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Cheung S, Heidari P, Truong D. A208 REAL WORLD EVIDENCE ANALYSIS WITH ADALIMUMAB BIOSIMILAR, MSB 11022, REPORTED WITH PATIENT CARE PROGRAM. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991362 DOI: 10.1093/jcag/gwac036.208] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background Injection site reactions (ISR), including injection site pain (ISP) are common adverse events reported with drugs administrated via subcutaneous injections. In clinical trials, the rates of ISR of adalimumab and adalimumab biosimilars range from 3% to 22.8% with citrate-buffer formulations, and from 1.7% to 16.6% with acetate-buffered and other formulations. Purpose The objective of this study is to evaluate ISR of adalimumab biosimilar, MSB 11022, in real world setting. Method Patients with immune mediated inflammatory diseases (IMIDs) enrolled with patient care program (PSP), and received at least one dose of adalimumab biosimilar, MSB 11022, were followed up. Incidences of injection site reactions, including injection site pain, burning sensation, bruise, erythema, hemorrhage, pruritus, and/or swelling were documented through unsolicited and solicited (outgoing following up calls with patients after their first injection through PSP contacts) reports. The data were collected between April 2021 and July 2022, and the rates of ISRs were assessed. Result(s) There were 2812 patients that met criteria through data collection period, with 219 cases of ISR. More than 99% of case reports were through solicited contacts, i.e., through case-manager follow up calls. Overall, rate of injection site reaction is 7.8% in patients with IMIDs treated with adalimumab biosimilar, MSB 11022. The rates of ISRs reported by disease are as follows: 6.8% of patients with Crohn's disease, 8.7% with ulcerative colitis, 8.8% with rheumatoid arthritis, 6.5% with psoriatic arthritis, 7.8% ankylosing spondylitis, 6.1% uveitis, 8.3% with hidradenitis suppurativa, and 11.1% of juvenile rheumatoid arthritis. Conclusion(s) Real world data provided evidence that ISR rate of adalimumab biosimilar, MSB 11022, is within the ranges of clinical trial data of adalimumab with citrate-buffer, and other formulations. As far as we know, this is the first real world evidence reported for ISR among adalimumab biosimilars with IMID patients. Please acknowledge all funding agencies by checking the applicable boxes below None Disclosure of Interest None Declared
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Affiliation(s)
- S Cheung
- Fresenius Kabi Canada, Toronto, Canada
| | - P Heidari
- Fresenius Kabi Canada, Toronto, Canada
| | - D Truong
- Fresenius Kabi Canada, Toronto, Canada
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Shams L, Tajik M, Heidari P, Nasiri T, Mohammadshahi M. Quality of life of Iranian and Afghan pregnant women in rural Iran. Ann Ig 2021; 34:70-78. [PMID: 34698763 DOI: 10.7416/ai.2021.2471] [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] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background Pregnancy is a unique experience in a woman's life, which comes with physiological, metabolic, social, and psychological changes. The combination of these changes along with migration, may reduce the quality of life of pregnant women and mothers. This study aims to determine the quality of life in rural pregnant women. Methods A cross-sectional study was conducted. Three hundred pregnant Iranian and Afghan women who attended the public health centers in regional Tehran, Iran, were systematically selected and included in the study. Different dimensions of health status were investigated using the standard health-related quality of life questionnaire (SF-26) through interviews. SPSS version 23 was used for data analysis. Results The psychological health subscale (38.00) in the Iranian pregnant women and the physical health subscale (38.83) in the Afghan pregnant women had the highest scores. The lowest score was in social functioning subscale in both groups (20.59 in Iranian and 21.22 in Afghans). In general, Iranian mothers had lower scores compared to Afghan mothers. There was a relationship between the quality of life of Iranian pregnant women, their level of education and family's monthly income (P <0.05), and between the quality of life of Afghan pregnant women with the lesser number of pregnancies (P <0.05). Conclusions In rural Iran, the quality of life score and its subscales is comparably low in both Iranian and Afghan pregnant women. Interventions are needed to improve the quality of life in this vulnerable population.
