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Faridhosseini F, Talaei A, Shahini N, Salimi Z, Eslamzadeh M, Ahrari S, Pourgholami M, Khadem-Rezaiyan M. Does celecoxib with sodium valproate have an augmentation effect on acute mania in bipolar disorder? A double-blind controlled clinical trial in Iran. Int Clin Psychopharmacol 2023; 38:336-341. [PMID: 37159172 DOI: 10.1097/yic.0000000000000454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Inflammatory processes in the brain play a role in acute mania etiopathogenesis. There is little evidence indicating the efficacy of celecoxib adjuvant therapy in treatmenting of manic episodes of bipolar disorder. Therefore, this clinical trial aimed to assess the celecoxib effect on treating acute mania. In a double-blind, placebo-controlled trial, 58 patients meeting the criteria for acute mania were enrolled. After considering eligibility, 45 patients were included in the study and randomly divided into two groups. The first group (23 patients) received sodium valproate 400 mg/day along with celecoxib 400 mg/day, and the second group (22 patients) received sodium valproate 400 mg/day and a placebo. The subjects were evaluated by the Young Mania Rating Scale (YMRS) at the beginning of the study and 9, 18, and 28 days following the initiation of the medication. Evaluation of baseline factors indicated a significant difference in age ( P = 0.01) and psychiatric history ( P = 0.02) between the two groups. However, other factors were similar between groups ( P ≥ 0.05). Comparing the YMRS score between celecoxib and placebo groups revealed no significant difference on days 0, 9, 18, and 28. However, the YMRS score at the end of the study decreased by 16.05 ± 7.65 in the intervention group ( P < 0.001) and 12.50 ± 5.98 in controls ( P < 0.001) compared to the baseline, the trend of change was not significant between the two groups during the time of the study ( F = 0.38; P = 0.84). Although celecoxib adjuvant therapy indicated no considerable side effects, a longer treatment duration may be needed to detect its beneficial effects for treating acute mania in bipolar patients. Trial registration: Iran clinical trial register: IRCT20200306046708N1.
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Affiliation(s)
- Farhad Faridhosseini
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Redcar & Cleveland community affective team, Foxrush House, Tees, Esk & Wear Valley NHS trust, Redcar, UK
| | - Ali Talaei
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Najmeh Shahini
- Golestan Research Center of Psychiatry (GRCP), Golestan University of Medical Sciences, Gorgan
- Clinical Research Development Unit (CRDU), 5 Azar Hospital, Golestan University of Medical Science, Gorgan, Iran
| | - Zanireh Salimi
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahboubeh Eslamzadeh
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Samira Ahrari
- Texas A&M University System Health Science Center College of Medicine
| | - Meysam Pourgholami
- Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran
| | - Majid Khadem-Rezaiyan
- Department of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Boostani R, Olfati N, Shamshiri H, Salimi Z, Fatehi F, Hedjazi SA, Fakharian A, Ghasemi M, Okhovat AA, Basiri K, Haghi Ashtiani B, Ansari B, Raissi GR, Khatoonabadi SA, Sarraf P, Movahed S, Panahi A, Ziaadini B, Yazdchi M, Bakhtiyari J, Nafissi S. Iranian clinical practice guideline for amyotrophic lateral sclerosis. Front Neurol 2023; 14:1154579. [PMID: 37333000 PMCID: PMC10272856 DOI: 10.3389/fneur.2023.1154579] [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: 01/30/2023] [Accepted: 05/09/2023] [Indexed: 06/20/2023] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegeneration involving motor neurons. The 3-5 years that patients have to live is marked by day-to-day loss of motor and sometimes cognitive abilities. Enormous amounts of healthcare services and resources are necessary to support patients and their caregivers during this relatively short but burdensome journey. Organization and management of these resources need to best meet patients' expectations and health system efficiency mandates. This can only occur in the setting of multidisciplinary ALS clinics which are known as the gold standard of ALS care worldwide. To introduce this standard to the care of Iranian ALS patients, which is an inevitable quality milestone, a national ALS clinical practice guideline is the necessary first step. The National ALS guideline will serve as the knowledge base for the development of local clinical pathways to guide patient journeys in multidisciplinary ALS clinics. To this end, we gathered a team of national neuromuscular experts as well as experts in related specialties necessary for delivering multidisciplinary care to ALS patients to develop the Iranian ALS clinical practice guideline. Clinical questions were prepared in the Patient, Intervention, Comparison, and Outcome (PICO) format to serve as a guide for the literature search. Considering the lack of adequate national/local studies at this time, a consensus-based approach was taken to evaluate the quality of the retrieved evidence and summarize recommendations.
