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Guilan MB, Bagheri SR, Roshani R, Alimohammadi E. Red cell distribution width to lymphocyte ratio could serve as a new inflammatory biomarker for predicting hematoma expansion in patients with intracerebral hemorrhage. BMC Neurol 2024; 24:162. [PMID: 38750430 PMCID: PMC11095002 DOI: 10.1186/s12883-024-03669-1] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 05/09/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Hematoma expansion is a critical factor associated with increased mortality and adverse outcomes in patients with intracerebral hemorrhage (ICH). Identifying and preventing hematoma expansion early on is crucial for effective therapeutic intervention. This study aimed to investigate the potential association between the Red cell distribution width to lymphocyte ratio (RDWLR) and hematoma expansion in ICH patients. METHODS We conducted a retrospective analysis of clinical data from 303 ICH patients treated at our department between May 2018 and May 2023. Demographic, clinical, radiological, and laboratory data, including RDWLR upon admission, were assessed. Binary logistic regression analysis was employed to determine independent associations between various variables and hematoma expansion. RESULTS The study included 303 ICH patients, comprising 167 (55.1%) males and 136 (44.9%) females, with a mean age of 65.25 ± 7.32 years at admission. Hematoma expansion occurred in 73 (24.1%) cases. Multivariate analysis revealed correlations between hematoma volume at baseline (OR, 2.73; 95% CI: 1.45 -4,78; P < 0.001), admission systolic blood pressure (OR, 2.98 ; 95% CI: 1.54-4.98; P < 0.001), Glasgow Coma Scale (GCS) (OR, 1.58; 95% CI: 1.25-2.46; P = 0.017), and RDWLR (OR, 1.58; 95% CI: 1.13-2.85; P = 0.022) and hematoma expansion in these patients. CONCLUSIONS Our findings suggest that RDWLR could serve as a new inflammatory biomarker for hematoma expansion in ICH patients. This cost-effective and readily available biomarker has the potential for early prediction of hematoma expansion in these patients.
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Affiliation(s)
- Milad Babaei Guilan
- Department of Neurosurgery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Seyed Reza Bagheri
- Department of neurosurgery, Kermanshah University of Medical Sciences, Imam Reza hospital, Kermanshah, Iran
| | - Rezvan Roshani
- Clinical Research Development Center, Taleghani and Imam Ali hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ehsan Alimohammadi
- Department of neurosurgery, Kermanshah University of Medical Sciences, Imam Reza hospital, Kermanshah, Iran.
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Alimohammadi E, Bagheri SR, Bostani A, Rezaie Z, Farid M. Preoperative platelet distribution width-to-platelet count ratio as a prognostic factor in patients with glioblastoma multiforme. Br J Neurosurg 2024; 38:307-313. [PMID: 33356619 DOI: 10.1080/02688697.2020.1864293] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 09/04/2020] [Revised: 12/08/2020] [Accepted: 12/11/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUNDS The prognostic significance of the platelet volume indices (PVIs), including the platelet distribution width (PDW), mean platelet volume (MPV), and platelet distribution width-to-platelet count ratio (PDW/P) has been demonstrated in a variety of malignancies. This study aimed to evaluate the prognostic value of PVIs in patients with a newly diagnosed glioblastoma multiforme (GBM). METHODS We retrospectively evaluated the clinical data of 143 patients with GBM who managed at our center between May 2010 and May 2019. Receiver operating characteristic curves (ROC) for cutoff value determination, Kaplan-Meier survival analysis, and univariate and multivariate Cox regression analyses were performed. RESULTS The corresponding cutoff values for MPV, PDW, and PDW/P were 9.05, 14.7, and 0.51, respectively. The Kaplan-Meier survival analyses showed that patients with an MPV < 9.05 and those with PDW <14.7 and cases with PDW/p < 0.51 had a longer overall survival (OS) (p < 0.05). Based on univariate analysis, age, Karnofsky Performance Status scores (KPS), tumor focality, MPV, PDW, and PDW/P were predictors of OS (p < 0.05). Final multivariate Cox regression analyses showed age (HR 1.040, 95% CI 1.009-1.071, P,0.011), KPS (HR 2.208, 95% CI 1.107-4.405, P,0.025), tumor focality (HR 4.596, 95% CI 1.988-10.626, p < 0.001), and PDW/P (HR 1.786, 95% CI 1.103-3.072, P,0.037) as the independent predictors of OS in patients with newly diagnosed glioblastoma. CONCLUSIONS Our results suggest an elevated preoperative PDW/P, along with previously established variables, as a simple and inexpensive prognostic factor for patients with GBM.
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Affiliation(s)
- Ehsan Alimohammadi
- Department of Neurosurgery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Seyed Reza Bagheri
- Department of Neurosurgery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Arash Bostani
- Department of Neurology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Zahra Rezaie
- Clinical Research Development Center, Imam Reza hospital Kermanshah University of Medical Sciences, Imam Reza hospital, Kermanshah, Iran
| | - Moradi Farid
- Department of Neurosurgery, Tehran University of Medical Sciences, Tehran, Iran
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Khaledian N, Bagheri SR, Sharifi H, Alimohammadi E. The efficacy of machine learning models in forecasting treatment failure in thoracolumbar burst fractures treated with short-segment posterior spinal fixation. J Orthop Surg Res 2024; 19:211. [PMID: 38561767 PMCID: PMC10983693 DOI: 10.1186/s13018-024-04690-3] [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: 02/11/2024] [Accepted: 03/16/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Although short-segment posterior spinal fixation (SSPSF) has shown promising clinical outcomes in thoracolumbar burst fractures, the treatment may be prone to a relatively high failure rate. This study aimed to assess the effectiveness of machine learning models (MLMs) in predicting factors associated with treatment failure in thoracolumbar burst fractures treated with SSPSF. METHODS A retrospective review of 332 consecutive patients with traumatic thoracolumbar burst fractures who underwent SSPSF at our institution between May 2016 and May 2023 was conducted. Patients were categorized into two groups based on treatment outcome (failure or non-failure). Potential risk factors for treatment failure were compared between the groups. Four MLMs, including random forest (RF), logistic regression (LR), support vector machine (SVM), and k-nearest neighborhood (k-NN), were employed to predict treatment failure. Additionally, LR and RF models were used to assess factors associated with treatment failure. RESULTS Of the 332 included patients, 61.4% were male (n = 204), and treatment failure was observed in 44 patients (13.3%). Logistic regression analysis identified Load Sharing Classification (LSC) score, lack of index level instrumentation, and interpedicular distance (IPD) as factors associated with treatment failure (P < 0.05). All models demonstrated satisfactory performance. RF exhibited the highest accuracy in predicting treatment failure (accuracy = 0.948), followed by SVM (0.933), k-NN (0.927), and LR (0.917). Moreover, the RF model outperformed other models in terms of sensitivity and specificity (sensitivity = 0.863, specificity = 0.959). The area under the curve (AUC) for RF, LR, SVM, and k-NN was 0.911, 0.823, 0.844, and 0.877, respectively. CONCLUSIONS This study demonstrated the utility of machine learning models in predicting treatment failure in thoracolumbar burst fractures treated with SSPSF. The findings support the potential of MLMs to predict treatment failure in this patient population, offering valuable prognostic information for early intervention and cost savings.
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Affiliation(s)
- Neda Khaledian
- Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Seyed Reza Bagheri
- Department of neurosurgery, Kermanshah University of Medical Sciences, Imam Reza hospital, Kermanshah, Iran
| | - Hasti Sharifi
- Clinical Research Development Center, Taleghani and Imam Ali Hospitals, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ehsan Alimohammadi
- Department of neurosurgery, Kermanshah University of Medical Sciences, Imam Reza hospital, Kermanshah, Iran.
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Khodadadi F, Bagheri SR, Ahmadi S, Rahmatinezhad M, Arjmandnia F, Abdi A, Alimohammadi E. The association between menopausal status and clinical outcomes of female patients with carpal tunnel release: a retrospective observational study. Int J Neurosci 2024; 134:318-322. [PMID: 35815446 DOI: 10.1080/00207454.2022.2100783] [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: 04/27/2022] [Revised: 06/07/2022] [Accepted: 06/23/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND The relationship between menopausal status and clinical outcomes of female patients with carpal tunnel release (CTR) has been not clearly investigated. This study aimed to evaluate the clinical outcomes of CTR among women with different menopausal statuses. METHODS Two hundred-eighteen consecutive female patients with carpal tunnel syndrome (CTS) who underwent surgery at our hospital between May 2016 and May 2020 were included in this study. Based on whether subjects had undergone menopause before surgery, they were divided into three groups: the premenopausal group, the early postmenopausal group (less than 10 years since menopause) and the late postmenopausal group (more than 10 years since menopause). The clinical outcome was assessed before surgery and at six-month postoperative visits using the Boston Carpal Tunnel Questionnaire (BCTQ). RESULTS There were 86 patients in the premenopausal group, 70 patients in the early postmenopausal group and 62 patients in the late postmenopausal group. All the groups showed significant improvements in their Symptom Severity Scale (SSS) and Functional Status Scale (FSS) compared with preoperative scores. Although, there was a significant difference between the groups based and post-surgical SSS and FSS (p < 0.05). Patients in the postmenopausal group had less improvement in SSS and FSS in comparison with those in the other groups (p < 0.05). CONCLUSIONS Our results showed that all the groups had significant improvement in their SSS and FSS. However, the clinical outcomes were poorer in late postmenopausal patients than in premenopausal or early postmenopausal patients. These findings can be used in pre-operative counseling and interpretation of outcomes in women with CTR.