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Affiliation(s)
- L Shams
- Virtual School of Medical Education and Management, Department of Health Management, Policy and Economic, Shahid Beheshti University of Medical Sciences, Tehran, Iran. ORCID: https://orcid.org/0000-0002-8518-8844
| | - M Tajik
- Social Sciences Health Education, Virtual School of Medical Education and Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - P Heidari
- Monash University, Faculty of Medicine, Nursing and Health Sciences, Clayton, Victoria, Australia.,Eastern Health, Spectrum, Richmond, Victoria, Australia. ORCID: https://orcid.org/0000-0002-1043-1555
| | - T Nasiri
- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.,Department of Health Services Management, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran. ORCID: https://orcid.org/0000-0002-7236-6920
| | - M Mohammadshahi
- National Institute of Health Research, Group of Payment and Financial Resources of the Health System, Tehran University of Medical Sciences, Tehran, Iran. ORCID: https://orcid.org/0000-0002-6956-0327
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Javan R, Rao A, Jeun BS, Herur-Raman A, Singh N, Heidari P. From CT to 3D Printed Models, Serious Gaming, and Virtual Reality: Framework for Educational 3D Visualization of Complex Anatomical Spaces From Within-the Pterygopalatine Fossa. J Digit Imaging 2021; 33:776-791. [PMID: 31916019 DOI: 10.1007/s10278-019-00315-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 01/17/2023] Open
Abstract
We describe the framework for capturing the internal view of complex anatomical spaces via multiple media and haptic platforms, exemplified by realistic and conceptual representations of the pterygopalatine fossa (PPF). A realistic three-dimensional (3D) mesh of the PPF was developed by segmenting the osseous anatomy on computed tomography (CT) using Materialize InPrint. Subsequently in Autodesk 3D Studio Max, the realistic mesh was enhanced with graphically designed neurovascular anatomy and additionally a conceptual representation of the PPF with its connections and contents was created. An interactive web-compatible Adobe Flash tutorial using ActionScript was developed, allowing users to advance through a series of educational slides that contained interactive rotatable interior camera views and scrollable CT cross-sectional content, incorporating both the realistic and conceptual models. Both models were also 3D printed using polyamide material. In the realistic model, the neurovasculature was colored with water-based acrylic paint. A 3-piece modular design with embedded magnets allows for internal visualization and seamless assembly. A serious gaming environment of the conceptual PPF was also developed using Truevision3D application programming interface, where users can freely move around rooms and hallways that represent various spaces. Lastly, the realistic model was incorporated into a headset-based virtual reality environment, Surgical Theater, allowing visualization and fly-through inside and outside the model. Multiple 3D techniques for visualization of complex 3D anatomical spaces from within were described, with the necessary software and skills detailed. A rough estimate of the time and cost needed to develop these tools as well as multiple supplementary source and end result files are also made available. Educators could utilize multiple advanced delivery methods to incorporate custom digital 3D models of complex anatomical spaces understood from inside.
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Affiliation(s)
- Ramin Javan
- Department of Radiology, George Washington University Hospital, 900 23rd St NW, Suite G2092, Washington, DC, 20037, USA.
| | - Aditya Rao
- Department of Radiology, Yale New Haven Hospital, New Haven, CT, USA
| | - Bryan S Jeun
- Department of Radiology, Cox Medical Center South, Springfield, MO, USA
| | | | - Neha Singh
- Department of Radiology, George Washington University Hospital, 900 23rd St NW, Suite G2092, Washington, DC, 20037, USA.,Department of Radiology, University of Pittsburg Medical Center, Pittsburgh, PA, USA
| | - Parisa Heidari
- Department of Radiology, George Washington University Hospital, 900 23rd St NW, Suite G2092, Washington, DC, 20037, USA.,Department of Neurology, George Washington University Hospital, Washington, DC, USA
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Javan R, Schickel M, Zhao Y, Agbo T, Fleming C, Heidari P, Gholipour T, Shields DC, Koubeissi M. Using 3D-Printed Mesh-Like Brain Cortex with Deep Structures for Planning Intracranial EEG Electrode Placement. J Digit Imaging 2021; 33:324-333. [PMID: 31512018 DOI: 10.1007/s10278-019-00275-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 01/17/2023] Open
Abstract
Surgical evaluation of medically refractory epilepsy frequently necessitates implantation of multiple intracranial electrodes for the identification of the seizure focus. Knowledge of the individual brain's surface anatomy and deep structures is crucial for planning the electrode implantation. We present a novel method of 3D printing a brain that allows for the simulation of placement of all types of intracranial electrodes. We used a DICOM dataset of a T1-weighted 3D-FSPGR brain MRI from one subject. The segmentation tools of Materialise Mimics 21.0 were used to remove the osseous anatomy from brain parenchyma. Materialise 3-matic 13.0 was then utilized in order to transform the cortex of the segmented brain parenchyma into a mesh-like surface. Using 3-matic tools, the model was modified to incorporate deep brain structures and create an opening in the medial aspect. The final model was then 3D printed as a cerebral hemisphere with nylon material using selective laser sintering technology. The final model was light and durable and reflected accurate details of the surface anatomy and some deep structures. Additionally, standard surgical depth electrodes could be passed through the model to reach deep structures without damaging the model. This novel 3D-printed brain model provides a unique combination of visualizing both the surface anatomy and deep structures through the mesh-like surface while allowing repeated needle insertions. This relatively low-cost technique can be implemented for interdisciplinary preprocedural planning in patients requiring intracranial EEG monitoring and for any intervention that requires needle insertion into a solid organ with unique anatomy and internal targets.
