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Mohebbi B, Sadeghipour P, Zolfaghari R, Vadalà G, Khalilipur E, Zahedmehr A, Diana D, Maadani M, Shakerian F, Kiani R, Hosseini Z, Rashidinejad A, Rouzitalab M, Khalesi S, Toulabi V, Sucato V, Di Fazio L, Taherian M, Amiripouya S, Ashuri S, Bayatian A, Naderi S, Bakhshandeh H, Moosavi J, Abdi S, Firouzi A, Alemzadeh-Ansari MJ, Galassi AR. Outcomes of chronic total occlusion percutaneous coronary intervention from the RAIAN (RAjaie - Iran) registry. Indian Heart J 2023; 75:429-435. [PMID: 37866775 PMCID: PMC10774591 DOI: 10.1016/j.ihj.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 05/24/2023] [Accepted: 10/16/2023] [Indexed: 10/24/2023] Open
Abstract
OBJECTIVE While most of the evidence in CTO interventions emerge from Western and Japanese studies, few data have been published up today from the Middle East. Objective of this study was to evaluate technical success rates and clinical outcomes of an Iranian population undergoing CTO PCI in a tertiary referral hospital. Moreover, we sought to evaluate the efficacy of our CTO teaching program. METHODS This is a retrospective single-center cohort study including 790 patients who underwent CTO PCI performed by operators with different volumes of CTOs PCI performed per year. According to PCI result, all patients have been divided into successful (n = 555, 70.3 %) and unsuccessful (n = 235, 29.7 %) groups. Study endpoints were Major Adverse Cardiovascular Events and Health Status Improvement evaluated using the Seattle Angina Questionnaire at one year. RESULTS A global success rate of 70 % for antegrade and 80 % for retrograde approach was shown despite the lack of some CTO-dedicated devices. During the enrollment period, the success rate increased significantly among operators with a lower number of CTO procedures per year. One-year MACE rate was similar in both successful and unsuccessful groups (13.5 % in successful and 10.6 % in unsuccessful group, p = 0.173). One year patients' health status improved significantly only in successful group. CONCLUSIONS No significant differences of in-hospital and one-year MACE were found between the successful and unsuccessful groups. Angina symptoms and quality of life significantly improved after successful CTO PCI. The RAIAN registry confirmed the importance of operator expertise for CTO PCI success.
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Affiliation(s)
- Bahram Mohebbi
- Cardiovascular Intervention Research Center, Cardio-Oncology Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Parham Sadeghipour
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Zolfaghari
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Giuseppe Vadalà
- Cardiology Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE) "G. D'Alessandro", Paolo Giaccone Hospital, University of Palermo, Italy.
| | - Ehsan Khalilipur
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Zahedmehr
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Davide Diana
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), University of Palermo, Palermo, Italy
| | - Mohsen Maadani
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Farshad Shakerian
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Kiani
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Zahara Hosseini
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Rashidinejad
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mostafa Rouzitalab
- Department of Cardiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Somayeh Khalesi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Vahid Toulabi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Vincenzo Sucato
- Cardiology Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE) "G. D'Alessandro", Paolo Giaccone Hospital, University of Palermo, Italy
| | - Luca Di Fazio
- Cardiology Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE) "G. D'Alessandro", Paolo Giaccone Hospital, University of Palermo, Italy
| | - Maisam Taherian
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Saeed Amiripouya
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Shahrzad Ashuri
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ayatollah Bayatian
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Sajad Naderi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hooman Bakhshandeh
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Jamal Moosavi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Seifollah Abdi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ata Firouzi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Javad Alemzadeh-Ansari
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Alfredo R Galassi
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), University of Palermo, Palermo, Italy
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Dale M, Eccles FJR, Melvin K, Khan Z, Jones L, Zarotti N, Kiani R, Johnson J, Wells R, Simpson J. Guided self-help for anxiety among Huntington's disease gene expansion carriers (GUIDE-HD) compared to treatment as usual: a randomised controlled feasibility trial. Pilot Feasibility Stud 2023; 9:159. [PMID: 37700320 PMCID: PMC10496323 DOI: 10.1186/s40814-023-01364-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 07/15/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND Huntington's disease (HD) is an adult-onset genetic neurodegenerative condition associated with cognitive decline, motor impairments, and emotional difficulties. Anxiety affects up to 71% of HD gene expansion carriers (i.e., those with the version of the gene that causes HD) and can negatively impact quality of life, worsen other HD symptoms, and increase suicide risk. Therefore, helping people with their anxiety should be a clinical priority. A significant evidence base now exists for low-cost talking therapies for anxiety, such as guided self-help, and with people with other neurodegenerative conditions (e.g., Parkinson's disease). However, this type of intervention has not been specifically assessed with HD gene expansion carriers. METHODS This protocol describes an exploratory randomised controlled feasibility study of a psychological intervention for anxiety for HD gene expansion carriers. The 10 session guided self-help intervention ('GUIDE-HD') is based on a blend of second and third wave cognitive behavioural models of anxiety (cognitive behaviour therapy [CBT] and acceptance and commitment therapy [ACT]) and is adapted to meet the specific needs of an HD population. This study will compare guided self-help with treatment as usual (TAU), with 15 HD gene expansion carriers randomly allocated to each group. Participants will be recruited across the UK. Quantitative data will be collected pre-intervention, immediately post-intervention, 3-month post-intervention and 6-month post-intervention. Qualitative data will be collected at one month post-intervention from participants, including HD carers. The data will be analysed to assess whether the current intervention and study design are feasible to progress to a larger randomised controlled trial. Feasibility has been defined in terms of recruitment rate, retention rate to both trial arms, intervention adherence, and acceptability of the intervention and measurement tools. DISCUSSION Given the lack of evidenced interventions to date to support the wellbeing of people with the expanded Huntington's gene, this study will assess the feasibility of progressing this particular intervention to a full trial. To try and increase the acceptability of the intervention, a number of stakeholders, including those affected by HD and in caring roles, have been fundamental to the creation of the intervention (e.g., therapy manual, planned therapy process) to date. TRIAL REGISTRATION Trial ID: ISRCTN47330596 . Date registered: 28/09/2022. Protocol version and date: Version 2, 09/06/22. Trial sponsor organisation and contact: Leicestershire Partnership NHS Trust (Dave Clarke). Role of sponsor: Overall responsibility for the conduct and governance of the trial. Role of funder: Review of initial research proposal.
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Affiliation(s)
- Maria Dale
- Leicestershire Partnership NHS Trust, Mill Lodge, Narborough, Leicestershire, LE19 4SL, Leicester, UK
| | - Fiona J R Eccles
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, LA1 4AH, UK
| | - Katie Melvin
- Leicestershire Partnership NHS Trust, Mill Lodge, Narborough, Leicestershire, LE19 4SL, Leicester, UK
| | - Zaynah Khan
- Leicestershire Partnership NHS Trust, Mill Lodge, Narborough, Leicestershire, LE19 4SL, Leicester, UK
| | - Lee Jones
- Leicestershire Partnership NHS Trust, Mill Lodge, Narborough, Leicestershire, LE19 4SL, Leicester, UK
| | - Nicolò Zarotti
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, LA1 4AH, UK
- Manchester Centre for Clinical Neurosciences, Salford Royal Hospital, Salford, M6 8HD, UK
| | - Reza Kiani
- Leicestershire Partnership NHS Trust, Mill Lodge, Narborough, Leicestershire, LE19 4SL, Leicester, UK
| | | | | | - Jane Simpson
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, LA1 4AH, UK.
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Tyrer F, Morriss R, Kiani R, Gangadharan SK, Kundaje H, Rutherford MJ. Comparing the number and length of primary care consultations in people with and without intellectual disabilities and health needs: observational cohort study using electronic health records. Fam Pract 2022:cmac135. [PMID: 36440948 DOI: 10.1093/fampra/cmac135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND In the United Kingdom, 15-min appointments with the general practitioner (GP) are recommended for people with complex health conditions, including intellectual disabilities and health needs, but we do not know whether this happens. AIMS We compared number and length of primary care consultations (GP, nurse, other allied health, other) for people with and without intellectual disabilities and health needs. METHODS Linked primary care data from the Clinical Practice Research Datalink (CPRD) in England were used to investigate face-to-face and telephone primary care consultations in 2017-2019. Health needs investigated were: epilepsy; incontinence; severe visual/hearing impairments; severe mobility difficulties; cerebral palsy; and percutaneous endoscopic gastrostomy feeding. Age and gender-standardized consultation rates per year (Poisson), duration of consultations, and the proportion of "long consultations" (≥15 min) were reported. RESULTS People with intellectual disabilities (n = 7,794) had 1.9 times as many GP consultations per year as those without (n = 176,807; consultation rate ratio = 1.87 [95% confidence interval 1.86-1.89]). Consultation rates with nurses and allied healthcare professionals were also twice as high. Mean GP consultation time was 9-10 min regardless of intellectual disability/health need status. Long GP consultations were less common in people with intellectual disabilities (18.2% [17.8-18.7] vs. 20.9% [20.8-21.0]). Long consultations with practice nurses were more common in people with health needs, particularly severe visual loss. CONCLUSIONS People with intellectual disabilities and/or health needs tend to have more, rather than longer, GP consultations compared with the rest of the population. We recommend further investigation into the role of practice nurses to support people with intellectual disabilities and health needs.
