Dr Amir Radfar, MD,MPH,MSC,DHSc - A.T.Still.University

Dr Amir Radfar

MD,MPH,MSC,DHSc

A.T.Still.University

United States

Main Specialties: Oncology, Preventive Medicine, Public Health

Additional Specialties: Oncology and Public Health

ORCID logohttps://orcid.org/0000-0001-6177-3048

Dr Amir Radfar, MD,MPH,MSC,DHSc - A.T.Still.University

Dr Amir Radfar

MD,MPH,MSC,DHSc

Introduction

Primary Affiliation: A.T.Still.University - United States

Specialties:

Additional Specialties:

Research Interests:

Education

Jan 1988 - Jan 1996
Shiraz University of Medical Sciences
Doctor of Medicine/MD
Florida International University
Master of Public Health
Occupational and Environmental Medicine
Universität Ulm Medizinische Fakultät
MSc
Advanced oncology
A.T Still University
Doctor of Health Sciences /DHSc
University of Southern California
Post doctoral Fellowship
University of Massachusetts Lowell
Post graduate training

Publications

66Publications

1108Reads

10Profile Views

985PubMed Central Citations

Global, regional, and national burden of traumatic brain injury and spinal cord injury, 1990–2016 : a systematic analysis for the Global Burden of Disease Study 2016

Background: Traumatic brain injury (TBI) and spinal cord injury (SCI) are increasingly recognised as global health priorities in view of the preventability of most injuries and the complex and expensive medical care they necessitate. We aimed to measure the incidence, prevalence, and years of life lived with disability (YLDs) for TBI and SCI from all causes of injury in every country, to describe how these measures have changed between 1990 and 2016, and to estimate the proportion of TBI and SCI cases caused by different types of injury. Methods: We used results from the Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study 2016 to measure the global, regional, and national burden of TBI and SCI by age and sex. We measured the incidence and prevalence of all causes of injury requiring medical care in inpatient and outpatient records, literature studies, and survey data. By use of clinical record data, we estimated the proportion of each cause of injury that required medical care that would result in TBI or SCI being considered as the nature of injury. We used literature studies to establish standardised mortality ratios and applied differential equations to convert incidence to prevalence of long-term disability. Finally, we applied GBD disability weights to calculate YLDs. We used a Bayesian meta-regression tool for epidemiological modelling, used cause-specific mortality rates for non-fatal estimation, and adjusted our results for disability experienced with comorbid conditions. We also analysed results on the basis of the Socio-demographic Index, a compound measure of income per capita, education, and fertility. Findings: In 2016, there were 27·08 million (95% uncertainty interval [UI] 24·30–30·30 million) new cases of TBI and 0·93 million (0·78–1·16 million) new cases of SCI, with age-standardised incidence rates of 369 (331–412) per 100 000 population for TBI and 13 (11–16) per 100 000 for SCI. In 2016, the number of prevalent cases of TBI was 55·50 million (53·40–57·62 million) and of SCI was 27·04 million (24·98–30·15 million). From 1990 to 2016, the age-standardised prevalence of TBI increased by 8·4% (95% UI 7·7 to 9·2), whereas that of SCI did not change significantly (−0·2% [–2·1 to 2·7]). Age-standardised incidence rates increased by 3·6% (1·8 to 5·5) for TBI, but did not change significantly for SCI (−3·6% [–7·4 to 4·0]). TBI caused 8·1 million (95% UI 6·0–10·4 million) YLDs and SCI caused 9·5 million (6·7–12·4 million) YLDs in 2016, corresponding to age-standardised rates of 111 (82–141) per 100 000 for TBI and 130 (90–170) per 100 000 for SCI. Falls and road injuries were the leading causes of new cases of TBI and SCI in most regions. Interpretation: TBI and SCI constitute a considerable portion of the global injury burden and are caused primarily by falls and road injuries. The increase in incidence of TBI over time might continue in view of increases in population density, population ageing, and increasing use of motor vehicles, motorcycles, and bicycles. The number of individuals living with SCI is expected to increase in view of population growth, which is concerning because of the specialised care that people with SCI can require. Our study was limited by data sparsity in some regions, and it will be important to invest greater resources in collection of data for TBI and SCI to improve the accuracy of future assessments. Funding: Bill & Melinda Gates Foundation.

https://doi.org/10.1016/S1474-4422(18)30415-0

View Article
2019

Danger ahead: the burden of diseases, injuries, and risk factors in the Eastern Mediterranean Region, 1990-2015.

