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Cooper JG, Stukas S, Ghodsi M, Ahmed N, Diaz-Arrastia R, Holmes DT, Wellington CL. Age specific reference intervals for plasma biomarkers of neurodegeneration and neurotrauma in a Canadian population. Clin Biochem 2023; 121-122:110680. [PMID: 37884086 DOI: 10.1016/j.clinbiochem.2023.110680] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 10/13/2023] [Accepted: 10/23/2023] [Indexed: 10/28/2023]
Abstract
INTRODUCTION In this study, we aimed to create reference intervals (RI) using a large Canadian population-based cohort, for plasma protein biomarkers with potential utility to screen, diagnosis, prognosticate and manage a variety of neurological diseases and disorders. RIs were generated for: the ratio of amyloid beta 42 over 40 (Aβ42/40), phosphorylated tau-181 (p-tau-181), neurofilament light (NfL), and glial fibrillary acidic protein (GFAP). METHODS 900 plasma specimens from male and female participants aged 3-79 years old were obtained from the Statistics Canada Biobank, which holds specimens from the Canadian Health Measures Survey. Analysis of Aβ42/40, p-tau-181, NfL and GFAP was performed on the Quanterix Simoa HD-X analyzer using the Neurology 4-plex E and p-tau-181 assays. Discrete RIs were produced according to Clinical Laboratory Standards Institute guidelines (EP28-A3c). Continuous RIs were created using quantile regression. RESULTS For discrete RIs, significant age partitions were determined for each biomarker. No significant sex partitions were found. The following ranges and age partitions were determined: Aβ42/40: 3-<55y = 0.053-0.098, 55-<80y = 0.040-0.090; p-tau-181: 3-<12y = 1.4-5.6 pg/ml, 12-<60y = 0.8-3.1 pg/ml, 60-<80y = 0.9-4.0 pg/ml; NfL: 3-<40y = 2.6-11.3 pg/ml, 40-<60y = 4.6-17.7 pg/ml, 60-<80y = 8.1-47.1 pg/ml; GFAP; 3-<10y = 47.0-226 pg/ml, 10-<60y = 21.2-91.9 pg/ml, 60-<80y = 40.7-228 pg/ml. Continuous RIs produced smooth centile curves across the age range, from which point estimates for each year of age were calculated. CONCLUSIONS Discrete and continuous RIs for neurological plasma biomarkers will help refine normative cut-offs across the lifespan and improve the precision of interpretating biomarker levels. Continuous RIs are recommended for use in age groups, such as pediatrics and older adults, that experience rapid concentration changes by age.
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Affiliation(s)
- Jennifer G Cooper
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia V6T 1Z3, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada
| | - Sophie Stukas
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia V6T 1Z3, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada
| | - Mohammad Ghodsi
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia V6T 1Z3, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada
| | - Nyra Ahmed
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia V6T 1Z3, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada
| | - Ramon Diaz-Arrastia
- Clinical TBI Research Center, Penn Presbyterian Medical Center, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Daniel T Holmes
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada; Department of Pathology and Laboratory Medicine, Providence Health, 1081 Burrard St, Vancouver, British Columbia V6Z 1Y6, Canada
| | - Cheryl L Wellington
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia V6T 1Z3, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada; School of Biomedical Engineering, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada; International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada.
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Tabor JB, Galarneau JM, Penner LC, Cooper J, Ghodsi M, Fraser DD, Wellington CL, Debert CT, Emery CA. Use of Biostatistical Models to Manage Replicate Error in Concussion Biomarker Research. JAMA Netw Open 2023; 6:e2339733. [PMID: 37870831 PMCID: PMC10594140 DOI: 10.1001/jamanetworkopen.2023.39733] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 09/13/2023] [Indexed: 10/24/2023] Open
Abstract
Importance Advancing research on fluid biomarkers associated with sport-related concussion (SRC) highlights the importance of detecting low concentrations using ultrasensitive platforms. However, common statistical practices may overlook replicate errors and specimen exclusion, emphasizing the need to explore robust modeling approaches that consider all available replicate data for comprehensive understanding of sample variation and statistical inferences. Objective To evaluate the impact of replicate error and different biostatistical modeling approaches on SRC biomarker interpretation. Design, Setting, and Participants This cross-sectional study within the Surveillance in High Schools to Reduce the Risk of Concussions and Their Consequences study used data from healthy youth athletes (ages 11-18 years) collected from 3 sites across Canada between September 2019 and November 2021. Data were analyzed from November 2022 to February 2023. Exposures Demographic variables included age, sex, and self-reported history of previous concussion. Main Outcomes and Measures Outcomes of interest were preinjury plasma glial fibrillary acidic protein (GFAP), ubiquitin C-terminal hydrolase-L1 (UCH-L1), neurofilament-light (NFL), total tau (t-tau) and phosphorylated-tau-181 (p-tau-181) assayed in duplicate. Bland-Altman analysis determined the 95% limits of agreement (LOAs) for each biomarker. The impact of replicate error was explored using 3 biostatistical modeling approaches assessing the associations of age, sex, and previous concussion on biomarker concentrations: multilevel regression using all available replicate data, single-level regression using the means of replicate data, and single-level regression with replicate means, excluding specimens demonstrating more than 20% coefficient variation (CV). Results The sample included 149 healthy youth athletes (78 [52%] male; mean [SD] age, 15.74 [1.41] years; 51 participants [34%] reporting ≥1 previous concussions). Wide 95% LOAs were observed for GFAP (-17.74 to 18.20 pg/mL), UCH-L1 (-13.80 to 14.77 pg/mL), and t-tau (65.27% to 150.03%). GFAP and UCH-L1 were significantly associated with sex in multilevel regression (GFAP: effect size, 15.65%; β = -0.17; 95% CI, -0.30 to -0.04]; P = .02; UCH-L1: effect size, 17.24%; β = -0.19; 95% CI, -0.36 to -0.02]; P = .03) and single-level regression using the means of replicate data (GFAP: effect size, 15.56%; β = -0.17; 95% CI, -0.30 to -0.03]; P = .02; UCH-L1: effect size, 18.02%; β = -0.20; 95% CI, -0.37 to -0.03]; P = .02); however, there was no association for UCH-L1 after excluding specimens demonstrating more than 20% CV. Excluding specimens demonstrating more than 20% CV resulted in decreased differences associated with sex in GFAP (effect size, 12.29%; β = -0.14; 95% CI, -0.273 to -0.004]; P = .04) and increased sex differences in UCH-L1 (effect size, 23.59%; β = -0.27; 95% CI, -0.55 to 0.01]; P = .06), with the widest 95% CIs (ie, least precision) found in UCH-L1. Conclusions and Relevance In this cross-sectional study of healthy youth athletes, varying levels of agreement between SRC biomarker technical replicates suggested that means of measurements may not optimize precision for population values. Multilevel regression modeling demonstrated how incorporating all available biomarker data could capture replicate variation, avoiding challenges associated with means and percentage of CV exclusion thresholds to produce more representative estimates of association.
