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Faraji N, Goli R, Mohsennezhad P, Mohammadpour Y, Parizad N, Salamat E, Pourbahram R, Bazbandi S. NSAID (nonsteroidal anti-inflammatory drugs) Induced Stevens Johnson Syndrome in a 50-year-old woman: A case study. Toxicol Rep 2024; 12:289-291. [PMID: 38469333 PMCID: PMC10925921 DOI: 10.1016/j.toxrep.2024.02.006] [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: 01/25/2024] [Revised: 02/25/2024] [Accepted: 02/26/2024] [Indexed: 03/13/2024] Open
Abstract
Stevens-Johnson Syndrome (SJS) is a severe and rare adverse drug reaction associated with significant morbidity and mortality. Although SJS is commonly triggered by multiple drugs, non-steroidal anti-inflammatory drugs (NSAIDs), including diclofenac, have been frequently implicated. A middle-aged woman, who is 50 years old, has a prior medical record of high blood pressure, type 2 diabetes, and has recently suffered from a pulmonary embolism. She was later admitted to the intensive care unit (ICU), where she was ultimately diagnosed with Steven Johnson syndrome. Careful drug selection, close monitoring of patients with predisposing factors, and prompt identification of adverse events are crucial to prevent severe drug reactions.
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Affiliation(s)
- Navid Faraji
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Rasoul Goli
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Pariya Mohsennezhad
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Islamic Azad University, Urmia, Iran
| | - Yousef Mohammadpour
- Department of Medical Education, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Naser Parizad
- Patient Safety Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Elaheh Salamat
- Department of Anesthesia and Surgical Technology, School of Allied Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Raheleh Pourbahram
- Department of Nursing, School of Nursing and Midwifery, Islamic Azad University Chalus, Iran
| | - Samaneh Bazbandi
- Department of Anesthesiology, School of Nursing and Midwifery, Islamic Azad University Tehran Medical sciences, Tehran, Iran
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Goli R, Torabzadeh A, Hassanpour A, Jafarimaraghoush A, Manouchehri E, Faraji N. The devastating impact of unresectable infectious undifferentiated pleomorphic sarcoma in the gluteal region: A case report. Int J Surg Case Rep 2024; 118:109592. [PMID: 38552374 PMCID: PMC10990712 DOI: 10.1016/j.ijscr.2024.109592] [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: 01/30/2024] [Revised: 03/23/2024] [Accepted: 03/26/2024] [Indexed: 04/07/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Undifferentiated pleomorphic sarcoma (UPS), previously known as malignant fibrous histiocytoma (MFH), is a highly aggressive soft tissue sarcoma characterized by its pleomorphic histology and lack of differentiation. CASE PRESENTATION A 35-year-old man visited our oncology department with a complaint of a growing mass in his left buttock area. The mass had been increasing in size for the past six months, affected by local and systemic infection. While it was initially painless, the patient started feeling discomfort during sitting and physical activities a few weeks, but later the complication of tumor became more aggressive. CLINICAL DISCUSSION UPS can arise in various anatomical sites, including the extremities, trunk, retroperitoneum, and head and neck region. Clinically, UPS may present as a rapidly growing mass, often with pain and limited range of motion. However, the presentation may vary depending on the site of origin. Treatment for UPS typically involves surgical resection, aiming to remove the tumor completely. Depending on the size, location, and aggressiveness of the tumor, additional treatments such as radiation therapy or chemotherapy may be recommended. CONCLUSION Undifferentiated pleomorphic sarcoma (UPS) represents a rare and aggressive soft tissue sarcoma requiring prompt and accurate diagnosis for appropriate management. With its non-specific clinical presentation and histological features, UPS can be challenging to differentiate from other soft tissue tumors.
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Affiliation(s)
- Rasoul Goli
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Aysan Torabzadeh
- Department of Nursing, School of Nursing and Midwifery, Urmia University of Medical Science, Urmia, Iran
| | - Amireh Hassanpour
- Department of Nursing, School of Nursing and Midwifery, Urmia University of Medical Science, Urmia, Iran
| | - Alireza Jafarimaraghoush
- Department of Technology and Engineering, Civil Engineering, Islamic Azad University of Tabriz, Tabriz, Iran
| | - Elaheh Manouchehri
- Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Science, Kermanshah, Iran
| | - Navid Faraji
- Department of Critical Care Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran.
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Tang SM, Durieux JC, Faraji N, Mohamed I, Wien M, Nayate AP. "Are They Listening, and Do They Find It Useful?"-Evaluation of Mid-Rotation Formative Subjective and Objective Feedback to Radiology Trainees. Curr Probl Diagn Radiol 2024; 53:114-120. [PMID: 37690968 DOI: 10.1067/j.cpradiol.2023.08.006] [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] [Received: 08/02/2023] [Accepted: 08/23/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Residents commonly receive only end-of-rotation evaluations and thus are often unaware of their progress during a rotation. In 2021, our neuroradiology section instituted mid-rotation feedback in which rotating residents received formative subjective and objective feedback. The purpose of this study was to describe our feedback method and to evaluate if residents found it helpful. METHODS Radiology residents rotate 3-4 times on the neuroradiology service for 1-month blocks. At the midpoint of the rotation (2 weeks), 7-10 neuroradiology attendings discussed the rotating residents' subjective performance. One attending was tasked with facilitating this discussion and taking notes. Objective metrics were obtained from our dictation software. Compiled feedback was relayed to residents via email. A 16-question anonymous survey was sent to 39 radiology residents (R1-R4) to evaluate the perceived value of mid-rotation feedback. Odds ratios and 95% confidence intervals were computed using logistic regression. RESULTS Sixty-nine percent (27/39) of residents responded to the survey; 92.6% (25/27) of residents reported receiving mid-rotation feedback in ≥50% of neuroradiology rotations; 92.3% (24/26) of residents found the subjective feedback helpful; 88.4% (23/26) of residents reported modifying their performance as suggested (100% R1-R2 vs 70% R3-R4; OR: 15.4 CI:1.26, >30.0);59.1% (13/22) of residents found the objective metrics helpful (75% R1-R2 vs 40% R3-R4; OR: 3.92 CI:0.74, 24.39) and 68.2% (15/22) stated they modified their performance based on these metrics (83.3% R1-R2 vs 50.0% R3-R4; OR:4.2 CI:0.73, 30.55); and 84.6% (22/26) of residents stated that mid-rotation subjective feedback and 45.5% (10/22) stated that mid-rotation objective feedback should be implemented in other sections. CONCLUSIONS Majority of residents found mid-rotation feedback to be helpful in informing them about their progress and areas for improvement in the neuroradiology rotation, more so for subjective feedback than objective feedback. The majority of residents stated all rotations should provide mid-rotation subjective feedback.
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Affiliation(s)
- Stephen M Tang
- Case Western Reserve University School of Medicine, Cleveland, OH
| | - Jared C Durieux
- University Hospitals Cleveland Medical Center, Cleveland, OH
| | - Navid Faraji
- University Hospitals Cleveland Medical Center, Cleveland, OH
| | - Inas Mohamed
- University Hospitals Cleveland Medical Center, Cleveland, OH
| | - Michael Wien
- University Hospitals Cleveland Medical Center, Cleveland, OH
| | - Ameya P Nayate
- University Hospitals Cleveland Medical Center, Cleveland, OH.
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Goli R, Faraji N, Maroofi H, Hassanpour A. Effect of spiritual care on the quality of life in patients who underwent intracranial hemorrhage surgery: a randomized controlled trial. Int J Surg 2024; 110:167-175. [PMID: 37800558 PMCID: PMC10793776 DOI: 10.1097/js9.0000000000000813] [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] [Received: 07/17/2023] [Accepted: 09/18/2023] [Indexed: 10/07/2023]
Abstract
INTRODUCTION One of the most important complications of stroke after intracranial haemorrhage surgery is impaired quality of life. This study was conducted to determine the impact of spiritual care on the quality of life of stroke patients. METHODS This single-blind clinical trial with a pre-test and post-test design was conducted on 100 stroke patients. Participants were recruited and randomly assigned to a control group and an intervention group. The stroke-specific quality of life (SS -QoL) scale was used to assess the quality of life of stroke patients. The intervention group received four sessions of spiritual care. RESULTS The independent t -test showed no significant difference between the two groups in the mean quality of life score ( t =-0.120, P =0.281) and its dimensions before the intervention. However, after the intervention, the results showed a significant difference between the two groups in terms of the mean quality of life score ( t =1.984, P <0.001) and its dimensions. In addition, the results of the paired t -test showed that in the intervention group, the mean score of quality of life ( t =5.161, P <0.001) and its dimensions were significantly different before and after the intervention. Furthermore, the results showed that before and after the intervention in the control group, the mean score of quality of life ( t =1.109, P =0.614) and its dimensions were not significantly different. CONCLUSIONS Based on this results, the authors strongly recommend the use of spiritual care as a holistic care and complementary method to improve the symptoms and quality of life of stroke patients.
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Affiliation(s)
| | | | - Himan Maroofi
- Faculty of Nursing and Midwifery, Qom University of Medical Sciences, Qom, Iran
| | - Amireh Hassanpour
- Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia
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Rahimi K, Goli R, Faraji N, Pourheidar B, Nabavi S, Pourheidar M, Babamiri B. The effects of coadministration of curcumin and vitamin E on the reproductive system of diabetic male rats; An experimental study. Toxicol Rep 2023; 11:241-248. [PMID: 37744019 PMCID: PMC10514388 DOI: 10.1016/j.toxrep.2023.08.005] [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: 07/23/2023] [Revised: 08/20/2023] [Accepted: 08/22/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Diabetes causes testicular damage due to oxidative stress. Nowadays, the use of vitamins and antioxidants is one of the common methods to treat this disease. Therefore, the aim of this study is to investigate the effect of single and combined administration of these two substances on the reproductive system of male diabetic rats. Method and materials In this study, 48 adult male Wistar rats weighing 250-270 grammes were divided into 6 groups: Control group, diabetic group, vehicle group, vitamin E, curcumin group, and vitamin E and curcumin group. The control group was the healthy group, and in the other groups, the rats were made diabetic by streptozotocin (60 mg/kg/ip). The vehicle group received 1 ml of olive oil, the vitamin E group (100 mg/kg/ip) received Vit.E, and the curcumin group (50 mg/kg/ip) received Cu. The group of rats received vitamin E and curcumin. At the end of the sixth week after treatment, blood was taken from the rats and biochemical analysis was performed to check the amount of malondialdehyde (MDA), LH hormones and serum testosterone, then the rats were killed and their testes and epididymides were removed. The weight of the testes and sperm parameters, the maturity of sperm nuclei and the integrity of their DNA were checked. The number of spermatogenic cells was determined by histological examination. Results This study showed that diabetes caused a decrease in testicular weight, sperm count, motility, and viability, an increased percentage of sperm with immature nuclei, and an increased percentage of sperm with denatured DNA. In addition, diabetes decreased the average number of matogenic sperm, and biochemical results showed that diabetes increased the level of MDA and decreased the level of the hormones LH and testosterone. Treatment with vitamin E, curcumin and their combination improved all these parameters, and this improvement was significant in the Toam group. Conclusion Combined administration of vitamin E and curcumin in diabetic rats significantly improves sperm parameters, matogenic sperm count, and improves MDA levels, LH, and serum testosterone compared with separate treatment.
