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کاربرد نوع شرط:
- جایگاه : پژوهشی
- مجله: Future of Medical Education Journal
- نوع مقاله: Journal Article
- کلمات کلیدی: general practitioners,choosing specialty,influential factors,Resident
- چکیده:
- چکیده انگلیسی: Background: For medical students, the selection of a specialty is one of the most critical decisions to be made. On a personal level, it determines lifetime career achievements and, for the community, it directly affects the outcome of public health programs. The aim of this study was to investigate which factors were more important among Iranian residents when considering a specialty.
Methods: A total of 354 residents from 19 specialties answered the questionnaire which explored their views on nine factors which could have a possible impact on their decision. These factors were selected based on a preliminary discussion with residents and a review of related articles.
Results: The first three most common specialties were internal medicine (12.2%), surgery (10.2%) and cardiology (9.6%) for men and obstetrics and gynecology (17.9%), internal medicine (12.6%), and pathology (9.3%) for women. The highest score was related to the personal scientific interest, with a mean of 82.62±19.07 and the lowest score to government regulations and aims, with a mean of 14.90±26.11 in both genders. After that, among females, the role of family (p=0.002) and controllable lifestyle were considered valuable. The second most important factor among males was financial reward (p=0.006).
Conclusions: Personal interest, knowledge about a specialty, controllable lifestyle and financial reward are the most common reported factors among participants. Considering such influential factors is critical for producing motivated specialists and successful health care planning.- انتشار مقاله: 14-04-1393
- نویسندگان: Maryam Sahebari,Shahrzad Mohhamdzahe Lari,Humain Baharvahdat,Leila Vazifeh Mostaan
- مشاهده
- جایگاه : پژوهشی
- مجله: Archives of Bone and Joint Surgery
- نوع مقاله: Journal Article
- کلمات کلیدی: Preoperative Care,B cell inhibitor,Biologic therapy,T cell inhibitor,TNF-α inhibitor
- چکیده:
- چکیده انگلیسی: The preoperative care of patients undergoing orthopedic surgery and treated with biologic agents is of great significance.
Perioperative use of biologic agents could lead to such complications as infection and delayed postoperative wound
healing. This narrative review aimed to evaluate the current information on the use of biologic agents in patients
undergoing orthopedic surgery, determine the rate of associated postoperative complications, and identify the
appropriate time for the continuation or discontinuation of biologic therapy in these patients. It can be stated that
all biologic agents increase the risk of infections depending on their half-lives. Biologic agents are suggested to be
withheld for at least twice their half-lives before major surgeries. However, in case of minor operations, they can be
continued given the low risk of infection and impaired wound healing in these cases.
Level of evidence: I- انتشار مقاله: 02-11-1396
- نویسندگان: Zahra Rezaieyazdi,Maryam Sahebari,Mandana Khodashahi
- مشاهده
- جایگاه : پژوهشی
- مجله: Archives of Bone and Joint Surgery
- نوع مقاله: Journal Article
- کلمات کلیدی: Preoperative Care,B cell inhibitor,Biologic therapy,T cell inhibitor,TNF-α inhibitor
- چکیده:
- چکیده انگلیسی: The preoperative care of patients undergoing orthopedic surgery and treated with biologic agents is of great significance.
Perioperative use of biologic agents could lead to such complications as infection and delayed postoperative wound
healing. This narrative review aimed to evaluate the current information on the use of biologic agents in patients
undergoing orthopedic surgery, determine the rate of associated postoperative complications, and identify the
appropriate time for the continuation or discontinuation of biologic therapy in these patients. It can be stated that
all biologic agents increase the risk of infections depending on their half-lives. Biologic agents are suggested to be
withheld for at least twice their half-lives before major surgeries. However, in case of minor operations, they can be
continued given the low risk of infection and impaired wound healing in these cases.
Level of evidence: I- انتشار مقاله: 02-11-1396
- نویسندگان: Zahra Rezaieyazdi,Maryam Sahebari,Mandana Khodashahi
- مشاهده
- جایگاه : پژوهشی
- مجله: Reviews in Clinical Medicine
- نوع مقاله: Journal Article
- کلمات کلیدی: Vitamin E,Tocopherols,Autoimmune Diseases,Tocotrienols
- چکیده:
- چکیده انگلیسی: Autoimmune diseases are characterized by the attack of the immune system to normal tissues. Patients with autoimmune diseases usually have the deficiency of dietary factors that may be related to the etiology of these conditions. Given the role of vitamin E as a physiologic stabilizer of lysosomal membranes, its deficiency can initiate the process of autoimmune diseases or accelerate its progress. It is supposed that vitamin E could reduce oxidative stress, which is an important factor in the pathogenesis of autoimmune diseases. The literature review is indicative of a decrease in the serum levels of vitamin E in almost all autoimmune diseases. Furthermore, there is evidence regarding the possible therapeutic value of vitamin E in the management of autoimmune diseases. Owing to the anti-inflammatory and protective effect of vitamin E against free radicals, and also its important effect on cytokines levels, this vitamin may play a powerful role in the prevention and treatment of rheumatoid arthritis, as well as joint inflammation and damage. Moreover, increased vitamin E intake might decrease the incidence and severity of certain autoimmune diseases through the regulation of the immune system.
