Publications by authors named "Elham Askari"

24 Publications

  • Page 1 of 1

Concurrent chronic lymphocytic leukemia and COVID-19: A comprehensive review of epidemiological, diagnostic, and therapeutic challenges.

Leuk Res Rep 2021 16;15:100239. Epub 2021 Mar 16.

Tropical and Communicable Diseases Research Centre, Iranshahr University of Medical Sciences, Iranshahr, Iran.

A comprehensive review of the literature on chronic lymphocytic leukemia (CLL) patients and recommendations regarding the evaluation and treatment of these patients was conducted. The overall prevalence of CLL and COVID-19 concurrence was found to be 0.6% (95%CI: 0.5% to 0.7%). Diagnostic interaction between CLL and COVID-19 remains a major challenge. Also, CLL patients have a lower rate of anti-SARS-CoV-2 IgG development. Evidences show the unacceptable therapeutic outcome in these patients. Although the CLL-COVID-19 occurrence is associated with adverse clinical consequences, no general and standard agreement has yet been presented for the management and treatment of this disease.
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http://dx.doi.org/10.1016/j.lrr.2021.100239DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7962997PMC
March 2021

Comparative evaluation of SARS-CoV-2 IgG assays against nucleocapsid and spike antigens.

Hum Antibodies 2021 Feb 26. Epub 2021 Feb 26.

Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: There are few studies to compare antibody response against anti-spike (S) and anti- nucleoprotein (N) SARS-CoV-2.

Objective: The aim of this study was to evaluate the IgG antibody production against S and N antigens of the virus and their correlation with the time and severity of the disease.

Methods: The IgG antibodies against S and N antigens of SARS-CoV-2 in serum specimens 72 symptomatic patients who tested real-time reverse transcription polymerase chain reaction positive for SARS-CoV-2 were detected using the ELISA technique. Different antibody response was compared and the correlation with the time from disease onset and the severity was evaluated.

Results: Forty-eight of 72 (67%) patients tested positive for anti-SARS-CoV-2 antibodies, while 24 (33%) did not have detectable antibodies. Comparison of antibody levels for N and S antibodies showed that they correlate with each other well (r= 0.81; P< 0.001). However, sensitivity of anti-S SARS-CoV-2 IgG and anti-N SARS-CoV-2 IgG was 30% and 60%, during the first 7 days after symptom onset (r= 0.53; P= 0.111), but increased to 73% and 68% at more than 1-week post symptom onset (r= 0.89, P= 0.111), respectively. Cases with positive IgG response showed a decreased CD8 cell percentage compared to the negative IgG groups (26 ± 14 vs. 58 ± 32, p= 0.066 in anti-N IgG group and 28 ± 15 vs. 60 ± 45, p= 0.004 in anti-S IgG group, respectively).

Conclusion: Nearly one-third of the confirmed COVID-19 patients had negative serology results. Lower percent positivity at early time points after symptom onset (less than 1 week) was seen using anti-S SARS-COV-2 IgG kit compare to the anti-N SARS-CoV-2 IgG; therefore, clinicians should interpret negative serology results of especially anti-S SARS-CoV-2 IgG with caution.
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http://dx.doi.org/10.3233/HAB-210440DOI Listing
February 2021

Development and validation of a predictive model of in-hospital mortality in COVID-19 patients.

PLoS One 2021 4;16(3):e0247676. Epub 2021 Mar 4.

Department of Hematology, Hospital Universitario Fundación Jiménez Díaz, IIS-FJD, Madrid, Spain.

We retrospectively evaluated 2879 hospitalized COVID-19 patients from four hospitals to evaluate the ability of demographic data, medical history, and on-admission laboratory parameters to predict in-hospital mortality. Association of previously published risk factors (age, gender, arterial hypertension, diabetes mellitus, smoking habit, obesity, renal failure, cardiovascular/ pulmonary diseases, serum ferritin, lymphocyte count, APTT, PT, fibrinogen, D-dimer, and platelet count) with death was tested by a multivariate logistic regression, and a predictive model was created, with further validation in an independent sample. A total of 2070 hospitalized COVID-19 patients were finally included in the multivariable analysis. Age 61-70 years (p<0.001; OR: 7.69; 95%CI: 2.93 to 20.14), age 71-80 years (p<0.001; OR: 14.99; 95%CI: 5.88 to 38.22), age >80 years (p<0.001; OR: 36.78; 95%CI: 14.42 to 93.85), male gender (p<0.001; OR: 1.84; 95%CI: 1.31 to 2.58), D-dimer levels >2 ULN (p = 0.003; OR: 1.79; 95%CI: 1.22 to 2.62), and prolonged PT (p<0.001; OR: 2.18; 95%CI: 1.49 to 3.18) were independently associated with increased in-hospital mortality. A predictive model performed with these parameters showed an AUC of 0.81 in the development cohort (n = 1270) [sensitivity of 95.83%, specificity of 41.46%, negative predictive value of 98.01%, and positive predictive value of 24.85%]. These results were then validated in an independent data sample (n = 800). Our predictive model of in-hospital mortality of COVID-19 patients has been developed, calibrated and validated. The model (MRS-COVID) included age, male gender, and on-admission coagulopathy markers as positively correlated factors with fatal outcome.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0247676PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7932507PMC
March 2021

