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Doolub D, Vibert N, Botta F, Razmkon A, Bouquet C, Wassouf I, Millet B, Harika-Germaneau G, Jaafari N. Neurological soft signs as trait markers of a subset of patients with obsessive-compulsive disorder with low insight and altered cognitive abilities. J Psychiatr Res 2024; 175:42-49. [PMID: 38704980 DOI: 10.1016/j.jpsychires.2024.04.052] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 09/04/2023] [Accepted: 04/25/2024] [Indexed: 05/07/2024]
Abstract
Neurological soft signs (NSS) are subtle motor control impairments that include involuntary movements and abnormalities of motor coordination, sensory integration and lateralization. They engage different brain networks, including the prefrontal networks that support the higher cognitive functions that are dysfunctional in obsessive-compulsive disorder (OCD). This study investigated the relationships between the presence of NSS and patients' severity of OCD symptoms, insight, and treatment resistance in a sample of 63 patients. Treatment-resistance was assessed considering all the treatments the patients received during the course of their disease. The four dimensions of OCD defined in the dimensional obsessive-compulsive scale were considered. Links between the patients' cognitive abilities and NSS were assessed using tests targeting specifically the core components of executive functions. As expected, OCD patients displayed more NSS than individually matched control participants. In OCD patients, high NSS scores were associated with poor insight and lower cognitive abilities. Multiple regression analysis identified worse visuospatial working memory, attentional control, and verbal fluency as predictive factors of high NSS scores among cognitive functions. Unexpectedly, the patients displaying symptoms in the contamination/washing dimension displayed less NSS than the other patients. In contrast, neither the severity of OCD symptoms nor long-range treatment resistance was significantly related to patients' NSS scores. Altogether, our findings suggest that high NSS scores may be a trait marker of a subset of OCD patients with low insight and particularly altered cognitive abilities who would not express the contamination/washing dimension of the pathology.
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Affiliation(s)
- Damien Doolub
- CNRS, Université de Poitiers, Université de Tours, CeRCA, Poitiers, France; Unité de Recherche Clinique Pierre Deniker du Centre Hospitalier Henri Laborit, Poitiers, France.
| | - Nicolas Vibert
- CNRS, Université de Poitiers, Université de Tours, CeRCA, Poitiers, France
| | - Fabiano Botta
- Unité de Recherche Clinique Pierre Deniker du Centre Hospitalier Henri Laborit, Poitiers, France
| | - Ali Razmkon
- Unité de Recherche Clinique Pierre Deniker du Centre Hospitalier Henri Laborit, Poitiers, France; Research Center for Neuromodulation and Pain, Shiraz, Iran
| | - Cédric Bouquet
- CNRS, Université de Poitiers, Université de Tours, CeRCA, Poitiers, France
| | - Issa Wassouf
- CNRS, Université de Poitiers, Université de Tours, CeRCA, Poitiers, France; Unité de Recherche Clinique Pierre Deniker du Centre Hospitalier Henri Laborit, Poitiers, France; Centre Hospitalier du Nord Deux-Sèvres, Service de Psychiatrie Adulte, Thouars, France
| | - Bruno Millet
- Institut du Cerveau et de la Moelle, UMR 7225, CNRS, INSERM, Sorbonne Université et Département de Psychiatrie Adulte, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Ghina Harika-Germaneau
- CNRS, Université de Poitiers, Université de Tours, CeRCA, Poitiers, France; Unité de Recherche Clinique Pierre Deniker du Centre Hospitalier Henri Laborit, Poitiers, France
| | - Nematollah Jaafari
- CNRS, Université de Poitiers, Université de Tours, CeRCA, Poitiers, France; Unité de Recherche Clinique Pierre Deniker du Centre Hospitalier Henri Laborit, Poitiers, France
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Moshfeghinia R, Shekouh D, Mostafavi S, Hosseinzadeh M, Bahadori AR, Abdollahifard S, Razmkon A. The effects of transcranial direct-current stimulation (tDCS) on pain intensity of patients with fibromyalgia: a systematic review and meta-analysis. BMC Neurol 2023; 23:395. [PMID: 37919664 PMCID: PMC10621179 DOI: 10.1186/s12883-023-03445-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 10/22/2023] [Indexed: 11/04/2023] Open
Abstract
INTRODUCTION Fibromyalgia (FM) is a chronic pain condition that affects millions of people worldwide. Transcranial Direct Current Stimulation (tDCS) is a non-invasive brain stimulation technique that has shown promise as a potential treatment for FM by modulating pain perception and reducing symptoms, such as fatigue and depression. We aimed to systematically review studies that assess the effect of tDCS on pain reduction in FM patients. METHODS Seven electronic databases (PubMed, Scopus, Embase, PsycINFO, Web of Science, Cochrane, and CINAHL Complete) were searched for records in English. Studies that measured the effect of tDCS on pain intensity in FM patients were included. The Cochrane Collaboration's tool was used to assess the quality of the included studies. A random-effect model was preferred, and statistical analysis was performed by Stata software version 17. RESULTS Twenty studies were included for qualitative, and eleven for quantitative analysis. Out of 664 patients included in the study, 443 were in the stimulation group. The left M1 area was the most common stimulation target (n = 12), and 2 mA was the most common stimulation amplitude (n = 19). The analysis showed that active tDCS significantly reduced pain intensity in FM patients in comparison to the sham group (SMD= -1.55; 95% CI -2.10, -0.99); also, no publication bias was noted. CONCLUSION Our systematic review highlights the potential effect of tDCS on the reduction of pain intensity in FM patients. Additionally, this current evidence could suggest that tDCS applied at an intensity of 2mA to the left M1 is the most effective strategy.
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Affiliation(s)
- Reza Moshfeghinia
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Research Center for Neuromodulation and Pain, 4th floor, Boghrat building, Zand Street, Shiraz, Iran
| | - Dorsa Shekouh
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Research Center for Neuromodulation and Pain, 4th floor, Boghrat building, Zand Street, Shiraz, Iran
| | - Sara Mostafavi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Research Center for Neuromodulation and Pain, 4th floor, Boghrat building, Zand Street, Shiraz, Iran
| | - Mehrnaz Hosseinzadeh
- Fasa Neuroscience Circle (FNC), Student Research Committee, Fasa University of Medical Sciences, Fasa, Iran
| | - Amir Reza Bahadori
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Research Center for Neuromodulation and Pain, 4th floor, Boghrat building, Zand Street, Shiraz, Iran
| | - Saeed Abdollahifard
- Research Center for Neuromodulation and Pain, 4th floor, Boghrat building, Zand Street, Shiraz, Iran
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Razmkon
- Research Center for Neuromodulation and Pain, 4th floor, Boghrat building, Zand Street, Shiraz, Iran.
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Doolub D, Vibert N, Botta F, Razmkon A, Bouquet C, Wassouf I, Millet B, Harika-Germaneau G, Jaafari N. High treatment resistance is associated with lower performance in the Stroop test in patients with obsessive-compulsive disorder. Front Psychiatry 2023; 14:1017206. [PMID: 37215653 PMCID: PMC10198575 DOI: 10.3389/fpsyt.2023.1017206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 04/17/2023] [Indexed: 05/24/2023] Open
Abstract
Around 50% of the patients with obsessive-compulsive disorder (OCD) are resistant to treatment, and patients with OCD show alterations in a broad range of cognitive abilities. The present study investigated the links between treatment-resistance, executive and working memory abilities, and the severity of OCD symptoms among 66 patients with OCD. The patients performed seven tests gauging their executive functions and working memory and filled in questionnaires for OCD severity and insight into their pathology. In addition, the executive and working memory abilities of a subset of these patients were compared with those of individually matched control participants. In contrast with previous studies, patients' treatment resistance was evaluated by considering the clinical outcomes of all the treatments that they received during the course of their disease. Higher treatment resistance was associated with lower performance in one particular executive test, the Stroop test, which assessed patients' ability to inhibit prepotent/automatic responses. Older age and more severe OCD symptoms were also associated with higher treatment resistance. Regardless of OCD severity, the patients displayed small to moderate deficits across most components of executive functions compared to control participants. Interestingly, patients with OCD took more time than control participants to perform speeded neuropsychological tests but never made more errors. Altogether, this study shows that the treatment-resistance of patients with OCD may be reliably quantified over the course of years and treatments using Pallanti and Quercioli's (2006) treatment resistance-related scales. The data suggest that the Stroop test could be used clinically to anticipate treatment outcomes in to-be-treated patients.
