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Kefayat A, Sartipzadeh O, Molaabasi F, Amiri M, Gholami R, Mirzadeh M, Shokati F, Khandaei M, Ghahremani F, Poursamar SA, Sarrami-Forooshani R. Microfluidic System Consisting of a Magnetic 3D-Printed Microchannel Filter for Isolation and Enrichment of Circulating Tumor Cells Targeted by Anti-HER2/MOF@Ferrite Core-Shell Nanostructures: A Theranostic CTC Dialysis System. Anal Chem 2024; 96:4377-4384. [PMID: 38442207 DOI: 10.1021/acs.analchem.3c03567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
Low number of circulating tumor cells (CTCs) in the blood samples and time-consuming properties of the current CTC isolation methods for processing a small volume of blood are the biggest obstacles to CTC usage in practice. Therefore, we aimed to design a CTC dialysis system with the ability to process cancer patients' whole blood within a reasonable time. Two strategies were employed for developing this dialysis setup, including (i) synthesizing novel in situ core-shell Cu ferrites consisting of the Cu-CuFe2O4 core and the MIL-88A shell, which are targeted by the anti-HER2 antibody for the efficient targeting and trapping of CTCs; and (ii) fabricating a microfluidic system containing a three-dimensional (3D)-printed microchannel filter composed of a polycaprolactone/Fe3O4 nanoparticle composite with pore diameter less than 200 μm on which a high-voltage magnetic field is focused to enrich and isolate the magnetic nanoparticle-targeted CTCs from a large volume of blood. The system was assessed in different aspects including capturing the efficacy of the magnetic nanoparticles, CTC enrichment and isolation from large volumes of human blood, side effects on blood cells, and the viability of CTCs after isolation for further analysis. Under the optimized conditions, the CTC dialysis system exhibited more than 80% efficacy in the isolation of CTCs from blood samples. The isolated CTCs were viable and were able to proliferate. Moreover, the CTC dialysis system was safe and did not cause side effects on normal blood cells. Taken together, the designed CTC dialysis system can process a high volume of blood for efficient dual diagnostic and therapeutic purposes.
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Affiliation(s)
- Amirhosein Kefayat
- Biomaterials and Tissue Engineering Research Group, Department of Interdisciplinary Technologies, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran 15179-64311, Iran
- Department of Oncology, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran
| | - Omid Sartipzadeh
- Biomaterials and Tissue Engineering Research Group, Department of Interdisciplinary Technologies, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran 15179-64311, Iran
| | - Fatemeh Molaabasi
- Biomaterials and Tissue Engineering Research Group, Department of Interdisciplinary Technologies, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran 15179-64311, Iran
| | - Maryam Amiri
- Faculty of Chemistry, Shahid Beheshti University, G.C., Evin, Tehran 19839-63113, Iran
| | - Reza Gholami
- Biomaterials and Tissue Engineering Research Group, Department of Interdisciplinary Technologies, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran 15179-64311, Iran
| | - Motahareh Mirzadeh
- Research & Development Department, H.B. Adli Ltd., Isfahan 81746-73461, Iran
| | - Farhad Shokati
- Biomaterials and Tissue Engineering Research Group, Department of Interdisciplinary Technologies, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran 15179-64311, Iran
| | - Mansoureh Khandaei
- Biomaterials, Nanotechnology and Tissue Engineering Department, School of Advanced Technologies in Medicine, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran
| | - Fatemeh Ghahremani
- School of Paramedicine, Arak University of Medical Sciences, Arak 38196-93345, Iran
| | - Seyed Ali Poursamar
- Biomaterials, Nanotechnology and Tissue Engineering Department, School of Advanced Technologies in Medicine, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran
| | - Ramin Sarrami-Forooshani
- ATMP Department, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran 15179-64311, Iran
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Emami H, Tajdini A, Amirzargar B, Habibi S, Varpaei HA, Gholami R, Karimi A, Jazini Zadeh S, Mehrban AH. Intratympanic Triamcinolone or Dexamethasone in Sudden Sensory Neural Hearing Loss: A Randomized Clinical Trial. Indian J Otolaryngol Head Neck Surg 2023; 75:3545-3552. [PMID: 37974838 PMCID: PMC10646033 DOI: 10.1007/s12070-023-04032-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 06/23/2023] [Indexed: 11/19/2023] Open
Abstract
Sudden sensorineural hearing loss (SSNHL) is a condition in which a person experiences a rapid loss of hearing, often in one ear. The cause of SSNHL is not always clear, but it is thought to be related to issues with the inner ear, auditory nerve, or other parts of the hearing pathway. Intratympanic injection is a treatment method for SSNHL in which a medication (corticosteroids) is injected directly into the middle ear space through the tympanic membrane. This randomized clinical trial was conducted in two hospitals in Tehran, Iran. Patients with SSNHL were randomized (using the 4-block method) and included in this study. 0.5 cc of dexamethasone or triamcinolone was injected via a 25-gauge spinal needle into the cone of light of tympanic membrane. This procedure was repeated six times. In the present study, the rate of response to treatment was compared in the two groups of triamcinolone and dexamethasone, which showed that in the group where intratympanic injection of dexamethasone was performed, 70.9% of patients responded to treatment (48.4% had a complete response and 22.5% had a partial response), and in the group receiving intratympanic triamcinolone, 72.5% responded to the treatment and improved, 50% showed a complete response and 22.5% showed a partial response, and no significant difference was found in the statistical analysis of the two groups. Also, the comparison of audiometric parameters (SDS and SRT) did not show any significant difference before and after the treatment based on the treatment group, and the treatment response was found in the same group. No significant differences were noted in terms of outcome. Intratympanic dexamethasone injection was associated with a 70.9% response and triamcinolone injection with a 72.5% response.