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Affiliation(s)
- Jason B. Tabor
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Jean-Michel Galarneau
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Linden C. Penner
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Jennifer Cooper
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mohammad Ghodsi
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Douglas D. Fraser
- Department of Pediatrics and Clinical Neurological Sciences, Western University, London, Ontario, Canada
| | - Cheryl L. Wellington
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Chantel T. Debert
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Carolyn A. Emery
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Departments of Pediatrics and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Tabor JB, Penner LC, Cooper JG, Ghodsi M, Galarneau JM, Fraser DD, Emery CA, Wellington CL, Debert CT. Characterizing Factors Influencing Baseline Plasma Biomarkers for Sport-Related Concussion in Adolescents. J Neurotrauma 2023; 40:1638-1650. [PMID: 36852497 DOI: 10.1089/neu.2022.0501] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Abstract
Abstract Developing objective measures to diagnose sport-related concussion (SRC) is a top priority, particularly in the pediatric context, given the vulnerability of the developing brain. While advances in SRC blood biomarkers are being made in adult populations, less data are available for adolescents. Clinical validation of blood biomarkers post-SRC will first require investigation in a healthy uninjured state. Further, rapid pubertal changes during adolescence may implicate possible interactions with circulating sex hormones and the menstrual cycle for females. This cross-sectional study aimed to characterize pre-injury plasma levels of glial fibrillary acidic protein (GFAP), neurofilament light (NF-L), ubiquitin C-terminal hydrolase-L1 (UCH-L1), total tau (T-tau), and phosphorylated tau-181 (P-tau-181), considering previous concussion, age, and sex in healthy adolescent sport participants. Possible associations with menstrual cycle phase and circulating sex hormone levels (i.e., progesterone, estradiol, testosterone) were also explored. Pre-injury blood samples were obtained from 149 healthy adolescents (48% female, ages 11-18) participating in a larger Surveillance in High Schools and Community Sports to Reduce Concussions and their Consequences (SHRed Concussions) multi-site longitudinal cohort study. Main outcomes were natural log (ln) transformed plasma GFAP, NF-L, UCH-L1, T-tau, and P-tau-181 concentrations, quantified on the Quanterix Simoa HD-X platform. Mixed-effects multi-variable linear regression was used to assess associations between biomarkers and self-reported previous concussion (yes/no), age (years), sex (male/female), objectively determined menstrual cycle phase (follicular/luteal), plasma progesterone, estradiol, and testosterone. Males had 19.8% lower UCH-L1 (β = -0.221, 95% confidence interval [CI; -0.396, -0.046]), 18.9% lower GFAP (β = -0.210, 95% CI [-0.352, -0.068]), and 21.8% higher P-tau-181 (β = 0.197, 95% CI [0.048, 0.346]) compared with females, adjusting for age and previous concussion. GFAP decreased 9.5% with each 1-year increase in age, adjusting for previous concussion and sex (β = -0.100, 95% CI [-0.152, -0.049]). No biomarkers were associated with a history of previous concussion. Exploratory investigations found no associations between biomarkers and menstrual cycle phase. Females displayed an age-adjusted negative association between T-tau and progesterone (β = -0.010, 95% CI [-0.018, -0.002]), whereas males had a negative age-adjusted association between UCH-L1 and testosterone (β = -0.020, 95% CI [-0.037, -0.002]). As such, age- and sex-specific reference intervals may be warranted for pediatric athlete populations prior to clinical validation of blood biomarkers for SRC. Additionally, hormonal associations highlight the need to consider puberty and development in adolescent studies. Overall, findings suggest these biomarkers are resilient to a history of previous concussion and menstrual cycle phase, supporting continued investigation in adolescent SRC.
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Affiliation(s)
- Jason Benjamin Tabor
- Sport Injury Prevention Research Center, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Linden Chase Penner
- Sport Injury Prevention Research Center, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Jennifer Gradi Cooper
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Center for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mohammad Ghodsi
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Center for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jean-Michel Galarneau
- Sport Injury Prevention Research Center, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Douglas Dale Fraser
- Department of Pediatrics and Clinical Neurological Sciences, Western University, London, Ontario, Canada
| | - Carolyn Ann Emery
- Sport Injury Prevention Research Center, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Cheryl Lea Wellington
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Center for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Chantel Teresa Debert
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Center for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
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Shafaei A, Ali Akbar Shamsian S, Ghodsi M, Sadabadi F, Shahi M. Influence of sexually transmitted infections on the cervical cytological abnormalities among Iranian women: A cross-sectional study. Int J Reprod Biomed 2023; 21:491-498. [PMID: 37560071 PMCID: PMC10407913 DOI: 10.18502/ijrm.v21i6.13636] [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: 12/12/2022] [Revised: 02/02/2023] [Accepted: 05/28/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Sexually transmitted infections (STIs) are one of the world's most severe health challenges. The existence of STIs such as human papillomavirus (HPV) might cause cervical cell changes leading to cervical cancer. OBJECTIVE This study aims to assess the association of STIs with cervical cytological abnormalities and genital warts among women in northeastern Iran. MATERIALS AND METHODS This cross-sectional study was carried out on 190 women referred to the central laboratory of Academic Center for Education, Culture, and Research, Mashhad, Iran from March to July 2022. The presence of genital infections caused by Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, and Herpes simplex viruses (1 and 2) were assessed using the real-time polymerase chain reaction method. HPV genital infection was detected based on the principles of reverse hybridization, and cellular changes in the cervix were examined by the liquid-based cytology technique. RESULTS The mean age of participants was 35.33 ± 8.9 yr. 34 different HPV genotypes were detected in all HPV-positive cases, and the most common genotype was low-risk HPV6. No significant association was found between STIs and cervical cytology abnormalities. The prevalence rates of sexually transmitted pathogens among HPV-positive and HPV-negative individuals were 10.9 and 1.6%, respectively. The frequency of genital warts was significantly higher in cases with multiple infections of high- and low-risk HPV genotypes. CONCLUSION High percentages of the participants with non-HPV STIs and HPV infection had normal cervical cytology. It is advised to use STIs and HPV diagnostic tests along with cytology examinations for cervical cancer screening.
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Affiliation(s)
- Azam Shafaei
- Blood Borne Infections Research Center, Academic Center for Education, Culture and Research (ACECR), Razavi Khorasan Branch, Mashhad, Iran
| | - Seyyed Ali Akbar Shamsian
- Department of Parasitology and Mycology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Clinical Laboratory Diagnostic Center, Academic Center for Education, Culture and Research (ACECR), Khorasan Razavi, Mashhad, Iran
| | - Mohammad Ghodsi
- Blood Borne Infections Research Center, Academic Center for Education, Culture and Research (ACECR), Razavi Khorasan Branch, Mashhad, Iran
| | - Fatemeh Sadabadi
- Cutaneous Leishmaniasis Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Shahi
- Blood Borne Infections Research Center, Academic Center for Education, Culture and Research (ACECR), Razavi Khorasan Branch, Mashhad, Iran
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Cooper JG, Stukas SK, Grey R, Ghodsi M, Ahmed N, Hoiland R, Thiara S, Foster D, Harper M, Panenka WJ, Silverberg NN, Stoessl JA, Sossi V, Sekhon MS, Wellington CL. The Utility of Blood Based Biomarkers in Detecting Neurological Complications of COVID‐19 in Critically Ill Patients. Alzheimers Dement 2022. [DOI: 10.1002/alz.069086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
| | | | - Rebecca Grey
- University of British Columbia Vancouver BC Canada
| | | | - Nyra Ahmed
- University of British Columbia Vancouver BC Canada
| | - Ryan Hoiland
- University of British Columbia Vancouver BC Canada
| | - Sonny Thiara
- University of British Columbia Vancouver BC Canada
| | | | - Megan Harper
- University of British Columbia Vancouver BC Canada
| | | | | | | | - Vesna Sossi
- Physics and Astronomy Department and DM Center for Brain Health, University of British Columbia Vancouver BC Canada
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Cooper JG, Stukas SK, Ghodsi M, Ahmed N, Holmes D, Wellington CL. Reference Intervals for Plasma Biomarkers of Alzheimer’s Disease. Alzheimers Dement 2022. [DOI: 10.1002/alz.064762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
| | | | | | - Nyra Ahmed
- University of British Columbia Vancouver BC Canada
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Ghodsi M, HajiAghayi M, Seddighin M, Seddighin S, Yami H. Fair allocation of indivisible goods: Beyond additive valuations. ARTIF INTELL 2022. [DOI: 10.1016/j.artint.2021.103633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ghodsi M, Hojati V, Attaranzadeh A, Saifi B. Evaluation of IL-3, IL-5, and IL-6 concentration in the follicular fluid of women with endometriosis: A cross-sectional study. Int J Reprod Biomed 2021; 20:213-220. [PMID: 35571503 PMCID: PMC9099369 DOI: 10.18502/ijrm.v20i3.10713] [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: 03/17/2020] [Revised: 01/27/2021] [Accepted: 10/02/2021] [Indexed: 11/24/2022] Open
Abstract
Background Endometriosis is associated with abnormal immunologic responses and combined inflammatory and anti-inflammatory conditions. Objective This study aims to investigate follicular fluid (FF) concentration of interleukin (IL)-3, IL-5, and IL-6 in women with and without endometriosis. Materials and Methods In this cross-sectionalstudy 68 women who were referred to the in vitro fertilization center of Imam Reza hospital in Mashhad during 2018 were selected randomly. Leaves of cytokines in the FF samples were evaluated in the endometriosis and the control group (n = 34/each). The diagnostic accuracy of cytokines and clinical characteristics were evaluated. Results IL-3 and IL-6 were significantly changed in the FF of the women with endometriosis compared with the control group (p = 0.04, and p < 0.01, respectively), and the mean concentration of IL-5 in the endometriosis group was lower than in the control group (p = 0.5), but this was not significant. There were significant differences in the menstrual cycle, dyspareunia, and dysmenorrhea between the groups (p < 0.01, p = 0.04, and p = 0.02, respectively). The diagnostic accuracy of IL-3 and IL-6 in the FF was low, with the area under the curve of 0.614 and 0.645, respectively. Conclusion Although none of the cytokines had a predictive value for endometriosis, the decreased levels of IL-3 and increased levels of IL-6 in the FF samples of women with endometriosis, and risk factors, including irregular menstrual cycle, dyspareunia, and dysmenorrhea, could be associated with the pathogenesis of this painful disease.
