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Khalaji A, Babajani N, Amirsardari Z, Saeedian B, Peiman S, Berger NA, Behnoush AH. Unveiling the Ghrelin and Obestatin Roles in Inflammatory Bowel Diseases: A Systematic Review and Meta-Analysis Assessing Their Pathogenic Implications and Biomarker Utility. Inflamm Bowel Dis 2024; 30:629-640. [PMID: 37669127 DOI: 10.1093/ibd/izad202] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND Inflammatory bowel disease (IBD), pathologically known as chronic inflammation of the gastrointestinal tract, is among the diseases with a high burden worldwide. Ghrelin and obestatin, as adipocytokines mainly in adipose tissues, are involved in immune responses and inflammatory pathways. Studies have assessed the circulatory ghrelin levels in patients with IBD. Herein, we aim to pool these studies through systematic review and meta-analysis. METHODS Four international databases, PubMed, Embase, Scopus, and the Web of Science were systematically searched for studies assessing ghrelin or obestatin levels in patients with IBD (either Crohn's disease [CD] or ulcerative colitis [UC]) in active phase or in remission. Random-effects meta-analysis was conducted in order to calculate the pooled estimate using the standardized mean difference (SMD) and 95% confidence interval (CI). RESULTS Nineteen studies were included in our systematic review, comprising 1064 patients with IBD (476 UC and 588 CD). A meta-analysis of 11 studies for comparison of active and quiescent disease showed that patients with active IBD had significantly higher levels of ghrelin (SMD, 0.70; 95% CI, 0.06 to 1.34; P = .03). However, in separate analyses for UC or CD, no such difference was observed (SMD, 1.30; 95% CI, -0.28 to 2.88, P = .11; and SMD, 0.80; 95% CI, -0.41 to 2.01; P = .20, respectively). No significant difference was also observed in ghrelin levels between patients with active IBD and healthy control subjects. Obestatin levels also were not different between patients with active disease and those in remission (SMD, 0.31; 95% CI, -0.05 to 0.68; P = .09). On the other hand, the obestatin/ghrelin ratio was significantly lower in patients with active IBD (SMD, -1.90; 95% CI, -2.45 to -1.35; P < .01). CONCLUSIONS Our results demonstrate that IBD patients with active disease have higher levels of ghrelin, which needs to be confirmed in future studies. Also, the obestatin/ghrelin ratio might be a promising biomarker for the assessment of disease activity.
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Affiliation(s)
| | - Nastaran Babajani
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Amirsardari
- Cardiogenetic Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Behrad Saeedian
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheil Peiman
- Department of Internal Medicine, AdventHealth Orlando Hospital, Orlando, FL, USA
| | - Nathan A Berger
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA
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Khalaji A, Amirkhani N, Sharifkashani S, Peiman S, Behnoush AH. Systematic Review of Endocan as a Potential Biomarker of COVID-19. Angiology 2024; 75:107-115. [PMID: 36680504 PMCID: PMC9895317 DOI: 10.1177/00033197231152941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Since the start of the coronavirus disease 2019 (COVID-19) pandemic, several biomarkers have been proposed to assess the diagnosis and prognosis of this disease. The present systematic review evaluated endocan (a marker of endothelial cell damage) as a potential diagnostic and prognostic biomarker for COVID-19. PubMed, Scopus, Web of Science, and Embase were searched for studies comparing circulating endocan levels between COVID-19 cases and controls, and/or different severities/complications of COVID-19. Eight studies (686 individuals) were included, from which four reported significantly higher levels of endocan in COVID-19 cases compared with healthy controls. More severe disease was also associated with higher endocan levels in some of the studies. Studies reported higher endocan levels in patients who died from COVID-19, were admitted to an intensive care unit, and had COVID-19-related complications. Endocan also acted as a diagnostic and prognostic biomarker with different cut-offs. In conclusion, endocan could be a novel diagnostic and prognostic biomarker for COVID-19. Further studies with larger sample sizes are warranted to evaluate this role of endocan.
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Affiliation(s)
- Amirmohammad Khalaji
- School of Medicine, Tehran University of Medical
Sciences, Tehran, Iran
- Non-Communicable Diseases Research
Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical
Sciences, Tehran, Iran
| | - Nikan Amirkhani
- School of Medicine, Tehran University of Medical
Sciences, Tehran, Iran
| | | | - Soheil Peiman
- Department of Internal Medicine, AdventHealth Orlando
Hospital, FL, USA
| | - Amir Hossein Behnoush
- School of Medicine, Tehran University of Medical
Sciences, Tehran, Iran
- Non-Communicable Diseases Research
Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical
Sciences, Tehran, Iran
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Ghamari SH, Mohebi F, Abbasi-Kangevari M, Peiman S, Rahimi B, Ahmadi N, Farzi Y, Seyfi S, Shahbal N, Modirian M, Azmin M, Zokaei H, Khezrian M, Sherafat R, Malekpour MR, Roshani S, Rezaei N, Fallahi MJ, Shoushtari MH, Akbaripour Z, Khatibzadeh S, Shahraz S. Patient experience with chronic obstructive pulmonary disease: a nationally representative demonstration study on quality and cost of healthcare services. Front Public Health 2023; 11:1112072. [PMID: 37397720 PMCID: PMC10308222 DOI: 10.3389/fpubh.2023.1112072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 05/16/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction Due to insufficient data on patient experience with healthcare system among patients with chronic obstructive pulmonary disease (COPD), particularly in developing countries, this study attempted to investigate the journey of patients with COPD in the healthcare system using nationally representative data in Iran. Methods This nationally representative demonstration study was conducted from 2016 to 2018 using a novel machine-learning based sampling method based on different districts' healthcare structures and outcome data. Pulmonologists confirmed eligible participants and nurses recruited and followed them up for 3 months/in 4 visits. Utilization of various healthcare services, direct and indirect costs (including non-health, absenteeism, loss of productivity, and time waste), and quality of healthcare services (using quality indicators) were assessed. Results This study constituted of a final sample of 235 patients with COPD, among whom 154 (65.5%) were male. Pharmacy and outpatient services were mostly utilized healthcare services, however, participants utilized outpatient services less than four times a year. The annual average direct cost of a patient with COPD was 1,605.5 USDs. Some 855, 359, 2,680, and 933 USDs were imposed annually on patients with COPD due to non-medical costs, absenteeism, loss of productivity, and time waste, respectively. Based on the quality indicators assessed during the study, the focus of healthcare providers has been the management of the acute phases of COPD as the blood oxygen levels of more than 80% of participants were documented by pulse oximetry devices. However, chronic phase management was mainly missed as less than a third of participants were referred to smoking and tobacco quit centers and got vaccinated. In addition, less than 10% of participants were considered for rehabilitation services, and only 2% completed four-session rehabilitation services. Conclusion COPD services have focused on inpatient care, where patients experience exacerbation of the condition. Upon discharge, patients do not receive appropriate follow-up services targeting on preventive care for optimal controlling of pulmonary function and preventing exacerbation.