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Affiliation(s)
- Reza Boostani
- Department of Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nahid Olfati
- Department of Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hosein Shamshiri
- Department of Neurology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Neuromuscular Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zanireh Salimi
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Psychiatry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farzad Fatehi
- Department of Neurology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Neuromuscular Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Arya Hedjazi
- Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
| | - Atefeh Fakharian
- Pulmonary Rehabilitation Research Center (PRRC), Shahid Beheshti University of Medical Sciences, Tehran, Iran
- National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Internal Medicine, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Majid Ghasemi
- Department of Neurology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Asghar Okhovat
- Department of Neurology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Neuromuscular Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Keivan Basiri
- Department of Neurology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
- Isfahan Neuroscience Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Bahram Haghi Ashtiani
- Department of Neurology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Behnaz Ansari
- Department of Neurology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
- Isfahan Neuroscience Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- AL Zahra Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gholam Reza Raissi
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Payam Sarraf
- Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Neurology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Movahed
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Akram Panahi
- Department of Neurology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Neuromuscular Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Bentolhoda Ziaadini
- Department of Neurology, Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
- Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Yazdchi
- Department of Neurology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
- Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Jalal Bakhtiyari
- Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahriar Nafissi
- Department of Neurology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Neuromuscular Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Shahini N, Salimi Z, Kiani D, Raftari A, Ziaee M. Relationship of serum estradiol and progesterone with symptoms and sex difference in schizophrenia: A cross-sectional study in Iran. Front Psychiatry 2023; 14:1075780. [PMID: 36970277 PMCID: PMC10030605 DOI: 10.3389/fpsyt.2023.1075780] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 01/25/2023] [Indexed: 03/29/2023] Open
Abstract
Background Schizophrenia is a devastating disease characterized by frequent relapses, cognitive decline, and emotional and functional disability, with unknown causes. The phenomenology and clinical course of schizophrenic disorders are different between the two genders, which is thought to be related mainly to the effects of steroid sex hormones on the nervous system. Regarding inconsistencies in the studies, we aimed to compare the levels of estradiol and progesterone between schizophrenia patients and healthy individuals. Methods This cross-sectional study was conducted on 66 patients referred to the specialized clinical psychiatric ward of a teaching hospital in the north of Iran, for 5 months in 2021. Thirty-three schizophrenia patients confirmed by a psychiatrist based on DSM5 criteria were included in the case group, and 33 individuals without a psychiatric disease were included in the control group. We completed a demographic information checklist for each patient, along with the Simpson-Angus extrapyramidal side effect scale (SAS) for drug side effects and the positive and negative syndrome scale (PANSS) for the severity of the disease symptoms. Then, a 3-ml blood sample was taken from each participant to determine the serum levels of estradiol and progesterone. The data were analyzed by SPSS16 software. Results Thirty-four (51.5%) and 32 (48.5%) participants in this study were male and female, respectively. The mean serum level of estradiol was 22.33 ± 13.65 pm/dl in schizophrenia patients and 29.36 ± 21.32 pm/dl in the control group, showing no significant difference between the two groups (P = 0.4). However, the mean serum level of progesterone was significantly lower in schizophrenia patients (0.37 ± 1.39 pm/dl) than in control subjects (3.15 ± 5.73 pm/dl) (P < 0.001). The PANSS and SAS scores were not significantly correlated with the level of sex hormones (P > 0.05). Serum estradiol and progesterone levels based on sex significantly differed between the two groups (except for female estradiol). Conclusion Considering the hormonal differences between schizophrenia patients and control subjects, determining hormonal levels in these patients and using complementary hormonal therapies with estradiol or similar compounds can be beneficial as the starting point of schizophrenia treatment, where therapeutic responses can draw the future developmental framework.
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Affiliation(s)
- Najmeh Shahini
- Golestan Research Center of Psychiatry (GRCP), Golestan University of Medical Sciences, Gorgan, Iran
- Clinical Research Development Unit (CRDU), 5 Azar Hospital, Golestan University of Medical Sciences, Gorgan, Iran
| | - Zanireh Salimi
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Dorsa Kiani
- Golestan Research Center of Psychiatry (GRCP), Golestan University of Medical Sciences, Gorgan, Iran
- Dorsa Kiani,
| | - Ahmad Raftari
- Golestan Research Center of Psychiatry (GRCP), Golestan University of Medical Sciences, Gorgan, Iran
| | - Maliheh Ziaee
- Department of Community Medicine, School of Medicine, Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
- *Correspondence: Maliheh Ziaee,
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Taheri E, Hosseini T, Kafami Z, Faridhosseini F, Saghebi A, Fayyazi Bordbar MR, Farhoudi F, Asgharipour N, Salimi Z, Aghebati A, Amiri M, Akbari A, Mohaddes Ardabili H. Mass management of mental health issues during COVID-19 pandemic: the role of professional volunteer groups; an Iranian experience. International Journal of Mental Health 2022. [DOI: 10.1080/00207411.2022.2072146] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Elham Taheri
- Department of Clinical Psychology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Tayebeh Hosseini
- Psychiatry and Behavioral Sciences Research Center, Ibn-e-Sina Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Kafami
- Psychiatry and Behavioral Sciences Research Center, Ibn-e-Sina Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farhad Faridhosseini
- Psychiatry and Behavioral Sciences Research Center, Ibn-e-Sina Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Saghebi
- Psychiatry and Behavioral Sciences Research Center, Ibn-e-Sina Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Reza Fayyazi Bordbar
- Psychiatry and Behavioral Sciences Research Center, Ibn-e-Sina Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fateme Farhoudi
- Psychiatry and Behavioral Sciences Research Center, Ibn-e-Sina Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Negar Asgharipour
- Psychiatry and Behavioral Sciences Research Center, Ibn-e-Sina Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zanireh Salimi
- Psychiatry and Behavioral Sciences Research Center, Ibn-e-Sina Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Asma Aghebati
- Clinical Psychology Department, School of Behavioral Sciences and Mental Health, (Tehran Institute of Psychiatry) Iran University of Medical Sciences, Tehran, Iran
| | - Mahdi Amiri
- Department of Clinical Psychology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abolfazl Akbari
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hossein Mohaddes Ardabili
- Psychiatry and Behavioral Sciences Research Center, Ibn-e-Sina Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
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Shahini N, Talaei A, Salimi Z, Adinepour Sarab M, Gholamzad S, Teimouri A, Hajebi Khaniki S, Kamkar M. Temperament and character traits in substance use disorder in Iran: a case control study. BMC Psychol 2021; 9:138. [PMID: 34511136 PMCID: PMC8436551 DOI: 10.1186/s40359-021-00647-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 09/04/2021] [Indexed: 11/23/2022] Open
Abstract
Background Patients with Substance use disorder have distinct personality traits, they were high score in novelty seeking (NS) and sensation seeking and lower in Self-directedness and higher in Self-transcendence, so we aim to investigate the relationships of temperament and characteristics with related some variables such as substance of choice.
