1
|
Pour-Rashidi A, Arabkheradmand J, Rahimian E, Aarabi J, Fallahpour M. Prone extension views in cervical MRI: A case-driven Novel approach. Heliyon 2024; 10:e23251. [PMID: 38163148 PMCID: PMC10755320 DOI: 10.1016/j.heliyon.2023.e23251] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 11/27/2023] [Accepted: 11/29/2023] [Indexed: 01/03/2024] Open
Abstract
The cervical spinal canal has a wide range of motion and specific biomechanics involved with different pathologies that may cause dynamic cord compressions. This study has introduced new protocol for acquiring an extension view of cervical MRI to assess dynamic cervical spinal canal compromise. We posit that dynamic MRI comprising extension view in prone position could be a practical option when deciding the best approach in treating challenging patients.
Collapse
Affiliation(s)
| | | | | | - Judith Aarabi
- Community College of Baltimore County, School of Health Professions, Baltimore, MD, USA
| | - Mahshid Fallahpour
- Department of Public Health, San Diego State University (SDSU)-University of California San Diego (UCSD), San Diego, CA 92182, USA
| |
Collapse
|
2
|
Pour‐Rashidi A, Pahwa B, Khanmirzaie MH, Fallahpour M, Hanif H, Shirani M. Risk factors and surgical approaches in neglected subaxial cervical spine fractures-dislocations: Experiences with two cases and literature review. Clin Case Rep 2024; 12:e8421. [PMID: 38223516 PMCID: PMC10784752 DOI: 10.1002/ccr3.8421] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 12/15/2023] [Accepted: 12/28/2023] [Indexed: 01/16/2024] Open
Abstract
This case report describes our experience of surgical strategies of two patients with neglected subaxial cervical spine fracture-dislocation that came to our center with subsequent follow-ups. Subaxial cervical spine fracture-dislocation must be immediately diagnosed and treated. However, it can be neglected in some cases, especially in developing health care systems and patients with low socioeconomic status. We reported two neglected subaxial cervical fracture-dislocation with a mean age of 54 years old who presented with axial cervical pain, and decreased muscle forces. In one out of two, cervical closed traction was applied, then unsuccessful result led to circumferential decompression and fixation via anterior-posterior (AP) approach. Accordingly, we used AP approach without applying closed reduction in another patient successfully. Except one of our cases who died after 2 weeks of surgery due to aspiration pneumonia, other one found complete improvement at the end of 6-month follow-up. Our study emphasizes the importance of AP approach in patients with irreducible joint dislocations. The approach can minimize the surgical risks and increase the cost-benefit as compared to three or more staged approaches. Our approach is less intensive than some other AP approaches while is a safe and efficacious procedure since the posterior reduction is not performed before discectomy and decompression.
Collapse
Affiliation(s)
- Ahmad Pour‐Rashidi
- Department of Neurosurgery, Sina HospitalTehran University of Medical SciencesTehranIran
| | - Bhavya Pahwa
- University College of Medical Sciences and GTB HospitalDelhiIndia
| | | | - Mahshid Fallahpour
- Department of Public HealthSan Diego State University (SDSU)‐University of California San Diego (UCSD)San DiegoCaliforniaUSA
| | - Hamed Hanif
- Department of Neurosurgery, Sina HospitalTehran University of Medical SciencesTehranIran
| | - Mohammad Shirani
- Department of Neurosurgery, Sina HospitalTehran University of Medical SciencesTehranIran
| |
Collapse
|
3
|
Pour-Rashidi A, Turgut M, Fallahpour M, Mohammadi E, Hanaei S, Rezaei N. Central nervous system hydatidosis around the world: a systematic review. J Neurosurg Sci 2023; 67:653-663. [PMID: 36800683 DOI: 10.23736/s0390-5616.22.05817-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
INTRODUCTION Echinococcosis is a chronic disease caused by Echinococcus species. The central nervous system (CNS) hydatidosis is still a major concern, especially in endemic countries, due to non-specific features and late diagnosis and treatment. This study aimed to provide a systematic review to elucidate the epidemiology and clinical characteristics of CNS hydatidosis worldwide over the past decades. EVIDENCE ACQUISITION PubMed, Scopus, EMBASE, Web of Science, Ovid, and Google Scholar were systematically searched. The gray literature and the references of included studies were searched as well. EVIDENCE SYNTHESIS Our results showed that the CNS hydatid cyst was more prevalent in the male gender, and it is known as a recurrent disease with a rate of 26.5%. CNS hydatidosis was more common in the supratentorial region and was also significantly common in developing countries, including Türkiye and Iran. CONCLUSIONS It was demonstrated that the disease would be more prevalent in developing countries. Also, there would be a trend toward a male predominance of CNS hydatid cyst, younger age involvement, and the recurrence rate of 25% in general. There is no consensus about chemotherapy unless in recurrent disease and the patients who experienced cyst rupture intraoperatively, recommended for a wide range of 3 to 12 months.