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Affiliation(s)
- Seyyed-Hadi Ghamari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnam Mohebi
- Haas School of Business, University of California, Berkeley, CA, United States
| | - Mohsen Abbasi-Kangevari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheil Peiman
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Besharat Rahimi
- Department of Internal Medicine, AdventHealth Orlando Hospital, Orlando, FL, United States
| | - Naser Ahmadi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Yousef Farzi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahedeh Seyfi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazila Shahbal
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Modirian
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Azmin
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Zokaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Khezrian
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Sherafat
- Heller School of Social Policy and Management, Brandeis University, Waltham, MA, United States
| | - Mohammad-Reza Malekpour
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahin Roshani
- The Netherlands Cancer Institute (NKI), Amsterdam, Netherlands
| | - Negar Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Javad Fallahi
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Haddadzadeh Shoushtari
- Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Zahra Akbaripour
- Razi University Hospital, Guilan University of Medical Sciences, Guilan, Iran
| | - Shahab Khatibzadeh
- Heller School of Social Policy and Management, Brandeis University, Waltham, MA, United States
| | - Saeid Shahraz
- Tufts Medical Center, Institute for Clinical Research and Health Policy Studies, Boston, MA, United States
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Khalaji A, Behnoush AH, Saeedian B, Khanmohammadi S, Shokri Varniab Z, Peiman S. Endocan in prediabetes, diabetes, and diabetes-related complications: a systematic review and meta-analysis. Diabetol Metab Syndr 2023; 15:102. [PMID: 37189201 DOI: 10.1186/s13098-023-01076-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 05/01/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Diabetes is one of the chronic conditions with a high burden all around the world. Macrovascular and microvascular involvement are among the common mechanisms by which diabetes can impact patients' lives. Endocan as an inflammatory endothelial biomarker has been shown to increase in several communicable and non-communicable diseases. Herein, we aim to investigate the role of endocan as a biomarker in diabetes as a systematic review and meta-analysis. METHODS International databases, including PubMed, Web of Science, Scopus, and Embase were searched for relevant studies assessing blood endocan in diabetic patients. Estimation of the standardized mean difference (SMD) and 95% confidence interval (CI) for comparison of circulating endocan levels between diabetic patients and non-diabetic controls were conducted through random-effect meta-analysis. RESULTS Totally, 24 studies were included, assessing 3354 cases with a mean age of 57.4 ± 8.4 years. Meta-analysis indicated that serum endocan levels were significantly higher in diabetic patients in comparison with healthy controls (SMD 1.00, 95% CI 0.81 to 1.19, p-value < 0.01). Moreover, in the analysis of studies with only type-2 diabetes, the same result showing higher endocan was obtained (SMD 1.01, 95% CI 0.78 to 1.24, p-value < 0.01). Higher endocan levels were also reported in chronic diabetes complications such as diabetic retinopathy, diabetic kidney disease, and peripheral neuropathy. CONCLUSION Based on our study's findings, endocan levels are increased in diabetes, however, further studies are needed for assessing this association. In addition, higher endocan levels were detected in chronic complications of diabetes. This can help researchers and clinicians in recognizing disease endothelial dysfunction and potential complications.
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Affiliation(s)
- Amirmohammad Khalaji
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Hossein Behnoush
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Behrad Saeedian
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Shaghayegh Khanmohammadi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Shokri Varniab
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Pediatric Urology and Regenerative Medicine Research Center, Gene, Cell and Tissue Research Institute, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheil Peiman
- Department of Internal Medicine, AdventHealth Orlando Hospital, Orlando, FL, USA
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Khalaji A, Behnoush AH, Alilou S, Rezaee M, Peiman S, Sahebkar A. Adjunctive therapy with lipid-lowering agents in COVID-19: a systematic review and meta-analysis of randomized controlled trials. Lipids Health Dis 2023; 22:61. [PMID: 37158917 PMCID: PMC10165571 DOI: 10.1186/s12944-023-01828-w] [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: 04/20/2023] [Accepted: 05/05/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND Many commonly used drugs were evaluated as repurposed treatment options since the emergence of the COVID-19 pandemic. The benefit of lipid-lowering agents has been controversial in this regard. In this systematic review, we assessed the effect of these medications as adjunctive therapy in COVID-19 by the inclusion of randomized controlled trials (RCTs). METHODS We searched four international databases including PubMed, the Web of Science, Scopus, and Embase for RCTs in April 2023. The primary outcome was mortality, while other efficacy indices were considered secondary outcomes. In order to estimate the pooled effect size of the outcomes, considering the odds ratio (OR) or standardized mean difference (SMD) and 95% confidence interval (CI), random-effect meta-analyses was conducted. RESULTS Ten studies involving 2,167 COVID-19 patients using statins, omega-3 fatty acids, fenofibrate, PCSK9 inhibitors, and nicotinamide as intervention compared to control or placebo, were included. No significant difference was found in terms of mortality (OR 0.96, 95% CI 0.58 to 1.59, p-value = 0.86, I2 = 20.4%) or length of hospital stay (SMD -0.10, 95% CI -0.78 to 0.59, p-value = 0.78, I2 = 92.4%) by adding a statin to the standard of care. The trend was similar for fenofibrate and nicotinamide. PCSK9 inhibition, however, led to decreased mortality and an overall better prognosis. Omega-3 supplementation showed contradicting results in two trials, suggesting the need for further evaluation. CONCLUSION Although some observational studies found improved outcomes in patients using lipid-lowering agents, our study found no benefit in adding statins, fenofibrate, or nicotinamide to COVID-19 treatment. On the other hand, PCSK9 inhibitors can be a good candidate for further assessment. Finally, there are major limitations in the use of omega-3 supplements in treating COVID-19 and more trials are warranted to evaluate this efficacy.