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Affiliation(s)
- Ramin Javan
- Department of Radiology, George Washington University Hospital, 900 23rd St NW, Suite G2092, Washington, DC, 20037, USA. .,George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
| | | | - Yuanlong Zhao
- George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Terry Agbo
- George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Cullen Fleming
- George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Parisa Heidari
- Department of Radiology, George Washington University Hospital, 900 23rd St NW, Suite G2092, Washington, DC, 20037, USA
| | - Taha Gholipour
- Department of Neurology, George Washington University Hospital, Washington, DC, USA
| | - Donald C Shields
- Department of Neurosurgery, George Washington University Hospital, Washington, DC, USA
| | - Mohamad Koubeissi
- Department of Neurology, George Washington University Hospital, Washington, DC, USA
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Yang L, Moubayed A, Shami A, Heidari P, Boukhtouta A, Larabi A, Brunner R, Preda S, Migault D. Multi-Perspective Content Delivery Networks Security Framework Using Optimized Unsupervised Anomaly Detection. IEEE Trans Netw Serv Manage 2021. [DOI: 10.1109/tnsm.2021.3100308] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Heidari P, Blayney S, Butler J, Hitomi E, Luby M, Leigh R. The Relationship Between Penumbral Tissue and Blood-Brain Barrier Disruption in Acute Stroke Patients Presenting in an Extended Time Window. Front Neurol 2020; 11:582994. [PMID: 33363505 PMCID: PMC7753006 DOI: 10.3389/fneur.2020.582994] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 11/19/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Penumbral brain tissue identified with multimodal imaging can be salvaged with reperfusion in an extended time window. The risk of severe hemorrhagic complications after reperfusion therapy increases with worsening disruption of the blood-brain barrier (BBB). The relationship between penumbral tissue and BBB disruption has not been previously studied. Methods: Stroke patients presenting in an extended time window without a large vessel occlusion who underwent diffusion-perfusion MRI within 24 h of last-seen-normal were included. The volume of penumbral tissue was calculated using mismatch on MRI. Mean permeability derangement (MPD) of the BBB was measured within the ischemic lesion. A target profile (TP) for treatment was defined based on the EXTEND trial. Results: 222 patients were included with a median age of 73 and 55% women. The median NIHSS was 6, the mean core volume was 14 ml, the mean ischemic volume was 47 mL and the mean mismatch volume was 33 mL. Higher MPD was significantly associated with less mismatch volume (p = 0.001). A target profile was associated with lower MPD (OR 0.97; CI 0.96:0.99; p < 0.001). Of the 105 patients who had a TP, 31 (30%) had a MPD > 20% suggesting an increased risk of hemorrhage. Thus, 33% (74/222) of patients had a favorable profile for benefit and safety. Conclusions: Patients presenting in an extended time window with a favorable penumbral profile for treatment have less severe BBB disruption. Up to a third of patients who currently go untreated could be considered for enrollment in a clinical trial of thrombolysis in an extended time window.
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Affiliation(s)
- Parisa Heidari
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, United States
| | - Sarah Blayney
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, United States
| | - Jarrhett Butler
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, United States
| | - Emi Hitomi
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, United States
| | - Marie Luby
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, United States
| | - Richard Leigh
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, United States
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Heidari P, Blayney S, Butler J, Hitomi E, Luby M, Leigh R. Frequency of thrombolytic targets in stroke patients presenting in an extended time window. Brain Circ 2020; 6:163-168. [PMID: 33210039 PMCID: PMC7646384 DOI: 10.4103/bc.bc_12_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 04/02/2020] [Revised: 06/04/2020] [Accepted: 07/01/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE: The objective of this study was to determine the proportion of stroke patients presenting in an extended time window who have a thrombolytic treatment target. BACKGROUND: Patients presenting up to 24 h after stroke onset have been found to have penumbral tissue on multimodal imaging. Stroke patients presenting in this extended time window without a large vessel occlusion (LVO) may benefit from reperfusion therapy using thrombolysis. METHODS: Patients seen at our institutions from 2011 through 2015 were reviewed to identify those who presented >4 h and <24 h from last seen normal (LSN) and did not receive acute treatment. Magnetic resonance imaging (MRI) scans were used to dichotomize patients using a diffusion–perfusion mismatch ratio of 1.2. RESULTS: During the study period, 3469 patients were evaluated by our stroke service, with 893 seen 4–24 h from LSN who were not treated. MRI was performed with diffusion and perfusion imaging in 439 patients, of whom 26 were excluded due to hemorrhage and 37 were excluded due to LVO. This left 376 patients who potentially could have been treated with thrombolysis in an extended time window and were included in the analysis. Of these, 156 (42%) demonstrated a mismatch ratio >1.2. Patients with a mismatch presented earlier (P = 0.012), were more likely to be female (P = 0.03), and had higher National Institutes of Health Stroke Scale (P < 0.001). CONCLUSIONS: Almost half of the patients presenting 4–24 h from LSN had a target for thrombolysis in our study. Multimodal imaging may be able to expand the population of treatable stroke patients given the results of recent clinical trials.