Design and setting A case–control study enrolling 70 Substance use disorder patients and 70 controls was conducted at Mashhad University of medical sciences. Methods Using a case–control design, a group of 70 Substance use disorder patients and 70 controls was conducted at Mashhad university of medical sciences. All participation completed the 240 questions of Temperament and Character Inventory-Revised (TCI-R). Multivariate analysis of covariance (MANCOVA) was employed to compare the relationship between temperament and character traits and patterns of substance use. Results The scores of reward dependence, persistence, self-directedness, cooperativeness, and self-transcendence were significantly lower in the case group compared to healthy individuals (P < 0.05). In contrast, the score of novel seeking was significantly higher in the case group (P < 0.05). On the other hand, harm avoidance was not significantly different between the two studied groups (P = 0.637). Conclusions Higher NS in patients with substance use disorder is common and different traits, and temperaments would choose different substance combinations.
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Affiliation(s)
- Najmeh Shahini
- Golestan Research Center of Psychiatry (GRCP), Golestan University of Medical Sciences, Gorgān, Iran
| | - Ali Talaei
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Zanireh Salimi
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Moussalreza Adinepour Sarab
- Educational Supervisor of Ibn Sina Hospital and Dr. Hejazi, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shakiba Gholamzad
- Student Research Committee, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Teimouri
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saeedeh Hajebi Khaniki
- Student Research Committee, Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammadzaman Kamkar
- Golestan Research Center of Psychiatry (GRCP), Golestan University of Medical Sciences, Gorgān, Iran
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Shahini N, Ghasemzadeh M, Javan M, Salimi Z. Evaluation of the COVID-19 pandemic effect on the development of somatic symptoms in patients with mood disorders: a case-control study. New Microbes New Infect 2021; 43:100917. [PMID: 34603735 PMCID: PMC8463032 DOI: 10.1016/j.nmni.2021.100917] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 06/21/2021] [Accepted: 07/05/2021] [Indexed: 12/28/2022] Open
Abstract
Somatic symptoms are one of the most common complaints among patients with psychiatric disorders and are considered as one of the most common psychiatric disorders in the new coronavirus pandemic. This study aimed to evaluate the effect of the COVID-19 pandemic on the physical symptoms in patients with mood disorders and compare it with healthy individuals. In this case-control study, 67 patients with mood disorders were referred to the psychiatric clinic of 5 Azar Hospital in Gorgan, who met the inclusion criteria, and 68 healthy individuals as control group were entered into the study. For all participants after informed consent, a demographic information questionnaire was completed along with Screening for Somatic Symptoms-7 (SOMS7) and Patient Health Questionnaire-15 (PHQ-15), and the data were analysed by SPSS software version 25. The mean score obtained for the SOMS-7 questionnaire for the group of patients with mood disorders and the control group was 32.37 ± 8.19 and 35.42 ± 11.3, respectively. The mean obtained for the PHQ-15 questionnaire for the mood disorders group and the control group was 8.56 ± 5.93 and 5.86 ± 4.63, respectively. In the mood disorder group, 26.9% of patients had no risk for physical symptoms, 31.3% of patients had a low risk, 25.4% of patients had a moderate risk, and 16.4% of patients had a high risk for physical symptoms. The statistical test showed that although the risk of physical symptoms was high in both groups, this rate was higher in the group with mood disorders, and there is a significant difference between the two groups (P < 0.05). The results also showed a significant and direct relationship between the two questionnaires (P < 0.05). According to the results, although the prevalence of somatic symptoms increased in both groups, the prevalence of somatic symptoms is significantly higher in the mood disorder group.
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Affiliation(s)
- N. Shahini
- Golestan Research Center of Psychiatry (GRCP), Golestan University of Medical Sciences, GorganIran
| | | | - M. Javan
- Golestan Research Center of Psychiatry (GRCP), Golestan University of Medical Sciences, GorganIran
| | - Z. Salimi
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Ghoryani M, Faridhosseini F, Talaei A, Faridhosseini R, Tavakkol-Afshari J, Dadgar Moghaddam M, Azim P, Salimi Z, Marzouni HZ, Mohammadi M. Gene expression pattern of CCL2, CCL3, and CXCL8 in patients with bipolar disorder. J Res Med Sci 2019; 24:45. [PMID: 31160912 PMCID: PMC6540773 DOI: 10.4103/jrms.jrms_763_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 12/24/2018] [Accepted: 02/21/2019] [Indexed: 12/23/2022]
Abstract
Background Bipolar disorder (BD) is one of the most important psychiatric disorders in the world. There is evidence suggesting the role of inflammatory mediators such as chemokines in the etiology of BD. The objective of the current study was to evaluate the gene expression of CCL2, CCL3, and CXCL8 in patients with BD and compare them to healthy controls. Materials and Methods A total of 48 patients with confirmed BD and 48 healthy controls enrolled in this study. All patients were recruited from April to August 2016 at Ibn-Sina Psychiatric Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. RNA was extracted from the whole blood samples and then cDNA was synthesized. Gene expression of CCL2, CCL3, and CXCL8 was measured using SYBR® Green real-time polymerase chain reaction. The difference of delta-CT values between patients and healthy controls was compared with the independent samples t-tests. Results CCL2 and CXCL8 genes expressed at higher levels in patients with BD as compared to healthy controls, but not significant. On the contrary, we found lower expression levels for CCL3 gene in our patients compared to healthy controls, but the difference was not statistically significant. Conclusion Our findings do not show an association between the gene expression of CCL2, CCL3 and CXCL8 and BD. Increasing the sample size and evaluation on the gene expression of other chemokines in depression and mania phases of BD might be helpful to get a better conclusion.
