Seyed Farzad Maroufi, Sina Azadnajafabad, Ghazaleh Kheiri, Seyed Behnam Jazayeri, Zahra Ghodsi, Heshmatollah Ghawami, Maryam Kheyri, James S Harrop, Michael G Fehlings, Vafa Rahimi-Movaghar
Background: Spinal cord injury (SCI) imposes a heavy burden on patients and health systems. Magnetic resonance imaging (MRI) provides a detailed evaluation of the spinal cord and associated soft tissues in a non-invasive manner. Objectives: We aimed to adopt and adapt suitable recommendations and guidelines in Iran for the utilization of MRI in the management of acute SCI patients based on available international guidelines and through a systematic review of literature, followed by guideline development based on the Delphi technique. Methods: After the primary systematic search and review of the literature and guidelines on the use of MRI in the management of acute SCI, all relevant recommendations were retrieved. Desired recommendations were then extracted and presented to our expert panel through the Delphi technique. The final decision for the inclusion or adaptation of recommendations to improve SCI care in the Iranian population was made through expert panel meetings. Results: Our literature search resulted in 769 records. Only three records provided recommendations on the role of MRI in the management of acute SCI, from which a total of six recommendations were extracted. Of these, the two final recommendations were extracted: (I) “Use MRI in adult patients with acute SCI prior to surgical interventions, when feasible, to facilitate clinical decision making,” and (II) “Use MRI in adult patients in the acute period following SCI and before or after surgical interventions (only when fixation is not used) to improve the prediction of neurologic outcomes following acute SCI.” Conclusions: The final recommendations help appropriately use MRI in patients with acute SCI, facilitating the management of these patients and improving their outcomes. This study shows that it is possible for developing countries to indigenize international guidelines, and with minor changes, an appropriate therapeutic framework can be created to improve service delivery.
{"title":"Adopting and Adapting Clinical Practice Guidelines for the Use of Baseline MRI in Acute Spinal Cord Injury in a Developing Country","authors":"Seyed Farzad Maroufi, Sina Azadnajafabad, Ghazaleh Kheiri, Seyed Behnam Jazayeri, Zahra Ghodsi, Heshmatollah Ghawami, Maryam Kheyri, James S Harrop, Michael G Fehlings, Vafa Rahimi-Movaghar","doi":"10.5812/ans-135297","DOIUrl":"https://doi.org/10.5812/ans-135297","url":null,"abstract":"Background: Spinal cord injury (SCI) imposes a heavy burden on patients and health systems. Magnetic resonance imaging (MRI) provides a detailed evaluation of the spinal cord and associated soft tissues in a non-invasive manner. Objectives: We aimed to adopt and adapt suitable recommendations and guidelines in Iran for the utilization of MRI in the management of acute SCI patients based on available international guidelines and through a systematic review of literature, followed by guideline development based on the Delphi technique. Methods: After the primary systematic search and review of the literature and guidelines on the use of MRI in the management of acute SCI, all relevant recommendations were retrieved. Desired recommendations were then extracted and presented to our expert panel through the Delphi technique. The final decision for the inclusion or adaptation of recommendations to improve SCI care in the Iranian population was made through expert panel meetings. Results: Our literature search resulted in 769 records. Only three records provided recommendations on the role of MRI in the management of acute SCI, from which a total of six recommendations were extracted. Of these, the two final recommendations were extracted: (I) “Use MRI in adult patients with acute SCI prior to surgical interventions, when feasible, to facilitate clinical decision making,” and (II) “Use MRI in adult patients in the acute period following SCI and before or after surgical interventions (only when fixation is not used) to improve the prediction of neurologic outcomes following acute SCI.” Conclusions: The final recommendations help appropriately use MRI in patients with acute SCI, facilitating the management of these patients and improving their outcomes. This study shows that it is possible for developing countries to indigenize international guidelines, and with minor changes, an appropriate therapeutic framework can be created to improve service delivery.","PeriodicalId":43970,"journal":{"name":"Archives of Neuroscience","volume":"172 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136241607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ali Talea, Monireh Aghajany-Nasab, Navid Alirezapour Asl Miandoab, Setila Dalili, Shahin Koohmanaee, Seyede Tahoura Hakemzadeh, Amir Mohammad Ghanbari, Nazanin Medghalchi
Context: There are severe and rare groups of genetic disorders due to defects in metabolic pathways, and they are generally called inborn errors of metabolism. Amino acids, as the building blocks of proteins, have many important structural and functional roles in the human body. The deficiencies of functional enzymes cause defects in metabolic pathways and lead to aminoacidopathies. The diagnosis of aminoacidopathies is challenging for most physicians, as they can present with multiple overlapping symptoms. Evidence Acquisition: PubMed, Cochrane, Embase, and CINAHL were searched with MeSH terms: ‘inborn errors of metabolism' OR ‘Metabolism, Inborn Errors' (MeSH) AND ‘Humans' (MeSH) AND 'Amino Acids/therapeutic use'[MeSH] AND ‘Newborn, Child' (MeSH) OR ‘child' OR ‘newborn' AND "Neonatal Screening"[MeSH]. Results: This study summarized some important issues, including clinical and laboratory diagnoses of phenylketonuria, tyrosinemia, methionine, homocysteine and cysteine, sulfite oxidase deficiency, molybdenum cofactor deficiency, tryptophan, glycine, hyperoxaluria, creatine deficiency disorders, serine, proline, glutamine, and urea cycle defect. Conclusions: The prognosis of many metabolic disorders has improved due to recent advances in diagnosis and treatment. The biochemical knowledge of clinicians should be improved to comprehend metabolic disorders. As the diagnostic methods are based on organic acids in urine and acylcarnitine profile, it is necessary to enhance biochemistry knowledge to understand the logic.