Prevalence, Risk Factors and Outcomes Associated with Acute Kidney Injury in Patients Hospitalized for COVID-19: A Comparative Study between Diabetic and Nondiabetic Patients.

J Diabetes Res 2021 6;2021:6666086. Epub 2021 Jan 6.

School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Background: The risk factors for acute kidney injury (AKI) development in patients with diabetes hospitalized for COVID-19 have not been fully studied yet. In this study, we aimed to estimate the rate of AKI among the hospitalized population with COVID-19 and to identify the risk factors associated with AKI among patients with diabetes. This retrospective cohort study included 254 patients (127 with diabetes and 127 without diabetes) who were admitted for COVID-19 to a tertiary hospital in Tehran, Iran, between February and May 2020. Clinical characteristics and outcomes, radiological findings, and laboratory data, including data on AKI, hematuria, and proteinuria were recorded and analyzed.

Results: Of 254 patients, 142 (55.9%) were male and the mean (± SD) age was 65.7 years (±12.5). In total, 58 patients (22.8%) developed AKI during hospitalization, of whom 36 patients had diabetes ( = 0.04); most patients (74.1%) had stage 1 or 2 AKI. Also, 8 patients (13.8%) required renal replacement therapy (RRT) after developing AKI. Regardless of diabetes status, patients who developed AKI had significantly higher mortality rates compared with patients who did not develop AKI ( = 0.02). Hematuria and proteinuria were observed in 38.1% and 55% of patients, respectively. Multivariate analysis showed that invasive mechanical ventilation, proteinuria, HBA1c level, history of cardiovascular disease, and use of statins were independent risk factors for AKI development in patients with diabetes.

Conclusion: Results of this study showed that AKI develops in a considerable percentage of patients with COVID-19, especially in those with diabetes, and is significantly associated with mortality.
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http://dx.doi.org/10.1155/2021/6666086DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7808817PMC
February 2021

Zanubrutinib for the treatment of MYD88 wild-type Waldenström macroglobulinemia: a substudy of the phase 3 ASPEN trial.

Blood Adv 2020 12;4(23):6009-6018

Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.

Patients with Waldenström macroglobulinemia (WM) lacking activating mutations in the MYD88 gene (MYD88WT) have demonstrated relatively poor outcomes to ibrutinib monotherapy, with no major responses reported in a phase 2 pivotal study. Zanubrutinib is a novel, selective Bruton tyrosine kinase (BTK) inhibitor designed to maximize BTK occupancy and minimize off-target activity. The ASPEN study consisted of a randomized comparison of zanubrutinib and ibrutinib efficacy and safety in patients with WM who have the MYD88 mutation, as well as a separate cohort of patients without MYD88 mutation (MYD88WT) or with unknown mutational status who received zanubrutinib. Results from the latter single-arm cohort are reported herein. Efficacy endpoints included overall, major and complete (CR) or very good partial response (VGPR) rates, progression-free survival (PFS), duration of response (DOR), and overall survival (OS). Twenty-eight patients (23 relapsed/refractory; 5 treatment-naïve) were enrolled, including 26 with centrally confirmed MYD88WT disease and 2 with unknown MYD88 mutational status. At a median follow-up of 17.9 months, 7 of 26 MYD88WT patients (27%) had achieved a VGPR and 50% a major response (partial response or better); there were no CRs. At 18 months, the estimated PFS and OS rates were 68% and 88%, respectively, while the median DOR had not been reached. Two patients discontinued zanubrutinib due to adverse events. Treatment-emergent hypertension, atrial fibrillation, and major hemorrhages were reported in 3, 1 and 2 patients (including 1 concurrent with enoxaparin therapy), respectively. Results of this substudy demonstrate that zanubrutinib monotherapy can induce high quality responses in patients with MYD88WT WM. This trial is registered on www.clinicaltrials.gov as NCT #03053440.
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http://dx.doi.org/10.1182/bloodadvances.2020003010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7724905PMC
December 2020

Lymphoplasmacytic lymphoma associated with diffuse large B-cell lymphoma: Progression or divergent evolution?

