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کاربرد نوع شرط:
- جایگاه : پژوهشی
- مجله: Women’s Health Bulletin
- نوع مقاله: Journal Article
- کلمات کلیدی: high,Frozen Sections,Conization,Grade Intraepithelial Neoplasia
- چکیده:
- چکیده انگلیسی: Background: Meticulous examination of frozen section of cone specimens is required to precisely evaluate the resection margin status and rule out invasion in cases with high-grade cervical intraepithelial neoplasia (CIN). Objectives: The aim of the present study was to determine the role of frozen section examination (FSE) of the cone specimen in the evaluation of the resection margin status and to rule out invasion in patients with high-grade CIN. Patients and Methods: This cross-sectional study was performed on 38 patients with high-grade CIN undergoing conization biopsy at Imam Hossein hospital in Tehran from April 2012 through May 2013. Then, FS examination was performed for all patients and the results obtained were compared with those of permanent paraffin sections. Results: Thirty-three (86.8%) out of 38 patients had the same results in frozen and permanent sections of cone biopsy margin specimens (P = 1). Two out of 33 (6.1%) patients had frozen and permanent positive margins and 31 (93.9%) patients had negative frozen and permanent margins. Among the other 5 patients (13.2%), 2 had positive frozen margins and negative permanent margins and 3 patients had negative frozen margins and positive permanent margins. Diagnostic accuracies in cone margin and lesion grading were 63.1% and 44.7%, respectively. Conclusions: In conclusion, in high-grade CIN, FS examination was a rapid, reliable and cost-effective means of evaluating cervical conization specimens.
- انتشار مقاله: 11-10-1348
- نویسندگان: Tahereh Ashraf Ganjooei,Zahra Vahedpoorfard,Mitra Rafiezadeh,Maliheh Arab,Farah Farzaneh,Maryam Sadat Hosseini,Mehdi Yaseri
- مشاهده
- جایگاه : پژوهشی
- مجله: International Journal of Pediatrics
- نوع مقاله: Journal Article
- کلمات کلیدی: Pediatrics,dialysis,Renal Replacement Therapy,Technique failure
- چکیده:
- چکیده انگلیسی: Background: Statistics have shown that the rate of technical failure in peritoneal dialysis (PD) is greater than hemodialysis. In this regard, the present study is aimed to determine the prevalence and risks factors of technique failure of PD in Iranian children using the country’s computerized PD data registry system.
Materials and Methods: Data of 405 PD patients younger than 20 years old were extracted from Iranian PD registry. The joint models of longitudinal and time-to-event data were used to assess independent risk factors of PD technique failure.
Results: PD technique failure occurred in 17.3% of the patients. 1 ng/ml increase in the baseline level of ferritin and 1 mmHg increase in the baseline systolic blood pressure will result in 0.11% (Hazard Ratio [HR]=1.0011; p=0.001), and 1.25% (HR=1.0125; p=0.046) increase in the risk of PD technique failure, respectively. In addition, 1 g/dl decrease in the baseline hemoglobin will cause a 16.25% increase in the risk of PD technique failure (HR=0.8602; p=0.026). Finally, 1 mg/l decrease in the blood urea nitrogen over time after starting PD will result in 1.75% increase in the risk of PD technique failure (HR=0.9829; p=0.006).
Conclusion: The findings from this study showed that an increase in ferritin as well as systolic blood pressure at the beginning of PD increase the risk of technique failure. Furthermore, an increase in the hemoglobin level at the beginning of PD as well as an increase in the blood urea nitrogen over time after starting PD have protective impacts on pediatric PD technique failure.- انتشار مقاله: 09-08-1398
- نویسندگان: Mostafa Hosseini,Shahin Roshani,Neamatollah Ataei,Fattah Hama Rahim Fattah,Mohammed Gubari,Michael Jones,Iraj Najafi,Fatemeh Darabi,Simin Darvishnoori Kalak,Mojtaba Fazel,Mehdi Yaseri,Mahmoud Yousefifard
- مشاهده
- جایگاه : پژوهشی
- مجله: International Journal of Pediatrics
- نوع مقاله: Journal Article
- کلمات کلیدی: children,Prognosis,Attention-Deficit/Hyperactivity Disorder,Methylphenidate
- چکیده:
- چکیده انگلیسی: Background
Attention-deficit/hyperactivity disorder (ADHD) is usually accompanied with other comorbidities that make treatment suboptimal and results in inadequate outcomes. Investigating the factors having an effect on improvement of ADHD can lead to better outcomes and a higher adherence to medication.
