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Jalali N, Sadeghi Hokmabadi E, Ghoreishi A, Sariaslan P, Rafie S, Borhani-Haghighi A, Moghadam Ahmadi A, Azin H, Vakilian A, Khalili P, Farhoudi M. Outcome predictors in anterior and posterior ischemic strokes: a study based on the Iranian SITS registry. Sci Rep 2023; 13:1231. [PMID: 36681721 PMCID: PMC9867737 DOI: 10.1038/s41598-023-28465-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 01/18/2023] [Indexed: 01/22/2023] Open
Abstract
Ischemic stroke is the major form of stroke with two separate vascular territories. Many risk factors are related to stroke outcomes in both territories. The present descriptive research was carried out on the basis of data obtained from the Safe Implementation of Treatments in Stroke (SITS) registry on Iranian intravenous thrombolysis ischemic stroke cases. Vascular territory involved in each case and three-month excellent outcome, functional independence, mortality rate, and brain hemorrhage occurrence were determined. Univariable and multivariable logistics regression analyses were utilized in order to investigate association of ischemic stroke outcomes with the vascular territory involved and other related factors. Among 1566 patients 95.4% was anterior circulation stroke patients and 4.6% was posterior circulation stroke cases. There is no significant association between vascular territory with mortality (OR of PCS vs ACS: 0.74, 95% CI 0.37-1.46), excellent functional outcome (OR 0.72, 95% CI 0.44-1.19), functional outcome (OR 0.86, 95% CI 0.52-1.42) and local hemorrhage (OR 0.98, 95% CI 0.30-3.21). Among major risk factors, age, diabetes, NIHSS score and admission duration, increased significantly odds of three-month mortality, excellent outcome, and functional independence in the multivariate analysis. The highest of odds was in NIHSS score with a dose-response association. The vascular territory was not an outcome predictor in ischemic strokes. The most important predictor was baseline NIHSS.
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Affiliation(s)
- Nazanin Jalali
- Department of Neurology, School of Medicine, Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Elyar Sadeghi Hokmabadi
- Neurosciences Research Center, Neurology Department, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Abdoreza Ghoreishi
- Stroke Research Group, Vali-E-Asr Hospital and Department of Neurology and Stroke Unit, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Payam Sariaslan
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shahram Rafie
- Department of Neurology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Amir Moghadam Ahmadi
- Department of Neurology, School of Medicine, Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Hossein Azin
- Department of Neurology, School of Medicine, Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Alireza Vakilian
- Department of Neurology, School of Medicine, Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
| | - Parvin Khalili
- Department of Epidemiology, School of Public Health, Social Determinants of Health Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Mehdi Farhoudi
- Neurosciences Research Center, Neurology Department, Tabriz University of Medical Sciences, Tabriz, Iran
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Borhani-Haghighi A, Hooshmandi E, Zahediasl F, Molavi Vardanjani H, Rezaei M, Rahimi-Jaberi A, Ashjazadeh N, Petramfar P, Ostovan VR, Fadakar N, Poursadeghfard M, Izadi S, Nazeri M, Zafarmand SS, Bayat M, Salehi MS, Owjfard M, Sedighi B, Iranmanesh F, Shafiei K, Vakilian A, Moghadam Ahmadi A, Nemati R, Rezaeian Jahromi F, Jalalijahromi M, Kashani K, Razmeh S, Bahrehbar M, Basir M, Qureshi AI. Early and mid-term outcomes of carotid angioplasty and stent placement in 579 patients. J Neuroimaging 2022; 32:1161-1169. [PMID: 35969379 DOI: 10.1111/jon.13036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 07/11/2022] [Accepted: 07/28/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND PURPOSE Carotid angioplasty and stenting (CAS) could be considered for preventing stroke in patients with carotid artery stenosis. This study aimed to determine the incidence and the risk factors of the early and mid-term complications associated with CAS. METHODS This is a retrospective cohort study conducted at Shiraz University of Medical Sciences from March 2011 to March 2019. Patients at high risk and standard risk for carotid endarterectomy were included. The primary composite outcome was defined as stroke, myocardial infarction (MI), and death in the first 30 days after CAS. All-cause mortality, vascular mortality, and stroke were investigated during mid-term follow-up. RESULTS A total of 579 patients (618 CAS) were recruited (mean age: 71.52 years). Overall, 394 (68.40%), 211 (36.63%), 179 (31.07%), and 96 (16.72%) patients had hypertension, dyslipidemia, diabetes mellitus, or were cigarette smokers, respectively. Primary composite outcomes were observed in 2.59% of patients (1.55% stroke, 0.69% MI, and 1.72% death). Atrial fibrillation was a predictor of primary composite outcome in multivariate logistic regression (p = .048). The presence of total occlusion in the contralateral carotid artery was significantly associated with the risk of stroke in univariate logistic regression (p = .041). The patients were followed for a period ranging from 1 to 83 months. The overall survival rate for all-cause mortality was 93.48% at 1 year, 77.24% at 5 years, and 52.92% at 8 years. All-cause mortality was significantly higher among patients with symptomatic carotid stenosis (p = .014). CONCLUSION CAS provides acceptable short-term and mid-term outcomes in a unique population of high- and standard-surgical-risk, symptomatic and asymptomatic, octogenarian, and nonoctogenarian patients.