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Affiliation(s)
- Parisa Heidari
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Sarah Blayney
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Jarrhett Butler
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Emi Hitomi
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Marie Luby
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Richard Leigh
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
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Heidari P, Fatahi J, Hoseinabadi R, Rouhbakhsh N, Dabiri Satri S, Helena Saunders G, Faghihzadeh E. Persian version of attitudes towards loss of hearing questionnaire. AVR 2019. [DOI: 10.18502/avr.v28i2.867] [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: 11/24/2022] Open
Abstract
Background and Aim: Investigations have shown that the patient’s attitudes toward hearing loss and hearing aids impact hearing aid benefits and its use. In this regard, Saunders and Cienkowski (1996) developed the “attitudes towards loss of hearing questionnaire” to examine some of the psychosocial factors underlying the use of hearing aids. This study has focused on preparing a Persian version of this questionnaire and analyzing its validity and reliability.
Methods: The original English version of the questionnaire was translated into Persian, and its content and face validities were determined by related experts. The final questionnaire was administered to 100 hearing impaired people (52 males and 48 females) aged 30 to 65 years with the mean (SD) age of 54.54 (12.05) years. The test-retest reliability was assessed in 20 patients.
Results: The results of face validity assessment revealed that our questionnaire has a high quality in translation, intelligibility, and cultural
compatibility. The mean scores of the content validity ratio and content validity index of this questionnaire was 0.71 and 0.98, respectively. The mean (SD) total score of this questionnaire was 60.46 (10.02) and the mean scores of denial of hearing loss, negative associations, negative coping strategies, manual dexterity and vision and hearing-related esteem were 15.58, 12.10, 20.40, 5.30, and 7.08, respectively. The overall Cronbach α value was 0.798. The test-retest reliability showed good results for the global score (Intraclass correlation = 0.989).
Conclusion: Based on the obtained results, the Persian version of the questionnaire possesses satisfactory validity and reliability.
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Heidari P, Fatahi F, Hoseinabadi R, Rouhbakhsh N. The Study of Affecting Factors on Attitude Toward Hearing Loss in Hearing Aid Users and Hearing Aid Non-users. J Mod Rehabil 2019. [DOI: 10.32598/jmr.13.2.97] [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: 11/20/2022] Open
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Amalou H, Xu S, Sajjadi A, Heidari P, Li M, Suh R, Mahmood U, Wood B. 3:18 PM Abstract No. 213 Real-time biopsy system for combined optical spectroscopy and electromagnetic tracking. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.239] [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: 11/16/2022] Open
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Vakilian A, Khorramdelazad H, Heidari P, Sheikh Rezaei Z, Hassanshahi G. CCL2/CCR2 signaling pathway in glioblastoma multiforme. Neurochem Int 2016; 103:1-7. [PMID: 28025034 DOI: 10.1016/j.neuint.2016.12.013] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [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: 11/01/2016] [Accepted: 12/20/2016] [Indexed: 02/04/2023]
Abstract
Glioblastoma multiform (GBM) is described as one of the most frequent primary brain tumors. These types of malignancies constitute only 15% of all primary brain tumors. Despite, extensive developments on effective therapeutic methods during the 20th century as well as the first decade of the present century (21st), the median survival rate for patients suffering from GBM is only approximately 15 months, even in response to multi-modal therapy. numerous types of reticuloendothelial system cells such as macrophages and microglial cells occupied within both GBM and also normal surrounding tissues. These immune cells acquire an otherwise activated phenotype with potent tumor-tropic functions that contribute to the glioma growth and invasion. The CC chemokine, CCL2 (previously named MCP-1) is of the most important CC chemokines family member involving in regulation of oriented migration and penetrative infiltration of mainly reticuloendothelial system cells specifically monocyte/macrophage phenotypes. Fundamental parts are played by CCL2 and its related receptor (the CCR2) in brain tumors and obviously in migration of monocytes from the bloodstream through the vascular endothelium. Therefore, CCL2/CCR2 axis is required for the routine immunological surveillance of tissues, in accordance with response to inflammation. Briefly, in this review, we have tried our best to collect the latest, straightened and summarize literature reports exist within data base regarding the interaction between microglia/macrophages and CCL2/CCR2 axis in GBM. We aimed to discuss potential application of this chemokine/receptor interaction axis for the expansion of future anti-glioma therapies as well.