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Affiliation(s)
- Amirmohammad Khalaji
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Hossein Behnoush
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Sanam Alilou
- School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Malihe Rezaee
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soheil Peiman
- Department of Internal Medicine, AdventHealth Orlando Hospital, Orlando, FL, USA
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- School of Medicine, The University of Western Australia, Perth, Australia
- Department of Biotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
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Sherafati A, Rahmanian M, Sattarzadeh Badkoubeh R, Khoshavi M, Foroumandi M, Peiman S, Shahi F, Sardari A, Pourkia R, Larti F. Hyepereosiniphilic syndrome and COVID-19: 2 case reports. J Cardiothorac Surg 2023; 18:158. [PMID: 37085890 PMCID: PMC10121068 DOI: 10.1186/s13019-023-02241-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 04/02/2023] [Indexed: 04/23/2023] Open
Abstract
BACKGROUND Nearly half of the patients with hypereosinophilic syndrome (HES) have cardiovascular involvement, a major cause of mortality. COVID-19 infection can lead to cardiac involvement, negatively impacting the clinical course and prognosis. We reported two patients with HES complicated by COVID-19, with cardiac involvement and valve replacement. CASE PRESENTATION Our first patient was a 27-year-old woman admitted due to dyspnea and signs of heart failure. She had severe mitral stenosis and mitral regurgitation on the echocardiogram. Corticosteroid therapy improved her symptoms initially, but she deteriorated following a positive COVID-19 test. A repeated echocardiogram showed right ventricular failure, severe mitral regurgitation, and torrential tricuspid regurgitation and, she underwent mitral and tricuspid valve replacement. Our second patient was a 43-year-old man with HES resulted in severe tricuspid stenosis, which was improved with corticosteroid treatment. He underwent tricuspid valve replacement due to severe valvular regurgitation. He was admitted again following tricuspid prosthetic mechanical valve thrombosis. Initial workups revealed lung involvement in favor of COVID-19 infection, and his PCR test was positive. CONCLUSION COVID-19 infection can change the clinical course of HES. It may result in a heart failure exacerbation due to myocardial injury and an increased risk of thrombosis in prosthetic valves or native vessels due to hypercoagulability.
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Affiliation(s)
- Alborz Sherafati
- Cardiology Department, Imam Khomeini Hospital, Tehran University of Medical Sciences, Keshavarz Boulevard, P.O. Box: 1419733141, Tehran, Iran
| | - Mehrzad Rahmanian
- Department of Cardiovascular Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Sattarzadeh Badkoubeh
- Cardiology Department, Imam Khomeini Hospital, Tehran University of Medical Sciences, Keshavarz Boulevard, P.O. Box: 1419733141, Tehran, Iran
| | - Meysam Khoshavi
- Cardiology Department, Imam Khomeini Hospital, Tehran University of Medical Sciences, Keshavarz Boulevard, P.O. Box: 1419733141, Tehran, Iran
| | - Morteza Foroumandi
- Anesthesiology and Intensive Care Department, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Farhad Shahi
- Department of Hematology and Medical Oncology, Tehran University of Medical Sciences, Tehran, Iran
| | - Akram Sardari
- Cardiology Department, Imam Khomeini Hospital, Tehran University of Medical Sciences, Keshavarz Boulevard, P.O. Box: 1419733141, Tehran, Iran
| | - Roghayeh Pourkia
- Department of Cardiology, School of Medicine, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Farnoosh Larti
- Cardiology Department, Imam Khomeini Hospital, Tehran University of Medical Sciences, Keshavarz Boulevard, P.O. Box: 1419733141, Tehran, Iran.
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Khalaji A, Behnoush AH, Peiman S. Aspirin and P2Y12 inhibitors in treating COVID-19. Eur J Intern Med 2023; 110:101-103. [PMID: 36464550 PMCID: PMC9682055 DOI: 10.1016/j.ejim.2022.11.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 11/18/2022] [Accepted: 11/21/2022] [Indexed: 11/24/2022]
Affiliation(s)
| | | | - Soheil Peiman
- Department of Internal Medicine, AdventHealth Orlando hospital, Orlando, FL, United States.
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Shahraz S, Shahin S, Farzi Y, Modirian M, Shahbal N, Azmin M, Mohebi F, Naderian M, Amin-Esmaeili M, Ahmadi N, Seyfi S, Zokaei H, Samadi R, Mohajer B, Sherafat-Kazemzadeh R, Balouchi A, Mesgarpour B, Parsaeian M, Gorgani F, Rahimi S, Saeedi Moghadam S, Khezrian M, Amin A, Baheshmat S, Beyranvand MR, Haghjoo M, Mahdavi-Mazdeh M, Mehrpour M, Moradi G, Peiman S, Rahimi B, Rahimi-Movaghar A, Rikhtegar R, Roshani S, Saadatnia M, Samimi Ardestani SM, Khatibzadeh S. Iran Quality of Care in Medicine Program (IQCAMP): Design and Outcomes. Arch Iran Med 2023; 26:126-137. [PMID: 37543935 PMCID: PMC10685727 DOI: 10.34172/aim.2023.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 02/08/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND Assessment of quality and cost of medical care has become a core health policy concern. We conducted a nationwide survey to assess these measures in Iran as a developing country. To present the protocol for the Iran Quality of Care in Medicine Program (IQCAMP) study, which estimates the quality, cost, and utilization of health services for seven diseases in Iran. METHODS We selected eight provinces for this nationally representative short longitudinal survey. Interviewers from each province were trained comprehensively. The standard definition of seven high-burden conditions (acute myocardial infarction [MI], heart failure [HF], diabetes mellitus [DM], stroke, chronic obstructive pulmonary (COPD) disease, major depression, and end-stage renal disease [ESRD]) helped customize a protocol for disease identification. With a 3-month follow-up window, the participants answered pre-specified questions four times. The expert panels developed a questionnaire in four modules (demographics, health status, utilization, cost, and quality). The expert panel chose an inclusive set of quality indicators from the current literature for each condition. The design team specified the necessary elements in the survey to calculate the cost of care for each condition. The utilization assessment included various services, including hospital admissions, outpatient visits, and medication. RESULTS Totally, 156 specialists and 78 trained nurses assisted with patient identification, recruitment, and interviewing. A total of 1666 patients participated in the study, and 1291 patients completed all four visits. CONCLUSION The IQCAMP study was the first healthcare utilization, cost, and quality survey in Iran with a longitudinal data collection to represent the pattern, quantity, and quality of medical care provided for high-burden conditions.