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Affiliation(s)
| | - Etrat Hooshmandi
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farzaneh Zahediasl
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Molavi Vardanjani
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahdiyeh Rezaei
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abbas Rahimi-Jaberi
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nahid Ashjazadeh
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Peyman Petramfar
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Vahid Reza Ostovan
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nima Fadakar
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Poursadeghfard
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sadegh Izadi
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoumeh Nazeri
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Mahnaz Bayat
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Saied Salehi
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Owjfard
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Behnaz Sedighi
- Neurology Research Center, Kerman University of Medical Science, Kerman, Iran
| | - Farhad Iranmanesh
- Neurology Research Center, Kerman University of Medical Science, Kerman, Iran
| | - Kaveh Shafiei
- Neurology Research Center, Kerman University of Medical Science, Kerman, Iran
| | - Alireza Vakilian
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Amir Moghadam Ahmadi
- Neuro-immunology Research Scholar, Thomas Jefferson University, Philadelphia, PA, USA
| | - Reza Nemati
- Department of Neurology, Bushehr Medical University Hospital, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | | | | | - Kaveh Kashani
- Department of Neurology, Fasa University of Medical Sciences, Fasa, Iran
| | - Saeed Razmeh
- Department of Neurology, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Mansour Bahrehbar
- Department of Neurology, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Marzieh Basir
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Adnan I Qureshi
- Zeenat Qureshi Stroke Institute and University of Missouri, Columbia, Missouri, USA
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Sasanejad P, Afshar Hezarkhani L, Arsang-Jang S, Tsivgoulis G, Ghoreishi A, Kristian B, Rahmig J, Farhoudi M, Sadeghi Hokmabadi E, Borhani-Haghighi A, Sariaslani P, Sharifi-Razavi A, Ghandehari K, Khosravi A, Smith C, Nilanont Y, Akbari Y, Nguyen TN, Bersano A, Yassi N, Yoshimoto T, Lattanzi S, Gupta A, Zand R, Rafie S, Pourandokht Mousavian S, Reza Shahsavaripour M, Amini S, Kamenova SU, Kondybayeva A, Zhanuzakov M, Macri EM, Nobleza COS, Ruland S, Cervantes-Arslanian AM, Desai MJ, Ranta A, Moghadam Ahmadi A, Rostamihosseinkhani M, Foroughi R, Hooshmandi E, Akhoundi FH, Shuaib A, Liebeskind DS, Siegler J, Romano JG, Mayer SA, Bavarsad Shahripour R, Zamani B, Woolsey A, Fazli Y, Mojtaba K, Isaac CF, Biller J, Di Napoli M, Azarpazhooh MR. Safety and Outcomes of Intravenous Thrombolytic Therapy in Ischemic Stroke Patients with COVID-19: CASCADE Initiative. J Stroke Cerebrovasc Dis 2021; 30:106121. [PMID: 34601242 PMCID: PMC8450304 DOI: 10.1016/j.jstrokecerebrovasdis.2021.106121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/09/2021] [Accepted: 09/13/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND There is little information regarding the safety of intravenous tissue plasminogen activator (IV-tPA) in patients with stroke and COVID-19. METHODS This multicenter study included consecutive stroke patients with and without COVID-19 treated with IV-tPA between February 18, 2019, to December 31, 2020, at 9 centers participating in the CASCADE initiative. Clinical outcomes included modified Rankin Scale (mRS) at hospital discharge, in-hospital mortality, the rate of hemorrhagic transformation. Using Bayesian multiple regression and after adjusting for variables with significant value in univariable analysis, we reported the posterior adjusted odds ratio (OR, with 95% Credible Intervals [CrI]) of the main outcomes. RESULTS A total of 545 stroke patients, including 101 patients with COVID-19 were evaluated. Patients with COVID-19 had a more severe stroke at admission. In the study cohort, 85 (15.9%) patients had a hemorrhagic transformation, and 72 (13.1%) died in the hospital. After adjustment for confounding variables, discharge