{"title":"Clinical Features and Laboratory Diagnosis of Aminoacidopathies: A Narrative Review","authors":"Ali Talea, Monireh Aghajany-Nasab, Navid Alirezapour Asl Miandoab, Setila Dalili, Shahin Koohmanaee, Seyede Tahoura Hakemzadeh, Amir Mohammad Ghanbari, Nazanin Medghalchi","doi":"10.5812/ans-136721","DOIUrl":"https://doi.org/10.5812/ans-136721","url":null,"abstract":"Context: There are severe and rare groups of genetic disorders due to defects in metabolic pathways, and they are generally called inborn errors of metabolism. Amino acids, as the building blocks of proteins, have many important structural and functional roles in the human body. The deficiencies of functional enzymes cause defects in metabolic pathways and lead to aminoacidopathies. The diagnosis of aminoacidopathies is challenging for most physicians, as they can present with multiple overlapping symptoms. Evidence Acquisition: PubMed, Cochrane, Embase, and CINAHL were searched with MeSH terms: ‘inborn errors of metabolism' OR ‘Metabolism, Inborn Errors' (MeSH) AND ‘Humans' (MeSH) AND 'Amino Acids/therapeutic use'[MeSH] AND ‘Newborn, Child' (MeSH) OR ‘child' OR ‘newborn' AND \"Neonatal Screening\"[MeSH]. Results: This study summarized some important issues, including clinical and laboratory diagnoses of phenylketonuria, tyrosinemia, methionine, homocysteine and cysteine, sulfite oxidase deficiency, molybdenum cofactor deficiency, tryptophan, glycine, hyperoxaluria, creatine deficiency disorders, serine, proline, glutamine, and urea cycle defect. Conclusions: The prognosis of many metabolic disorders has improved due to recent advances in diagnosis and treatment. The biochemical knowledge of clinicians should be improved to comprehend metabolic disorders. As the diagnostic methods are based on organic acids in urine and acylcarnitine profile, it is necessary to enhance biochemistry knowledge to understand the logic.","PeriodicalId":43970,"journal":{"name":"Archives of Neuroscience","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46435194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Meshkat, Yeganeh Behjati, Mansooreh Bakhshi, Z. Meshkat, Mina Yazdan Mehr, R. Boostani, M. Saeidi, M. Khoshakhlagh, Amin Hooshyar Chechaklou, Mahya Najjari, Samaneh Abolbashari, A. Gholoubi
Background: Multiple sclerosis (MS) is an autoimmune inflammatory disorder of the central nervous system of unknown etiology, which is believed to be caused by immune dysregulation triggered by genetic and environmental factors, leading to demyelination and axonal loss. Researchers consider infectious agents, like Helicobacter pylori, as these environmental factors. H. pylori can permanently infect someone’s stomach and cause an acute or chronic inflammatory response, in which inflammatory mediators affect the brain and cause a pathologic disease. Methods: In this cross-sectional study, 38 patients with multiple sclerosis who were referred to the Neurology Clinic of Ghaem Hospital were included, and their serum samples were analyzed for IgM, IgA, and IgG antibodies against H. pylori by using enzyme-linked immunosorbent assay (ELISA). Results were compared with the samples of 41 sex- and age-matched controls admitted to other wards of Ghaem Hospital & had no symptoms of MS. In the end, we analyzed the data with SPSS v.20. Results: In this study, 79 patients, including 38 patients with MS disease in the case group and 41 healthy individuals in the control group, were studied. These two groups had no significant differences in demographic characteristics, including age, gender, and occupation. H. pylori seropositivity was significantly higher in patients with MS than in controls (68.4% vs 39%) (P = 0.009). In addition, comparing H. pylori seropositivity in 20 of 30 patients with relapsing-remitting MS versus 6 of 8 patients with progressive MS suggested a significant difference between these two groups (P = 0.030). Also, H. pylori seropositivity had no significant difference between males and females (39.1% vs 58.9%). Conclusions: The prevalence of H. pylori seropositivity was significantly higher in patients with MS than in control, besides this seems more frequent in a progressive type of MS than in a relapsing-remitting one, suggesting that H. pylori might be a causal factor for developing & progressing MS and this may have an adverse impact on the prognosis and course of the disease.