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Affiliation(s)
- Saeid Shahraz
- Tufts Medical Center, Institute for Clinical Research and Health Policy Studies, Boston, Massachusetts, USA
| | - Sarvenaz Shahin
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Yosef Farzi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Modirian
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazila Shahbal
- School of Agriculture and Food Science, The University of Queensland, Brisbane, Australia
| | - Mehrdad Azmin
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnam Mohebi
- Haas School of Business, University of California, Berkeley, CA, USA
| | - Mohammadreza Naderian
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoume Amin-Esmaeili
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Naser Ahmadi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahedeh Seyfi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Zokaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Samadi
- Psychiatry and Behavioral Sciences Research Center, Department of Psychiatry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Bahram Mohajer
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Sherafat-Kazemzadeh
- Institute for Global Health and Development, The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts, USA
| | - Abbas Balouchi
- Nursing Department, Iranshahr University of Medical Sciences, Iranshahr, Iran
| | - Bita Mesgarpour
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahboubeh Parsaeian
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Fatemeh Gorgani
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Saral Rahimi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Saeedi Moghadam
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Khezrian
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Amin
- Cardiogenetics Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Shahab Baheshmat
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine (SATiM), Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Beyranvand
- Department of Cardiology, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Majid Haghjoo
- Cardiac Electrophysiology Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mitra Mahdavi-Mazdeh
- Iranian Tissue Bank and Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Mehrpour
- Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ghobad Moradi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Soheil Peiman
- Department of Internal Medicine, AdventHealth Orlando Hospital, Orlando, Florida, USA
| | - Besharat Rahimi
- Advanced Thoracic Research Centre, Tehran University of Medical Science, Tehran, Iran
| | - Afarin Rahimi-Movaghar
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Rikhtegar
- Institute for Diagnostic and Interventional Radiology, Alfried Krupp Hospital Ruttenscheid, Essen, Germany
| | - Shahin Roshani
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Saadatnia
- Isfahan Neurosciences Research Centre, Alzahra Research Institute, Department of Neurology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyed Mehdi Samimi Ardestani
- Departments of Psychiatry, Behavioral Sciences Research Center, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahab Khatibzadeh
- Heller School of Social Policy and Management, Brandeis University, Waltham, Massachusetts, USA
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Behnoush AH, Shobeiri P, Bahiraie P, Amirkhani N, Khalaji A, Peiman S. Chemerin levels in chronic kidney disease: A systematic review and meta-analysis. Front Endocrinol (Lausanne) 2023; 14:1120774. [PMID: 36761204 PMCID: PMC9907439 DOI: 10.3389/fendo.2023.1120774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 01/11/2023] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION Chemerin as an inflammatory biomarker has gained attention in its biomarker capability. Several studies measured its levels in chronic kidney disease (CKD), as one of the common non-communicable causes of mortality and morbidity. Hence, this systematic review and meta-analysis aimed to investigate this association. METHODS PubMed, Scopus, Embase, and the Web of Science databases were systematically searched for studies investigating chemerin levels in any CKD stage (including end-stage renal disease patients undergoing hemodialysis (HD)) and comparing it with healthy controls. Random effect meta-analysis was performed to calculate the standardized mean difference (SMD) and 95% confidence interval (CI). RESULTS A total of eight studies were included, comprised of 875 individuals, with a mean age of 56.92 ± 11.78 years. All studies had high quality based on the New Castle-Ottawa Scale (NOS). Meta-analysis revealed significantly higher levels of chemerin in CKD patients compared to healthy controls (SMD 2.15, 95% CI 0.83-3.48, p-value<0.01). Additionally, HD patients had statistically higher levels of chemerin than controls (SMD 2.10, 95% CI 0.58-3.62, p-value=0.01). In meta-regression, publication year accounted for 23.50% and 24.17% of heterogeneity for these analyses, respectively. CONCLUSION Chemerin can be potentially used as a biomarker in CKD patients, which can suggest the inflammatory pathways for the disease. Further research is warranted for the assessment of its clinical applications and enlightening its role in the pathophysiology of CKD.
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Affiliation(s)
- Amir Hossein Behnoush
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Non–Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Parnian Shobeiri
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Non–Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Pegah Bahiraie
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nikan Amirkhani
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirmohammad Khalaji
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Non–Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- *Correspondence: Amirmohammad Khalaji,
| | - Soheil Peiman
- Department of Internal Medicine, AdventHealth Orlando Hospital, Orlando, FL, United States
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10
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Parsirad M, Rahimi B, Peiman S, Zebardast J, Zangene E. A survey of physicians’ opinions about the treatment of subsegmental pulmonary embolism. Can J Respir Ther 2022; 58:53-56. [PMID: 35509977 PMCID: PMC9020570 DOI: 10.29390/cjrt-2021-053] [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] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Introduction The aim of this study was to survey the attitudes of internists, cardiologists, and pulmonologists regarding treatment or no treatment of isolated subsegmental pulmonary embolism (ISSPE) with anticoagulant drugs. Methods Qualified physicians were asked to select their management options from a questionnaire that included a patient scenario with subsegmental pulmonary embolism (SSPE) and negative past medical history of thromboembolism. Results A total of 113 physicians responded to the survey. Of these, 8.8% preferred not to treat patients without further evaluation; 15% decided not to treat, but follow-up the patient with a serial lower-limb colour Doppler ultrasonography; 1.7% preferred anticoagulant treatment only during hospitalization and follow-up without medication; 5% preferred anticoagulant treatment for less than 3 months; and 34.5% chose a 3–6-month treatment with anticoagulation. Furthermore, 24% of physicians opted for anticoagulant treatment for more than 6 months, and 9.7% left the decision up to the patient. Opting not to treat was an option selected by more board-certified faculty members specialized in cardiology, internal medicine, and pulmonology compared with residents (p = 0.038). Willingness to provide anticoagulant therapy in the internal medicine, cardiology and pulmonology groups was 56.6%, 37.3% and 6%, respectively (p = 0.007). Conclusion The majority of physicians surveyed prefer anticoagulant therapy in patients with SSPE.
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Affiliation(s)
- Mahdokht Parsirad
- Internal Medicine specialist, Tehran University of Medical Sciences, Tehran, Iran
| | - Besharat Rahimi
- Advanced thoracic research center, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheil Peiman
- Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Jayran Zebardast
- Ph.D. Candidate of Cognitive Science linguistics, Institute for Cognitive Science Studies (ICSS), Tehran, Iran
| | - Elham Zangene
- Internal Medicine specialist, Tehran University of Medical Sciences, Tehran, Iran
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11
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Zarei Jalalabadi N, Rahimi B, Foroumandi M, Lackey A, Peiman S. Willingness to participate in a lung cancer screening program: Patients' attitudes towards United States Preventive Services Taskforce (USPSTF) recommendations. Eur J Intern Med 2022; 98:128-129. [PMID: 34949493 DOI: 10.1016/j.ejim.2021.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 11/06/2021] [Accepted: 12/04/2021] [Indexed: 11/19/2022]
Affiliation(s)
| | - Besharat Rahimi
- Advanced Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Morteza Foroumandi
- Intensive Care Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Alexandra Lackey
- Department of Internal Medicine, AdventHealth Orlando hospital, Orlando, FL, United States
| | - Soheil Peiman
- Department of Internal Medicine, AdventHealth Orlando hospital, Orlando, FL, United States.
