1
|
Kheshti F, Abdollahifard S, Hosseinpour A, Bazrafshan M, Attar A. Ablation versus medical therapy for patients with atrial fibrillation: An updated meta-analysis. Clin Cardiol 2024; 47:e24184. [PMID: 37937825 PMCID: PMC10826237 DOI: 10.1002/clc.24184] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 10/17/2023] [Accepted: 10/26/2023] [Indexed: 11/09/2023] Open
Abstract
To investigate the effect of ablation compared to medical therapy on clinical outcomes of patients with atrial fibrillation (AF). PubMed, Scopus, Embase, and Web of Science databases were searched using ablation, medical treatment, AF, and related words. The effect of ablation and medical therapy was sought to be gathered on stroke or transitional ischemic attack, mortality, hospitalization, recurrence of AF, progression of AF, and left ventricular ejection fraction. Analyses were performed using R software. 31 studies (the results of 27 randomized controlled trials), compromising an overall 6965 patients (Ablation, n = 3643; Medical treatment, n = 3322) were reviewed in our study, revealed that catheter ablation would result in substantial benefits for patients with AF without significant difference in serious adverse events compared to medical management (Risk Ratio: 0.92, [95% Confidence Interval (CI), 0.64-1.33]). Catheter ablation in patients with AF significantly resulted in a 29% reduction in all-cause mortality (RR: 0.71, [95% CI, 0.57-0.88]), a 57% reduction in hospitalization (RR: 0.43, [95% CI, 0.27-0.67]), a 53% reduction in AF recurrence (RR: 0.47, [95% CI, 0.36-0.61]), and a dramatic reduction, 89%, in progression of paroxysmal to persistent AF (RR: 0.11, [95% CI, 0.02-0.65]); also associated with a remarkable improvement in their left ventricular ejection fraction (LVEF) (Mean Difference, MD: 6.84%, [95% CI, 3.27-10.42]) compared to medical therapy. Our study showed that ablation may be superior to medical therapy in patients with AF regarding AF recurrence, mortality, LVEF improvement, hospitalization, and AF progression outcomes.
Collapse
Affiliation(s)
- Fatemeh Kheshti
- Department of Cardiovascular Medicine, School of MedicineShiraz University of Medical SciencesShirazIran
- Students' Research CommitteeShiraz University of Medical SciencesShirazIran
| | - Saeed Abdollahifard
- Students' Research CommitteeShiraz University of Medical SciencesShirazIran
- Research Center for Neuromodulation and PainShirazIran
| | - Alireza Hosseinpour
- Department of Cardiovascular Medicine, School of MedicineShiraz University of Medical SciencesShirazIran
- Students' Research CommitteeShiraz University of Medical SciencesShirazIran
| | - Mehdi Bazrafshan
- Students' Research CommitteeShiraz University of Medical SciencesShirazIran
| | - Armin Attar
- Department of Cardiovascular Medicine, School of MedicineShiraz University of Medical SciencesShirazIran
| |
Collapse
|
2
|
Abdollahifard S, Farrokhi A, Yousefi O, Valibeygi A, Azami P, Mowla A. Particle embolic agents for embolization of middle meningeal artery in the treatment of chronic subdural hematoma: A systematic review and meta-analysis. Interv Neuroradiol 2024; 30:94-104. [PMID: 36112765 PMCID: PMC10956449 DOI: 10.1177/15910199221125977] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 08/25/2022] [Indexed: 02/18/2024] Open
Abstract
OBJECTIVE In this systematic review and meta-analysis, we investigated the efficacy and safety of middle meningeal artery embolization (MMAE) using particle embolic agents to treat cSDH. METHODS To retrieve articles investigating outcomes of patients following MMAE with particle agents and to compare their outcome with conventional treatment, Scopus, PubMed, Embase, and Web of Science were searched using relevant keywords. Original articles with more than 10 cases were included. The meta-analysis was carried out using the R studio and the random-effects model. Publication bias was assessed using Peter's test and quality assessment using NIH tools. RESULTS Eleven studies with 359 patients were included. The analysis revealed a pooled recurrence rate of 5% (CI: 3-8%), a need for reoperation rate of 5% (3-9%), and a peri-procedural complication rate of 4% (CI:2-9%) following MMAE with particle embolic agents. The pooled rates of decrease in size or resolution of the hematoma were 85% (CI:66-94%) and 66% (39-86%), respectively. Comparing MMAE using particulate embolysate with conventional treatments, risk ratio (RR) of 0.10 (CI:0.04-0.27) was achieved for recurrence, 0.25(CI:0.13-0.49) for reoperation, and 0.34 (CI:0.16-0.27) for peri-procedural complications. 91% of cSDH cases responded to MMAE with particles in the way they showed either down-sizing or complete resolution of the hematoma on follow-up imaging. In comparison, this rate was found to be 63% following conventional treatment. CONCLUSION Middle meningeal artery embolization using particle embolysates is a safe and effective technique for the treatment of cSDH, whether as a standalone intervention or in combination with conventional treatments.
