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Hosseinpour S, Razmara E, Heidari M, Rezaei Z, Ashrafi MR, Dehnavi AZ, Kameli R, Bereshneh AH, Vahidnezhad H, Azizimalamiri R, Zamani Z, Pak N, Rasulinezhad M, Mohammadi B, Ghabeli H, Ghafouri M, Mohammadi M, Zamani GR, Badv RS, Saket S, Rabbani B, Mahdieh N, Ahani A, Garshasbi M, Tavasoli AR. A comprehensive study of mutation and phenotypic heterogeneity of childhood mitochondrial leukodystrophies. Brain Dev 2024; 46:167-179. [PMID: 38129218 DOI: 10.1016/j.braindev.2023.12.003] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 12/10/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE Mitochondrial leukodystrophies (MLs) are mainly caused by impairments of the mitochondrial respiratory chains. This study reports the mutation and phenotypic spectrum of a cohort of 41 pediatric patients from 39 distinct families with MLs among 320 patients with a molecular diagnosis of leukodystrophies. METHODS This study summarizes the clinical, imaging, and molecular data of these patients for five years. RESULTS The three most common symptoms were neurologic regression (58.5%), pyramidal signs (58.5%), and extrapyramidal signs (43.9%). Because nuclear DNA mutations are responsible for a high percentage of pediatric MLs, whole exome sequencing was performed on all patients. In total, 39 homozygous variants were detected. Additionally, two previously reported mtDNA variants were identified with different levels of heteroplasmy in two patients. Among 41 mutant alleles, 33 (80.4%) were missense, 4 (9.8%) were frameshift (including 3 deletions and one duplication), and 4 (9.8%) were splicing mutations. Oxidative phosphorylation in 27 cases (65.8%) and mtDNA maintenance pathways in 8 patients (19.5%) were the most commonly affected mitochondrial pathways. In total, 5 novel variants in PDSS1, NDUFB9, FXBL4, SURF1, and NDUSF1 were also detected. In silico analyses showed how each novel variant may contribute to ML pathogenesis. CONCLUSIONS The findings of this study suggest whole-exome sequencing as a strong diagnostic genetic tool to identify the causative variants in pediatric MLs. In comparison between oxidative phosphorylation (OXPHOS) and mtDNA maintenance groups, brain stem and periaqueductal gray matter (PAGM) involvement were more commonly seen in OXPHOS group (P value of 0.002 and 0.009, respectively), and thinning of corpus callosum was observed more frequently in mtDNA maintenance group (P value of 0.042).
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Affiliation(s)
- Sareh Hosseinpour
- Department of Pediatric Neurology, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ehsan Razmara
- Australian Regenerative Medicine Institute, Monash University, Clayton, VIC, 3800, Australia
| | - Morteza Heidari
- Myelin Disorders Clinic, Division of Pediatric Neurology, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Rezaei
- Myelin Disorders Clinic, Division of Pediatric Neurology, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmoud Reza Ashrafi
- Myelin Disorders Clinic, Division of Pediatric Neurology, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Zare Dehnavi
- Myelin Disorders Clinic, Division of Pediatric Neurology, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine and Science, Rochester, MN 55905, USA
| | - Reyhaneh Kameli
- Department of Cell and Molecular Biology & Microbiology, Faculty of Biological Science and Technology, University of Isfahan, Isfahan, Iran
| | - Ali Hosseini Bereshneh
- Prenatal Diagnosis and Genetic Research Center, Dastgheib Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hassan Vahidnezhad
- Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, USA; Department of Pediatrics, The University of Pennsylvania School of Medicine, Philadelphia, USA
| | - Reza Azizimalamiri
- Department of Pediatric Neurology, Golestan Medical, Educational, and Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Zahra Zamani
- MD, MPH, Community Medicine Specialist, Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Pak
- Department of Radiology, Children's Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Rasulinezhad
- Myelin Disorders Clinic, Division of Pediatric Neurology, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahram Mohammadi
- Myelin Disorders Clinic, Division of Pediatric Neurology, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Homa Ghabeli
- Myelin Disorders Clinic, Division of Pediatric Neurology, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ghafouri
- Myelin Disorders Clinic, Division of Pediatric Neurology, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmoud Mohammadi
- Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholam Reza Zamani
- Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Shervin Badv
- Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Sasan Saket
- Iranian Child Neurology Center of Excellence, Pediatric Neurology Research Center, Research Institute for Children Health, Mofid Children's and Shohada-e Tajrish Hospitals, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahareh Rabbani
- Growth and Development Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Nejat Mahdieh
- Growth and Development Research Center, Tehran University of Medical Sciences, Tehran, Iran; Cardiogenetic Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Ahani
- Mendel Medical Genetics Laboratory, Iran University of Medical Sciences, Tehran, Iran
| | - Masoud Garshasbi
- Department of Medical Genetics, Faculty of Medical Sciences, Jalal-Al Ahmad Hwy, Tarbiat Modares University, Tehran, Iran.
| | - Ali Reza Tavasoli
- Myelin Disorders Clinic, Division of Pediatric Neurology, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran; Neurology Division, Barrow Neurological Institute, Phoenix Children's Hospital, Phoenix, AZ, USA.
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Khodaeian M, Bitarafan F, Garrousi F, Sardehie EA, Pak N, Hosseinpour S, Shakiba M, Falah M, Garshasbi M, Tavasoli AR. Expanding phenotype heterogeneity of NARS2 by presenting subdural hematoma and parenchymal hemorrhage. J Clin Lab Anal 2023; 37:e24983. [PMID: 37950505 PMCID: PMC10749492 DOI: 10.1002/jcla.24983] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 10/12/2023] [Accepted: 10/22/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND NARS2 encodes mitochondrial Asparaginyl-tRNA Synthetase 2, which catalyzes the aminoacylation of tRNA-Asn in the mitochondria. To date, 24 variants have been reported in NARS2 gene in 35 patients. The phenotypic variability of NARS2-associated disorder is broad, ranging from neurodevelopmental disorders to hearing loss. In this study, we report some novel imaging findings in an Iranian patient suffering from epileptic encephalopathy, caused by a previously reported variant, c.500A > G; p.(His167Arg), in NARS2. METHODS The spectrum of clinical manifestations of two Iranian patients was investigated and genetic analysis was performed by Whole-exome sequencing (WES). Additionally, we also reviewed the literature and summarized the phenotypes of previously reported patients with variants in the NARS2 gene. RESULTS Here, we present the phenotypic and genetic features of 2 unrelated Iranian infants presented with neurodevelopmental delay, seizures, hearing impairment, feeding problems, elevated serum lactate levels in addition to subdural hematoma and cerebral parenchymal hemorrhage in the brain magnetic resonance imaging (MRI) of one of the patients. Genetic analysis revealed a biallelic missense variant in NARS2: c.500A > G; p.(His167Arg). We described the subdural hematoma and cerebral parenchymal hemorrhage of the brain for the first time. CONCLUSIONS Our study provides new clinical findings, subdural hematoma, and parenchymal hemorrhage, in NARS2-related disorders. Our findings along with previous studies provide more evidence of the clinical presentation of the disease caused by pathogenic variants in NARS2. Expanding the clinical spectrum increases the diagnostic rate of molecular testing and improves the quality of counseling for at-risk couples.
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Affiliation(s)
| | - Fatemeh Bitarafan
- Department of Medical GeneticsOslo University Hospital and University of Oslo0450OsloNorway
| | | | | | - Neda Pak
- Pediatric Radiology Division, Children's Medical Center, Pediatrics Center of ExcellenceTehran University of Medical SciencesTehranIran
| | - Sareh Hosseinpour
- Myelin Disorders Clinic, Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of ExcellenceTehran University of Medical SciencesTehranIran
| | - Marjan Shakiba
- Department of Pediatric Endocrinology and Metabolism, Mofid Children's HospitalShahid Beheshti University of Medical SciencesTehranIran
| | - Masoumeh Falah
- ENT and Head and Neck Research Center and Department, The Five Senses Health Institute, School of Medicine, Hazrat Rasoul Akram HospitalIran University of Medical SciencesTehranIran
| | - Masoud Garshasbi
- Department of Medical Genetics, Faculty of Medical SciencesTarbiat Modares UniversityTeheranIran
| | - Ali Reza Tavasoli
- Myelin Disorders Clinic, Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of ExcellenceTehran University of Medical SciencesTehranIran
- Department of Neurology, Barrow Neurological InstitutePhoenix Children's HospitalPhoenixArizonaUSA
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Saghebdoust S, Khadivar F, Ekrami M, Mehrizi MAA, Lajimi AV, Zahmatkesh MRR, Pak N, Jouibari MF, Mirsaeed SSG, Boustani MR. Transforaminal Endoscopic Lumbar Diskectomy versus Open Microdiskectomy for Symptomatic Lumbar Disk Herniation: A Comparative Cohort Study on Costs and Long-Term Outcomes. J Neurol Surg A Cent Eur Neurosurg 2023. [PMID: 37879346 DOI: 10.1055/s-0043-1775760] [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: 10/27/2023]
Abstract
BACKGROUND Transforaminal endoscopic lumbar diskectomy (TELD) is considered an effective treatment for lumbar disk herniation (LDH). There is a paucity of studies comparing in detail the costs and long-term clinical outcomes of TELD and open microdiskectomy (MD), especially in developing countries. Thus, we sought to provide a multidimensional insight into this matter by comparing the direct costs and long-term outcomes of TELD with those of MD. METHODS The electronic health records of 434 patients with LDH who underwent either TELD or MD were collected from February 2011 to October 2014. Within a 7-year follow-up period, 412 patients, comprising 203 patients treated with TELD and 209 patients treated with MD, were fully evaluated. Patient characteristics, operative time, intraoperative blood loss (IBL), postoperative hospital stay, time to return to work (RTW), perioperative complications, and direct costs were collected. Clinical outcomes were assessed using the Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and modified MacNab criteria. RESULTS The postoperative ODI and VAS scores improved significantly in both groups (p < 0.001). In accordance with the modified MacNab criteria, the rate of excellent and good outcomes was 88.67 and 88.03% in the TELD and MD groups, respectively. There were no significant differences between the groups in the clinical outcomes and perioperative complications. However, IBL, hospital stay, and RTW were significantly reduced in the TELD group (p < 0.05). Twenty-one cases in the TELD group and nine in the MD group underwent reoperation due to recurrence (p < 0.05). Total inpatient cost per patient was $1,596 in the TELD group and $1,990 in the MD group (p < 0.05). CONCLUSION TELD for the treatment of symptomatic LDH could be an affordable strategy, providing certain advantages of minimally invasive procedures such as shorter hospital stay and earlier recovery along with comparable clinical outcomes to the conventional surgical method.
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Affiliation(s)
- Sajjad Saghebdoust
- Department of Neurosurgery, Razavi Hospital, Mashhad, Iran
- Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Department of Neurosurgery, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farshid Khadivar
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Mehran Ekrami
- Department of Neurosurgery, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Amir Valinezhad Lajimi
- Department of Neurosurgery, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Reza Rouhbakhsh Zahmatkesh
- Department of Neurosurgery, Razavi Hospital, Mashhad, Iran
- Department of Neurosurgery, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Neda Pak
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Morteza Faghih Jouibari
- Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mohammad Reza Boustani
- Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Department of Neurosurgery, Golestan Hospital, Tehran, Iran
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4
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Ashrafi M, Kameli R, Hosseinpour S, Razmara E, Zamani Z, Rezaei Z, Mashayekhi R, Pak N, Barzegar M, Azizimalamiri R, Kashani MR, Khosroshahi N, Rasulinezhad M, Heidari M, Amanat M, Abdi A, Mohammadi B, Mohammadi M, Zamani GR, Badv RS, Omrani A, Nikbakht S, Bereshneh AH, Movahedinia M, Moghaddam HF, Ardakani HS, Akbari MG, Tousi MB, Shahi MV, Hosseini F, Amouzadeh MH, Hosseini SA, Nikkhah A, Khajeh A, Alizadeh H, Yarali B, Rohani M, Karimi P, Elahi HML, Hosseiny SMM, Sadeghzadeh MS, Mohebbi H, Moghadam MH, Aryan H, Vahidnezhad H, Soveizi M, Rabbani B, Rabbani A, Mahdieh N, Garshasbi M, Tavasoli AR. High genetic heterogeneity of leukodystrophies in Iranian children: the first report of Iranian Leukodystrophy Registry. Neurogenetics 2023; 24:279-289. [PMID: 37597066 DOI: 10.1007/s10048-023-00730-y] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 08/09/2023] [Indexed: 08/21/2023]
Abstract
Leukodystrophies (LDs) are a heterogeneous group of progressive neurological disorders and characterized by primary involvement of white matter of the central nervous system (CNS). This is the first report of the Iranian LD Registry database to describe the clinical, radiological, and genomic data of Persian patients with leukodystrophies. From 2016 to 2019, patients suspicious of LDs were examined followed by a brain magnetic resonance imaging (MRI). A single gene testing or whole-exome sequencing (WES) was used depending on the neuroradiologic phenotypes. In a few cases, the diagnosis was made by metabolic studies. Based on the MRI pattern, diagnosed patients were divided into cohorts A (hypomyelinating LDs) versus cohort B (Other LDs). The most recent LD classification was utilized for classification of diagnosed patients. For novel variants, in silico analyses were performed to verify their pathogenicity. Out of 680 registered patients, 342 completed the diagnostic evaluations. In total, 245 patients met a diagnosis which in turn 24.5% were categorized in cohort A and the remaining in cohort B. Genetic tests revealed causal variants in 228 patients consisting of 213 variants in 110 genes with 78 novel variants. WES and single gene testing identified a causal variant in 65.5% and 34.5% cases, respectively. The total diagnostic rate of WES was 60.7%. Lysosomal disorders (27.3%; GM2-gangliosidosis-9.8%, MLD-6.1%, KD-4.5%), amino and organic acid disorders (17.15%; Canavan disease-4.5%, L-2-HGA-3.6%), mitochondrial leukodystrophies (12.6%), ion and water homeostasis disorders (7.3%; MLC-4.5%), peroxisomal disorders (6.5%; X-ALD-3.6%), and myelin protein disorders (3.6%; PMLD-3.6%) were the most commonly diagnosed disorders. Thirty-seven percent of cases had a pathogenic variant in nine genes (ARSA, HEXA, ASPA, MLC1, GALC, GJC2, ABCD1, L2HGDH, GCDH). This study highlights the most common types as well as the genetic heterogeneity of LDs in Iranian children.