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Affiliation(s)
- Mohsen Ghoryani
- Immunology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Laboratory Sciences, School of Para-Medical Sciences, Torbat Heydarieh University of Medical Sciences, Torbat Heydarieh, Iran
| | - Farhad Faridhosseini
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, 0Mashhad, Iran.,Department of Psychiatry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Talaei
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, 0Mashhad, Iran.,Department of Psychiatry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Faridhosseini
- Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Immunology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Jalil Tavakkol-Afshari
- Immunology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Immunology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Parisa Azim
- Department of Psychiatry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zanireh Salimi
- Department of Psychiatry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hadi Zare Marzouni
- Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mojgan Mohammadi
- Immunology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Aasfara J, Salimi Z, Hazim A, Tazi R, Slassi I. La douleur chez l’hémodialysé chronique : qu’en est-il de la douleur neuropathique ? Résultats d’une enquête. Rev Neurol (Paris) 2019. [DOI: 10.1016/j.neurol.2019.01.385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Qi L, Ferguson-Pell M, Salimi Z, Haennel R, Ramadi A. Wheelchair users' perceived exertion during typical mobility activities. Spinal Cord 2015; 53:687-91. [PMID: 25777329 DOI: 10.1038/sc.2015.30] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 01/20/2015] [Accepted: 01/22/2015] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Each participant performed a series of wheelchair exercises equivalent in intensity to minimal functional speed (1 m s(-1)), functional walking speed (1.3 m s(-1)), a relatively challenging speed (1.6 m s(-1)) and a self-selected speed. Each participant also completed a graded exercise test (GXT) to volitional exhaustion (VO2peak). OBJECTIVES The purpose of this study was (1) to assess the physical capacity of wheelchair users as they undertake typical mobility activities and (2) to investigate how closely the components of a differentiated model of perceived exertion mirror wheelchair users' own perception of exertion. METHODS Eleven (eight males and three females) spinal cord-injured or congenitally impaired wheelchair-dependent participants volunteered for the study. Differentiated ratings of perceived exertion (RPE_arm and RPE_respiration) and oxygen uptake (VO2) and heart rate were recorded during each exercise. RESULTS The mean comfortable speed at which the participants propelled their own wheelchairs on the wheelchair ergometer was 1.1±0.2 m s(-1). Speeds of 1 m s(-1) and 1.3 m s(-1) are typical of everyday functional propulsion. The corresponding RPE_respiration and RPE_arm ranged from 7 to 13 on the Borg scale; the %VO2peak measured in these trials ranged from 37 to 80% VO2peak. For propulsion intensities used in the present study-low, moderate, high and graded exercise intensity-no difference could be observed between RPE_respiration and RPE_arm. There were no significant differences between RPE_arm and RPE_respiration at the termination of the GXT. CONCLUSION The current study showed potential for the use of RPE to assess and monitor daily wheelchair propulsion intensity in individuals with paraplegia.
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Affiliation(s)
- L Qi
- Department of Biomedical Engineering, Dalian University of Technology, Dalian, Liaoning, China.,Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - M Ferguson-Pell
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Z Salimi
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - R Haennel
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - A Ramadi
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
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Asadi-Lari M, Farshad AA, Assaei SE, Vaez Mahdavi MR, Akbari ME, Ameri A, Salimi Z, Gray D. Applying a basic development needs approach for sustainable and integrated community development in less-developed areas: report of ongoing Iranian experience. Public Health 2005; 119:474-82. [PMID: 15826888 DOI: 10.1016/j.puhe.2004.08.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2004] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Despite considerable achievements in the provision of basic developmental facilities in terms of drinking water, access to primary healthcare services, high-quality and nutritious food, social services, and proper housing facilities, there are many rural and slum communities in Iran where these essential needs remain unfulfilled. Lack of equity is prominent, as large differences exist in underprivileged provinces. New policies developed in the past two decades have resulted in substantial achievements in meeting population needs and reducing the socio-economic gap; nevertheless, poverty levels, unemployment due to a large increase in the birth rate in the early 1980s, and lack of community participation are matters yet to be addressed. To overcome these deficiencies, a basic development needs approach was adopted to promote the concept of community self-help and self-reliance through intersectoral collaboration, creating an environment where people could take an active part in the development process, with the Iranian government providing the necessary support to achieve the desired level of development. DESCRIPTION OF THE PROJECT Following firm commitment from the Iranian government and technical support from the World Health Organization Regional Office, basic development needs was assigned a high priority in health and health-related sectors, reflected in the third National Masterplan (2001-2005). A comprehensive intersectoral plan was designed, and pilot projects were commenced in three villages. Each village elected a representative, and committee clusters were formed to run and monitor projects identified by a process of local needs assessment and priority assignment. In each region, a variety of needs were elicited from these assessments, which were actively supported by local authorities. LESSON LEARNED A basic development needs approach was found to be a reliable discipline to improve community participation, needs-led resource allocation and intersectoral co-operation in community development, particularly in underprivileged areas. Iran's initial experience of basic development needs has gained widespread public support but will require periodical evaluation as it is introduced into other rural and urban regions across the country.
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Affiliation(s)
- M Asadi-Lari
- Division of Cardiovascular Medicine, Queens Medical Centre, University of Nottingham, Nottingham NG7 2UH, UK.
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Cordes BG, Collins BT, McDonald JW, Khosla A, Salimi Z. Fine needle aspiration biopsy of primary leiomyosarcoma arising from a pulmonary vein. Acta Cytol 1999; 43:523-6. [PMID: 10349399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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12
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Salimi Z, Sharafuddin M. Ultrasound appearance of primary carcinoid tumor of the gallbladder associated with carcinoid syndrome. J Clin Ultrasound 1995; 23:435-437. [PMID: 7560158 DOI: 10.1002/jcu.1870230708] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Affiliation(s)
- Z Salimi
- Department of Radiology, St. Louis University Medical Center, Missouri 63110-0250, USA
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Durham RM, Zuckerman D, Wolverson M, Heiberg E, Luchtefeld WB, Herr DJ, Shapiro MJ, Mazuski JE, Salimi Z, Sundaram M. Computed tomography as a screening exam in patients with suspected blunt aortic injury. Ann Surg 1994; 220:699-704. [PMID: 7979620 PMCID: PMC1234460 DOI: 10.1097/00000658-199411000-00015] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.4] [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: 01/28/2023]
Abstract
BACKGROUND Chest computed tomography (CT) screening of patients with blunt trauma for thoracic aortic injury is controversial. This study was undertaken to determine whether CT could exclude aortic injury and be used to select patients for aortography. METHODS Computed tomography and aortography were used to evaluate 155 patients with blunt trauma. Computed tomography scans were reviewed separately by four attending radiologists who were unaware of the patients' clinical course and angiographic findings. RESULTS Eight of 155 patients had aortic injuries requiring operation. Computed tomography scans in five patients were read as positive by all reviewers. One scan was read as positive by three reviewers and as negative by one. Two scans were read as positive by two radiologists and as negative by two. After poor scans were excluded, the combined sensitivity of CT for detecting aortic injury was 88%, specificity was 54%, positive predictive value was 9%, and negative predictive value 99%. CONCLUSIONS The sensitivity of CT scan for indicating the need for aortography is observer dependent. As CT manifestations of aortic injury are often subtle, CT does not reliably exclude aortic injury.