PLoS One 2020 12;15(11):e0241634. Epub 2020 Nov 12.

Pathology Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.

Aim: Lymphoplasmacytic lymphoma (LPL) is an indolent mature B-cell-neoplasm with involvement of the bone marrow. At least 90% of LPLs carry MYD88-L265P mutation and some of them (~10%) transform into diffuse large B-cell-lymphoma (DLBCL).

Material And Methods: Over the past 15 years we have collected 7 cases where the both LPL and DLBCL were diagnosed in the same patient. Clinical records, analytical data and histopathological specimens were reviewed. FISH studies on paraffin-embedded tissue for MYC, BCL2 and BCL6 genes were performed, as well as MYD88-L265P mutation and IGH rearrangement analysis by PCR. A mutational study was done by massive next generation sequencing (NGS).

Results: There were 4 women and 3 men between 36-91 years of age. Diagnoses were made simultaneously in 4 patients. In two cases the LPL appeared before the DLBCL and in the remaining case the high-grade component was discovered 5 years before the LPL. In 6 cases both samples shared the MYD88-L265P mutation. IGH rearrangement analysis showed overlapping features in two of 6 cases tested. Mutational study was evaluable in three cases for both samples showing shared and divergent mutations.

Conclusions: These data suggest different mechanisms of DLBCL development in LPL patients.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0241634PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7661053PMC
December 2020

Diffuse alveolar damage and thrombotic microangiopathy are the main histopathological findings in lung tissue biopsy samples of COVID-19 patients.

Pathol Res Pract 2020 Oct 19;216(10):153228. Epub 2020 Sep 19.

Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: Since the outbreak of the novel coronavirus disease-2019 (COVID-19) in December 2019, limited studies have investigated the histopathologic findings of patients infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2).

Material And Methods: This study was conducted on 31 deceased patients who were hospitalized for COVID-19 in a tertiary hospital in Tehran, Iran. A total of 52 postmortem tissue biopsy samples were obtained from the lungs and liver of decedents. Clinical characteristics, laboratory data, and microscopic features were evaluated. Reverse transcription polymerase chain reaction (RT-PCR) assay for SARS-CoV-2 was performed on specimens obtained from nasopharyngeal swabs and tissue biopsies.

Results: The median age of deceased patients was 66 years (range, 30-87 years) and 25 decedents (81 %) were male. The average interval from symptom onset to death was 13 days (range, 6-34 days). On histopathologic examination of the lung specimens, diffuse alveolar damage and thrombotic microangiopathy were the most common findings (80 % and 60 %, respectively). Liver specimens mainly showed macrovesicular steatosis, portal lymphoplasmacytic inflammation and passive congestion. No definitive viral inclusions were observed in any of the specimens. In addition, 92 % of lung tissue samples tested positive for SARS-CoV-2 by RT-PCR.

Conclusions: Further studies are needed to investigate whether SARS-CoV-2 causes direct cytopathic changes in various organs of the human body.
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http://dx.doi.org/10.1016/j.prp.2020.153228DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7837112PMC
October 2020

Clinical efficacy of convalescent plasma for treatment of COVID-19 infections: Results of a multicenter clinical study.

Transfus Apher Sci 2020 Oct 15;59(5):102875. Epub 2020 Jul 15.

Department of Radiology, Baqiyatallah University of Medical Sciences, Tehran, Iran.