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Affiliation(s)
- Mahmoudreza Ashrafi
- Myelin Disorders Clinic, Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, No. 61, Gharib Street, Keshavarz Blvd, Tehran, 1419733151, Iran
| | - Reyhaneh Kameli
- Myelin Disorders Clinic, Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, No. 61, Gharib Street, Keshavarz Blvd, Tehran, 1419733151, Iran
| | - Sareh Hosseinpour
- Myelin Disorders Clinic, Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, No. 61, Gharib Street, Keshavarz Blvd, Tehran, 1419733151, Iran
| | - Ehsan Razmara
- Australian Regenerative Medicine Institute, Monash University, Clayton, VIC, 3800, Australia
| | - Zahra Zamani
- MD, MPH, Community Medicine Specialist, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Rezaei
- Myelin Disorders Clinic, Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, No. 61, Gharib Street, Keshavarz Blvd, Tehran, 1419733151, Iran
| | - Raziyeh Mashayekhi
- Myelin Disorders Clinic, Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, No. 61, Gharib Street, Keshavarz Blvd, Tehran, 1419733151, Iran
| | - Neda Pak
- Department of Radiology, Children's Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Barzegar
- Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Azizimalamiri
- Department of Pediatric Neurology, Golestan Medical, Educational, and Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Nahideh Khosroshahi
- Department of Pediatric Neurology, Bahrami Children Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Rasulinezhad
- Myelin Disorders Clinic, Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, No. 61, Gharib Street, Keshavarz Blvd, Tehran, 1419733151, Iran
| | - Morteza Heidari
- Myelin Disorders Clinic, Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, No. 61, Gharib Street, Keshavarz Blvd, Tehran, 1419733151, Iran
| | - Man Amanat
- Myelin Disorders Clinic, Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, No. 61, Gharib Street, Keshavarz Blvd, Tehran, 1419733151, Iran
| | - Alireza Abdi
- Myelin Disorders Clinic, Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, No. 61, Gharib Street, Keshavarz Blvd, Tehran, 1419733151, Iran
| | - Bahram Mohammadi
- Myelin Disorders Clinic, Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, No. 61, Gharib Street, Keshavarz Blvd, Tehran, 1419733151, Iran
| | - Mahmoud Mohammadi
- Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholam Reza Zamani
- Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Shervin Badv
- Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Abdolmajid Omrani
- Division of Clinical Studies, The Persian Gulf Nuclear Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Sedigheh Nikbakht
- Myelin Disorders Clinic, Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, No. 61, Gharib Street, Keshavarz Blvd, Tehran, 1419733151, Iran
| | - Ali Hosseini Bereshneh
- Prenatal Diagnosis and Genetic Research Center, Dastgheib Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mojtaba Movahedinia
- Department of Pediatric, Growth Disorders of Children Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | | | - Masood Ghahvechi Akbari
- Department of Physical Medicine and Rehabilitation, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehran Beiraghi Tousi
- Pediatric Ward, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Vafaee Shahi
- Pediatric Growth and Development Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Firouzeh Hosseini
- Department of Pediatric Neurology, Hamedan University of Medical Sciences, Hamedan, Iran
| | | | - Seyed Ahmad Hosseini
- Department of Pediatric Neurology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Ali Nikkhah
- Department of Pediatric Neurology, Mofid Children Hospital, Shahid Beheshti University of Medical, Tehran, Iran
| | - Ali Khajeh
- Children and Adolescence Research Center, Zahedan University of Medical Sciences, Zahedan, 000000321469345, Iran
| | - Hooman Alizadeh
- Department of Radiology, Children's Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahram Yarali
- Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Rohani
- Department of Neurology, Hazrat-E-Rasool Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Parviz Karimi
- Department of Pediatric Neurology, Ilam University of Medical Sciences, Ilam, Iran
| | - Hadi Montazer Lotf Elahi
- Department of Pediatric Neurology, Imam Ali Hospital, Alborz University of Medical Sciences, Karaj, Iran
| | - Seyyed Mohamad Mahdi Hosseiny
- Myelin Disorders Clinic, Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, No. 61, Gharib Street, Keshavarz Blvd, Tehran, 1419733151, Iran
| | - Masoumeh Sadat Sadeghzadeh
- Myelin Disorders Clinic, Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, No. 61, Gharib Street, Keshavarz Blvd, Tehran, 1419733151, Iran
| | - Hossein Mohebbi
- Department of Pediatric Neurology, AJA University of Medical Sciences, Tehran, Iran
| | - Maryam Hosseini Moghadam
- Cardiogenetic Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hajar Aryan
- Farhud Medical Genetic Laboratory, Tehran University of Medical Sciences, Tehran, Iran
| | - Hassan Vahidnezhad
- Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, USA
- Department of Pediatrics, The University of Pennsylvania School of Medicine, Philadelphia, USA
| | - Mahdieh Soveizi
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Bahareh Rabbani
- Growth and Development Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Rabbani
- Growth and Development Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Nejat Mahdieh
- Growth and Development Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Garshasbi
- Department of Medical Genetics, Faculty of Medical Sciences, Tarbiat Modares University, Jalal-Al Ahmad Hwy, Tehran, Iran.
| | - Ali Reza Tavasoli
- Myelin Disorders Clinic, Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, No. 61, Gharib Street, Keshavarz Blvd, Tehran, 1419733151, Iran.
- Pediatric Headache Program, Barrow Neurological Institute, Phoenix Children's Hospital, Phoenix, AZ, USA.
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5
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Ashrafi M, Kameli R, Hosseinpour S, Razmara E, Zamani Z, Rezaei Z, Mashayekhi R, Pak N, Barzegar M, Azizimalamiri R, Kashani MR, Khosroshahi N, Rasulinezhad M, Heidari M, Amanat M, Abdi A, Mohammadi B, Mohammadi M, Zamani GR, Badv RS, Omrani A, Nikbakht S, Bereshneh AH, Movahedinia M, Moghaddam HF, Ardakani HS, Akbari MG, Tousi MB, Shahi MV, Hosseini F, Amouzadeh MH, Hosseini SA, Nikkhah A, Khajeh A, Alizadeh H, Yarali B, Rohani M, Karimi P, Elahi HML, Hosseiny SMM, Sadeghzadeh MS, Mohebbi H, Moghadam MH, Aryan H, Vahidnezhad H, Soveizi M, Rabbani B, Rabbani A, Mahdieh N, Garshasbi M, Tavasoli AR. Correction to: High genetic heterogeneity of leukodystrophies in Iranian children: the first report of Iranian Leukodystrophy Registry. Neurogenetics 2023; 24:317-318. [PMID: 37668767 DOI: 10.1007/s10048-023-00733-9] [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: 09/06/2023]
Affiliation(s)
- Mahmoudreza Ashrafi
- Myelin Disorders Clinic, Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, No. 61, Gharib Street, Keshavarz Blvd, Tehran, 1419733151, Iran
| | - Reyhaneh Kameli
- Myelin Disorders Clinic, Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, No. 61, Gharib Street, Keshavarz Blvd, Tehran, 1419733151, Iran
| | - Sareh Hosseinpour
- Myelin Disorders Clinic, Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, No. 61, Gharib Street, Keshavarz Blvd, Tehran, 1419733151, Iran
| | - Ehsan Razmara
- Australian Regenerative Medicine Institute, Monash University, Clayton, VIC, 3800, Australia
| | - Zahra Zamani
- MD, MPH, Community Medicine Specialist, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Rezaei
- Myelin Disorders Clinic, Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, No. 61, Gharib Street, Keshavarz Blvd, Tehran, 1419733151, Iran
| | - Raziyeh Mashayekhi
- Myelin Disorders Clinic, Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, No. 61, Gharib Street, Keshavarz Blvd, Tehran, 1419733151, Iran
| | - Neda Pak
- Department of Radiology, Children's Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Barzegar
- Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Azizimalamiri
- Department of Pediatric Neurology, Golestan Medical, Educational, and Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Nahideh Khosroshahi
- Department of Pediatric Neurology, Bahrami Children Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Rasulinezhad
- Myelin Disorders Clinic, Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, No. 61, Gharib Street, Keshavarz Blvd, Tehran, 1419733151, Iran
| | - Morteza Heidari
- Myelin Disorders Clinic, Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, No. 61, Gharib Street, Keshavarz Blvd, Tehran, 1419733151, Iran
| | - Man Amanat
- Myelin Disorders Clinic, Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, No. 61, Gharib Street, Keshavarz Blvd, Tehran, 1419733151, Iran
| | - Alireza Abdi
- Myelin Disorders Clinic, Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, No. 61, Gharib Street, Keshavarz Blvd, Tehran, 1419733151, Iran
| | - Bahram Mohammadi
- Myelin Disorders Clinic, Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, No. 61, Gharib Street, Keshavarz Blvd, Tehran, 1419733151, Iran
| | - Mahmoud Mohammadi
- Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholam Reza Zamani
- Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Shervin Badv
- Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Abdolmajid Omrani
- Division of Clinical Studies, The Persian Gulf Nuclear Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Sedigheh Nikbakht
- Myelin Disorders Clinic, Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, No. 61, Gharib Street, Keshavarz Blvd, Tehran, 1419733151, Iran
| | - Ali Hosseini Bereshneh
- Prenatal Diagnosis and Genetic Research Center, Dastgheib Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mojtaba Movahedinia
- Department of Pediatric, Growth Disorders of Children Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | | | - Masood Ghahvechi Akbari
- Department of Physical Medicine and Rehabilitation, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehran Beiraghi Tousi
- Pediatric Ward, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Vafaee Shahi
- Pediatric Growth and Development Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Firouzeh Hosseini
- Department of Pediatric Neurology, Hamedan University of Medical Sciences, Hamedan, Iran
| | | | - Seyed Ahmad Hosseini
- Department of Pediatric Neurology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Ali Nikkhah
- Department of Pediatric Neurology, Mofid Children Hospital, Shahid Beheshti University of Medical, Tehran, Iran
| | - Ali Khajeh
- Children and Adolescence Research Center, Zahedan University of Medical Sciences, Zahedan, 000000321469345, Iran
| | - Hooman Alizadeh
- Department of Radiology, Children's Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahram Yarali
- Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Rohani
- Department of Neurology, Hazrat-E-Rasool Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Parviz Karimi
- Department of Pediatric Neurology, Ilam University of Medical Sciences, Ilam, Iran
| | - Hadi Montazer Lotf Elahi
- Department of Pediatric Neurology, Imam Ali Hospital, Alborz University of Medical Sciences, Karaj, Iran
| | - Seyyed Mohamad Mahdi Hosseiny
- Myelin Disorders Clinic, Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, No. 61, Gharib Street, Keshavarz Blvd, Tehran, 1419733151, Iran
| | - Masoumeh Sadat Sadeghzadeh
- Myelin Disorders Clinic, Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, No. 61, Gharib Street, Keshavarz Blvd, Tehran, 1419733151, Iran
| | - Hossein Mohebbi
- Department of Pediatric Neurology, AJA University of Medical Sciences, Tehran, Iran
| | - Maryam Hosseini Moghadam
- Cardiogenetic Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hajar Aryan
- Farhud Medical Genetic Laboratory, Tehran University of Medical Sciences, Tehran, Iran
| | - Hassan Vahidnezhad
- Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, USA
- Department of Pediatrics, The University of Pennsylvania School of Medicine, Philadelphia, USA
| | - Mahdieh Soveizi
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Bahareh Rabbani
- Growth and Development Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Rabbani
- Growth and Development Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Nejat Mahdieh
- Cardiogenetic Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
- Growth and Development Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Garshasbi
- Department of Medical Genetics, Faculty of Medical Sciences, Tarbiat Modares University, Jalal‑Al Ahmad Hwy, Tehran, Iran.
| | - Ali Reza Tavasoli
- Myelin Disorders Clinic, Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, No. 61, Gharib Street, Keshavarz Blvd, Tehran, 1419733151, Iran.
- Pediatric Headache Program, Barrow Neurological Institute, Phoenix Children's Hospital, Phoenix, AZ, USA.
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Shirzadi R, Roshanzamir Z, Pak N, Rajabi R, Mohammadi F. An unusual site of a pericardial cyst in a child: A case report. Radiol Case Rep 2023; 18:1498-1501. [PMID: 36816338 PMCID: PMC9932291 DOI: 10.1016/j.radcr.2023.01.010] [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: 12/14/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 02/05/2023] Open
Abstract
Pericardial cysts are rare congenital anomalies, often clinically silent and incidentally found on imaging. However, patients with pericardial cysts may present with chest pain, tachypnea, and, rarely, symptoms secondary to cardiac tamponade. Echocardiography (transthoracic or transesophageal) and chest computed tomography (CT) scan with contrast are diagnostic modalities of choice in patients with pericardial cysts. Conservative management is justified in asymptomatic patients, while a surgical approach is recommended in symptomatic patients. Here, we describe the case of a 12-year-old boy who underwent imaging during the coronavirus disease 2019 (COVID-19) pandemic and was incidentally found to have a pericardial cyst.
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Affiliation(s)
- Rohola Shirzadi
- Pediatric Respiratory and Sleep Medicine Research Center, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Roshanzamir
- Pediatric Respiratory and Sleep Medicine Research Center, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran,Pediatric Respiratory Center, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Neda Pak
- Department of Radiology, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Fatemeh Mohammadi
- Tehran University of Medical Sciences, Tehran, Iran,Children's Medical Center, No 63, Gharib Ave, Keshavarz Blvd., Tehran, 14194, Iran,Corresponding author.
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7
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Khosravi B, Salehnia A, Pak N, Montazeri SA, Sima AR, Vahedi H, Malekzadeh R, Radmard AR. A Practical Index to Distinguish Backwash Ileitis From Crohn's Terminal Ileitis in MR Enterography. Inflamm Bowel Dis 2023; 29:42-50. [PMID: 35259254 DOI: 10.1093/ibd/izac040] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Differentiating ulcerative colitis-associated "backwash" ileitis (BWI) from Crohn's terminal ileitis (CTI) is a diagnostic challenge and highly affects patient's management. This study aimed to investigate magnetic resonance enterography (MRE) features including ileocecal valve patency index (ICPI) in patients with BWI and CTI and distinguish these entities based on MRE findings. METHODS After obtaining institutional review board approval, we reviewed 1654 MREs; 60 patients with pathologically proven BWI (n = 30) and CTI (n = 30) were enrolled. Two radiologists who were blinded to the clinical diagnosis analyzed MREs. We evaluated bowel wall thickness and enhancement pattern, ileocecal valve (ICV) diameter, and lip thickness. Ileocecal valve patency index-T and ICPI-C were calculated to normalize the ICV diameter with respect to terminal ileum (TI) and cecum, respectively. An additional group of non-BWI-UC patients (n = 30) was also included to validate indices. RESULTS Circumferential mural thickening (90% vs 1%, P < .001) and inner-wall enhancement (P < .001) of TI were more frequent in BWI patients than CTI. Serosal irregularity (53% vs 13%, P = .002), higher mural thickness (5mm vs 3mm, P < .001), and asymmetric hyperenhancement (P < .001) of TI were more prevalent in CTI than BWI. Ileocecal valve patency and lip atrophy were significantly higher in BWI than CTI and non-BWI-UC groups (both P < .001). Ileocecal valve patency indices-C and ICPI-T indices were able to accurately distinguish BWI from CTI (area under the ROC curve [AUC], 0.864 and 0.847 for ICPI-T and ICPI-C, respectively) and non-BWI-UC (AUC, 0.777 and 0.791 for ICPI-T and ICPI-C, respectively). Ileocecal valve patency indices-T ≥31.5% were 100% specific to distinguish BWI from CTI, but sensitivity was 63%. CONCLUSIONS Magnetic resonance enterography features of ICV and TI can accurately differentiate BWI from CTI. Two practical indices introduced in this study showed high specificity to distinguish BWI from CTI.
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Affiliation(s)
- Bardia Khosravi
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Aneseh Salehnia
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Pak
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ali Reza Sima
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Homayoun Vahedi
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Malekzadeh
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Reza Radmard
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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8
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Saghebdoust S, Shafagh SG, Pak N, Fekrazad R, Khadivi M, Faghih Jouibari M, Boustani MR. Role of Percutaneous Laser Disc Decompression in Patients with Lumbar Disc Herniation on Pain Relief: A Quasi-Experimental Pilot Study:. Galen Med J 2022; 11:e2382. [PMID: 36698697 PMCID: PMC9838109 DOI: 10.31661/gmj.v11i.2382] [Citation(s) in RCA: 1] [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: 11/24/2021] [Indexed: 01/28/2023] Open
Abstract
Background: Disc herniation is broadly defined as a localized or focal displacement of disc material beyond the limits of the intervertebral disc space. The disc material may be the nucleus, cartilage, fragmented apophyseal bone, annular tissue, or any combination thereof. Laser surgery is one of the treatment modalities for treating patients with lumbar disc herniation. This study aims to examine the effect of Percutaneous Laser Disc Decompression (PLDD) in patients with lumbar disc herniation. Materials and Methods: This study was conducted on 58 patients who underwent PLDD (optical fiber inserted through an 18G needle, 8 joules, and 8 watts). Individuals were monitored before and after treatment using the comparing visual analog scale (VAS) pain score (from 0 [no pain] to 10 [severe pain]). Results: The mean age of participants was 63.19±13.48 years. Regarding gender, 24 patients (41.4%) were female. The mean VAS score before surgery was 8.73±1.29, and VAS score after surgery was 55.2±2.71, which means pain was significantly reduced (P0.001). Conclusion: The patients' post-PLDD pain may decrease; hence, PLDD can use as an appropriate method for treating lumbar disc herniation.