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Affiliation(s)
- Alireza Vakilian
- Geriatric Care Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Hossein Khorramdelazad
- Molecular Medicine Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Parisa Heidari
- Department of Hematology and Medical Laboratory Sciences, School of Allied Medical Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Zahra Sheikh Rezaei
- Department of Hematology and Medical Laboratory Sciences, School of Allied Medical Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Gholamhossein Hassanshahi
- Molecular Medicine Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran; Department of Hematology and Medical Laboratory Sciences, School of Allied Medical Sciences, Kerman University of Medical Sciences, Kerman, Iran.
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Ahmadi SF, Khoshkish S, Soltani-Arabshahi K, Hafezi-Moghadam P, Zahmatkesh G, Heidari P, Baba-Beigloo D, Baradaran HR, Lotfipour S. Challenging script concordance test reference standard by evidence: do judgments by emergency medicine consultants agree with likelihood ratios? Int J Emerg Med 2014; 7:34. [PMID: 25635194 PMCID: PMC4306062 DOI: 10.1186/s12245-014-0034-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [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: 02/16/2014] [Accepted: 08/30/2014] [Indexed: 11/10/2022] Open
Abstract
Background We aimed to compare the clinical judgments of a reference panel of emergency medicine academic physicians against evidence-based likelihood ratios (LRs) regarding the diagnostic value of selected clinical and paraclinical findings in the context of a script concordance test (SCT). Findings A SCT with six scenarios and five questions per scenario was developed. Subsequently, 15 emergency medicine attending physicians (reference panel) took the test and their judgments regarding the diagnostic value of those findings for given diseases were recorded. The LRs of the same findings for the same diseases were extracted from a series of published systematic reviews. Then, the reference panel judgments were compared to evidence-based LRs. To investigate the test-retest reliability, five participants took the test one month later, and the correlation of their first and second judgments were quantified using Spearman rank-order coefficient. In 22 out of 30 (73.3%) findings, the expert judgments were significantly different from the LRs. The differences included overestimation (30%), underestimation (30%), and judging the diagnostic value in an opposite direction (13.3%). Moreover, the score of a hypothetical test-taker was calculated to be 21.73 out of 30 if his/her answers were based on evidence-based LRs. The test showed an acceptable test-retest reliability coefficient (Spearman coefficient: 0.83). Conclusions Although SCT is an interesting test to evaluate clinical decision-making in emergency medicine, our results raise concerns regarding whether the judgments of an expert panel are sufficiently valid as the reference standard for this test.
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Affiliation(s)
- Seyed-Foad Ahmadi
- Center for Educational Research in Medical Sciences, Iran University of Medical Sciences, Tehran 14496, Iran ; Program in Public Health, Department of Population Health and Disease Prevention, University of California Irvine, 653 E. Peltason Dr., Irvine 92697, CA, USA
| | - Shahin Khoshkish
- Center for Educational Research in Medical Sciences, Iran University of Medical Sciences, Tehran 14496, Iran ; Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Homburg/Saar 66421, Germany
| | - Kamran Soltani-Arabshahi
- Center for Educational Research in Medical Sciences, Iran University of Medical Sciences, Tehran 14496, Iran
| | - Peyman Hafezi-Moghadam
- Department of Emergency Medicine, Iran University of Medical Sciences, Tehran 14496, Iran
| | - Golara Zahmatkesh
- Center for Educational Research in Medical Sciences, Iran University of Medical Sciences, Tehran 14496, Iran
| | - Parisa Heidari
- Center for Educational Research in Medical Sciences, Iran University of Medical Sciences, Tehran 14496, Iran ; Department of Neurology, Saarland University Medical Center, Homburg/Saar 66421, Germany
| | | | - Hamid R Baradaran
- Center for Educational Research in Medical Sciences, Iran University of Medical Sciences, Tehran 14496, Iran
| | - Shahram Lotfipour
- Department of Emergency Medicine, School of Medicine, University of California Irvine, Irvine 92697, CA, USA
