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Tehran, Iran

Tehran University of Medical science is the largest, "most distinguished", and most highly ranked medical school of Iran. In September 2008, the health minister of Iran called TUMS a pioneer in research throughout the country with a noticeable lead over its counterpart universities.Located in Tehran adjacent to the main University of Tehran campus, it was founded as part of Dar ol-Fonoon, and later absorbed into Tehran University in 1934. It finally separated from Tehran University by parliamentary legislation in 1986, coming under the new Ministry of Health and Medical Education.TUMS is ranked as one of Iran's top research universities, with an annual research budget of over 300 billion Rials from the government. The school trains over 13,000 students in over 80 postgraduate programs. The school operates 15 teaching hospitals, is equipped with over 40 libraries, and publishes 34 journals, some in collaboration with academic societies.The university operates The National Museum of Medical science History as well.TUMS is accredited by Accreditation Service for International Colleges and Universities Wikipedia.


Nickavar A.,Tehran University of Medical Sciences
Iranian Journal of Public Health | Year: 2015

A 6.5 yr old girl was admitted with a category of clinical signs and symptoms including recurrent gross hematuria, ab-dominal pain, and fever. After different examinations including genetic analysis, the disease was diagnosed as Familial Mediterranean fever (FMF). It is suggested to consider FMF as a rare cause of recurrent gross hematuria, which is re-sponsive to colchicine treatment. © 2015, Iranian Journal of Public Health. All rights reserved.


Nateghi Rostami M.,Tehran University of Medical Sciences
PLoS neglected tropical diseases | Year: 2010

In human leishmaniasis Th1/Th2 dichotomy similar to murine model is not clearly defined and surrogate marker(s) of protection is not yet known. In this study, Th1/Th2 cytokines (IL-5, IL-10, IL-13 and IFN-γ) profile induced by purified CD4(+)/CD8(+) T cells in response to Leishmania antigens were assessed at transcript and protein levels in 14 volunteers with a history of self-healing cutaneous leishmaniasis (HCL) and compared with 18 healthy control volunteers. CD4(+)/CD8(+)/CD14(+) cells were purified from peripheral blood using magnetic beads; CD4(+)/CD8(+) T cells were co-cultured with autologous CD14(+) monocytes in the presence of soluble Leishmania antigens (SLA). Stimulation of either CD4(+) T cells or CD8(+) T cells of HCL volunteers with SLA induced a significantly (P<0.05) higher IFN-γ production compared with the cells of controls. Upregulation of IFN-γ gene expression in CD4(+) cells (P<0.001) and CD8(+) cells (P = 0.006) of HCL volunteers was significantly more than that of controls. Significantly (P<0.05) higher fold-expression of IFN-γ gene was seen in CD4(+) cells than in CD8(+) cells. In HCL volunteers a significantly (P = 0.014) higher number of CD4(+) cells were positive for intracellular IFN-γ production than CD8(+) cells. Collectively, the volunteers have shown maintenance of specific long-term immune responses characterized by a strong reaction to leishmanin skin test and IFN-γ production. The dominant IFN-γ response was the result of expansion of both CD4(+) and CD8(+) T cells. The results suggested that immune response in protected individuals with a history of zoonotic cutaneous leishmaniasis (ZCL) due to L. major is mediated not only through the expansion of antigen-specific IFN-γ producing CD4(+) Th1 cells, but also through IFN-γ producing CD8(+) T cells.


Tajdini M.,Tehran University of Medical Sciences
Journal of the Saudi Heart Association | Year: 2015

A majority of acute pericarditis cases have some degree of myocarditis. Viruses are the common etiological factor of this disease. Corticosteroids are considered for treatment, especially in recurrent models of the disease. In this article, we report the case of a 47-year-old man with myopericarditis who was under daily intra-muscular dexamethasone injection for an unknown reason. This is a unique case of spontaneous myopericarditis under corticosteroid abuse that has not been reported previously. © 2015 The Author.


Laurent S.,University of Mons | Burtea C.,University of Mons | Thirifays C.,University of Mons | Hafeli U.O.,University of British Columbia | And 2 more authors.
PLoS ONE | Year: 2012

Until now, the results of nanotoxicology research have shown that the interactions between nanoparticles (NPs) and cells are remarkably complex. In order to get a deep understanding of the NP-cell interactions, scientists have focused on the physicochemical effects. However, there are still considerable debates about the regulation of nanomaterials and the reported results are usually in contradictions. Here, we are going to introduce the potential key reasons for these conflicts. In this case, modification of conventional in vitro toxicity assays, is one of the crucial ignored matter in nanotoxicological sciences. More specifically, the conventional methods neglect important factors such as the sedimentation of NPs and absorption of proteins and other essential biomolecules onto the surface of NPs. Another ignored matter in nanotoxicological sciences is the effect of cell "vision" (i.e., cell type). In order to show the effects of these ignored subjects, we probed the effect of superparamagnetic iron oxide NPs (SPIONs), with various surface chemistries, on various cell lines. We found thatthe modification of conventional toxicity assays and the consideration of the "cell vision" concept are crucial matters to obtain reliable, and reproducible nanotoxicology data. These new concepts offer a suitable way to obtain a deep understanding on the cell-NP interactions. In addition, by consideration of these ignored factors, the conflict of future toxicological reports would be significantly decreased. © 2012 Laurent et al.


Aminimoghaddam S.,Tehran University of Medical Sciences
The Gulf journal of oncology | Year: 2012

Swyer syndrome is a type of pure gonadal dysgenesis correlating with 46 XY karyotype, primary amenorrhea, and female internal and external genitalia. It reveals a testicular differentiation abnormality.A 16-year old girl admitted to our center with primary amenorrhea and abdominal mass. In spite of the absence of normal testis, clitoromegaly was noticed. Peripheral blood karyotype analysis showed 46 XY. Histopathology of the excised gonads determined mixed germ cell tumor in right ovary and streak left gonad without gonadoblastoma in left side. In patients suffering from Swyer syndrome, high risk of gonadal neoplasia dictates early prophylactic gonadal excision to lengthen survival.


Cheraghali A.M.,Baqiyatallah Medical Sciences University | Yazdanpanah H.,Tehran University of Medical Sciences
Journal of Food Safety | Year: 2010

Pistachio nut is an important agricultural and economical commodity in Iran. Annually, several hundred tons of pistachio nuts are produced in Iran. Therefore, the country earns substantial amount of hard currency from exporting pistachio nuts. In addition, livelihood of some million people in pistachio-growing area depends on this crop. Traditionally, the European Union (EU) has been one of the major destinations of pistachio exported from Iran. Pistachio nuts are rich sources of fat, and contain linoleic and linolenic fatty acids. However, they are among the commodities with the highest risk of aflatoxins (AF) contamination. As a consequence of detection of unacceptable level of AF in pistachio consignments arriving in EU ports in 1997, special conditions were imposed on Iran pistachio entering the EU. Therefore, extensive efforts were made to overcome the problem. Iranian authorities in collaboration with EU authorities planned a multi-approach intervention to prevent and control AF contamination of Iran pistachio nuts. Iran experience to prevent and control AF contamination in pistachio nuts was fruitful, and Iran pistachio nuts now have significantly lower level of AF contamination. In addition to economic aspects, these improvements have greatly contributed to protection of both local and international consumers from possible health hazard caused by AF contamination. © 2010, Wiley Periodicals, Inc.


Alizadeh K.,Lorestan University | Parooi R.,Lorestan University | Hashemi P.,Lorestan University | Rezaei B.,Lorestan University | And 2 more authors.
Journal of Hazardous Materials | Year: 2011

A highly selective optical sensor was developed for the Hg2+ determination by chemical immobilization of 2-[(2-sulfanylphenyl)ethanimidoyl]phenol (L), on an agarose membrane. Spectrophotometric studies of complex formation between the Schiff's base ligand L and Hg2+, Sr2+, Mn2+, Cu2+, Al3+, Cd2+, Zn2+, Co2+ and Ag+ metal ions in methanol solution indicated a substantially larger stability constant for the mercury ion complex. Consequently, the Schiff's base L was used as an appropriate ionophore for the preparation of a selective Hg2+ optical sensor, by its immobilization on a transparent agarose film. A distinct color change, from yellow to green-blue, was observed by contacting the sensing membrane with Hg2+ ions at pH 4.5. The effects of pH, ionophore concentration, ionic strength and reaction time on the immobilization of L were studied. A linear relationship was observed between the membrane absorbance at 650nm and Hg2+ concentrations in a range from 1×10-2 to 1×10-5molL-1 with a detection limit (3σ) of 1×10-6molL-1. No significant interference from 100 times concentrations of a number of potentially interfering ions was detected for the mercury ion determination. The optical sensor was successfully applied to the determination of mercury in amalgam alloy and spiked water samples. © 2010 Elsevier B.V.


Hosseinsabet A.,Tehran University of Medical Sciences
Anadolu Kardiyoloji Dergisi | Year: 2015

Objective: Abnormalities in atrial electromechanical delays (EMDs) are considered independent predictors of atrial fibrillation and can reflect atrial remodeling. The main purpose in this study was to compare inter-left and right intra-atrial EMDs of patients with mild left ventricular (LV) diastolic dysfunction, without left atrial (LA) structural remodeling in the absence of high filling pressure, with healthy individuals. Methods: In this prospective study, a total of 41 consecutive outpatients who were referred to our echocardiography laboratory with mild diastolic dysfunction (age: 60.9±9.6 years) and 45 healthy control subjects who were referred from an outpatient clinic for check-up (age: 32.2±10.3 years) with normal diastolic function were enrolled into this study. All subjects had normal LA volume and normal right atrial area and did not have high filling pressure. Diastolic dysfunction were determined per American Society of Echocardiography recommendations; so, the following indices were measured: Peak early (E) and atrial (A) flow velocities (cm/s), E/A ratio, and deceleration time (DT) (ms) of mitral inflow, systolic (S) and diastolic (D) pulmonary vein wave velocities (cm/s) by pulse wave Doppler, and e’ in septal and lateral mitral annulus by pulse wave tissue Doppler. Time interval from the onset of P wave on the ECG to the beginning of the late diastolic wave (Am wave) on tissue Doppler trace, which is named PA, was obtained from the lateral and septal mitral annulus and right ventricular (RV) tricuspid annulus as atrial conduction times (ACTs) and were named lateral PA, septal PA, and RV PA, respectively. The difference between lateral PA and septal, PA septal and RV PA was defined as left and right intra-atrial EMD, respectively. The difference between lateral PA and RV PA was defined as inter-atrial EMD. Data analysis was done by independent student’s t-test, Mann-Whitney U test, χ2 test, Spearman rank order, Pearson’s correlation coefficient, and multivariate regression analysis in the appropriate site. Results: A, DT, S/D ratio, and E/e’ (average) were significantly lower in the control group, and E, D, E/A ratio, e’ septal, and e’ lateral wall were significantly lower in the patient group. Atrial conduction times were longer in the patient group, but in the multivariate analysis, there was no correlation between ACTs and diastolic dysfunction. There was no significant difference in left intra-atrial EMD (14.2±9.7 ms vs. 16.4±11.4 ms; p=0.336), right intra-atrial EMD (12.8±12.2 ms vs. 15.4±12.1 ms; p=0.321), and inter-atrial EMD (26.9±13.7 ms vs. 31.7±13.7 ms; p=0.108) between the two groups. Multivariate analysis showed no correlation between inter- and intra-atrial EMDs and diastolic dysfunction. Conclusion: There was no significant difference in ACTs and inter-atrial and left and right intra-atrial EMD in patients with mild LV diastolic dysfunction and normal LA volume in the absence high filling pressure compared with normal subjects. © 2015 by Turkish Society of Cardiology.


Derakhshanrad N.,Tehran University of Medical Sciences
Spinal Cord | Year: 2016

Study design:A cross-sectional study.Objectives:This study was performed for epidemiological assessment of Iranian Traumatic Spinal Cord Injuries (TSCI), referred to a specialized spine center.Setting:Patient recruitment and evaluations were conducted at the Brain and Spinal Injury Research Center, Tehran, Iran.Methods:This study was performed from September 2011 to March 2015 on 1137 consecutive TSCIs. History, clinicoradiological findings as well as chronic complications and social integration were recorded. The capture–recapture method was used to calculate a rough estimation of TSCI prevalence in Tehran Province.Results:Our report includes 1137 cases with a mean age of 29.1 years (s.d.=11.2 year)—79.2% of them being male (M/F=3.8/1). Rough estimation of TSCI prevalence in Tehran province was 2.36 per 10 000 population. Regarding etiology, 61.8% were due to motor vehicle accident (MVA), followed by falling 24.5%, heavy drop 5.2%, violence 3.8%, sport 2.8% and others causes 1.9%. Regarding injury level, 31.5% were cervical, 57.9% thoracic and 10.6% lumbar. Complete lesions were 53.5% of patients and 46.5% were incomplete. Most common neurological type was T1-S5 (American Spinal Injury Association Impairment Scale: A, B, C, 61.7%). Most common complications included urinary tract infection followed by pressure sore (grade III and IV, 37.5%), autonomic dysreflexia (37%) and neuropathic pain (31.2%). Substance abuse was observed in 8.8% of cases. Overall, ~25% in our cases were employed after TSCI. Secondary divorce was also much more frequent than normal matched controls.Conclusion:MVA was the most common cause for TSCI. The elderly subjects were less frequent among our patients than more developed countries. The high rate of unemployment and divorce in our cases deserves special consideration.Spinal Cord advance online publication, 16 February 2016; doi:10.1038/sc.2016.10. © 2016 International Spinal Cord Society


Savaj S.,Tehran University of Medical Sciences | Vaziri N.D.,University of California at Irvine
Iranian Journal of Kidney Diseases | Year: 2012

Preeclampsia is a serious complication of pregnancy, which is the cause of 60 000 maternal deaths annually worldwide. In addition to the well-known maternal risk factors such as hypertension, diabetes mellitus, antiphospholipid antibody syndrome, obesity, aging, and multiple pregnancies, recent studies have identified the role of genetic and immunological factors in the pathogenesis of preeclampsia. In particular, imbalance between angiogenic and anti-angiogenic factors, anti-angiotensin II type 1 receptor antibodies and dysregulation of oxygen supplies can cause preeclampsia. A group of biomarkers have been introduced for diagnosis of preeclampsia. Chief among them is the ratio of soluble fms-like tyrosine kinase-1 to placental growth factor, which can be used in clinical practice. Recent studies have shown high specificity and sensitivity of these markers for early diagnosis of preeclampsia, which is critical for prevention of fetal and maternal complications.


Almasi Z.,Isfahan University of Medical Sciences | Salehiniya H.,Tehran University of Medical Sciences
Asian Pacific Journal of Cancer Prevention | Year: 2015

Background: Stomach cancer is the fourth most common cancer and the second leading cause of cancer-related death through the world. It is predicted that the number of new cancer cases will be more than 15 million cases by 2020. Regarding the lack of studies on this topic in the country, we have thoroughly examined the patho-epidemiology of stomach cancer in Iran. Materials and Methods: In this cross- sectional study data were collected retrospectively reviewing all new stomach cancer patients in Cancer Registry Center report of health deputy for Iran during a 6-year period (2003-2008). The study also examined the morphology of common stomach cancers. Trends in incidence and morphology underwent joinpoint regression analysis. Results: During the six-year period, a total of 35,171 cases of stomach cancer were registered. Average age standardized rate for females and males were equal to 7.1 and 15.1 per 100,000 persons, respectively. Most common histological type was adenocarcinoma, NOS with 21,980 cases (62.50%). The annual percentage change (APC) in age-standardized incidence rate (per 100,000) was increase in both females and males at 11.1 (CI: 4.3 to 18.3) and 9.2 (CI: 5.2 to 13.4), respectively. Conclusions: According to our results, the incidence of gastric cancer is increasing in Iran, so further epidemiological studies into the etiology and early detection are essential.


Arjmandi R.,Islamic Azad University at Tehran | Tavakol M.,Islamic Azad University at Tehran | Shayeghi M.,Tehran University of Medical Sciences
International Journal of Environmental Science and Technology | Year: 2010

In most rice paddies in Mazandaran Province, diazinon is applied to control Chilo suppressalis. Due to the extensive application of insecticides in the rice paddies of the Caspian coasts of Iran, this investigation was carried out on the rice fields in order to obtain the necessary data and information on the concentration of insecticide residues. A total of 125 samples were taken from five areas of Amol township in 2007. Then, according to the analysis of variance procedures, the water samples were statistically analyzed after the spraying of diazinon. Results indicate that the insecticide was used frequently to control stem boring caterpillar of rice. The residuals of this toxic chemical were observed in the majority of stations from the day after the spraying until one to two months later. The greatest level of diazinon was observed in station 1 in amount of 1.14 ppm. This study revealed that the physical and chemical properties of the studied diazinon such as fumigation characteristic as well as the ecological conditions and soil type influence the reduction and eventual removal of the insecticides during the cultivation and harvest periods. © IRSEN, CEERS, IAU.


Jadali Z.,Tehran University of Medical Sciences
Archives of Iranian Medicine | Year: 2012

The skin could be a main target organ for extrahepatic manifestations in hepatitis C virus (HCV) infected patients and research data suggest that interferon treatment may be associated with immune-mediated skin lesions. However, case reports propose that the response of dermatologic extrahepatic manifestations to interferon in patients with chronic HCV is greatly different. The objective of this study is to summarize currently available data on dermatologic conditions associated with chronic HCV infection. In addition, we investigate the incidence of the development of immune mediated dermatologic disorders during interferon therapy in these patients.


Karimi P.,Program in Occupational and Environmental Health | Karimi P.,George Washington University | Peters K.O.,Program in Occupational and Environmental Health | Bidad K.,Tehran University of Medical Sciences | Strickland P.T.,Program in Occupational and Environmental Health
European Journal of Epidemiology | Year: 2015

Asthma is the most common chronic illness in children living in developed countries and the leading cause of childhood hospitalization and school absenteeism. Prevalence rates of asthma are increasing and show disparities across gender, geographic regions, and ethnic/racial groups. Common risk factors for developing childhood asthma include exposure to tobacco smoke, previous allergic reactions, a family history of asthma, allergic rhinitis or eczema, living in an urban environment, obesity and lack of physical exercise, severe lower respiratory tract infections, and male gender. Asthma exacerbation in children can be triggered by a variety of factors, including allergens (e.g., pollen, dust mites, and animal dander), viral and bacterial infections, exercise, and exposure to airway irritants. Recent studies have shown that exposure to polycyclic aromatic hydrocarbons (PAHs), a major component of fine particulate matter from combustion sources, is also associated with onset of asthma, and increasing asthmatic symptoms. In this paper, we review sources of childhood PAH exposure and the association between airborne PAH exposure and childhood asthma prevalence and exacerbation. © 2015, Springer Science+Business Media Dordrecht.


Hoy D.,University of Queensland | Geere J.-A.,University of East Anglia | Davatchi F.,Tehran University of Medical Sciences | Meggitt B.,Independent Consultant | Barrero L.H.,Pontifical Xavierian University
Best Practice and Research: Clinical Rheumatology | Year: 2014

Musculoskeletal (MSK) conditions cause an enormous global burden, and this is dramatically increasing in developing countries, particularly due to rapidly ageing populations and increasing obesity. Many of the global non-communicable disease (NCD) initiatives need to expand beyond the traditional 'top four' NCD groups by incorporating MSK diseases. It is critical that MSK initiatives in developing countries integrate well with health systems, rather than being stand-alone. A better inclusion of MSK conditions will avoid doubling of efforts and wasting of resources, and will help to promote a more streamlined, cost-effective approach. Other key opportunities for action include the following: ensuring the principles of 'development effectiveness' are met; strengthening leadership and commitment; building the research, information and evidence base; and reducing the incidence and disability of MSK conditions through better prevention. Each of these elements is necessary to mitigate and reduce the growing burden from the MSKs. © 2014 Elsevier Ltd. All rights reserved.


Najafi A.,Tehran University of Medical Sciences
Acta medica Iranica | Year: 2011

To compare intubating conditions and hemodynamic changes between Bonfils Intubation Fiberscope and Macintosh laryngoscopy without administering neuromuscular blocking drugs (NMBDs). METHODS: In this randomized controlled trial,80 male and female patients, scheduled for elective surgery, aged 15 to 60 years, ASA class II or I, non-obese, non smokers, without anticipated difficult intubation; were randomly allocated into two groups of 40: Bonfils and Macintosh. Following adequate hydration and preoxygenation, midazolam 0.03 mg.kg(-1) was administered, followed by intravenous alfentanil 20 μg.kg(-1), lidocaine 1.0 mg.kg(-1), and propofol 2 mg.kg(-1) sequentially. Trachea was then intubated using Bonfils Intubation Fiberscope in the Bonfils group and conventional Macintosh laryngoscopy in the Macintosh group. Intubating condition, mean arterial blood pressure, heart rate, pulse oximetry, and success rate were measured. RESULTS: Clinically acceptable intubating condition scores did not differ significantly between the groups (P=0.465). Compared to the baseline values, heart rate rose significantly after intubation only in the Macintosh group (P<0.001). Although mean arterial blood pressure increased immediately after intubation in the Macintosh group (P=0.022), its post-intubation values were significantly less than baseline in both groups (P<0.001). Intubation time took much longer in the Bonfils group (40 s) than the Macintosh group (11 s), P<0.001. In the absence of NMBDs, Bonfils Intubation Fiberscope compares well with Macintosh laryngoscopy in terms of success rate and intubating conditions, but with less mechanical stress and hemodynamic compromise and longer intubation time.


Eslami L.,Golestan University of Medical Sciences | Nasseri-Moghaddam S.,Tehran University of Medical Sciences
Archives of Iranian Medicine | Year: 2013

Background: Proton pump inhibitors (PPIs) are the most effective agents available for reducing acid secretion. They are used for medical treatment of various acid-related disorders. PPIs are used extensively and for extended periods of time in gastroesophageal reflux disease (GERD). A troublesome issue regarding maintenance therapy has been the propensity of PPI-treated patients to develop chronic atrophic gastritis while on therapy that could theoretically lead to an increased incidence of gastric cancer. In addition, animal studies have raised concern for development of enterochromaffin-like cell hyperplasia and carcinoid tumors in the stomachs of mice receiving high dose PPIs. Current literature does not provide a clear-cut conclusion on the subject and the reports are sometimes contradictory. Therefore, this study is a systematic review of the available literature to address the safety of long-term PPI use and its relation to the development of malignant/premalignant gastric lesions. Methods: A literature search of biomedical databases was performed. The reference lists of retrieved articles were reviewed to further identify relevant trials. We hand-searched the abstracts of the American Digestive Disease Week (DDW) and the United European Gastroenterology Week (UEGW) from 1995 to 2013. Only randomized clinical trials (RCTs) that used PPIs as the primary treatment for at least six month versus no treatment, placebo, antacid or anti-reflux surgery (ARS) were included. Two reviewers independently extracted the data. Discrepancies in the interpretation were resolved by consensus. All analyses of outcomes were based on the intention-to-treat principle. We performed statistical analysis using Review Manager software. The effect measure of choice was relative risk (RR) for dichotomous data. Results: Six RCTs with a total of 785 patients met the inclusion criteria. Two multicenter RCTs compared Esomeprazole with placebo. One RCT compared omeprazole with ARS. Two RCTs compared omeprazole with ranitidine and one RCT compared lansoprazole with ranitidine. Four of the included RCTs had moderate risk of bias and two had low risk of bias. The number of patients with increased corporal atrophy score, intestinal metaplasia score and chronic antral inflammation did not statistically differ between the PPI maintenance group and controls. Similar results were found when ECL-cell hyperplasia was assessed between the groups. ConclusionS: Maintenance PPIs did not have an association with increased gastric atrophic changes or ECL-cell hyperplasia for at least three years in RCTs.


Abbasi S.-H.,Tehran University of Medical Sciences | Kassaian S.-E.,Research Institute of Petroleum Industry RIPI
Journal of Tehran University Heart Center | Year: 2011

Women die of cardiovascular disorders even more than a combination of breast cancer, stroke, chronic obstructive pulmonary disease, and lung cancer. Recent data show that while 1 out of 2.6 women die of coronary artery disease (CAD), only 1 out of 4.6 die from cancer. Whereas some studies show an increase in the age-adjusted mortality of CAD in both women and men, some other studies report an increase in mortality amongst young women. There is a significant decrease in sudden cardiac death in men without significant change in women, and more women die of CAD before their arrival at the emergency room of hospitals than do men. It is, therefore, regrettable that many women and their physicians are not sufficiently aware of the problem and this unawareness is believed to be a major culprit for the existing gender disparities and inaction on the part of women as regards risk modification. What is more, the bulk of our knowledge, preventive measures, diagnostic strategies, and treatment plans are on the basis of studies conducted chiefly in men, when powerful evidence-based gender-specific recommendations call for efforts to enroll more women in order to reach a desirable level of sex representation. Given the significance of CAD assessment in women, it is essential that an acceptable risk score system be devised to estimate the risk of coronary events. The Framingham Risk Score, which has been used for this purpose for a long time, is no longer suitable for women and the Reynolds Risk Score seems to be a more appropriate tool. Finally, from a pathophysiological point of view, endothelial and microvascular dysfunctions are the most salient contributors to the development of CAD in women by comparison with men and they give rise to non-obstructive CAD. Lamentably, most of the relevant studies conducted hitherto have focused predominantly on men; any attempt to redress the balance would be of great value in the endeavors to decrease the risk in women.


Maughan R.J.,Loughborough University | Fallah J.S.,Loughborough University | Fallah J.S.,Tehran University of Medical Sciences | Coyle E.F.,University of Texas at Austin
British Journal of Sports Medicine | Year: 2010

An overnight fast of 8-10 h is normal for most people. Fasting is characterised by a coordinated set of metabolic changes designed to spare carbohydrate and increase reliance on fat as a substrate for energy supply. As well as sparing the limited endogenous carbohydrate, and increased rate of gluconeogenesis from amino acids, glycerol and ketone bodies help maintain the supply of carbohydrate. Many individuals undergo periodic fasts for health, religious or cultural reasons. Ramadan fasting, involving 1 month of abstention from food and fl uid intake during daylight hours, is practised by a large part of the world population. This period involves a shift in the pattern of intake from daytime to the hours of darkness. There seems to be little effect on overall daily dietary intake and only small metabolic effects, but there may be implications for both physical and cognitive function. The limited evidence suggests that effects of Ramadanstyle fasting on exercise performance are generally small. This needs to be balanced, however, against the observation that small differences in performance are critical in determining the outcomes of sporting events. Studies involving challenging sporting events (prolonged sustained or intermittent high-intensity events, hot and humid environments) are needed. Increases in subjective sensations of fatigue may be the result of loss of sleep or disruption of normal sleep patterns. Modifi cations to the competition timetable may minimise or even eliminate any effect on performance in sport, but there may be negative effects on performance in some events.


Shahcheraghi F.,Pasteur Institute of Iran | Badmasti F.,Pasteur Institute of Iran | Feizabadi M.M.,Tehran University of Medical Sciences
FEMS Immunology and Medical Microbiology | Year: 2010

Seven hundred and fifty nonreplicated clinical isolates of Pseudomonas aeruginosa were collected from five hospitals during March 2007 to May 2009. Forty-one isolates (5.46%) were characterized as multidrug-resistant P. aeruginosa (MDRPA). PCR assays were used to detect class 1 integrons. Amplifications of internal variable regions (IVRs) of class 1 integrons revealed three different arrays (0.8, 1.3, and 1.7 kb) with different distributions in clinical isolates. The amplified IVRs were sequenced and three gene cassette arrays including aadB (0.8 kb), aadA6-orfD (1.3 kb), and bla OXA10- aacA4 (1.7 kb) were identified. In conclusion, we confirmed the high prevalence of class 1 integons with limited diversity of gene cassette arrays in MDRPA clinical isolates found from five hospitals. This is the first report showing gene cassette contents of class 1 integrons in P. aeruginosa isolates in Iran.


Fallahian F.,Tehran University of Medical Sciences
Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia | Year: 2010

Chemotherapy drugs, biological medications that are used to treat cancer, may cause hepatic side effects. Patients with pre-existing viral hepatitis may be more susceptible to exacerbation of their underlying liver disease, and risk of drug-induced hepatotoxicity. We conducted a search on immunosuppression, and its impact on reactivation of viral hepatitis, using the electro-nic medical databases. Before starting chemotherapy, it is recommended to record the past history of liver disease and check for hepatitis B virus (HBV) and hepatitis C virus (HCV) serology. In immunosuppressed patients, radiation toxicity, graft versus host disease, hepatic veno-occlusive disease, acalculous cholecystitis, tumor infiltration, ischemia, other viruses such as CMV and her-pes virus, and systemic infection should also be considered. Transplant recipients with serologic evidence of previous infection with hepatitis B or C, or those who receive organs from a seropositive donor, should have viral load levels monitored before and after transplantation and, may also require treatment. We believe that there is a role for prophylactic use of antiviral treatment in patients at risk for HBV reactivation.


Beheshtnejad A.H.,Tehran University of Medical Sciences
Cornea | Year: 2015

PURPOSE:: To assess tear film stability, ocular surface disease index (OSDI) score, Schirmer test value, tear film breakup time (TBUT), and tear osmolarity after photorefractive keratectomy (PRK). METHODS:: We enrolled 50 eyes from 25 patients who were PRK candidates (15 men, 10 women). The mean age was 31.9 ± 4.5 years. Dry eye severity was evaluated using OSDI questionnaire, TBUT, Schirmer test, and tear osmolarity preoperatively and in each postoperative follow-up visit during the 4-month follow-up period. RESULTS:: Tear osmolarity changed from 302 ± 5.9 mOsm/L preoperatively to 308.8 ± 5.8 mOsm/L (P < 0.0001) and 304.1 ± 9.4 mOsm/L (P = 0.40) after 2 and 4 months, respectively. Schirmer test did not change significantly 4 months after PRK (P = 0.410). TBUT decreased significantly after 2 months and did not return to its preoperative value after 4 months. Subjective complaints measured by OSDI score, improved after 4 months compared with the preoperative level. CONCLUSIONS:: Although dry eye tests (Schirmer, TBUT, and tear osmolarity) are abnormal 2 months after PRK, they returned to preoperative values after 4 months. We can conclude that post-PRK dry eye is a transient complication which will last less than 4 months with regular use of topical lubricants. © 2015 Wolters Kluwer Health, Inc. All rights reserved.


Ghadimi H.R.,Tehran University of Medical Sciences
Genetics in the Third Millennium | Year: 2014

Nowadays, the science of genetics and relevant issues have influenced various fields of science, particularly the fields of medical sciences (research and clinical field). Considering the high prevalence of hereditary and non- hereditary genetic disorders, especially in our country due to the relatively high prevalence of consanguineous marriages, application of genetic testing for diagnosis, treatment, prognosis, etc. is of considerable importance. However, evolution in the field of genetic testing is very fast and better introduction of different genetic tests can effectively help the scientific community to follow these extensive developments. In this paper, a brief introduction to different genetic tests based on their functional purposes will be provided. In the following, we will present a brief description of the processes, applications, advantages and disadvantages of some of the most commonly used genetic tests in both cytogenetics and molecular genetics fields. In the field of cytogenetics, karyotyping, flow cytometry, FISH, and CGH will be included and in the field of molecular genetics, PCR-based methods, multiplex PCR quantification such as MAPH/MLPA, microarrays and related technologies and next generation sequencing (NGS) will be discussed. © 2014, Iranian Neurogenetics Society. All rights reserved.


Yousefpour P.,Tehran University of Medical Sciences
International journal of nanomedicine | Year: 2011

This study deals with the preparation and investigation of a nanoscale delivery system for the anticancer drug doxorubicin (DOX) using its complexation with polyanionic carbohydrate dextran sulfate (DS). Dynamic light scattering, SEM, and zeta potential determination were used to characterize nanocomplexes. DOX-DS complexation was studied in the presence of ethanol as a hydrogen-bond disrupting agent, NaCl as an electrostatic shielding agent, and chitosan as a positively charged polymer. Thermodynamics of DOX-DS interaction was studied using isothermal titration calorimetry (ITC). A dialysis method was applied to investigate the release profile of DOX from DOX-DS nanocomplexes. Spherical and smooth-surfaced DOX-DS nanocomplexes (250-500 nm) with negative zeta potential were formed at a DS/DOX (w/w) ratio of 0.4-0.6, with over 90% drug encapsulation efficiency. DOX when complexed with DS showed lower fluorescence emission and 480 nm absorbance plus a 15 nm bathometric shift in its visible absorbance spectrum. Electrostatic hydrogen bonding and π-π stacking interactions are the main contributing interactions in DOX-DS complexation. Thermal analysis of DOX-DS complexation by ITC revealed that each DOX molecule binds with 3 DS glycosyl monomers. Drug release profile of nanocomplexes showed a fast DOX release followed by a slow sustained release, leading to release of 32% of entrapped DOX within 15 days. DOX-DS nanocomplexes may serve as a drug delivery system with efficient drug encapsulation and also may be taken into consideration in designing DOX controlled-release systems.


Mahmoudi M.,Pasteur Institute of Iran | Mahmoudi M.,Tehran University of Medical Sciences | Shokrgozar M.A.,Pasteur Institute of Iran
Chemical Communications | Year: 2012

Because of their multifunctionality and unique magnetic properties, superparamagnetic iron oxide nanoparticles (SPIONs) have been recognized as very promising materials for various biomedical applications. The main difficulty with the use of SPIONs as multimodal bioimaging agents is their lack of fluorescence. Since cells can act as extremely efficient filters for the elution of surface-bound fluorescent tags with nanoparticles, the surface loaded fluorescence dyes significantly decay after a short period of time. Here, for the first time, we introduce novel, engineered multimodal SPIONs with a permanent fluorescence capability, the study of which can lead to a deeper understanding of biological processes at the biomolecular level, greatly influencing molecular diagnostics, imaging and therapeutic applications. © 2012 The Royal Society of Chemistry.