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Affiliation(s)
| | | | - Neda Pak
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Fekrazad
- Radiation Sciences Research Center, Laser Research Center in Medical Sciences, AJA University of Medical Sciences, Tehran, Iran
- International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Masoud Khadivi
- Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Morteza Faghih Jouibari
- Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Boustani
- Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Department of Neurosurgery, AJA University of Medical Sciences, Tehran, Iran
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9
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Khoei S, Boustani MR, Pak N. An atypical imaging characteristic of calvarial metastasis of neuroblastoma as multiple multi-loculated cystic masses with internal blood-fluid levels: a case report. BMC Neurol 2022; 22:471. [PMID: 36494678 PMCID: PMC9733139 DOI: 10.1186/s12883-022-03001-9] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 12/02/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND As the third most common malignancy of childhood, Neuroblastoma has a great propensity to metastasize to multiple organs. The most common site of metastasis is the bone and bone marrow. Concerning the central nervous system, neuroblastoma usually involves the calvarium and the external dural surface. The skull metastases may show different appearances, including: multiple lytic bone lesions, bone thickening, hair-on-end periosteal reaction, irregular suture widening and/or plaque like epidural deposits. Here we present a case of metastatic neuroblastoma, appearing as multiple multi-loculated cystic epidural masses with internal blood-fluid levels as a rare imaging manifestation of calvarial metastasis. CASE PRESENTATION An 8-year-old boy with known history of autism, presented to the emergency department with a 3-month history of intermittent fever, malaise and myalgia and headache along with significant weight loss. Laboratory examination revealed elevated ESR and CRP and anemia. On Abdomino-Pelvic imaging a well-defined, 45*30*24 mm, solid-cystic mass was observed, replacing the normal left adrenal gland. On brain MRI, multiple multi-loculated cystic, lentiform masses were observed on the external surface of cerebral hemispheric dura. Multiple fluid-fluid levels were noted in the locules in some of which the dependent fluid was hyperintense on T1w and FLAIR and hypointense on T2w sequences, compatible with blood, representing blood-fluid level. The wall and septa of the masses, enhanced after contrast administration. Associated abnormal marrow signal and aggressive type periosteal reactions were identified in the overlying bone. All of the lesions had increased uptake in MIBG scan. Bone marrow biopsy revealed small round cells, diagnostic for neuroblastoma. The patient underwent chemotherapy treatment. All calvarial/epidural metastatic lesions resolved after chemotherapy and residual adrenal tumor was resected. CONCLUSION Cystic epidural lesions, especially when associated with adjacent abnormal bone marrow signal, or periosteal reaction and containing blood-fluid level should raise the suspicion of a calvarial metastasis.
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Affiliation(s)
- Samin Khoei
- grid.414574.70000 0004 0369 3463Radiology Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Boustani
- grid.411259.a0000 0000 9286 0323Department of Neurosurgery, AJA University of Medical Sciences, Tehran, Iran ,grid.411705.60000 0001 0166 0922Department of Neurosurgery, Dr. Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Pak
- grid.411705.60000 0001 0166 0922Department of Radiology, Children’s Medical Center of Excellence and Dr. Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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10
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Momtazmanesh S, Gholami M, Pak N, Sima AR, Montazeri SA, Kolahdoozan S, Vahedi H, Radmard AR. The clinical significance of biliary findings in magnetic resonance enterography of patients with inflammatory bowel disease. Pol J Radiol 2022; 87:e613-e621. [PMID: 36532253 PMCID: PMC9749785 DOI: 10.5114/pjr.2022.121443] [Citation(s) in RCA: 1] [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: 02/12/2022] [Accepted: 04/18/2022] [Indexed: 08/30/2023] Open
Abstract
PURPOSE Given the association of inflammatory bowel disease (IBD) and primary sclerosing cholangitis (PSC), we aimed to investigate the clinical relevance of abnormal hepatobiliary findings on magnetic resonance enterography (MRE) of IBD patients considering the risk of over- or underestimation of PSC at MRE. MATERIAL AND METHODS Using the MRE dataset of patients referring to a tertiary hospital and the National Registry of Crohn's and Colitis, 69 MREs, including 23 IBD-PSC, 23 IBD-without PSC, and 23 healthy controls (HC), were retrospectively reviewed by 2 experienced radiologists blinded to the clinical data, to evaluate hepatobiliary abnormalities. Sensitivity, specificity, and likelihood ratios were calculated. RESULTS Bile duct irregularities were the most common finding in the IBD-PSC group, with a frequency of 91%. Intra- and extrahepatic bile duct (IHBD and EHBD) irregularities were observed in 87% and 78% of PSC patients, respectively. Higher frequency of IHBD and EHBD wall thickening, bile duct dilation, EHBD stricture, and periportal oedema were observed in the IBD-PSC group. Peribiliary T2-weighted hyperintensities and contrast-enhancement were significantly more common in the IBD-PSC group than in the IBD and HC groups (48% and 35%, respectively) (p < 0.001). Detection of biliary irregularities on MRE had a specificity of 94% (95% CI: 82-99%), a sensitivity of 91% (95% CI: 72-99%), and a positive likelihood ratio of 14.0 (95% CI: 4.7-42.1) for the diagnosis of PSC. CONCLUSIONS This study emphasizes the importance of assessing and reporting hepatobiliary abnormalities visible in the MRE of patients with IBD to avoid a delayed diagnosis of PSC.
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Affiliation(s)
- Sara Momtazmanesh
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehran Gholami
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Pak
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Reza Sima
- Digestive Diseases Research Centre, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Shadi Kolahdoozan
- Digestive Diseases Research Centre, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Homayoun Vahedi
- Digestive Diseases Research Centre, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Reza Radmard
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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11
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Shokri Varniab Z, Pourabhari Langroudi A, Amouei M, Pak N, Khosravi B, Radmard AR. Abdominal Imaging Findings in Patients with COVID-19 Part 2: Solid Organs. Middle East J Dig Dis 2022; 14:373-381. [PMID: 37547497 PMCID: PMC10404099 DOI: 10.34172/mejdd.2022.298] [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: 01/25/2022] [Accepted: 06/10/2022] [Indexed: 08/08/2023] Open
Abstract
Since severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) first appeared in China in December 2019, the globe has been dealing with an ever-increasing incidence of coronavirus disease 2019 (COVID-19). In addition to respiratory disorders, 40% of patients present with gastrointestinal (GI) involvement. Abdominal pain is the most common indication for computed tomography (CT) and ultrasonography. After GI tract involvement, solid visceral organ infarction is the most prevalent abdominal abnormality in COVID-19. This review aims to gather the available data in the literature about imaging features of solid abdominal organs in patients with COVID-19. Gallbladder wall thickening and distension, cholelithiasis, hyperdense biliary sludge, acalculous cholecystitis, periportal edema, heterogeneous liver enhancement, and liver hypodensity and infarction are among hepatobiliary imaging findings in CT, particularly in patients admitted to ICU. Pancreatic involvement can develop as a result of direct SARS-CoV2 invasion with signs of acute pancreatitis in abdominal CT, such as edema and inflammation of the pancreas. Infarction was the most prevalent renal and splenic involvement in patients with COVID-19 who underwent abdominal CT presenting with areas of parenchymal hypodensity. In conclusion, although solid abdominal organs are rarely affected by COVID-19, clinicians must be familiar with the manifestations since they are associated with the disease severity and poor outcome.
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Affiliation(s)
- Zahra Shokri Varniab
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mehrnam Amouei
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Pak
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Bardia Khosravi
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Reza Radmard
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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12
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Moradi B, Taherian R, Tahmasebpour AR, Sanei Taheri M, Kazemi MA, Pak N, Shirazi M, Radmanesh A, Oztekin O, Arab-Ahmadi M. Fetal corpus callosum abnormalities: Ultrasound and magnetic resonance imaging role. J Clin Ultrasound 2022; 50:989-1003. [PMID: 35488776 DOI: 10.1002/jcu.23212] [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] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 03/19/2022] [Accepted: 03/24/2022] [Indexed: 06/14/2023]
Abstract
The corpus callosum (CC) is the major interhemispheric commissure and its abnormalities include agenesis, hypoplasia, and hyperplasia. The CC anomalies are typically related to other central nervous system (CNS) or extra-CNS malformations. The antenatal diagnosis of complete CC agenesis is easy after mid-trimester by ultrasound (US) even in the axial plane. The non-visualization of cavum septum pellucidum and colpocephaly are critical signs in the axial view. More subtle findings (i.e., hypoplasia and partial agenesis) might also be recognized antenatally. In this review, the focus was given on the prenatal diagnosis of CC abnormalities in US and magnetic resonance imaging.
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Affiliation(s)
- Behnaz Moradi
- Department of Radiology, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Taherian
- Department of Radiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | | | - Morteza Sanei Taheri
- Department of Radiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Kazemi
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran
- Department of Radiology, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Pak
- Department of Radiology, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahboobeh Shirazi
- Maternal Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Radmanesh
- Department of Radiology, School of Medicine, New York University, New York, New York, USA
| | - Ozgur Oztekin
- Radiology Department, Izmir Education and Research Hospital, Izmir, Turkey
| | - Mehran Arab-Ahmadi
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran
- Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran
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13
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Khoei S, Samani PR, Fazelnia F, Pak N. Cholecysto-hepatic duct serving as the only drainage pathway of bile from the intrahepatic to the extrahepatic biliary system in an infant: a case report. BMC Pediatr 2022; 22:438. [PMID: 35864479 PMCID: PMC9306022 DOI: 10.1186/s12887-022-03491-z] [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: 12/13/2021] [Accepted: 07/12/2022] [Indexed: 11/10/2022] Open
Abstract
Background Cholecystohepatic duct is a rare anomaly of the biliary system which involves drainage of bile into the gallbladder which may be associated with agenesis of the common hepatic duct or common bile duct. Case presentation A 2.5-month-old infant presented to our emergency department with icterus. He had a history of esophageal atresia and imperforate anus which had been treated surgically by thoracotomy, esophagostomy, gastrostomy and colostomy placement. Following imaging studies by ultrasound and MRCP, the diagnosis of common hepatic duct agenesis was made. Cholecystohepatic duct was present as the solitary drainage pathway of bile from the intrahepatic to extrahepatic biliary system. Conclusions Cholecystohepatic ducts need a high index of suspicion to be diagnosed on preoperative hepatobiliary imaging. As they may be asymptomatic, they are predisposed to iatrogenic injury during hepatobiliary surgeries.
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Affiliation(s)
- Samin Khoei
- Radiology resident, Imam Khomeini hospital complex, Tehran university of medical sciences, Tehran, Iran
| | - Payam Riahi Samani
- Radiology resident, Imam Khomeini hospital complex, Tehran university of medical sciences, Tehran, Iran
| | - Faezeh Fazelnia
- Radiology resident, Shariati hospital, Tehran university of medical sciences, Tehran, Iran
| | - Neda Pak
- Neda Pak, associate professor of radiology, children medical center of excellence, Tehran university of medical sciences (TUMS), Tehran, Iran.
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14
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Zardadi S, Razmara E, Rasoulinezhad M, Babaei M, Ashrafi MR, Pak N, Garshasbi M, Tavasoli AR. Symptomatic care of late-onset Alexander disease presenting with area postrema-like syndrome with prednisolone; a case report. BMC Pediatr 2022; 22:412. [PMID: 35831840 PMCID: PMC9277918 DOI: 10.1186/s12887-022-03468-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 11/20/2021] [Accepted: 07/04/2022] [Indexed: 11/23/2022] Open
Abstract
Background Alexander disease (AxD) is classified into AxD type I (infantile) and AxD type II (juvenile and adult form). We aimed to determine the potential genetic cause(s) contributing to the AxD type II manifestations in a 9-year-old male who presented area postrema-like syndrome and his vomiting and weight loss improved after taking prednisolone. Case presentation A normal cognitive 9-year-old boy with persistent nausea, vomiting, and a significant weight loss at the age of 6 years was noticed. He also experienced an episode of status epilepticus with generalized atonic seizures. He showed non-febrile infrequent multifocal motor seizures at the age of 40 days which were treated with phenobarbital. He exhibited normal physical growth and neurologic developmental milestones by the age of six. Occasionally vomiting unrelated to feeding was reported. Upon examination at 9 years, a weak gag reflex, prominent drooling, exaggerated knee-deep tendon reflexes (3+), and nasal tone speech was detected. All gastroenterological, biochemical, and metabolic assessments were normal. Brain magnetic resonance imaging (MRI) revealed bifrontal confluent deep and periventricular white matter signal changes, fine symmetric frontal white matter and bilateral caudate nucleus involvements with garland changes, and a hyperintense tumefactive-like lesion in the brain stem around the floor of the fourth ventricle and area postrema with contrast uptake in post-contrast T1-W images. Latter MRI at the age of 8 years showed enlarged area postrema lesion and bilateral middle cerebellar peduncles and dentate nuclei involvements. Due to clinical and genetic heterogeneities, whole-exome sequencing was performed and the candidate variant was confirmed by Sanger sequencing. A de novo heterozygous mutation, NM_001242376.1:c.262 C > T;R88C in exon 1 of the GFAP (OMIM: 137,780) was verified. Because of persistent vomiting and weight loss of 6.0 kg, prednisolone was prescribed which brought about ceasing vomiting and led to weight gaining of 3.0 kg over the next 3 months after treatment. Occasional attempts to discontinue prednisolone had been resulting in the reappearance of vomiting. Conclusions This study broadens the spectrum of symptomatic treatment in leukodystrophies and also shows that R88C mutation may lead to a broad range of phenotypes in AxD type II patients.
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Affiliation(s)
- Safoura Zardadi
- Department of Biology, School of Basic Sciences, Science and Research Branch, Islamic Azad University, Tehran, Iran.,Present affiliation: Australian Regenerative Medicine Institute, Monash University, Clayton, VIC, 3800, Australia
| | - Ehsan Razmara
- Present affiliation: Australian Regenerative Medicine Institute, Monash University, Clayton, VIC, 3800, Australia.,Department of Medical Genetics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Maryam Rasoulinezhad
- Myelin Disorders Clinic, Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Meisam Babaei
- Department of Pediatrics, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Mohammad Reza Ashrafi
- Myelin Disorders Clinic, Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Pak
- Pediatric Radiology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Garshasbi
- Department of Medical Genetics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
| | - Ali Reza Tavasoli
- Myelin Disorders Clinic, Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran.
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15
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Pourabhari Langroudi A, Shokri Varniab Z, Amouei M, Pak N, Khosravi B, Mirsharifi A, Radmard AR. Findings of Abdominal Imaging in Patients with COVID-19 - Part 1: Hollow Organs. Middle East J Dig Dis 2022; 14:278-286. [PMID: 36619269 PMCID: PMC9489432 DOI: 10.34172/mejdd.2022.284] [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: 10/25/2021] [Accepted: 04/04/2022] [Indexed: 11/06/2022] Open
Abstract
Since COVID-19 has spread worldwide, the role of imaging for early detection of the disease has become more prominent. Abdominal symptoms in COVID-19 are common in addition to respiratory manifestations. This review collected the available data about abdominal computed tomography (CT) and ultrasonography indications in hollow abdominal organs in patients with COVID-19 and their findings. Since abdominal imaging is less frequently used in COVID-19, there is limited information about the gastrointestinal findings. The most common indications for abdominal CT in patients with COVID-19 were abdominal pain and sepsis. Bowel wall thickening and fluid-filled colon were the most common findings in abdominal imaging. Acute mesenteric ischemia (AMI) was one of the COVID-19 presentations secondary to coagulation dysfunction. AMI manifests with sudden abdominal pain associated with high morbidity and mortality in admitted patients; therefore, CT angiography should be considered for early diagnosis of AMI. Ultrasonography is a practical modality because of its availability, safety, rapidity, and ability to be used at the bedside. Clinicians and radiologists should be alert to indications and findings of abdominal imaging modalities in COVID-19 to diagnose the disease and its potentially serious complications promptly.