Collapse
Affiliation(s)
- Saeed Abdollahifard
- Student research committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Research center for neuromodulation and pain, Shiraz, Iran
| | - Amirmohammad Farrokhi
- Student research committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Research center for neuromodulation and pain, Shiraz, Iran
| | - Omid Yousefi
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Adib Valibeygi
- Fasa Neuroscience Circle (FNC), Student Research Committee, Fasa University of Medical Sciences, Fasa, Iran
| | - Pouria Azami
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ashkan Mowla
- Division of Stroke and Endovascular Neurosurgery, Department of Neurological Surgery, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA
| |
Collapse
|
3
|
Yousefi O, Saghebdoust S, Abdollahifard S, Motlagh MA, Farrokhi MR, Motiei-Langroudi R, Mousavi SR. Spinal Ganglioneuroma: A Systematic Review of the Literature. World Neurosurg 2023; 180:163-168.e7. [PMID: 37659751 DOI: 10.1016/j.wneu.2023.08.057] [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: 06/06/2023] [Revised: 08/11/2023] [Accepted: 08/12/2023] [Indexed: 09/04/2023]
Abstract
OBJECTIVE Spinal ganglioneuromas (GNs) are rare benign tumors that often manifest as symptoms related to the compression of neural elements. The preferred treatment for affected patients is surgical resection, which typically improves symptoms and accompanies a low likelihood of tumor recurrence. We conducted a systematic review of reports of GNs involving the spinal cord and nerve roots, examining their clinical presentation, surgical management, and outcomes. METHODS Using the keywords "ganglioneuroma" and "spinal," we conducted a systematic database review of MEDLINE (PubMed), Scopus, and Embase, querying studies reporting cases of spinal GNs. Patients' demographics, location of the tumors, clinical features, and surgical outcomes were extracted from eligible articles. RESULTS A total of 93 spinal GN cases in 52 case reports/series met our criteria. Data analysis revealed a general male predominance, though thoracic spinal GNs were seen more in females. The mean age of patients with cervical, thoracic, thoracolumbar, and lumbar spinal GNs were 41.28, 27.65, 15.61, and 38.73 years, respectively. Multiple-level GNs were mostly seen in male patients or individuals with neurofibromatosis type 1. In all but 1 case, recurrence and reoperation were not reported in the short-term (months) and long-term (2-10 years) follow-up. CONCLUSIONS We found unique epidemiologic characteristics for patients with GNs of different spinal regions. The treatment of choice is achieving gross total resection, but given the eloquency of the lesions, achieving decompression via subtotal resection can also be associated with improved outcomes. To date, no global postoperative surveillance protocol exists, considering the low recurrence rate and relevant cost-benefit ratios.
Collapse
Affiliation(s)
- Omid Yousefi
- Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Saeed Abdollahifard
- Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Majid Reza Farrokhi
- Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran; Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Seyed Reza Mousavi
- Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran; Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| |
Collapse
|
4
|
Abdollahifard S, Taherifard E, Sadeghi A, Kiadeh PRH, Yousefi O, Mowla A. Endovascular therapy for acute stroke with a large infarct core: A systematic review and meta-analysis. J Stroke Cerebrovasc Dis 2023; 32:107427. [PMID: 37925765 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107427] [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: 08/09/2023] [Revised: 10/09/2023] [Accepted: 10/12/2023] [Indexed: 11/07/2023] Open
Abstract
OBJECTIVE In this meta-analysis, we aimed to investigate the efficacy and safety of endovascular treatment (EVT) for acute ischemic stroke (AIS) patients with large core infarct. METHODS Three online databases of Web of Science, PubMed and Scopus were systematically searched. Original studies which evaluated AIS participants with large core infarction who underwent EVT were included. R statistical software was used for statistical analyses. Effect sizes were presented with odds ratios (ORs) with their 95% confidence intervals (CIs). The effect sizes were pooled using random effects modeling. RESULTS Including 47 studies and 15,173 patients, this meta-analysis showed that compared with medical management (MM), EVT was significantly associated with decreased odds of mortality (0.67, 95% CI: 0.51-0.87) and increased odds of favorable outcomes, including a modified Rankin Scale of 0-3 (2.36, 95% CI: 1.69-3.291) and of 0-2 (3.54, 95% CI: 1.96-6.4) in 90 days and remarkable improvement in National Institutes of Health Stroke Scale within 48 h after the procedure (3.6, 95% CI:1.32-9.79). Besides, there was a higher chance of intracranial hemorrhage (ICH) development (1.88, 95% CI: 1.32-2.68) but not symptomatic ICH (1.34, 95% CI: 0.78-2.31) in those who underwent EVT. CONCLUSION Our study suggests that EVT might be an effective and relatively safe treatment option for the treatment of AIS patients with large vessel occlusion who have large core infarcts, although more large-scale trials are needed to consolidate the results and to make inclusion criteria and the patient selection process clearer.
Collapse
Affiliation(s)
| | - Erfan Taherifard
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; MPH Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Sadeghi
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Omid Yousefi
- Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ashkan Mowla
- Division of Stroke and Endovascular Neurosurgery, Department of Neurological Surgery, Keck School of Medicine, University of Southern California (USC), 1200 North State St., Suite 3300, Los Angeles, CA 90033, USA.
| |
Collapse
|
5
|
Abdollahifard S, Farrokhi A, Kheshti F, Jalali M, Mowla A. Application of convolutional network models in detection of intracranial aneurysms: A systematic review and meta-analysis. Interv Neuroradiol 2023; 29:738-747. [PMID: 35549574 PMCID: PMC10680951 DOI: 10.1177/15910199221097475] [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: 03/03/2022] [Accepted: 04/11/2022] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Intracranial aneurysms have a high prevalence in human population. It also has a heavy burden of disease and high mortality rate in the case of rupture. Convolutional neural network(CNN) is a type of deep learning architecture which has been proven powerful to detect intracranial aneurysms. METHODS Four databases were searched using artificial intelligence, intracranial aneurysms, and synonyms to find eligible studies. Articles which had applied CNN for detection of intracranial aneurisms were included in this review. Sensitivity and specificity of the models and human readers regarding modality, size, and location of aneurysms were sought to be extracted. Random model was the preferred model for analyses using CMA 2 to determine pooled sensitivity and specificity. RESULTS Overall, 20 studies were used in this review. Deep learning models could detect intracranial aneurysms with a sensitivity of 90/6% (CI: 87/2-93/2%) and specificity of 94/6% (CI: 0/914-0/966). CTA was the most sensitive modality (92.0%(CI:85/2-95/8%)). Overall sensitivity of the models for aneurysms more than 3 mm was above 98% (98%-100%) and 74.6 for aneurysms less than 3 mm. With the aid of AI, the clinicians' sensitivity increased to 12/8% and interrater agreement to 0/193. CONCLUSION CNN models had an acceptable sensitivity for detection of intracranial aneurysms, surpassing human readers in some fields. The logical approach for application of deep learning models would be its use as a highly capable assistant. In essence, deep learning models are a groundbreaking technology that can assist clinicians and allow them to diagnose intracranial aneurysms more accurately.