Collapse
Affiliation(s)
- Ahmad Pour-Rashidi
- Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Mehmet Turgut
- Department of Neurosurgery, Faculty of Medicine, Aydın Adnan Menderes University, Efeler, Türkiye
- Department of Histology and Embryology, Aydın Adnan Menderes University Health Sciences Institute, Efeler, Türkiye
| | - Mahshid Fallahpour
- Department of Public Health, San Diego State University (SDSU), - University of California San Diego (UCSD), San Diego, CA, USA
| | - Esmaeil Mohammadi
- Department of Neurosurgery, Children's Medical Center, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Sara Hanaei
- Department of Neurosurgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences (TUMS), Tehran, Iran
- Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Research Center for Immunodeficiencies, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Nima Rezaei
- Universal Scientific Education and Research Network (USERN), Tehran, Iran -
- Research Center for Immunodeficiencies, Tehran University of Medical Sciences (TUMS), Tehran, Iran
- School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| |
Collapse
|
4
|
Pashangzadeh S, Delavari S, Shad TM, Salami F, Rasouli SE, Yazdani R, Mahdaviani SA, Nabavi M, Aleyasin S, Ahanchian H, Azad FJ, Chavoshzadeh Z, Nazari F, Momen T, Sherkat R, Abolnezhadian F, Esmaeilzadeh H, Fallahpour M, Arshi S, Bemanian MH, Shokri S, Ebrahimi SS, Abolmolouki M, Farid AS, Rezaei A, Esmaeili M, Kalantari A, Sadeghi-Shabestari M, Shirkani A, Behniafard N, Khalili A, Eslamian MH, Cheraghi T, Shafie A, Tavakol M, Khoshkhui M, Iranparast S, Shamshiri M, Shahri MA, Khazaei R, Asadi M, Babaha F, Aghamohammadi A, Rezaei N, Abolhassani H. Non-Infectious Complications in B-Lymphopenic Common Variable Immunodeficiency. J Investig Allergol Clin Immunol 2023:0. [PMID: 37103527 DOI: 10.18176/jiaci.0902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Common variable immunodeficiency (CVID) is considered the most symptomatic type of inborn errors of immunity in humans. Along with infectious complications, which have numerous consequences, non-infectious complications are also a major challenge among CVID patients. METHODS All registered CVID patients in the national database were included in this retrospective cohort study. Patients were divided into two groups based on the presence of B-cell lymphopenia. Demographic characteristics, laboratory findings, non-infectious organ involvements, autoimmunity, and lymphoproliferative diseases were evaluated. RESULTS Among 387 enrolled patients, 66.4% were diagnosed with non-infectious complications; however, 33.6% had only infectious presentations. Enteropathy, autoimmunity, and lymphoproliferative disorders were reported in 35.1%, 24.3%, and 21.4% of patients, respectively. Some complications, including autoimmunity and hepatosplenomegaly, were reported to be significantly higher among patients with B-cell lymphopenia. Among organ involvement, dermatologic, endocrine and musculoskeletal systems were predominantly affected in CVID patients with B-cell lymphopenia. Among autoimmune manifestations, the frequency of rheumatologic, hematologic, and gastrointestinal autoimmunity was reported to be higher compared to other types of autoimmunity independent from the B cell-lymphopenia. Furthermore, hematological cancers, particularly lymphoma, were slightly introduced as the most common type of malignancy. Meanwhile, the mortality rate was 24.5%, and respiratory failure and malignancies were reported as the most common cause of death in our patients without significant differences between the two groups. CONCLUSION Considering that some of the non-infectious complications might be associated with B-cell lymphopenia, therefore, regular patient monitoring and follow-up along with proper medications (besides immunoglobulins replacement therapy) are highly recommended to prevent further sequels and increase the patients' quality of life.
