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Evaluation of Met and Unmet Needs in Patients with Severe Psychiatric Disorders and its Relation to the Quality of Life: A Cross-Sectional Study. Med J Islam Repub Iran 2024; 38:10. [PMID: 38586497 PMCID: PMC10999011 DOI: 10.47176/mjiri.38.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Indexed: 04/09/2024] Open
Abstract
Background Paying attention to the needs of patients with psychiatric disorders has recently come into focus. Failure to meet the needs of patients can affect their quality of life. This study aimed to determine the main areas of the needs of patients with severe psychiatric disorders and evaluate their relationship with the quality of life. Methods In this cross-sectional study, 174 patients with severe mental illness who were referred to Iran Psychiatric Hospital for hospitalization or outpatient treatment were enrolled in this study (68 with schizophrenia and schizoaffective disorder, 106 with bipolar disorder type 1). A qualified psychiatry resident conducted interviews with each patient to determine their needs using the Camberwell Assessment of Need Short Appraisal Schedule (CANSAS) and the severity of their illness using the Hamilton Depression Rating Scale (HAM-D), Positive and Negative Syndrome Scale (PANSS), and Young Mania Rating Scale. A checklist for demographic data and the World Health Organization Quality of Life Brief Version (WHOQOL-BREF) questionnaire was completed by patients. Data were analyzed using descriptive statistics. Since the number of needs distribution was not normal, we used the Mann-Whitney, Kruskal-Wallis, and chi-square tests for qualitative variables. Results The total number of patient needs was 9 (mean = 9.1, SD = 3.7). The most unmet needs were intimate relationships (69.5%), sexual expression (65.5%), and information on condition and treatment (51.1%). Unmet needs showed a negative correlation with the quality of life (P < 0.001) and a positive correlation with the severity of depression (P = 0.045), negative symptoms (P = 0.001), and general psychopathology (P < 0.001). Conclusion A higher number of unmet needs of severe psychiatric patients is associated with lower quality of life and more severe disorders.
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Effects of bariatric surgery on cognitive function in older adults: a prospective longitudinal study. Surg Obes Relat Dis 2023; 19:1264-1269. [PMID: 37253649 DOI: 10.1016/j.soard.2023.04.336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 03/17/2023] [Accepted: 04/23/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND Obesity is now well-recognized as an independent risk factor for cognitive decline. Although extensive research has been conducted on cognitive outcomes following bariatric surgery in young adults, very little is known about the impact of advanced age on the cognitive benefits of weight-loss procedures. OBJECTIVES This study aimed to assess cognitive function in older Iranian patients before and after bariatric surgery. SETTING University Hospital METHODS: In this prospective longitudinal study, 24 older adults were examined before and 4 months after bariatric surgery using the Digit Span Test (DGS), the computerized version of the Wisconsin Card Sorting Test-64 (WCST-64), and the paper-and-pencil versions of the Trail Making Test (TMT), parts A and B, spanning the 4 cognitive domains of attention, working memory, processing speed, and executive functioning. The bariatric surgery group was simultaneously compared to a waiting list control group. RESULTS At 4 months of follow-up, comparisons between the groups revealed that the surgical group performed significantly better than the control group on the forward DGS, WCST, and TMT parts A and B. In contrast, there was no significant difference between groups on the backward DGS. Further within-group comparisons demonstrated significant improvements from baseline in forward DGS, WCST, and TMT components A and B. Nevertheless, the same variables did not alter significantly over time in the control group. CONCLUSIONS The study suggests measurable cognitive benefits following bariatric surgery in older adults.
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Evaluating the association of vitamin D3, parathyroid hormone, and C-reactive protein serum levels in patients with an acute psychotic episode: a cross-sectional study in tertiary centre in Iran. BMC Psychiatry 2023; 23:724. [PMID: 37803327 PMCID: PMC10557165 DOI: 10.1186/s12888-023-05234-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 09/29/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND The high impact of vitamin D on brain development and its relationship with inflammatory markers in the clinical course of psychiatric disorders have compelled researchers to investigate the potential association between vitamin D levels, C-reactive protein (CRP) levels, and the incidence of mental disorders. In the present study, we aimed to compare the serum levels of vitamin D and its related markers, including calcium, phosphorus, and parathyroid hormone (PTH), along with CRP, in 3 groups of patients with acute psychotic episodes, including schizophrenia, bipolar disorder, and methamphetamine-induced psychosis, with a standard control group of the Iranian population. METHODS This descriptive cross-sectional study was conducted at a psychiatric hospital in Tehran, Iran, and involved a total of 185 subjects. The subjects included four groups: acute phase of schizophrenia (n = 49), acute manic episodes of bipolar disorder (n = 43), methamphetamine-induced psychotic disorder (n = 46), and control group (n = 47). Among 138 patients in acute psychotic episodes, 33 patients were in their first episode of psychosis, while 105 patients were in acute exacerbation of their chronic psychotic disorders. The Brief Psychiatric Rating Scale (BPRS) was measured by an expert attending psychiatrist for all patients. Then, serum levels of calcium, phosphorus, parathormone, vitamin D, and CRP were assessed in all study groups. RESULTS Among our 185 study subjects, it was observed that individuals with higher education levels and those who were married had a lower prevalence of mental disorders. In all patient groups, the serum levels of CRP were significantly higher, and PTH levels were significantly lower than in the control group (p < 0.001). The serum levels of calcium, phosphorus, and vitamin D were not statistically significantly different between the patient and control groups of the study. In chronic psychotic patients, CRP levels were significantly higher (p < 0.031), and vitamin D levels were significantly lower (p < 0.044) compared to first-episode psychotic patients. CONCLUSION This study suggests that CRP levels are significantly higher and PHT level is significantly lower in acute psychotic patients. Moreover, vitamin D levels were significantly lower in chronic psychotic patients compared to first-episode psychotic patients.
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First-episode mania after COVID-19: A case series in Iran. Front Psychiatry 2023; 14:1102450. [PMID: 37113541 PMCID: PMC10129056 DOI: 10.3389/fpsyt.2023.1102450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 02/06/2023] [Indexed: 04/29/2023] Open
Abstract
Background Increasing reports of manic episodes in patients during acute infection with COVID-19 have been documented since the pandemic began, including individuals without a previous personal or family history of bipolar disorder. As infections and autoimmunity have putative roles in bipolar disorder, we aimed to document the clinical presentations, associated stressors, family aggregation patterns, and brain imaging and electroencephalographic correlates with a series of patients with episodes of mania that emerged shortly after COVID-19 infections. Methods We obtained all relevant clinical information from 12 patients whose first manic episode started within a month of COVID-19 infection and were treated at Rasool-e-Akram hospital and Iran psychiatric hospital, two tertiary medical centers in Tehran, Iran, in 2021. Results Patients had a mean age of 44. The interval between the onset of symptoms of COVID and mania ranged between 0 and 28 days (mean: 16.25, median: 14 days); it was observed to be shorter in patients with a family history of mood disorders but not in those receiving corticosteroids. Alongside a descriptive overview of our sample, we provide detailed narrative descriptions of two of the cases for illustrative purposes and discuss our observations in the context of other cases reported elsewhere and the state-of-the-art regarding infectious diseases, COVID-19, and bipolar disorder as reported in previous literature. Conclusion Our case series documents observational and naturalistic evidence from a dozen of cases of mania in the context of acute COVID-19, which, while limited, calls for analytical research of the phenomenon, and points at a family history of bipolar disorder and the use of corticosteroids as factors for particular focus.
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Comparison the effects of gabapentin and oxazepam on sleep quality, anxiety, and pain in unstable angina patients admitted to coronary care unit of Hazrat Rasool Akram Hospital. Adv Biomed Res 2022; 11:57. [PMID: 36124023 PMCID: PMC9482373 DOI: 10.4103/abr.abr_154_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 03/15/2021] [Accepted: 09/22/2021] [Indexed: 11/04/2022] Open
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Verbal Fluency Performance in Normal Adult Population in Iran: Norms and Effects of Age, Education, and Gender. Basic Clin Neurosci 2022; 13:129-138. [PMID: 36589021 PMCID: PMC9790095 DOI: 10.32598/bcn.2021.363.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 03/05/2020] [Accepted: 08/24/2020] [Indexed: 02/01/2023] Open
Abstract
Introduction Verbal fluency is a cognitive function that can be easily assessed at the bedside and provide valuable data for clinical assessment of various cognitive functions. We decided to provide a standardized test to assess verbal fluency in the Persian language, including both phonemic and semantic fluency subtests. Methods First, three phonemes (/p/, /d/, and /ʃ/) and three categories (animals, fruits, and kitchen appliances) were selected based on a pilot study and a panel of specialists. Then, we selected 500 Persian-speaking participants (47.8% male) aged 18 to 65 years via a convenient sampling method from the general population. Participants were grouped according to age, gender, and education. They performed the verbal fluency test. Results The Mean±SD number of generated words in letter fluency and semantic fluency was 8.3±4.1 and 18.0±5.5, respectively. Age, educational level, and mother tongue were associated with letter fluency. Semantic fluency was associated with age, gender, education level, and mother tongue. Conclusion For a more reliable clinical assessment, we suggest using all three letters (phonemes) and three semantic categories for each subject, calculating the mean of the produced words, and comparing them with the suggested cut-off points provided for each subcategory. Age was negatively correlated with the number of generated words in letter fluency (r=-0.33; P<0.001) and semantic fluency tasks (r=-0.26; P<0.001). In the letter fluency task, there was no statistically significant difference between males and females according to the number of generated words (P=0.057). However, in semantic fluency, female participants generated more words (P=0.005). Mother tongue (Farsi) showed a significant effect both on letter fluency (t=5.55, P<0.001) and semantic fluency (t=9.41, P<0.001). Level of education had a significant association with both letter fluency (F=117.23, P<0.001) and semantic fluency (F=64.48, P<0.001). Highlights The study subjects generated 8.3±4.1 words in one minute in the letter fluency test.Letter fluency was associated with educational level and mother tongue.The Mean±SD number of generated words in semantic fluency (18±5.5) was higher than letter fluency.Semantic fluency was associated with age, gender, education level, and mother tongue. Plain Language Summary Practitioners use neuropsychological tests to diagnose mental problems. Verbal fluency is a test in which participants have to generate as many words as possible from a specified category in a given time. This category can be phonemic (letter), which means words beginning with a specified letter or semantic, including objects such as animals or fruits. The number of words produced by participants is essential, and if it is fewer than normal, it shows psychological or neurological conditions such as Alzheimer disease. The norms are variable in different languages, cultures, and educational levels. We found that the Mean±SD numbers of generated words in letter fluency and semantic fluency were 8.3±4.1 and 18.0±5.5, respectively. These values can be used for neuropsychological testing in the Iranian population.