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Affiliation(s)
- Freya Tyrer
- Department of Population Health Sciences, University of Leicester, Leicester, United Kingdom
| | - Richard Morriss
- Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Reza Kiani
- Department of Population Health Sciences, University of Leicester, Leicester, United Kingdom
- Leicestershire Learning Disability Services (Psychiatry), Leicestershire Partnership NHS Trust, Leicester, United Kingdom
| | - Satheesh K Gangadharan
- Department of Population Health Sciences, University of Leicester, Leicester, United Kingdom
- Leicestershire Learning Disability Services (Psychiatry), Leicestershire Partnership NHS Trust, Leicester, United Kingdom
| | - Harish Kundaje
- Lakeside Healthcare, NHS General Practice, Corby, United Kingdom
| | - Mark J Rutherford
- Department of Population Health Sciences, University of Leicester, Leicester, United Kingdom
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Karimi Y, Sehati F, Sarreshtedari A, Mirzad M, Khalili Y, Kiani R, Taheri Bajgan E, Hosseini Moghadam M, Mehrvarz F, Bakhshandeh H, Parham M, Malakootian M, Sadeghipour P. Endothelial nitric oxide synthase Asp298Glu (894G/T) gene polymorphism as a possible risk factor for the coronary slow flow phenomenon among Iranians. BMC Cardiovasc Disord 2022; 22:300. [PMID: 35773625 PMCID: PMC9248196 DOI: 10.1186/s12872-022-02736-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 06/27/2022] [Indexed: 11/30/2022] Open
Abstract
Background Mounting evidence indicates an association between endothelial dysfunction and the coronary slow flow phenomenon (CSFP). In the present study, we aimed to evaluate the possible role of endothelial nitric oxide synthase (eNOS) 894G/T and interleukin-1β (IL-1β) 315C/T polymorphisms as possible risk factors for CSFP. Methods This prospective study enrolled patients with CSFP and individuals with normal coronary arteries. Genotypes were assessed using regular polymerase chain reaction and direct Sanger-sequencing techniques. Results The study population consisted of 267 individuals: 180 patients with CSFP (49 women [27.2%]) at a median age of 55 (48–62) years and 87 controls with normal coronary arteries (56 women [64.4%]) at a median age of 47 (41–58) years. The allelic distribution of eNOS 894G/T was significantly associated with CSFP (odds ratio [OR], 1.58; 95% confidence interval (CI), 1.04–2.42; P = 0.03). This polymorphism increased the risk of CSFP under the dominant model (OR 1.73; 95% CI I.02–2.95; P = 0.04). However, the allelic frequencies (1.05; 95% CI 0.68–1.59; P = 0.83) and genotypic frequencies (0.88; 95% CI 0.52–1.49; P = 0.63) of the IL-1β 315C/T polymorphism were not associated with the incidence of CSFP in the Iranian population. Conclusions The CSFP and control groups were statistically different regarding the eNOS 894G/T polymorphism. Our findings also demonstrated that the IL-1β 315C/T polymorphism was not a risk factor for CSFP. Supplementary Information The online version contains supplementary material available at 10.1186/s12872-022-02736-0.
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Affiliation(s)
- Yeganeh Karimi
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Sehati
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Sarreshtedari
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mina Mirzad
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Yasaman Khalili
- Cardiogenetic Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Vali-Asr Ave, Niyayesh Blvd, Tehran, 1996911101, Iran
| | - Reza Kiani
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Vali-Asr Ave, Niyayesh Blvd, Tehran, 1996911101, Iran
| | - Elham Taheri Bajgan
- Molecular Genetics Department, Faculty of Biological Sciences, Tarbiat Modares University, Tehran, Iran
| | - Maryam Hosseini Moghadam
- Cardiogenetic Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Vali-Asr Ave, Niyayesh Blvd, Tehran, 1996911101, Iran
| | - Farzaneh Mehrvarz
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hooman Bakhshandeh
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Parham
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Vali-Asr Ave, Niyayesh Blvd, Tehran, 1996911101, Iran
| | - Mahshid Malakootian
- Cardiogenetic Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Vali-Asr Ave, Niyayesh Blvd, Tehran, 1996911101, Iran.
| | - Parham Sadeghipour
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Vali-Asr Ave, Niyayesh Blvd, Tehran, 1996911101, Iran. .,Cardiogenetic Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Vali-Asr Ave, Niyayesh Blvd, Tehran, 1996911101, Iran.
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Tyrer F, Morriss R, Kiani R, Gangadharan SK, Rutherford MJ. Mortality disparities and deprivation among people with intellectual disabilities in England: 2000-2019. J Epidemiol Community Health 2021; 76:168-174. [PMID: 34244310 DOI: 10.1136/jech-2021-216798] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 07/03/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND The effect of policy initiatives and deprivation on mortality disparities in people with intellectual disabilities is not clear. METHODS An electronic health record observational study of linked primary care data in England from the Clinical Practice Research Datalink and the Office for National Statistics deaths data from 2000 to 2019 was undertaken. All-cause and cause-specific mortality for people with intellectual disabilities were calculated by gender and deprivation status (index of multiple deprivation quintile) using direct age-standardised mortality rates (all years) and ratios (SMR; 2000-2009 vs 2010-2019). RESULTS Among 1.0 million patients (n=33 844 with intellectual disability; n=980 586 general population without intellectual disability), differential mortality was consistently higher in people with intellectual disabilities and there was no evidence of attenuation over time. There was a dose-response relationship between all-cause mortality and lower deprivation quintile in the general population which was not observed in people with intellectual disabilities. Cause-specific SMR were consistent in both the 2000-2009 and 2010-2019 calendar periods, with a threefold increased risk of death in both males and females with intellectual disabilities (SMR ranges: 2.91-3.51). Mortality was highest from epilepsy (SMR ranges: 22.90-52.74) and aspiration pneumonia (SMR ranges: 19.31-35.44). SMRs were disproportionately high for people with intellectual disabilities living in the least deprived areas. CONCLUSIONS People with intellectual disabilities in England continue to experience significant mortality disparities and there is no evidence that the situation is improving. Deprivation indicators may not be effective for targeting vulnerable individuals.
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Affiliation(s)
- Freya Tyrer
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Richard Morriss
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Reza Kiani
- Intellectual Disability Psychiatry Department, Leicestershire Partnership NHS Trust, Leicester, UK
| | - Satheesh K Gangadharan
- Intellectual Disability Psychiatry Department, Leicestershire Partnership NHS Trust, Leicester, UK
| | - Mark J Rutherford
- Department of Health Sciences, University of Leicester, Leicester, UK
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Firouzi A, Baay M, Mazayanimonfared A, Pouraliakbar H, Sadeghipour P, Noohi F, Maleki M, Mehdi Peighambari M, Kiavar M, Abdi S, Maadani M, Shakerian F, Zahedmehr A, Kiani R, Alemzadeh-Ansari MJ, Rashidinejad A, Hosseini Z. Effects of the COVID-19 Pandemic on the Management of Patients With ST-elevation Myocardial Infarction in a Tertiary Cardiovascular Center. Crit Pathw Cardiol 2021; 20:53-55. [PMID: 32467422 PMCID: PMC7288762 DOI: 10.1097/hpc.0000000000000228] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 05/26/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND In the Coronavirus Disease 2019 (COVID-19) pandemic, the appropriate reperfusion strategy in patients with ST-segment elevation myocardial infarction (STEMI) is unclear. METHODS This retrospective single-center study consecutively enrolled patients who presented with STEMI and scheduled for primary percutaneous coronary intervention (PPCI) during the outbreak of COVID-19. Due to the delay in the reporting of the polymerase chain reaction test results, our postprocedural triage regarding COVID-19, followed by the isolation strategy, was based on lung computerized tomography scan results. RESULTS Forty-eight patients with STEMI referred to our center. PPCI was done for 44 (91%) of these patients. The mean symptom-to-device time was 490.93 ± 454.608 minutes, and the mean first medical contact-to-device time was and 154.12 ± 36.27 minutes. Nine (18%) patients with STEMI were diagnosed as having typical/indeterminate features indicating COVID-19 involvement. During hospitalization, 1 (2.0%) patient died of cardiogenic shock. The study population was followed for 35.9 ± 12.7 days. Two patients expired in another centers due to COVID-19. No cardiac catheterization laboratory staff members were infected by COVID-19 during the study period. CONCLUSIONS Our small report indicates that by taking the recommended safety measures and using appropriate PPE, we can continue PPCI as the main reperfusion strategy safely and effectively.
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Affiliation(s)
- Ata Firouzi
- From the Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Baay
- From the Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Azadeh Mazayanimonfared
- From the Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Pouraliakbar
- From the Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Parham Sadeghipour
- From the Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Feridoun Noohi
- From the Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Majid Maleki
- From the Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohamad Mehdi Peighambari
- From the Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Majid Kiavar
- From the Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Seifollah Abdi
- From the Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohsen Maadani
- From the Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Farshad Shakerian
- From the Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Zahedmehr
- From the Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Kiani
- From the Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Javad Alemzadeh-Ansari
- From the Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Rashidinejad
- From the Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Hosseini
- From the Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
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Zanganehfar M, Parhizgar S, Kiani R, Pouraliakbar H, Kaviani R, Kamali M, Vahedinezhad M, Sanavi A. Two aortic root pseudoaneurysms in infective endocarditis in a patient with bicuspid aortic valve. Res Cardiovasc Med 2021. [DOI: 10.4103/rcm.rcm_13_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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8
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Tromans S, Yao G, Alexander R, Mukaetova-Ladinska E, Kiani R, Al-Uzri M, Chester V, Carr R, Morgan Z, Vounzoulaki E, Brugha T. The Prevalence of Diabetes in Autistic Persons: A Systematic Review. Clin Pract Epidemiol Ment Health 2020; 16:212-225. [PMID: 33719361 PMCID: PMC7931154 DOI: 10.2174/1745017902016010212] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 11/01/2020] [Accepted: 11/23/2020] [Indexed: 02/08/2023]
Abstract
Background: It has been proposed that autistic individuals are at an increased risk of type 1 and type 2 diabetes. Improved understanding of diabetes prevalence in autistic persons will help inform resource allocation for diabetes-related public health measures for this patient group. Objective: To conduct a systematic review of published literature pertaining to type 1 and type 2 diabetes prevalence in autistic individuals, including comparison with their non-autistic peers. Methods: Eligibility criteria included studies investigating the prevalence of diabetes in autistic individuals, as well as having been published in the English language. A systematic search of online databases (MEDLINE, PsycINFO, CINAHL, EMBASE and PubMed) was conducted on 4th April 2020. Additional approaches included the ancestry method, grey literature searches and expert consultation. Studies were qualitatively analysed with reporting quality appraised. Results: 19 eligible studies were identified, 7 of which provided type-specific diabetes prevalence data. Of 15 studies that included a non-autistic control group, 9 reported a higher diabetes prevalence among autistic persons, with a statistically significant difference in 4 studies. Studies demonstrating a higher diabetes prevalence in autistic groups had higher average study population sizes and reporting quality ratings. Conclusion: It is uncertain whether diabetes is significantly more prevalent in autistic persons relative to their non-autistic peers, though larger studies suggest a trend in this direction. Nevertheless, diabetes is a significant public health issue for the autistic community, which may require a tailored approach for identification and management. Prospero database registration number: CRD42019122176.