Collapse
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
| | - Fatemeh Kheshti
- Research center for neuromodulation and pain, Shiraz, Iran
- Student research committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahtab Jalali
- Research center for neuromodulation and pain, Shiraz, Iran
- Student research committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ashkan Mowla
- Division of Stroke and Endovascular Neurosurgery, Department of Neurological Surgery, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA
| |
Collapse
|
6
|
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.
Collapse
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.
| |
Collapse
|
7
|
Abdollahifard S, Farrokhi A, Mowla A. Response to 'Application of deep learning models for detection of subdural hematoma: a systematic review and meta-analysis'. J Neurointerv Surg 2023; 15:1057-1058. [PMID: 37714539 DOI: 10.1136/jnis-2023-020804] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 07/15/2023] [Indexed: 09/17/2023]
Affiliation(s)
- Saeed Abdollahifard
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Research Center for Neuromodulation and Pain, Shiraz, Iran
| | - Amirmohammad Farrokhi
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Research Center for Neuromodulation and Pain, Shiraz, Iran
| | - Ashkan Mowla
- Division of Stroke and Endovascular Neurosurgery, Department of Neurological Surgery, Keck School of Medicine University of Southern California (USC), Los Angeles, California, USA
| |
Collapse
|
8
|
Abdollahifard S, Farrokhi A, Mowla A. Application of deep learning models for detection of subdural hematoma: a systematic review and meta-analysis. J Neurointerv Surg 2023; 15:995-1000. [PMID: 36418163 DOI: 10.1136/jnis-2022-019627] [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: 09/13/2022] [Accepted: 11/09/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND This study aimed to investigate the application of deep learning (DL) models for the detection of subdural hematoma (SDH). METHODS We conducted a comprehensive search using relevant keywords. Articles extracted were original studies in which sensitivity and/or specificity were reported. Two different approaches of frequentist and Bayesian inference were applied. For quality and risk of bias assessment we used Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). RESULTS We analyzed 22 articles that included 1,997,749 patients. In the first step, the frequentist method showed a pooled sensitivity of 88.8% (95% confidence interval (CI): 83.9% to 92.4%) and a specificity of 97.2% (95% CI 94.6% to 98.6%). In the second step, using Bayesian methods including 11 studies that reported sensitivity and specificity, a sensitivity rate of 86.8% (95% CI: 77.6% to 92.9%) at a specificity level of 86.9% (95% CI: 60.9% to 97.2%) was achieved. The risk of bias assessment was not remarkable using QUADAS-2. CONCLUSION DL models might be an appropriate tool for detecting SDHs with a reasonably high sensitivity and specificity.
Collapse
Affiliation(s)
- Saeed Abdollahifard
- Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
- Center for Neuromodulation and Pain, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amirmohammad Farrokhi
- Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
- Center for Neuromodulation and Pain, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ashkan Mowla
- Neurological Surgery, University of Southern California, Los Angeles, California, USA
| |
Collapse
|
9
|
Mowla A, Abdollahifard S, Farrokhi A, Yousefi O, Valibeygi A, Azami P. Middle Meningeal Artery Embolization with Liquid Embolic Agents for Chronic Subdural Hematoma: A Systematic Review and Meta-analysis. J Vasc Interv Radiol 2023; 34:1493-1500.e7. [PMID: 37182671 DOI: 10.1016/j.jvir.2023.05.010] [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] [Received: 08/09/2022] [Revised: 04/03/2023] [Accepted: 05/04/2023] [Indexed: 05/16/2023] Open
Abstract
PURPOSE To assess the efficacy and safety of middle meningeal artery (MMA) embolization with liquid embolic agents and the outcomes of patients following this procedure. MATERIALS AND METHODS A review of the literature was conducted to identify studies investigating the efficacy and safety of MMA embolization with liquid embolic agents in patients with chronic subdural hematoma (cSDH) in PubMed, Scopus, Embase, and Web of Science. The keywords "liquid embolic agent," "middle meningeal artery," "cSDH," and "embolization" as well as their synonyms were used to build up the search strategy. The R statistical software and random-effects model were used for analysis. Heterogeneity was reported as I2, and publication bias was calculated using the Egger test. RESULTS Of 628 articles retrieved, 14 studies were eligible to be included in this study. Data of 276 patients were analyzed. n-Butyl cyanoacrylate and ethylene vinyl alcohol copolymer were the most commonly used embolic agents. This study revealed a pooled mortality rate of 0% (95% confidence interval [CI], 0.00%-100%), recurrence and failure rate of 3% (95% CI, 1%-10%), reoperation/reintervention rate of 4% (95% CI, 2%-12%), rate of size decrease of 94% (95% CI, 79%-98%), technical success rate of 100% (95% CI, 76%-100%), and adverse event rate of 1% (95% CI, 0.00%-4%). CONCLUSIONS With low mortality, recurrence, reoperation, and adverse event rates and a remarkable decrease in the size of hematomas, MMA embolization with liquid embolic agents may be considered a safe and effective treatment option in patients in whom surgical intervention has previously failed and as an alternative to conventional treatments.