Since Dec. 2019 the new coronavirus (SARS-CoV-2) has infected millions and claimed life of several hundred thousand worldwide. However, so far no approved vaccine or drug therapy is available for treatment of virus infection. Convalescent plasma has been considered a potential modality for COVID-19 infection. One hundred eighty-nine COVID-19 positive patients including 115 patients in plasma therapy group and 74 patients in control group, registered in the hospitals with confirmed COVID-19 infection, entered this multi-center clinical study. Comparison of outcomes including all-cause mortality, total hospitalization days and patients' need for intubation between the two patient groups shows that total of 98 (98.2 %) of patients who received convalescent plasma were discharged from hospital which is substantially higher compared to 56 (78.7 %) patients in control group. Length of hospitalization days was significantly lower (9.54 days) in convalescent plasma group compared with that of control group (12.88 days). Only 8 patients (7%) in convalescent plasma group required intubation while that was 20 % in control group. This clinical study provides strong evidence to support the efficacy of convalescent plasma therapy in COVID-19 patients and recommends this treatment for management of these patients. Clinical efficacy, immediate availability and potential cost effectiveness could be considered as main advantages of convalescent plasma therapy.
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http://dx.doi.org/10.1016/j.transci.2020.102875DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7362821PMC
October 2020

Prevalence and prognostic value of monoclonal gammopathy in heart failure patients with preserved ejection fraction: A prospective study.

Cardiol J 2020 04 24. Epub 2020 Apr 24.

Department of Cardiology, IIS-Hospital Universitario Fundación Jiménez Díaz - Quironsalud, Av Reyes Catolicos 2, 28040 Madrid, Spain.

Background: Heart failure (HF) with preserved ejection fraction (HFpEF) and monoclonal gammopathy of uncertain significance (MGUS) are two entities that share pathophysiological mechanisms. The aim herein, was to assess the prevalence of MGUS in patients with HFpEF and no left ventricular (LV) hypertrophy, as well as its association with a pre-specified clinical endpoint at 12 months.

Methods: The present study prospectively enrolled 69 patients admitted with HF, with ejection fraction ≥ 50%, and LV wall thickness < 12 mm. All patients were screened for MGUS. Clinical events were determined over a 12 month follow-up. The pre-specified composite clinical endpoint was readmission for heart failure or death.

Results: The prevalence of MGUS in this population was 13%. There were no differences in the incidence of the composite clinical endpoint between patients with and without MGUS. Multivariate analysis showed that treatment with angiotensin converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) was associated with fewer clinical events (HR: 0.153, 95% CI: 0.037-0.622, p = 0.009) and indicated a trend to lower risk of readmission for HF and death. Beta-blockers were associated with lower rates of the composite clinical endpoint (HR: 0.192, 95% CI: 0.05-0.736, p = 0.016), readmission for HF (HR: 0.272, 95% CI: 0.087-0.851, p = 0.025) and indicated a trend to lower mortality. Moreover, potassium serum levels > 5 mEq/L were associated with higher rates of the composite endpoint (HR: 6.074, 95% CI: 1.6-22.65,p = 0.007).

Conclusions: The prevalence of MGUS in patients with HFpEF without hypertrophy was 3-fold that of the general population. There was no significant correlation between clinical outcomes and the presence of MGUS. Beta-blockers and ACEIs/ARBs reduced the composite of mortality and readmissions for HF in HFpEF patients. Hyperpotassemia was related to worse prognosis.
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http://dx.doi.org/10.5603/CJ.a2020.0059DOI Listing
April 2020

Treatment with daratumumab in patients with relapsed/refractory AL amyloidosis: a multicentric retrospective study and review of the literature.

Amyloid 2020 Sep 28;27(3):163-167. Epub 2020 Feb 28.

Hematology Department, Hospital Clinic, Barcelona, Spain.

Management of patients with relapsed or refractory (R/R) AL amyloidosis is complex. Some initial reports have shown positive results with daratumumab in heavily pre-treated AL amyloidosis patients. In this retrospective multicentric study, 38 patients (mean age 64 ± 9 years) with R/R AL amyloidosis treated with daratumumab were included. Cardiac and renal involvement was present in 76 and 74% of patients, and 42% had ≥3 organs involved. Median number of previous lines of therapy was 2 (range 1-8). Overall hematological response was 72%, including 28% complete responses. The median time to first hematological response was 2 weeks. A high-quality response (≥very good partial response) was obtained in 65% of patients who had never achieved such depth of response previously. Hematological responses were more frequent among patients receiving daratumumab as second-line therapy compared to subsequent therapies (92 vs. 61%). Cardiac and renal organ response rates were 37 and 59%. At 12 months, overall and progression-free survival were 59% (95%CI: 0.36-0.77) and 52% (95%CI: 0.29-0.70), respectively. Daratumumab is a safe and effective drug in the treatment of R/R AL amyloidosis and should be considered early in the course of the disease.
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http://dx.doi.org/10.1080/13506129.2020.1730791DOI Listing
September 2020

The success of various endometrioma treatments in infertility: A systematic review and meta-analysis of prospective studies.