Collapse
Affiliation(s)
- S Pashangzadeh
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children´s Medical Center, Tehran University of Medical Science, Tehran, Iran
| | - S Delavari
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children´s Medical Center, Tehran University of Medical Science, Tehran, Iran
- Primary Immunodeficiency Diseases Network (PIDNet), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - T M Shad
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children´s Medical Center, Tehran University of Medical Science, Tehran, Iran
| | - F Salami
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children´s Medical Center, Tehran University of Medical Science, Tehran, Iran
- Primary Immunodeficiency Diseases Network (PIDNet), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - S E Rasouli
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children´s Medical Center, Tehran University of Medical Science, Tehran, Iran
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - R Yazdani
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children´s Medical Center, Tehran University of Medical Science, Tehran, Iran
| | - S A Mahdaviani
- Pediatric Respiratory Disease Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - M Nabavi
- Department of Allergy and Clinical Immunology, Rasool e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - S Aleyasin
- Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - H Ahanchian
- Allergy Research Center, Mashhad University Of Medical Sciences, Mashhad, Iran
| | - F J Azad
- Allergy Research Center, Mashhad University Of Medical Sciences, Mashhad, Iran
| | - Z Chavoshzadeh
- Pediatric Infections Research Center, Mofid Children´s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - F Nazari
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children´s Medical Center, Tehran University of Medical Science, Tehran, Iran
| | - T Momen
- Department of Allergy and Clinical Immunology, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Noncommunicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - R Sherkat
- Immunodeficiency Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - F Abolnezhadian
- Department of Pediatrics, Abuzar Children´s Hospital, Ahvaz University of Medical Sciences, Ahvaz, Iran
| | - H Esmaeilzadeh
- Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - M Fallahpour
- Department of Allergy and Clinical Immunology, Rasool e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - S Arshi
- Department of Allergy and Clinical Immunology, Rasool e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - M H Bemanian
- Department of Allergy and Clinical Immunology, Rasool e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - S Shokri
- Department of Allergy and Clinical Immunology, Rasool e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - S S Ebrahimi
- Department of Immunology and Allergy, Kerman University of Medical Sciences, Kerman, Iran
| | - M Abolmolouki
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children´s Medical Center, Tehran University of Medical Science, Tehran, Iran
| | - A S Farid
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children´s Medical Center, Tehran University of Medical Science, Tehran, Iran
| | - A Rezaei
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children´s Medical Center, Tehran University of Medical Science, Tehran, Iran
| | - M Esmaeili
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children´s Medical Center, Tehran University of Medical Science, Tehran, Iran
- Primary Immunodeficiency Diseases Network (PIDNet), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - A Kalantari
- Department of Immunology and Allergy, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - M Sadeghi-Shabestari
- Department of Immunology and Allergy, Tabriz University of Medical Sciences, Tabriz, Iran
| | - A Shirkani
- Allergy and Clinical Immunology Department, Bushehr University of Medical Sciences, School of Medicine, Bushehr, Iran
| | - N Behniafard
- Children Growth Disorder Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - A Khalili
- Department of Pediatrics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - M H Eslamian
- Department of Pediatrics, Hamedan University of Medical Sciences, Hamedan, Iran
| | - T Cheraghi
- Department of Pediatrics, 17 Shahrivar Children's Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - A Shafie
- Department of Immunology, Bahrami Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - M Tavakol
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - M Khoshkhui
- Allergy Research Center, Mashhad University Of Medical Sciences, Mashhad, Iran
| | - S Iranparast
- Department of Immunology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - M Shamshiri
- Department of Immunology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - M A Shahri
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children´s Medical Center, Tehran University of Medical Science, Tehran, Iran
| | - R Khazaei
- Department of Pediatrics, Abuzar Children´s Hospital, Ahvaz University of Medical Sciences, Ahvaz, Iran