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Affiliation(s)
- R M Durham
- Department of Surgery, St. Louis University Health Sciences Center, MO 63110-0250
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Harnsberger JR, Charvat P, Longo WE, Vernava AM, Salimi Z, Arends T, Daniel G. The role of intrarectal ultrasound (IRUS) in staging of rectal cancer and detection of extrarectal pathology. Am Surg 1994; 60:571-6; discussion 576-7. [PMID: 8030810] [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: 01/28/2023]
Abstract
Intrarectal Ultrasound (IRUS) is rapidly becoming an effective tool in the staging of rectal cancer. Twenty-nine consecutive patients with adenocarcinoma of the rectum underwent both CT scanning and IRUS in the preoperative assessment of rectal cancer in an effort to correlate IRUS staging with surgical pathology, correlate tumor staging comparing IRUS with CT scan, and determine incidence of extrarectal pathology by IRUS. Patients were reviewed as to IRUS stage, results of CT scan, TNM stage of extirpated tumor, incidence of genitourinary pathology, and sonographic result of preoperative radiotherapy (RT). The mean age of all patients was 69 years; there were 25 males and four females. Twenty-four patients underwent proctectomy with either low pelvic anastomosis or end stoma; five underwent local surgical therapy. Thirteen patients received preoperative RT. CT scan correlated poorly with IRUS staging of tumors penetrating the muscularis propria. IRUS overstaged 40 per cent, understaged 5 per cent, and correctly staged 55 per cent of patients when compared with pathological specimens. Eleven of the 25 males (44 per cent) had abnormal prostates by IRUS. Five (20%) had further urologic intervention, resulting in two prostatic cancers found. Our data suggests that CT scan staging correlated poorly with IRUS staging. CT poorly determines depth of rectal tumor wall invasion. IRUS correlated well with pathology and understaged 5 per cent of patients before surgery. Genitourinary abnormalities were detected in a significant number of patients. IRUS is an effective modality for preoperative staging of rectal cancer.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- J R Harnsberger
- Department of Surgery, St. Louis University School of Medicine, Missouri
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Farahvash MJ, Janney CG, Salimi Z, Majdi G, Bacon BR. Jejunized colon: a rare complication of carcinoid tumor. Am J Gastroenterol 1994; 89:429-33. [PMID: 8122659] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
A 23-yr-old female with a history of dyspnea, palpitation, productive cough, occasional hemoptysis, intermittent diarrhea, and abdominal pain was found to have metastatic carcinoid tumor and a "jejunized colon." Carcinoid tumors are relatively rare neoplasms found throughout the gastrointestinal tract, the ovaries, and the lungs. Barium enema showed a normal rectum and a pattern identical to jejunum in the proximal colon. Endoscopic biopsies confirmed the presence of small intestinal mucosa in the colon. Foreshortening of the colon was probably due to a desmoplastic reaction secondary to the carcinoid tumor. Histologic confirmation of these findings has never been described before.
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Affiliation(s)
- M J Farahvash
- Department of Internal Medicine, St. Louis University School of Medicine
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Abstract
A villous adenoma of the common bile duct (CBD) causing obstructive jaundice was demonstrated by sonography and ERCP in a 34-year-old man. The radiological and clinical features of this rare tumor are herein presented.
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Affiliation(s)
- J G Buckley
- Department of Radiology, St. Louis University Medical Center, MO 63110-0250
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Abstract
A large extrarenal pseudoaneurysm, originating from the arterial anastomosis of a renal allograft, occurred spontaneously 7 years after transplantation in a 29-year-old diabetic patient. Although the scintigraphic examination was diagnostic of a pseudoaneurysm, pulsed Doppler and color coded Doppler ultrasound failed to demonstrate a Doppler signal, suggesting erroneously a nonvascular fluid collection. The role of scintigraphy combined with duplex ultrasound in this rare but potentially fatal complication of renal transplantation is discussed.
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Affiliation(s)
- J G Buckley
- Department of Radiology, St. Louis University Medical Center, Missouri 63110-0250
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Abstract
An unusual case of pancreatic lymphangioma presenting as a large mid-abdominal mass with sunburst pattern of calcification is herein described. The findings noted on computed tomography (CT), magnetic resonance imaging (MRI), and mesenteric angiography are illustrated.