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2021 Canadian Surgery Forum01. Design and validation of a unique endoscopy simulator using a commercial video game03. Is ethnicity an appropriate measure of health care marginalization?: A systematic review and meta-analysis of the outcomes of diabetic foot ulceration in the Aboriginal population04. Racial disparities in surgery — a cross-specialty matched comparison between black and white patients05. Starting late does not increase the risk of postoperative complications in patients undergoing common general surgical procedures06. Ethical decision-making during a health care crisis: a resource allocation framework and tool07. Ensuring stability in surgical training program leadership: a survey of program directors08. Introducing oncoplastic breast surgery in a community hospital09. Leadership development programs for surgical residents: a review of the literature10. Superiority of non-opioid postoperative pain management after thyroid and parathyroid operations: a systematic review and meta-analysis11. Timing of ERCP relative to cholecystectomy in patients with ductal gallstone disease12. A systematic review and meta-analysis of randomized controlled trials comparing intraoperative red blood cell transfusion strategies13. Postoperative outcomes after frail elderly preoperative assessment clinic: a single-institution Canadian perspective14. Selective opioid antagonists following bowel resection for prevention of postoperative ileus: a systematic review and meta-analysis15. Peer-to-peer coaching after bile duct injury16. Laparoscopic median arcuate ligament release: a video abstract17. Retroperitoneoscopic approach to adrenalectomy19. Endoscopic Zenker diverticulotomy: a video abstract20. Variability in surgeons’ perioperative management of pheochromocytomas in Canada21. The contribution of surgeon and hospital variation in transfusion practice to outcomes for patients undergoing elective gastrointestinal cancer surgery: a population-based analysis22. Perioperative transfusions for gastroesophageal cancers: risk factors and short- and long-term outcomes23. The association between frailty and time alive and at home after cancer surgery among older adults: a population-based analysis24. Psychological and workplace-related effects of providing surgical care during the COVID-19 pandemic in British Columbia, Canada25. Safety of venous thromboembolism prophylaxis in endoscopic retrograde cholangiopancreatography: a systematic review26. Complications and reintervention following laparoscopic subtotal cholecystectomy: a systematic review and meta-analysis27. Synchronization of pupil dilations correlates with team performance in a simulated laparoscopic team coordination task28. Receptivity to and desired design features of a surgical peer coaching program: an international survey9. Impact of the COVID-19 pandemic on rates of emergency department utilization due to general surgery conditions30. The impact of the current COVID-19 pandemic on the exposure of general surgery trainees to operative procedures31. Association between academic degrees and research productivity: an assessment of academic general surgeons in Canada32. Laparoscopic endoscopic cooperative surgery (LECS) for subepithelial gastric lesion: a video presentation33. Effect of the COVID-19 pandemic on acute care general surgery at an academic Canadian centre34. Opioid-free analgesia after outpatient general surgery: a pilot randomized controlled trial35. Impact of neoadjuvant immunotherapy or targeted therapies on surgical resection in patients with solid tumours: a systematic review and meta-analysis37. Surgical data recording in the operating room: a systematic review of modalities and metrics38. Association between nonaccidental trauma and neighbourhood socioeconomic status during the COVID-19 pandemic: a retrospective analysis39. Laparoscopic repair of a transdiaphragmatic gastropleural fistula40. Video-based interviewing in medicine: a scoping review41. Indocyanine green fluorescence angiography for prevention of anastomotic leakage in colorectal surgery: a cost analysis from the hospital payer’s perspective43. Perception or reality: surgical resident and faculty assessments of resident workload compared with objective data45. When illness and loss hit close to home: Do health care providers learn how to cope?46. Remote video-based suturing education with smartphones (REVISE): a randomized controlled trial47. The evolving use of robotic surgery: a population-based analysis48. Prophylactic retromuscular mesh placement for parastomal hernia prevention: a retrospective cohort study of permanent colostomies and ileostomies49. Intracorporeal versus extracorporeal anastomosis in laparoscopic right hemicolectomy: a retrospective cohort study on anastomotic complications50. A lay of the land — a description of Canadian academic acute care surgery models51. Emergency general surgery in Ontario: interhospital variability in structures, processes and models of care52. Trauma 101: a virtual case-based trauma conference as an adjunct to medical education53. Assessment of the National Surgical Quality Improvement Program Surgical Risk Calculator for predicting patient-centred outcomes of emergency general surgery patients in a Canadian health care system54. Sustainability of a narcotic reduction initiative: 1 year following the Standardization of Outpatient Procedure (STOP) Narcotics Study55. Barriers to transanal endoscopic microsurgery referral56. Geospatial analysis of severely injured rural patients in a geographically complex landscape57. Implementation of an incentive spirometry protocol in a trauma ward: a single-centre pilot study58. Impostor phenomenon is a significant risk factor for burnout and anxiety in Canadian resident physicians: a cross-sectional survey59. Understanding the influence of perioperative education on performance among surgical trainees: a single-centre experience60. The effect of COVID-19 pandemic on current and future endoscopic personal protective equipment practices: a national survey of 77 endoscopists61. Case report: delayed presentation of perforated sigmoid diverticulitis as necrotizing infection of the lower limb62. Investigating disparities in surgical outcomes in Canadian Indigenous populations63. Fundoplication is superior to medical therapy for Barrett esophagus disease regression and progression: a systematic review and meta-analysis64. Development of a novel online general surgery learning platform and a qualitative preimplementation analysis65. Hagfish slime exudate as a potential novel hemostatic agent: developing a standardized assessment protocol66. The effect of the first wave of the COVID-19 pandemic on surgical oncology case volumes and wait times67. Safety of same-day discharge in high-risk patients undergoing ambulatory general surgery68. External validation of the Codman score in colorectal surgery: a pragmatic tool to drive quality improvement69. Improved morbidity and gastrointestinal restoration rates without compromising survival rates for diverting loop ileostomy with colonic lavage versus total abdominal colectomy for fulminant Clostridioides difficile colitis: a multicentre retrospective cohort study70. Potential access to emergency general surgical care in Ontario71. Immersive virtual reality (iVR) improves procedural duration, task completion and accuracy in surgical trainees: a systematic review01. Clinical validation of the Canada Lymph Node Score for endobronchial ultrasound02. Venous thromboembolism in surgically treated esophageal cancer patients: a provincial population-based study03. Venous thromboembolism in surgically treated lung cancer patients: a population-based study04. Is frailty associated with failure to rescue after esophagectomy? A multi-institutional comparative analysis of outcomes05. Routine systematic sampling versus targeted sampling of lymph nodes during endobronchial ultrasound: a feasibility randomized controlled trial06. Gastric ischemic conditioning reduces anastomotic complications in patients undergoing esophagectomy: a systematic review and meta-analysis07. Move For Surgery, a novel preconditioning program to optimize health before thoracic surgery: a randomized controlled trial08. In case of emergency, go to your nearest emergency department — Or maybe not?09. Does preoperative SABR increase the risk of complications from lung cancer resection? A secondary analysis of the MISSILE trial10. Segmental resection for lung cancer: the added value of near-infrared fluorescence mapping diminishes with surgeon experience11. Toward competency-based continuing professional development for practising surgeons12. Stereotactic body radiotherapy versus surgery in older adults with NSCLC — a population-based, matched analysis of long-term dependency outcomes13. Role of adjuvant therapy in esophageal cancer patients after neoadjuvant therapy and curative esophagectomy: a systematic review and meta-analysis14. Evaluation of population characteristics on the incidence of thoracic empyema: an ecological study15. Determining the optimal stiffness colour threshold and stiffness area ratio cut-off for mediastinal lymph node staging using EBUS elastography and AI: a pilot study16. Quality assurance on the use of sequential compression stockings in thoracic surgery (QUESTs)17. The relationship between fissureless technique and prolonged air leak for patients undergoing video-assisted thoracoscopic lobectomy18. CXCR2 inhibition as a candidate for immunomodulation in the treatment of K-RAS-driven lung adenocarcinoma19. Assessment tools for evaluating competency in video-assisted thoracoscopic lobectomy: a systematic review20. Understanding the current practice on chest tube management following lung resection among thoracic surgeons across Canada21. Effect of routine jejunostomy tube insertion in esophagectomy: a systematic review and meta-analysis22. Recurrence of primary spontaneous pneumothorax following bullectomy with pleurodesis or pleurectomy: a retrospective analysis23. Surgical outcomes following chest wall resection and reconstruction24. Outcomes following surgical management of primary mediastinal nonseminomatous germ cell tumours25. Does robotic approach offer better nodal staging than thoracoscopic approach in anatomical resection for non–small cell lung cancer? A single-centre propensity matching analysis26. Competency assessment for mediastinal mass resection and thymectomy: design and Delphi process27. The contemporary significance of venous thromboembolism (deep venous thrombosis [DVT] and pulmonary embolus [PE]) in patients undergoing esophagectomy: a prospective, multicentre cohort study to evaluate the incidence and clinical outcomes of VTE after major esophageal resections28. Esophageal cancer: symptom severity at the end of life29. The impact of pulmonary artery reconstruction on postoperative and oncologic outcomes: a systematic review30. Association with surgical technique and recurrence after laparoscopic repair of paraesophageal hernia: a single-centre experience31. Enhanced recovery after surgery (ERAS) in esophagectomy32. Surgical treatment of esophageal cancer: trends in surgical approach and early mortality at a single institution over the past 18 years34. Adverse events and length of stay following minimally invasive surgery in paraesophageal hernia repair35. Long-term symptom control comparison of Dor and Nissen fundoplication following laparoscopic para-esophageal hernia repair: a retrospective analysis36. Willingness to pay: a survey of Canadian patients’ willingness to contribute to the cost of robotic thoracic surgery37. Radiomics in early-stage lung adenocarcinoma: a prediction tool for tumour immune microenvironments38. Effectiveness of intraoperative pyloric botox injection during esophagectomy: how often is endoscopic intervention required?39. An artificial intelligence algorithm for predicting lymph node malignancy during endobronchial ultrasound40. The effect of major and minor complications after lung surgery on length of stay and readmission41. Measuring cost of adverse events following thoracic surgery: a scoping review42. Laparoscopic paraesophageal hernia repair: characterization by hospital and surgeon volume and impact on outcomes43. NSQIP 5-Factor Modified Frailty Index predicts morbidity but not mortality after esophagectomy44. Trajectory of perioperative HRQOL and association with postoperative complications in thoracic surgery patients45. Variation in treatment patterns and outcomes for resected esophageal cancer at designated thoracic surgery centres46. Patient-reported pretreatment health-related quality of life (HRQOL) predicts short-term survival in esophageal cancer patients47. Analgesic efficacy of surgeon-placed paravertebral catheters compared with thoracic epidural analgesia after Ivor Lewis esophagectomy: a retrospective noninferiority study48. Rapid return to normal oxygenation after lung surgery49. Examination of local and systemic inflammatory changes during lung surgery01. Implications of near-infrared imaging and indocyanine green on anastomotic leaks following colorectal surgery: a systematic review and meta-analysis02. Repeat preoperative endoscopy after regional implementation of electronic synoptic endoscopy reporting: a retrospective comparative study03. Consensus-derived quality indicators for operative reporting in transanal endoscopic surgery (TES)04. Colorectal lesion localization practices at endoscopy to facilitate surgical and endoscopic planning: recommendations from a national consensus Delphi process05. Black race is associated with increased mortality in colon cancer — a population-based and propensity-score