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Affiliation(s)
- Samuel Tromans
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom.,Leicestershire Partnership NHS Trust, Leicester, United Kingdom
| | - Guiqing Yao
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom
| | - Regi Alexander
- Department of Psychiatry, University of Hertfordshire, Hatfield, United Kingdom.,Hertfordshire Partnership University NHS Foundation Trust, Hatfield, United Kingdom
| | - Elizabeta Mukaetova-Ladinska
- Leicestershire Partnership NHS Trust, Leicester, United Kingdom.,Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, United Kingdom
| | - Reza Kiani
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom.,Leicestershire Partnership NHS Trust, Leicester, United Kingdom
| | - Mohammed Al-Uzri
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom.,Leicestershire Partnership NHS Trust, Leicester, United Kingdom
| | - Verity Chester
- Hertfordshire Partnership University NHS Foundation Trust, Hatfield, United Kingdom.,Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Richard Carr
- Leicestershire Partnership NHS Trust, Leicester, United Kingdom
| | - Zoe Morgan
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom
| | - Elpida Vounzoulaki
- Diabetes Research Centre, University of Leicester, Leicester, United Kingdom
| | - Traolach Brugha
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom.,Leicestershire Partnership NHS Trust, Leicester, United Kingdom
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9
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Banifatemeh SA, Sadeghipour P, Alemzadeh-Ansari MJ, Fakhrabadi AA, Zolfaghari F, Zahedmehr A, Mohebbi B, Kiani R, Shakerian F, Rashidinejad A, Hosseini Z, Firouzi A. Role of stent oversizing in patients undergoing primary percutaneous coronary intervention. An open-labeled randomized controlled trial. Minerva Cardiol Angiol 2020; 69:513-521. [PMID: 33258566 DOI: 10.23736/s2724-5683.20.05396-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND In patients with ST-segment-elevation myocardial infarction (STEMI), primary percutaneous coronary intervention (PPCI) is the treatment of choice. Stent undersizing might occur due to catecholamine release and coronary spasm. Although routine oversizing has been promising in several investigations, it has never been tested in randomized clinical trials. In this single-center open-label randomized clinical trial, we evaluated the role of stent oversizing in PPCI. METHODS Candidates for PPCI were randomly divided into oversized and non-oversized groups. In the oversized group, the stent was oversized by 10% according to the mean lumen diameter, retrieved from the quantitative coronary analysis. Primary composite endpoints were defined as the occurrence of complete total ST-segment (STR)resolution and postprocedural thrombolysis in myocardial infarction (TIMI) flow grade III. RESULTS The study population was comprised of 122 patients, allocated to the oversized group (N.=61) and the non-oversized group (N.=61). There was no significant difference between the 2 groups regarding the final TIMI flow grade. Complete STR was marginally more favorable in the non-oversized group (56.05±55.12 vs. 64.64±23.28; P=0.056). The troponin ratio, CK-MB ratio, and 6-month follow-up outcome - defined as target lesion revascularization, heart failure, and cardiovascular death - were comparable between the 2 groups. CONCLUSIONS Our study showed that routine oversizing in patients undergoing PPCI had no benefit regarding ST-segment resolution and the final TIMI flow, as well as hard cardiac events, during the follow-up.
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Affiliation(s)
- Seyed A Banifatemeh
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research, Center, Iran University of Medical Sciences, Tehran, Iran.,Department of Cardiovascular Medicine, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Parham Sadeghipour
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research, Center, Iran University of Medical Sciences, Tehran, Iran.,Clinical Trial Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad J Alemzadeh-Ansari
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research, Center, Iran University of Medical Sciences, Tehran, Iran
| | - Amir A Fakhrabadi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research, Center, Iran University of Medical Sciences, Tehran, Iran
| | - Fereshte Zolfaghari
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research, Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Zahedmehr
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research, Center, Iran University of Medical Sciences, Tehran, Iran
| | - Bahram Mohebbi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research, Center, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Kiani
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research, Center, Iran University of Medical Sciences, Tehran, Iran
| | - Farshad Shakerian
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research, Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Rashidinejad
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research, Center, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Hosseini
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research, Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ata Firouzi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research, Center, Iran University of Medical Sciences, Tehran, Iran -
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10
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Banifatemeh SA, Sadeghipour P, Alemzadeh-Ansari MJ, Fakhrabadi AA, Zolfaghari F, Zahedmehr A, Mohebbi B, Kiani R, Shakerian F, Rashidinejad A, Hosseini Z, Firouzi A. Role of stent oversizing in patients undergoing primary percutaneous coronary intervention. An open-labeled randomized controlled trial. Minerva Cardioangiol 2020. [PMID: 33258566 DOI: 10.23736/s0026-4725.20.05396-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND In patients with ST-segment-elevation myocardial infarction (STEMI), primary percutaneous coronary intervention (PPCI) is the treatment of choice. Stent undersizing might occur due to catecholamine release and coronary spasm. Although routine oversizing has been promising in several investigations, it has never been tested in randomized clinical trials. In this single-center open-label randomized clinical trial, we evaluated the role of stent oversizing in PPCI. METHODS Candidates for PPCI were randomly divided into oversized and non-oversized groups. In the oversized group, the stent was oversized by 10% according to the mean lumen diameter, retrieved from the quantitative coronary analysis. Primary composite endpoints were defined as the occurrence of complete total ST-segment (STR)resolution and postprocedural thrombolysis in myocardial infarction (TIMI) flow grade III. RESULTS The study population was comprised of 122 patients, allocated to the oversized group (n = 61) and the non-oversized group (n = 61). There was no significant difference between the 2 groups regarding the final TIMI flow grade. Complete STR was marginally more favorable in the non-oversized group (56.05 ± 55.12 vs 64.64 ± 23.28; P = 0.056). The troponin ratio, CK-MB ratio, and 6-month follow up outcome-defined as target lesion revascularization, heart failure, and cardiovascular death-were comparable between the 2 groups. CONCLUSIONS Our study showed that routine oversizing in patients undergoing PPCI had no benefit regarding ST-segment resolution and the final TIMI flow, as well as hard cardiac events, during the follow-up.
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Affiliation(s)
- Seyed A Banifatemeh
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran.,Department of Cardiovascular Medicine, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Parham Sadeghipour
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran.,Clinical Trial Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Iran
| | - Mohammad J Alemzadeh-Ansari
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Amir A Fakhrabadi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Fereshte Zolfaghari
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Zahedmehr
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Bahram Mohebbi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Kiani
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Farshad Shakerian
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Rashidinejad
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Hosseini
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ata Firouzi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran -
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11
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Kiani R, Pouraliakbar H, Alemzadeh-Ansari MJ, Khademi A, Peighambari MM, Mohebbi B, Firouzi A, Zahedmehr A, Shakerian F, Hosseini Z, Rashidinejad A. The significance of coronary artery calcium score as a predictor of coronary artery stenosis in individuals referred for CT angiography. J Cardiovasc Thorac Res 2020; 12:203-208. [PMID: 33123326 PMCID: PMC7581835 DOI: 10.34172/jcvtr.2020.34] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 08/11/2020] [Indexed: 11/09/2022] Open
Abstract
Introduction: Cardiovascular diseases, including coronary artery disease (CAD), are among the most common causes of death in the elderly population. Recent studies have found that coronary artery calcium score (CACS) is a strong independent predictor of CAD. Here we aimed to investigate the association between CACS and demographic, clinical, laboratory, and CT angiographic findings inpatients with suspected CAD. Methods: From June 2008 to August 2018, we retrospectively reviewed 219 consecutive patients suspected with CAD who were referred for CT angiography in Rajaie Cardiovascular, Medical, and Research Center. Medical records were reviewed, and relevant demographic, clinical, laboratory and imaging were collected. Results: A total of 219 patients with an average age of 62.64±12.39 were included. Twelve patients(5.5%) had normal coronary angiography, and 50.2% had mild CAD. An obstructive CAD was found in97 patients (44.3%). The median CACS was 76.4 (IQR, 13.0-289.1). The frequency of obstructive CAD was 28.1% in the CACS <100 group, and 67.0% in CACS >100 group (P < 0.001). On multiple logistic regression analysis, age (OR=1.04 [1.01-1.07], P = 0.006), CACS (OR= 4.31 [2.33-7.98], P < 0.001), and neutrophil to lymphocyte ratio (NLR) (OR = 0.82 [0.68-0.98], P = 0.027) were independent predictors of obstructive CAD. Conclusion: We found a direct association between higher CACS and obstructive patterns in coronary CT angiography. Our findings indicate that the possibility of the presence of obstructive CAD was higher among symptomatic patients with older age, lower NLR, and CACS >100.
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Affiliation(s)
- Reza Kiani
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Pouraliakbar
- Department of Radiology, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Javad Alemzadeh-Ansari
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.,Cardio-Oncology Research Center, Rajaie Cardiovascular Medical and Research Center, Tehran, Iran
| | - Ali Khademi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohamad Mehdi Peighambari
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Bahram Mohebbi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ata Firouzi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Zahedmehr
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Farshad Shakerian
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Hosseini
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Rashidinejad
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
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12
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Kiani R, Naghavi B, Amin A, Sadeghpour A, Zahedmehr A, Firouzi A, Pouraliakbar HR, Ebrahimi Meymand S, Marashizadeh A, Almasi S. Central Nervous System and Cardiac Involvement in the Hypereosinophilic Syndrome: A Case Report. Immunol Invest 2020; 50:356-362. [PMID: 32718188 DOI: 10.1080/08820139.2020.1758131] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Hypereosinophilic syndrome is a rare entity and heterogeneous group of disorders characterized by hypereosinophilia and organ involvement. In this study, we presented a 49-year-old woman with cardiac tamponade in the context of Hypereosinophilic syndrome. Identifying hypereosinophilia as the underlying cause can have tremendous clinical implications for rapid initiation of appropriate treatment to minimize further end organ damage.