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Affiliation(s)
| | - Zahra Shokri Varniab
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrnam Amouei
- Assistant Professor, Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Pak
- Associate Professor, Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Bardia Khosravi
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Mirsharifi
- Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Reza Radmard
- Associate Professor, Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran,Corresponding Author: Amir Reza Radmard, MD Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Shariati Hospital, 14117, North Kargar St., Tehran, Iran Tel: +98 21 84902178 Fax:+98 21 82415400 ,
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16
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Zarrabi M, Akbari MG, Amanat M, Majmaa A, Moaiedi AR, Montazerlotfelahi H, Nouri M, Hamidieh AA, Badv RS, Karimi H, Rabbani A, Mohebbi A, Rahimi-Dehgolan S, Rahimi R, Dehghan E, Vosough M, Abroun S, Shamsabadi FM, Tavasoli AR, Alizadeh H, Pak N, Zamani GR, Mohammadi M, Javadzadeh M, Ghofrani M, Hassanpour SH, Heidari M, Taghdiri MM, Mohseni MJ, Noparast Z, Masoomi S, Goudarzi M, Mohamadpour M, Shodjaee R, Samimi S, Mohammad M, Gholami M, Vafaei N, Koochakzadeh L, Valizadeh A, Malamiri RA, Ashrafi MR. The safety and efficacy of umbilical cord blood mononuclear cells in individuals with spastic cerebral palsy: a randomized double-blind sham-controlled clinical trial. BMC Neurol 2022; 22:123. [PMID: 35351020 PMCID: PMC8966246 DOI: 10.1186/s12883-022-02636-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 03/15/2022] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION The current multi-center, randomized, double-blind study was conducted among children with cerebral palsy (CP) to assess the safety and efficacy of umbilical cord blood mononuclear cell (UCB-MNC). We performed the diffusion tensor imaging to assess the changes in the white matter structure. METHODS Males and females aged 4 to 14 years old with spastic CP were included. Eligible participants were allocated in 4:1 ratio to be in the experimental or control groups; respectively. Individuals who were assigned in UCB-MNC group were tested for human leukocyte antigen (HLA) and fully-matched individuals were treated with UCB-MNCs. A single dose (5 × 106 /kg) UCB-MNCs were administered via intrathecal route in experimental group. The changes in gross motor function measure (GMFM)-66 from baseline to one year after treatment were the primary endpoints. The mean changes in modified Ashworth scale (MAS), pediatric evaluation of disability inventory (PEDI), and CP quality of life (CP-QoL) were also evaluated and compared between groups. The mean changes in fractional anisotropy (FA) and mean diffusivity (MD) of corticospinal tract (CST) and posterior thalamic radiation (PTR) were the secondary endpoints. Adverse events were safety endpoint. RESULTS There were 72 included individuals (36 cases in each group). The mean GMFM-66 scores increased in experimental group; compared to baseline (+ 9.62; 95%CI: 6.75, 12.49) and control arm (β: 7.10; 95%CI: 2.08, 12.76; Cohen's d: 0.62) and mean MAS reduced in individuals treated with UCB-MNCs compared to the baseline (-0.87; 95%CI: -1.2, -0.54) and control group (β: -0.58; 95%CI: -1.18, -0.11; Cohen's d: 0.36). The mean PEDI scores and mean CP-QoL scores in two domains were higher in the experimental group compared to the control. The imaging data indicated that mean FA increased and MD decreased in participants of UCB-MNC group indicating improvements in white matter structure. Lower back pain, headaches, and irritability were the most common adverse events within 24 h of treatment that were related to lumbar puncture. No side effects were observed during follow-up. CONCLUSIONS This trial showed that intrathecal injection of UCB-MNCs were safe and effective in children with CP. TRIAL REGISTRATION The study was registered with ClinicalTrials.gov ( NCT03795974 ).
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Affiliation(s)
- Morteza Zarrabi
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Masood Ghahvechi Akbari
- Physical Medicine and Rehabilitation Department, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Man Amanat
- Division of Neurogenetics and Neuroscience, The Moser Center for Leukodystrophies, Kennedy Krieger Institute, Johns Hopkins University, Baltimore, MD, USA
| | - Anahita Majmaa
- Pediatrics Center of Excellence, Pediatric Intensive Unit, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Reza Moaiedi
- Department of Pediatric Neurology, Clinical Research Development Center of Children Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Hadi Montazerlotfelahi
- Department of Pediatrics, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Masoumeh Nouri
- R & D Department, Royan Stem Cell Technology Co, Tehran, Iran
| | - Amir Ali Hamidieh
- Pediatrics Center of Excellence Pediatric Hematology, Oncology and Stem Cell Transplantation Department, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Shervin Badv
- Pediatrics Center of Excellence, Department of Pediatric Neurology, Children's Medical Center, Growth and Development Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Karimi
- Neurorehabilitation Research Center University of Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ali Rabbani
- Pediatrics Center of Excellence Pediatric Endocrinology Department, Growth and Development Research Center, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Mohebbi
- Pediatrics Center of Excellence, Growth and Development Research Center, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahram Rahimi-Dehgolan
- Physical Medicine and Rehabilitation Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Rosa Rahimi
- Physical Medicine and Rehabilitation Department, Khatamolanbia Hospital, Tehran, Iran
| | - Ensieh Dehghan
- Transplantation Department, Royan Stem Cell Technology Co, Tehran, Iran
| | - Massoud Vosough
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Saeed Abroun
- Department of Hematology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | | | - Ali Reza Tavasoli
- Pediatrics Center of Excellence, Department of Pediatric Neurology, Children's Medical Center, Growth and Development Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Houman Alizadeh
- Pediatrics Center of Excellence, Department of Radiology, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Pak
- Pediatrics Center of Excellence, Department of Radiology, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholam Reza Zamani
- Pediatrics Center of Excellence, Department of Pediatric Neurology, Children's Medical Center, Growth and Development Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmoud Mohammadi
- Pediatrics Center of Excellence, Department of Pediatric Neurology, Children's Medical Center, Growth and Development Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Javadzadeh
- Department of Pediatric Neurology, Mofid Children's Hospital, Pediatric Neurology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Ghofrani
- Department of Pediatric Neurology, Mofid Children's Hospital, Pediatric Neurology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Hossein Hassanpour
- Department of Pediatric Neurology, Aliasghar Children's Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Morteza Heidari
- Pediatrics Center of Excellence, Department of Pediatric Neurology, Children's Medical Center, Growth and Development Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Mehdi Taghdiri
- Department of Pediatric Neurology, Mofid Children's Hospital, Pediatric Neurology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohamad Javad Mohseni
- Pediatric Urology Research Center, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Noparast
- Department of Pediatric Nephrology, Bahrami Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Safdar Masoomi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Goudarzi
- Department of Pediatric Anesthesiology, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Masood Mohamadpour
- Pediatrics Center of Excellence, Pediatric Intensive Unit, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Razieh Shodjaee
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Solaleh Samimi
- Physical Medicine and Rehabilitation Department, Khatamolanbia Hospital, Tehran, Iran
| | | | - Mona Gholami
- Physical Medicine and Rehabilitation Department, Khatamolanbia Hospital, Tehran, Iran
| | - Nahid Vafaei
- Faculty of Medicine, Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Leyli Koochakzadeh
- Pediatrics Center of Excellence Pediatric Hematology, Department of Hematology & Oncology, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Valizadeh
- Faculty of Medicine, Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Azizi Malamiri
- Department of Paediatric Neurology, Golestan Medical, Educational, and Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mahmoud Reza Ashrafi
- Pediatrics Center of Excellence, Department of Pediatric Neurology, Children's Medical Center, Growth and Development Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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17
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Sedighi I, Fahimzad A, Pak N, Khalili M, Shokrollahi MR, Heydari H, Movahedi Z, Dashti AS, Cheraghali F, Shamsizadeh A, Mirkarimi M, Alisamir M, Hashemian H, Soltani J, Hosseininasab A, Hamedi A, Rezai MS, Sayyahfar S, Kahbazi M, Abedini A, Akhondzadeh A, Sherkatolabbasieh HR, Razlansari AA, Alibeik M, Malayeri SO, Shalchi Z, Shahabinezhad A, Asl PK, Monfared FN, Maleki S, Kakavand R, Farahmand M, Shahbaz B, Tavakoli A, Rezayat SA, Karimi MR, Erfani Y, Jafarpour A, Soltani S, Zandi M, Ghaziasadi A, Dowran R, Azimi S, Marvi SS, Abazari MF, Norouzi M, Azhar IR, Jazayeri SM. A multicenter retrospective study of clinical features, laboratory characteristics, and outcomes of 166 hospitalized children with coronavirus disease 2019 (COVID-19): A preliminary report from Iranian Network for Research in Viral Diseases (INRVD). Pediatr Pulmonol 2022; 57:498-507. [PMID: 34779156 PMCID: PMC8661970 DOI: 10.1002/ppul.25756] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 02/03/2021] [Revised: 09/20/2021] [Accepted: 11/06/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND The objectives of this study were to analyze the clinical features and laboratory profiles and risk factors associated with critical illness of children with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS One hundred and sixty-six coronavirus disease 2019 (COVID-19) Iranian pediatric patients were recruited through a collaborative research network between March and May 2020. Demographics, clinical, laboratory, and radiological results were obtained from patient files. RESULTS Of 166 patients, 102 (61%) and 64 (39%) were males and females, respectively. Ninety-six (57.8%) and 70 (42.2%), had moderate and severe conditions, respectively. Thirty (18%) of patients died. The common symptoms were fever (73%), cough (54%), and shortness of breath, headache decrease in neutrophil and platelet counts; increase values in lactate dehydrogenase, decrease in the blood pH and HCO3 were significantly associated with the disease severity. 54% and 56% of patients showed abnormal radiographic appearance in Chest X-ray and in chest computed tomography scan, respectively. Sixty-one (36.7%) of patients were referred to intensive care unit (ICU). The coexistence of comorbidity was the main factor associated with ICU admission, shock, arrhythmia, acute kidney injury, acute respiratory distress syndrome, acute cardiac injury, and death. CONCLUSIONS We describe a higher than previously recognized rate of COVID-19 mortality in Iranian pediatric patients. Epidemiological factors, such as the relatively high case fatality rate in the country and the presence of underlying diseases were the main factors for the high death rate.
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Affiliation(s)
- Iraj Sedighi
- Department of Pediatric, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.,Iranian Network for Research in Viral Diseases (INRVD)
| | - Alireza Fahimzad
- Iranian Network for Research in Viral Diseases (INRVD).,Pediatric Infectious Diseases Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Neda Pak
- Iranian Network for Research in Viral Diseases (INRVD).,Children Medical Centre of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Khalili
- Iranian Network for Research in Viral Diseases (INRVD).,Department of Radiology, Mofid Children Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad R Shokrollahi
- Iranian Network for Research in Viral Diseases (INRVD).,Pediatric Medicine Research Center, Qom University of Medical Sciences, Qom, Iran
| | - Hosein Heydari
- Iranian Network for Research in Viral Diseases (INRVD).,Pediatric Medicine Research Center, Qom University of Medical Sciences, Qom, Iran
| | - Zahra Movahedi
- Iranian Network for Research in Viral Diseases (INRVD).,Pediatric Medicine Research Center, Qom University of Medical Sciences, Qom, Iran
| | - Anahita S Dashti
- Iranian Network for Research in Viral Diseases (INRVD).,Alborzi Clinical Microbiology Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Cheraghali
- Iranian Network for Research in Viral Diseases (INRVD).,Department of Pediatric, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Ahmad Shamsizadeh
- Iranian Network for Research in Viral Diseases (INRVD).,Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammadreza Mirkarimi
- Iranian Network for Research in Viral Diseases (INRVD).,Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohsen Alisamir
- Iranian Network for Research in Viral Diseases (INRVD).,Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Houman Hashemian
- Iranian Network for Research in Viral Diseases (INRVD).,Pediatric Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Jafar Soltani
- Iranian Network for Research in Viral Diseases (INRVD).,Department of Pediatrics, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Ali Hosseininasab
- Iranian Network for Research in Viral Diseases (INRVD).,Infectious and Tropical Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Abdolkarim Hamedi
- Iranian Network for Research in Viral Diseases (INRVD).,Infection Control Hand and Hygiene Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad S Rezai
- Iranian Network for Research in Viral Diseases (INRVD).,Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Shirin Sayyahfar
- Iranian Network for Research in Viral Diseases (INRVD).,Research Center of Pediatric Infectious Diseases, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran
| | - Manijeh Kahbazi
- Iranian Network for Research in Viral Diseases (INRVD).,Infectious Diseases Research Center (IDRC), Arak University of Medical Sciences, Arak, Iran
| | - Aliakbar Abedini
- Iranian Network for Research in Viral Diseases (INRVD).,Department of Pediatric Infectious Disease, Faculty of Medicine, Children, Clinical Research Development Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Afsaneh Akhondzadeh
- Iranian Network for Research in Viral Diseases (INRVD).,Department of Pediatrics, Arak University of Medical Sciences, Arak, Iran
| | - Hamid R Sherkatolabbasieh
- Iranian Network for Research in Viral Diseases (INRVD).,Department of Pediatrics, Lorestan University of medical Sciences, Khorramabad, Iran
| | - Ali Akbar Razlansari
- Iranian Network for Research in Viral Diseases (INRVD).,Department of Pediatrics, Lorestan University of medical Sciences, Khorramabad, Iran
| | - Mina Alibeik
- Iranian Network for Research in Viral Diseases (INRVD).,Pediatric Infectious Diseases Research Center, Mofid Children Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soheil Omid Malayeri
- Iranian Network for Research in Viral Diseases (INRVD).,Health Clinical Sciences Research Center, Zahedan Branch, Islamic Azad University, Zahedan, Iran
| | - Zohreh Shalchi
- Department of Pediatric, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.,Iranian Network for Research in Viral Diseases (INRVD)
| | - Ali Shahabinezhad
- Iranian Network for Research in Viral Diseases (INRVD).,Joint Reconstruction Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Parinaz K Asl
- Iranian Network for Research in Viral Diseases (INRVD).,International Branch, Golestsn University of Medical Sciences, Gorgan, Iran
| | - Fatemeh N Monfared
- Iranian Network for Research in Viral Diseases (INRVD).,Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Shiva Maleki
- Iranian Network for Research in Viral Diseases (INRVD).,Department of Virology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Rezvan Kakavand
- Iranian Network for Research in Viral Diseases (INRVD).,Department of Virology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Mohammad Farahmand
- Iranian Network for Research in Viral Diseases (INRVD).,Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Babak Shahbaz
- Iranian Network for Research in Viral Diseases (INRVD).,Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Tavakoli
- Iranian Network for Research in Viral Diseases (INRVD).,Department of Medical Virology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Research Center of Pediatric Infectious Diseases, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran
| | - Sara A Rezayat
- Iranian Network for Research in Viral Diseases (INRVD).,Department of Health Care Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad R Karimi
- Iranian Network for Research in Viral Diseases (INRVD).,Department of Laboratory Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Yousef Erfani
- Iranian Network for Research in Viral Diseases (INRVD).,Department of Laboratory Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Jafarpour
- Iranian Network for Research in Viral Diseases (INRVD).,Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Research Center For Clinical Virology, Tehran University of Medical Sciences, Tehran, Iran
| | - Saber Soltani
- Iranian Network for Research in Viral Diseases (INRVD).,Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Research Center For Clinical Virology, Tehran University of Medical Sciences, Tehran, Iran
| | - Milad Zandi
- Iranian Network for Research in Viral Diseases (INRVD).,Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Research Center For Clinical Virology, Tehran University of Medical Sciences, Tehran, Iran
| | - Azam Ghaziasadi
- Iranian Network for Research in Viral Diseases (INRVD).,Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Research Center For Clinical Virology, Tehran University of Medical Sciences, Tehran, Iran
| | - Razieh Dowran
- Iranian Network for Research in Viral Diseases (INRVD).,Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Research Center For Clinical Virology, Tehran University of Medical Sciences, Tehran, Iran
| | - Shohreh Azimi
- Iranian Network for Research in Viral Diseases (INRVD).,Research Center For Clinical Virology, Tehran University of Medical Sciences, Tehran, Iran
| | - Shima S Marvi
- Iranian Network for Research in Viral Diseases (INRVD).,Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Research Center For Clinical Virology, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad F Abazari
- Iranian Network for Research in Viral Diseases (INRVD).,Research Center For Clinical Virology, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Norouzi
- Iranian Network for Research in Viral Diseases (INRVD).,Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Research Center For Clinical Virology, Tehran University of Medical Sciences, Tehran, Iran
| | - Iman R Azhar
- Iranian Network for Research in Viral Diseases (INRVD).,Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Research Center For Clinical Virology, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed M Jazayeri
- Iranian Network for Research in Viral Diseases (INRVD).,Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Research Center For Clinical Virology, Tehran University of Medical Sciences, Tehran, Iran
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18
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Mohammadpour M, Hassani SA, Sharifzadeh M, Tahernia L, Mamishi S, Yaghmaie B, Najafi Z, Beirami F, Afsharipour M, Minuyeefar M, Dolatzadeh M, Pak N, Majmaa A, Zamani Z, Mahmoudi S. COVID-19 Pandemic Experiences in Pediatric Intensive Care Unit: An Iranian Referral Hospital-Based Study. Int J Clin Pract 2022; 2022:1682986. [PMID: 36380748 PMCID: PMC9626193 DOI: 10.1155/2022/1682986] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 10/07/2022] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION In late February 2020, after we had informed about the presence of some cases of COVID-19 in Iran and its rapid spread throughout the country, we decided to make the necessary arrangements for patients with critical conditions in Pediatric Intensive Care Unit (PICU) at Children's Medical Center. There are a little data on critically ill children with COVID-19 infection with ICU requirements. The aim of this study was to describe clinical characteristics, laboratory parameters, treatment, and outcomes of the pediatrics population infected by SARS-CoV-2 admitted to PICU. MATERIALS AND METHODS This study was performed between February 2020 and May 2020 in the COVID PICU of the Children's Medical Center Hospital in Tehran, Iran. Patients were evaluated in terms of demographic categories, primary symptoms and signs at presentation, underlying disease, SARS-CoV-2 RT-PCR test result, laboratory findings at PICU admission, chest X-ray (CXR) and lung CT findings, and treatment. Moreover, the need to noninvasive ventilation (NIV) or mechanical ventilation, the length of hospital stay in the PICU, and outcomes were assessed. RESULTS In total, 99 patients were admitted to COVID PICU, 42.4% (42 patients) were males, and 66 patients had positive SARS-CoV-2 real-time reverse transcriptase-polymerase chain reaction (RT-PCR). There was no statistically significant difference in the frequency of clinical signs and symptoms (except for fever) among patients with positive SARS-CoV-2 RT-PCR and negative ones. Among all admitted patients, the presence of underlying diseases was noticed in 81 (82%) patients. Of 99 patients, 34 patients were treated with NIV during their admission. Furthermore, 35 patients were intubated and treated with mechanical ventilation. Unfortunately, 11 out of 35 mechanically ventilated patients (31%) passed away. CONCLUSION No laboratory and radiological findings in children infected with COVID-19 were diagnostic in cases with COVID-19 admitted to PICU. There are higher risks of severe COVID-19, PICU admission, and mortality in children with comorbidities.