matched analysis06. Improved survival in a cohort of patients 75 years and over with FIT-detected colorectal neoplasms07. Laparoscopic versus open loop ileostomy reversal: a systematic review and meta-analysis08. Posterior mesorectal thickness as a predictor of increased operative time in rectal cancer surgery: a retrospective cohort study09. Improvement of colonic anastomotic healing in mice with oral supplementation of oligosaccharides10. How can we better identify patients with rectal bleeding who are at high risk of colorectal cancer?11. Assessment of long-term bowel dysfunction in rectal cancer survivors: a population-based cohort study12. Observational versus antibiotic therapy for acute uncomplicated diverticulitis: a noninferiority meta-analysis based on a Delphi consensus13. Radiotherapy alone versus chemoradiotherapy for stage I anal squamous cell carcinoma: a systematic review and meta-analysis14. Is the Hartmann procedure for diverticulitis obsolete? National trends in colectomy for diverticulitis in the emergency setting from 1993 to 201515. Sugammadex in colorectal surgery: a systematic review and meta-analysis16. Sexuality and rectal cancer treatment: a qualitative study exploring patients’ information needs and expectations on sexual dysfunction after rectal cancer treatment17. Video-based interviews in selection process18. Impact of delaying colonoscopies during the COVID-19 pandemic on colorectal cancer detection and prevention19. Opioid use disorder associated with increased anastomotic leak and major complications after colorectal surgery20. Effectiveness of a rectal cancer education video on patient expectations21. Robotic-assisted rectosigmoid and rectal cancer resection: implementation and early experience at a Canadian tertiary centre22. An online educational app for rectal cancer survivors with low anterior resection syndrome: a pilot study23. The effects of surgeon specialization on the outcome of emergency colorectal surgery24. Outcomes after colorectal cancer resections in octogenarians and older in a regional New Zealand setting — What are the predictors of mortality?25. Long-term outcomes after seton placement for perianal fistulae with and without Crohn disease26. A survey of patient and surgeon preference for early ileostomy closure following restorative proctectomy for rectal cancer — Why aren’t we doing it?27. Crohn disease independently associated with longer hospital admission after surgery28. Short-stay (≤ 1 d) diverting loop ileostomy closure can be selectively implemented without an increase in readmission and complication rates: an ACS-NSQIP analysis29. A comparison of perineal stapled rectal prolapse resection and the Altemeier procedure at 2 Canadian academic hospitals30. Mental health and substance use disorders predict 90-day readmission and postoperative complications following rectal cancer surgery31. Early discharge after colorectal cancer resection: trends and impact on patient outcomes32. Oral antibiotics without mechanical bowel preparation prior to emergency colectomy reduces the risk of organ space surgical site infections: a NSQIP propensity score matched study33. The impact of robotic surgery on a tertiary care colorectal surgery program, an assessment of costs and short-term outcomes — a Canadian perspective34. Should we scope beyond the age limit of guidelines? Adenoma detection rates and outcomes of screening and surveillance colonoscopies in patients aged 75–79 years35. Emergency department admissions for uncomplicated diverticulitis: a nationwide study36. Obesity is associated with a complicated episode of acute diverticulitis: a nationwide study37. Green indocyanine angiography for low anterior resection in patients with rectal cancer: a prospective before-and-after study38. The impact of age on surgical recurrence of fibrostenotic ileocolic Crohn disease39. A qualitative study to explore the optimal timing and approach for the LARS discussion01. Racial, ethnic and socioeconomic disparities in diagnosis, treatment and survival of patients with breast cancer: a SEER-based population analysis02. First-line palliative chemotherapy for esophageal and gastric cancer: practice patterns and outcomes in the general population03. Frailty as a predictor for postoperative outcomes following pancreaticoduodenectomy04. Synoptic electronic operative reports identify practice variation in cancer surgery allowing for directed interventions to decrease variation05. The role of Hedgehog signalling in basal-like breast cancer07. Clinical and patient-reported outcomes in oncoplastic breast conservation surgery from a single surgeon’s practice in a busy community hospital in Canada08. Upgrade rate of atypical ductal hyperplasia: 10 years of experience and predictive factors09. Time to first adjuvant treatment after oncoplastic breast reduction10. Preparing to survive: improving outcomes for young women with breast cancer11. Opioid prescription and consumption in patients undergoing outpatient breast surgery — baseline data for a quality improvement initiative12. Rectal anastomosis and hyperthermic intraperitoneal chemotherapy: Should we avoid diverting loop ileostomy?13. Delays in operative management of early-stage, estrogen-receptor positive breast cancer during the COVID-19 pandemic — a multi-institutional matched historical cohort study14. Opioid prescribing practices in breast oncologic surgery15. Oncoplastic breast reduction (OBR) complications and patient-reported outcomes16. De-escalating breast cancer surgery: Should we apply quality indicators from other jurisdictions in Canada?17. The breast cancer patient experience of telemedicine during COVID-1918. A novel ex vivo human peritoneal model to investigate mechanisms of peritoneal metastasis in gastric adenocarcinoma (GCa)19. Preliminary uptake and outcomes utilizing the BREAST-Q patient-reported outcomes questionnaire in patients following breast cancer surgery20. Routine elastin staining improves detection of venous invasion and enhances prognostication in resected colorectal cancer21. Analysis of exhaled volatile organic compounds: a new frontier in colon cancer screening and surveillance22. A clinical pathway for radical cystectomy leads to a shorter hospital stay and decreases 30-day postoperative complications: a NSQIP analysis23. Fertility preservation in young breast cancer patients: a population-based study24. Investigating factors associated with postmastectomy unplanned emergency department visits: a population-based analysis25. Impact of patient, tumour and treatment factors on psychosocial outcomes after treatment in women with invasive breast cancer26. The relationship between breast and axillary pathologic complete response in women receiving neoadjuvant chemotherapy for breast cancer01. The association between bacterobilia and the risk of postoperative complications following pancreaticoduodenectomy02. Surgical outcome and quality of life following exercise-based prehabilitation for hepatobiliary surgery: a systematic review and meta-analysis03. Does intraoperative frozen section and revision of margins lead to improved survival in patients undergoing resection of perihilar cholangiocarcinoma? A systematic review and meta-analysis04. Prolonged kidney procurement time is associated with worse graft survival after transplantation05. Venous thromboembolism following hepatectomy for colorectal metastases: a population-based retrospective cohort study06. Association between resection approach and transfusion exposure in liver resection for gastrointestinal cancer07. The association between surgeon volume and use of laparoscopic liver resection for gastrointestinal cancer08. Immune suppression through TIGIT in colorectal cancer liver metastases09. “The whole is greater than the sum of its parts” — a combined strategy to reduce postoperative pancreatic fistula after pancreaticoduodenectomy10. Laparoscopic versus open synchronous colorectal and hepatic resection for metastatic colorectal cancer11. Identifying prognostic factors for overall survival in patients with recurrent disease following liver resection for colorectal cancer metastasis12. Modified Blumgart pancreatojejunostomy with external stenting in laparoscopic Whipple reconstruction13. Laparoscopic versus open pancreaticoduodenectomy: a single centre’s initial experience with introduction of a novel surgical approach14. Neoadjuvant chemotherapy versus upfront surgery for borderline resectable pancreatic cancer: a single-centre cohort analysis15. Thermal ablation and telemedicine to reduce resource utilization during the COVID-19 pandemic16. Cost-utility analysis of normothermic machine perfusion compared with static cold storage in liver transplantation in the Canadian setting17. Impact of adjuvant therapy on overall survival in early-stage ampullary cancers: a single-centre retrospective review18. Presence of biliary anaerobes enhances response to neoadjuvant chemotherapy in pancreatic ductal adenocarcinoma19. How does tumour viability influence the predictive capability of the Metroticket model? Comparing predicted-to-observed 5-year survival after liver transplant for hepatocellular carcinoma20. Does caudate resection improve outcomes in patients undergoing curative resection for perihilar cholangiocarcinoma? A systematic review and meta-analysis21. Appraisal of multivariable prognostic models for postoperative liver decompensation following partial hepatectomy: a systematic review22. Predictors of postoperative liver decompensation events following resection in patients with cirrhosis and hepatocellular carcinoma: a population-based study23. Characteristics of bacteriobilia and impact on outcomes after Whipple procedure01. Inverting the y-axis: the future of MIS abdominal wall reconstruction is upside down02. Progressive preoperative pneumoperitoneum: a single-centre retrospective study03. The role of radiologic classification of parastomal hernia as a predictor of the need for surgical hernia repair: a retrospective cohort study04. Comparison of 2 fascial defect closure methods for laparoscopic incisional hernia repair01. Hypoalbuminemia predicts serious complications following elective bariatric surgery02. Laparoscopic adjustable gastric band migration inducing jejunal obstruction associated with acute pancreatitis: aurgical approach of band removal03. Can visceral adipose tissue gene expression determine metabolic outcomes after bariatric surgery?04. Improvement of kidney function in patients with chronic kidney disease and severe obesity after bariatric surgery: a systematic review and meta-analysis05. A prediction model for delayed discharge following gastric bypass surgery06. Experiences and outcomes of Indigenous patients undergoing bariatric surgery: a mixed-methods scoping review07. What is the optimal common channel length in revisional bariatric surgery?08. Laparoscopic management of internal hernia in a 34-week pregnant woman09. Characterizing timing of postoperative complications following elective Roux-en-Y gastric bypass and sleeve gastrectomy10. Canadian trends in bariatric surgery11. Common surgical stapler problems and how to correct them12. Management of choledocholithiasis following Roux-en-Y gastric bypass: a systematic review and meta-analysis. Can J Surg 2021; 64:S80-S159. [PMID: 35483046 PMCID: PMC8677574 DOI: 10.1503/cjs.021321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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The Comparison Between Positive & Negative Symptoms Severity in Prolonged Methamphetamine-Induced Psychotic Disorder and Schizophrenia. Basic Clin Neurosci 2021; 13:325-333. [DOI: 10.32598/bcn.2021.2837.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Revised: 05/15/2020] [Accepted: 10/10/2020] [Indexed: 11/20/2022] Open
Abstract
Introduction: This study aims to compare the positive and negative symptoms of schizophrenia in patients who had psychotic symptoms more than one month after discontinuation of methamphetamine abuse. These factors were analyzed by the PANSS (Positive and Negative Syndrome Scale) questionnaire. Materials and Methods: 60 participants were selected from patients referred to Iran Psychiatric Hospital with psychotic symptoms (delusions or hallucinations, disorganized behavior, and speech). The control group was 30 patients with schizophrenia based on a semi-structured interview according to DSM-IV-TR (SCID). 30 patients with the prolonged methamphetamine-induced psychotic disorder had been also placed in the case group. For both groups of patients, questionnaires of PANSS, BPRS, GAF was filled after obtaining the consent of the company. The scale scores were compared between groups. To evaluate the mean of PANSS, BPRS, and the GAF scores between the two groups we used the Mann-Whitney and the chi-square test. Results: There was no significant difference in terms of positive and general pathology scores between two groups but the total score of negative symptoms in the schizophrenia group was significantly higher than the group of prolonged methamphetamine psychotic disorders (P = 0.034). Average scores of Uncooperativeness (0.013), Unusual thought content (0.004), Motor retardation (0.011), unusual thought content (0.002) and, Hostility (0.001) in schizophrenia were significantly higher than prolonged methamphetamine psychosis. Conclusion: The results showed that most of the disturbances in patients with schizophrenia may be more influenced by the expression of cognitive disabilities in them compared to patients with methamphetamine psychosis. The difference in scores of negative symptoms suggesting that schizophrenia and prolonged methamphetamine psychotic disorder can be two different disorders.