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Affiliation(s)
- Foziyeh Khodadadi
- Department of anesthesiology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Seyed Reza Bagheri
- Department of neurosurgery, Kermanshah University of Medical Sciences, Imam Reza hospital, Kermanshah, Iran
| | - Samane Ahmadi
- Imam Reza hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Maryam Rahmatinezhad
- Department of anesthesiology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Alireza Abdi
- Imam Reza hospital, Nursing and midwifery school, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ehsan Alimohammadi
- Department of neurosurgery, Kermanshah University of Medical Sciences, Imam Reza hospital, Kermanshah, Iran
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Arjmandnia F, Alimohammadi E. The value of machine learning technology and artificial intelligence to enhance patient safety in spine surgery: a review. Patient Saf Surg 2024; 18:11. [PMID: 38528562 DOI: 10.1186/s13037-024-00393-0] [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: 02/25/2024] [Accepted: 03/15/2024] [Indexed: 03/27/2024] Open
Abstract
Machine learning algorithms have the potential to significantly improve patient safety in spine surgeries by providing healthcare professionals with valuable insights and predictive analytics. These algorithms can analyze preoperative data, such as patient demographics, medical history, and imaging studies, to identify potential risk factors and predict postoperative complications. By leveraging machine learning, surgeons can make more informed decisions, personalize treatment plans, and optimize surgical techniques to minimize risks and enhance patient outcomes. Moreover, by harnessing the power of machine learning, healthcare providers can make data-driven decisions, personalize treatment plans, and optimize surgical interventions, ultimately enhancing the quality of care in spine surgery. The findings highlight the potential of integrating artificial intelligence in healthcare settings to mitigate risks and enhance patient safety in surgical practices. The integration of machine learning holds immense potential for enhancing patient safety in spine surgeries. By leveraging advanced algorithms and predictive analytics, healthcare providers can optimize surgical decision-making, mitigate risks, and personalize treatment strategies to improve outcomes and ensure the highest standard of care for patients undergoing spine procedures. As technology continues to evolve, the future of spine surgery lies in harnessing the power of machine learning to transform patient safety and revolutionize surgical practices. The present review article was designed to discuss the available literature in the field of machine learning techniques to enhance patient safety in spine surgery.
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Affiliation(s)
- Fatemeh Arjmandnia
- Department of Aneasthesiology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ehsan Alimohammadi
- Department of Neurosurgery, Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran.
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Ahmadi K, Alimohammadi E. White blood cell subtypes and neutrophil extracellular traps as biomarkers for stroke etiology. Thromb Res 2024; 235:181-182. [PMID: 38367284 DOI: 10.1016/j.thromres.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 01/30/2024] [Accepted: 02/01/2024] [Indexed: 02/19/2024]
Affiliation(s)
- Kousar Ahmadi
- Department of Neurosurgery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ehsan Alimohammadi
- Department of Neurosurgery, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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7
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Peter-Okaka UI, Shiri S, Owodunni O, Bagheri SR, Jalilian A, Uzoukwu C, Eden S, Alimohammadi E. Are there any benefits for post-operative splinting after carpal tunnel release? A systematic review and meta-analysis. BMC Musculoskelet Disord 2024; 25:163. [PMID: 38383364 PMCID: PMC10880356 DOI: 10.1186/s12891-024-07230-6] [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: 05/27/2023] [Accepted: 01/24/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND There is a controversy on the effectiveness of post-operating splinting in patients with carpal tunnel release (CTR) surgery. This study aimed to systematically evaluate various outcomes regarding the effectiveness of post-operating splinting in CTR surgery. METHODS Multiple databases, including PubMed, EMBASE, CINAHL, Web of Science, and Cochrane, were searched for terms related to carpal tunnel syndrome. A total of eight studies involving 596 patients were included in this meta-analysis. The quality of studies was evaluated, and their risk of bias was calculated using the methodological index for non-randomized studies (MINORS) and Cochrane's collaboration tool for assessing the risk of bias in randomized controlled trials. Data including the visual analogue scale (VAS), pinch strength, grip strength, two-point discrimination, symptom severity score (SSS), and functional status scale (FSS) were extracted. RESULTS Our analysis showed no significant differences between the splinted and non-splinted groups based on the VAS, SSS, FSS, grip strength, pinch strength, and two-point discrimination. The calculated values of the standardized mean difference (SMD) or the weighted mean difference (WMD) and a 95% confidence interval (CI) for different variables were as follows: VAS [SMD = 0.004, 95% CI (-0.214, 0.222)], pinch strength [WMD = 1.061, 95% CI (-0.559, 2.681)], grip strength [SMD = 0.178, 95% CI (-0.014, 0.369)], SSS [WMD = 0.026, 95% CI (- 0.191, 0.242)], FSS [SMD = 0.089, 95% CI (-0.092, 0.269)], and the two-point discrimination [SMD = 0.557, 95% CI (-0.140, 1.253)]. CONCLUSIONS Our findings revealed no statistically significant differences between the splinted and non-splinted groups in terms of the VAS, SSS, FSS, grip strength, pinch strength, and two-point discrimination. These results indicate that there is no substantial evidence supporting a significant advantage of post-operative splinting after CTR.
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Affiliation(s)
| | - Samira Shiri
- Clinical Research Development Center, Taleghani and Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Oluwafemi Owodunni
- Department of Neurosurgery, University of New Mexico Hospital, Albuquerque, NM, USA
| | - Seyed Reza Bagheri
- Department of Neurosurgery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Amir Jalilian
- Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Sonia Eden
- Semmes Murphey Clinic and University of Tennessee Health Science Center, Memphis, TN, USA
| | - Ehsan Alimohammadi
- Department of Neurosurgery, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Alimohammadi E. Letter to the Editor - "Preventing Surgical Site Hematoma Using Topical with or without Intravenous Tranexamic Acid in Lumbosacral Surgery: A Quality Improvement Project". World Neurosurg 2024; 182:226-227. [PMID: 38390884 DOI: 10.1016/j.wneu.2023.10.005] [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: 09/30/2023] [Accepted: 10/03/2023] [Indexed: 02/24/2024]
Affiliation(s)
- Ehsan Alimohammadi
- Department of Neurosurgery, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Foroushani AZ, Alimohammadi E. The dynamics of neutrophil-to-lymphocyte ratio as a promising biomarker for predicting clinical outcomes in pediatric traumatic brain injury. Childs Nerv Syst 2024; 40:281-283. [PMID: 38072857 DOI: 10.1007/s00381-023-06252-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 12/04/2023] [Indexed: 02/03/2024]
Affiliation(s)
- A Zamani Foroushani
- Department of Pediatrics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - E Alimohammadi
- Department of Neurosurgery, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Mohammadi P, Alimohammadi E. Letter to the Editor: Risk Factors for Residual Back Pain After Percutaneous Vertebroplasty Treatment for Osteoporotic Thoracolumbar Compression Fractures: A Retrospective Cohort Study. World Neurosurg 2024; 182:219-221. [PMID: 38390880 DOI: 10.1016/j.wneu.2023.09.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 09/30/2023] [Indexed: 02/24/2024]
Affiliation(s)
- Parvin Mohammadi
- Department of Neurosurgery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ehsan Alimohammadi
- Department of Neurosurgery, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Fallah K, Alimohammadi E. Letter to the editor: "Fusion with and without lever reduction in degenerative lumbar spondylolisthesis-a retrospective study". J Orthop Surg Res 2024; 19:48. [PMID: 38195506 PMCID: PMC10775424 DOI: 10.1186/s13018-024-04537-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 01/04/2024] [Indexed: 01/11/2024] Open
Affiliation(s)
- Kosar Fallah
- Clinical Research Development Center of Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ehsan Alimohammadi
- Department of Neurosurgery, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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12
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Guilan MB, Alimohammadi E. Letter to the editor regarding: risk factors for axial symptoms following laminoplasty for cervical spondylotic myelopathy. J Orthop Surg Res 2024; 19:18. [PMID: 38167447 PMCID: PMC10762988 DOI: 10.1186/s13018-023-04508-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 12/22/2023] [Indexed: 01/05/2024] Open
Affiliation(s)
- Milad Babaei Guilan
- Department of Neurosurgery, Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran
| | - Ehsan Alimohammadi
- Department of Neurosurgery, Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran.
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Ranjbari F, Alimohammadi E. Letter to the Editor: Evaluating the efficacy of OLIF combined with pedicle screw internal fixation for lumbar spinal stenosis. J Orthop Surg Res 2023; 18:872. [PMID: 37974157 PMCID: PMC10652486 DOI: 10.1186/s13018-023-04260-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 10/02/2023] [Indexed: 11/19/2023] Open
Affiliation(s)
- Fatemeh Ranjbari
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ehsan Alimohammadi
- Department of Neurosurgery, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Alimohammadi E, Lawton MT, Bagheri SR, Siahkamari E, Mehrbani H, Tondro A, Amiri A, Kakavand P. High prognostic nutritional index could be associated with improved survival in patients with brain metastases: a retrospective observational study. Neurol Res 2023; 45:1044-1049. [PMID: 37700395 DOI: 10.1080/01616412.2023.2257438] [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: 02/15/2023] [Accepted: 07/02/2023] [Indexed: 09/14/2023]
Abstract
BACKGROUND Prognostic nutritional index (PNI) is an indicator of immunonutritional status. The present study aimed to evaluate the association between PNI and overall survival in patients with brain metastases. METHODS A total of 257 patients with histologically confirmed brain metastasis who underwent surgery at our center between April 2011 and April 2021 were investigated retrospectively.Demographic, clinical, and radiologic data of all cases were extracted. Patients were divided into the low PNI group(PNI <45) (malnutrition status) and the high PNI group (PNI ≥45)(normal nutritional status). Survival analyses were performed using the Kaplan-Meier method and compared using the log-rank test. Univariate and multivariate analyses were performed using the Cox proportional hazards method. RESULTS From the 257 cases of brain metastases, there were 148 (57.6%) males and 109 (42.4%) females. The mean age was 57.02 ± 8.7. The median overall survival was 13 months. The results of the multivariate Cox regression analyses showed primary cancer site (HR 2.196, 95% CI 1.988-6.52605, P = 0.000), the number of metastases (HR 1.829, 95% CI 1.380-2.872, P = 0.037), extracranial involvement (HR 2.186, 95% CI 1.213-4.171, P = 0.026), adjuvant radiotherapy (HR 2.823, 95% CI 1.187-5.415, P = 0.017) and PNI (HR 1.961, 95% CI 1.168-3.515, P = 0.021) as the independent predictors of overall survival in patients with brain metastases. CONCLUSION Our results suggest that PNI could be associated with survival in patients with brain metastases. Patients with a lower PNI had a significantly worse outcome in comparison with those with a higher PNI. Evaluation of PNI may provide additional prognostic information in patients with brain metastases.