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Naseri M, Shahsavan M, Salahshour F, Peiman S, Allameh SF, Farzanehfar S, Emami-Ardekani AR, Pouraliakbar H, Abbasi M. EFFECTIVE DOSE FOR RADIOLOGICAL PROCEDURES IN AN EMERGENCY DEPARTMENT: A CROSS-SECTIONAL STUDY. Radiat Prot Dosimetry 2020; 189:63-68. [PMID: 32140712 DOI: 10.1093/rpd/ncaa013] [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] [Received: 07/20/2019] [Revised: 12/05/2019] [Accepted: 01/15/2020] [Indexed: 06/10/2023]
Abstract
The extent of radiation exposure in emergency settings is not well documented; here, the corresponding effective dose (ED) is provided. In 500 patients admitted in row to the emergency department, ED was compared in patients according to complaints and their visiting physicians. Out of all, 220 patients aged 43.5 ± 22.2 years (admission: 2.0 ± 1.6 days) had at least an imaging. The main reasons for admission were trauma (10.5%) and then orthopedic problems (8.6%). EDs from CT and radiography were 1.66 ± 3.59 and 0.71 ± 1.67 mSv, respectively (from all 2.29 ± 4.12). Patients with abdominal (5.8 ± 5.2 mSv; p < 0.002) and pelvic (12.0 ± 6.3 mSv; p < 0.007) complaints received higher ED from CT and radiography and, also, patients visited by surgeons (7.94 ± 6.9 mSv). CT scan was the main source for ED to patients. Irrespective of the final diagnosis, patients with abdominopelvic complaints and those visited by surgeons are at higher exposure risk.
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Affiliation(s)
- Maryam Naseri
- Department of Nuclear Medicine, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Shahsavan
- Department of Nuclear Medicine, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Faeze Salahshour
- Department of Radiology, Imam-Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheil Peiman
- Department of Internal Medicine, Imam-Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Farshad Allameh
- Department of Internal Medicine, Imam-Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Farzanehfar
- Department of Nuclear Medicine, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Reza Emami-Ardekani
- Research Center for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Pouraliakbar
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mehrshad Abbasi
- Department of Nuclear Medicine, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
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13
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Peiman S, Mirzazadeh A, Alizadeh M, Mortaz Hejri S, Najafi MT, Tafakhori A, Larti F, Rahimi B, Geraiely B, Pasbakhsh P, Hassanzadeh G, Nabavizadeh Rafsanjani F, Ansari M, Allameh SF. A Case Based-Shared Teaching Approach in Undergraduate Medical Curriculum: A Way for Integration in Basic and Clinical Sciences. Acta Med Iran 2017; 55:259-264. [PMID: 28532138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2017] [Indexed: 06/07/2023] Open
Abstract
To present a multiple-instructor, active-learning strategy in the undergraduate medical curriculum. This educational research is a descriptive one. Shared teaching sessions, were designed for undergraduate medical students in six organ-system based courses. Sessions that involved in-class discussions of integrated clinical cases were designed implemented and moderated by at least 3 faculties (clinicians and basic scientists). The participants in this study include the basic sciences medical students of The Tehran University of Medical Sciences. Students' reactions were assessed using an immediate post-session evaluation form on a 5-point Likert scale. Six two-hour sessions for 2 cohorts of students, 2013 and 2014 medical students during their two first years of study were implemented from April 2014 to March 2015. 17 faculty members participated in the program, 21 cases were designed, and participation average was 60 % at 6 sessions. Students were highly appreciative of this strategy. The majority of students in each course strongly agreed that this learning practice positively contributed to their learning (78%) and provided better understanding and application of the material learned in an integrated classroom course (74%). They believed that the sessions affected their view about medicine (73%), and should be continued in future courses (80%). The percentage demonstrates the average of all courses. The program helped the students learn how to apply basic sciences concepts to clinical medicine. Evaluation of the program indicated that students found the sessions beneficial to their learning.
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Affiliation(s)
- Soheil Peiman
- Department of Internal Medicine, School of Medicine, Tehran University of Medical Sciences. Tehran, Iran
| | - Azim Mirzazadeh
- Department of Internal Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Internal Medicine, Health Professions Education Research Center, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Medical Education, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Alizadeh
- Department of Medical Education, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Mortaz Hejri
- Department of Medical Education, Health Professions Education Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad-Taghi Najafi
- Department of Nephrology, Nephrology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Tafakhori
- Department of Neurology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Neurology, Iranian Center of Neurological Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnoosh Larti
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Besharat Rahimi
- Department of Pulmonary and Critical Care Medicine, Advanced Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Babak Geraiely
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Parichehr Pasbakhsh
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Hassanzadeh
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mohammad Ansari
- Department of Biochemistry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Farshad Allameh
- Department of Internal Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
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Yassin Z, Saadat M, Abtahi H, Rahimi Foroushani A, Peiman S. Prognostic value of on admission arterial PCO 2 in hospitalized patients with community-acquired pneumonia. J Thorac Dis 2016; 8:2765-2771. [PMID: 27867552 DOI: 10.21037/jtd.2016.10.21] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND There is little data about the correlation between the outcome of community acquired pneumonia (CAP) and the hypercapnic type respiratory failure. In this study we prospectively investigated the prognostic significance of first arterial CO2 tension in patients hospitalized with CAP. METHODS In this prospective study patients with CAP, admitted to a general hospital were included. PaCO2 was measured for each subject in an arterial blood sample drawn in the first 2 hours and its correlations with three major outcomes were evaluated: intensive care unit (ICU) admission, duration of admission and mortality in 30 days. RESULTS A total of 114 patients (mean age: 60.9±18.3; male: 51.8%) diagnosed with CAP were included. Significant relationship was not found between PaCO2 and mortality (P=0.544) or ICU admission (P=0.863). However advanced age, associated CHF, high BUN levels, high CURB-65 scores, associated pleural effusion in chest X-ray and being admitted to the ICU (P=0.012, 0.004, 0.003, <0.001, 0.045 and <0.001 respectively) were all significant prognostic factors of higher mortality risks. Prognostic factors for ICU admission were a history of malignancy (P=0.004), higher CURB-65 (P<0.001) scores and concomitant pleural effusion (P=0.028) in chest X-ray. Hypercapnic patients hospitalized for longer duration compared with normocapnic subjects. Furthermore, patients with lower pH (P=0.041) and pleural effusions (P=0.002) were hospitalized longer than the others. CONCLUSIONS There was less prominent prognostic value regarding on-admission PaCO2 in comparison to other factors such as CURB-65. Considering the inconsistent results of surveys conducted on prognostic value of PaCO2 for CAP outcomes, further investigations are required to reach a consensus on this matter.