mRS score ≥2 (OR: 0.73, 95% CrI: 0.16, 3.05), in-hospital mortality (OR: 2.06, 95% CrI: 0.76, 5.53), and hemorrhagic transformation (OR: 1.514, 95% CrI: 0.66, 3.31) were similar in COVID-19 and non COVID-19 patients. High-sensitivity C reactive protein level was a predictor of hemorrhagic transformation in all cases (OR:1.01, 95%CI: 1.0026, 1.018), including those with COVID-19 (OR:1.024, 95%CI:1.002, 1.054). CONCLUSION IV-tPA treatment in patients with acute ischemic stroke and COVID-19 was not associated with an increased risk of disability, mortality, and hemorrhagic transformation compared to those without COVID-19. IV-tPA should continue to be considered as the standard of care in patients with hyper acute stroke and COVID-19.
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Affiliation(s)
- Payam Sasanejad
- Department of Neurology Mashhad Fellowship of interventional radiology Mashhad University of Medical Sciences.
| | - Leila Afshar Hezarkhani
- Department of Neurology School of Medicine Farabi Hospital Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shahram Arsang-Jang
- Department of Biostatistics and Epidemiology School of Medicine Zanjan University of Medical Sciences, Zanjan, Iran
| | - Georgios Tsivgoulis
- Second Department of Neurology National & Kapodistrian University of Athens,Professor of Neurology, Athens, Greece
| | - Abdoreza Ghoreishi
- Department of Neurology, Vali-e-Asr Hospital, School of Medicine, Zanjan University of Medical Sciences
| | - Barlinn Kristian
- University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden
| | - Jan Rahmig
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Mehdi Farhoudi
- Neurosciences Research Center, Imam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Elyar Sadeghi Hokmabadi
- Neurosciences Research Center, Imam Reza Hospital, Tabriz University of Medical Sciences, Tabriz
| | | | - Payam Sariaslani
- Department of Neurology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Athena Sharifi-Razavi
- Clinical Research Development Unit of Bou-Ali Sina Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Kavian Ghandehari
- Department of Neurology Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Khosravi
- Clinical Immunology Research Center, Department of Neurology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Craig Smith
- Manchester Centre for Clinical Neurosciences, Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Salford, UK; Division of Cardiovascular Sciences, Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, UK
| | - Yongchai Nilanont
- Siriraj Stroke Center, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Yama Akbari
- Departments of Neurology, Neurological Surgery, and Anatomy & Neurobiology, and Beckman Laser Institute & Medical Clinic, School of Medicine, University of California, Irvine, CA, USA
| | - Thanh N Nguyen
- Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Anna Bersano
- Cerebrovascular Unit, Fondazione IRCCS Istituto Neurologico carlo Besta, Milano, Italy
| | - Nawaf Yassi
- Department of Medicine and Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital, University of Melbourne, Parkville, Australia; Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
| | - Takeshi Yoshimoto
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Simona Lattanzi
- Department of Experimental and Clinical Medicine, Marche Polytechnic University, Via Conca, Ancona, Italy
| | - Animesh Gupta
- Department of Neurology, School of Medicine, University of New Mexico, Albuquerque, New Mexico, USA
| | - Ramin Zand
- Department of Neurology, Neuroscience Institute, Geisinger Medical Center, Danville, PA, USA
| | - Shahram Rafie
- Department of Neurology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | | | - Shahram Amini
- Department of Anesthesia, Intensive care Unit, Lung Research Center, Mashhad, Mashhad University of Medical Sciences
| | - Saltanat U Kamenova
- Department of Medicine, Al-Farabi Kazakh National University, Doctor of Medical Science, Professor. Almaty, Kazakhstan
| | - Aida Kondybayeva
- Doctor of Medical Science, Professor Doctor of Medical Science, Professor, Department of Medicine, Al-Farabi Kazakh National University. Almaty, Kazakhstan
| | - Murat Zhanuzakov
- Doctor of Medical Science Professor, Department of Internal Medicine, Kazakh-Russian Medical University. Almaty, Kazakhstan
