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Colonoscopic evaluation of minimal rectal bleeding in average-risk patients for colorectal cancer

World Journal of Gastroenterology 2008年第42期14卷 6536-6540页

作者： Shahriar Nikpour Ali Ali Asgari Department of InternalMedicine Loghman Hakim Hospital Shaheed BeheshtiUniversity of Medical Sciences Tehran Iran

AIM: To assess the prevalence of clinically signifi cant lesions in patients with minimal bright red bleeding per rectum (BRBPR). METHODS: Consecutive outpatients prospectively underwent colonoscopy at loghman hakim hospital, Tehran. Minimal BRBPR was defi ned as small amounts of red blood after wiping or in the toilet bowl. Patients with the following alarm signs were excluded: Positive personal history of colorectal neoplasms or inflamma-tory bowel disease (IBD), positive fi rst degree family history of colorectal neoplasms, history of altered bow- el habits, recent signifi cant weight loss, and presence of iron defi ciency anemia. Neoplastic polyps, colorectal carcinoma, and IBD were def ined as signif icant lesions. RESULTS: A total of 402 patients (183 female and 219 male, aged 43.6 ± 15.7 years) were studied. Hemorrhoids (54.2%), anal fi ssures (14.2%) and ul-cerative colitis (14.2%) were the most common lesions and colonoscopy was normal in 8.0%. Signifi cant le-sions were found in 121 (30.1%) patients, including 26 patients (6.5%) with adenocarcinoma and 30 (7.5%) with adenomatous polyps. Almost all patients with signifi cant lesions had at least one lesion in the distal colon; an adenocarcinoma and an adenomatous polyp in the proximal colon were found in 2 patients with hemorrhoids. CONCLUSION: Flexible sigmoidoscopy appears to be sufficient for the evaluation of average risk patients with minimal BRBPR. Rigid sigmoidoscopy may be used as an alternative in patients less than 40 years of age in settings where the former is not available. Thechoice of colonoscopy over flexible sigmoidoscopy in patients aged over 50 years should be individualized.

关键词： Gastrointestinal hemorrhage Colonoscopy Colorectal neoplasms Inflammatory bowel disease

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Prognostic value of cortisol and thyroid function tests in poisoned patients admitted to toxicology ICU

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World Journal of Emergency Medicine 2018年第1期9卷 51-55页

作者： Shahin Shadnia Nasim Zamani Hossein Hassanian-Moghaddam Hamed Shafaroodi Mina Padandar Mohammad Hasan Rezaeizadeh Toxicological Research Center Department of Clinical ToxicologyLoghman Hakim HospitalShahid Beheshti University of Medical Sciences Excellence Center of Clinical Toxicology Iranian Ministry of Health Pharmaceutical Sciences Branch Islamic Azad University(IAUPS)

BACKGROUND: Prognostic value of cortisol and thyroid function tests(TFTs) has previously been evaluated in medical ICUs. We aimed to evaluate prognostic efficacy of cortisol and TFTs in critically ill poisoned patients admitted to toxicology intensive care unit(ICU).METHODS: In a prospective study of consecutively enrolled subjects admitted to the toxicology ICU, lab analyses included TFTs(total T3 and T4 as well as TSH) and cortisol levels drawn between 8 am–10 am during period of the first 24 hours post-ingestion/exposure. Simplified Acute Physiology Score Ⅱ(SAPS Ⅱ) and Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ) were recorded. All scores were compared to detect the best prognostic factor. Type of poisoning was also ***: In 200 patients evaluated, 129 were male and mean age was 31 years. In general, SAPS Ⅱ, T4, and cortisol could prognosticate death. After regression analysis, only cortisol had such efficacy(P=0.04; OR=1.06; 95%CI=1.05–1.08; cut-off=42 μg/d L; sensitivity=70%; specificity=82%). Between aluminium phosphide(ALP)-and non ALP-poisoned patients, level of consciousness, mean arterial pressure, and cortisol level could prognosticate death in ALP poisoning(all Ps<0.001 in both uni and multivariate analyses). Median(interquartile range; IQR) GCS was 7(6, 10) and 15(8, 15) in non-ALP and ALP-poisoned patients(P<0.003). SAPS Ⅱ and APACHE Ⅱ could not prognosticate death at ***: Cortisol best prognosticated outcomes for subjects admitted to the toxicology ICU. Its level is higher in ALP-poisoned patients probably due to the higher stress while they remain conscious till the final stages of toxicity and are aware of deterioration of their clinical condition or may be due to their significantly lower blood pressures.