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Supporting the victims of domestic violence in Iran: two decades of effort. J Inj Violence Res 2021; 13:161-164. [PMID: 33893731 PMCID: PMC8435080 DOI: 10.5249/jivr.v13i2.1638] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 04/01/2021] [Indexed: 10/24/2022] Open
Abstract
For years there were no organized supporting system helping victims of domestic violence in Iran. 16 years ago Ministry of Interior started a national survey which led to try legislating bills in order to improve preventive and supporting services. This has inspired many health care professionals, including Ministry of Health, Treatment and Medical Training, to pursue this field for research. Since then, many studies has been done; which were reviewed in this paper. We tried to build a stepping stone for the future researchers and activists, since despite all what has been done, still there is no legislated bill or enough organizations to protect the victims.
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Iranian and American Moral Judgments for Everyday Dilemmas Are Mostly Similar. Front Psychol 2021; 12:640620. [PMID: 33859595 PMCID: PMC8042310 DOI: 10.3389/fpsyg.2021.640620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 02/22/2021] [Indexed: 11/13/2022] Open
Abstract
Moral judgment is a complex cognitive process that partly depends upon social and individual cultural values. There have been various efforts to categorize different aspects of moral judgment, but most studies depend upon rare dilemmas. We recruited 25 subjects from Tehran, Iran, to rate 150 everyday moral scenarios developed by Knutson et al. Using exploratory factor analysis (EFA), we observed that the same moral dimensions (except socialness dimension) were driven by the same moral cognitive factors (norm violation, intention, and social affect) in Iranian vs. American studies. However, there were minor differences in the factor loadings between the two cultures. Furthermore, based on the EFA results, we developed a short form of the questionnaire by removing eleven of the fifteen scenarios from each of the ten categories. These results could be used in further studies to better understand the similarities and differences in moral judgment in everyday interactions across different cultures.
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High-Risk Sexual Behaviors Among Transgender Individuals in Tehran, Iran. ACTA MEDICA IRANICA 2021. [DOI: 10.18502/acta.v59i2.5578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Global evidence indicates that transgender people are disproportionately at risk for HIV infection. However, limited data are available characterizing sexual behaviors and HIV infection among transgender people in Iran. This study aims to determine the prevalence of high-risk sexual behaviors and HIV infection among transgender people in Iran. In 2009, we assessed data of 58 transgender individuals (41 female-to-male (FTM) and 17 male-to-female (MTF)). Their demographic characteristics and risky sexual behaviors, and other risky behaviors such as substance use were gathered using a structured questionnaire. Rapid tests were used to confirm HIV seropositivity. Fifty-four participants who provided blood samples, none were positive (exact 95% confidence intervals: 0.0, 0.07). 75.6% of FTM and 64.7% of MTF reported having sex in the past six months, respectively. Of the sample who reported having sex in the past six months (n=42), only 19% reported using condoms. No participants reported a history of injection. In this study of HIV infection among a small sample of transgender people in Iran, no one was HIV positive. Some reasons for these findings can be outlined as a lack of history of intravenous drug use and related behaviors, limited high-risk relationships and behaviors, and the limited number of males among the samples.
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Assessment of psychiatrists' approaches regarding disclosure of psychiatric disorders to their patients: a qualitative study. Med J Islam Repub Iran 2020; 34:82. [PMID: 33306057 PMCID: PMC7711037 DOI: 10.34171/mjiri.34.82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Indexed: 11/10/2022] Open
Abstract
Background: Diagnosis disclosure is the result of a shift in medical approaches from traditional paternalism to participatory and patient-centered decision making. Disclosure of psychiatric diagnosis remained uncommon and controversial. Giving information about psychiatric illnesses is very complicated, and it is affected by several factors. While clinical guidelines provide a clear pathway for treating patients, in practice, the treatment of patients is influenced by cultural and social factors. The aim of the current study was a qualitative assessment of psychiatrists’ approaches regarding the disclosure of psychiatric disorders to their patients.
Methods: The current study was conducted with a qualitative approach. The participants were purposefully selected psychiatrists from three medical universities in Tehran, Iran. The data gathered using the semi-structured interview method. Sixteen interviews with 14 psychiatrists were conducted. Data were analyzed using thematic analysis.
Results: Psychiatrists decide to disclose the diagnosis based on several factors. We summarized these factors in a central theme, passive situational decision making based on paternalism and displacement of responsibility. It has two subthemes, including "passive and situational decision making" and "paternalism and displacement of responsibility." Each theme presented by detailed quotations.
Conclusion: The results of this study showed that psychiatrists did not actively disclose the diagnosis name to patients. Diagnosis disclosure was influenced by several factors, such as the certainty about the diagnosis and the severity of the disease. This passive approach does not respect the patient's rights. The paternalistic nature of this approach mandates psychiatrists to consider themselves as the responsible perosn for their patients’ welfare.
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Endoluminal vacuum-assisted therapy and transanal minimally invasive surgery closure of leak following ileal pouch-anal anastomosis - a video vignette. Colorectal Dis 2020; 22:1797-1798. [PMID: 32584488 DOI: 10.1111/codi.15218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 06/05/2020] [Indexed: 02/08/2023]
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Assessment of psychiatrists’ approaches regarding disclosure of psychiatric disorders to their patients: a qualitative study. Med J Islam Repub Iran 2020. [DOI: 10.47176/mjiri.34.82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Relationship of personality characteristics and eating attitude with the success of bariatric surgery. Med J Islam Repub Iran 2020. [DOI: 10.47176/mjiri.34.89] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Resolution of multiply recurrent and multifocal diverticulitis after fecal microbiota transplantation. Tech Coloproctol 2020; 24:971-975. [PMID: 32601752 DOI: 10.1007/s10151-020-02275-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 06/20/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND The exact pathophysiology of diverticulitis is not well understood and may be multifactorial. Recent studies highlight dysbiosis as a plausible mechanism. FMT is a safe strategy to restore commensal colon microbiota and has proven to be an effective treatment for gastrointestinal dysbiosis such as Clostridium difficile infection (CDI). There have been no studies reporting the treatment of diverticulitis with FMT. Our aim was to describe the novel application of fecal microbiota transplantation (FMT) for the treatment of recurrent diverticulitis. CASE We report a case of a 63-year-old woman who had a 13-year history of multiply recurrent and multifocal diverticulitis previously treated with numerous short courses of intravenous and oral antibiotics for acute flares, two segmental colon resections, and suppressive antibiotic therapy for recurrent disease. Secondary to multiple courses of antibiotics , the patient developed CDI. She was treated with a single round of FMT and subsequently stopped all antibiotics at the time of FMT. RESULTS In 20 months of follow-up, the patient has had no further recurrence of diverticulitis or CDI. CONCLUSIONS FMT could prove to be a novel therapy for refractory diverticulitis but requires further investigation.