Reprod Med Biol 2019 Oct 19;18(4):312-322. Epub 2019 Jun 19.

Department of Obstetrics and Gynecology, School of Medicine, Laparoscopy Research Center Shiraz University of Medical Sciences Shiraz Iran.

Background: Endometriosis is seen in 0.5%-5% of fertile and 25%-40% of infertile women. To investigate this conflict between gynecologists that ovarian endometriomas should be removed or not before making any decision about pregnancy among infertile women, the authors decided to carry out a systematic review and meta-analysis to compare the effect of various available therapeutic methods and notice the impact of these options on women's pregnancy rate.

Methods: This review is based on PRISMA recommendations with an electronic search using the following databases: PubMed, Scopus, Google scholar, etc, from 2000 to 2018, in the English language. The studies compare pregnancy rate based on four different treatment types of OMAs between infertile women: (surgery + ART, surgery + spontaneous pregnancy, aspiration ± sclerotherapy + ART, and ART alone).

Main Findings: At least eight prospective studies were included, in which 553 infertile women were compared in terms of treatment methods of OMAs before trying to become pregnant.

Conclusion: Treatments are usually based on the patient's clinical condition and must be individual, with the purpose of relieving pain, improving fertility, or both. The authors do not have not any significant difference between our four groups of study; however, the success of surgical procedure compared to other methods was higher and the success of ART alone was the least.
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http://dx.doi.org/10.1002/rmb2.12286DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6780037PMC
October 2019

Monoclonal Gammopathy of Uncertain Significance and Transthyretin Cardiac Amyloidosis.

Circ Cardiovasc Imaging 2019 09 27;12(9):e009493. Epub 2019 Aug 27.

Cardiology Department, Fundación Jiménez Díaz, Madrid, Spain (A.D.-A., A.A.-N., A.M.P.-L., M.O.O., E.A., A.M., G.L., F.N., B.I., J.T.-F.).

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http://dx.doi.org/10.1161/CIRCIMAGING.119.009493DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7099853PMC
September 2019

Modeling the connections of brain regions in children with autism using cellular neural networks and electroencephalography analysis.

Artif Intell Med 2018 07 11;89:40-50. Epub 2018 Jul 11.

Department of Control Engineering, K. N. Toosi University of Technology, Tehran, Iran.

The brain connections in the different regions demonstrate the characteristics of brain activities. In addition, in various conditions and with neuropsychological disorders, the brain has special patterns in different regions. This paper presents a model to show and compare the connection patterns in different brain regions of children with autism (53 boys and 36 girls) and control children (61 boys and 33 girls). The model is designed by cellular neural networks and it uses the proper features of electroencephalography. The results show that there are significant differences and abnormalities in the left hemisphere, (p < 0.05) at the electrodes AF3, F3, P7, T7, and O1 in the children with autism compared with the control group. Also, the evaluation of the obtained connections values between brain regions demonstrated that there are more abnormalities in the connectivity of frontal and parietal lobes and the relations of the neighboring regions in children with autism. It is observed that the proposed model is able to distinguish the autistic children from the control subjects with an accuracy rate of 95.1% based on the obtained values of CNN using the SVM method.
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http://dx.doi.org/10.1016/j.artmed.2018.05.003DOI Listing
July 2018

Designing a model to detect the brain connections abnormalities in children with autism using 3D-cellular neural networks.

J Integr Neurosci 2018 ;17(3-4):391-411

Department of Control Engineering, K.N. Toosi University of Technology, Tehran, Iran.

In neuropsychological disorders, the significant abnormalities in the brain connections in some regions are observed. This paper presents a novel model to demonstrate the connections between different regions in children with autism. The proposed model first conducts the wavelet decomposition of electroencephalography signals by wavelet transform then the features are extracted, such as relative energy and entropy. These features are fed to the 3D-cellular neural network model as inputs to indicate the brain connections. The results showed that there are significant differences and abnormalities in the left hemisphere, (p<0.05) at the electrodes AF3, F3, P7, T7 and O1 in alpha band, AF3, F7, T7 and O1 in beta band, T7 and P7 in gamma band for children with autism compared with the control children. Also, the evaluation of the obtained connections values between brain regions indicated that there are more abnormalities in the connectivity of frontal and parietal lobes and the relations of the neighboring regions in all three bands especially in gamma band for autistic children. Evaluation of the analysis demonstrated that alpha frequency band had the best distinction level of 96.6% based on the obtained values of the cellular neural network using support vector machine method.
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http://dx.doi.org/10.3233/JIN-180075DOI Listing
December 2018

Immunologic and psychologic parameters associated with geographic tongue.