{"title":"Serum Evaluation of Helicobacter pylori in Patients with Multiple Sclerosis","authors":"M. Meshkat, Yeganeh Behjati, Mansooreh Bakhshi, Z. Meshkat, Mina Yazdan Mehr, R. Boostani, M. Saeidi, M. Khoshakhlagh, Amin Hooshyar Chechaklou, Mahya Najjari, Samaneh Abolbashari, A. Gholoubi","doi":"10.5812/ans-133607","DOIUrl":"https://doi.org/10.5812/ans-133607","url":null,"abstract":"Background: Multiple sclerosis (MS) is an autoimmune inflammatory disorder of the central nervous system of unknown etiology, which is believed to be caused by immune dysregulation triggered by genetic and environmental factors, leading to demyelination and axonal loss. Researchers consider infectious agents, like Helicobacter pylori, as these environmental factors. H. pylori can permanently infect someone’s stomach and cause an acute or chronic inflammatory response, in which inflammatory mediators affect the brain and cause a pathologic disease. Methods: In this cross-sectional study, 38 patients with multiple sclerosis who were referred to the Neurology Clinic of Ghaem Hospital were included, and their serum samples were analyzed for IgM, IgA, and IgG antibodies against H. pylori by using enzyme-linked immunosorbent assay (ELISA). Results were compared with the samples of 41 sex- and age-matched controls admitted to other wards of Ghaem Hospital & had no symptoms of MS. In the end, we analyzed the data with SPSS v.20. Results: In this study, 79 patients, including 38 patients with MS disease in the case group and 41 healthy individuals in the control group, were studied. These two groups had no significant differences in demographic characteristics, including age, gender, and occupation. H. pylori seropositivity was significantly higher in patients with MS than in controls (68.4% vs 39%) (P = 0.009). In addition, comparing H. pylori seropositivity in 20 of 30 patients with relapsing-remitting MS versus 6 of 8 patients with progressive MS suggested a significant difference between these two groups (P = 0.030). Also, H. pylori seropositivity had no significant difference between males and females (39.1% vs 58.9%). Conclusions: The prevalence of H. pylori seropositivity was significantly higher in patients with MS than in control, besides this seems more frequent in a progressive type of MS than in a relapsing-remitting one, suggesting that H. pylori might be a causal factor for developing & progressing MS and this may have an adverse impact on the prognosis and course of the disease.","PeriodicalId":43970,"journal":{"name":"Archives of Neuroscience","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43417404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Hassanzadeh, O. Mirmosayyeb, Sara Bagherieh, A. Afshari-Safavi, Mahdi Barzegar, Elham Moases Ghaffary, V. Shaygannejad
Background: Multiple sclerosis (MS) is categorized into four subtypes, including clinically-isolated syndrome (CIS), primary progressive multiple sclerosis (PPMS), secondary progressive multiple sclerosis (SPMS), and relapsing-remitting multiple sclerosis (RRMS). On the other hand, radiologically-isolated syndrome (RIS) is characterized by the imaging manifestations of MS rather than its clinical symptoms. Objectives: This study aimed to compare the sociodemographic and neuroimaging findings of different MS phenotypes and RIS. Methods: The current cross-sectional study was conducted on 3716 patients at the Multiple Sclerosis Clinic of Kashani Hospital, Isfahan, Iran, from June 2018 to April 2019. Patients presenting with RIS, CIS, and MS were included in this study. Results: The age of disease onset was remarkably lower in patients with RRMS, while the body mass index was significantly higher in RIS (P-value < 0.05). Other factors, including gender, occupation, marital status, smoking, and family history of MS, showed no significant difference (P-value > 0.05). Neuroimaging assessments revealed significant differences in terms of the location of the plaques, the activity of the plaques, brain atrophy, lesion load, the number of cervical plaques, and the presence of longitudinally-extended transverse myelitis (P-value < 0.05), but not regarding the activity of cervical and thoracolumbar plaques and the number of thoracolumbar lesions (P-value > 0.05). Conclusions: Different MS phenotypes showed variations in terms of sociodemographic and neuroimaging characteristics. Follow-up studies are recommended to determine the risk factors predicting the conversion of RIS and CIS to other MS phenotypes.
{"title":"Sociodemographic and Neuroimaging Evaluation of Patients with Multiple Sclerosis and Radiologically Isolated Syndrome in Isfahan, Iran","authors":"S. Hassanzadeh, O. Mirmosayyeb, Sara Bagherieh, A. Afshari-Safavi, Mahdi Barzegar, Elham Moases Ghaffary, V. Shaygannejad","doi":"10.5812/ans-137025","DOIUrl":"https://doi.org/10.5812/ans-137025","url":null,"abstract":"Background: Multiple sclerosis (MS) is categorized into four subtypes, including clinically-isolated syndrome (CIS), primary progressive multiple sclerosis (PPMS), secondary progressive multiple sclerosis (SPMS), and relapsing-remitting multiple sclerosis (RRMS). On the other hand, radiologically-isolated syndrome (RIS) is characterized by the imaging manifestations of MS rather than its clinical symptoms. Objectives: This study aimed to compare the sociodemographic and neuroimaging findings of different MS phenotypes and RIS. Methods: The current cross-sectional study was conducted on 3716 patients at the Multiple Sclerosis Clinic of Kashani Hospital, Isfahan, Iran, from June 2018 to April 2019. Patients presenting with RIS, CIS, and MS were included in this study. Results: The age of disease onset was remarkably lower in patients with RRMS, while the body mass index was significantly higher in RIS (P-value < 0.05). Other factors, including gender, occupation, marital status, smoking, and family history of MS, showed no significant difference (P-value > 0.05). Neuroimaging assessments revealed significant differences in terms of the location of the plaques, the activity of the plaques, brain atrophy, lesion load, the number of cervical plaques, and the presence of longitudinally-extended transverse myelitis (P-value < 0.05), but not regarding the activity of cervical and thoracolumbar plaques and the number of thoracolumbar lesions (P-value > 0.05). Conclusions: Different MS phenotypes showed variations in terms of sociodemographic and neuroimaging characteristics. Follow-up studies are recommended to determine the risk factors predicting the conversion of RIS and CIS to other MS phenotypes.","PeriodicalId":43970,"journal":{"name":"Archives of Neuroscience","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49067384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Mirzashahi, Mohammad Javad Dehghani Firoozabadi, M. Rostami, S. Panahi, Parham Talebiyan, Furqan Mohammed Yaseen Khan