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Relationship of personality characteristics and eating attitude with the success of bariatric surgery. Med J Islam Repub Iran 2020; 34:89. [PMID: 33306062 PMCID: PMC7711033 DOI: 10.34171/mjiri.34.89] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Indexed: 11/05/2022] Open
Abstract
Background: Obesity is a chronic disease that causes several medical and psychiatric complications. There are plenty of pharmacological and non-pharmacological therapies for obesity treatment. Bariatric surgery is one of the most efficient nonpharmacological treatment for morbid obesity; however, several psychological factors affect the success of bariatric surgery. This study aims to evaluate personality characteristics and eating attitude relationship with the success of bariatric surgery. Methods: This study was carried out on 75 patients with obesity who were candidates of bariatric surgery in the obesity clinic of Rasoul-e-Akram Hospital in Tehran. The patients were asked to fill the TCI and EAT-26 questionnaires before and after the surgery. Statistical analyses were performed using the SPSS-23 applying T-test, Mann-Whitney tests and Pearson and Spearman's correlation coefficient. The significance level was set at 0.05. Results: Seventy-five patients, including 13 men and 62 women, were assessed through this study. The mean of the BMI of the participants was 44.7 prior to the surgery and 30 after the operation. Personality characteristics and eating attitudes had no significant relationship with the success of bariatric surgery. Conclusion: Although the eating attitude and personal characteristics of the bariatric surgery candidates before the surgery was not related to the outcome of the surgery, they should be considered in post-operational psychological assessments.
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Validity and reliability of Persian translation of the Borderline Evaluation of Severity over Time (BEST) questionnaire. Med J Islam Repub Iran 2019; 33:133. [PMID: 32280639 PMCID: PMC7137880 DOI: 10.34171/mjiri.33.133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Indexed: 11/08/2022] Open
Abstract
Background: Borderline Evaluation of Severity over Time (BEST) is one of the self-reported tools for evaluation of the severity and track the response of treatment of borderline personality disorder. The present study evaluated the validity and reliability of Persian Translation of the Borderline Evaluation of Severity over Time (BEST) Questionnaire and to compare it with a semi-structured clinical interview for DSM-IV axis II (SCID-II).
Methods: The questionnaire was translated into Persian and then, the content and face validities of the questionnaire were determined. The translated BEST questionnaire and SCID-II were conducted on 33 outpatients and 32 hospitalized patients with diagnosis of borderline personality disorder and 30 patients’ companions. Forty-five patients completed the questionnaire again in an interval between 7 to 45 days. The data were analyzed using exploratory factor analysis, paired sample t-test, and the Pearson correlation coefficient and Cronbach’s α coefficient.
Results: This study evaluates the content validity, face validity, and criterion validity and reliability of the Persian version of the BEST Questionnaire. The mean scores of the BEST questionnaire were 45.6, 39.2, and 24.3 in in-patients, outpatients, and controls, respectively (p=0.001). The mean scores of the BEST questionnaire were 43.7 in the first evaluation, and 41.4 in the second one (r=0.619, p<0.001). Cronbach’s α coefficient was 0.761, and it reached to 0.898 after omitting items 13 to 15. The questionnaire had a two-factor structure, including internal turmoil and the disturbance in interpersonal relationships.
Conclusion: The Persian version of the BEST Questionnaire has a high face and content validity, high criterion validity, moderate to high reliability, and an acceptable two-factor structure.
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Prolonged Methamphetamine-Induced Psychosis: Difference With Schizophrenia. ACTA MEDICA IRANICA 2019. [DOI: 10.18502/acta.v57i4.1843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The main objective of the present study was to compare the distribution of underlying factors such as neurological soft signs, obstetric complications, and family history of psychiatric disorders between two groups of schizophrenic patients and patients with prolonged methamphetamine-induced psychosis. In a case-control study, 30 patients with prolonged methamphetamine-induced psychosis and 30 patients with schizophrenia were selected. Data were collected through a demographic questionnaire, the Buchanan and Heinrichs’ Neurological Evaluation Scale (NES), the Lewis-Murray’s Obstetric Complications Scale (LMOCS), and the Weissman’s Family History Screen (FHS). Mean scores of the neurological soft signs (±SD) in the two groups of schizophrenic patients and patients with prolonged methamphetamine-induced psychosis were 15.7±8.7 and 11.7±6.2, respectively (P=0.040), and a significant difference was observed in the sensory integration between the two groups (P=0.022). Obstetric complications revealed similar distributions in the two groups. Patients with prolonged methamphetamine-induced psychosis reported higher prevalence of alcohol and other substances use disorders (P=0.003 and P=0.001, respectively) in their close relatives; however, the distributions of other disorders were not statistically different between the two groups’ close relatives. Similarities and differences in certain aspects were observed between the two groups, suggesting susceptibility for psychosis in patients with prolonged methamphetamine-induced psychosis; yet we found diversities that distinguish the two disorders.
© 2019 Tehran University of Medical Sciences. All rights reserved.
Acta Med Iran 2019;57(4):235-243
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Defense Mechanisms in Patients with Irritable Bowel Syndrome and Their Relationship with Symptom Severity and Quality of Life. Middle East J Dig Dis 2019; 11:158-165. [PMID: 31687115 PMCID: PMC6819962 DOI: 10.15171/mejdd.2019.143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 06/01/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Despite the fact that there is theoretical evidence about the association between unconscious defense mechanisms and irritable bowel syndrome (IBS), experimental evidence in this regard is limited. The aim of the present study was to compare the defense mechanisms used by the patients with IBS and a control group, and to investigate the relationship between these mechanisms with the severity of the disease and patients' quality of life. METHODS Fourty-five patients with IBS (mean age of 37.1 years; 14 males) and 45 controls (mean age of 38.0 years; 13 males) were evaluated. IBS diagnosis was determined based on Rome III criteria and the predominant pattern of the disease was determined based on the patient's history (13 diarrheapredominant, 16 constipation-predominant, and 16 alternating IBS). Defense Style Questionnaire-40, IBS Severity Scale, and IBS-Quality of Life questionnaire were used. RESULTS The mean scores of projection, acting-out, somatization, autistic fantasy, passive-aggression, and reaction formation in the IBS group were significantly higher than the control group and the mean scores of humor and anticipation mechanisms were higher in the control group. There was no significant correlation between the score of defense mechanisms and the severity of IBS and the patients' quality of life. CONCLUSION The severity of immature defenses in the IBS group was significantly higher, whereas the severity of mature defenses was higher in the control group. These defenses were not correlated with the severity of IBS. Considering the limited sample size, these relationships need to be more investigated.
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Validity and reliability of Persian translation of the Borderline Evaluation of Severity over Time (BEST) questionnaire. Med J Islam Repub Iran 2019. [DOI: 10.47176/mjiri.33.133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Palmitoylethanolamide as adjunctive therapy for autism: Efficacy and safety results from a randomized controlled trial. J Psychiatr Res 2018; 103:104-111. [PMID: 29807317 DOI: 10.1016/j.jpsychires.2018.04.022] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 04/28/2018] [Accepted: 04/30/2018] [Indexed: 11/25/2022]
Abstract
Inflammation as well as glutamate excitotoxicity have been proposed to participate in the propagation of autism. Palmitoylethanolamide (PEA) is an endocannabinoid proven to prevent glutamatergic toxicity and inhibit inflammatory responses simultaneously. The present randomized, parallel group, double-blind placebo-controlled trial is the first study depicted to probe the efficacy of co-treatment with risperidone and PEA over 10 weeks in children with autism. Seventy children (aged 4-12 years) with autism and moderate to severe symptoms of irritability were randomly assigned to two treatment regimens. The study outcomes were measured using the Aberrant Behavior Checklist-Community Edition (ABC-C). At trial endpoint (week 10), combination of PEA and risperidone had superior efficacy in ameliorating the ABC-irritability and hyperactivity/noncompliance symptoms (Cohen's d, 95% confidence interval (CI) = 0.94, 0.41 to 1.46, p = 0.001) compared with a risperidone plus placebo regimen. Interestingly, effect of combination treatment on hyperactivity symptoms was also observed at trial midpoint (week 5) but with a smaller effect size (d = 0.53, p = 0.04) than that at the endpoint (d = 0.94, p = 0.001). Meanwhile, there was a trend toward significance for superior effect of risperidone plus PEA over risperidone plus placebo on inappropriate speech at trial endpoint (d = 0.51, p = 0.051). No significant differences existed between the two treatment groups for the other two ABC-C subscales (lethargy/social withdrawal and stereotypic behavior). The findings suggest that PEA may augment therapeutic effects of risperidone on autism-related irritability and hyperactivity. Future studies are warranted to investigate whether PEA can serve as a stand-alone treatment for autism.
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A Randomized Controlled Trial of Telephone Follow-Up in Patients With Severe Mental Illness: Study Protocol. IRANIAN JOURNAL OF PSYCHIATRY AND CLINICAL PSYCHOLOGY 2017. [DOI: 10.18869/nirp.ijpcp.23.1.108] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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C-reactive protein and parathyroid hormone in acute severe psychotic disorders (schizophrenia, bipolar disorder and methamphetamine-induced psychotic disorder). Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.2104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Introductionand objectives Schizophrenia accompanies with elevated C-reactive protein (CRP) and vitamin D deficiency. However, there are scarce documentations regarding bipolar disorder and methamphetamine-induced psychotic disorder.AimTo compare serum levels of vitamin D, parathyroid hormone (PTH), calcium, phosphorus and CRP levels in psychotic disorder patients and control group.MethodsA case-control study was conducted on four groups: acute phase of schizophrenia, acute manic episode of bipolar disorder, methamphetamine-induced psychotic disorder and healthy control subjects. Sample size was 45 in each group. Weekly duration of sun exposure, monthly vitamin D intake and serum levels of vitamin D, calcium, phosphorus, PTH and CRP were assessed. Brief Psychiatric Rating Scale (BPRS) was used to evaluate psychotic symptoms.ResultsDuration of sun exposure and monthly vitamin D intake were comparable among groups. Serum levels of vitamin D, calcium and phosphorus were not statistically different between groups (P = 0.463, P = 0.086 and P = 0.339, respectively). Serum levels of PTH were significantly higher in control group (P < 0.001). CRP levels were significantly lower in control subjects (P < 0.001). The levels of serum vitamin D and CRP did not show statistically significant difference among three groups of patients.ConclusionAcute psychotic disorders seem to be associated with higher CRP and lower PTH levels. Clinical importance of the findings and relation of these differences to the metabolic and inflammatory bases of psychosis are not clear yet.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Factor Structure of Personality Inventory for DSM-5 (PID-5) in an Iranian Sample. IRANIAN JOURNAL OF PSYCHIATRY AND CLINICAL PSYCHOLOGY 2017. [DOI: 10.18869/nirp.ijpcp.22.4.308] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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A comparison of pattern of psychiatric symptoms in inpatients with bipolar disorder type one with & without methamphetamine use. Med J Islam Repub Iran 2016; 30:421. [PMID: 28210586 PMCID: PMC5307614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 01/24/2016] [Indexed: 10/26/2022] Open
Abstract
Background: Iran is facing an outbreak of methamphetamine-induced disorders and frequent use of these substances in patients with bipolar disorder. Using or intoxication of methamphetamine in patients with bipolar I disorder may alter the patient's clinical profile; however there is limited studies about impact of methamphetamine on clinical manifestation of bipolar disorders. This study aimed to compare psychiatric symptoms in patients with bipolar I disorder with and without concomitant use of methamphetamine. Methods: In a cross-sectional study, psychiatric symptoms of bipolar I disorder in patients with (Meth+) and without (Meth-) methamphetamine use was evaluated. A number of 57 participants with Meth + and 50 subjects with Meth- were recruited. The clinical picture of bipolar disorder was investigated by Young Mania Rating Scale (YMRS), 17-item Hamilton Depressive Rating Scale (HDRS-17) and the Scale for Assessment of Positive Symptoms (SAPS). Statistical comparisons were performed using the T-test for independent samples and Mann- Whitney test. Results: There was no statistically significant difference between two groups regarding age, duration of illness and hospitalizations. However, male participants were significantly higher in Meth+ group than in Meth- one (p<0.001). The mean (± SD) scores in the two groups of Meth+ and Meth- for YMRS, HDRS, and SAPS were 31.3 (±1.3) and 34.0 (±1.2), 13.7 (±0.7) and 13.5±(0.5), and 50.0 (±1.9) and 48.0 (±2.1), respectively, which were not statistically significant (p<0.05). Conclusion: There was no significant difference in the overall clinical manifestation of bipolar I disorder in patients with and without methamphetamine use. However, in some symptomatology domains, there were some differences between the two groups.