Oral Surg Oral Med Oral Pathol Oral Radiol 2014 Jul 15;118(1):68-71. Epub 2014 Mar 15.

Professor Emeritus, Department of Oral Pathology and Oral Medicine, Faculty of Medicine, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address:

Objective: Several conditions have been associated with geographic tongue (GT). However, there is no consensus on the etiology of GT. The purpose of this study was to investigate whether immunologic and psychologic parameters are associated with diagnosis of GT.

Study Design: A case-control study was performed on 170 participants (85 with GT, 85 controls). Unstimulated whole saliva was collected, and tumor necrosis factor alpha (TNF-α) and interleukin 6 (IL-6) concentrations were measured. Anxiety level was measured using psychologic and physiologic testing instruments. An independent t test and a Pearson correlation analysis were performed with SPSS (α = .05).

Results: There was a significant difference between the 2 groups regarding the salivary concentrations of TNF-α (P = .008) and IL-6 (P = .001). The concentration of salivary cortisol and state and trait anxiety levels in the GT group were significantly higher than those in the control group (P = .001).

Conclusions: Immunologic and psychologic parameters appear associated with GT and may constitute risk factors of this condition.
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http://dx.doi.org/10.1016/j.oooo.2014.03.007DOI Listing
July 2014

Direct vitamin K antagonist anticoagulant treatment health care costs in patients with non-valvular atrial fibrillation.

BMC Health Serv Res 2014 Jan 30;14:46. Epub 2014 Jan 30.

Department of Economic and Financial Analysis, Faculty of Social Sciences, University of Castilla-La Mancha, Mancha, Avda Real Fábrica de Seda s/n, 45600 Talavera de la Reina Toledo, Spain.

Background: There is evidence suggesting that most thromboembolic complications could be prevented with adequate pharmacological anticoagulation. We estimated the direct health care costs of anticoagulant treatment with oral vitamin K antagonists in patients diagnosed with non-valvular atrial fibrillation.

Methods: This observational study examined the clinical records of patients diagnosed with non-valvular atrial fibrillation who received anticoagulant treatment with oral vitamin K antagonists. Data from clinical records were used in the study: international normalized ratio, number of monitoring visits, type of anticoagulant, hospital admissions from complications, and concomitant medication. Drug cost was calculated based on the official Spanish Ministry of Health price list. Monitoring expenses were included the cost of the medical supplies used in the procedures. Hospitalization costs were calculated using the Diagnosis Related Group price for each case. Hospital visits costs were calculated by one of four different scenarios, using either the invoice rates for the regional health care authority or cost per visit as established by analytical accounting methods.

Results: We collected data from 1,257 patients diagnosed with non-valvular atrial fibrillation who were receiving oral anticoagulant therapy. Depending on the scheme used, the direct health care costs for these patients ranged from €423,695 - €1,436,038 per annum. The average cost per patient varied between €392 - €1,341, depending on the approach used. Patients with international normalized ratio values within the therapeutic range on 25% of their visits represented an average cost between €441.70 - €1,592. Those within the therapeutic range on 25%-50% of visits had associated costs of €512.37 - €1,703.91. When international normalized ratio values were within the therapeutic range on 50% - 75% of the visits, the costs ranged between €400.80- €1,375.74. The average cost was €305.23 - €1,049.84 when the values were within the therapeutic range for over 75% of visits.

Conclusions: Most direct health care costs associated with the sampled patients arise from the specialist-care monitoring required for the treatment. Good monitoring is inversely related to direct health care costs.
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http://dx.doi.org/10.1186/1472-6963-14-46DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3914362PMC
January 2014

Novel nanostructure zinc zirconate, zinc oxide or zirconium oxide pastes coated on fluorine doped tin oxide thin film as photoelectrochemical working electrodes for dye-sensitized solar cell.

Spectrochim Acta A Mol Biomol Spectrosc 2013 Mar 5;104:197-202. Epub 2012 Dec 5.

Nanotechnology Laboratory, Department of Chemistry, University of Isfahan, Isfahan 81746-73441, Islamic Republic of Iran.

