Tehrān, Iran
Tehrān, Iran

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Hirnschall N.,Hanusch Hospital | Hoffmann P.C.,Private Clinic | Draschl P.,Hanusch Hospital | Maedel S.,Hanusch Hospital | And 2 more authors.
Journal of Refractive Surgery | Year: 2014

PURPOSE: To evaluate the influencing factors on remaining astigmatism after implanting a toric intraocular lens during cataract surgery. METHODS: In this observational study, consecutive patients with cataract from three different centers who received toric intraocular lenses were included. Keratometry was performed with an optical biometry device preoperatively. The IOLMaster 500 (Carl Zeiss Meditec AG, Jena, Germany) was used in Vienna, Lenstar (Haag- Streit, Köniz, Switzerland) in Castrop-Rauxel, and IOLMaster (Carl Zeiss Meditec AG) in London. Partial least squares regression was used to detect the influence of different parameters on remaining astigmatism. RESULTS: In total, 235 eyes of 200 patients were included. Mean corneal astigmatism measured preoperatively with the optical biometry device was -2.24 ± 0.87 diopters (D) (range: -5.75 to -1.00 D). Mean absolute and vector difference between the aimed for and the postoperatively measured astigmatism were 0.48 ± 0.37 D (range: 0.00 to 2.05 D) and 0.73 ± 0.46 D (range: 0.031 to -2.20 D), respectively ( P = .576). Partial least squares regression showed a significant effect of preoperatively measured corneal astigmatism and deviation between preoperative measurements of the cornea on the postoperative (unintended) remaining astigmatism. CONCLUSIONS: The main source of error when using toric intraocular lenses is the preoperative measurement of corneal astigmatism, especially in eyes with low astigmatism. The influence of the postoperative anterior chamber depth on the cylindrical power of toric intraocular lenses and the effect of misalignment on the reduction of the astigmatism-reducing effect can be easily calculated. Copyright © SLACK Incorporated.

Hassanian-Moghaddam H.,Shahid Beheshti University | Farajidana H.,University of Tehran | Sarjami S.,Private Clinic | Owliaey H.,Shahid Beheshti University
American Journal of Emergency Medicine | Year: 2013

Background and Objectives: In contrast with other opioids, there are few cases of tramadol-related respiratory depression described in the literature, and renal impairment is a proposed risk factor. The aim of this study is to determine the prevalence of and predisposing factors for tramadol-related apnea in patients referred to our center. Patients and Methods: All patients referred to Loghman-Hakim Hospital between February 2009 and April 2010 with pure tramadol intoxication were identified retrospectively. Data collected included the patient's age, sex, ingested dose, route of exposure, reason for poisoning (acute overdose or supratherapeutic use), previous history of suicidal attempts, previous history of drug or substance abuse (including tramadol), and clinical features on admission including seizures and apnea. Results: We identified 525 patients with deliberate self-poisoning (359; 68.4%) or abuse (146; 27.8%), and in 114 (21.7%) of these, there was a history of tramadol abuse. Four hundred twenty-nine (81.7%) of patients had acute poisoning and were referred to hospital within 6 hours of ingestion. Nineteen patients (3.6%) experienced apnea and received respiratory support (16; 84.2%) or naloxone administration (3; 15.8%) within 24 hours of ingestion (mean, 7.7 ± 7 hours; range, 1-24 hours). The mean dose ingested by patients experiencing apnea was 2125 ± 1360 mg (range, 200-4600 mg), which was significantly higher than those who did not experience apnea, 1383 ± 1088 mg (range, 100-6000 mg), P <.001. One death occurred in each group, which was significant (P <.001). Renal impairment was not observed in any of the patients who experienced apnea. © 2013 Elsevier Inc. All rights reserved.

Stasinopoulos D.,Private Clinic | Stasinopoulos D.,European University Cyprus | Manias P.,Private Clinic
Journal of Bodywork and Movement Therapies | Year: 2013

Objective: To compare eccentric and static exercises as proposed by Stanish with eccentric exercises as proposed by Alfredson in the management of Achilles tendinopathy. Methods: Patients with midportion Achilles tendinopathy for at least 3 months were included in this trial. They were sequentially allocated to receive either Stanish's exercise programme or Alfredson's exercise programme. Outcome measures were pain and function using the VISA-A score. Patients were evaluated at baseline, at the end of treatment (week 12), and 6 months (week 36) after the end of treatment. Results: 41 patients met the inclusion criteria. At the end of treatment, there was a rise in VISA-A score in both groups compared with baseline (. p<0.05, paired t-test). There were significant differences in the VISA-A score between the groups at the end of treatment and at the 6-month follow up; Alfredson exercise programme group produced the largest effect (. p<0.0005, independent t-test). Conclusion: An exercise programme based on Alfredson protocol was superior to Stanish model to reduce pain and improve function in patients with Achilles tendinopathy at the end of the treatment and at the follow-up. Further research is needed to confirm our results. © 2012 Elsevier Ltd.