Collapse
Affiliation(s)
- Ashkan Mowla
- Division of Stroke and Endovascular Neurosurgery, Department of Neurological Surgery, Keck School of Medicine, University of Southern California (USC), Los Angeles, California.
| | - Saeed Abdollahifard
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz; Research Center for Neuromodulation and Pain, Shiraz
| | - Amirmohammad Farrokhi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz; Research Center for Neuromodulation and Pain, Shiraz
| | - Omid Yousefi
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz
| | - Adib Valibeygi
- Fasa Neuroscience Circle, Student Research Committee, Fasa University of Medical Sciences, Fasa, Iran
| | - Pouria Azami
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz
| |
Collapse
|
10
|
Abdollahifard S, Taherifard E, Sadeghi A, Farrokhi A, Cohen-Gadol AA, Palmisciano P. Early Morning Cortisol Level as a Predictive Factor for Long-Term Glucocorticoid Replacement After Pituitary Surgery: A Systematic Review and Meta-Analysis. World Neurosurg 2023; 176:168-178. [PMID: 37201788 DOI: 10.1016/j.wneu.2023.05.029] [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: 03/09/2023] [Revised: 05/06/2023] [Accepted: 05/08/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND A reliable strategy for predicting long-term adrenal insufficiency after pituitary surgery can reduce the risk of glucocorticoid overexposure or missing patients with pituitary insufficiency. For this purpose, we aimed to assess the predictive value of early postoperative morning serum cortisol level for the detection of hypothalamic-pituitary-adrenal axis dysfunction in patients who underwent pituitary surgery. METHODS A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-based systematic review was conducted to include articles investigating morning blood cortisol levels after pituitary surgery for lesions of the pituitary gland as a determinant for administration of long-term supplemental glucocorticoids. Bayesian statistics were used to pool the sensitivity and specificity rates. Sensitivity and specificity were also determined for each potential cortisol level on postoperative day (POD) 1 and POD 2. RESULTS The study included 17 articles encompassing 1648 patients. Morning cortisol levels on POD 1 and POD 2 showed pooled sensitivity rates of 86.4% and 86.6% and pooled specificity rates of 73.1% and 78.2%, respectively, for predicting long-term glucocorticoid replacement after surgery. A cortisol level of 2.1 μg/dL showed the highest sensitivity rate (98.78%), and 22.5 μg/dL showed the highest specificity rate (72.5%) on POD 1. CONCLUSIONS In this review and Bayesian meta-analysis, we found that postoperative serum cortisol measurement may have high accuracy in prediction of the long-term need for glucocorticoid administration in patients who underwent pituitary surgery.
Collapse
Affiliation(s)
| | - Erfan Taherifard
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; MPH Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Sadeghi
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | | - Paolo Palmisciano
- Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
| |
Collapse
|
11
|
Hezarkhani LA, Abdollahifard S, Mirbolouk MH, Hooshmand S, Mowla A, Baharvahdat H. Mechanical Thrombectomy in a 12-Month-Old Infant with Acute Ischemic Stroke Possibly due to Internal Carotid Artery Dissection: A Case Report. Neurointervention 2023:neuroint.2023.00045. [PMID: 37165626 DOI: 10.5469/neuroint.2023.00045] [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: 01/26/2023] [Accepted: 05/01/2023] [Indexed: 05/12/2023] Open
Abstract
Stroke in children is a rare but devastating disease. Although endovascular treatment has been reported to be safe and effective in the treatment of stroke with large vessel occlusion in this population, there are still limitations and controversies. In this case report, we describe a 12-month-old girl who was admitted to the hospital with acute onset of left-sided hemiplegia and confusion, which turned out to be due to a large infarct in the right middle cerebral artery territory, possibly caused by dissection of the right cervical internal carotid artery. Aspiration thrombectomy was successfully performed, and the patient was able to walk a few steps and raise her left upper extremity at the 12-month follow-up. The aspiration-only technique in thrombectomy may be safe and technically feasible to treat acute ischemic stroke with large vessel occlusion in children as young as 12 months, although large-volume prospective studies are needed.
Collapse
Affiliation(s)
- Leila Afshar Hezarkhani
- Division of Neurovascular Intervention, Department of Neurosurgery, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Mohammad Hossein Mirbolouk
- Division of Neurovascular Intervention, Department of Neurosurgery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shohre Hooshmand
- Hematologic Malignancies Research Institute, Beckman Research Institute, City of Hope, Duarte, CA, USA
| | - Ashkan Mowla
- Division of Stroke and Endovascular Neurosurgery, Department of Neurological Surgery, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA
| | - Humain Baharvahdat
- Division of Neurovascular Intervention, Department of Neurosurgery, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Interventional Neuroradiology, Fondation Rothschild Hospital, Paris, France
| |
Collapse
|
12
|
Mirbolouk MH, Ebrahimnia F, Gorji R, Sasannejad P, Zabihyan S, Hoveizavi MA, Garivani Y, Mirzaasgari Z, Abdollahifard S, Mowla A, Baharvahdat H. Transradial access for neurointerventional procedures: A practical approach. Brain Circ 2023; 9:88-93. [PMID: 37576579 PMCID: PMC10419729 DOI: 10.4103/bc.bc_101_22] [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: 12/17/2022] [Revised: 03/22/2023] [Accepted: 04/03/2023] [Indexed: 08/15/2023] Open
Abstract
INTRODUCTION Transradial approach (TRA) is a new technique proposed for performing cerebral angiography and neuro-interventional procedures. In this article, we sought to provide a step-by-step guide for carrying out a diagnostic cerebral angiography using this approach and summarize our center's experience. MATERIAL AND METHODS Records of patients since January 2020 were investigated, and data on demographic indices, reports of the procedures, outcomes, and complications were extracted. Then, these data were used to develop a step-by-step instruction for TRA cerebral angiography. RESULTS Two hundred eighty-nine patients matched our eligibility criteria with a mean age of 50 years and a female-to-male ratio of 1.18. Overall, TRA was carried out successfully for 97.2% (281 patients). In case TRA failed, transfemoral approach was considered for the procedure. Three minor complications (two vasospasm and one small hematoma) and two major complications (one pseudoaneurysm of the radial artery and one radial artery avulsion) were observed. CONCLUSION This article covers challenges a neurointerventionalist may face during a diagnostic cerebral angiography using TRA. Furthermore, our findings indicated that cerebral angiography with TRA might be performed safely and with a great success rate.