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Affiliation(s)
- Hamed Emami
- Otorhinolaryngology Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Ardavan Tajdini
- Otorhinolaryngology Research Center, Amiralam Hospital, Tehran University of Medical Sciences, North Sa’adi Ave, Enghelab Blv, Tehran, Iran
| | - Behrooz Amirzargar
- Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Saleh Habibi
- Otorhinolaryngology Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Reza Gholami
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Ahang Karimi
- Department of Anesthesiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Saber Jazini Zadeh
- Otorhinolaryngology Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Hosein Mehrban
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
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Khan R, Homsi H, Gimpaya N, Lisondra J, Sabrie N, Gholami R, Bansal R, Scaffidi MA, Lightfoot D, James PD, Siau K, Forbes N, Wani S, Keswani RN, Walsh CM, Grover SC. Validity evidence for observational ERCP competency assessment tools: a systematic review. Endoscopy 2023; 55:847-856. [PMID: 36822219 DOI: 10.1055/a-2041-7546] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
BACKGROUND : Assessment of competence in endoscopic retrograde cholangiopancreatography (ERCP) is critical for supporting learning and documenting attainment of skill. Validity evidence supporting ERCP observational assessment tools has not been systematically evaluated. METHODS : We conducted a systematic search using electronic databases and hand-searching from inception until August 2021 for studies evaluating observational assessment tools of ERCP performance. We used a unified validity framework to characterize validity evidence from five sources: content, response process, internal structure, relations to other variables, and consequences. Each domain was assigned a score of 0-3 (maximum score 15). We assessed educational utility and methodological quality using the Accreditation Council for Graduate Medical Education framework and the Medical Education Research Quality Instrument, respectively. RESULTS : From 2769 records, we included 17 studies evaluating 7 assessment tools. Five tools were studied for clinical ERCP, one for simulated ERCP, and one for simulated and clinical ERCP. Validity evidence scores ranged from 2 to 12. The Bethesda ERCP Skills Assessment Tool (BESAT), ERCP Direct Observation of Procedural Skills Tool (ERCP DOPS), and The Endoscopic Ultrasound (EUS) and ERCP Skills Assessment Tool (TEESAT) had the strongest validity evidence, with scores of 10, 12, and 11, respectively. Regarding educational utility, most tools were easy to use and interpret, and required minimal additional resources. Overall methodological quality (maximum score 13.5) was strong, with scores ranging from 10 to 12.5. CONCLUSIONS : The BESAT, ERCP DOPS, and TEESAT had strong validity evidence compared with other assessments. Integrating tools into training may help drive learners' development and support competency decision making.
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Affiliation(s)
- Rishad Khan
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Toronto, Toronto, Canada
| | - Hoomam Homsi
- Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Nikko Gimpaya
- Division of Gastroenterology, St. Michael's Hospital, Toronto, Canada
| | - James Lisondra
- Division of Gastroenterology, St. Michael's Hospital, Toronto, Canada
| | | | - Reza Gholami
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Toronto, Toronto, Canada
- Division of Gastroenterology, St. Michael's Hospital, Toronto, Canada
| | - Rishi Bansal
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Canada
| | | | - David Lightfoot
- Health Science Library, Unity Health Toronto, St. Michael's Hospital, Toronto, Canada
| | - Paul D James
- Division of Gastroenterology, University Health Network, Toronto, Canada
| | - Keith Siau
- Joint Advisory Group on Gastrointestinal Endoscopy, Royal College of Physicians, London, United Kingdom
- Immunology and Immunotherapy, University of Birmingham College of Medical and Dental Sciences, Birmingham, United Kingdom
| | - Nauzer Forbes
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Sachin Wani
- Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Rajesh N Keswani
- Division of Gastroenterology, Department of Medicine, Northwestern University, Chicago, Illinois, United States
| | - Catharine M Walsh
- The Wilson Centre, University of Toronto, Toronto, Canada
- SickKids Research and Learning Institute, The Hospital for Sick Children, Toronto, Canada
- Division of Gastroenterology, Hepatology, and Nutrition, The Hospital for Sick Children, Toronto, Canada
- Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Samir C Grover
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Toronto, Toronto, Canada
- Division of Gastroenterology, St. Michael's Hospital, Toronto, Canada
- Department of Medicine, University of Toronto, Toronto, Canada
- Li Ka Shing Knowledge Institute, Toronto, Canada
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Khan R, Homsi H, Gimpaya N, Sabrie N, Gholami R, Bansal R, Scaffidi M, Lightfoot D, James P, Siau K, Forbes N, Wani S, Keswani R, Walsh C, Grover S. A117 VALIDITY EVIDENCE FOR ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY COMPETENCY ASSESSMENT TOOLS: A SYSTEMATIC REVIEW. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991253 DOI: 10.1093/jcag/gwac036.117] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background Assessment of competence in endoscopic retrograde cholangiopancreatography (ERCP) is essential to ensure trainees possess the skills needed for independent practice. Traditionally, ERCP training has used the apprenticeship model, whereby novices learn skills under the supervision of an expert. A growing focus on procedural quality, however, has supported the implementation of competency-based medical education models which require documentation of a trainee’s competence for independent practice. Observational assessment tools with strong evidence of validity are critical to this process. Validity evidence supporting ERCP observational assessment tools has not been systematically evaluated. Purpose To conduct a systematic review of ERCP assessment tools and identify tools with strong evidence of validity using a unified validity evidence framework Method We conducted a systematic search using electronic databases and hand-searching from inception until August 2021 for studies evaluating observational assessment tools of ERCP performance. We used a unified validity framework to characterize validity evidence from five sources: content, response process, internal structure, relations to other variables, and consequences. Each domain was assigned a score of 0-3 (maximum score 15). We assessed educational utility and methodological