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Affiliation(s)
- Z Salimi
- Department of Radiology, St. Louis University Medical Center, Missouri 63110
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Abstract
The efficacies of two scintigraphic and two sonographic techniques and resultant index values, as markers of renal allograft pathology, were assessed. Index values of 183 combined scintigraphic and sonographic examinations in 47 graft recipients were compared to the pathological diagnosis of transplant biopsies and subsequent clinical outcome. All recipients were studied with baseline imaging techniques postoperatively, again when indicated by predefined clinical criteria, and prior to graft biopsy. The scintigraphic technique involved the calculation of indices of thrombotic activity and cortical graft perfusion. Ultrasound involved determination of the Doppler resistance index of Pourcelot and estimations of graft volume from real time images. A decreased cortical perfusion index was, overall, the most sensitive index of acute or chronic graft pathology, but it lacked specificity. Increased thrombotic and resistance indices were 96% and 86% sensitive for acute vascular rejection and were 82% and 76% specific. Jointly increased thrombotic and resistance indices improved the specificity for acute vascular rejection to 98%. An increase in graft volume of more than 50% over stable values was 100% sensitive and 92% specific for acute interstitial rejection, and 95% specific when paired with a normal thrombotic index. A marked increase in the thrombotic index was 100% sensitive for cyclosporine-induced thrombotic microangiopathy, but only 49% specific. The specificity of a markedly increased thrombotic index for thrombotic microangiopathy improved to 93% when the Doppler resistance index remained normal or was only marginally elevated. None of the scintigraphic or ultrasound indices were helpful for the diagnosis of acute tubular necrosis, chronic rejection, recurrent glomerulopathy, or graft infection.
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Affiliation(s)
- E A George
- Department of the Medicine, St. Louis University Medical School, Missouri
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Vas W, Patel B, Mahanta B, Salimi Z, Markivee C, Garvin P. Innocuous gas collections in pancreatic allografts demonstrated by computed tomography. Gastrointest Radiol 1989; 14:118-22. [PMID: 2651193 DOI: 10.1007/bf01889174] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Over a 4-year period, 6 pancreatic abscesses were found in 37 patients who had combined renal and segmental pancreatic transplants. An additional 4 patients who were nontoxic at the time of their computed tomographic (CT) examinations had innocuous gas collections, either in the pancreatic allograft or the surrounding peripancreatic tissue. The possible etiology of this gas formation is discussed. These collections do not have the same ominous clinical significance as would be expected in abscess formation. Radiological evaluation should include examination of the gastrointestinal tract and voiding cystograms to detect fistula formation. Simultaneous percutaneous aspiration of this area should be performed to rule out an infective process. If this is negative in a nontoxic transplant patient, the radiologist will be in a position to obviate unnecessary surgical intervention.
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Affiliation(s)
- W Vas
- Department of Radiology, John Cochran Veterans Administration Medical Center, St. Louis, Missouri
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Abstract
The computed tomography findings of 10 patients with neutropenic colitis are described and illustrated. Seven of these patients had leukemia, one had lymphocytic lymphoma, and two had systemic lupus erythematosus. All patients had colon wall thickening which was either isodense with the normal bowel tissue or showed areas of intramural low density. Air in the thickened bowel wall was seen in six patients. These computed tomography findings in neutropenic patients with fever, abdominal pain, and diarrhea should suggest the diagnosis in most instances, resulting in prompt treatment of this usually life-threatening entity.
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Affiliation(s)
- W G Vas
- Veterans Administration Medical Center, St. Louis, Missouri
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Abstract
Hip pain due to aseptic necrosis of the femoral head was the first clinical manifestation of chronic myelogenous leukemia in a 9-year-old white female. An erroneous diagnosis of rheumatoid arthritis was first entertained. Physical examination showed splenomegaly, complete blood count revealed leucocytosis of 359,000. The initial radiograph of the involved hip was negative. Biopsy revealed aseptic necrosis of the femoral head. Chronic myelogenous leukemia (CML) was diagnosed on the basis of the peripheral blood smear and bone marrow biopsy. Two months later, radiograph, radionuclide bone scan, and magnetic resonance imaging (MR) of the involved hip were positive for aseptic necrosis of the femoral head.
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Affiliation(s)
- Z Salimi
- Department of Radiology, St. Louis University Medical Center, Missouri 63104
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Abstract
To determine the value of scintigraphy to detect posttransplantation complications of the allografted pancreas, we retrospectively reviewed 209 scintigrams obtained with 99mTc-sulfur colloid (99mTc-SC) and 99mTc-glucoheptonate (99mTc-GH). The scintigraphic studies were performed in 37 recipients of simultaneous renal and pancreatic allografts harvested from the same donor. 99mTc-SC was used as an indicator of thrombotic vasculitis; pancreatic perfusion and blood-pool parameters were monitored with 99mTc-GH. In 11 of the 37 recipients, scintigraphic abnormalities suggested posttransplantation infarction. Recurrent episodes of acute rejection of the pancreatic allograft, which always coincided with acute rejection of the renal allograft, were monitored in 24 recipients. Rejection-induced ischemic pancreatitis was suggested in 12 of the 24 recipients and persisted in 10 recipients for several weeks after improvement of renal allograft rejection. Pancreatic atrophy was suggested scintigraphically in 16 of the 24 recipients with recurrent episodes of rejection. Spontaneous pancreatic-duct obstruction and obstructive pancreatitis were associated with a scintigraphic pattern similar to that of rejection-induced ischemic pancreatitis. We concluded that the specific radionuclides used in this series are useful for the surveillance and assessment of posttransplantation pancreatic infarction, acute rejection, pancreatitis, and atrophy.
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Affiliation(s)
- E A George
- Department of Medicine, Veterans Administration Medical Center, St. Louis, MO 63106
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Abstract
This case report presents clinical, scintigraphic, duplex sonographic, and biopsy findings in a 23-year-old female renal allograft (RAG) recipient, who had transplantation for chronic renal failure secondary to hemolytic uremic syndrome (HUS). She demonstrated acute and rapidly progressing RAG failure at 7 weeks after transplantation.