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Affiliation(s)
- Reza Kiani
- Department of adult cardiology, Rajaie Cardiovascular Medical and Research Center, Tehran, Iran
| | - Batoul Naghavi
- Department of adult cardiology, Rajaie Cardiovascular Medical and Research Center, Tehran, Iran
| | - Ahmad Amin
- Department of adult cardiology, Rajaie Cardiovascular Medical and Research Center, Tehran, Iran
| | - Anita Sadeghpour
- Department of adult cardiology, Rajaie Cardiovascular Medical and Research Center, Tehran, Iran
| | - Ali Zahedmehr
- Department of adult cardiology, Rajaie Cardiovascular Medical and Research Center, Tehran, Iran
| | - Ata Firouzi
- Department of adult cardiology, Rajaie Cardiovascular Medical and Research Center, Tehran, Iran
| | - Hamid Reza Pouraliakbar
- Department of adult cardiology, Rajaie Cardiovascular Medical and Research Center, Tehran, Iran
| | - Saeed Ebrahimi Meymand
- Department of adult cardiology, Rajaie Cardiovascular Medical and Research Center, Tehran, Iran
| | - Armin Marashizadeh
- Department of internal medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Simin Almasi
- Department of internal medicine, Iran University of Medical Sciences, Tehran, Iran
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13
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Shahriari M, Kiani R, Khayati G. Study of phase behavior and Congo red dye partitioning in aqueous two-phase systems composed of hydrophilic alcohols (1-propanol/ 1-butanol) and sodium salts. SEP SCI TECHNOL 2020. [DOI: 10.1080/01496395.2019.1594900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Mohadeseh Shahriari
- Department of Chemical Engineering, Faculty of Engineering, University of Guilan, Rasht, Iran
| | - Reza Kiani
- Department of Chemical Engineering, Faculty of Engineering, University of Guilan, Rasht, Iran
| | - Gholam Khayati
- Department of Chemical Engineering, Faculty of Engineering, University of Guilan, Rasht, Iran
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14
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Firouzi A, Alemzadeh-Ansari MJ, Mohammadhadi N, Peighambari MM, Zahedmehr A, Mohebbi B, Kiani R, Sanati HR, Shakerian F, Rashidinejad A, Ghadrdoost B, Asghari R, Shokrollahi Yancheshmeh S. Association between the risks of contrast-induced nephropathy after diagnostic or interventional coronary management and the transradial and transfemoral access approaches. J Cardiovasc Thorac Res 2020; 12:51-55. [PMID: 32211138 PMCID: PMC7080339 DOI: 10.34172/jcvtr.2020.08] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Accepted: 01/17/2020] [Indexed: 01/02/2023] Open
Abstract
Introduction: The risk of contrast-induced nephropathy (CIN) as a common and important complication of coronary procedures may be influenced by the vascular access site. We compared the risks of CIN in diagnostic or interventional coronary management between patients treated via the transradial access (TRA) and those treated via the transfemoral access (TFA). Methods: Patients undergoing invasive coronary catheterization or percutaneous coronary intervention (PCI) were enrolled. We excluded patients with congenital or structural heart disease and those with end-stage renal disease on dialysis. Based on the vascular access site used for invasive coronary catheterization, the patients were divided into 2 study groups: the TFA and the TRA. CIN was defined as an absolute (≥0.5 mg/dL) or relative (>25%) increase in the baseline serum creatinine level within 48 hours following cardiac catheterization or PCI. Results: Overall, 410 patients (mean age = 61.3 ± 10.8 years) underwent diagnostic or interventional coronary management: 258 were treated via the TFA approach and 152 via the TRA approach. The patients treated via the TFA had a significantly higher incidence of postprocedural CIN (15.1% vs 6.6%; P= 0.01). The multivariate analysis showed that the TFA was the independent predictor of CIN (OR: 2.37, 95% CI: 1.11 to 5.10, and P= 0.027). Moreover, the BARC (Bleeding Academic Research Consortium) and Mehran scores were the other independent predictors of CIN in our study. Conclusion: The risk of CIN was lower with the TRA, and the TFA was the independent predictor of CIN after the diagnostic or interventional coronary management.
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Affiliation(s)
- Ata Firouzi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Javad Alemzadeh-Ansari
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Naser Mohammadhadi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Mehdi Peighambari
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Zahedmehr
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Bahram Mohebbi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Kiani
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Sanati
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Farshad Shakerian
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Rashidinejad
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Behshid Ghadrdoost
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Raana Asghari
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Simin Shokrollahi Yancheshmeh
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
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15
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Maleki M, Basiri H, Khalilipur E, Sarreshtedari A, Zolfaghari R, Sadeghipour P, Alemzadeh-Ansari M, Mohebbi B, Rashidinejad A, Hosseini Z, Zahedmedhr A, Firouzi A, Noohi F, Kiavar M, Peighambari M, Abdi S, Maadani M, Shakerian F, Kiani R, Mohebbi A, Momtahen M, Sadrameli M, Sanati H, Shafe O, Moosavi J, Moghadam Y, Golpira R. Rajaie cardiovascular medical and research center-percutaneous coronary intervention registry: A real-world registry on coronary interventions in a tertiary teaching cardiovascular center. Res Cardiovasc Med 2020. [DOI: 10.4103/rcm.rcm_11_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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16
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Khalilipur E, Alemzade-Ansari M, Nouhi F, Maleki M, Kiavar M, Basiri H, Peighambari M, Firouzi A, Mohebbi B, Sadeghipour P, Madaani M, Zahedmehr A, Shakerian F, Kiani R, Hosseini Z, Rashidinejad A, Bakhshandeh H. Acute Clinical and Procedural Outcome of Rajaie Cardiovascular Medical and Research Center Acute Coronary Syndrome Registry. Res Cardiovasc Med 2020. [DOI: 10.4103/rcm.rcm_27_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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17
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Shoham N, Lewis G, Hayes J, McManus S, Kiani R, Brugha T, Bebbington P, Cooper C. Psychotic symptoms and sensory impairment: Findings from the 2014 adult psychiatric morbidity survey. Schizophr Res 2020; 215:357-364. [PMID: 31481335 PMCID: PMC7613093 DOI: 10.1016/j.schres.2019.08.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 08/07/2019] [Accepted: 08/26/2019] [Indexed: 01/13/2023]
Abstract
PURPOSE Hearing and visual impairment have been associated with psychosis. Mechanisms behind this are poorly understood. We tested whether i) self-reported hearing and visual impairments are associated with psychotic symptoms in the 2014 UK Adult Psychiatric Morbidity Survey; ii) the odds of having psychotic symptoms vary with self-perceived degree of impairments; and iii) reduced social functioning partially explains these associations. METHODS We analysed cross-sectional data using logistic regression. Hearing and visual impairment were the exposures, and screening positive on the Psychosis Screening Questionnaire was the outcome. We used structural equation modelling to assess mediation by social functioning, measured by the Social Functioning Questionnaire. RESULTS Psychotic symptoms were strongly associated with visual impairment (Adjusted Odds Ratio (AOR) 1.81, 95% Confidence Intervals (CI) 1.33 to 2.44), especially moderate visual impairment (AOR 2.75, 95% CI 1.78 to 4.24, p < .001). Psychotic symptoms were associated with a severe degree of hearing impairment (AOR 4.94, 95% CI 1.66 to 14.67, p = .004), and weakly associated with hearing impairment overall (AOR 1.50, 95% CI 1.10 to 2.04, p = .010). Social functioning accounted for approximately 50% of associations with both types of sensory impairment, but the confidence intervals around these estimates were broad. CONCLUSIONS Our findings suggest an association between psychosis and visual impairment, with the strongest evidence for moderate visual impairment; the findings also support a linear relationship between psychosis and degree of hearing impairment. Social functioning may mediate these relationships and be a potential target for intervention, alongside sensory correction. These should be investigated longitudinally.
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Affiliation(s)
- Natalie Shoham
- Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London W1T 7BN, United Kingdom of Great Britain and Northern Ireland.
| | - Gemma Lewis
- Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London W1T 7BN, United Kingdom of Great Britain and Northern Ireland
| | - Joseph Hayes
- Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London W1T 7BN, United Kingdom of Great Britain and Northern Ireland
| | - Sally McManus
- NatCen Social Research, 35 Northampton Square, London EC1V 0AX, United Kingdom of Great Britain and Northern Ireland
| | - Reza Kiani
- University of Leicester, Centre for Medicine, University Road, Leicester LE1 7RH, United Kingdom of Great Britain and Northern Ireland
| | - Traolach Brugha
- University of Leicester, Centre for Medicine, University Road, Leicester LE1 7RH, United Kingdom of Great Britain and Northern Ireland
| | - Paul Bebbington
- Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London W1T 7BN, United Kingdom of Great Britain and Northern Ireland
| | - Claudia Cooper
- Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London W1T 7BN, United Kingdom of Great Britain and Northern Ireland
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18
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Kiani R, Alilou S, Rafatnia S, Taslimi Y, Habibzadeh S, Gharibzadeh S, Firouzi A, Rahim S, Zahedmehr A, Mehrvarz F, Moghadam Ahari M, Sadeghipour P. Role of polymorphisms of the endothelial nitric oxide synthase gene in predicting slow-flow phenomenon after primary percutaneous coronary intervention. Turk Kardiyol Dern Ars 2020; 48:472-483. [PMID: 32633262 DOI: 10.5543/tkda.2020.53849] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The aim of the present study was to examine the association between 2 polymorphisms of the endothelial nitric oxide (eNOS) gene (-786T>C and +894G>T) and the no-reflow/slow-flow phenomenon in post-primary percutaneous coronary intervention (PPCI) patients. METHODS A total of 103 post-PPCI patients were enrolled. Coronary no-reflow phenomenon was defined as a Thrombolysis in Myocardial Infarction (TIMI) flow grade 0-1 and coronary slow-flow phenomenon (CSFP) was defined as a TIMI flow grade ≤2. RESULTS Due to the small number of post-PPCI patients with the no-reflow phenomenon (n=4), the primary comparison was made between CSFP (n=20) and normal flow (n=83) groups. There was a greater frequency of CSFP among carriers of the -786C allele of the eNOS -786T>C polymorphism (odds ratio [OR]: 3.90; 95% confidence interval [CI]: 0.87-17.45; p=0.07). However, no such association was detected between the +894T allele of the eNOS +894G>T and CSFP (OR: 0.92; 95% CI: 0.21-3.98; p=0.91). In the adjusted analysis, the -786T>C polymorphism did not reach statistical significance. CONCLUSION There was no significant association between CSFP and 2 of the most common polymorphisms of the eNOS gene in post-PPCI patients.