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Affiliation(s)
- Kamal Rahimi
- Department of Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Islamic Republic of Iran
| | - Rasoul Goli
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Islamic Republic of Iran
| | - Navid Faraji
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Islamic Republic of Iran
| | - Bagher Pourheidar
- Neurophysiology Research Center, Department of Anatomy, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Islamic Republic of Iran
| | - Somaye Nabavi
- Department of Accounting, School of Accounting, Islamic Azad University, Boukan, Islamic Republic of Iran
| | - Maryam Pourheidar
- Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Islamic Republic of Iran
| | - Behnam Babamiri
- Department of Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Islamic Republic of Iran
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Faraji N, Parizad N, Goli R, Nikkhah F, Golhkar M. Fighting diabetic foot ulcer by combination therapy, including larva therapy, Medi honey ointment, and silver alginate dressings: A case report. Int J Surg Case Rep 2023; 113:109055. [PMID: 37976722 PMCID: PMC10684802 DOI: 10.1016/j.ijscr.2023.109055] [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: 09/15/2023] [Revised: 11/10/2023] [Accepted: 11/10/2023] [Indexed: 11/19/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Diabetic foot ulcers (DFUs) are a common complication of diabetes and can be challenging to manage. A combined approach can lead to faster healing and better outcomes for individuals with DFUs. CASE PRESENTATION This case report presents a 70-year-old man with a 15-year history of diabetes who developed a diabetic foot ulcer. The patient was undergoing treatment with routine therapy. Despite the severity of the ulcer, a combination therapy approach, including larva therapy, Medi honey ointment, and silver alginate dressings, was implemented, leading to successful healing. CLINICAL DISCUSSION By combining these three treatment modalities, we may be able to achieve a synergistic effect and maximize wound healing and infection control benefits. CONCLUSION The combined use a honey-based Media Honey ointment and silver alginate larva therapy can be an effective treatment option for diabetic foot ulcers.
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Affiliation(s)
- Navid Faraji
- Department of Medical-surgical nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Iran
| | - Naser Parizad
- Patient Safety Research Center, Urmia University of Medical Sciences, Iran
| | - Rasoul Goli
- Department of Medical-surgical nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Iran.
| | - Fatemeh Nikkhah
- Department of midwifery, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Mahdi Golhkar
- Department of nursing, School of Nursing, islamic azad university gonabad, Khorasan-e Razavi, Iran
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Mohamed I, Hom GL, Jiang S, Nayate A, Faraji N, Wien M, Ramaiya N. Psychological Safety as a New ACGME Requirement: A Comprehensive All-in-One Guide to Radiology Residency Programs. Acad Radiol 2023; 30:3137-3146. [PMID: 37743164 DOI: 10.1016/j.acra.2023.08.032] [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: 07/17/2023] [Revised: 08/19/2023] [Accepted: 08/23/2023] [Indexed: 09/26/2023]
Abstract
RATIONALE AND OBJECTIVES With the Accreditation Council for Graduate Medical Education recently updating their common program requirements to include components of psychological safety as a core principle, radiology training programs and academic radiology institutions will need to evaluate psychological safety within their residency programs and implement practices to sustain a safety culture. This article reviews current literature to present a concise guide for radiology programs on best practices for implementing psychological safety, considering the plethora of literature that is available. MATERIALS AND METHODS We searched PubMed for published studies evaluating safety culture in medical education and residency. The key words used were Psychological Safety, Education, Radiology, Workplace Culture, and Leadership. RESULTS Ninety two studies were reviewed that contributed to the topics examined throughout this manuscript, including a brief history of psychological safety, evolving challenges, and a summation of best practices at the institutional, interpersonal, and individual levels that can result in a sustainable psychologically safe culture for radiology residents. CONCLUSION This article will highlight unique considerations pertinent to a radiology residency program, including suggestions for creating a less stressful environment during case conferences, fostering and supporting residents who are struggling, and inclusive psychological safety practices that also consider non-resident contributors to a residency program, such as attending physician faculty and non-physician radiology technicians.
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Affiliation(s)
- Inas Mohamed
- University Hospitals, Department of Radiology, Cleveland, Ohio (I.M., G.L.H., S.J., A.N., N.F., M.W., N.R.).
| | - Grant L Hom
- University Hospitals, Department of Radiology, Cleveland, Ohio (I.M., G.L.H., S.J., A.N., N.F., M.W., N.R.); Case Western Reserve University School of Medicine, Cleveland, Ohio (G.L.H.)
| | - Sirui Jiang
- University Hospitals, Department of Radiology, Cleveland, Ohio (I.M., G.L.H., S.J., A.N., N.F., M.W., N.R.)
| | - Ameya Nayate
- University Hospitals, Department of Radiology, Cleveland, Ohio (I.M., G.L.H., S.J., A.N., N.F., M.W., N.R.)
| | - Navid Faraji
- University Hospitals, Department of Radiology, Cleveland, Ohio (I.M., G.L.H., S.J., A.N., N.F., M.W., N.R.)
| | - Michael Wien
- University Hospitals, Department of Radiology, Cleveland, Ohio (I.M., G.L.H., S.J., A.N., N.F., M.W., N.R.)
| | - Nikhil Ramaiya
- University Hospitals, Department of Radiology, Cleveland, Ohio (I.M., G.L.H., S.J., A.N., N.F., M.W., N.R.)
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Goli R, Faraji N, Janghiyamachi R, Talebiazar N. Nicolau syndrome after intramuscular injection of methocarbamol: A rare case report. Toxicol Rep 2023; 11:346-348. [PMID: 37859670 PMCID: PMC10582772 DOI: 10.1016/j.toxrep.2023.10.002] [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: 08/22/2023] [Revised: 10/02/2023] [Accepted: 10/08/2023] [Indexed: 10/21/2023] Open
Abstract
Background Methocarbamol is a muscle relaxant medication that is commonly used to treat muscle spasms and musculoskeletal pain. Methocarbamol intramuscular injection can cause necrosis of the soft tissue. This rare condition can create severe adverse event with permanent disability. Case presentation A 32-year-old woman with no significant past medical history presented to the emergency department with severe pain, redness, and swelling involving her left buttock and the surrounding back area. Clinical discussion The necrotic changes due to methocarbamol intramuscular injection can progress rapidly, leading to the formation of deep ulcers, cellulitis, and even abscesses. Prompt recognition and intervention are crucial to prevent further tissue damage and complications. Conclusion Comprehending the fundamental mechanisms and identifying risk factors related to this complication is imperative in enabling healthcare professionals to proficiently manage and avert its manifestation.
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Affiliation(s)
- Rasoul Goli
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Navid Faraji
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Razieh Janghiyamachi
- Department of Nursing, School of Nursing and Midwifery, Islamic Azad University, Marand Branch, Tabriz, Iran
| | - Nasim Talebiazar
- Department of Psychiatric, Urmia University of Medical Sciences, Urmia, Iran
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Fu T, Viswanathan V, Attia A, Zerbib-Attal E, Kosaraju V, Barger R, Vidal J, Bittencourt LK, Faraji N. Assessing the Potential of a Deep Learning Tool to Improve Fracture Detection by Radiologists and Emergency Physicians on Extremity Radiographs. Acad Radiol 2023:S1076-6332(23)00595-0. [PMID: 37993303 DOI: 10.1016/j.acra.2023.10.042] [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: 09/16/2023] [Revised: 10/23/2023] [Accepted: 10/25/2023] [Indexed: 11/24/2023]
Abstract
RATIONALE AND OBJECTIVES To evaluate the standalone performance of a deep learning (DL) based fracture detection tool on extremity radiographs and assess the performance of radiologists and emergency physicians in identifying fractures of the extremities with and without the DL aid. MATERIALS AND METHODS The DL tool was previously developed using 132,000 appendicular skeletal radiographs divided into 87% training, 11% validation, and 2% test sets. Stand-alone performance was evaluated on 2626 de-identified radiographs from a single institution in Ohio, including at least 140 exams per body region. Consensus from three US board-certified musculoskeletal (MSK) radiologists served as ground truth. A multi-reader retrospective study was performed in which 24 readers (eight each of emergency physicians, non-MSK radiologists, and MSK radiologists) identified fractures in 186 cases during two independent sessions with and without DL aid, separated by a one-month washout period. The accuracy (area under the receiver operating curve), sensitivity, specificity, and reading time were compared with and without model aid. RESULTS The model achieved a stand-alone accuracy of 0.986, sensitivity of 0.987, and specificity of 0.885, and high accuracy (> 0.95) across stratification for body part, age, gender, radiographic views, and scanner type. With DL aid, reader accuracy increased by 0.047 (95% CI: 0.034, 0.061; p = 0.004) and sensitivity significantly improved from 0.865 (95% CI: 0.848, 0.881) to 0.955 (95% CI: 0.944, 0.964). Average reading time was shortened by 7.1 s (27%) per exam. When stratified by physician type, this improvement was greater for emergency physicians and non-MSK radiologists. CONCLUSION The DL tool demonstrated high stand-alone accuracy, aided physician diagnostic accuracy, and decreased interpretation time.
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Affiliation(s)
- Tianyuan Fu
- University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA (T.F., V.V., V.K., R.B., L.K.B., N.F.).
| | - Vidya Viswanathan
- University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA (T.F., V.V., V.K., R.B., L.K.B., N.F.)
| | - Alexandre Attia
- Azmed, 10 Rue d'Uzès, 75002, Paris, France (A.A., E.Z.A., J.V.)
| | | | - Vijaya Kosaraju
- University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA (T.F., V.V., V.K., R.B., L.K.B., N.F.)
| | - Richard Barger
- University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA (T.F., V.V., V.K., R.B., L.K.B., N.F.)
| | - Julien Vidal
- Azmed, 10 Rue d'Uzès, 75002, Paris, France (A.A., E.Z.A., J.V.)
| | - Leonardo K Bittencourt
- University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA (T.F., V.V., V.K., R.B., L.K.B., N.F.)
| | - Navid Faraji
- University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA (T.F., V.V., V.K., R.B., L.K.B., N.F.)
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Yavari S, Radfar M, Faraji N, Goli R, Bagherzadi A, Atharifar R, Kazemi S, Dadashi M. Self-esteem and optimism in patients with major depression disorder: a cross-sectional study. Ann Med Surg (Lond) 2023; 85:5379-5383. [PMID: 37915636 PMCID: PMC10617889 DOI: 10.1097/ms9.0000000000001263] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 08/23/2023] [Indexed: 11/03/2023] Open
Abstract
Background Depressive disorders are common mental illnesses characterized by persistent feelings of sadness, hopelessness, and loss of interest in activities. Self-esteem refers to the appraisal of one's worth and personality, whereas optimism reflects a positive attitude and the expectation of positive outcomes. Therefore, the present study aims to determine the average self-esteem and optimism of patients with depression in 2022. Methods The present study is a single center and prospective descriptive-analytical study in which 121 patients out of 154 participants with major depression using convenience sampling were studied. Recruitment started on 10 June 2022 and ended on 12 July 2022. Data were collected using a demographic questionnaire, the Rosenberg Self-Esteem Scale (RSES), and the Revised Life Orientation Test (LOT -R). Data analysis was performed using statistical tests and the Pearson correlation coefficient with SPSS software version 21. Results The mean and SD of patients' self-esteem scores were 14.68±1.30, and the mean and SD for optimism scores were 9.90±1.68. Pearson correlation analysis showed that educational level had a significant inverse relationship with patients' self-esteem scores (r=-0.009, P=0.03), and sex had a significant relationship with patients' optimism scores (r=0.175, P=0.008). Conclusion Considering the importance of self-esteem and optimism in the recovery and return to society of patients with major depression, it is necessary to take measures to strengthen and increase self-esteem and optimism in these patients.