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Affiliation(s)
- D B Granato
- Department of Radiology, University Hospital, St. Louis, Missouri 63104
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Tessier JE, Salimi Z, Restrepo GL, Samuels LD, Joist JH. Experimental hemarthrosis in dogs: progressive synovitis monitored with technetium-99m pyrophosphate joint imaging. Haemostasis 1988; 18:83-90. [PMID: 2842240 DOI: 10.1159/000215787] [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] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
We examined the time course of the development of hemorrhagic synovitis in response to repeated autologous blood injections into knee joints in mature dogs and the possible usefulness of joint imaging with technetium-99m pyrophosphate (Tc99m-PYP) in monitoring the early response of synovium to blood. Experimental hemarthrosis was induced in dogs by twice weekly injection of autologous blood into the knee joints. Sequential examination of the synovium at monthly intervals over a period of 12 weeks revealed early inflammatory cell infiltration and capillary neovascularization with eventual replacement of the normal fatty synovium by dense fibrous tissue. Serial Tc99m-PYP joint images demonstrated a progressive increase in isotope accumulation in the knees during the course of the study. Further isotope accumulation was observed after CO2 laser synovectomy. During the 24-week course of the entire study, no changes in joint cartilage or bone were observed by gross inspection or radiologic and light-microscopic examination. The findings indicate that the progressive proliferative, inflammatory, fibrotic changes in joint synovium associated with experimental hemarthrosis in dogs may be noninvasively and semiquantitatively assessed with the use of Tc99m-PYP scintigraphy. Evidence is also presented that the intensity of Tc99m-PYP joint accumulation (immediate static images) may not readily reflect synovial vascularity or synovial tissue mass.
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Affiliation(s)
- J E Tessier
- Department of Orthopedic Surgery, St. Louis University School of Medicine, Mo
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Salimi Z, Wolverson MK, Herbold DR, Vas W, Salimi A. Treatment of frostbite with i.v. streptokinase: an experimental study in rabbits. AJR Am J Roentgenol 1987; 149:773-6. [PMID: 2820216 DOI: 10.2214/ajr.149.4.773] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Experiments were conducted in 32 rabbits to determine whether treatment with IV streptokinase can effectively limit the extent of tissue damage associated with frostbite injury of the hind limbs. Other variables studied were the temperature of the tissue during freezing, the time taken to rewarm the exposed limbs, and the delay between the initiation of treatment with streptokinase and cessation of freezing. A control group of 16 rabbits was not given streptokinase. The extent of tissue damage was estimated by sequential radionuclide perfusion scans of the exposed limbs. This estimate was based on the proportional loss of tissue perfusion on subsequent twice-weekly nuclear scans in comparison with that shown by scans performed immediately after thawing. Pathologic changes in exposed tissues were studied by histology. Streptokinase treatment and rapid rewarming both resulted in less tissue damage at all freezing temperatures. Streptokinase was most beneficial when given 12 hr after freezing, but was effective even when treatment was delayed up to 48 hr.
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Abstract
We designed an experimental model using a new method of freezing to study the pathogenesis and treatment of frostbite. Frostbite was simulated in a manner that closely resembles that which occurs in a natural environment. We used a radionuclide imaging technique to monitor the evolution and extent of tissue damage relative to temperature, rate of freezing, and controlled rewarming. Characteristic sequential changes were demonstrated on sequential nuclear scans. Nonperfusion, followed by perfusion, and finally again by nonperfusion occurred in all areas in which necrosis developed. The reappearance of nonperfusion corresponded to vascular injury and thrombosis evidenced at pathologic examination. We determined that lack of tissue perfusion corresponded to tissue injury. We believe that our experimental model provides an effective means of evaluating potential therapeutic regimens.
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Salimi Z, Vas W, Restrepo G. Joint scintigraphy using technetium-99m pyrophosphate in experimental hemarthrosis. J Nucl Med 1986; 27:246-55. [PMID: 3012023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
To determine the validity of a method for induction of experimental hemarthrosis in dogs and for the nuclear imaging of hemarthrosis, serial technetium-99m pyrophosphate [( 99mTc]PYP) flow and blood-pool scans were performed monthly in eight dogs who received bi-weekly injections of autologous blood into their femoro-tibial joints (also called stifle joint). In four control dogs, one joint was injected with saline while the other joint received only a sham injection. In addition, two dogs received intra-articular injections of autologous blood into their right stifle joint and saline into their left stifle joint. These dogs were studied with 99mTcO4 joint scintigraphy at monthly intervals. The dogs were periodically taken out of the study and explored surgically. Pathologic examination of synovial tissue was performed. Serial radiographs were also obtained and correlated with the scan and surgical findings. There was a striking abnormal increase in blood-pool activity of [99mTc]PYP in the treated stifle joints, commencing at the first examination after 1 mo of blood injections and continuing for the length of the study. All radiographs showed only minimal joint space widening and some soft-tissue swelling. On pathologic examination, both grossly and microscopically, there was profuse pannus formation, with intense inflammatory infiltrate replacing much of the subsynovial fat. The scintigraphic findings correlated well with these pathologic findings. This study not only validates this method for simulating hemophilic hemarthrosis but also suggests that [99mTc]PYP joint scintigraphy is a simple, and noninvasive method for monitoring the early changes in hemophilic arthropathy and is superior to pertechnetate imaging for this disease process. Instead of the previously recommended delayed bone images, we recommend, in addition, flow studies to assess joint hypervascularity and immediate static images to visualize the synovium and joint capsule.
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Tang-Barton P, Vas W, Weissman J, Salimi Z, Patel R, Morris L. Focal fatty liver lesions in alcoholic liver disease: a broadened spectrum of CT appearances. Gastrointest Radiol 1985; 10:133-7. [PMID: 3996827 DOI: 10.1007/bf01893087] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The CT examinations of 26 consecutive alcoholic patients with focal fatty infiltration of the liver were analyzed. Five different patterns of focal fatty infiltration were noted. In most alcoholic patients these appearances present no diagnostic problem and further confirmation can be obtained by repeating the CT scan within 1-2 weeks to see if interval resolution occurs following enforced abstinence. In select instances, more invasive and definitive procedures such as superselective angiography or liver biopsy may be necessary to differentiate these findings from other more serious diseases they may closely resemble, such as primary or secondary liver neoplasms.