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Religious experiences of Iranian transgenders: A qualitative study. Med J Islam Repub Iran 2016; 30:385. [PMID: 27493929 PMCID: PMC4972060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 02/10/2016] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Gender identity disorder and its treatment with sex reassignment surgery is a profound experience, which can affect the mental, interpersonal, social and religious aspects of one's life. METHODS This was a qualitative content analysis study focusing on the various dimensions of the experiences of seven patients suffering from gender identity disorder in a female-to-male subgroup. This study presents a report concerning the religious aspects of their experience. RESULTS The findings of this study were categorized into the four following conceptual categories: sense of guilt; accomplishing a sense of submission to God's will as well as God's pleasing; practical commitment to religion; and rejection by the religious communities. CONCLUSION Diminishing religion to spirituality comprised the core experiences of these patients having intimate relations with such concepts as secularism, stigma, and technocracy.
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Evaluation of the psychometric properties of the Persian version of the Pittsburgh Sleep Quality Index in depressed patients. Electron Physician 2016; 7:1644-52. [PMID: 26813351 PMCID: PMC4725419 DOI: 10.19082/1644] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 08/21/2015] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION The Pittsburgh Sleep Quality Questionnaire is capable of covering different stages of sleep, and it is regarded as one of the best ones available, and checking for its validity and reliability among depressed patients is a step in this direction. The aim of this study was to evaluate the reliability and validity of the Persian version of the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) questionnaires in patients with depression. METHODS In this study, 93 depressed patients were in the study group, and 100 patients were in the control group. The Persian translation of the PSQI and ESS questionnaires and the Beck Depression Inventory (BDI) were at the disposal of both validity and reliability of PSQI and ESS, and its correlation with BDI scores were analyzed. RESULTS In our study, Cronbach's alpha coefficient of the PSQI questionnaire was 0.821. According to the PSQI and BDI-II scores, the results between the PSQI and ESS scores were significantly correlated. CONCLUSION Using the Persian PSQI and ESS questionnaires to evaluate sleep quality and daytime sleepiness in patients with depression provides a reliable and valid measure for subjective sleep quality in clinical practice and research.
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Bibliographic Characteristics and the Time Course of Published Studies About Gender Dysphoria: 1970–2011. INT J TRANSGENDERISM 2015. [DOI: 10.1080/15532739.2015.1080648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Psychometric assessment of beck scale for suicidal ideation (BSSI) in general population in Tehran. Med J Islam Repub Iran 2015; 29:268. [PMID: 26793659 PMCID: PMC4715388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 10/29/2014] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Beck Scale for Suicidal Ideation (BSSI) is a widely used instrument to assess suicidality. However, there is only limited information about the psychometric characteristics of BSSI in the Persian language. In this study, we investigated the validity, reliability and factor structure of the BSSI in the general population of Tehran. METHODS Initially, 900 questionnaire packages were distributed to the general population of Tehran (response rate: 59 percent), using cluster random sampling method. The questionnaire package consisted of a demographic questionnaire, the Persian translation of the BSSI, Symptom checklist-90- Revised (SCL-90-R), Beck Hopelessness Inventory (BHI) and Philips Social Support Appraisal Scale. Internal consistency and correlations of the BSSI scores with other constructs were investigated. Factor analysis was done using principal component method. RESULTS The Cronbach's alpha coefficients of the screening part and the whole scale were satisfactory (>0.8). The scores of both the screening part and the total scale in individuals who experienced suicidal attempt were higher than others. Both the screening part and the total scale had a positive correlation with depression and Global Severity Index in SCL-90-R, and a negative correlation with social support. The scores of the screening part had a positive correlation with anxiety, psychoticism, hostility and hopelessness as well. The screening part consisted of a single factor which explains 60% of the total variance. CONCLUSION The Persian translation of the BSSI has desirable psychometric properties in research setting. However, the clinical usage of the scale remains to be explored, and the factor structure of the whole questionnaire should be assessed in a clinical sample.
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Suicide Prevention and Follow-Up Services: A Narrative Review. Glob J Health Sci 2015; 8:145-53. [PMID: 26652085 PMCID: PMC4877223 DOI: 10.5539/gjhs.v8n5p145] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Revised: 08/21/2015] [Accepted: 09/28/2015] [Indexed: 01/03/2023] Open
Abstract
Previous suicide attempt is the most important predictor of death by suicide. Thus preventive interventions after attempting to suicide is essential to prevent reattempts. This paper attempts to determine whether phone preventive interventions or other vehicles (postal cards, email and case management) are effective in reattempt prevention and health promotion after discharge by providing an overview of studies on suicide reattempts. The research investigated in this review conducted from 1995 to 2014. A total of 26 cases related to the aim of this research were derived from 36 English articles with the aforementioned keywords Research shows that providing comprehensive aids, social support, and follow-up after discharge can significantly prevent suicide reattempts. Several studies showed that follow-up support (phone calls, crisis cards, mails, postal cards.) after discharge can significantly decrease the risk of suicide. More randomized controlled trials (RCT) are required to determine what factors of follow-up are more effective than other methods.
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Comparison of Masculine and Feminine Gender Roles in Iranian Patients with Gender Identity Disorder. Sex Med 2015; 3:261-8. [PMID: 26797060 PMCID: PMC4721038 DOI: 10.1002/sm2.79] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Introduction Gender identity disorders (GID) are heterogeneous disorders that may be influenced by culture and social norms. Aim The aim of this study was to determine masculine and feminine gender roles in a group of Iranian patients with GID and compare these roles with two control groups. Methods Twelve male‐to‐female (MF) and 27 female‐to‐male (FM) individuals with GID referred to Tehran Psychiatric Institute in Tehran, I. R. Iran were evaluated by self‐report inventories and were compared with two groups of healthy controls (81 men and 89 women). Diagnoses were established based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM‐IV) criteria. Data analysis was done using analysis of variance and chi‐squared test. Main Outcome Measures Masculine and feminine gender roles were assessed by two questionnaires: (i) Gender‐Masculine (GM) and Gender‐Feminine (GF) scales derived from the Minnesota Multiphasic Inventory‐2 (MMPI‐2); (ii) Bem Sex Role Inventory (BSRI). Results In the scales of masculinity, MF‐GID individuals scored as male controls, but lower than female controls. FM‐GID individuals scored similar to female controls and higher than male controls. In femininity scales, MF‐GID individuals and control women seemed similar, and both scored higher than the other groups. FM‐GID persons were considered less feminine than both controls in the GF scale of MMPI‐2, but not in the BSRI. In both scales, FM‐GID persons had higher scores than control women and MF‐GID individuals. Conclusion Iranian FM‐GID individuals were less feminine than normal men. However, MF‐GID individuals were similar to normal women or more feminine. Cultural considerations remain to be investigated. Alavi K, Eftekhar M and Jalali Nadoushan AH. Comparison of masculine and feminine gender roles in Iranian patients with gender identity disorder. Sex Med 2015;3:261–268.
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Celecoxib as an Adjuvant to Fluvoxamine in Moderate to Severe Obsessive-compulsive Disorder: A Double-blind, Placebo-controlled, Randomized Trial. PHARMACOPSYCHIATRY 2015; 48:136-40. [PMID: 25959196 DOI: 10.1055/s-0035-1549929] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION A growing body of evidence implicates inflammatory cascades in the pathophysiology of obsessive-compulsive disorder (OCD), making this pathway a target for development of novel treatments. METHODS 50 outpatients with moderate to severe OCD participated in the trial, and underwent 10 weeks of treatment with either celecoxib (200 mg twice daily) or placebo as an adjuvant to fluvoxamine. Participants were investigated using Yale-Brown Obsessive Compulsive Scale (Y-BOCS). The main outcome measure was to assess the efficacy of celecoxib in improving the OCD symptoms. RESULTS General linear model repeated measures demonstrated significant effect for time × treatment interaction on the Y-BOCS total scores [F (1.38, 66.34)=6.91, p=0.005]. Kaplan-Meier estimation with log-rank test demonstrated significantly more rapid response in the celecoxib group than the placebo group (p<0.001). There was no significant difference in adverse event frequencies between the groups. DISCUSSION The results of the current study suggest that celecoxib could be a tolerable and effective adjunctive treatment for more rapid and more satisfying improvements in OCD symptoms.