关键词： Prognosis Intensive care unit Cortisol Thyroid function tests Poisoning

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BMI-Adjusted Tube Current in Chest CT and Comparison of Lifetime Attributable Risk (LAR) of Breast Cancer in Two Different BMI-Based Protocols

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Open Journal of Emergency Medicine 2023年第3期11卷 115-125页

作者： Amin Shams Akhtari Babak Heidariaghdam Faeze Vahid Alireza Oloumi Latif Gachkar Mehrdad Taghizadeh Seyedeh Hedieh Mousavipaak Clinical Research Development Unit of loghman hakim hospital Tehran Iran Emergency Department of Hervey Bay hospital Queensland Australia Jam hospital Tehran Iran Independent Researcher Tehran Iran loghman hakim hospital Tehran Iran Department of Basic Sciences Islamic Azad University Tehran Medical Branch

Possible strategies to reduce radiation dose during CT scanning have been investigated over recent decades;here the optimization of the tube current and its link with patient’s cancer incidence are being evaluated. 154 consecutive trauma patients with the need for chest CT scan were included. Two different BMI-adjusted CT protocols at a fixed voltage tube and the same scan length were applied. Dose estimation parameters like CT dose index (CTDI), dose length product (DLP) and effective breast dose were calculated. Breast surface dose was obtained by using thermoluminescence dosimeters (TLDs) and eventually, the life attributable risk (LAR) of cancer incidence was estimated. The mean effective dose was 4.87 ± 2.3 mSv and 5.12 ± 2.8 mSv for patients who were scanned with tube currents of 120 mAs and 200 mAs, respectively. There was no significant difference between organ surface doses for females but in males it was notable. The risk of cancer incidence is lower for protocol 1 in comparison with protocol 2. Optimizing tube current of 120 mAs reduced breast surface dose up to 50% in comparison with the tube current of 200 mAs. In trauma patients, using lower tube current based on BMI has notable impact on the absorbed dose in the breast and can reduce the breast cancer risk by nearly 33.6% for women.

关键词： Radiation Dose Trauma Patients Cancer Risk

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Comparison of the Use of Conventional and Antibiotic-Coated Tracheal Tubes and EVAC on the Incidence of Ventilator-Associated Pneumonia (VAP)

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Open Journal of Emergency Medicine 2023年第3期11卷 45-56页

作者： Mehrdad Taghizadeh Amin Shams Akhtari Babak Heidariaghdam Seyedeh Hedieh Mousavipak Siamak Moghadamzadeh Mohammad Reza Haji Esmaili Faeze Vahid Department of Emergency Medicine Loghman Hakim Hospital Shahid Beheshti University of Medical Sciences Tehran Iran Clinical Research Development Unit of loghman hakim hospital Shahid Beheshti University of Medical Sciences Tehran Iran Emergency Department of Hervey Bay hospital Queensland Hervey Bay Australia Department of Cardiology Jam Hospital Tehran Iran Department of Basic Sciences Islamic Azad University Tehran Iran Department of Anesthesia Loghman Hakim Hospital Shahid Beheshti University of Medical Sciences Tehran Iran Independent Researcher Tehran Iran

Ventilator-associated pneumonia (VAP) is one of the most important hospital infections in hospitalized patients, which is associated with increased mortality and patient costs. The tracheal tube itself seems to be a major risk factor for VAP. Contaminated secretions pass through the endotracheal tube and reach the lungs. Also, bacteria form a bacterial biofilm on the tracheal tube and are transferred from there to the lungs. Different tracheal tube designs have been produced to overcome these cases. The purpose of this study is to investigate the effect of an Evac tracheal tube covered with antibiotics and normal on the incidence of pneumonia caused by the ventilator. Research method: 180 patients were randomly intubated in three groups of 60 people with three types of tracheal tubes, Evac and Bactiguard. Clinical examinations, endotracheal tube aspiration culture, and chest radiography were obtained from the patients and the incidence of VAP was calculated based on the CPIS standard. The relationship between the type of endotracheal tube and the incidence of VAP and the length of stay in the intensive care unit (ICU) and being discharged alive from the ICU were investigated. Findings and conclusions: The average incidence of VAP for the group of patients intubated with a conventional tracheal tube was 50%, EVAC was 45% and Bactiguard was 40%. The results showed that there is no significant relationship between the incidence of ventilator-induced pneumonia and the type of tracheal tube. The incidence of ventilator-induced pneumonia was not significantly reduced by suctioning subglottic secretions and Bactiguard tracheal tubes. It seems that using one method alone is not effective in reducing ventilator-induced pneumonia.