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Affiliation(s)
| | | | | | - Abbas Rahimi Foroushani
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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15
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Mirdamadi M, Rahimi B, Safavi E, Abtahi H, Peiman S. Correlation of cardiopulmonary exercise testing parameters with quality of life in stable COPD patients. J Thorac Dis 2016; 8:2138-45. [PMID: 27621870 DOI: 10.21037/jtd.2016.07.07] [Citation(s) in RCA: 8] [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] [Indexed: 11/06/2022]
Abstract
BACKGROUND The precise head to head relationships between Cardio-pulmonary exercise testing (CPET) parameters and patients' daily symptoms/activities and the disease social/emotional impact are less well defined. In this study, the correlation of COPD daily symptoms and quality of life [assessed by St. George's Respiratory Questionnaire (SGRQ)] and COPD severity index (BODE-index) with CPET parameters were investigated. METHODS Symptom-limited CPET was performed in 37 consecutive COPD (GOLD I-III) subjects during non-exacerbation phase. The SGRQ was also completed by each patient. RESULTS SGRQ-score correlated negatively with FEV1 (r=-0.49, P<0.01), predicted maximal work-rate (%WR-max) (r=-0.44, P<0.01), V'O2/WR (r=-0.52, P<0.01) and breathing reserve (r=-0.50, P<0.01). However it did not correlate with Peak-V'O2% predicted (r=-0.27, P=0.10). In 20 (54.1%) subjects in which leg fatigue was the main cause for stopping the test, Peak-V'O2, %WR-max, HR-Reserve and Breathing reserve were higher (P=0.04, <0.01, 0.04 and <0.01 respectively) than the others. There was also a significant correlation between BODE-index and ∆VO2/∆WR (r=-0.64, P<0.001) and breathing-reserve (r=-0.38, P=0.018). CONCLUSIONS The observed relationships between CPET parameter and daily subjective complaints in COPD were not strong. Those who discontinued the CPET because of leg fatigue were in the earlier stages of COPD. Significant negative correlation between ∆VO2/∆WR and BODE-index suggests that along with COPD progression, regardless of negative past history, other comorbidities such as cardiac/musculoskeletal problems should be sought.
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Affiliation(s)
- Mahsa Mirdamadi
- Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Besharat Rahimi
- Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Enayat Safavi
- Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Abtahi
- Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheil Peiman
- Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran;; Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran
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16
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Abtahi H, Peiman S, Foroumandi M, Safavi E. Long Term Follow-Up of Sulfur Mustard Related Bronchiolitis Obliterans Treatment. Acta Med Iran 2016; 54:605-609. [PMID: 27832694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2016] [Indexed: 06/06/2023] Open
Abstract
Bronchiolitis obliterans (BO) is the most remarkable pulmonary sequels of war-related sulfur mustard inhalation. There is little if any data about long-term efficacy of associated BO treatment. Five years spirometric records of three groups of patients with obstructive pulmonary diseases (asthma, COPD, BO) and documented sulfur mustard inhalation were evaluated. The BO patients were treated with inhaled Seretide 125-250/25 (2 puffs BID), azithromycin (250 mg, three times/week) and N-acetylcysteine (1200-1800/day). Asthma and COPD patients were treated according to existing guidelines. Seventy-three (38 asthma, 16 COPD and 19 BO) patients completed the 5 years follow-up. Basal and final FEV1 in BO patients (2.69±0.81 and 2.39±0.65 respectively) were not significantly different from COPD patients (2.46±0.56 and 1.96±0.76 respectively). There was also no significant difference between the yearly FEV1 decline in BO patients compared to COPD patients (60±84 cc vs. 99±79 cc respectively, P=0.163). The non-significant difference of FEV1 decline in BO compared to COPD patients suggests the effectiveness of azithromycin, inhaled steroid and N-acetyl cysteine in BO patients. Considering safety and possible effectiveness, this treatment is recommended until more data is available from controlled clinical studies.
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Affiliation(s)
- Hamidreza Abtahi
- Department of Pulmonary and Critical Care, Advanced Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran. AND department of Pulmonary and Critical Care, Imam Khomeini Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheil Peiman
- Department of Pulmonary and Critical Care, Advanced Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran.AND Department of Internal Medicine, Imam Khomeini Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Morteza Foroumandi
- Department of Internal Medicine, Imam Khomeini Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Enayat Safavi
- Department of Pulmonary and Critical Care, Advanced Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Pulmonary and Critical Care, Imam Khomeini Medical Center, Tehran University of Medical Sciences, Tehran, Iran
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Khabaz Mafinejad M, Mirzazadeh A, Peiman S, Khajavirad N, Mirabdolhagh Hazaveh M, Edalatifard M, Allameh SF, Naderi N, Foroumandi M, Afshari A, Asghari F. Medical students' attitudes towards early clinical exposure in Iran. Int J Med Educ 2016; 7:195-9. [PMID: 27318794 PMCID: PMC4939216 DOI: 10.5116/ijme.5749.78af] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 05/28/2016] [Indexed: 05/12/2023]
Abstract
OBJECTIVE This study was carried out to investigate the medical students' attitudes towards early clinical exposure at Tehran University of Medical Sciences. METHODS A cross-sectional study was conducted during 2012-2015. A convenience sample of 298 first- and second-year students, enrolled in the undergraduate medical curriculum, participated in an early clinical exposure program. To collect data from medical students, a questionnaire consisting of open-ended questions and structured questions, rated on a five-point Likert scale, was used to investigate students' attitudes toward early clinical exposure. RESULTS Of the 298 medical students, 216 (72%) completed the questionnaires. The results demonstrated that medical students had a positive attitude toward early clinical exposure. Most students (80.1%) stated that early clinical exposure could familiarize them with the role of basic sciences knowledge in medicine and how to apply this knowledge in clinical settings. Moreover, 84.5% of them believed that early clinical exposure increased their interest in medicine and encouraged them to read more. Furthermore, content analysis of the students' responses uncovered three main themes of early clinical exposure, were considered helpful to improve learning: "integration of theory and practice", "interaction with others and professional development" and "desire and motivation for learning medicine". CONCLUSIONS Medical students found their first experience with clinical setting valuable. Providing clinical exposure in the initial years of medical curricula and teaching the application of basic sciences knowledge in clinical practice can enhance students' understanding of the role they will play in the future as a physician.