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Affiliation(s)
| | | | | | | | - Aynaz Bagherzadi
- Department of Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Reza Atharifar
- Department of Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
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MacBeth R, Ravi S, Abuhamdeh I, Avery R, Wien M, Faraji N. Decreasing Workflow and Educational Interruptions in the Reading Room: Working Smarter, Not Harder. Curr Probl Diagn Radiol 2023; 52:511-514. [PMID: 37460359 DOI: 10.1067/j.cpradiol.2023.06.007] [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] [Received: 02/20/2023] [Revised: 05/26/2023] [Accepted: 06/28/2023] [Indexed: 10/16/2023]
Abstract
OBJECTIVE Disruptions in image interpretation lead to interrupted education and inefficiency, and ultimately delay patient care. In the academic reading room, time can often be spent rerouting phone calls. The objective of this study was to evaluate resident perception of current workflow, decrease interruptions, and improve patient care and resident education by implementing a cost-effective automated centralized phone tree. MATERIALS AND METHODS Phone call records were obtained between January 25 and February 23, 2021 and May 3 and June 30, 2021 prior to implementation of an automated centralized phone tree within the Emergency Radiology reading room. Calls during weekday business hours were evaluated. Postimplementation phone records were obtained over 4 weeks (August 20-September 16, 2021). Residents on rotation were surveyed prior to and after phone tree implementation regarding the qualitative impact. RESULTS The total number of phone calls decreased after phone tree implementation to 8 calls over a 19-day period from 100-200 phone calls over a 20-22 day period. There is a statistically significant difference (p-value < 0.017) in the median number of phone calls postimplementation for all compared preimplementation time points. Resident surveys also demonstrate a statistically significant improvement (p-value < 0.05) in the evaluated metrics. CONCLUSIONS Data demonstrate a quantitative decrease in the number of calls arriving at the Emergency Radiology reading room as well as qualitative improvements in resident workplace satisfaction, feelings of burnout, and burden of interruptions. These data suggest that a self-directed triage system (eg, phone tree) could provide a cost-effective and simple means of decreasing interruptions.
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Affiliation(s)
- RaeLynne MacBeth
- Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH.
| | - Shweta Ravi
- Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH
| | - Imran Abuhamdeh
- Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH
| | - Ross Avery
- Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH
| | - Michael Wien
- Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH
| | - Navid Faraji
- Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH
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Toth E, Araich H, Patel S, Murugesan A, Bhargava P, Faraji N. Anki Flashcards for Radiology Education. Curr Probl Diagn Radiol 2023; 52:453-455. [PMID: 37679227 DOI: 10.1067/j.cpradiol.2023.08.001] [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] [Received: 08/13/2023] [Accepted: 08/13/2023] [Indexed: 09/09/2023]
Abstract
From online textbooks to educational social media posts, digital learning tools are transforming medical education. Spaced repetition programs are a popular tool, with 70% of first-year medical students reporting using the free, open-source flashcard application Anki.1 The Anki program pairs active recall and spaced repetition learning principles with a simple but versatile user interface.2 Spaced repetition flashcard programs such as Anki are uniquely suited to radiology education because they strengthen image-based recall, a necessary skill for radiology trainees to develop. In this review, we will describe the science behind active recall and spaced repetition programs, introduce the Anki platform, and describe future directions for its potential as an educational resource for radiology.
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Affiliation(s)
- Emma Toth
- School of Medicine, Case Western Reserve University, Cleveland, OH.
| | - Harman Araich
- School of Medicine, Case Western Reserve University, Cleveland, OH
| | | | - Arun Murugesan
- University Hospitals Cleveland Medical Center, Cleveland, OH
| | - Puneet Bhargava
- Department of Radiology, University of Washington Medical Center, Seattle, Washington
| | - Navid Faraji
- Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH
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13
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Velez-Martinez O, Hom GL, Jayasinghe S, Kosaraju V, Faraji N, Nicholas J, Barger R. Play in the reading room: Utilizing soft modeling compound to teach musculoskeletal anatomy and pathology. Curr Probl Diagn Radiol 2023:S0363-0188(23)00170-6. [PMID: 37891085 DOI: 10.1067/j.cpradiol.2023.10.009] [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: 10/11/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023]
Abstract
PROBLEM DESCRIPTION Musculoskeletal (MSK) anatomy and pathology from a radiology perspective can be difficult to conceptualize and understand due to the challenge of visualizing 3D structures in stacks of 2D imaging. Consequently, trainees may benefit from inexpensive methods that can help trainees better visualize MSK anatomy and pathology. The purpose of this study is to provide proof of concept for inexpensive methodology to help learners such as radiology residents quickly and inexpensively understand musculoskeletal anatomy and pathology. This can help trainees become better at applying musculoskeletal knowledge to clinical practice. INSTITUTIONAL METHODOLOGY Soft-modeling compounds such as Play-Doh® was utilized in a variety of colors with pottery tools to recreate 3D models of challenging MSK anatomy and pathology for trainees. Qualitative feedback from the residents was collected. RESULTS Eighteen different pathological conditions across six major bone structures were modeled with a soft modeling compound. Residents qualitatively identified the experience as educational in terms of helping them better understand MSK pathology and positive in terms of making learning fun, less stressful, and memorable due to uniqueness of the learning modality. Residents report challenges modeling complex anatomical features and pathology via this methodology. CONCLUSION Radiology residents and other learners can enhance their knowledge of musculoskeletal anatomy and pathology via utilization of inexpensive soft modeling compounds. This may offer a cheaper and more time sensitive alternative to current 3-dimensional hardware and software technologies being developed for educational purposes. Additional work needs to be done to examine the utility of this methodology across larger and diverse groups of learners.
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Affiliation(s)
| | - Grant L Hom
- University Hospitals, Department of Radiology, Cleveland, Ohio; Case Western Reserve University School of Medicine, Cleveland, Ohio
| | | | - Vijaya Kosaraju
- University Hospitals, Department of Radiology, Cleveland, Ohio; Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Navid Faraji
- University Hospitals, Department of Radiology, Cleveland, Ohio; Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Jennifer Nicholas
- Cincinnati Children's Hospital, Department of Radiology, Cincinnati, Ohio
| | - Richard Barger
- University Hospitals, Department of Radiology, Cleveland, Ohio; Case Western Reserve University School of Medicine, Cleveland, Ohio.
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Hajimohammadi K, Parizad N, Bagheri M, Faraji N, Goli R. Maggot therapy, alginate dressing, and surgical sharp debridement: Unique path to save unresponsive diabetic foot ulcer. Int J Surg Case Rep 2023; 111:108907. [PMID: 37804682 PMCID: PMC10570003 DOI: 10.1016/j.ijscr.2023.108907] [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: 08/19/2023] [Revised: 09/27/2023] [Accepted: 09/28/2023] [Indexed: 10/09/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Diabetic foot ulcers are a severe complication of diabetes mellitus, affecting a significant proportion of the diabetic population. In some cases, ulcer progression and infection can lead to the need for amputation. CASE PRESENTATION An 84-year-old male with a history of poorly controlled type 2 DM and HTN presented with an infected DFU on the plantar aspect of his right foot. This case report illustrates the successful management of an 84-year-old patient with a DFU amputation candidate, emphasizing the effectiveness of a combined treatment approach. CLINICAL DISCUSSION Conventional treatment options, including antibiotic therapy, often fail to provide adequate healing in these high-risk patients. Alternative approaches, such as maggot therapy, which involves the application of sterile maggots to the wound bed, have shown promising results. CONCLUSION This case highlights the potential therapeutic benefits and clinical efficacy of such a combined treatment approach, particularly in challenging cases with limited response to conventional therapies. Further studies and randomized trials may be warranted to support the incorporation of this therapy combination into clinical practice guidelines for DFU management.
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Affiliation(s)
- Kazem Hajimohammadi
- Imam Khomeini Teaching Hospital, Urmia University of Medical Sciences, Nursing and Midwifery Faculty, Campus Nazlu, 11 KM Road Seru, Urmia, West Azerbaijan 575611-5111, Iran
| | - Naser Parizad
- Patient Safety Research Center, Urmia University of Medical Sciences, Nursing and Midwifery Faculty, Campus Nazlu, 11 KM Road Seru, Urmia, West Azerbaijan 575611-5111, Iran
| | - Mojde Bagheri
- Department of Medicine, Faculty of Medicine, Shiraz University of Medical Science, Department of Nursing, Shiraz University of Medical Science (SUMS), Shiraz 575611-5111, Iran
| | - Navid Faraji
- Department of Medical-surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Campus Nazlu, 11 KM Road Seru, Urmia, West Azerbaijan 575611-5111, Iran
| | - Rasoul Goli
- Department of Medical-surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Campus Nazlu, 11 KM Road Seru, Urmia, West Azerbaijan 575611-5111, Iran.
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Blackburn CW, Richardson SM, DeVita RR, Dong O, Faraji N, Wurtz LD, Collier CD, Getty PJ. What Is the Prevalence of Clinically Important Findings Among Incidentally Found Osseous Lesions? Clin Orthop Relat Res 2023; 481:1993-2002. [PMID: 36975798 PMCID: PMC10499109 DOI: 10.1097/corr.0000000000002630] [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: 10/20/2022] [Revised: 01/31/2023] [Accepted: 02/28/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND Patients with incidentally found musculoskeletal lesions are regularly referred to orthopaedic oncology. Most orthopaedic oncologists understand that many incidental findings are nonaggressive and can be managed nonoperatively. However, the prevalence of clinically important lesions (defined as those indicated for biopsy or treatment, and those found to be malignant) remains unknown. Missing clinically important lesions can result in harm to patients, but needless surveillance may exacerbate patient anxiety about their diagnosis and accrue low-value costs to the payor. QUESTIONS/PURPOSES (1) What percentage of patients with incidentally discovered osseous lesions referred to orthopaedic oncology had lesions that were clinically important, defined as those receiving biopsy or treatment or those found to be malignant? (2) Using standardized Medicare reimbursements as a surrogate for payor expense, what is the value of reimbursements accruing to the hospital system for the imaging of incidentally found osseous lesions performed during the initial workup period and during the surveillance period, if indicated? METHODS This was a retrospective study of patients referred to orthopaedic oncology for incidentally found osseous lesions at two large academic hospital systems. Medical records were queried for the word "incidental," and matches were confirmed by manual review. Patients evaluated at Indiana University Health between January 1, 2014, and December 31, 2020, and those evaluated at University Hospitals between January 1, 2017, and December 31, 2020, were included. All patients were evaluated and treated by the two senior authors of this study and no others were included. Our search identified 625 patients. Sixteen percent (97 of 625) of patients were excluded because their lesions were not incidentally found, and 12% (78 of 625) were excluded because the incidental findings were not bone lesions. Another 4% (24 of 625) were excluded because they had received workup or treatment by an outside orthopaedic oncologist, and 2% (10 of 625) were excluded for missing information. A total of 416 patients were available for preliminary analysis. Among these patients, 33% (136 of 416) were indicated for surveillance. The primary indication for surveillance included lesions with a benign appearance on imaging and low clinical suspicion of malignancy or fracture. A total of 33% (45 of 136) of these patients had less than 12 months of follow-up and were excluded from further analysis. No minimum follow-up criteria were applied to patients not indicated for surveillance because this would artificially inflate our estimated rate of clinically important findings. A total of 371 patients were included in the final study group. Notes from all clinical encounters with orthopaedic and nonorthopaedic providers were screened for our endpoints (biopsy, treatment, or malignancy). Indications for biopsy included lesions with aggressive features, lesions with nonspecific imaging characteristics and a clinical picture concerning for malignancy, and lesion changes seen on imaging during the surveillance period. Indications for treatment included lesions with increased risk of fracture or deformity, certain malignancies, and pathologic fracture. Diagnoses were determined using biopsy results if available or the documented opinion of the consulting orthopaedic oncologist. Imaging reimbursements were obtained from the Medicare Physician Fee Schedule for 2022. Because imaging charges vary across institutions and reimbursements vary across payors, this method was chosen to enhance the comparability of our findings across multiple health systems and studies. RESULTS Seven percent (26 of 371) of incidental findings were determined to be clinically important, as previously defined. Five percent (20 of 371) of lesions underwent tissue biopsy, and 2% (eight of 371) received surgical intervention. Fewer than 2% (six of 371) of lesions were malignant. Serial imaging changed the treatment of 1% (two of 136) of the patients, corresponding to a rate of one in 47 person-years. Median reimbursements to work up the incidental findings analyzed was USD 219 (interquartile range USD 0 to 404), with a range of USD 0 to 890. Among patients indicated for surveillance, the median annual reimbursement was USD 78 (IQR USD 0 to 389), with a range of USD 0 to 2706. CONCLUSION The prevalence of clinically important findings among patients referred to orthopaedic oncology for incidentally found osseous lesions is modest. The likelihood of surveillance resulting in a change of management was low, but the median reimbursements associated with following these lesions was also low. We conclude that after appropriate risk stratification by orthopaedic oncology, incidental lesions are rarely clinically important, and judicious follow-up with serial imaging can be performed without incurring high costs. LEVEL OF EVIDENCE Level III, therapeutic study.