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Affiliation(s)
- Mohammad Ghodsi
- Department of Biology, Damghan Branch, Islamic Azad University, Damghan, Iran
| | - Vida Hojati
- Department of Biology, Damghan Branch, Islamic Azad University, Damghan, Iran
| | - Armin Attaranzadeh
- Imam Reza Hospital, Mashhad University of Medical Science, Mashhad, Iran
| | - Bita Saifi
- Department of Anatomy, Faculty of Medicine, Mashhad Medical Sciences, Islamic Azad University, Mashhad, Iran
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Seddighin M, Latifian M, Ghodsi M. On the Distortion Value of Elections with Abstention. J ARTIF INTELL RES 2021. [DOI: 10.1613/jair.1.12306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
In Spatial Voting Theory, distortion is a measure of how good the winner is. It has been proved that no deterministic voting mechanism can guarantee a distortion better than 3, even for simple metrics such as a line. In this study, we wish to answer the following question: how does the distortion value change if we allow less motivated agents to abstain from the election?
We consider an election with two candidates and suggest an abstention model, which is a general form of the abstention model proposed by Kirchgässner. Our results characterize the distortion ¨ value and provide a rather complete picture of the model.
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Ghodsi M, Hojati V, Attaranzade A, Saifi B. A Cross-sectional Study on the Follicular Fluid Concentration of Some Interleukins and Clinical Factors in Polycystic Ovary Syndrome Patients. International Journal of Women’s Health and Reproduction Sciences 2020. [DOI: 10.15296/ijwhr.2021.22] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Farhadi A, Ghodsi M, Hajiaghayi MT, Lahaie S, Pennock D, Seddighin M, Seddighin S, Yami H. Fair Allocation of Indivisible Goods to Asymmetric Agents. J ARTIF INTELL RES 2019. [DOI: 10.1613/jair.1.11291] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We study fair allocation of indivisible goods to agents with unequal entitlements. Fair allocation has been the subject of many studies in both divisible and indivisible settings. Our emphasis is on the case where the goods are indivisible and agents have unequal entitlements. This problem is a generalization of the work by Procaccia and Wang (2014) wherein the agents are assumed to be symmetric with respect to their entitlements. Although Procaccia and Wang show an almost fair (constant approximation) allocation exists in their setting, our main result is in sharp contrast to their observation. We show that, in some cases with n agents, no allocation can guarantee better than 1/n approximation of a fair allocation when the entitlements are not necessarily equal. Furthermore, we devise a simple algorithm that ensures a 1/n approximation guarantee.
Our second result is for a restricted version of the problem where the valuation of every agent for each good is bounded by the total value he wishes to receive in a fair allocation. Although this assumption might seem without loss of generality, we show it enables us to find a 1/2 approximation fair allocation via a greedy algorithm. Finally, we run some experiments on real-world data and show that, in practice, a fair allocation is likely to exist. We also support our experiments by showing positive results for two stochastic variants of the problem, namely stochastic agents and stochastic items.
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Shabestarian H, Ghodsi M, Mallak AJ, Jafarian AH, Montazer M, Forghanifard MM. DPPA2 Protein Expression is Associated with Gastric Cancer Metastasis. Asian Pac J Cancer Prev 2016; 16:8461-5. [DOI: 10.7314/apjcp.2015.16.18.8461] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Escott-Price V, Ghodsi M, Schmidt KM. How allele frequency and study design affect association test statistics with misrepresentation errors. Biostatistics 2013; 15:311-26. [DOI: 10.1093/biostatistics/kxt048] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ghodsi M, Mortazavi A, Shahjouei S, Hanaei S, Esmaeili A, Nejat F, El Khashab M. Exophytic glioma of the medulla: presentation, management and outcome. Pediatr Neurosurg 2013; 49:195-201. [PMID: 24861884 DOI: 10.1159/000362621] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 03/29/2014] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Exophytic gliomas of the medulla are rare childhood tumors that mostly are pilocytic astrocytomas. Here we report our experience in 11 -children with this rare tumor. METHODS A retrospective study was performed using the records of children with exophytic gliomas of the medulla at Children's Hospital Medical Center in Tehran, Iran, from 2002 through 2013. The general, clinical, and radiological data and follow-up of all patients were reviewed. RESULTS The patients mostly were male aged from 11 months to 7 years. Swallowing problems, failure to thrive and nausea and vomiting were the most common symptoms. The time span between the onset of symptoms and the diagnosis was 2-24 months. Gross total resection of tumor was possible in 8 patients. Most tumors were pilocytic astrocytomas. Patients were followed for 2 months to 11 years (mean = 3.6 years). There was no intraoperative mortality. Recurrence occurred in 1 child with fibrillary astrocytoma. CONCLUSION Gross total resection of symptomatic dorsal exophytic medullary glioma is recommended. Most tumors are pilocytic astrocytomas. The attachment of these tumors to important brainstem structures usually inhibits total resection. Electrophysiological monitoring of sensorimotor pathways and cranial nerves can be helpful to preserve surrounding neural tissue during tumor resection and to minimize complications. Regular follow-up of patients with clinical examination and brain MRI is mandatory. Repeated surgery, radiation therapy and chemotherapy are suggested in cases with tumor recurrence or progression.
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Affiliation(s)
- Mohammad Ghodsi
- Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Science, Tehran, Iran
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Fakhri M, Oghabian MA, Vedaei F, Zandieh A, Masoom N, Sharifi G, Ghodsi M, Firouznia K. Atypical language lateralization: an fMRI study in patients with cerebral lesions. Funct Neurol 2013; 28:55-61. [PMID: 23731916 PMCID: PMC3812717] [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] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Differences in the lateralization of language processes between healthy subjects and patients with neurological complaints other than epilepsy have been less documented than those between healthy subjects and epilepsy patients. Moreover, the contribution of factors such as the location and type of lesion in determining interhemispheric shift of language function is poorly understood. Sixty-seven patients who underwent presurgical evaluations at the Medical Imaging Center of the Imam Khomeini University Hospital, Tehran, and the same number of healthy controls, were recruited. The laterality index (LI) of language activation, calculated from two separate functional magnetic resonance imaging tasks, was compared between the patients and the age-/gender-/handedness-matched controls. Chi square testing showed that the percentages of subjects with "typical" and "atypical" language dominance in the patient group were significantly different from the percentages recorded in the matched healthy controls for both tasks (p<0.005). Lesion type, lesion location, lesion hemisphere, presenting symptom and patient gender had no statistically significant effect on the hemispheric LI (p>0.05). In a logistic regression model including all potential determinants of atypical LI, age emerged as the only independent predictor (p<0.05, odds ratio=0.9). Abnormal language lateralization is found in patients with a variety of cerebral lesions and with a diversity of clinical manifestations. In our selected population, symptom duration, lesion hemisphere and anatomical site of the lesion were not found to impact significantly on the development of an abnormal LI while patient age can independently predict the presence of an atypical LI.