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Affiliation(s)
| | - Azim Mirzazadeh
- Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheil Peiman
- Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasim Khajavirad
- Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Maryam Edalatifard
- Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed-Farshad Allameh
- Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Naderi
- Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Morteza Foroumandi
- Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Afshari
- Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Fariba Asghari
- Department of Medical Ethics, Tehran University of Medical Sciences, Tehran, Iran
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Peiman S, Abbasi M, Allameh SF, Asadi Gharabaghi M, Abtahi H, Safavi E. Subsegmental pulmonary embolism: A narrative review. Thromb Res 2015; 138:55-60. [PMID: 26702485 DOI: 10.1016/j.thromres.2015.12.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2015] [Revised: 11/27/2015] [Accepted: 12/08/2015] [Indexed: 12/12/2022]
Abstract
Through the introduction of computed tomography pulmonary angiography (CTPA) for diagnosis of the pulmonary embolism (PE), the high sensitivity of this diagnostic tool led to detecting peripheral filling defects as small as 2-3mm, termed as subsegmental pulmonary embolism (SSPE). However, despite these substantial increases in diagnosis of small pulmonary embolism, there are minimal changes in mortality. Moreover, SSPE patients generally are hemodynamically stable with mild clinical presentation, lower serum level of biomarkers, lower incidence of associated proximal DVTs and less frequent echocardiographic changes compared to the patients with emboli located in more central pulmonary arteries. However, the pros and cons of anticoagulant therapy versus non-treating, monitoring protocol and exact long term outcome of these patients are still unclear. In this article we review existing evidence and provide an overview of what is known about the diagnosis and management of subsegmental pulmonary embolism.
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Affiliation(s)
- Soheil Peiman
- Advanced Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mehrshad Abbasi
- Department of Nuclear Medicine, Vali-asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Farshad Allameh
- Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Hamidreza Abtahi
- Advanced Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Enayat Safavi
- Advanced Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Peiman S, Abtahi H, Akhondzadeh S, Safavi E, Moin M, Rahimi Foroushani A. Fluticasone propionate in clinically suspected asthma patients with negative methacholine challenge test. Clin Respir J 2015; 11:433-439. [PMID: 26256808 DOI: 10.1111/crj.12353] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/24/2014] [Revised: 05/17/2015] [Accepted: 08/03/2015] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Despite reports of response to steroid inhaler in some clinically suspected asthma patients with negative methacholine challenge test (CSA/MCT-), treatment in these patients has not been prospectively studied. OBJECTIVE We studied the role of a 12 week high dose inhaled fluticasone trial in CSA/MCT- patients. METHODS After a 2 week run-in period, CSA/MCT-patients were treated with 12 weeks of Fluticasone propionate 1000 µg/day. The Asthma Control Test (ACT), numeric cough score (NCS) and bronchodilator use were compared with their pretreatment values. RESULTS Thirty-four of 42 CSA/MCT-patients completed the study. Mean pretreatment ACT score (pACT) was significantly increased after treatment (14.7 ± 3.37 to 20.9 ± 3.1, P < 0.001). Posttreatment values of daytime (1.0 ± 1.0) and night-time (0.6 ± 0.9) NCS decreased compared to their pretreatment values (2.8 ± 1.1 and 1.9 ± 1.3, respectively; P < 0.001). ACT score change (ΔACT) were significantly greater in those with pACT < 15 than in those ≥15 (P < 0.001) . Fifteen of 21 patients with ΔACT > 5 did not need to use bronchodilator for their symptom relief. Wheeze disappeared in all six patients with ΔACT > 5 after the trial. Six months after the study, steroid inhaler continued to be used by 72.2% of patients. CONCLUSION A significant portion of CSA/MCT- (especially those with pretreatment ACT score <15) respond to high dose fluticasone inhaler in terms of symptoms relief, disappearance of wheeze and need to bronchodilator use. ΔACT could not be predicted with any individual symptoms or signs before MCT, % FEV1 decline or symptoms during MCT and exhaled nitric oxide.
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Affiliation(s)
- Soheil Peiman
- Department of Pulmonary and Critical Care, Advanced Thoracic Research Center, Imamkhomeini Medical center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Abtahi
- Department of Pulmonary and Critical Care, Advanced Thoracic Research Center, Imamkhomeini Medical center, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahin Akhondzadeh
- Department of Psychiatry, Psychiatric Research Center, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Enayat Safavi
- Department of Pulmonary and Critical Care, Advanced Thoracic Research Center, Imamkhomeini Medical center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Moin
- Department of Pediatrics, Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Rahimi Foroushani
- Department of Epidemiology and Biostatistics, School of Public Health and Institute of Public Health Research, Tehran University of Medical Sciences, Tehran, Iran
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Molaee S, Ghanaati H, Safavi E, Foroumandi M, Peiman S. Computed Tomography Pulmonary Angiography for Evaluation of Patients With Suspected Pulmonary Embolism: Use or Overuse. Iran J Radiol 2015; 12:e22383. [PMID: 26557282 PMCID: PMC4632556 DOI: 10.5812/iranjradiol.12(2)2015.22383] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 08/24/2014] [Accepted: 08/31/2014] [Indexed: 12/01/2022]
Abstract
Background: The use of computed tomography pulmonary angiography (CTPA) has been increased during the last decade. Objectives: We studied the adherence to current diagnostic recommendations for evaluation of pulmonary embolism in a teaching hospital of Tehran University of Medical Sciences. Patients and Methods: The registered medical records (Wells scores and serum D-dimer level) of all patients whose CTPA was performed with suspicion of pulmonary thromboembolism (PTE) were studied retrospectively. Modified Wells score of each patient was determined without being aware of the CTPA results. The patients were categorized to those with a high (likely) clinical probability (score > 4) and low (unlikely) clinical probability (score≤ 4) of PTE. Results: During a 6-month period, 82 patients who underwent CTPA were included. The prevalence of PTE was 62.2% in the group of subjects with a likely clinical risk. In 45 (54.8%) of those patients whose CTPA was requested, the PTE was unlikely based on modified Wells criteria. In the clinically unlikely group, serum D-dimer assay was done in 15 out of 45 (33.3%), while it was inappropriately checked in 10 out of 37 (27.0%) with a clinically likely risk. General adherence rate to diagnostic algorithm of PTE was 43.9%. Conclusion: There is still excessive unjustified concern of PTE in less trained physicians leading to excessive diagnostic work-up. Loyalty to the existing guideline for management of suspected PTE in educational hospitals and supervision of attending physicians could prevent overuse of CTPA.