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Affiliation(s)
- Collin W. Blackburn
- Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Spencer M. Richardson
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Robert R. DeVita
- Department of Radiology, Wake Forest Baptist Medical Center, Winston-Salem, NC, USA
| | - Oliver Dong
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Navid Faraji
- Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - L. Daniel Wurtz
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Christopher D. Collier
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Patrick J. Getty
- Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
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Faraji N, Nikkhah F, Goli R, Hassanpour A, Imanzadeh F, Yavari S. Pyknodysostosis: A case report of an 8-year-old male with a rare genetic disorder. Int J Surg Case Rep 2023; 110:108793. [PMID: 37689021 PMCID: PMC10510051 DOI: 10.1016/j.ijscr.2023.108793] [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: 08/18/2023] [Revised: 09/01/2023] [Accepted: 09/02/2023] [Indexed: 09/11/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Pyknodysostosis is a rare genetic disorder characterized by skeletal and craniofacial abnormalities. It is an autosomal recessive disorder caused by mutations in the gene encoding cathepsin K. Pyknodysostosis is associated with short stature, brittle bones, and distinctive facial features. CASE PRESENTATION This case report presents the clinical manifestations, diagnostic challenges, and management strategies of an 8-year-old male with pyknodysostosis, an extremely rare genetic disorder characterized by skeletal and craniofacial abnormalities. The patient's clinical presentation, radiographic findings, genetic testing results, and treatment approach are discussed. Additionally, the importance of genetic counseling and multidisciplinary care in managing this condition is emphasized. CLINICAL DISCUSSION A multidisciplinary approach involving orthopedics, genetics, dentistry, and psychological support is crucial for managing patients with pyknodysostosis. Regular follow-up visits, careful monitoring of fractures, and appropriate interventions can improve the patient's quality of life and reduce complications. CONCLUSION The importance of early recognition, genetic testing, and multidisciplinary care is emphasized for effective treatment and support. Further research is needed to enhance our understanding of this rare genetic disorder and develop targeted therapies.
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Affiliation(s)
- Navid Faraji
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Fatemeh Nikkhah
- Department of midwifery, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Rasoul Goli
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran.
| | - Amireh Hassanpour
- Department of nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Fatemeh Imanzadeh
- Department of Nursing, School of Nursing and Midwifery, Islamic Azad University of Urmia, Urmia, Iran
| | - Saeed Yavari
- Department of Psychiatric Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
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Karimi A, El-Abtah M, Sinkler M, Faraji N, Voos J, Harlow E, Miskovsky S. Asymptomatic Bone Marrow Edema in Weight-bearing Bones in Athletes and Military Trainees: A Systematic Literature Review. Int J Sports Med 2023; 44:683-691. [PMID: 37263276 DOI: 10.1055/a-2013-2226] [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: 06/03/2023]
Abstract
Asymptomatic bone marrow edema (aBME) is a non-specific radiographic finding often found in athletes. Although aBME may represent the body's physiological response to training load, the etiology, MRI characteristics, and natural history of aBME remain unknown. To better characterize aBME in the lower extremities of military trainees and athletes. A systematic literature review in accordance with PRISMA guidelines was performed to identify primary research articles reporting on aBME in the lower extremities of athletes and military trainees. We identified 347 unique articles and after applying inclusion and exclusion criteria, 10 articles were included for qualitative synthesis. There were a total of 444 patients with an average age of 28.4±9.6 included. The most commonly used MRI sequences were proton-density with fat-saturation and T1-weighted imaging. The pattern of BME was inconsistently described, with various classification schemas used. The changes in aBME during longitudinal follow-up were dynamic and demonstrated both radiographic progression and regression. aBME is a highly prevalent and radiographically dynamic entity observed in high-level athletes and military trainees. Although follow-up was limited in the included studies, aBME may represent a natural, non-pathologic, reaction in response to specific biomechanical stressors.
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Affiliation(s)
- Amir Karimi
- Medical School, Case Western Reserve University School of Medicine, Cleveland, United States
| | - Mohamed El-Abtah
- Medical School, Case Western Reserve University School of Medicine, Cleveland, United States
| | - Margaret Sinkler
- Department Of Orthopedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, United States
| | - Navid Faraji
- Department of Diagnostic Radiology, Division of Musculoskeletal Radiology, University Hospitals Cleveland Medical Center, Cleveland, United States
| | - James Voos
- Department Of Orthopedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, United States
- University Hospitals Drusinsky Sports Medicine Institute, Cleveland, United States
| | - Ethan Harlow
- Department Of Orthopedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, United States
| | - Shana Miskovsky
- Department Of Orthopedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, United States
- University Hospitals Drusinsky Sports Medicine Institute, Cleveland, United States
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18
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Faraji N, Goli R, Shaddeli S, Rahmati A, Amirashayeri M, Yengejeh SY. Surgical management on a rare type of vertical liner fracture of tibia: A case report study. Int J Surg Case Rep 2023; 110:108692. [PMID: 37633194 PMCID: PMC10509799 DOI: 10.1016/j.ijscr.2023.108692] [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: 07/10/2023] [Revised: 08/08/2023] [Accepted: 08/09/2023] [Indexed: 08/28/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE The vertical liner fracture of the tibia is an infrequent and intricate injury that presents considerable difficulties in terms of its diagnosis, treatment, and long-term consequences. This particular fracture pattern is distinguished by a vertical line of fracture along the length of the tibial shaft, spanning from the proximal to the distal end. CASE PRESENTATION The 31-year-old female patient, who had no prior medical conditions, presented to the emergency department with complaints of intense pain and impaired ambulation in her right lower limb. She reported an accidental fall while descending a staircase, resulting in substantial impact and pressure on her right leg. CLINICAL DISCUSSION While fractures of the tibia are frequently encountered, there exist exceptional instances of vertical liner fractures within this category. A vertical long liner fracture of the tibia denotes a distinct fracture type in the elongated bone of the lower limb, characterized by a vertical fracture line that extends along the length of the bone. CONCLUSION Vertical liner fractures of the tibia, although rare, are distinct from more common tibial fracture patterns. Accurate diagnosis and thorough evaluation using various imaging methods are crucial for assessing the extent of the fracture and any associated injuries.
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Affiliation(s)
- Navid Faraji
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Rasoul Goli
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Sevda Shaddeli
- School of Medicine, Urmia University of Medical Sciences, Urmia, Iran.
| | - Ata Rahmati
- School of Paramedical, Hamedan University of Medical Sciences, Hamedan, Iran
| | | | - Sepideh Yousefi Yengejeh
- Department of Nursing, School of Nursing and Midwifery, Islamic Azad University of Urmia, Urmia, Iran
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Babamiri B, Nikkhah F, Faraji N, Goli R, Moghaddam NV, Rahimi K. Diabetic foot ulcer: Successful healing with combination therapy, including surgical debridement, maggot therapy, and negative pressure wound therapy. Int J Surg Case Rep 2023; 110:108695. [PMID: 37603913 PMCID: PMC10469558 DOI: 10.1016/j.ijscr.2023.108695] [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: 07/22/2023] [Revised: 08/15/2023] [Accepted: 08/15/2023] [Indexed: 08/23/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Diabetic foot ulcers (DFUs) are a common and serious complication of diabetes. A variety of treatments available to help heal diabetic foot ulcers, including sharp debridement, maggot therapy, and negative pressure wound therapy. CASE PRESENTATION This case report presents the case study of a male patient with an 8-year history of diabetes who developed a diabetic foot ulcer. The patient was undergoing treatment with metformin and insulin. Despite the severity of the ulcer, a combination therapy approach, including surgical debridement, maggot therapy, and negative pressure wound therapy, was implemented, leading to successful healing. CLINICAL DISCUSSION DFUs are caused by various pathological mechanisms, the single therapy would lead to a very low level of recovery. Therefore, DFU management requires multimodal care and interdisciplinary treatment. CONCLUSION This case study highlights the effectiveness of a multimodal treatment strategy for diabetic foot ulcers, emphasizing the importance of individualized care and combining evidence-based practices.
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Affiliation(s)
- Behnam Babamiri
- Department of Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Fatemeh Nikkhah
- Department of Midwifery, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Navid Faraji
- Department of medical-surgical nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Rasoul Goli
- Department of medical-surgical nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Neda Vahidi Moghaddam
- Department of Clinical psychology, School of Paramedicine, Islamic Azad University Science and Research Branch, Tehran, Iran
| | - Kamal Rahimi
- Department of Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran.
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Chagarlamudi K, Faraji N, Higinbotham A, Bomberger T, Nayate A, Wien M, Mohamed I. Decoding Program Signals: A Radiology Residency Program's Experience With the ERAS Supplemental Application. Curr Probl Diagn Radiol 2023; 52:383-386. [PMID: 37147218 DOI: 10.1067/j.cpradiol.2023.04.004] [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] [Received: 03/25/2023] [Accepted: 04/13/2023] [Indexed: 05/07/2023]
Abstract
The ERAS supplemental application has had a profound impact on the interview selection process. At our institution, we found the information in the supplemental application, particularly program signals, especially useful when inviting applicants for interviews. Applicant data was reviewed from this application cycle and the previous cycle and was subcategorized according to various demographic variables. Our analysis revealed that we were able to invite more geographically diverse candidates compared to last year. Program signaling was also beneficial for applicants in demonstrating interest in our program. 47% of interview offers were sent to those who had signaled, despite only 5% of total applications containing a program signal to our institution. Overall, we viewed the supplemental application favorably and reaffirmed its value in the interview selection process.
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Affiliation(s)
- Kaushik Chagarlamudi
- Department of Radiology, University Hospitals Cleveland Medical Center/Case Western Reserve University, Cleveland, OH.
| | - Navid Faraji
- Department of Radiology, University Hospitals Cleveland Medical Center/Case Western Reserve University, Cleveland, OH
| | - Anthony Higinbotham
- Department of Radiology, University Hospitals Cleveland Medical Center/Case Western Reserve University, Cleveland, OH
| | - Thomas Bomberger
- Department of Radiology, University Hospitals Cleveland Medical Center/Case Western Reserve University, Cleveland, OH
| | - Ameya Nayate
- Department of Radiology, University Hospitals Cleveland Medical Center/Case Western Reserve University, Cleveland, OH
| | - Michael Wien
- Department of Radiology, University Hospitals Cleveland Medical Center/Case Western Reserve University, Cleveland, OH
| | - Inas Mohamed
- Department of Radiology, University Hospitals Cleveland Medical Center/Case Western Reserve University, Cleveland, OH
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21
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Amann N, Johnson S, Chagarlamudi K, Gupta A, Faraji N. Scheduling Musculoskeletal MRI for Patients With Metallic Hardware: Initial Observations on Decreasing Nondiagnostic and Repeat Examinations at a Multisite Academic Medical Center. Curr Probl Diagn Radiol 2023; 52:327-329. [PMID: 37037716 DOI: 10.1067/j.cpradiol.2023.03.004] [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] [Received: 02/21/2023] [Accepted: 03/16/2023] [Indexed: 04/12/2023]
Abstract
OBJECTIVE As healthcare delivery systems expand to include multiple imaging centers, the process of scheduling patients at the site which best meets their needs continues to become more complex. This quality improvement study aims to create a protocol for patients with metallic hardware at sites with metallic artifact reduction sequences (MARS), increasing the proportion of exams that are diagnostic and reducing the need for repeat imaging. MATERIALS AND METHODS The study population included 322 patients with metallic hardware receiving an MRI at a large multisite healthcare system, divided into a pre-intervention and postintervention cohort. A retrospective PACS query was performed using several keywords in musculoskeletal MRI reports indicating the presence of metallic hardware. This cohort was studied to better understand the existing system failures. An intervention was then implemented by meeting with the departmental RIS and scheduling teams to discuss workflow when scheduling exams for patients with metallic hardware System changes were implemented and results were again studied retrospectively. RESULTS Before protocol implementation, 134/244 (55%) of exams were performed at sites with metallic artifact reduction sequences which improved to 54 of 78 (69%) in the postintervention cohort (P = 0.02). Additionally, the number of exams performed on 3T MRI machines pre-intervention was 14 of 244 (5.7%) compared to 1 of 78 (1.2%) postintervention (P = 0.13). The rate of nondiagnostic exams in the preintervention cohort was significantly higher at 41 of 244 (16.8%) when compared to the postintervention cohort at 4 of 78 (5.1% P = 0.01). CONCLUSIONS The implementation of this quality improvement protocol reduced the rate of nondiagnostic MSK MRI exams and reduced the inappropriate use of 3T scanners, ultimately saving time and cost for both patients and the health care system.