Collapse
Affiliation(s)
- Mohammad Hossein Mirbolouk
- Department of Neurosurgery, Section of Neurovascular Intervention, Neurosurgical, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Neurosurgery, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Feizollah Ebrahimnia
- Department of Neurosurgery, Section of Neurovascular Intervention, Neurosurgical, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Gorji
- Department of Neurosurgery, Section of Neurovascular Intervention, Neurosurgical, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Payam Sasannejad
- Department of Neurosurgery, Section of Neurovascular Intervention, Neurosurgical, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Samira Zabihyan
- Department of Neurosurgery, Section of Neurovascular Intervention, Neurosurgical, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Adeeb Hoveizavi
- Department of Neurosurgery, Section of Neurovascular Intervention, Neurosurgical, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Yousefali Garivani
- Department of Neurosurgery, Section of Neurovascular Intervention, Neurosurgical, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Mirzaasgari
- Department of Neurology, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Saeed Abdollahifard
- Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
- Research Center for Neuromodulation and Pain, Shiraz, Iran
| | - Ashkan Mowla
- Department of Neurological Surgery, Division of Stroke and Endovascular, Keck School of Medicine, Neurosurgery, University of Southern California, Los Angeles, CA, USA
| | - Humain Baharvahdat
- Department of Neurosurgery, Section of Neurovascular Intervention, Neurosurgical, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Interventional Neuroradiology, Rothschild Foundation Hospital, Paris, France
| |
Collapse
|
13
|
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.
Collapse
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.
| |
Collapse
|
14
|
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.
Collapse
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
| |
Collapse
|
15
|
Khalili H, Abdollahifard S, Niakan A, Aryaie M. The effect of Vitamins C and E on clinical outcomes of patients with severe traumatic brain injury: A propensity score matching study. Surg Neurol Int 2022; 13:548. [PMID: 36600753 PMCID: PMC9805612 DOI: 10.25259/sni_932_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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 11/03/2022] [Indexed: 11/27/2022] Open
Abstract
Background The aim of this study was to assess the effect of Vitamins C and E on mortality, intensive care unit (ICU) length of stay, and Glasgow Outcome Scale-Extended (GOS-E) score of traumatic brain injury (TBI) patients. Methods Using data from records of patients in a retrospective cohort study, we included 1321 TBI patients, 269 treated and 1052 untreated, aged over 18 years with information on exposure (i.e., Vitamins C and E) and confounders. Age, Glasgow Coma Scale, pupil status, Rotterdam classification, blood sugar, blood pressure, international normalized ratio, and comorbidity of patients were considered as the confounding factors. Endpoints were GOS-E on follow-up, mortality, and ICU length of stay. Propensity score matching was performed to adjust the confounders. Results Based on the average treatment effect estimates, the use of Vitamins C and E reduced the risk of mortality (risk difference [RD]: -0.07; 95% confidence interval [CI]: -0.14--0.003) and reduced the length of ICU stay (RD -1.77 95% CI:-3.71-0.16). Furthermore, our results showed that GOS-E was improved significantly (RD: 0.09, 95% CI : 0.03-0.16). Conclusion Our study suggests that using Vitamins C and E could decrease mortality and length of ICU stay and improve the GOS-E score and functions of the patients with severe TBI. As they are safe and inexpensive medications, they can be used in routine practice in ICUs to improve the outcomes of TBI patients.
Collapse
Affiliation(s)
- Hosseinali Khalili
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Amin Niakan
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Aryaie
- Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.,Corresponding author: Mohammad Aryaie, Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
| |
Collapse
|
16
|
Firouzabadi D, Kheshti F, Abdollahifard S, Taherifard E, Kheshti MR. The effect of selective serotonin and norepinephrine reuptake inhibitors on clinical outcome of COVID-19 patients: A systematic review and meta-analysis. Health Sci Rep 2022; 5:e892. [PMID: 36268458 PMCID: PMC9577115 DOI: 10.1002/hsr2.892] [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: 07/31/2022] [Revised: 09/18/2022] [Accepted: 09/26/2022] [Indexed: 11/07/2022] Open
Abstract
Background and Aim Due to the high social and economic burden and also mortality and morbidity caused by coronavirus disease 2019 (COVID‐19) in the past few years, researchers have aimed at finding solutions to suppressing the severity of infection. Recently, selective serotonin and serotonin‐norepinephrine reuptake inhibitors (SSRI/SNRI) have been investigated as an adjuvant treatment for COVID‐19. The aim of the current study was to investigate the impact of SSRI/SNRIs on outcomes of COVID‐19 patients. Methods In this systematic review and meta‐analysis, a comprehensive search strategy consisting of relevant words was performed by two researchers in PubMed, Scopus and EMBASE libraries. Studies reporting the effect of SSRI and/or SNRI use in COVID‐19 patients' outcome were included. Hospitalization, mortality, hospitalization event, and length of hospital stay were considered as main outcomes of this study. Analysis was carried out using Comprehensive Meta‐Analysis (CMA‐version 2) and final data were reported as odds ratio (OR) and 95% confidence interval (CI). Results Our search led to the final selection of 9 articles including 15,287 patients. The effect of fluvoxamine, fluoxetine, and the overall effect of SSRI/SNRI use on mortality of COVID‐19 patients were investigated in 3, 2, and 7 articles, respectively. The results of our analyses showed that these medications could significantly decrease mortality of COVID‐19 patients (OR and 95% [CI]: 0.595 [0.467–0.758], 0.620 [0.469–0.821], and 0.596 [0.437–0.813]). The effect of SSRI/SNRIs on hospitalization events of COVID‐19 patients was not significant (OR: 0.240% and 95% CI: 0.041–1.4). Also, length of hospital stay was longer in patients who administrated SSRIs. Conclusion According to this study's results, SSRI/SNRIs may be effective in reducing mortality of COVID‐19 patients, suggesting the superiority of fluvoxamine to fluoxetine. The safety profile and affordable cost of SSRI/SNRIs for a short‐term use may be other reasons to propose them as beneficial medications in preventing mortality in COVID‐19.
