literature, 1-9% of solitary GCTs metastasizes to the lung, more commonly in cases with local recurrence. There are limited case reports on multicentric GCT (MCGCT) in the literature. The MCGCT can be synchronous or metachronous depending upon the time interval between the two lesions. Herein, we presented a very rare case of metachronous MCGCT with benign lung metastasis in form of a huge lung mass.Mashhad University of Medical SciencesJournal of Cardio-Thoracic Medicine2345-24476320180901Late lumen loss in thoracic aortic end graft after endovascular procedure of a traumatic pseudoaneurysm3553591137010.22038/jctm.2018.31635.1162ENAsal YadollahiCardivascolar Department, Ghaem Hospital, Mashhad university of medical science, Mashhad, Iran0000-0002-7598-4257Aliasghar MoeinipourCardiac Surgeon, Department of Cardiac Surgery, Mashhad University of Medical Sciences, Mashhad, Iran0000-0002-4208-800XHamid HoseinikhahCardiac Surgeon, Department of Cardiac Surgery, Mashhad University of Medical Sciences, Mashhad, Iran0000-0003-1812-9200Javad RamezaniCardiologist, Atherosclerosis Prevention Research Center and Department of Cardiovascular, Mashhad University of Medical Sciences, Mashhad, Iran0000-0002-1980-5605Journal Article20180507We report the case of a 23-year-old woman who died due to endograft stenosis 20 months after thoracic endovascular aortic repair. The patient presented with the pseudocoarctation syndrome. Although angioplasty of stenosis endograft was successfully performed, severe metabolic complications were lethal.