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Cheng L, Huang Z, Zhou W, Wu Q, Rich J, Bao S, Baxter P, Mao H, Zhao X, Liu Z, Huang Y, Voicu H, Gurusiddappa S, Su JM, Perlaky L, Dauser R, Leung HCE, Muraszko KM, Heth JA, Fan X, Lau CC, Man TK, Chintagumpala M, Li XN, Clark P, Zorniak M, Cho Y, Zhang X, Walden D, Shusta E, Kuo J, Sengupta S, Goel-Bhattacharya S, Kulkarni S, Cochran B, Cusulin C, Luchman A, Weiss S, Wu M, Fernandez N, Agnihotri S, Diaz R, Rutka J, Bredel M, Karamchandani J, Das S, Day B, Stringer B, Al-Ejeh F, Ting M, Wilson J, Ensbey K, Jamieson P, Bruce Z, Lim YC, Offenhauser C, Charmsaz S, Cooper L, Ellacott J, Harding A, Lickliter J, Inglis P, Reynolds B, Walker D, Lackmann M, Boyd A, Berezovsky A, Poisson L, Hasselbach L, Irtenkauf S, Transou A, Mikkelsen T, deCarvalho AC, Emlet D, Del Vecchio C, Gupta P, Li G, Skirboll S, Wong A, Figueroa J, Shahar T, Hossain A, Lang F, Fouse S, Nakamura J, James CD, Chang S, Costello J, Frerich JM, Rahimpour S, Zhuang Z, Heiss JD, Golebiewska A, Stieber D, Evers L, Lenkiewicz E, Brons NHC, Nicot N, Oudin A, Bougnaud S, Hertel F, Bjerkvig R, Barrett M, Vallar L, Niclou SP, Hao X, Rahn J, Ujack E, Lun X, Cairncross G, Weiss S, Senger D, Robbins S, Harness J, Lerner R, Ihara Y, Santos R, Torre JDL, Lu A, Ozawa T, Nicolaides T, James D, Petritsch C, Higgins D, Schroeder M, Ball B, Milligan B, Meyer F, Sarkaria J, Henley J, Flavahan W, Wu Q, Hitomi M, Rahim N, Kim Y, Sloan A, Weil R, Nakano I, Sarkaria J, Stringer B, Li M, Lathia J, Rich J, Hjelmeland A, Kaluzova M, Platt S, Kent M, Bouras A, Machaidze R, Hadjipanayis C, Kang SG, Kim SH, Huh YM, Kim EH, Park EK, Chang JH, Kim SH, Hong YK, Kim DS, Lee SJ, Kim EH, Kang SG, Hitomi M, Deleyrolle L, Sinyuk M, Li M, Goan W, Otvos B, Rohaus M, Oli M, Vedam-Mai V, Schonberg D, Wu Q, Rich J, Reynolds B, Lathia J, Lee ST, Chu K, Kim SH, Lee SK, Kim M, Roh JK, Lerner R, Griveau A, Ihara Y, Reichholf B, McMahon M, Rowitch D, James D, Petritsch C, Nitta R, Mitra S, Agarwal M, Bui T, Li G, Lin J, Adamson C, Martinez-Quintanilla J, Choi SH, Bhere D, Heidari P, He D, Mahmood U, Shah K, Mitra S, Gholamin S, Feroze A, Achrol A, Kahn S, Weissman I, Cheshier S, Nakano I, Sulman EP, Wang Q, Mostovenko E, Liu H, Lichti CF, Shavkunov A, Kroes RA, Moskal JR, Conrad CA, Lang FF, Emmett MR, Nilsson CL, Osuka S, Sampetrean O, Shimizu T, Saga I, Onishi N, Sugihara E, Okubo J, Fujita S, Takano S, Matsumura A, Saya H, Saito N, Fu J, Wang S, Yung WKA, Koul D, Schmid RS, Irvin DM, Vitucci M, Bash RE, Werneke AM, Miller CR, Shinojima N, Hossain A, Takezaki T, Fueyo J, Gumin J, Gao F, Nwajei F, Marini FC, Andreeff M, Kuratsu JI, Lang FF, Singh S, Burrell K, Koch E, Agnihotri S, Jalali S, Vartanian A, Gumin J, Sulman E, Lang F, Wouters B, Zadeh G, Spelat R, Singer E, Matlaf L, McAllister S, Soroceanu L, Spiegl-Kreinecker S, Loetsch D, Laaber M, Schrangl C, Wohrer A, Hainfellner J, Marosi C, Pichler J, Weis S, Wurm G, Widhalm G, Knosp E, Berger W, Takezaki T, Shinojima N, Kuratsu JI, Lang F, Tam Q, Tanaka S, Nakada M, Yamada D, Nakano I, Todo T, Hayashi Y, Hamada JI, Hirao A, Tilghman J, Ying M, Laterra J, Venere M, Chang C, Wu Q, Summers M, Rosenfeld S, Rich J, Tanaka S, Luk S, Chang C, Iafrate J, Cahill D, Martuza R, Rabkin S, Chi A, Wakimoto H, Wirsching HG, Krishnan S, Frei K, Krayenbuhl N, Reifenberger G, Weller M, Tabatabai G, Man J, Shoemake J, Venere M, Rich J, Yu J. STEM CELLS. Neuro Oncol 2013. [DOI: 10.1093/neuonc/not190] [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: 11/13/2022] Open
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Arvold N, Heidari P, Kunawudhi A, Sequist L, Mahmood U. FMISO-PET as Biomarker of Early Response to Targeted Therapy in EGFR-Mutant Non-Small Cell Lung Cancer (NSCLC). Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1709] [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: 11/16/2022]
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Abstract
There are several well established methods to correct congenital and acquired lacrimal canalicular stenosis. The primary goal of all these surgical methods is the reopening and recanalization of a functional lacrimal pathway. Intubation by bicanalicular or monocanalicular silicone tubes has been established as a means of enhancing the redevelopment of a smooth epithelial surface and keeping the recanalized tear ducts continuously open. The use after endocanalicular surgery is mostly undisputed and unequivocally advocated after trauma but the use after either endonasal or transcutaneous dacryocystorhinostomy is still controversial as there is no clear evidence that it produces superior results. There are several systems available to place monocanalicular or bicanalicular silicone tubes. The decision to place an intubation depends mainly on the level and the type of stenosis.