| | - M Asadi
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children´s Medical Center, Tehran University of Medical Science, Tehran, Iran
| | - F Babaha
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children´s Medical Center, Tehran University of Medical Science, Tehran, Iran
| | - A Aghamohammadi
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children´s Medical Center, Tehran University of Medical Science, Tehran, Iran
| | - N Rezaei
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children´s Medical Center, Tehran University of Medical Science, Tehran, Iran
- Primary Immunodeficiency Diseases Network (PIDNet), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - H Abolhassani
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children´s Medical Center, Tehran University of Medical Science, Tehran, Iran
- Division of Clinical Immunology, Department of Biosciences and Nutrition, Karolinska Institute, Stockholm, Sweden
| |
Collapse
|
5
|
Pourvali A, Arshi S, Nabavi M, Bemanian MH, Shokri S, Khajoei S, Seif F, Fallahpour M. Sustained unresponsiveness development in wheat oral immunotherapy: predictive factors and flexible regimen in the maintenance phase. Eur Ann Allergy Clin Immunol 2022. [PMID: 35620981 DOI: 10.23822/eurannaci.1764-1489.254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Summary Background and aim. Immunotherapy may induce sustained unresponsiveness (SU) in which the patient can tolerate the allergen without any severe symptoms after discontinuing immunotherapy. The present study evaluated serum and cutaneous markers for predicting SU in patients with wheat anaphylaxis who underwent oral immunotherapy. Moreover, we investigated the effectiveness of a flexible regimen of 5 to 10 g wheat protein (WP) in the maintenance phase of oral immunotherapy (OIT). Methods. This study was conducted on 19 patients with wheat anaphylaxis who underwent OIT. The result of the skin prick test (SPT), besides specific serum IgE (sIgE) and IgG4 (sIgG4) to WP, were evaluated before the desensitization. The maintenance dose started from the preferred dose of 5 to 10 g WP after the build-up phase, if the patient could tolerate it. All patients were recruited 7 to 9 months after undergoing this flexible regimen, and the results of SPT and sIgE, and sIgG4 levels were obtained once more. The patients underwent oral food challenge (OFC) after a 3-4-week avoidance to evaluate SU. Results. There was an association between mean IgE reduction and SU (p less than 0.0006), while no association was observed between the mean increase in specific IgG4 (p = 0.1) and the mean wheal diameter decrease (p = 0.29). In the present study, a 50% reduction in sIgE was associated with SU. Thirteen patients were considered to have a SU. Moreover, there was no association between the flexible regimen and the desensitization rate. Conclusions. The results revealed that the reduction of 50% sIgE is a predictive factor for SU in patients with IgE-mediated wheat allergy.
Collapse
Affiliation(s)
- A Pourvali
- Department of Pediatrics, Amir Kabir Hospital, Arak University of Medical Sciences, Arak, Iran
| | - S Arshi
- Department of Allergy, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - M Nabavi
- Department of Allergy, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - M H Bemanian
- Department of Allergy, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - S Shokri
- Department of Allergy, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - S Khajoei
- Clinical Research Development Center, Imam Khomeini Hospital, Jiroft University of Medical Sciences, Jiroft, Iran
| | - F Seif
- Department of Immunology and Allergy, Academic Center for Education, Culture, and Research (ACECR), Tehran, Iran.,Neuroscience Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - M Fallahpour
- Department of Allergy, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
6
|
Bemanian MH, Alizadeh F, Nabavi M, Arshi S, Shokri S, Khoshmirsafa M, Seif F, Fallahpour M. Sustained Unresponsiveness Induced by Oral Immunotherapy Is Not a Completely Symptom-Free Condition: A Prospective Case Series. J Investig Allergol Clin Immunol 2021; 31:259-260. [PMID: 32732177 DOI: 10.18176/jiaci.0636] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- M H Bemanian
- Allergy Department, Rasoul e Akram hospital, Iran University of Medical Sciences, Tehran, Iran
| | - F Alizadeh
- Pediatric Department, Rasoul e Akram hospital, Iran University of Medical Sciences, Tehran, Iran
| | - M Nabavi
- Allergy Department, Rasoul e Akram hospital, Iran University of Medical Sciences, Tehran, Iran
| | - S Arshi
- Allergy Department, Rasoul e Akram hospital, Iran University of Medical Sciences, Tehran, Iran
| | - S Shokri
- Allergy Department, Rasoul e Akram hospital, Iran University of Medical Sciences, Tehran, Iran
| | - M Khoshmirsafa
- Immunology Department, Medical School, Iran University of Medical Sciences, Tehran, Iran
| | - F Seif
- Department of Allergy and Immunology, Academic Center for Education, Culture, and Research, Tehran, Iran