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Affiliation(s)
- Mohammad Fakhri
- Neuroimaging and Analysis Group, Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Oghabian
- Neuroimaging and Analysis Group, Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran
| | - Faeze Vedaei
- Neuroimaging and Analysis Group, Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Zandieh
- Iranian Center of Neurological Research, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Nina Masoom
- Iranian Center of Neurological Research, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Guive Sharifi
- Department of Neurosurgery, Loghman Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Ghodsi
- Department of Neurosurgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Kavous Firouznia
- Department of Neurosurgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
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Liu B, Faller LL, Klitgord N, Mazumdar V, Ghodsi M, Sommer DD, Gibbons TR, Treangen TJ, Chang YC, Li S, Stine OC, Hasturk H, Kasif S, Segrè D, Pop M, Amar S. Deep sequencing of the oral microbiome reveals signatures of periodontal disease. PLoS One 2012; 7:e37919. [PMID: 22675498 PMCID: PMC3366996 DOI: 10.1371/journal.pone.0037919] [Citation(s) in RCA: 263] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Accepted: 04/30/2012] [Indexed: 11/18/2022] Open
Abstract
The oral microbiome, the complex ecosystem of microbes inhabiting the human mouth, harbors several thousands of bacterial types. The proliferation of pathogenic bacteria within the mouth gives rise to periodontitis, an inflammatory disease known to also constitute a risk factor for cardiovascular disease. While much is known about individual species associated with pathogenesis, the system-level mechanisms underlying the transition from health to disease are still poorly understood. Through the sequencing of the 16S rRNA gene and of whole community DNA we provide a glimpse at the global genetic, metabolic, and ecological changes associated with periodontitis in 15 subgingival plaque samples, four from each of two periodontitis patients, and the remaining samples from three healthy individuals. We also demonstrate the power of whole-metagenome sequencing approaches in characterizing the genomes of key players in the oral microbiome, including an unculturable TM7 organism. We reveal the disease microbiome to be enriched in virulence factors, and adapted to a parasitic lifestyle that takes advantage of the disrupted host homeostasis. Furthermore, diseased samples share a common structure that was not found in completely healthy samples, suggesting that the disease state may occupy a narrow region within the space of possible configurations of the oral microbiome. Our pilot study demonstrates the power of high-throughput sequencing as a tool for understanding the role of the oral microbiome in periodontal disease. Despite a modest level of sequencing (~2 lanes Illumina 76 bp PE) and high human DNA contamination (up to ~90%) we were able to partially reconstruct several oral microbes and to preliminarily characterize some systems-level differences between the healthy and diseased oral microbiomes.
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Affiliation(s)
- Bo Liu
- Center for Bioinformatics and Computational Biology, University of Maryland, College Park, Maryland, United States of America
- Department of Computer Science, University of Maryland, College Park, Maryland, United States of America
| | - Lina L. Faller
- Bioinformatics Program, Boston University, Boston, Massachusetts, United States of America
| | - Niels Klitgord
- Bioinformatics Program, Boston University, Boston, Massachusetts, United States of America
| | - Varun Mazumdar
- Bioinformatics Program, Boston University, Boston, Massachusetts, United States of America
| | - Mohammad Ghodsi
- Center for Bioinformatics and Computational Biology, University of Maryland, College Park, Maryland, United States of America
- Department of Computer Science, University of Maryland, College Park, Maryland, United States of America
| | - Daniel D. Sommer
- Center for Bioinformatics and Computational Biology, University of Maryland, College Park, Maryland, United States of America
| | - Theodore R. Gibbons
- Center for Bioinformatics and Computational Biology, University of Maryland, College Park, Maryland, United States of America
- Biological Sciences Graduate Program, University of Maryland, College Park, Maryland, United States of America
| | - Todd J. Treangen
- Center for Bioinformatics and Computational Biology, University of Maryland, College Park, Maryland, United States of America
- The McKusick-Nathans Institute for Genetic Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Yi-Chien Chang
- Bioinformatics Program, Boston University, Boston, Massachusetts, United States of America
| | - Shan Li
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - O. Colin Stine
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Hatice Hasturk
- The Forysth Institute, Department of Periodontology, Cambridge, Massachusetts, United States of America
| | - Simon Kasif
- Bioinformatics Program, Boston University, Boston, Massachusetts, United States of America
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts, United States of America
- Children’s Informatics Program, Harvard-Massachusetts Institute of Technology Division of Health Sciences and Technology, Boston, Massachusetts, United States of America
| | - Daniel Segrè
- Bioinformatics Program, Boston University, Boston, Massachusetts, United States of America
- Department of Biology, Boston University, Boston, Massachusetts, United States of America
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts, United States of America
| | - Mihai Pop
- Center for Bioinformatics and Computational Biology, University of Maryland, College Park, Maryland, United States of America
- Department of Computer Science, University of Maryland, College Park, Maryland, United States of America
- Biological Sciences Graduate Program, University of Maryland, College Park, Maryland, United States of America
| | - Salomon Amar
- Bioinformatics Program, Boston University, Boston, Massachusetts, United States of America
- Center for Anti-Inflammatory Therapeutics; Boston University Goldman School of Dental Medicine, Boston, Massachusetts, United States of America
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Liu B, Gibbons T, Ghodsi M, Treangen T, Pop M. Accurate and fast estimation of taxonomic profiles from metagenomic shotgun sequences. Genome Biol 2011. [DOI: 10.1186/1465-6906-12-s1-p11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Abstract
Background A major goal of metagenomics is to characterize the microbial composition of an environment. The most popular approach relies on 16S rRNA sequencing, however this approach can generate biased estimates due to differences in the copy number of the gene between even closely related organisms, and due to PCR artifacts. The taxonomic composition can also be determined from metagenomic shotgun sequencing data by matching individual reads against a database of reference sequences. One major limitation of prior computational methods used for this purpose is the use of a universal classification threshold for all genes at all taxonomic levels. Results We propose that better classification results can be obtained by tuning the taxonomic classifier to each matching length, reference gene, and taxonomic level. We present a novel taxonomic classifier MetaPhyler (http://metaphyler.cbcb.umd.edu), which uses phylogenetic marker genes as a taxonomic reference. Results on simulated datasets demonstrate that MetaPhyler outperforms other tools commonly used in this context (CARMA, Megan and PhymmBL). We also present interesting results by analyzing a real metagenomic dataset. Conclusions We have introduced a novel taxonomic classification method for analyzing the microbial diversity from whole-metagenome shotgun sequences. Compared with previous approaches, MetaPhyler is much more accurate in estimating the phylogenetic composition. In addition, we have shown that MetaPhyler can be used to guide the discovery of novel organisms from metagenomic samples.
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Affiliation(s)
- Bo Liu
- Center for Bioinformatics and Computational Biology, University of Maryland, College Park, USA
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Abadi MRH, Ghodsi M, Merazin M, Roozbeh H. Pituitary function impairment after moderate traumatic brain injury. Acta Med Iran 2011; 49:438-441. [PMID: 21960075] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
To determine the prevalence of pituitary hormone deficiencies after moderate traumatic brain injury (TBI). We conducted a prospective cohort and included 75 patients with moderate TBI with GCS between 9 and 13 who referred to emergency department of Shariati Hospital, Tehran/Iran, during 2004-2007. Pituitary hormones were assessed 3 and 6 months after injury. In 3(rd) month post-injury, 39 cases had not any pituitary dysfunction; however, deficiencies in one, two and three of the pituitary hormones were found in 26, 8 and 2 patients, respectively. Twenty one patients showed a deficiency in one of the pituitary hormones and only one case with deficiency of two after 6 months. The most prevalent changes occur in IGF-1 and LH/FSH after moderate TBI. However, the whole deficiencies decrease over the time.