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Affiliation(s)
- Damien Doolub
- Centre de Recherches sur la Cognition et l’Apprentissage, CNRS UMR 7295, Université de Poitiers, Poitiers, France
- Centre de Recherches sur la Cognition et l’Apprentissage, CNRS UMR 7295, Université de Tours, Tours, France
- Unité de Recherche Clinique Pierre Deniker du Centre Hospitalier Henri Laborit, Poitiers, France
| | - Nicolas Vibert
- Centre de Recherches sur la Cognition et l’Apprentissage, CNRS UMR 7295, Université de Poitiers, Poitiers, France
- Centre de Recherches sur la Cognition et l’Apprentissage, CNRS UMR 7295, Université de Tours, Tours, France
| | - Fabiano Botta
- Unité de Recherche Clinique Pierre Deniker du Centre Hospitalier Henri Laborit, Poitiers, France
| | - Ali Razmkon
- Unité de Recherche Clinique Pierre Deniker du Centre Hospitalier Henri Laborit, Poitiers, France
- Research Center for Neuromodulation and Pain, Shiraz, Iran
| | - Cédric Bouquet
- Centre de Recherches sur la Cognition et l’Apprentissage, CNRS UMR 7295, Université de Poitiers, Poitiers, France
- Centre de Recherches sur la Cognition et l’Apprentissage, CNRS UMR 7295, Université de Tours, Tours, France
| | - Issa Wassouf
- Centre de Recherches sur la Cognition et l’Apprentissage, CNRS UMR 7295, Université de Poitiers, Poitiers, France
- Centre de Recherches sur la Cognition et l’Apprentissage, CNRS UMR 7295, Université de Tours, Tours, France
- Unité de Recherche Clinique Pierre Deniker du Centre Hospitalier Henri Laborit, Poitiers, France
- Centre Hospitalier du Nord Deux-Sèvres, Service de Psychiatrie Adulte, Thouars, France
| | - Bruno Millet
- Institut du Cerveau et de la Moelle, UMR 7225 CNRS, INSERM, Sorbonne Université et Département de Psychiatrie Adulte, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Ghina Harika-Germaneau
- Centre de Recherches sur la Cognition et l’Apprentissage, CNRS UMR 7295, Université de Poitiers, Poitiers, France
- Centre de Recherches sur la Cognition et l’Apprentissage, CNRS UMR 7295, Université de Tours, Tours, France
- Unité de Recherche Clinique Pierre Deniker du Centre Hospitalier Henri Laborit, Poitiers, France
| | - Nematollah Jaafari
- Centre de Recherches sur la Cognition et l’Apprentissage, CNRS UMR 7295, Université de Poitiers, Poitiers, France
- Centre de Recherches sur la Cognition et l’Apprentissage, CNRS UMR 7295, Université de Tours, Tours, France
- Unité de Recherche Clinique Pierre Deniker du Centre Hospitalier Henri Laborit, Poitiers, France
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Abdollahifard S, Farrokhi A, Mosalamiaghili S, Assadian K, Yousefi O, Razmkon A. Constant current or constant voltage deep brain stimulation: short answers to a long story. Acta Neurol Belg 2023; 123:1-8. [PMID: 36309957 DOI: 10.1007/s13760-022-02118-5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 10/11/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE Recently, the feature of generating constant current output has been added to the implantable pulse generators (IPGs). The efficacy of the conventionally used constant voltage (CV) stimulation has been proved in different movement and psychiatric disorders. In this systematic review, we aimed to discuss the effect of constant current (CC) and constant voltage stimulation on patients with Parkinson's disease (PD) who had subthalamic nucleus deep brain stimulation implantation; we also compared these methods of stimulation with each other. METHODS Using the words "Deep brain stimulation", "constant current" and "constant voltage", we developed a broad search strategy and a systematic search was conducted in PubMed, Scopus, Web of Science and Cochrane electronic bibliographic databases. Studies on the Parkinson's disease patients with subthalamic deep brain stimulation, which mentioned constant current or/and constant voltage setting stimulation were included. RESULTS After screening of 284 articles, 10 reports were found eligible for this study. The score of unified Parkinson's disease rating scale part 3 was improved compared to the baseline, whether the stimulation was CV at baseline or CC. No significant change in non-motor outcomes was found. CONCLUSIONS Although CC stimulation has shown a significant improvement in both motor and non-motor symptoms of PD, switching from CV to CC did not result in a significant change in the score of these items based on UPDRS. To sum up, implantation of constant current devices is safe and significantly improves motor function; it also maintains an acceptable safety profile in patients with PD.
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Affiliation(s)
- Saeed Abdollahifard
- Research Center for Neuromodulation and Pain, Shiraz, Iran
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amirmohammad Farrokhi
- Research Center for Neuromodulation and Pain, Shiraz, Iran
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyedarad Mosalamiaghili
- Research Center for Neuromodulation and Pain, Shiraz, Iran
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kasra Assadian
- Research Center for Neuromodulation and Pain, Shiraz, Iran
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Omid Yousefi
- Research Center for Neuromodulation and Pain, Shiraz, Iran
| | - Ali Razmkon
- Research Center for Neuromodulation and Pain, Shiraz, Iran.
- Pierre Deniker Clinical Research Unit, Henri Laborit Hospital Centre, Poitiers, France.
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Razmkon A, Abdollahifard S, Taherifard E, Roshanshad A, Shahrivar K. Effect of deep brain stimulation on freezing of gait in patients with Parkinson's disease: a systematic review. Br J Neurosurg 2023; 37:3-11. [PMID: 35603983 DOI: 10.1080/02688697.2022.2077308] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 11/02/2022]
Abstract
BACKGROUND AND OBJECTIVES Freezing of gait (FOG) is a disabling gait disorder in patients with Parkinson's disease (PD), characterized by recurrent episodes of halting steps. Dopaminergic drugs are common treatments for PD and FOG; however, these drugs may worsen FOG. Deep brain stimulation (DBS) is another option used to treat selected patients. The device needs to be programmed at a specific frequency, amplitude, and pulse width to achieve optimum effects for each patient. This systematic review aimed to evaluate the efficacy of DBS for FOG and its correlation with programmed parameters and the location of the electrodes in the brain. MATERIALS AND METHODS Data for this systematic review were gathered from five online databases: Medline (via PubMed), Scopus, Embase, Web of Science, and Cochrane Library (including both Cochrane Reviews and Cochrane Trials) with a broad search strategy. We included those articles that reported clinical trials and a specific measurement for FOG. RESULTS This review included 13 studies of DBS that targeted the subthalamic nucleus (STN), substantia nigra (SNr), or pedunculopontine nucleus (PPN). Our analysis showed that low-frequency stimulation (LFS) was superior to high-frequency stimulation (HFS) for improving FOG. In the long term, the efficacy of both LFS and HFS decreased. The effect of amplitude was variable, and this parameter needed to be adjusted for each patient. Bilateral stimulation was better than unilateral stimulation. CONCLUSION DBS is a promising choice for the treatment of severe FOG in patients with PD. Bilateral, low-frequency stimulation combined with medical therapy is associated with better responses, especially in the first 2 years of treatment. However, individualizing the DBS parameters should be considered to optimize treatment response.
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Affiliation(s)
- Ali Razmkon
- Research Center for Neuromodulation and Pain, Shiraz, Iran.,Unite de Recherche Clinique du Centre Hospitalier Henri Laborit, Poitiers, France
| | - Saeed Abdollahifard
- Research Center for Neuromodulation and Pain, Shiraz, Iran.,Unite de Recherche Clinique du Centre Hospitalier Henri Laborit, Poitiers, France
| | - Erfan Taherifard
- Research Center for Neuromodulation and Pain, Shiraz, Iran.,Department of Master Public Health (MPH), School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amirhossein Roshanshad
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Master Public Health (MPH), School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kamyab Shahrivar
- Research Center for Neuromodulation and Pain, Shiraz, Iran.,Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
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Ghaedian T, Razmkon A, Kalhor L, Ostovan VR, Yousefi O, Rezaei R, Hossein-Tehrani MR, Rakhsha A. Correlation of response to subthalamic deep brain stimulation in Parkinson’s disease patients with striatal dopamine transporter density on 99mtc-TRODAT-1 SPECT. Neurol Res 2022; 45:505-509. [PMID: 36573915 DOI: 10.1080/01616412.2022.2162219] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Deep brain stimulation (DBS) is a surgical approach with electrical stimulation of certain parts of the brain, which reduce Parkinson's disease (PD) symptoms. Since the loss of dopaminergic neurons in the substantia nigra is the main pathophysiology of PD, we aimed to evaluate the association of response to DBS with preoperative dopamine transporter density (DAT) and its postoperative changes in PD patients who underwent the bilateral implantation of the electrodes in the subthalamic nucleus (STN). METHOD A prospective evaluation of Parkinson's disease patients who underwent STN-DBS for 2 years was done. 99mTc-TRODAT-1 single-photon emission computed tomography (SPECT) scan and assessment of PD using unified Parkinson's disease rating scale (UPDRS) III were performed in both pre- and post-operation states. The correlation of response to DBS after 6 months was assessed with baseline findings and postoperative changes of 99mTc-TRODAT-1 SPECT parameters. RESULTS Compared to the preoperative state, UPDRS III scores and Levodopa equivalent daily dose (LEDD) were significantly decreased after DBS. However, in 17 patients who underwent both pre-and post-operative 99mTc-TRODAT-1 SPECT, no significant change was seen in any quantitative parameters, including right and left striatal-binding ratio (SBR) as well as striatal asymmetry index (SAI). No significant correlation was also found between the percent of UPDRS III change after DBS and values of preoperative SBRs. The percentage of LEDD reduction also showed no significant correlation with the preoperative state of 99 m-TRODAT-1 SPECT. CONCLUSION Our results showed that the mechanism of DBS action is not accompanied by short-term compensation of DAT in basal ganglia in severely advanced PD.
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Affiliation(s)
- Tahereh Ghaedian
- Nuclear Medicine and Molecular Imaging Research Center, Department of Nuclear Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Razmkon
- Research Center for Neuromodulation and Pain, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Leila Kalhor
- Department of Nuclear Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Vahid Reza Ostovan
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Omid Yousefi
- Research Center for Neuromodulation and Pain, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Raziyeh Rezaei
- Research Center for Neuromodulation and Pain, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Abbas Rakhsha
- Department of Neurosurgery, School of medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Yousefi O, Dayyani M, Rezaei R, Kamran H, Razmkon A. Deep brain stimulation of the posterior subthalamic area as an alternative strategy for management of Holmes tremor: A case report and review of the literature. Surg Neurol Int 2022; 13:489. [DOI: 10.25259/sni_435_2022] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 10/10/2022] [Indexed: 11/04/2022] Open
Abstract
Background:
Holmes tremor is often refractory to medical treatment and deep brain stimulation of the ventralis intermedius nucleus of the thalamus (VIM-DBS) is the intervention of choice in controlling the tremor. Herein, we present a beneficial alternative strategy for the management of such situations, considering the posterior subthalamic area (PSA) as the target of stimulation.