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Affiliation(s)
- Nathan Amann
- Case Western Reserve University School of Medicine, Cleveland, OH.
| | - Shaun Johnson
- Case Western Reserve University School of Medicine, Cleveland, OH
| | - Kaushik Chagarlamudi
- Case Western Reserve University School of Medicine, Cleveland, OH; Department of Radiology, University Hospitals, Cleveland, OH
| | - Amit Gupta
- Case Western Reserve University School of Medicine, Cleveland, OH; Department of Radiology, University Hospitals, Cleveland, OH
| | - Navid Faraji
- Case Western Reserve University School of Medicine, Cleveland, OH; Department of Radiology, University Hospitals, Cleveland, OH
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Esmaeili S, Faraji N, Bahrami S, Shaddeli S, Ahmadi A, Mostafaei B. Deep excision surgery of face due to cruel invasion of basal cell carcinoma: A case report study. Int J Surg Case Rep 2023; 109:108551. [PMID: 37487354 PMCID: PMC10374954 DOI: 10.1016/j.ijscr.2023.108551] [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: 06/27/2023] [Revised: 07/14/2023] [Accepted: 07/16/2023] [Indexed: 07/26/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE The predominant variant of skin cancer is Basal cell carcinoma (BCC), constituting about 80 % of all non-melanoma skin cancers on a global scale. Typically, it manifests on skin surfaces that are frequently exposed to sunlight, such as the neck, face, and ears. CASE PRESENTATION A 65-year-old man presented to a specialized cancer hospital with a large pigmented lesion on the left cheek that had gradually increased in size for about a year. The tumor had become raised and ulcerated, which necessitated deep surgery on his face due to extensive invasion of BCC was done. CLINICAL DISCUSSION Basal cell carcinoma is a slow-growing, locally invasive cancerous tumor of the basal cells of the skin, which line the deepest layer of the epidermis. BCC often occurs on areas of the body that are exposed to the sun. It develops in response to cumulative UV irradiation and sporadic UV irradiation, as occurs with sunburns. CONCLUSION BCC is a common and potentially devastating skin cancer that primarily affects fair-skinned people over the age of 50. Lesions on the face can be particularly challenging. Early detection and treatment is critical to minimize the need for extensive excision and reconstruction.
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Affiliation(s)
- Sogand Esmaeili
- Department of Laboratory Sciences, School of Paramedical, Urmia University of Medical Sciences, Nursing and Midwifery Faculty, Campus Nazlu, 11 KM Road Seru, Urmia, West Azerbaijan 575611-5111, Iran
| | - Navid Faraji
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Nursing and Midwifery Faculty, Campus Nazlu, 11 KM Road Seru, Urmia, West Azerbaijan 575611-5111, Iran
| | - Soheyla Bahrami
- Department of Nursing, School of Nursing and Midwifery Bonab, Nursing and Midwifery Faculty, Velayat Highway, Bonab, West Azerbaijan 5551785176, Iran
| | - Sevda Shaddeli
- School of Medicine, Urmia University of Medical Sciences, Medicine Faculty, Campus Nazlu, 11 KM Road Seru, Urmia, West Azerbaijan 575611-5111, Iran
| | - Abdolhadi Ahmadi
- Department of Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Nursing and Midwifery Faculty, Campus Nazlu, 11 KM Road Seru, Urmia, West Azerbaijan 575611-5111, Iran
| | - Behnam Mostafaei
- Department of Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Nursing and Midwifery Faculty, Campus Nazlu, 11 KM Road Seru, Urmia, West Azerbaijan 575611-5111, Iran.
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Anari S, Goli R, Faraji N, Rahimi K, Babamiri B, Zare F. Surgical excision for gigantic bilateral pulmonary hydatid cyst in a 14-year-old adolescent: A case report study. Int J Surg Case Rep 2023; 109:108548. [PMID: 37506528 PMCID: PMC10413066 DOI: 10.1016/j.ijscr.2023.108548] [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: 05/14/2023] [Revised: 07/07/2023] [Accepted: 07/15/2023] [Indexed: 07/30/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Bilateral pulmonary hydatid cysts in adolescents are rare and present unique diagnostic and treatment challenges. Adolescents with pulmonary hydatid disease often present with nonspecific symptoms such as cough, abdominal pain, nausea, vomiting, and hepatosplenomegaly. CASE PRESENTATION This case is about 14-year-old adolescent who reported feeling a mass in his chest and experienced a loss of appetite. Imaging studies were performed which showed the presence of bilateral hydatid cyst in the lung. The cyst contents were sent for histopathological analysis, which confirmed the diagnosis of hydatid cysts. CLINICAL DISCUSSION The clinical presentation of hydatid cysts varies depending on the organs involved. Bilateral hydatid cysts may occur in various organs such as liver, lung, brain, spleen, kidney, bone and other sites. Diagnosis of bilateral hydatid cysts in adolescents is difficult because symptoms may be nonspecific and the cysts may not be apparent until they reach a sufficient size. The type of surgical approach depends on the location, size, and number of cysts. CONCLUSION Bilateral pulmonary hydatid cysts have become an increasingly important diagnosis in adolescent patients. Imaging plays a critical role in prompt diagnosis, and surgical intervention remains the mainstay of management. There are limited studies regarding the management of such rare cases, but through a multidisciplinary approach, improved outcomes can be achieved.
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Affiliation(s)
- Sina Anari
- Department of Nursing, School of Nursing and Midwifery, Islamic Azad University Maragheh Branch, Nursing and Midwifery Faculty Maragheh Branch, Tabriz 575611-5111, Iran
| | - Rasoul Goli
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Nursing and Midwifery Faculty, Campus Nazlu, 11 KM Road Seru, Urmia 575611-5111, West Azerbaijan, Iran
| | - Navid Faraji
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Nursing and Midwifery Faculty, Campus Nazlu, 11 KM Road Seru, Urmia 575611-5111, West Azerbaijan, Iran
| | - Kamal Rahimi
- Department of Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Nursing and Midwifery Faculty, Campus Nazlu, 11 KM Road Seru, Urmia 575611-5111, West Azerbaijan, Iran
| | - Behnam Babamiri
- Department of Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Nursing and Midwifery Faculty, Campus Nazlu, 11 KM Road Seru, Urmia 575611-5111, West Azerbaijan, Iran
| | - Farzaneh Zare
- Department of Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Nursing and Midwifery Faculty, Campus Nazlu, 11 KM Road Seru, Urmia 575611-5111, West Azerbaijan, Iran.
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Goli R, Majidi Balaneji S, Hosseinpour L, Abbasi M, Feizi M, Nafe P, Faraji N, Heydari Bisafar M, Arad M. Ectopia cordis with multiple ventricular septal defect and sternal cleft in a newborn: a case report. Ann Med Surg (Lond) 2023; 85:3595-3598. [PMID: 37427174 PMCID: PMC10328574 DOI: 10.1097/ms9.0000000000000329] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 02/12/2023] [Indexed: 07/11/2023] Open
Abstract
Ectopia cordis is a rare type of malformation where the heart is not located normally. It may be partially or completely located outside the thoracic cavity and can be associated with other congenital abnormalities. Case presentation This case report is of a 34-week- and 6-day-old female fetus with a birth weight of 2040 g, a height of 41 cm, and a head circumference of 32 cm. The initial physical examination revealed a responsive newborn with an externalized heart outside the chest, with pericardium protection. In addition, a thoracic wall defect was detected suggesting incomplete formation of the septum bone. Moreover, in this case, the echocardiography report showed a multiple ventricular septal defect. Conclusion The management of ectopia cordis is a challenge for any obstetrician and pediatric surgeon due to its rarity. It causes mental agony and anxiety to the parents. With an early diagnosis, termination of pregnancy can be one of the options. Once it is diagnosed late, it needs a multidisciplinary approach, and the services of a very experienced pediatric surgeon to improve the prognosis.
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Affiliation(s)
| | - Sahar Majidi Balaneji
- Department of Midwifery, School of Nursing and Midwifery, Islamic Azad University of Urmia, West Azerbaijan
| | - Leila Hosseinpour
- Department of Midwifery, School of Nursing and Midwifery, Islamic Azad University of Tabriz, East Azerbaijan
| | - Mahdiyeh Abbasi
- Department of Psychiatric Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia
| | - Milad Feizi
- Department of Psychiatric Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia
| | - Parihan Nafe
- Department of Nursing, School of Nursing and Midwifery, Islamic Azad University of Urmia, Urmia
| | | | - Mojgan Heydari Bisafar
- Department of Nursing, School of Nursing and Midwifery, Islamic Azad University of Urmia, Urmia
| | - Mansour Arad
- Department of Medical-Surgical Nursing, Clinical Care Research Center, Research Institute for Health Development, Kurdistan university of Medical Science, Sanandaj, Iran
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Zare F, Shahbazi N, Faraji N, Goli R, Mostafaei B, Anari S. A cruel invasion of Ewing's sarcoma of the skull: A rare case report. Int J Surg Case Rep 2023; 108:108380. [PMID: 37406533 PMCID: PMC10382727 DOI: 10.1016/j.ijscr.2023.108380] [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: 04/30/2023] [Revised: 05/31/2023] [Accepted: 05/31/2023] [Indexed: 07/07/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Ewing's sarcoma, a highly malignant bone tumor, typically affects the pelvis and long bones of the lower extremities in children and young adults; primary involvement of the skull is rare. Primary Ewing's sarcoma arising from the skull is very rare. In most cases, this disease is fatal, although the prognosis of Ewing sarcoma improves with radiation and chemotherapy after surgery. CASE PRESENTATION This case is about 25-year-old woman who was referred to Omid Hospital in Urmia because of frequent headaches, where a tumor mass was found according to the results of CT scan. Biopsy confirmed small round cell sarcoma as the diagnosis. Chemotherapy was ineffective and tumor growth was unstoppable, causing the patient to die after 3 months. CLINICAL DISCUSSION Ewing's sarcoma can affect various parts of the human body, including bone and soft tissue, but rarely the skull. Ewing's sarcoma typically grows extradural and often reaches a very large size before invading the skull or being detected clinically. CONCLUSION In most cases, Ewing's sarcoma is fatal, although the prognosis of this disease improves with radiation and chemotherapy after surgery.
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Affiliation(s)
- Farzaneh Zare
- Department of Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Niloofar Shahbazi
- Department of Nursing, School of Nursing and Midwifery, Islamic Azad University Zarand, Kerman, Iran
| | - Navid Faraji
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Rasoul Goli
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Behnam Mostafaei
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Sina Anari
- Department of Nursing, School of Nursing and Midwifery, Islamic Azad University Maragheh Branch, Tabriz, Iran.