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Ezzat Ahmadi M, Noormohammadi G, Ghodsi M, Kafi M. Effects of water deficit and spraying of dessicant on yield, yield components and water use efficiency of wheat genotypes. Pak J Biol Sci 2010; 12:1399-407. [PMID: 20128510 DOI: 10.3923/pjbs.2009.1399.1407] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
To evaluate yield, yield components and water use efficiency of bread wheat in water stress conditions and spraying of dessicant, a field experiment was carried out in 2006-2007 and 2007-2008. Main plots were assigned to two levels of water stress treatments; D1: optimum irrigation and D2: cessation of watering from anthesis to maturity stages. Sub plots were assigned to eight bread wheat genotypes; and assimilates limitations with two levels: P1: no source limitation and P2: inhibition of current photosynthesis were in sub-sub plots. Grain yield, biological yield, harvest index, the number of grains per spike, thousand grain weight and water use efficiency were significantly influenced by irrigation treatments and source limitation. Grain Yield (GY) significantly decreased by 35 and 68% under water deficiency and postanthesis photosynthetic inhibition, respectively; compared with control. Water use efficiency was higher for well-watered compared with postanthesis drought stress conditions. WUEgrain decrease due to water deficit was attributed to grain yield reduction. Under water stress, current photosynthetic inhibition reduced grain yield by 62%, but under well-watered condition; it significantly decreased grain yield by 71%, that indicate the source is limititing factor under different irrigation regimes. Considering that C-81-10, 9103 and 9116 genotypes showed the highest grain yield, potential for reserves and remobilizations of assimilates under different irrigation conditions; thus, these genotypes could be introduced as promising in breeding programs for arid and semi-arid regions.
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Affiliation(s)
- M Ezzat Ahmadi
- Faculty of Agriculture and Natural Resources, Science and Research Branch, Islamic Azad University, Tehran, Iran
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Salimi J, Ghodsi M, Zavvarh MN, Khaji A. Hospital management of abdominal trauma in Tehran, Iran: a review of 228 patients. Chin J Traumatol 2009; 12:259-62. [PMID: 19788841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE Today, trauma is a major public health problem in some countries. Abdominal trauma is the source of significant mortality and morbidity with both blunt and penetrating injuries. We performed an epidemiological study of abdominal trauma (AT) in Tehran, Iran. We used all our sources to describe the epidemiology and outcome of patients with AT. METHODS This study was done in Tehran. The study population included trauma patients admitted to the emergency department of six general hospitals in Tehran during one year. The data were collected through a questionnaire that was completed by a trained physician at the trauma center. The statistical analysis was performed using the SPSS software (version 11.5 for Windows). The statistical analysis was conducted using the chi-square and P < 0.05 was accepted as being statistically significant. RESULTS Two hundred and twenty-eight (2.8%) out of 8,000 patients were referred to the above mentioned centers with abdominal trauma. One hundred and twenty-five (54.9%) of the patients were in their 2nd and 3rd decades of life and 189 (83%) of our patients were male. Road traffic accidents (RTA) were the leading cause of AT with 119 (52.2%) patients. Spleen was the commonly injured organ with 51 cases. Following the analysis of injury severity, 159 (69.7%) patients had mild injuries (ISS < 16) and 69 (30.3%) patients had severe injuries (ISS equal to 16). The overall mortality rate was 46 (20.2%). CONCLUSIONS Blunt abdominal trauma is more common than penetrating abdominal trauma. Road traffic accidents and stab wound are the most common causes of blunt and penetrating trauma, respectively. Spleen is the most commonly injured organ in these patients. The mortality rate is higher in blunt trauma than penetrating one.
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Affiliation(s)
- Javad Salimi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran 11364, Iran.
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Eftekhar B, Sahraian MA, Nouralishahi B, Khaji A, Vahabi Z, Ghodsi M, Araghizadeh H, Soroush MR, Esmaeili SK, Masoumi M. Prognostic factors in the persistence of posttraumatic epilepsy after penetrating head injuries sustained in war. J Neurosurg 2009; 110:319-26. [DOI: 10.3171/2008.4.17519] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Object
The goal of this paper was to investigate the long-term outcome and the possible prognostic factors that might have influenced the persistence of posttraumatic epilepsy after penetrating head injuries sustained during the Iraq–Iran war (1980–1988).
Methods
In this retrospective study, the authors evaluated 189 patients who sustained penetrating head injury and suffered posttraumatic epilepsy during the Iraq–Iran war (mean 18.6 ± 4.7 years after injury). The probabilities of persistent seizures (seizure occurrence in the past 2 years) in different periods after injury were estimated using the Kaplan-Meier method. The possible prognostic factors (patients and injury characteristics, clinical findings, and seizure characteristics) were studied using log-rank and Cox regression analysis.
Results
The probability of persistent seizures was 86.4% after 16 years and 74.7% after 21 years. In patients with < 3 pieces of shrapnel or no sphincter disturbances during seizure attacks, the probability of being seizure free after these 16 and 21 years was significantly higher.
Conclusions
Early seizures, prophylactic antiepileptics drugs, and surgical intervention did not significantly affect long-term outcome in regard to persistence of seizures.
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Affiliation(s)
| | | | | | | | | | | | - Hassan Araghizadeh
- 2Medical and Engineering Research Center, Janbazan Foundation, Tehran, Iran
| | | | | | - Mehdi Masoumi
- 2Medical and Engineering Research Center, Janbazan Foundation, Tehran, Iran
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Ardakani SK, Dadmehr M, Nejat F, Ansari S, Eftekhar B, Tajik P, El Khashab M, Yazdani S, Ghodsi M, Mahjoub F, Monajemzadeh M, Nazparvar B, Abdi-Rad A. The cerebral arterial circle (circulus arteriosus cerebri): an anatomical study in fetus and infant samples. Pediatr Neurosurg 2008; 44:388-92. [PMID: 18703885 DOI: 10.1159/000149906] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2007] [Accepted: 04/24/2008] [Indexed: 11/19/2022]
Abstract
BACKGROUND Many studies have investigated the variations in the anatomy of each segment of the cerebral arterial circle while a few have addressed the variations of the cerebral arterial circle as a whole. METHODS Thirty brains of recently deceased Iranian infants and fetuses were dissected. The dissection process was filmed and digitized so as to be readily available for further studies. The variations of the circle as a whole and segmental variations were evaluated. RESULTS Variants with uni- and bilateral hypoplasia of posterior communicating arteries (PcoAs) were the most common in our study, similar to previous works. No aplasia of the precommunicating part of the anterior cerebral artery (A1), the precommunicating part of the posterior cerebral artery (P1) and anterior communicating artery was seen. Hypoplasia of the right and left PcoA was observed in 8 and 5 cases, respectively. Aplasia of the right PcoA was found in 16.6% and of the left PcoA in 3.3%. CONCLUSION In this study, we confirmed the previously described finding that the symmetrical, circular configuration of the circulus arteriosus cerebri is present in only about 42.1%. The main differences between the fetal and adult disposition are the diameter of the PcoA and the circular part of the posterior cerebral artery. According to previous studies, the fetal brain older than 4 months has anatomical characteristics very similar to the adult's circle; our finding was mostly similar to adult samples as most samples were from infants, not fetuses.
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Affiliation(s)
- Shahab Kamali Ardakani
- Department of Neurosurgery, Children's Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran
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Ghodsi M, Mahini H, Mirjalali K, Oveis Gharan S, Sayedi R. AS, Zadimoghaddam M. Spanning trees with minimum weighted degrees. INFORM PROCESS LETT 2007. [DOI: 10.1016/j.ipl.2007.06.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Affiliation(s)
- Behzad Eftekhar
- Department of Neurosurgery, Sina Hospital, Tehran University, Tehran, Iran.