Case Description:
We report a 57-year-old male with the right-sided tremor following a traumatic brain injury 20 years ago. He had been diagnosed with Holmes tremor that was not responsive to nonsurgical therapeutic options. When refractoriness confirmed, he became a candidate for VIM-DBS. During the operation, by performing macrostimulation with a maximum of 2 mA of amplitude, the tremor had no response to the stimulation of different tracts, and severe right hemi-body paresthesia occurred; therefore, we modified our approach and targeted the PSA, which resulted in satisfactory control of the tremor. The permanent lead was implanted into the left side PSA. At 1-year follow-up, the right side tremor was under complete control.
Conclusion:
Our case and other similar pieces of evidence are consistently indicating the potential regulatory effects of PSA-DBS in controlling the Holmes tremor as a feasible alternative strategy when VIM-DBS does not provide a satisfactory response. However, further studies with larger sample size are required to evaluate the long-term response and its possible long-term stimulation-related effects.
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Affiliation(s)
- Omid Yousefi
- Department of Neurosurgery, Neuromapc, Shiraz, Iran,
| | - Mojtaba Dayyani
- Division of Neurosurgery, City of Hope Beckman Research Institute and Medical Center, Duarte, California, United States
| | - Razieh Rezaei
- Department of Neurosurgery, Neuromapc, Shiraz, Iran,
| | - Hooman Kamran
- Department of Neurosurgery, Neuromapc, Shiraz, Iran,
| | - Ali Razmkon
- Department of Neurosurgery, Neuromapc, Shiraz, Iran,
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Razmkon A, Abdollahifard S, Rezaei H, Bahadori AR, Eskandarzadeh P, Kazerooni AR. Effect of Deep Brain Stimulation on Parkinson’s Disease Dementia: A Systematic Review and Meta-Analysis. Basic Clin Neurosci 2021. [DOI: 10.32598/bcn.2021.3420.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Patients in the early stages of Parkinson’s disease(PD) may have subtle cognitive deficits, while overt cognitive deficits are usually manifestations of late-stage PD. There is still a debate on the outcome of deep brain stimulation (DBS) on cognitive function of PD patients. This study aimed to investigate the effect of subthalamic nucleus(STN)-DBS on dementia of PD patients after surgery as compared to medical therapy and other procedures. We searched PubMed, Scopus, Cochrane library and Web of Science database in 22th October 2020. The words Deep Brain stimulation, Parkinson’s disease, dementia, and memory have been searched. Reviews, abstracts, case presentations and letters were excluded. Totally, 490 studies were screened after removing the duplicates. The screening results yielded 81 articles to be screened for eligibility. Finally, 6 studies were included in this meta-analysis for synthesis. Overall, 800 patients were included in this meta-analysis, using Mattis dementia rating scale (MDRS) along with descriptive data of the articles was extracted for assessment of global dementia. Our results indicated that STN-DBS group showed a larger cognitive decline than the best medical treatment(BMT). DBS diminished the score of Mattis dementia rating scale in PD patients more than BMT. The effect of STN-DBS vs. other procedures on dementia was not significant; our results showed that STN stimulation made no significant change in global dementia of PD patients in midterm compared to GPi, Pallidal stimulation and pallidotomy.
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Razmkon A, Abdollahifard S, Yousefi O, Rezaei H. Asymptomatic dural ectasia in neurofibromatosis-1: A case report. Curr J Neurol 2021; 20:246-247. [PMID: 38011477 PMCID: PMC9107577 DOI: 10.18502/cjn.v20i4.8352] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 08/07/2021] [Indexed: 11/24/2022]
Abstract
The article's abstract is not available.
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Affiliation(s)
- Ali Razmkon
- Research Center for Neuromodulation and Pain, Shiraz, Iran
- Unite de Recherche Clinique du Centre Hospitalier Henri Laborit, Poitiers, France
| | - Saeed Abdollahifard
- Research Center for Neuromodulation and Pain, Shiraz, Iran
- Unite de Recherche Clinique du Centre Hospitalier Henri Laborit, Poitiers, France
| | - Omid Yousefi
- Research Center for Neuromodulation and Pain, Shiraz, Iran
| | - Hirad Rezaei
- Research Center for Neuromodulation and Pain, Shiraz, Iran
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
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Razmkon A, Derakhshan N, Kamran H. Letter to the Editor Regarding "Split-Pons Syndrome by Epidermoid Cyst: A Case Report and Review of the Literature". World Neurosurg 2021; 147:230-232. [PMID: 33685008 DOI: 10.1016/j.wneu.2020.12.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 12/07/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Ali Razmkon
- Research Center for Neuromodulation and Pain, Shiraz University of Medical Sciences, Shiraz, Iran; Unite de Recherché Clinique du Centre Hospitalier Henri Laborit, Poitiers, France
| | - Nima Derakhshan
- Research Center for Neuromodulation and Pain, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Hooman Kamran
- Research Center for Neuromodulation and Pain, Shiraz University of Medical Sciences, Shiraz, Iran; Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
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Momeni F, Abedi-Firouzjah R, Farshidfar Z, Taleinezhad N, Ansari L, Razmkon A, Banaei A, Mehdizadeh A. Differentiating Between Low- and High-grade Glioma Tumors Measuring Apparent Diffusion Coefficient Values in Various Regions of the Brain. Oman Med J 2021; 36:e251. [PMID: 33936779 PMCID: PMC8077446 DOI: 10.5001/omj.2021.59] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 08/31/2020] [Indexed: 11/03/2022] Open
Abstract
Objectives Our study aimed to apply the apparent diffusion coefficient (ADC) values to quantify the differences between low- and high-grade glioma tumors. Methods We conducted a multicenter, retrospective study between September to December 2019. Magnetic resonance imaging (MRI) diffusion-weighted images (DWIs), and the pathologic findings of 56 patients with glioma tumors (low grade = 28 and high grade = 28) were assessed to measure the ADC values in the tumor center, tumor edema, boundary area between tumor with normal tissue, and inside the healthy hemisphere. These values were compared between the two groups, and cut-off values were calculated using the receiver operating characteristic curve. Results We saw significant differences between the mean ADC values measured in the tumor center and edema between high- and low-grade tumors (p< 0.005). The ADC values in the boundary area between tumors with normal tissue and inside healthy hemisphere did not significantly differ in the groups. The ADC values at tumor center and edema were higher than 1.12 × 10-3 mm2/s (sensitivity = 100% and specificity = 96.0%) and 1.15 × 10-3 mm2/s (sensitivity = 75.0% and specificity = 64.0%), respectively, could be classified as low-grade tumors. Conclusions The ADC values from the MRI DWIs in the tumor center and edema could be used as an appropriate method for investigating the differences between low- and high-grade glioma tumors. The ADC values in the boundary area and healthy tissues had no diagnostic values in grading the glioma tumors.
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Affiliation(s)
- Farideh Momeni
- Medical Physics and Biomedical Engineering Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.,Research Center for Neuromodulation and Pain, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Razzagh Abedi-Firouzjah
- Department of Medical Physics, Radiobiology and Radiation Protection, Babol University of Medical Sciences, Babol, Iran
| | - Zahra Farshidfar
- Radiology Technology Department, School of Paramedicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nastaran Taleinezhad
- Medical Physics and Biomedical Engineering Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Leila Ansari
- Medical Physics and Biomedical Engineering Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Razmkon
- Research Center for Neuromodulation and Pain, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amin Banaei
- Department of Medical Physics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.,Department of Radiology, Faculty of Paramedical Sciences, AJA University of Medical Sciences, Tehran, Iran
| | - Alireza Mehdizadeh
- Medical Physics and Biomedical Engineering Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.,Research Center for Neuromodulation and Pain, Shiraz University of Medical Sciences, Shiraz, Iran
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12
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Razmkon A, Yousefi O, Vaidyanathan J. Using Preimplanted Deep Brain Stimulation Electrodes for Rescue Thalamotomy in a Case of Holmes Tremor: A Case Report and Review of the Literature. Stereotact Funct Neurosurg 2020; 98:136-141. [PMID: 32209790 DOI: 10.1159/000506083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 10/04/2019] [Accepted: 01/10/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Chronic stimulation of the thalamus is a surgical option in the management of intractable Holmes tremor. Patients with deep brain stimulation (DBS) can encounter infection as a postoperative complication, necessitating explantation of the hardware. Some studies have reported on the technique and the resulting efficacy of therapeutic lesioning through implanted DBS leads before their explantation. CASE DESCRIPTION We report the case of a patient with Holmes tremor who had stable control of symptoms with DBS of the nucleus ventralis intermedius of the thalamus (VIM) but developed localized infection over the extension at the neck, followed by gradual loss of a therapeutic effect as the neurostimulator reached the end of its service life. Three courses of systemic antibiotic therapy failed to control the infection. After careful consideration, we decided to make a rescue lesion through the implanted lead in the right VIM before explanting the complete DBS hardware. The tremor was well controlled after the rescue lesion procedure, and the effect was sustained during a 2-year follow-up period. CONCLUSION This case and the previously discussed ones from the literature demonstrate that making a rescue lesion through the DBS lead can be the last plausible option in cases where the DBS system has to be explanted because of an infection and reimplantation is a remote possibility.