Taghavi N.,Shahid Beheshti University of Medical Sciences | Yazdi I.,Tehran University of Medical Sciences | Yazdi I.,Academy of Medical science
Archives of Iranian Medicine | Year: 2015

Background: oral squamous cell carcinoma (OSCC) represents 95% of all forms of head and neck cancers. The five-year survival rate of OSCC patients has been reported approximately 50%, which is not satisfactory despite new treatment modalities. The aim of the current review is to present factors (histologic, clinical, genetic and molecular biomarkers) correlated with survival rate in OSCC patients. Methods: A web-based search for all types of articles published was initiated using MEDLINE/PUBMED. The search was restricted to articles focusing on relevant clinical, histologic, genetic and molecular factors of survival rate in OSCC and presenting new concepts in this field. Results: Mode of invasion, presence of lymph node metastasis, extra-capsular spread, surgical margins and invasive tumor front grade are clinical and histologic parameters, which are strongly associated with survival rate. Focusing on selected proteins, wide range of molecular markers and gene alterations involving in cell cycle regulation, apoptosis, cell migration, cell adhesion and tumor microenvironment have been documented.Among well-known molecular markers ,cyclin dependent kinase, survivin, CD44, BUBR1, and heat shock proteins (27,70) can be considered as independent prognostic factors of survival rate. Conclusion: The identified prognostic factors imply a relatively comprehensive understanding of factors related to survival rate in OSCC patients, and provide an additional tool for selecting patients who need more aggressive treatment design. © 2015, Academy of Medical Sciences of I.R. Iran. All rights reserved.


Abbasi S.,Tehran University of Medical Sciences
BMC Medical Genetics | Year: 2010

ER-alpha and ER-beta genes have been proven to play a significant role in breast cancer. Epidemiologic studies have revealed that age-incidence patterns of breast cancer in Middle East differ from those in the Western countries. Two selected coding regions in the ER-Β; gene (exons 3 and 7) were scanned in Iranian women with breast cancer (150) and in healthy individuals (147). PCR single-strand conformation polymorphism was performed. A site of silent single nucleotide polymorphism was found only on exon 7. The SNP was found only in breast cancer patients (5.7%) (×2= 17.122, P = 0.01). Codon 392 (C1176G) of allele 1 was found to have direct association with the occurrence of lymph node metastasis. Our data suggest that ER-Β polymorphism in exon 7 codon 392 (C1176G) is correlated with various aspects of breast cancer and lymph node metastasis in our group of patients. © 2010 Abbasi; licensee BioMed Central Ltd.


Nourashrafeddin S.,Tehran University of Medical Sciences
Medical Hypotheses | Year: 2015

Spermatogenesis is a highly regulated process that takes place in the seminiferous tubules of testis. This process initiates at puberty with differentiation of spermatogonia and their meiotic entry. The initiation of spermatogenesis depends on gonadotropins secreted by the pituitary gland; i.e., follicle-stimulating hormone (FSH) and luteinizing hormone (LH). In the absence of FSH and LH only premeiotic germ cells are present in the testis. The prepubertal development phase in juvenile testis is characterized by a protracted hypogonadotropic state, which only consists of Sertoli and undifferentiated germ cells in the seminiferous epithelium. All germ cells in the juvenile testis are undifferentiated spermatogonia, which are proliferating in a relatively gonadotropin-independent manner. It has been revealed that vitamin A deficient (VAD) animals are also infertile, and only premeiotic germ cells (undifferentiated spermatogonia) are present in their seminiferous tubules. The developmental block in VAD animal can be removed by administration of retinol and germ cell differentiation reinitiates in a synchronous manner. Recent studies have revealed that the biologically active form of vitamin A, retinoic acid (RA), regulates germ cell differentiation and lead to the generation of the cycle of the seminiferous epithelium and normal spermatogenic wave. Recent study has shown that synchronous spermatogenesis at neonatal mouse, but not after initiation of meiosis, can be induced by treating vitamin A sufficient males with RA. The treatment of neonatal males at different ages with exogenous RA has revealed that although RA is sufficient to induce differentiation of spermatogonial at 4. dpp and earlier, it fails to alter asynchrony and it does not irreversibly cause a spermatogonial differentiation. These observations led us to suggest that gonadotropins trigger differentiation of spermatogonia and spermatogenesis through regulation of RA signaling in the seminiferous epithelium of the adult testis. © 2015 Elsevier Ltd.


Alaeddini M.,Tehran University of Medical Sciences
Applied Immunohistochemistry and Molecular Morphology | Year: 2015

The aim of the present study was to evaluate angiogenesis, lymphangiogenesis, and mast cell density in association with the histologic risk assessment (HRA) model in oral squamous cell carcinoma. One hundred oral squamous cell carcinomas were graded according to the HRA system and immunostained with antibodies against D2-40, CD34, and CD105 to determine lymphvessel density (LVD) and microvessel density (MVD). Mast cells were detected by toluidine blue and counted in all samples. Assessments were made between the evaluated factors and the histologic variables of HRA. Kruskal-Wallis and Mann-Whitney U test were used for statistical analysis and P<0.05 was considered significant. There were 32, 26, and 42 cases of low, intermediate, and high-grade neoplasms, respectively. Only LVD (P=0.05) and CD34MVD (P=0.03) showed significant associations with lymphocytic infiltration and were both higher in score 0 cases compared with score 3 tumors (P=0.05 and <0.001, respectively). None of the other variables showed significant relationships with the HRA risk scores or subcategories (P>0.05). According to our findings, it appears that the role of lymphangiogenesis and angiogenesis is limited in the HRA system. The significant relationship of lymphocytic infiltration with LVD and CD34MVD, but not CD105MVD, might indicate that “inflammatory lymphangiogenesis/angiogenesis” may differ from that induced by noninflamed neoplastic tissues. It also seems that the vasculature in inflamed tumor tissues is not entirely newly formed. Copyright 2015 Wolters Kluwer Health, Inc. All rights reserved.


Ganji M.R.,Tehran University of Medical Sciences | Haririan A.,University of Maryland Baltimore County
Iranian Journal of Kidney Diseases | Year: 2012

Chronic, progressive, and irreversible loss of a transplanted kidney function, previously named chronic allograft nephropathy, is the leading cause of chronic allograft failure among kidney transplant recipients. Chronic allograft dysfunction (CAD) is a multifactorial process associated with progressive interstitial fibrosis and tubular atrophy. Current Data confirms that an additive series of time-dependent immunological factors such as acute and chronic antibody- and/or cell-mediated rejection and nonimmunological factors are involved in development of interstitial fibrosis and tubular atrophy as the fundamental parts of CAD. The use of calcineurin inhibitors has produced a major impact on achieving successful organ transplantation; however, although this assumption has been doubted recently, calcineurin inhibitors are deemed to be associated with nephrotoxicity and subsequent interstitial fibrosis, tubular atrophy, and kidney dysfunction. The early fibrotic changes are due to implantation stress, T-cell-mediated rejection, and infection; however, usually they do not lead to progressive fibrosis and allograft dysfunction per se. In the setting of CAD, many factors occurring lately after 1 year, such as chronic antibodymediated rejection, recurrent or de novo glomerulonephritis, and nonadherent adequately address the existence of ongoing injuries and progression to fibrosis. Identification of patients who are at risk, close clinical monitoring, and optimization and individualization of their maintenance immunosuppressive regimen are among the means that could help us to improve the long-term outcome of kidney transplantation.


Azizi K.,Shiraz University of Medical Sciences | Azizi K.,Hormozgan University of Medical Sciences | Rassi Y.,Tehran University of Medical Sciences | Moemenbellah-Fard M.D.,Shiraz University of Medical Sciences
Transactions of the Royal Society of Tropical Medicine and Hygiene | Year: 2010

The annual incidence of cutaneous leishmaniasis (CL) in Iran rose by 43% over a five year period, from 2002 to 2006; most of these cases were caused by Leishmania major. Two complementary standard and nested polymerase chain reactions (PCRs) were used to detect parasites within their natural vector, Phlebotomus papatasi. Twelve different sand fly species were morphologically identified. The most abundant species (31.3%) was P. papatasi. Leptomonads were found in nine (2.4%) phlebotomines. Twenty (5.3%) sand fly species were found positive for Leishmania-genus DNA using standard PCR. The infection rate of this species was 5% and 7% by microscopic and molecular methods, respectively. © 2010 Royal Society of Tropical Medicine and Hygiene.


Shabgah A.G.,Tehran University of Medical Sciences | Fattahi E.,Tabriz University of Medical Sciences | Shahneh F.Z.,Max Planck Institute for Chemistry | Shahneh F.Z.,Johannes Gutenberg University Mainz
Postepy Dermatologii i Alergologii | Year: 2014

Human Th17 pro-inflammatory cells are currently defined as cells that produce IL-17A and F, tumor necrosis factor (TNF)-α, IL-6, IL-21, IL-22 and IL-23. Recently discovered related molecules are forming a family of cytokines, the IL-17 family, IL-17A, IL-17B, IL-17C, IL-17D, IL-17E and IL-17F. The associated receptors for the IL-17 family identified are IL-17R, IL-17RH1, IL-17RL (receptor like), IL-17RD and IL-17RE. This review introduces the roles of IL-17 and Th17 cells in human autoimmune diseases. Studies have shown that T cells with inflammatory effects on epithelial, endothelial and fibroblast cells express IL-17. Th17 cells are supposed to be involved in various autoimmune diseases, such as rheumatoid arthritis, psoriasis, multiple sclerosis, and inflammatory bowel diseases. Base on the biologic functions and regulation, IL-17 has regulatory roles in host defense and chronic inflammation which result in tissue damage and autoimmunity. So the IL-17 links links innate and adaptive immunity and has both beneficial and pathological effects on the immune system. This paper will focus on the possible roles of IL-17 in autoimmune diseases, a fundamental player in immune regulation. © 2014 Termedia Sp. z o.o. All rights reserved.


Hashemi Doulabi A.,Amirkabir University of Technology | Mirzadeh H.,Amirkabir University of Technology | Imani M.,Iran Polymer And Petrochemical Institute | Samadi N.,Tehran University of Medical Sciences
Carbohydrate Polymers | Year: 2013

The objective of this work was to prepare chitosan/polyethylene glycol fumarate (chitosan/PEGF) blend films as wound dressings and to evaluate the influence of composition ratio on the blending properties of the films. Blending chitosan with PEGF obviated the brittleness of neat chitosan film. Film topography performed by atomic force microscopy illustrated that blending could increase and control the surface roughness of the neat film. Their water vapor transmission rates were close to the range of 904-1447 g-2 day -1 found to be proper candidates for dressing the wounds with moderate exudates. Controlled water solubility, swelling, wettability and surface tension of the blend films were also evaluated. The blend films showed a powerful antibacterial activity against Pseudomonas aeruginosa and Staphylococcus aureus (Kill% > 99.76 ± 0.16%). Physical properties as well as antibacterial activity assessments showed that among different compositions, the film comprising 80 wt% chitosan and 20 wt% PEGF is a suitable candidate for biomedical applications as a wound dressing material. © 2012 Elsevier Ltd. All rights reserved.


Jafari-Sabet M.,Tehran University of Medical Sciences | Jafari-Sabet M.,Qazvin University of Medical Sciences
Life Sciences | Year: 2011

Aims: In the present study, the effects of bilateral intra-dorsal hippocampal (intra-CA1) injections of cholinergic agents on muscimol state-dependent memory were examined in mice. Main methods: A single-trial step-down passive avoidance task was used for the assessment of memory retention in adult male NMRI mice. Key findings: Pre-training intra-CA1 administration of a GABA-A receptor agonist, muscimol (0.05 and 0.1 μg/mouse) dose dependently induced impairment of memory retention. Pre-test injection of muscimol (0.05 and 0.1 μg/mouse, intra-CA1) induced state-dependent retrieval of the memory acquired under pre-training muscimol (0.1 μg/mouse, intra-CA1) influence. Pre-test intra-CA1 injection of an acetylcholinesterase inhibitor, physostigmine (0.5 and 1 μg/mouse, intra-CA1) reversed the memory impairment induced by pre-training administration of muscimol (0.1 μg/mouse, intra-CA1). Moreover, pre-test administration of physostigmine (0.5 and 1 μg/mouse, intra-CA1) with an ineffective dose of muscimol (0.025 μg/mouse, intra-CA1) significantly restored the retrieval and induced muscimol state-dependent memory. Pre-test intra-CA1 administration of physostigmine (0.25, 0.5 and 1 μg/mouse) by itself cannot affect memory retention. Pre-test intra-CA1 injection of the muscarinic receptor antagonist, atropine (1 and 2 μg/mouse) 5 min before the administration of muscimol (0.1 μg/mouse, intra-CA1) dose dependently inhibited muscimol state-dependent memory. Pre-test intra-CA1 administration of atropine (0.5, 1 and 2 μg/mouse) by itself cannot affect memory retention. Significance: The results suggest that muscarinic cholinergic mechanism of the CA1 may influence muscimol state-dependent memory. © 2011 Elsevier Inc. All rights reserved.


Azizi G.,Alborz University of Medical Science | Khannazer N.,University of Tehran | Mirshafiey A.,Tehran University of Medical Sciences
American Journal of Alzheimer's Disease and other Dementias | Year: 2014

Alzheimer's disease (AD) is a neurodegenerative disorder and leading cause of dementia, which begins with impaired memory. The neuropathological hallmarks of AD include destructive alterations of neurons by neurofibrillary tangles, neuritic amyloid plaques, and neuroinflammatory process in the brain. Chemokines have a major role in inflammatory cell attraction and glial cell activation and/or modulation in the central nervous system. Moreover, the clinical and immunopathological evidence could show dual key role of chemokines in their pro- and anti-inflammatory properties in AD. However, their effects in neurodegeneration and/or neuroprotection remain an area of investigation. This review article provides an overview of characteristic, cellular source and activity of chemokines, and their roles in neuronal glial cell interaction in AD. © The Author(s) 2014.


Shidfar F.,Tehran University of Medical Sciences
Journal of complementary & integrative medicine | Year: 2012

Although some herbal remedies in association with vitamin therapy have been investigated in eradicating HP, no research has been done to investigate the effects of lycopene it. Our aim was to understand if lycopene could be effective in eradication of HP. In this parallel group quasi-control trial, a total of 54 patients whose diagnosis of HP had been confirmed by rapid urease test (RUT) were enrolled. Group 1 received the standard 4-drug therapy to eradicate HP (Metronidazole 500 mg/BD, Amoxicillin 1g/BD, Omeprazole 20mg/BD, and Bismuth 240 mg/BD) and group 2 received the same regimen in association with Lycopene (30 mg/daily). One month after the initiation of the treatment, the patients were evaluated for HP eradication by RUT. Although eradication rate was higher in the second group, bivariate analysis showed no significant statistical difference between the two groups. In contrast with other nutrients, it seems that Lycopene does not have any significant effects on eradicating HP in comparison with the standard antibiotic therapy. The prevalence of HP is in association with socioeconomic situation, so the patients in different studies should be paid more attention about their own life style. We recommend that more studies can be designed by considering control group and placebo administration.


Nateghi Rostami M.,Qom University of Medical Sciences | Saghafipour A.,Tehran University of Medical Sciences | Vesali E.,Qom University of Medical Sciences
International Journal of Infectious Diseases | Year: 2013

Objectives: This study was performed to evaluate the epidemiological status of cutaneous leishmaniasis (CL) in the most important endemic foci of Qom Province, central Iran. The city of Qom is the largest center for Shi'a scholarship in the world and is a significant pilgrimage destination. Methods: During 2006-2011, all suspected CL patients with skin lesion(s) referred to regional health centers of Ghomrood and Ghanavat regions, and all actively detected cases, were examined clinically and parasitologically for CL. Patient information was recorded and patients were categorized based on the number and size of the lesions. Odds ratios (OR) of different risk factors were calculated. Results: A total of 849 (59.2% male, 40.8% female) confirmed cases of CL were enrolled; the average incidence rate of the disease was 14.9 per 100. 000 people. During the study period 2006-2011, the trend in CL incidence showed no sudden variations in the areas studied, except for an outbreak of CL in 2009. Leishmania major was identified as the causative agent based on internal transcribed spacer 1 (ITS1) ribosomal DNA PCR analysis. During the study period, the age distribution of CL cases was relatively stable, with the majority (50%) of patients aged 1-25 years. Most cases ( n = 468; 55.1%) had a single lesion and 82 (9.6%) patients had four or more lesions (range 1-29). The risk of developing multiple lesions was significantly increased in patients with seasonal jobs (summer workers) ( p = 0.023; OR 1.516) and significantly decreased in patients who were affected in winter ( p = 0.010; OR 0.398). The risk of developing large-sized lesions (>1. cm) was significantly increased in patients in the age groups >25 years ( p = 0.001-0.015; OR 2.5-3.5) and decreased in patients with seasonal jobs (summer workers) ( p = 0.005; OR 0.570). Conclusions: The present data show the importance of CL as a health problem in suburban areas of Qom Province. In order to identify other epidemiological aspects of leishmaniasis in this area, studies on vectors and reservoirs are recommended. Since leishmaniasis caused by L. major is typically zoonotic, control measures should focus on rodents as the main reservoirs and Phlebotomus papatasi as the main vector. Awareness should be raised in the high-risk populations comprising people with diabetes, young adults (<25 years old), and those who work outdoors during the summer. © 2013 International Society for Infectious Diseases.


Ghods A.J.,Tehran University of Medical Sciences
Iranian Journal of Kidney Diseases | Year: 2012

By advances in surgical techniques, success in prevention and treatment of transplant-related infections, and introduction of new immunosuppressive drugs, the patient and graft survival rates in solid organ transplant recipients has steadily and remarkably improved. It has been shown that the longer the transplant patients survival rate, the more saturation with cardiovascular risk factors and the greater risk of cardiovascular mortality. Currently, cardiovascular disease is the primary cause of death after kidney transplantation and is among the three most common causes of death after heart and liver transplantation. Over the past decades, because of risk factor reduction, mortality from coronary artery disease has substantially decreased in the general population. Recent studies suggest that risk factors reduction also significantly decreases cardiovascular events and deaths in solid organ transplant recipients.


Izadi F.,Tehran University of Medical Sciences
Genetics and molecular research : GMR | Year: 2012

Lipoid proteinosis (LP) is a rare autosomal recessive disorder. Classical clinical features include warty skin infiltration, papules on the eyelids, skin scarring, as well as extracutaneous abnormalities such as hoarseness of the voice, epilepsy, and neuropsychiatric abnormalities. A defect in the ECM1 gene is responsible for this disease. A 21-year-old female patient from consanguineous parents (first cousins) was referred to our clinic with many symptoms of LP, such as hoarse voice from infancy, diffuse acneiform scars on her face, and hyperkeratosis on her knees and elbows. The entire ECM1 gene was screened using PCR and sequencing. A novel missense mutation was found in exon 7 of this patient. We report a novel missense mutation in exon 7 of the ECM1 gene found in an Iranian LP patient that causes a C269Y amino acid exchange.


Eslamian L.,Shahid Beheshti University of Medical Sciences | Borzabadi-Farahani A.,University of Warwick | Borzabadi-Farahani A.,University of Southern California | Hassanzadeh-Azhiri A.,Shahid Beheshti University of Medical Sciences | And 2 more authors.
Lasers in Medical Science | Year: 2014

The purpose of this study was to assess the effect of 810-nm (DMC Equipamentos, Sao Carlos, Brazil) continuous wave low-level laser therapy (LLLT) on the pain caused by orthodontic elastomeric separators. Thirty-seven orthodontic patients (12 male and 25 female, aged 11-32 years, mean age = 24.97 years) participated in the study, including 20 subjects aged 18 years or more, and 17 under 18 years of age. Four elastomeric separators (Dentarum, Springen, Germany) were placed for the first permanent molars (distal and mesial), either for maxillary (22 patients) or mandibular (15 patients) arches; one quadrant was randomly selected and used as a placebo group (received no laser irradiation). After separator placement for each quadrant, patients received 10 doses (2 J/cm2, 100 mW, 20 s) of laser irradiation on the buccal side (at the cervical third of the roots), for distal and mesial of the second premolars and first permanent molars, as well as distal of second permanent molars (five doses). The same procedure was repeated for the lingual or palatal side (five doses). After 24 h, patients returned to the clinic and received another 10 doses of laser irradiation on the same quadrant. Postseparation pain level recorded on a 10-cm visual analog scale for both jaws immediately (hour 0), and after 6, 24, 30 h, as well as on days 3, 4, 5, 6, and 7. Significant differences in the pain perception (PP) were found between the laser and placebo groups at 6, 24, 30 h, and day 3 of the experiment (P < 0.05). Friedman's test of multiple comparisons revealed significant differences in the PP among various time intervals for laser (chi-square = 173.407, P = 0.000) and placebo (chi-square = 184.712, P = 0.000) groups. In both groups, pain was highest at 6 and 30 h after placing elastomeric separators. No gender differences were observed in both groups. More pain was recorded in the mandible (P < 0.05) at 24 (laser group) and 30 h (both groups) after starting the experiment. The PP was significantly higher (P < 0.05) for the group aged 18 years or more, only at days 3 [both groups] and 4 [laser group only] of the experiment. The 810-nm continuous wave LLLT significantly reduced the PP in the first 3 days after orthodontic separation. However, the mean postseparation PP in both groups was low and wide ranges of PP scores were observed. © 2013 Springer-Verlag.


Moghimi J.,Semnan University of Medical Sciences | Sheikhvatan M.,Tehran University of Medical Sciences | Semnani V.,Semnan University of Medical Sciences
Rheumatology International | Year: 2012

During recent decades, biological medications play a crucial role for treating rheumatologic disorders and thus are strongly recommended for initial treatment of ankylosing spondylitis. However, because of high cost of biological drugs, the use of these drugs has been limited. In current series, we tried to assess safety of low-dose eta-nercept as a common usable biological drug in patients with ankylosing spondylitis. In a case-series study, 4 men with ankylosing spondylitis were treated with low-dose Etanercept (25 mg/2 weeks) plus methotrexate (10 mg/week). Safety was assessed by measuring rate of differences in severity of clinical manifestations and level of C-reactive protein (CRP). After the completion of treatment with low-dose etanercept, inflammatory low back pain and morning stiffness was reduced lower than 30 min in all patients. Only one patient had baseline high serum ESR and positive CRP that was changed to negative following treatment protocol. At one-year follow-up, all participants continued their regular treatment regimen with the etanercept survival rate 100%. Neither side effects related to drug nor clinical complications were observed within the follow-up period. Our findings suggest that low-dose etanercept (25 mg/2 weeks) has an acceptable safety and effectiveness profile in individuals with ankylosing spondylitis and can be good alternative instead of conventional therapy with etanercept (25 mg two times per week). © Springer-Verlag 2011.


Eshtiaghi R.,Tehran University of Medical Sciences | Keihani S.,Shahid Beheshti University of Medical Sciences | Hosseinpanah F.,Shahid Beheshti University of Medical Sciences | Barzin M.,Shahid Beheshti University of Medical Sciences | Azizi F.,Shahid Beheshti University of Medical Sciences
International Journal of Obesity | Year: 2015

Objective:This study aims to assess the natural course of metabolically healthy abdominal obese (MHAO) phenotype and determine the predictors of change in the metabolic status in this population over 10 years of follow-up.Methods:A total of 916 MHAO subjects from the Tehran Lipid and Glucose Study were followed for changes in their metabolic health status. Anthropometric and metabolic indices were measured at baseline and were compared between subjects with healthy and unhealthy metabolic conditions at the end of follow-up. Predictors of change in metabolic health were assessed in logistic regression models. National waist circumference cutoffs were used for definition of abdominal obesity. Metabolic health was defined as ≤1 metabolic components of metabolic syndrome according to the Joint Interim Statement criteria.Results:At the end of the follow-up, nearly half of the MHAO subjects lost their metabolic health and 42.1% developed metabolic syndrome by definition. Low high-density lipoprotein cholesterol, hypertriglyceridemia and homeostasis model assessment-insulin resistance at baseline were significant predictors of change in metabolic health condition.Conclusion:MHAO is a relatively unstable condition and a considerable percentage of these individuals will lose their metabolic health as time passes. Baseline metabolic characteristics may be useful predictors of this change and should be considered in the care of these individuals. © 2015 Macmillan Publishers Limited.


Danaei G.,Harvard University | Singh G.M.,Harvard University | Paciorek C.J.,University of California at Berkeley | Lin J.K.,Harvard University | And 8 more authors.
Circulation | Year: 2013

Background.It is commonly assumed that cardiovascular disease risk factors are associated with affluence and Westernization. We investigated the associations of body mass index (BMI), fasting plasma glucose, systolic blood pressure, and serum total cholesterol with national income, Western diet, and, for BMI, urbanization in 1980 and 2008. Methods and Results.Country-level risk factor estimates for 199 countries between 1980 and 2008 were from a previous systematic analysis of population-based data. We analyzed the associations between risk factors and per capita national income, a measure of Western diet, and, for BMI, the percentage of the population living in urban areas. In 1980, there was a positive association between national income and population mean BMI, systolic blood pressure, and total cholesterol. By 2008, the slope of the association between national income and systolic blood pressure became negative for women and zero for men. Total cholesterol was associated with national income and Western diet in both 1980 and 2008. In 1980, BMI rose with national income and then flattened at.Int$7000; by 2008, the relationship resembled an inverted U for women, peaking at middle-income levels. BMI had a positive relationship with the percentage of urban population in both 1980 and 2008. Fasting plasma glucose had weaker associations with these country macro characteristics, but it was positively associated with BMI. Conclusions.The changing associations of metabolic risk factors with macroeconomic variables indicate that there will be a global pandemic of hyperglycemia and diabetes mellitus, together with high blood pressure in low-income countries, unless effective lifestyle and pharmacological interventions are implemented. © 2013 American Heart Association, Inc.


Shakeri-Zadeh A.,Tehran University of Medical Sciences | Ghasemifard M.,Ferdowsi University of Mashhad | Ali Mansoori G.,University of Illinois at Chicago
Physica E: Low-Dimensional Systems and Nanostructures | Year: 2010

Gold nanoparticles (AuNPs) represent a novel nanomaterials applied in various nanotechnology fields because of their special optical properties. On the other hand, folic acid and folate can be used for selective targeting of nanoparticles towards cancer cells. Folate conjugated AuNPs can be considered as an effective nanoconjugate in the field of nanotargeted photothermal therapy of cancer. In the present work, we report our synthesis of a new nanoconjugate composed of folate, AuNP and 4-aminothiophenol (4Atp) as the linker and named Folate-4Atp-AuNP. The results of our investigations on properties of this new nanoconjugate are presented here including the effects of addition of folate and 4Atp to AuNP on its structural and optical properties. We studied the structural characteristics of Folate-4Atp-AuNP using X-ray diffraction. In addition, we determined its optical band gap energy (1.365 eV), its optical constants using Kramers-Kronig analysis and we identified its metallic face-centered cubic (fcc) lattice structure and particular crystal planes. Our findings indicate that the presence of 4Atp and folate in Folate-4Atp-AuNP had no significant effect on its optical band gap energy. However, some appreciable changes in its optical constants were observed due to the presence of 4Atp and folate in nanoconjugate. The significant changes in optical constants values are apparently as a result of the presence of some special bonds and a few particular functional groups in the nanoconjugate. © 2009 Elsevier B.V. All rights reserved.


Hosseini M.,Islamic Azad University | Abkenar S.D.,Islamic Azad University | Ganjali M.R.,University of Tehran | Faridbod F.,Tehran University of Medical Sciences
Materials Science and Engineering C | Year: 2011

A highly selective and sensitive zinc ion-selective membrane electrode based on N,N′-phenylenebis (salicylideaminato) (L) as a new carrier is reported. The membrane is composed of poly (vinyl chloride) (PVC), o-nitrophenyl octyl ether (NPOE) as plasticizer, potassium tetrakis(p-chlorophenyl) borate (KTpClPB) as lipophilic ionic additive, and L as sensing material. The proposed electrode displays a Nernstian response to Zn2+ ions over a wide concentration range of 5.0 × 10- 7-1.0 × 10- 1 M with the slope of 29.4 ± 0.2 mV per decade and a detection limit of 2.6 × 10- 7 M. The sensor has a relatively fast response time of < 10 s and it can be used in the pH range of 3.0-7.0 for at least 2 months without any significant divergency in potential. The selectivity coefficients for mono-, di-, and trivalent cations indicate the good selectivity of sensor for Zn2+ ions over a large number of interfering cations. As a result the proposed electrode was applied to Zn2+ ions determination in mixture solutions and wastewater samples. © 2010 Elsevier B.V. All rights reserved.


PURPOSE:: To compare choroidal thickness (CT) and retinal thickness (RT) between eyes with proliferative diabetic retinopathy treated with panretinal photocoagulation (PRP) or PRP with intravitreal bevacizumab (PRP + IVB). METHODS:: Thirty-three patients with proliferative diabetic retinopathy were randomized to have one eye treated with PRP and the other with PRP + IVB. Change in CT was compared with baseline using enhanced depth imaging–optical coherence tomography at baseline and Months 1, 3, 6, and 10 after treatment. Change in RT was similarly assessed using spectral domain optical coherence tomography. Changes in both CT and RT were assessed in all nine macular areas as defined by Early Treatment Diabetic Retinopathy Study subfields. RESULTS:: The PRP + IVB group had a significant decrease in subfoveal CT at 3 and 10 months (323.9 ± 62 μm at baseline vs. 320.7 ± 64.8 μm at Month 3 [P = 0.024] and 304.7 ± 65.6 μm at Month 10 [P = 0.003]). Subfoveal CT significantly decreased at 10 months compared with baseline in the PRP group (320.8 ± 57.7 at baseline to 297 ± 66.3 μm at 10 months, P = 0.01). Subfoveal CT was not significantly different between the 2 groups at 10 months. The best-corrected visual acuity did not change after treatment in the two groups, and there was no correlation between BCVA and CT changes (r = 0.222, P = 0.37 in the PRP group and r = 0.387, P = 0.12 in the PRP + IVB group). Significant increases in RT were seen in the PRP + IVB group at 6 months and in the PRP group at Months 1, 3, 6, and 10. A correlation between changes in CT and RT was only seen in the PRP group at 10 months after treatment. CONCLUSION:: Eyes with proliferative diabetic retinopathy treated with PRP + IVB and PRP both had significant reduction in CT at 10 months; however, the eyes that were also treated with IVB also underwent an earlier but transient reduction at 3 months. Patients treated with IVB underwent less increase in RT. © 2016 by Ophthalmic Communications Society, Inc.


Mansournia M.A.,Tehran University of Medical Sciences | Hernan M.A.,Harvard University | Hernan M.A.,Harvard-MIT Division of Health Sciences and Technology | Greenland S.,University of California at Los Angeles
International Journal of Epidemiology | Year: 2013

We use causal diagrams to illustrate the consequences of matching and the appropriate handling of matched variables in cohort and case-control studies. The matching process generally forces certain variables to be independent despite their being connected in thecausal diagram, a phenomenon known as unfaithfulness. We show how causal diagrams can be used to visualize many previous results about matched studies. Cohort matching can prevent confounding by the matched variables, but censoring or other missing data and further adjustment may necessitate control of matching variables. Case-control matching generally does not prevent confounding by the matched variables, and control of matching variables may be necessary even if those were not confounders initially. Matching on variables thatare affected by the exposure and the outcome, or intermediates between the exposure and the outcome, will ordinarily produce irremediable bias.


Ghassemi F.,Tehran University of Medical Sciences | Shields C.L.,Thomas Jefferson University
Archives of Ophthalmology | Year: 2012

Objective: To evaluate the efficacy and complications of intravitreal chemotherapy for viable vitreous seeding from retinoblastoma. Methods: Intravitreal injection of melphalan (8-50 μg in 0.05 mL) followed by injection site cryotherapy. Results: Among 12 treated cases, success with control of vitreous seeds was achieved in 10 of 12 cases at immediate follow-up (0-3 months), 8 of 10 cases at short-term follow-up (3-6 months), and 6 of 10 cases at long-term (>6 months) follow-up. Among those 8 cases that received an 8- to 10-μg dose, control was achieved in 6 of 8 cases at immediate follow-up, 5 of 7 cases at short-term follow-up, and 3 of 7 cases at long-term follow-up. Complications with the 8- to 10-μg dose were minor and included preretinal hemorrhage and retinal vasculitis with retinal pigment epithelial alterations. Of those 4 that received a 50-μg dose, immediate, short-term, and long-term control was 100%, but complications of cataract, vitreous hemorrhage, subretinal hemorrhage, severe hypotonia, and phthisis lead to enucleation in 2 cases. There was no case of orbital tumor recurrence or retinoblastoma metastasis (follow-up range, 8-66 months). Conclusions: Intravitreal melphalan for recurrent vitreous seeds from retinoblastoma appears to provide vitreous seed control in some patients. A high dose (50 μg) of melphalan is toxic and should be avoided. ©2012 American Medical Association. All rights reserved.


Salamatrad A.,Tehran University of Medical Sciences
Cornea | Year: 2014

PURPOSE:: The aim of this study was to evaluate biocompatibility of a newly proposed intrastromal inlay in rabbit corneas.METHODS:: Eighteen eyes of 9 New Zealand rabbits were included in this prospective study. An intrastromal pocket was created in both eyes using Melles instruments. Annular intracorneal inlays made of hexafocon A were implanted randomly into the stromal pocket of one eye of each rabbit. Confocal microscopy was performed at each visit during 6-month follow-up. After 6 months, the rabbits were killed and corneal tissues of both eyes were sent for light microscopic studies.RESULTS:: Mild stromal edema was present during the first few days and disappeared afterward with mild haze around the tunnel site in all cases. Deposits around the lamellar channel developed in 3 implanted eyes and in none of the pocket-only eyes. No neovascularization or epithelial downgrowth was present at the incision site in any case. All inlays remained centered and optically clear. In confocal imaging, we observed no significant difference in keratocyte cell density and inflammatory cells between the control pocket-only group and inlay group. In pathological evaluation, there was no difference in the average epithelial thickness between both groups. Descemet membrane and endothelium appeared normal in both groups.CONCLUSIONS:: This study revealed safety and biocompatibility of hexafocon A as an intracorneal inlay in rabbits. © 2014 by Lippincott Williams & Wilkins.