| | | | | | - Sean Ruland
- Department of Neurology, Loyola University Chicago-Stritch School of Medicine, Chicago, IL
| | - Anna M Cervantes-Arslanian
- Departments of Neurology, Neurosurgery, and Medicine (Infectious Disease), Boston University School of Medicine, Boston Medical Center, Boston, MA
| | - Masoom J Desai
- Assistant Professor of Neurology, University of New Mexico, Albuquerque
| | - Annemarei Ranta
- Department of Medicine, University of Otago, Wellington and Department of Neurology, Wellington Regional Hospital, New Zealand
| | - Amir Moghadam Ahmadi
- Associate Professor of Neurology, School of Medicine, Non-communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | | | - Razieh Foroughi
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Etrat Hooshmandi
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fahimeh H Akhoundi
- Department of Neurology, Iran University of medical Sciences, Tehran, Iran
| | - Ashfaq Shuaib
- Professor of Neurology and Director Stroke Program University of Alberta, Alberta, Canada
| | | | - James Siegler
- Cooper Neurological Institute, Cooper University Hospital, Camden, NJ
| | - Jose G Romano
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Stephan A Mayer
- Professor of Neurology and Neurosurgery, New York Medical College, Westchester Medical Center, Valhalla, NY
| | - Reza Bavarsad Shahripour
- University of California San Diego Neurosciences center, Comprehensive Stroke center, San Diego, CA
| | - Babak Zamani
- Department of Neurology, Iran University of Medical Sciences, Tehran, Iran
| | - Amadene Woolsey
- Stroke Prevention and Atherosclerosis Research Centre, Robarts Research Institute, Western University, London, Ontario, Canada. Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Yasaman Fazli
- School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Khazaei Mojtaba
- Assistant Professor of Neurology, Assistant Professor of Neurology, Hamadan Medical University of Medical Sciences, Fellowship of neurovascular intervention
| | | | - Jose Biller
- Department of Neurology, Loyola University Health System, Stritch School of Medicine, Chicago, IL, USA
| | - Mario Di Napoli
- Department of Neurology and Stroke Unit, San Camillo de' Lellis General District Hospital, Rieti, Italy; Neurological Section, Neuro-epidemiology Unit, SMDN-Centre for Cardiovascular Medicine and Cerebrovascular Disease Prevention, Sulmona, L'Aquila, Italy
| | - M Reza Azarpazhooh
- Stroke Prevention and Atherosclerosis Research Centre, Robarts Research Institute, Western University, London, Ontario, Canada; Department of Clinical Neurological Sciences, Western University, London, ON, Canada; Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada
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Vakilian A, Ahmadi AM, Heidari M, Jalali N, Nazer M, Bidaki MZ, Hashemi SM, Mirabzadeh M, Rezaei A, Amirteimoury M, Najmaddini P. Vitamin B12 Administration Facilitates The Antipsychotic And Pain-Relieving Effects Of Quetiapine, In The Alzheimer Patients With Psychotic Symptoms. J Ayub Med Coll Abbottabad 2021; 33(Suppl 1):S744-S751. [PMID: 35077620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Psychotic symptoms in Alzheimer's disease (AD) patients are a problem in medicine. The efficacy of the vitamin B12 on the treatment of the psychotic symptoms of the AD patients in the association with antipsychotic drugs Quetiapine and Risperidone, was evaluated in this Study. METHODS The effects of vitamin B12 along with two other drugs were studied on the Mini-Mental State Examination (MMSE), Clinical Global Impression (CGI), Brief Psychiatric Rating Scale (BPRS) and pain Visual Analogue Scale (VAS) in 47 AD patients with psychotic symptoms, including 4 groups, psychotic AD patients treated with Risperidone, Risperidone plus vitamin B12, Quetiapine and Quetiapine plus vitamin B12 . RESULTS The results showed that Quetiapine improved all of the psychotic criteria, while Quetiapine plus vitamin B12 had better results on BPRS after 2 weeks, VAS score and MMSE. Risperidone also improves all of the criteria except MMSE and drug efficacy index, while, vitamin B12 neutralize the effects of the Risperidone on the BPRS, VAS, and severity of illness. CONCLUSION Due to these results, Quetiapine is the preferred antipsychotics drug and Vitamin B12 plays an effective role in treatment as an adjunct therapy.