Background: The deformity in the coronal plane is over-emphasized in the surgical management of adolescent idiopathic scoliosis (AIS), whereas the importance of the patient’s sagittal profile is generally neglected. Gold standard treatment in AIS consists of posterior instrumentation, deformity correction - through a reduction maneuver - and arthrodesis. The main focus in most reduction techniques is placed on the correction of deformity in the coronal and/or axial plane, worsening the patient’s sagittal profile. Objectives: This outcome analysis study aimed to investigate the surgical treatment of AIS patients with severe thoracic hypokyphosis (< 10) by adopting the posteromedial translation technique (PMT). Methods: In this retrospective study, the data and records of the patients with minimum 2-year follow-ups were analyzed. Correction of the deformity was radiologically assessed based on Cobb’s angle, thoracic kyphosis, and apex translation. The Scoliosis Research Society 22-item questionnaire (SRS-22r) was used for clinical evaluation before and after the surgery. Results: A total of 11 AIS patients (8 females and 3 males) with hypokyphosis underwent operations by the PMT at Imam Khomeini Hospital Complex between 2000 and 2020. According to the results, 78% correction in the coronal plane and an average correction of 56° (P < 0.001) were obtained. As for the sagittal plane, 18.8° correction was recorded (75%) (P < 0.001). Scoliosis Research Society 22-item questionnaire subscale analysis showed a significant improvement in patients' self-image (P = 0.035) and satisfaction (P = 0.043). Conclusions: The management of hypokyphosis in AIS was challenging. The PMT facilitated the tri-planar deformity correction, including a restoration of the thoracic kyphosis in all patients. A significant improvement was observed in both the coronal and sagittal profiles of the patients.
{"title":"Posteromedial Translation for Correction of Severe Hypokyphosis in Adolescent Idiopathic Scoliosis: Outcome Analysis with 2-year Follow-ups","authors":"B. Mirzashahi, Mohammad Javad Dehghani Firoozabadi, M. Rostami, S. Panahi, Parham Talebiyan, Furqan Mohammed Yaseen Khan","doi":"10.5812/ans-133139","DOIUrl":"https://doi.org/10.5812/ans-133139","url":null,"abstract":"Background: The deformity in the coronal plane is over-emphasized in the surgical management of adolescent idiopathic scoliosis (AIS), whereas the importance of the patient’s sagittal profile is generally neglected. Gold standard treatment in AIS consists of posterior instrumentation, deformity correction - through a reduction maneuver - and arthrodesis. The main focus in most reduction techniques is placed on the correction of deformity in the coronal and/or axial plane, worsening the patient’s sagittal profile. Objectives: This outcome analysis study aimed to investigate the surgical treatment of AIS patients with severe thoracic hypokyphosis (< 10) by adopting the posteromedial translation technique (PMT). Methods: In this retrospective study, the data and records of the patients with minimum 2-year follow-ups were analyzed. Correction of the deformity was radiologically assessed based on Cobb’s angle, thoracic kyphosis, and apex translation. The Scoliosis Research Society 22-item questionnaire (SRS-22r) was used for clinical evaluation before and after the surgery. Results: A total of 11 AIS patients (8 females and 3 males) with hypokyphosis underwent operations by the PMT at Imam Khomeini Hospital Complex between 2000 and 2020. According to the results, 78% correction in the coronal plane and an average correction of 56° (P < 0.001) were obtained. As for the sagittal plane, 18.8° correction was recorded (75%) (P < 0.001). Scoliosis Research Society 22-item questionnaire subscale analysis showed a significant improvement in patients' self-image (P = 0.035) and satisfaction (P = 0.043). Conclusions: The management of hypokyphosis in AIS was challenging. The PMT facilitated the tri-planar deformity correction, including a restoration of the thoracic kyphosis in all patients. A significant improvement was observed in both the coronal and sagittal profiles of the patients.","PeriodicalId":43970,"journal":{"name":"Archives of Neuroscience","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47220989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hassan Reza Mohammadi, Sohrab Sadeghi, M. Hatefi, Aryoobarzan Rahmatian
Background: One of the clinical manifestations and complications of traumatic brain injury patients is traumatic intracranial hemorrhages, divided into primary and secondary hemorrhages. Objectives: The present study was conducted to determine the prevalence of subarachnoid hemorrhage (SAH) in traumatic brain injury (TBI) patients. Methods: The present cross-sectional study was conducted on all TBI patients with SAH for one year. Data collection tools include a demographic profile form and a researcher-made checklist. The severity of TBI is divided according to the Glasgow Coma Scale (GCS) score. The patient’s history and clinical examinations were considered when admitting to the hospital. The consciousness level was measured at 6-to-24-hour intervals, a computed tomography (CT) scan was performed, and any abnormal SAH-related clinical findings and symptoms were recorded. If the patient had other hemorrhages besides SAH, the hematoma volume was recorded. The collected data were entered into and analyzed by SPSS version 16 software. Results: A total of 534 patients were investigated, of whom 84 (15.3%) had intracranial hemorrhage. Out of 84 patients with intracranial hemorrhage, 12 (2.2%) had SAH, of whom ten were male and 2 were female. Also, SAH occurred to traffic accidents, falls, and other related reasons in 7 (58.3%), 4 (33.3%), and 1 (8.3%) patients, respectively. It was also shown that 1 (8.3%), 2 (16.6%), and 9 (75%) patients with SAH had mild, moderate, and severe consciousness, respectively. Regarding the frequency of SAH-related diseases, it was shown that 2 (16.6%) and 10 (82.3%) patients were diabetic and non-diabetic, 4 (33.3%) and 8(66.6%) patients were hypertensive and non-hypertensive, and 7 (58.3%) and 5 (41.6%) patients were with and without a history of skull fractures, respectively, 12 (100%) of them had a history of coagulation disorders. Conclusions: The prevalence of intracranial hemorrhage and SAH in TBI patients is significantly high, which should be taken into consideration when performing diagnostic and therapeutic procedures for these patients.