Hassanian-Moghaddam H.,Shahid Beheshti University | Sarjami S.,Private Clinic | Kolahi A.-A.,Shahid Beheshti University | Carter G.L.,University of Newcastle
British Journal of Psychiatry | Year: 2011

Background: Hospital-treated self-poisoning is common, with limited effective interventions for reducing subsequent suicidal behaviour. Aims: To test the efficacy of a postcard intervention to reduce suicidal behaviour. Method: Randomised controlled trial of individuals who self-poisoned (n = 2300), the intervention consisted of nine postcards sent over 12 months versus usual treatment. Outcomes assessed at 12 months (n = 2113) were suicidal ideation, suicide attempts and self-cutting (proportion and event rates). Results: There was a significant reduction in any suicidal ideation (relative risk reduction (RRR) = 0.31, 95% CI 0.22-0.38), any suicide attempt (RRR = 0.42, 95% CI 0.11-0.63) and number of attempts (incidence rate ratios (IRR) = 0.64, 95% CI 0.42-0.97). There was no significant reduction in any self-cutting (RRR = 0.14, 95% CI -0.29 to 0.42) or self-cutting events (IRR = 1.03 95% CI 0.76-1.39). Conclusions: A postcard intervention reduced suicidal ideation and suicide attempts in a non-Western population. Sustained, brief contact by mail may reduce suicidal ideation and suicide attempts in individuals who self-poison. © 2011 The Royal College of Psychiatrists.

Addor F.A.S.,Private clinic
Anais Brasileiros de Dermatologia | Year: 2016

Recent studies about the cutaneous barrier demonstrated consistent evidence that the stratum corneum is a metabolically active structure and also has adaptive functions, may play a regulatory role in the inflammatory response with activation of keratinocytes, angiogenesis and fibroplasia, whose intensity depends primarily on the intensity the stimulus. There are few studies investigating the abnormalities of the skin barrier in rosacea, but the existing data already show that there are changes resulting from inflammation, which can generate a vicious circle caused a prolongation of flare-ups and worsening of symptoms. This article aims to gather the most relevant literature data about the characteristics and effects of the state of the skin barrier in rosacea. © 2016 by Anais Brasileiros de Dermatologia.

Bowins B.E.,Private Clinic
Counselling Psychology Quarterly | Year: 2012

Milder forms of dissociation often provide a defensive function diminishing the impact of disturbing emotional states. It is proposed that compartmentalization and absorption can be applied as psychotherapy strategies. Therapeutic compartmentalization and therapeutic absorption are easy to learn and master, and can be used to treat anxiety, depression, and other adverse emotional states. Therapeutic dissociation strategies fit in well with the real-life eclectic mix of techniques used by most psychotherapists, and can serve as an adjunct to other forms of therapy. © 2012 Copyright Taylor and Francis Group, LLC.

Handel A.C.,Private clinic | Miot L.D.B.,São Paulo State University | Miot H.A.,São Paulo State University
Anais Brasileiros de Dermatologia | Year: 2014

Melasma is a chronic acquired hypermelanosis of the skin, characterized by irregular brown macules symmetrically distributed on sun-exposed areas of the body, particularly on the face. It is a common cause of demand for dermatological care that affects mainly women (especially during the menacme), and more pigment-ed phenotypes (Fitzpatrick skin types III-V). Due to its frequent facial involvement, the disease has an impact on the quality of life of patients. Its pathogeny is not yet completely understood, although there are some known triggering factors such as sun exposure, pregnancy, sexual hormones, inflammatory processes of the skin, use of cosmetics, steroids, and photosensitizing drugs. There is also a clear genetic predisposition, since over 40% of patients reported having relatives affected with the disease. In this manuscript, the authors discuss the main clinical and epidemiological aspects of melasma. © 2014 by Anais Brasileiros de Dermatologia.

Zillo F.C.,Private clinic
Anais Brasileiros de Dermatologia | Year: 2014

Mycetomas are a chronic skin infection characterized by perilesional edema, formation of sinus tracts, and discharge of purulent or seropurulent exudate containing grains. This report aims to demonstrate the clinical diagnosis (by dermoscopy) of a skin lesion that initially bared no clinical features of a mycetoma. © 2014 by Anais Brasileiros de Dermatologia.

Marques S.A.,São Paulo State University | Hortense J.,Private clinic
Anais Brasileiros de Dermatologia | Year: 2014

Herpes zoster-associated urinary retention is an uncommon event related to virus infection of the S2-S4 dermatome. The possible major reasons are ipsilateral hemicystitis, neuritis-induced or myelitis-associated virus infection. We report a case of a 65-year-old immunocompetent female patient who presented an acute urinary retention after four days under treatment with valacyclovir for gluteal herpes zoster. The patient had to use a vesical catheter, was treated with antibiotics and corticosteroids and fully recovered after eight weeks. © 2014 by Anais Brasileiros de Dermatologia.

Moers-Carpi M.M.,Private Clinic | Sherwood S.,Sally Sherwood Communications New York
Dermatologic Surgery | Year: 2013

Background In this study, we examined two polycaprolactone (PCL)-based dermal filler formulas (PCL-1; PCL-2) for safety, patient satisfaction, likelihood to return, efficacy, and duration of correction. Objective This 40-patient, 24-month, prospective, randomized, controlled study evaluated the efficacy, safety, longevity, and volume of two PCL formulas for correction of nasolabial folds. Methods Patients enrolled in a medical clinic in Europe received two injections 1 month apart and returned at 3, 6, 9, 12, 15, 18, and 24 months for blinded patient evaluation using accepted aesthetic rating scales. Results At 12 months, the efficacy outcomes on Wrinkle Severity Rating Scale (WSRS) and Global Aesthetic Improvement Scale (GAIS) of PCL-1 and PCL-2 were consistently maintained, with sustained improvement in 90% and 91.4% of patients, respectively. At 24 months, PCL-2 was found to be more effective than PCL-1 with respect to GAIS and WSRS, showing sustained improvement for the entire 2-year study period (linear p =.52; quadratic p >.99). Patient satisfaction at 24 months was 72.4% for PCL-1 and 81.7% for PCL-2. Both products were found to be safe and well tolerated. Conclusions PCL-1 and PCL-2 are safe and have sustained efficacy and high patient satisfaction, with PCL-2 demonstrating longer-lasting results than PCL-1. © 2013 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

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