Collapse
Affiliation(s)
- Dena Firouzabadi
- Department of Clinical Pharmacy, School of PharmacyShiraz University of Medical SciencesShirazIran,Shahid Faghihi HospitalShiraz University of Medical SciencesShirazIran
| | - Fatemeh Kheshti
- Student Research CommitteeShiraz University of Medical SciencesShirazIran
| | - Saeed Abdollahifard
- Student Research CommitteeShiraz University of Medical SciencesShirazIran,Research Center for Neuromodulation and PainShirazIran
| | | | | |
Collapse
|
17
|
Hosseinpour A, Hosseinpour H, Kheshti F, Abdollahifard S, Attar A. Prognostic value of various markers in recovery from peripartum cardiomyopathy: a systematic review and meta-analysis. ESC Heart Fail 2022; 9:3483-3495. [PMID: 35883253 DOI: 10.1002/ehf2.14085] [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] [Received: 03/26/2022] [Revised: 07/09/2022] [Accepted: 07/15/2022] [Indexed: 11/08/2022] Open
Abstract
AIMS The aetiology of peripartum cardiomyopathy (PPCM) is still not clear, and it is unknown who would recover from PPCM. In this meta-analysis, for the first time, we aimed to explore the prognostic value of potential baseline factors that may help predict recovery in patients with PPCM. METHODS A systematic approach following the Meta-analysis of Observational Studies in Epidemiology guideline was taken by using appropriate keywords in PubMed, Scopus, and Embase databases. Studies that had compared different clinical and paraclinical markers at the time of diagnosis related to cardiovascular function between recovered and non-recovered patients with PPCM were included. To find potential predictors of recovery, the odds ratio (OR) was calculated for different parameters using the random-effects model. RESULTS Eighteen cohort studies including 1047 patients with PPCM were enrolled. Six markers out of the 11 potentially eligible markers were associated with PPCM recovery. Baseline echocardiographic parameters [left ventricular ejection fraction (LVEF) (OR = 4.84 [2.53; 9.26]), left ventricular end-diastolic diameter (OR = 3.67 [2.58; 5.23]), left ventricular end-systolic diameter (OR = 3.99 [2.27; 7.02]), and fractional shortening (OR = 6.14 [1.81; 20.85])] were strong predictors of PPCM recovery. Systolic blood pressure (OR = 2.16 [1.38; 3.38]) and diastolic blood pressure (OR = 2.06 [1.07; 3.96]) at diagnosis were also associated with recovery. CONCLUSIONS Patients with PPCM who have a higher baseline LVEF, lower left ventricular diameters, and higher blood pressure levels have a greater chance to recover from PPCM.
Collapse
Affiliation(s)
- Alireza Hosseinpour
- Department of Cardiovascular Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Fatemeh Kheshti
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Saeed Abdollahifard
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.,Research Center for Neuromodulation and Pain, Shiraz, Iran
| | - Armin Attar
- Department of Cardiovascular Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
18
|
Abdollahifard S, Yousefi O, Kamran H, Mowla A. Balloon-mounting stent for intracranial arterial stenosis: A comprehensive and comparative systematic review and meta-analysis. Interv Neuroradiol 2022:15910199221100620. [PMID: 35549530 PMCID: PMC10399500 DOI: 10.1177/15910199221100620] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 12/24/2022] Open
Abstract
INTRODUCTION As one of the major causes of acute ischemic stroke, intracranial arterial stenosis necessitates an intervention that ranges from medical treatment to balloon angioplasty and stenting. Self-expandable stents (SES) and balloon-mounted stents (BMS) are two types of stents and their comparative efficacy and safety for intracranial stenosis are not well established. METHODS Studies that investigate balloon-mounted stenting for intracranial stenosis were extracted from PubMed, Scopus, and Cochrane library. We sought to gather data on the success rate, change in mean arterial stenosis, and complications such as minor and major stroke and death (MMD), symptomatic intracranial hemorrhage, myocardial infarction, all-cause mortality, and in-stent re-stenosis. RESULTS 3049 patients from 35 studies were included in this study. 20 studies investigated BMS alone and others compared BMS with SES. BMS was significantly more effective in reducing the degree of stenosis compared to SES (Difference in mean -5.953, CI 95% -7.727 to -4.179), had less complications compared to SES such as MMD (8.5% vs. 11.2%) and less in-stent re-stenosis (18.6% vs. 19.6%), but patients with SES experienced a lower rate of all-cause mortality(1.7% vs. 4.1%). CONCLUSION Intracranial stenting with BMS is more effective in reducing the degree of stenosis and has lower rates of complications when compared to SES.
Collapse
Affiliation(s)
- Saeed Abdollahifard
- Research center for neuromodulation and pain, Shiraz, Iran.,Student research committee, 48435Shiraz University of Medical Sciences, Shiraz, Iran
| | - Omid Yousefi
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, 48435Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hooman Kamran
- Student research committee, 48435Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ashkan Mowla
- Division of Stroke and Endovascular Neurosurgery, Department of Neurological Surgery, Keck School of Medicine, 5116University of Southern California (USC), Los Angeles, CA, USA
| |
Collapse
|
19
|
Taherifard E, Movahed H, Kiani Salmi S, Taherifard A, Abdollahifard S, Taherifard E. Cytomegalovirus coinfection in patients with severe acute respiratory syndrome coronavirus 2 infection: a systematic review of reported cases. Infect Dis (Lond) 2022; 54:543-557. [PMID: 35522073 DOI: 10.1080/23744235.2022.2070273] [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] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Dysfunction of both the innate and the adaptive immune systems is observed in severe coronavirus disease 2019 which, together with administration of immunosuppressive drugs, could lead to cytomegalovirus coinfection or reactivation associated with a poorer outcome. The current study aimed to systematically review the pattern, presentations, clinical course and outcome of patients with severe acute respiratory syndrome coronavirus 2 and cytomegalovirus coinfection. METHODS Three online databases, PubMed, Scopus and Web of Science, were searched, and after excluding duplicates and irrelevant reports, eligible articles were identified. Information about patients' age and gender, comorbidities, presentations of coronavirus disease 2019 and cytomegalovirus, treatment courses and outcomes were extracted. RESULTS A total of 34 reports with 59 patients with coinfection were considered to be eligible for data extraction. A majority of patients were middle-aged or elderly (84.5%). More than three-fourths (79.2%) had at least one comorbidity. Cytomegalovirus viremia was documented in 43 patients. The most common end organ involved was the gastrointestinal tract in 13 patients (48.1% of 27 patients with end organ involvement), mostly as cytomegalovirus colitis, followed by the respiratory tract in 12 patients. There was a significant association between intubation and fatal outcome (p = .011). CONCLUSION We comprehensively reviewed published cases with coronavirus disease 2019 and cytomegalovirus reactivation. The findings may assist in appraising signs and symptoms for early suspicion, detection and treatment in patients with unusual clinical courses or with severe, prolonged or unexplained deterioration of end organ function.