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Eftekhar B, Dadmehr M, Ansari S, Ghodsi M, Nazparvar B, Ketabchi E. Are the distributions of variations of circle of Willis different in different populations? - Results of an anatomical study and review of literature. BMC Neurol 2006; 6:22. [PMID: 16796761 PMCID: PMC1543654 DOI: 10.1186/1471-2377-6-22] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2006] [Accepted: 06/24/2006] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous studies have proposed correlation between variants of the cerebral arterial circle (also known as circle of Willis) and some cerebrovascular diseases. Differences in the incidence of these diseases in different populations have also been investigated. The study of variations in the anatomy of the cerebral arterial circle may partially explain differences in the incidence of some of the cerebrovascular diseases in different ethnic or racial groups. While many studies have investigated the variations in the anatomy of each segment of the cerebral arterial circle, few have addressed the variants of the cerebral arterial circle as a whole. Similarly, the frequency of occurrence of such variants in different ethnic or racial groups has not been compared. METHODS 102 brains of recently deceased Iranian males were dissected, in order to observe variations in the anatomy of the cerebral arterial circle. The dissection process was recorded on film and digitized. One resized picture from each dissection, showing complete circle has been made available online. The variations of the circle as whole and segmental variations were compared with previous studies. RESULTS On the whole, the frequencies of the different variants of the entire cerebral arterial circle and segmental variations were comparable with previous studies.More specifically variants with uni- and bilateral hypoplasia of posterior communicating arteries were the most common in our study, similar to the previous works. No hypoplasia of the precommunicating part of the left anterior cerebral artery (A1), aplasia of A1 or the precommunicating part of the posterior cerebral artery (P1) was seen. In 3% both right and left posterior communcating arteries were absent. CONCLUSION The anatomical variations found in the cerebral arterial circle of the Iranian males in the current study were not significantly different to those of more diverse populations reported in the literature. While taking into account potential confounding factors, the authors conclude that based on available studies, there is no evidence suggesting that the distributions of the variations of cerebral arterial circle differ in different populations.
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Affiliation(s)
- Behzad Eftekhar
- Sina Trauma and Surgery Research Center and Department of Neurosurgery, Sina Hospital, Tehran University, Tehran, Iran
| | - Majid Dadmehr
- Sina Trauma and Surgery Research Center and Department of Neurosurgery, Sina Hospital, Tehran University, Tehran, Iran
| | - Saeed Ansari
- Sina Trauma and Surgery Research Center and Department of Neurosurgery, Sina Hospital, Tehran University, Tehran, Iran
| | - Mohammad Ghodsi
- Sina Trauma and Surgery Research Center and Department of Neurosurgery, Sina Hospital, Tehran University, Tehran, Iran
| | - Bashir Nazparvar
- Sina Trauma and Surgery Research Center and Department of Neurosurgery, Sina Hospital, Tehran University, Tehran, Iran
| | - Ebrahim Ketabchi
- Sina Trauma and Surgery Research Center and Department of Neurosurgery, Sina Hospital, Tehran University, Tehran, Iran
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Roudsari BS, Shadman M, Ghodsi M. Childhood trauma fatality and resource allocation in injury control programs in a developing country. BMC Public Health 2006; 6:117. [PMID: 16670023 PMCID: PMC1471786 DOI: 10.1186/1471-2458-6-117] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2006] [Accepted: 05/02/2006] [Indexed: 11/21/2022] Open
Abstract
Background Only a few studies have addressed the trimodal distribution of childhood trauma fatalities in lesser developed countries. We conducted this study to evaluate pre-hospital, Emergency Department (ED) and in-hospital distribution of childhood injury-related death for each mechanism of injury in Tehran, Iran. This information will be used for the efficient allocation of the limited injury control resources in the city. Methods We used Tehran's Legal Medicine Organization (LMO) database. This is the largest and the most complete database that receives information about trauma fatalities from more than 100 small and large hospitals in Tehran. We reviewed all the medical records and legal documents of the deceased registered in LMO from September 1999 to September 2000. Demographic and injury related characteristics of the children 15 years old or younger were extracted from the records. Results Ten percent of the 4,233 trauma deaths registered in LMO occurred among children 15 years old or younger. Motor vehicle crashes (MVCs) (50%), burns (18%), falls (6%) and poisonings (6%) were the most common mechanisms of unintentional fatal injuries. Prehospital, emergency department and hospital deaths comprised 42%, 20% and 37% of the trauma fatalities, respectively. While, more than 80% of fatal injuries due to poisoning and drowning occurred in prehospital setting, 92% of burn-related fatalities happened after hospital admission. Conclusion Injury prevention is the single most important solution for controlling trauma fatalities due to poisoning and drowning. Improvements in the quality of care in hospitals and intensive care units might substantially alleviate the magnitude of the problem due to burns. Improvements in prehospital and ED care might significantly decrease MVC and falls-related fatalities.
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Affiliation(s)
- Bahman S Roudsari
- Harborview Injury Prevention and Research Center and Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Mazyar Shadman
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ghodsi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Eftekhar B, Ghodsi M, Hadadi A, Taghipoor M, Sigarchi SZ, Rahimi-Movaghar V, Kazemzadeh ES, Esmaeeli B, Nejat F, Yalda A, Ketabchi E. Prophylactic antibiotic for prevention of posttraumatic meningitis after traumatic pneumocephalus: design and rationale of a placebo-controlled randomized multicenter trial [ISRCTN71132784]. Trials 2006; 7:2. [PMID: 16542035 PMCID: PMC1402327 DOI: 10.1186/1745-6215-7-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2005] [Accepted: 01/18/2006] [Indexed: 11/10/2022] Open
Abstract
Background The purpose of this study is to compare the efficacy of prophylactic antibiotic for prevention of meningitis in acute traumatic pneumocephalus patients. Methods In this prospective, randomized controlled clinical trial, 200 selected head injury patients with traumatic pneumocephalus are randomly assigned to receive intravenous antibiotics (2 grams Ceftriaxone twice a day), oral antibiotics (Azithromycin) or placebo for at least 7 days after trauma. The patients will be followed for one month posttrauma. Conclusion The authors hope that this study helps clarifying the effectiveness and indications of antibiotics in prevention of meningitis in traumatic pneumocephalus after head injury and in specific subgroup of these patients.
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Affiliation(s)
- Behzad Eftekhar
- Sina Trauma and Surgery Research Center and Department of Neurosurgery, Sina Hospital, Tehran University, Iran
| | - Mohammad Ghodsi
- Sina Trauma and Surgery Research Center and Department of Neurosurgery, Sina Hospital, Tehran University, Iran
| | - Azar Hadadi
- Department of Infectious Diseases, Sina Hospital, Tehran University, Iran
| | - Mousa Taghipoor
- Department of Neurosurgery, Namazi Hospital, Shiraz University, Iran
| | | | | | | | | | - Farideh Nejat
- Department of Neurosurgery, Children's Hospital Medical Center, Tehran University, Iran
| | - Alireza Yalda
- Department of Infectious Diseases, Imam Hospital, Tehran University, Iran
| | - Ebrahim Ketabchi
- Sina Trauma and Surgery Research Center and Department of Neurosurgery, Sina Hospital, Tehran University, Iran
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Eftekhar B, Zarei MR, Ghodsi M, Moezardalan K, Zargar M, Ketabchi E. Comparing logistic models based on modified GCS motor component with other prognostic tools in prediction of mortality: results of study in 7226 trauma patients. Injury 2005; 36:900-4. [PMID: 15964571 DOI: 10.1016/j.injury.2004.12.067] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2004] [Revised: 11/30/2004] [Accepted: 12/20/2004] [Indexed: 02/02/2023]
Abstract
A simple reproducible and sensitive prognostic trauma tool is still needed. In this article we have introduced modified GCS motor response (MGMR) and evaluated the performance of logistic models based on this variable. The records of 8452 trauma patients admitted to major hospitals of Tehran from 1999 to 2000 were analysed. 7226 records with known outcome were included in our study. Logistic models based on outcome (death versus survival) as a dependent variable and Injury Severity Score (ISS), Revised Trauma Score (RTS), Glasgow Coma Scale (GCS), GCS motor component (GMR) and MGMR (following command [=2], movement but not following [=1] command and without movement [=0]) were compared based on their accuracy and area under the Receiver Operating Characteristic (ROC) curve. The accuracy of the Trauma and Injury Severity Score (TRISS), RTS, GCS, GMR and MGMR models were almost the same. Considering both the area under the ROC curve and accuracy, the age included MGMR model was also comparable with other age included models (RTS+age, GCS+age, GMR+age). We concluded that although in some situations we need more sophisticated models, should our results be reproducible in other populations, MGMR (with or without age added) model may be of considerable practical value.