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Affiliation(s)
- Ali Razmkon
- Research Center for Neuromodulation and Pain, Shiraz, Iran,
| | - Omid Yousefi
- Research Center for Neuromodulation and Pain, Shiraz, Iran
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13
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Razmkon A, Yousefi O, Rezaei R, Salehi S, Petramfar P, Mani A, Rahmati H, Vaidyanathan J, Ilami G, Amirmoezzi Y. Initial Results of Bilateral Subthalamic Nucleus Stimulation for Parkinson Disease in a Newly Established Center in a Developing Country: Shiraz, Southern Iran. World Neurosurg 2018; 121:e129-e135. [PMID: 30236810 DOI: 10.1016/j.wneu.2018.09.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 05/05/2018] [Revised: 09/03/2018] [Accepted: 09/05/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To report the establishment of a new center for deep brain stimulation (DBS) as a surgical treatment for Parkinson disease and the surgical outcomes, from 2014 to 2017 in Shiraz, Southern Iran. METHODS A new treatment program was established in Shiraz through a multidisciplinary team in 2014. Thirty-four patients underwent implantation of subthalamic nucleus (STN) electrodes during the last 3 years. Twenty-five patients fulfilled the minimum 6-month follow-up criteria. The baseline Unified Parkinson Disease Rating Scale (UPDRS) was assessed 1 month before surgery in both off-medication and on-medication states by a movement disorder neurologist. To evaluate the outcomes, subscores of the UPDRS were assessed in all patients before surgery and at least 6 months after the operation. RESULTS All 25 patients had advanced Parkinson disease categorized as stage 3 or 4 using the Hoehn and Yahr scale. STN DBS resulted in a dramatic improvement in motor function of most patients. A reduction in dopaminergic medication dosage (average 60% reduction) was observed. The mean improvement was 40% in UPDRS II and 67% in UPDRS III. No surgical or hardware complications were observed. Stimulation-related adverse effects, including increased falling and worsening of speech, occurred in a few patients after surgery. Most of the patients experienced weight gain after surgery. CONCLUSIONS Bilateral STN DBS is a satisfactory and safe treatment for carefully selected patients with advanced Parkinson disease. According to the results, the procedure can be performed safely and with comparable results in developing countries around the world.
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Affiliation(s)
- Ali Razmkon
- Research Center for Neuromodulation and Pain, Kowsar Hospital, Shiraz, Iran.
| | - Omid Yousefi
- Research Center for Neuromodulation and Pain, Kowsar Hospital, Shiraz, Iran
| | - Raziyeh Rezaei
- Research Center for Neuromodulation and Pain, Kowsar Hospital, Shiraz, Iran
| | - Sina Salehi
- Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Peyman Petramfar
- Department of Neurology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Arash Mani
- Research Center for Psychiatry and Behavioral Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hashem Rahmati
- Community-based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Ghazal Ilami
- Research Center for Neuromodulation and Pain, Kowsar Hospital, Shiraz, Iran
| | - Yalda Amirmoezzi
- Research Center for Neuromodulation and Pain, Kowsar Hospital, Shiraz, Iran
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14
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Ansari M, Mosalaei A, Ahmadloo N, Rasekhi A, Geramizadeh B, Razmkon A, Anvari K, Afarid M, Dadras A, Nafarieh L, Mohammadianpanah M, Nasrolahi H, Hamedi SH, Omidvari S, Nami M. A comprehensive approach in high-grade glioma management: position statement from the Neuro-Oncology Scientific Club (NOSC), Shiraz, Iran. Ger Med Sci 2017; 15:Doc05. [PMID: 28325997 PMCID: PMC5332812 DOI: 10.3205/000246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Revised: 02/09/2017] [Indexed: 12/21/2022]
Abstract
Establishing a robust teamwork model in the practice of neuro-oncology requires continued interdisciplinary efforts. The Neuro-Oncology Scientific Club (NOSC) initiative is an interdisciplinary clinical forum promoting the comprehensive approach across involved disciplines in the management of central nervous system (CNS) malignancies. With its provincial founding panels and national steering board, NOSC has been operational in Iran since 2011. This initiative has pursued its mission through interval strategic meetings, tumor boards, case discussions as well as publishing neuro-oncology updates, case study periodicals, and newsletters. A provincial meeting of NOSC in Shiraz put together insights from international practice guidelines, emerging evidence, and expert opinions to draw a position statement on high-grade glioma management in adults. The present report summarizes key highlights from the above clinical forum.
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Affiliation(s)
- Mansour Ansari
- Department of Radiation Oncology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ahmad Mosalaei
- Department of Radiation Oncology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Niloufar Ahmadloo
- Department of Radiation Oncology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Rasekhi
- Department of Radiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Bita Geramizadeh
- Department of Pathology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Razmkon
- Department of Neurosurgery, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kazem Anvari
- Cancer Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Afarid
- Behestan Medical Scientific Committee, Behestan Group, Tehran, Iran
| | - Ali Dadras
- Behestan Medical Scientific Committee, Behestan Group, Tehran, Iran; Institute of Biochemistry and Biophysics (IBB), University of Tehran, Tehran, Iran
| | - Leila Nafarieh
- Behestan Medical Scientific Committee, Behestan Group, Tehran, Iran
| | - Mohammad Mohammadianpanah
- Department of Radiation Oncology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamid Nasrolahi
- Department of Radiation Oncology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Hasan Hamedi
- Department of Radiation Oncology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shapour Omidvari
- Department of Radiation Oncology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Nami
- Behestan Medical Scientific Committee, Behestan Group, Tehran, Iran; Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran; Neuroscience Laboratory (Brain, Cognition and Behavior), Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran; Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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15
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Razmkon A. Neurotrauma as an Evolving Indication for Neuromodulation. Bull Emerg Trauma 2017; 5:4-5. [PMID: 28246616 PMCID: PMC5316129] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Accepted: 12/21/2016] [Indexed: 06/06/2023] Open
Affiliation(s)
- Ali Razmkon
- Center for Neuromodulation and Pain, Health Technology Research Center, Kowsar Hospital, Shiraz, Iran
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16
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Abdi M, Navidbakhsh M, Razmkon A. A Lumped Parameter Method to Calculate the Effect of Internal Carotid Artery Occlusion on Anterior Cerebral Artery Pressure Waveform. J Biomed Phys Eng 2016; 6:33-40. [PMID: 27026953 PMCID: PMC4795327] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2014] [Revised: 01/14/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND AND OBJECTIVE Numerical modeling of biological structures would be very helpful tool to analyze hundreds of human body phenomena and also diseases diagnosis. One physiologic phenomenon is blood circulatory system and heart hemodynamic performance that can be simulated by utilizing lumped method. In this study, we can predict hemodynamic behavior of one artery of circulatory system (anterior cerebral artery) when disease such as internal carotid artery occlusion is occurred. METHOD Pressure-flow simulation is one the leading common approaches for modeling of circulatory system behavior and forecasts of hemodynamic in numerous physiological conditions. In this paper, by using lumped model (electrical analogy), CV system is simulated in MATLAB software (SIMULINK environment). RESULTS The performance of healthy blood circulation and heart is modeled and the obtained results used for further analyses. The stenosis of internal carotid artery at different rates was, then, induced in the circuit and the effects are studied. In stenosis cases, the effects of internal carotid artery occlusion on left anterior cerebral artery pressure waveform are investigated. CONCLUSION The findings of this study may have implications not only for understanding the behavior of human biological system at healthy condition but also for diagnosis of diseases in circulatory and cardiovascular system of human body.
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Affiliation(s)
- M. Abdi
- School of Mechanical Engineering, Iran University of Science and Technology, Tehran, Iran
- Tissue Engineering and Biological Systems Research Laboratory, School of Mechanical Engineering, Iran University of Science and Technology, Tehran, Iran
| | - M. Navidbakhsh
- School of Mechanical Engineering, Iran University of Science and Technology, Tehran, Iran
- Tissue Engineering and Biological Systems Research Laboratory, School of Mechanical Engineering, Iran University of Science and Technology, Tehran, Iran
| | - A. Razmkon
- Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran
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17
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Moayer A, Mohebali N, Razmkon A. Incidence of Deep Vein Thrombosis in Patients Undergoing Degenerative Spine Surgery onProphylactic Dalteparin; A Single Center Report. Bull Emerg Trauma 2016; 4:38-42. [PMID: 27162925 PMCID: PMC4779468] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 11/14/2015] [Accepted: 12/23/2015] [Indexed: 06/05/2023] Open
Abstract
OBJECTIVE To determine the incidence of deep vein thrombosis (DVT)in patients undergoing spinal surgeries receiving prophylactic doses of Deltaparin in a single center in central Iran. METHOD This cross-sectional study was conducted in Shariatee hospital of Isfahan during a 12-month period. We included all the patients undergoing elective spinal surgeries in our center during the study period who received prophylactic dosages of subcutaneous Dalteparin (5000unit daily) thefirst postoperative day. Those with absolute contraindications of anticoagulation therapy were not included in the study. Patients were followed for 3 months clinically and the incidence of DVT was recorded. DVT was suspected clinically and was confirmed by color Doppler sonography. RESULTS Overall we included 120 patients with mean age of 44.8 ± 12.6years among whom there were 54 (45%) men and 66 (55%) women. Lumbar discectomy (32.9%)and laminectomy (20.2%)were the most common performed procedures. DVT was detected in 1 (0.83%) patient in postoperative period. None of the patients developed pulmonary embolism and none hemorrhagic adverse event was recorded. The patient was treated with therapeutic unfractionated heparin and was discharged with warfarin. CONCLUSION Our results shows the efficacy of LMWH (Dalteparin) in reducing the incidence of DVT to 0.83%. These results also show the safety of Dalteparin in spine surgery because of lack of bleeding complication.