- انتشار مقاله: 13-10-1396
- نویسندگان: Zahra Rezaieyazdi,Maryam Sahebari,Nayyereh Saadati,Mandana Khodashahi
- مشاهده
- جایگاه : پژوهشی
- مجله: Reviews in Clinical Medicine
- نوع مقاله: Journal Article
- کلمات کلیدی: Neuropathy,vasculitis,Mononeuropathy
- چکیده:
- چکیده انگلیسی: Primary systemic vasculitis in pre-capillary arteries is associated with peripheral neuropathy. In some types of systematic vasculitis about 60 % of patients have peripheral nervous system (PNS) involvement. In vasculitic peripheral neuropathies (VPN) a necrotizing and inflammatory process leads to narrowing of vasa nervorum lumen and eventually the appearance of ischemic lesions in peripheral nerves. Some features might be suggestive of VPN, like: axonal nerve degeneration, wallerian-like degeneration, and diameter irregularity of nerve. Peripheral nervous system (PNS) destruction during systemic vasculitides should be considered, due to its frequency and early occurrence in vasculitis progression. The first line treatment of non systematic VPNs is corticosteroid agents, but these drugs might worsen the VPNs or systemic vasculitis.
- انتشار مقاله: 15-10-1392
- نویسندگان: Mona Amini,Reza Boostani,Maryam Sahebari
- مشاهده
- جایگاه : پژوهشی
- مجله: Reviews in Clinical Medicine
- نوع مقاله: Journal Article
- کلمات کلیدی: Vitamin E,Tocopherols,Autoimmune Diseases,Tocotrienols
- چکیده:
- چکیده انگلیسی: Autoimmune diseases are characterized by the attack of the immune system to normal tissues. Patients with autoimmune diseases usually have the deficiency of dietary factors that may be related to the etiology of these conditions. Given the role of vitamin E as a physiologic stabilizer of lysosomal membranes, its deficiency can initiate the process of autoimmune diseases or accelerate its progress. It is supposed that vitamin E could reduce oxidative stress, which is an important factor in the pathogenesis of autoimmune diseases. The literature review is indicative of a decrease in the serum levels of vitamin E in almost all autoimmune diseases. Furthermore, there is evidence regarding the possible therapeutic value of vitamin E in the management of autoimmune diseases. Owing to the anti-inflammatory and protective effect of vitamin E against free radicals, and also its important effect on cytokines levels, this vitamin may play a powerful role in the prevention and treatment of rheumatoid arthritis, as well as joint inflammation and damage. Moreover, increased vitamin E intake might decrease the incidence and severity of certain autoimmune diseases through the regulation of the immune system.
- انتشار مقاله: 13-10-1396
- نویسندگان: Zahra Rezaieyazdi,Maryam Sahebari,Nayyereh Saadati,Mandana Khodashahi
- مشاهده
- جایگاه : پژوهشی
- مجله: Reviews in Clinical Medicine
- نوع مقاله: Journal Article
- کلمات کلیدی: Neuropathy,vasculitis,Mononeuropathy
- چکیده:
- چکیده انگلیسی: Primary systemic vasculitis in pre-capillary arteries is associated with peripheral neuropathy. In some types of systematic vasculitis about 60 % of patients have peripheral nervous system (PNS) involvement. In vasculitic peripheral neuropathies (VPN) a necrotizing and inflammatory process leads to narrowing of vasa nervorum lumen and eventually the appearance of ischemic lesions in peripheral nerves. Some features might be suggestive of VPN, like: axonal nerve degeneration, wallerian-like degeneration, and diameter irregularity of nerve. Peripheral nervous system (PNS) destruction during systemic vasculitides should be considered, due to its frequency and early occurrence in vasculitis progression. The first line treatment of non systematic VPNs is corticosteroid agents, but these drugs might worsen the VPNs or systemic vasculitis.
- انتشار مقاله: 15-10-1392
- نویسندگان: Mona Amini,Reza Boostani,Maryam Sahebari
- مشاهده
- جایگاه : پژوهشی
- مجله: Journal of Emergency Practice and Trauma
- نوع مقاله: Journal Article
- کلمات کلیدی: Osteoarthritis,cartilage,Knee, Ultrasonography
- چکیده:
- چکیده انگلیسی: Objective: This study was designed to evaluate the clinical symptoms and sonographic characteristics of femoral trochlear cartilage in patients with knee joint osteoarthritis (OA). Methods: This cross-sectional study was conducted on 94 patients with painful primary knee OA according to the American College of Rheumatology criteria with a visual analog scale pain score of 30 mm or more. Clinical features were evaluated by a rheumatologist according to the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) criteria, and a radiologist performed ultrasonography within a week. The thickness and echogenicity grade of three cartilage regions were evaluated. Other findings such as meniscal extrusion, effusion, and Baker’s cyst were recorded. Results: The average age of patients was 60 years. The linear regression model showed a significant association of grades II and III trochlear cartilage injury with the pain index, physical activity, and WOMAC overall index. However, there was no significant association between the trochlear cartilage thickness in these three regions and the WOMAC indexes (including pain, physical activity, and the overall index). There was also no significant association between Baker’s cyst and the WOMAC indexes, but a significant association was found between meniscal extrusion and the WOMAC index (P≤0.001). Conclusion: According to our study, the echogenicity grade determined by ultrasonography of femoral trochlear cartilage affects the clinical symptoms of patients including pain. These findings indicate the role of this diagnostic device in understanding changes due to the disease, and it can help physicians focus on the pathology in order to control clinical symptoms in patients.