Collapse
Affiliation(s)
| | - Hamed Movahed
- Shiraz University of Medical Sciences, Shiraz, Fars, Iran
| | - Sima Kiani Salmi
- Radiology Department, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
| | - Ali Taherifard
- Radiology Department, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
| | - Saeed Abdollahifard
- Research Center for Neuromodulation and Pain, Shiraz, Fars, Iran.,Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
| | | |
Collapse
|
20
|
Mosalanejad L, Abdollahifard S. Testing adaptation and psychometric properties of survey instrument for students' perspectives on e-professionalism and social media in Iranian students: Corona crisis and medical education. J Educ Health Promot 2022; 11:6. [PMID: 35281386 PMCID: PMC8893103 DOI: 10.4103/jehp.jehp_1666_20] [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] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 04/27/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND The use of social networks in the field of education has also accelerated and has become a powerful source of learning for transformation and empowerment in various fields. This study aimed to test the adaptation and psychometric properties of an instrument for students' prospective on e-professionalism in the use of social media in Iranian medical science students. MATERIALS AND METHODS In this questionnaire, with the aim of psychometric properties of the perception toward social media in Iranian students, this survey instrument developed by (Ness et al.) in five fields in 2nd-year pharmacology students in Purdue University The fields include accountability, hiring decisions, profile editing, professionalism, and privacy settings. In this study, first, a cultural adaptation was done by an expert panel. Then, psychometric properties of an instrument by content validity and construct validity using explanatory factor analysis were performed. Reliability was assessed by test-retest and internal consistency of items. The reliability of the survey instrument with three factors was 0.82 using the test-retest, and the internal consistency was good (r = 0.94). RESULTS The result of psychometric properties using the principal component method extracted three factors (accountability, hiring decision, and professionalism) to assessment of students' attitude to professionalism using social media in Iranian students. CONCLUSION The adapted and psychometric properties of the instrument developed by Ness et al., 2013, with three dimensions and ten items proved to be a valid, reliable instrument for use for assessing perspectives on e-professionalism and social media in Iranian medical students. This questioner may be suitable for Iranian researches in medical education.
Collapse
Affiliation(s)
- Leili Mosalanejad
- Department of Medical Education, Virtual Center, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Saeed Abdollahifard
- Medical Student, Student Research Committee, Shiraz Universty of Medical Sciences, Shiraz, Iran
| |
Collapse
|
21
|
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.
Collapse
|
22
|
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.
Collapse
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
| |
Collapse
|
23
|
Mosalanejad L, Abdollahifard S. Development and validation of a questionnaire for professionalism in cyber users in medical sciences in Iran. J Educ Health Promot 2021; 10:56. [PMID: 34084803 PMCID: PMC8057182 DOI: 10.4103/jehp.jehp_681_20] [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: 06/17/2020] [Accepted: 08/17/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Considering the importance of virtual professionalism and professional ethics in medical sciences, and the necessity to pay attention to this issue and its impact on medical professionalism, this study aimed to build a professional culture questionnaire in a virtual environment for students of medical sciences in Iran. MATERIALS AND METHODS This is an exploratory, sequential, mixed-methods research which was conducted in three sections. In the first section, the concept of e-professionalism in medical sciences was analyzed using the hybrid concept analysis in the theoretical work, field work, and final analysis stages in order to extract information related to the concept. In the second section, an item of the questionnaire was designed based on the concept, reviewed texts, and related questionnaires, in the third section, psychometric properties of a questionnaires were evaluated. RESULTS Totally, 39 items were included in the initial pool, which reduced to 33 items in the final questionnaire after reviewing the psychometric properties. Factor analyses led to extraction of five factors including appraisal of e-professionalism compliance with the laws and regulations governing cyberspace, individual professionalism, knowledge management, respect for professionalism in interpersonal and group rules, and complying with ethics in the use of cyberspace. The internal consistency of questionnaire was also confirmed by Cronbach's alpha coefficient of 0.78, also all factor correlations absed stability were significant (P < 0.05). CONCLUSION An exploratory sequential study in this study led to the extraction of five factors and development of a 33-item questionnaire in e-professionalism. As results and analysis of the psychometric properties and validation of each item, this questionnaire is valid and reliable for the assessment of levels of e-professionalism in medical sciences in Iran.
Collapse
Affiliation(s)
- Leili Mosalanejad
- Department of Medical Education, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Saeed Abdollahifard
- Department of Medical, Student Research Committed, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
24
|
Mosalanejad L, Abdollahifard S, Abdian T. Psychiatry gamification from blended learning models and efficacy of this program on students. J Educ Health Promot 2020; 9:68. [PMID: 32490003 PMCID: PMC7255577 DOI: 10.4103/jehp.jehp_352_19] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 12/01/2019] [Indexed: 06/11/2023]
Abstract
BACKGROUND New gamification technology with a detailed understanding of the goals and prospects, and with the help of game elements and techniques, leads to promotion of motivation and participation, and ultimately behavior change. Therefore, this study aimed to evaluate the implementation of a mental gamification from blended learning based on the flex model and efficacy of this program on students. METHODS In this study, with the design of mental illness lessons for undergraduate and executive groups, using flex model, two parts of technical and educational design were used. In the technical section, three parts on dynamics, mechanisms, and elements of gaming were considered. Intervention was studied on different groups of medical students including medical, health, and laboratory sciences. Effect of this educational program and its impact on their students' learning, motivation, and satisfaction was studied using quantitative and qualitative analyses. RESULTS The results of the students' prospective about the efficacy of the method showed that the mean scores of most of the items were higher than the average. This implies that students' attitude toward using gamification was positive. In the other part, the qualitative results of the study were analyzed and the students' analysis of their advantages and disadvantages and their perceptions on the impact of the intervention was examined. CONCLUSION Based on the flex model, mental gamification based on blended learning is effective in shaping the students' satisfaction.
