Publications by authors named "Masoud Baikpour"

44 Publications

Age, Period and Cohort Analysis of Smoking Prevalence in Iranian Population over a 25-Year Period.

Arch Iran Med 2021 01 1;24(1):7-14. Epub 2021 Jan 1.

Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Background: Current and daily smoking prevalence rates have been have investigated in several cross-sectional studies. However, analyses in terms of age-period-cohort (APC) have not been carried out. We assessed daily smoking dynamics over a 25-year period using the APC model.

Methods: In our analyses, we used data from 214,652 people aged 15 to 64 years, collected by national health surveys conducted in 1990-1991, 1999, 2005, 2007, 2011 and 2016. The Intrinsic Estimator model was used to analyze the impact of APC on daily smoking prevalence.

Results: Males were found to exhibit a higher prevalence of smoking compared to females (26.0% against 2.7%). Prevalence of smoking increased by age, peaking at the age groups of 40-44 in men and 45-49 in women, followed by a decreasing trend. The 1990 period had the highest prevalence in both genders, and the 2016 period had the lowest. The coefficients of birth cohort effects showed different patter19s of fluctuations in the two genders with the maximum and minimum coefficients for men calculated in the 1966-1970 and 1991-95 birth cohorts, and for females the 1931-1935 and 1971-1975 birth cohorts, respectively.

Conclusion: We showed the impact of APC on daily tobacco smoking prevalence, and these factors should be considered when dealing with smoking.
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http://dx.doi.org/10.34172/aim.2021.02DOI Listing
January 2021

Cervical Extension of the Normal Thymus in Children and Adolescents: Sonographic Features and Prevalence.

J Ultrasound Med 2021 Jan 25. Epub 2021 Jan 25.

Center for Ultrasound Research & Translation, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.

Objective: This study aims to confirm the prevalence of incidental cervical extension of normal thymus in children and adolescents undergoing neck ultrasound and describe the ultrasound appearance to minimize future misdiagnosis.

Materials And Methods: This retrospective study was conducted in a single institution. Thyroid and lower neck ultrasound images of the consecutive pediatric subjects between January 1, 2011 and September 30, 2017 were independently reviewed by 2 radiologists for the presence of cervical thymus. When identified on sonographic images, cervical thymus was described on the basis of echogenicity, location, and shape.

Results: In 278 consecutive cases, the 2 reviewers identified 105 (37.8%) and 103 (37.1%) cases respectively as having sonographically visible tissue in the expected location of cervical extension of the thymus. The internal echotexture was variable with 38.1% of cases being hypoechoic, 37.1% mixed, and 24.8% hyperechoic. Cervical extension of the thymus was most commonly (65.0%) to the left of the trachea or (30.9%) bilateral/anterior to the trachea; isolated right paratracheal thymus was uncommon. Thymic shape was variable: quadrilateral (30.9%), oval (29.9%), triangular (25.8%), and other (13.4%). The logistic regression model including age, gender, and BMI z-scores showed that, when controlled for sex and BMI z-scores, younger age was a predictor for the presence of cervical thymic extension (p < 0.001).

Conclusion: Cervical thymic extension is sonographically visible as a soft tissue mass of variable appearance in about a third of children and adolescents undergoing neck ultrasonography with decreasing prevalence with age. Sonographically visible cervical thymic tissue is more common in younger patients.
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http://dx.doi.org/10.1002/jum.15619DOI Listing
January 2021

Reply to "Biomarkers for High-Risk Nonalcoholic Fatty Liver Disease: Beyond Portal Venous Pulsatility Index".

AJR Am J Roentgenol 2021 01;216(1):W2

Massachusetts General Hospital, Boston, MA

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http://dx.doi.org/10.2214/AJR.20.23981DOI Listing
January 2021

Normal Liver Stiffness Measured with MR Elastography in Children.

Radiology 2020 12 22;297(3):663-669. Epub 2020 Sep 22.

From the Department of Radiology (A.T.T., J.R.D.), Division of Gastroenterology, Hepatology and Nutrition (S.A.X.), and Division of Biostatistics and Epidemiology (B.Z.), Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, MLC 5031, Cincinnati, OH 45229; Departments of Radiology (A.T.T., J.R.D.) and Pediatrics (A.T.T., S.A.X., B.Z.), University of Cincinnati College of Medicine, Cincinnati, Ohio; Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, Pa (S.A.A., S.D.S., J.S.C.T.); Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (S.A.A., S.D.S.); Department of Radiology (M.S.G.) and Center for Ultrasound Research & Translation, Department of Radiology (M.B., A.O.), Massachusetts General Hospital, Boston, Mass; Department of Radiology, Harvard Medical School, Boston, Mass (M.S.G.); and Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (G.K.).