{"title":"Prevalence of Subarachnoid Hemorrhage in Traumatic Brain Injury Patients: A Cross-Sectional Study","authors":"Hassan Reza Mohammadi, Sohrab Sadeghi, M. Hatefi, Aryoobarzan Rahmatian","doi":"10.5812/ans-136402","DOIUrl":"https://doi.org/10.5812/ans-136402","url":null,"abstract":"Background: One of the clinical manifestations and complications of traumatic brain injury patients is traumatic intracranial hemorrhages, divided into primary and secondary hemorrhages. Objectives: The present study was conducted to determine the prevalence of subarachnoid hemorrhage (SAH) in traumatic brain injury (TBI) patients. Methods: The present cross-sectional study was conducted on all TBI patients with SAH for one year. Data collection tools include a demographic profile form and a researcher-made checklist. The severity of TBI is divided according to the Glasgow Coma Scale (GCS) score. The patient’s history and clinical examinations were considered when admitting to the hospital. The consciousness level was measured at 6-to-24-hour intervals, a computed tomography (CT) scan was performed, and any abnormal SAH-related clinical findings and symptoms were recorded. If the patient had other hemorrhages besides SAH, the hematoma volume was recorded. The collected data were entered into and analyzed by SPSS version 16 software. Results: A total of 534 patients were investigated, of whom 84 (15.3%) had intracranial hemorrhage. Out of 84 patients with intracranial hemorrhage, 12 (2.2%) had SAH, of whom ten were male and 2 were female. Also, SAH occurred to traffic accidents, falls, and other related reasons in 7 (58.3%), 4 (33.3%), and 1 (8.3%) patients, respectively. It was also shown that 1 (8.3%), 2 (16.6%), and 9 (75%) patients with SAH had mild, moderate, and severe consciousness, respectively. Regarding the frequency of SAH-related diseases, it was shown that 2 (16.6%) and 10 (82.3%) patients were diabetic and non-diabetic, 4 (33.3%) and 8(66.6%) patients were hypertensive and non-hypertensive, and 7 (58.3%) and 5 (41.6%) patients were with and without a history of skull fractures, respectively, 12 (100%) of them had a history of coagulation disorders. Conclusions: The prevalence of intracranial hemorrhage and SAH in TBI patients is significantly high, which should be taken into consideration when performing diagnostic and therapeutic procedures for these patients.","PeriodicalId":43970,"journal":{"name":"Archives of Neuroscience","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46578765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nazanin Azizi, M. Maghbooli, Mina Rostami, Saeid Kian
Background: Cerebral venous sinus thrombosis (CVST) is a potentially life-threatening condition with a wide range of clinical presentations, from localized headache (the most common symptom) to mental status disturbances, seizures, and coma. Objectives: The main purpose of this study was to evaluate serum levels of ferritin, iron, and total iron binding capacity (TIBC) and their possible relationship with different parameters in CVST patients. Methods: Thirty patients with a definitive diagnosis of CVST based on brain magnetic resonance imaging (MRI) and magnetic resonance venography (MRV) results participated in the study. During the first 24 hours after admission, 5 cc of blood sample was collected from each patient and delivered to the laboratory to measure serum ferritin, iron, and TIBC levels. Results: Twenty-four women and six men (mean age: 42.6 ± 16.33 years) participated in the study. The mean levels of serum iron, TIBC, and ferritin were within normal ranges (99.40 ± 29.97 mg/dL, 324.50 ± 49.57 mg/dL, and 87.36 ± 88.84 ng/mL, respectively). There were no significant relationships between serum ferritin, iron, TIBC levels, oral contraceptive pills consumption, history of CVST or cerebrovascular accident (CVA), underlying diseases, and the involved sinus. Conclusions: The current study showed no possible benefits of using serum ferritin, iron, and TIBC indices in CVST patients.