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Affiliation(s)
- Masoud Mohammadpour
- Division of Pediatric Intensive Care Unit, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Abbas Hassani
- Division of Pediatric Intensive Care Unit, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Meisam Sharifzadeh
- Division of Pediatric Intensive Care Unit, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Tahernia
- Division of Pediatric Intensive Care Unit, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Setareh Mamishi
- Department of Infectious Diseases, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Pediatric Infectious Disease Research Center, Tehran University of Medical Science, Tehran, Iran
| | - Bahareh Yaghmaie
- Division of Pediatric Intensive Care Unit, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zeinab Najafi
- Division of Pediatric Intensive Care Unit, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzaneh Beirami
- Division of Pediatric Intensive Care Unit, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrnoush Afsharipour
- Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Minuyeefar
- Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mina Dolatzadeh
- Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Pak
- Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Anahita Majmaa
- Division of Pediatric Intensive Care Unit, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Zamani
- Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Shima Mahmoudi
- Pediatric Infectious Disease Research Center, Tehran University of Medical Science, Tehran, Iran
- Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
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19
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Fahimzad A, Sedighi I, Pak N, Khalili M, Farahmand M, Shokrollahi MR, Heydari H, Movahedi Z, Sanaei Dashti A, Cheraghali F, Shamsizadeh A, Mirkarimi M, Alisamir M, Hashemian H, Soltani J, Hosseininasab A, Hamedi A, Rezai MS, Sayyahfar S, Kahbazi M, Abedini A, Akhondzadeh A, Sherkatolabbasieh HR, Razlansari AA, Alibeik M, Malayeri SO, Shalchi Z, Shahabinezhad A, Khalkhali Asl P, Erfani Y, Norouzi M, Nafe Monfared F, Maleki S, Kakavand R, Shahbaz B, Poortahmasebi V, Akhavan Rezayat S, Karimi MR, Jafarpour A, Soltani S, Ghaziasadi A, Dowran R, Azimi S, Sadeghipour Marvi S, Abazari F, Zandi M, Jazayeri SM, Tavakoli A. A Comparative Analysis of Clinical Characteristics and Laboratory Findings of COVID-19 between Intensive Care Unit and Non-Intensive Care Unit Pediatric Patients: A Multicenter, Retrospective, Observational Study from Iranian Network for Research in Viral. FEM 2021. [DOI: 10.18502/fem.v5i4.6692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Introduction: To date, little is known about the clinical features of pediatric COVID-19 patients admitted to intensive care units (ICUs).
Objective: Herein, we aimed to describe the differences in demographic characteristics, laboratory findings, clinical presentations, and outcomes of Iranian pediatric COVID-19 patients admitted to ICU versus those in non-ICU settings.
Methods: This multicenter investigation involved 15 general and pediatrics hospitals and included cases with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection based on positive real-time reverse transcription polymerase chain reaction (RT-PCR) admitted to these centers between March and May 2020, during the initial peak of the COVID-19 pandemic in Iran.
Results: Overall, 166 patients were included, 61 (36.7%) of whom required ICU admission. The highest number of admitted cases to ICU were in the age group of 1–5 years old. Malignancy and heart diseases were the most frequent underlying conditions. Dyspnea was the major symptom for ICU-admitted patients. There were significant decreases in PH, HCO3 and base excess, as well as increases in creatinine, creatine phosphokinase (CPK), lactate dehydrogenase (LDH), and potassium levels between ICU-admitted and non-ICU patients. Acute respiratory distress syndrome (ARDS), shock, and acute cardiac injury were the most common features among ICU-admitted patients. The mortality rate in the ICU-admitted patients was substantially higher than non-ICU cases (45.9% vs. 1.9%, respectively; p<0.001).
Conclusions: Underlying diseases were the major risk factors for the increased ICU admissions and mortality rates in pediatric COVID-19 patients. There were few paraclinical parameters that could differentiate between pediatrics in terms of prognosis and serious outcomes of COVID-19. Healthcare providers should consider children as a high-risk group, especially those with underlying medical conditions.
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20
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Heidari E, Rasoulinezhad M, Pak N, Reza Ashrafi M, Heidari M, Banwell B, Garshasbi M, Reza Tavasoli A. Defective complex III mitochondrial respiratory chain due to a novel variant in CYC1 gene masquerades acute demyelinating syndrome or Leber hereditary optic neuropathy. Mitochondrion 2021; 60:12-20. [PMID: 34252606 DOI: 10.1016/j.mito.2021.07.001] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 07/03/2021] [Accepted: 07/07/2021] [Indexed: 11/15/2022]
Abstract
Complex III (CIII) is the third out of five mitochondrial respiratory chain complexes residing at the mitochondrial inner membrane. The assembly of 10 subunits encoded by nuclear DNA and one by mitochondrial DNA result in the functional CIII which transfers electrons from ubiquinol to cytochrome c. Deficiencies of CIII are among the least investigated mitochondrial disorders and thus clinical spectrum of patients with mutations in CIII is not well defined. We report on a 10-year-old girl born to consanguineous Iranian parents presenting with recurrent visual loss episodes and optic nerve contrast enhancement in brain imaging reminiscent of an acquired demyelination syndrome (i.e. optic neuritis or multiple sclerosis), who was ultimately confirmed to have a novel homozygous missense variant of unknown significance, c.949C > T; p.(Arg317Trp) in the CYC1 gene, a nuclear DNA subunit of complex III of the mitochondrial chain. Sanger sequencing confirmed the segregation of this variant with disease in the family. The effect of this variant on the protein structure was shown in-silico. Our findings, not only expand the clinical spectrum due to defects in CYC1 gene but also highlight that mitochondrial respiratory chain disorders could be considered as a potential differential diagnosis in children who present with unusual patterns of acquired demyelination syndromes (ADS). In addition, our results support the hypothesis that mitochondrial disorders might have an overlapping presentation with ADS.
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Affiliation(s)
- Erfan Heidari
- Department of Medical Genetics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Maryam Rasoulinezhad
- Myelin Disorders Clinic, Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Pak
- Pediatric Radiology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmoud Reza Ashrafi
- Myelin Disorders Clinic, Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Morteza Heidari
- Myelin Disorders Clinic, Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Brenda Banwell
- Division of Child Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Masoud Garshasbi
- Department of Medical Genetics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Ali Reza Tavasoli
- Myelin Disorders Clinic, Pediatric Neurology Division, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran.
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21
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Vafaee-Shahi M, Saeedi R, Pak N, Riahi A, Ghasemi S. Snake Eye Appearance; A Rare Radiology Presentation in Acute Flaccid Paralysis: A Case Report. Open Neurol J 2021. [DOI: 10.2174/1874205x02115010043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Acute flaccid paralysis (AFP) is defined by the acute onset of weakness or paralysis with reduced muscle tone in children. There are many non-infectious and infectious causes. Snake eye appearance (SEA) is a rare radiologic appearance and helps narrow down differential diagnoses in flaccid paralysis.
Case Presentation:
Here, we reported a 6 months-old girl who was admitted with sudden onset flaccid paralysis. She was lethargic and ill without any detectable deep tendon reflexes. She had a high fever that had started 3 days earlier with malaise, poor feeding and coryza. The first child of the family was a boy who expired with similar symptoms; however, the reason is still unknown. Her parents were relatives (cousins). The laboratory and cerebrospinal fluid tests analysis were normal. The brain MRI analysis revealed T1 dim Hypo intensity and T2 hyperintensity along with obvious ADC map hyperintensity in the brain stem. At first, the PCR tests analysis of stool samples for poliovirus and enterovirus were normal. Spinal MRI showed snake eye appearance and helped us narrow our differential diagnosis. We repeated the PCR tests of stool because of snake eye appearance in cervical MRI that was positive for poliovirus and indicated vaccine-associated Paralytic Poliomyelitis (VAPP). Unfortunately, she expired from vaccine associated poliomyelitis.
Conclusion:
Snake eye appearance is a rare radiologic appearance that can be seen in several pathological conditions; however, it is very rare in patients with acute flaccid paralysis. Radiology signs, especially in spinal cord MRI, can help recognizing abnormalities in images, and narrow the list of differential diagnosis in acute flaccid paralysis. Therefore, spinal cord MRI has an important role in the evaluation of patient with brain stem involvement in acute flaccid paralysis.
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22
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Ashjaei B, Ghamari Khameneh A, Pak N, Darban Hosseini Amirkhiz G, Meysamie A, Safavi M, Darban Hosseini Amirkhiz S, Tanzifi P. What is the appropriate aganglionic bowel length on contrast enema for attempting single stage transanal endorectal pull-through in Hirschsprung disease? J Pediatr Surg 2021; 56:975-978. [PMID: 32943197 DOI: 10.1016/j.jpedsurg.2020.08.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 08/14/2020] [Accepted: 08/17/2020] [Indexed: 01/04/2023]
Abstract
PURPOSE To identify influence of different values of age and abnormal bowel length in HD patients selected for single stage TERPT which affects the technique of surgery. METHODS This observational study was carried out for over 2.5 years. All children younger than 14 years old with clinical suspicion for HD, typical transitional zone (TZ) on contrast enema (CE) distal to splenic flexure, preoperative diagnosis approved by full thickness biopsy, no previous surgical history and no urgency were included. The distance between the anus and TZ was considered as aganglionic length on CE. Biopsy was taken from distal to proximal of resected bowel to reach circumferentially normal innervated bowel. Paired sample Student's t-test, Pearson correlation test, receiver operating characteristic (ROC) analysis were performed. RESULTS Forty-eight patients were enrolled in this study. Measured mean for aganglionic bowel length on CE and pathology were 33.5 ± 17.1 cm and 56.8 ± 33.5 cm, respectively (p < 0.01). Correlation coefficient (R) and coefficient of determination (R2) were 0.632 and 40%, respectively (p < 0.01). The difference between radiologic and pathologic measurements in females was higher than males (mean: 29.3 vs 21.9 cm) but was not statistically significant (p = 0.75). There was statistically significant difference between CE and pathologic results in the infants younger than 10 months (p = .004). Abnormal bowel length equal to 52 cm predicted requirement of laparoscopy assistance/laparotomy with 75% sensitivity and 85% specificity. CONCLUSION Our investigation showed it is safe to attempt for single stage TERPT when aganglionic length on CE is less than 52 cm and the child with HD is older than 10 months. Chance of requiring additional laparotomy or laparoscopy assistance is low in these patients. TYPE OF STUDY Study of diagnostic test. LEVEL OF EVIDENCE Level II.