quality using the Accreditation Council for Graduate Medical Education framework and the Medical Education Research Quality Instrument, respectively. Result(s) From 2769 records, we included 17 studies evaluating 7 assessment tools. Five tools were studied for clinical ERCP, one on simulated ERCP, and one on simulated and clinical ERCP. Validity evidence scores ranged from 2-12. The Bethesda ERCP Skills Assessment Tool (BESAT), ERCP Direct Observation of Procedural Skills Tool (ERCP DOPS), and The Endoscopic Ultrasound (EUS) and ERCP Skills Assessment Tool (TEESAT) had the strongest validity evidence with scores of 10, 12, and 11, respectively. Regarding educational utility, most tools were easy to use and interpret, and required minimal additional resources. Overall methodological quality was strong, with scores ranging from 10-12.5 (maximum 13.5). Conclusion(s) The BESAT, ERCP DOPS, and TEESAT have strong validity evidence compared to other assessments. Integrating tools into training may help drive learners’ development and support competency decision-making. Please acknowledge all funding agencies by checking the applicable boxes below CAG Disclosure of Interest None Declared
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Affiliation(s)
- R Khan
- Western University, London
| | | | | | | | | | | | | | | | - P James
- University Health Network, Toronto, Canada
| | - K Siau
- University of Birmingham College of Medical and Dental Sciences, Birmingham, United Kingdom
| | - N Forbes
- University of Calgary, Calgary, Canada
| | - S Wani
- University of Colorado Anschutz Medical Campus, Aurora
| | - R Keswani
- Northwestern University, Chicago, United States
| | - C Walsh
- The Hospital for Sick Children, Toronto, Canada
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Moudi S, Heidari B, Yousefghahari B, Gholami R, Gholinia H, Babaei M. The prevalence and correlation of depression and anxiety with disease activity in rheumatoid arthritis. Reumatologia 2023; 61:86-91. [PMID: 37223374 PMCID: PMC10201383 DOI: 10.5114/reum/154905] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 09/23/2022] [Indexed: 11/02/2023] Open
Abstract
INTRODUCTION Depression and anxiety share similar symptoms with rheumatoid arthritis (RA) and these conditions are often not diagnosed or overlooked in RA. This study aimed to determine the prevalence of depression/anxiety in RA and their correlation with RA activity. MATERIAL AND METHODS Rheumatoid arthritis patients who presented at a rheumatology clinic were selected consecutively. The diagnosis of RA was confirmed by the ACR/EULAR criteria, disease activity was assessed by Disease Activity Score based on the 28-joint count (DAS28) and patients with DAS28 > 2.6 were considered to have active RA. The diagnosis of depression and anxiety was made by the Hospital Anxiety and Depression Scale (HADS). The Pearson test was used to determine the correlation between DAS28 and HADS scores. RESULTS Two-hundred patients (female, 82%) with a mean age of 53.5 ±10.1 years and mean disease duration of 6.6 ±6.8 years were studied. Depression was diagnosed in 27 (13.5%) patients and anxiety in 38 (19%) patients. The DAS28 score correlated positively with depression (r = 0.173, p = 0.014) and anxiety score (r = 0.229, p = 0.001). In multiple logistic regression analysis after adjustment for all covariates, age < 40 years and female sex were independently associated with RA activity in patients with depression, with OR = 4.21 (p = 0.002) and OR = 3.56 (p = 0.028) respectively. CONCLUSIONS These findings indicate that depression and anxiety are prevalent in RA and correlate positively with active disease in particular in depressive female patients aged < 40 years.
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Affiliation(s)
- Sousan Moudi
- Health Research Center, Master of Biostatistics and Epidemiology, Babol University of Medical Science, Iran
| | - Behzad Heidari
- Clinical Research Development Unit of Rouhani, Babol University of Medical Sciences, Iran
| | - Behnaz Yousefghahari
- Clinical Research Development Unit of Rouhani, Babol University of Medical Sciences, Iran
| | - Reza Gholami
- Student Research Committee, Babol University of Medical Sciences, Iran
| | - Hemmat Gholinia
- Clinical Research Development Unit of Rouhani, Babol University of Medical Sciences, Iran
| | - Mansour Babaei
- Clinical Research Development Unit of Rouhani Hospital, Babol University of Medical Sciences, Iran
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Tahmasbi V, Qasemi M, Ghasemi R, Gholami R. Experimental study and sensitivity analysis of force behavior in cortical bone milling. Med Eng Phys 2022; 105:103821. [DOI: 10.1016/j.medengphy.2022.103821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 04/24/2022] [Accepted: 05/18/2022] [Indexed: 10/18/2022]
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Gholami R, Khan R, Ramkissoon A, Alabdulqader A, Gimpaya N, Bansal R, Scaffidi MA, Prasad V, Detsky AS, Baker JP, Grover SC. Recommendation Reversals in Gastroenterology Clinical Practice Guidelines. J Can Assoc Gastroenterol 2022; 5:98-99. [PMID: 35368318 PMCID: PMC8972276 DOI: 10.1093/jcag/gwab040] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 09/28/2021] [Indexed: 11/23/2022] Open
Abstract
Background Recommendations in clinical practice guidelines (CPGs) may be reversed when evidence emerges to show they are futile or unsafe. In this study, we identified and characterized recommendation reversals in gastroenterology CPGs. Methods We searched CPGs published by 20 gastroenterology societies from January 1990 to December 2019. We included guidelines which had at least two iterations of the same topic. We defined reversals as when (a) the more recent iteration of a CPG recommends against a specific practice that was previously recommend in an earlier iteration of a CPG from the same body, and (b) the recommendation in the previous iteration of the CPG is not replaced by a new diagnostic or therapeutic recommendation in the more recent iteration of the CPG. The primary outcome was the number of recommendation reversals. Secondary outcomes included the strength of recommendations and quality of evidence cited for reversals. Results Twenty societies published 1022 CPGs from 1990 to 2019. Our sample for analysis included 129 unique CPGs. There were 11 recommendation reversals from 10 guidelines. New evidence was presented for 10 recommendation reversals. Meta-analyses were cited for two reversals, and randomized controlled trials (RCTs) for seven reversals. Recommendations were stronger after the reversal for three cases, weaker in two cases, and of similar strength in three cases. We were unable to compare recommendation strengths for three reversals. Conclusion Recommendation reversals in gastroenterology CPGs are uncommon but highlight low value or harmful practices.