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Affiliation(s)
- Alireza Vakilian
- Geriatric Care Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran. & Department Neurology, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Amir Moghadam Ahmadi
- Department Neurology, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran & Non- Communicable Diseases Research Center. Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Moslem Heidari
- Department Neurology, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Nazanin Jalali
- Department Neurology, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran & Clinical Research Development Center, Ali Ibn Abitalib Hospital, Rafsanjan University of Medical Sciences,Iran
| | - Mohammad Nazer
- Psychiatry Department, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Mohammad Zare Bidaki
- Immunology of Infectious Diseases Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran & Department of Microbiology, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Seyed Meysam Hashemi
- Clinical Research Development Center, Ali Ibn Abitalib Hospital, Rafsanjan University of Medical Sciences, Iran
| | - Mohammad Mirabzadeh
- Clinical Research Development Center, Ali Ibn Abitalib Hospital, Rafsanjan University of Medical Sciences, Iran
| | - Amirreza Rezaei
- Clinical Research Development Center, Ali Ibn Abitalib Hospital, Rafsanjan University of Medical Sciences, Iran
| | - Morteza Amirteimoury
- Clinical Research Development Center, Ali Ibn Abitalib Hospital, Rafsanjan University of Medical Sciences, Iran
| | - Pooria Najmaddini
- Clinical Research Development Center, Ali Ibn Abitalib Hospital, Rafsanjan University of Medical Sciences, Iran
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Hodoodi F, Allah-Tavakoli M, Tajik F, Fatemi I, Moghadam Ahmadi A. The effect of head cooling and remote ischemic conditioning on patients with traumatic brain injury. iScience 2021; 24:102472. [PMID: 34169235 PMCID: PMC8207229 DOI: 10.1016/j.isci.2021.102472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/12/2020] [Accepted: 04/22/2021] [Indexed: 11/17/2022] Open
Abstract
Cerebral impairment caused by an external force to the head is known as traumatic brain injury (TBI). The aim of this study was to determine the role of local hypothermia and remote ischemic conditioning (RIC) on oxidative stress, inflammatory response after TBI, and other involved variables. The present study is a clinical trial on 84 patients with TBI who were divided into 4 groups. The head cooling for 1.5 to 6 hr was performed in the first three days after TBI. RIC intervention was performed within the golden time after TBI in the form of four 5-min cycles with full cuff and 5 min of emptying of cuff. The group receiving the head cooling technique recovered better than the group receiving the RIC technique. Generally, combination of the two interventions of head cooling and RIC techniques is more effective on the improvement of clinical status of patients than each separate technique. The effect of the head cooling method in controlling secondary injury in patients with TBI. The effect of the RIC method in controlling secondary injury in patients with TBI. Comparison of two interventions of head cooling and RIC. Evaluation of clinical and paraclinical parameters.