Authors:

Int J Public Health 2018 May 3;63(Suppl 1):11-23. Epub 2017 Aug 3.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00038-017-1017-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5973982PMC
May 2018
5 Citations
1.970 Impact Factor

Adolescent health in the Eastern Mediterranean Region: findings from the global burden of disease 2015 study.

Authors:

Int J Public Health 2018 May 3;63(Suppl 1):79-96. Epub 2017 Aug 3.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00038-017-1003-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5701730PMC
May 2018
6 Reads
4 Citations
1.970 Impact Factor

Burden of cardiovascular diseases in the Eastern Mediterranean Region, 1990-2015: findings from the Global Burden of Disease 2015 study.

Authors:

Int J Public Health 2018 May 3;63(Suppl 1):137-149. Epub 2017 Aug 3.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00038-017-1012-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5973984PMC
May 2018
2 Reads
5 Citations
1.970 Impact Factor

Maternal mortality and morbidity burden in the Eastern Mediterranean Region: findings from the Global Burden of Disease 2015 study.

Authors:

Int J Public Health 2018 May 3;63(Suppl 1):47-61. Epub 2017 Aug 3.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00038-017-1004-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5973988PMC
May 2018
27 Reads
2 Citations
1.970 Impact Factor

Burden of diarrhea in the Eastern Mediterranean Region, 1990-2015: Findings from the Global Burden of Disease 2015 study.

Authors:

Int J Public Health 2018 May 3;63(Suppl 1):109-121. Epub 2017 Aug 3.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00038-017-1008-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5973974PMC
May 2018
2 Reads
2 Citations
1.970 Impact Factor

Maternal mortality and morbidity burden in the Eastern Mediterranean Region: findings from the Global Burden of Disease 2015 study.

Authors:

Int J Public Health 2018 May 3;63(Suppl 1):47-61. Epub 2017 Aug 3.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00038-017-1004-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5973988PMC
May 2018
27 Reads
2 Citations
1.970 Impact Factor

[In Press] Trends in HIV/AIDS morbidity and mortality in Eastern Mediterranean countries, 1990–2015 : findings from the Global Burden of Disease 2015 Study

Objectives: We used the results of the Global Burden of Disease 2015 study to estimate trends of HIV/AIDS burden in Eastern Mediterranean Region (EMR) countries between 1990 and 2015. Methods: Tailored estimation methods were used to produce final estimates of mortality. Years of life lost (YLLs) were calculated by multiplying the mortality rate by population by age-specific life expectancy. Years lived with disability (YLDs) were computed as the prevalence of a sequela multiplied by its disability weight. Results: In 2015, the rate of HIV/AIDS deaths in the EMR was 1.8 (1.4–2.5) per 100,000 population, a 43% increase from 1990 (0.3; 0.2–0.8). Consequently, the rate of YLLs due to HIV/AIDS increased from 15.3 (7.6–36.2) per 100,000 in 1990 to 81.9 (65.3–114.4) in 2015. The rate of YLDs increased from 1.3 (0.6–3.1) in 1990 to 4.4 (2.7–6.6) in 2015. Conclusions: HIV/AIDS morbidity and mortality increased in the EMR since 1990. To reverse this trend and achieve epidemic control, EMR countries should strengthen HIV surveillance, and scale up HIV antiretroviral therapy and comprehensive prevention services.

https://doi.org/10.1007/s00038-017-1023-0

View Article
2017

Telemedicine: New horizons in healthcare.

Telemedicine allows physicians to provide medical care remotely through audiovisual technology. Telemedicine may address many challenges facing our society: an aging population, chronic disease management, and healthcare cost. With this work, we attempt to evaluate how telemedicine can effect a change in these challenges, and evaluate what obstacles prevent some providers from using it.Methods: In this work, the cost-effectiveness, success of telemedicine care, usefulness in reaching developing and underdeveloped areas, difficulties preventing the use of telemedicine, and proposals to overcome these challenges were reviewed and analyzed.Results: Cost of telemedicine was reported 19% less expensive than traditional face-to-face care. In several studies, telemedicine was documented to have had equal or better outcomes for obstructive sleep apnea, geriatrics, heart failure, preventative medicine, and patient compliance. Difficulties in using telemedicine include affordability of equipment, lack of technical support in developing or underdeveloped areas, legality of licensure and patient privacy and satisfaction.Conclusions: Although cost savings and convenience are major advantages of this technology, concerns with delivery barriers and challenges require cautious embracement of telemedicine. A great deal of research is needed to show that telemedicine improves patient centered outcomes. Telemedicine: New horizons in healthcare. Available from: https://www.researchgate.net/publication/314107938_Telemedicine_New_horizons_in_healthcare [accessed Jun 4, 2017].

http://nsuworks.nova.edu/hpd_hs_facarticles/1

View Article
2017

The Burden of Primary Liver Cancer and Underlying Etiologies From 1990 to 2015 at the Global, Regional, and National Level: Results From the Global Burden of Disease Study 2015.