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Affiliation(s)
- Ehsan Alimohammadi
- Imam Reza hospital, Department of neurosurgery Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Michael T Lawton
- Department of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA
| | - Seyed Reza Bagheri
- Department of neurosurgery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Elham Siahkamari
- Department of anesthesiology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hajir Mehrbani
- Clinical Research Development Center, Taleghani and Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Amirhossein Tondro
- nursing and midwifery school, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Akram Amiri
- Imam Reza hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Parivash Kakavand
- Department of neurosurgery, Kermanshah University of Medical Sciences, Kermanshah, Iran
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15
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Alimohammadi E, Bagheri SR, Joseph B, Sharifi H, Shokri B, Khodadadi L. Analysis of factors associated with the failure of treatment in thoracolumbar burst fractures treated with short-segment posterior spinal fixation. J Orthop Surg Res 2023; 18:690. [PMID: 37715197 PMCID: PMC10503025 DOI: 10.1186/s13018-023-04190-w] [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: 07/19/2023] [Accepted: 09/12/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND The treatment of thoracolumbar burst fractures continues to pose challenges. Although short-segment posterior spinal fixation (SSPSF) has shown satisfactory clinical outcomes, it is accompanied by a relatively high rate of treatment failure. This study aimed to assess factors associated with treatment failure in thoracolumbar burst fractures treated with SSPSF. METHODS The clinical data of 241 consecutive patients with a traumatic thoracolumbar burst fracture who underwent SSPSF at our center between Apr 2016 and Apr 2021 were retrospectively reviewed. Patients were divided into two groups (failure of the treatment group and non-failure of the treatment group). We compared potential risk factors for the failure of treatment including age, gender, body mass index, smoking, diabetes, vertebral body compression rate, use of crosslinks, percentage of anterior height compression, presence of index level instrumentation, Cobb angle, interpedicular distance (IPD), canal compromise, Load Sharing Classification (LSC) score, use of posterolateral fusion, and pain intensity between the two groups. RESULTS A sum of 137 (56.8%) males and 104 (43.2%) females were enrolled where the mean age and follow-up of the participants were 48.34 ± 10.23 years and 18.67 ± 5.23 months, respectively. Treatment failure was observed in 34 cases (14.1%). The results of the binary logistic regression analysis revealed that the lack of index level instrumentation (OR 2.21; 95% CI 1.78-3.04; P = 0.014), LSC score (odds ratio [OR] 2.64; 95% confidence interval [95% CI], 1.34-3.77; P = 0.007), and IPD (OR 1.77; 95% CI 1.51-2.67; P = 0.023) were independently associated with a higher rate of failure of treatment. CONCLUSIONS The findings of this study revealed that increased rates of treatment failure in thoracolumbar burst fractures treated with SSPSF were associated with factors such as the absence of index level instrumentation, higher LSC scores, and larger IPD. These findings could be helpful in the proper management of patients with unstable thoracolumbar burst fractures.
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Affiliation(s)
- Ehsan Alimohammadi
- Department of Neurosurgery, Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran.
| | - Seyed Reza Bagheri
- Department of Neurosurgery, Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran
| | - Benson Joseph
- Department of General Surgery, University of Tennessee Health Science Center, Memphis, USA
| | - Hasti Sharifi
- Clinical Research Development Center, Taleghani and Imam Ali Hospitals, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Bita Shokri
- Clinical Research Development Center, Taleghani and Imam Ali Hospitals, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Lida Khodadadi
- Kermanshah University of Medical Sciences, Kermanshah, Iran
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Hamid S, Moradi F, Bagheri SR, Zarpoosh M, Amirian P, Ghasemi H, Alimohammadi E. Evaluation of clinical outcomes, complication rate, feasibility, and applicability of transfacet pedicle-sparing approach in thoracic disc herniation: a systematic review and meta-analysis. J Orthop Surg Res 2023; 18:516. [PMID: 37475044 PMCID: PMC10360238 DOI: 10.1186/s13018-023-04016-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/14/2023] [Indexed: 07/22/2023] Open
Abstract
OBJECTIVE This study aimed to evaluate the clinical outcomes, complication rate, feasibility, and applicability of transfacet pedicle-sparing approach for treating thoracic disc herniation. METHODS We searched three databases including the Cochrane Library, PubMed, and Embase for eligible studies until Dec 2022. The quality of studies and their risk of bias were assessed using the methodological index for non-randomized studies. We evaluated the heterogeneity between studies using the I2 statistic and the P-value for the heterogeneity. RESULTS A total of 328 patients described in 11 included articles were published from 2009 to 2022. Pain outcomes using the visual analog scale (VAS score) were reported in four studies. The standardized mean difference was reported as 0.749 (CI 95% 0.555-0.943). The obtained result showed the positive effect of the procedure and the improvement of patients' pain after the surgery. Myelopathy outcomes using the Nurick score were reported in five studies. The standardized mean difference was reported as 0.775 (CI 95% 0.479-1.071). The result showed the positive effect of the procedure. Eight studies assessed postoperative complications and neurological deterioration. The pooled overall complication was 12.4% (32/258) and 3.5% (9/258) neurological worsening. CONCLUSION The results of this study demonstrated a positive effect of the transfacet pedicle-sparing approach on the clinical outcomes of patients with thoracic disc herniation surgery. The technique has been shown to be safe and effective for the right patient. The technique is associated with lower rates of complications and a shorter hospital stay compared to other surgical approaches. This information can assist clinicians in making informed decisions when selecting the most appropriate surgical technique for their patients with thoracic disc herniation.
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Affiliation(s)
- Shafi Hamid
- School of Medicine, Wayne State University, Detroit, MI, USA
| | - Farid Moradi
- Department of Neurosurgery, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Seyed Reza Bagheri
- Department of Neurosurgery, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mahsa Zarpoosh
- Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Parsa Amirian
- Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hooman Ghasemi
- School of Nursing and Midwifery, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ehsan Alimohammadi
- Department of Neurosurgery, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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17
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Alimohammadi E, Arast A, Vlaisavljevic Z, Abdi A, Ramadhan H. The experiences of the caregivers caring for the patients in persistent vegetative state due to traumatic brain injury. SAGE Open Med 2023; 11:20503121231177550. [PMID: 37324120 PMCID: PMC10262620 DOI: 10.1177/20503121231177550] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 05/07/2023] [Indexed: 06/17/2023] Open
Abstract
Objective Persistent vegetative state often occurs as a result of traumatic brain injuries; these patients are usually hospitalized for sustained periods, and the family caregivers are the main care providers in Iranian hospitals, especially for chronic and persistent vegetative state patients. The current study was conducted to investigate the family caregivers' experiences of caring for persistent vegetative state patients following traumatic brain injury. Methods This descriptive phenomenological study was carried out in 2019. Semi-structured interviews were done with 12 family caregivers caring for the patients in persistent vegetative state, hospitalized in a trauma center, after taking informed written consent and assuring about anonymity and confidentiality of their personal information. The interviews were analyzed using the Colaizzis҆ method. Results After analysis of 12 interviews, 5 themes, and 10 subthemes were extracted from 428 codes. Five themes include "uncountable struggles/challenges," "looking for peace," "therapeutic concerns," "preserving the connection," and "unheard sounds." Conclusion In this study, the family caregivers of the persistent vegetative state patients in the hospital experienced some challenges, and looked for peace by doing some work, for example, praying. They had some therapeutic concerns and unheard sounds and tried to fulfill them. We recommend, by using the results of this study and other related research, necessary care and facilities would be provided for the family caregivers of persistent vegetative state patients in hospitals.
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Affiliation(s)
- Ehsan Alimohammadi
- Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Atefeh Arast
- Student Research Committee, Kermanshah University of Medical Sciences, Imam Reza hospital, Kermanshah, Iran
| | - Zeljko Vlaisavljevic
- Department of Nursing, High School of Medical Professional Studies Medika, Clinical Center of Serbia, Belgrade, Serbia
| | - Alireza Abdi
- Nursing and Midwifery School, Kermanshah University of Medical Sciences, Kermanshah, Iran
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18
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Moradi F, Bagheri SR, Saeidiborojeni H, Eden SV, Naderi M, Hamid S, Amirian S, Amiri A, Alimohammadi E. Predictors of poor clinical outcome in patients with cervical spondylotic myelopathy undergoing cervical laminectomy and fusion. Musculoskelet Surg 2023; 107:77-83. [PMID: 34569018 DOI: 10.1007/s12306-021-00731-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 05/30/2021] [Accepted: 09/17/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Cervical spondylotic myelopathy (CSM) is a common degenerative disease that arises from spinal cord compression and injury. Laminectomy with posterior spinal fusion (LPSF) is one of the most common approaches used to treat patients with CSM. The present study aimed to evaluate predictors of poor clinical outcome in patients with CSM undergoing LPSF. METHODS We retrospectively evaluated 157 patients with CSM who underwent LPSF at our center between April 2014 and June 2019. The neurological outcome was assessed using the modified Japanese Orthopaedic Association (mJOA) scale before the surgery and at the last follow-up visit. Based on the clinical outcomes, all patients were divided into two groups [the good group (recovery rates ≥ 75%) and the poor group (recovery rates < 75%)]. The following suggested variables as potential predictors for the poor clinical outcome were compared between the two groups:age, gender, body mass index (BMI), smoking, diabetes, number of laminectomy levels, presence of signal changes in Magnetic Resonance Imaging (MRI), duration of symptoms, preoperative JOA scale, preoperative Pavlov ratio, preoperative cervical curvature, and preoperative cervical range of motion (ROM). RESULTS There were 86 males (54.8%) and 71 females (45.2%) with the mean follow-up time of 24.96 ± 1.67 months. Overall, 114 patients (72.6%) had a good clinical outcome. However, 43 subjects (27.4%) failed to achieve a good outcome. According to the binary logistic regression analysis, age (odds ratio [OR], 2.14; 95% confidence interval [95% CI], 1.87-2.63; P = 0.014) and preoperative JOA scale (OR, 3.73; 95% CI 2.96-4.87; p < 0.001) were independent predictors of poor clinical outcome. CONCLUSIONS The results of the present study showed that age and preoperative JOA scale were predictors of poor clinical outcome in patients with CSM undergoing LPSF. These findings will be of great value in preoperative counseling and management of postoperative expectations.