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450 – The epidemiology of transsexualism in Iran. Eur Psychiatry 2013. [DOI: 10.1016/s0924-9338(13)75779-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Attitudes of Iranian dental students toward their future careers: an exploratory study. J Dent Educ 2011; 75:1489-1495. [PMID: 22058399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Students' attitudes toward and reasons for choosing careers are of great interest for educational systems around the world. The aims of this study were to investigate Iranian dental students' motivations in choosing dentistry as a career and their attitudes toward their future profession. A cross-sectional study of a group of 219 out of 225 (response rate: 97 percent) final-year dental students in four accredited dental schools in Tehran was conducted using a self-administered, structured questionnaire. The data were analyzed using SPSS version 11.5 and the Mann-Whitney test. The most popular reasons for these students' choice of dentistry as a career were a general interest in medicine and desire to enter a prestigious profession with high social status. The majority of the students planned to enter private practice; fewer intended to pursue specialty education abroad. Most of the female students planned to work in a group practice environment such as a clinic rather than a solo practice. Single students showed greater enthusiasm than married ones for pursuing further studies abroad after graduation. Overall, these dental students appeared to have positive attitudes about the dental profession.
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Correlation between Burning Mouth Syndrome and Anxiety in the Elderly Inmates of Sanitaria in Tehran. J Dent Res Dent Clin Dent Prospects 2010; 4:37-41. [PMID: 22991594 PMCID: PMC3429973 DOI: 10.5681/joddd.2010.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2009] [Accepted: 02/24/2010] [Indexed: 11/17/2022] Open
Abstract
Background and aims
Burning mouth syndrome (BMS) is a chronic pain disorder characterized by a chief complaint of oral burning/pain with no clinically observable oral mucosal lesions. The prevalence of BMS has been reported to be 2.5-5.1% in the general population and several psychological disorders have been reported as associated or predisposing factors for BMS. The aim of this study was to determine the correlation between BMS and anxiety in the elderly residents of sani-taria in Tehran, Iran.
Materials and methods
In a cross-sectional analytical study, 50 patients with BMS were included along with 50 healthy individuals as controls. Inclusion criteria were: age over 60 years, burning sensation in the mouth, normal oral mu-cosa, absence of diabetes, satisfactory prosthesis, absence of iron deficiency and other nutrients, and no heavy smoking habits. Similar inclusion criteria were considered for the control group without any oral complaints. Burning/pain severity was assessed by a 100-mm visual analog scale and the severity of anxiety (state, trait, and total) was determined by Cattell's Anxiety Scale. Data was analyzed by t-test and Pearson's correlation coefficient.
Results
Individuals with BMS assessed their burning/pain severity to be 27.4 mm (95% CI=25.2 - 29.6 mm). Standard-ized total anxiety scale in individuals with and without BMS (±SE for mean) was 5.9±0.2 and 4.6±0.3 with significant dif-ferences (p=0.001). Similar significant differences were observed in state and trait anxiety between the two groups.
Conclusion It seems that both state and trait anxiety are associated with burning mouth syndrome.
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Abstract
Background. Almost any medical illness that causes significant pain or discomfort may negatively affect the quality of sleep. Moreover sleep disorders may coexist with medical disorders in people of all ages. Measuring sleep dysfunction is an area of active research, but few studies examined subjective ratings of sleep quality in medical patients Method. A total of 250 medical patients with various somatic complaints who attended the ENT, internal, neurology, orthopaedics and urology clinics participated in this study. The patients completed the Pittsburgh Sleep Quality Index (PSQI) which measures the quality of sleep in seven major domains and helps discriminate between individuals who experience poor sleep versus individuals who sleep well. A score ≥6 is considered as a significant sleep disturbance. Results. The PSQI score of the patients from all selected clinics were higher than the reported cut-off point (Mean = 8, SD = 3.42). Significant differences were found in sleep duration (component 3) and sleep disturbances (component 5) between clinics. Pain and worry were the major causes of sleep disturbances reported by the majority of the patients. Conclusion. Sleep disturbances in medically ill patients require careful evaluation for proper treatment that will alleviate the sleep problem without exacerbating concomitant illnesses. Essentially any condition that causes pain or discomfort may cause insomnia and must be considered in the overall treatment plan.
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Canal-centring ability of three rotary file systems in simulated curved canals: A comparative study. Indian J Dent Res 2009; 20:400-3. [DOI: 10.4103/0970-9290.59430] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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A study of the relationship between Helicobacter pylori and recurrent aphthous stomatitis using a urea breath test. J Contemp Dent Pract 2009; 10:9-16. [PMID: 19142251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
AIM Helicobacter pylori (H. pylori) is one of the most common, well-known pathogenic agents in the development of peptic ulcers. Some investigators have shown a relationship between H. pylori and recurrent aphthous stomatitis (RAS). However, this relationship is controversial. The aim of this study was to determine the association between H. pylori and RAS using the urea breath test (UBT). METHODS AND MATERIALS Forty-three patients with RAS and 44 non-RAS controls were evaluated. There were no differences in gender or age in the two groups. The UBT was used to detect H. pylori infection. Data were analyzed using the Chi Square Test. RESULTS Sixteen individuals in the RAS patients (37.2%) and 14 individuals in the control group (31.8%) had a positive breath test. The difference was not considered statistically significant (p=0.597). CONCLUSION In the present study no statistically significant difference was found between frequency of a positive UBT in the RAS patients and the control group. CLINICAL SIGNIFICANCE Since the probability of a positive test was higher in the more severe cases this factor needs to be considered in the diagnosis and treatment of RAS.
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Assessment of oral malodor: a comparison of the organoleptic method with sulfide monitoring. J Contemp Dent Pract 2008; 9:76-83. [PMID: 18633472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
AIM The purpose of the present study was to measure the oral malodor of volunteers by means of a subjective organoleptic method and a sulfide monitor as well as to evaluate the diagnostic value of the Halimeter in the diagnosis of halitosis. METHODS AND MATERIALS Sulfide monitoring and organoleptic oral malodor assessment methods were performed on 77 volunteers (51 females, 26 males) selected from academic staff, students, clerks, and patients of the Shaheed Beheshti University of Medical Sciences and Health Services, Dental School. The organoleptic method of assessment and sulphide monitoring were conducted by three calibrated judges. The Kendall's tau-b correlation analysis was used to calculate correlation coefficients between the sulfide monitor and organoleptic scores. RESULTS The Kendall's correlation coefficient between sulfide monitoring and organoleptic scores was 0.493 (p<0.001). Sensitivity and specificity were assessed to be 61.1% and 87.8% respectively. The positive predictive value (PPV) and the negative predictive value (NPV) were 81.5% and 72%, respectively. The intra-class correlation coefficient for the three episodes of monitoring was calculated as 97%. CONCLUSION Use of a sulfide montoring device in conjunction with the organoleptic method is an effective strategy for diagnosing oral malodor. CLINICAL RELEVANCE Because of its small size and simplicity of handling the Halimeter sulfide monitor is convenient to use. This method of evaluation of patients for oral malodor is capable of differentiating normal patients (such as with Pseudohalitosis and halitophobia) from the others and for halitosis screening along with other techniques such as the organoleptic method. However, when used alone, it may lead to a misdiagnosis of some cases in terms of intensity.
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Abstract
Isolated fungal infections of the perianal skin are rare and their diagnosis is frequently overlooked. We report a case of a 78-year-old male patient who presented with a friable, violaceous, papulopustular lesion, with heaped-up edges along the anal verge. Biopsy revealed unicellular yeast consistent with blastomycosis. The patient was treated with itraconazole with resolution of this lesion. An extensive MEDLINE literature review from 1958 to the present indicates that this is an uncommon manifestation of cutaneous blastomycosis. A summary of the medical literature is presented with a review of the characteristics, diagnosis, and management of blastomycosis.
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Abstract
BACKGROUND/PURPOSE The authors' previous laboratory results have shown that rats treated for 3 days with intravenous GLP-2alpha, a synthetic protease-resistant form of glucagonlike peptide-2, showed increased mucosal mass and absorptive function when compared with saline-treated controls after intestinal ischemia/reperfusion (I/R). This study was designed to explore the temporal relationship between injury that occurs secondary to intestinal I/R and recovery of mucosal absorptive function with and without GLP-2alpha treatment. METHODS Each of 18 male Sprague-Dawley rats (300 to 333 g) was subjected to superior mesenteric artery occlusion for 30 minutes, during which time a jugular venous catheter was placed and connected to a subcutaneous infusion pump. Rats were divided into 4 groups based on the type and duration of infusion as follows: group 1, systemic saline at 1 microL/h for 24 hours (n = 5); group 2, systemic GLP-2alpha at 100 microg/kg/d for 24 hours (n = 5); group 3, systemic saline at 1 microL/h for 72 hours (n = 4); and group 4, systemic GLP-2alpha at 100 microg/kg/d for 72 hours (n = 4). Immediately after the infusions, (14)C-galactose and (14)C-glycine absorption was measured using an in vivo, closed-recirculation technique and expressed as micromoles per square centimeter intestine +/- SEM. Statistical analysis was performed using analysis of variance. RESULTS Twenty-four hours after intestinal I/R injury, there was a decrease in substrate absorption but no significant difference between the saline and GLP-2alpha-treated groups (galactose absorption, 1.13 +/- 0.09 in group 1 v 1.35 +/- 0.11 in group 2, P =.15; glycine absorption, 1.18 +/- 0.13 in group 1 v 1.34 +/- 0.15 in group 2, P =.36). However, after the 72-hour infusion, absorption of galactose and glycine was significantly increased in the rats receiving GLP-2alpha as compared with the saline-infused control group (galactose absorption, 1.24 +/- 0.13 in group 3 v 1.88 +/- 0.10 in group 4, P <.01; glycine absorption, 1.64 +/- 0.07 in group 3 v 2.05 +/- 0.08 in group 4, P <.05). Compared with previously determined levels of absorption in normal, uninjured rat intestine (1.50 +/- 0.12 micromol/cm(2) for galactose and 1.85 +/- 0.17 micromol/cm(2) for glycine), after I/R a 72-hour infusion of GLP-2alpha increased galactose absorption 26% (P <.05) and glycine absorption 11% (P =.29) beyond baseline. CONCLUSIONS When initiated at the time of intestinal I/R, a continuous infusion of GLP-2alpha accelerated recovery of mucosal absorptive function in rats. Remarkably, carbohydrate absorption at 72 hours was increased to a level significantly greater than that in normal, uninjured rat intestine. J Pediatr Surg 36:570-572.