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Affiliation(s)
- Behzad Eftekhar
- Department of Neurosurgery and Surgery, Sina Trauma Research Center, Sina Hospital, Tehran University, Iran.
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Eftekhar B, Ghodsi M, Ketabchi E, Ghazvini AR. Play dough as an educational tool for visualization of complicated cerebral aneurysm anatomy. BMC Med Educ 2005; 5:15. [PMID: 15885141 PMCID: PMC1274244 DOI: 10.1186/1472-6920-5-15] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2004] [Accepted: 05/10/2005] [Indexed: 05/02/2023]
Abstract
BACKGROUND Imagination of the three-dimensional (3D) structure of cerebral vascular lesions using two-dimensional (2D) angiograms is one of the skills that neurosurgical residents should achieve during their training. Although ongoing progress in computer software and digital imaging systems has facilitated viewing and interpretation of cerebral angiograms enormously, these facilities are not always available. METHODS We have presented the use of play dough as an adjunct to the teaching armamentarium for training in visualization of cerebral aneurysms in some cases. RESULTS The advantages of play dough are low cost, availability and simplicity of use, being more efficient and realistic in training the less experienced resident in comparison with the simple drawings and even angiographic views from different angles without the need for computers and similar equipment. The disadvantages include the psychological resistance of residents to the use of something in surgical training that usually is considered to be a toy, and not being as clean as drawings or computerized images. CONCLUSION Although technology and computerized software using the patients' own imaging data seems likely to become more advanced in the future, use of play dough in some complicated cerebral aneurysm cases may be helpful in 3D reconstruction of the real situation.
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Affiliation(s)
- Behzad Eftekhar
- Department of Neurosurgery, Sina Hospital, Tehran University, Iran
| | - Mohammad Ghodsi
- Department of Neurosurgery, Sina Hospital, Tehran University, Iran
| | - Ebrahim Ketabchi
- Department of Neurosurgery, Sina Hospital, Tehran University, Iran
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Eftekhar B, Mohammad K, Ardebili HE, Ghodsi M, Ketabchi E. Comparison of artificial neural network and logistic regression models for prediction of mortality in head trauma based on initial clinical data. BMC Med Inform Decis Mak 2005; 5:3. [PMID: 15713231 PMCID: PMC551612 DOI: 10.1186/1472-6947-5-3] [Citation(s) in RCA: 143] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2004] [Accepted: 02/15/2005] [Indexed: 12/03/2022] Open
Abstract
Background In recent years, outcome prediction models using artificial neural network and multivariable logistic regression analysis have been developed in many areas of health care research. Both these methods have advantages and disadvantages. In this study we have compared the performance of artificial neural network and multivariable logistic regression models, in prediction of outcomes in head trauma and studied the reproducibility of the findings. Methods 1000 Logistic regression and ANN models based on initial clinical data related to the GCS, tracheal intubation status, age, systolic blood pressure, respiratory rate, pulse rate, injury severity score and the outcome of 1271 mainly head injured patients were compared in this study. For each of one thousand pairs of ANN and logistic models, the area under the receiver operating characteristic (ROC) curves, Hosmer-Lemeshow (HL) statistics and accuracy rate were calculated and compared using paired T-tests. Results ANN significantly outperformed logistic models in both fields of discrimination and calibration but under performed in accuracy. In 77.8% of cases the area under the ROC curves and in 56.4% of cases the HL statistics for the neural network model were superior to that for the logistic model. In 68% of cases the accuracy of the logistic model was superior to the neural network model. Conclusions ANN significantly outperformed the logistic models in both fields of discrimination and calibration but lagged behind in accuracy. This study clearly showed that any single comparison between these two models might not reliably represent the true end results. External validation of the designed models, using larger databases with different rates of outcomes is necessary to get an accurate measure of performance outside the development population.
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Affiliation(s)
- Behzad Eftekhar
- Department of Neurosurgery, Sina Hospital, Tehran University, Tehran, Iran
| | - Kazem Mohammad
- Department of Biostatistics and Epidemiology, Faculty of Public Health, Tehran University, Tehran, Iran
| | | | - Mohammad Ghodsi
- Department of Neurosurgery, Sina Hospital, Tehran University, Tehran, Iran
| | - Ebrahim Ketabchi
- Department of Neurosurgery, Sina Hospital, Tehran University, Tehran, Iran
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Abstract
As the first step in evaluation of the magnitude of the occupational injuries (OIs) in our community, we focused on hospital records of more than 8400 hospitalized trauma patients in six large university hospitals during 13 months of data gathering process. Fourteen percent of 8426 trauma patients had OIs (1180 cases) and 95% of them were male. Adults 19-39 years comprised 63% of the patients. Eleven percent of the patients were 18 years old or younger. Construction workers (26%), simple workers (26%), and industrial workers (17%) comprised nearly 70% of the OIs. Falls (39%) and striking by blunt objects (29%) were the most common mechanisms of injury. More than 60% of the patients did not have any type of insurance. A younger patient has a higher the probability of being uninsured. Head (49%) wrist and hand (46%) and knee and leg (36%) injuries were the most common regions injured. Additional community-based studies are needed to determine the risk of OIs among different occupational categories, as well as to identify the most vulnerable groups.
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Affiliation(s)
- Bahman Sayyar Roudsari
- Sina Trauma Research Center, Sina General Hospital, Tehran University of Medical Sciences, Tehran 11365, Iran.
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Eftekhar B, Ghodsi M, Nejat F, Ketabchi E, Esmaeeli B. Prophylactic administration of ceftriaxone for the prevention of meningitis after traumatic pneumocephalus: results of a clinical trial. J Neurosurg 2004; 101:757-61. [PMID: 15540912 DOI: 10.3171/jns.2004.101.5.0757] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT The purpose of this study was to compare the efficacy of the prophylactic use of ceftriaxone for the prevention of meningitis in patients with acute traumatic pneumocephalus. METHODS In this prospective, single-institution, randomized clinical trial, 109 patients with mild head injury and traumatic pneumocephalus were randomly assigned to receive or not receive an antibiotic medication (ceftriaxone, 1 g given twice a day) until occurrence of meningitis or at least 5 days after trauma. The patients were followed up for 1 month posttrauma. The 109 patients were divided into two groups: 53 were assigned to the prophylactic antibiotics therapy group and 56 to the control group. The overall rate of meningitis was 20.1% and the rates of meningitis in the two groups were not significantly different. The results were the same when adjusted for the patient's Glasgow Coma Scale score, sex, and age, as well as for an intradural location of air, air volume, presence of cerebrospinal fluid (CSF) rhinorrhea or CSF otorrhea, radiological sign of a skull base fracture, or intracranial hemorrhage. CONCLUSIONS The results of this study do not substantiate the efficacy of ceftriaxone used in the prevention of meningitis in patients with traumatic pneumocephalus after mild head injury or in any specific subgroup of these patients. Cerebrospinal fluid rhinorrhea and intracranial hemorrhage may be considered primary risk factors for the development of meningitis in patients with posttraumatic pneumocephalus and, in the absence of these symptoms, intradural location of air and air volume greater than 10 ml may be considered secondary risk factors. Further studies in this area are warranted.
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Affiliation(s)
- Behzad Eftekhar
- Department of Neurosurgery, Sina Hospital, Tehran University, Iran.