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Affiliation(s)
- Reza Kiani
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Sanam Alilou
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Shirin Rafatnia
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Yasaman Taslimi
- Department of Immunotherapy and Leishmania Vaccine Research, Pasteur Institute of Iran, Tehran, Iran
| | - Sima Habibzadeh
- Department of Immunotherapy and Leishmania Vaccine Research, Pasteur Institute of Iran, Tehran, Iran
| | - Safoora Gharibzadeh
- Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
| | - Ata Firouzi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Shahin Rahim
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Zahedmehr
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Farzaneh Mehrvarz
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Moghadam Ahari
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Parham Sadeghipour
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
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Tromans S, Yao GL, Kiani R, Alexander R, Al-Uzri M, Brugha T. Study protocol: an investigation of the prevalence of autism among adults admitted to acute mental health wards: a cross-sectional pilot study. BMJ Open 2019; 9:e033169. [PMID: 31874885 PMCID: PMC7008424 DOI: 10.1136/bmjopen-2019-033169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Autism spectrum disorders (ASDs) are associated with difficulties in social interaction, communication and restricted, repetitive behaviours. Much is known about their community prevalence among adults, data on adult inpatients within an acute mental health setting is lacking.This pilot study aimed to estimate the prevalence of ASDs among adults admitted to acute mental health wards and to examine the association between ASDs and psychiatric and physical comorbidities within this group. METHODS AND ANALYSIS A multiple-phase approach will be used. Phase I will involve testing of 200 patients and corresponding informants, using the autism quotient (AQ), the informant version of the Social Responsiveness Scale, second edition-Adult, the self and informant versions of the Adult Social Behaviour Questionnaire and the EuroQol-5D-5L. Patients with intellectual disability (ID) will bypass Phase I.Phase II will involve diagnostic testing of a subgroup of 40 patients with the Diagnostic Interview for Social and Communication Disorders, the Autism Diagnostic Observation Schedule version 2 and the ASD interview within the Schedules for Clinical Assessment in Neuropsychiatry version 3. 25±5 patients will not have ID and be selected via stratified random sampling according to AQ score; 15±5 patients will have ID. Phase II patients will be interviewed with the Physical Health Conditions and Mental Illness Diagnoses and Treatment sections of the 2014 Adult Psychiatric Morbidity Survey.Prevalence estimates will be based on the proportion of Phase II participants who satisfy the 10th revision of the International Statistical Classification of Diseases and Related Health Problems Diagnostic Criteria for Research (ICD-10-DCR) and the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnostic criteria for ASD, adjusting for selection and non-response. Univariate analysis will be conducted for comorbidities to identify the level of their association with an ASD diagnosis. ETHICS AND DISSEMINATION Study oversight is provided by the University of Leicester. The National Health Service Health Research Authority have provided written approval. Study results will be disseminated via conference presentations and peer-reviewed publications. TRIAL REGISTRATION NUMBER ISRCTN27739943.
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Affiliation(s)
- Sam Tromans
- Department of Health Sciences, University of Leicester, Leicester, UK
- Learning Disability Psychiatry, Leicestershire Partnership NHS Trust, Leicester, UK
| | - Guiqing Lily Yao
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Reza Kiani
- Department of Health Sciences, University of Leicester, Leicester, UK
- Learning Disability Psychiatry, Leicestershire Partnership NHS Trust, Leicester, UK
| | - Regi Alexander
- Department of Health Sciences, University of Leicester, Leicester, UK
- Learning Disability Psychiatry, Hertfordshire Partnership University NHS Foundation Trust, Norwich, UK
| | - Mohammed Al-Uzri
- Department of Health Sciences, University of Leicester, Leicester, UK
- General Adult Psychiatry, Leicestershire Partnership NHS Trust, Leicester, UK
| | - Traolach Brugha
- Department of Health Sciences, University of Leicester, Leicester, UK
- General Adult Psychiatry, Leicestershire Partnership NHS Trust, Leicester, UK
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Mohammadzadeh A, Farzaneh M, Zahedmehr A, Kiani R, Shakiba M, Borhani A, Rouzitalab M, Ahmadi S, Mohammadzadeh M. Coronary CT Angiography and Dual-Energy Computed Tomography in Ischemic Heart Disease Suspected Patients. Arch Iran Med 2019; 22:376-383. [PMID: 31679380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 12/24/2018] [Indexed: 06/10/2023]
Abstract
BACKGROUND Advanced computed tomography (CT) scanners enable concurrent assessment of coronary artery anatomy and myocardial perfusion. The purpose of this study was to assess dual-energy CT images in a group of patients suspected for ischemic heart disease and to evaluate agreement of cardiac computed tomography perfusion (CTP) images with CT angiography results in a single dual-energy computed tomography (DECT) acquisition. METHODS Thirty patients (mean age: 53.8 ± 12.9 years, 60% male) with angina pectoris or atypical chest pain, suspected for ischemic heart disease, were investigated using a 384-row detector CT scanner in dual-energy mode (DECT). Firstly, resting CTP images were acquired, and then from the same raw data, computed tomography angiography (CTA) studies were reconstructed for stenosis detection. CT-based dipyridamole-stress myocardial perfusion imaging was then performed in patients who exhibited coronary stenosis >50% or had myocardial bridge (MB). A color-coded iodine map was used for evaluation of myocardial perfusion defects using the 17-segment model. Two independent blinded readers analyzed all images for stenosis and myocardial perfusion defects. Different myocardial iodine content (mg/mL) was calculated by parametric tests. The kappa agreement was calculated between results of two methods in cardiac scans. RESULTS All 30 CT angiograms were evaluated and assessment ability was 100% for combined CTA/CTP. According to the combined CT examination, 17 patients (56.7%) exhibited significant coronary stenosis and/or deep MB (DMB). A total of 510 myocardial segments and 90 vascular territories were analyzed. Coronary CTA demonstrated significant stenosis in 22 vessels (24.4% of all main coronary arteries) among 12 patients (40%), DMB in 6 vessels (6.7% of all main coronary arteries) in 17 out of 30 patients (56.7%). Twenty-eight out of 90 vascular territories (31.1%) and 41 out of 510 segments (8%) showed reversible perfusion defects on stress DECT. Kappa agreement between CTA and CTP results in whole heart was 0.79 (95% confidence interval=0.57-1). There were significant differences in mean iodine concentration between ischemic (0.59 ± 0.07 mg/mL) and normal segments (2.2 ± 0.15) with P < 0.001. CONCLUSION Agreement of CTA and CTP in whole heart and in LAD considering DMB and significant CAD together were good to excellent; however, considering sole pathologies, most of the agreements were weak (<0.5). DECT with iodine quantification may provide a valuable method in comparison with previous methods for identifying both coronary stenosis and myocardial ischemia.
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Affiliation(s)
- Ali Mohammadzadeh
- Department of Radiology, Rajaie Cardiovascular and Medical Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mehdi Farzaneh
- Rajaie Cardiovascular and Medical Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Zahedmehr
- Department of Interventional Cardiology, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Kiani
- Department of Interventional Cardiology, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Madjid Shakiba
- Advanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Borhani
- Advanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Rouzitalab
- Rajaie Cardiovascular and Medical Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Samaneh Ahmadi
- Rajaie Cardiovascular and Medical Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Mohammadzadeh
- Department of Radiology, Amiralalm Hospital, Tehran University of Medical Sciences, Tehran, Iran (C. O)
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Tromans S, Diehl B, Kiani R. Association of temporal lobe epilepsy with gambling disorder in a patient with mild intellectual disability and autism spectrum disorder. Seizure 2019; 69:17-19. [DOI: 10.1016/j.seizure.2019.03.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 03/15/2019] [Accepted: 03/27/2019] [Indexed: 10/27/2022] Open
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Kiani R, Bhaumik S, Tyrer F, Bankart J, Miller H, Cooper SA, Brugha TS. The relationship between symptoms of autism spectrum disorder and visual impairment among adults with intellectual disability. Autism Res 2019; 12:1411-1422. [DOI: 10.1002/aur.2138] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 05/13/2019] [Indexed: 11/09/2022]
Affiliation(s)
- Reza Kiani
- Leicestershire Learning Disability ServiceLeicestershire Partnership NHS Trust Leicester United Kingdom
- Department of Health SciencesUniversity of Leicester Leicester United Kingdom
| | - Sabyasachy Bhaumik
- Leicestershire Learning Disability ServiceLeicestershire Partnership NHS Trust Leicester United Kingdom
- Department of Health SciencesUniversity of Leicester Leicester United Kingdom
| | - Freya Tyrer
- Department of Health SciencesUniversity of Leicester Leicester United Kingdom
| | - John Bankart
- Department of Health SciencesUniversity of Leicester Leicester United Kingdom
| | - Helen Miller
- National Deaf Services, South West London and St. Georges Mental Health NHS Trust London United Kingdom
| | - Sally Ann Cooper
- Institute of Health and WellbeingUniversity of Glasgow Glasgow United Kingdom
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Firouzi A, Kazem Moussavi A, Mohebbi A, Alemzadeh-Ansari MJ, Kiani R, Sanati HR, Mohebbi B, Shakerian F, Zahedmehr A, Ansari-Ramandi MM, Oni Heris S, Ghaleshi B, Ghorbani F. Comparison between rosuvastatin and atorvastatin for the prevention of contrast-induced nephropathy in patients with STEMI undergoing primary percutaneous coronary intervention. J Cardiovasc Thorac Res 2018; 10:149-152. [PMID: 30386535 PMCID: PMC6203872 DOI: 10.15171/jcvtr.2018.24] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 08/31/2018] [Indexed: 11/22/2022] Open
Abstract
Introduction: There is some controversy over the efficacy of statins for the prevention of contrastinduced
nephropathy (CIN). There have also been reports on varying efficacies of different
statins. Hence, in this study the efficacy of atorvastatin and rosuvastatin for the prevention of
CIN was assessed.
Methods: This single-blind randomized clinical trial was performed on 495 random patients with
myocardial infarction with ST-segment elevation undergoing primary percutaneous coronary
intervention (PCI) in a training referral hospital in 2015. Patients were randomly assigned to
receive either atorvastatin 80 mg at admission and daily or rosuvastatin 40 mg at admission and
daily. CIN was defined based on serum creatinine elevation after 48 hours from the PCI.
Results: The incidence of CIN was observed in 63 patients (21.4%) After 48 hours from primary
PCI. Of those, 17% (n = 50) were grade 1 CIN, while 4.4% (n = 13) were grade 2 CIN. There
was no significant difference between rosuvastatin group compared with atorvastatin group,
regarding the CIN grading (P = 0.14).
Conclusion: Our results indicate that atorvastatin and rosuvastatin have similar efficacy for the
prevention of CIN.