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Affiliation(s)
- Reza Gholami
- Division of Gastroenterology, St. Michael’s Hospital, Toronto, Ontario, Canada
| | - Rishad Khan
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Anushka Ramkissoon
- Division of Gastroenterology, St. Michael’s Hospital, Toronto, Ontario, Canada
| | | | - Nikko Gimpaya
- Division of Gastroenterology, St. Michael’s Hospital, Toronto, Ontario, Canada
| | - Rishi Bansal
- Division of Gastroenterology, St. Michael’s Hospital, Toronto, Ontario, Canada
| | - Michael A Scaffidi
- Division of Gastroenterology, St. Michael’s Hospital, Toronto, Ontario, Canada
| | - Vinay Prasad
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California,USA
| | - Allan S Detsky
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, Mount Sinai Hospital and University Health Network, Toronto, Ontario, Canada
| | - Jeffrey P Baker
- Division of Gastroenterology, St. Michael’s Hospital, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Samir C Grover
- Division of Gastroenterology, St. Michael’s Hospital, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
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Tham D, Gimpaya N, Gholami R, Pattni C, Seleq S, Bansal R, Fujiyoshi MA, Ramkissoon A, Lisondra J, Ariaratnam J, Scaffidi M, Khan R, Grover S. A25 CRITICAL APPRAISAL OF GI ENDOSCOPY CLINICAL PRACTICE GUIDELINES DURING THE COVID-19 PANDEMIC. J Can Assoc Gastroenterol 2022. [PMCID: PMC8859207 DOI: 10.1093/jcag/gwab049.024] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Clinical Practice Guidelines (CPGs) are integral during a pandemic, offering guidance to clinicians through uncertainty. Existing literature has established that the need for rapid publication of CPGs during previous infectious disease outbreaks resulted in less rigorous guidelines. CPGs were rapidly developed since the onset of the pandemic in December 2019, providing guidance in gastrointestinal (GI) endoscopy, an area where COVID-19 may pose risk of transmission.
Aims
To evaluate the quality of GI endoscopy guidelines developed during the COVID-19 pandemic and to compare these with (a) endoscopy CPGs developed prior to the pandemic; (b) CPGs for other endoscopic topics unrelated to COVID-19; and, (c) non-endoscopic CPGs published during the pandemic.
Methods
We systematically searched Medline, Embase and Scopus for CPGs published by GI societies from January 1, 2018 to December 31, 2020. A grey literature search was conducted. Two authors screened full-texts. In this interim analysis, CPGs were grouped based on publication year: before 2020, or 2020. Endoscopy CPGs published in 2020 were categorized as COVID or non-COVID related. Two authors independently assessed the CPGs using the AGREE II tool, consisting of six domains for evaluating guidelines. A domain score of 60 was set as a threshold to indicate good quality.
Results
There were 70 endoscopy guidelines and 27 CPGs focused on other GI topics. The mean overall scores were 69% (±12%) for endoscopy CPGs published before 2020 (n=28), and 51% (±23%) for CPGs published in 2020 (n=42). For individual AGREE II domains, mean scores for pre-2020 CPGs ranged from 33.11 (±17.39) in Applicability to 81.55 (±10.37) in Clarity of Presentation. For CPGs published during COVID-19, mean domain scores ranged from 34.18 (±10.52) in Applicability to 75.26 (±13.85) in Clarity of Presentation. 21 of 42 CPGs published in 2020 were related to COVID. Mean overall scores were 35% (±20%) for COVID-related CPGs and 67% (±13%) for non-COVID-19 CPGs. For COVID-19 CPGs, scores ranged from 27.88 (±20.31) in Rigour of Development to 69.58 (±10.81) in Scope and Purpose. For non-COVID CPGs, the scores ranged from 37.30 (±8.93) in Applicability to 84.52 (±5.93) in Clarity of Presentation.
Conclusions
The difference in overall scores between COVID-19 endoscopy CPGs and non-COVID endoscopy CPGs may suggest that the urgency to disseminate COVID-19 information decreased CPG quality or completeness of reporting. This interim analysis is limited by the lack of distinction between peer-reviewed CPGs and non-peer reviewed recommendations. Given the importance of CPGs in clinical decision making, it is important to ensure that the rapid development of guidelines does not compromise quality and rigour.
Funding Agencies
None
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Affiliation(s)
- D Tham
- St. Michael’s Hospital, Toronto, ON, Canada
| | - N Gimpaya
- St. Michael’s Hospital, Toronto, ON, Canada
| | - R Gholami
- St. Michael’s Hospital, Toronto, ON, Canada
| | - C Pattni
- St. Michael’s Hospital, Toronto, ON, Canada
| | - S Seleq
- St. Michael’s Hospital, Toronto, ON, Canada
| | - R Bansal
- St. Michael’s Hospital, Toronto, ON, Canada
| | | | | | - J Lisondra
- St. Michael’s Hospital, Toronto, ON, Canada
| | | | - M Scaffidi
- St. Michael’s Hospital, Toronto, ON, Canada
| | - R Khan
- St. Michael’s Hospital, Toronto, ON, Canada
| | - S Grover
- St. Michael’s Hospital, Toronto, ON, Canada
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Gimpaya N, Khan R, Gallinger ZR, Scaffidi MA, Al Abdulqader AK, Ahmed M, Gholami R, Ramkissoon A, James PD, Mosko J, Griller N, Bansal R, Grover SC. A77 A REUSABLE POLYCARBONATE BOX TO DECREASE DROPLET CONTAMINATION DURING UPPER ENDOSCOPY: A SIMULATION-BASED STUDY FOR THE COVID-19 PANDEMIC. J Can Assoc Gastroenterol 2021. [PMCID: PMC7989228 DOI: 10.1093/jcag/gwab002.075] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Upper gastrointestinal (GI) endoscopic procedures are aerosol-generating, increasing the risk of healthcare workers (HCW) contracting Coronavirus disease 2019 (COVID-19). Aims To present a polycarbonate box (EndoBox) designed for use in upper GI endoscopy and evaluate its impact on the contamination of endoscopy staff during simulated procedures. Methods Simulated gastroscopies were performed using an upper body simulator placed in left lateral decubitus (LLD) and supine positions. The endoscopist and assistant wore personal protective equipment. Droplet exposure was measured using fluorescent abiotic surrogate particles. Two blinded observers independently viewed images from each scenario to qualitatively evaluate contamination levels. The primary outcome was the level of HCW contamination by droplets generated from a simulated cough with and without the EndoBox on the upper body simulator. The endoscopist’s