| | - M Fallahpour
- Allergy Department, Rasoul e Akram hospital, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
7
|
Atefi N, Fallahpour M, Sharifi S, Ghassemi M, Roohaninasab M, Goodarzi A. Probiotic as an adjuvant therapy in chronic urticaria: a blinded randomized controlled clinical trial. Eur Ann Allergy Clin Immunol 2021; 54:123-130. [PMID: 33939347 DOI: 10.23822/eurannaci.1764-1489.200] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 11/17/2022]
Abstract
Summary Background. Chronic spontaneous urticaria (CSU) is a common and treatment challenging disorder which may involve about 2% of normal population and in 50% do not respond properly even to the second line therapies. We aimed to evaluate the efficacy and safety of a synbiotic (prebiotic + probiotic) named as LactoCare in treatment of CSU in the RCT for the first time. Methods. This blinded RCT conducted on 42 patients (21 patients in control antihistamine group and 21 in intervention antihistamine + probiotic group) with CSU during 8 weeks. The efficacy assessed by Urticaria Activity Score (UAS7) and quality of life measured by Persian validated Dermatology Life Quality Index (DLQI). Results. Before and after UAS7 score in control group was 35.33 ± 7.81 and 16.86 ± 13.54, respectively. There was 53% score reduction in control group. Before and after UAS7 score in intervention group was 32 ± 7.84 and 11 ± 11.41, respectively. There was 66% score reduction in intervention group. Improvement of DLQI in control and intervention group was 44% and 66%, respectively. At the end, UAS7 score reduction and DLQI improvement in both groups was statistically significant. Conclusions. Probiotics are effective, safe and satisfactory adjuvant therapy for CSU. Combination of probiotic and antihistamines had no statistically significant different efficacy than the antihistamine alone, based on UAS7 score. But Patients with combination therapy may experience higher reduction rate of itch, number of urticaria and total UAS7 score that is clinically of great value and is really practical by itself. Patients with combination therapy experienced more improvement of quality of life (DLQI).
Collapse
Affiliation(s)
- N Atefi
- School of Medicine, Department of Dermatology, School of Medicine, Iran University of Medical Sciences (IUMS), Rasool Akram Medical Complex, Tehran, Iran
| | - M Fallahpour
- Department of Allergy and Clinical Immunology, School of Medicine, Iran University of Medical Sciences (IUMS), Rasool Akram Medical Complex, Tehran, Iran
| | - S Sharifi
- School of Medicine, Department of Dermatology, School of Medicine, Iran University of Medical Sciences (IUMS), Rasool Akram Medical Complex, Tehran, Iran
| | - M Ghassemi
- School of Medicine, Department of Dermatology, School of Medicine, Iran University of Medical Sciences (IUMS), Rasool Akram Medical Complex, Tehran, Iran
| | - M Roohaninasab
- School of Medicine, Department of Dermatology, School of Medicine, Iran University of Medical Sciences (IUMS), Rasool Akram Medical Complex, Tehran, Iran
| | - A Goodarzi
- School of Medicine, Department of Dermatology, School of Medicine, Iran University of Medical Sciences (IUMS), Rasool Akram Medical Complex, Tehran, Iran
| |
Collapse
|
8
|
Yousefi A, Nasehi S, Arshi S, Nabavi M, Bemanian MH, Shokri S, Seif F, Khoshmirsafa M, Saeedi Y, Sadeghian M, Talachian E, Rajabian B, Mahjoub F, Fallahpour M. Assessment of IgE- and cell-mediated immunity in pediatric patients with eosinophilic esophagitis. Eur Ann Allergy Clin Immunol 2021; 53:86-90. [PMID: 32496031 DOI: 10.23822/eurannaci.1764-1489.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Summary Eosinophilic esophagitis (EoE) is a chronic allergen/immune-mediated disease leading to esophageal dysfunction. Food allergens play critical roles in the pathogenesis and treatment of EoE via different mechanisms. This study aimed to present the characteristics and evaluate the ability of skin prick test (SPT), skin prick to prick test (SPP) (IgE-mediated), and atopic patch test (APT) (cell-mediated) individually or simultaneously to diagnose food allergy in patients suffering from EoE. This prospective study was conducted on 58 patients with EoE. Seven patients (12.1%) were positive to only one, 3 (5.2%) were simultaneously positive to two, and 32 (55.2%) were simultaneously positive to three tests. Single and double sensitizations were totally 10.4% in IgE-mediated reactions, while 36.5% in cell-mediated reactions. In contrast, poly sensitization (> 2 allergens) was 51.7% in IgE-mediated tests and 20.7% in the cell-mediated test. Multiple sensitization findings showed egg white, milk, yolk, and soy were the most frequent allergens. Our findings indicate that EoE is early onset and associated with multiple food sensitizations, particularly via IgE-mediated mechanisms. These immune-mediated responses encompass both IgE-mediated (SPT and SPP) and cell-mediated (APT) reactions simultaneously not individually. Therefore, employing multiple assays may strengthen the diagnosis of food sensitization.