Background Stiffness thresholds for liver MR elastography in children vary between studies and may differ from thresholds in adults. Normative liver stiffness data are needed to optimize diagnostic thresholds for children. Purpose To determine normal liver stiffness, and associated normal ranges for children, as measured with MR elastography across vendors and field strengths. Materials and Methods This was a prospective multicenter cohort study (ClinicalTrials.gov identifier: NCT03235414). Volunteers aged 7-17.9 years without a known history of liver disease were recruited at four sites for a research MRI and blood draw between February 2018 and October 2019. MRI was performed on three vendor platforms and at two field strengths (1.5 T and 3.0 T). All MRI scans were centrally analyzed; stiffness, proton density fat fraction (PDFF), and R2* values were expressed as means of means. Mean and 95% confidence intervals (CIs) for liver stiffness were calculated. Pearson correlation coefficient two-sample test, or analysis of variance was used to assess univariable associations. Results Seventy-one volunteers had complete data and no documented exclusion criterion (median age, 12 years; interquartile range [IQR], 10-15 years; 39 female participants). Median body mass index percentile was 54% (IQR, 32.5%-69.5%). Mean liver stiffness was 2.1 kPa (95% CI: 2.0, 2.2 kPa) with mean ± 1.96 kPa standard deviation of 1.5-2.8 kPa. Median liver PDFF was 2.0% (IQR, 1.7%-2.6%). There was no association between liver stiffness and any patient variable or MRI scanner factor. Conclusion Mean liver stiffness measured with MR elastography in children without liver disease was 2.1 kPa (similar to that in adults). The 95th percentile of normal liver stiffness was 2.8 kPa. Liver stiffness was independent of sex, age, or body mass index and did not vary with MRI scanner vendor or field strength. © RSNA, 2020 See also the editorial by Yin in this issue.
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http://dx.doi.org/10.1148/radiol.2020201513DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7706876PMC
December 2020

Magnetic resonance imaging/transrectal ultrasonography fusion guided seed placement in a phantom: Accuracy between 2-seed versus 1-seed strategies.

Eur J Radiol 2020 Aug 10;129:109126. Epub 2020 Jun 10.

Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 270, Boston, MA, 02114, USA. Electronic address:

Purpose: To investigate whether the 2-seed placement per Magnetic Resonance Imaging (MRI) suspicious lesion yields a higher seed placement accuracy than a 1-seed strategy on a phantom.

Methods: Eight olives embedded in gelatin, each simulating a prostate, underwent MRI. Three virtual spherical lesions (3, 5, and 8 mm diameters) were marked in each olive on the MRI images and co-registered to the MRI/Transrectal Ultrasonography (TRUS) fusion biopsy system. Two radiologists placed 0.5 mm fiducials, targeting the center of each virtual lesion under fusion image guidance. Half of the 8 olives in each phantom were assigned either to the 1-seed or 2-seeds per lesion strategy. Post-procedure Computed Tomography (CT) images identified each seed and were fused with MR to localize each virtual lesion and collected the seed placement error - distance between the virtual target and the corresponding seed (using the closer seed for the 2-seed strategy). Seed placement success is defined as fiducial placement within a lesion boundary.

Results: Each operator repeated the procedure on three different phantoms, and data from 209 seeds placed for 137 lesions were analyzed, with an overall error of 3.03 ± 1.52 mm. The operator skill, operator phantom procedural experience, lesion size, and number of seeds, were independently associated with the seed placement error. Seed placement success rate was higher for the 2-seed group compared to 1-seed, although the difference was not statistically significant.

Conclusions: Placing 2 seeds per MRI lesion yielded a significantly lower error compared to 1-seed strategy, although seed placement success rate was not significantly different.
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http://dx.doi.org/10.1016/j.ejrad.2020.109126DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7657060PMC
August 2020

Age-Period-Cohort Analysis of Abdominal Obesity in Iranian Children and Adolescents: The CASPIAN Study.

Int J Endocrinol Metab 2020 Jan 19;18(1):e82866. Epub 2020 Jan 19.

Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: The assessment of the trend of changes in the prevalence of abdominal obesity can provide useful health information.

Objectives: This study aimed to conduct an age-period-cohort (APC) analysis to provide the trend of the prevalence of abdominal obesity in the Iranian pediatric population through the three temporal dimensions of age, period, and cohort.

Methods: Data were gathered from a total number of 53,962 Iranian children and adolescents aged 5 to 19 years through four surveys of a national surveillance program (the CASPIAN study) conducted in 2003, 2007, 2011, and 2015. Abdominal obesity was defined as a waist-to-height ratio of ≥ 0.5. The APC analysis was performed using the "apc_ie"command in STATA software.