Collapse
Affiliation(s)
- Leili Mosalanejad
- Department of Medical Education, Virtual Center, Jahrom University of Medical Sciences, Jahrom, Iran
| | | | - Tahereh Abdian
- Department of Nursing, Jahrom University of Medical Sciences, Jahrom, Iran
| |
Collapse
|
25
|
Keshavarz F, Mosalanejad L, Ghavi F, Abdollahifard S, Khodabakhshi Koolaee A. Coping Strategies and Perceived Stress in Infertile Couples. J Client Cent Nurs Care 2018. [DOI: 10.32598/jccnc.4.2.80] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
26
|
Mosalanejad L, Kargar Z, Kalani N, Abdollahifard S. Evaluation of perfectionism and its relationship with hardiness and mental health in students of Jahrom University of Medical Sciences. J Fundam and Appl Sci 2018. [DOI: 10.4314/jfas.v8i3.621] [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: 11/17/2022] Open
|
27
|
Mosalanejad L, Dastpak M, Abdollahifard S, Pendar R. Spiritual Self-care in Iranian People: A Qualitative Study using a Phenomenological Approach. J Clin Diagn Res 2018. [DOI: 10.7860/jcdr/2018/25106.11141] [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: 11/24/2022]
|
28
|
Mosalanejad L, Raofi R, Montaseri MA, Abdollahifard S. Optimal Use of the Forum to Develop Problem-Based Learning: Effective Use of Cyber space in a Holistic Process. Bangladesh J Med Sci 2017. [DOI: 10.3329/bjms.v16i4.33613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction: Many medical schools have introduced PBL into their curricula because of the potential advantages for students learning over traditional lecture based curricula. Integration of online discussion forums could help students, PBL and the curriculum. The aim of this article is the use of the Forum to Develop Problem-Based Learning as a Cyberspace in a Holistic Process and the investigating the effect of this program on students satisfaction and students cognitive competence.Methodology: For each curriculum used a discussion forum (DF) was created with 90 student and 8 tutors. Using forum for problem based learning- virtual quiz and virtual round develop and design to develop problem based learning and the best use of virtual space to promote teaching and learning also best use of technology in teaching as a new method.Results: Included: reforming and finalizing learning objectives, posting the concept map constructed in the face-to-face session and questioning, encouraging and motivating each other. In addition, posts included tutors feedback and redirection.Conclusions: Blending e-learning with conventional PBL may help overcome student-perceived shortcomings of conventional PBL and improve the learning experience, making learning more interactive and interesting.Bangladesh Journal of Medical Science Vol.16(4) 2017 p.564-571
Collapse
|
29
|
Abdollahifard S, Maddahfar M. The effect of vitamin B1 on the change of appetite related to premenstrual syndrome in young women. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.1834] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
IntroductionMany women in the premenstrual period may be faced with physical and psychological changes that restricted the acceptance of the responsibility of daily living, jobs and reduced quality of life outdoors. One of these mental disorders is the changes in appetite. Preventing the initiation is the first step in reducing premenstrual syndrome, is very important. Vitamin B1 (Thiamin) may reduce symptoms of PMS through affecting the performance of coenzymes in the metabolism of carbohydrates.ObjectivesThis study was conducted to determine the effect of vitamin B1 on the change of appetite related to PMS.MethodsIn this double-blind placebo-controlled clinical trial, 100 students with PMS residing at dormitories of Jahrom University were divided randomly into two groups, vitamin B1 and placebo. The severity of mental symptoms specially change in appetite and desire to eat sweets in two cycles, before and during the intervention, was recorded by the students. The data were analyzed using descriptive and inferential statistics.ResultsThe comparison of vitamin B1 group before and after the intervention showed that vitamin B1 reduced mean mental (35.08%) symptoms significantly (P < 0.0001). The reduction of severity was observed in desire to eat sweets was 2.42%. The average of mental symptoms severity of PMS has been reduced in vitamin B1 group, and the comparison was significantly different.ConclusionsTherefore, vitamin B1 is recommended for reduction of symptom severity of PMS include desire to eat sweet. This vitamin can be used to reach a major goal of midwifery, without any side effects.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Collapse
|
30
|
Abdollahifard S, Maddahfard M. Sexual satisfaction among women with breast cancer. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.1676] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BackgroundDespite the outstanding breakthroughs in medical sciences, breast cancer is still regarded as one of the most important diseases, worldwide. This condition is also the most common cancer among women and the second leading cause of death.AimThis study aimed to investigate on sexual satisfaction among breast cancer patientsMethodsThis review article has written by more than 32 published papers in websites during 2008 until 2016.ResultEsfandiari et al. (2015) have done a study about a comparison of marital satisfaction, public health and body image among normal subjects and breast cancer patients with breast evacuation and conservation in Tehran, Iran. The result of this study showed that women with breast cancer were significantly different from normal subjects in terms of marital satisfaction, mental health and body image.Rezaipour et al. (2004) has done a study about relationship between women's experience of orgasm and marital relation satisfaction in health care centers of Arak. This result showed there was a relationship between women's orgasm experience and the amount of satisfaction from marital relation.Nekoueifard and Jahangiry (2014) have done a study about sexual function among patients with breast cancer in Tehran. In their study, there was a meaningful and direct relationship between type of surgery and sexual satisfaction. The results of that study show that disease and treatment have a considerable influence on marital relationship.ConclusionIt seems that dealing with marital satisfaction of women during the early stages of breast cancer diagnosis and treatment is a necessary for mental health.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Collapse
|