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Affiliation(s)
- Ata Firouzi
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Kazem Moussavi
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Mohebbi
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Reza Kiani
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Sanati
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Bahram Mohebbi
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Farshad Shakerian
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Zahedmehr
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Saeed Oni Heris
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Bahar Ghaleshi
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Ghorbani
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
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Tromans S, Chester V, Kiani R, Alexander R, Brugha T. The Prevalence of Autism Spectrum Disorders in Adult Psychiatric Inpatients: A Systematic Review. Clin Pract Epidemiol Ment Health 2018; 14:177-187. [PMID: 30197663 PMCID: PMC6118035 DOI: 10.2174/1745017901814010177] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 05/22/2018] [Accepted: 06/16/2018] [Indexed: 12/27/2022]
Abstract
Background: Whilst the prevalence of autism spectrum disorders in adults within the community setting is well-established, less is known about the prevalence among adults based within a psychiatric inpatient setting. Objective: To conduct a systematic literature review pertaining to the prevalence of autism spectrum disorders among the adult psychiatric inpatient population. Method: Eligibility criteria included: (a) investigation of the prevalence of autism spectrum disorders (b) adult psychiatric inpatient study population (c) published in English language. Electronic databases accessed included PubMed, Medline, CINAHL, PsycINFO and EMBASE. Additionally, the ancestry method was utilised for the references of eligible papers, as well as grey literature searches and consultation with experts in the field. Results: From the search, 4 studies were identified which satisfied the inclusion criteria, conducted in a variety of inpatient psychiatric settings, including secure forensic and intellectual disability units and a state psychiatric hospital. There were significant differences in methodological approaches, including the screening tests, diagnostic instruments and diagnostic criteria utilised. Autism spectrum disorder prevalence estimates varied considerably, from 2.4-9.9%. Conclusion: From the limited research data currently available, it appears that the prevalence of autism spectrum disorders is increased in inpatient psychiatric settings relative to the general population. There is a need for further high quality research in this patient group, to add to this limited evidence base, as well as in developing effective strategies to identify patients with a high likelihood of autism spectrum disorders within this setting.
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Affiliation(s)
- Samuel Tromans
- Department of Health Sciences, University of Leicester, Leicester, Leicestershire, United Kingdom.,Leicestershire Partnership NHS Trust, Leicester, Leicestershire, United Kingdom
| | - Verity Chester
- Priory Group, Norwich, Norfolk, United Kingdom.,Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Reza Kiani
- Department of Health Sciences, University of Leicester, Leicester, Leicestershire, United Kingdom.,Leicestershire Partnership NHS Trust, Leicester, Leicestershire, United Kingdom
| | - Regi Alexander
- Department of Health Sciences, University of Leicester, Leicester, Leicestershire, United Kingdom.,Hertfordshire Partnership University NHS Foundation Trust, Broadland Clinic & Astley Court, Norwich, United Kingdom
| | - Terry Brugha
- Department of Health Sciences, University of Leicester, Leicester, Leicestershire, United Kingdom.,Leicestershire Partnership NHS Trust, Leicester, Leicestershire, United Kingdom
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Abstract
SummarySensory (visual and hearing) impairment has significant detrimental impact on sociocognitive and language development. Despite this, it is very much underrecognised and underdiagnosed in people with intellectual disability. Raising awareness of sensory impairment among professionals and carers is extremely important for early management to prevent further social handicap in people with intellectual disability. This article reviews sensory impairment in intellectual disability and its association with autism-spectrum disorder and mental illness.
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Sadeghipour P, Sanati H, Ahmadi S, Farrashi M, Firouzi A, Zahedmehr A, Shakerian F, Kiani R, Shafe O, Moosavi S, Bakhshande H, Hoghooghi A, Jalili F. Effect of preinfarction angina on primary percutaneous coronary intervention outcomes. Res Cardiovasc Med 2018. [DOI: 10.4103/rcm.rcm_20_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Feghhi V, Kiani R, Alemzadeh-Ansari M, Firouzi A, Sanati H, Zahedmehr A, Shakerian F, Shakeri A, Namdar R, Baay M, Mikailvand A, Taghavi S. Comparison of Enoxaparin versus Heparin among Patients Undergoing Elective Coronary Angiography via Radial Artery Access. Res Cardiovasc Med 2018. [DOI: 10.4103/rcm.rcm_15_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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30
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Barron J, Kiani R. Trinucleotide repeat disorders: An interesting interface between psychiatry and medicine. BJPsych advances 2017. [DOI: 10.1192/apt.bp.117.017467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SummaryThe discovery of conditions resulting from the expansion of unstable trinucleotide repeats, with their neuropsychiatric presentations crossing the boundaries of different specialties, provides ample opportunity for research and liaison work between medical and psychiatric subspecialties. Clinicians’ awareness of the presentations and genetic basis of these conditions improves management strategies and the quality of life of patients and their carers.
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Mohammadzadeh A, Faeghi F, Sahraee N, Pouraliakbar H, Kiani R, Mohammadzadeh V, Entezari P, Borhani A, Shakiba M, Kadivar S, Mohammadzadeh M. Diagnostic Efficacy of Coronary Artery Three-Dimensional Steady-State Free Precession Magnetic Resonance Angiography in Comparison with Invasive Coronary Angiography for Detecting Coronary Artery Disease. Arch Iran Med 2017; 20:314-319. [PMID: 28510468 DOI: 0172005/aim.0010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To assess the diagnostic value of three-dimensional steady-state free precession magnetic resonance angiography (3D-SSFP MRA) for detecting coronary artery disease (CAD). MATERIALS AND METHODS Patients suspected of CAD based on clinical evaluation, underwent invasive coronary angiography (CAG) and Cardiac MRA (CMRA). Collected data in favor of any CAD findings in CMRA were compared to CAG results as the standard diagnostic method in CAD detection. Analysis was performed on per-patient, per-vessel and per-segment bases. RESULTS A total of 30 patients (mean age: 43 ± 10 years, 19 men) were enrolled for analysis. On per-patient analysis, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and area under receiver operator characteristic (ROC) curve of CMRA for detection of coronary artery stenosis were 100% (CI95%: 75% - 100%), 50% (CI95%: 18% - 81%), 73.33% (CI95%: 46% - 90%), 100% (CI95%: 47% - 100%) and 0.827, respectively. On per-vessel analysis, CMRA had a sensitivity of 89.29% (CI95%: 71%-97%), specificity of 80.56% (CI95%: 63% - 91%), PPV of 78.13% (CI95%: 60% - 90%), NPV of 90.63% (CI95%: 74% - 98%) and area under ROC curve of 0.845. On per-segment analysis, sensitivity, specificity, PPV and NPV of CMRA for segmental stenosis detection were 77.78% (CI95%: 60% - 89%), 87% (CI95%: 81% - 92%), 62% (CI95%: 46% - 76%), and 93.89% (CI95%: 88% - 97%), respectively. Area under ROC curve was 0.835 on per-segment analysis. CONCLUSION 3D SSFP CMRA provides a promising non-invasive diagnostic tool for assessing coronary artery disease.
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Affiliation(s)
- Ali Mohammadzadeh
- Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Fariborz Faeghi
- Faculty of Allied Health Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nazanin Sahraee
- Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Pouraliakbar
- Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Kiani
- Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Pouya Entezari
- Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Borhani
- Advanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Madjid Shakiba
- Advanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sakineh Kadivar
- Amiralmomenin Hospital, Guilan University of Medical Sciences, Rasht, Iran
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Sanati H, Zolfaghari R, Samiei N, Rezaei Y, Chitsazan M, Zahedmehr A, Shakerian F, Kiani R, Firouzi A, Rezaei Tabrizi R. Mitral valve resistance determines hemodynamic consequences of severe rheumatic mitral stenosis and immediate outcomes of percutaneous valvuloplasty. Echocardiography 2017; 34:162-168. [PMID: 28070915 DOI: 10.1111/echo.13448] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION The mitral valve area (MVA) poorly reflects the hemodynamic status of (MS). In this study, we compared the MVA with mitral valve resistance (MVR) with regard to the determination of hemodynamic consequences of MS and the immediate outcomes of percutaneous balloon mitral valvuloplasty (PBMV). METHODS In a prospective study, 36 patients with severe rheumatic MS with left ventricular ejection fraction (LVEF) >50% were evaluated. They underwent transthoracic echocardiography (TTE) and catheterization. The MVA was measured by two-dimensional planimetry and pressure half-time (PHT), and the MVR was calculated using the equation: 1333 × transmitral pressure gradient mean transmitral diastolic flow rate. RESULTS The patients' mean age was 47.8±10.5 years. MVR ≥140.6 dynes·s/cm5 detected systolic pulmonary arterial pressure (sPAP) >55 mm Hg with a sensitivity of 100% and a specificity of 74%. The sensitivity and specificity of MVA<0.75 cm2 to discriminate elevated sPAP were 81% and 89%, respectively. PHT ≥323.5 mseconds had a sensitivity of 78% and a specificity of 96% to detect an elevated sPAP. To predict a successful PBMV, preprocedural MVR ≥106.1 dynes·s/cm5 had a sensitivity of 100% and a specificity of 67% (area under the curve [AUC]=0.763; 95% confidence interval [CI]=0.520-1.006; P=.034); preprocedural MVA <0.95 cm2 had a sensitivity of 78% and a specificity of 73% (AUC=0.730; 95% CI=0.503-0.956; P=.065); and preprocedural PHT ≥210.5 mseconds had a sensitivity of 73% and a specificity of 78% (AUC=0.707; 95% CI=0.474-0.941; P=.095). CONCLUSIONS MVR seems to be more accurate than MVA in determining the hemodynamic consequences of severe MS as determined by sPAP. In addition, preprocedural MVR detected successful PBMVs.
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Affiliation(s)
- Hamidreza Sanati
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Zolfaghari
- Department of Cardiology, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Niloufar Samiei
- Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Yousef Rezaei
- Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mitra Chitsazan
- Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Zahedmehr
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Farshad Shakerian
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Kiani
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ata Firouzi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Rezaei Tabrizi
- Department of Cardiology, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
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Abstract
Recent years have seen a growing interest in understanding the neural mechanisms that support decision-making. The advent of new tools for measuring and manipulating neurons, alongside the inclusion of multiple new animal models and sensory systems has led to the generation of many novel datasets. The potential for these new approaches to constrain decision-making models is unprecedented. Here, we argue that to fully leverage these new approaches, three challenges must be met. First, experimenters must design well-controlled behavioral experiments that make it possible to distinguish competing behavioral strategies. Second, analyses of neural responses should think beyond single neurons, taking into account tradeoffs of single-trial versus trial-averaged approaches. Finally, quantitative model comparisons should be used, but must consider common obstacles.