{"title":"Serum Levels of Ferritin, Iron, and TIBC in Cerebral Venous Sinus Thrombosis","authors":"Nazanin Azizi, M. Maghbooli, Mina Rostami, Saeid Kian","doi":"10.5812/ans-134857","DOIUrl":"https://doi.org/10.5812/ans-134857","url":null,"abstract":"Background: Cerebral venous sinus thrombosis (CVST) is a potentially life-threatening condition with a wide range of clinical presentations, from localized headache (the most common symptom) to mental status disturbances, seizures, and coma. Objectives: The main purpose of this study was to evaluate serum levels of ferritin, iron, and total iron binding capacity (TIBC) and their possible relationship with different parameters in CVST patients. Methods: Thirty patients with a definitive diagnosis of CVST based on brain magnetic resonance imaging (MRI) and magnetic resonance venography (MRV) results participated in the study. During the first 24 hours after admission, 5 cc of blood sample was collected from each patient and delivered to the laboratory to measure serum ferritin, iron, and TIBC levels. Results: Twenty-four women and six men (mean age: 42.6 ± 16.33 years) participated in the study. The mean levels of serum iron, TIBC, and ferritin were within normal ranges (99.40 ± 29.97 mg/dL, 324.50 ± 49.57 mg/dL, and 87.36 ± 88.84 ng/mL, respectively). There were no significant relationships between serum ferritin, iron, TIBC levels, oral contraceptive pills consumption, history of CVST or cerebrovascular accident (CVA), underlying diseases, and the involved sinus. Conclusions: The current study showed no possible benefits of using serum ferritin, iron, and TIBC indices in CVST patients.","PeriodicalId":43970,"journal":{"name":"Archives of Neuroscience","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42263365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Z. Zolghadr, S. A. Batouli, M. Tehrani-Doost, Lida Shafaghi, M. Hadjighassem, H. Alavi Majd, Y. Mehrabi
Background: The precise identification of attention deficit-hyperactivity disorder (ADHD) is one of the challenging clinical processes. Disorganizations in functional neural networks revealed via functional magnetic resonance imaging have recently been contributing. Machine learning approaches, particularly classification methods, have commonly been employed as a framework for diverse data analysis, indicating promising medical diagnosis results. However, as the neuroimaging data are high-dimensional with a low sample size (the current dataset), this study aimed to evaluate the classification performance of the models by considering the specific contribution of the sparsity of data matrices. Methods: This cross-sectional study analyzed the preprocessed data from the 2011 ADHD-200 Global Competition. A total of 768 and 171 data items were considered training and test, respectively. The diagnosis status was used as a response variable. Age, gender, hand dominance, and activity relationship between 116 brain regions derived from inverse covariance matrix and inverse sparse covariance matrix were used as predictive variables. Accordingly, this study compared the performance of three models, namely support vector machine (SVM), distance-weighted discrimination (DWD), and data maximum dispersion classifier (DMDC) for ADHD categorization. Results: The highest value for the total accuracy was reported for the SVM model on the sparse covariance matrix. Moreover, the highest values for the balanced classification rate (BCR) (59%) and sensitivity (64%) were reported for DMDC on the sparse covariance matrix. The best level of specificity (99%) was obtained from DWD using the sparse covariance matrix. The highest levels of the values (i.e., total accuracy and BCR) were achieved through the model fitting on the sparse matrices. Among the six models, the DMDC model on sparse covariance matrix was the most optimal algorithm due to the superiority of the two indices (i.e., accuracy: 60% and BCR: 60%) and the favorable balance between sensitivity and specificity values. Conclusions: Among the current studied three models, DMDC performance, applying the sparse data, remarkably improved the results of classification processes. Based on the present findings, the neuronal connectivity among subcortical structures comprising parts of the basal ganglia and cerebellum provides a distinction between ADHD subjects and healthy controls.
背景:注意缺陷多动障碍(ADHD)的准确诊断是具有挑战性的临床过程之一。通过功能性磁共振成像揭示的功能神经网络的紊乱最近有所贡献。机器学习方法，特别是分类方法，通常被用作各种数据分析的框架，表明有希望的医学诊断结果。然而，由于神经成像数据是高维的，样本量小(当前数据集)，本研究旨在通过考虑数据矩阵稀疏度的具体贡献来评估模型的分类性能。方法:本横断面研究分析了2011年ADHD-200全球竞赛的预处理数据。总共有768和171个数据项分别被认为是训练和测试。诊断状态作为响应变量。用逆协方差矩阵和逆稀疏协方差矩阵得出的116个脑区年龄、性别、手优势和活动关系作为预测变量。因此，本研究比较了支持向量机(SVM)、距离加权判别(distance-weighted discrimination, DWD)和数据最大离散分类器(data maximum dispersion classifier, DMDC)三种模型对ADHD分类的性能。结果:SVM模型在稀疏协方差矩阵上的总准确率最高。此外，据报道，稀疏协方差矩阵上的DMDC的平衡分类率(BCR)(59%)和灵敏度(64%)最高。使用稀疏协方差矩阵从DWD获得最佳特异性水平(99%)。通过在稀疏矩阵上进行模型拟合，获得了最高水平的值(即总精度和BCR)。在6个模型中，基于稀疏协方差矩阵的DMDC模型由于两个指标(准确率为60%，BCR为60%)的优越性以及灵敏度和特异性值之间的良好平衡，是最优算法。结论:在目前研究的三种模型中，应用稀疏数据的DMDC性能显著改善了分类过程的结果。基于目前的发现，包括基底神经节和小脑部分的皮质下结构之间的神经元连接提供了ADHD受试者和健康对照组之间的区别。