Collapse
Affiliation(s)
- A Yousefi
- Department of Pediatric Gastroenterology, Rasool e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - S Nasehi
- Department of Pediatric Gastroenterology, Rasool e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - S Arshi
- Department of Allergy and Clinical Immunology, Rasool e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - M Nabavi
- Department of Allergy and Clinical Immunology, Rasool e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - M H Bemanian
- Department of Allergy and Clinical Immunology, Rasool e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - S Shokri
- Department of Allergy and Clinical Immunology, Rasool e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - F Seif
- Department of Immunology and Allergy, Academic Center for Education, Culture, and Research (ACECR), Tehran, Iran
| | - M Khoshmirsafa
- Department of Allergy and Clinical Immunology, Rasool e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Y Saeedi
- Department of Allergy and Clinical Immunology, Rasool e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - M Sadeghian
- Department of Pediatric Gastroenterology, Children Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - E Talachian
- Division of Pediatric Gastroenterology, Ali-Asghar Children's Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - B Rajabian
- Department of Clinical Pathology, Atieh Hospital, Tehran, Iran
| | - F Mahjoub
- Bahrami Children Hospital, Tehran University of Medical Sciences, Roshan Azma Pathobiology Laboratory, Pediatric Gastro- Enterology Research Center, Tehran, Iran
| | - M Fallahpour
- Department of Allergy and Clinical Immunology, Rasool e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
9
|
Baniadam L, Arshi S, Nabavi M, Yousefi A, Fallahpour M, Shokri S, Zare Mehrjerdi F, Salari F, Bemanian MH. Can concurrent lower gastrointestinal manifestations help the timely diagnosis of small intestinal bacterial overgrowth in CVID patients? Eur Ann Allergy Clin Immunol 2020; 53:18-22. [PMID: 32186350 DOI: 10.23822/eurannaci.1764-1489.137] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Summary Introduction and objective. Gastrointestinal complications are considered as one of the most common manifestations in patients with Common Variable Immunodeficiency (CVID). These complications can result from Small Intestinal Bacterial Overgrowth (SIBO). Hydrogen breath test is extensively used to diagnose SIBO. The objective of this study was to evaluate the prevalence of SIBO using the Hydrogen Breath Test (HBT) in patients with CVID. Materials and methods. Twenty-seven patients with CVID entered this cross-sectional study. Demographic and lower gastrointestinal symptoms were recorded in a check list. Hemoglobin level was measured in all patients. The concentration of IgA and IgG was assessed using nephelometry. Moreover, SIBO was detected by means of Glucose hydrogen breath test. Results. The mean (plus-minus SD) age of the patients was 35.25 (plus-minus 11.69) years. Twenty patients (74.1%) manifested at least one lower gastrointestinal symptom. The most frequent lower gastrointestinal manifestations were bloating (66.7%) and chronic diarrhea (40.7%), respectively. IgA level less than 10 mg/dl and IgG level less than 600 mg/dl were determined in 77.8% and 25.9% of patients, respectively. Positive HBT was detected in 40.7% (n = 11) of the patients. In the positive HBT group, bloating, chronic diarrhea and abdominal pain were the most common lower GI manifestations. There was no significant difference in terms of age, BMI, IgA level, and duration of CVID between the positive and negative HBT groups. The significant association of co-occurrence of anemia and abdominal pain with positive HBT (positive predictive value: 100%) might be considered as a clue to SIBO diagnosis. Conclusions. Regarding the high prevalence and non-specific manifestation of SIBO, it is suggested to consider concurrent symptoms in patients with CVID to manage the timely and precise diagnosis of SIBO.