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Affiliation(s)
| | - R Kiani
- Center for Neural Science, New York University, New York University
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Aeinfar K, Firouzi A, Shahsavari H, Sanati H, Kiani R, Shakerian F, Zahed Mehr A. The Predictors of No-Reflow Phenomenon after Primary Angioplasty for Acute Myocardial Infarction. Int Cardiovasc Res J 2016. [DOI: 10.17795/icrj-10(03)107] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Peighambari M, Sanati H, Hadjikarimi M, Zahedmehr A, Shakerian F, Firouzi A, Kiani R, Sadeghipour P, Kzaemi Asl S. The Effects of Side Branch Predilation During Provisional Stenting of Coronary Bifurcation Lesions: A Double-Blind Randomized Controlled Trial. Res Cardiovasc Med 2016; 5:e31378. [PMID: 26949691 PMCID: PMC4756256 DOI: 10.5812/cardiovascmed.31378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 08/18/2015] [Accepted: 09/01/2015] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND There is a paucity of data regarding the role of side branch (SB) predilation during the provisional stenting of bifurcation lesions. OBJECTIVES The present study aimed to assess the effects of SB predilation on the outcomes of true bifurcation interventions. PATIENTS AND METHODS Sixty patients with true bifurcation lesions according to the Medina classification were included in the study and randomly assigned to receive SB predilation before stenting the main branch (n = 30) or no predilation as the control group (n = 30). RESULTS There was a trend toward the higher occurrence of dissection in the predilated ostial lesions of the SB compared to the non-predilated group (16.7% vs. 0, P = 0.07). Performance of the SB predilation was not associated with improved flow of the SB or fewer degrees of ostial stenosis after stenting the main branch, the need to rewire, rewiring time, or the rate of use of the final kissing balloon dilation and double stents procedures. CONCLUSIONS Routine predilation of the SB in provisional stenting of true bifurcation lesions seems to be ineffective and might be associated with some undesirable consequences. Still, there are some complex ostial lesions of the SB which could benefit from predilation.
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Affiliation(s)
- Mohammadmehdi Peighambari
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
| | - Hamidreza Sanati
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
| | - Majid Hadjikarimi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
| | - Ali Zahedmehr
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
| | - Farshad Shakerian
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
| | - Ata Firouzi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
| | - Reza Kiani
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
| | - Parham Sadeghipour
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
| | - Siamak Kzaemi Asl
- Centers of Excellence Secretariat, Ministry of Health and Education of Iran, Tehran, IR Iran
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Sanati H, Kiani R, Shakerian F, Firouzi A, Zahedmehr A, Peighambari M, Shokrian L, Ashrafi P. Coronary Slow Flow Phenomenon Clinical Findings and Predictors. Res Cardiovasc Med 2016; 5:e30296. [PMID: 26889458 PMCID: PMC4752610 DOI: 10.5812/cardiovascmed.30296] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 06/28/2015] [Accepted: 07/06/2015] [Indexed: 11/29/2022] Open
Abstract
Background: In some patients with chest pain, selective coronary angiography reveals slow contrast agent passage through the epicardial coronary arteries in the absence of stenosis. This phenomenon has been designated the slow coronary flow (SCF) phenomenon. Objectives: In this study, we aimed to describe the demographic and clinical findings and presence of common atherosclerosis risk factors in patients with the SCF phenomenon. Patients and Methods: Between October 2014 and March 2015, demographic data, clinical histories, atherosclerosis risk factors, and laboratory and angiographic findings were recorded for all consecutive patients scheduled for coronary angiography and diagnosed with the SCF phenomenon, as well as a control group (patients with normal epicardial coronary arteries; NECA). SCF was diagnosed based on the thrombolysis in myocardial infarction frame count (TFC). A TFC > 27 indicated a diagnosis of SCF phenomenon. Results: Among the 3600 patients scheduled for selective coronary angiography, 75 (2%) met the SCF criteria. SCF and NECA patients did not exhibit statistically significant differences in traditional risk factors except for hypertension, which was more prevalent in SCF than NECA patients (52% versus 31%, P = 0.008). A multivariable analysis indicated a low body mass index, presence of hypertension, low high-density lipoprotein cholesterol (HDL-c) level, and high hemoglobin level as independent predictors of the SCF phenomenon; of these, hypertension was the strongest predictor (odds ratio = 6.3, 95% confidence interval: 2.2 - 17.9, P = 0.001). Conclusions: The SCF phenomenon is relatively frequent, particularly among patients with acute coronary syndrome who are scheduled for coronary angiography. Hypertension, a low HDL-c level, and high hemoglobin level can be considered independent predictors of this phenomenon.
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Affiliation(s)
- Hamidreza Sanati
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
| | - Reza Kiani
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
| | - Farshad Shakerian
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
| | - Ata Firouzi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
| | - Ali Zahedmehr
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Ali Zahedmehr, Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Vali-Asr ST., Niayesh Blvd, Tehran, IR Iran. Tel: +98-2123922108, Fax: +98-2122042026, E-mail:
| | - Mohammadmehdi Peighambari
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
| | - Leila Shokrian
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
| | - Peiman Ashrafi
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
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Kiani R. 'Hat on, hat off!' A memorable clinical encounter - extra. Br J Psychiatry 2016; 208:8. [PMID: 26729840 DOI: 10.1192/bjp.bp.115.172726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Zahedmehr A, Sanati H, Kiani R, Shakerian F, Firouzi A, Peighambari M, Shokrian L, Ashrafi P. Coronary slow flow phenomenon: Clinical findings and predictors. Res Cardiovasc Med 2016. [DOI: 10.4103/2251-9572.218699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Noohi F, Hashemi I, Sanati HR, Peighambari MM, Kiavar M, Maadani M, Bassiri HA, Zahedmehr A, Shakerian F, Firouzi A, Kiani R, Abdi S. In-hospital and six-month outcomes of elderly patients undergoing primary percutaneous coronary intervention for acute ST-elevation myocardial infarction. ARYA Atheroscler 2016; 12:28-34. [PMID: 27114734 PMCID: PMC4834178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
BACKGROUND Elderly patients constitute a rapidly growing proportion of the population, and hence the increasing rises in the number of patients with ST-segment-elevation myocardial infarction (STEMI). Primary percutaneous coronary intervention (PCI), which is now established as the preferred reperfusion strategy in STEMI patients, has been inadequately investigated in this high-risk group. The aim of the present study was to investigate the in-hospital and 6-month outcomes of primary PCI in elderly patients (≥ 75 years) with STEMI. METHODS A total of 100 elderly patients with STEMI including those with cardiogenic shock were included. Primary PCI procedures were performed in a tertiary referral center between 2009 and 2014. In-hospital and 6-month outcomes of patients were recorded and analyzed. RESULTS The average age of the patients was 79.6 ± 3.8 years (range = 75-90 years) and 27.0% were women. Cardiovascular risk factors and prior events were common. Nearly, half of the patients had three-vessel disease and the left anterior descending artery (LAD) was the most common infarct-related artery. The presence of cardiogenic shock but not the other variables was associated with less anatomic and procedural success (P < 0.001). It was also the major independent predictors of 6-month mortality in the patients aged ≥ 75 years, [hazard ratio (HR) = 8.02; 95% confidence interval (CI): 1.75-25.97, P < 0.001]. In-hospital mortality was 2.4% in the patients without and 83.0% in those with cardiogenic shock. CONCLUSION Primary PCI in aged patients could be associated with low complication rates and improved survival if performed in high-volume centers with experienced operators. Considering the very high rate of mortality in patients with cardiogenic shock, there should be measures to treat these patients before the onset of hemodynamic instability.
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Affiliation(s)
- Fereydoon Noohi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Isa Hashemi
- Rajaie Cardiovascular Medical and Research Center AND Department of Cardiology, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Sanati
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran,Correspondence to: Hamid Reza Sanati,
| | - Mohammad Mehdi Peighambari
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Majid Kiavar
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohsen Maadani
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hossein Ali Bassiri
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Zahedmehr
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Farshad Shakerian
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ata Firouzi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Kiani
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Seifollah Abdi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
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Kiani R. Do We Need an Eye-Shield in Our Cath-Labs? Res Cardiovasc Med 2015; 4:e27874. [PMID: 26396974 PMCID: PMC4576162 DOI: 10.5812/cardiovascmed.4(2)2015.27874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 02/14/2015] [Indexed: 12/02/2022] Open
Affiliation(s)
- Reza Kiani
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Reza Kiani, Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Vali-Asr St., Niayesh Blvd, Tehran, IR Iran. Tel: + 98-2123922187, E-mail:
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Shakerian F, Sanati H, Kiani R, Khezerlou N, Firouzi A, Zahedmehr A. Comparison of outcomes of diseased coronary arteries ectasia, stenosis and combined. Res Cardiovasc Med 2015; 4:e25206. [PMID: 25789259 PMCID: PMC4350184 DOI: 10.5812/cardiovascmed.25206] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Revised: 12/01/2014] [Accepted: 12/30/2014] [Indexed: 01/18/2023] Open
Abstract
Background: Coronary artery ectasia (CAE) is a localized or diffuse abnormal dilatation of coronary arteries. Controversy still remains about its cardiovascular events rate, prognosis, and etiology. Adverse effects of CAE coinciding with coronary artery stenosis (CAS) (and in isolated form) are unclear. Objectives: We aimed to investigate the cardiovascular event rate of CAE in comparison to ‘CAS only’, and comparing their etiology. Patients and Methods: This cross-sectional study was conducted on 200 patients between May 2011 and June 2012. Of them, 40 had CAE (case group) and 160 had only CAS (control group). Patients with CAE were divided into 2 subgroups according to the absence (E1) or presence (E2) of CAS. They were followed up for at least 6 month for cardiovascular events, including death, unstable angina and myocardial infarction (MI). Finally, we compared findings in CAE, CAS, and E1 and E2 subgroups and evaluated the relationship between severity of ectasia (1-1.5 times, 1.5-2 times, and > 2 times) and CAS. Results: Hypertension (HTN), dyslipidemia (DLP), and male sex were matched in both groups without significant difference. Cigarette smoking (C/S) was significantly higher and diabetes mellitus (DM) was significantly lower in CAE compared to CAS patients. A subgroup of CAE patients with CAS (E2 subgroup) had significantly higher mortality rate than isolated CAS (P = 0.043). MI was seen in several isolated CAE patients (E1) subgroup. Severity of ectasia showed no significant relationship with CAS. Conclusions: Presence of CAE in patients with CAS increases its cardiovascular event rate. Isolated CAE is not a benign finding and MI can occur. Risk factors of CAE are similar to CAS, but C/S is more associated with CAE than CAS. DM is seen in CAE patients less than CAS.