Amini E.,Tehran University of Medical Sciences | Djaladat H.,University of Southern California
Current Opinion in Urology | Year: 2015

Purpose of review Radical cystectomy and urinary diversion remains the cornerstone in surgical management of patients with muscle-invasive or high-risk nonmuscle-invasive bladder cancer. This approach has been associated with remarkable increase in patient survival and more patients are now living for years after surgery who may present with long-term complications. This review describes long-term complications associated with urinary diversion including renal function deterioration, voiding dysfunction, stoma and bowel-related complications, ureteroenteric stricture, metabolic disorders, and infectious complications. Recent findings The overall complication rate reported in recent large studies assessing long-term complications of urinary diversion is as high as 60%. Stoma-related complications followed by urinary tract infections are among the most common complications. Some of these complications may occur years after surgery; therefore, long-term follow-up of patients with urinary diversion is of utmost importance. Summary Long-term regular follow-up is imperative in patients with urinary diversion as nonfatal complications may occur years after surgery. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.


To compare the efficacy of acupressure wrist bands, ondansetron, metoclopramide and placebo in the prevention of vomiting and nausea after strabismus surgery. Two hundred patients, ASA physical status I or II, aged between 10 and 60 years, undergoing strabismus surgery in Farabi Hospital in 2007-2008 years, were included in this randomized, prospective, double-blind and placebo-controlled study. Group I was the Control, group II received metoclopramide 0.2 mg/kg, group III received ondansetron 0.15 mg/kg iv just before induction, in Group IV acupressure wristbands were applied at the P6 points. Acupressure wrist bands were placed inappropriately in Groups I, II and III. The acupressure wrist bands were applied 30 min prior to the induction of anesthesia and removed six hours after surgery. Postoperative nausea and vomiting (PONV) was evaluated within 0-2 hours and 2-24 hours after surgery by a blinded observer. Results were analyzed by X(2) test. A P value of < 0.05 was taken as significant. The incidence of PONV was not significantly different in acupressure, metoclopramide and ondansetron during the 24 hours. Acupressure at P6 causes a significant reduction in the incidence of PONV 24 hours after strabismus surgery as well as metoclopramide 0.2 mg/kg and ondansetron 0.15 mg/kg iv for patients aged 10 or more.


Hossein Mahvi A.,Tehran University of Medical Sciences
The British journal of nutrition | Year: 2012

High concentrations of fluoride (F) in powdered milk (formula milk) can have adverse health effects on the body. The F concentration in powdered milk was analysed in Iran in 2010. A total of twelve commercial brands of highly consumed powdered milk were selected to analyse the F content through the standard F ion-selective electrode method. From each brand, three samples with different production dates were selected. The means and standard deviation for F concentration in all the samples was 1·73 (sd 0·3) μg F/g. The minimum and maximum F content in powdered milk brands Humana2 and Humana3 was 1·32 (sd 0·1) and 2·36 (sd 0·3) μg F/g, respectively. The study revealed that there was no significant difference in F concentration in the samples that belonged to various dates. Humana3 had a high F concentration (with an average of 2·36 (sd 0·3) μg F/g), which can be a risk factor for increased dental fluorosis, especially when being prepared using water with a high content of F.


Mohseni Salehi Monfared S.S.,Tehran University of Medical Sciences | Pournourmohammadi S.,Kerman Medical University
Biological Trace Element Research | Year: 2010

Islet transplantation has become a promising treatment in the therapy of type 1 diabetes. Its function improvement, after isolation and before transplantation, is crucial because of their loss both in number and function of islets after isolation procedures. Trace elements sodium orthovanadate (SOV) and sodium molybdate (SM), as well as medicinal plant Teucrium polium L. (TP),. showed and possessed high beneficial antioxidative potential and even hypoglycemic properties via their effect on islets. We evaluated the effect of these components in combination on cultured islet function in order to improve pancreatic islet transplantation. Rat pancreatic islets were cultured for 24 h then incubated with different concentrations of TP (0.01 and 0.1 mg/mL) alone and in combination with SOV (1 mM) or SM (1 mM). Insulin concentration in buffer media was measured as islet secretory function. Administration of TP (0.01 mg/mL), SM, and SOV alone or in combination with each other significantly increased insulin secretion at high glucose concentration (16.7 mM); insulin secretion was significantly greater in the group containing both TP and SM than other treated groups (p<0.05). The combination of the mentioned trace elements especially molybdate with TP could improve islet cells function before transplantation. © Springer Science+Business Media, LLC 2009.


Bananej M.,Islamic Azad University at Tehran | Karimi-Sori A.,Islamic Azad University at Tehran | Zarrindast M.R.,Tehran University of Medical Sciences | Ahmadi S.,University of Kurdistan
Journal of Psychopharmacology | Year: 2012

Involvement of the dopamine receptors in the basolateral amygdala (BLA) in the effects of histamine on anxiety-like behaviors of the elevated plus maze in male Wistar rats was investigated. The results showed that bilateral intra-BLA injections of histamine (2.5, 5 and 7.5 μg/rat) induced an anxiogenic-like effect, revealed by decreases in percentage of open arm time (%OAT) and open arm entries (%OAE). Intra-BLA administration of dopamine D1 receptor agonist, SKF38393 (0.25 μg/rat), and dopamine D2 receptor agonist, quinpirole (0.03 and 0.05 μg/rat), decreased %OAT but not %OAE. Conversely, intra-BLA administration of dopamine D1 receptor antagonist, SCH23390 (0.5 and 1 μg/rat), and dopamine D2 receptor antagonist, sulpiride (0.3 and 0.5 μg/rat), increased %OAT and %OAE, suggesting an anxiolytic-like effect for both drugs. Interestingly, co-administration of a silent dose of SCH23390 or sulpiride prevented anxiogenic-like effects of SKF38393 and quinpirole, respectively. Conjoint administration of a sub-effective dose of SKF38393 (0.125 μg/rat) or quinpirole (0.01 μg/rat) along with lower doses of histamine (1 and 2.5 μg/rat) induced anxiolytic-like effects. On the other hand, intra-BLA pretreatment with a silent dose of SCH23390 (0.25 μg/rat) or sulpiride (0.1 μg/rat) prevented the anxiogenic-like effect of higher doses of histamine (5 and 7.5 μg/rat). No significant change was observed in total closed arm entries, as an index for motor activity of the animals. It can be concluded that the dopamine D1 and D2 receptors in the BLA may be involved in the anxiogenic-like effects induced by histamine. © The Author(s) 2012.


Emami M.,University of Tehran | Shamsipur M.,Razi University | Saber R.,Tehran University of Medical Sciences | Saber R.,Research Center for Science and Technology in Medicine | Irajirad R.,Research Center for Science and Technology in Medicine
Analyst | Year: 2014

A label free immunosensor was designed for ultra-detection of human epidermal growth factor receptor 2 (HER2) in real samples using a differential pulse voltammetry (DPV) method. In a separate process, antiHER2 antibodies were attached to iron oxide nanoparticles (Fe3O4 NPs) to form stable bioconjugates which were later laid over the gold electrode surface. In this way, by the advantage of their long terminals, the bioconjugates provided the most possible space for the immuno-reaction between biomolecules. Under optimal conditions, the immunosensor was responsive to HER2 concentrations over the ranges of 0.01-10 ng mL-1 and 10-100 ng mL-1 linearly and benefited from a satisfactory detection limit as low as 0.995 pg mL -1 and a favorable sensitivity as sharp as 5.921 μA mL ng -1. The reliability of the method in clinical analysis was proved by successful quantization of HER2 levels in serum samples obtained from patients. Furthermore, the precision and the stability of the method were evaluated and verified to be acceptable in immunoassay studies. © the Partner Organisations 2014.


Fateh M.,Shahroud University of Medical Sciences | Emamian M.H.,Shahroud University of Medical Sciences | Asgari F.,Center for Diseases Control | Alami A.,Gonabad University of Medical Sciences | Fotouhi A.,Tehran University of Medical Sciences
Journal of Hypertension | Year: 2014

OBJECTIVE:: Hypertension covers a large portion of burden of diseases, especially in the developing countries. The unequal distribution of hypertension in the population may affect 'health for all' goal. This study aimed to investigate the socioeconomic inequality of hypertension in Iran and to identify its influencing factors. METHODS:: We used data from Iran's surveillance system for risk factors of noncommunicable diseases which was conducted on 89400 individuals aged 15-64 years in 2005. To determine the socioeconomic status of participants, a new variable was created using a principal component analysis. We examined hypertension at different levels of this new variable and calculated slop index of inequality (SII) and concentration index (C) for hypertension. We then applied Oaxaca-Blinder decomposition analysis to determine the causes of inequality. RESULTS:: The SII and C for hypertension were -32.3 and -0.170, respectively. The concentration indices varied widely between different provinces in Iran and was lower (more unequal) in women than in men. There was significant socioeconomic inequality in hypertension. The results of decomposition indicated that 40.5% of the low-socioeconomic group (n=18190) and 16.4% of the high-socioeconomic group (n=16335) had hypertension. Age, education level, sex and residency location were the main associated factors of the difference among groups. CONCLUSION:: According to our results, there was an inequality in hypertension in Iran, so that individuals with low socioeconomic status had a higher prevalence of hypertension. Age was the most contributed factor in this inequality and women in low-socioeconomic group were the most vulnerable people for hypertension. © 2014 Wolters Kluwer Health Lippincott Williams & Wilkins.


Naghii M.R.,Tehran University of Medical Sciences
Endocrine Regulations | Year: 2014

Objective. Stone disease is an increasingly common form of renal disease. Diet plays an important role in expression of the tendency to stone formation. Renal epithelial cell injury by reactive oxygen species is a pre-requisite step and the administration of natural antioxidants has been used to protect against nephrolithiasis. Considering the nutrients, boron as an ultra-trace element is revealing to enhance the antioxidant defense mechanism and along vitamin status seems to have an impact on the stone removal. Methods. A male patient with urolithiasis received daily boron plus antioxidants supplement and asked to consume enough of the dairy serving products plus adequate liquids. Result. Ultrasonography assessment revealed continuous stone removal or disposal without hydronephrosis with significant pain alleviation and reduction in hematuria. The lithiasic residues were collected. The 9*20 mm size of the one eliminated stone is of noteworthy. Conclusion. Successful and comfortable kidney stone repulsion with a minor pain and bleeding indicates that this impact of boron plus antioxidants deserves further study and clarification. © 2014, Institute of Experimental Endocrinology. All rights reserved.


Amanlou M.,Tehran University of Medical Sciences
Daru : journal of Faculty of Pharmacy, Tehran University of Medical Sciences | Year: 2015

BACKGROUND: Gold nanoparticles now command a great deal of attention for medical applications. Despite the importance of nano-bio interfaces, interaction between peptides and proteins with gold surfaces is not still fully understood, especially in a molecular level.METHODS: In the present study computational simulation of adsorption of 20 amino acids, in three forms of mono-amino acid, homo di-peptide and homo tri-peptide, on the gold nanoparticles was performed by Gromacs using OPLSAA force field. The flexibility, stability, and size effect of the peptides on the gold nanoparticles were studied as well as the molecular structure of them.RESULTS: According to our results, adsorbed homo tri-peptides on the gold surface had more flexibility, more gyration, and the farthest distance from the GNP in comparison with homo di-peptides and mono-amino acids.CONCLUSION: Our findings provide new insights into the precise control of interactions between amino acids anchored on the GNPs.


Teymoortash A.,University of Marburg | Fasunla J.A.,University of Marburg | Sazgar A.A.,Tehran University of Medical Sciences
European Archives of Oto-Rhino-Laryngology | Year: 2012

The value of spreader grafts in rhinoplasty cannot be underestimated. Various studies have demonstrated that they play a valuable role in the restoration of nasal dorsum aesthetics, provide support for the nasal valve and maintain the straightened position of the corrected deviated cartilaginous septal dorsum. However, there is still controversy on the extent of its value in nasal patency. This study reviews the literature and describes the values and limitations of spreader grafts in rhinoplasty and the alternatives to classic spreader grafts. © The Author(s) 2011.


Ghazizadeh S.,Tehran University of Medical Sciences
Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia | Year: 2011

The objective of this study was to evaluate the incidence of genital human papilloma virus (HPV) infection and cervical intra-epithelial lesions in transplanted patients. Cervical Papanicolaou (Pap) smear/HPV test and colposcopic examinations were performed in 58 patients who were candidates for renal transplant surgery; these tests were repeated one year later. Their age range was 26-53 years (mean, 37.2 years). Hypertension was the most common cause of renal insufficiency (34.4%), while in 41.4% of the patients, the causative pathology was unknown. In 24.1% of the patients, there was no history of dialysis, i.e. they had pre-emptive transplantation. The mean duration of marriage (years since first intercourse) was 16.2 years (range, 1-35). Coitus interruptus was the most common contraceptive method used (37.9%), followed by tubal ligation and condom (10.3% and 6.9%, respectively). All patients had negative Pap tests and normal gynecologic exam before undergoing transplantation. The Pap test remained normal after transplant surgery, although the HPV test became positive in four patients (6.9%). There were five cases of white epithelium on colposcopy, but biopsy showed normal metaplasia. Two cases of extensive anogenital warts were treated by CO 2 laser, and one patient had recurrent warts, which responded well to second laser surgery. None of the study patients had squamous intra-epithelial lesions (SIL) or vulvar intra-epithelial neoplasia. Our study suggests that screening with HPV and Pap test should be performed before transplant surgery and should be repeated at regular intervals in order to avoid irreversible situations such as high-grade SILs, which are difficult to treat. Avoiding high-risk sexual relations in this group of patients is highly recommended.


Niazi M.,Golestan University of Medical Sciences | Maleki A.R.,Golestan University of Medical Sciences | Talebpour M.,Tehran University of Medical Sciences
Obesity Surgery | Year: 2013

Demand for feasible, safe, and preferably low-cost methods of weight reduction is rising every day. The present study reports findings from laparoscopic gastric plication (LGP), which is a new restrictive bariatric technique, combined with a postoperative follow-up program. A 2-year prospective study was performed following LGP in 53 female morbidly obese patients from Gorgan, Iran, with a mean age of 36.3 years and mean body mass index (BMI) of 42.6 kg/m2 (35.3-62.4). Through a four-port approach, the greater omentum and short gastric vessels were transected and the greater curvature was imbricated into the body of the stomach with two rows of nonabsorbable sutures. After surgery, all patients were scheduled to attend a weekly group meeting for behavioral modification and psychotherapy. The mean operative time and hospital stay was 95 min and 72 h, respectively. No intraoperative complications occurred. Mean percentages of excess weight loss (%EWL) were 25.6 %, 54.2 %, 70.2 %, and 74.4 % after 1, 6, 12, and 24 months, respectively. Six patients lost >84 % of their excess weight after 24 months. Patients who did not participate in the group meetings had a lower %EWL after 12 (79.5 % vs. 55.6 %) and 24 months (90 % vs. 43.4 %) compared with the patients who regularly participated in the group meetings (P < 0.005). LGP is a feasible, safe, and effective surgical method for weight loss for at least 24 months when performed on morbidly obese patients. Postoperative group meetings (POGM) for psychotherapy and behavioral modification helped patients to achieve better results. © 2012 Springer Science + Business Media, LLC.


Mansournia M.A.,Tehran University of Medical Sciences | Greenland S.,University of California at Los Angeles
Epidemiology | Year: 2015

A probability distribution may have some properties that are stable under a structure (e.g., a causal graph) and other properties that are unstable. Stable properties are implied by the structure and thus will be shared by populations following the structure. In contrast, unstable properties correspond to special circumstances that are unlikely to be replicated across those populations. A probability distribution is faithful to the structure if all independencies in the distribution are logical consequences of the structure. We explore the distinction between confounding and noncollapsibility in relation to the concepts of faithfulness and stability. Simple collapsibility of an odds ratio over a risk factor is unstable and thus unlikely if the exposure affects the outcome, whether or not the risk factor is associated with exposure. For a binary exposure with no effect, collapsibility over a confounder also requires unfaithfulness. Nonetheless, if present, simple collapsibility of the odds ratio limits the degree of confounding by the covariate. Collapsibility of effect measures is stable if the covariate is independent of the outcome given exposure, but it is unstable if the covariate is an instrumental variable. Understanding stable and unstable properties of distributions under causal structures, and the distinction between stability and faithfulness, yields important insights into the correspondence between noncollapsibility and confounding. © 2015 Wolters Kluwer Health, Inc.


Greenland S.,University of California at Los Angeles | Mansournia M.A.,Tehran University of Medical Sciences
Statistics in Medicine | Year: 2015

Penalization is a very general method of stabilizing or regularizing estimates, which has both frequentist and Bayesian rationales. We consider some questions that arise when considering alternative penalties for logistic regression and related models. The most widely programmed penalty appears to be the Firth small-sample bias-reduction method (albeit with small differences among implementations and the results they provide), which corresponds to using the log density of the Jeffreys invariant prior distribution as a penalty function. The latter representation raises some serious contextual objections to the Firth reduction, which also apply to alternative penalties based on t-distributions (including Cauchy priors). Taking simplicity of implementation and interpretation as our chief criteria, we propose that the log-F(1,1) prior provides a better default penalty than other proposals. Penalization based on more general log-F priors is trivial to implement and facilitates mean-squared error reduction and sensitivity analyses of penalty strength by varying the number of prior degrees of freedom. We caution however against penalization of intercepts, which are unduly sensitive to covariate coding and design idiosyncrasies. © 2015John Wiley & Sons, Ltd.


Huseini H.F.,Research Institute of Medicinal Plants | Kianbakht S.,Research Institute of Medicinal Plants | Hajiaghaee R.,Research Institute of Medicinal Plants | Dabaghian F.H.,Tehran University of Medical Sciences
Planta Medica | Year: 2012

Diabetes mellitus type 2 with dyslipidemia is a common disease. Previous studies suggest that aloe (Aloe vera L.) leaf gel may positively affect the blood glucose and lipid levels in dyslipidemic type 2 diabetic patients. Thus, in this randomized double-blind placebo-controlled clinical trial with hyperlipidemic (hypercholesterolemic and/or hypertriglyceridemic) type 2 diabetic patients aged 40 to 60 years not using other anti-hyperlipidemic agents and resistant to daily intake of two 5 mg glyburide tablets and two 500 mg metformin tablets, the efficacy and safety of taking aloe gel (one 300 mg capsule every 12 hours for 2 months) combined with the aforementioned drugs in treatment of 30 patients were evaluated and compared with the placebo group (n = 30). The aloe gel lowered the fasting blood glucose, HbA1c, total cholesterol, and LDL levels significantly (p = 0.036, p = 0.036, p = 0.006, and p = 0.004, respectively) without any significant effects on the other blood lipid levels and liver/kidney function tests (p > 0.05) compared with the placebo at the endpoint. No adverse effects were reported. The results suggest that aloe gel may be a safe anti-hyperglycemic and anti-hypercholesterolemic agent for hyperlipidemic type 2 diabetic patients. © Georg Thieme Verlag KG Stuttgart.


Joolaee S.,Tehran University of Medical Sciences
Indian journal of medical ethics | Year: 2013

This study aimed to provide an understanding of the relationship between the ethical climate at the workplace and job satisfaction among nurses. 210 nurses working in selected wards in the Tehran University of Medical Sciences were asked to fill out questionnaires on their work environment and level of job satisfaction. The data collection tools included a questionnaire to obtain demographic data, the Olson moral climate questionnaire and Minnesota job satisfaction questionnaire. The data were analysed using SPSS software version 14. We found a significant positive relationship between the ethical climate and the level of job satisfaction among the nurses. Among the demographic variables, the working shift, income level and type of duties allocated had a significant relationship with job satisfaction. Hospital managements should pay attention to the factors influencing job motivation among nurses, including the ethical climate of the work environment.


Hashemi A.,Pasteur Institute of Iran | Roohvand F.,Pasteur Institute of Iran | Ghahremani M.-H.,Tehran University of Medical Sciences
Biochemical and Biophysical Research Communications | Year: 2012

The proper selection of reference genes to normalize the quantitative real-time PCR (RT-qPCR) results under particular experimental conditions is crucial for validation of the gene quantification data. Herein, using SYBR green RT-qPCR, five reference genes (GAPDH, ACTB, HMBS, HPRT-1 and TBP) were evaluated to determine the most stable reference genes in hepatic cell lines (Huh-7 and HepG2) under IFN-α treatment conditions. Analyses by geNorm program ranked GAPDH and HPRT-1 in Huh-7 and that of ACTB and HMBS in HepG2 cells as the most stable reference genes under IFN-α treatment. While, same reference gene pairs were ranked by NormFinder program in Huh-7 cells, GAPDH was assessed as the most stable gene in HepG2 group by this program, implying the importance of the employed algorithm in comparative interpretation of the data. Finally, cumulative analyses by one-way ANOVA, geNorm and NormFinder programs indicated that use of two reference genes (HMBS and GAPDH) in Huh-7 and three (HMBS, ACTB and GAPDH) in HepG2 cells would greatly improve the normalization of the RT-qPCR data under IFN-α. Data presented in this paper will aid the selection of the most stable reference genes in RT-qPCR studies on evaluation of hepatic viral proteins and IFN pathway. © 2012 Elsevier Inc.


Baradaran-Rafii A.,Shahid Beheshti University of Medical Sciences | Eslani M.,Shahid Beheshti University of Medical Sciences | Eslani M.,Tehran University of Medical Sciences | Djalillian A.R.,University of Illinois at Chicago
Cornea | Year: 2013

Purpose: To report postoperative complications of keratolimbal allograft (KLAL) transplantation in patients with bilateral total limbal stem cell deficiency. Methods: In this retrospective observational case series, medical charts of 45 patients with at least 6 months of follow-up were reviewed. The main outcome measure was postoperative complications including graft-related issues (thickness, position, and alignment) and immunologic rejection. Results: Sixty-six KLALs were performed on 45 eyes. The mean follow-up period was 26.1 ± 11.8 months (range, 6-48 months). Primary failure occurred in 5 eyes primarily as a result of ocular surface exposure and severe dry eyes. Graft-related complications included misalignment (4 eyes), buttonhole (4), inner-edge tear (4), inadvertent limbal trephination (2), and thick KLAL (2). Postoperatively, regional thinning of the graft was observed in 8 KLALs as a result of exposure, regional ischemia, and after epithelial rejection. Acute rejection was diagnosed 16 times in 8 eyes, whereas chronic rejection was observed in 24 eyes. At last follow-up, 12 cases (26.6%) had failed because of recurrent acute rejection (4), chronic rejection (5), refractory herpetic keratitis (1), exposure (1), and refractory papillomavirus keratitis (1). Conclusions: KLAL may be complicated by several adverse events. The most important complications are immunologic rejections, chronic ocular surface exposure, and graft-related complications. © 2013 Lippincott Williams & Wilkins.


Dargahi H.,Tehran University of Medical Sciences
Journal of Medical Ethics and History of Medicine | Year: 2011

As medical ethics indisputably needs to consider patients' religious beliefs and spiritual ideas, one can suggest that hospitals are responsible for not only patients' rights and dignity, but also for her/his religious concerns and expectations. The current study is designed shed some light on the patients' view of the implementation of religious law in Iranian hospitals, specifically, the right of patients to be visited and delivered health services by professionals from the same sex. This protocol is proposed by the Ministry of Health and Medical Education of the Islamic Republic of Iran as a response to the increasing demand for implementation of the religious law by Iranian patients. This research is a cross-sectional study which was conducted at four teaching general hospitals in Tehran, Iran. The data was collected by the means of a questionnaire distributed to 120 women who were admitted to different wards of the hospitals. These women were asked to express their opinion of the implementation the Same Sex Health Care Delivery (SSHCD) system in Iranian hospitals. All analyses were performed with the use of SPSS software, version 16.0. The results indicate that half of the hospitalized women believed that being visited by a physician from the same gender is necessary who advocated the implementation of SSHCD in a clinical setting; and most of their husbands preferred their wives to be visited exclusively by female physicians. This study highlights the view of the Iranian patients towards the issue and urges the Ministry of Health and Medical Education of the Islamic Republic of Iran to accelerate the implementation of this law. SSHCD is what the majority of Iranian patients prefer, and, considering patients' rights and the medical ethics, it should be implemented by Iranian policy makers. © 2011 Hossein Dargahi.


Zahedi F.,Tehran University of Medical Sciences
Journal of Medical Ethics and History of Medicine | Year: 2011

Accompanied with various opinions across cultures, truth telling is a major debate in bioethics. Many studies have focused on attitudes toward truth disclosure. We intend to review several relevant research studies, and discuss the issue through a clinical case consultation. It seems that while the right to know is emphasized in bioethics, in some cultural contexts, health professionals fear communicating bad news. The patients may not receive information directly, because it is believed that the truth may make the patient feel hopeless and unable to cope with the problem. Nevertheless, some believe that sharing information may strengthen a trusting relationship between patients and medical professionals. Extensive efforts are in process in some societies to make patient rights to know the truth as a natural part of medical practice. However, in some cases, the principles of respect for patient autonomy require us to accept patient's refusal to know the truth, with the provision that he assigns someone to receive information and make medical decisions on his behalf. In conclusion, it is suggested that healthcare professionals should not act on a unique presumption in all cases and they should explore what the real interest of patient is, in order to respect individual autonomy. © 2012 Farzaneh Zahedi; licensee Tehran Univ. Med. Sci.


Mowlavi G.,Tehran University of Medical Sciences
Asian Pacific journal of tropical medicine | Year: 2012

To find importance of morphometric criterion of larval rostellar hook of Echinococcus granulosus (E. granulosus) and the easy and reliable method for distinguish sheep and camel strains in epidemiologic studies. Larval rostellar hooks (n=1860) of 31 camel and sheep isolates in Iran, which already had been characterized by PCR, were carefully processed by computerized imagime analysis system (CIAS) and acquired data about rostellar hooks were analyzed using software SPSS. Measurement analysis of rostellar hooks [mean length (24.23±3.12) μ m] indicated that length of the large hook was a remarkable parameter for strain differentiation. Data analysis demonstrated that CIAS could be used as a reliable tool to distinguish camel from sheep strains with high sensitivity (95.2%) and specificity (91.5%). CIAS as a specific, sensitive, economic, fast, and reliable means might be used for differentiation of E. granulosus strains. Although perimeter and area were measured by digital technology, they were not shown as discriminative criterion as total hook length did. Copyright © 2012 Hainan Medical College. Published by Elsevier B.V. All rights reserved.


Marzabadi E. A.,Baqiyatallah Medical Sciences University | Fesharaki M. G.,Tehran University of Medical Sciences
Journal of Military Medicine | Year: 2011

Aims: Occupational stress is a common problem in modern societies. Military related jobs are among high stress occupations. This study was performed to identify factors influencing occupational stress in military personnel in Iran. Methods: This cross-sectional study was performed on 749 official military personnel from different provinces of Iran, who were selected using two-stage cluster sampling, in year 2010. Occupational Descriptive Index (containing 35 questions) was used in order to collect data. Data was analyzed using descriptive statistics including mean and standard deviation, and inferential statistical methods including variance analysis and independent t-test by SPSS 16 software. Results: The relationship between age and occupational stress shown to be as a broken curve in which the greatest amount of stress was observed in range of 26 to 40 years and after that the stress decreased as the age increased. Based on results, age had effect on all areas of occupational stress, except for Demand and Relationship. Results showed a reverse relationship between occupational satisfaction and occupational stress. Occupational satisfaction affected all areas of occupational stress. Conclusion: Occupational stress decreases with age increase and age has impact on all areas of occupational stress. Work experience has a significant relationship with occupational stress.


Goldust M.,Tabriz University of Medical Sciences | Rezaee E.,Shahid Beheshti University of Medical Sciences | Hemayat S.,Tehran University of Medical Sciences
Journal of Dermatology | Year: 2012

Scabies is an ectoparasitic, highly contagious skin disease caused by a mite called Sarcoptes scabiei. The insecticides ivermectin and permethrin are commonly used for treatment of scabies. This study aimed at comparing the efficacy of oral ivermectin with topical permethrin in treating scabies. Two hundred and forty-two patients with scabies attending the dermatology outpatient department of Sina Hospital, Tabriz University of Medical Sciences were admitted. Patients were divided into two groups randomly. The first group and their family contacts received 5% permethrin cream and the other received oral ivermectin. Treatment was evaluated at intervals of 2 and 4 weeks. A single dose of ivermectin provided a cure rate of 85.9% at a 2-week interval, which increased to 100% after crossing over to the permethrin group at a 4-week interval. Twice application of permethrin with a 1-week interval was effective in 92.5% of patients, which increased to 94.2% after crossing over to the ivermectin group at a 4-week interval. Permethrin-treated patients recovered earlier. Twice application of permethrin with a 1-week interval is superior to a single dose of ivermectin. The temporal dissociation in clinical response suggests that ivermectin may not be effective against all the stages in the life cycle of the parasite. © 2012 Japanese Dermatological Association.


Sodagar A.,Tehran University of Medical Sciences
World journal of orthodontics | Year: 2010

To study the relationship between incisor retraction and soft tissue profile alterations and to identify and quantify the parameters that influence it. Pre- and posttreatment lateral cephalograms of 37 Class I and Class II Division 1 Iranian females in whom at least one maxillary premolar was bilaterally extracted were analyzed and compared. Significant positive correlations were found between retraction of the maxillary and mandibular incisors and posterior movement of the upper lip (r=0.53, P<.001), the lower lip (r=0.63, P<.001), thickness increase of the upper (r=0.59, P<.001) and lower (r=0.69, P<.001) lip, increase of the soft tissue lower anterior face height (r=0.81, P<.001) and lower soft tissue component (r=0.49, P<.001), and an increase of the nasolabial angle (r=0.43, P<.01). The ratio of maxillary incisor to upper lip retraction was 2:1. In Iranian girls, a strong correlation exists between anterior tooth retraction and the position and configuration of both lips. © 2010 BY QUINTESSENCE PUBLISHING CO, INC.


Farnia P.,Tehran University of Medical Sciences
Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Conference | Year: 2011

Intra-operative brain deformation (brain shift) limits the accuracy of image-guided neuro-surgery systems. Ultrasound imaging as a simple, fast and being real time has become an alternative to MR imaging which is an expensive system for brain shift calculation. The main challenges due to speckle noise and artifacts in US images, is to perform an accurate and fast registration of Us images with pre-operative MR images. In this paper an efficient point based registration method based on the alignment of probability density functions called Coherent Point Drift (CPD) is implemented and compared to the conventional ICP method. To perform this, a brain phantom that allows simulating the brain deformation is made. As the results of our phantom study confirm the CPD method clearly outperforms the ICP algorithm for brain shift calculation. Also the result proves that using intra-operative US has led to recover almost 80% of displacement in the region of interest.


Laurent S.,University of Mons | Mahmoudi M.,Pasteur Institute of Iran | Mahmoudi M.,Tehran University of Medical Sciences
International Journal of Molecular Epidemiology and Genetics | Year: 2011

During the last decade, significant scientific research efforts have led to a significant growth in understanding of cancer at the genetic, molecular, and cellular levels providing great opportunities for diagnosis and treatment of cancer diseases. The hopes for fast cancer diagnosis and treatment were significantly increased by the entrance of nanoparticles to the medical sciences. Nanoparticles are attractive due to their unique opportunities together with negligible side effects not only in cancer therapy but also in the treatment of other ailments. Among all types of nanoparticles, surface-engineered superparamagnetic iron oxide nanoparticles (SPIONs) have been attracted a great attention for cancer therapy applications. This review covers the recent advances in the development of SPIONs together with their opportunities and challenges, as theranosis agents, in cancer treatment.


Mahvi A.H.,Tehran University of Medical Sciences | Maleki A.,Kurdistan University of Medical Sciences
Desalination and Water Treatment | Year: 2010

The aim of this work is to evaluate the efficiency of the sonochemical effect in conjunction with a photochemical irradiation and the effects of parameters such as pH, ultrasound frequency (35 and 130 kHz), and initial concentration on the degradation processes. The oxidation of a model pollutant, phenol, has been carried out in photosonochemical reactor. It was considerably more effective than ultrasound wave or ultraviolet light alone. It may be the result of three different oxidative processes: direct photochemical action, high frequency sonochemistry and reaction with ozone (produced by ultraviolet irradiation of air). Identification of the first intermediates of the reaction (hydroquinone, catechol, benzoquinone and resorcinol) indicates that hydroxyl radicals are involved in the photosonochemical degradation mechanisms. The disappearance of phenol in each case approximately obeyed first-order kinetics with the apparent first-order decay constant increasing with decreasing solute concentration. © 2010 Desalination Publications.


Baheiraei N.,Amirkabir University of Technology | Moztarzadeh F.,Amirkabir University of Technology | Hedayati M.,Tehran University of Medical Sciences
Ceramics International | Year: 2012

In the present study, silver-doped silica thin films on glazed surface of ceramic tiles were well prepared by sol-gel method to achieve antibacterial activity. Thermal treatment was done in the air at 1100 °C for two hours. The Ag/SiO 2 thin films were investigated through Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), X-ray diffraction (XRD) and wavelength dispersive spectrometry (WDS). Atomic absorption spectroscopy (AAS) was used for the quantitative determination of the silver ion concentration being released from Ag/SiO 2 films over a 24 day period. The antibacterial effects of Ag/SiO 2 thin films against Escherichia coli and Staphylococcus aureus were also examined. From the analysis results, it was found that high temperature treated coating consists of two phases of SiO 2 and Ag based on the trapping of the Ag phase in the silica matrix. The presence of Ag elements on the surface of the coated tiles, were also observed. Thermal treatment at high temperatures caused sharp XRD peaks and high crystallinity in this system. Ag + ions were released constantly and the mean release rate (±SD) was 0.104 ±0.01 μg/ml during 24 days. Coating films exhibited an excellent antibacterial performance against both bacterium. © 2011 Elsevier Ltd and Techna Group S.r.l.