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Affiliation(s)
| | - Navideh Mohebali
- Department of Neurosurgery, Yazd University of Medical Sciences, Rahnemoon Hospital, Yazd, Iran
| | - Ali Razmkon
- Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran
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18
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Rahmanian A, Mohebali N, Haghnegahdar A, Kamali Sarvestani E, Razmkon A, Kivelev J, Baghban F. Serum Levels of Monocyte Chemoattractant Protein-1 Correlate with Poor Clinical Grades in Cerebral Aneurysms. Iran J Immunol 2015; 12:302-310. [PMID: 26714421] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Ruptured cerebral aneurysms (ICAs) are the most common non-traumatic cause of subarachnoid hemorrhage (SAH) that is associated with life threatening complications such as Vasospasm, Infarction, and Hydrocephalus (HCP). The active participation of macrophage/monocyte-mediated inflammatory response in the pathogenesis of cerebral aneurysm as labeled with Monocyte Chemoattractant Protein-1 (MCP-1) is suggested. OBJECTIVE To measure the serum level of MCP-1 in ruptured CAs in different time intervals. METHODS We measured the serum levels of MCP-1 in SAH patients who had CAs and compared it with that of MCP-1 in two control groups: including patients with SAH without CAs, and the normal population of blood donors. We also measured the MCP-1 levels in patients with CAs one week afterward to evaluate the effect of treatment. Serum level of MCP-1 was measured by a commercial ELISA assay. RESULTS Mean serum MCP-1 level in patients with SAH and CAs was 188.2168 Pg/ml and 331.3982 Pg/ml in the normal population. There was no statistically significant difference between serum levels of MCP-1 on the first (mean=188.2168 Pg/ml) and 7th days after SAH onset (mean=171.8450 Pg/ml) (p=0.739). Serum level of MCP-1 increased significantly as Glasgow Coma Scale decreased (p=0.078) and Hunt and Hess score increased (p=0.089). CONCLUSION Our results did not show an increasing MCP-1 serum level in patients with aneurysmal SAH. There was a relationship between poor clinical grade and MCP-1 levels in patients with CAs. MCP-1 may be a local inflammatory marker for cerebral aneurysms without systemic manifestation.
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Affiliation(s)
- Abdolkarim Rahmanian
- Department of Neurosurgery, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran, e-mail:
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19
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Asadi-Pooya AA, Rakei SM, Kamgarpour A, Taghipour M, Ashjazadeh N, Razmkon A, Zare Z, Bagheri MH. Outcome after temporal lobectomy in patients with medically-refractory mesial temporal epilepsy in Iran. J Neurosurg Sci 2015; 61:277-282. [PMID: 25665526 DOI: 10.23736/s0390-5616.16.02843-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Epilepsy surgery has been proved to be feasible and cost-effective in developing countries. In the current paper, we discussed the outcome of patients with mesial temporal lobe epilepsy (MTLE) and medically-refractory seizures who had surgery at our center in Shiraz, Iran. METHODS Patients aged 18 years and older with refractory MTLE and mesial temporal sclerosis operated at Namazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran from May 2009 through December 2011 were enrolled. Presurgical evaluation included clinical history, neurological examination, 2-hour video-EEG recording, and 1.5-T MRI. All patients were submitted to standard temporal lobectomy at the side determined by MRI and video-EEG. RESULTS Twenty-two patients (12 women and 10 men) underwent surgery between May 2009 and December 2011. All patients were followed postoperatively for at least 12 months (mean=24.8±7.7 months; minimum=12 months; maximum=36 months). At the last follow-up visit, 18 patients (81.8%) had a good outcome (15 patients [68.2%] had Engel class 1 and three others had Engel class 2). The total cost of presurgical evaluation and epilepsy surgery at our center was less than $500. CONCLUSIONS Resources are limited for the vast majority of medically-refractory patients with epilepsy who live in the developing countries. However, it is feasible to select good surgical candidates for anterior temporal lobectomy relying on the clinical history and examination, MRI and interictal EEG. Broader application of epilepsy surgery should be encouraged in countries with limited financial resources.
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Affiliation(s)
- Ali A Asadi-Pooya
- Neurosciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran - .,Department of Neurology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran - .,Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA -
| | - Seyed M Rakei
- Department of Neurosurgery, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ahmad Kamgarpour
- Department of Neurosurgery, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mousa Taghipour
- Neurosciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Neurosurgery, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nahid Ashjazadeh
- Neurosciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Neurology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Razmkon
- Neurosciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Neurosurgery, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Zare
- Department of Radiology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad H Bagheri
- Medical Imaging Research Center, Department of Radiology, Namazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
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20
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Javidi M, Heydari M, Karimi A, Haghpanahi M, Navidbakhsh M, Razmkon A. Evaluation of the effects of injection velocity and different gel concentrations on nanoparticles in hyperthermia therapy. J Biomed Phys Eng 2014; 4:151-62. [PMID: 25599061 PMCID: PMC4289522] [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: 09/21/2014] [Accepted: 11/18/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND AND OBJECTIVE In magnetic fluid hyperthermia therapy, controlling temperature elevation and optimizing heat generation is an immense challenge in practice. The resultant heating configuration by magnetic fluid in the tumor is closely related to the dispersion of particles, frequency and intensity of magnetic field, and biological tissue properties. METHODS In this study, to solve heat transfer equation, we used COMSOL Multiphysics and to verify the model, an experimental setup has been used. To show the accuracy of the model, simulations have been compared with experimental results. In the second part, by using experimental results of nanoparticles distribution inside Agarose gel according to various gel concentration, 0.5%, 1%, 2%, and 4%, as well as the injection velocity, 4 µL/min, 10 µL/min, 20 µL/min, and 40 µL/min, for 0.3 cc magnetite fluid, power dissipation inside gel has been calculated and used for temperature prediction inside of the gel. RESULTS The Outcomes demonstrated that by increasing the flow rate injection at determined concentrations, mean temperature drops. In addition, 2% concentration has a higher mean temperature than semi spherical nanoparticles distribution. CONCLUSION The results may have implications for treatment of the tumor and any kind of cancer diseases.
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Affiliation(s)
- M Javidi
- School of Mechanical Engineering, Iran University of Science and Technology, Tehran 16846, Iran
- Tissue Engineering and Biological Systems Research Laboratory, School of Mechanical Engineering, Iran University of Science and Technology, Tehran 16846, Iran
| | - M Heydari
- School of Mechanical Engineering, Iran University of Science and Technology, Tehran 16846, Iran
- Tissue Engineering and Biological Systems Research Laboratory, School of Mechanical Engineering, Iran University of Science and Technology, Tehran 16846, Iran
| | - A Karimi
- School of Mechanical Engineering, Iran University of Science and Technology, Tehran 16846, Iran
- Tissue Engineering and Biological Systems Research Laboratory, School of Mechanical Engineering, Iran University of Science and Technology, Tehran 16846, Iran
| | - M Haghpanahi
- School of Mechanical Engineering, Iran University of Science and Technology, Tehran 16846, Iran
| | - M Navidbakhsh
- School of Mechanical Engineering, Iran University of Science and Technology, Tehran 16846, Iran
- Tissue Engineering and Biological Systems Research Laboratory, School of Mechanical Engineering, Iran University of Science and Technology, Tehran 16846, Iran
| | - A Razmkon
- Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran
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21
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Ghaffarpasand F, Razmkon A, Khalili H. Deep Brain Stimulation in Patients with Traumatic Brain Injury; Facts and Figures. Bull Emerg Trauma 2014; 2:101-102. [PMID: 27162876 PMCID: PMC4771271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Accepted: 06/20/2014] [Indexed: 06/05/2023] Open
Affiliation(s)
| | - Ali Razmkon
- Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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22
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Asadi-Pooya AA, Ashjazadeh N, Kamgarpour A, Taghipour M, Rakei SM, Farazdaghi M, Inaloo S, Bagheri MH, Razmkon A, Zare Z. Management of epilepsy in resource-limited areas: establishing an epilepsy surgery program in Iran. Med J Islam Repub Iran 2014; 28:24. [PMID: 25250284 PMCID: PMC4154273] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Accepted: 08/07/2013] [Indexed: 11/23/2022] Open
Abstract
Background Of about 40 million people with epilepsy, who live in developing countries, the majority do not receive appropriate treatment. Nonetheless, there are striking disparities among the so-called developing countries, however generally speaking, access to and availability of epilepsy management programs in developing countries are very limited and therefore, the issue of developing epilepsy centers in resource-limited settings in a large scale is very essential. The surgery for epilepsy, including temporal lobotomy, lesionectomy and corpus colostomy, for patients with medically-refractory seizures, defined as failure of adequate trials of two tolerated, appropriately chosen and using antiepileptic drug to achieve sustained freedom, from seizure has been proved to be feasible and cost-effective in developing countries. However, the success of epilepsy surgery depends upon the accurate identification of good surgical candidates based on the available resources and technologies without jeopardizing safety. In the current paper, we will share our experiences of establishing an epilepsy surgery program in Iran, despite all short-comings and limitations and try to provide some answers to those challenges, which helped us establish our program.
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Affiliation(s)
- Ali A Asadi-Pooya
- 1. MD., Associate Professor of Epileptology, Neurosciences Research Center, Department of Neurology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran, & Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, USA.
| | - Nahid Ashjazadeh
- 2. MD., Neurosciences Research Center, Department of Neurology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Ahmad Kamgarpour
- 3. Department of Neurosurgery, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Mousa Taghipour
- 4. MD., Neurosciences Research Center, and Department of Neurosurgery, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Seyed Mohamad Rakei
- 5. MD., Department of Neurosurgery, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Mohsen Farazdaghi
- 6. MD., Department of Neurology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Soroor Inaloo
- 7. MD., Neonatal Research Center, and Department of Pediatrics, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Mohammad Hadi Bagheri
- 8. MD., Medical Imaging Research Center, and Department of Radiology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Ali Razmkon
- 9. MD., Neurosciences Research Center, and Department of Neurosurgery, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Zahra Zare
- 10. MD., Department of Radiology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.