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Affiliation(s)
- U Schaudig
- Asklepios Klinik Hamburg, Rübenkamp 220, Hamburg, Germany.
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Schaudig U, Heidari P, Schumacher S. [Lower lid entropion and ectropion. Indication, technique and key points of "classical" surgical methods]. Ophthalmologe 2012; 109:443-9. [PMID: 22532044 DOI: 10.1007/s00347-012-2609-9] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Lower lid malposition is common, increases with age and leads to impaired optical function of the ocular surface through chronic irritation of the conjunctiva and cornea. Numerous techniques have been described to reposition the lid margin to the globe and secure this position while maintaining intact motility. Some of these techniques have passed the test of time and have reached the status of "classic" standard procedures that need to be in the armamentarium of every oculoplastic surgeon. The aim of this article is to consider the merits of a selection of standard methods for the correction of lower lid entropion and ectropion by describing their indication, technique and key points.
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Affiliation(s)
- U Schaudig
- Augenklinik, Asklepios Klinik Barmbek, Rübenkamp 220, 22291, Hamburg, Deutschland.
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Heidari B, Hoshmand S, Hajian K, Heidari P. Comparing bone mineral density in postmenopausal women with and without vertebral fracture and its value in recognizing high-risk individuals. East Mediterr Health J 2010; 16:868-873. [PMID: 21469569] [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: 05/30/2023]
Abstract
Vertebral fracture, the hallmark of osteoporosis, usually occurs in postmenopausal women with low bone mineral density (BMD). The aim this study was to determine which BMD parameter can best predict women at high risk of fracture. BMD values at the spine and femoral neck were compared in 34 women with vertebral fracture and 34 controls. Mean BMD (g/cm2), T-score, and Z-score values at both femoral neck and spine were significantly lower in the fracture than the nonfracture group. Z-score was more sensitive than BMD T-score for detecting low bone mass. T-score was not sensitive enough to identify low BMD in the spine, whereas the femoral neck T-score could recognize women at high risk of fracture with higher accuracy.
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Affiliation(s)
- B Heidari
- Department of Internal Medicine, Shaheed Beheshti Hospital, Babol University of Medical Sciences, Babol, Islamic Republic of Iran.
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Heidari B, Hoshmand S, Hajian K, Heidari P. Comparing bone mineral density in postmenopausal women with and without vertebral fracture and its value in recognizing high-risk individuals. East Mediterr Health J 2010. [DOI: 10.26719/2010.16.8.868] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Mortazavi SMJ, Heidari P, Asadollahi S, Farzan M. Severe tardy ulnar nerve palsy caused by traumatic cubitus valgus deformity: functional outcome of subcutaneous anterior transposition. J Hand Surg Eur Vol 2008; 33:575-80. [PMID: 18662958 DOI: 10.1177/1753193408092252] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Ten male patients with McGowan's grade III ulnar neuropathy due to traumatic cubitus valgus deformity underwent anterior subcutaneous ulnar transposition. Evaluation was performed using subjective and objective measures, and a modified Bishop score. After operation, subjective sensory and motor disturbances were improved or resolved in most of the patients, while objective measures improved less well. Improvement in two-point discrimination (2PD) was consistently associated with symptom relief. All of the patients reported satisfaction with the operation. There were no complications or recurrences. The results of ulnar nerve transposition in our patients were comparable to the results of this operation in patients with severe idiopathic cubital tunnel syndrome. Although the outcome of surgery is not always satisfactory in severe ulnar neuropathy, symptom relief may justify performing the operation.
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Affiliation(s)
- S M Javad Mortazavi
- Department of Orthopaedic Surgery, Imam University Hospital, affiliated to Medical Sciences, University of Tehran, Tehran, Iran.