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Affiliation(s)
- Fardin Hodoodi
- Department of Physiology and Pharmacology, Schoole of Medicine, Rafsanjan University of Medical Science, Rafsanjan, Iran
| | - Mohammad Allah-Tavakoli
- Department of Physiology and Pharmacology, Schoole of Medicine, Rafsanjan University of Medical Science, Rafsanjan, Iran
- Physiology-pharmacology Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Farzad Tajik
- Department of Clinical Research Sciences, Department of Medicine, Rafsanjan University of Medical Science, Rafsanjan, Iran
- Department of Neurology, Department of Medicine, Rafsanjan University of Medical Science, Rafsanjan, Iran
| | - Iman Fatemi
- Research Center of Tropical and Infectious Diseases, Kerman University of Medical Sciences, Kerman, Iran
| | - Amir Moghadam Ahmadi
- Department of Neurology, Department of Medicine, Rafsanjan University of Medical Science, Rafsanjan, Iran
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Corresponding author
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Bidaki R, Majidi N, Moghadam Ahmadi A, Bakhshi H, Sadr Mohammadi R, Mostafavi SA, Kazemi Arababadi M, Hadavi M, Mirzaei A. Vitiligo and social acceptance. Clin Cosmet Investig Dermatol 2018; 11:383-386. [PMID: 30046249 PMCID: PMC6054323 DOI: 10.2147/ccid.s151114] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIM Vitiligo is a chronic skin disease characterized by a total or partial loss of melanocytes from the epidermis and other tissues of the skin. It is placed in the class of secondary psychiatric disorders and can also lead to psychological problems. The main aim of this study was to assess social acceptance in vitiligo patients. METHODS This cross-sectional study was conducted on all of the patients (n=150) with vitiligo who were referred to dermatology clinics in Rafsanjan, Iran. The patients completed a social acceptability questionnaire (Marlowe-Crowne Social Desirability Scale), and information regarding their demographic characteristics was also collected. Data were gathered and analyzed with descriptive and inferential statistics using SPSS-19 software. RESULTS The mean age of the patients was 27.56±10.53 years and 65.9% were female. Mean score of social acceptance among the patients was 13.51±7.08. The results showed that the mean scores of social acceptance were significantly lower in women, in those with single marital status, in those with face and neck lesions, and in those with disease duration less than 5 years. CONCLUSION The results showed that certain groups of patients with vitiligo are at greater risk of experiencing lower social acceptance.
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Affiliation(s)
- Reza Bidaki
- Research Center of Addiction and Behavioral Sciences, Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Niloofar Majidi
- Department of Psychiatry, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Amir Moghadam Ahmadi
- Department of Neurology, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Hamid Bakhshi
- Continuing Medical Education Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Rezvan Sadr Mohammadi
- Department of Psychiatry, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Seyed-Ali Mostafavi
- Psychiatry Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Kazemi Arababadi
- Department of Laboratory Sciences, Faculty of Paramedicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Maryam Hadavi
- Department of Anesthesiology, Paramedical Faculty, Molecular Medicine Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran,
| | - Afshin Mirzaei
- Rafsanjan University of Medical Sciences, Rafsanjan, Iran
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Ahmadi AM, Amjadi A, Bahrampour AR, Ravanbod H, Tofighi S. Acoustical gas-leak detection in the presence of multiple reflections, dispersion, and uncorrelated noise using optimized residual complexity. J Acoust Soc Am 2016; 140:1817. [PMID: 27914447 DOI: 10.1121/1.4962482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Precise acoustical leak detection calls for robust time-delay estimates, which minimize the probability of false alarms in the face of dispersive propagation, multiple reflections, and uncorrelated background noise. Providing evidence that higher order modes and multi-reflected signals behave like sets of correlated noise, this work uses a regression model to optimize residual complexity in the presence of both correlated and uncorrelated noise. This optimized residual complexity (ORC) is highly robust since it takes into account both the level and complexity of noise. The lower complexity of the dispersive modes and multiple reflections, compared to the complexity of the plane mode, points to the robustness of ORC against multiple reflections and dispersion. Experimental investigations using recorded sounds of gas leaking from a pipe confirm the robustness of ORC against multiple reflections. Numerical simulations also show robustness against dispersive modes, even when they disturb the linearity of the cross-spectrum phase. Comparisons with other methods-mutual information, cross correlation, and residual complexity-underline the general advantages of ORC in terms of robustness in the presence of reflection and dispersion, against both correlated and uncorrelated noise, and to short signals.