{"title":"Improvement of Classification Performance in High-Dimension Low-Sample-Size Modeling by Sparse Functional Connectivity States in Subjects with Attention Deficit-Hyperactivity Disorder and Healthy Controls","authors":"Z. Zolghadr, S. A. Batouli, M. Tehrani-Doost, Lida Shafaghi, M. Hadjighassem, H. Alavi Majd, Y. Mehrabi","doi":"10.5812/ans-134329","DOIUrl":"https://doi.org/10.5812/ans-134329","url":null,"abstract":"Background: The precise identification of attention deficit-hyperactivity disorder (ADHD) is one of the challenging clinical processes. Disorganizations in functional neural networks revealed via functional magnetic resonance imaging have recently been contributing. Machine learning approaches, particularly classification methods, have commonly been employed as a framework for diverse data analysis, indicating promising medical diagnosis results. However, as the neuroimaging data are high-dimensional with a low sample size (the current dataset), this study aimed to evaluate the classification performance of the models by considering the specific contribution of the sparsity of data matrices. Methods: This cross-sectional study analyzed the preprocessed data from the 2011 ADHD-200 Global Competition. A total of 768 and 171 data items were considered training and test, respectively. The diagnosis status was used as a response variable. Age, gender, hand dominance, and activity relationship between 116 brain regions derived from inverse covariance matrix and inverse sparse covariance matrix were used as predictive variables. Accordingly, this study compared the performance of three models, namely support vector machine (SVM), distance-weighted discrimination (DWD), and data maximum dispersion classifier (DMDC) for ADHD categorization. Results: The highest value for the total accuracy was reported for the SVM model on the sparse covariance matrix. Moreover, the highest values for the balanced classification rate (BCR) (59%) and sensitivity (64%) were reported for DMDC on the sparse covariance matrix. The best level of specificity (99%) was obtained from DWD using the sparse covariance matrix. The highest levels of the values (i.e., total accuracy and BCR) were achieved through the model fitting on the sparse matrices. Among the six models, the DMDC model on sparse covariance matrix was the most optimal algorithm due to the superiority of the two indices (i.e., accuracy: 60% and BCR: 60%) and the favorable balance between sensitivity and specificity values. Conclusions: Among the current studied three models, DMDC performance, applying the sparse data, remarkably improved the results of classification processes. Based on the present findings, the neuronal connectivity among subcortical structures comprising parts of the basal ganglia and cerebellum provides a distinction between ADHD subjects and healthy controls.","PeriodicalId":43970,"journal":{"name":"Archives of Neuroscience","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44120159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The enhanced recovery after surgery (ERAS) protocol encompasses a set of evidence-based interventions implemented preoperatively, intraoperatively, and postoperatively. Objectives: This study aimed to assess the impact of applying an accelerated recovery method on remobilization time in patients undergoing spinal surgery compared to a control group. Methods: This randomized controlled trial took place at Shariati Hospital in Tehran, Iran. Eligible participants scheduled for elective spine surgery were enrolled in the study. Remobilization was defined as the patient's ability to independently leave the bed and ambulate. The ERAS protocol, derived from recommendations by the ERAS Society, was implemented. Total intravenous anesthesia was administered for induction and maintenance. The means of variables between the control and intervention groups were compared using an independent t-test. Changes in patients' pain intensity over time were examined through a repeated-measures ANOVA test. Multiple regression analysis was conducted to identify predictors of remobilization time. Results: A total of 70 patients (mean age 47.56 ± 14.08) were included in the study. The control group exhibited a significantly longer hospital stay compared to the ERAS group (46 h vs. 32 h). Furthermore, the ERAS group demonstrated a significantly shorter remobilization time after surgery compared to the control group (18 h vs. 8 h) (P < 0.001). Both groups exhibited a downward trend in overall pain, with the ERAS group experiencing a significantly faster pain reduction (η2 = 0.106, λ = 0.171, P < 0.001). Remobilization time exhibited significant correlations with pain intensity immediately after surgery (r = 0.651, P < 0.001), pain intensity one hour after surgery (r = 0.723, P < 0.001), pain intensity six hours after surgery (r = 0.391, P = 0.001), fentanyl dose (r = 0.728, P < 0.001), and length of hospital stay (r = 0.727, P < 0.001). Multiple regression analysis revealed that pain intensity one hour after surgery, fentanyl dose, and hospital stay significantly predicted remobilization time (F (9,60) = 22.751, P < 0.001). Conclusions: The implementation of the ERAS protocol yielded several beneficial outcomes, including reduced pain intensity, shorter ICU and hospital stays, and accelerated remobilization time. Pain intensity and opioid consumption (as analgesia) emerged as significant predictors of remobilization time.