Sazgar A.A.,Tehran University of Medical Sciences
Archives of Facial Plastic Surgery | Year: 2010

Herein, I describe lateral crural setback with cephalic turn-in flap as a new technique for management of the drooping nose. I report a technique for reinforcement of the alar cartilage after partial removal of its caudal portion used in 23 patients during open rhinoplasty. An objective assessment, which included measurement of nasal tip rotation and projection, was applied preoperatively and postoperatively. The average follow-up period was 11 months. Satisfactory results were achieved that resulted in an increase in the degree of nasal tip rotation. The mean increase of the nasolabial angle was 12°. This technique allows increasing the nasal tip rotation in an incremental fashion with preservation of nasal valve function and the strength and stability of the tip complex. © 2010 American Medical Association. All rights reserved.


Faramarzi F.,Tehran University of Medical Sciences
Australian Endodontic Journal | Year: 2010

To succeed in any dental procedure, the clinician's awareness of the patient's dental anatomy and its variations is crucial. In endodontic therapy, obtaining full information about the root canals' variations can affect the outcome substantially. This case report presents the endodontic treatment of a mandibular first molar exhibiting three mesial root canals with 4 mm of a separated K-file in the coronal third of the mesiolingual canal on an 18-year-old female patient. This case demonstrates the importance of locating additional canals in any roots undergoing endodontic treatment and how the clinician's awareness of aberrant internal anatomy may change the treatment results. © 2009 The Authors. Journal compilation © 2009 Australian Society of Endodontology.


Yazdi H.R.,Tehran University of Medical Sciences
American journal of orthopedics (Belle Mead, N.J.) | Year: 2012

Triceps tendon rupture or avulsion is a rare tendon injury. The most common feature of injury is avulsion from osseous insertion on the olecranon. The diagnosis of acute triceps tendon rupture may be missed, and a missed diagnosis can result in prolonged disability and delayed operative management. In this article, we report 2 cases of neglected triceps tendon avulsion and a new V-Y-plasty surgical technique for repair.


Changizi V.,Tehran University of Medical Sciences
Current Medical Imaging Reviews | Year: 2015

Aim of Study: The lung cancer is noted at the end stages of disease, the morbidity and mortality rate related to is higher than others. To minimize this rate, early diagnosis of lung solitary nodules before spreading metastases to lymph nodes and other organs is of consideration. At the moment, Computerized Tomography is one of the most important modalities in diagnosing lung solitary nodules, however the CT exposure rates are much higher than diagnostic radiology field. Therefore it is necessary to do evaluation of CT. Scan ability in detecting chest nodules for preventing unnecessary radiation dose to patient. Materials and Methods: In this study, a chest phantom including different nodules of sizes and types was designed. Imaging of phantom was performed by TOSHIBA spiral CT of Imam Khomaini medical complex and GE spiral CT of Fayyazbakhsh hospital with 5,3,1 mm slices and 80, 120 kVp and 50,60,80,100 mA. Results: This study revealed, 4 mm width nodules were noted both in slices with 120 kV and 50, 100 mA and 3, 5 mm thickness and in 80 kV and 60 mA with 3 mm thickness. The calcium carbonated particles were noted in 6, 8, and 10 mm whitish but not in smaller nodules; however a low density of carbonated calcium was noted just in 10 mm width nodules. Conclusion: CT.scan is a useful technique for detection of lung tumor with sizes more than 4mm. © 2015 Bentham Science Publishers.


Purpose: To determine outcomes after anterior and nasal transposition of the inferior oblique muscle for dissociated vertical deviation (DVD) associated with inferior oblique overaction. Methods: A total of 10 patients who had bilateral DVD with ipsilateral inferior oblique muscle overaction were included in this study. Patients underwent anterior and nasal transposition of the inferior oblique muscles to the medial edge of the inferior rectus muscle insertion; the horizontal rectus muscle was operated on for horizontal strabismus in 2 cases. The primary outcome variables were changes in DVD, inferior oblique muscle action, V pattern, and vertical deviation in primary and side gazes. Patients were evaluated 6 to 10 months (mean, 7.3 months) postoperatively for alignment and oculomotor examination. Results: Mean age at the time of surgery was 17.5 years. The average preoperative DVD for all eyes was 18.3Δ ± 6.8Δ, which decreased to 5.0Δ ± 3.1Δ (p < 0.001) at 6 months. Mean inferior oblique muscle overaction decreased from +2.1 (range, +1 to +3) to +0.40 (range, -1 to 2). The mean preoperative V pattern was 24.9Δ. After surgery, the mean correction of the V pattern was 14.8Δ. Four patients developed 2Δ to 5Δ postoperative hypotropias in primary position at 6 months. Conclusions: Anterior and nasal transposition of the inferior oblique muscle reduces DVD, V pattern, and inferior oblique muscle overaction with minimal complications. © 2010 American Association for Pediatric Ophthalmology and Strabismus.


Mazloom Z.,Shiraz University of Medical Sciences | Yousefinejad A.,Tehran University of Medical Sciences | Dabbaghmanesh M.H.,Shiraz University of Medical Sciences
Iranian Journal of Medical Sciences | Year: 2013

Background: The dramatic increase in the incidence of diabetes and its associated complications require a natural and safe solution to control and delay such complications. The present study tested the hypothesis that probiotics may affect biochemical indices of diabetic patients Methods: Thirty four types 2 diabetic patients aged between 25 to 65 years, and diagnosed with diabetes for less than 15 years were selected for this single-blinded clinical trial. Using balanced block random sampling, the patients were divided into two groups of intervention (probiotics) and placebo. Blood samples tested for baseline glucose, insulin, TG, total cholesterol, LDL-C, HDL-C, malondialdehyde, high sensitive CRP (hs-CRP) and IL-6. After six weeks of experiment, fasting blood samples were re-tested and the data obtained were analyzed using SPSS software. Results: There were no significant differences between anthropometric data including body mass index and waist to hip ratio in placebo and treatment groups. There was no significant difference in FBS, Serum TG concentration total cholesterol and LDL-C levels between placebo and treatment groups. HDL-C levels were slightly elevated after probiotic treatment, which were not statistically significant. Insulin, MDA and IL-6 levels were reduced and high sensitive CRP hs.CRP levels were elevated, although, not statistically significant. Conclusion: The result of this study indicates a non-significant declining trend in the level of TG, MDA and IL-6 and insulin resistance after consumption of probiotics.


Ebneshahidi A.,Sadi Hospital | Mohseni M.,Tehran University of Medical Sciences
Anesthesiology and Pain Medicine | Year: 2011

Background: Intentional lowering of blood pressure helps to produce a desirably clean surgical field. Many drugs can be used to induce a hypotensive state, but due to their high potency and rapid effect, drugs that more easily and safely control the induction of hypotension are desirable. Objectives: To investigate the effects of premedication with oral clonidine on intraoperative bleeding and hemodynamic variables in patients undergoing cesarean sections. Patients and Methods: A total of 110 patients classified as American Society of Anesthesiologists (ASA) physical status I and II and who were scheduled for elective cesarean section under general anesthesia were enrolled. The patients were randomized to receive either oral clonidine (0.2 mg) or identical-looking placebo tablets 90 minutes before arriving at the operating room. Induction of anesthesia was performed by the same standard protocol in all patients. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) and heart rate (HR) were recorded before and after induction; immediately after intubation; 5, 10, and 15 minutes thereafter; at the time of extubation; and one hour after the operation. The surgeons were asked to rate the quality of the operative field on a four-point scale that ranged from mild (1) to abundant bleeding (2). Results: Intraoperative SBP was lower in the clonidine group. After both intubation and extubation, the increases in SBP, DBP, and HR in clonidine-treated subjects were significantly less than the changes in the control patients. The amount of fentanyl given to control blood pressure and HR was significantly less in the clonidine group (18 ± 38 vs. 39 ± 53 μg, P = 0.02). The responses to the four-point scale indicated that intraoperative bleeding in the clonidine group was less than in the placebo group (1.2 ± 0.4 vs. 1.7 ± 0.6, P < 0.05). Conclusions: Premedication with oral clonidine can improve the hemodynamic management of cesarean cases. © 2014, Iranian Society of Regional Anesthesia and Pain Medicine (ISRAPM).


Davatchi F.,Tehran University of Medical Sciences
Pathology Research International | Year: 2012

Historical Background. The ISG criteria for Behcet's, created in 1990, have excellent specificity, but lack sensitivity. The International Criteria for Behcet's Disease (ICBD) was created in 2006, as replacement to ISG. The aim of this study was to compare their performance. ISG and ICBD Criteria. For ISG oral aphthosis is mandatory. The presence of any two of the following (genital aphthosis, skin lesions, eye lesions, and positive pathergy test) will diagnose/classify the patient as BD. For ICBD, vascular lesions were added, while oral aphthosis is no more mandatory. Getting 3 or more points diagnose/classify the patient as BD (genital aphthosis 2 points, eye lesions 2 points, and the remaining each one point). Performance and Comparison of ISG and ICBD. Their sensitivity, specificity, and accuracy (percent agreement), were tested in three independent cohort of patients from Far-East (China), Middle-East (Iran), and Europe (Germany). The sensitivity for ISG was respectively 65.4, 78.1, 83.7 and for ICBD 87, 98.2, and 96.5. The specificity for ISG was 99.2, 98.8, 89.5 and for ICBD 94.1, 95.6, and 73.7. The accuracy for ISG was 74.2, 85.5, 85.5 and for ICBD 88.9, 97.3, and 89.5. Conclusion. ICBD has better sensitivity, and accuracy than ISG. © 2012 Fereydoun Davatchi.


Azarm H.M.,Tarbiat Modares University | Kenari A.A.,Tarbiat Modares University | Hedayati M.,Tehran University of Medical Sciences
Aquaculture Research | Year: 2013

This study was conducted to evaluate the effect of soybean lecithin (SBL) and chicken egg lecithin (EGL) on growth performance; pancreatic and intestine enzymes, cholecystokinin (CCK) and lipoprotein fractions of rainbow trout, Oncorhynchus mykiss (Walbaum) fry. Seven isonitrogenic and isolipidic diets were prepared by replacing 0 (as a control), 2%, 4% and 6% soybean and chicken egg lecithin instead of soybean oil in diets. Trout fry with initial average weight of 120 ± 4.08 mg, were randomly distributed in 21 90 L tanks. Triplicate groups (165 fish for each tank) of fry were fed each diet to visual satiation at six meals per day for 40 days. Dietary supplements of 2% and 4% chicken egg lecithin led to increase in fry final weight, weight gain and specific growth rate suggesting that moderate PL levels are needed during this stage of rainbow trout. Also 2% chicken egg lecithin caused significantly higher activity of amylase, lipase, phospholipase A2, alkaline phosphatase (AP), aminopeptidase-N (AN) and lower activity of leucine alanine peptidase (leu-ala) in the digestive tract of fry than those in control group. Furthermore, fry fed 2% chicken egg lecithin had a higher ratio of AN/leu-ala and AP/leu-ala than that in the control group. Chicken egg lecithin increased significantly cholecystokinin (CCK) and chylomicron fractions of fry compared to control group. It is noteworthy that soybean lecithin had moderate effect on final growth, weight gain and specific growth rate of fry and induced significantly higher activity of amylase, lipase, phospholipase A2 and secretion of CCK compared to control group. The results of this study indicate that dietary supplementation 2% chicken egg lecithin indirectly through some biochemical parameters improves growth performance of rainbow trout fry. © 2012 Blackwell Publishing Ltd.


Esmaili S.,University of Sydney | Esmaili S.,Tehran University of Medical Sciences | Xu A.,University of Hong Kong | George J.,University of Sydney
Trends in Endocrinology and Metabolism | Year: 2014

Adiponectin, one of the most abundant adipose-derived hormones, has variable actions in many tissues and organs. Although principally known for its insulin-sensitizing activity, recent data also highlight its homeostatic function, which is mediated both by direct actions on metabolic cells and indirectly through immunomodulatory effects on immune cells. Here we review the multifaceted immunometabolic actions of adiponectin and attempt to unify some of the contradictory reports on adiponectin function in inflammatory processes. We propose that a holistic understanding of adiponectin function can be garnered only from understanding its actions both on the immune system and on metabolism. © 2014 Elsevier Ltd.


Tavana A.M.,Tehran University of Medical Sciences
HealthMED | Year: 2012

Sand fly fever is still unknown with manifestations such as severe fever, headache and photophobia. The disease is endemic in many parts of the world as well as Middle East countries. The disease could be imported by travelers when they are travelling in tropical and semitropical countries. This review article describes the situation of diseases at the present time. A few health measures are recommended at the end of this paper in order to prevent the risk of infection.


Yaghoobi-Ershadi M.,Tehran University of Medical Sciences
Journal of Arthropod-Borne Diseases | Year: 2012

Sand fly research has a long history in Iran beginning with the work of Adler, Theodor and Lourie in 1930 and followed by Mesghali's foundational taxonomic work on sand flies in 1943. Since then, research has been continued unabated throughout the country and official publications report the existence of at least 44 species of sand flies (26 of the genus Phlebotomus and 18 of genus Sergentomyia) in Iran. So far, seven Phlebotomus species and one Sergentomyia species have been collected and described by Iranian researchers for the first time. Natural promastigote infections have been repeatedly found in 13 species of sand flies and modern molecular techniques are used routinely to characterize Leishmania parasite isolates from endemic areas of cutaneous and visceral leishmaniasis. Because of anthropogenic environmental modifications or human population movements, data on phlebotomine sand flies should be regularly updated and verified at least every five years by fieldwork and taxonomy in foci of leishmaniasis, to incriminate vector species of relevance to the ecology of transmission and to support development and implementation of control programs.


Aghaey Meibody F.,Tehran University of Medical Sciences
Archives of gynecology and obstetrics | Year: 2011

Recent studies indicated that there is a high density of small nerve fibers in the functional layer of the endometrium in women with endometriosis and that it can be used as a marker to detect endometriosis. In this study, the efficacy assessment of small nerve fibers' density as a diagnostic marker was compared in patients with and without endometriosis. In this study, women with history of pelvic pain and/or infertility who were candidates for laparoscopy or laparotomy in Rassoul hospital (2007-2009) were enrolled. Histological sections of endometrial tissue were prepared from endometrial biopsy from women with endometriosis (n = 12) (1) and without endometriosis (n = 15) (2). Protein gene product 9.5 and neurofilament were evaluated as marker from endometrial biopsies by immunohistochemical methods. There was no statistically significant difference between two groups according to age, body mass index. Nerve fibers were detected in all endometrial biopsies from all women with endometriosis but detected only in three women without endometriosis. The mean density of nerve fibers was 2.2 ± 4.7 mm(-2) in group without endometriosis and) 13.1 ± 3.3 (in group with endometriosis (p < 0.001). Women with endometriosis had significantly higher nerve fiber density in comparison with women without endometriosis. Our findings indicated that endometrial biopsy for detecting density of nerve fibers by usage of protein gene product 9.5, provided a reliable marker for diagnosis of endometriosis.


Sheikhazadi A.,Tehran University of Medical Sciences | Saberi Anary S.H.,Kerman Medical University | Ghadyani M.H.,Legal Medicine Organization of Iran
American Journal of Forensic Medicine and Pathology | Year: 2010

Objective: To depict the epidemiology of deaths due to carbon monoxide (CO) poisoning in Tehran, distinguishing those at greatest risk for acute poisoning resulting in death. Methods: A retrospective survey was carried out with regularly collected information set in Tehran's Legal Medicine Organization, with a population of 11.1 million. The data included 666 deaths due to CO poisoning from January 2002 through December 2006. The principal consequence measures were age and sex standardized incidence rates for unintentional, suicidal, and undetermined poisonings for legal authorities. Results: The overall rate of unintentional poisonings over the 5-year period was 7.5 per 100,000, with an annual rate of 1.5 per 100,000. The 5-year rates were highest in people aged 25 to 34 years: men, 16.4 per 100,000; women, 7.8 per 100,000. For suicides, the 5-year rate was 0.1 per 100,000; annual rate, 0.02 per 100,000. The suicidal 5-year rates were highest in men aged 35 to 44 years, that is, 0.9 per 100,000; there was no case for women. Unintentional poisonings displayed a powerfully seasonal variation with the highest rates being documented in the months October to March. Over the 5-year period, increasing rates of death from CO poisoning were found annually to be approximately 20%. Conclusions: In this study, middle-age people, young adults, and elderly people were at the greatest risk for unintentional CO poisoning, and rates were highest in the winter months. Death from suicidal CO poisoning was very rare in this study; on the other hand, unintentional CO poisoning deaths are increasing in Tehran. Health authorities require to consider all populations in any prevention plan. Copyright © 2010 by Lippincott Williams & Wilkins.


Mahdavi-Mazdeh M.,Tehran University of Medical Sciences
Kidney International | Year: 2012

Organ shortage for transplantation remains a worldwide serious problem for kidney patients with end-stage renal failure, and several countries have tried different models to address this issue. Iran has 20 years of experience with one such model that involves the active role of the government and charity foundations. Patients with a desperate demand for a kidney have given rise to a black market of brokers and other forms of organ commercialism only accessible to those with sufficient financial resources. The current Iranian model has enabled most of the Iranian kidney transplant candidates, irrespective of socioeconomic class, to have access to kidney transplantation. The Iranian government has committed a large budget through funding hospital and staff at the Ministry of Health and Medical Education by supporting the brain death donation (BDD) program or redirecting part of the budget of living unrelated renal donation (LURD) to the BDD program. It has been shown that it did not prevent the development and progression of a BDD program. However, the LURD program is characterized by several controversial procedures (e.g., confrontation of donor and recipient at the end of the evaluation procedure along with some financial interactions) that should be ethically reviewed. Operational weaknesses such as the lack of a registration system and long-term follow-up of the donors are identified as the Achilles heel of the model. © 2012 International Society of Nephrology.


Khezri M.-B.,Qazvin University of Medical Sciences | Oladi M.-R.,Qazvin University of Medical Sciences | Atlasbaf A.,Tehran University of Medical Sciences
Indian Journal of Pharmacology | Year: 2013

Objectives: To compare the effect of melatonin and gabapentin on anxiety, pain, sedation scores, and satisfaction of surgeon in patients of cataract surgery. Materials and Methods: One hundred thirty patients aged between 35 and 85 years scheduled for cataract surgery were randomly allocated to three study groups to receive melatonin (6 mg), gabapentin (600 mg) or placebo 90 min before arrival in the operating room. Pain, anxiety, and sedation scores during block and surgery as well as the surgeon′s satisfaction with the surgery were assessed. Results: Anxiety scores decreased significantly in melatonin and gabapentin groups compared to the placebo group after premedication and extended to early postoperative period. The level of anxiety showed no statistically significant difference between melatonin and gabapentin groups at any time of measurement. There were significant differences between the pain scores during retrobulbar placement in gabapentin versus placebo (95% CI 3 to 4; P = 0.001) and melatonin (95% CI 3 to 4; P = 0.040) groups. Also, there were significant differences between the sedation scores during retrobulbar placement in gabapentin and placebo groups (95% CI 2 to 2.5; P = 0.046). The difference in sedation scores during retrobulbar placement in melatonin versus gabapentin and placebo groups was not significant. Neither the intraoperative pain scores nor the postoperative pain scores were different between the three groups. The surgeon reported similar quality of operation conditions during surgery for the three study groups. Conclusion: The level of anxiety was significantly lower with both anxiolytic drugs compared to placebo. Furthermore, gabapentin decreased the pain and improved the sedation scores only during retrobulbar placement compared to the placebo.


Gharaeipour M.,Tehran University of Medical Sciences | Scott B.J.,Pacific University in Oregon
Schizophrenia Research | Year: 2012

Objective: Many individuals diagnosed with schizophrenia have significant neurocognitive deficits, especially in the areas of attention, memory, and executive function. These deficits may exacerbate patients' psychiatric symptoms. Cognitive remediation has shown efficacy in improving neurocognitive functioning and may lead to amelioration of psychiatric symptoms in persons with schizophrenia. Method: Forty-two schizophrenic inpatients were randomly assigned to either a cognitive remediation group (n = 21) or a control group (n = 21) and were assessed using a neuropsychological battery and symptom scales for depression, anxiety, and positive and negative symptoms of schizophrenia at baseline and after two months of participation in a cognitive remediation program. Results: The intervention group showed significant improvements in neuropsychological functioning, depression and negative symptoms of schizophrenia after the intervention compared to the control group. Conclusion: Results of the study provide support for cognitive remediation as an efficacious intervention to improve neurocognitive functioning and decrease psychiatric symptoms of schizophrenia. © 2012 Elsevier B.V.


Baghal Asghari F.,Health Science University | Nikaeen M.,Isfahan University of Medical Sciences | Mirhendi H.,Tehran University of Medical Sciences
FEMS Microbiology Letters | Year: 2013

Pseudomonas aeruginosa has emerged as a major pathogen in nosocomial infections. Biofilm formation allows the microorganism to persist in hospital water systems for extended periods, which have been associated with nosocomial infections. The aim of this study was to evaluate the frequency of P. aeruginosa colonization of hospital tap waters by nested PCR assay. A total of 44 water samples were collected from 11 hospitals and analyzed for the presence of Pseudomonas spp. and P. aeruginosa by specific primer sets of 16S rRNA gene. Some physicochemical parameters and heterotrophic plate count (HPC) of samples for possible association with P. aeruginosa contamination were also determined. The nested PCR revealed 32% of the water samples being positive for P. aeruginosa. From the 11 hospitals surveyed, 82% (9 of 11) of the hospitals water systems were positive for P. aeruginosa. No correlation was seen between the presence of P. aeruginosa and HPC as well as physicochemical parameters. Identification of contaminated sources could be a key priority in waterborne nosocomial infections. PCR assay was used in the study provides simple, rapid, and reliable identification of P. aeruginosa in hospital water systems, which could eliminate the infections of P. aeruginosa through implementation of immediate control measures. © 2013 Federation of European Microbiological Societies.


Mosadeghrad A.M.,Tehran University of Medical Sciences
International Journal of Health Care Quality Assurance | Year: 2013

Purpose: The main purpose of this study is to define healthcare quality to encompass healthcare stakeholder needs and expectations because healthcare quality has varying definitions for clients, professionals, managers, policy makers and payers. Design/methodology/approach: This study represents an exploratory effort to understand healthcare quality in an Iranian context. In-depth individual and focus group interviews were conducted with key healthcare stakeholders. Findings: Quality healthcare is defined as "consistently delighting the patient by providing efficacious, effective and efficient healthcare services according to the latest clinical guidelines and standards, which meet the patient's needs and satisfies providers". Healthcare quality definitions common to all stakeholders involve offering effective care that contributes to the patient well-being and satisfaction. Practical implications: This study helps us to understand quality healthcare, highlighting its complex nature, which has direct implications for healthcare providers who are encouraged to regularly monitor healthcare quality using the attributes identified in this study. Accordingly, they can initiate continuous quality improvement programmes to maintain high patient-satisfaction levels. Originality/value: This is the first time a comprehensive healthcare quality definition has been developed using various healthcare stakeholder perceptions and expectations. © Emerald Group Publishing Limited.


Mahmoudi M.,Pasteur Institute of Iran | Mahmoudi M.,Tehran University of Medical Sciences | Laurent S.,University of Mons | Shokrgozar M.A.,Pasteur Institute of Iran | And 2 more authors.
ACS Nano | Year: 2011

In the last few decades, nanoparticles (NPs) have been recognized as promising candidates for starting a new revolution in science and technology due to their unusual properties, attracting the attention of physicists, chemists, biologists, and engineers. The aim of this study is to evaluate the toxicities (at both cellular and molecular levels) of three forms of superparamagnetic iron oxide nanoparticles (SPIONs) of various surface chemistries (COOH, plain, and NH2) through the comparison with gene expression patterns of three cell types (i.e., human heart, brain, and kidney). For this purpose, both an MTT assay and a DNA microarray analysis were applied in three human cell lines-HCM (heart), BE-2-C (brain), and 293T (kidney)-under the exposure to SPIONs-COOH, SPIONs-NH2, and bare SPIONs. The specific gene alteration and hierarchical clustering revealed that SPIONs-COOH altered genes associated with cell proliferative responses due to their reactive oxygen species (ROS) properties. It was also found that the cell type can have quite a significant role in the definition of suitable pathways for detoxification of NPs, which has deep implications for the safe and high yield design of NPs for biomedical applications and will require serious consideration in the future. © 2011 American Chemical Society.


Badiee A.,Mashhad University of Medical Sciences | Heravi Shargh V.,Mashhad University of Medical Sciences | Khamesipour A.,Tehran University of Medical Sciences | Jaafari M.R.,Mashhad University of Medical Sciences
Vaccine | Year: 2013

Leishmania infection continues to have a major impact on public health inducing significant morbidity and mortality mostly in the poorest populations. Drug resistance, toxicity and side effects associated with expensive chemotherapeutic treatments and difficult reservoir control emphasize the need for a safe and effective vaccine which is not available yet. Although, Leishmanization (LZ) was shown to be effective against cutaneous leishmaniasis, standardization and safety are the main problems of LZ. First generation killed parasites demonstrated limited efficacy in phase 3 trials and moreover well defined molecules have not reached to phase 3 yet. Limited efficacy in vaccines against leishmaniasis is partly due to lack of an appropriate adjuvant. Hence, the use of particulate delivery systems as carriers for antigen and/or immunostimulatory adjuvants for effective delivery to the antigen-presenting cells (APCs) is a valuable strategy to enhance vaccine efficacies. Particle-based delivery systems such as emulsions, liposomes, virosomes, and polymeric microspheres have the potential for successfully delivering antigens, which can then be further improved via incorporation of additional antigenic or immustimulatory adjuvant components in or onto the particle carrier system. In this review, we have attempted to provide a list of particulate vaccine delivery systems involved in the production of candidate leishmaniasis vaccines and introduced some potentially useful vaccine delivery systems for leishmaniasis in future experiments. In conclusion, combination vaccines (adjuvant systems) composed of candidate antigens and more importantly well-developed particulate delivery systems, such as lipid-based particles containing immunostimulatory adjuvants, have a chance to succeed as antileishmanial vaccines. © 2012 Elsevier Ltd.


Haghjoo M.,Tehran University of Medical Sciences
Journal of Tehran University Heart Center | Year: 2012

Atrial fibrillation (AF) is the most common complication of coronary artery bypass graft surgery (CABG). The reported incidence of AF after CABG varies from 20% to 40%. Postoperative AF (POAF) is associated with increased incidence of hemodynamic instability, thromboembolic events, longer hospital stays, and increased health care costs. A variety of pharmacological and nonpharmacological strategies have been employed to prevent AF after CABG. Preoperative and postoperative beta blockers are recommended in all cardiac surgery patients as the first-line medication to prevent POAF. Sotalol and amiodarone are also effective and can be regarded as appropriate alternatives in high-risk patients. Corticosteroids and biatrial pacing may be considered in selected CABG patients but are associated with risk. Magnesium supplementation should be considered in patients with hypomagnesemia. There are no definitive data to support the treatment with nonsteroidal anti-inflammatory drugs, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, procainamide, and propafenone, or anterior fat pad preservation to reduce POAF.


Alam-mehrjerdi Z.,University of New South Wales | Mokri A.,Tehran University of Medical Sciences | Dolan K.,University of New South Wales
Asian Journal of Psychiatry | Year: 2015

Methamphetamine use is a new health concern in Iran, the most populated Persian Gulf country. However, there is no well-documented literature. The current study objectives were to systematically review all published English and Persian studies of the prevalence of methamphetamine use, the general physical and psychiatric-related harms and the availability of methamphetamine treatment and harm reduction services for adult users in Iran. Materials and methodsA comprehensive search of the international peer-reviewed and gray literature was undertaken. Multiple electronic and scientific English and Persian databases were systematically searched from January 2002 to September 2014. Additionally, English and Persian gray literature on methamphetamine use was sought using online gray literature databases, library databases and general online searches over the same period of time. ResultsNineteen thousand and two hundred and eight studies, reports and conference papers were identified but only 42 studies were relevant to the study objectives. They were mainly published in 2010-2014. The search results confirmed the seizures of methamphetamine (six studies), the prevalence of methamphetamine use among the general population (three studies), drug users (four studies), women (nine studies) and opiate users in opiate treatment programs (five studies). In addition, methamphetamine use had resulted in blood-borne viral infections (one study), psychosis and intoxication (ten studies). Different reasons had facilitated methamphetamine use. However, the Matrix Model, community therapy and harm reduction services (four studies) had been provided for methamphetamine users in some cities. ConclusionThe current situation of methamphetamine use necessitates more research on the epidemiology and health-related implications. These studies should help in identifying priorities for designing and implementing prevention and educational programs. More active models of engagement with Persian methamphetamine users and the provision of services that meet their specific treatment needs are required. © 2015 Elsevier B.V.


Nokar S.,Tehran University of Medical Sciences
The International journal of oral & maxillofacial implants | Year: 2011

To determine and compare the accuracy of an advanced surgical template based on computer-aided design/computer-assisted manufacture (CAD/CAM) with the conventional surgical template in different respects such as entry point, length, and osteotomy angle. Computed tomography (CT) scanning of a dentate epoxy mandible was performed and its three-dimensional computerized model was simulated. Sixteen rapid-prototyped models were fabricated and divided into two groups. In the first group, a radiographic template was fabricated and placed on the model during CT scanning and then was modified to the conventional surgical template form. In the second group, a coordinate measuring machine was used to reformat a nonanatomic radiographic template fabricated by a stereolithographic machine, and four implants were planned and then placed in the jaw. The differences between planned and actual mesiodistal and buccolingual entry points, lengths, and angles of the implants were measured. Statistical analysis was performed with the Mann-Whitney and Friedman tests to detect differences between groups. The average differences between the planned and actual entry points in the mesiodistal and buccolingual directions, lengths, and angles of the implants and the osteotomy showed a considerable reduction in the CAD/CAM group versus the conventional group (P < .005). The accuracy of implant placement was improved using an innovative CAD/CAM surgical template.


Mears E.R.,University of Swansea | Mears E.R.,University of Auckland | Modabber F.,Drugs for Neglected Diseases Initiative | Modabber F.,Tehran University of Medical Sciences | And 2 more authors.
PLoS Neglected Tropical Diseases | Year: 2015

The current in vivo models for the utility and discovery of new potential anti-leishmanial drugs targeting Cutaneous Leishmaniasis (CL) differ vastly in their immunological responses to the disease and clinical presentation of symptoms. Animal models that show similarities to the human form of CL after infection with Leishmania should be more representative as to the effect of the parasite within a human. Thus, these models are used to evaluate the efficacy of new anti-leishmanial compounds before human clinical trials. Current animal models aim to investigate (i) host–parasite interactions, (ii) pathogenesis, (iii) biochemical changes/pathways, (iv) in vivo maintenance of parasites, and (v) clinical evaluation of drug candidates. This review focuses on the trends of infection observed between Leishmania parasites, the predictability of different strains, and the determination of parasite load. These factors were used to investigate the overall effectiveness of the current animal models. The main aim was to assess the efficacy and limitations of the various CL models and their potential for drug discovery and evaluation. In conclusion, we found that the following models are the most suitable for the assessment of anti-leishmanial drugs: L. major–C57BL/6 mice (or–vervet monkey, or–rhesus monkeys), L. tropica–CsS-16 mice, L. amazonensis–CBA mice, L. braziliensis–golden hamster (or–rhesus monkey). We also provide in-depth guidance for which models are not suitable for these investigations. © 2015 Mears et al.


Attarchi N.,Amirkabir University of Technology | Montazer M.,Amirkabir University of Technology | Toliyat T.,Tehran University of Medical Sciences
Applied Catalysis A: General | Year: 2013

In this paper, Ag/TiO2/beta-cyclodextrin (β-CD) nano composite was successfully synthesized as a novel friendly nano photo catalyst with ability of loading various compounds. The influence of different β-cyclodextrin content in the formation of nano composites was investigated. Various analysis including FTIR, dynamic light scattering (DLS), diffuse reflectance spectroscopy (DRS), XRD, FESEM, EDAX, and TEM were used to characterize the prepared nano composites. The presence of β-CD in the nano composite was confirmed by FTIR patterns. FE-SEM pictures indicated roughly spherical particles and DLS results showed the average hydrodynamic diameters of 95 nm in aqueous dispersion that was bigger with more β-CD. TEM images confirmed the presence of three compounds in the nano composites. The peak intensity and the spectra intensity in the visible region increased with more β-CD confirming synthesis of more Ag on TiO2. The effective role of β-CD as stabilizer was also proved by the low reduction of the peak intensity for various nano composites after 15 days. One factor response surface methodology (RSM) was applied to model Methylene Blue degradation rate by Ag/TiO2/β-CD under UV irradiation. The mathematical model suggested significant improvement in the photo degradation rate of Ag/TiO 2/β-CD in comparing with Ag/TiO2. However, more β-CD limitedly improved the degradation rate of Methylen Blue and excess β-CD was detrimental on the reduction of photo degradation rate. © 2013 Elsevier B.V. All rights reserved.


Kimiagar M.,Tehran University of Medical Sciences
Journal of Kerman University of Medical Sciences | Year: 2011

Background & Aims: One of the problems hindering people's success in losing weight is their lack of knowledge about the limitations they face. The aim of this research was to investigate the contributing factors to BMI decrease in women referring to the clinic for weight reduction programs. Method: In this cross-sectional study, the medical files of 100 women (18-65 years old) with BMI>23, being at least 3 months under weight reduction programs, were observed. Data related to their anthropometric statue, demographic features, physical activity and some other features were recorded into four designed questionnaires. Data were analyzed by using paired t-test, One-way ANOVA, Chi-square and logistic regression and considering P<0.05 as the statistically significant level. Results: In women who had the highest rate of BMI decrease, reducing fat consumption (77%) and also consumption of starchy, sweet foods (74%) were the main reasons of weight loss success. Meanwhile, women with weight loss ≥10%, stated that the strategy of reducing food volume (43.8%) and substitution of fruits vegetables in their diets (81.2%) had been main reasons of weight loss success. The most important obstacles in weight reduction program were respectively the difficulty of bearing a low-calorie diet (42%), dissatisfaction of husbands & families (33%) and medical problems (27%). There was an indirect relation between educational level and fatness (P=0.005) and a direct relation between age & fatness (P=0.004). The most efficient motives of weight loss were beauty reasons in women younger than 45 and physicians advice in women over 45 years. There was no significant relationship between physical activity and BMI decrease (r=0.08, P=0.93). Conclusion: Nutritionists advice for avoiding high-fat foods and suggesting appropriate substitutes to people before starting weight loss program is essential. Difficulty of tolerating low-calorie diets necessitates nutritionists attempt to introduce appropriate weight loss diets.