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Affiliation(s)
- Farshad Shakerian
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
| | - Hamidreza Sanati
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Hamidreza Sanati, Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Vali-Asr St., Niayesh Blvd., Tehran, IR Iran. Tel: +98-2123922178, Fax: +98-2122055594, E-mail:
| | - Reza Kiani
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
| | - Naser Khezerlou
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
| | - Ata Firouzi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
| | - Ali Zahedmehr
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
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Kiani R, Lawden M, Eames P, Critchley P, Bhaumik S, Odedra S, Gumber R. Anti-NMDA-receptor encephalitis presenting with catatonia and neuroleptic malignant syndrome in patients with intellectual disability and autism. BJPsych Bull 2015; 39:32-5. [PMID: 26191422 PMCID: PMC4495827 DOI: 10.1192/pb.bp.112.041954] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2012] [Accepted: 12/13/2012] [Indexed: 11/23/2022] Open
Abstract
We report anti-N-methyl-d-aspartate (NMDA) receptor encephalitis in two patients with autism and intellectual disability presenting with neuropsychiatric symptoms of catatonia and neuroleptic malignant syndrome. Case reports such as these help raise awareness of this clinical issue. By paving the way for earlier diagnoses they ultimately maximise the potential for curative treatments and prevention of long-term complications.
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Affiliation(s)
- Reza Kiani
- Adult Learning Disability Service, Leicestershire Partnership NHS Trust ; Department of Medical Education, School of Medicine, University of Leicester
| | - Mark Lawden
- Department of Neurology, University Hospitals of Leicester
| | - Penelope Eames
- Department of Neurology, University Hospitals of Leicester
| | | | - Sabyasachi Bhaumik
- Adult Learning Disability Service, Leicestershire Partnership NHS Trust ; University of Leicester
| | | | - Rohit Gumber
- Adult Learning Disability Service, Leicestershire Partnership NHS Trust
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Mahdavi-Roshan M, Zahedmehr A, Mohammad-Zadeh A, Sanati HR, Shakerian F, Firouzi A, Kiani R, Nasrollahzadeh J. Effect of garlic powder tablet on carotid intima-media thickness in patients with coronary artery disease: a preliminary randomized controlled trial. Nutr Health 2015; 22:143-55. [PMID: 25573347 DOI: 10.1177/0260106014563446] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND/OBJECTIVES This study was designed to investigate whether garlic powder tablets in adjunct to conventional medical treatment could have an effect on carotid intima-media thickness (CIMT) and plasma lipoproteins and lipids in patients with coronary artery disease (CAD). SUBJECTS/METHODS A randomized, placebo-controlled, clinical trial was conducted on 56 patients with CAD between the ages of 25 and 75 years. The patients were randomly divided into two groups: garlic group (n = 27), receiving garlic powder tablet (1200 µg allicin/tab) twice daily and the placebo group (n = 29), receiving placebo for 3 months. The rate of atherosclerosis progression was measured by B-mode ultrasonography as the increase in CIMT. RESULTS After 3 months of taking garlic tablets, CIMT values had minor variations (0.009 ± 0.007 mm reduction from baseline), while in the placebo group, an increase in CIMT values was observed (0.04 ± 0.01 mm increase from baseline). After 3 months of treatment, mean CIMT difference from baseline was significantly differ between the two groups (p < 0.001). Plasma lipids and lipoproteins (total cholesterol, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, Apolipoprotein A1 and Apolipoprotein B) did not differ between the two groups. CONCLUSIONS The results suggest that dry garlic powder tablet is superior to placebo in prevention of CIMT progression in patients with CAD and may be considered as an adjunct treatment for atherosclerosis.
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Affiliation(s)
- Marjan Mahdavi-Roshan
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Zahedmehr
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Mohammad-Zadeh
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid-Reza Sanati
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Farshad Shakerian
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ata Firouzi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Kiani
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Javad Nasrollahzadeh
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Sanati H, Shakerian F, Kiani R, Khezerlou N, Firouzi A, Zahedmehr A. Comparison of outcomes of diseased coronary arteries ectasia, stenosis and combined. Res Cardiovasc Med 2015. [DOI: 10.4103/2251-9572.218767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Kiani R. Do we need an eye-shield in our cath-labs? Res Cardiovasc Med 2015. [DOI: 10.4103/2251-9572.218781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Firouzi A, Maadani M, Kiani R, Shakerian F, Sanati HR, Zahedmehr A, Nabavi S, Heidarali M. Intravenous magnesium sulfate: new method in prevention of contrast-induced nephropathy in primary percutaneous coronary intervention. Int Urol Nephrol 2014; 47:521-5. [PMID: 25475196 DOI: 10.1007/s11255-014-0890-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 10/28/2014] [Indexed: 12/31/2022]
Abstract
BACKGROUND Contrast-induced acute kidney injury (CI-AKI) is an adverse consequence of percutaneous coronary interventions which results in significant morbidity and mortality and adds to the costs of diagnostic and interventional cardiology procedures. Various pathophysiological mechanisms have been proposed for CI-AKI and various agents tested for its prevention. There is currently a general agreement that adequate pre-procedural hydration constitutes the cornerstone of prevention, yet there are reports of the use of some other agents with various efficacies. We prospectively tested IV magnesium sulfate (Mg) for CI-AKI prevention. METHOD AND DESIGN This study is a prospective, randomized, open-labeled, single-center clinical trial. We randomly assigned 122 consecutive patients to two groups. The first group was the control group with routine treatment (n = 64), and second group was the study group with routine treatment plus IV magnesium sulfate 1 g just before the procedure (n = 62). Serum creatinine was measured before the procedure and 2 days after the procedure. The primary end point was the occurrence of CI-AKI within 48 h. CI-AKI was defined as 0.5 mg/dl or more increase in serum creatinine or 25% or more increase above baseline serum creatinine. There was no difference in definition if both of these parameters were present. RESULTS The control and study groups were comparable in the overall predicted risk of CI-AKI. Also, the type and volume of the contrast were not significantly different between the two groups. Following angioplasty, CI-AKI occurred in 17 (26.6%) patients in the control group and nine (14.5%) patients in the study group; there was a significant reduction in CI-AKI in the study group (P = 0.01). Additionally, there was no mortality or a need for hemodialysis in either group. CONCLUSION In primary PCI patients, the prophylactic use of intravenous Mg can be recommended to be added to traditional hydration for CI-AKI prevention.
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Affiliation(s)
- Ata Firouzi
- Department of Interventional Cardiology, Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
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Kiani R, Tyrer F, Jesu A, Bhaumik S, Gangavati S, Walker G, Kazmi S, Barrett M. Mortality from sudden unexpected death in epilepsy (SUDEP) in a cohort of adults with intellectual disability. J Intellect Disabil Res 2014; 58:508-520. [PMID: 23647577 DOI: 10.1111/jir.12047] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/02/2013] [Indexed: 06/02/2023]
Abstract
BACKGROUND People with intellectual disability (ID) and epilepsy are more likely to die prematurely than the general population. A significant number of deaths in people with epilepsy may be potentially preventable through better seizure control, regular monitoring and raising awareness among patients and carers. The aim of this project was to study mortality from sudden unexpected death in epilepsy (SUDEP) in adults with ID. METHODS All adults (≥20 years old) living in Leicester city, Leicestershire and Rutland, UK, with ID between 1993 and 2010 were identified using the Leicestershire Intellectual Disability Register database. People with and without ID who died during the same period were identified using death certificate data from the Office for National Statistics (ONS). Deaths from probable and definite SUDEP were identified. Additional information on adults with ID who had died from probable or definite SUDEP was obtained from case notes and post-mortem reports, where available. Cases of probable and definite SUDEP in adults with ID were compared with the general population using standardised mortality ratios (SMRs). RESULTS A total of 898 adults with ID had died over the 18-year study period. Of these, 244 deaths (27%) occurred in people with ID who had a diagnosis of epilepsy. Twenty-six people with ID died from probable or definite SUDEP, which was the second most common cause of death among adults with ID and epilepsy. All-cause specific SMRs were 2.2 [95% confidence interval (CI): 2.0-2.4] and 2.8 (95% CI: 2.5-3.1) for men and women with ID respectively. SMRs were 3.2 (95% CI: 2.7-3.8) and 5.6 (95% CI: 4.6-6.7) for men and women with epilepsy and ID respectively. During the same study period, 83 adults without ID had died of probable or definite SUDEP. The SMRs for SUDEP in patients with ID were 37.6 for men (95% CI: 21.9-60.2) and 52.0 for women (95% CI: 23.8-98.8). We found that in the majority of ID cases there was little detailed documentation on the circumstances surrounding deaths, no communication with patients/carers about risk of SUDEP and an absence of post-mortem reports or carers' referral for bereavement counselling. CONCLUSION The authors believe that a comprehensive risk management under a multiagency/multidisciplinary framework should be undertaken for all adults with ID and epilepsy in day-to-day clinical practice to reduce mortality in people with ID.
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Affiliation(s)
- R Kiani
- Adult Learning Disability Service, Leicestershire Partnership NHS Trust, Leicester, UK; Department of Health Sciences, University of Leicester, Leicester, UK
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Jorfi F, Sanati HR, Zahedmehr A, Shakerian F, Zahedi L, Firouzi A, Kiani R, Elmi G. Difficult management of coronary artery disease in a patient with thrombotic thrombocytopenic purpura. J Tehran Heart Cent 2014; 9:140-2. [PMID: 25870634 PMCID: PMC4393839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Accepted: 06/10/2013] [Indexed: 10/26/2022] Open
Abstract
Thrombotic thrombocytopenic purpura (TTP) is a rare syndrome affecting multiple organs. There is no sufficient evidence regarding the clinical cardiac manifestations of TTP. Nonetheless, pathologic cardiac involvement is quite frequent in acute TTP, which is predominantly manifested as myocardial necrosis due to coronary arteriolar microthrombosis. The present case report describes a 43-year-old man with long-standing remitted TTP, who suffered from a sequence of refractory thrombotic epicardial coronary events. Aggressive medical and interventional therapies, including long-term dual antiplatelets and coronary angioplasty, were finally successful in remitting the thrombotic events. During his two-year follow up, he has been asymptomatic.
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Affiliation(s)
| | - Hamid Reza Sanati
- Corresponding Author: Hamid Reza Sanati, Assistant Professor of Cardiology, Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.1996911151. Tel: +982123922178. Fax: +98 21 22055594. Mobile: +98 912 3765828.
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Witthoft N, Winawer J, Kiani R. Behavioral The Behavioral Effects of Adaptation to Facial Expressions are Explained by Changes in the Decision-Making Process. J Vis 2013. [DOI: 10.1167/13.9.1275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Hiremath A, Gangavati S, Bhaumik S, Kiani R, Devapriam J. A Study on the Use of Propranolol in Managing Behavioural Problems in People with Intellectual Disability. ACTA ACUST UNITED AC 2013. [DOI: 10.1179/096979510799102934] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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