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Affiliation(s)
- A M Ahmadi
- Physics Department, Sharif University of Technology, Tehran, Iran
| | - A Amjadi
- Physics Department, Sharif University of Technology, Tehran, Iran
| | - A R Bahrampour
- Physics Department, Sharif University of Technology, Tehran, Iran
| | - H Ravanbod
- Electronics Research Institute, Sharif University of Technology, Tehran, Iran
| | - S Tofighi
- Physics Department, Sharif University of Technology, Tehran, Iran
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Solhdoost F, Sadr Mohammadi R, Moghadam Ahmadi A, Bidaki R, Mostafavi SA, Bahmanyar M, Rezaei Nejad S, Ahmadie MH. Frequency of Anxiety in Patients With Drug Poisoning in Rafsanjan City, Iran, in 2013. Int J High Risk Behav Addict 2016; 4:e19646. [PMID: 26870705 PMCID: PMC4744909 DOI: 10.5812/ijhrba.19646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Revised: 01/12/2015] [Accepted: 02/10/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Expansion of technology and progression of sciences have led to wider access to agricultural and industrial drugs and chemicals, which has resulted in many problems. Both in wanted and unwanted ways people may take these toxic agents, which perhaps may be along with many unpredictable, life-threatening and mortal outcomes. Based on many studies, most of intentional poisonings arise from an origin of patients' psychological backgrounds, which confirms necessity and importance of the recent study. OBJECTIVES This study aimed to study the prevalence of psychiatric disorders in patients with drug poisoning. PATIENTS AND METHODS In this descriptive cross-sectional study, 116 cases of poisoning referred to emergency room of Ali-Ebn-Abitaleb Hospital in Rafsanjan city, Iran, were randomly selected. Frequency of anxiety among participants was evaluated through the Spielberger questionnaire. A past history of depression and obsession was also evaluated through interview by a psychiatrist based on diagnostic and statistical manual of mental disorders (DSM-5) criteria. All data were then collected and analyzed using SPSS version 17. RESULTS Anxiety, as the second most common reason of psychiatric disorders in cases of poisoning, with a prevalence of 12.1% in form of mild, 75.9% moderate and 12.1% severe, was confirmed among the participants of this study. CONCLUSIONS The prevalence of anxiety among cases of poisoning with both drugs and chemicals are noticeably higher than general population. This fact strongly suggests the necessity of in-advance consultation and treatment of any underlying psychiatric disorders of patients to prevent prospective complications.
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Affiliation(s)
- Fereshteh Solhdoost
- Department of Psychiatry, Islamic Azad University, Yazd Branch, Yazd, IR Iran
| | - Rezvan Sadr Mohammadi
- Department of Clinical Psychology, Kar Higher Education Institute of Rafsanjan, Rafsanjan, IR Iran
| | - Amir Moghadam Ahmadi
- Department of Neurology, Rafsanjan University of Medical Sciences, Rafsanjan, IR Iran
| | - Reza Bidaki
- Department of Psychiatry, Research Center of Addiction and Behavioral Sciences, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran
- Corresponding author: Reza Bidaki, Department of Psychiatry, Research Center of Addiction and Behavioral Sciences, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran. Tel: +98-3536232003, Fax: +98-3532633555, E-mail:
| | - Seyed Ali Mostafavi
- Psychiatry Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Mojde Bahmanyar
- Rafsanjan University of Medical Sciences, Rafsanjan, IR Iran
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Khorasheh F, Sattari S, Gerayeli A, Ahmadi AM. Application of direct search optimization for pharmacokinetic parameter estimation. J Pharm Pharm Sci 1999; 2:92-8. [PMID: 10953255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
PURPOSE For simple pharmacokinetic compartmental models, analytical solution to the governing differential equations along with common graphical methods provide a mean to evaluate the associated rate constants. These graphical methods, however, can not be used for the more complex multi-compartment models. Furthermore, parameter estimation using slope and intercept values from the graphical methods is often accompanied with error. In this study a numerical solution is applied for the solution of the governing differential equations and a simple direct search optimization procedure utilizing random numbers is used for pharmacokinetic parameter estimation. METHOD The methodology is demonstrated with reference to experimental literature data for ciprofloxacin and ofloxacin whose pharmacokinetic behavior has been reported in terms of a two-compartment model. RESULTS Examination of the predicted drug concentrations from the graphical method and the optimization methodology indicate that both methods have comparable accuracy in predicting the drug concentrations. The graphical method, however, only shows good accuracy in the early stages both after i.v. and oral drug administration whereas the optimization procedure, due to the nature of the objective function formulation, provides good accuracy over the entire range of times after drug administration. CONCLUSIONS The methodology is simple, provides optimized parameters which accurately predict drug concentrations, and is flexible to include more weight on the early-time data or be extended to multi-compartment models.
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Affiliation(s)
- F Khorasheh
- Department of Chemical Engineering, Sharif University of Technology, Tehran, Iran.
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