Baradaran-Rafii A.,Shahid Beheshti University of Medical Sciences | Eslani M.,Shahid Beheshti University of Medical Sciences | Eslani M.,Tehran University of Medical Sciences | Sadoughi M.-M.,Shahid Beheshti University of Medical Sciences | And 2 more authors.
Ophthalmology | Year: 2013

Purpose: To compare the outcomes of 2 techniques (Anwar vs. Melles) of deep anterior lamellar keratoplasty (DALK) in patients with keratoconus. Design: Randomized, double-blind clinical trial. Participants: Fifty-seven eyes of 57 patients 20 to 35 years of age were enrolled. Methods: Patients with clinical diagnosis of keratoconus who were contact lens intolerant and whose corrected distance visual acuity (CDVA) was less than 20/80 were enrolled. Eligible eyes were allocated randomly into 2 groups: the Anwar technique (23 eyes) or the Melles technique (25 eyes). Main Outcome Measures: The primary outcome measure was CDVA. Secondary outcomes were spherical equivalent, contrast sensitivity, corneal aberrations, corneal biomechanical properties, endothelial cell count, and central corneal thickness. All outcomes were compared 15 months after surgery. Results: The CDVA was 0.17±0.09 logarithm of the minimum angle of resolution (logMAR) units and 0.18±0.11 logMAR units in the Anwar and Melles groups, respectively (P = 0.803). Spherical equivalent was -1.82±2.7 diopters (D) and -2.69±3.94 D in the Anwar and Melles groups, respectively (P = 0.155). Overall, the difference in photopic and mesopic contrast sensitivity function between the 2 groups was statistically significant (P<0.05). There was no significant difference between 2 groups in total and higher-order aberrations up to the fifth order (P>0.05 for all parameters). Corneal hysteresis was not significantly different between the 2 groups (9.9±0.8 vs. 9.9±0.6; P = 0.606). The corneal resistance factor was 10.02±0.8 and 10.13±0.76 (P = 0.509). There was no significant difference in percentage of endothelial cell loss between the 2 groups (1±2% vs. 1±3% in the Anwar and Melles groups, respectively; P = 0.869). Mean central corneal thickness was 525.56±47.87 μm versus 504.64±54.20 μm in the Anwar and Melles groups, respectively (P = 0.155). Conclusions: The Anwar and Melles techniques of DALK have comparable visual acuity and refractive outcomes, aberrometric profiles, biomechanical properties, corneal thicknesses, and endothelial cell densities. However, patients who underwent the Anwar technique showed better contrast sensitivity. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. © 2013 American Academy of Ophthalmology.


Ebrahiminia A.,Tarbiat Modares University | Mokhtari-Dizaji M.,Tarbiat Modares University | Toliyat T.,Tehran University of Medical Sciences
Ultrasonics Sonochemistry | Year: 2013

Acoustic cavitation plays an important role in sonochemical processes and the rate of sonochemical reaction is influenced by sonication parameters. There are several methods to evaluate cavitation activity such as chemical dosimetry. In this study, to comparison between iodide dosimetry and terephthalic acid dosimetry, efficacy of sonication parameters in reactive radical production has been considered by iodide and terephthalic acid dosimetries. For this purpose, efficacy of different exposure parameters on cavitations production by 1 MHz ultrasound has been studied. The absorbance of KI dosimeter was measured by spectrophotometer and the fluorescence of terephthalic acid dosimeter was measured using spectrofluorometer after sonication. The result of experiments related to sonication time and intensity showed that with increasing time of sonication or intensity, the absorbance is increased. It has been shown that the absorbance for continuous mode is remarkably higher than for pulsing mode (p-value < 0.05). Also results show that with increasing the duty cycles of pulsed field, the inertial cavitation activity is increased. With compensation of sonication time or intensity in different duty cycles, no significant absorbance difference were observed unless 20% duty cycle. A significant correlation between the absorbance and fluorescence intensities (count) at different intensity (R = 0.971), different sonication time (R = 0.999) and different duty cycle (R = 0.967) were observed (p-value < 0.05). It is concluded that the sonication parameters having important influences on reactive radical production. These results suggest that there is a correlation between iodide dosimetry and terephthalic acid dosimetry to examine the acoustic cavitation activity in ultrasound field. © 2012 Elsevier B.V. All rights reserved.


Aghapour A.A.,Tarbiat Modares University | Moussavi G.,Tarbiat Modares University | Yaghmaeian K.,Tehran University of Medical Sciences
Bioresource Technology | Year: 2013

The main objective of this study was to investigate the performance of a cyclic rotating-bed biological reactor (CRBR) in comparison to a sequencing continuous-inflow reactor (SCR) for the biodegradation and mineralization of catechol. Results showed that catechol degradation and mineralization in the SCR at the organic loading of 7.82kgCOD/m3d and the hydraulic retention time (HRT) of 9h were 28.2% and 10.3%, respectively. Under similar operating conditions to SCR, steady-state performance of CRBR with polyurethane foam (PUF) media for degradation and mineralization of catechol achieved was 98.7% and 97.9%, respectively. In comparison, the CRBR with 2H media attained average steady-state catechol degradation and mineralization of 89.1% and 83.6%, respectively, under similar conditions. Accordingly, the CRBR with PUF media presents a promising process for efficiently treating wastewater containing high concentrations of toxic, inhibitory and resistant compounds at a relatively short HRT. © 2013 Elsevier Ltd.


Farzan M.,Tehran University of Medical Sciences
American journal of orthopedics (Belle Mead, N.J.) | Year: 2011

Tumoral calcinosis (TC) is a rare problem that can be idiopathic (primary) or secondary to other diseases, particularly end-stage renal disease. Although these 2 types of TC do not differ in their radiologic and histopathologic presentations, their treatment modalities may be changed on the basis of etiology. Surgical resection of the calcified mass is the main treatment for the primary type, but should be avoided in hemodialysis-related types, which are instead often treated with parathyroidectomy. In this article, we report on 2 cases of TC (different types). We also describe several aspects of diagnosis and different therapeutic approaches through a review of the literature.


Pakravan M.,Shahid Beheshti University of Medical Sciences | Rad S.S.,Shahid Beheshti University of Medical Sciences | Yazdani S.,Shahid Beheshti University of Medical Sciences | Ghahari E.,Shahid Beheshti University of Medical Sciences | Yaseri M.,Tehran University of Medical Sciences
Ophthalmology | Year: 2014

Objective To evaluate the effect of early aqueous suppressant treatment on Ahmed glaucoma valve (AGV) surgery outcomes. Design Randomized clinical trial. Participants Ninety-four eyes of 94 patients with refractory glaucoma. Methods After AGV implantation, 47 cases (group 1) received topical timolol-dorzolamide fixed-combination drops twice daily when intraocular pressure (IOP) exceeded 10 mmHg, whereas 47 controls (group 2) received conventional stepwise treatment when IOP exceeded target pressure. Main Outcome Measures Main outcome measures included IOP and success rate (6 mmHg < IOP < 15 mmHg and IOP reduction of at least 30% from baseline). Other outcome measures included best-corrected visual acuity, complications, and hypertensive phase frequency. Results Groups 1 and 2 were both followed up for a mean of 45±11.6 and 47.2±7.4 weeks, respectively (P = 0.74). Mixed model analysis revealed a significantly greater IOP reduction in group 1 at all intervals (P<0.001). At 1 year, the cases exhibited a significantly higher success rate (63.2% vs. 33.3%; P = 0.008) and reduced hypertensive phase frequency (23.4% vs. 66.0%; P<0.001). Conclusions Early aqueous suppressant treatment may improve AGV implantation outcomes in terms of IOP reduction, success rate, and hypertensive phase frequency. © 2014 by the American Academy of Ophthalmology.


Despite numerous studies on the benefits of exclusive breastfeeding during the first half year of life, little information is available on actual breastfeeding practices in terms of daily duration and frequency of suckling. This study proposes to determine daily breastfeeding patterns among exclusively breastfed infants from birth to six months. An observational prospective follow-up study of daily feeding practices among exclusively breastfed infants was conducted in 2007/2008. Mothers were recruited and interviewed during their first month postpartum health center visit. A total of 287 mothers were recruited into the study. Primary outcome measures were suckling duration and frequency of breastfeeding during daytime and nighttime. Mothers were asked at each healthcare visit to report the daily duration in minutes and the daily number of breastfeeding sessions. Mixed models were used to determine breastfeeding patterns and predictors. Of 287 mothers selected for this study, 174 (61%) exclusively breastfeeding until six months after delivery. Mixed modeling showed that as the infant's age increased duration of one suckling, cumulative duration and frequency of breastfeeding during daytime, nighttime and a twenty four hour period all gradually decreased. Infants gender and receiving professional advice about breastfeeding were also significant factors in breastfeeding patterns (p<0.05). The one suckling duration and frequency of feeds in this study population were considerably higher than values reported in other populations. The variation of feeding patterns between exclusively breastfed infants was very wide. The distributions of one suckling duration, frequency of breastfeeding and cumulative duration of feeds were right-skewed. The current professional advices about breastfeeding are not appropriate because they do not consider unique condition within specific populations.


Biazar E.,Islamic Azad University at Tonekabon | Keshel S.H.,Shahid Beheshti University of Medical Sciences | Keshel S.H.,Tehran University of Medical Sciences
Journal of Biomedical Nanotechnology | Year: 2013

In this study, we have evaluated the wound-healing effects of unrestricted somatic stem cells loaded in chitosan-cross linked PHBV nanofibrous scaffold, implanted into the full thickness skin defects of rats. Afterwards, the scaffolds were evaluated by structural, microscopic, physical and mechanical assays and cell culture analyses. Defects were treated with the scaffolds without and with USSCs. MTT assay, immunostaining, and wound pathology were performed for groups twenty one days after implantation. SEM images showed the average diameter of about 100 nm for the nanofibrous scaffolds, increasing up to 500 nm after chitosan-crosslinking. Results of physical and mechanical analyses also showed a good resilience and compliance with movement as a skin graft. Cellular experiments showed a better cell adhesion, growth and proliferation inside the cross-linked nanofibrous scaffolds compared to un-cross linked ones. In animal models, all groups, excluding the control group, exhibited the most pronounced effect on wound closure, with the statistically significant improvement in wound healing being seen at post-operative day 21. Histological and immunostaining examinations of healed wounds from all groups, especially the groups treated with stem cells. Thus, the grafting of chitosan-cross-linked nanofibrous scaffold loaded with USSC showed better results during the healing process of skin defects in rat models. Copyright © 2013 American Scientific Publishers All rights reserved.


Poursamar S.A.,University of Northampton | Azami M.,Amirkabir University of Technology | Azami M.,Tehran University of Medical Sciences | Mozafari M.,Amirkabir University of Technology
Colloids and Surfaces B: Biointerfaces | Year: 2011

During the last decades, there have been several attempts to combine bioactive materials with biocompatible and biodegradable polymers to create nanocomposite scaffolds with excellent biocompatibility, bioactivity, biodegradability and mechanical properties. In this research, the nanocomposite scaffolds with compositions based on PVA and HAp nanoparticles were successfully prepared using colloidal HAp nanoparticles combined with freeze-drying technique for tissue engineering applications. In addition, the effect of the pH value of the reactive solution and different percentages of PVA and HAp on the synthesis of PVA/HAp nanocomposites were investigated. The SEM observations revealed that the prepared scaffolds were porous with three dimensional microstructures, and in vitro experiments with osteoblast cells indicated an appropriate penetration of the cells into the scaffold's pores, and also the continuous increase in cell aggregation on the scaffolds with increase in the incubation time demonstrated the ability of the scaffolds to support cell growth. According to the obtained results, the nanocomposite scaffolds could be considered as highly bioactive and potential bone tissue engineering implants. © 2011 Elsevier B.V.


Biazar E.,Islamic Azad University at Tonekabon | Keshel S.H.,Shahid Beheshti University of Medical Sciences | Keshel S.H.,Tehran University of Medical Sciences
ASAIO Journal | Year: 2013

The aim of this study was to produce a chitosan-cross-linked nanofibrous biodegradable poly (3-hydroxybutyrate-co-3-hydroxyvalerate) nerve conduit. The artificial nerve scaffold designed by electrospinning method and cross-linked with chitosan by chemical method. Afterwards, the scaffolds were evaluated by microscopic, physical, and mechanical analyses and cell culture assays with Schwann cells. The conduits were implanted into a 10 mm gap in the sciatic nerves of the rats. Four months after surgery, the regenerated nerves were evaluated by macroscopic assessments and histology. This polymeric conduit had sufficiently good mechanical properties to serve as a nerve guide. Cellular experiments showed a better cell adhesion, growth, and proliferation inside the cross-linked nanofibrous scaffolds compared with un-cross-linked ones, also Schwann cells well attached on chitosan-cross-linked nanofibrous surface. The in vivo results demonstrated that in the nanofibrous graft, the sciatic nerve trunk had been reconstructed with restoration of nerve continuity and formatted nerve fibers with myelination. This neural conduit appears to have the right organization for testing in vivo nerve tissue engineering studies. © 2013 by the American Society for Artificial Internal Organs.


Talasaz A.H.,Tehran University of Medical Sciences
Journal of Tehran University Heart Center | Year: 2012

Clinical pharmacy is deemed an integral component of a health care system. The presence of clinical pharmacists in medical rounds could assist physicians in optimizing patients' pharmacotherapy. Moreover, clinical pharmacists may reduce adverse effects and medication errors insofar as they contribute significantly to the detection and management of drug-related problems, not least in patients with cardiovascular diseases, who have the highest rank in the frequency of medication errors. Clinical pharmacists can also collaborate with physicians in the management of cardiovascular risk factors as well as anticoagulation therapy based on patients 'specific situations. In summary, the practice of clinical pharmacy is considered a crucial part of a health care team to improve the level of patients' care by increasing the quality of therapy with the least expense for a health care system.


Jafari Z.,Tehran University of Medical Sciences | Asad-Malayeri S.,University of Tehran
Iranian Journal of Pediatrics | Year: 2012

Objective: The term 'child development' is used to describe the skills acquired by children between birth and the age of 6 years. Development is rather an integrated process and impairment in one developmental milestone can affect other areas too. The goal of the present study was preparation and determination of validity and reliability of the "Newsha Developmental Scale" as an integrated scale for assessing developmental skills of Persian speaking children up to the age of six years. Methods: The Newsha developmental scale was created to thoroughly evaluate seven developmental domains in 13 age groups from birth to 72 months. It was based on the concerns of parents and nursery teachers about child development. In order to obtain the scores of normal population, 593 children in nurseries and health centers of Tehran were assessed. The children had no medical concern or confirmed disorders. With consideration of the age of each child, the score of minimum or higher in each developmental milestone was considered as the normal range. The test-retest reliability and inter-rater reliability were measured. In addition, the content validity was assessed by ideas taken from 10 specialists in the field of child development and the content validity Index (CVI) was calculated. Also construct validity was considered by establishing the effect of age on test results. Findings: A correlation of more than 95% was shown in both test-retest and inter-rater reliabilities (P<0.001). The CVI of various skills of the age groups was between 0.8 and 1, and construct validity revealed the effect of age on the test results. The gender difference was shown only in 6 items among 646 items of the scale (P<0.02). Conclusion: The "Newsha Developmental Scale" is an integrated and comprehensive scale for evaluating the developmental process of children and identification of any probable delay in developmental abilities of children with Persian language up to 6 years of age. © 2012 by Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, All rights reserved.


Rajaei S.,Tehran University of Medical Sciences | Dabbagh A.,Shahid Beheshti University of Medical Sciences
Anesthesiology and Pain Medicine | Year: 2012

Nowadays, coronary artery bypass grafting (CABG) is considered to be one of the most common surgical procedures. This procedure has been the main topic in many clinical research studies, which have assessed the effect of the procedure on patients' outcomes. Like other surgical procedures, this procedure is also accompanied by a number of unwanted complications, including those of the respiratory system. Since the respiratory system plays an integral role in defining the clinical outcome of patients, improvements in studies that can assess and predict clinical outcomes of the respiratory system, assume greater importance. There are a number of predictive models which can assess patients in the preoperative period and introduce a number of risk factors, which could be considered as prognostic factors for patients undergoing CABG. The respiratory system is among the clinical systems that are assessed in many prediction scoring systems. This review assesses the main studies which have evaluated the possible risk factors for postoperative respiratory mortality and morbidity, in patients undergoing CABG. © 2012 Iranian Society of Regional Anesthesia and Pain Medicine; Published by Kowsar Corp.


Mahdavi-Mazdeh M.,Tehran University of Medical Sciences
Iranian Journal of Kidney Diseases | Year: 2010

Dialysis and transplantation are life-saving but very expensive treatments. Current increases in the number of hemodialysis centers, machines, shifts, and kidney transplantations cannot keep pace with the increasing number of end-stage renal disease patients globally. The only way to decrease the incidence of end-stage renal disease is identifying patients with low glomerular filtration rate. The risk groups to be targeted, the expected outcomes, and the tests to be ordered are reviewed in this article. The ways that it is possible to make a screening program sustainable and likely cost-efficient model is discussed. It seems the high-risk target population for chronic kidney disease screening in our country can be those with diabetes mellitus, hypertension, hyperlipidemia, age over 40 years, and obesity (possibly abdominal obesity). Macroalbuminuria check in addition to serum creatinine measurement in high-risk population may look a practical approach to initiate a national program.


Ghafari A.,Tehran University of Medical Sciences
Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia | Year: 2011

Generalized edema is one of the most important complications in patients with nephrotic syndrome. Diuretics like furosemide are the first choice for reducing the edema. Hypo-albuminemia reduces the effect of furosemide, and thus, this drug is co-administered with albumin to reinforce the therapeutic effect and for the correction of reduced oncotic pressure. The aim of this study was to compare urine volume and 24-hour sodium levels after using furosemide alone versus using furosemide along with albumin in patients with nephrotic syndrome. In a randomized clinical trial, ten patients with nephrotic syndrome were chosen and were randomly allocated into four groups. Three therapeutic protocols were chosen, and at the end, each patient had received all three protocols randomly. Data were gathered and analyzed using non-parametric tests in SPSS software. The average urine volume after receiving albumin alone, furosemide alone and albumin plus furosemide were 742 mL (SD = 528), 1707 mL (SD = 745) and 2175 mL (SD = 971), respectively (P = 0.015); the fractional excretion of sodium was 1.96 (SD = 0.251), 3.18 (SD = 0.25), and 4.77 (SD = 8.45), respectively (P = 0.000); the 24-hour urinary sodium levels were 18.3 (SD = 6.68), 208.4 (SD = 5.27) and 206 (SD = 8.45), respectively; while the glomerular filtration rate (GFR) was 104.5, 96.6 and 106.6 (P = 0.021), respectively, in the three therapy groups. Our study shows that albumin administration alone and with furosemide in patients with nephrotic syndrome who had normal kidney function, results in different urine volumes and sodium levels. Co-administration of albumin and furosemide increased the urine volume and sodium level, which is due to increase in the GFR as well as the diuretic effects of furosemide.


Mahshidfar B.,Tehran University of Medical Sciences
Prehospital and disaster medicine | Year: 2013

Patients with possible spinal injury must be immobilized properly during transport to medical facilities. The aim of this research was comparing spinal immobilization using a long backboard (LBB) with using a vacuum mattress splint (VMS) in trauma victims transported by an Emergency Medical Services (EMS) system. In this randomized clinical trial, 60 trauma victims with possible spinal trauma were divided to two groups, each group immobilized with one of the two instruments. Speed and ease of application, immobilization rate, and the patients' comfort were recorded. In this survey, LBB was faster to apply: 211.66 (SD = 28.53) seconds vs 654.00 (SD = 16.61) seconds. Various measures of immobilization were better by LBB. Also, LBB offered a significant improvement in comfort over a VMS for the patient with possible spinal injury. All of the results were statistically significant. The results of this study showed that immobilization using LBB was easier, faster, and more comfortable for the patient, and provided additional decrease in spinal movement when compared with a VMS.


Mohamadnejad M.,Tehran University of Medical Sciences | Eloubeidi M.A.,American University of Beirut
Archives of Iranian Medicine | Year: 2013

Pancreatic cysts (PCs) are being increasingly detected due to the widespread use of high-resolution abdominal imaging. The main imaging modalities to diagnose PCs include high-resolution spiral CT scan, MRI, and endoscopic ultrasound (EUS). EUS has the added benefit of enabling cyst fluid sampling through FNA and significantly improves clinical diagnosis of PCs. Some PCs like pseudocysts, serous cystadenomas, and lymphoepethelial cysts are entirely benign lesions and can be managed non-operatively. However, other lesions like mucinous cystic neoplasms, or cystic neuroendocrine tumors are pre-malignant or malignant lesions and require surgical intervention. In this review, we describe diagnosis and management of common pancreatic cystic lesions.


Rahimi-Movaghar A.,Tehran University of Medical Sciences
Cochrane database of systematic reviews (Online) | Year: 2013

Pharmacologic therapies for maintenance treatment of heroin dependence have been used and studied widely. Systematic reviews have demonstrated the effectiveness of such therapies. Opium dependence is associated with less problems and impairments and is less likely to be used by injecting, with consequent reductions in risk of overdose and blood-borne diseases. Although it is a common substance use disorder in many countries, a systematic review of the literature is lacking on the maintenance treatment for opium dependence. To evaluate the effectiveness and safety of various pharmacological therapies on maintenance of opium dependence (alone or in combination with psychosocial interventions) compared to no intervention, detoxification, different doses of the same intervention, other pharmacologic interventions and any psychosocial interventions. We searched the following sources up to February 2012: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, PsycINFO, regional databases (IMEMR and ASCI), national databases (Iranmedex and Iranpsych), main electronic sources of ongoing trials and reference lists of all relevant papers. Also, we contacted known investigators from some Asian countries to obtain details about unpublished trials. Randomised controlled clinical trials (RCTs) comparing any maintenance pharmacologic intervention versus no intervention, other pharmacologic or non-pharmacologic intervention for opium dependence. Two reviewers assessed the risks of biases and extracted data, independently. Three RCTs recruiting 870 opium dependents were included. The studies made different comparisons so it was not possible to pool data. Only retention rate was assessed by the studies. Two studies compared different doses of buprenorphine: in one study, 4 mg/day of buprenorphine was compared with doses of 2 mg/day and 1 mg/day and in another study, 8 mg/day of buprenorphine was compared with doses of 3 mg/day and 1 mg/day. Comparisons showed a statistically significant difference between groups; higher doses of buprenorphine increased the probability of retention in treatment. The studies had high risks of biases. In the third study, after a process of detoxification, baclofen (60 mg/day) was compared with placebo for maintenance treatment. The difference in retention rate between groups was high, but it was not statistically significant. It is not possible to conclude about the use of any kind of pharmacologic therapies for maintenance treatment of opium dependence.


Zakerimoghadam M.,Tehran University of Medical Sciences
Acta medica Indonesiana | Year: 2011

to assess the effect of breathing exercises on fatigue level of the patients with COPD. this quasi-experimental research was conducted on 60 COPD patients hospitalized at hospitals affiliated to Tehran University of Medical Sciences. The subjects were randomized into "experience" and "control" groups. Data were gathered by interview and data registration from the files. The data gathering tools were questionnaires, fatigue severity scale (FSS) and respiratory exercise usage checklist. The data were analyzed using SPSS software with the descriptive and deductive statistical methods (Paired-T, Chi-Square and Pearson correlation tests). the average fatigue severity before (55.766) and after (40.166) using the respiratory exercises in the experience group (p=0%) was significantly different. While in the control group (p=0.002) before (54.166) and after (52.200) the study has a slight difference. There was a significant inverse correlation between using respiratory exercises and fatigue severity (r=-0.593, p=0.001). Mean fatigue intensity for the experience and control groups decreased to 40.916 ± 14.4 and 52.20 ± 8.539 after the study, respectively (p=0.001). There was a significant difference in fatigue severity between experience and control groups after the study. respiratory exercise is effective in reducing the fatigue in the patients with COPD.


Jadali Z.,Tehran University of Medical Sciences | Alavian S.-M.,Baqiyatallah Research Center for Gastroenterology and Liver Disease
Iranian Journal of Allergy, Asthma and Immunology | Year: 2010

Autoimmunity and viral infections are closely associated fields, and viruses have been proposed as a likely aetiological, contributory or triggering factors of systemic autoimmune diseases. Hepatitis C virus seems to be the virus usually associated with the appearance of autoimmune diseases, and the relationship between chronic hepatitis C virus infection and some autoimmune disease has been studied. For some of these disorders their association with hepatitis C virus infection is well recognized while for others it remains probable or weak. Examples of autoimmune phenomena observed in chronic hepatitis C virus infection include rheumatoid arthritis, thyroid disease, cryoglobulinaemia, immune thrombocytopenic purpura, systemic lupus erythematosus and sjogren syndrome. To date, the etiological role and the pathogenetic involvement of the hepatitis C infection remains unknown.The aim of this study is to assess the presence of different autoimmune manifestations of hepatitis C virus infection reported in literature. Copyright© 2010, Iranian Journal of Allergy, Asthma and Immunology. All rights reserved.


Dargahi H.,Tehran University of Medical Sciences
Acta Medica Iranica | Year: 2013

Quantum organizations are referred where stakeholders know how to access the infinite potential of the quantum field. Viewing healthcare organizations from perspective of quantum theory suggest new approaches into management techniques for effective and efficient delivery of healthcare services. This research is aimed to determine the quantum skills, quantum leadership characteristics and functions of Tehran University of Medical Sciences hospitals' nursing administrators. A cross-sectional, descriptive and analytical study was conducted among 25 nursing administrators of Tehran University of Medical Sciences (TUMS) hospitals, Tehran, Iran. The research tool for data collection was a self-constructed questionnaire that measured the quantum skills, quantum leadership characteristics and functions of TUMS hospitals' nursing administrators. The validity of questionnaire was confirmed by 5 management science experts and its reliability was performed by using test-retest method yielded a Cronbach's alpha coefficient of 0.90. Data were collected and analyzed by SPSS software and t-test statistical methods. The results of this research showed that all respondents had desired quantum skills (75.71±5.98), quantum leadership characteristics (82.01±6.77), and quantum leadership functions (78.57±6.28) and total quantum leadership (78.76±4.50). Also, passing management training courses of the respondents was significantly correlated with their quantum leadership. Iranian healthcare organizations require quantum leadership that provides an important resource to advance Iranian nursing leadership to the organizational excellence. We hope Iranian hospitals' nursing leaders who have quantum skills potentially, present a highly developed sense of self and the ability to improve nursing care outcomes in these hospitals. © 2013 Tehran University of Medical Sciences. All rights reserved.


Koucheki B.,Noor Ophthalmology Research Center | Hashemi H.,Noor Ophthalmology Research Center | Hashemi H.,Tehran University of Medical Sciences
Journal of Glaucoma | Year: 2012

Purpose: To determine the effect of selective laser trabeculoplasty (SLT) on different types of open-angle glaucoma (OAG) in terms of intraocular pressure (IOP). Methods and Materials: In this prospective, nonrandomized, interventional study, patients with OAG, unresponsive to maximum tolerable antiglaucoma medication, were enrolled. One thirty six eyes were studied. Distribution of glaucoma type was 91 primary OAG eyes (POAG, 66.9%), 22 pseudoexfoliative glaucoma (PEX, 16.2%) eyes, and 23 pigmentary glaucoma (PG, 16.9%) eyes. Main outcome measures were IOP and number of antiglaucoma medications used before operation, at 1 day, at 1 week, and at 1 to 18 months after surgery. Using the standard approach 360-degree SLT was done. RESULTS: The mean follow-up was 16.6±4.3 months. The mean preoperative IOP was 22.0±3.7 mm Hg, and reduced to 18.3±3.7 mm Hg at last visit. The overall mean IOP decrease was 3.6±2.6 mm Hg (16.3%) on the last visit compared with before surgery, indicating a reduction of 16.7% in POAG, 16.6% in PEX, and 14.5% in PG. Comparison of IOP values at 6 and 16 months showed an increase of 0.5 and 2.7 mm Hg in total sample and PG group. IOP reduction was significantly less among diabetic patients. Conclusions: SLT resulted in a significant IOP reduction of 16.3% at 16 months after surgery. The level of IOP reduction did not vary in POAG, PEX, and PG groups. A significant increase in IOP was observed in PG group after 6 months. The procedure seemed least effective in diabetic patients. © 2012 by Lippincott Williams & Wilkins.


Alipour E.,University of Tabriz | Majidi M.R.,University of Tabriz | Saadatirad A.,University of Tabriz | Golabi S.M.,University of Tabriz | Alizadeh A.M.,Tehran University of Medical Sciences
Electrochimica Acta | Year: 2013

An electrochemically pretreated pencil graphite electrode (PGE) has been proposed for simultaneous determination of dopamine (DA) and uric acid (UA) in the presence of high levels of ascorbic acid (AA). The electrochemical pretreatment of PGE was achieved in phosphate buffer (pH 7) by the potential recycling between 1.5-2.0 V/SCE for 100 cycles, and at the scan rate of 100 mV s-1. The influence of electrochemical pretreatment of PGE on the separation of overlapped peaks of AA, DA and UA were studied and optimum conditions were suggested. Differential pulse voltammetry (DPV) was used for simultaneous determination of DA and UA in the presence of high concentrations of AA. The peak separation between DA and AA, and also between DA and UA was up to 260 and 160 mV, respectively. The calibration curves were in the range of 0.15-15 μM and 0.3-150 μM for DA and UA in the presence of AA, respectively. The detection limits (S/N = 3) were 0.033 and 0.12 μM for DA and UA, respectively. The results reveal that pretreatment of the pencil graphite electrode surface not only improves its electrochemical catalytic activities towards the oxidation of DA and UA, but also resolves the overlapped oxidation peaks of AA, DA and UA into three well-defined peaks. The present method can apply for UA and DA determination in human serum and urine, and also for some commercial pharmaceutical samples without additional sample pre-treatment. © 2012 Elsevier Ltd. All rights reserved.


Baghayeria M.,Hakim Sabzevari University | Namadchianba M.,Tehran University of Medical Sciences
Electrochimica Acta | Year: 2013

The present study aims to investigate the preparation of new modified surfaces for electrodes based ondirect electrochemical and electrocatalytic properties of luteolin (LU) immobilized on the functional-ized multi-wall carbon nanotubes (fMWCNT) modified glassy carbon electrode (fMWCNT/GCE). The LUlayer on fMWCNT/GCE was characterized by scanning electrochemical microscopy (SEM). The modifiedelectrode was characterized as electrochemical sensor by different electrochemical techniques such ascyclic voltammetry and chornoamperommetry. The modified electrode showed a large electrocatalyticactivity for oxidation of levodopa (LD), acetaminophen (AC) and tyramine (TR). Using differential pulsevoltammetry (DPV), a sensitive simultaneous electrochemical oxidation of LD, AC and TR was attained:concentration at the ranges of 0.7-100.0 μM, 1.0-90.0 μM and 0.5-70.0 μM, respectively and the detec-tion limits for LD, AC and TR were sequentially 0.25 μM, 0.52 μM and 0.12 μM. The developed LU biosensorexhibited good sensitivity, stability, and reproducibility for the determination of LD, AC and TR by DPV.The method was applied for the determination of LD, AC and TR in pharmaceutical formulations, dairyproduct and in human urine samples. © 2013 Elsevier Ltd. All rights reserved.


Keshel S.H.,Tehran University of Medical Sciences
International journal of nanomedicine | Year: 2011

Surface modification of medical polymers is carried out to improve biocompatibility. In this study, conventional polyurethane was exposed to microwave plasma treatment with oxygen and argon gases for 30 seconds and 60 seconds. Attenuated total reflection Fourier transform infrared spectra investigations of irradiated samples indicated the presence of functional groups. Atomic force microscope images of samples irradiated with inert and active gases indicated the nanometric topography of the sample surfaces. Samples irradiated by oxygen plasma indicated high roughness compared with those irradiated by inert plasma for the different lengths of time. In addition, surface roughness increased with time, which can be due to a reduction of contact angle of samples irradiated by oxygen plasma. Contact angle analysis indicated a reduction in samples irradiated with both types of plasma. However, samples irradiated with oxygen plasma indicated lower contact angle compared with those irradiated by argon plasma. Cellular investigations with unrestricted somatic stem cells showed better adhesion, cell growth, and proliferation among samples radiated by oxygen plasma for longer than for normal samples.


Sobhani Z.,Tehran University of Medical Sciences
International journal of nanomedicine | Year: 2011

Potential applications of carbon nanotubes have attracted many researchers in the field of drug delivery systems. In this study, multiwalled carbon nanotubes (MWNTs) were first functionalized using hyperbranched poly citric acid (PCA) to improve their hydrophilicity and functionality. Then, paclitaxel (PTX), a potent anticancer agent, was conjugated to the carboxyl functional groups of poly citric acid via a cleavable ester bond to obtain a MWNT-g-PCA-PTX conjugate. Drug content of the conjugate was about 38% (w/w). The particle size of MWNT-g-PCA and MWNT-g-PCA-PTX was approximately 125 and 200 nm, respectively. Atomic force microscopy and transmission electron microscopy images showed a curved shape for MWNT-g-PCA and MWNT-g-PCA-PTX, which was in contrast with the straight or linear conformation expected from carbon nanotubes. It seems that the high hydrophilicity of poly citric acid and high hydrophobicity of MWNTs led to conformational changes from a linear state to a curved state. Paclitaxel can be released from the MWNT-g-PCA-PTX conjugates faster at pH 6.8 and 5.0 than at pH 7.4, which was suitable for the release of the drug in tumor tissues and tumor cells. In vitro cytotoxicity studies were evaluated in the A549 and SKOV3 cell lines. MWNT-g-PCA had an insignificant cytotoxic effect on both cell lines. MWNT-g-PCA-PTX had more of a cytotoxic effect than the free drug over a shorter incubation time (eg, 24 hours versus 48 hours), which suggests improved cell penetration of MWNT-g-PCA-PTX. Therefore, paclitaxel conjugated to MWNT-g-PCA is promising for cancer therapeutics.