Collapse
Affiliation(s)
- L Baniadam
- Department of Allergy and Clinical Immunology, Rasool e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - S Arshi
- Department of Allergy and Clinical Immunology, Rasool e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - M Nabavi
- Department of Allergy and Clinical Immunology, Rasool e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - A Yousefi
- Department of Pediatric Gastroenterology, Rasool e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - M Fallahpour
- Department of Allergy and Clinical Immunology, Rasool e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - S Shokri
- Department of Allergy and Clinical Immunology, Rasool e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - F Zare Mehrjerdi
- Department of Allergy and Clinical Immunology, Rasool e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - F Salari
- Department of Allergy and Clinical Immunology, Rasool e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - M H Bemanian
- Department of Allergy and Clinical Immunology, Rasool e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
10
|
Vakili Moghaddam M, Fallahpour M, Mohammadi M, Rasi Varaee FS, Mokhtarian K, Khoshmirsafa M, Jafari R, Shirzad N, Falak R. Identification of polcalcin as a novel allergen of Amaranthus retroflexus pollen. Allergol Immunopathol (Madr) 2019; 47:357-364. [PMID: 30770138 DOI: 10.1016/j.aller.2018.12.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 08/09/2018] [Revised: 12/13/2018] [Accepted: 12/29/2018] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Amaranthus retroflexus (Redroot Pigweed) is one of the main sources of allergenic pollens in temperate areas. Polcalcin is a well-known panallergen involved in cross-reactivity between different plants. The aim of this study was the molecular cloning and expression of polcalcin, as well as evaluating its IgE-reactivity with A. retroflexus sensitive patients' sera. METHODS Allergenic extract was prepared from A. retroflexus pollen and the IgE-reactivity profile was determined by ELISA and immunoblotting using sera from twenty A. retroflexus sensitive patients. Polcalcin-coding sequence was amplified by conventional PCR method and the product was inserted into pET-21b(+) vector. The recombinant protein was expressed in E. coli BL21 and purified by metal affinity chromatography. The IgE-binding capability of the recombinant protein was analyzed by ELISA and immunoblotting assays, and compared with crude extract. RESULTS Of 20 skin prick test positive patients, 17 patients were positive in IgE-specific ELISA. Western blotting confirmed that approximately 53% of ELISA positive patients reacted with 10kDa protein in crude extract. The A. retroflexus polcalcin gene, encoding to 80 amino acid residues was cloned and expressed as a soluble protein and designated as Ama r 3. The recombinant polcalcin showed rather identical IgE-reactivity in ELISA and western blotting with 10kDa protein in crude extract. These results were confirmed by inhibition methods, too. CONCLUSION The recombinant form of A. retroflexus polcalcin (Ama r 3) could be easily produced in E. coli in a soluble form and shows rather similar IgE-reactivity with its natural counterpart.
Collapse
Affiliation(s)
- M Vakili Moghaddam
- Immunology Research Center, Iran University of Medical Sciences, Tehran, Iran; Department of Immunology, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - M Fallahpour
- Department of Allergy and Clinical Immunology, Iran University of Medical Sciences, Tehran, Iran
| | - M Mohammadi
- Persian Gulf Marine Biotechnology Research Center, Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - F S Rasi Varaee
- Immunology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - K Mokhtarian
- Clinical Biochemistry Research Center, Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - M Khoshmirsafa
- Immunology Research Center, Iran University of Medical Sciences, Tehran, Iran; Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - R Jafari
- Department of Immunology, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - N Shirzad
- Department of Immunology, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - R Falak
- Immunology Research Center, Iran University of Medical Sciences, Tehran, Iran; Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
11
|
Nabavi M, Arshi S, Bemanian M, Aghamohammadi A, Mansouri D, Hedayat M, Nateghian A, Noorbakhsh S, Ehsanipour F, Faranoush M, Shakeri R, Mesdaghi M, Taghvaei B, Ghalebaghi B, Babaie D, Bahrami A, Fallahpour M, Esmaeilzadeh H, Ali Hamidieh A, Rekabi M, Ahmadian J, Eslami N, Shokri S, Afshar M, Jalali F, Akbarpour N, Molatefi R, Rezaei N. Long-term follow-up of ninety eight Iranian patients with primary immune deficiency in a single tertiary centre. Allergol Immunopathol (Madr) 2016; 44:322-30. [PMID: 26803694 DOI: 10.1016/j.aller.2015.09.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 09/27/2015] [Accepted: 09/30/2015] [Indexed: 11/27/2022]
Abstract
PURPOSE The aim was to describe the clinical manifestations, complications and long-term outcome of a cohort of Iranian patients with primary immune deficiency (PID). METHOD We retrospectively studied the demographic, clinical and immunological characteristics of the PID patients in a single tertiary centre, from January 1989 to July 2014. The patients were classified according to the International Union of Immunological Societies Expert Committee on PID. RESULTS 98 patients were diagnosed with and followed-up for 15 disorders. The mean age at onset and diagnosis and the diagnostic delay were 8±10, 14.2±13.1 and 6.1±7 years, respectively. Parental consanguinity rate was 57%. Predominantly Antibody Deficiency was the most common diagnosis (n=63), followed by congenital defects of phagocytes (n=16), combined immunodeficiencies (n=12), well defined syndromes (n=4) and defects in innate immunity (n=3). Recurrent sinopulmonary infection was the most common presentation. Active infections were treated appropriately, in addition to prophylactic therapy with IVIG and antimicrobials. Not all the patients were compliant with prophylactic regimens due to cost and unavailability. One SCID patient underwent successful bone marrow transplantation. The total mortality rate was 19% during the follow-up period (7.8±7.6 years). The mean age of living patients at the time of study was 23±11.7 years. CONCLUSIONS Physicians awareness of PID has been rising dramatically in Iran, ensuring an increasing number of patients being diagnosed and treated. More effective treatment services, including health insurance coverage and drug availability are needed to improve the outcome of PID patients.