Materials and Methods
This historical cohort study was carried out on records of 6 to 13 year old patients with ADHD during the years 2008 to 2015 in the Children's Medical Center in Tehran, Iran. Baseline characteristics of patients such as gender, birth weight, the age of the first diagnosis, weight, severity of ADHD at the baseline, time duration of receiving the Methylphenidate, types of comorbidity, and dosage of Methylphenidate were extracted from hospital records. The Generalized Estimating Equation (GEE) was used to develop a multivariable model. This model is based on a stepwise procedure.
Results
One hundred and thirty-nine children (75.5% boys, mean age of 97.8±26.8 months) were assessed. Time duration of receiving Methylphenidate (OR=1.06; p< 0.001), severity of ADHD at the baseline (OR=0.94; p< 0.001), and dosage of Methylphenidate (OR=2.34; p< 0.001) had a significant relationship with improvement. In this study any relationship between improvement of ADHD and other factors was not found.
Conclusion
In this study, the clinical severity of ADHD at baseline, logarithm of dosage of Methylphenidate, and time duration of receiving the Methylphenidate were associated with improvement of ADHD.- انتشار مقاله: 30-05-1398
- نویسندگان: Hoda Shirafkan,Akbar Fotouhi,Javad Mahmoudi-Gharaei,Seyyed Ali Mozaffarpur,Mostafa Hosseini,Mehdi Yaseri
- مشاهده
- جایگاه : پژوهشی
- مجله: International Journal of Pediatrics
- نوع مقاله: Journal Article
- کلمات کلیدی: risk factors,Children, Mortality, Peritoneal Dialysis, Survival
- چکیده:
- چکیده انگلیسی: Background: There is little information about the survival rate of pediatric peritoneal dialysis (PD) patients and its risk factors. Therefore, the aim of the present study was to assess survival rate and its risk factors in Iranian children undergoing PD.
Materials and Methods: Demographic and laboratory data of 407 Iranian children (up to 19 years old) undergoing PD, from 20 centers in Iran were included. The outcome of interest in our study was survival rate and determination of its risk factors in PD children. The joint models of longitudinal and time-to-event data analysis was used.
Results: The median duration of follow-up was 537 (interquartile range: 146 to 1,177) days. Finally, 72 (17.7%) patients died during a period of 23 years. Our results showed that one-year survival rate of PD patients was 93.6% and five-year survival rate was 76.9%. In addition, the most important risk factors for the PD all-cause mortality were age (HR=0.9301; 95% CI: 0.9031 to 0.9587), serum creatinine (HR=0.8907; 95% CI: 0.8138 to 0.9750), platelet count (HR=0.9999; 95% CI: 0.99995 to 0.99999), aspartate aminotransferase level (HR=1.0001; 95% CI: 0.9999, 1.0002), alkaline phosphatase (HR=0.9989; 95% CI: 0.9982 to 0.9997), renal solute clearance rate (HR=0.9839; 95% CI: 0.9700 to 0.9981), and normalized protein catabolic rate (HR=0.4031; 95% CI: 0.1879, 0.8648).
Conclusion: The survival rate of Iranian pediatric PD patients is similar to other countries. It is suggested that laboratory assessment be continually- انتشار مقاله: 24-04-1398
- نویسندگان: Mahmoud Yousefifard,Neamatollah Ataei,Shahin Roshani,Fatemeh Darabi,Iraj Najafi,Mojtaba Fazel,Zeynab Talayi,Michael Jones,Mehdi Yaseri,Mostafa Hosseini
- مشاهده
- جایگاه : پژوهشی
- مجله: International Journal of Pediatrics
- نوع مقاله: Journal Article
- کلمات کلیدی: children,ELISA,Ataxia telangiectasia,PBMC,SMC1
- چکیده:
- چکیده انگلیسی: Background
Ataxia telangiectasia (A-T) is a common genetically inherited cause of early childhood-onset ataxia. The infrequency of this disease, vast phenotype variation, disorders with features similar to those of A-T, and lack of definite laboratory test, make diagnosis difficult. In addition, there is no rapid reliable laboratory method for identifying A-T heterozygotes, who susceptible to ionizing radiation (IR), atherosclerosis, diabetes, and cancers. We used SMC1pSer966 (pSMC1) in-cell colorimetric ELISA to diagnosis and screen in A-T families.