Farboud E.S.,Tehran University of Medical Sciences
International journal of nanomedicine | Year: 2011

Solid lipid nanoparticles (SLNs) of coenzyme Q10 (CoQ10) were formulated by a high-pressure homogenization method. The best formulation of SLN dispersion consisted of 13% lipid (cetyl palmitate or stearic acid), 8% surfactant (Tween 80 or Tego Care 450), and water. Stability tests, particle size analysis, differential scanning calorimetry, transmission electron microscopy, and release study were conducted to find the best formulation. A simple cream of CoQ10 and a cream containing CoQ10-loaded SLNs were prepared and compared on volunteers aged 20-30 years. SLNs with particle size between 50 nm and100 nm exhibited the most suitable stability. In vitro release profiles of CoQ10 from simple cream, SLN alone, and CoQ10-loaded SLN cream showed prolonged release for SLNs compared with the simple cream, whereas there was no significant difference between SLN alone and SLN in cream. In vitro release studies also demonstrated that CoQ10-loaded SLN and SLN cream possessed a biphasic release pattern in comparison with simple cream. In vivo skin hydration and elasticity studies on 25 volunteers suggested good dermal penetration and useful activity of Q10 on skin as a hydratant and antiwrinkle cream.


Taheri A.,Tehran University of Medical Sciences
International journal of nanomedicine | Year: 2011

Biotin molecules could be used as suitable targeting moieties in targeted drug delivery systems against tumors. To develop a biotin targeted drug delivery system, we employed human serum albumin (HSA) as a carrier. Methotrexate (MTX) molecules were conjugated to HSA. MTX-HSA nanoparticles (MTX-HSA NPs) were prepared from these conjugates by cross-linking the HSA molecules. Biotin molecules were then conjugated on the surface of MTX-HSA NPs. The anticancer efficacy of biotin targeted MTX-HSA NPs was evaluated in mice bearing 4T1 breast carcinoma. A single dose of biotin targeted MTX-HSA NPs showed stronger in vivo antitumor activity than non-targeted MTX-HSA NPs and free MTX. By 7 days after treatment, average tumor volume in the biotin targeted MTX-HSA NPs-treated group decreased to 17.6% of the initial tumor volume when the number of attached biotin molecules on MTX-HSA-NPs was the highest. Average tumor volume in non-targeted MTX-HSA NPs-treated mice grew rapidly and reached 250.7% of the initial tumor volume. Biotin targeted MTX-HSA NPs increased the survival of tumor-bearing mice to 47.5 ± 0.71 days and increased their life span up to 216.7%. Mice treated with biotin targeted MTX-HSA NPs showed slight body weight loss (8%) 21 days after treatment, whereas non-targeted MTX-HSA NPs treatment at the same dose caused a body weight loss of 27.05% ± 3.1%.


Amanlou M.,Tehran University of Medical Sciences
International journal of nanomedicine | Year: 2011

Difficulties in the use, preparation, and cost of radioactively-labeled glycosylated compounds led to this research and development study of a new gadolinium-labeled glucose compound that does not have a radioactive half-life or difficulties in its synthesis and utilization. Based on the structure of the 2-fluoro-2-deoxy-D-glucose molecule ((18)FDG), a new compound consisting of D-glucose (1.1 nm) conjugated to a well-known chelator, diethylenetriamine penta-acetic acid (DTPA), was synthesized, labeled with Gd(3+), and examined in vitro and in vivo. This novel compound not only demonstrated excellent and less costly imaging capability, but also showed anticancer effects on treated cells. Our results demonstrated that the new Gd(3+)-DTPA-DG compound (GDD, with GDD conjugate aggregation of about 8 nm at 0.02 mg/mL concentration) significantly decreased HT1080 and HT29 tumor cell numbers. Application of GDD to cancer cells also increased levels of tumor necrosis factor alpha, but did not alter blood glucose levels. Interestingly, no toxicological findings were seen in normal human kidney cells. Dual application of GDD for both imaging and treatment of tumor cells could be remarkably advantageous in both the diagnosis and treatment of cancer.


Shirkoohi R.,Tehran University of Medical Sciences
Cancer Science | Year: 2013

The epithelial to mesenchymal transition (EMT), a pathologic phenomenon in cancer, has a twin in the embryonic period of life. In the first one, its promotion will cause metastasis to become a life-threatening stage of cancer, while in the second it will lead to organogenesis, which is necessary for all living creatures. There is one more from this phenomenon, which occurs during the wound healing process and if dys-regulated can lead to fibrosis. In both there are stimulants in common and one that are different. Stages start from cell-cell junction dissociation followed by morphological changes and behavioral and essence alterations. To control the EMT as a bizarre disturbance in cancer and metastasis, initially it is better to understand the wonder of natural gestational orchestration in early life. In this review, first the structure of the two heads of the spectrum is described followed by the cellular and micro-environmental alterations during this phenomenon. Understanding cellular behavior in this process and what makes them invasive resistant stemness cells will be of great importance in highlighting roads to cancer treatment. © 2012 Japanese Cancer Association.


Laal M.,Tehran University of Medical Sciences | Aliramaie N.,Kurdistan University of Medical Sciences
International Journal of Collaborative Research on Internal Medicine and Public Health | Year: 2010

Introduction: Stress could be defined simply as the rate of wear and tear on the body systems caused by life. Stress at work is a big problem. Working in the profession of nursing is a demanding and often stressful occupation. Thus, nurses' health could be affected by stress dangerous consequences. Coping strategies are key elements of nurses' stress reactions. Coping strategy as a stabilizing factor may be as important as the stressful event itself. Purpose: To determine how and how much nursing staff cope with the stressful events and to find out the relationships between job coping and health outcomes in the study population. Material and Methods: This cross-sectional study included one hundred nursing staff working in two hospitals (Tohid and Besat) of Sanandaj City (Kurdistan, Iran). They completed the questionnaires containing coping strategies based on the Adolescent Coping Orientation for Problem Experiences (A-COPE), in the year of 2006. We examined the relationships between age, gender, position, tenure state, marriage state, job experience, work shift and place (environment) to application of coping methods. Analysis was done using SPSS 18. Statistical significance was set at P ≤0.05. Result: Out of one hundred nurses of all grades included in this study, fifty-seven were female (57%), 60(%) were between 30-39 years old and 50(%) were single. There was no significant difference between junior and senior staff in applying positive methods (p=0.666) or negative responses to cope with stress (p=0.195). The majority of nurses 55(%) had job experience of 5-10 years, 40(%) worked in the evening and night shift and 54(%) were in Tohid hospital. Generally in our study, the rate of application positive methods of coping was good 19%, medium 51% and weak 30%. Negative responses to stress were high 49%, medium 29% and low 22%. There were significant associations between: age, tenure state, work place and job experience with positive coping as follow; (p=0.028), (P =0.006), (p=0.001) and (p=0.026), accordingly. In this study, those in the age of 30-39 years, officially (permanent) employed, working in Tohid hospital and had job experience of 5-9 years more used positive methods of coping. They more applied positive methods of: listening to music, reading, talking with the partner or a colleague and walking to cope with stress. This study showed significant differences between gender (p=0.000) and job experience (p=0.035) with negative response to stress. Males and those with low job experience (less than 5 years) were more disputatious and impatient, accordingly. Conclusions: Most of our research community coped with stress positively (70%; good and moderate). Unfortunately 49% of our study population had high level of negative responses. This study showed significant associations between both some personal information, i.e: age, job experience, tenure state and the environment with positive application of coping methods. From this study, We concluded that the way of response to stress in nursing staff depends not only to the personality and one's defensive styles but also the healthcare work environment. There is a necessity to teach positive methods of coping to the nursing community as well as providing a proper environment of work. © 2010 Laal M, Aliramaie N.


Poustchi H.,Tehran University of Medical Sciences | Poustchi H.,University of Sydney | Farrell G.C.,Australian National University | Strasser S.I.,University of Sydney | And 3 more authors.
Hepatology | Year: 2011

Screening for hepatocellular carcinoma (HCC) is commonly practiced and recommended in published guidelines, but evidence for its efficacy has been controversial. We tested the feasibility of conducting a randomized controlled trial (RCT) of HCC surveillance in patients with cirrhosis and followed up those offered screening to detect clinical outcomes. Participation was offered to patients with cirrhosis attending liver clinics at three university hospitals. Following discussion, patients received a decision aid (DA) that outlined the risks and benefits of surveillance. The proposed screening program comprised ultrasonography 6-monthly and serum alpha-fetoprotein every 3 months. We envisaged five groups of patients: those who agreed to randomization, those choosing nonrandomized screening, those wanting continuation of usual care, those who were undecided, and those refusing participation. Among 205 patients, 204 (99.5%) declined randomization. Of these, 181 (88%) elected for a nonrandomized screening program, 10% chose usual care (which typically included ad hoc screening), and two were undecided. Among 176 patients fluent in English communication skills, 160 (91%) preferred nonrandomized screening compared with 22/29 (76%) patients needing an interpreter (P < 0.026). Of 173 patients in nonrandomized screening followed up for a mean 13.5 ± 6.04 months, three developed HCC, two died from nonliver-related causes, and one underwent liver transplantation for liver failure. Eighteen of 21 patients in "usual care" received ad hoc screening. A simultaneous survey on the quality of the DA showed that the majority of participants believed that the information provided was unbiased. Conclusion: Although an RCT is theoretically ideal for determining the efficacy, efficiency, and cost-effectiveness of HCC screening, informed patients prefer surveillance. A randomized study of HCC screening is not feasible when informed consent is imparted. (HEPATOLOGY 2011;) Copyright © 2011 American Association for the Study of Liver Diseases.


Vaziri M.,Tehran University of Medical Sciences
General Thoracic and Cardiovascular Surgery | Year: 2012

Primary leiomyosarcoma of the mediastinum is a very rare malignant mesenchymal tumor, which may arise in the soft tissue of the mediastinum or from the great vessels. Due to its rarity and nonspecific clinical symptoms, the correct diagnosis and proper management are often delayed and not well established. We report a 55-year-old woman with a large right-sided mediastinal leiomyosarcoma with adhesion to the pericardium and right middle lobe, which was completely removed via right thoracotomy along with pericardial resection and right middle lobectomy. © The Japanese Association for Thoracic Surgery 2012.


Kiadaliri A.A.,Lund University | Kiadaliri A.A.,Tehran University of Medical Sciences
International Journal of Preventive Medicine | Year: 2013

Background: High daily intake of fruit and vegetables promotes population health and is inversely associated with morbidity and mortality. Demographic and socioeconomic characteristics are among main predictors of fruit and vegetables consumption. The current study aimed to evaluate these associations using province-level data in Iran during the years 2007-2009. Methods: Data on the mean number of fruit and vegetables consumption per day in age and sex stratum at the province level from three consecutive stepwise non-communicable diseases risk factors surveys were obtained. Data about provinces' socioeconomic status (SES) were obtained from the Statistical Centre of Iran and published reports. One-way repeated measures ANOVA and random effect linear regression models were applied for non-stratified and stratified analyses, respectively. Results: There were substantial variations in the fruit and vegetables consumption across the country. Consumption of vegetables was higher than fruit over the study period. There were no statistically significant differences in fruit (P = 0.52) and vegetables (P = 0.14) intake among men and women. Older age was associated with lower consumption of fruit. People in the provinces with better SES consumed higher amounts of combined fruit and vegetables and this association was more profound among females. Conclusions: The results suggest that policies and interventions to improve the intake of fruit and vegetables in the country may be significantly beneficial, especially for older people and women in low socioeconomic groups.


Talaei F.,Tehran University of Medical Sciences
International journal of nanomedicine | Year: 2011

Thiolated chitosan has high transfection and mucoadhesive properties. We investigated the potential of two recently synthesized polymers: NAC-C (N-acetyl cysteine-chitosan) and NAP-C (N-acetyl penicillamine-chitosan) in anticancer drug delivery targeting epidermal growth factor receptor (EGFR). Doxorubicin (DOX) and antisense oligonucleotide (ASOND)-loaded polymer nanoparticles were prepared in water by a gelation process. Particle characterization, drug loading, and drug release were evaluated. To verify drug delivery efficiency in vitro experiments on a breast cancer cell line (T47D) were performed. EGFR gene and protein expression was analyzed by real time quantitative polymerase chain reaction and Western blotting, respectively. A loading percentage of 63% ± 5% for ASOND and 70% ± 5% for DOX was achieved. Drug release data after 15 hours showed that ASOND and DOX were completely released from chitosan-based particles while a lower and more sustained release of only 22% ± 8% was measured for thiolated particles. In a cytosol simulated release medium/reducing environment, such as found intracellularly, polymer-based nanoparticles dissociated, liberating approximately 50% of both active substances within 7 hours. ASOND-loaded polymer nanoparticles had higher stability and high mucoadhesive properties. The ASOND-loaded thiolated particles significantly suppressed EGFR gene expression in T47D cells compared with ASOND-loaded chitosan particles and downregulated EGFR protein expression in cells. This study could facilitate future investigations into the functionality of NAP-C and NAC-C polymers as an efficient ASOND delivery system in vitro and in vivo.


Koopaei M.N.,Tehran University of Medical Sciences
International journal of nanomedicine | Year: 2011

The objective of this study was to develop pegylated poly lactide-co-glycolide acid (PLGA) immunonanocarriers for targeting delivery of docetaxel to human breast cancer cells. The polyethylene glycol (PEG) groups on the surface of the PLGA nanoparticles were functionalized using maleimide groups. Trastuzumab, a monoclonal antibody against human epidermal growth factor receptor 2 (HER2) antigens of cancer cells, used as the targeting moiety, was attached to the maleimide groups on the surface of pegylated PLGA nanoparticles. Nanoparticles prepared by a nanoprecipitation method were characterized for their size, size distribution, surface charge, surface morphology, drug-loading, and in vitro drug release profile. The average size of the trastuzumab-decorated nanoparticles was 254 ± 16.4 nm and their zeta potential was -11.5 ± 1.4 mV. The average size of the nontargeted PLGA nanoparticles was 183 ± 22 nm and their zeta potential was -2.6 ± 0.34 mV. The cellular uptake of nanoparticles was studied using both HER2-positive (SKBR3 and BT-474) and HER2-negative (Calu-6) cell lines. The cytotoxicity of the immunonanocarriers against HER2-positive cell lines was significantly higher than that of nontargeted PLGA nanoparticles and free docetaxel.


Alvar J.,Drugs for Neglected Disease initiative DNDi 15 | Croft S.L.,London School of Hygiene and Tropical Medicine | Kaye P.,University of York | Khamesipour A.,Tehran University of Medical Sciences | And 2 more authors.
Vaccine | Year: 2013

Leishmaniasis in many ways offers a unique vaccine case study. Two reasons for this are that leishmaniasis is a disease complex caused by several different species of parasite that are highly related, thus raising the possibility of developing a single vaccine to protect against multiple diseases. Another reason is the demonstration that a leishmaniasis vaccine may be used therapeutically as well as prophylactically. Although there is no registered human leishmaniasis vaccine today, immunization approaches using live or killed organisms, as well as defined vaccine candidates, have demonstrated at least some degree of efficacy in humans to prevent and to treat some forms of leishmaniasis, and there is a vigorous pipeline of candidates in development. Current approaches include using individual or combined antigens of the parasite or of salivary gland extract of the parasites' insect vector, administered with or without formulation in adjuvant. Animal data obtained with several vaccine candidates are promising and some have been or will be entered into clinical testing in the near future. There is sufficient scientific and epidemiological justification to continue to invest in the development of vaccines against leishmaniasis. © 2012 Elsevier Ltd.


Massarrat S.,Tehran University of Medical Sciences
Archives of Iranian Medicine | Year: 2014

Gastric cancer is a heterogeneous disorder; genetic factors, H. pylori infection and various environmental factors contribute to its development. Advanced atrophic corpus-predominant gastritis provides the histological base for its genesis. Low socio-economic status and poor hygienic conditions, smoking habits, heavy alcohol consumption, high salt and low intake of vegetables and fruits are important external factors for the occurrence of gastric cancer. For its prevention, the eradication of H. pylori infection at an early age is mandatory for subjects at high risk or those living in areas with high prevalence of gastric cancer. Given that an increased serum level of Pepsinogen II is a good biomarker for the presence of gastritis, it seems reasonable to screen all infected subjects at risk of gastric cancer with increased serum pepsinogen II at an early age (at around 30 years) to eradicate H. pylori. An endoscopy should be performed for subjects at an older age (40 years and older), when increased serum pepsinogen II level is associated with decreased serum pepsinogen I and pepsinogen I to II ratio.


Hashemi H.M.,Tehran University of Medical Sciences
International Journal of Oral and Maxillofacial Surgery | Year: 2010

This prospective cohort study investigates the types and duration of neurosensory disturbances (NDs) related to mandibular nerve (MN) lateralization for placement of implants. From March 2001 to March 2007, 87 patients underwent implant placement surgery with MN lateralization. All patients had panoramic radiograph and CT scans taken preoperatively. Patients completed questionnaires to report NDs 1 week after surgery, and at the end of each month within the year after surgery. All 87 patients (110 posterior segments, 23 bilateral and 64 unilateral) participated in the study. All patients reported NDs in the first week: anaesthesia in 81 sites, hypoesthesia in nine sites, burning in nine sites, pain in eight sites, pinching in two sites, and tickling in one site. The sites with NDs decreased to 29 sites (26%) at the end of first month, and to three sites (3%) at the end of the sixth month with no changes to the end of the year. 82 patients were satisfied with the result of nerve lateralization after 1 year. The mean time for full recovery of MN was 37 ± 15 days. These findings indicate that concerning NDs, MN lateralization is a useful method for placing implants in the atrophic posterior mandible. © 2010 International Association of Oral and Maxillofacial Surgeons.


Dehkordy S.F.,Tehran University of Medical Sciences
Journal of clinical immunology | Year: 2012

Primary immunodeficiency diseases (PID) are a heterogeneous group of inherited disorders of the immune system, predisposing individuals to recurrent infections, allergy, autoimmunity, and malignancies. A considerable number of these conditions have been found to be also associated with neurologic signs and symptoms. These manifestations are considered core features of some immunodeficiency syndromes, such as ataxia-telangiectasia and purine nucleoside phosphorylase deficiency, or occur less prominently in some others. Diverse pathological mechanisms including defective responses to DNA damage, metabolic errors, and autoimmune phenomena have been associated with neurologic abnormalities; however, several issues remain to be elucidated. Greater awareness of these associated features and gaining a better understanding of the contributing mechanisms will lead to prompt diagnosis and treatment and possibly development of novel preventive and therapeutic strategies. In this review, we aim to provide a brief description of the clinical and genetic characteristics of PID associated with neurologic complications.


Sedaghat S.,Tehran University of Medical Sciences
Applied Immunohistochemistry and Molecular Morphology | Year: 2016

BACKGROUND:: Treatment failure, recurrence, and metastasis in bladder cancer are attributed to a subset of tumor cells expressing cancer stem cell (CSC) markers. This study aimed to explore the expression levels and the clinical significance of putative CSC markers OCT4 and CD133 in bladder cancer. MATERIALS AND METHODS:: Tissue microarray-based immunohistochemical analysis was applied to investigate the expression patterns of potential CSC markers OCT4 and CD133 in bladder cancer samples. The correlation between the expressions of each marker and clinicopathologic parameters was then analyzed. RESULTS:: There was a significant association between OCT4 expression and the TNM stage of bladder cancer (P<0.001). Our analysis demonstrated a significant association between the intensity of staining and the presence of lamina propria and muscularis propria invasion (P=0.02 and 0.02, respectively), whereas a relative inverse correlation was found between CD133 expression with lamina propria invasion (P=0.051) and muscularis propria invasion (P=0.07). CONCLUSIONS:: The correlation of OCT4, but not CD133, with the invasiveness of bladder cancer revealed that OCT4 can be considered as a key regulator of tumor progression, aggressive behavior, and metastasis; therefore, OCT4 can be a potential marker for targeted therapy of bladder cancer. Copyright 2016 Wolters Kluwer Health, Inc. All rights reserved.


Bajoghli H.,Tehran University of Medical Sciences | Alipouri A.,Islamic Azad University at Tonekabon | Holsboer-Trachsler E.,University of Basel | Brand S.,University of Basel
Journal of Adolescence | Year: 2013

Sleep and well-being of adolescents and their parents are related, but data from non-Western countries are scarce. The aim of the present study was to investigate the relationship between adolescents' and their parents' sleep patterns and psychological functioning in northeastern Iran. A total of 81 families (81 mothers, 78 fathers, 130 children aged 12-20 years) took part in the study. They individually and separately completed questionnaires related to sleep and psychological functioning. Sleep quality was related within families. Poor sleep among children and parents was related in each case to more depressive symptoms and stress. Mothers' sleep and psychological functioning were more related to adolescent children's sleep and psychological functioning than were those of fathers. Results confirm research showing that adolescent's and parents' sleep and psychological functioning are inter-related. This association holds also true for families in northeastern Iran, suggesting that the association reflects universal features of family functioning. © 2013 The Foundation for Professionals in Services for Adolescents.


Parkin B.L.,University College London | Ekhtiari H.,Iranian Institute for Cognitive science Studies and 18 Pezeshkpour Alley | Ekhtiari H.,Tehran University of Medical Sciences | Walsh V.F.,University College London
Neuron | Year: 2015

The use of non-invasive brain stimulation is widespread in studies of human cognitive neuroscience. This has led to some genuine advances in understanding perception and cognition, and has raised some hopes of applying the knowledge in clinical contexts. There are now several forms of stimulation, the ability to combine these with other methods, and ethical questions that are special to brain stimulation. In this Primer, we aim to give the users of these methods a starting point and perspective from which to view the key questions and usefulness of the different forms of non-invasive brain stimulation. We have done so by taking a critical view of recent highlights in the literature, selected case studies to illustrate the elements necessary and sufficient for good experiments, and pointed to questions and findings that can only be addressed using interference methods. © 2015 Elsevier Inc.


Resalat S.N.,University of Tehran | Saba V.,Tehran University of Medical Sciences
Signal, Image and Video Processing | Year: 2015

A novel steady state visual evoked potential (SSVEP)-based BCI system for driver’s sleepiness monitoring is proposed. Detecting the driver’s concentration is one of the most challenging assignments for researchers in these decades. A continuous attention and awareness is necessary to drive safely. Otherwise, one tragedy of drowsy driving would probably happen. Therefore, real-time sleepiness detection can restrain accidents effectively. In this study, SSVEPs are used for running the proposed system and two experimental setups consisting four single and paired light-emitting diodes (LEDs) using two different fast Fourier transform-based feature extraction methods, and three different classifiers of the linear discriminant analysis, the support vector machine (SVM) and the Max ones on the accuracy of the system are studied. For real-time application, related features are extracted from four different sweep lengths (temporal durations) of 0.5, 1, 2, and 3 s. The experimental results show that higher sweeps have higher accuracies and the SVM classifier, experimental setup of 4-paired LEDs in sweep length of 3 s has the highest accuracy of 98.2 %, while with the comparable information transfer rate (ITR) value of 24 bits/min within the sweep length of 1 s, this time is considered as the best response time. Therefore, this study demonstrates the feasibility of the proposed system in a practical driving application. © 2015, Springer-Verlag London.


Bahrami Z.,University of Tehran | Badiei A.,University of Tehran | Atyabi F.,Tehran University of Medical Sciences
Chemical Engineering Research and Design | Year: 2014

•SBA-15 nanorods and their functionalized samples were synthesized.•These materials used as nanocarriers for anticancer drug delivery.•Surface functionalization increases the loading amount of the drug.•The samples with NH2 groups on their surfaces show pH dependent release behavior. SBA-15 nanorods with high surface area (1010m2g-1) were functionalized by post grafting method with three different alkoxysilanes including (3-aminopropyl) triethoxysilane (APTES), 3-[bis(2-hydroxyethyl)amino] propyl triethoxysilane (HAPS) and 3-[2-(2-aminoethylamino) ethylamino] propyl trimethoxysilane (AEPS). The prepared materials were used as nanocarriers for an anticancer drug (gemcitabine). The obtained samples were characterized by SAXS, elemental analysis, TGA, N2 adsorption/desorption, SEM, TEM, FTIR and UV spectroscopies. The adsorption and release properties of all samples were investigated. It was found that the surface functionalization increases the interaction between the carrier and gemcitabine and results in the loading enhancement of the drug. In addition, the adsorption of gemcitabine on the modified mesoporous matrix depends on the type and the amount of alkoxysilanes groups. The maximum content of the deposited drug in the modified SBA-15 nanorods is close to 22wt.%. The rate of the drug release from the modified samples containing NH2 groups on their surfaces is pH dependent. © 2013 The Institution of Chemical Engineers.


Amini M.,Tehran University of Medical Sciences
Tropical gastroenterology : official journal of the Digestive Diseases Foundation | Year: 2010

The association of Helicobacterpylori with peptic ulcer disease, atrophic gastritis, gastric adenocarcinoma, MALT (mucosa associated lymphoid tissue) lymphoma is well recognized. This study was conducted to see whether there was any relation between H. pylori eradication and reflux esophagitis in Iran. Eligible dyspeptic patients referred to Gastroenterology clinic in Baqiyatollah hospital were endoscopied and evaluated for endoscopic and pathologic esophagitis and the H. pylori infection status was determined by rapid urease test. H. pylori infection was treated by an anti H. pylori drug regimen and successfully eradicated patients according to negative C14 urea breath test were followed and re-endoscopy was performed 6-9 months after the end of treatment. From 175 eligible patients, 54% were H. pylori positive, 68 of them (72%) had successful H.P. eradication and 64 patients completed the follow-up. The rate of histopathologic inflammatory esophagitis was higher in second endoscopy, compared with that of first endoscopy, i.e., before H. pylori eradication (75% vs 40.6%) (p < 0.05). Progression of pathological esophagitis was seen in 56.3% of patients between the two endoscopic evaluations in spite of no change in clinical and endoscopic findings. There were no significant differences in dietary and smoking habits and body weights on re-endoscopy session compared with that of the first endoscopy visit (p > 0.05). This study suggests that H. pylori eradication in dyspeptic patients may lead to increased frequency of histopathological esophagitis. Hence, In patients presenting with symptoms of dyspepsia, a cautious approach should be exercised if H. pylori eradication is being contemplated.


Kashani Farid M.A.,Tehran University of Medical Sciences
Lipids in health and disease | Year: 2010

Low level of high density lipoprotein cholesterol (HDL-C) has high prevalence in the Tehran Lipid and Glucose Study (TLGS) cohort. About 50% of the inter-individual variation in serum HDL-C levels is genetically determined. Polymorphisms in cholesteryl ester transfer protein (CETP) and hepatic lipase (LIPC) genes have been found to be associated with the metabolism and serum concentration of the HDL-C. To determine the association between Taq1B polymorphism in CETP gene and -514C/T polymorphism in LIPC gene with serum lipid levels and lipid peroxidation in a subgroup of the TLGS population. Serum HDL-C level had significant association with CETP Taq1B polymorphism and B2B2 subjects had the highest HDL-C levels compared to B2B1 and B1B1 genotypes (37.9 vs. 36.9 and 35.3 mg/dl, respectively; P = 0.01). However, carriers of "B1" allele, in comparison to the non carriers (B2B2), had significantly lower levels of TC (200.1 vs. 215.2 mg/dl; P = 0.005), HDL-C (35.8 vs. 37.9 mg/dl; P = 0.009) and malondialdehyde MDA (4.5 vs. 5.0 nmol/mL; P=0.031). Carriers of the "T" allele in -514C/T polymorphism in LIPC gene had higher means of HDL-C than non carriers (37.7 vs. 35.7 mg/dl, P = 0.04). No other association was found between -514C/T polymorphism and any other serum lipids or MDA level. This study demonstrates the association between Taq1B and -514C/T polymorphisms in the CETP and LIPC genes with the serum HDL-C levels.


Naroienejad M.,Tehran University of Medical Sciences
Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia | Year: 2010

To determine prevalence of central vein stenosis following catheterization with double-lumen temporary catheters, we performed color Doppler sonography in 100 consecutive patients. We detected central vein stenosis in 18 cases; 11 patients in subclavian vein (SCV), 4 patients in internal jugular vein (IJV) and SCV, 2 patients in SCV and brachiocephalic vein, and 2 patients in IJV stenosis. There were statistical difference between groups with and without stenosis regarding time from discontinuation of catheters and use of aspirin (ASA). We could not find any statistical difference between these two groups regarding age, sex, duration of having chronic kidney disease (CKD), and duration of catheter remaining in place. We also found that there was a high proportion of stenosis in patients who still had catheter in their veins (15 from 44 patients, 34%) in comparison with patients who had already the catheters removed from their veins (3 from 56 patients, 5%). We conclude that stenosis of central veins can result from long indwelling time of central catheter used for hemodialysis. Aspirin may have a protective role against stenosis.


Kazerooni A.F.,Tehran University of Medical Sciences
Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Conference | Year: 2011

The gradient vector flow (GVF) algorithm has been used extensively as an efficient method for medical image segmentation. This algorithm suffers from poor robustness against noise as well as lack of convergence in small scale details and concavities. As a cure to this problem, in this paper the idea of multi scale is applied to the traditional GVF algorithm for segmentation of brain tumors in MRI images. Using this idea, the active contour is evolved with respect to scaled edge maps in a multi scale manner. The edge detection performance of the modified GVF algorithm is further enhanced by applying a threshold-based edge detector to improve the edge map. The Bspline snake is selected for representation of the active contour, due to its ability to capture corners and its local control. The results showed an improvement of 30% in the accuracy of tumor segmentation against traditional GVF and 10 % as compared to Bspline GVF in the presence of noise, besides the repeatability of the algorithm in contrast to traditional GVF. The clinical evaluation also proved the accuracy and sensitivity of the proposed method as 92.8% and 95.4%, respectively.


Beyranvand M.,Tehran University of Medical Sciences
Journal of injury & violence research | Year: 2014

Hip fracture is the most serious complication of osteoporosis and imposes a significant financial burden on countries' economy. This study aimed to assess the hospitalization costs and length of stay associated with osteoporosis hip fractures and identify the major cost components in a referral hospital in Kermanshah city, Iran. In a prospective study, from May 21 2007 to May 21 2008, all patients with osteoporotic hip fracture admitted to a referral hospital for operation were recruited as the study sample. For each patient, information such as age, gender, length of stay (LOS) in hospital and intensive care unit (ICU), medical and diagnostic procedures and cost of surgery and implant were collected both through interview with the patient or a family member and the patients' hospital records. A total of 103 patients (56 men and 47 women) were studied. The average hospital length of stay (LOS) for the patients was 9.7 days, ranging from 5 to 38 days. The average total hospitalization costs was 7,208,588 IRR (US$774). The main components of the costs were ward stay (16.3%), operative (54.6%), implant (26%) and medical and diagnostic procedures (3.1%). The results of this study demonstrate that the hospital resource burden associated with osteoporotic hip fractures in Iran is substantial and expected to rise with the projected increase of life expectancy and the number of elderly in Iran. Estimating the economic burden of osteoporotic hip fractures provide information that can be of importance in the planning and design of preventive strategies. © 2014 KUMS, All rights reserved.


Fadaei A.M.,Shahrekord University of Medical Sciences | Dehghani M.H.,Tehran University of Medical Sciences
Research Journal of Chemistry and Environment | Year: 2012

In recent years, the application of heteroge-neous photocatalytic water treatment processses has gained wide attention due to its effectiveness in degrading and mineralizing the pesticides. These pesticides are often found in many surface and groundwater sources and their concentration levels often exceed the drinking water permissible limits recommended by Iran and European drinking water standards. The aim of the present study was to investigate the influence of various parameters such as initial malathion and diazinon concentration catalyst amount, initial pH of the reaction medium and pesticide types on the photocatalytic decomposition of pesticides in the presence of ZnO using an ultraviolet lamp as the light source. The best conditions for the photocatalytic degradation of pesticides were obtained. Results showed that the optimal concentration of catalyst was found to be 100 mg. L -1. The photodegradation efficiency of pesticides increases with the increase of the illumination time. The photodegradation rate of pesticides was higher in alkaline than in acidic conditions. The photocatalytic degradation rate of the malathion was more than diazinon. The photodegradation efficiency decreases with the increase in the initial concentration of pesticides. The photocatalytic system afforded the highest removed percentage at initial concentration for diazinon and malatlion were 100 and 200 mg.L -1 respectively.


Mahmoudi M.,Pasteur Institute of Iran | Mahmoudi M.,Tehran University of Medical Sciences | Azadmanesh K.,Pasteur Institute of Iran | Shokrgozar M.A.,Pasteur Institute of Iran | And 3 more authors.
Chemical Reviews | Year: 2011

A scientific review presents a broad overview of the effect of nanoparticles on the cell life cycle and their corresponding phase arresting the existing data. A comprehensive description of the available assays for probing the effect of nanoparticles on the cell life cycle is also presented. The cell cycle corresponds to a series of events which lead the cell to its division and duplication. The cell cycle can be divided into two brief periods in eukaryotes, such as the interphase during which the cell grows and accumulates nutrients needed for mitosis and DNA replication and the mitosis phase in which the cell splits itself into two distinct daughter cells. The mitosis phase corresponds to the actual cell division and requires significant amounts of energy. The final division is called cytokinesis after which the two daughter cells produced restart the cell cycle.