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Affiliation(s)
- Farid Moradi
- Department of Neurosurgery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Seyed Reza Bagheri
- Department of Neurosurgery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Sonia V Eden
- Wayne State University School of Medicine, Detroit, USA
| | - Mobin Naderi
- Clinical Research Development Center, Imam Reza Hospital Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran
| | - Shafi Hamid
- Wayne State University School of Medicine, Detroit, USA
| | - Sepideh Amirian
- Department of Neurosurgery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Akram Amiri
- Department of Neurosurgery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ehsan Alimohammadi
- Department of Neurosurgery, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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19
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Abdi A, Bagheri SR, Shekarbeigi Z, Usefvand S, Alimohammadi E. The effect of repeated flexion-based exercises versus extension-based exercises on the clinical outcomes of patients with lumbar disk herniation surgery: a randomized clinical trial. Neurol Res 2023; 45:28-40. [PMID: 36039973 DOI: 10.1080/01616412.2022.2116686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Valuable impact of postoperative exercises on the clinical outcomes of patients with lumbar discectomy has been demonstrated. However, there is a lack of consensus on the best kind of postoperative exercises. This study aimed to evaluate the impact of the early postoperative flexion-based and extension-based exercises on the clinical outcomes of patients with lumbar discectomy. METHODS In this single-blind randomized clinical trial (RCT), 90 subjects with lumbar discectomy were randomly assigned to three groups. The flexion-based and extension-based exercises were planned for the first and the second groups, respectively. The third group was considered as the control group. Subjects in the experimental groups started their exercise program at the end of the 6th postoperative week and continued exercises for 8 weeks. We used Visual analogue scale (VAS), Oswestry Disability Index (ODI), modified Biering-Sorensen test (mBST), and Trunk Flexion Endurance Test (TFET) to evaluate back pain, disability, back and abdominal muscle endurance, respectively. The outcomes were investigated before starting the exercises program as well as at the end of the study. Moreover, return to work was evaluated at the end of the study. Data were analyzed using descriptive and inferential statistics by SPSS-24 software. RESULTS Our results showed that the VAS pain diminished in all the groups. However, this reduction was most in the McKenzie group (P < 0.001). Moreover, extension-based exercises reduced ODI more than other groups (P < 0.001). We found that extension-based and flexion-based exercises had more efficacy in increasing the back and trunk flexion endurance, respectively (P < 0.001). There was not a significant difference between the three groups in the term of returning to work (P = 0.06). CONCLUSIONS Both flexion-based and extension-based exercises could reduce postoperative back pain and disability. However, the impact of the extension-based program was more dominant. Moreover, these exercises could increase back and abdominal muscle endurance. Therefore, prescribing such low-cost home-based exercises could be very helpful for patients with lumbar discectomy.
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Affiliation(s)
- Alireza Abdi
- Nursing and Midwifery School, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Seyed Reza Bagheri
- Neurosurgery, Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran
| | - Zahra Shekarbeigi
- Clinical Research Development Center, Taleghani and Imam Ali Hospital, Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Soheila Usefvand
- Master of Science of Sports Biomechanics, Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran
| | - Ehsan Alimohammadi
- Neurosurgery, Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran
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Alimohammadi E, Foroushani AZ, Moradi F, Ebrahimzadeh K, Nadersepahi MJ, Amiri A, Asadzadeh S, Hosseini S, Eden SV, Bagheri SR. Response to the letter to the Editor Neutrophil-to-lymphocyte ratio could be used for early prediction of coagulopathy occurrence in traumatic brain injury. Injury 2022; 53:3558-3559. [PMID: 35989116 DOI: 10.1016/j.injury.2022.08.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 08/06/2022] [Indexed: 02/02/2023]
Affiliation(s)
- Ehsan Alimohammadi
- Department of neurosurgery Kermanshah University of Medical Sciences, Imam Reza hospital, Kermanshah, Iran.
| | | | - Farid Moradi
- Department of neurosurgery, Kermanshah University of Medical Sciences, Imam Reza hospital, Kermanshah, Iran
| | - Kaveh Ebrahimzadeh
- Department of neurosurgery, Shahid Beheshti University of Medical Sciences, Loghman Hakim hospital
| | - Mohammad Javad Nadersepahi
- Department of anesthesiology, Kermanshah University of Medical Sciences, Imam Reza hospital, Kermanshah,Iran
| | - Akram Amiri
- Kermanshah University of Medical Sciences, Imam Reza hospital, Kermanshah, Iran
| | - Sahel Asadzadeh
- Clinical Research Development Center, Imam Reza hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sahar Hosseini
- Kermanshah University of Medical Sciences, Imam Reza hospital, Kermanshah, Iran
| | - Sonia V Eden
- Wayne State University School of Medicine, Detroit, MI, USA.
| | - Seyed Reza Bagheri
- Department of neurosurgery, Kermanshah University of Medical Sciences, Imam Reza hospital, Kermanshah, Iran
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21
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Alimohammadi E, Bagheri SR, Arast A, Hadidi H, Safari-Faramani R. Pediatric Medulloblastoma: Prognostic Value of Preoperative Blood Cell Ratios. Int J Hematol Oncol Stem Cell Res 2022; 16:131-139. [PMID: 36694701 PMCID: PMC9831869 DOI: 10.18502/ijhoscr.v16i3.10135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 07/02/2021] [Indexed: 01/27/2023] Open
Abstract
Background: The prognostic significance of preoperative neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), and platelet to lymphocyte ratio (PLR) have been demonstrated in various tumors. This study aimed to evaluate the prognostic role of these ratios in pediatric medulloblastoma. Materials and Methods: Forty-three pediatric patients with medulloblastoma were evaluated, retrospectively. Clinical, radiological, and laboratory data were extracted from the electronic medical records of the patients. Univariate and multivariate Cox proportional hazard models were used to evaluate the impact of suggested variables, including NLR, LMR, and PLR on progression-free survival (PFS) and overall survival (OS). Kaplan-Meier curves were plotted for the assessment of PFS and OS. The Log-rank test was used to assess differences between the PFS and OS in the related categories. Results: There were 27 males (62.8%) and 16 females (37.2%) with a mean age of 7.4 ±3.3 years. The median OS and PFS were 62.8 ±17.2 and 43.3 ±15.6 months, respectively. The multivariate Cox model showed the clinical risk group, NLR, and LMR as independent predictors of the PFS and the OS (p<0.05). The Log-rank test revealed that OS and PFS were higher in patients with NLR <4 and those with LMR ≥ 3.48 (p <0.05). There were no differences between patients with PLR>200 and PLR< 200 based on OS and PFS. Conclusion: Our results suggest an elevated preoperative NLR and a lowered preoperative LMR as simple predictors of survival in pediatric medulloblastoma. These cost-effective and easily available ratios, along with previously established variables, could be valuable to predict survival in pediatrics with medulloblastoma.
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Affiliation(s)
- Ehsan Alimohammadi
- Department of Neurosurgery, Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran
| | - Seyed Reza Bagheri
- Department of Neurosurgery, Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran
| | - Atefeh Arast
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Homa Hadidi
- Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran
| | - Roya Safari-Faramani
- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
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22
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Alimohammadi E, Foroushani AZ, Moradi F, Ebrahimzadeh K, Nadersepahi MJ, Asadzadeh S, Amiri A, Hosseini S, Eden SV, Bagheri SR. Dynamics of neutrophil-to-lymphocyte ratio can be associated with clinical outcomes of children with moderate to severe traumatic brain injury: A retrospective observational study. Injury 2022; 53:999-1004. [PMID: 34625239 DOI: 10.1016/j.injury.2021.09.052] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 09/21/2021] [Accepted: 09/26/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND The neutrophil to lymphocyte ratio (NLR) has been reported to be associated with clinical outcomes of patients with severe traumatic brain injury (TBI). This study aimed to evaluate the correlation between the dynamics of NLR and clinical outcomes of pediatric patients with moderate to severe TBI. METHODS We retrospectively evaluated the clinical data of a total of 374 pediatric patients with moder-ate to severe TBI who were treated in our department between May 2016 and May 2020. Clinical and laboratory data including the NLR upon admission and the NLR on hospital day four were collected. Poor clinical outcome was defined as Glasgow Outcome Scale (GOS) of 1-3. Multivariable logistic regression analyses were performed to investigate the correlation between the dynamics of NLR and clinical outcome. RESULTS Three hundred seventy-four pediatric patients (mean age 7.37 ± 3.11, 52.7% male) were evaluated. Based on the ROC curves, a value of 5 was determined as the NLR cut-off value. The corresponding cutoff value for delta NLR was 1. The Glasgow Coma Scale (GCS) (OR, 3.42; 95% CI: 1.88-5.28; P <0.001), the light reflex (OR, 1.79; 95% CI: 1.34- 2.84; P = 0.027), the Rotterdam CT score (OR, 2.71; 95% CI: 1.72-4.13; P = 0.021), and delta NLR (OR, 1.71; 95% CI: 1.13- 2.52; P = 0.034) were identified as independent predictors for unfavorable outcomes in multivariable logistic regression analysis. CONCLUSIONS The result of the present study suggest that delta NLR could be a predictor of poor clinical outcome of pediatrics with moderate to severe TBI. This cost-effective and easily available biomarker could be used to predict clinical outcomes in these patients.