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Anzali BC, Goli R, Faraji N, Torabzadeh A, Najafzad Z, Nikpey S. Invasion of undifferentiated pleomorphic sarcoma (UPS) in breast tissue; a case report study. Int J Surg Case Rep 2023; 107:108307. [PMID: 37178658 DOI: 10.1016/j.ijscr.2023.108307] [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: 04/11/2023] [Revised: 05/06/2023] [Accepted: 05/06/2023] [Indexed: 05/15/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Breast sarcomas are scarce, histologically heterogeneous with nonepithelial malignancies that originate from the connective tissue within the parenchyma of breast. They can develop primarily, after radio-therapy (RT), or secondary due to chronic condition, including metastatic cancers. CASE PRESENTATION The present case report concerns 58-year-old women which was unbeknown to her malignancy in the early stages, until the mass became substantial in size. Chemotherapy and also radiotherapy were not effective, and the growth of tumor could not be prevented which the patient eventually died, due to respiratory complications. CLINICAL DISCUSSION Breast sarcomas are categorized in very rare malignancies, and the mortality of these types of cancers are significantly high as they often are not diagnosed in early stages. Based on the location and condition of the malignant tumor, therapeutic methods considered as chemotherapy, radiotherapy, and surgery. CONCLUSION In advance stages of breast sarcoma, chemotherapy, radiotherapy, and even surgery cannot be effectual. Therefore, periodical evaluation of breast wellness by diagnostic methods are recommended to all adult women.
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Affiliation(s)
- Babak Choobi Anzali
- Department of Emergency Medicine, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Rasoul Goli
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Navid Faraji
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Aysan Torabzadeh
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Zahra Najafzad
- Master of Science Medical and Surgical Nursing, Student Research Center of Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shayan Nikpey
- Department of Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, East Azerbaijan, Iran.
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27
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Miskovsky S, Khambete P, Faraji N, Harlow ER, Ina J, Mengers S, Voos J. Prevalence of Asymptomatic Talar Bone Marrow Edema in Professional Ballet Dancers: Preliminary Data From a 2-Year Prospective Study. Orthop J Sports Med 2023; 11:23259671231159910. [PMID: 37152549 PMCID: PMC10159254 DOI: 10.1177/23259671231159910] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 11/15/2022] [Indexed: 05/09/2023] Open
Abstract
Background Compared with symptomatic bone marrow edema (BME) associated with stress fractures, asymptomatic BME seen on magnetic resonance imaging (MRI) is a phenomenon that has been described in high-level athletes and is thought to be related to bone adaptation to biomechanical loading unique to each sport. However, the prevalence, natural history, and management of these lesions remain poorly understood, particularly in dance, which places tremendous stress on the feet and ankles. Purposes/Hypothesis The purposes of this study were to (1) determine the prevalence of asymptomatic BME in the talus before the start of the performance season, (2) identify contributing demographic and training factors, and (3) compare the radiological evidence of talar BME with validated functional foot and ankle scores. We hypothesized that talar BME would be highly prevalent among asymptomatic professional dancers. Study Design Case series; Level of evidence, 4. Methods A total of 14 professional ballet dancers (6 female and 8 male; mean age, 24 years) were included in this 2-year prospective study. For each participant, we recorded complete medical and surgical history along with scores on the Foot and Ankle Ability Measure (FAAM) and the Foot and Ankle Disability Index. Bilateral foot and ankle 3.0-T MRI scans without contrast were completed before the start of the performance season and were evaluated for BME of the talus using the Fredericson criteria. Results Evidence of talar BME was seen in 15 of the 28 (54%) ankles examined and in 9 of 14 (64%) dancers. We found that 6 dancers demonstrated bilateral talar BME, 3 dancers demonstrated unilateral BME, and 5 dancers demonstrated no evidence of BME. The most common location of BME was the posterior talus, seen in 8 of 15 (53%) ankles. No statistically significant differences were noted in dancers with versus those without talar BME with regard to functional scores, demographic characteristics, or weekly training hours. Conclusion Asymptomatic talar BME was highly prevalent (64%) in professional ballet dancers and tended to occur posteriorly. Long-term clinical and radiographic follow-up is necessary to determine the natural history of these lesions.
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Affiliation(s)
- Shana Miskovsky
- Department of Orthopaedic Surgery,
University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
- Sports Medicine Institute, University
Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
- Shana Miskovsky, MD,
Department of Orthopaedic Surgery, University Hospitals Cleveland Medical
Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA (
)
| | - Pranav Khambete
- Case Western Reserve University School
of Medicine, Cleveland, Ohio, USA
| | - Navid Faraji
- Musculoskeletal Imaging Division,
Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland,
Ohio, USA
| | - Ethan R. Harlow
- Department of Orthopaedic Surgery,
University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Jason Ina
- Department of Orthopaedic Surgery,
University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Sunita Mengers
- Department of Orthopaedic Surgery,
University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - James Voos
- Department of Orthopaedic Surgery,
University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
- Sports Medicine Institute, University
Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
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Babamiri B, Yavari S, Nikpey S, Faraji N, Goli R, Rahimi K. Undifferentiated soft-tissue sarcoma (STS) in a 34-year-old woman: A case report. Int J Surg Case Rep 2023; 105:108104. [PMID: 37018948 PMCID: PMC10112150 DOI: 10.1016/j.ijscr.2023.108104] [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] [Received: 12/16/2022] [Revised: 03/26/2023] [Accepted: 03/29/2023] [Indexed: 04/03/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE: soft tissue sarcoma (STS) is a type of cancer that can affect connective tissue. Diagnosis of this malignant tumor is difficult, and complications are related to the pressure it can exert on surrounding body organs. Up to 50 % of STS patients develop metastatic disease, which greatly affects the prognosis and is challenging for the treating physician. CASE PRESENTATION This case report is about a 34-year-old woman who was found to have significant growth of malignant tumor in her lower back due to misdiagnosis and negligence about her disease. After the cancer invaded the abdominal cavity, she died from related complications. CLINICAL DISCUSSION STS are among the rare malignant tumors, and the mortality rate of these cancers is very high because they are often not properly diagnosed. CONCLUSION Educating medical personnel, especially primary care physicians, about the symptoms and manifestations of STS can make a significant contribution to successful treatment. Due to the complexity of treatment, any soft-tissue swelling suspected of malignancy is best referred directly to a sarcoma center, where therapeutic management is carefully planned by an experienced multidisciplinary team.
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Affiliation(s)
- Behnam Babamiri
- Department of Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Saeed Yavari
- Department of Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Shayan Nikpey
- Department of Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, East Azerbaijan, Iran
| | - Navid Faraji
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Rasoul Goli
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Kamal Rahimi
- Department of Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran.
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Rahimi K, Hosseinpour L, Balaneji SM, Goli R, Faraji N, Babamiri B. Large wound surgery of diabetic foot ulcer with Split-thickness skin graft (STSG), and maggot debridement therapy (MDT): A case report. Int J Surg Case Rep 2023; 104:107947. [PMID: 36822027 PMCID: PMC9978508 DOI: 10.1016/j.ijscr.2023.107947] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 11/09/2022] [Revised: 01/14/2023] [Accepted: 01/30/2023] [Indexed: 02/22/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Diabetic foot ulcers (DFUs) as one of the complications of diabetes mellitus (DM) can lead to death. CASE PRESENTATION The present case reports a 56-year-old woman with an 11-year history of type 2 diabetes who has had left DFUs for two years. The patient had antibiotic-resistant DFUs her left foot, which were completely gangrenous and a superficial ulcer up and under her left foot. Despite the routine DFU care, the patient did not recover from DFU using standard methods. The patient was referred to our wound management team. DFU was treated and managed using split-thickness skin graft (STSG) and surgical debridement, maggot debridement therapy (MDT). After two months, the patient's DFUs healed, and he was discharged from our service in good condition. CLINICAL DISCUSSION DFU can lead to infection, amputation, and even patient death. Therefore, effective treatment methods are very important for managing DFUs. CONCLUSION This case report study was shown that the combined use of STSG, surgical debridement, and MDT is a safe and effective approach to improve the healing of DFUs and prevent foot amputation.
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Affiliation(s)
- Kamal Rahimi
- Department of Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Leila Hosseinpour
- Department of Midwifery, School of Nursing and Midwifery, Islamic Azad University of Tabriz, East Azerbaijan, Iran
| | - Sahar Majidi Balaneji
- Department of Midwifery, School of Nursing and Midwifery, Islamic Azad University of Urmia, West Azerbaijan, Iran
| | - Rasoul Goli
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Navid Faraji
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Behnam Babamiri
- Department of Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran.
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Parizad N, Hajimohammadi K, Goli R, Mohammadpour Y, Faraji N, Makhdomi K. Surgical debridement and maggot debridement therapy (MDT) bring the light of hope to patients with diabetic foot ulcers (DFUs): A case report. Int J Surg Case Rep 2022; 99:107723. [PMID: 36261953 PMCID: PMC9568830 DOI: 10.1016/j.ijscr.2022.107723] [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: 08/27/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 11/11/2022] Open
Abstract
Introduction and importance Management of diabetic foot ulcers (DFUs), one of the complications of diabetes mellitus, can lead to death and amputation, and it is one of the most critical challenges for the patients and their families. Case presentation The present case report concerns a 72-year-old man with a 5-year history of uncontrolled type 2 diabetes mellitus. The patient had antibiotic-resistant DFUs on two phalanges of his left foot, which were completely gangrenous, and a superficial ulcer of 1 × 1 cm under his left foot. Despite the routine DFU care, the phalanges of his DFU were amputated. The patient was moved to our wound management team. DFU was treated and managed using surgical debridement and maggot debridement therapy. Ten sessions of Maggot Debridement Therapy (MDT) were conducted (one therapy session every 48 h). After three months, the patient's DFUs healed, and he was discharged from our service in good condition. Clinical discussion DFU can lead to infection, amputation, and even patient death. Therefore, effective treatment methods are very important for managing DFUs. Conclusion Using surgical debridement and MDT is a safe and effective approach to facilitate the healing of DFUs. Management of diabetic foot ulcers (DFUs) is one of the most critical challenges for the patients. Diabetic foot ulcers do not respond to standard drug therapies. Surgical debridement and Maggot Debridement Therapy (MDT) can manage diabetic foot ulcers.
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Affiliation(s)
- Naser Parizad
- Patient Safety Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Kazem Hajimohammadi
- Imam Khomeini Teaching Hospital, Urmia University of Medical Sciences, Urmia, Iran
| | - Rasoul Goli
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran,Corresponding author at: Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran.
| | - Yousef Mohammadpour
- Department of Medical Education, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Navid Faraji
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Khadijeh Makhdomi
- Department of Nephrology, Faculty of Medicine, Urmia University of Medical Science, Urmia, IR, Iran
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Heo JU, Zhou F, Jones R, Zheng J, Song X, Qian P, Baydoun A, Traughber MS, Kuo JW, Helo RA, Thompson C, Avril N, DeVincent D, Hunt H, Gupta A, Faraji N, Kharouta MZ, Kardan A, Bitonte D, Langmack CB, Nelson A, Kruzer A, Yao M, Dorth J, Nakayama J, Waggoner SE, Biswas T, Harris E, Sandstrom S, Traughber BJ, Muzic RF. Abdominopelvic MR to CT registration using a synthetic CT intermediate. J Appl Clin Med Phys 2022; 23:e13731. [PMID: 35920116 PMCID: PMC9512351 DOI: 10.1002/acm2.13731] [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: 10/21/2020] [Revised: 04/25/2022] [Accepted: 06/27/2022] [Indexed: 11/21/2022] Open
Abstract
Accurate coregistration of computed tomography (CT) and magnetic resonance (MR) imaging can provide clinically relevant and complementary information and can serve to facilitate multiple clinical tasks including surgical and radiation treatment planning, and generating a virtual Positron Emission Tomography (PET)/MR for the sites that do not have a PET/MR system available. Despite the long‐standing interest in multimodality co‐registration, a robust, routine clinical solution remains an unmet need. Part of the challenge may be the use of mutual information (MI) maximization and local phase difference (LPD) as similarity metrics, which have limited robustness, efficiency, and are difficult to optimize. Accordingly, we propose registering MR to CT by mapping the MR to a synthetic CT intermediate (sCT) and further using it in a sCT‐CT deformable image registration (DIR) that minimizes the sum of squared differences. The resultant deformation field of a sCT‐CT DIR is applied to the MRI to register it with the CT. Twenty‐five sets of abdominopelvic imaging data are used for evaluation. The proposed method is compared to standard MI‐ and LPD‐based methods, and the multimodality DIR provided by a state of the art, commercially available FDA‐cleared clinical software package. The results are compared using global similarity metrics, Modified Hausdorff Distance, and Dice Similarity Index on six structures. Further, four physicians visually assessed and scored registered images for their registration accuracy. As evident from both quantitative and qualitative evaluation, the proposed method achieved registration accuracy superior to LPD‐ and MI‐based methods and can refine the results of the commercial package DIR when using its results as a starting point. Supported by these, this manuscript concludes the proposed registration method is more robust, accurate, and efficient than the MI‐ and LPD‐based methods.