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Affiliation(s)
- Bahar Ashjaei
- Department of Pediatric surgery, Pediatric center of excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Afshar Ghamari Khameneh
- Department of Pediatric surgery, Pediatric center of excellence, Tehran University of Medical Sciences, Tehran, Iran; Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Neda Pak
- Department of Radiology, Pediatric center of excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Gisoo Darban Hosseini Amirkhiz
- Department of Pediatric surgery, Pediatric center of excellence, Tehran University of Medical Sciences, Tehran, Iran; Research Center for Prevention of Cardiovascular Disease, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Alipasha Meysamie
- Department of Community medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Moeinadin Safavi
- Department of Pathology, Pediatric center of excellence, Tehran University of Medical Sciences, Faculty of Medicine, Tehran, Iran
| | | | - Parin Tanzifi
- Department of Pathology, Pediatric center of excellence, Tehran University of Medical Sciences, Faculty of Medicine, Tehran, Iran
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23
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Hashemian SMR, Aliannejad R, Zarrabi M, Soleimani M, Vosough M, Hosseini SE, Hossieni H, Keshel SH, Naderpour Z, Hajizadeh-Saffar E, Shajareh E, Jamaati H, Soufi-Zomorrod M, Khavandgar N, Alemi H, Karimi A, Pak N, Rouzbahani NH, Nouri M, Sorouri M, Kashani L, Madani H, Aghdami N, Vasei M, Baharvand H. Mesenchymal stem cells derived from perinatal tissues for treatment of critically ill COVID-19-induced ARDS patients: a case series. Stem Cell Res Ther 2021; 12:91. [PMID: 33514427 PMCID: PMC7844804 DOI: 10.1186/s13287-021-02165-4] [Citation(s) in RCA: 117] [Impact Index Per Article: 39.0] [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: 09/12/2020] [Accepted: 01/12/2021] [Indexed: 12/18/2022] Open
Abstract
Background Acute respiratory distress syndrome (ARDS) is a fatal complication of coronavirus disease 2019 (COVID-19). There are a few reports of allogeneic human mesenchymal stem cells (MSCs) as a potential treatment for ARDS. In this phase 1 clinical trial, we present the safety, feasibility, and tolerability of the multiple infusions of high dose MSCs, which originated from the placenta and umbilical cord, in critically ill COVID-19-induced ARDS patients. Methods A total of 11 patients diagnosed with COVID-19-induced ARDS who were admitted to the intensive care units (ICUs) of two hospitals enrolled in this study. The patients were critically ill with severe hypoxemia and required mechanical ventilation. The patients received three intravenous infusions (200 × 106 cells) every other day for a total of 600 × 106 human umbilical cord MSCs (UC-MSCs; 6 cases) or placental MSCs (PL-MSCs; 5 cases). Findings There were eight men and three women who were 42 to 66 years of age. Of these, six (55%) patients had comorbidities of diabetes, hypertension, chronic lymphocytic leukemia (CLL), and cardiomyopathy (CMP). There were no serious adverse events reported 24–48 h after the cell infusions. We observed reduced dyspnea and increased SpO2 within 48–96 h after the first infusion in seven patients. Of these seven patients, five were discharged from the ICU within 2–7 days (average: 4 days), one patient who had signs of acute renal and hepatic failure was discharged from the ICU on day 18, and the last patient suddenly developed cardiac arrest on day 7 of the cell infusion. Significant reductions in serum levels of tumor necrosis factor-alpha (TNF-α; P < 0.01), IL-8 (P < 0.05), and C-reactive protein (CRP) (P < 0.01) were seen in all six survivors. IL-6 levels decreased in five (P = 0.06) patients and interferon gamma (IFN-γ) levels decreased in four (P = 0.14) patients. Four patients who had signs of multi-organ failure or sepsis died in 5–19 days (average: 10 days) after the first MSC infusion. A low percentage of lymphocytes (< 10%) and leukocytosis were associated with poor outcome (P = 0.02). All six survivors were well with no complaints of dyspnea on day 60 post-infusion. Radiological parameters of the lung computed tomography (CT) scans showed remarkable signs of recovery. Interpretation We suggest that multiple infusions of high dose allogeneic prenatal MSCs are safe and can rapidly improve respiratory distress and reduce inflammatory biomarkers in some critically ill COVID-19-induced ARDS cases. Patients that develop sepsis or multi-organ failure may not be good candidates for stem cell therapy. Large randomized multicenter clinical trials are needed to discern the exact therapeutic potentials of MSC in COVID-19-induced ARDS. Supplementary Information The online version contains supplementary material available at 10.1186/s13287-021-02165-4.
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Affiliation(s)
- Seyed-Mohammad Reza Hashemian
- Chronic Respiratory Diseases Research Center (CRDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Rasoul Aliannejad
- Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Pulmonary Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Morteza Zarrabi
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Masoud Soleimani
- Hematology and Cell Therapy Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.,Department of Tissue Engineering and Applied Cell Science, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Massoud Vosough
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Seyedeh-Esmat Hosseini
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran.,Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamed Hossieni
- Center for Research and Training in Skin Diseases and Leprosy (CRTSDL), Tehran University of Medical Sciences, Tehran, Iran
| | - Saeid Heidari Keshel
- Department of Tissue Engineering and Applied Cell Science, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zeinab Naderpour
- Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Pulmonary Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ensiyeh Hajizadeh-Saffar
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran.,Department of Diabetes, Obesity, and Metabolism, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran.,Advanced Therapy Medicinal Product Technology Development Center (ATMP-TDC), Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Elham Shajareh
- Department of Pathology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Jamaati
- Chronic Respiratory Diseases Research Center (CRDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mina Soufi-Zomorrod
- Hematology and Cell Therapy Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Naghmeh Khavandgar
- Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Pulmonary Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hediyeh Alemi
- Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Pulmonary Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Aliasghar Karimi
- Non-Commuting Diseases Research Center (NCDRC), Fasa University of Medical Sciences, Fasa, Iran
| | - Neda Pak
- Department of Radiology, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Negin Hossieni Rouzbahani
- Department of Medical Immunology, Faculty of Medicine, Aja University of Medical Sciences, Tehran, Iran.,Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoumeh Nouri
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Majid Sorouri
- Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ladan Kashani
- Department of Obstetrics and Gynecology, Arash Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hoda Madani
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Nasser Aghdami
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Mohammad Vasei
- Cell-based Therapies Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Science, Tehran, Iran.
| | - Hossein Baharvand
- Department of Stem Cells and Developmental Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran. .,Department of Cell and Developmental Biology, Faculty of Sciences and Advanced Technologies in Biology, University of Science and Culture, Tehran, Iran.
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24
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Pak N, Selehnia A, Hunfeld MAW, Lequin MH, Neuteboom RF, de Vries ACH, Kroon AA, Dremmen MHG. Atypical neuroimaging characteristics of hemophagocytic lymphohistiocytosis in infants: a case series of hemorrhagic brain lesions in the deep grey matter. Neuroradiology 2020; 63:285-288. [PMID: 33156371 PMCID: PMC7846521 DOI: 10.1007/s00234-020-02595-6] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 10/27/2020] [Indexed: 12/17/2022]
Abstract
Hemophagocytic lymphohistiocytosis (HLH) is a rare multisystem condition associated with uncontrolled overproduction and infiltration of lymphocytes and histiocytes predominantly in liver, lymph nodes, spleen, and central nervous system. Neuroimaging findings on MRI are fairly nonspecific and classically include periventricular white matter signal abnormalities and diffuse atrophy. Focal parenchymal lesions may demonstrate post contrast ring or nodular enhancement and calcification. However, the MR imaging characteristics can be highly variable. Here, we present two cases of HLH in infants with multiple hemorrhagic lesions mostly depicted in both thalami and basal ganglia regions. Thalamic, basal ganglia, and brain stem involvement with hemorrhagic changes in HLH are rarely described in literature. Early diagnosis of HLH may be lifesaving. Awareness of the disease is necessary to investigate its characteristic findings and avoiding a delay in diagnosis.
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Affiliation(s)
- Neda Pak
- Department of Radiology & Nuclear Medicine, Erasmus Medical Center-Sophia Children's Hospital, P.O. Box 2060, CB, 3000, Rotterdam, The Netherlands.,Department of Radiology, Tehran University of Medical Sciences-Children's Medical Center, Tehran, Iran
| | - Anseh Selehnia
- Department of Radiology, Tehran University of Medical Sciences-Children's Medical Center, Tehran, Iran
| | - Maayke A W Hunfeld
- Department of Neurology, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Maarten H Lequin
- Department of Radiology, University Medical Center Utrecht-Wilhelmina Children's Hospital, Utrecht, The Netherlands
| | - Rinze F Neuteboom
- Department of Neurology, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Andrica C H de Vries
- Department of Pediatrics, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Andre A Kroon
- Department of Neonatology, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Marjolein H G Dremmen
- Department of Radiology & Nuclear Medicine, Erasmus Medical Center-Sophia Children's Hospital, P.O. Box 2060, CB, 3000, Rotterdam, The Netherlands.
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25
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Safavi M, Panjavi B, Pak N. Rosai-Dorfman Disease Arising in Patella. Arch Iran Med 2019; 22:731-732. [PMID: 31823626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 09/18/2019] [Indexed: 06/10/2023]
Affiliation(s)
- Moeinadin Safavi
- Pathology Department, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Behnam Panjavi
- Orthopedics Department, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Pak
- Radiology Department, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
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26
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Abshirini M, Siassi F, Koohdani F, Qorbani M, Khosravi S, Aslani Z, Pak N, Sotoudeh G. Higher intake of dietary n-3 PUFA and lower MUFA are associated with fewer menopausal symptoms. Climacteric 2019; 22:195-201. [PMID: 30628472 DOI: 10.1080/13697137.2018.1547700] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE This study aimed to investigate the association between dietary fat quality and menopausal symptoms. METHODS We carried out a cross-sectional study with 393 Iranian postmenopausal women. Dietary intakes and menopausal symptoms were assessed, using a validated food frequency questionnaire and a menopausal rating scale (MRS) questionnaire, respectively. Participants were divided into low and high total MRS and its domain scores. RESULTS Women in the highest quartiles of monounsaturated fatty acids (MUFA) had higher somatic symptoms compared with women in the lowest quartile (odds ratio [OR] 3.41; 95% confidence interval [CI] 1.17-9.95). Women in the highest quartiles of n-3 polyunsaturated fatty acids (PUFA) (OR 0.58; 95% CI 0.32-1.05), eicosapentaenoic acid (EPA) (OR 0.66; 95% CI 0.37-1.20), and n-3:n-6 PUFA ratio (OR 0.49; 95% CI 0.25-0.97) had lower somatic symptoms compared to the lowest quartiles. The OR for psychological symptoms decreased from the lowest to the highest quartiles of n-3 PUFA (OR 0.47; 95% CI 0.20-1.11) and n-3:n-6 PUFA ratio (OR 0.46; 95% CI 0.24-0.86). Higher intakes of EPA (OR 0.53; 95% CI 0.29-0.99) and docosahexaenoic acid (OR 0.51; 95% CI 0.27-0.95) were found to be related with fewer urogenital symptoms. CONCLUSION Consuming diets low in MUFA intake, but high in n-3 PUFA, and with a more favorable ratio of n-3:n-6 PUFA may be helpful for improving menopausal symptoms.
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Affiliation(s)
- M Abshirini
- a Department of Community Nutrition, School of Nutritional Sciences and Dietetics , Tehran University of Medical Sciences , Tehran , Iran.,b Students' Scientific Research Center , Tehran University of Medical Sciences , Tehran , Iran
| | - F Siassi
- a Department of Community Nutrition, School of Nutritional Sciences and Dietetics , Tehran University of Medical Sciences , Tehran , Iran
| | - F Koohdani
- c Department of Cellular, Molecular Nutrition, School of Nutritional Sciences and Dietetics , Tehran University of Medical Sciences , Tehran , Iran
| | - M Qorbani
- d Non-communicable Diseases Research Center , Alborz University of Medical Sciences , Karaj, Iran
| | - S Khosravi
- e Department of Social Medicine, School of Medicine , Tehran University of Medical Sciences , Tehran , Iran
| | - Z Aslani
- a Department of Community Nutrition, School of Nutritional Sciences and Dietetics , Tehran University of Medical Sciences , Tehran , Iran.,b Students' Scientific Research Center , Tehran University of Medical Sciences , Tehran , Iran
| | - N Pak
- f Shariati Hospital, School of Medicine , Tehran University of Medical Sciences , Tehran , Iran.,g Children Hospital of Excellence, School of Medicine , Tehran University of Medical Sciences , Tehran , Iran
| | - G Sotoudeh
- a Department of Community Nutrition, School of Nutritional Sciences and Dietetics , Tehran University of Medical Sciences , Tehran , Iran
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Pak N, Shakki Katouli F, Radmard AR, Shaki Katuli MH, Rezwanifar MM, Sepehri Boroujeni N. Multiple Cranial Nerve Palsy Concomitant with Leptomeningeal Involvement in Multiple Myeloma: A Case Report and Review of Literature. Int J Hematol Oncol Stem Cell Res 2018; 12:8-13. [PMID: 29951172 PMCID: PMC6018249] [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] [Indexed: 11/26/2022] Open
Abstract
Neurologic symptoms are quite common in multiple myeloma, but direct invasion of central nervous system is extremely rare. Leptomeningeal multiple myeloma, as a rare neurological manifestation of multiple myeloma, presents with impairment of consciousness, cranial nerve palsies and convulsions. Here, we describe a 52-year- old male patient, known case of multiple myeloma, who presented with bilateral visual loss and difficulty in swallowing.
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Affiliation(s)
- Neda Pak
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Shakki Katouli
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Reza Radmard
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mohamad Mehdi Rezwanifar
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Sepehri Boroujeni
- Department of Pathology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Baharzadeh E, Siassi F, Qorbani M, Koohdani F, Pak N, Sotoudeh G. Fruits and vegetables intake and its subgroups are related to depression: a cross-sectional study from a developing country. Ann Gen Psychiatry 2018; 17:46. [PMID: 30410566 PMCID: PMC6211514 DOI: 10.1186/s12991-018-0216-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 10/21/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The association of fruits and vegetables (FV) specific subgroups consumption and depression has not been investigated in healthy adult populations. Therefore, the aim of our study was to determine the relationship between intake of FV as well as their subgroups and depression. METHODS This cross-sectional study was conducted on 400 women attending healthcare centers. The scores of depression, anxiety, and stress were measured using the 21-item depression, anxiety and stress scales questionnaire. The participants' anthropometric and physical activity data were collected and the 147-item semi-quantitative FFQ was used for estimating the FV intake. RESULTS After adjustment for confounding variables, the participants in the lower quartiles of total FV, total vegetables, total fruits, citrus, other fruits and green leafy vegetables intake were more likely to experience depression compared to those in the higher quartiles (p trend < 0.03). CONCLUSION Our findings suggest that higher intake of total FV and some of its specific subgroups might be associated with depression.
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Affiliation(s)
- Elham Baharzadeh
- 1Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Hojatdost Street, Naderi Street, KeshavarzBlv., Tehran, Iran
| | - Fereydoun Siassi
- 1Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Hojatdost Street, Naderi Street, KeshavarzBlv., Tehran, Iran
| | - Mostafa Qorbani
- 2Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Fariba Koohdani
- 3Department of Cellular, Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Pak
- 4Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,5Children Hospital of Excellence, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Gity Sotoudeh
- 1Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Hojatdost Street, Naderi Street, KeshavarzBlv., Tehran, Iran
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Poorrezaeian M, Siassi F, Milajerdi A, Qorbani M, Karimi J, Sohrabi-Kabi R, Pak N, Sotoudeh G. Depression is related to dietary diversity score in women: a cross-sectional study from a developing country. Ann Gen Psychiatry 2017; 16:39. [PMID: 29176995 PMCID: PMC5689184 DOI: 10.1186/s12991-017-0162-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 11/06/2017] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Substantial evidence provides support for the role of diet in the prevention and control of mental disorders. However, since there is no study regarding the relationship between dietary diversity and stress or depression, we aimed to determine the relationship between the dietary diversity score (DDS) and stress and depression in women. METHODS This descriptive-analytical cross-sectional study was performed on 360 women aged 20-49 years attending health centers in the south of Tehran. The dietary intake and score of depression, anxiety, and stress were measured using a 24-h dietary recall and the 42-item depression, anxiety, stress scales questionnaire, respectively. The DDS was calculated based on the FAO 2013 guidelines. Data were analyzed using Chi-square, analysis of variance, Spearman correlation coefficient, and multivariable logistic regression tests. RESULTS In total, 31.4 and 25.8% of the subjects suffered from depression and stress, respectively. After adjusting for confounders, a one-unit increase in DDS was associated with a 39% reduction in the risk of severe depression. The DDS was not significantly associated with mild or moderate depression, and no significant relationship was observed between the DDS and stress. CONCLUSIONS The DDS could be inversely associated with depression in women. Since we observed no significant relationship between stress and DDS, further studies are needed in this regard.