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Rahmanian A, Seifzadeh B, Razmkon A, Petramfar P, Kivelev J, Alibai EA, Hernesniemi J. Outcome of decompressive craniectomy in comparison to nonsurgical treatment in patients with malignant MCA infarction. Springerplus 2014; 3:115. [PMID: 24711983 PMCID: PMC3977016 DOI: 10.1186/2193-1801-3-115] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [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: 09/16/2013] [Accepted: 01/13/2014] [Indexed: 11/17/2022]
Abstract
Background Malignant cerebral infarction is a well-recognized disease, comprising 10-15% of all cases with cerebral infarction and causing herniation and death in 80% of cases. In this study, we compare the effects of decompressive craniectomy versus conventional medical treatment on mortality rate and functional and neurological outcome in patients with malignant MCA infarction. Methods We performed a prospective case–control study on 60 patients younger than 80years of age suffering malignant MCA cerebral infarction. The case group underwent decompressive craniectomy in addition to routine aggressive medical care; while the control group received routine medical treatment. Patient outcome was assessed using Glasgow outcome scale and modified Rankin scale within three months of follow-up. The data were analyzed by SPSS version 16.0 software using Chi Square, One-way ANOVA and Mann–Whitney tests. Results There were 27 male and 33 female patients with a mean age of 60.6 years (SD = 12.3). Glasgow outcome scale score averaged 2.93 in the surgical versus 1.53 in the medical group; this difference was significant (p = 0.001). Outcome in modified Rankin scale was also significantly lower in the surgical (3.27) versus medical (5.27) group (p < 0.001). Surgery could decrease the mortality rate about 47%. Conclusion In this study, decompressive craniectomy could decrease mortality rate, and improve neurological and functional outcome, and decrease long-term disability in patients with malignant MCA infarction.
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Affiliation(s)
- Abdolkarim Rahmanian
- Department of Neurosurgery, Shiraz University of Medical Sciences, Nemazee Hospital, P.O. Box: 71937-11351, Shiraz, Iran
| | - Babak Seifzadeh
- Department of Neurosurgery, Shiraz University of Medical Sciences, Nemazee Hospital, P.O. Box: 71937-11351, Shiraz, Iran
| | - Ali Razmkon
- Department of Neurosurgery, Shiraz University of Medical Sciences, Nemazee Hospital, P.O. Box: 71937-11351, Shiraz, Iran ; Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Peyman Petramfar
- Department of Neurology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Juri Kivelev
- Department of Neurosurgery, Helsinki University Central Hospital, Topeliuksenkatu 5, 00260 Helsinki, Finland
| | - Ehsan-Ali Alibai
- Department of Neurosurgery, Shiraz University of Medical Sciences, Nemazee Hospital, P.O. Box: 71937-11351, Shiraz, Iran
| | - Juha Hernesniemi
- Department of Neurosurgery, Helsinki University Central Hospital, Topeliuksenkatu 5, 00260 Helsinki, Finland
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Ashjazadeh N, Boostani R, Ekhtiari H, Emamghoreishi M, Farrokhi M, Ghanizadeh A, Hatam G, Hadianfard H, Lotfi M, Mortazavi SMJ, Mousavi M, Montakhab A, Nili M, Razmkon A, Salehi S, Sodagar AM, Setoodeh P, Taghipour M, Torabi-Nami M, Vesal A. Operationalizing Cognitive Science and Technologies' Research and Development; the "Brain and Cognition Study Group (BCSG)" Initiative from Shiraz, Iran. Basic Clin Neurosci 2014; 5:104-16. [PMID: 25337368 PMCID: PMC4202589] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Recent advances in brain and cognitive science studies have revolutionized concepts in neural dynamics, regulating mechanisms, coding systems and information processing networks which govern our function and behavior. Hidden aspects of neurological and psychiatric diseases are being understood and hopes for their treatment are emerging. Although the two comprehensive mega-projects on brain mapping are in place in the United States and Europe; the proportion of science contributed by the developing countries should not be downsized. With the granted supports from the Cognitive Sciences and Technologies Council (CSTC), Iran can take its role in research on brain and cognition further. The idea of research and development in Cognitive Sciences and Technologies (CST) is being disseminated across the country by CSTC. Towards this goal, the first Shiraz interdisciplinary meeting on CST was held on 9 January 2014 in Namazi hospital, Shiraz. CST research priorities, infrastructure development, education and promotion were among the main topics discussed during this interactive meeting. The steering committee of the first CST meeting in Shiraz decided to frame future research works within the "Brain and Cognition Study Group-Shiraz" (BCSG-Shiraz). The study group comprises scientific leaders from various allied disciplines including neuroscience, neurosurgery, neurology, psychiatry, psychology, radiology, physiology, bioengineering, biophysics, applied physics and telecommunication. As the headquarter for CST in the southern Iran, BCSG-Shiraz is determined to advocate "brain and cognition" awareness, education and research in close collaboration with CSTC. Together with CSTC, Shiraz Neuroscience Research center (SNRC) will take the initiative to cross boundaries in interdisciplinary works and multi-centric research projects within the study group.
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Affiliation(s)
- Nahid Ashjazadeh
- Department of Neurology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran,Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Boostani
- Department of Bioengineering, School of Electrical and Computer Engineering, Shiraz University, Shiraz, Iran
| | - Hamed Ekhtiari
- Iranian Cognitive Science and Technologies Council, Tehran, Iran
| | - Masoumeh Emamghoreishi
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran,Department of Pharmacology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Majidreza Farrokhi
- Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran,Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran,Department of Neurosurgery, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ahmad Ghanizadeh
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran,Research Center for Psychiatry and Behavioral Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Gholamreza Hatam
- Department of Molecular Medicine, School of Advanced Medical Science and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Habib Hadianfard
- Department of Clinical Psychology, Shiraz University, Shiraz, Iran
| | - Mehrzad Lotfi
- Department of Radiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Mohammad Javad Mortazavi
- Ionizing and Non-ionizing Radiation Protection Research Center (INIRPRC), School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Mousavi
- Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran,Department of Physiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Majid Nili
- Iranian Cognitive Science and Technologies Council, Tehran, Iran
| | - Ali Razmkon
- Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran,Department of Neurosurgery, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sina Salehi
- Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Peiman Setoodeh
- School of Mechanical Engineering, Shiraz University, Shiraz, Iran
| | - Mousa Taghipour
- Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran,Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran,Department of Neurosurgery, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Torabi-Nami
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran,Corresponding Author: Mohammad Torabi-Nami MD, PhD, Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran. Tel: +98-7112333138 / Fax: +98-711 2343848. E-mail:
| | - Abdolkarim Vesal
- Department of Radiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran,Academy of Medical Sciences, Iran, Tehran, Iran
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Asadi-Pooya AA, Malekmohamadi Z, Kamgarpour A, Rakei SM, Taghipour M, Ashjazadeh N, Inaloo S, Razmkon A, Zare Z. Corpus callosotomy is a valuable therapeutic option for patients with Lennox-Gastaut syndrome and medically refractory seizures. Epilepsy Behav 2013; 29:285-8. [PMID: 24012506 DOI: 10.1016/j.yebeh.2013.08.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [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: 07/11/2013] [Revised: 08/08/2013] [Accepted: 08/09/2013] [Indexed: 11/28/2022]
Abstract
PURPOSE We present our experience with corpus callosotomy (CC) in a developing country with limited resources in patients with Lennox-Gastaut syndrome (LGS) and medically refractory seizures. METHODS All patients with LGS who underwent CC for medically refractory epilepsy at Namazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran from May 2009 through March 2012 were reviewed in a retrospective study. Presurgical evaluation included clinical history, neurological examination, a 2-hour video-EEG recording, and 1.5-T MRI. Outcome was evaluated at 6, 12, and 24 months postoperatively. We considered the outcome as a success if the patients were either seizure-free or had more than 85% reduction in seizure frequency compared to their preoperative status. RESULTS Eighteen patients (14 males and 4 females) had surgery. Overall, seizures in 11 patients (61.1%) responded favorably one year after surgery; this figure was 6 out of 9 patients (66.6%) two years after surgery. Seven patients (38.8%) were free of disabling seizures one year after CC; this figure was three out of nine patients (33.3%) two years after CC. Three patients (16.6%) were free of all seizure types one year after surgery. Ten patients (55.5%) had no postoperative complications of any kind. CONCLUSION Corpus callosotomy is an effective palliative surgical procedure for patients with LGS with intractable seizures whose seizures are not amenable to focal resection. This is a feasible treatment option for patients, even for those in developing countries with limited resources.
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Affiliation(s)
- Ali A Asadi-Pooya
- Department of Neurology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran; Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, USA.
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26
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Ghaffarpasand F, Razmkon A, Dehghankhalili M. Glasgow Coma Scale Score in Pediatric Patients with Traumatic Brain Injury; Limitations and Reliability. Bull Emerg Trauma 2013; 1:135-136. [PMID: 27162843 PMCID: PMC4789445] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Accepted: 08/22/2013] [Indexed: 06/05/2023] Open
Affiliation(s)
| | - Ali Razmkon
- Shiraz Neuroscience Research Center, Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran
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Rahmanian A, Jamali M, Razmkon A, Kivelev J, Romani R, Alibai EA, Hernesniemi J. Benefits of early aneurysm surgery: Southern Iran experience. Surg Neurol Int 2013; 3:156. [PMID: 23372972 PMCID: PMC3551498 DOI: 10.4103/2152-7806.105095] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2012] [Accepted: 10/10/2012] [Indexed: 11/24/2022] Open
Abstract
Background: Neurovascular surgery has been practiced in Shiraz, the main referral center of the Southern Iran, for over 30 years; however, the trend has accelerated tremendously in recent years following subspecialization of neurovascular surgery in Shiraz, Department of Neurosurgery. Over 100 patients are operated each year, and nearly all are addressed during the first 72 hours after presentation. Methods: In this paper, we focus on the description of techniques we apply for early clipping of ruptured intracranial aneurysms in the anterior circulation. Improvements in outcome, mortality, and rebleeding rates are also discussed. Results: Mortality and rebleeding rates have declined significantly since the institution of new techniques. Conclusion: The establishment of early surgery for ruptured anterior circulation aneurysms through the lateral supraorbital approach along with specific anesthetic protocol has resulted in significant improvement of morbidity, mortality, and rebleeding rates at our department.