Materials and Methods: With informed consent, 2cc peripheral blood was collected from the 15 A-T patients, their parents, and 24 healthy controls with no family history of malignancy, diabetes, and atherosclerosis. Extracted peripheral blood mononuclear cells (PBMCs) were cultured in poly-L-Lysine treated 96-well plate with density of 70,000 cells per well. SMC1 phosphorylation was evaluated with cell-based ELISA kit 1 hour after 5 Gy IR and the pSMC1data normalized with Glyceraldehyde-3-phosphate dehydrogenase (GAPDH).
Results: SMC1 phosphorylation was significantly low in A-T`s PBMC (mean + standard deviation [SD]: 0.075 + 0.034) in comparison to carriers (mean + SD: 0.190 + 0.060) and healthy controls (mean + SD: 0.312 +0.081), but unluckily could only discriminate A-T patients (Area Under the Curve -receiver operating characteristic [AUC-ROC]: 1.00, 1.00-1.00). This method in spite of rapidness and simplicity showed poor imprecision (22.49% coefficient of variation [CV] for intraday imprecision).
Conclusion: It seems pSMC1 assessment by in-cell ELISA can be used for detection of A-T patients, but it may not sensitive enough for identification of carriers. This ELISA test is very simple, rapid, and requires less than 2cc blood. Thus it may be proposed for the early differential diagnosis of A-T as an alternative method.- انتشار مقاله: 24-07-1395
- نویسندگان: Majid Zaki Dizaji,Nima Rezaei,Marjan Yaghmaie,Mehdi Yaseri,Seyed Javad Sayedi,Gholamreza Azizi,Asghar Aghamohammadi,Seyed Mohammad Akrami
- مشاهده
- جایگاه : پژوهشی
- مجله: International Journal of Pediatrics
- نوع مقاله: Journal Article
- کلمات کلیدی: Pregnancy,Methotrexate,Beta Subunit,Chorionic Gonadotropin,Ectopic
- چکیده:
- چکیده انگلیسی: Background: No consensus has been reached on prognostic value of serum concentration of β (beta) subunit of human chorionic gonadotropin (β-hCG) in treatment response to methotrexate in management of ectopic pregnancy. Therefore, the present study aimed to evaluate this subject through a systematic review and meta-analysis.
Materials and Methods: An extensive literature search on online databases was performed. All studies performed on ectopic pregnancy patients treated by methotrexate from all age groups were included. After collecting data, random effect models were used to calculate the pooled standardized mean difference (SMD) of β-hCG level in treatment success and treatment failure groups. Finally, pooled performance screening characteristics of serum β-hCG level were assessed in different cut offs.
Results: Finally, 51 articles were included in meta-analysis. Overall treatment success rate of methotrexate was 84% [95% confidence interval (CI): 84-85 percent]. A negative association was found between serum β-hCG level and the treatment response before intervention (SMD= -1.10, 95% CI: -1.39 to -0.88). In addition, pooled sensitivity, specificity, and prognostic odds ratio of β-hCG in the 2000 mIU/mL cut off were: 0.75 (0.65-0.82), 0.68 (0.58-0.82), and 6.0 (5.0-8.0), respectively.
Conclusion: The present meta-analysis showed that serum β-hCG concentration before treatment could predict success of methotrexate in management of ectopic pregnancy.- انتشار مقاله: 01-06-1395
- نویسندگان: Parisa Ghelichkhani,Mahmoud Yousefifard,Lyly Nazemi,Saeed Safari,Mostafa Hosseini,Masoud Baikpour,Samira Salamati Ghamsari,Mehdi Yaseri
- مشاهده
- جایگاه : پژوهشی
- مجله: International Journal of Pediatrics
- نوع مقاله: Journal Article
- کلمات کلیدی: children,blood pressure,weight,Nomograms,References
- چکیده:
- چکیده انگلیسی: Background: Normal standard references of blood pressure (BP) for children and adolescents have been suggested to be constructed based on anthropometric indices. Accordingly, we aimed to develop first BP reference percentiles by weight and age for Iranian children aged 3-18 years old.