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Affiliation(s)
- Ehsan Alimohammadi
- Department of neurosurgery Kermanshah University of Medical Sciences, Imam Reza hospital, Kermanshah, Iran.
| | | | - Farid Moradi
- Department of neurosurgery Kermanshah University of Medical Sciences, Imam Reza hospital, Kermanshah, Iran
| | - Kaveh Ebrahimzadeh
- Department of neurosurgery, Shahid Beheshti University of Medical Sciences, Loghman Hakim hospital
| | - Mohammad Javad Nadersepahi
- Department of anesthesiology, Kermanshah University of Medical Sciences, Imam Reza hospital, Kermanshah,Iran
| | - Sahel Asadzadeh
- Clinical Research Development Center, Imam Reza hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Akram Amiri
- Kermanshah University of Medical Sciences, Imam Reza hospital, Kermanshah, Iran
| | - Sahar Hosseini
- Kermanshah University of Medical Sciences, Imam Reza hospital, Kermanshah, Iran
| | - Sonia V Eden
- Wayne State University School of Medicine, Detroit, MI, USA.
| | - Seyed Reza Bagheri
- Department of neurosurgery, Kermanshah University of Medical Sciences, Imam Reza hospital, Kermanshah, Iran
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Kumar Anand S, Sardari H, Sadeghsalehi A, Bagheri SR, Eden SV, Lawton MT, Alimohammadi E. Radiopathologic predictors of recurrence in patients with a gross totally resected atypical meningioma. Neurol Res 2021; 44:468-474. [DOI: 10.1080/01616412.2021.2022915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Hamid Sardari
- Student Research Committee, Clinical Research Development Center, Taleghani and Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Sadeghsalehi
- Department of Pathology, Kermanshah University of Medical Sciences, Taleghani Hospital, Kermanshah, Iran
| | - Seyed Reza Bagheri
- Neurosurgery Department of Neurosurgery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sonia V Eden
- School of Medicine, Wayne State University, Detroit, MI, USA
| | - Michael T Lawton
- Neurosurgery, Department of Neurological Surgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USA
| | - Ehsan Alimohammadi
- Neurosurgery Department of Neurosurgery, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Reza Bagheri S, Abdi A, Benson J, Naghdi N, Eden SV, Arjmand M, Amini Z, Lawton MT, Alimohammadi E. The significant impact of Coronavirus disease 2019 (COVID-19) on in-hospital mortality of elderly patients with moderate to severe traumatic brain injury: A retrospective observational study. J Clin Neurosci 2021; 93:241-246. [PMID: 34656255 PMCID: PMC8462266 DOI: 10.1016/j.jocn.2021.09.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/19/2021] [Accepted: 09/15/2021] [Indexed: 12/23/2022]
Abstract
Background Traumatic brain injury (TBI) is one of the main causes of death and disability among the elderly patient population. This study aimed to assess the predictors of in-hospital mortality of elderly patients with moderate to severe TBI who presented during the Coronavirus disease 2019 (COVID-19) pandemic. Methods In this retrospective analytical study, all elderly patients with moderate to severe TBI who were referred to our center between March 2nd, 2020 to August 1st, 2020 were investigated and compared against the TBI patients receiving treatment during the same time period within the year 2019. Patients were followed until discharge from the hospital or death. The demographic, clinical, radiological, and laboratory test data were evaluated. Data were analyzed using SPSS-21 software. Findings In this study, 359 elderly patients were evaluated (n = 162, Post-COVID-19). Fifty-four patients of the cohort had COVID-19 disease with a mortality rate was 33.3%. The patients with COVID-19 were 5.45 times more likely to expire before discharge (P < 0.001) than the TBI patients who were not COVID-19 positive. Other variables such as hypotension (OR, 4.57P < 0.001), hyperglycemia (OR, 2.39, P = 0.002), and use of anticoagulant drugs (OR, 2.41P = 0.001) were also associated with in-hospital death. According to the binary logistic regression analysis Age (OR, 1.72; 95% CI: 1.26–2.18; P = 0.033), Coronavirus infection (OR, 2.21; 95% CI: 1.83–2.92; P = 0.011) and Glasgow Coma Scale (GCS) (OR, 3.11; 95% CI: 2.12–4.53; P < 0.001) were independent risk factors correlated with increased risk of in-hospital mortality of elderly patients with moderate to severe TBI. Conclusion Our results showed that Coronavirus infection could increase the risk of in-hospital mortality of elderly patients with moderate to severe TBI significantly.
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Affiliation(s)
- Seyed Reza Bagheri
- Department of Neurosurgery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Abdi
- Nursing and Midwifery School, Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran
| | | | - Negin Naghdi
- Clinical Research Development Center, Taleghani and Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sonia V Eden
- Wayne State University School of Medicine, Detroit, MI, USA.
| | - Minoo Arjmand
- Kermanshah University of Medical Sciences, Taleghani Hospital, Kermanshah, Iran
| | - Zahra Amini
- Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran
| | - Michael T Lawton
- Department of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA.
| | - Ehsan Alimohammadi
- Department of Neurosurgery, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Alimohammadi E, Nikzad A, Khedri M, Shafiee S, Miri Jahromi A, Maleki R, Rezaei N. Molecular Tuning of the Nano–Bio Interface: Alpha-Synuclein’s Surface Targeting with Doped Carbon Nanostructures. ACS Appl Bio Mater 2021; 4:6073-6083. [DOI: 10.1021/acsabm.1c00421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Ehsan Alimohammadi
- Department of Neurosurgery, Kermanshah University of Medical Sciences, Imam Reza Hospital, 67158-47141 Kermanshah, Iran
| | - Arash Nikzad
- Department of Mechanical Engineering, University of British Columbia, 2054-6250 Applied
Science Lane, Vancouver, British Columbia V6T1Z4, Canada
| | - Mohammad Khedri
- Computational Biology and Chemistry Group (CBCG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Sepehr Shafiee
- School of Medicine, Shahid Beheshti University of Medical Sciences, 19839-63113 Tehran, Iran
| | - Ahmad Miri Jahromi
- Computational Biology and Chemistry Group (CBCG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Reza Maleki
- Computational Biology and Chemistry Group (CBCG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children’s Medical Center, Tehran University of Medical Sciences, 14167-53955 Tehran, Iran
- Network of Immunity in Infection, Malignancy, and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran 1419733141, Iran
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, 14167-53955 Tehran, Iran
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Alimohammadi E, Ahadi P, Karbasforoushan A, Rahmani S, Bagheri SR, Abdi A. Nontraumatic Nonaneurysmal Subarachnoid Hemorrhage: Risk Factors, Complications, and Clinical Outcomes. Indian Journal of Neurosurgery 2021. [DOI: 10.1055/s-0040-1714302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Abstract
Background The present study aimed to investigate the risk factors, complications, and clinical outcomes of patients with nontraumatic, nonaneurysmal subarachnoid hemorrhage (NNSAH).
Methods We retrospectively evaluated 78 consecutive patients with NNSAH admitted to our center between April 2009 and April 2019. Patients were divided into two groups based on the distribution of blood in the CT scan, perimesencephalic subarachnoid hemorrhage ( PM-SAH) and nonperimesencephalic subarachnoid hemorrhage (nPM-SAH) groups. The outcome was assessed according to the Glasgow outcome scale (GOS). The demographic data and clinical records including age, sex, smoking history, hypertension, diabetes, history of anticoagulant medication, Glasgow coma score (GCS), Hunt–Hess (HH) grades, and in-hospital complications and clinical outcomes were retrospectively reviewed and compared between the two groups.
Results There were 45 patients (57.69%) in the PM-SAH group and 33 cases (42.30%) in the nPM-SAH group with the mean age of 53.98 ± 7.7 years. There were no significant differences between the two groups based on age, sex, smoking history, diabetes, hypertension, anticoagulation medication history, and HH grade at admission. The nPM-SAH group was significantly associated with a higher incidence of radiological and clinical vasospasm (p < 0.05). Moreover, the need for external ventricular drainage (EVD) placement because of the development of hydrocephalus was significantly higher in the nPM group (p < 0.05). Patients with PM-SAH had better clinical outcomes than those with nPM-SAH (p = 0.037).
Conclusions Our results showed that patients with nonaneurysmal subarachnoid hemorrhage (NSAH) had favorable clinical outcomes. The PM group had better clinical outcomes and lower complication rates in comparison with the nPM group. Repeated digital subtraction angiography (DSA) examinations are strongly recommended for patients with nPM-SAH.
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Affiliation(s)
- Ehsan Alimohammadi
- Department of Neurosurgery, Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran
| | - Paniz Ahadi
- Clinical Research Development Center of Taleghani and Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Karbasforoushan
- Department of Anesthesiology, Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran
| | - Shamsoddin Rahmani
- Department of Neurosurgery, Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran
| | - Seyed Reza Bagheri
- Department of Neurosurgery, Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran
| | - Alireza Abdi
- Nursing and Midwifery School, Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran
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Alimohammadi E, Eden SV, Anand SK, Ahadi P, Bostani A, Bagheri SR. The impact of coronavirus 2019 (COVID-19) on neurosurgical practice and training: a review article. Br J Neurosurg 2021; 36:569-573. [PMID: 33612023 DOI: 10.1080/02688697.2021.1888874] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The 2019 coronavirus pandemic (COVID-19) has affected all of society at different levels. Similarly, COVID-19 has significantly impacted every medical field, including neurosurgery. By exposing scarcities in the healthcare industry and requiring the reallocation of available resources towards the priority setting and away from elective surgeries and outpatient visits, the pandemic posed new, unprecedented challenges to the medical community. Despite the redistribution of resources towards COVID-19 patients and away from elective surgeries, urgent and emergent surgeries for life-threatening conditions needed to be continued. The neurosurgical community, like other specialties not directly involved in the care of COVID-19 patients, initially struggled to balance the needs of COVID-19 patients with those of neurosurgical patients, residents, and researchers. Several articles describing the effect of COVID-19 on neurosurgical practice and training have been published throughout the COVID-19 pandemic. This article aims to provide a focused review of the impact COVID-19 has had on neurosurgical practice and training as well as describe neurological manifestations of the disease.