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Affiliation(s)
- Abdolkarim Rahmanian
- Shiraz Neuroscience Research Center, Department of Neurosurgery, Shiraz University of Medical Sciences, Nemazee Hospital, Shiraz, Iran
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Kamgarpour A, Riaz-Montazer N, Razmkon A, Derakhshan N, Heidari-Esfahani M. Melanotic progonoma: an unusual pathology for an infantile midline scalp mass. Pediatr Neurosurg 2013; 49:254-5. [PMID: 25034885 DOI: 10.1159/000363192] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 04/08/2014] [Indexed: 11/19/2022]
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Razmkon A. Priorities and Concerns for Research on Neurotrauma in the Developing World. Bull Emerg Trauma 2013; 1:5-6. [PMID: 27162814 PMCID: PMC4771235] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2012] [Accepted: 12/08/2012] [Indexed: 06/05/2023] Open
Affiliation(s)
- Ali Razmkon
- Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Rahmanian A, Alibai EA, Jamali M, Razmkon A. Benefits of early aneurysm surgery: Southern Iran experience. J Inj Violence Res 2012. [PMCID: PMC3571555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Background: Methods: Results: Conclusions: Keywords:
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Affiliation(s)
- Abdolkarim Rahmanian
- Shiraz Neurosciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ehsan Ali Alibai
- Shiraz Neurosciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Jamali
- Shiraz Neurosciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Razmkon
- Shiraz Neurosciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
,
Corresponding Author at:
Ali Razmkon: Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran, Tel: 09173148711,,(Razmkon A.)
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31
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Taghipour M, Razmkon A. Isolation and growth of neural stem cells derived from adult human hippocampus. J Inj Violence Res 2012. [PMCID: PMC3571544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background: The hippocampus is known to be required in the processing of spatial and contextual memories. A specific role in this context appears to be played by the new neurons continuously generated during adulthood from progenitor cells in the subgranular zone of the dentate gyrus. Ablation of neurogenesis by toxins, x-ray irradiation or virus-activated pro-drugs causes severe cognitive deficits in mice models. Methods: Histologic specimens from adult human hippocampus, dissected during the amygdalohippocampectomy process for mesial temporal sclerosis, were obtained and cultured in suitable media. Neural stem cells were characterized using an appropriate in-vitro molecular biomarker profiling. Results: A total of six adult human hippocampal tissues were evaluated of which, two specimens retrieved well-characterized neural stem cells. Conclusions: The adult mammalian hippocampus contains neural precursor cell populations, which give rise to new neurons by passing a sequence of different amplifying lineage-determined progenitor cells. While some of the newborn neurons are integrated into the functional circuitry, most of them have only a transient existence. These cells provide the substrate for neuronal plasticity at the cellular level eventually playing a role in learning and memory. Keywords: Neural stem cell, Cell cultutre, Hippocampus, Neural stems cells
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Affiliation(s)
- Mousa Taghipour
- Shiraz Neurosciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Razmkon
- Shiraz Neurosciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
,
Corresponding Author at:
Ali Razmkon: Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran, Tel:09173148711, ,(Razmkon A.)
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Khalili H, Razmkon A. Optimal timing of cranioplasty after post-injury decompressive craniectomy: a case control study. J Inj Violence Res 2012. [PMCID: PMC3571539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background: Cranioplasty after postinjury decompressive craniectomy (DC) is routinely performed with a three-month delay to avoid the risk of infection and other complications. Recent experience suggests that performing Cranioplasty surgery at shorter period than three months following DC not only may not cause more infections, but also has the privilege of easier dissection, less bleeding, and reduced costs. The present study was aimed at evaluating the optimal timing of cranioplasty by comparing different parameters using two different time frames. Methods: A total of ninety-five patients underwent cranioplasty surgery during March 2010 to March 2011 in Rajaee Hospital affiliated to Shiraz University of Medical Sciences (Shiraz, Iran). All of them underwent DC surgery because of post traumatic intracranial hypertension. All of patients were divided into two groups with respect o the time period between cranioplasty and DC. For one group this period was 2 months and the other was higher. All relevant demographic and clinical data as well as operative variables such as length of operation, amount of bleeding (post-op Hb drop) and late prognosis were compared between these two groups. Results: Mean age was 32.2 ± 13.3(SD) years, and 92.6% of patients were male. No significant difference was observed in independent parameters between the two groups with respect to the length of operation (p=0.004) and amount of bleeding (p=0.013) decreased significantly in patients operated earlier than two months from their DC. No significant difference was observed in postoperative complications and final 6 months prognosis. Conclusions: Findings of the present study showed that performing cranioplasty earlier than two months following craniectomy was associated with shorter surgical duration and lower amounts of bleeding. Performing of cranioplasty in shorter time is accompanied by an easier dissection with no more complications. Keywords: Cranioplasty, Decompressive, Craniectomy, TBI
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Affiliation(s)
- Hosseinali Khalili
- Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran.
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Corresponding Author at:
Hosseinali Khalili: Shiraz Neuroscience Center, Department of Neurosurgery, SUMS, Shiraz, Iran, Tel: 09173174156, ,(Khalili H.)
| | - Ali Razmkon
- Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran
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Asadi-Pooya AA, Taghipour M, Kamgarpour A, Rakei SM, Razmkon A. Management of epilepsy in resource-limited settings: establishing an epileptic surgery program in Southern Iran. J Inj Violence Res 2012. [PMCID: PMC3571542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: The most common treatment modality for epileptic patients is antiepileptic drug (AED) therapy. However, more than 30% of epileptic patient suffers from drug-resistant epilepsy despite the use of appropriate AEDs. Surgery is a common option for these patients. Epilepsy surgery requires sophisticated medical technologies, many of them not available in Iran. The authors of the present study aim to report the clinical and technical issues of establishing an epilepsy surgery protocol in Iran and the limitations and recommendations for further development. Methods: Medically-refractory epileptic patients underwent common imaging techniques (mainly brain MRI using a specific temporal lobe protocol) as well as continuous video EEG monitoring. A specialized committee consisting of epileptologists, neurologists, neurosurgeons and radiologists discussed the eligibility of each patient, and defining treatment plans for the surgery. Results: A total of 22 committee sessions were hold to discuss 140 cases with medically-refractory seizures during March 2009 to May 2012. Eighty-eight patients (62%) underwent the surgery, 35 patients (25%) were considered not appropriate for surgery, and 17 patients (12%) refused to undergo surgery. The most common cause of intractable seizures was mesial temporal sclerosis (36%), brain tumors (21%), cortical malformations (6%), and encephalomalacia (4%). Among 81 operated patients, 39.5% had anterior temporal lobectomy, 34.5% corpus callosotomy, and 30% underwent lesionectomy. Conclusions: The success of epilepsy surgery depends on the accurate identification of good surgical candidates based on available resources and technologies without jeopardizing safety. The key step in establishing a successful plan is having access to trained epileptologist and neurosurgeon. Keywords: Epileptology, Epilepsy surgery, Antiepileptic drug, Surgery portocol
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Affiliation(s)
- Ali Akbar Asadi-Pooya
- Shiraz Neurosciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mousa Taghipour
- Shiraz Neurosciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ahmad Kamgarpour
- Shiraz Neurosciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Mohammad Rakei
- Shiraz Neurosciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Razmkon
- Shiraz Neurosciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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Corresponding Author at:
Ali Razmkon: Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran, Tel: 09173148711,(Razmkon A.)
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Razmkon A. Facial paralysis: Rhazes' deviation. Arch Iran Med 2011; 14:365-366. [PMID: 21994977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Razmkon A, Sadidi A, Sherafat-Kazemzadeh E, Mehrafshan A, Jamali M, Malekpour B, Saghafinia M. Administration of Vitamin C and Vitamin E in Severe Head Injury: A Randomized Double-blind Controlled Trial. Neurosurgery 2011; 58:133-7. [DOI: 10.1227/neu.0b013e3182279a8f] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Razmkon A, Mehrafshan A, Bakhtazad A. Management of post-neurosurgical Acinetobacter infections: experiences obtained during an outbreak. Acta Neurochir (Wien) 2011; 153:435-6. [PMID: 21052742 DOI: 10.1007/s00701-010-0857-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2010] [Accepted: 10/25/2010] [Indexed: 10/18/2022]
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Rashid M, Razmkon A, Ziaei AR, Taghipour M. Handle with care, penetrating neurotrauma: Case report and review of literature. The Indian Journal of Neurotrauma 2010. [DOI: 10.1016/s0973-0508(10)80033-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Razmkon A, Sadidi A, Sherafat-Kazemzadeh E, Mehrafshan A, Bakhtazad A. Beneficial Effects of Vitamin C and Vitamin E Administration in Severe Head Injury: A Randomized Double-Blind Controlled Trial. Neurosurgery 2010. [DOI: 10.1227/01.neu.0000387003.89378.eb] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Farrokhi MR, Razmkon A, Maghami Z, Nikoo Z. Inclusion of the fracture level in short segment fixation of thoracolumbar fractures. Eur Spine J 2010; 19:1651-6. [PMID: 20495932 DOI: 10.1007/s00586-010-1449-z] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2009] [Revised: 03/22/2010] [Accepted: 05/09/2010] [Indexed: 11/30/2022]
Abstract
Short segment posterior fixation is the preferred method for stabilizing thoracolumbar fractures. In case of significant disruption of the anterior column, the simple short segment construct does not ensure adequate stability. In this study, we tried to evaluate the effect of inclusion of the fractured vertebra in short segment fixation of thoracolumbar fractures. In a prospective randomized study, eighty patients with thoracolumbar fractures treated just with posterior pedicular fixation were randomized into two groups receiving either the one level above and one level below excluding the fracture level (bridging group), or including the fracture level (including group). Different clinical and radiological parameters were recorded and followed. A sum of 80 patients (42 patients in group 1 and 38 patients in group 2) were enrolled in the study. The patients in both the groups showed similar clinical outcome. There was a high rate of instrumentation failure in the "bridging" group. The "bridging" group showed a mean worsening (29%) in kyphosis, whereas the "including" group improved significantly by a mean of 6%. The significant effect of the "including" technique on the reduction of kyphotic deformity was most prominent in type C fractures. In conclusion, inclusion of the fracture level into the construct offers a better kyphosis correction, in addition to fewer instrument failures, without additional complications, and with a comparable-if not better-clinical and functional outcome. We recommend insertion of screws into pedicles of the fractured thoracolumbar vertebra when considering a short segment posterior fixation, especially in Magerl type C fractures.