JAMA Oncol 2017 12;3(12):1683-1691

University of Washington, Institute for Health Metrics and Evaluation, Seattle

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1001/jamaoncol.2017.3055DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5824275PMC
December 2017
72 Reads
25 Citations

Ki67 Labeling Correlated With Invasion But Not With Recurrence.

Appl Immunohistochem Mol Morphol 2017 May/Jun;25(5):341-345

*Onco-Pathology Research Center Departments of ‡Otolaryngology and Head & Neck Surgery ¶Pathology, Rasoul Akram Hospital, Iran University of Medical Sciences †Department of Endocrinology, Iran Mehr Hospital, Tehran, Iran §A.T. Still University, Mesa, AZ ∥Keiser Permanente, Fontana, CA.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/PAI.0000000000000303DOI Listing
November 2017
10 Reads
4 Citations

Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-years for 32 Cancer Groups, 1990 to 2015: A Systematic Analysis for the Global Burden of Disease Study.

Authors:
Christina Fitzmaurice Christine Allen Ryan M Barber Lars Barregard Zulfiqar A Bhutta Hermann Brenner Daniel J Dicker Odgerel Chimed-Orchir Rakhi Dandona Lalit Dandona Tom Fleming Mohammad H Forouzanfar Jamie Hancock Roderick J Hay Rachel Hunter-Merrill Chantal Huynh H Dean Hosgood Catherine O Johnson Jost B Jonas Jagdish Khubchandani G Anil Kumar Michael Kutz Qing Lan Heidi J Larson Xiaofeng Liang Stephen S Lim Alan D Lopez Michael F MacIntyre Laurie Marczak Neal Marquez Ali H Mokdad Christine Pinho Farshad Pourmalek Joshua A Salomon Juan Ramon Sanabria Logan Sandar Benn Sartorius Stephen M Schwartz Katya A Shackelford Kenji Shibuya Jeff Stanaway Caitlyn Steiner Jiandong Sun Ken Takahashi Stein Emil Vollset Theo Vos Joseph A Wagner Haidong Wang Ronny Westerman Hajo Zeeb Leo Zoeckler Foad Abd-Allah Muktar Beshir Ahmed Samer Alabed Noore K Alam Saleh Fahed Aldhahri Girma Alem Mulubirhan Assefa Alemayohu Raghib Ali Rajaa Al-Raddadi Azmeraw Amare Yaw Amoako Al Artaman Hamid Asayesh Niguse Atnafu Ashish Awasthi Huda Ba Saleem Aleksandra Barac Neeraj Bedi Isabela Bensenor Adugnaw Berhane Eduardo Bernabé Balem Betsu Agnes Binagwaho Dube Boneya Ismael Campos-Nonato Carlos Castañeda-Orjuela Ferrán Catalá-López Peggy Chiang Chioma Chibueze Abdulaal Chitheer Jee-Young Choi Benjamin Cowie Solomon Damtew José das Neves Suhojit Dey Samath Dharmaratne Preet Dhillon Eric Ding Tim Driscoll Donatus Ekwueme Aman Yesuf Endries Maryam Farvid Farshad Farzadfar Joao Fernandes Florian Fischer Tsegaye Tewelde G/Hiwot Alemseged Gebru Sameer Gopalani Alemayehu Hailu Masako Horino Nobuyuki Horita Abdullatif Husseini Inge Huybrechts Manami Inoue Farhad Islami Mihajlo Jakovljevic Spencer James Mehdi Javanbakht Sun Ha Jee Amir Kasaeian Muktar Sano Kedir Yousef S Khader Young-Ho Khang Daniel Kim James Leigh Shai Linn Raimundas Lunevicius Hassan Magdy Abd El Razek Reza Malekzadeh Deborah Carvalho Malta Wagner Marcenes Desalegn Markos Yohannes A Melaku Kidanu G Meles Walter Mendoza Desalegn Tadese Mengiste Tuomo J Meretoja Ted R Miller Karzan Abdulmuhsin Mohammad Alireza Mohammadi Shafiu Mohammed Maziar Moradi-Lakeh Gabriele Nagel Devina Nand Quyen Le Nguyen Sandra Nolte Felix A Ogbo Kelechi E Oladimeji Eyal Oren Mahesh Pa Eun-Kee Park David M Pereira Dietrich Plass Mostafa Qorbani Amir Radfar Anwar Rafay Mahfuzar Rahman Saleem M Rana Kjetil Søreide Maheswar Satpathy Monika Sawhney Sadaf G Sepanlou Masood Ali Shaikh Jun She Ivy Shiue Hirbo Roba Shore Mark G Shrime Samuel So Samir Soneji Vasiliki Stathopoulou Konstantinos Stroumpoulis Muawiyyah Babale Sufiyan Bryan L Sykes Rafael Tabarés-Seisdedos Fentaw Tadese Bemnet Amare Tedla Gizachew Assefa Tessema J S Thakur Bach Xuan Tran Kingsley Nnanna Ukwaja Benjamin S Chudi Uzochukwu Vasiliy Victorovich Vlassov Elisabete Weiderpass Mamo Wubshet Terefe Henock Gebremedhin Yebyo Hassen Hamid Yimam Naohiro Yonemoto Mustafa Z Younis Chuanhua Yu Zoubida Zaidi Maysaa El Sayed Zaki Zerihun Menlkalew Zenebe Christopher J L Murray Mohsen Naghavi