- انتشار مقاله: 12-07-1398
- نویسندگان: Bita Abbasi,Masoud Pezeshki-Rad,Mozhdeh Amini,Mahdi Foroughian,Maryam Sahebari,Sirous Nekooei,Reza Akhvan
- مشاهده
- جایگاه : پژوهشی
- مجله: Iranian Journal of Immunology
- نوع مقاله: Journal Article
- کلمات کلیدی: Rheumatoid arthritis,Regulatory T cells,disease activity,Soluble sLAG3
- چکیده:
- چکیده انگلیسی: Background: Rheumatoid arthritis (RA) is described as a systemic and chronic autoimmune disease characterized by inflammatory polyarthritis. Lymphocyte-activation gene 3 (LAG3) is a membrane glycoprotein expressed on activated, exhausted, and regulatory T cells. LAG3 plays a major role in the function of Treg cells. LAG3 also has a soluble form (sLAG3) with a controversial role. Objective: To evaluate the serum level of sLAG3 in rheumatoid arthritis patients in comparison with healthy subjects and assess its association with the disease activity. Methods: This cross-sectional study was performed on 105 patients with RA referred to Ghaem hospital of Mashhad, Iran. We divided the participants into four groups: 1) 35 untreated patients with newly diagnosed RA, 2) 35 active RA patients, 3) 35 patients in the remission phase of the disease, and 4) 35 healthy individuals matched in terms of age and sex. After completing the interview and questionnaire, the sLAG3 was evaluated by commercial ELISA. Results: The serum level of sLAG3 significantly increased in RA patients (76.78 ng/ml) as compared with the healthy participants (51.67, p=0.002). However, there was no significant difference between RA patients in the remission phase of the disease (114.11 ng/ml) and those with moderate to high disease activity (63.06 ng/ml, p=0.076). Conclusion: This study provided insights into the role of sLAG3 in the immunopathogenesis of RA disease, but further investigations are also warranted.
- انتشار مقاله: 23-06-1398
- نویسندگان: Nayyereh Saadati,Mandana Khodashahi,Zahra Rezaieyazdi,Maryam Sahebari,Zeinab Saremi,Saeed Mohammadian Haftcheshmeh,Houshang Rafatpanah,Maryam Salehi
- مشاهده
- جایگاه : پژوهشی
- مجله: Iranian Journal of Immunology
- نوع مقاله: Journal Article
- کلمات کلیدی: systemic lupus erythematosus,IL-17,Vitamin D,TGF-β,Th17,IL-23
- چکیده:
- چکیده انگلیسی: Background: Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease. Emerging data suggests that T helper 17 (Th17) cells play a pathogenic role in SLE and the increased number of these cells correlates with disease activity. In recent years, 1α, 25-dihydroxyvitamin D3 (1,25VitD3) has been considered as an immunomodulatory factor.
Objective: To investigate the effect of 1,25VitD3 on Th17 cells and on the expression of related cytokines in SLE patients.
Method: Thirty SLE patients (newly diagnosed or in remission) were sampled for 10 ml whole blood to isolate peripheral blood mononuclear cells (PBMCs) using Ficoll-Hypaque density gradient centrifugation. Isolated cells were cultured in the presence and absence of 50 nM 1,25VitD3. After incubation, cells were harvested and stimulated for 4-5 hours with phorbol myristate acetate (PMA) and ionomycin in the presence of brefeldin A. IL-17 secreting cells were analyzed by flowcytometry. RNA was extracted from cultured cells, cDNA was synthesized, and the expression levels of IL-6, IL-17, IL-23 and TGF- β genes were assessed by real-time PCR.
Results: The percentage of Th17 cells (CD3+ CD8- IL-17+ T cells) decreased significantly in 1,25VitD3-treated cells (3.67 ± 2.43%) compared to untreated cells (4.65 ± 2.75%) ( p=0.003). The expression of TGF- β up regulated (1.38-fold) and the expression of IL-6 (50%), IL-17 (27%) and IL-23 (64%) down regulated after 1,25VitD3 treatment.
Conclusion: This study showed that 1,25VitD3 modulates Th17 related pathways in SLE patients and revealed the immunomodulatory effect of 1,25VitD3 on the Th17 mediated autoimmunity.- انتشار مقاله: 14-05-1395
- نویسندگان: Hadi Reihani,Maryam Rastin,Mahmoud Mahmoudi,Mohsen Ghoryani,Nafiseh Abdollahi,Nafiseh Sadat Tabasi,Shahrzad Zamani Taghizadeh Rabe,Maryam Sahebari
- مشاهده