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Affiliation(s)
- Majid-Reza Farrokhi
- Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz Neurosciences Research Center, PO Box 71455-166, Shiraz, Iran
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Affiliation(s)
- M Taghipoor
- Department of Neurosurgery, Shiraz Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Razmkon A, Bakhtazad A. Possible mechanisms of rapid neurological deterioration and acute hydrocephalus in drug abusers. Pediatr Radiol 2009; 39:309. [PMID: 19172258 DOI: 10.1007/s00247-008-1099-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2008] [Accepted: 11/18/2008] [Indexed: 11/28/2022]
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Alibai EA, Rahmanian AK, Razmkon A, Nabavizadeh SA. Tension pneumocephalus following pterional craniotomy for treatment of intracavernous internal carotid artery aneurysm. Emerg Radiol 2008; 15:441-4. [DOI: 10.1007/s10140-007-0697-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2007] [Accepted: 10/29/2007] [Indexed: 11/30/2022]
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Abstract
BACKGROUND Intramedullary spinal cord abscesses are rare and can be potential harmful lesions that cause a variety of neurologic problems. It is a treatable cause of paraparesis; however, diagnosis is not often straightforward due to the indolent course and rarity of the disease. CASE REPORT We report a case of a 32-month-old boy referred to our institution with a neglected intramedullary cord abscess after 6 months. CONCLUSION Strong clinical suspicion, in addition to prompt surgical drainage with proper antibiotic therapy, seems crucial in prevention of permanent neurological disability.
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Affiliation(s)
- Ahmad Kamgarpour
- Department of Neurosurgery, Shiraz University of Medical Sciences, P.O. Box 71455-166, Shiraz, Iran
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Taghipour M, Razmkon A. May head-injured patients with thinner skull bones have a better prognosis? Med Hypotheses 2007; 70:894. [PMID: 18053654 DOI: 10.1016/j.mehy.2007.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2007] [Accepted: 10/06/2007] [Indexed: 11/28/2022]
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Ostovan MA, Fazelzadeh A, Mehdizadeh AR, Razmkon A, Malek-Hosseini SA. How to Decrease Cardiovascular Mortality in Renal Transplant Recipients. Transplant Proc 2006; 38:2887-92. [PMID: 17112856 DOI: 10.1016/j.transproceed.2006.08.091] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2005] [Indexed: 11/26/2022]
Abstract
Cardiovascular disease is the leading cause of death following renal transplantation, accounting for 40% to 55% of all deaths. An analysis in our center showed a 15% mortality in a cohort of renal transplant recipients followed for an average of 10 years. Various contributing risk factors of cardiovascular diseases in transplant recipients such as tobacco use, hypertension, hyperlipidemia, hereditary risk, diabetes, physical inactivity, obesity, dialysis duration, hyperuricemia, proteinuria, hyperhomocysteinemia, hyperparathyroidism, anemia; C-reactive protein level, and immunosuppressive regimen as well as some rare risk factors, such as cytomegalovirus infection, were evaluated in a population of 1200 kidney transplant recipients. Also we introduced methods for early detection, monitoring, and follow-up of proven risk factors of cardiovascular disease.
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Affiliation(s)
- M A Ostovan
- Southern Iran Organ Transplant Center, Shiraz, Fars, Iran
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Abstract
Repeated access to the circulation is essential to perform adequate maintenance hemodialysis (HD). Dysfunction of fistulae is the most common reason for a second intervention and recurrent hospitalization. The aim of this study was to evaluate the complications of HD fistulas seeking to evaluate the impact of age, site of arteriovenous fistula (AVF) (proximal or distal), side (left or right), and history of previous vascular access. We evaluated the clinical complications in 273 patients from the beginning of the use of the current access using the history and physical examination obtained at every dialysis session. We performed further investigations including doppler ultrasound or spiral computed tomography to confirm the clinical diagnosis. Of our patients, 40% had diabetes mellitus as the cause of end-stage renal disease. Almost half (49%) the patients dialyzed through an AVF and 13% with a catheter. One hundred eighty-four cases (67.6%) experienced complications. Of 145 cases that had elbow AVFs, 103 cases (71%) had complications; of 128 cases with wrist AVFs, 80 cases (62.5%) had complications. There were 115 (62.5%) complicated cases among 185 patients with left AVFs, and 69 (78%) among 88 patients with right AVFs. The rate of AVF complications increased with age. The 1-year survival rate was 94%. We did not observe any significant difference between AVF complications in patients with diabetes mellitus or hypertension as the underlying cause of renal failure. Mean cholesterol plasma level did not differ significantly between the patients with and without AVF complications. Mean hematocrit levels were not significantly different between the two groups. However, mean EPO weekly dose was significantly higher among the group of patients with AVF complications. We did find that rate of complications increased with age (P<.05). Our results showed that the frequency of complications was higher among patients with elbow and right-side AVFs, and also among patients with a history of a previous failed shunt but no significant relationship was observed between these variables (P>.05).
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Affiliation(s)
- H Salahi
- Southern Iran Organ Transplant Center, Fars, Iran.
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Abstract
In coping with the shortage of living-related and cadaveric donor groups for renal transplantation, and in the fear of organ marketing, spousal donors are considered an invaluable potential source. Survival rates have been reported to be as high as even some related groups. This study evaluated 1039 renal transplantations up to 2003. Patient survival rates in different donor groups were determined using the Kaplan-Meier method. The 3-year patient survival rates were 93% for kidneys from 61 spouses; 92% for kidneys from 433 living-related donors; 91% for kidneys from 427 living-unrelated (excluding spouses) donors; and 90.5% for 118 cadaveric kidneys. Such results were consistent with many other reports which consistently showed that spousal donors were at least as good as living-related donors, representing a reliable source in cases of organ shortage. The high survival rate of spousal donors is probably related to their strong emotional support.
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Affiliation(s)
- J Roozbeh
- Shiraz Transplant Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
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Malek-Hosseini S, Razmkon A, Mehdizadeh A, Salahi H, Bahador A, Raiss-Jalali GH, Roozbeh J, Behzadi S, Salehipour M, Khosravi M, Anbardar MH. Long-Term Results of Renal Transplantation: A Single-Center Analysis of 1200 Transplants. Transplant Proc 2006; 38:454-6. [PMID: 16549145 DOI: 10.1016/j.transproceed.2006.01.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The present study is a report of long-term results of the first 1200 operations from December 1988 to December 2003. Graft and patient survival rates in eligible cases were computed with Kaplan-Meier analysis. Recipients were 808 men, 392 women of mean age 33.6 +/- 12.5 years. Eighty six percent of cases used organs from living donors (40% related, 41% unrelated, and 5% spouses) and 14% from cadaveric source. The most common causes of end-stage renal disease were chronic glomerulonephritis (18.2%); reflux nephropathy (13.4%); and diabetic nephropathy (10.1%). Among 215 (17.9%) patients, 156 patients (13%) died in the posttransplant period. Most common causes of death were cardiovascular (28.3%), graft loss (20.7%), and infections (19.6%). The 1- and 3-year patient survival rates were 94% and 91.5%, and graft survival rates were 88% and 84%. Although the success rate of operations was not satisfactory at the beginning, the current data reflect a >90% survival rate comparable to the major centers in the world.
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Affiliation(s)
- S Malek-Hosseini
- Shiraz Transplant Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
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Malek-Hosseini SA, Salahi H, Bahador A, Imanieh MH, Mehdizadeh A, Razmkon A, Anbardar MH, Gholami S. Pediatric Liver Transplantation in the Shiraz Transplant Center. Transplant Proc 2006; 38:594-5. [PMID: 16549183 DOI: 10.1016/j.transproceed.2005.12.104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- S-A Malek-Hosseini
- Nemazee Hospital, Shiraz (Southern Iran) Organ Transplant Center, Shiraz, Iran
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Malek-Hosseini SA, Mehdizadeh AR, Salahi H, Saberi-Firouzi M, Bagheri-Lankarani K, Bahador A, Imanieh MH, Nik-Eghbalian S, Lahsaee M, Khosravi MB, Arasteh MM, Bagheri MH, Geramizadeh B, Razmkon A, Tabei SZ. Results of liver transplantation: analysis of 140 cases at a single center. Transplant Proc 2006; 37:3157-8. [PMID: 16213335 DOI: 10.1016/j.transproceed.2005.07.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The Shiraz Organ Transplant Center in southern Iran has been performing all liver transplantations in Iran and certain neighboring countries for 12 years. This study evaluated the 140 operations performed from April 1993 through November 2004. Sixty-one percent of the recipients were men and 39% were women. The average recipient age was 29.9 +/- 14.0 years. One hundred twenty-eight patients has a full-size cadaveric transplant. Most frequent causes of cirrhosis were cryptogenic and viral. An acute rejection episode occurred in 47.5% of cases, and two episodes in 8%. Most frequent short-term complications included respiratory, neurologic, and biliary problems. The 1-, 2-, and 3-year patient survival rates were 92%, 89%, and 85%, respectively. The experience that the Shiraz Organ Transplant Center has had with liver transplantation indicated success comparable to that noted in other reports. The calculated trend suggests that a goal of 100 transplantations for 2005 is within reach.
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