Materials and Methods: A total of 16,246 children and adolescents aged 3-18 years were included from 3 cross-sectional studies conducted in Tehran- Iran. Data on demographic characteristics, anthropometric indices and BP values of these subjects were gathered. Quantile regression model was used to assess the need for weight adjustment in different percentiles of systolic and diastolic BPs with age, gender, and the corresponding weight percentiles. Then, Age- and sex-specific BP nomograms were developed according to weight.
Results: All the regression coefficients for weight percentiles were statistically significant in quantile regression of BPs, which confirms the positive effect of adjustment for weight (P<0.05). The BP percentiles by age and weight are presented for each gender. All the BP percentiles rose steadily in all the weight percentiles with minor discrepancies between the two genders. Based on the weight-adjusted BP curves, lean subjects are estimated to have a higher prevalence of hypertension while this figure is lower among the overweight and obese children.
Conclusion: This study presents the first Iranian BP references by age and weight for 3 to 18 year old children and adolescents. BMI-adjusted BP curves were found to be a better tool for assessing the prevalence of hypertension in children and adolescents, on the basis of which a more reliable classification standard for hypertension could be obtained.- انتشار مقاله: 16-03-1395
- نویسندگان: Mostafa Hosseini,Masoud Baikpour,Mahmoud Yousefifard,Mehdi Yaseri,Mohammad Fayaz,Hoda Shirafkan,Arash Abbasi,Hadi Asady,Faezeh Javidilarijani,Behnaz Bazargani,Neamatollah Ataei
- مشاهده
- جایگاه : پژوهشی
- مجله: International Journal of Pediatrics
- نوع مقاله: Journal Article
- کلمات کلیدی: children,Body Mass Index,Lambda-Mu-Sigma method Percentile curves
- چکیده:
- چکیده انگلیسی: Background: The children’s body composition status is an important indicator of health condition evaluated through their body mass index (BMI). We aimed to provide standardized percentile curves of BMI in a population of Iranian children and adolescents. We assessed the nationally representative of sample populations from Tehran.
Materials and Methods: A total sample of 14,865 children aged 7-18 years was gathered. The Lambda-Mu-Sigma method was used to derive sex-specific smoothed centiles for age via the Lambda-Mu-Sigma Chart Maker Program. Finally, the prevalence of overweight and obesity with 95% confidence interval (CI) was calculated.
Results: BMI percentiles obtained from Tehran’s population, except for the 10th percentile, seem to be very slightly greater than the urban boys from all over Iran. BMI percentiles have an increasing trend by age that is S-shaped with a slight slope. Only in the 90th and 97th percentiles of BMI for girls, this rising trend seems to stop. Boys generally have higher BMIs than girls. The exceptions are younger ages of 90th and 97th percentiles and older ages of 3rd and 10th percentiles. A total number of 1,008 (13.20%; 95% CI: 12.46-13.98) boys and 603 (8.34%; 95% CI: 7.72-9.00) girls were categorized as overweight and obese. Obesity were observed in 402 (5.27%; 95% CI: 4.79-5.79) boys and 274 (3.76%; 95% CI: 3.35-4.22) girls.
Conclusion: We construct BMI percentile curves by age and gender for 7 to 18 years Iranian children and adolescents. It can be concluded that sample populations from Tehran are nationally representative.- انتشار مقاله: 14-02-1395
- نویسندگان: Mostafa Hosseini,Masoud Baikpour,Mahmoud Yousefifard,Mohammad Ali Mansournia,Mehdi Yaseri,Hadi Asady,Mostafa Qorbani,Roya Kelishadi,Fatemeh Ataei,Neamatollah Ataei
- مشاهده
- جایگاه : پژوهشی
- مجله: International Journal of Health Policy and Management
- نوع مقاله: Journal Article
- کلمات کلیدی: risk factors,Hospital,Accidental Fall,Nested Case Control
- چکیده:
- چکیده انگلیسی: Background
Patient falls are considered a challenge to the patient’s safety in hospitals, which, in addition to increasing the length of stay and costs, may also result in severe injuries or even the death of the patient. This study aims to investigate the associations between risk factors among fallers in comparison with the control group.