Alinia S.,Tehran University of Medical Sciences
Journal of injury & violence research | Year: 2013

Fireworks are commonly used in local and national celebrations. The aim of this study is to explore the extent, nature and hospital costs of injuries related to the Persian Wednesday Eve festival in Iran. Data for injuries caused by fireworks during the 2009 Persian Wednesday Eve festival were collected from the national Ministry of Health database. Injuries were divided into nine groups and the average and total hospital costs were estimated for each group. The cost of care for patients with burns was estimated by reviewing a sample of 100 patients randomly selected from a large burn center in Tehran. Other costs were estimated by conducting semi structured interviews with expert managers at two large government hospitals. 1817 people were injured by fireworks during the 2009 Wednesday Eve festival. The most frequently injured sites were the hand (43.3%), eye (24.5%) and face (13.2%), and the most common types of injury were burns (39.9%), contusions/abrasions (24.6%) and lacerations (12.7%). The mean length of hospital stay was 8.15 days for patients with burns, 10.7 days for those with amputations, and 3 days for those with other types of injury. The total hospital cost of injuries was US$ 284 000 and the average cost per injury was US$ 156. The total hospital cost of patients with amputations was US$ 48 598. Most of the costs were related to burns (56.6%) followed by amputations (12.2%). Injuries related to the Persian Wednesday Eve festival are common and lead to extensive morbidity and medical costs. © 2013 KUMS, All rights reserved.


Abdollahi M.,Tehran University of Medical Sciences
European Science Editing | Year: 2011

Scientists have the skills to write and structure their papers but frequently need support of other professionals to edit and publicize their works. Nowadays, scientific papers are evaluated on the basis of their "impact", and a journal's quality is dependent on high quality publications. In Iran, two options are available for scientific journals to overcome the issue of growing editing and publishing costs: to involve leading regional and global publishers in the publishing process and to establish outlets for these publishing agencies. The problem is not just Iranian but affects many other developed and developing countries and is becoming a big issue in times of global financial crisis.


Nabatchian F.,Tehran University of Medical Sciences | Vaisi-Raygani A.,Kermanshah University of Medical Sciences
Analytical Biochemistry | Year: 2013

The Bradford protein assay is a popular method because of its rapidity, sensitivity, and relative specificity. This method is subject to some interference by nonprotein compounds. In this study, we describe the interference of cetyltrimethylammonium bromide (CTAB) with the Bradford assay. This interference is based on the interaction of Coomassie Brilliant Blue G-250 (CBB) with this cationic detergent. This study suggests that both electrostatic and hydrophobic interactions are involved in the interaction of CTAB and CBB. The anionic and neutral forms of CBB bind to CTAB by electrostatic attraction, which accelerates hydrophobic interactions of these CBB forms and the hydrophobic tail of CTAB. Consequently, the hydrophobic regions of the dominant free cationic form of CBB dye compete for the tail of CTAB with two other forms of the dye and gradually displace the primary hydrophobic interactions and rearrange the primary CBB-CTAB complex. This interaction of CTAB and CBB dye produces a primary 650-nm-absorbing complex that then gradually rearranges to a complex that shows an absorbance shoulder at 800-950 nm. This study conclusively shows a strong response of CBB to CTAB that causes a time-dependent and nearly additive interference with the Bradford assay. This study also may promote an application of CBB for CTAB quantification. © 2012 Elsevier Inc. All rights reserved.


Kajbaf T.Z.,Golestan University of Medical Sciences | Asar S.,Golestan University of Medical Sciences | Alipoor M.R.,Tehran University of Medical Sciences
Italian Journal of Pediatrics | Year: 2011

Background: Obesity has been identified as a risk factor for higher prevalence of asthma and asthma-related symptoms in children. The objective of this study was to evaluate the relationship between the prevalence of asthma symptoms and obesity among school-age children in the city of Ahvaz, Iran. Methods. A total of 903 children, 7 to 11 years of age, were enrolled in this study through cluster sampling. The International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was used to identify the children who were currently suffering from asthma. Height and weight were measured and body mass index (BMI) was calculated in kg/m 2. Overweight was defined as BMI greater than the age- and sex-specific 85th percentile, and obesity as BMI greater than the 95th percentile. We determined the relationship between obesity and asthma symptoms by chi-square tests. Results: The prevalence of wheeze ever, current wheezing, obesity, and overweight was 21.56%, 8.7%, 6.87%, and 9.5%, respectively. The current prevalence of wheezing among obese and overweight children was 68.75% and 37%, respectively, and there was a statistical association between obesity and the prevalence of current wheezing (p < 0.001), night cough (p < 0.001), and exercise-induced wheezing (p = 0.009), but obesity and overweight were not associated with eczema and allergic rhinoconjunctivitis, so it seems that the pathophysiology of asthma in obese and overweight children is not related to allergy. Conclusion: There is a strong association between asthma symptoms and both overweight and obesity in both sexes among school-age children. © 2011 Kajbaf et al; licensee BioMed Central Ltd.


Zeraatkar N.,Tehran University of Medical Sciences
Iranian Journal of Nuclear Medicine | Year: 2013

Introduction: Nowadays, science mapping is considered an excellent technique for decision-makers to find solutions for problems in research planning and development. In this work, we aimed to depict a science map of "radiology, nuclear medicine, and medical imaging" in Iran. Methods: All publications indexed in Thomson Reuters Web of Science database in the fields mentioned above with at least one affiliation corresponding to "Iran" were included in the study. "Visualization of similarities" (VOS) viewer software was then utilized to analyze the data for generating density maps and density cluster maps of organizations, authors, and journals based on bibliographic coupling and co-citation similarity measures. Results: Various maps were then formed and discussed. Tehran University of Medical Sciences in all fields of radiology, nuclear medicine, and medical imaging was proved to be the dominant organization in the country. Conclusion: Applying VOSviewer software, data was analyzed for extracting bibliographic coupling and co-citation relations and theirs corresponding science maps in terms of affiliated organizations, authors, and publishing journals. More comprehensive studies can be performed to obtain more mature science maps. Performing such analyses for other countries and then comparing with the internal science maps can be useful for decision-makers.


Jazayeri S.M.,Tehran University of Medical Sciences | Alavian S.M.,Baqiyatallah Medical Sciences University | Carman W.F.,West of Scotland Specialist Virology Center
Journal of Viral Hepatitis | Year: 2010

The pathogenesis of hepatitis B virus (HBV) is complex and it appears that molecular variants play a role in this process. HBV undergoes numerous rounds of error prone production within an infected host. The resulting quasispecies are heterogeneous and in the absence of archaeological records of past infection, the evolution of HBV can only be inferred indirectly from its epidemiology and by genetic analysis. This review gathered the controversies about the HBV origin and factors influencing its quasispecies. Also, it provided some evidence on how HBV genotypes correlated with human history and patterns of migration. It is our belief that this topic deserves further attention and thus it is likely that more critical research work will be performed to elucidate the unknown mechanisms and processes in this area. © 2009 Blackwell Publishing Ltd.


Saber M.M.,Tarbiat Modares University | Boroumand M.,Tehran University of Medical Sciences | Behmanesh M.,Tarbiat Modares University
Thrombosis Research | Year: 2014

CytochromeP4502C19 is a genetically polymorphic gene with prominent role in drug metabolism. Regarding its critical medical importance, this study was conducted to achieve accurate CYP2C19allele frequencies in Iranian population and hereby paving the way for a tailor-made CYP2C19 DNA test. Iran is a large multi-ethnic country, however, its population structure for CYP2C19 alleles is calculated as nearly zero (Fwc (st) = 0.001). The Study was conducted on 691 individuals in Tehran, the conurbation in which total population structure is significantly eroded by massive immigration and DNA was analyzed by TaqMan SNP genotyping assay. A cumulative meta-analysis was then conducted to achieve less than five percent variation range in allele frequencies with 99.9% confidence level. High degree of Hardy-Weinberg equilibrium in pooled data proved the authenticity of meta-analysis. By cumulative meta-analysis the average frequencies of CYP2C19*2 and CYP2C19*3 alleles were calculated as 0.125[99.9% CI, 0.112-0.139] and 0.006[99.9% CI, 0.004-0.009], respectively. According to the solid frequency data obtained by pooling the data and meta-analysis and comparing with other ethnicities, Iranian population's CYP2C19 allele frequencies completely differ from other Asian ethnicities and matches African and European ethnicities the most. Since this is the biggest CYP2C19 allele frequency study in the Middle East, the results of this study will also be useful in cross-population and regional CYP2C19 genetic variation studies. © 2013 Elsevier Ltd © 2013 Published by Elsevier Ltd.


Izadyar S.,Tehran University of Medical Sciences
Clinical nuclear medicine | Year: 2011

A 33-year-old man with Glanzmann thrombasthenia, enduring retractable melena, and with an active upper gastrointestinal bleeding (GIB) of unknown origin lasting intermittently for 6 months, was admitted. Abdominal ultrasound and computed tomography were not diagnostic. The patient underwent upper gastrointestinal endoscopy twice, both of which showed blood issuing forth from ampulla of vater and possible diagnoses of bleeding from papilla/hematobilia or hemosuccus pancreaticus were suspected. Digital subtraction angiography of celiac/superior mesenteric arteries was unremarkable. In GIB scintigraphy, a focus of activity appeared in the epigastric area early in the study (arrow), intensity of which increased gradually. Exploratory laparatomy confirmed the diagnosis of hemosuccus pancreaticus. Although the patient was doing well for few weeks after the surgery, he died 3 months later after an acute episode of severe GIB.


Karrari P.,Birjand University | Mehrpour O.,Birjand University | Abdollahi M.,Tehran University of Medical Sciences
DARU, Journal of Pharmaceutical Sciences | Year: 2012

Lead is an old environmental metal which is presented everywhere and lead poisoning is an important health issue in many countries in the world including Iran. It is known as a silent environmental disease which can have life-long adverse health effects. In children, the most vulnerable population, mental development of children health effects is of the greatest influence. Low level lead exposure can significantly induce motor dysfunctions and cognitive impairment in children. The sources of lead exposure vary among countries. Occupational lead exposure is an important health issue in Iran and mine workers, employees of paint factories, workers of copying centers, drivers, and tile making factories are in higher risk of lead toxicity. Moreover lead processing industry has always been a major of concern which affects surface water, drinking waters, and ground waters, even water of Caspian Sea, Persian Gulf and rivers due to increasing the number of industries in vicinity of rivers that release their waste discharges into river or sea. In addition, lead contamination of soil and air especially in vicinity of polluted and industrialized cities is another health problem in Iran. Even foods such as rice and fishes, raw milk, and vegetables which are the most common food of Iranian population are polluted to lead in some area of Iran. Adding lead to the opium is a recently health hazard in Iran that has been observed among opium addicts. There are few studies evaluated current status of lead exposure and toxicity in the Iranian children and pregnant women which should be taken into account of authorities. We recommend to identify sources, eliminate or control sources, and monitor environmental exposures and hazards to prevent lead poisoning. © 2012 Karrari et al.; licensee BioMed Central Ltd.


Soudbakhsh A.,Tehran University of Medical Sciences
Acta medica Iranica | Year: 2011

We report a rare case of brucellosis presenting with pleural and pericardial effusions in a 35 year-old male rancher in Iran with fever and dyspnea. Such findings should prompt inclusion of brucellosis in the differential diagnosis in endemic areas.


Ebrahimi M.,Tehran University of Medical Sciences | Asbagh F.A.,Bushehr University of Medical Sciences
International Journal of Fertility and Sterility | Year: 2011

Premature ovarian failure (POF) affects 1% of young women. This condition has significant psychological sequelae and major health implications. POF seriously interferes with fertility and family planning. Diverse etiologies are associated with POF. Literature review related to the causes and pathogenesis of POF, cited between the year 1900 and May 2010. POF may be either spontaneous or induced. The known causes include: - Genetic disorders, which could involve the X chromosome or autosomes. However, the growing body of literature demonstrates a list of newly discovered mutations that may be responsible for causing POF. Most of these mutations are extremely rare, and most cases of POF are still considered to be idiopathic. - Autoimmune causes; there is some evidence of an association of POF with lymphocytic oophoritis and other autoimmune disorders. Antiovarian antibodies are reported in POF, but their specificity and pathogenic role are obscure. - Iatrogenic causes; chemotherapy, radiotherapy and pelvic surgery can lead to POF. - Infectious Causes; some viral and microbial infections can be followed by POF. - Environmental toxins, such as cigarette smoking are reported as risk factors of spontaneous POF. - Idiopathic; in most cases, no identifiable etiology can be recognized after complete evaluation.


Koosha F.,Tehran University of Medical Sciences
IFMBE Proceedings | Year: 2015

The passage of ionizing radiation in living cells creates clusters of damaged nucleotides in DNA. In this study, DNA strand breaks induced by the beta particle of iodine-131 (I-131), have been determined experimentally and compared to Monte Carlo simulation results as a theoretical method of determining131I damage. For conducting this experimental study, Glioblastoma (GBM) cells were exposed to 10 mCi I-131, at a dose of 2 Gy, in order create single strand breaks (SSB) and double strand breaks (DSB) in the DNA of irradiated cells. Cells were evaluated quantitatively by the Fast Micromethod assay. The energy spectrum of electrons released in cells were obtained by the macroscopic Monte Carlo code (MCNP4c) and used as an input of the micro Monte Carlo code (MCDS). The percent of damage induced in cells was calculated by Man vitny test. A significant reduction (p<0.05) in fluorescence intensity in irradiated cells compared to control cells as determined by the Fast Micro method assay represented induced SSB and DSB damages in the DNA of irradiated cells. By comparing the experimental and theoretical results, the difference between the percent of SSB per Gy was about 7.4% and DSB was about 1% per Gy. The differences in experimental and theoretical results may be due to the algorithm of applied codes. Since the Fast Micromethod and other experimental techniques do not provide information about the amount of detailed and complex damages of DNA-like base damages, the applied Monte Carlo codes, due to their capability to predict the amount of detailed damages that occur in the DNA of irradiated cells, can be used in in vitro experiments and radiation protection areas. © Springer International Publishing Switzerland 2015.


Ghods A.J.,Tehran University of Medical Sciences
Experimental and Clinical Transplantation | Year: 2014

The first kidney transplant in Iran was performed in 1967, and this was the first organ transplant in countries that are current members of the Middle East Society for Organ Transplantation. In 1988, in response to the long waiting list at the Iranian Ministry of Health for kidney transplant, a stateregulated living-unrelated donor kidney transplant program was adopted. By 1999, the kidney transplant waiting list in Iran was eliminated. In 1989, a fatwa (religious approval) from the Supreme Religious Leader was obtained that recognized brain death and allowed deceaseddonor organ transplant. Subsequently, transplant centers began performing deceased-donor kidney, liver, and heart transplants. In 2000, the Brain Death and Organ Transplantation Act was passed by the Iranian parliament, legalizing deceaseddonor organ transplant. The transplant team at Shiraz began performing more deceased-donor kidney and liver transplants and became a successful deceased-donor organ transplant model in the country. By the end of 2012, there were 34166 kidney (including 4436 deceased-donor) and 2021 liver (including 1788 deceased-donor), 482 heart, 147 pancreas, 63 lung, and several intestine and multiorgan transplants performed in Iran. In 2011, there were 2771 solid-organ transplants performed in Iran (37 transplants per million population), and Iran ranked as number 33 among the 50 most active countries worldwide. In 2011 and 2012, Iran was ahead of all country members of the Middle East Society for Organ Transplantation in performing deceased-donor kidney and liver transplants. © Baskent University 2014 Printed in Turkey. All Rights Reserved.


Rouchi A.H.,Ministry of Health and Medical Education | Ghaemi F.,Ministry of Health and Medical Education | Aghighi M.,Tehran University of Medical Sciences
Iranian Journal of Kidney Diseases | Year: 2014

Organ transplantation as an undeniable life-saving therapeutic modality fundamentally requires infrastructure, devoted and trained professionals, and positive public attitude to be set up in a well-organized manner at the national level. In addition to sharing achievements and reviewing the increasing trend of transplanted organs in the past 12 years following legislations in Iran, this report raises some concerns from the point of transplantation outcome view.


Panahi N.,Islamic Azad University at Tehran | Mahmoudian M.,Tehran University of Medical Sciences | Mortazavi P.,Islamic Azad University at Tehran | Hashjin G.S.,University of Tehran
Archives of Medical Science | Year: 2013

Introduction: Relevant aspects of Alzheimer's disease (AD) can be modeled by aluminium-maltolate injection into specific regions of the brain. The possible role of berberine chloride (BC) as an anti-inflammatory agent in the brain has been previously addressed. Material and methods: Rabbits were divided into control (C), untreated lesion (L) and BC-treated + lesion (L + BC) groups. Animals in L + BC received BC (50 mg/ kg) orally 1 day after surgery and daily for 2 weeks. The lesion was induced by injection of 100 μu of either vehicle or water containing 25 mM aluminium-maltol into intraventricular fissure. Weight loss, ataxia, paralysis and tremor were monitored. For histopathology, Bielschowsky silver and H&E staining were employed. β-Secretase activity in hippocampus was finally assessed. Results: All L animals died on days 12-15 after lesion. Seven to 10 days after lesion, abnormal symptoms as well as cachexia were seen in over 90% of cases. L rabbits lost an average of 0.5 kg which was significant on days 10 and 12 (p < 0.05); this was not completely prevented by BC. Up to day 15, all L animals had lost their lives (p < 0.001). BC treatment protected the hippocampus from degeneration, altered the behavior and decreased the activity of β-site amyloid precursor protein cleaving enzyme-1 (BACE-1). Conclusions: Considering the findings in regard to physiological abilities, histological changes and BACE-1 activity in hippocampus changes, it is concluded that BC treatment could be an effective therapy in restoring Al maltol-induced behavioral derangements in the rabbit model of AD. © 2013 Termedia & Banach.


Bastani P.,Tehran University of Medical Sciences | Kiadaliri A.A.,Lund University
International Journal of Technology Assessment in Health Care | Year: 2012

Objectives: The aim of this study was to evaluate the cost-utility of Docetaxel with doxorubicin and cyclophosphamide (TAC) and 5-fluorouracil, doxorubicin, cyclophosphamide (FAC) in node-positive breast cancer patients in the south of Iran. Methods: A double blind study was done on a cohort of 100 patients suffering from breast cancer with node-positive over 8 months in the radiotherapy center of Namazi hospital, Shiraz-Iran. Health-related quality of life was assessed using questionnaire (QLQ-C30) from European Organization for Research and Treatment of Cancer (EORTC). QLQ-C30 scale scores were mapped to 15D and EuroQol 5D utilities to measure the quality-adjusted life-years (QALYs).Third party payer point of view was applied to measure and value the cost of treatments. Cost data were extracted from hospital and health insurance organizations. Robustness of the results was checked through a two way sensitivity analysis. Results: TAC was associated with higher deterioration in HRQoL during treatment and higher improvements over 4 months follow-up. On average, the cost of treatment per patient in TAC was 15 times higher than FAC (p <.001). In overall, TAC was resulted in lower QALYs and higher cost over study period. Conclusions: FAC was a dominant option versus TAC in short-term. The higher improvement in HRQoL over follow-up in TAC may not compensate the more intensive deterioration caused during treatment in short-term. The short time horizon of study may limit the generalizability of our findings and, hence, there is a need to conduct long-term economic evaluation studies whenever data is available to inform decision making. © 2012 Cambridge University Press.


Kamangar F.,Morgan State University | Kamangar F.,Tehran University of Medical Sciences
Archives of Iranian Medicine | Year: 2012

Effect modification, also known as interaction or heterogeneity of effect, is an important concept in epidemiology. This article reviews the definition and types of effect modification, methods to detect effect modification, the reasons for observing effect modification in epidemiologic studies, the importance of choice of model in finding effect modifiers, and effect modifications that are important to public health.


Peeri M.,Islamic Azad University at Tehran | Amiri S.,Tehran University of Medical Sciences
Medical Hypotheses | Year: 2015

While beneficial properties of physical activity and exercise on human health have been extensively reported in literature, the exact mechanism(s) underpinning impacts of exercise are not well understood. Focusing on metabolic disorders, as the main causes of social and economic burden in current century, exercise exhibited promising effects in prevention, alleviation and retardation of these disorders including, type 2 diabetes (T2D), Alzheimer's disease (AD), major depressive disorder (MDD) and obesity. Recent evidence has unmasked the role of mitochondrial dysfunction and chronic inflammation in pathophysiology of these disorders. Despite of the wealth of research on the etiology of metabolic disorders, intimate connections between these diseases, complex pathophysiology and their comorbidity still remains a challenging dilemma. In addition, although physical activity has improving effects on human health, it is not clear that how exercise is able to exert its modulatory effects on outcomes of metabolic disorders. Among several mechanisms, we assumed the hypothesis that exercise mitigates the production of mitochondrial-induced reactive oxygen species (ROS) and danger associated molecular patterns (DAMPs) as the main triggering factors for inflammasome formation. Since inflammasomes are of highly deleterious molecules relevant to pathogenesis of metabolic disorders, we hypothesized that beneficial effects of exercise may be associated with its ability to enhance the mitochondrial biogenesis and glucose transportation through generation of brain derived neurotrophic factor (BDNF). Also, we proposed that boosting impact of exercise on autophagy process accelerates the elimination of damaged mitochondria and thus, results in considerable decrease in production of ROS and DAMPs and consequently sterile inflammation. © 2015 Elsevier Ltd.


Chronic Obstructive Pulmonary Disease (COPD) is a common disease that tends to occur worldwide and is a common cause of respiratory failure requiring mechanical ventilation and admission to the intensive care unit (ICU). The present study was carried out to investigate the efficacy of sildenafil in facilitating the weaning of COPD patients from the ventilator. This randomized double blind clinical trial study was carried out with 40 patients suffering from COPD. The patients were divided in two study groups. 20 patients belonging to Group I received 20 mg sildenafil tablets twice a day for one week while 20 patients of the second group (Group II) received placebo tablets with the same dosage. Respiratory parameters like rapid shallow breathing index (RSBI), mixed venous oxygen pressure (PvO2) and plateau pressure were measured in both groups. Data were analyzed on the basis of student's t-test and Chi2 test using SPSS 16 software. The results are expressed as mean +/- SE and P < 0.05 is considered statistically significant. According to our findings RSBI was lower in Group I compared with Group II after one week of treatment (P = 0.032). PvO2 value was higher in sildenafil group compared with placebo group (P = 0.025). Plateau pressure was lower in first group than group II (P = 0.022). Sildenafil facilitated weaning of COPD patients from the ventilator by improving the respiratory parameters.


Soleymanian T.,Tehran University of Medical Sciences
Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia | Year: 2011

One of the main causes of protein-energy malnutrition in patients on maintenance hemodialysis (MHD) is metabolic acidosis. The aim of this study was to evaluate the effect of metabolic acidosis on nutritional status in a group of MHD patients with adequately delivered dialysis treatment. Of 165 eligible anuric MHD outpatients with Kt/V ≥ 1 and no underlying inflammatory diseases, 47 subjects were enrolled. In order to evaluate the effect of different parameters on serum albumin, we measured the pre-dialysis serum albumin, blood pH, serum bicarbonate (HCO 3- ), Kt/V, normalized protein catabolic rate (nPCR) and body mass index (BMI) in these patients. The mean age of the study patients was 55 ± 13.8 years; there were 22 females and six diabetics. The average Kt/V was 1.22 ± 0.16, pH was 7.40 ± 0.15, serum HCO 3- was 23.18 ± 2.38 mEq/L, serum albumin was 4.03 ± 0.56 g/dL, nPCR was 1.00 ± 0.16 g/kg/day, post-dialysis body weight was 58.50 ± 11.50 kg and BMI was 23.47 ± 2.70 kg/m 2 . There was a statistically significant direct correlation between serum albumin and BMI (r = 0.415, P = 0.004), and between serum albumin and serum HCO 3 (r = 0.341, P = 0.019). On multiple regression analysis, the predictors of serum albumin were serum HCO3- and BMI (direct effect) and nPCR (inverse effect). In 17 patients on MHD with serum HCO3- <22 mEq/L, there was a significant inverse correlation between HCO 3 and nPCR (r = 0.492, P = 0.045), and these patients had significantly lower serum albumin compared with patients with serum HCO3- >22 mEq/L (P = 0.046). These data demonstrate that patients on MHD with metabolic acidosis had a lower serum albumin concentration despite adequate dialysis treatment. The inverse effect of nPCR on serum albumin concentration in acidotic MHD patients may be due to hypercatabolism in the setting of metabolic acidosis, leading to deleterious effects on the nutritional status of patients on MHD.


Hallaji Z.,Tehran University of Medical Sciences
Skinmed | Year: 2010

A 49-year-old man was first seen in our department for the evaluation of scleroderma-like skin changes and a nonhealing ulcer on his leg from years before referral. His medical history was of long duration. His growth was stunted at the age of 12. At 21 years of age, the patient noted graying of the scalp hair, most prominent on his temples, and the process was progressively completed by the age of 23. At the same age, atrophy and thinning of the skin and loss of subcutaneous fat resulted in a tense, shining, and adherent appearance of his skin, most obvious on his face and extremities. Soon after, he developed a high-pitched, hoarse voice. He had undergone bilateral cataract surgery at the age of 30. Around the age of 46, he developed a unilateral nonhealing chronic leg ulcer (Figure 1). He had separated from his wife because of infertility. He was the first offspring of his second-degree healthy relative parents. The other 3 siblings had similar signs and symptoms. Our patient gave the history of premature graying of the hair of his younger brother at the age of 18 and his 2 younger sisters at the age of 12 and 16. His brother had recently received diagnoses of bilateral cataract and diabetes mellitus. All of the siblings had ceased growth from early adolescence. On physical examination, our patient's weight was 48 kg and his height was 150 cm. He had normal intelligence. He was speaking with a high-pitched and childish voice. He had a bird-like appearance with a beak-shaped nose. Mottled and diffuse pigmentation and poikiloderma appearance was conspicuous on his neck (Figure 2). The entire skin was smooth, shiny, and scleroderma-like, and a marked decrease in the subcutaneous fat was noted over the extremities. A deep cutaneous ulcer was evident on his slimmed leg. Digital ulcers were not found, and radial and dorsalis pedis pulses were palpable. Clinodactyly of the toes were conspicuous. His nails were dystrophic and he had used dentures from the age of 20. On examination of the external genitalia, his testes were smaller than normal. In the biopsy taken from the leg ulcer, there were no signs of malignancy. There were no signs ofosteomyelitis on x-ray. Biopsy of the normal skin revealed atrophic epidermis and thick dermis with hyalinization of the collagen fibers and absence of pilosebaceous structures (Figure 3). The patient's scalp hair was thin and sparse and there were few axillary and pubic hairs. His fasting plasma glucose level was normal.


Dorgalaleh A.,Tehran University of Medical Sciences | Naderi M.,Zahedan University of Medical Sciences | Shamsizadeh M.,Shahroud University of Medical Sciences
Annals of Hematology | Year: 2016

With 473 patients, Iran has about one third of the world’s patients with severe congenital factor XIII (FXIII) deficiency. A considerable number of patients with FXIII deficiency (FXIIID) are affected by life-threatening bleeding episodes, such as central nervous system (CNS) bleeding or recurrent miscarriage and umbilical cord bleeding (UCB), that cause a high rate of morbidity and mortality in Iranian patients with FXIIID. Among 317 Iranian patients with FXIIID, 145 cases experienced 166 CNS bleeds (CNSBs) that recurred in 21 cases. CNSB caused different types of neurological complications in 69 patients. A total of 62 miscarriages were observed in 24 women of childbearing age, and 21 deaths were observed due to umbilical cord bleeding or mucosal bleeding. In fact, 49 deaths (15.4 %) were observed in these patients, which highlight the importance of early diagnosis and intensive health care among patients with FXIIID. © 2015, Springer-Verlag Berlin Heidelberg.


Mahboobi N.,Tehran University of Medical Sciences | Porter S.R.,University College London | Karayiannis P.,Imperial College London | Alavian S.-M.,Baqiyatallah Medical Sciences University
Journal of Gastrointestinal and Liver Diseases | Year: 2013

Background & Aim: Patients chronically infected either with hepatitis B (HBV) or hepatitis C virus (HCV) are at increased risk of developing cirrhosis, end stage liver disease and hepatocellular carcinoma. Different risk factors were found to be associated with the transmission of these viruses in various settings. HBV and HCV transmission seems to be also acquired by n on-parenteral and non-sexual routes. A large number of patients infected with HCV might have non identifiable routes of viral acquisition. Hence, viral hepatitis transmission risk factors identification is the main way to reduce infection. Dental treatment may be one of such risk factors, and this aspect is addressed in the present literature review, drawing information from existing literature. Methods: An online database search was conducted, limited to publications from January 1999 to February 2012 on specific aspects of HBV and HCV infection, including articles on risk factors, markers of infection, dentistry, epidemiology and transmission. Relevant material was evaluated and reviewed. Results: Overall, 53 studies which met the selection criteria were evaluated. Although these studies were from different geographical regions of varied socioeconomic status and study populations and assessed different dental procedures, using different types of statistical analysis, we found that, although weak, there is an all-time risk of HBV and HCV infection during dental treatment. This is more important in developing countries where the rate of hepatitis infected individuals is higher. There is a need for more studies on this subject, properly planned, controlled and analyzed. Conclusion: Dental treatment can be included among the risk factors of HBV and HCV infection. This risk can easily be eliminated using standard precautionary measures.


Rashidi L.,Institute of Standard and Industrial Research of Iran | Khosravi-Darani K.,Tehran University of Medical Sciences
Critical Reviews in Food Science and Nutrition | Year: 2011

Nanotechnology has the potential of application in the food industry and processing as new tools for pathogen detection, disease treatment delivery systems, food packaging, and delivery of bioactive compounds to target sites. The application of nanotechnology in food systems will provide new methods to improve safety and the nutritional value of food products. This article will review the current advances of applications of nanotechnology in food science and technology. Also, it describes new current food laws for nanofood and novel articles in the field of risk assessment of using nanotechnology in the food industry. © 2011 National Nutrition and Food Technology Research Institute.


Nickavar A.,Tehran University of Medical Sciences
International Journal of Preventive Medicine | Year: 2013

Nephrolithiasis, obstructive renal failure, essential hypertension, and chronic tubulointerstitial nephritis have been considered as the renal complications of hyperuricemia. Massive proteinuria has been rarely reported as the primary manifestation of increased serum uric acid. This is the report of a child presented with proteinuira, hypertension, and glomerular scelrosis secondary to hypouricosuric hyperuricemia, who was treated by uric acid lowering management.


Rahimi-Movaghar V.,Tehran University of Medical Sciences | Vaccaro A.R.,Thomas Jefferson University
Acta Medica Iranica | Year: 2012

Spinal cord injured (SCI) patients have sexual disorders including erectile dysfunction (ED), impotence, priapism, ejaculatory dysfunction and infertility. Treatments for erectile dysfunction include four steps. Step 1 involves smoking cessation, weight loss, and increasing physical activity. Step 2 is phosphodiesterase type 5 inhibitors (PDE5I) such as Sildenafil (Viagra), intracavernous injections of Papaverine or prostaglandins, and vacuum constriction devices. Step 3 is a penile prosthesis, and Step 4 is sacral neuromodulation (SNM). Priapism can be resolved spontaneously if there is no ischemia found on blood gas measurement or by Phenylephrine. For anejaculatory dysfunction, massage, vibrator, electrical stimulation and direct surgical biopsy can be used to obtain sperm which can then be used for intra-uterine or in-vitro fertilization. Infertility treatment in male SCI patients involves a combination of the above treatments for erectile and anejaculatory dysfunctions. The basic approach to and management of sexual dysfunction in female SCI patients are similar as for men but do not require treatment for erectile or ejaculatory problems. © 2012 Tehran University of Medical Sciences. All rights reserved.


Minagar A.,Louisiana State University Health Sciences Center | Barnett M.H.,Royal Prince Alfred Hospital | Barnett M.H.,University of Sydney | Benedict R.H.B.,State University of New York at Buffalo | And 5 more authors.
Neurology | Year: 2013

The paired thalamic nuclei are graymatter (GM) structures on both sides of the third ventricle that play major roles in cortical activation, relaying sensory information to the higher cortical centers that influence cognition. Multiple sclerosis (MS) is an immune-mediated disease of the human CNS that affects both the white matter (WM) and GM. A number of clinical observations as well as recent neuropathologic and neuroimaging studies have clearly demonstrated extensive involvement of the thalamus, basal ganglia, and neocortex in patients with MS. Modern MRI techniques permit visualization of GM lesions and measurement of atrophy. These contemporary methods have fundamentally altered our understanding of the pathophysiologic nature of MS. Evidence confirms the contention that GM injury can be detected in the earliest phases of MS, and that iron deposition and atrophy of deep gray nuclei are closely related to the magnitude of inflammation. Extensive involvement of GM, and particularly of the thalamus, is associated with a wide range of clinical manifestations including cognitive decline, motor deficits, fatigue, painful syndromes, and ocular motility disturbances in patients with MS. In this review, we characterize the neuropathologic, neuroimaging, and clinical features of thalamic involvement in MS. Further, we underscore the contention that neuropathologic and neuroimaging correlative investigations of thalamic derangements inMSmay elucidate not heretofore considered pathobiological underpinnings germane to understanding the ontogeny, magnitude, and progression of the disease process. © 2013 American Academy of Neurology.


Karimi P.,Johns Hopkins University | Shahrokni A.,University of California at Los Angeles | Moradi S.,Tehran University of Medical Sciences
Asian Pacific Journal of Cancer Prevention | Year: 2013

Breast cancer is the most common cancer among females, worldwide, accounting for 22.9% of all cancers (excluding non-melanoma skin cancer) in females. Mammography is a sensitive (77-95%) and specific (94-97%) screening method for breast cancer. Previously, females between the 40-50 years old were recommended to have mammograms every one to two years. However, based on current evidence, in 2009, USPSTF recommended that the decision to start regular, biennial screening mammography for females younger than 50 years should be an individual decision and take patient context into account, including the patient's values regarding specific benefits and harms. This decision was based on findings regarding radiation exposure, false-positive and false-negative rates, over-diagnosis, and pain and psychological responses. The goal of this paper is to focus on evidence for updating the U.S. Preventive Services Task Force (USPSTF) recommendation against routine mammography for females between 40-49 years of age.