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Affiliation(s)
- Ehsan Alimohammadi
- Neurosurgery, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sonia V Eden
- Wayne State University School of Medicine, Detroit, MI, USA
| | | | - Paniz Ahadi
- Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Arash Bostani
- Neurology, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Seyed Reza Bagheri
- Neurosurgery, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Lawton MT, Alimohammadi E, Bagheri SR, Bostani A, Vaziri S, Karbasforoushan A, Mozaffari K, Bukani MB, Abdi A. Coronavirus disease 2019 (COVID-19) can predispose young to Intracerebral hemorrhage: a retrospective observational study. BMC Neurol 2021; 21:83. [PMID: 33607952 PMCID: PMC7892324 DOI: 10.1186/s12883-021-02109-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 02/10/2021] [Indexed: 12/14/2022] Open
Abstract
Background The respiratory system involvement is the most common presentation of Coronavirus disease 2019 (COVID-19). However, other organs including the central nervous system (CNS) could be affected by the virus. Strokes, seizures, change in mental status, and encephalitis have been reported as the neurological manifestation of the disease. We hypothesized that COVID-19 could predispose younger patients to spontaneous intracerebral hemorrhage (ICH). The present study aimed to investigate whether COVID-19 has any relationship with the occurrence of spontaneous ICH in young or not. Methods We retrospectively evaluated all the patients with spontaneous ICH who were referred to our center between 20 Feb and 1 Sep 2020. The demographic, clinical, radiological, and laboratory test data were evaluated. Patients were divided into two groups. The COVID-19 positive patients and COVID-19 negative ones. All the variables including age, sex, history of hypertension, diabetes mellitus, smoking, Glasgow Coma Scale (GCS), hematoma volume and location, the presence of intraventricular hemorrhage and hydrocephalus on admission, the length of hospital stay, the lab test results and the clinical outcome at last visit or discharge as Glasgow Outcome Scale (GOS) were compared between the two groups. Results There were 22 COVID-19 positive patients (20.8%) and 84 COVID-19 negative ones (79.2%). The mean age of the patients in the case group (54.27 ± 4.67) was significantly lower than that in the control group (69.88 ± 4.47) (p < 0.05). Meanwhile, our results showed a significant difference between the two groups based on the presence of chronic arterial hypertension (p < 0.05). There were no significant differences between the two groups based on gender, diabetes mellitus, smoking, Glasgow Coma Scale (GCS), hematoma volume, need for surgery, the presence of intraventricular hemorrhage and hydrocephalus on admission, White Blood Cell (WBC) count, platelet count, Prothrombin Time (PT), and Partial Thromboplastin Time (PTT) (p > 0.05). Conclusions Our results show that COVID positive patients with ICH are younger and with less predisposing factors than COVID negative subjects with ICH.
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Affiliation(s)
- Michael T Lawton
- Department of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA
| | - Ehsan Alimohammadi
- Department of neurosurgery, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Seyed Reza Bagheri
- Department of neurosurgery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Arash Bostani
- Department of neurology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Siavash Vaziri
- Infectious Disease Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Karbasforoushan
- Department of anesthesiology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Kossar Mozaffari
- Clinical Research Development Center, Imam Reza hospital Kermanshah University of Medical Sciences, Imam Reza hospital, Kermanshah, Iran
| | - Mehran Bahrami Bukani
- Department of neurosurgery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Abdi
- Nursing and midwifery school, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Alimohammadi E, Maleki R, Akbarialiabad H, Dahri M. Novel pH-responsive nanohybrid for simultaneous delivery of doxorubicin and paclitaxel: an in-silico insight. BMC Chem 2021; 15:11. [PMID: 33573669 PMCID: PMC7879683 DOI: 10.1186/s13065-021-00735-4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 01/16/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The distribution of drugs could not be controlled in the conventional delivery systems. This has led to the developing of a specific nanoparticle-based delivery system, called smart drug delivery systems. In cancer therapy, innovative biocompatible nanocarriers have received much attention for various ranges of anti-cancer drugs. In this work, the effect of an interesting and novel copolymer named "dimethyl acrylamide-trimethyl chitosan" was investigated on delivery of paclitaxel and doxorubicin applying carboxylated fullerene nanohybrid. The current study was run via molecular dynamics simulation and quantum calculations based on the acidic pH differences between cancerous microenvironment and normal tissues. Furthermore, hydrogen bonds, radius of gyration, and nanoparticle interaction energies were studied here. Stimulatingly, a simultaneous pH and temperature-responsive system were proposed for paclitaxel and doxorubicin for a co-polymer. A pH-responsive and thermal responsive copolymer were utilized based on trimethyl chitosan and dimethyl acrylamide, respectively. In such a dualistic approach, co-polymer makes an excellent system to possess two simultaneous properties in one bio-polymer. RESULTS The simulation results proposed dramatic and indisputable effects of the copolymer in the release of drugs in cancerous tissues, as well as increased biocompatibility and drug uptake in healthy tissues. Repeated simulations of a similar article performed for the validation test. The results are very close to those of the reference paper. CONCLUSIONS Overall, conjugated modified fullerene and dimethyl acrylamide-trimethyl chitosan (DMAA-TMC) as nanohybrid can be an appropriate proposition for drug loading, drug delivery, and drug release on dual responsive smart drug delivery system.
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Affiliation(s)
- Ehsan Alimohammadi
- Neurosurgery Department, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Reza Maleki
- Computational Biology and Chemistry Group (CBCG), Universal Scientific and Education and Research Network (USERN), Tehran, Iran
| | - Hossein Akbarialiabad
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Dahri
- Computational Biology and Chemistry Group (CBCG), Universal Scientific and Education and Research Network (USERN), Tehran, Iran
- Student Research Committee, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
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Alimohammadi E, Nikzad A, Khedri M, Rezaian M, Jahromi AM, Rezaei N, Maleki R. Potential treatment of Parkinson's disease using new-generation carbon nanotubes: a biomolecular in silico study. Nanomedicine (Lond) 2021; 16:189-204. [PMID: 33502255 DOI: 10.2217/nnm-2020-0372] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 12/16/2022] Open
Abstract
Background: One of the underlying mechanisms of Parkinson's disease is the aggregation of α-synuclein proteins, including amyloids and Lewy bodies in the brain. Aim: To study the inhibitory effect of doped carbon nanotubes (CNTs) on amyloid aggregation. Materials & methods: Molecular dynamics tools were utilized to simulate the influence of CNTs doped with phosphorus, nitrogen and bromine and nitrogen on the formation of α-synuclein amyloid. Results: The CNTs exhibited strong interactions with α-synuclein, with phosphorus-doped CNTs having the most substantial interactions. Conclusion: Doped-CNTs, especially phosphorus-doped carbon nanotube could effectively prevent α-synuclein amyloid formation, thus, it could be considered as a potential treatment for Parkinson's disease. However, further in vitro and clinical investigations are required.
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Affiliation(s)
- Ehsan Alimohammadi
- Neurosurgery Department, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Arash Nikzad
- Department of Mechanical Engineering, University of British Columbia, 2054-6250 Applied Science Lane, Vancouver, BC V6T1Z4, Canada
| | - Mohammad Khedri
- Department of Chemical Engineering, Amirkabir University of Technology (Tehran Polytechnic), 424 Hafez Avenue, Tehran 1591634311, Iran
| | - Milad Rezaian
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran 19839 63113, Iran
| | - Ahmad Miri Jahromi
- Department of Petroleum Engineering, Amirkabir University of Technology (Tehran Polytechnic), 424 Hafez Avenue, Tehran 1591634311, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.,Network of Immunity in Infection, Malignancy & Autoimmunity (NIIMA), Universal Scientific Education & Research Network (USERN), Tehran, Iran.,Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Maleki
- Computational Biology & Chemistry Group (CBCG), Universal Scientific Education & Research Network (USERN), Tehran, Iran
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Alimohammadi E, Sharifi G. A Rare Case of Primary Malignant Melanoma Presenting with Lower Extremity Weakness. Indian Journal of Neurosurgery 2020. [DOI: 10.1055/s-0040-1708081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
AbstractThe authors report a pathologically confirmed case of primary malignant melanoma located in the intradural lumbosacral area, which is extremely rare due to its atypical location and manifestation. However rare, primary malignant melanoma could present as an intradural tumor and cause neurological deficit.
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Affiliation(s)
- Ehsan Alimohammadi
- Department of Neurosurgery, Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran
| | - Guive Sharifi
- Department of Neurosurgery, Shahid Beheshti University of Medical Sciences, Loghman Hakim Hospital, Tehran, Iran
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Alimohammadi E, Bagheri SR, Delfani N, Safari-Faramani R, Janatolmakan M. Pediatric Non–Brain Stem High-Grade Glioma: A Single-Center Experience. Indian Journal of Neurosurgery 2020. [DOI: 10.1055/s-0040-1712067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Abstract
Background Pediatric high-grade gliomas (PHGGs) consist of a heterogeneous class of central nervous system (CNS) neoplasms with a poor prognosis. We aimed to present our 10-year experience in the management of children with high-grade glioma focusing on patients’ survival and related factors.
Methods All pediatric patients with high- grade glioma (HGG) who were admitted to our center between May 2009 and May 2018 were investigated. Overall survival (OS) was calculated from the time of diagnosis until the day of death. The impact of suggested variables on survival was evaluated using the univariate and multivariate analyses.
Results There were 41 children with non–brain stem high-grade glioma (NBSHGG). The mean OS of patients was 21.24 ± 10.16 months. The extent of resection (p = 0.002, hazard ratio [HR] = 4.84), the grade of the tumor (p = 0.017, HR = 4.36), and temozolomide (TMZ) therapy (p = 0.038, HR = 3.57) were the independent predictors of OS in children with NBSHGG. Age, gender, tumor location, and size of tumor were not associated with the survival of these patients.
Conclusion HGGs are uncommon pediatric tumors with an aggressive nature and a poor prognosis. Our results revealed that in NBSHGG cases, children with maximal safe tumor resection and children that received temozolomide therapy as well as children with grade III of the tumor had higher survival.