Collapse
|
12
|
Bemanin MH, Fallahpour M, Arshi S, Nabavi M, Yousofi T, Shariatifar A. First report of asthma prevalence in Afghanistan using international standardized methods. East Mediterr Health J 2015; 21:194-8. [PMID: 26074219 DOI: 10.26719/2015.21.3.194] [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] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Accepted: 12/16/2014] [Indexed: 11/09/2022]
Abstract
No data on the prevalence of asthma in Afghanistan have been published before. In a school-based survey in 2010-2011 the wheezing section of the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was completed by a random sample of 1500 children aged 6-7 years and 1500 adolescents aged 13-14 years old. The prevalence of physician-diagnosed asthma was 12.5% in 6-7-year-olds and 17.3% in 13-14-year-olds (P = 0.002). The prevalence of wheeze in the last 12 months was similar in children and adolescents (19.2% and 21.7% respectively). The prevalence of ever wheezing, night attacks, speech-limiting wheeze and exercise-induced wheeze was 23.1%, 4.8%, 12.2% and 9.6% respectively in children and 30.5%, 4.4%, 13.0% and 13.6% respectively in adolescents. These rates are higher than those in neighbouring countries. This first epidemiological survey of asthma in Afghanistan shows that asthma and wheezing are common in Kabul students.
Collapse
Affiliation(s)
- M H Bemanin
- Department of Allergy and Clinical Immunology, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - M Fallahpour
- Department of Allergy and Clinical Immunology, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran.
| | - S Arshi
- Department of Allergy and Clinical Immunology, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - M Nabavi
- Department of Allergy and Clinical Immunology, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - T Yousofi
- Department of Paediatrics, Shahid Sadoughi University of Medical Sciences, Yazd, Islamic Republic of Iran
| | - A Shariatifar
- Department of Paediatrics, Shahid Sadoughi University of Medical Sciences, Yazd, Islamic Republic of Iran
| |
Collapse
|
13
|
Nabavi M, Esmaeilzadeh H, Arshi S, Fallahpour M, Mortazavi N, Rezaei N. Could oral administration of immunoglobulin reduce diarrheal severity in common variable immunodeficiency? Allergol Immunopathol (Madr) 2014; 42:371-2. [PMID: 23578779 DOI: 10.1016/j.aller.2012.12.008] [Citation(s) in RCA: 1] [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: 10/30/2012] [Revised: 12/06/2012] [Accepted: 12/08/2012] [Indexed: 10/27/2022]
|
14
|
Fallahpour M, Kottorp A, Nygård L, Lund M. Perceived difficulty in use of everyday technology in persons with acquired brain injury of different severity: A comparison with controls. J Rehabil Med 2014; 46:635-41. [DOI: 10.2340/16501977-1818] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
15
|
Fallahpour M, Jonsson H, Joghataei M, Nasrabadi A, Tham K. “I am not living my lifeâ€: Lived experience of participation in everyday occupations after stroke in Tehran. J Rehabil Med 2013; 45:528-34. [DOI: 10.2340/16501977-1143] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
16
|
Fallahpour M, Tham K, Joghataei MT, Jonsson H. Perceived participation and autonomy: Aspects of functioning and contextual factors predicting participation after stroke. J Rehabil Med 2011; 43:388-97. [DOI: 10.2340/16501977-0789] [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: 11/16/2022] Open
|
17
|
Bakhtiari M, Faezi M, Fallahpour M, Noohi A, Moazami N, Amidi Z. Medium optimization by orthogonal array designs for urease production by Aspergillus niger PTCC5011. Process Biochem 2006. [DOI: 10.1016/j.procbio.2005.09.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|