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Affiliation(s)
- Mina Poorrezaeian
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Hojatdost Street, Naderi Street, Keshavarz Blv., Tehran, Iran
| | - Fereydoun Siassi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Hojatdost Street, Naderi Street, Keshavarz Blv., Tehran, Iran
| | - Alireza Milajerdi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Hojatdost Street, Naderi Street, Keshavarz Blv., Tehran, Iran
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Javad Karimi
- Department of Psychology, School of Literature and Humanity Sciences, Malayer University, Malayer, Iran
| | - Reza Sohrabi-Kabi
- Ibn Sina Psychiatric Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Neda Pak
- Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Children Hospital of Excellence, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Gity Sotoudeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Hojatdost Street, Naderi Street, Keshavarz Blv., Tehran, Iran
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Radmard AR, Haghighi S, Hashemi Taheri AP, Mohammadinejad P, Eftekhar Vaghefi R, Naybandi Atashi S, Pak N, Aghaghazvini L, Malekzadeh R. Magnetic Resonance Enterography in 300 Known Cases of Crohn's Disease: An Initial Report from a Referral Center in Iran. Middle East J Dig Dis 2016; 8:273-281. [PMID: 27957290 PMCID: PMC5145294 DOI: 10.15171/mejdd.2016.36] [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] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Magnetic resonance enterography (MRE) has become the modality of choice in assessment of patients with Crohn’s disease (CD). We aimed to present our experience on 300 patients with CD who underwent MRE during the first 30 months after setting up MRE for the first time in a referral center in Iran. METHODS Patients with a definite diagnosis of CD based on either ileocolonoscopy or histopathological studies were included in the final report and categorized into four phenotypes of inactive, active, stricturing, and penetrating disease. RESULTS This was a case series study on 300 patients with known CD out of 594 referred subjects. The most prevalent phenotype was inactive observed in 162 (54.0%) patients followed by stricturing in 44 (14.7%), active in 40 (13.3%), penetrating in 27(9%), and active on chronic in 27 (9%) cases. The number of referred patients increased from 51 cases in the first 6 months to 165 in the last 6 months. CONCLUSION This study presents the first report on the application of MRE in Iran as superb modality for management of CD. The growing number of referred patients indicates that MRE has been successful in addressing the most critical concerns of clinicians on determining the dominant disease phenotype.
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Affiliation(s)
- Amir Reza Radmard
- Department of Radiology, Shariati hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Sepehr Haghighi
- Department of Radiology, Shariati hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Payam Mohammadinejad
- Department of Radiology, Shariati hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Rana Eftekhar Vaghefi
- Department of Radiology, Shariati hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Naybandi Atashi
- Department of Radiology, Shariati hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Pak
- Department of Radiology, Shariati hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Aghaghazvini
- Department of Radiology, Shariati hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Malekzadeh
- Autoimmune and Motility Disorders of the Gastro-Intestinal Tract Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Gharib B, Mohammadpour M, Sharifzadeh M, Mirashrafi F, Yaghmaie B, Pak N, Mehdizadeh M, Eshaghi H, Gorji M, Memarian S. A 15-Month-Old Boy With Respiratory Distress and Parapharyngeal Abscess: A Case Report. Acta Med Iran 2016; 54:812-816. [PMID: 28120594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2016] [Indexed: 06/06/2023] Open
Abstract
Parapharyngeal abscess is a life-threatening disease. Upper respiratory tract infection is the main cause in children. We present a 15-month-old boy admitted to the emergency ward with the chief complaint of difficulty in breathing caused by parapharyngealabscess. His condition deteriorated gradually, and he transferred to the operation theater quickly for abscess drainage and because of the difficulty in orotracheal intubation; a tracheostomy was performed. His respiratory condition deteriorated 2 days after PICU admission, and the medical team noticed an unexplainable respiratory distress. A chest x ray obtained and showed a right side pneumothorax and subcutaneous emphysema around theneck area. The case presented here, had not been diagnosed at the first examination; however, there were enough clinical clues (such as respiratory distress, drooling, torticollis, bulging of theneck, previous viral respiratory infection, possible pharyngeal trauma). The story of this case reminds us the importance of the precise physical exam and history taking which could be life-saving.
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Affiliation(s)
- Behdad Gharib
- Department of Pediatric Intensive Care, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Mohammadpour
- Department of Pediatric Intensive Care, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Meisam Sharifzadeh
- Department of Pediatric Intensive Care, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Mirashrafi
- Department of Pediatrics, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahareh Yaghmaie
- Department of Pediatric Intensive Care, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Pak
- Department of Pediatrics, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrzad Mehdizadeh
- Department of Pediatrics, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Eshaghi
- Department of Pediatrics, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Gorji
- Department of Pediatrics, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Memarian
- Department of Pediatrics, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
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Pak N, Patel SG, Hashemi Taheri AP, Hashemi F, Eftekhari Vaghefi R, Naybandi Atashi S, Mirjalili SA. A reappraisal of adult thoracic and abdominal surface anatomy in Iranians in vivo using computed tomography. Clin Anat 2015; 29:191-6. [DOI: 10.1002/ca.22669] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Accepted: 10/07/2015] [Indexed: 11/10/2022]
Affiliation(s)
- Neda Pak
- Department of Radiology; Shariati Hospital, Tehran University of Medical Sciences; Tehran Iran
| | - Shilpan G. Patel
- Department of Anatomy with Radiology, Faculty of Medical and Health Sciences; University of Auckland; Auckland New Zealand
| | - Amir P. Hashemi Taheri
- Department of Radiology; Shariati Hospital, Tehran University of Medical Sciences; Tehran Iran
| | - Fariba Hashemi
- Department of Radiology; Shariati Hospital, Tehran University of Medical Sciences; Tehran Iran
| | - Raana Eftekhari Vaghefi
- Department of Radiology; Shariati Hospital, Tehran University of Medical Sciences; Tehran Iran
| | - Sara Naybandi Atashi
- Department of Radiology; Shariati Hospital, Tehran University of Medical Sciences; Tehran Iran
| | - S. Ali Mirjalili
- Department of Anatomy with Radiology, Faculty of Medical and Health Sciences; University of Auckland; Auckland New Zealand
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Tarr GP, Pak N, Taghavi K, Iwan T, Dumble C, Davies-Payne D, Mirjalili SA. Defining the surface anatomy of the central venous system in children. Clin Anat 2015; 29:157-64. [PMID: 26518452 DOI: 10.1002/ca.22663] [Citation(s) in RCA: 12] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 10/20/2015] [Accepted: 10/28/2015] [Indexed: 11/06/2022]
Abstract
Pediatric emergency physicians, pediatric critical care specialists, and pediatric surgeons perform central venous catheterization in many clinical settings. Complications of the procedure are not uncommon and can be fatal. Despite the frequency of application, the evidence-base describing the surface landmarks involved is missing. The aim of the current study was to critically investigate the surface markings of the central venous system in children. The superior vena cava/right atrial (SVC/RA) junction, superior vena cava (SVC) formation, and brachiocephalic vein (BCV) formation were examined independently by two investigators. Three hundred computed tomography (CT) scans collected across multiple centers were categorized by age group into: 0-3 years, 4-7 years, and 8-11 years. Scans with pathology that distorted or obscured the regional anatomy were excluded. The BCV formation was commonly found behind the ipsilateral medial clavicular head throughout childhood. This contrasts with the variable levels of SVC formation, SVC length, and SVC/RA junction. In the youngest group, SVC formation was most commonly at the second costal cartilage (CC), but moved to the first CC/first intercostal space (ICS) as the child grew. The SVC/RA junction was at the fourth CC in the youngest group and moved to the third CC/third ICS as the child grew. This study demonstrates the variable anatomy of SVC formation and the SVC/RA junction with respect to rib level. This variability underscores the unreliability of surface anatomical landmarks of the SVC/RA junction as a guide to catheter tip position.
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Affiliation(s)
- Gregory P Tarr
- Department of Radiology, Auckland City Hospital, Auckland, New Zealand
| | - Neda Pak
- Department of Radiology, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Kiarash Taghavi
- Department of Paediatric Surgery, Wellington Hospital, Wellington, New Zealand
| | - Tom Iwan
- Department of Anatomy with Radiology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Charlotte Dumble
- Department of Anatomy with Radiology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | | | - S Ali Mirjalili
- Department of Anatomy with Radiology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Hashemi Taheri AP, Radmard AR, Kooraki S, Behfar M, Pak N, Hamidieh AA, Ghavamzadeh A. Radiologic resolution of malignant infantile osteopetrosis skeletal changes following hematopoietic stem cell transplantation. Pediatr Blood Cancer 2015; 62:1645-9. [PMID: 25820806 DOI: 10.1002/pbc.25524] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 03/03/2015] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Hematopoietic stem cell transplantation (HSCT) is the only known curative treatment of malignant infantile osteopetrosis (MIOP). In this study, short-term serial bone surveys were used to assess radiologic evolution of skeletal changes after HSCT in MIOP. MATERIALS AND METHODS Baseline whole-body bone survey was performed in all patients. HSCT was successful in 14 patients (11 with full chimerism, three with mixed chimerism) in whom follow-up bone surveys were carried out at 6 and 12 months after HSCT. RESULTS Normal corticomedullary differentiation was evident in five (P = 0.06) and 12 (P < 0.005) patients at 6 and 12 months, respectively. Abnormal endobone appearance in long bones, present in 11 participants at baseline exam, disappeared in eight (P = 0.008) and all (P = 0.001) patients at 6 and 12 months, respectively. In 6-month follow-up, rachitic changes significantly disappeared (P < 0.01) in long bones; however, they were evident in ribs of 12 patients (P = 0.50). No patient had rickets in ribs or long bones after 12 months. CONCLUSION We observed considerable resolution of MIOP skeletal changes after HSCT in all patients with either full or mixed chimerism. Rachitic changes in long bones, attenuated corticomedullary differentiation, and endobone appearance were the first to resolve. We propose using single long bone plain x-ray to demonstrate short-term skeletal response to HSCT.
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Affiliation(s)
| | - Amir Reza Radmard
- Department of Radiology, Shariati hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheil Kooraki
- Department of Radiology, Shariati hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Behfar
- Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Pak
- Department of Radiology, Shariati hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Ali Hamidieh
- Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ardeshir Ghavamzadeh
- Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Pak N, Mcdonald AM, McKenzie J, Tukuitonga C. Soft drink consumption in Pacific Island countries and territories: a review of trade data. Pac Health Dialog 2014; 20:59-66. [PMID: 25928998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
INTRODUCTION Pacific Islands Countries and Territories (PICTs) have some of the highest rates of obesity and diabetes in the world. Research has demonstrated a strong link between sugar-sweetened beverage (SSB) consumption and subsequent risk of overweight, obesity, dental caries and type II diabetes. To address the impact of SSBs on noncommunicable diseases, it is crucial to understand the level of SSB consumption in PICTs. METHODS The volume of soft drinks imported and exported was requested from PICTs to estimate the litres of soft drink consumption per head of population. Analysis was confined to PICTs who did not produce their own soft drinks because production data was limited. The Harmonised Commodity Description and Coding System (HS) category 22.02 was used which includes both diet and sugar-sweetened soft drinks. The trade data estimates were then compared with school survey data to explore how the data sources corresponded given the strengths and weaknesses of each. RESULTS Soft drink import volumes were a feasible way of estimating total soft drink consumption in PICTs and look at trends over time. Seven out of eleven non-producing PICTs contacted were able to provide volume of soft drinks imported. In 2011, estimates of soft drink consumption per person were 84L in Palau, 47L in the Commonwealth of the Northern Mariana Islands (CNMI), 41L in Niue, 31L in Tonga, 22L in Federates States of Micronesia, 8L in Tuvalu and 1L in Kiribati. CONCLUSIONS Trade data is a feasible way of monitoring soft drink consumption and may be useful to evaluate the impact of changes in government policy on importation of soft drinks. Data quality could be maximised by including export data, adjusting for visitor numbers and cross-checking exports from corresponding countries. To monitor SSB consumption, a wider range of categories could be included such as categories for sugar-sweetened juice and sweetened-milk drinks.
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Shakeri M, Boustani MR, Pak N, Panahi F, Salehpour F, Lotfinia I, Meshkini A, Daghighi S, vahedi P, Khani M, Taghiloo D. Effect of progesterone administration on prognosis of patients with diffuse axonal injury due to severe head trauma. Clin Neurol Neurosurg 2013; 115:2019-22. [PMID: 23871679 DOI: 10.1016/j.clineuro.2013.06.013] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2012] [Revised: 05/23/2013] [Accepted: 06/19/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Severe traumatic brain injury (TBI) has a major role in mortality rate among the other types of trauma. The aim of this clinical study was to assess the effect of progesterone on the improvement of neurologic outcome in patients with acute severe TBI. METHODS A total of 76 patients who had arrived within 8h of injury with a Glasgow Coma Score≤8 were enrolled in the study. In a randomized style 38 received progesterone (1mg/kg per 12h for 5 days) and 38 did not. RESULTS There was a better recovery rate and GOS score for the patients who were given progesterone than for those in the control group in a 3-months follow-up period (50% vs. 21%); subgroup analysis showed a significant difference in the percentage of favorable outcome between the two groups with GCS of 5-8 (p=0.03). CONCLUSION The use of progesterone may significantly improve neurologic outcome of patients suffering severe TBI up to 3 months after injury, especially those with 5≤GCS≤8, providing a potential benefit to the treatment of acute severe TBI patients. Considering this drug had no significant side effects, so progesterone could be used in patients with severe TBI as a neuro-protective drug.
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Affiliation(s)
- Moslem Shakeri
- Department of Neurosurgery, Imam Reza Teaching Hospital, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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Javadrashid R, Salehi A, Tarzamni MK, Aslanabadi N, Pak N. Diagnostic efficacy of coronary calcium score in the assessment of significant coronary artery stenosis. Kardiol Pol 2010; 68:285-291. [PMID: 20411452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
BACKGROUND Coronary artery calcium score (CCS) is a quantitative assessment of calcifications detectable by multidetector computed tomography (MDCT). AIM To evaluate diagnostic accuracy of CCS to detect significant stenosis in coronary arteries in symptomatic patients. METHODS The study population included consecutive symptomatic patients with suspected coronary artery disease (CAD) who were referred for coronary angiography. The group included 158 patients (64.6% males) who were all evaluated by unenhanced 64-slice computed tomography where calcium was quantified according to the Agatston method. The ROC curves were constructed to evaluate the discriminating power of the total CCS and CCS for each individual coronary artery in predicting the presence of significant stenosis. RESULTS The prevalence of significant CAD strongly increased with higher CCS. The area under the curve (AUC) for total CCS for diagnosing significant stenosis (> or = 50%) in at least one coronary artery was 0.83 (95% CI 0.74-0.92). Using the cut-off value of CCS > or = 7.7 at least one significant coronary stenosis was detected with the sensitivity and specificity of 86% and 71%, respectively. Significant coronary artery stenosis was better predicted by measuring CCS for individual coronary arteries than total CCS. The AUC of CCS for significant stenosis of each coronary artery was 0.80 for the right coronary artery (RCA), 0.72 for the left main (LM), 0.73 for the left anterior descending (LAD) and 0.76 for the left circumflex arteries (LCX). The optimal cut-off point was estimated for CCS of each coronary artery. It was set at > or = 3.1 for RCA, > or = 7.7 for LM, > or = 9.5 for LAD and > or = 4.5 for LCX. Positive and negative predictive values for an intact artery using a CCS of zero were 92.8% and 83.8%, respectively. Diagnostic performance of CCS for predicting stenosis of LM and LCX arteries was better in patients over age 65 than in younger patients. CONCLUSIONS Coronary artery calcium score is useful in predicting coronary artery stenosis, especially in subjects in whom invasive diagnostic or therapeutic utilities seem to be used untimely. The current study suggests an optimal cut-off value of total CCS > or = 7.7 for detecting significant stenosis, and underlines the better predictive value for CCS of individual arteries.
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Affiliation(s)
- Reza Javadrashid
- Department of Radiology, Tabriz University of Medical Sciences, Tabriz, Iran
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Araya H, Contreras P, Alviña M, Vera G, Pak N. A comparison between an in vitro method to determine carbohydrate digestion rate and the glycemic response in young men. Eur J Clin Nutr 2002; 56:735-9. [PMID: 12122549 DOI: 10.1038/sj.ejcn.1601386] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2001] [Revised: 11/07/2001] [Accepted: 11/12/2001] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study examines the relationship between the results of in vitro determinations of carbohydrate digestion rates and the glycemic index. SUBJECTS Ten healthy non smoking men, aged between 21 and 24-y-old, were selected to participate in the study. METHODS Six different meals with similar levels of carbohydrates were assayed at breakfast in ten subjects and blood samples were obtained at 0, 15, 30, 60 and 120 min to determine glucose levels. The Englyst's enzymatic method was used in the in vitro study. The six meals were based in cereals (rice or spaghetti); legumes (lentil soup and beans with spaghetti); and potato (potato stew with meat and vegetables). RESULTS The meals showed different glycemic indices: rice and spaghetti based meals had lower values (mean value 31.4 and 42, respectively); the intermediate values corresponded to lentil soup and the bean dish (49.3, and 76.8 respectively) and the higher glycemic index was shown by the potato based meal (82). CONCLUSIONS A significant correlation was observed when the ratio of rapid carbohydrate digestion rate and the lente carbohydrate digestion rate was correlated with the glycemic index of the meals, but not when only the rapid carbohydrate digestion rate was considered. These results demonstrate a useful, simple and inexpensive method to estimate the biological response of high carbohydrate meals.