关键词： Intensive Care Unit Pneumonia Suction Ventilator

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Trend of blood lactate level in acute aluminum phosphide poisoning

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World Journal of Emergency Medicine 2017年第2期8卷 116-120页

作者： Peyman Erfantalab Kambiz Soltaninejad Shahin Shadnia Nasim Zamani Hossein Hassanian-Moghaddam Arezou Mahdavinejad Behrooz Hashemi Damaneh Toxicological Research Center Excellent Center of Clinical ToxicologyDepartment of Clinical ToxicologyLoghman Hakim HospitalSchool of MedicineShahid Beheshti University of Medical SciencesTehranIran Department of Forensic Toxicology Legal Medicine Research CenterLegal Medicine OrganizationTehranIran

BACKGROUND: Aluminum phosphide(Al P) poisoning is common in the developing countries. There is no specifi c antidote for the treatment of acute Al P poisoning. Early diagnosis of poisoning and outcome predictors may facilitate treatment decisions. The objective of this study was to determine the trend of blood lactate level in acute Al P poisoning to evaluate its role as a prognostic ***: This was a prospective study on acute Al P intoxicated patients during one year. Demographic data, clinical and laboratory data on admission, and outcome were recorded in a selfmade questionnaire. Blood lactate levels were analyzed every two hours for 24 ***: Thirty-nine(27 male, 12 female) patients were included in the study. The mortality rate was 38.5%. The mean blood pressure, pulse rate, blood p H and serum bicarbonate level were significantly different between the survivors and non-survivors groups. Blood lactate level was signifi cantly higher in the non-survivors group during 8 to 16 hours post ***: Blood lactate level could be used as an index of severity of acute Al P poisoning.

关键词： Aluminum phosphide Poisoning Blood lactate Prognostic factor

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Leveraging Nanotechnology for Addressing COVID-19: Revealing Antiviral Approaches and Hurdles

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World Journal of Nano Science and Engineering 2024年第1期14卷 1-14页

作者： Mehrnaz Mostafavi Mahtab Shabani Department of Physics Faculty of Allied Medicine Shahid Beheshti University of Medical Sciences Tehran Iran Department of Internal Medicine Loghman Hakim Hospital Shahid Beheshti University of Medical Sciences Tehran Iran

The emergence of COVID-19 has caused extensive harm and is recognized as a significant threat to human life worldwide. Currently, the application of nanomedicine techniques in pre-clinical studies related to various infections, such as respiratory viruses, herpes viruses, human papillomavirus, and HIV, has demonstrated success. Nanoparticles, due to their specific attributes, have garnered considerable attention in combating COVID-19. Strategies employing nanomaterials for COVID-19 prevention encompass the development of rapid, precise diagnostic tools, the creation of effective disinfectants, the delivery of mRNA vaccines to the biological system, and the administration of antiretroviral medications within the body. This article focuses on recent research regarding the effectiveness of nano platforms as antiviral measures against coronaviruses. It delves into the molecular characteristics of coronaviruses and the affected target systems, highlighting challenges and limitations in combating SARS-CoV-2. Additionally, it explores potential nanotechnology-based treatments to confront current and future variants of coronaviruses associated with COVID-19 infections.

关键词： COVID-19 Coronavirus Nanomaterials Nano-Based Vaccine SARS-CoV-2

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Critical role of SDF-1/CXCR4 signaling pathway in stem cell homing in the deafened rat cochlea after acoustic trauma

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Neural Regeneration Research 2018年第1期13卷 154-160页

作者： Ali Asghar Peyvandi Navid Ahmady Roozbahany Hassan Peyvandi Hojjat-Allah Abbaszadeh Niloofar Majdinasab Mohammad Faridan Somayeh Niknazar Hearing Disorders Research Center Loghman Hakim Medical Center Shahid Beheshti University of Medical Sciences Tehran Iran G. Raymond Chang School Ryerson University Toronto Canada Yale University New Haven CT USA Department of Biology and Anatomical Sciences School of Medicine Shahid Beheshti University of Medical Sciences Tehran Iran Department of Occupational Health Engineering School of Health Loorestan University of Medical Sciences Khorramabad Iran

Previous animal studies have shown that stromal cell-derived factor-1 （SDF-1）/CXC chemokine receptor-4 （CXCR4） signaling pathway plays an important role in the targeted migration of bone marrow-derived mesenchymal stem cells （BMSCs） to the injured area. In the present study, we aimed to investigate the potential role of chemotactic SDF-1/CXCR4 signaling pathway in the homing of transplanted BMSCs to the injured cochlea after noise-induced hearing loss （NIHL） in a rat model. White noise exposure （110 dB） paradigm was used for hearing loss induction in male rats for 6 hours in 5 days. Distortion-product otoacoustic emission （DPOAE） responses were recorded before the experiment and post noise *** 33342-labeled BMSCs and CXCR4 antagonist （AMD3100）-treated BMSCs were injected into the rat cochlea through the round window. SDF-1 protein expression in the cochlear tissue was assayed using western blot assay. The number of labeled BMSCs reaching the endolymph was determined after 24 ***-1 was significantly increased in the cochlear tissue of rats in the noise exposure group than in the control group. The number of Hoechst 33342-labeled BMSCs reaching the endolymph of the cochlea was significantly smaller in the AMD3100-treated BMSCs group than in the normal BMSCs group. Our present findings suggest that the SDF-1/CXCR4 signaling pathway has a critical role in BMSCs migration to the injured cochlea in a rat model of noise-induced hearing loss.