{"title":"Accelerating Remobilization Time Following Spine Surgery Using Enhanced Recovery After Surgery: A Randomized Controlled Trial","authors":"Arash Heroabadi, Sahar Adeli, H. A. Varpaei","doi":"10.5812/ans-133609","DOIUrl":"https://doi.org/10.5812/ans-133609","url":null,"abstract":"Background: The enhanced recovery after surgery (ERAS) protocol encompasses a set of evidence-based interventions implemented preoperatively, intraoperatively, and postoperatively. Objectives: This study aimed to assess the impact of applying an accelerated recovery method on remobilization time in patients undergoing spinal surgery compared to a control group. Methods: This randomized controlled trial took place at Shariati Hospital in Tehran, Iran. Eligible participants scheduled for elective spine surgery were enrolled in the study. Remobilization was defined as the patient's ability to independently leave the bed and ambulate. The ERAS protocol, derived from recommendations by the ERAS Society, was implemented. Total intravenous anesthesia was administered for induction and maintenance. The means of variables between the control and intervention groups were compared using an independent t-test. Changes in patients' pain intensity over time were examined through a repeated-measures ANOVA test. Multiple regression analysis was conducted to identify predictors of remobilization time. Results: A total of 70 patients (mean age 47.56 ± 14.08) were included in the study. The control group exhibited a significantly longer hospital stay compared to the ERAS group (46 h vs. 32 h). Furthermore, the ERAS group demonstrated a significantly shorter remobilization time after surgery compared to the control group (18 h vs. 8 h) (P < 0.001). Both groups exhibited a downward trend in overall pain, with the ERAS group experiencing a significantly faster pain reduction (η2 = 0.106, λ = 0.171, P < 0.001). Remobilization time exhibited significant correlations with pain intensity immediately after surgery (r = 0.651, P < 0.001), pain intensity one hour after surgery (r = 0.723, P < 0.001), pain intensity six hours after surgery (r = 0.391, P = 0.001), fentanyl dose (r = 0.728, P < 0.001), and length of hospital stay (r = 0.727, P < 0.001). Multiple regression analysis revealed that pain intensity one hour after surgery, fentanyl dose, and hospital stay significantly predicted remobilization time (F (9,60) = 22.751, P < 0.001). Conclusions: The implementation of the ERAS protocol yielded several beneficial outcomes, including reduced pain intensity, shorter ICU and hospital stays, and accelerated remobilization time. Pain intensity and opioid consumption (as analgesia) emerged as significant predictors of remobilization time.","PeriodicalId":43970,"journal":{"name":"Archives of Neuroscience","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43571648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hassan Reza Mohammadi, Aryoobarzan Rahmatian, M. Hatefi, Sohrab Sadeghi
Background: Lumbar spine surgery (LSS) is performed to manage patients with lumbar discs. These patients commonly experience pain, fear, and disability after LSS surgery. Objectives: Considering the importance of LSS surgery and its outcomes in these patients, the purpose of the present study was to compare pain intensity, fear of movement, and disability before and after LSS. Methods: In this descriptive and analytical research, the population under study included all patients undergoing LSS at the Imam Khomeini Hospital of Ilam City from October 2015 to October 2016. Demographic and clinical information questionnaires, pain catastrophizing scale (PCS), tampa scale for kinesiophobia (TSK), and Physical Disability Questionnaire (PDQ) were data collection tools, which were completed for the patients referring to our center and undergoing LSS according to diagnostic findings and clinical documents. The patient’s condition was evaluated using the aforementioned questionnaires six months to one year after the study. The collected data were analyzed using SPSS software. Results: The mean (SD) score of PCS before surgery was equal to 51.17 (7.53) in men and 63.84 (4.72) in women (P = 0.004). Nine weeks after the surgery, the PCS score was 19.36 (4.94) in men and 23.31 (6.68) in women (P = 0.04). There were significant decreases in all variables, including the PCS score, Brief Pain Inventory score, and PDQ score after the intervention compared to pre-intervention (P < 0.05). Conclusions: Considering that LSS can effectively reduce patients’ pain intensity, disability, and fear of movement, this intervention is recommended for patients who need surgery according to relevant diagnostic criteria and clinical examination findings.
{"title":"Comparison of Pain Intensity, Fear of Movement, and Disability Before and After Lumbar Spine Surgery","authors":"Hassan Reza Mohammadi, Aryoobarzan Rahmatian, M. Hatefi, Sohrab Sadeghi","doi":"10.5812/ans-136537","DOIUrl":"https://doi.org/10.5812/ans-136537","url":null,"abstract":"Background: Lumbar spine surgery (LSS) is performed to manage patients with lumbar discs. These patients commonly experience pain, fear, and disability after LSS surgery. Objectives: Considering the importance of LSS surgery and its outcomes in these patients, the purpose of the present study was to compare pain intensity, fear of movement, and disability before and after LSS. Methods: In this descriptive and analytical research, the population under study included all patients undergoing LSS at the Imam Khomeini Hospital of Ilam City from October 2015 to October 2016. Demographic and clinical information questionnaires, pain catastrophizing scale (PCS), tampa scale for kinesiophobia (TSK), and Physical Disability Questionnaire (PDQ) were data collection tools, which were completed for the patients referring to our center and undergoing LSS according to diagnostic findings and clinical documents. The patient’s condition was evaluated using the aforementioned questionnaires six months to one year after the study. The collected data were analyzed using SPSS software. Results: The mean (SD) score of PCS before surgery was equal to 51.17 (7.53) in men and 63.84 (4.72) in women (P = 0.004). Nine weeks after the surgery, the PCS score was 19.36 (4.94) in men and 23.31 (6.68) in women (P = 0.04). There were significant decreases in all variables, including the PCS score, Brief Pain Inventory score, and PDQ score after the intervention compared to pre-intervention (P < 0.05). Conclusions: Considering that LSS can effectively reduce patients’ pain intensity, disability, and fear of movement, this intervention is recommended for patients who need surgery according to relevant diagnostic criteria and clinical examination findings.","PeriodicalId":43970,"journal":{"name":"Archives of Neuroscience","volume":"1 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41343413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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