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Affiliation(s)
- H Araya
- Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile
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Pak N. [Dietary fiber in vegetables cultivated in Chile]. Arch Latinoam Nutr 2000; 50:97-101. [PMID: 11048579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
The objective of this study was to determine the soluble, insoluble, and total dietary fiber contents in vegetables produced in Chile. The analyses were conducted in the vegetables in the same conditions as they are consumed. Thirty-three vegetables obtained from local markets and the Instituto de Investigaciones Agropecuarias (INIA) were studied. Water and fiber contents were determined in 16 raw and 17 cooked (boiled) samples. Moisture range between 63.2% and 96.2%. Average (+/- sd) total, soluble and insoluble contents, expressed as g% on wet basis were: 3.00 +/- 1.59, range 0.96 7.3; 0.93 +/- 0.50 range; 0.30 2.60, and 2.06 +/- 1.26, range 0.51-5.90 respectively. On dry weight basis total fiber concentration was 30.1 +/- 12.5, with a proportion of 68.5% and 31.5% of the insoluble and soluble form, respectively. On dry weight basis total fiber concentration was 30.1 +/- 12.5, with a proportion of 68.5% and 31.5% of the insoluble and soluble form, respectively. Dietary fiber supply ranged between 1.0 to 10.7 g in the large serving sizes. The ratios insoluble fiber/crude fiber and total dietary fiber/crude fiber did not present constant results. Values ranged between 1.1 and 4.5 (mean 2.2 +/- 1.0) in the former, and from 1.4 to 6.5 (mean 3.2 +/- 1.5) in the latter. We conclude that both soluble and insoluble fiber vary widely among vegetables produced in Chile. This study provides information on the fiber composition of vegetables. Such information may help to choose them according to these variables in order to be used in the prevention or treatment of selected pathologies.
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Affiliation(s)
- N Pak
- Centro de Nutrición Humana, Facultad de Medicina Universidad de Chile
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Vera G, Alviña M, Pak N, Sola JC, Díaz C, Araya H. [Effect of energy density and fat level of milk formulas on subsequent food and energy intake in preschool children]. Arch Latinoam Nutr 1996; 46:210-5. [PMID: 9429623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The aim of this study was to examine the effects of two levels of energy intakes and two levels of fat at breakfast, on the food and energy intakes in subsequent meal (lunch). The study was performed in 51 children both genders, with ages ranging from 24 to 48 months, attending a day care center. The children selected had normal nutritional status (weight/height index) according to the NCHS standards. The food intake was determined by differential weighing and energy intake was calculated from proximal analysis. The energy densities of the cow's milk formula used were 0.8 and 1.2 kcal/g, resulting in a total energy offer (breakfast) of 267.5 and 367.5 kcal respectively, the fat levels were 6.3 and 0.9 g/250 g of formula, using the design 2 x 2 factorial. In the study, 720 observations of food intake were conducted in those children consuming higher than 75% of the total food offered at breakfast. In the lunch-time were offered in alternated form two preparations with an 0.97 kcal/g of energy density. The results demonstrated that the children consumed significantly higher energy amounts in the subsequent meal, after being fed the high fat and lower energy-content breakfast. When the total energy intake (breakfast + lunch) was compared these results show that the caloric difference of breakfast was reduced and the degree of reduction was influenced by the fat level. These results show evidence for partial caloric compensation of 67% in the higher-fat level, and only 34% for the children with the lower of fat-level. It is conclude that the energy intake and fat intake at breakfast influences the energy intake at the subsequent meal. These findings are important to the preschool children's feeding with risk of malnutrition.
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Affiliation(s)
- G Vera
- Universidad de Chile, Departamento de Nutrición, Facultad de Medicina
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Pak N, Araya H. [Chilean edible sea macroalgae as sources of dietary fiber: effect on apparent digestibility of protein, fiber, and energy and fecal weight of rats]. Arch Latinoam Nutr 1996; 46:42-6. [PMID: 9161459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The inclusion of algae as a source of fiber in the diet is justified by the present need to increase the intake of this nutrient. The aim of this study was to study on rats, the effect of dietary algae fiber on fecal weight and apparent digestibility of energy, protein and fiber. The type of algae studied were cochayuyo (frond) and ulte (basal part) (Durvillea antarctica), luche verde (Ulva lactuca) and luche rojo (Porphyra columbina). All these algae were boiled and dried at 55 degrees under air flow. Male rats, Wistar strain of 25 days of age, were fed during 29 days with diets containing casein plus the inclusion of 10% (weight) of one of these algae dietary fiber. A group having no fiber intake was used as a Control group. Algae content of dietary fiber ranged between 58.2-75.6 g/100 g (dry weight), soluble fiber portion constituted 37.9-52.4%. In relation to the Control group it was found significant reduction in the apparent digestibility of protein and energy, and a significant reduction in fecal weight. Dietary fiber digestibility ranged between 21.1 and 43.1%. This study shows that algae can be an excellent dietary fiber source, very useful to prevent or treat different fiber-deficiency related diseases.
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Affiliation(s)
- N Pak
- Departamento de Nutrición, Facultad de Medicina, Universidad de Chile
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Affiliation(s)
- H Reyes
- Department of Medicine, University of Chile School of Medicine, Santiago
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Araya H, Vera G, Alviña M, Fuentes A, Oyarzun MT, Pak N. [Effect of different starch and dietary fiber of preparations levels on immediate and subsequent consumption in preschool children 24-48 months of age]. Arch Latinoam Nutr 1994; 44:12-7. [PMID: 7717800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The aim of this study was to examine in preschool children the effects of different levels of starch and dietary fiber of a meal time on the immediate food and energy intake (in the same meal time) and in the following meal (subsequent intake). The study was performed in 50 children both genders, with ages ranging from 24 to 48 months, with normal nutritional status (weight/height index) according to the NCHS standards. The food intake was determined by differential weighing and energy intake was calculated from proximal analysis. In the lunch, several meals were offered differing in their starch and dietary fiber but with similar energy density (1 kcal/g). The results of the immediate consumption demonstrated that the two dietary treatments were significantly and the effect was a lower consumption of food and energy, while the starch an dietary lower consumption of food and energy, while the starch an dietary fiber levels increased. It was observed and interaction between both variables. The subsequent food and energy intake showed the same tendency that was observed in the immediate consumption but there was not an interaction between both variables. The lowest value of intake was showed by the children who consumed the meal with the highest level of starch and dietary fiber. When results of both meal times were combined, the same effects were demonstrated. The findings described have been not reported by others authors. A probable explanation for these results are the lower gastric emptying caused bu high levels of starch and dietary fiber and in the specific case of starch by its glycemic index.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- H Araya
- Universidad de Chile, Facultad de Medicina, Departamento de Nutrición
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Araya H, Alviña M, Vera G, Pak N. [Recommended values of energy density in soup or gruel-like foods, for feeding of preschool children]. Arch Latinoam Nutr 1991; 41:53-61. [PMID: 1822069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The low energy density of the diets has been proposed by several authors as an essential factor which conditions the inadequate energy intake of preschool children of developing countries. However, there are few controlled studies in relation to the volumes which children are able to consume when energy density changes. The objective of this research was to establish recommended values of energy density for preparations with a soup or gruel consistency. The study was carried out in 100 preschool children from 3 to 4 years old who attended a Day Care Center in Santiago, Chile. Six formulas of a mixture of extruded pea-rice with different energy densities and viscosities: 0.8, 1.2 and 1.6 kcal/g and 3,000 and 9,000 cp. were studied. These experimental conditions were obtained modifying the product concentration and adding malt flour. Food consumption was determined at lunch time. Energy adequacy was calculated using the 1985 FAO-OMS-UNU requirements. Children increased significantly their energy intake when energy density of both types of consistency, soup or gruel, was higher. Energy adequacy ranged from 15% when preparations had an energy density of 0.8 kcal/g to 35%, when the preparations had an energy density of 1.6 kcal/g. The formulas which had 1.6 kcal/g fulfilled 100% of the energy requirements of preschool children for lunch time, and should be the recommended energy density for soup or gruels, when they are given as the only food. The energy density of 1.2 kcal/g needs a food complement which supplies 120 kcal, and lower values would be inadequate for preschool children feeding purposes.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- H Araya
- Universidad de Chile, Santiago
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Araya H, Alviña M, Vera G, Pak N. [Nutritional quality of the protein of the false lentil (Vicia sativa ssp. abovata (Ser) Gaudin]. Arch Latinoam Nutr 1990; 40:588-93. [PMID: 1967029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The common vetch (Vicia sativa) is a legume that grows spontaneously in the central zone of Chile. It is consumed by the rural population, as lentil, and frequently it is utilized in animal feeding. The objective of the present work was to study the biological quality of its protein and protein digestibility, as well as its dietary fiber pattern. The samples studied were provided by the Instituto de Investigaciones Agropecuarias (INIA), where in its chemical composition, dietary fiber, biological protein quality (PER) and apparent and true protein digestibility, were determined. Results showed a high protein concentration (23.5%), higher than (in the legumes commonly consumed. Total dietary fiber and its fractions, insoluble and soluble fiber, attained values of 14.2%, 13.2% and 1.0% respectively. The PER in the raw material was 1.30 +/- 0.44 and 1.32 +/- 0.37 in the cooked one; supplementation with 0.15% DL-methionine caused a rise to 2.43 +/- 0.32, the casein value being 3.02 +/- 0.36. True digestibility was 76.2 +/- 2.0 in the raw material, and 73.8 +/- 2.2 in the cooked one. These findings suggest that common vetch has no termolabile toxics, which are normally present in legumes. However, the literature mentions that it contains a neurotoxic, the B-ciano-L-alanine. The present study suggests that common vetch is a promisory food resource; thus, it is highly desirable that studies be undertaken oriented to determine the toxicity in this food.
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Affiliation(s)
- H Araya
- Departamento de Nutrición, Facultad de Medicina, Universidad de Chile, Santiago
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Araya J, Vera G, Araya H, Pak N. [Effect of increase of dietary polyunsaturated fatty acids (omega 6) on the hepatic glutathione content and gamma-glutamil transpeptidase activity in the kidney of rats]. Arch Latinoam Nutr 1990; 40:231-9. [PMID: 1983460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The effect of feeding 24 to 52-days-old male rats of the Wistar strain, with beans diet deficient in sulfur-containing amino acids or supplemented with 0.3% DL-methionine and two corn oil concentrations, 2% and 20% (g/kg/diet), on the glutathione content (GSH) in liver, and on the renal gamma glutamyl transpeptidase (GGTP) (E.C.2.3.2.2) activity was studied. Results indicated that rats fed the bean diet with 2% corn oil decreased significantly the liver GSH content and GGTP renal activity. Supplementation with 0.3% methionine and/or the 20% increment of the diet corn oil, significantly stimulated the liver GSH content and the transpeptidase activity in the kidney. It is postulated that the increase of polyunsaturated fatty acids, stimulated the GGTP activity as a way of increasing substrate bioavailability for synthesis de novo of liver GSH, necessary for the protection of the hydroperoxides formation, attributed to the increment of polyunsaturated acids at cellular level.
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Affiliation(s)
- J Araya
- Facultad de Medicina, Universidad de Chile, Santiago
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Pak N, Ayala C, Vera G, Pennacchiotti I, Araya H. [Soluble and insoluble dietary fiber in cereals and legumes cultivated in Chile]. Arch Latinoam Nutr 1990; 40:116-25. [PMID: 1966507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Insoluble, soluble and total dietary fiber (DF) were determined in 35 varieties of certified whole seeds (without processing) of cereals (rice, oat, rye, and wheat) and legumes (pea, cowpea, beans, chikpea, lentil and lupine). The enzymatic method of Asp, Johansson and Siljestrom was used, with modifications in relation to time of incubation with alpha amylase, filtration system and volumes of the filtrates. Results were expressed as g/100 g dry weight. Total DF for cereals showed a range from 10.1 (wheat var. Chasqui) to 22.2 (rice var Quella). Rye, var. Tetra Baer and oats var. Pony Baer presented the highest soluble fiber content (3.3 and 3.9, respectively). In legumes, total DF fluctuated between 12.7 (pea, var. yellow) and 36.6 (lupine, var. Multolupa). Bean, var. Pinto INIA and lupine var. Multolupa presented the highest soluble fiber values (5.8 for both). Based on the results of this research work, it might be concluded that great variation exists in regard to the amount of total soluble and insoluble DF in cereals and legumes, a fact which impedes generalization as to its content in each food item.
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Affiliation(s)
- N Pak
- Universidad de Chile, Santiago
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Araya H, Vera G, Ruz M, Pak N. [Index of nutritional quality per volume: a new indicator to evaluate the nutritional quality of food preparations and diets]. Arch Latinoam Nutr 1989; 39:17-26. [PMID: 2487018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The purpose of this study was to propose a new dietary index to evaluate the nutritional quality of common dishes and diets: the index of nutritional quality per volume (INQV). In its expression, this index takes into account the nutrient density (amount of nutrient/1,000 g of diet) and the nutrient density per reference volume. The last one is the ratio between the recommended allowances of the nutrient and the volume that it is possible to consume during the day, when the diet is offered freely. Zinc was used as example in the analysis. A total of 14 dishes of habitual consumption in Chile were studied in relation to its consumption by 30 preschool children. The volume that children were able to consume was determined by differential weighing between the amount offered and the amount left on the dish, during a period of 180 days. The percentage of water and energy value were established by means of chemical analysis performed according to the AOAC, and the zinc concentration by atomic absorption spectrophotometry. The results of the INQV were then compared with those of the index of nutritional quality (INQ), which considers zinc density/1,000 kcal, and zinc and energy requirements. This comparison demonstrated that the INQV values were lower than those of the INQ in dishes with energy densities lower than 1.0 kcal/g. The opposite tendency was observed in the case of those dishes with energy densities higher than 1.0 kcal/g. The analysis herein presented demonstrates the usefulness of the INQV in diets which are voluminous and with low energy densities, commonly consumed by the low socioeconomic strata of developing countries.
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Affiliation(s)
- H Araya
- Universidad de Chile, Santiago
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Pak N, Vera G, Araya H. [Nutritive value of shellfish consumed in Chile]. Arch Latinoam Nutr 1985; 35:63-9. [PMID: 3834878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The purpose of the present study was to determine the protein quality and digestibility of shellfish commonly consumed in Chile, and to estimate its contribution to the protein needs of the Chilean population. The shellfish studied were chorito (Mytilus edulis chilensis), macha (Mesodesma donacium), loco (Concholepas concholepas), cholga (Aulacomya ater), erizo (Loxechinus albus) and almeja (no specific variety). The NPU method was used to determine protein quality. The percentage of protein adequacy for adult rations was calculated according to FAO/WHO 1973. The contribution of shellfish to the protein availability according to the family income of the Santiago population, was also calculated. Most of the shellfish presented NPU values of about 70; the lowest values were found for loco (54.9) and macha (63.3). The apparent and true digestibility gave an average of 83.6 and 90.4, respectively. The percentage of protein adequacy of habitual rations ranged between 27% (erizo) and 58% (loco). The availability of shellfish protein in relation to total protein increased from 0.4 to 2.5% when income increased. It is concluded therefore, that shellfish protein is, in general, of good quality. Nevertheless, it might be considered of poor influence insofar as fulfilling the protein needs of the population studied, whatever its socioeconomic level.
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