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Affiliation(s)
- Shima Molaee
- Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Ghanaati
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran
- Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran
| | - Enayat Safavi
- Advanced Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Corresponding author: Enayat Safavi, Advanced Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran. Tel: +98-2166939922, E-mail:
| | - Morteza Foroumandi
- Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheil Peiman
- Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Advanced Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran
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21
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Seradj MH, Naderi N, Peiman S, Saffar H. Metastatic transitional cell carcinoma of the skin presenting as painful zosteriform eruptions. Oxf Med Case Reports 2015; 2015:281-3. [PMID: 26019884 PMCID: PMC4434576 DOI: 10.1093/omcr/omv036] [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] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 04/10/2015] [Accepted: 04/12/2015] [Indexed: 11/14/2022] Open
Abstract
Metastatic skin disease is an uncommon manifestation of visceral malignancies and failure to diagnose this early may result in incorrect treatment. Here, we report a 65-year-old man with bilateral painful eruptions on the abdominal skin and a past history of transitional cell carcinoma of urinary bladder.
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Affiliation(s)
- Mehran Heydari Seradj
- Department of Dermatology , Mostafa Khomeini Hospital, Shahed University , Tehran , Iran
| | - Neda Naderi
- Department of Internal Medicine , Imam Khomeini Hospital, Tehran University of Medical Sciences , Tehran , Iran
| | - Soheil Peiman
- Department of Internal Medicine , Imam Khomeini Hospital, Tehran University of Medical Sciences , Tehran , Iran
| | - Hana Saffar
- Department of Pathology , Cancer Institute, Tehran University of Medical Sciences , Tehran , Iran
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22
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Naderi N, Peiman S, Alamdari A, Dormohammadi Toosi T, Taghdiri F. A salty cause of cough in a 24-year-old man. Oxf Med Case Reports 2015; 2014:71-3. [PMID: 25988033 PMCID: PMC4399509 DOI: 10.1093/omcr/omu029] [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] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Revised: 05/02/2014] [Accepted: 06/03/2014] [Indexed: 11/23/2022] Open
Abstract
With improvement in the diagnosis and treatment of cystic fibrosis cases in recent years, the survival of these cases has been increased. On the other hand, an increasing number of cases are presented during adulthood. Here we report a 24-year-old man with a history of productive cough, bilateral paranasal sinusitis and polyps, and recurrent abdominal pain. Thoracic computed tomography revealed a bilateral scattered tree in bud pattern and some bronchiectatic changes. Semen analysis showed azoospermia. A sweat chloride test was >60 mEq/l in two occasions.
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Affiliation(s)
- Neda Naderi
- Department of General Internal Medicine , ImamKhomeini Hospital Complex, Tehran University of Medical Sciences , Tehran , Iran
| | - Soheil Peiman
- Department of General Internal Medicine , ImamKhomeini Hospital Complex, Tehran University of Medical Sciences , Tehran , Iran ; Advanced Thoracic Research Center , Tehran University of Medical Sciences , Tehran , Iran
| | - Azam Alamdari
- Department of General Internal Medicine , ImamKhomeini Hospital Complex, Tehran University of Medical Sciences , Tehran , Iran
| | - Taraneh Dormohammadi Toosi
- Department of General Internal Medicine , ImamKhomeini Hospital Complex, Tehran University of Medical Sciences , Tehran , Iran
| | - Foad Taghdiri
- Department of General Internal Medicine , ImamKhomeini Hospital Complex, Tehran University of Medical Sciences , Tehran , Iran
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23
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Mohammadhoseini E, Safavi E, Seifi S, Seifirad S, Firoozbakhsh S, Peiman S. Effect of Sample Storage Temperature and Time Delay on Blood Gases, Bicarbonate and pH in Human Arterial Blood Samples. Iran Red Crescent Med J 2015; 17:e13577. [PMID: 26019892 PMCID: PMC4441774 DOI: 10.5812/ircmj.13577] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Revised: 01/22/2014] [Accepted: 12/27/2014] [Indexed: 11/25/2022]
Abstract
Background: Results of arterial blood gas analysis can be biased by pre-analytical factors, such as time interval before analysis, temperature during storage and syringe type. Objectives: To investigate the effects of samples storage temperature and time delay on blood gases, bicarbonate and PH results in human arterial blood samples. Patients and Methods: 2.5 mL arterial blood samples were drawn from 45 patients via an indwelling Intraarterial catheter. Each sample was divided into five equal samples and stored in multipurpose tuberculin plastic syringes. Blood gas analysis was performed on one of five samples as soon as possible. Four other samples were divided into two groups stored at 22°C and 0°C. Blood gas analyses were repeated at 30 and 60 minutes after sampling. Results: PaO2 of the samples stored at 0°C was increased significantly after 60 minutes (P = 0.007). The PaCO2 of the samples kept for 30 and 60 minutes at 22°C was significantly higher than primary result (P = 0.04, P < 0.001). In samples stored at 22°C, pH decreased significantly after 30 and 60 minutes (P = 0.017, P = 0.001). There were no significant differences in other results of samples stored at 0°C or 22°C after 30 or 60 minutes. Conclusions: In samples stored in plastic syringes, overestimation of PaO2 levels should be noted if samples cooled before analysis. In samples stored in plastic syringes, it is not necessary to store samples in iced water when analysis delayed up to one hour.
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Affiliation(s)
- Elham Mohammadhoseini
- Advanced Thoracic Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Enayat Safavi
- Advanced Thoracic Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, IR Iran
- Corresponding Author: Enayat Safavi, Advanced Thoracic Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, IR Iran. Tel/Fax: +98-2166581594, E-mail:
| | - Sepideh Seifi
- Department of Nephrology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Soroush Seifirad
- Advanced Thoracic Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Shahram Firoozbakhsh
- Advanced Thoracic Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Soheil Peiman
- Advanced Thoracic Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, IR Iran
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Alamdari A, Naderi N, Peiman S, Shahi F. Non-Hodgkin lymphoma with primary involvement of skeletal muscle. Int J Hematol Oncol Stem Cell Res 2014; 8:55-7. [PMID: 25642309 PMCID: PMC4305382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2014] [Accepted: 02/03/2014] [Indexed: 12/02/2022] Open
Abstract
Non-Hodgkin lymphoma usually presents with generalized lymphadenopathy, but it can also involve any part of the human body. Lymphomatous involvement of muscles is a rare presentation and has been reported to occur in only 1.1% in non-Hodgkin lymphoma. Here we, present a 32 year-old Iranian man with primary involvement of spleen, bone, bone marrow and muscle, mimicking soft tissue sarcoma; core needle biopsy of the gluteal muscle showed diffuse large B cell lymphoma.
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Affiliation(s)
- Azam Alamdari
- Department of Internal Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Naderi
- Department of Internal Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheil Peiman
- Department of Internal Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Farhad Shahi
- Department of Hematology and Oncology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
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