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Affiliation(s)
- Jin Uk Heo
- Department of Radiology, Case Western Reserve University, Cleveland, Ohio, USA.,Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA
| | - Feifei Zhou
- Department of Radiology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Robert Jones
- Department of Radiology, Case Western Reserve University, Cleveland, Ohio, USA.,Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Jiamin Zheng
- School of Artificial Intelligence and Computer Science, Jiangnan University, Wuxi, Jiangsu, China
| | - Xin Song
- School of Artificial Intelligence and Computer Science, Jiangnan University, Wuxi, Jiangsu, China
| | - Pengjiang Qian
- School of Artificial Intelligence and Computer Science, Jiangnan University, Wuxi, Jiangsu, China
| | - Atallah Baydoun
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA.,Department of Internal Medicine, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio, USA
| | - Melanie S Traughber
- Department of Radiation Oncology, Penn State University, Hershey, Pennsylvania, USA
| | - Jung-Wen Kuo
- Department of Radiology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Rose Al Helo
- Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Cheryl Thompson
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Norbert Avril
- Department of Radiology, Case Western Reserve University, Cleveland, Ohio, USA.,Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Daniel DeVincent
- Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Harold Hunt
- Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Amit Gupta
- Department of Radiology, Case Western Reserve University, Cleveland, Ohio, USA.,Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Navid Faraji
- Department of Radiology, Case Western Reserve University, Cleveland, Ohio, USA.,Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Michael Z Kharouta
- Department of Radiation Oncology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Arash Kardan
- Department of Radiology, Case Western Reserve University, Cleveland, Ohio, USA.,Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - David Bitonte
- Department of Radiology, Case Western Reserve University, Cleveland, Ohio, USA.,Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Christian B Langmack
- Department of Radiation Oncology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | | | | | - Min Yao
- Department of Radiation Oncology, Penn State University, Hershey, Pennsylvania, USA
| | - Jennifer Dorth
- Department of Radiation Oncology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA.,Department of Radiation Oncology, Case Western Reserve University, Cleveland, Ohio, USA
| | - John Nakayama
- Department of Obstetrics and Gynecology, Allegheny Health Network, Pittsburgh, Pennsylvania, USA
| | - Steven E Waggoner
- Department of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Tithi Biswas
- Department of Radiation Oncology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA.,Department of Radiation Oncology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Eleanor Harris
- Department of Radiation Oncology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA.,Department of Radiation Oncology, Case Western Reserve University, Cleveland, Ohio, USA
| | - Susan Sandstrom
- Department of Radiation Oncology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Bryan J Traughber
- Department of Radiation Oncology, Penn State University, Hershey, Pennsylvania, USA
| | - Raymond F Muzic
- Department of Radiology, Case Western Reserve University, Cleveland, Ohio, USA.,Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA.,Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
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Murugesan A, Patel S, Viswanathan VS, Bhargava P, Faraji N. Dear Medical Students - Artificial Intelligence is NOT taking away a Radiologist's Job. Curr Probl Diagn Radiol 2022; 52:1-5. [DOI: 10.1067/j.cpradiol.2022.08.001] [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] [Received: 08/15/2022] [Accepted: 08/22/2022] [Indexed: 11/22/2022]
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Aghakhani N, Faraji N, Parizad N, Goli R, Alinejad V, Kazemzadeh J. Guided Imagery: An Effective and Practical Complementary Medicine Method to Alleviate Pain Severity and Pain-Related Anxiety During Dressing Change in Burn Victims. J Burn Care Res 2022; 43:756. [PMID: 35213722 DOI: 10.1093/jbcr/irac024] [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: 11/13/2022]
Affiliation(s)
- Nader Aghakhani
- Patient Safety Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran
| | - Navid Faraji
- Department of Medical Surgical Nursing, Nursing and Midwifery Faculty, Urmia University of Medical Sciences, Urmia, Iran
| | - Naser Parizad
- Patient Safety Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran
| | - Rasoul Goli
- Department of Medical Surgical Nursing, Nursing and Midwifery Faculty, Urmia University of Medical Sciences, Urmia, Iran
| | - Vahid Alinejad
- Department of Biostatistics, Medicine Faculty, Urmia University of Medical Sciences, Urmia, Iran
| | - Jafar Kazemzadeh
- Reconstructive and Burn Surgery Department, Medicine Faculty, Urmia University of Medical Sciences, Urmia, Iran
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Parizad N, Faraji N, Goli R, Salmanzadeh H, Mostafaei B, Bisafar MH. Extensive excisional surgery; the last hope for a patient with human papillomavirus-associated severe head and neck squamous cell carcinoma: A case report. Int J Surg Case Rep 2022; 94:107049. [PMID: 35413673 PMCID: PMC9010730 DOI: 10.1016/j.ijscr.2022.107049] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 04/03/2022] [Accepted: 04/05/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction and importance Cutaneous squamous cell carcinoma (CSCC) is one of the most common malignant tumors of skin cancer. Most of these cancers occur on the head and neck. CSCC makes up the seventh most common type of cancer worldwide. The incidence of human papillomavirus (HPV)-associated head and neck squamous cell carcinoma became more prevalent, and HPV infection is mainly linked to head and neck squamous cell carcinoma (HNSCC). Case presentation A 57-year-old non-smoking man was admitted to Omid Hospital in Urmia, West Azerbaijan, Iran; there were extensive bleeding masses on his head and neck due to squamous cell carcinoma (SCC), and he has been diagnosed with HPV infection so accidentally. The operation room had prepared for excisional treatment and the masses had been removed as much as possible. Patient was referred to the wound care team to receive advanced treatment interventions. Clinical discussion Incidence of HPV-associated HNSCC has been more noticeable recently, and HPV infection alone can be a distinct risk factor for metastatic HNSCC. Most patients with HPV positive have peripheral lymph node involvement. Radiation therapy and surgery can offer equally good long-term results in small initial head and neck tumors. Traditionally, advanced head and neck tumors managed surgically more advantageous. Conclusion This case illustrates that history of HPV positive can be associated with a more severe and resistant type of HNSCC with poor treatment outcomes. Patients with HPV should be monitored regularly for HNSCC, and treatment should be started as soon as possible for a better result. Cutaneous squamous cell carcinoma (CSCC) is one of the most common malignant tumors of skin cancer. Approximately 80% of cutaneous squamous cell carcinoma (CSCC) occur on the head and neck. The human papillomavirus (HPV) is a third risk factor for head and neck carcinogenesis. Advanced head and neck tumors are managed surgically is more advantageous.
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Raji Y, LaTulip SM, Faraji N, DeLozier SJ, Vallier HA, Ochenjele G. Radiographic Templating for Calcaneus Operative Fixation: How Similar Is Side-to-Side Comparison? J Orthop Trauma 2022; 36:201-207. [PMID: 34483326 DOI: 10.1097/bot.0000000000002263] [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] [Accepted: 08/26/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Calcaneal fractures often require contralateral, uninjured calcaneus radiographs as a template. The purpose of this study was to establish mean values for calcaneal radiographic parameters in an uninjured urban American population and perform side-by-side comparison with respect to age, sex, laterality, and radiograph obliquity (XRO). DESIGN Retrospective analysis of consecutive patients. SETTING Fourteen hospitals including Level 1 trauma center. PATIENTS/PARTICIPANTS Retrospective review of >800 uninjured patients with bilateral foot and calcaneus radiographs obtained between June and December 2019 was performed. Inclusion criteria were the following: age 18-89 years without fracture; previous foot surgical procedures; radiographic evidence of arthrosis in ankle, hindfoot, or midfoot; osteomyelitis; tumor; or foot deformities. INTERVENTION The lateral radiographs were independently reviewed by 3 observers, measuring Böhler angle (BA), crucial angle of Gissane (CAG), calcaneal length (CL), calcaneal height (CH), calcaneotalar ratio (CTR), and XRO. MAIN OUTCOME MEASUREMENTS The mean values of BA, CAG, CL, CH, and CTR were established. Side-by-side comparisons were completed with respect to age, sex, laterality, and XRO. RESULTS There were no statistically significant differences in side-by-side measurements of the BA, CAG, CL, or CH. XRO had significant effects on the measurements of BA, CAG, CH, and CTR. Side-by-side comparisons showed greater intersubject variability than within-subject differences. CONCLUSIONS We did not observe any differences in commonly measured calcaneal radiographic parameters. CAG is not a reliable parameter for diagnostic and operative planning purposes. We conclude that the use of contralateral calcaneus radiographs as templates for calcaneus fractures is a valid technique.
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Affiliation(s)
- Yazdan Raji
- Department of Orthopaedic Surgery, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, OH
| | - Scott M LaTulip
- Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, OH
| | - Navid Faraji
- Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, OH
| | - Sarah J DeLozier
- Clinical Research Center, University Hospitals of Cleveland, Cleveland, OH; and
| | - Heather A Vallier
- Department of Orthopaedic Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH
| | - George Ochenjele
- Department of Orthopaedic Surgery, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, OH
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Parizad N, Faraji N, Hassanpour A, Goli R, Rostami S, Amanollahzadeh A. Cyclopia, a newborn with a single eye, a rare but lethal congenital anomaly: A case report. Int J Surg Case Rep 2021; 88:106548. [PMID: 34741865 PMCID: PMC8581486 DOI: 10.1016/j.ijscr.2021.106548] [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: 10/01/2021] [Revised: 10/19/2021] [Accepted: 10/27/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction and importance Cyclopia is a rare congenital disorder characterized by facial abnormalities. In this condition, the orbits of the eye are not properly divided into two cavities so that they can be seen either as a single eye field or two bilateral fields that are very close to each other. This syndrome affects the embryos that are either aborted or stillborn upon delivery or, at best, die shortly after birth. Case presentation This case report is of a 37-week- and 5-day-old female fetus with a birth weight of 2300 g, a height of 43 cm, and a head circumference of 31 cm. She was born to a 44-year-old mother through normal vaginal delivery at Mahzad Hospital, Urmia, Iran. In the physical examination, an eye and a 4-cm proboscis were seen in the middle of the forehead. The newborn also had no nose, and his outer ears were normal. No cleft lip or cleft palate was observed. Unfortunately, the newborn expired 13 h after birth. Clinical discussion Cyclopia leads to a stillbirth since the brain and other parts of the body do not grow normally in fetuses with this disorder. Moreover, it can be diagnosed using ultrasonography while the fetus is growing inside the uterus. Conclusion Early diagnosis during pregnancy using diagnostic methods and proper management of this abnormality should be emphasized to prevent further harm to the newborn and the mother with this syndrome. Moreover, many of these newborns should be offered early neonatal palliative care. Cyclopia is a rare congenital disorder with life-threatening complications. Cyclopia mostly affects the embryos that are either aborted or stillborn. Early diagnosis during pregnancy should be emphasized to prevent its complications. Prenatal palliative care emphasizes the importance of planning for the experience of losing an infant. Parental involvement in end-of-life care for their infant is an important aspect of neonatal palliative care.