Methods
A prospective nested case control study was performed on 185 patients who fell and 1141 controls were matched with the patients at risk of fall in the same ward and during the same time. This study was conducted in a university educational hospital in Tehran with 800 beds during a 9-month period. The data included demographics, comorbidities, admission details, types of medication, clinical conditions, and activities before or during the fall. The data was collected from clinical records, hospital information system, error reporting system and observations, and the interviews with the fallers, their families and care givers (physicians, nurses, etc). Data analysis was conducted through time-based matching using a multi-level analysis.
Results
In a multilevel model including patient-related, medication, and care-related variables, the factors that were significantly associated with an increased risk of patient falls included: longer length of stay (odds ratio [OR] = 1.01; CI = 0.32 to 0.73), using chemotherapy drugs, sedatives, anticonvulsants, benzodiazepines, and angiotensin-converting enzyme (ACE) inhibitors, visual acuity (OR = 6.93; CI = 4.22 to 11.38), balance condition (OR = 6.41; CI = 4.51 to 9.11), manual transfer aid (OR = 8.47; CI = 5.65 to 12.69), urinary incontinence (OR = 8.47, CI = 5.65 to 12.69), and cancer (OR = 2.86, CI = 1.84-4.44). These factors were found to be associating with more odds for a falling accident among patients. Several characteristics such as fall history (OR = 0.48; CI = 1.003 to 1.02), poly-pharmacy (OR = 1.37, CI = 00.85 to 2.2), stroke (OR = 0.94, CI = 0.44 to 2.02), and nurse to patient ratio (incidence rate ratio = 1.01, CI = 0.01 to 0.03) were not significantly associated with falling in hospitals.
Conclusion
It seems that a combination of both patient-related factors and history of medication should be considered. Moreover, modifiable clinical characteristics of patients such as vision improvement, provision of manual transfer aid, diabetes control, regular toilet program, and drug modification should be considered during the formulation of interventions.- انتشار مقاله: 07-03-1397
- نویسندگان: Zhila Najafpour,Zahra Godarzi,Mohammad Arab,Mehdi Yaseri
- مشاهده
- جایگاه : پژوهشی
- مجله: Asian Pacific Journal of Cancer Prevention
- نوع مقاله: Journal Article
- کلمات کلیدی: Survival analysis,Stomach Neoplasm,Esophageal Neoplasm
- چکیده:
- چکیده انگلیسی: Background: Esophageal cancer (EC) and Gastric cancer (GC) have been identified as two of the most common
cancers in the northeastern regions of Iran. The increasing rates of these types of cancers requires attention. This study
aims to assess the potential risk factors for these two cancers and then determine shared risk factors between them
in a population of Iranian patients using parametric survival models. Methods: This retrospective cohort study was
conducted using 127 patients with EC and 184 patients with GC in East Azarbaijan, Iran who were diagnosed and
registered during the years 2009-2010 in Iran’s National Cancer Control Registration Program and were followed for
five years. Parametric survival models were used to find the risk factors of the patients. Akaike Information Criteria was
used to identify the best parametric model in this study. Interaction analysis was used to determine shared risk factors
between EC and GC. Results: The mean (±standard deviation) age of diagnoses for EC and GC were 66.92(±11.95) and
66.5(±11.5) respectively. The survival time ranges of GC patients was (0.07-70.33) and the survival time ranges were
from 0.10 to 69.03 months for EC patients. Multivariable Log- logistic model showed that being married (OR=2.25, 95%
CI: 1.33 - 3.81) for EC patients and Esophagectomy surgery for EC (OR: 1.62, 95% CI: 1.04 – 2.55) and GC (OR: 1.60,
95% CI: 1.02 – 2.53) had significant effects on survival. Age at the time of diagnosis, job status, and Esophagectomy
surgery were statistically comparable regarding their magnitude of effect on survival of two cancers (all Ps>0.05).
Conclusion: Esophagectomy surgery and being married were important risk factors in EC and GC. The log-logistic
model was the most appropriate statistical approach to identify significant risk factors on survival of both cancers.- انتشار مقاله: 17-01-1397
- نویسندگان: Elaheh Zarean,Payam Amini,Mehdi Yaseri,Morteza Hajihosseini,Tara Azimi,Mahmood Mahmoudi
- مشاهده