ergonomic behaviour was also assessed using the Rapid Upper Limb Assessment (RULA) tool. Results Without the EndoBox, there was a higher level of contamination on the endoscopist when the upper body simulator is in the LLD position. A higher level of contamination was observed on the assistant when the simulator is in supine position. With the EndoBox, the contamination levels on the endoscopy staff were lower in both LLD and supine scenarios. The endoscopist’s ergonomics were rated 2 to 3 on the RULA tool when using the EndoBox. Conclusions The EndoBox reduces macroscopic droplet contamination during simulated gastroscopy. The endoscopist’s risk of musculoskeletal injury remained in the low risk categories as assessed by the RULA tool. Another advantage of the EndoBox design is the arch extending from the bottom that allows for removal of the box without withdrawing the endoscope. This enables rapid access to the patient’s airway if they experience respiratory distress. This study was limited by an inability to assess microscopic contamination and contamination at the level of the port or buttons when suction is applied. Within these limitations, the EndoBox may be a useful adjunct to traditional personal protective equipment. Funding Agencies SMHA AFP COVID-Related Innovation Funds
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Affiliation(s)
- N Gimpaya
- Gastroenterology, St Michael’s Hospital, Toronto, ON, Canada
| | - R Khan
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Z R Gallinger
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - M A Scaffidi
- Gastroenterology, St Michael’s Hospital, Toronto, ON, Canada
| | | | - M Ahmed
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, Birmingham, United Kingdom
| | - R Gholami
- Gastroenterology, St Michael’s Hospital, Toronto, ON, Canada
| | - A Ramkissoon
- Gastroenterology, St Michael’s Hospital, Toronto, ON, Canada
| | - P D James
- University Health Network, Toronto, ON, Canada
| | - J Mosko
- Gastroenterology, St Michael’s Hospital, Toronto, ON, Canada
| | - N Griller
- Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - R Bansal
- Gastroenterology, St Michael’s Hospital, Toronto, ON, Canada
| | - S C Grover
- Gastroenterology, St Michael’s Hospital, Toronto, ON, Canada
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10
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Gholami R, Gimpaya N, Khan R, Scaffidi MA, Bansal R, Ramkissoon A, Alabdulqader A, Grover SC. A71 RECOMMENDATION REVERSALS IN GASTROENTEROLOGY CLINICAL PRACTICE GUIDELINES. J Can Assoc Gastroenterol 2021. [DOI: 10.1093/jcag/gwab002.069] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Clinical practice guidelines are evidence-based resources designed to inform clinical decision making. Often, superior evidence will support the inclusion of novel procedures and practices to replace older recommendations. Recommendation reversals occur when (a) superior quality evidence emerges to suggest the harm or non-beneficence of prior recommendations, and (b) that recommendation is not supplanted by a newer one.
Aims
The primary objective of this study was to describe the content, frequency and rationale for recommendation reversals in CPGs published by gastroenterological societies.
Methods
For this meta-epidemiologic study, we considered two criteria to define a recommendation reversal: (a) the more recent CPG makes a recommendation that contradicts a previously accepted practice; and (b) the prior recommendation is not replaced by any novel intervention. We searched CPGs published by 20 major GI societies from 1991- 2019. Guidelines were included if had at least two iterations with the same title and used a valid evidence rating system (such as GRADE). Explicit recommendations which reported definite levels of evidence and strength of recommendation were extracted.
Results
We identified 1022 clinical guidelines from GI societies over 28 years. 292 CPGs were included for data synthesis. 5985 explicit statements were extracted. 12 reversals were confirmed and are summarized in the Table. Six reversals (50.0%) occurred due to studies reporting non-beneficence and 3 (25.0%) occrred due to studies reporting harm. Three recommendations (25.0%) were reversed due to new clinical trials; 3 (25.0%) due to systematic reviews or meta-analyses; and 2 to conform with CPGs of other societies (16.7%).
Conclusions
We describe recommendation reversals made in gastroenterology CPGs, and the reasons thereof. Investigation of recommendation reversals allows for the identification of low-value medical practices. This reinforces the need for GI CPG committees to (1) iteratively review guidelines to re-evaluate recommendations made on low-quality evidence and; (2) refrain from making recommendations when evidence for the same is weak.
Funding Agencies
None
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Affiliation(s)
- R Gholami
- Gastroenterology, St Michael’s Hospital, Toronto, ON, Canada
| | - N Gimpaya
- Gastroenterology, St Michael’s Hospital, Toronto, ON, Canada
| | - R Khan
- Gastroenterology, St Michael’s Hospital, Toronto, ON, Canada
| | - M A Scaffidi
- Gastroenterology, St Michael’s Hospital, Toronto, ON, Canada
| | - R Bansal
- McMaster University Faculty of Health Sciences, Richmond Hill, ON, Canada
| | - A Ramkissoon
- Gastroenterology, St Michael’s Hospital, Toronto, ON, Canada
| | - A Alabdulqader
- Gastroenterology, St Michael’s Hospital, Toronto, ON, Canada
| | - S C Grover
- Gastroenterology, St Michael’s Hospital, Toronto, ON, Canada
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11
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Mardani R, Alamdary A, Mousavi Nasab SD, Gholami R, Ahmadi N, Gholami A. Association of vitamin D with the modulation of the disease severity in COVID-19. Virus Res 2020; 289:198148. [PMID: 32866536 PMCID: PMC7455115 DOI: 10.1016/j.virusres.2020.198148] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 08/25/2020] [Accepted: 08/26/2020] [Indexed: 01/15/2023]
Abstract
Insufficient levels of Vitamin D could be seen in COVID-19 patients. Increase in the ACE could be seen in COVID-19 patients with higher quantities in the individuals who died from the COVID-19. The Neutrophil to Lymphocyte ratio (NLR) is higher in COVID-19 than the control group. Serum levels of vitamin D and ACE are associated with the progression and severity of the COVID-19.