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Glucagonlike peptide-2 analogue enhances intestinal mucosal mass and absorptive function after ischemia-reperfusion injury. J Pediatr Surg 2000; 35:1537-9. [PMID: 11083417 DOI: 10.1053/jpsu.2000.18301] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND/PURPOSE This study was designed to explore the efficacy of a synthetic analogue of glucagonlike peptide-2 (GLP-2a) in enhancing mucosal mass and absorptive function in a rat model of intestinal ischemia-reperfusion (I-R) injury. METHODS Each of 20 Sprague-Dawley rats underwent placement of a jugular venous catheter connected to a subcutaneous osmotic pump designed to deliver its contents over 3 days. Rats were divided into 4 groups (n = 5 per group): (1) normal intestine/saline infusion; (2) 30-minute superior mesenteric artery occlusion/saline infusion, (3) normal intestine/ GLP-2alpha infusion, and (4) 30-minute superior mesenteric artery occlusion/GLP-2alpha infusion. Subsequently, mean mucosal 14C-galactose and 14C-glycine absorption and DNA content were determined for each group. RESULTS In saline-treated rats, 30 minutes of mesenteric ischemia decreased mean mucosal galactose absorption by 29% (P < .05), glycine absorption by 22% (P = .12), and DNA content by 28% (P < .01) when compared with rats with uninjured intestine. In rats subjected to 30 minutes of intestinal ischemia, GLP-2alpha significantly improved galactose absorption by 46% (P < .05), glycine absorption by 84% (P < .01), and DNA content by 63% (P < .01) when compared with saline-treated control rats. In rats with mesenteric I-R injury treated with GLP-2a, galactose absorption was returned to normal. Glycine absorption and DNA content were increased significantly by 44% (P < .01) and 18% (P < .05), respectively, beyond the baseline for normal intestine. CONCLUSIONS Thirty minutes of intestinal ischemia followed by immediate reperfusion significantly decreased mucosal mass and absorptive function, validating this rat model of I-R injury. After mesenteric I-R, GLP-2a significantly increased mucosal DNA content and absorption of 14C-galactose and 14C-glycine when compared with untreated control rats. After I-R injury, GLP-2a restored mucosal mass and absorptive function to normal or above-normal levels.
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Treatment of inflammatory bowel disease in a rodent model with the intestinal growth factor glucagon-like peptide-2. J Pediatr Surg 2000; 35:847-51. [PMID: 10873024 DOI: 10.1053/jpsu.2000.6861] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND/PURPOSE Microinjection of a Fisher (F344) rat zygote with human HLA-B27 and beta2-microglobulin genes induces spontaneous chronic gastrointestinal (GI) inflammation similar to lesions seen in patients with inflammatory bowel disease (IBD). This study was designed to evaluate the potential therapeutic benefit of GLP-2, an intestinal growth factor, in this transgenic rat model of IBD. METHODS Five F344 (control) and 10 HLA-B27 (on a F344 background) rats at 25 weeks of age were used. Rats were divided into the following 3 groups: group 1, F344 rats, no treatment (n = 5); group 2, HLA-B27, no treatment (n = 5); and group 3, HLA-B27, treated with a 14-day systemic infusion (via the jugular vein) of GLP-2 at 50 microg/kg/d (n = 5). After infusion, all rats underwent laparotomy, and the intestine from the ligament of Treitz to the rectum was harvested. Total mucosal damage (percent surface area) was measured using image analysis software (Sigmascan 2.0). Microscopic analysis was performed by a blinded reviewer and scored as follows: 0, no inflammation; 1, mild inflammation; 2, moderate inflammation; and 3, severe inflammation. Colonic mucosal total RNA was assayed for tumor necrosis factor alpha (TNF-alpha), interferon-gamma (IFN-gamma), interleukin-2 (IL-2), and glyceraldehyde-3-phosphate dehydrogenase (GAPDH), internal standard, mRNA by reverse transcriptase polymerase chain reaction. Statistical analysis was performed using analysis of variance (ANOVA) and expressed as mean +/- SEM. RESULTS Normal F344 rats did not show evidence of gross or histological lesions in the small or large intestine. GLP-2 reduced total mucosal damage from 9.0% +/- 0.7% in group 2 to 0.9% +/- 0.5% in group 3 (P < .01). The histological lesion score was reduced from 7.0 +/- 0.6 in group 2 to 4.4 +/- 0.8 in group 3 (P < .01). Furthermore, GLP-2 reduced the mean band intensity (MBI) of TNF-alpha (0.4 +/- 0.04 in group 2 to 0 in group 3, P < .01) and IFN-gamma (0.3 +/- 0.02 in group 2 to 0 in group 3, P < .01). CONCLUSIONS These data show for the first time that GLP-2 significantly reduces gross (90% decrease) and histological (40% decrease) lesions in this rat model of IBD. This is further supported by a significant decrease in gene expression of the inflammatory mediators TNF-alpha (100% decrease) and IFN-gamma (100% decrease). These data suggest a potential therapeutic role for GLP-2 in IBD.
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Abstract
BACKGROUND/PURPOSE Interleukin-11 (IL-11) recently has been shown to enhance mucosal mass after massive small bowel resection (MSBR). However, enhanced mucosal mass may not correlate with increased substrate absorption. This study was designed to examine the effect of systemic administration of increasing doses of IL-11 on small intestine absorptive function and mucosal mass after MSBR. METHODS Twenty-five Sprague-Dawley rats underwent an 80% small bowel resection and end-to-end jejunoileal anastomosis. Seven days after resection, all rats had placement of a jugular venous catheter connected to a subcutaneously placed osmotic pump. The rats were divided into 5 groups based on the content of the pump: group 1 (control, n = 5) received 0.1% bovine serum albumin (BSA) and groups 2 through 5 (n = 5 each) received IL-11 at 250, 500, 750, and 1,000 microg/kg/d, respectively. After a 14-day infusion period, [14C] galactose and [14C] glycine absorption was measured using an in vivo closed-recirculation technique. Mucosal DNA content also was determined for each group. Statistical analysis was performed by analysis of variance and expressed as mean +/-SEM. RESULTS IL-11 administered at 250 microg/kg/d, a dose used in previous studies, did not significantly affect substrate absorption. However, compared with the control group, administration of higher doses of IL-11 produced a significant increase in substrate absorption and mucosal mass. The dose of IL-11 producing the overall optimal response based on the parameters measured (galactose absorption, 72% increase over control; glycine absorption, 112% increase over control; and DNA content, 98% increase over control) was 750 microg/kg/d. CONCLUSIONS In addition to an increase in mucosal mass, these data show for the first time that IL-11 enhances absorptive function beyond the normal adaptive response after MSBR. Furthermore, the maximum effect of IL-11 on absorptive function was shown at 750 microg/kg/d, which is 3 times the dose used in previously reported studies. This study suggests that IL-11 may be useful clinically in patients with inadequate intestinal function.
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Abstract
BACKGROUND/PURPOSE Glucagonlike peptide-2 (GLP-2), a product of the posttranslational processing of proglucagon, has been shown to enhance mucosal mass and function in both normal intestine and in the residual intestine after massive small bowel resection. This study was designed to determine if a synthetic, protease-resistant analogue of GLP-2 (GLP-2alpha) can enhance mucosal mass in small intestine after ischemia and reperfusion (I/R) injury. METHODS Ten young adult male Sprague-Dawley rats underwent laparotomy and superior mesenteric artery occlusion for a period of 40 minutes. During this period of ischemia, each rat underwent placement of a jugular venous catheter that was connected to a subcutaneously placed osmotic pump designed to deliver its contents over 3 days. The rats were divided into 2 groups based on the contents of the pumps: group 1, saline at 1 microL/h (n = 6) and group 2, GLP-2alpha at 100 microg/kg/d (n = 4). Three days after insertion of the pumps the small intestine was harvested from the surviving rats for determination of mucosal DNA and protein content. Statistical analysis was performed using unpaired Student's t test. RESULTS After I/R injury to the small intestine, a 3-day systemic infusion of GLP-2alpha significantly increased mucosal DNA content 41% (P<.05) and mucosal protein content 60% (P<.05) when compared with saline-treated controls. In addition, infusion of GLP-2alpha reduced mortality from 50% to 25%. CONCLUSIONS These data show for the first time that GLP-2alpha enhances mucosal mass following I/R injury to the small intestine. GLP-2alpha may be of benefit to patients with intestinal ischemia syndromes such as necrotizing enterocolitis and midgut volvulus.
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Abstract
PURPOSE This study was designed to determine if luminally administered glutamine alone functions as a growth factor or is synergistic with hepatocyte growth factor (HGF) after massive small bowel resection (MSBR). METHODS Twenty Sprague-Dawley rats underwent an 80% small bowel resection and jejunostomy tube placement. Seven days later the rats were divided into four groups: group 1, control, no further treatment (n = 5); group 2 received glutamine (4% of total food intake per day) via an orogastric tube (n = 5); group 3 received intraluminal HGF via a jejunostomy tube at 75 microg/kg/d (n = 5); and group 4 received glutamine and HGF at the same doses, respectively. After a 14-day HGF infusion, glutamine feeding, or both combined, [C14] glycine absorption (micromol/L/cm2 intestine) and mucosal DNA and protein content (microg/mg mucosa) were measured in the remaining small bowel. RESULTS Glutamine alone had no effect on substrate absorption and protein or DNA content. HGF increased galactose absorption (106% increase over control, P<.01), glycine absorption (95% increase over control, P<.05), protein content (44% increase over control, P<.01), and DNA content (32% increase over control, P<.01). The combination of glutamine and HGF did not prove to be synergistic. CONCLUSIONS These data demonstrate that in this short bowel model, glutamine alone did not enhance intestinal function. Furthermore, glutamine is not synergistic with HGF. This study suggests that glutamine alone may not be useful clinically in patients with inadequate intestinal function.
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Impurity band and magnetic-field-induced metal-insulator transition in a doped GaAs/AlxGa1-xAs superlattice. PHYSICAL REVIEW. B, CONDENSED MATTER 1996; 53:6919-6922. [PMID: 9982122 DOI: 10.1103/physrevb.53.6919] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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