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Abstract
A significant right-to-left shunt at the atrial level was diagnosed by radionuclide angiocardiographic examination in a patient with hypoxemia whose perfusion scan showed no pulmonary uptake. The shunt occurred through a patent foramen ovale due to increased right ventricular afterload, subsequently confirmed at autopsy. It is concluded that radionuclide angiocardiography with technetium 99m macroaggregated albumin (99mTc MAA), followed immediately by a perfusion lung scan, may have a place in the evaluation of patients with refractory hypoxemia, since pulmonary embolism and/or right-to-left shunting are two of several causes of hypoxemia in the absence of congenital heart disease. A review of the literature on different pathophysiologic factors is presented and some therapeutic implications, specifically the adverse effect of PEEP in such situations, are discussed.
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Vas W, Wolverson M, Freel J, Salimi Z, Sundaram M. Computed tomography in the pretreatment assessment of carcinoma of the cervix. J Comput Tomogr 1985; 9:359-68. [PMID: 4053665 DOI: 10.1016/0149-936x(85)90033-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Fifty-nine patients with primary or recurrent carcinoma of the cervix were evaluated by computed tomography as part of their presurgical evaluation. The computed tomography staging results were compared with the surgical staging. Computed tomography staging was accurate in 71% (42 of 59), whereas clinical staging was accurate in 66% (39 of 59). In assessing paraaortic nodes by CT, there were 10 true-positive, 20 true-negative, 1 false-positive, and 2 false-negative results (sensitivity, 83%; specificity, 95%), for an overall accuracy of 91%. For pelvic nodes, there were 10 true-positive, 11 true-negative, 3 false-positive, and 6 false-negative results (sensitivity, 62.5% specificity, 78%), for an overall accuracy of 70%. Excretory urograms and barium enemas provided no information not obtained by computed tomography and are probably unnecessary if computed tomography is used as a routine staging examination. At present, computed tomography should not replace clinical assessment of extent of the disease. Its chief advantage over clinical staging is its ability to detect metastases beyond the true pelvis.
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Abstract
The radiographic and CT appearance of air within the mammary parenchyma is described along with a discussion of the possible routes of dissection of gas from regions of subcutaneous emphysema into the breast tissue.
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Vas W, Catral B, Carlin B, Tang-Barton P, Salimi Z. Computed tomography and ultrasound appearance of bladder malacoplakia. J Comput Tomogr 1985; 9:119-23. [PMID: 3886296 DOI: 10.1016/0149-936x(85)90005-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The computed tomography and ultrasound findings of two patients with malacoplakia of the bladder, both at the time of initial diagnosis and following response to treatment, are presented. Because bladder wall involvement is demonstrated by these modalities in female patients with repeated episodes of urinary tract infection, this entity should be entertained in the differential diagnosis.
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Abstract
Emphysematous pyelonephritis is a rare but frequently fatal complication of renal infection in the diabetic patient. The diagnosis is usually only made roentgenographically. We present a patient in whom the initial plain abdominal film was normal and renal sonogram was nondiagnostic. The correct diagnosis was made only on the subsequent CT scan.
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Vas W, Salimi Z, Tang-Barton P, Vargas F, Sidharthan AS. Computed tomography and ultrasound demonstration of squamous cell carcinoma of the kidney. J Comput Tomogr 1985; 9:87-9. [PMID: 3882331 DOI: 10.1016/0149-936x(85)90057-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The computed tomography and ultrasound appearance of a case of squamous cell carcinoma of the kidney is reported and the relevant clinical and urographic findings in this rare entity are reviewed.
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Vas W, Suresh PL, Tang-Barton P, Salimi Z, Carlin B. Ultrasonographic differentiation of cervical abortion from cervical pregnancy. J Clin Ultrasound 1984; 12:553-557. [PMID: 6439749 DOI: 10.1002/jcu.1870120905] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Cervical abortion is a spontaneous abortion of a normal intrauterine pregnancy into the cervical canal where the abortus is retained by a closed external os, causing distention of the cervical canal. This entity closely simulates ectopic cervical pregnancy clinically. The ultrasonic findings in four patients with cervical abortion are described and these could alert the physician to the possibility of this condition.
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Abstract
Unilateral focal areas of intense, increased renal uptake of Tc-99m oxidronate sodium (technetium-99m HDP) were incidentally detected in the bone scan of a female patient who subsequently gave a history of recent trauma to her flank. Increased renal parenchymal uptake of Tc-99m HDP in this patient was thought to be due to kidney contusion. The case is interesting in itself and for its possible implications regarding the use of radio-labeled phosphate compounds for detection of renal contusion.
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Salimi Z, Vas W, Tang-Barton P, Eachempati RG, Morris L, Carron M. Assessment of tissue viability in frostbite by 99mTc pertechnetate scintigraphy. AJR Am J Roentgenol 1984; 142:415-9. [PMID: 6141716 DOI: 10.2214/ajr.142.2.415] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Technetium-99m pertechnetate scintigraphy was performed in the involved extremities of six patients with severe frostbite of the hands (six cases) and feet (one case). There was good correlation between the scintigraphic findings and the extent of deep tissue ultimately requiring surgical resection. Technetium-99m pertechnetate imaging distinguishes viable from dead tissue in frostbite in a simple, noninvasive manner, and findings are easy to interpret. A persistent perfusion defect is seen in nonviable tissue.
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Abstract
Computed tomography in a case of tuberculous psoas abscess is described. Additional information useful in planning surgical drainage was obtained by intraabscess contrast medium injection through a draining sinus.
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Abstract
In computed tomography of the skeleton, as in other radiologic modalities, recognition of normal skeletal variants is essential for defining the extent and type of injury or neoplasm. Computed tomography findings, because of the unique use of cross-sectional anatomy, must be carefully studied to avoid labeling a normal variant as an abnormal entity. We describe here an observation of a normal variant--distal femoral, anterior articular (trochlear) groove--found in a patient with an osteochondral fracture and loose intra-articular bony fragment.
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