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Affiliation(s)
- Naser Parizad
- Patient Safety Research Center, Clinical Research Institute, Nursing & Midwifery School, Urmia University of Medical Sciences, Urmia, Iran
| | - Navid Faraji
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Amireh Hassanpour
- Department of Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Rasoul Goli
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran.
| | - Sajjad Rostami
- Department of Nursing, School of Nursing and Midwifery, Islamic Azad university of Zanjan, Zanjan, Iran
| | - Akram Amanollahzadeh
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
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Faraji N, Goli R, Choobianzali B, Bahrami S, Sadeghian A, Sepehrnia N, Ghalandari M. Ozone therapy as an alternative method for the treatment of diabetic foot ulcer: a case report. J Med Case Rep 2021; 15:234. [PMID: 33980300 PMCID: PMC8117654 DOI: 10.1186/s13256-021-02829-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 01/02/2021] [Accepted: 03/26/2021] [Indexed: 01/17/2023] Open
Abstract
Background Diabetic foot ulcer (DFU) is one of the most important complications of diabetes that can lead to amputation. Treatment of DFUs is a major challenge and places a heavy economic and social burden on patients and their families. Case presentation The present case report is of a 52-year-old kurdish male patient with a 7-year history of type 2 diabetes. While on a bike ride, he sustained a traumatic injury to his right leg, which caused a deep gash measuring 14 × 5 cm on the tibia. During the hospital stay, no improvement was observed after routine wound care including suturing, antibiotic therapy, and dressing change. The patient was referred to our wound-care team. In the first step, the necrotic tissues of his foot ulcer were irrigated and then debrided using mechanical debridement and saline. Next, the patient underwent a 70 μg/dL dose of ozone therapy over a 30-day period in 10 sessions (one 20-minute session every 3 days). Between each session, the patient's wound was wrapped in silver-containing gauze bandages. After 1 month of wound-care using ozone therapy, the patient's foot ulcer had healed and he was discharged from our wound-care service with a stable and good general condition. Conclusion Considering the effectiveness of ozone therapy along with silver-containing dressing in the treatment of DFUs, wound-care teams can utilize it as an adjunct to the standard methods of DFU treatment.
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Affiliation(s)
- Navid Faraji
- Department of Medical-Surgical Nursing, Nursing and Midwifery Faculty, School of Nursing and Midwifery, Urmia University of Medical Sciences, Campus Nazlu, 11 KM Road Seru, 575611-5111, Urmia, West Azerbaijan, Iran
| | - Rasoul Goli
- Department of Medical-Surgical Nursing, Nursing and Midwifery Faculty, School of Nursing and Midwifery, Urmia University of Medical Sciences, Campus Nazlu, 11 KM Road Seru, 575611-5111, Urmia, West Azerbaijan, Iran.
| | - Babak Choobianzali
- Department of Emergency Medicine, Medicine Faculty, Urmia University of Medical Sciences, Campus Nazlu, 11 KM Road Seru, 575611-5111, Urmia, West Azerbaijan, Iran
| | - Soheyla Bahrami
- Department of Medical-Surgical Nursing, Nursing and Midwifery Faculty, School of Nursing and Midwifery, Islamic Azad University of BonaB Branch, Velayat Highway, 555178-5176, Bonab, East Azerbaijan, Iran
| | - Ali Sadeghian
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Dr.Sobouti Blvd., 451395-6111, Zanjan, Iran
| | - Nazila Sepehrnia
- Department of Psychiatric Nursing, Nursing and Midwifery Faculty, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Shahnaz Street, 575611-5111, Tabriz, East Azerbaijan, Iran
| | - Mahmoodreza Ghalandari
- Department of Medical-Surgical Nursing, Nursing and Midwifery Faculty, School of Nursing and Midwifery, Urmia University of Medical Sciences, Campus Nazlu, 11 KM Road Seru, 575611-5111, Urmia, West Azerbaijan, Iran
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Faraji N, Goli R. Reduction of urinary tract infection by modification of Foley catheter: A letter to the Editor. Int J Surg Case Rep 2021; 82:105895. [PMID: 33892447 PMCID: PMC8085694 DOI: 10.1016/j.ijscr.2021.105895] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 04/09/2021] [Accepted: 04/12/2021] [Indexed: 11/18/2022] Open
Affiliation(s)
- Navid Faraji
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran.
| | - Rasoul Goli
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran.
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DeVita R, Faraji N, Nakfoor R, Elliott R, Kosmas C. Hyaline fibromatosis syndrome: A rare case of multifocal intra-articular involvement. Clin Imaging 2021; 70:51-55. [PMID: 33120290 DOI: 10.1016/j.clinimag.2020.10.015] [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] [Received: 07/14/2020] [Revised: 09/17/2020] [Accepted: 10/07/2020] [Indexed: 10/23/2022]
Abstract
Hyaline fibromatosis syndrome (HFS) is a rare, progressive, autosomal recessive disorder that presents with connective tissue deposition of amorphous hyaline material within the musculocutaneous tissue and/or visceral organs. HFS presents clinically in infancy or early childhood and can result in severe disability and life threatening complications. Given the rarity of the disorder, the imaging characteristics of HFS are seldom described in the literature. We describe a case of a 25-year-old patient presenting with bilateral knee pain, limited range of motion in her extremities, and lower extremity weakness with detailed MR imaging demonstrating the first case of multifocal intra-articular deposition of hyaline material within several joints.
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Affiliation(s)
- Robert DeVita
- Department of Radiology, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, United States of America.
| | - Navid Faraji
- Department of Radiology, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, United States of America.
| | - Rachael Nakfoor
- Department of Pathology, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, United States of America.
| | - Robin Elliott
- Department of Pathology, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, United States of America.
| | - Christos Kosmas
- Department of Radiology, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, United States of America.
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Abboud S, Kosaraju V, Bhatt A, Egler R, Elliott R, Faraji N, Mangla A, Mansur D, Rothermel L, Saab S, Young P, Getty P, Kosmas C. Multidisciplinary approach for repeat musculoskeletal lesion biopsy after nondiagnostic initial sampling: A 10-year single-center experience. J Surg Oncol 2020; 123:342-351. [PMID: 33051865 DOI: 10.1002/jso.26255] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 09/27/2020] [Accepted: 10/03/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND AND OBJECTIVES Success rates for initial image-guided biopsy of musculoskeletal (MSK) lesions have been well documented; evidence regarding success rates for repeat biopsy following initially nondiagnostic (ND) image-guided biopsy of MSK lesions is more limited. This study evaluates the outcomes of repeat computerized tomography-guided MSK biopsies following ND biopsies using a multidisciplinary approach. MATERIALS AND METHODS Electronic medical record search covering a 10-year period identified patients that received two or more biopsies for an MSK tumor or tumor-like process. The decision for initial and repeat image-guided biopsy of each lesion was made following multidisciplinary MSK tumor board review. Lesion location, histopathology results, size of biopsy needle when available, and change in technique between biopsy attempts was documented. RESULTS Repeat biopsy rate was 1.6%. 23 patients with repeat MSK biopsy were identified. A total of 17 of 23 (74%) repeat biopsy attempts were diagnostic. A total of 22 of 23 (96%) repeat biopsy attempts were clinically useful. Diagnostic repeat biopsies were described as employing one or more of five technical differences compared to the first biopsy attempt, the most common being improved targeting of the lesion itself. CONCLUSIONS A multidisciplinary approach may yield improved repeat-biopsy rates and clinical utility of repeat MSK biopsies compared to prior reports.
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Affiliation(s)
- Salim Abboud
- Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Vijaya Kosaraju
- Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Aashish Bhatt
- Department of Radiation Oncology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Rachel Egler
- Division of Pediatric Hematology and Oncology, University Hospitals Rainbow Babies and Children's, Cleveland, Ohio, USA
| | - Robin Elliott
- Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Navid Faraji
- Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Ankit Mangla
- Department of Medical Oncology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - David Mansur
- Department of Radiation Oncology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Luke Rothermel
- Department of Surgical Oncology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Shahrazad Saab
- Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Peter Young
- Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Patrick Getty
- Department of Orthopedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Christos Kosmas
- Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
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Faraji N, Smith DA, Laukamp K, Parikh K, Kosmas C, Ramaiya NH. Appendicular skeleton MRI in multiple myeloma: Utility and clinical implications. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e19527] [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: 11/20/2022] Open
Abstract
e19527 Background: Skeletal MRI plays an integral role in diagnosing Multiple Myeloma and, in many cases, dictates need for treatment. While axial skeleton MRI is performed with established clinical utility, appendicular MRI is performed sparingly with utility not fully ascertained. We aim to assess the utility of appendicular MRI while establishing clinical factors which may predict outcomes. Methods: 107 appendicular skeleton MRIs were included for retrospective analysis over 15 years. No statistically significant age or gender related variability was noted. Variables including patient age, diagnosis, disease stage/activity, indication, transplant status, MRI result, treatment course, and survival were analyzed via Likelihood Ratio Chi-Square test or logistic regression. Results: Patient age, disease stage, presence of active marrow disease, history of relapse, and presence of axial or appendicular osseous disease were found to have a statistically significant correlation with MRI result. Disease stage and presence of active hematologic disease correlated with post MRI management alterations. Additionally, presence of active hematologic disease at time of MRI demonstrated a correlation with post MRI management strategy. Furthermore, MRI result was a predictor of downstream development of additional skeletal lesions. Interestingly, MRI result was not a predictor of survival. Conclusions: Several parameters may be used to determine a clinical pre-test probability of appendicular disease at the time of MRI. In addition, these clinical parameters and MRI results correlate with trends in subsequent patient treatment strategies. [Table: see text]
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Affiliation(s)
- Navid Faraji
- University Hospitals Cleveland Medical Center, Cleveland, OH
| | - Daniel Arnold Smith
- University Hospitals Cleveland Medical Center/Case Western Reserve University, Cleveland, OH
| | - Kai Laukamp
- University Hospitals Cleveland Medical Center/Case Western Reserve University, Cleveland, OH
| | - Keval Parikh
- University Hospitals Cleveland Medical Center, Cleveland, OH
| | - Christos Kosmas
- University Hospitals Cleveland Medical Center, Cleveland, OH
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Lang M, Faraji N, Coffey M, Badve C. MRI of acquired Brown syndrome: a report of two cases. Radiol Case Rep 2018; 13:92-95. [PMID: 29487642 PMCID: PMC5826689 DOI: 10.1016/j.radcr.2017.09.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 07/24/2017] [Revised: 09/19/2017] [Accepted: 09/25/2017] [Indexed: 11/30/2022] Open
Abstract
Brown syndrome is characterized by upward gaze impairment while the eye is in adduction. It is caused by abnormalities involving the superior oblique tendon-trochlea complex. Imaging can help confirm the diagnosis, shed light on its etiology, and determine the best course of treatment. However, reports of magnetic resonance imaging findings of acquired Brown syndrome are scarce in the literature. Here, we describe magnetic resonance imaging features of 2 cases of acquired Brown syndrome.
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Affiliation(s)
- Min Lang
- School of Medicine, Case Western Reserve University, Cleveland, OH
| | - Navid Faraji
- Department of Radiology, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue Cleveland, OH 44106 USA
| | - Michael Coffey
- Department of Radiology, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue Cleveland, OH 44106 USA
| | - Chaitra Badve
- Department of Radiology, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue Cleveland, OH 44106 USA
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Faraji N, Adelung R, Mishra YK, Seidel J. Nanoscale electromechanical and electronic properties of free-standing ZnO nano- and microstructured platelets. Nanotechnology 2017; 28:405701. [PMID: 28832338 DOI: 10.1088/1361-6528/aa87f8] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The piezoelectric response, conductivity and surface potential of individual grains and grain boundaries in free-standing polycrystalline ZnO nano- and microstructured platelets is studied using scanning probe based techniques on the nanoscale. We find that applied dc electric fields can alter the piezoresponse in individual grains, as well as the local nanoscale conductivity, and invert the relative surface potential at grain boundaries. This can be attributed to defect accumulation at the grain surfaces and at grain boundaries and the associated density of carriers. Together with recently observed below-bandgap photoconductivity at grain boundaries, the presented observation opens new venues for potential nanoelectronic applications that rely on grain and grain boundary engineering and functionality in a wide-bandgap transparent material.
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Affiliation(s)
- N Faraji
- School of Materials Science and Engineering, UNSW Sydney, Sydney, NSW 2052, Australia
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