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Affiliation(s)
- Ehsan Alimohammadi
- Department of Neurosurgery, Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran
| | - Seyed Reza Bagheri
- Department of Neurosurgery, Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran
| | - Nasrin Delfani
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Roya Safari-Faramani
- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Maryam Janatolmakan
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Alimohammadi E, Bagheri SR, Sadeghsalehi A, Rizevandi P, Rezaie Z, Abdi A. Prognostic factors in patients with glioblastoma multiforme: focus on the pathologic variants. Acta Neurol Belg 2020; 120:1341-1350. [PMID: 31222512 DOI: 10.1007/s13760-019-01171-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 04/22/2019] [Accepted: 06/11/2019] [Indexed: 12/16/2022]
Abstract
The aim of this study was to offer predicting factors for survival in adult patients with glioblastoma multiforme. 153 consecutive patients with high-grade glioma (WHO grade IV) were studied in Imam Reza hospital, Kermanshah University of Medical Science, Kermanshah, Iran, between April 2003 and April 2017. All patients treated with surgical resection and standard postoperative radiotherapy (54 Gy). Using the patients' charts and electronic medical records system, the following data were obtained: gender, age, Karnofsky performance status (KPS) score on admission, primary vs. secondary type, extent of surgery, tumor location, tumor size, necrosis size, use of Temozolomide (TMZ), pathology subtype, and immunohistochemistry results. Patients were followed from the time of the surgery until the death occurred. Overall survival (OS) and progression-free survival (PFS) were calculated by the Kaplan-Meier method. Survival time curves for various subgroups were compared by the log-rank test. The impact of the suggested prognostic factors on survival was evaluated by univariate and multivariate analyses. Age, gender, KPS, extent of surgery, tumor location, necrosis size, and reoperation in recurrence had not any statistically significant effect on survival. Univariate analysis revealed a significant impact on outcome for pathology subtype (PFS: P < 0.001, OS: P < 0.001), tumor type (primary vs. secondary) (PFS: P = P < 0.001, OS: P < 0.001), tumor size (PFS: P = 0.044, OS: P = 0.04), TMZ therapy (PFS: P < 0.001, OS: P < 0.001), P53 (PFS: P < 0.001, OS: P < 0.001), and Ki67 (PFS: P < 0.001, OS: P < 0.001). In multivariate analysis, independent favorable prognostic factors for survival were pathology subtype (PFS: P < 0.001, OS: P < 0.001), type (PFS: P < 0.001, OS: 0.012), TMZ (PFS: P < 0.001, OS: P < 0.001), P53 (PFS: P < 0.001, OS: P < 0.001), and Ki67 (PFS: P < 0.001, OS: P < 0.001). The results suggest that pathology subtype, primary vs. secondary type, TMZ therapy, P53, and Ki 63 may play an important role in the survival of patients with glioblastoma multiforme. There is no relationship detected between age, gender, KPS, tumor size and location, necrosis size, extent of surgery, reoperation in recurrence, and patient survival.
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Affiliation(s)
- Ehsan Alimohammadi
- Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Seyed Reza Bagheri
- Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Parisa Rizevandi
- Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Zahra Rezaie
- Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Abdi
- Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Alimohammadi E, Bagheri SR, Sadeghsalehi A, Rizevandi P, Rezaie Z, Abdi A. Correction to: Prognostic factors in patients with glioblastoma multiforme: focus on the pathologic variants. Acta Neurol Belg 2020; 120:1497. [PMID: 31313265 DOI: 10.1007/s13760-019-01190-8] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Unfortunately, the third author name was incorrectly published in the original publication. The complete correct name should read as follows.
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Affiliation(s)
- Ehsan Alimohammadi
- Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Seyed Reza Bagheri
- Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Parisa Rizevandi
- Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Zahra Rezaie
- Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Abdi
- Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Alimohammadi E, Bagheri SR, Ahadi P, Cheshmehkaboodi S, Hadidi H, Maleki S, Abdi A. Predictors of the failure of conservative treatment in patients with a thoracolumbar burst fracture. J Orthop Surg Res 2020; 15:514. [PMID: 33168095 PMCID: PMC7654172 DOI: 10.1186/s13018-020-02044-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 10/28/2020] [Indexed: 12/27/2022] Open
Abstract
Background There is a controversy about the management of patients with a thoracolumbar burst fracture. Despite the success of the conservative treatment in most of the cases, some patients failed the conservative treatment. The present study aimed to evaluate risk factors for the need for surgery during the follow-up period in these patients. Methods We retrospectively evaluated 67 patients with a traumatic thoracolumbar burst fracture who managed conservatively at our center between May 2014 and May 2019. Suggested variables as potential risk factors for the failure of conservative treatment including age, gender, body mass index (BMI), smoking, diabetes, vertebral body compression rate (VBCR), percentage of anterior height compression (PAHC), Cobb angle, interpedicular distance (IPD), canal compromise, and pain intensity as visual analog scale (VAS) were compared between patients with successful conservative treatment and those with failure of non-operative management. Results There were 41 males (61.2%) and 26 females (38.8%) with the mean follow-up time of 15.52 ± 5.30 months. Overall, 51 patients (76.1%) successfully completed conservative treatment. However, 16 cases (23.9%) failed the non-operative management. According to the binary logistic regression analysis, only age (risk ratio [RR], 2.21; 95% confidence interval [95%], 1.78–2.64; P = 0.019) and IPD (RR 1.97; 95% CI 1.61–2.33; P = 0.005) were the independent risk factors for the failure of the non-operative management. Conclusions Our results showed that older patients and those with greater interpedicular distance are at a higher risk for failure of the conservative treatment. As a result, a closer follow-up should be considered for them.
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Affiliation(s)
- Ehsan Alimohammadi
- Department of Neurosurgery, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Seyed Reza Bagheri
- Department of Neurosurgery, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Paniz Ahadi
- Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran
| | | | - Homa Hadidi
- Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran
| | - Shokofeh Maleki
- Clinical Research Development Center, Taleghani and Imam Ali Hospitals, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Abdi
- Nursing and Midwifery School, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Alimohammadi E, Ahadi P, Rezaee C, Safari-Faramani R, Bagheri SR, Janatolmakan M. Acute traumatic quadriplegia: Predictors of in-hospital and six-month mortality. Trauma 2020. [DOI: 10.1177/1460408620909005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Traumatic spinal cord injury is one of the most disastrous and devastating health burdens all over the world with a high mortality rate. The present study aimed to evaluate the predictors of in-hospital and six-month mortality in these patients. Methods The electronic medical records of 87 consecutive patients with acute complete traumatic quadriplegia were reviewed to extract clinical, radiological, and laboratory data. Simple and multiple logistic regression models were used to estimate crude and adjusted odds with 95% confidence interval (CI) ratios for the predictors of in-hospital mortality and six-month mortality. Results There were 48 males and the mean age was 38.67 ± 12.81; in-hospital and six-month mortality were 21.84% and 11.76%, respectively. Traffic road accidents (67.8%) and falls (12.6%) were the most common causes of injury. The univariate analysis demonstrated advanced age, level of injury, late surgery or no surgical intervention, the lack of methylprednisolone therapy, a higher Charlson comorbidity index, the Injury Severity Score, and the presence of respiratory failure or bradycardia on admission were predictors of in-hospital mortality ( p < 0.05). In the final multiple logistic regression model, the level of injury (OR = 0.02 (0.001,0.35), p = 0.008) and the presence of respiratory failure (OR = 2.37 (0.03,13.88), p = 0.024) were the only predictors of in-hospital mortality. The univariate model showed that the level of injury, respiratory failure on admission, and the Injury Severity Score were the predictors of six-month mortality; however, the level of injury was the only predictor of the six-month mortality (OR = 1.12 (0.99, 1.27), p = 0.028) according to the multiple logistic regression model. Conclusions Several factors could affect in-hospital and six-month mortality in patients with traumatic spinal cord injury. Our findings demonstrated the level of injury and respiratory failure on admission as independent predictors of in-hospital mortality in these patients. Furthermore, the level of injury was the only independent predictor of six-month mortality in the present study.
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Affiliation(s)
- Ehsan Alimohammadi
- Department of Neurosurgery Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran
| | - Paniz Ahadi
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Cyrous Rezaee
- Kermanshah University of Medical Sciences, Taleghani Hospital, Kermanshah, Iran
| | - Roya Safari-Faramani
- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Seyed Reza Bagheri
- Department of Neurosurgery Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran
| | - Maryam Janatolmakan
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Alimohammadi E, Khedri M, Miri Jahromi A, Maleki R, Rezaian M. Graphene-Based Nanoparticles as Potential Treatment Options for Parkinson's Disease: A Molecular Dynamics Study. Int J Nanomedicine 2020; 15:6887-6903. [PMID: 32982240 PMCID: PMC7509323 DOI: 10.2147/ijn.s265140] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 09/08/2020] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION The study of abnormal aggregation of proteins in different tissues of the body has recently earned great attention from researchers in various fields of science. Concerning neurological diseases, for instance, the accumulation of amyloid fibrils can contribute to Parkinson's disease, a progressively severe neurodegenerative disorder. The most prominent features of this disease are the degeneration of neurons in the substantia nigra and accumulation of α-synuclein aggregates, especially in the brainstem, spinal cord, and cortical areas. Dopamine replacement therapies and other medications have reduced motor impairment and had positive consequences on patients' quality of life. However, if these medications are stopped, symptoms of the disease will recur even more severely. Therefore, the improvement of therapies targeting more basic mechanisms like prevention of amyloid formation seems to be critical. It has been shown that the interactions between monolayers like graphene and amyloids could prevent their fibrillation. METHODS For the first time, the impact of four types of last-generation graphene-based nanostructures on the prevention of α-synuclein amyloid fibrillation was investigated in this study by using molecular dynamics simulation tools. RESULTS Although all monolayers were shown to prevent amyloid fibrillation, nitrogen-doped graphene (N-Graphene) caused the most instability in the secondary structure of α-synuclein amyloids. Moreover, among the four monolayers, N-Graphene was shown to present the highest absolute value of interaction energy, the lowest contact level of amyloid particles, the highest number of hydrogen bonds between water and amyloid molecules, the highest instability caused in α-synuclein particles, and the most significant decrease in the compactness of α-synuclein protein. DISCUSSION Ultimately, it was concluded that N-Graphene could be the most effective monolayer to disrupt amyloid fibrillation, and consequently, prevent the progression of Parkinson's disease.
