Reviews in Clinical Medicine

97-104

Authors: Jafar Malmir; Ehsan Bolvardi; Monavar Afzal Aghaee

The severe sepsis and septic shock are as common and lethal that emergency physicians routinely confront. Actually, more than two thirds of sepsis patients present initially to the ED. Only a few laboratory tests for markers of sepsis are currently available. The serum lactate level can help in determining prognosis and to risk-stratify patients with severe sepsis. This independent review of the literature includes 83 studies published in all electronic-based database such as Elsevier, PubMed, and SID during the last 18 years (40–320 patients in each). Data gathered from English language articles and books published between 1995 and 2013. The serum lactate concentrations measured in almost all patients with severe sepsis raised at admission and were higher in patients who had the worst outcomes such as higher Apache-II and SOFA score. Serum lactate was associated with mortality independent of clinically apparent organ dysfunction and shock in patients with severe sepsis admitted to the emergency department and intensive care unit. This review focuses on the association between initial and serial serum lactate level and mortality in patients presenting to the emergency department with severe sepsis.

109-114

Authors: Zohre Seidi

Leishmaniasis including Cutaneous, mocucutaneous and Visceral forms of clinical syndromes is one of the important health care problem in the world specially in developing countries. Because of long time duration of treatment, being expensive, many associated side effects and eventually resisted cases to conventional therapy, enormous efforts have been performed to replace herbal and new therapeutic strategies as alternative choices. This review argue about reported studies have conducted by many researchers around the world since 1990 that the subject of all of them were about herbal medicine in treatment of leishmaniasis with emphasis on cutaneous leishmaniasis.

125-130

Authors: Mohsen Mouhebati; Afsoon Fazlinejhad; Mona Yadollahi

Coronary artery diseases affect both systolic and diastolic functions and can be assessed both globally and regionally. Tissue doppler imaging is a novel technique with additional advantages to the currently used two-dimensional echocardiography. This paper is a review of the published articles on documented Coronary artery diseases patients confirmed by angiography, without any previous myocardial infarction and with normal left ventricular ejection fraction. Accordingly, a significant relationship was achieved between systolic rather than diastolic parameters with Coronary artery diseases. Furthermore, major heterogeneity was noticed among the available studies in this respect. The incremental values of tissue doppler imaging in patients with stable angina in addition to other non invasive tests has led to its recommendation by ACC/AHA.

135-140

Authors: Payam Izadpanahi; Kazem Anvari; Mitra Fazl Ersi

In this research Glioblastoma has been studied as one of the most common brain tumors and a short review of the available therapeutic methods have presented including surgery, radiotherapy, chemotherapy and particularly adjuvant chemotherapy with temozolomide, as the most effective developed treatment. Moreover, MGMT gene promoter methylation has been introduced as an important predictive factor of treatment response to temozolamide. The different mechanisms of methylation and the available literature on its association with patient survival and disease recurrence have been summarized. Taken together, Glioblastoma is a tumor in which the MGMT gene expression can potentially deliver the highest amount of data in comparison to other tumors; as almost every related study has emphasized on the direct association between MGMT methylation and patient survival. Regarding this debate, the pseudoprogression pattern in Glioblastoma patients and the laboratory methods studying MGMT gene methylation have been examined. At the end of this review, the obstacles to its development have been briefly mentioned.

149-153

Authors: Seyed Mousalreza Hoseini; Abbas Esmaeelzadeh; Masoumeh Salari; Bita Dadpour; Khadijeh Yekta Roudi; Mohammad Yekta Roudi; Zahra Javid Arabshahi

Pancreatitis is the most common and important complication of endoscopic retrograde cholangiopancreatography (ERCP). Several risk factors play a role in the formation and progression of pancreatitis. These risk factors may be related to the patient, procedure or operator. All of these risk factors should be considered and should be lowered as far as possible with attention to pathogenesis of the development of post-ERCP pancreatitis. The pathogenesis include sphincter spasm, infection, contrast toxicity and pancreatic secretion that induce the activation of proteolytic enzymes and inflammatory processes. Some methods and pharmacologic agents assessed for the prevention of pathway in the pathogenesis to decrease post-ERCP pancreatitis.

160-164

Authors: Reza Ghadimi; Alireza Abdollahi Moghadam; Marzieh Rahimzadegan

Ischemic nephropathy is defined as a clinically significant progressive reduction in glomerular filtration rate that is usually associated with significant renal artery stenosis (unilateral or bilateral involvement). Atherosclerotic renal artery disease is known as the most common cause of the ischemic nephropathy. These patients may develop secondary hypertension. In addition, epidemiologic data has showed a clear association between atherosclerotic renal artery stenosis and coronary artery disease and other cardiovascular disease. Despite the preserving function of kidney on various autoregulation processes, unusual microvascular function will be resulted due to sustained decline in renal perfusion. The ischemic nephropathy of asymptomatic cases may result in renovascular hypertension and renal failure. The reduction of renal function in these patients might be decreased or stopped by early appropriate diagnosis and also might be treated with renal artery angioplasty or surgery, after medical management. There is a debate about the occurrence of ischemic nephropathy as a result of atherosclerotic renal artery stenosis. In this study we aimed to review the prevalence of ischemic nephropathy due to atherosclerotic renal artery stenosis.