关键词： nerve regeneration stem cells migration SDF-1/ CXCR4 axis noise-induced hearing loss neural regeneration

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HLA allele frequencies in Iranian opticospinal multiple sclerosis patients<br>——HLA in Opticospinal MS

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Journal of Biomedical Science and Engineering 2011年第7期4卷 511-515页

作者： Hossein Kalanie Malihe Kamgooyan Yadollah Kholghie Ali Amini Harandi Zahra Hosseinzadeh MS Research Center Mehr and Loghman Hospital Shahid Beheshti University of Medical Sciences Bahar Medical Laboratory Department of Immunology and Transplantation loghman hospital Shahid Beheshti University of Medical Sciences Mehr hospital

Background: In Iranian patients with opticospinal multiple sclerosis (OSMS), a paucity of brain lesions and short spinal cord lesions extending less than three spinal segments are characteristic findings on magnetic resonance imaging (MRI). It also shows a relatively benign course with negative CSF oligo-coonal bands. Objective: We aimed to clarify the possible relationship between clinical phenotype and MRI features of OSMS and human leucocyte antigen (HLA) system in Iran. Methods: Genotyping of HLA class II allele frequencies in 20 patients with OSMS were done, using polymerase chain reaction sequence-specific primer amplification method. Blood samples were extracted and typed for HLA-DRB, DQA, and DQB loci and compared with 100 controls. Results: Significant positive association was observed in DRB1*03, DQA1*0201, DQA1*03, DQB1*0201, and DQB1*0611, while DQB1*0602 was absent in our patients. Conclusion: These finding suggest that HLA-DRB association pattern in OSMS is different from conventional MS in Iran which is mostly associated with DRB1*1501 and from similar Japanese OSMS who are negative for brain lesions fulfilling the Barkhof criteria and negative for the presence of longitudinally extensive spinal cord lesions who carries the DRB*0405 allele. OSMS is immunogenetically heterogeneous. Also absence of DQB1*0602 allele may negatively be associated with the absence of Barkhof brain lesion.

关键词： Epidemiology HLA-Class II Allele Frequency Opticospinal Multiple Sclerosis Neuromyelitis Optica NMO-Igg Antibody Devic’s Neuromyelitis Optica Iranian Demyelinating Disease

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Toxoplasma encephalitis and AIDS in a patient with seizure and altered mental status:A case report

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World Journal of Emergency Medicine 2017年第1期8卷 65-67页

作者： Somayeh Valadkhani Amir Reza Radmard Morteza Saeedi Sara Nikpour Mohammad Reza Farnia Emergency Department Imam Reza HospitalKermanshah University of Medical SciencesKermanshah 67146Iran Radiology Department Shariati HospitalTehran University of Medical SciencesTehran 14117-13137Iran Emergency Department Shariati HospitalTehran University of Medical SciencesTehran 14117-13137Iran Forensic Medicine Department Loghman HospitalShahid Beheshti University of Medical SciencesTehran 19857-17443Iran

INTRODUCTIONIncreasing incidences of neurological complications are being encountered with the increase in the incidence of human immunodeficiency virus （HIV）. These can be due to the direct involvement of the centr... 详细信息

关键词： Toxoplasma encephalitis AIDS

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Colonoscopic diagnosis of appendiceal intussusception in a patient with intermittent abdominal pain: A case report

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World Journal of Gastroenterology 2007年第31期13卷 4274-4277页

作者： Hamid Tavakkoli Sayed Mohammad Sadrkabir Parvin Mahzouni Department of Gastroenterology Alzahra Hospital Isfahan University of Medical Sciences (IUMS) and Poursina Hakim Research Institute Isfahan Iran Department of Internal Medicine Alzahra Hospital IUMS Isfahan Iran Department of Pathology Alzahra Hospital IUMS Isfahan Iran

Intussusception of the appendix is a rare condition. Most cases are diagnosed during operation of the patients suspected to have appendicitis. In this report we present a seventy one year-old man with a history of periumbilical intermittent abdominal pain for several months. None of the paraclinical tests were useful for determining the diagnosis. Colonoscopy performed during the last episode of abdominal pain revealed the prolapsed appendix in the cecum and the patient was sent to the operating room. Macroscopic appearance of the appendix was normal and microscopic examination revealed follicular hyperplasia and acute focal appendicitis. Appendiceal intussusception should be considered in differential diagnosis of intermittent abdominal pain and colonoscopic diagnosis could be very important to avoid dangerous or unnecessary decision making.

关键词： Appendix Intussusception Colonoscopicdiagnosis

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