Zinc zirconate (ZnZrO(3)) (ZZ), zinc oxide (ZnO) (ZO) and zirconium oxide (ZrO(2)) (ZRO) nano-particles were synthesized by simple sol-gel method. ZZ, ZO and ZRO nano-particles were characterized by scanning electron microscopy (SEM), X-ray diffraction (XRD) and UV-Vis diffuse reflectance spectrum (DRS). Nanoporous ZZ, ZO and ZRO thin films were prepared doctor blade technique on the fluorine-doped tin oxide (FTO) and used as working electrodes in dye sensitized solar cells (DSSC). Their photovoltaic behavior were compared with standard using D35 dye and an electrolyte containing [Co(bpy)(3)](PF(6))(2), [Co(pby)(3)](PF(6))(3), LiClO(4), and 4-tert-butylpyridine (TBP). The properties of DSSC have been studied by measuring their short-circuit photocurrent density (Jsc), open-circuit voltage (VOC) and fill factor (ff). The application of ZnZrO(3) as working electrode produces a significant improvement in the fill factor (ff) of the dye-sensitized solar cells (ff=56%) compared to ZnO working electrode (ff=40%) under the same condition.
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http://dx.doi.org/10.1016/j.saa.2012.11.055DOI Listing
March 2013

Syntheses, spectral, electrochemical and thermal studies of mononuclear manganese(III) complexes with ligands derived from 1,2-propanediamine and 2-hydroxy-3 or 5-methoxybenzaldehyde: self-assembled monolayer formation on nanostructure zinc oxide thin film.

Spectrochim Acta A Mol Biomol Spectrosc 2011 Aug 6;79(3):666-71. Epub 2011 Apr 6.

Department of Chemistry, University of Isfahan, Isfahan, 81746-73441 I.R. Iran.

Mononuclear Mn(III) complexes have been prepared via the Mn(II) reaction of an equimolar of Schiff-bases derived from reaction of 2-hydroxy-3-methoxybenzaldehyde or 2-hydroxy-5-methoxybenzaldehyde with 1,2-diaminopropane. Axial ligands L include: pyridine (py) and H(2)O. The resulting complexes have been characterized by FT-IR and UV-vis spectroscopy. The crystal structures of the complexes were determined and indicate that in the solid state the complex adopts a slightly distorted octahedral environment of the imine N and hydroxo O with the two axial ligands. The electrochemical reduction of these complexes at a glassy carbon electrode in acetonitrile solution indicates that the first reduction process corresponding to Mn(III)-Mn(II) is electrochemically quasi-reversible. Thermal stability of these complexes was determined by TG and DTG. Layers of these complexes were formed on nanostructure zinc oxide thin film and a red shift was observed when zinc oxide thin film is modified by complex.
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http://dx.doi.org/10.1016/j.saa.2011.03.055DOI Listing
August 2011

Bis{μ-4,4'-dimeth-oxy-2,2'-[propane-1,2-diylbis(nitrilo-methyl-idyne)]diphenolato}bis-({4,4'-dimeth-oxy-2,2'-[propane-1,2-diylbis(nitrilo-methyl-idyne)]diphenol}manganese(III)) bis-(hexa-fluorido-phosphate).

Acta Crystallogr Sect E Struct Rep Online 2009 Jul 29;65(Pt 8):m1004-5. Epub 2009 Jul 29.

In the title complex, [Mn(2)(C(19)H(20)N(2)O(4))(2)(C(19)H(22)N(2)O(4))(2)](PF(6))(2), the Mn(III) ion is coordinated by two O [Mn-O = 1.855 (2) and 1.887 (2) Å] and two N [Mn-N = 1.982 (3) and 1.977 (3) Å] atoms from the tetra-dentate Schiff base ligand and a coordinated axial ligand [Mn-O = 2.129 (2) Å]. The centrosymmetric dimer contains two Jahn-Teller-distorted Mn(III) ions, each in a nearly octa-hedral geometry, connected through two phenolate bridges from two ligands. There are two stereogenic centers. The methyl group and the H atom attached to the middle propane C atom are disordered over two positions with occupancy factors in the ratio 0.58:0.42. The crystal is therefore a mixture of two diasteroisomers, viz. RS/SR and RR/SS. In the axial ligand, the two benzene rings form a dihedral angle of 56.97 (5)° and the dihedral angle between the two MnNC(3)O chelate rings is 2.98 (12)°
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http://dx.doi.org/10.1107/S1600536809028591DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2977226PMC
July 2009

Immunophenotype in chronic myelomonocytic leukemia: is it closer to myelodysplastic syndromes or to myeloproliferative disorders?