In late 2019, SARS-CoV-2 started to spread throughout the world causing the COVID-19 that has taken a considerable number of lives. Results obtained from several investigations have explained the virus origin, pathogenicity, and transmission. Similar to SARS coronavirus, the pulmonary angiotensin converting enzyme (ACE) 2 was introduced as the virus receptor for entering the cell. An increased body of epidemiological and clinical evidences has shown modulating effects of vitamin D in lung injuries through several mechanisms. Several clinical symptoms as well as molecular factors have shown to be related to the disease transmission and severity. In this study, vitamin D, ACE concentrations, and neutrophil to lymphocyte ratio (NLR) were measured in patients with confirmed COVID-19 in comparison with control group. Results demonstrated significant alterations in vitamin D and ACE levels as well as NLR in the patients’ group. Contribution of those factors with the prognosis and severity of the disease has been shown.
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Affiliation(s)
- R Mardani
- Viral Vaccines Production Unit, Pasteur Institute of Iran Production Complex, Tehran, Iran
| | - A Alamdary
- Viral Vaccines Production Unit, Pasteur Institute of Iran Production Complex, Tehran, Iran
| | - S D Mousavi Nasab
- Rotavaccine Research Lab, Pasteur Institute of Iran Production Complex, Tehran, Iran
| | - R Gholami
- Shoushtar University of Medical Sciences, Shoushtar, Iran
| | - N Ahmadi
- Proteomics Research Center, Department of Medical Lab Technology, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - A Gholami
- Viral Vaccines Production Unit, Pasteur Institute of Iran Production Complex, Tehran, Iran.
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12
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Nazarian A, Bishay K, Gholami R, Scaffidi MA, Khan R, Cohen-Lyons D, Griller N, Satchwell JB, Baker JP, Grover SC, Irvine EJ. Factors Associated with Poor Quality of Life in a Canadian Cohort of Patients with Inflammatory Bowel Disease: A Cross-sectional Study. J Can Assoc Gastroenterol 2020; 4:91-96. [PMID: 33855267 PMCID: PMC8023811 DOI: 10.1093/jcag/gwaa014] [Citation(s) in RCA: 4] [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: 08/26/2019] [Accepted: 04/05/2020] [Indexed: 12/22/2022] Open
Abstract
Background Health-related quality of life (QoL) is often adversely affected in patients with inflammatory bowel disease (IBD). We aimed to identify factors associated with poor QoL among Canadian patients with IBD in clinical remission. Methods We enrolled patients at a single academic tertiary care center with inactive IBD. All eligible patients completed a series of questionnaires that included questions on demographics, disease activity, anxiety, depression and the presence of irritable bowel syndrome (IBS) symptoms. Stool sample for fecal calprotectin (FC) was also collected to assess for subclinical inflammation. The primary outcome measure was QoL assessed by the short inflammatory bowel disease questionnaire (SIBDQ), with planned subgroup comparisons for fatigue, anxiety, depression and IBS symptoms. Results Ninety-three patients were eligible for inclusion in this study. The median SIBDQ scores were lower in patients with anxiety (P < 0.001), depression (P = 0.004), IBS symptoms (P < 0.001) and fatigue (P = 0.018). Elevated FC in patients in clinical remission did not impact QoL. These findings were consistent on multivariate linear regression. Conclusions Anxiety, depression, fatigue and IBS symptoms are all independently associated with lower QoL in patients with inactive IBD. Clinicians are encouraged to screen for these important factors as they may detrimentally impact QoL in IBD patients even in clinical remission.
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Affiliation(s)
- Amir Nazarian
- Division of Gastroenterology, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Kirles Bishay
- Division of Gastroenterology, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Reza Gholami
- Division of Gastroenterology, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Michael A Scaffidi
- Division of Gastroenterology, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Rishad Khan
- Division of Gastroenterology, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Daniel Cohen-Lyons
- Division of Gastroenterology, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Nadia Griller
- Division of Gastroenterology, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Joshua B Satchwell
- Division of Gastroenterology, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Jeffrey P Baker
- Division of Gastroenterology, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Samir C Grover
- Division of Gastroenterology, St. Michael's Hospital, Toronto, Ontario, Canada.,Li Ka Shing Knowledge Institute, University of Toronto, Toronto, Ontario, Canada
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13
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Nazarian A, Bishay K, Gholami R, Scaffidi MA, Khan R, Cohen-Lyons D, Griller N, Satchwell JB, Baker J, Irvine EJ, Grover SC. A243 FACTORS ASSOCIATED WITH POOR QUALITY OF LIFE IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE IN CLINICAL REMISSION: A CROSS-SECTIONAL STUDY. J Can Assoc Gastroenterol 2020. [DOI: 10.1093/jcag/gwz047.242] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Inflammatory bowel disease (IBD) is associated with a substantial burden on quality of life (QoL). Functional gastrointestinal disorders such as irritable bowel syndrome (IBS) as well as depression and anxiety are more common in patients with IBD as compared with the general population. Although poorer QoL is correlated with IBS, depression and anxiety in individuals with IBD at times of IBD diagnosis and disease activity, it is unclear what, if any, impact these may have on overall quality of life at times of disease remission.
Aims
We aimed to identify factors associated with poor QoL among Canadian patients with IBD in clinical remission.
Methods
We conducted a prospective, cross-sectional study to determine whether fatigue, depression, anxiety and IBS were associated with lower QoL in patients with IBD in clinical remission. We enrolled patients at a single academic tertiary care center with inactive IBD. All eligible patients completed a series of questionnaires that included questions on demographics, disease activity, anxiety, depression, and the presence of irritable bowel syndrome (IBS) symptoms. Stool samples for fecal calprotectin (FC) were also collected to assess for subclinical inflammation. The primary outcome measure was QoL assessed by the short inflammatory bowel disease questionnaire (SIBDQ), with planned subgroup comparisons for fatigue, anxiety, depression and IBS symptoms.
Results
Ninety-three patients were eligible for inclusion in this study. The median SIBDQ scores were lower in patients with anxiety (P<0.001), depression (P=0.004), IBS symptoms (P<0.001), and fatigue (P=0.018).