JAMA Oncol 2017 Apr;3(4):524-548

Institute for Health Metrics and Evaluation, University of Washington, Seattle.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1001/jamaoncol.2016.5688DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6103527PMC
April 2017
213 Reads
262 Citations

Health in times of uncertainty in the eastern Mediterranean region, 1990�2013: a systematic analysis for the Global Burden of Disease Study 2013

Background The eastern Mediterranean region is comprised of 22 countries: Afghanistan, Bahrain, Djibouti, Egypt, Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Palestine, Qatar, Saudi Arabia, Somalia, Sudan, Syria, Tunisia, the United Arab Emirates, and Yemen. Since our Global Burden of Disease Study 2010 (GBD 2010), the region has faced unrest as a result of revolutions, wars, and the so-called Arab uprisings. The objective of this study was to present the burden of diseases, injuries, and risk factors in the eastern Mediterranean region as of 2013. Methods GBD 2013 includes an annual assessment covering 188 countries from 1990 to 2013. The study covers 306 diseases and injuries, 1233 sequelae, and 79 risk factors. Our GBD 2013 analyses included the addition of new data through updated systematic reviews and through the contribution of unpublished data sources from collaborators, an updated version of modelling software, and several improvements in our methods. In this systematic analysis, we use data from GBD 2013 to analyse the burden of disease and injuries in the eastern Mediterranean region specifically. Findings The leading cause of death in the region in 2013 was ischaemic heart disease (90·3 deaths per 100�000 people), which increased by 17·2 since 1990. However, diarrhoeal diseases were the leading cause of death in Somalia (186·7 deaths per 100�000 people) in 2013, which decreased by 26·9 since 1990. The leading cause of disability-adjusted life-years (DALYs) was ischaemic heart disease for males and lower respiratory infection for females. High blood pressure was the leading risk factor for DALYs in 2013, with an increase of 83·3 since 1990. Risk factors for DALYs varied by country. In low-income countries, childhood wasting was the leading cause of DALYs in Afghanistan, Somalia, and Yemen, whereas unsafe sex was the leading cause in Djibouti. Non-communicable risk factors were the leading cause of DALYs in high-income and middle-income countries in the region. DALY risk factors varied by age, with child and maternal malnutrition affecting the younger age groups (aged 28 days to 4 years), whereas high bodyweight and systolic blood pressure affected older people (aged 60�80 years). The proportion of DALYs attributed to high body-mass index increased from 3·7 to 7·5 between 1990 and 2013. Burden of mental health problems and drug use increased. Most increases in DALYs, especially from non-communicable diseases, were due to population growth. The crises in Egypt, Yemen, Libya, and Syria have resulted in a reduction in life expectancy; life expectancy in Syria would have been 5 years higher than that recorded for females and 6 years higher for males had the crisis not occurred. Interpretation Our study shows that the eastern Mediterranean region is going through a crucial health phase. The Arab uprisings and the wars that followed, coupled with ageing and population growth, will have a major impact on the region's health and resources. The region has historically seen improvements in life expectancy and other health indicators, even under stress. However, the current situation will cause deteriorating health conditions for many countries and for many years and will have an impact on the region and the rest of the world. Based on our findings, we call for increased investment in health in the region in addition to reducing the conflicts. Funding Bill & Melinda Gates Foundation. © 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license

http://eprints.iums.ac.ir/3249/

View Article
2016

Measuring the health-related Sustainable Development Goals in 188 countries: a baseline analysis from the Global Burden of Disease Study 2015.