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Sharifi-Mollayousefi A, Yazdchi-Marandi M, Ayramlou H, Heidari P, Salavati A, Zarrintan S, Sharifi-Mollayousefi A. Assessment of body mass index and hand anthropometric measurements as independent risk factors for carpal tunnel syndrome. Folia Morphol (Warsz) 2008; 67:36-42. [PMID: 18335412] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The goal of this study was to clarify the role of body mass index (BMI) (weight divided by square of height; kg/m2) and hand anthropometric measurements as independent risk determinants in the development of carpal tunnel syndrome (CTS) and their relationship to the severity of CTS. A total of 131 patients with clinical symptoms of CTS and 131 normal subjects were enrolled, of whom 121 were female both in the CTS cases and the controls. All cases were electrodiagnostically confirmed and assigned to three severity groups. BMI, wrist ratio, shape index, digit index and hand length/height ratio were measured in all participants. Mean values for each item were compared between cases and controls and severity subgroups. A logistic regression analysis was performed to determine independent CTS risk factors. The mean values of BMI, wrist ratio and shape index were significantly higher in all CTS patients and females compared to controls, whereas in males only BMI and wrist ratio were higher. The patients in the mild severity subgroup had a significantly lower age and wrist ratio. BMI, wrist ratio and shape index were found to be independent risk factors of CTS development in all patients and females. Our study showed BMI, wrist ratio and shape index as independent risk factors for CTS. These findings are of potential anatomical and clinical importance and outline the risk factors of anatomical malfunction of the wrist in CTS.
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Affiliation(s)
- A Sharifi-Mollayousefi
- Department of Neurology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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Mortazavi SMJ, Heidari P, Esfandiari H, Motamedi M. Trapezoid supracondylar femoral extension osteotomy for knee flexion contractures in patients with haemophilia. Haemophilia 2007; 14:85-90. [PMID: 18005146 DOI: 10.1111/j.1365-2516.2007.01585.x] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Flexion deformity of the haemophilic knee is a considerable cause of disability and may need to be managed surgically in severe cases. We have used a trapezoid supracondylar femoral extension osteotomy to correct severe knee flexion deformity. Nine severe haemophilic patients with contractures >30 degrees that were unresponsive to conservative measures underwent 11 trapezoid osteotomies. The angle of deformity was measured using anteroposterior and lateral knee X-ray films at maximum extension. Factor levels of 80-100% were achieved before the operation. A trapezoid osteotomy of the distal femur bone was performed using a lateral approach. The frontal plane angular deformity (if any) was corrected at the same time. The osteotomy site was fixed using an Arbeitsgemeinschaft für Osteo synthesefragen (AO) condylar blade plate. Following surgery, the knee was supported by a plaster splint at 20 degrees of flexion. Physiotherapy was started on third postoperative day and continued three times a week. There was no serious complication. The deformities were corrected in all of the patients and the mean range of motion increased form 68.6 degrees to 98.1 degrees . Bleeding episodes decreased in all four knees which had a bleeding score of 3 before surgery. Using the Orthopaedic Advisory Committee of the World Federation of Haemophilia scores, nine good and two fair results were obtained. All patients regained the ability to walk for both short and long distance without any aid, climb the stairs, bath, and use public transportation. Trapezoid supracondylar femoral extension osteotomy should be considered in the surgical management of severe haemophilic flexion deformity of the knee joint.
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Affiliation(s)
- S M J Mortazavi
- Iranian Tissue Bank (Research and Preparation Centre), Tehran, Iran.
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Heidari B, Bijani K, Eissazadeh M, Heidari P. Exudative pleural effusion: effectiveness of pleural fluid analysis and pleural biopsy. East Mediterr Health J 2007; 13:765-773. [PMID: 17955757] [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: 05/25/2023]
Abstract
The study compared pleural fluid analysis and pleural biopsy in the diagnosis of 100 patients with exudative pleural effusion (PE) in Babol, Islamic Republic of Iran. Tuberculous pleurisy and malignant pleural effusion were confirmed by the identification of acid-fast bacilli from body fluids or tumour cells from tissue specimens. Malignant diseases and tuberculosis were the causes of exudative PE in 43% and 33% of patients respectively. The diagnostic sensitivity of pleural biopsy in patients with tuberculous PE and malignant PE was 70% and 54%, and the diagnostic sensitivity of pleural fluid analysis was 33% and 70% respectively. Combined pleural biopsy and pleural fluid analysis were positive in 97% of tuberculous PE cases and 91% of malignant PE.
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Affiliation(s)
- B Heidari
- Department of Medicine, Shahid Beheshti Hospital, Babol University of Medical Sciences, Babol, Islamic Republic of Iran.
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