Conclusions
In this cross-sectional study, we found that anxiety, depression, fatigue, and IBS-like symptoms were all independently associated with lower QoL among patients with inactive IBD. Importantly, subclinical inflammation as defined by a positive fecal calprotectin in the absence of clinical symptoms did not have an adverse effect on QoL. The findings of this study suggest that patients with IBD would likely benefit from screening for depression, anxiety, fatigue and IBS. Further research is warranted to determine if targeted treatment of these conditions, specifically in patients with quiescent IBD would lead to improved outcomes.
Funding Agencies
None
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Affiliation(s)
| | - K Bishay
- University of Toronto, Toronto, ON, Canada
| | - R Gholami
- University of Toronto, Toronto, ON, Canada
| | | | - R Khan
- University of Toronto, Toronto, ON, Canada
| | | | - N Griller
- University of Toronto, Toronto, ON, Canada
| | - J B Satchwell
- Gastroenterology, St Michael’s Hospital, Toronto, ON, Canada
| | - J Baker
- Gastroenterology, St Michael’s Hospital, Toronto, ON, Canada
| | - E J Irvine
- University of Toronto, Toronto, ON, Canada
| | - S C Grover
- University of Toronto, Toronto, ON, Canada
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14
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Khan R, Scaffidi MA, Gimpaya N, Tham D, Atalla M, Al-Mazroui A, Gholami R, Satchwell JB, Walsh CM, Grover SC. A143 IMPACT OF A SIMULATION-BASED AUGMENTED REALITY CURRICULUM ON POLYPECTOMY SKILLS AMONG NOVICE ENDOSCOPISTS: A RANDOMIZED CONTROLLED TRIAL. J Can Assoc Gastroenterol 2020. [DOI: 10.1093/jcag/gwz047.142] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Polypectomy is an essential endoscopic skill. Training in polypectomy has been identified as a major deficiency for endoscopists worldwide as polypectomy occurs ad hoc during a colonoscopy when a polyp is detected, and a lack of standardized curricula. Augmented reality (AR), which superimposes computer-generated images on a user’s view of the world, can address these gaps by standardizing encounters with polyps while completing simulated procedures and enabling polypectomy-specific teaching.
Aims
Evaluate the impact of a simulation-based augmented reality curriculum on polypectomy performance among novice endoscopists.
Methods
This study includes two cohorts of participants from 2019 to 2020. In 2019, participants were randomized into either: (1) a control curriculum, involving 6 hours of simulation-based training (SBT) supplemented by expert feedback, interlaced with 4 hours of small group teaching on the theory of colonoscopy; or (2) the augmented reality curriculum (ARC), in involving the same curriculum with integrated AR, wherein participants engaged with an AR-enhanced video demonstrating relevant therapeutic and pathologic details during polypectomy. The SBT for all participants involved a progressive curriculum starting on a bench-top model and then moving to the EndoVR® virtual reality simulator. The primary outcome was polypectomy-specific performance using the Direct Observation of Polypectomy Skills (DOPyS) tool during a simulated polypectomy after training, with a maximum score of 100.
Results
Demographic characteristics are summarized in Table. In 2019, 21 novice endoscopists were enrolled. Immediately after training, the mean DOPyS score among ARC group participants was 76.2 (SD=17.9) compared to 71.8 (SD=13.2) among control group participants (Figure). In this interim analysis, there was no significant difference between groups. Data analysis will be completed after 2020 participants complete the study.
Conclusions
Interim results show a trend towards improved polypectomy performance with no significant difference. The results of this study have the potential to impact polypectomy education among novices. Simulation-based AR interventions may allow learners to progress towards achieving competency in polypectomy in a risk-free environment prior to first patient contact.
Funding Agencies
None
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Affiliation(s)
- R Khan
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | | | - N Gimpaya
- Gastroenterology, St Michael’s Hospital, Toronto, ON, Canada
| | - D Tham
- Gastroenterology, St Michael’s Hospital, Toronto, ON, Canada
| | - M Atalla
- Gastroenterology, St Michael’s Hospital, Toronto, ON, Canada
| | - A Al-Mazroui
- Gastroenterology, St Michael’s Hospital, Toronto, ON, Canada
| | - R Gholami
- Gastroenterology, St Michael’s Hospital, Toronto, ON, Canada
| | - J B Satchwell
- Gastroenterology, St Michael’s Hospital, Toronto, ON, Canada
| | - C M Walsh
- Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children and The Wilson Centre, Toronto, ON, Canada
| | - S C Grover
- Gastroenterology, St Michael’s Hospital, Toronto, ON, Canada
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15
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Amiri Dash Atan N, Koushki M, Motedayen M, Dousti M, Sayehmiri F, Vafaee R, Norouzinia M, Gholami R. Type 2 diabetes mellitus and non-alcoholic fatty liver disease: a systematic review and meta-analysis. Gastroenterol Hepatol Bed Bench 2017; 10:S1-S7. [PMID: 29511464 PMCID: PMC5838173] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIM The aim of this study was the evaluation of the prevalence of NAFLD in patients with type 2 diabetes mellitus. BACKGROUND Non-alcoholic fatty liver disease (NAFLD) is an emerging disease with high prevalence in patients with type 2 diabetes mellitus (T2DM). Many studies have reported the prevalence of NAFLD in type 2 diabetes mellitus patients. However, these results are inconsistent. METHODS A Literature search was conducted in PubMed, Scopus, web of science and Science Direct from 2005 to August 2017. The necessary information was extracted. Heterogeneity was evaluated using I2 statistic. Meta-regression analyses were performed to the estimation of the relationship between the year of study and sample size with the prevalence of NAFLD. Publication bias was assessed by both Begg rank correlation and Egger tests. Subgroup analysis was performed for identification of sources heterogeneity. RESULTS Seventeen studies involving 10897 type 2 diabetes mellitus patients with NAFLD were included in this meta-analysis. The overall prevalence of NAFLD in type 2 diabetes mellitus patients by random effects models was 54% (95% CI, 45%- 64%). There is a significant heterogeneity across studies with (I2= 99%, p> 0.01). The funnel plot as graphically and Begg and Egger as statistically showed no publication bias among studies. Subgroup analysis indicated that the prevalence of NAFLD in type 2 diabetes mellitus patients differed in predictive factors such as lipid profile, BMI, HbA1c, AST, and ALT. This finding in spite of heterogeneity of documents is corresponding to the positive correlation between NAFLD and type 2 diabetes mellitus. CONCLUSION The findings indicated that the overall prevalence of NAFLD among type 2 diabetes mellitus patients is significantly higher. It can be concluded that type 2 diabetes mellitus patients should be managed to prevent NAFLD.