Transl Res 2008 May 7;151(5):240-5. Epub 2008 Apr 7.

Department of Hematology, Fundación Jiménez Díaz, Madrid, Spain.

Chronic myelomonocytic leukemia (CMML) is a heterogeneous disease balanced between myelodysplastic syndromes (MDS) and myeloproliferative disorders (MPD). We used flow cytometry to describe and compare the immunophenotypic profile of 20 patients with CMML, 38 patients with MDS, and 20 patients with MPD. CMML and MDS only showed statistically significant differences (P<0.05) in CD56 monocyte expression. CMML and MPD showed significant differences in CD45 myeloid distribution, myeloid antigenic profile, CD56 and CD2 monocyte expression, and B-cell development. These data support the classic concept of CMML as part of MDS diseases and encourage including immunophenotyping among the studies to be performed in these diseases.
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http://dx.doi.org/10.1016/j.trsl.2008.03.001DOI Listing
May 2008

Morphine state-dependent learning sensitization and interaction with nitric oxide.

Pharmacology 2006 4;78(2):66-71. Epub 2006 Aug 4.

Department of Pharmacology and Iranian National Center for Addiction Studies, School of Medicine, Tehran University of Medical Sciences, PO Box 13145-784 Tehran, Iran.

In the present study, the effects of nitric oxide (NO) precursor L-arginine and L-NAME, a potent inhibitor of NO synthase (NOS), on the expression of sensitization of morphine were investigated. Pre-training administration of morphine (5 mg/kg) impaired memory retrieval compared to pre-training saline-treated animals. Amnesia due to pre-training morphine (5 mg/kg) was restored by pre-test morphine (5 mg/kg). The retrieval impairment was also inhibited in mice which had received once-daily injections of morphine (20 and 30 mg/kg, s.c.) for 3 days, followed by 5 days of no drug treatment before training (in order to induce morphine sensitization). Administration of L-arginine (60 mg/kg/day - 3 days) or L-NAME (20 mg/kg/day - 3 days) before training did not alter morphine state dependency. During acquisition of sensitization, administration of L-arginine (60 mg/kg) 20 min before morphine (10 mg/kg/day, for 3 days) increased, while injection of L-NAME (20 mg/kg) 20 min before morphine (30 mg/kg/day, for 3 days) decreased morphine state dependency. It is concluded that NO is involved in the morphine-induced sensitization.
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http://dx.doi.org/10.1159/000095541DOI Listing
December 2006

Influence of acute and sub-chronic nicotine pretreatment on morphine state-dependent learning.

Behav Brain Res 2006 Oct 8;173(2):268-73. Epub 2006 Aug 8.

Department of Pharmacology and Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran.

In the present study, the effects of acute and sub-chronic pretreatment of nicotine on impairment of memory formation and the state-dependent learning by morphine have been investigated in mice. Pre-training administration of morphine (5mg/kg) decreased the learning of a one-trial passive avoidance task, which was reversed by pre-test administration of the same dose of morphine. Amnesia induced by pre-training morphine was also significantly reversed in nicotine (0.001, 0.01 and 0.1 mg/kg)-treated animals on the test day. Morphine induced amnesia was also reversed in animals which had previously received sub-chronic injections of nicotine, once daily for 3 days followed by 14 days of no drug treatment. The restoration of memory by pre-test morphine was also reduced in animals which had previously received once daily injections of atropine (0.25, 0.5 and 1 mg/kg, i.p.) for 3 days after 14 of being days drug free. In the animals, restoration of memory by sub-chronic nicotine administration, was also decreased by once daily administration of atropine (0.25, 0.5 and 1 mg/kg) 10 min prior to injection of nicotine (0.1 microg/kg/day, for 3 days) but not with SCH 23390; R(+)-7-chloro-8-hydroxy-3-methyl-1-phenyl-2,3,4,5-tetrahydro-1H-3-benzazepine HCl (0.01, 0.05 and 0.1 mg/kg) or sulpiride (25, 50 and 100 mg/kg) during 3-days of treatment with nicotine. The results suggest that nicotine may induce sensitization which affects the impairment of memory formation via cholinergic but not dopaminergic systems.
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http://dx.doi.org/10.1016/j.bbr.2006.06.032DOI Listing
October 2006