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Eftekhar B, Ketabchi E, Ghodsi M, Esmaeeli B. Bilateral asynchronous acute epidural hematoma : a case report. BMC Emerg Med 2003; 3:1. [PMID: 14697100 PMCID: PMC317469 DOI: 10.1186/1471-227x-3-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2003] [Accepted: 12/30/2003] [Indexed: 11/28/2022] Open
Abstract
Background Bilateral extradural hematomas have only rarely been reported in the literature. Even rarer are cases where the hematomas develop sequentially, one after removal of the other. Among 187 cases of operated epidural hematomas during past 4 years in our hospital, we found one case of sequentially developed bilateral epidural hematoma. Case Presentation An 18-year-old conscious male worker was admitted to our hospital after a fall. After deterioration of his consciousness, an emergency brain CT scan showed a right temporoparietal epidural hematoma. The hematoma was evacuated, but the patient did not improve afterwards. Another CT scan showed contralateral epidural hematoma and the patient was reoperated. Postoperatively, the patient recovered completely. Conclusions This case underlines the need for monitoring after an operation for an epidural hematoma and the need for repeat brain CT scans if the patient does not recover quickly after removal of the hematoma, especially if the first CT scan has been done less than 6 hours after the trauma. Intraoperative brain swelling can be considered as a clue for the development of contralateral hematoma.
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Affiliation(s)
- Behzad Eftekhar
- Department of Neurosurgery, Sina Hospital, Tehran University, Tehran, IRAN
| | - Ebrahim Ketabchi
- Department of Neurosurgery, Sina Hospital, Tehran University, Tehran, IRAN
| | - Mohammad Ghodsi
- Department of Neurosurgery, Sina Hospital, Tehran University, Tehran, IRAN
| | - Babak Esmaeeli
- Department of Neurosurgery, Sina Hospital, Tehran University, Tehran, IRAN
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Eftekhar B, Ghodsi M, Ketabchi E, Bakhtiari A, Mostajabi P. Spinal subdural hematoma revealing hemophilia A in a child: A case report. BMC Blood Disord 2003; 3:2. [PMID: 12904268 PMCID: PMC194670 DOI: 10.1186/1471-2326-3-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2003] [Accepted: 08/07/2003] [Indexed: 11/17/2022]
Abstract
BACKGROUND: Intraspinal bleeding especially in the form of subdural hematoma is rare in hemophiliacs. In the present case, we report a neglected hemophilic A child with such a problem and discuss its management options. CASE PRESENTATION: A 9-year old hemophilic A boy presented with quadriparesis, confusion and meningismus after a fall 4 days previously. There was no sign of direct trauma to his back. His CT Scan and MRI showed spinal extramedullary hematoma extended from C5 to L2. We corrected the factor VIII level, but two days later, the patient's lower limbs weakened to 1/5 proximally as well as distally. We performed a laminectomy from T11 to L2, according to the level of the maximal neurological deficit and recent deterioration course. The subdural hematoma was evacuated. The hematoma in other spinal levels was managed conservatively. In the week following the operation, the patient's neurological status approached normal. CONCLUSION: This case calls attention to the clinical manifestation, radiological features and management options of the rarely reported intraspinal hematoma in hemophilic children. Although this case has been managed operatively for its hematoma in the thoracolumbar region, at the same time it can be considered a successful case of conservative management of intraspinal hematoma in the cervicothoracic region. Both conservative and surgical management could be an option in managing these patients considering their neurological course.
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Affiliation(s)
- Behzad Eftekhar
- Department of Neurosurgery, Sina Hospital, Tehran University, Iran
| | - Mohammad Ghodsi
- Department of Neurosurgery, Sina Hospital, Tehran University, Iran
| | - Ebrahim Ketabchi
- Department of Neurosurgery, Sina Hospital, Tehran University, Iran
| | - Abbas Bakhtiari
- Department of Neurosurgery, Sina Hospital, Tehran University, Iran
| | - Pardis Mostajabi
- Department of Neurosurgery, Sina Hospital, Tehran University, Iran
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Abstract
BACKGROUND Vestibular schwannoma (acoustic neuroma) most commonly presents with ipsilateral disturbances of acoustic, vestibular, trigeminal and facial nerves. Presentation of vestibular schwannoma with contralateral facial pain is quite uncommon. CASE PRESENTATION Among 156 cases of operated vestibular schwannoma, we found one case with unusual presentation of contralateral hemifacial pain. CONCLUSION The presentation of contralateral facial pain in the vestibular schwannoma is rare. It seems that displacement and distortion of the brainstem and compression of the contralateral trigeminal nerve in Meckel's cave by the large mass lesion may lead to this atypical presentation. The best practice in these patients is removal of the tumour, although persistent contralateral pain after operation has been reported.
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Affiliation(s)
- Behzad Eftekhar
- Department of Neurosurgery and Neurology, Sina Hospital, Tehran University, Iran
| | - Mohammadreza Gheini
- Department of Neurosurgery and Neurology, Sina Hospital, Tehran University, Iran
| | - Mohammad Ghodsi
- Department of Neurosurgery and Neurology, Sina Hospital, Tehran University, Iran
| | - Ebrahim Ketabchi
- Department of Neurosurgery and Neurology, Sina Hospital, Tehran University, Iran
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Eftekhar B, Ghodsi M, Ketabchi E, Rasaee S. Surgical simulation software for insertion of pedicle screws. Neurosurgery 2002; 50:222-3; discussion 223-4. [PMID: 11844256 DOI: 10.1097/00006123-200201000-00038] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2001] [Accepted: 07/26/2001] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE As the first step toward finding noninvasive alternatives to the traditional methods of surgical training, we have developed a small, stand-alone computer program that simulates insertion of pedicle screws in different spinal vertebrae (T10-L5). METHODS We used Delphi 5.0 and DirectX 7.0 extension for Microsoft Windows. This is a stand-alone and portable program. RESULTS The program can run on most personal computers. It provides the trainee with visual feedback during practice of the technique. At present, it uses predefined three-dimensional images of the vertebrae, but we are attempting to adapt the program to three-dimensional objects based on real computed tomographic scans of the patients. The program can be downloaded at no cost from the web site: www.tums.ac.ir/downloads CONCLUSION As a preliminary work, it requires further development, particularly toward better visual, auditory, and even proprioceptive feedback and use of the individual patient's data.
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Affiliation(s)
- Behzad Eftekhar
- Department of Neurosurgery, Sina Hospital, Tehran University, Tehran, Iran.
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Eftekhar B, Ketabchi E, Ghodsi M, Ahmadi A. Cervical epidural actinomycosis. Case report. J Neurosurg 2001; 95:132-4. [PMID: 11453415 DOI: 10.3171/spi.2001.95.1.0132] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Cervical actinomycosis causing spinal cord compression is a rare clinical entity. In a review of the literature, the authors found only 13 cases with actinomycosis-related spinal neurological deficit. The authors describe the case of a 26-year-old man who presented with neck pain and partial paresis of the upper limbs. Magnetic resonance imaging revealed a long cervical epidural enhancing lesion that extended from C-1 to T-2. The radiological findings resembled metastasis and other epidural infections. The patient was treated medically with penicillin and amoxicillin for 7 months and recovered neurologically. The authors conclude that although cervical epidural actinomycosis is a rare clinical entity resembling metastasis and other infections in this region, it should be considered so that this unique infection can be diagnosed in the least invasive fashion and, whenever possible, unnecessary surgery can be avoided.
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Affiliation(s)
- B Eftekhar
- Department of Neurosurgery, Sina Hospital, Tehran University, Iran.
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Abstract
An hour-glass-shaped multidensity lesion found by CT in a 6-year-old boy who had been admitted to the emergency department after a mild car accident. This lesion turned out to be a congenital dermoid tumour of the right cerebellopontine angle-tentorial notch region containing 12 mature teeth and 14 pseudocarilagenous structures. This is the first case of dermoid tumour containing so many teeth, reported in an asymptomatic person and located off the midline.
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Ghodsi M, Duvigneaud PH, Glade G. X-Ray Fluorescence Study of Manganese Compounds at Stoichiometric Compositions. BCSJ 1985. [DOI: 10.1246/bcsj.58.3563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Detournay J, Ghodsi M. D�termination de la nature du processus �l�mentaire le plus lent qui d�termine La cin�tique de l'�change du fer dans le green rust II, en l'absence d'oxyg�ne et � la temp�rature ambiante. Z Anorg Allg Chem 1982. [DOI: 10.1002/zaac.19824930117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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