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Affiliation(s)
- Nasrin Amiri Dash Atan
- Proteomics Research Center, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences Tehran, Iran
| | - Mehdi Koushki
- Medicine Faculty, Tehran University of Medical Sciences, Tehran, Iran
| | - Morteza Motedayen
- Department of Cardiology, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Majid Dousti
- Department of Parasitology, Faculty of Medicine, Shiraz University of Medical Sciences, Fars, Iran
| | - Fatemeh Sayehmiri
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Reza Vafaee
- Proteomics Research Center, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences Tehran, Iran,Safety promotion and Injury prevention Research Center, Shahid Beheshti University of medical sciences, Tehran, Iran
| | - Mohsen Norouzinia
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Reza Gholami
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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16
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Lorestani A, Gholami R, Zareie M. Physical and mechanical properties of milk thistle seeds. Quality Assurance and Safety of Crops & Foods 2014. [DOI: 10.3920/qas2012.0184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- A.N. Lorestani
- Mechanical Engineering of Agricultural Machinery Department, Razi University, Faculty of Agriculture, Imam Khomeini Highway, 6715685438 Kermanshah, Iran
| | - R. Gholami
- Mechanical Engineering of Agricultural Machinery Department, Razi University, Faculty of Agriculture, Imam Khomeini Highway, 6715685438 Kermanshah, Iran
| | - M. Zareie
- Mechanical Engineering of Agricultural Machinery Department, Razi University, Faculty of Agriculture, Imam Khomeini Highway, 6715685438 Kermanshah, Iran
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17
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Arshi S, Babaie D, Nabavi M, Tebianian M, Ghalehbaghi B, Jalali F, Ahmadvand A, Gholami R. Circulating level of CD4+ CD25+ FOXP3+ T cells in patients with chronic urticaria. Int J Dermatol 2014; 53:e561-6. [PMID: 25311400 DOI: 10.1111/ijd.12630] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND CD4+ CD25+ T-regulatory (Treg) cells play critical roles in maintaining peripheral tolerance and preventing autoimmunity. As characteristics of Treg cells have not been precisely investigated in chronic urticaria (CU) yet, this study was performed. OBJECTIVE To determine the frequencies of circulating CD4+ CD25+ FOXP3+ T cells and serum levels of interleukin (IL)-10, transforming growth factor (TGF)-β, and IL-17 in patients with chronic autoimmune urticaria and chronic idiopathic urticaria compared to healthy controls. METHODS Peripheral blood mononuclear cells (PBMCs) were obtained from patients with CU and healthy controls. The frequency of CD4+ CD25+ T cells in PBMCs and expression levels of FOXP3 were detected by flow cytometry. The serum levels of IL-10, TGF-β, and IL-17 were measured by enzyme-linked immunosorbent assay. RESULTS A significant decrease in the percentage of circulating CD4+ CD25+ FOXP3+ T cells was detected in patients with CU, compared to control subjects. However, no significant difference was detected on the serum levels of IL-10, TGF-β, and IL-17 between patients with CU and control subjects. CONCLUSIONS This study demonstrated that the frequency of Treg cells in PBMCs was decreased in patients with CU. Further studies are needed to clarify the exact role of Treg cells in the pathogenesis of CU and factors regulating their function.
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Affiliation(s)
- Saba Arshi
- Department of Allergy and Clinical Immunology, Hazrate Rasool Hospital, Iran University of Medical Sciences, Tehran, Iran
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18
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Nahidi F, Gholami R, Rashidi Y, Majd HA. Relationship between air pollution and pre-eclampsia in pregnant women: a case-control study. East Mediterr Health J 2014; 19 Suppl 3:S60-S66. [PMID: 24995762] [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] [Received: 06/19/2012] [Accepted: 09/20/2012] [Indexed: 06/03/2023]
Abstract
Pre-eclampsia is the main cause of maternal and fetal death and disability worldwide. Its incidence in the Islamic Republic of Iran is 5%-12%. Air pollution has been reported to be one of the causative factors, and this case-control study determined its effect on pre-eclampsia in 195 pregnant women (65 with pre-eclampsia and 130 without) admitted to hospitals in Tehran. Women were divided into high and low exposure groups according to the mean density of exposure to pollutants during pregnancy. There was no statistically significant relationship between exposure to air pollutants including CO, particulate matter, SO2, NO2 and O3 and pre-eclampsia. The combined effect was also not significant. Air pollution is one of the problems of modern society and its avoidance is almost impossible for pregnant women. This study should reduce concern about pregnant women living in polluted cities.
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Affiliation(s)
- F Nahidi
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shaheed Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - R Gholami
- Department of Reproductive Endocrinology, Research Institute for Endocrine Sciences, Shaheed Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Y Rashidi
- Air Quality Control Company, Tehran, Islamic Republic of Iran
| | - H Alavi Majd
- Departmentof Biostatistics, School of Paramedical Sciences, Shaheed Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
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Hassanzadeh V, Gholami R, Allahyar N, Noordin N. Motivation and Personality Traits of TESL Postgraduate Students towards the Use of Information and Communications Technology (ICT) in Second Language Teaching. ACTA ACUST UNITED AC 2012. [DOI: 10.5539/elt.v5n4p74] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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20
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Gholami R, Zainab Abd Rahman S, Mustapha G. Social Context as an Indirect Trigger in EFL Contexts: Issues and Solutions. ELT 2012; 5. [DOI: 10.5539/elt.v5n3p73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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21
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Ansari R, Gholami R, Hosseini K, Sahmani S. A sixth-order compact finite difference method for vibrational analysis of nanobeams embedded in an elastic medium based on nonlocal beam theory. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/j.mcm.2011.06.030] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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