Authors:

Lancet 2016 Oct 21;388(10053):1813-1850. Epub 2016 Sep 21.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/S0140-6736(16)31467-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5055583PMC
October 2016
52 Reads
62 Citations
45.220 Impact Factor

Diagnostic Accuracy of Fine Needle Aspiration Cytology versus Concurrent Core Needle Biopsy in Evaluation of Intrathoracic Lesions: a Retrospective Comparative Study.

Asian Pac J Cancer Prev 2015 ;16(16):7385-90

Department of Pathology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran E-mail :

View Article

Download full-text PDF

Source
http://dx.doi.org/10.7314/apjcp.2015.16.16.7385DOI Listing
September 2016
2 Reads
1.500 Impact Factor

Validation of Oxford Classification of Immunoglobulin A Nephropathy: an Iranian Experience.

Iran J Kidney Dis 2016 Jan;10(1):17-21

Department of Pathology, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.

View Article

Download full-text PDF

Source
January 2016
27 Reads
0.980 Impact Factor

Avicenna's doctrine and institutional review board in international bio-medical research.

Cent Eur J Public Health 2012 Dec;20(4):297-8

University of Massachusetts, Lowell, PO Box 17584, Encino, California 91416, USA.

View Article

Download full-text PDF

Source
December 2012
5 Reads
0.800 Impact Factor

Above DNA: Predicting Epigenetic Signature Hypoxic Response

http://www.celljournal.org/components4.php?rQV==wHQwAkO0JXY0N3XmxHQ2YDQ6QWS05WZyFGcfZGfAVzMwIDQ6QWSt

Cell Journal Yakhteh

Article abstract: Hypoxia response system is a tissue-specific Oxygensensing system, which regulates the synthesis of a transcription factor known as hypoxia inducible factor 1 (HIF 1). This transcription factor controls the expression of many important genes that have impacts on both development and hypoxia related diseases. Body response in hypoxic states such as altitude change or work performance has been different. Data suggest that 10% of the mountaineers seem to react to hypoxia with an exaggerated increase of pulmonary circulation pressure. It can be argued that substantial inter-individual variability in the adaptive response to hypoxia could represent non-physiological factors as well as insensitivity of physiological markers to hypoxia-induced adaptation. These findings may be also attributed to the fact that environmental cues like hypoxia can trigger gene expression. This presentation addresses the normo-baric hypoxic state in an environmental and occupational setting and its effect on cellular and organ level. This study postulates that epigenetic signatures may represent an additional mechanism to promote and maintain a hypoxicadapted cellular phenotype. In other word, normo-baric hypoxic states might induce stable changes in phenotype, perhaps through epigenetic modifications. Article keywords: Normo-Baric Hhypoxia, HIF, Celular Adaptation, Eigenetic Effects

View Article
March 2011
5 Reads

nfliximab (Remicade) Is Effective In Controlling Multisystem Sarcoidosis: A Report Of 10 Patients

Chest Journal

PURPOSE: Sarcoidosis is a chronic granulomatous disease in which primary cytokine tumor necrosis factor (TNF)-alpha plays a major role in perpetuating the inflamation. Corticosteroids, antimalerials, immunosupperssive agents, thalidomide, and pentoxifylline have been used to control the disease. We used infliximab (Remicade) in ten patients with sarcoidosis who had earlier developed severe side-effects or responded poorly to traditional treatment. METHODS: Ten patients with biopsy proven multisystem sarcoidosis selected for infliximab therapy include 7 women and 3 men. The group comprised of 6 Caucasians, 3 African-Americans, and 1 Hispanic. The duration of sarcoidosis varied from 3 to 37 years. Eight patients had chronic skin lesions, 3 patients had pulmonary involvement and 2 patients had neurosarcoidosis. Hypercalcemia and peripheral lymphadenopathy occurred in 1 patient. RESULTS: All patients treated with infliximab showed objective evidence of improvement. One patient developed plasma cell dyscrasia after showing a marked improvement of her sarcoidosis after six infusions. CONCLUSION: Infliximab is an effective treatment for patients with refractory sarcoidosis of skin, central nervous system, bones, lungs, and herpercalcemia. The long-term effects of the drug are not known. The drug may reactivate latent tuberculosis. The relationship with plasma cell dyscrasias and lymphoproliferative diseases remains unexplained. CLINICAL IMPLICATIONS: Infliximab may be used as an effective therapeutic agent for patients with sarcoidosis who are refractory to traditional treatment options.

View Article
October 2004
6 Reads