Ardalan A.,Tehran University of Medical Sciences
American journal of disaster medicine | Year: 2010

OBJECTIVE: To evaluate effectiveness of a community-based preparedness program for flash floods. DESIGN: A controlled community intervention trial with preassessment and postassessment. SETTING: Fifteen intervention villages and 16 control villages in Golestan province of Iran. PARTICIPANTS: People more than six years of age. INTERVENTION: Intervention program consisted assembling Village Disaster Taskforces (VDTs), training of VDTs and community, evacuation drill, and program monitoring. MAIN OUTCOME MEASURES: Individual participation in household preparedness actions including, preparedness meeting, risk mapping, preparation of emergency supplies, assisting vulnerable people, and evacuation drill. RESULTS: Our intervention improved preparedness of local community for flash floods in term of all interested outcome measures. For instance, adjusted odds ratio for participation in an evacuation drill in intervention area in postassessment compared with preassessment was 29.05 (95% confidence interval [CI]: 21.77-38.76), whereas in control area it was 2.69 (95% CI: 1.96-3.70). Difference in these odds ratios was statistically significant (p < 0.001). Participation in a family preparedness meeting and risk mapping were helpful in motivating individuals to take other preparedness actions. Women were found prepared as much as the men. Younger people showed lower participation in preparation of family emergency supplies but higher attendance in evacuation drills. Participation in evacuation drills decreased with increasing age. It was a positive association between risk perception and taking all preparedness actions. CONCLUSION: Flood preparedness programs should focus on participatory risk assessment and preparedness techniques, strive to improve risk perception and female capabilities, and ensure providing assistance to the older people during evacuation.


Laurent S.,University of Mons | Dutz S.,University of British Columbia | Dutz S.,Institute of Photonic Technology | Hafeli U.O.,University of British Columbia | And 2 more authors.
Advances in Colloid and Interface Science | Year: 2011

Due to their unique magnetic properties, excellent biocompatibility as well as multi-purpose biomedical potential (e.g., applications in cancer therapy and general drug delivery), superparamagnetic iron oxide nanoparticles (SPIONs) are attracting increasing attention in both pharmaceutical and industrial communities. The precise control of the physiochemical properties of these magnetic systems is crucial for hyperthermia applications, as the induced heat is highly dependent on these properties. In this review, the limitations and recent advances in the development of superparamagnetic iron oxide nanoparticles for hyperthermia are presented. © 2011 Elsevier B.V.


Forouzan A.S.,Tehran University of Medical Sciences
Global journal of health science | Year: 2013

Iran is one of the ten most earthquake prone countries in the world. Earthquakes not only cause new psychological needs among the population but particularly so when one considers vulnerable groups. This in - depth study was conducted with the aim of assessing psychosocial needs six months after an earthquake happened in the west of the county in Lorestan province. This is a qualitative study using focus group discussion that focuses mainly on the vulnerable groups (women, children, elderly and disabled people) after an earthquake in Bozazna; a village in Lorestan province in western part of Iran. Results of the psychosocial assessment indicated feelings of anxiety and worries in four vulnerable groups. Horror, hyper-excitement, avoidance and disturbing thoughts were observed in all groups with the exception of the elderly. Educational failures, loneliness and isolation were highlighted in children. All groups encountered socio-economic needs that included loss of assets and sense of insecurity and also reproductive problems were reported in women's group. Modification of a protocol on psychosocial support considering the context of the rural and urban areas with emphasis on the specific needs of the vulnerable groups is an appropriate strategy in crisis management. It seems that appropriate public awareness regarding assistance programs can be effective in reducing stress and needs of disaster survivors.


Heshmat R.,Tehran University of Medical Sciences
Acta medica Indonesiana | Year: 2010

To estimate the prevalence of obesity particularly abdominal obesity among adults aged between 19 to 65 years in five major cities in Iran. In this cross-sectional study, the anthropometric measurements including weight, height, body mass index, waist and hip circumferences were performed in 5724 healthy adults, representative sample of Iranian population, in the urban areas of five great cities of Iran. The prevalence of obesity was calculated in each district. ROC curves were used to evaluate an optimal WC cutoff for predicting obesity. Considering BMI categories, 38.5% were overweight and 19.7% were obese. Abdominal obesity by WC criteria was reported in 45.1% and 19.6% of women and men, respectively. The waist circumference cut-off points corresponding to BMI values of ≥ 30 kg/m2 were 99.5 cm for men and 94.25 cm for women. The present study provides alarming evidences for health professionals and policy makers about the high prevalence of generalized and abdominal obesity in Iran.


Zanjani K.S.,Tehran University of Medical Sciences
Iranian Journal of Pediatrics | Year: 2012

Pathophysiology of pulmonary arterial hypertension is based on three basic mechanisms: thrombotic pulmonary vascular lesions, vasoconstriction and vascular remodeling. Platelets are related to all of these mechanisms by their aggregation, production, storage and release of several mediators. The role of platelets is more prominent in some types of pulmonary arterial hypertension, including those which are secondary to inflammatory and infectious diseases, hemoglobinopathies, essential thrombocythemia, drugs, thromboembolism, and cardiac surgery. Most pulmonary antihypertensive drugs have a negative effect on platelets. In this review, the mechanisms of platelets association with pulmonary arterial hypertension, those types of pulmonary arterial hypertension with greatest platelet contribution to their pathophysiology, and the effects of pulmonary antihypertensive drugs on platelets are summarized. © 2012 by Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences.


Boloursaz M.R.,Tehran University of Medical Sciences
Pneumologia (Bucharest, Romania) | Year: 2010

This report described a 2-year-old boy who presented with severe respiratory distress and stridor. Bronchoscopy and CT revealed a mass in the left anterolateral tracheal wall and histopathology showed a tracheal inflammatory myofibroblastic tumor. Initial removal by rigid bronchoscopy resulted in prompt recurrence of the tumor. Therefore he underwent tracheal surgical resection. A bronchoscopy at 12 months after surgery did not show any recurrence sign.


Hafizi S.,Tehran University of Medical Sciences
Asian Journal of Psychiatry | Year: 2013

Sleep problems are very common among psychiatric patients. Borderline personality disorder, as a common and severe mental disorder, is associated with different types of sleep disturbances, such as disturbances of sleep continuity, altered REM sleep regulation and nightmares. These disturbances are the result of interaction of the personality traits, concomitant and comorbid diseases and environmental factors. Despite the high prevalence of sleep related disorders in BPD patients, this aspect of BPD is still neglected in clinical and research settings. To date there has been little agreement on sleep characteristics of BPD among different studies, and presence of some uncontrolled confounding factors, make interpretation of the results difficult. However, it seems that appropriate diagnosis and treatment of sleep disorders in BPD patients might lead to better outcome. This article aimed to review the current literature of sleep studies in BPD. Some recommendations and suggestions were made for future researches in this field. © 2013 Elsevier B.V.


Esteghamati A.,Tehran University of Medical Sciences
Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et métabolisme | Year: 2013

The aim of the study was to assess the effects of metformin on serum concentrations of vaspin and adiponectin in diabetes. Randomized clinical trial of 99 newly diagnosed, medication-naïve, type 2 diabetes patients (NCT01521624) was carried out. Patients were randomly assigned to either metformin 1 000 mg daily plus advice for exercise and lifestyle modification (n=50) or modification alone (n=49). A third group of 50 normoglycemic subjects were also enrolled to compare adipokine concentrations between healthy and diabetes subjects. Serum concentrations of adipokines were measured at baseline and after 12 weeks using ELISA method. Healthy subjects had significantly higher adiponectin levels, but lower concentrations of serum vaspin (p<0.001 in all cases). Vaspin and adiponectin concentrations were 23% and 26% higher in women compared with men. Vaspin dropped significantly after 3-month metformin therapy only in women (1.36 vs. 0.98, p=0.003 in women and 1.31 vs. 1.20, p=0.335 in men). Metformin therapy did not change adiponectin concentration in neither women nor men of the case group (12.66 vs. 12.44 p=0.699 in women and 10.13 vs. 10.94 p=0.253 in men). Comparing case and control groups, metformin decreased vaspin levels more significantly than lifestyle modification in the final multivariate model after controlling for potential confounders only in women (p=0.002) but not men (p=0.896). Conversely, adiponectin levels increased more significantly in the control group, again only in women (p=0.012 and 0.579 for women and men, respectively). Our findings suggest that metformin therapy reduces vaspin concentration in a gender-specific manner. Metformin exerts little benefit in increasing adiponectin levels in diabetes patients. © Georg Thieme Verlag KG Stuttgart · New York.


Although certain evidence has indicated a role for angiogenesis in the pathophysiology of hematopoietic malignancies, its role in chronic lymphocytic leukemia (CLL) prognosis is yet to be defined. To our knowledge, the effects of CLL plasma on cell culture have not been addressed. Therefore, we investigated the effects of CLL plasma on cell cycle regulation and von Willebrand factor (vWF) secretion, and expression in human umbilical vein endothelial cell cultures (HUVECs). Since nuclear factor–kappa B (NF-κB) transcription factor has been a therapeutic target for treatment of cancer, we inhibited NF-κB using small interfering RNA to clarify if there is a role for this factor in probable effects. The cells were treated with the plasma of patients with CLL. Subsequently, cell cycle phase distribution, vWF secretion, expression, and storage were detected using ELISA, flow cytometry, and immunohistochemical staining. In addition, NF-κB was inhibited using small interfering RNA. Plasma treatment promoted cell cycle progression by decreasing the cell number in G1 phase, while increasing the cell number in S phase and G2M phase. A significant increase of vWF expression, secretion, and storage was found, associated with the vWF levels of patients’ plasma. We found that induction of cell cycle promotion, but not vWF expression and secretion, was partially suppressed by this inhibition. We found that endothelial cell cycle and vWF expression and secretion affected by CLL plasma and NF-κB play a role in the former. These findings would be useful for understanding the prognostic importance of plasma angiogenic factor levels in CLL. Copyright © 2016 YEAR Wolters Kluwer Health, Inc. All rights reserved.


Vasaghi-Gharamaleki B.,Tehran University of Medical Sciences
Acta medica Iranica | Year: 2011

The typical features of eccentric exercise-induced muscle damage is prolonged loss of muscle strength and the most rapid structural change in the fibers is loss of immunostaining for the intermediate filament protein, desmin. In this study isolated perfused rat muscle was used to examine the direct effect of temperature changes on the eccentric contraction-induced force and desmin loss. The left medial gastrocnemius muscle was separated and the entire lower limb was transferred into a prewarmed (35°C) organ bath. Temperature was adjusted to 31 or 39°C during and after eccentric contractions. Maximal isometric force and desmin loss were measured after 15 isometric or eccentric contractions. According to our data, organ bath temperature changes during or after eccentric contractions had no significant effect on force loss. However, a strong correlation between desmin loss and temperature changes during (r = 0.886, P< 0.05) and a weak correlation between desmin loss and temperature changes after (r= 0.699, P<0.05) eccentric contractions was observed. Our results suggest that cooling during eccentric contractions may decrease desmin loss but temperature changes after eccentric contractions have no effect on desmin loss.


Aryan Z.,Students Scientific Research Center | Rezaei N.,Research Center for Immunodeficiencies | Rezaei N.,Tehran University of Medical Sciences | Rezaei N.,A+ Network
Current Opinion in Allergy and Clinical Immunology | Year: 2015

Purpose of review: Toll-like receptors (TLRs) are novel and promising targets for allergen immunotherapy. Bench studies suggest that TLR agonists reduce Th2 responses and ameliorate airway hyper-responsiveness. In addition, clinical trials are at initial phases to evaluate the safety and efficacy of TLR agonists for the allergen immunotherapy of patients with allergic rhinitis and asthma. Recent findings: To date, two allergy vaccine-containing TLR agonists have been investigated in clinical trials; Pollinex Quattro and AIC. The former contains monophosphoryl lipid, a TLR4 agonist and the latter contains, CpG motifs activating the TLR9 cascade. Preseasonal subcutaneous injection of both of these allergy vaccines has been safe and efficacious in control of nasal symptoms of patients with allergic rhinitis. CRX-675 (a TLR4 agonist), AZD8848 (a TLR7 agonist), VTX-1463 (a TLR8 agonist) and 1018 ISS and QbG10 (TLR9 agonists) are currently in clinical development for allergic rhinitis and asthma. Summary: TLR agonists herald promising results for allergen immunotherapy of patients with allergic rhinitis and asthma. Future research should be directed at utilizing these agents for immunotherapy of food allergy (for instance, peanut allergy) as well. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.


Allahyarzadeh V.,Amirkabir University of Technology | Montazer M.,Amirkabir University of Technology | Nejad N.H.,Amirkabir University of Technology | Samadi N.,Tehran University of Medical Sciences
Journal of Applied Polymer Science | Year: 2013

Alkali hydrolysis of polyester along with application of nano silver/nano TiO2 to produce hydrolyzed polyester fabric with antibacterial and self-cleaning properties is a very interesting subject. In this article, a novel idea is introduced to achieve a polyester fabric with self-cleaning and antibacterial properties with a good feeling handle in one step. The polyester fabric is hydrolyzed in alkali media to enhance the surface activity, improve nanoparticle absorption, and produce ethylene glycol for reducing silver nitrate into nano silver. XRD pattern confirms the presence of nanoparticles with crystal size of 10 nm on the fabric surface and FESEM pictures show the distribution of nanocomposite particles on the fiber surfaces with average size of 54 nm. The degradation of Methylene Blue under daylight irradiation confirms the photoactivity of nano TiO2 on the polyester fabric. Also, very good bactericidal efficiency is obtained against S. aureus and E. coli. Interestingly, the fabric tensile strength improves even with the action of alkali in surface hydrolysis of polyester. Copyright © 2013 Wiley Periodicals, Inc.


Meymandi M.S.,Kerman Medical University | Keyhanfar F.,Tehran University of Medical Sciences
Pharmacology Biochemistry and Behavior | Year: 2013

Visceral pain currently represents one of the most important pain treatment challenges in clinical practice, and investigators across the world are continuously designing and conducting numerous studies in search of new analgesics and new combination therapies. The current study assessed the analgesic effects of saline, pregabalin (2, 5, 17, 50, 100, and 200 mg/kg, i.p.) and morphine (0.25, 0.5, 1, 3 and 5 mg/kg) alone or in combination on acetic-acid induced abdominal contractions in mice. The number of writhes and the inhibitory effects (as percentages, %E)were calculated as antinociception indexes. These indexes indicated that both pregabalin (Prg) and morphine (Mrp) produced dose-dependent antinociception. Pregabalin at 5 mg/kg (%E = 32.5 ± 4.0) or 2 mg/kg (%E = 20.8 ± 4.5) and morphine at 0.25 mg/kg (%E = 20.2 ± 7.8) and 0.5 mg/kg (%E = 43.6 ± 4.5) exhibited antinociceptive effects, and the combination of pregabalin and morphine produced significantly greater antinociceptive effects (%E = 62.4 ± 5.8 for Prg5 + Mrp0.25; %E = 71.7 ± 4.8 for Prg5 + Mrp0.5; and %E = 54.1 ± 4.0 for Prg2 + Mrp0.25), although this enhancement was not observed when morphine was combined with 17 mg/kg pregabalin. Pre-treatment with 2 mg/kg (i.p.) naloxone did not affect increased analgesia when combined with these drugs. A dose-response curve was established for pregabalin at a fixed morphine dose and revealed that, at lowdoses, pregabalin dose-dependently enhanced the antinociceptive effects,while the opposite was true at high doses (17 and 25 mg/kg). In conclusion, pregabalin can produce levels of antinociception that are similar to those of morphine in acetic acid-induced viscero-somatic pain. The enhancement of antinociception produced by the co-administration of morphine and pregabalin is termed a supra-additive interaction and occurred at lowdoses but not at high doses. These findings militate for increased attention and caution in clinical settings. © 2013 Elsevier Inc. All rights reserved.


Naseri N.,Tehran University of Medical Sciences | Pourkazemi F.,University of Sydney
Knee Surgery, Sports Traumatology, Arthroscopy | Year: 2012

Purpose: The purpose of this study was to evaluate knee joint position sense (JPS) in athletes with patellofemoral pain syndrome (PFPS) and compare it with healthy participants under non-weight bearing (sitting) and weight bearing (standing) conditions. Methods: Twenty patients and 20 healthy athletes participated in this study. JPS was evaluated by active replication of knee angles with visual cues eliminated. Two target angles in sitting and one in standing were tested. Each test and replication was repeated three times. By subtracting the test angle from the replicated angle, the absolute error was calculated as a dependent variable. Results: No significant difference in knee JPS was found between groups either in the sitting or in the standing tests. Conclusion: It seems that PFPS does not affect the knee JPS in athletes. The lack of deficiency in patients could possibly be attributed to their severity of knee pathology, pain intensity and their physical activity level. Level of evidence: Case-control study, Level III. © 2011 Springer-Verlag.


Greenland S.,University of California at Los Angeles | Mansournia M.A.,Tehran University of Medical Sciences
European Journal of Epidemiology | Year: 2015

We describe how ordinary interpretations of causal models and causal graphs fail to capture important distinctions among ignorable allocation mechanisms for subject selection or allocation. We illustrate these limitations in the case of random confounding and designs that prevent such confounding. In many experimental designs individual treatment allocations are dependent, and explicit population models are needed to show this dependency. In particular, certain designs impose unfaithful covariate-treatment distributions to prevent random confounding, yet ordinary causal graphs cannot discriminate between these unconfounded designs and confounded studies. Causal models for populations are better suited for displaying these phenomena than are individual-level models, because they allow representation of allocation dependencies as well as outcome dependencies across individuals. Nonetheless, even with this extension, ordinary graphical models still fail to capture distinctions between hypothetical superpopulations (sampling distributions) and observed populations (actual distributions), although potential-outcome models can be adapted to show these distinctions and their consequences. © 2015, Springer Science+Business Media Dordrecht.


Ziyadi H.,Tarbiat Modares University | Heydari A.,Tarbiat Modares University | Rezayat S.M.,Tehran University of Medical Sciences
Ceramics International | Year: 2014

Magnetic composite fibers with α-Fe2O3/SiO 2 core-shell structure were prepared by the electrospinning and sol-gel method. The α-Fe2O3 ceramic nanofibers were prepared by electrospinning of solution of poly (vinyl alcohol) (PVA) and Fe(NO3)3·9H2O composite nanofibers followed by calcinations. Controlled hydrolysis and condensation of tetraethyl orthosilicate (TEOS) caused a dense silica layer deposit on the surface of α-Fe2O3 nanofibers with a desired thickness using the sol-gel method (denoted as α-Fe2O3@SiO 2). The products were characterized with scanning electron microscope (SEM), transmission electron microscope (TEM), energy dispersive X-ray spectroscope (EDX), vibrating sample magnetometer (VSM), X-ray diffraction (XRD) and Fourier transform infrared (FT-IR). The α-Fe2O 3@SiO2 core/shell fibers showed a high value of specific saturation magnetization. © 2013 Elsevier Ltd and Techna Group S.r.l.


Zamani F.,Tehran University of Medical Sciences
Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia | Year: 2010

Hepatitis C virus (HCV) is one of the perilous problems in hemodialysis (HD) centers around the world. There are many risk factors regarding HCV infection in HD units. The aim of this study was to evaluate the incidence of HCV infection in HD units and also to assess the potential risk factors in this regard. A total of 334 patients on regular HD were evaluated. All the patients were seronegative for anti-HCV antibody in the beginning of this study. They were followed every 6 months with repetition of tests. Positive samples were tested by polymerase chain reaction (PCR) for confirmation. The prevalence of HCV infection was about 20%. No significant relationship between numbers of blood transfusion, age and sex was obtained. A positive correlation between HCV infection and duration of HD for more than 5 years was significant. In conclusion, our study found the prevalence of HCV infection to be significantly higher than its incidence in the general population.


Dargahi H.,Tehran University of Medical Sciences
Journal of Medical Ethics and History of Medicine | Year: 2012

Organizational behaviors are commonly acknowledged as fundamentals of organizational life that strongly influence both formal and informal organizational processes, interpersonal relationships, work environments, and pay and promotion policies. The current study aims to investigate political behavior tendencies among employees of Tehran University of Medical Sciences (TUMS). This cross-sectional, descriptive and analytical study was conducted on 810 TUMS employees at the headquarters of the Tehran University of Medical Sciences, Iran during 2010-2011. The research tool for data collection was a researcher-tailored questionnaire on political behaviors. The validity of the questionnaire was confirmed by seven management professors, and its reliability was tested by a pilot study using test-retest method which yielded a Cronbach's alpha coefficient of 0.71. The respondents were asked to fill the questionnaire and express their perceptions and tendencies to engage in organizational behaviors. The collected data was read to and analyzed by IBM SPSS environment and correlation analytical methods. Overall, 729 respondents filled and returned the questionnaire yielding a response rate of 90%. Most of the respondents indicated that they had no tendency to engage in political behavior. Moreover, we found that there was a significant correlation between sex, higher education degrees, tenure and the employees' tendency to engage in political behavior. The participants were not overtly political because of their personal belief, ethical values, and personal characters. Non-political and overtly political employees are both prejudicial for all organizations. Therefore, it seems that the medium rate of good political behavior is vital and prevalent in Iranian organizations. © 2012 Hossein Dargahi.


Saddadi F.,Tehran University of Medical Sciences
Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia | Year: 2014

Patients with end-stage renal disease (ESRD) are at an increased risk of cardiovascular disease due to many factors including inflammation and oxidative stress. N-acetylcysteine (NAC) is a thiol-containing anti-oxidant with anti-inflammatory properties. We aimed to assess the effect of three months treatment with oral NAC on the plasma levels of inflammatory mediators like interleukin-6 (IL-6) and C-reactive protein (hs-CRP) in patients on hemodialysis (HD). Twenty-four patients (nine males and 15 females) on maintenance HD were recruited in the study. Their mean age was 55.3 years. All the patients received oral NAC (600 mg twice a day) for a period of three months. The serum levels of biomedical parameters and IL-6 and hs-CRP were measured at baseline and three months after initiation of treatment. A significant decrease in serum levels of hs-CRP (22.4 vs. 5.2), IL-6 (8.1 vs. 3.6), parathyroid hormone (iPTH) (257.2 vs. 158.8), ferritin (632.0 vs. 515.1) and erythrocyte sedimentation rate (ESR) (54.2 vs. 38.3) was observed following NAC treatment. Female subjects presented with a significantly higher change in serum levels of hs-CRP compared with males (23 vs. 5.4). In three subjects who were less than 40 years old, the hs-CRP and IL-6 levels showed an increase following NAC treatment. Our study found that short-term oral NAC treatment might result in the reduction of IL-6 and hs-CRP in patients who are on regular HD. This suggests that patients with ESRD may benefit from the anti-inflammatory effects of NAC.


Kianbakht S.,Research Institute of Medicinal Plants | Dabaghian F.H.,Tehran University of Medical Sciences
Complementary Therapies in Medicine | Year: 2013

Objectives: Evaluation of the efficacy and safety of Salvia officinalis L. (S. officinalis) leaf extract in the treatment of hyperlipidemic type 2 diabetic patients. Design: Randomized placebo-controlled parallel group study. Setting: Diabetes Clinic (Karaj City, Alborz Province of Iran). Interventions: The efficacy and safety of taking S. officinalis leaf extract (one 500. mg capsule t.i.d. for 3 months) in treatment of 40 hyperlipidemic (hypercholesterolemic and/or hypertriglyceridemic) type 2 diabetic patients were evaluated and compared with the placebo group (n=40). Main outcome measures: Fasting blood levels of glucose, glycosylated hemoglobin (HbA1c), total cholesterol, triglyceride, LDL-C (low density lipoprotein cholesterol), HDL-C (high density lipoprotein cholesterol), SGOT (serum glutamic-oxaloacetic transaminase), SGPT (serum glutamic-pyruvic transaminase) and creatinine. Results: The extract lowered fasting glucose, HbA1c, total cholesterol, triglyceride and LDL-C but increased HDL-C compared to baseline at endpoint. Percent difference mean (95% confidence interval) between the extract and placebo groups in terms of effects on fasting glucose, HbA1c, total cholesterol, triglyceride, LDL-C and HDL-C at endpoint were 32.2 (26.5, 37.9), 22.7 (16.8, 28.6), 16.9 (9.7, 24.1), 56.4 (36.1, 76.7), 35.6 (29.9, 41.3) and 27.6 (15.8, 39.4) (P=0.001, P=0.01, P=0.01, P=0.009, P< 0.001 and P=0.008), respectively. Moreover, the extract did not have any significant effects on the other parameters compared to the placebo group at endpoint (P> 0.05). No adverse effects were reported. Conclusions: S. officinalis leaves may be safe and have anti-hyperglycemic and lipid profile improving effects in hyperlipidemic type 2 diabetic patients. © 2013 Elsevier Ltd.


Heidari P.,Tehran University of Medical Sciences
Journal of orthopaedic surgery (Hong Kong) | Year: 2010

To evaluate the effects of continuous local injection of risedronate in the prevention of bone resorption in a lengthened segment. 11 male rabbits underwent subperiosteal osteotomy of the left tibia and an external fixator was applied anteromedially. After a lag phase of one week, a 2-week distraction phase and a 5-week consolidation phase followed. Risedronate was continuously injected into the centre of the distracted segment at a rate of 10 micro g/kg/day during the first 14 days of consolidation by a subcutaneously implanted osmotic pump. A control group received purified buffer solution (PBS) using the same protocol. The lengthened bone segments were evaluated using radiography, quantitative computed tomography, and 3-point bending mechanical test. Risedronate injection prevented osteopenia as compared to PBS injection. The mean bone mineral content, volumetric density and cross-sectional area of the lengthened segments were significantly higher in the risedronate group than in controls (as much as 65%, 30%, and 25%, respectively). There was no significant difference between the 2 groups regarding the ultimate load to failure. Continuous local injection of risedronate into the lengthened segment can prevent osteopenia during distraction osteogenesis but fails to enhance mechanical strength of newly distracted segments.


Aryan Z.,Molecular Immunology Research Center | Holgate S.T.,University of Sfax | Radzioch D.,McGill University | Rezaei N.,Molecular Immunology Research Center | And 2 more authors.
International Archives of Allergy and Immunology | Year: 2014

Toll-like receptors (TLR) belong to a large family of pattern recognition receptors known as the ancient 'gatekeepers' of the immune system. TLRs are located at the first line of defense against invading pathogens as well as aeroallergens, making them interesting targets to modulate the natural history of respiratory allergy. Agonists of TLRs have been widely employed in therapeutic or prophylactic preparations useful for asthma/allergic rhinitis (AR) patients. MPL® (a TLR4 agonist) and the CpG oligodeoxynucleotide of 1018 ISS, a TLR9 agonist, show strong immunogenicity effects that make them appropriate adjuvants for allergy vaccines. Targeting the TLRs can enhance the efficacy of specific allergen immunotherapy, currently the only available 'curative' treatment for respiratory allergies. In addition, intranasal administration of AZD8848 (a TLR7 agonist) and VTX-1463 (a TLR8 agonist) as stand-alone therapeutics have revealed efficacy in the relief of the symptoms of AR patients. No anaphylaxis has been so far reported with such compounds targeting TLRs, with the most common adverse effects being transient and local irritation (e.g. redness, swelling and pruritus). Many other compounds that target TLRs have been found to suppress airway inflammation, eosinophilia and airway hyper-responsiveness in various animal models of allergic inflammation. Indeed, in the future a wide variability of TLR agonists and even antagonists that exhibit anti-asthma/AR effects are likely to emerge. © 2014 S. Karger AG, Basel.


Heidarian E.,Shahrekord University of Medical Sciences | Jafari-Dehkordi E.,Tehran University of Medical Sciences | Seidkhani-Nahal A.,Ilam University
Food and Chemical Toxicology | Year: 2011

Studies on the effects of garlic (Allium sativum) on hyperlipidemia have demonstrated somewhat controversial results and there have been few studies on its enzymatic mechanism. The purpose of this study was to assess the effect of garlic on the liver phosphatidate phosphohydrolase (PAP) activity, plasma lipid levels, malondialdehyde (MDA) and plasma antioxidant in rats fed either by normal or high-lipogenic diet with or without garlic. Male Wistar rats were fed by standard pellet diet (group I), standard diet supplemented with 4% garlic (group II), lipogenic diet (containing sunflower oil, cholesterol and ethanol) plus 4% garlic (group III) and only lipogenic diet (group IV). Results showed that garlic significantly reduced total cholesterol (TC), plasma triglyceride (TG), LDL-C, VLDL-C, liver triglyceride, plasma malondialdehyde (MDA) and elevated plasma antioxidant in garlic treated rats (groups II and III) compared to group IV (lipogenic diet group). Also, liver PAP activity was decreased in group II than group I whereas, the decrease in its activity in groups III and IV was due to the accumulation of triglyceride in liver. Therefore, the results are clearly indicative of the beneficial effects of garlic in reducing lateral side effects of hyperlipidemia. © 2011 Elsevier Ltd.


Psychometric testing of the Persian Functional Rating Index (PFRI). To determine the reliability and validity of the PFRI in Persian-speaking subjects with neck pain (NP). The Functional Rating Index is a self-report questionnaire that can be used for patients with back pain or NP. The PFRI has been recently validated in patients with low back pain, whereas it is not validated in patients with NP. One hundred patients with NP, mean age of 42 years, participated in the study; 50 patients agreed to be tested on 2 occasions during a 7-day interval for the reliability phase of the study. A visual analogue scale, the Neck Disability Index, and the Neck Pain and Disability Scale were also completed to assess validity. Fifty healthy subjects completed the PFRI for discriminative validity. Floor and ceiling effects were not observed. Independent t test showed a statistically significant difference in PFRI total scores between patients and healthy subjects supporting the discriminative validity of the PFRI (P < 0.001). PFRI and visual analogue scale demonstrated concurrent criterion validity, with Pearson correlation coefficients of 0.75 for test and 0.70 for retest. Construct validity was supported by a significant Pearson correlation between the PFRI and the Neck Disability Index (r = 0.72, P < 0.0001) and between the PFRI and the Neck Pain and Disability Scale (r = 0.63, P < 0.0001). Factor analysis revealed a 2-factor solution, which jointly accounted for 64.75% of the total variance. Additional factor analysis suggested 8-item PFRI as a unidimensional functional instrument for patients with NP. Internal consistency for the PFRI was high. (Cronbach α coefficients were 0.88 for test, 0.89 for retest, and 0.89 for 8-item PFRI.) Reproducibility assessed by test-retest reliability was excellent (intraclass correlation coefficient [ICC](agreement) of 0.96, P < 0.0001). The PFRI is valid and reliable for use in a Persian-speaking population with NP.


Abolghasemian M.,Tehran University of Medical Sciences
The bone & joint journal | Year: 2013

The conventional method for reconstructing acetabular bone loss at revision surgery includes using structural bone allograft. The disadvantages of this technique promoted the advent of metallic but biocompatible porous implants to fill bone defects enhancing initial and long-term stability of the acetabular component. This paper presents the indications, surgical technique and the outcome of using porous metal acetabular augments for reconstructing acetabular defects.


Ai J.,Tehran University of Medical Sciences | Mehrabani D.,Shiraz University of Medical Sciences
Iranian Red Crescent Medical Journal | Year: 2010

The endometrial stem cells were shown to have an excellent pluripotency potential. Human endometrium contains a small population of mesenchymal stem cells (MSC) that may be responsible for its cyclical growth and may provide a readily available source of MSC. However, endometrial stromal cells are easier to isolate and expand with less technical problems compared to bone marrow MSCs. Here we hypothesized that endometrial stem cells may differentiate into osteogenic cells as one of the most important issues in orthopedic surgery associated with bone loss in traumas, infections, tumors or congenital disorders.


Abolghasemian M.,Sinai University | Sadeghi Naini M.,Tehran University of Medical Sciences | Tangsataporn S.,Sinai University | Lee P.,Royal London Hospital | And 4 more authors.
Bone and Joint Journal | Year: 2014

We retrospectively reviewed 44 consecutive patients (50 hips) who underwent acetabular re-revision after a failed previous revision that had been performed using structural or morcellised allograft bone, with a cage or ring for uncontained defects. Of the 50 previous revisions, 41 cages and nine rings were used with allografts for 14 minor-column and 36 major-column defects. We routinely assessed the size of the acetabular bone defect at the time of revision and re-revision surgery. This allowed us to assess whether host bone stock was restored. We also assessed the outcome of re-revision surgery in these circumstances by means of radiological characteristics, rates of failure and modes of failure. We subsequently investigated the factors that may affect the potential for the restoration of bone stock and the durability of the re-revision reconstruction using multivariate analysis. At the time of re-revision, there were ten host acetabula with no significant defects, 14 with contained defects, nine with minor-column, seven with major-column defects and ten with pelvic discontinuity. When bone defects at re-revision were compared with those at the previous revision, there was restoration of bone stock in 31 hips, deterioration of bone stock in nine and remained unchanged in ten. This was a significant improvement (p < 0.001). Morselised allografting at the index revision was not associated with the restoration of bone stock. In 17 hips (34%), re-revision was possible using a simple acetabular component without allograft, augments, rings or cages. There were 47 patients with a mean follow-up of 70 months (6 to 146) available for survival analysis. Within this group, the successful cases had a minimum follow-up of two years after re-revision. There were 22 clinical or radiological failures (46.7%), 18 of which were due to aseptic loosening. The five and ten year Kaplan-Meier survival rate was 75% (95% CI, 60 to 86) and 56% (95% CI, 40 to 70) respectively with aseptic loosening as the endpoint. The rate of aseptic loosening was higher for hips with pelvic discontinuity (p = 0.049) and less when the allograft had been in place for longer periods (p = 0.040). The use of a cage or ring over structural allograft bone for massive uncontained defects in acetabular revision can restore host bone stock and facilitate subsequent re-revision surgery to a certain extent. © 2014 The British Editorial Society of Bone & Joint Surgery.