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Affiliation(s)
- Ehsan Alimohammadi
- Neurosurgery Department, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Khedri
- Department of Chemical Engineering, Amirkabir University of Technology (Tehran Polytechnic), Tehran1591634311, Iran
| | - Ahmad Miri Jahromi
- Department of Petroleum Engineering, Amirkabir University of Technology (Tehran Polytechnic), Tehran1591634311, Iran
| | - Reza Maleki
- Department of Chemical Engineering, Sharif University of Technology, Tehran, Iran
| | - Milad Rezaian
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran19839-63113, Iran
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Alimohammadi E, Bagheri SR, Hadidi H, Habibi S, Amiri A, Moradi S, Abdi A. Factors Associated with the Need for Ventriculoperitoneal Shunting in Patients with Spontaneous Intracerebral Hemorrhage Requiring Emergency Cerebrospinal Fluid Diversion. Indian Journal of Neurosurgery 2020. [DOI: 10.1055/s-0040-1710149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Abstract
Introduction Intracerebral hemorrhage (ICH) is a serious medical condition that is frequently complicated by acute hydrocephalus, necessitating emergency cerebrospinal fluid (CSF) diversion in a subset of patients, ultimately requiring long-term treatment via placement of permanent ventricular shunts. The present study aimed to determine factors associated with the need for permanent ventricular shunt placement in these patients.
Methods A total of 309 consecutive patients who underwent emergent CSF diversion with external ventricular drain (EVD) as a treatment for ICH between July 2009 and July 2018 were studied retrospectively to assess the factors that might be correlated with shunt-dependent chronic hydrocephalus. A binary logistic regression model was designed to identify independent related factors of shunt-dependent hydrocephalus after ICH.
Results Of 309 patients included in this study, 102 (33.00%) required permanent ventricular CSF shunting before discharge. In univariate analysis, age,ventriculitis, ICP elevation >30 mm Hg, ICH evacuation, the Graeb score, days of EVD in place, and CSF protein levels were significantly associated with the requirement for permanent CSF diversion (p < 0.05). The age and ICH evacuation were protective variables and the ventriculoperitoneal (VP) shunt possibility was reduced by 22.6 and 63.5%, respectively.
Conclusion Our results showed that higher Graeb score, ICP elevation >30 mm Hg, more days of EVD in place, and higher CSF protein levels were associated with permanent CSF diversion in these patients. Advanced age and ICH evacuation decreased the possibility of VP shunting in our study.These factors may help in predicting which patients will need permanent CSF diversion and could ultimately lead to improvements in the management of these patients.
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Affiliation(s)
- Ehsan Alimohammadi
- Department of Neurosurgery, Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran
| | - Seyed Reza Bagheri
- Department of Neurosurgery, Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran
| | - Homa Hadidi
- Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran
| | - Shabnam Habibi
- Clinical Research Development Center, Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Islamic Republic of Iran
| | - Akram Amiri
- Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran
| | - Sahar Moradi
- Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran
| | - Alireza Abdi
- Department of Nursing, Kermanshah University of Medical Sciences, Imam Reza Hospital, Kermanshah, Iran
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Bagheri SR, Alimohammadi E, Zamani Froushani A, Abdi A. Adjacent segment disease after posterior lumbar instrumentation surgery for degenerative disease: Incidence and risk factors. J Orthop Surg (Hong Kong) 2020; 27:2309499019842378. [PMID: 31046589 DOI: 10.1177/2309499019842378] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [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: 11/15/2022] Open
Abstract
PURPOSE To identify risk factors for occurrence of symptomatic adjacent segment disease (ASD) after posterior lumbar instrumentation surgery. METHODS This retrospective study evaluated 630 patients who underwent posterior lumbar transpedicular instrumentation for degenerative lumbar disorders between April 2008 and April 2012. On the basis of developing ASD at follow-up, patients were categorized into two groups: the ASD group and the non-ASD (N-ASD) group. These two groups were compared for patient characteristics, surgical variables, and radiographic parameters to investigate the possible predictive factors of ASD. RESULTS Of the 630 individuals participated in the study, 76 (12.1%) patients had ASD. Mean and standard deviation of age were 61.37 ± 4.12 years for the ASD group and 62.37 ± 3.9 for the N-ASD group ( p = 0.79). The average follow-up period was 51 ± 2.2 months in the ASD group and 52 ± 2.3 months in the N-ASD group ( p = 0.691). There were no significant differences between the two groups in terms of gender, diabetes mellitus (DM), hypertension, smoking, and osteoporosis, with all p > 0.05. The logistic regression analysis demonstrated that higher preoperative body mass index (BMI; odds ratio (OR) 1.233, p = 0.005), preoperative disc degeneration (OR 1.033, p = 0.024), decreased postoperative lumbar lordosis (OR 3.080, p = 0.011), fusion at more than four levels (OR 4.280, p = 0.014), and intraoperative superior facet joint violation (OR 7.480, p = 0.009) were independently associated with ASD. CONCLUSIONS Patients with higher preoperative BMI, preoperative disc degeneration, decreased postoperative lumbar lordosis, fusion at more than four levels, and intraoperative superior facet joint violation have a statistically significant increased risk of developing ASD.
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Affiliation(s)
- Seyed Reza Bagheri
- 1 Department of Neurosurgery, Kermanshah University of Medical Science, Kermanshah, Iran
| | - Ehsan Alimohammadi
- 2 Department of Neurosurgery, Shahid Beheshti University of Medical Science, Tehran, Iran
| | | | - Alireza Abdi
- 1 Department of Neurosurgery, Kermanshah University of Medical Science, Kermanshah, Iran
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Alimohammadi E, Bagheri SR, Taheri S, Dayani M, Abdi A. The impact of extended adjuvant temozolomide in newly diagnosed glioblastoma multiforme: a meta-analysis and systematic review. Oncol Rev 2020; 14:461. [PMID: 32153727 PMCID: PMC7036706 DOI: 10.4081/oncol.2020.461] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Accepted: 01/02/2020] [Indexed: 12/28/2022] Open
Abstract
Surgical resection followed by concurrent radiation therapy and temozolomide (TMZ) chemotherapy is the current standard treatment for glioblastoma multiforme (GBM). The present metaanalysis investigated the impact of prolonged TMZ maintenance therapy (more than 6 cycles) in comparison with standard TMZ maintenance therapy (exactly six cycles) on overall survival (OS) and progression-free survival (PFS) of patients with GBM. A meta-analysis of the literature was conducted using Medline, PubMed, EMBASE and the Cochrane Library in accordance with PRISMA guidelines. Seven articles involving 1018 patients were included. The overall survival was higher in the case group (>6 cycles TMZ) compared to the control group (6 cycles TMZ) (Z=2.375, P=0.018). The lower and upper limits were between 1.002-10.467 months. The case group had higher progression-free survival compared with the control group (Z=3.84; P<0.001). The lower and upper limits were between 2.559-7.894 months. Evidence from this meta-analysis suggests that prolonged TMZ therapy compared to the standard 6-cycle TMZ therapy was associated with higher survival in patients with glioblastoma.
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Affiliation(s)
| | | | | | | | - Alireza Abdi
- Nursing and Midwifery School, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Alimohammadi E, Bagheri SR, Hadidi H, Rizevandi P, Abdi A. Carpal tunnel surgery: predictors of clinical outcomes and patients' satisfaction. BMC Musculoskelet Disord 2020; 21:51. [PMID: 31992298 PMCID: PMC6988299 DOI: 10.1186/s12891-020-3082-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 01/20/2020] [Indexed: 12/31/2022] Open
Abstract
Background Carpal tunnel syndrome (CTS) is the most common peripheral neuropathy. Moreover, carpal tunnel release (CTR) surgery generally has excellent results. The present study aimed to investigate the predictors of clinical outcomes and satisfaction in patients with CTR. Methods In this observational prospective cohort study, 152 patients with open carpal tunnel release surgery were investigated. Complete clinical examinations were performed and recorded before the surgery, two weeks after the surgery and 6 months after the surgery. The Boston Carpal Tunnel Questionnaire (BCTQ) were assessed on admission and at last follow-up visits to evaluate clinical outcomes. Patients’ satisfaction was determined by a 10-point verbal descriptor nominal scale (1 = very poor, 5 = fair and 10 = excellent) and recorded during the last follow -up visits. Results Among 152 patients who were investigated, there were 118 (77.6%) females and 34 (22.36%) males. Overall, surgery improved the outcomes based on Symptom Severity Scale (SSS) and Functional Status Scale (FSS) (P < 0.05). Most of the considered variables did not show significant effects on clinical outcomes and patients’ satisfaction. However, duration of symptoms and electrophysiological severity were the predictors of the change score in SSS(P < 0.05). As well as, age was the only predictor of the change score in FSS (P < 0.05). Finally, according to the linear regression model, the pre-operative grip strength and age were the independent predictors of post-operative satisfaction (P < 0.05). Conclusions Results of the present study revealed that there was a significant improvement in clinical outcomes after CTS surgery. Stronger pre-operative grip strength and younger age were independent predictors of higher post-operative satisfaction. These results can be used in pre-operative counseling and management of post-operative expectations.
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Affiliation(s)
- Ehsan Alimohammadi
- Department of Neurosurgery, Kermanshah University of Medical Sciences, Imam Reza hospital, Kermanshah, Iran.
| | - Seyed Reza Bagheri
- Department of Neurosurgery, University of Medical Sciences, Imam Reza hospital, Kermanshah, Iran
| | - Homa Hadidi
- Clinical Research Development Center, Taleghani and Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Parisa Rizevandi
- operating room department, Kermanshah University of Medical Sciences, Imam Reza hospital, Kermanshah, Iran
| | - Alireza Abdi
- nursing and midwifery school, Kermanshah University of Medical Sciences, Imam Reza hospital, Kermanshah, Iran
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