Results: A significant correlation existed between age, period, and cohort effects and the prevalence of abdominal obesity in children and adolescents. With increasing age, regardless of considerable fluctuations, the prevalence of abdominal obesity followed an overall increasing trend in both genders. The age effect coefficient increased from -2.1 in the age group of 5 - 9 years to 1.1 in the age group of 10 - 14 years and then decreased to 1.0 in the age group of 15 - 19 years among boys; figures followed an increasing trend in girls from -2.2 to 0.8 and 1.5, respectively. As for the period effect, in both boys and girls, the prevalence of abdominal obesity followed an increasing trend when coming from the earlier periods to the recent ones (from -4.6 to 4.0 in boys and from -4.1 to 2.4 in girls). Likewise, this prevalence increased from earlier birth cohorts to the recent ones in both genders.

Conclusions: The prevalence of abdominal obesity is increasing among Iranian children and adolescents and this rising trend is affected by age, period, and birth cohort effects. The findings of this study emphasize the necessity of implementing comprehensive interventions for tackling the epidemic of childhood obesity.
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http://dx.doi.org/10.5812/ijem.82866DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7138598PMC
January 2020

Development of a generalized model for kidney depth estimation in the Chinese population: A multi-center study.

Eur J Radiol 2020 Mar 16;124:108840. Epub 2020 Jan 16.

Department of Nuclear Medicine, Affiliated Cancer Hospital of Zhengzhou University, 127 Dongming Road, Jinshui District, Zhengzhou, 450003, Henan, China. Electronic address:

Purpose: To establish an accurate and reliable equation for kidney depth estimation in adult patients from different Chinese geographical regions.

Method: This multicenter study enrolled Eastern Asian Chinese patients with abdominal PET/CT scans at 26 imaging centers from six macro-regions across China in 3 years. Age, gender, height, weight, primary disease and its extent on PET scans of the participants were collected as potential predictive factors. Kidney depth on CT, defined as the average of the vertical distances from the posterior skin to the farthest anterior and closest posterior surfaces of each kidney, was measured as the standard reference. The new kidney depth model was constructed using a multiple regression model, and its performance was compared to those of three established models by computing the absolute value of estimation errors in comparison with CT-measured kidney depth.

Results: A total of 2502 patients were enrolled and classified into training (n=1653) and testing (n = 849) subsets. In the training subset, two kidney depth models were constructed: Left (cm): 0.013×age+0.117×gender-0.044×height+0.087×weight+7.951, Right (cm): 0.005×age+0.013×gender-0.035×height+0.082×weight+7.266 (weight: kg, height: cm, gender = 0 if female, 1 if male). In the testing subset, one-way analysis of variance showed that the estimation errors of the new models did not significantly differ among the 6 regions. Bland-Altman analysis determined that new equations had lower estimated biases (left: 0.039 cm, right: 0.018 cm) compared with other existing models.

Conclusion: The new equations were highly accurate for kidney depth estimation in adults from all over China, with lower estimation errors compared to other established models.
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http://dx.doi.org/10.1016/j.ejrad.2020.108840DOI Listing
March 2020

Portal Venous Pulsatility Index: A Novel Biomarker for Diagnosis of High-Risk Nonalcoholic Fatty Liver Disease.

AJR Am J Roentgenol 2020 04 15;214(4):786-791. Epub 2020 Jan 15.

Department of Radiology, Center for Ultrasound Research and Translation, Massachusetts General Hospital, 101 Merrimac St, 3rd Fl, Boston, MA 02114.

The purpose of this study was to assess the accuracy of portal vein pulsatility for noninvasive diagnosis of high-risk nonalcoholic fatty liver disease (NAFLD). This retrospective study included patients with biopsy-proven diagnosis of NAFLD who underwent duplex Doppler ultrasound assessment of the main portal vein within 1 year of liver biopsy (January 2014 to February 2018). Doppler ultrasound images were reviewed. The spectral waveform was used to measure the maximum () and minimum () velocity of blood in the portal veins. Venous pulsatility index (VPI) defined as ( - ) / was calculated. ROC curve analysis was used to calculate AUC as a measure of accuracy to determine the value of this index for diagnosis of high-risk NAFLD and compared with that of the following four clinical decision aids: NAFLD fibrosis score (FS), fibrosis-4 index (FIB-4), BARD score (body mass index, aspartate aminotransferase [AST]-to-alanine aminotransferase ratio, diabetes mellitus), and AST-to-platelet ratio index (APRI). The value of adding VPI to these indexes was also investigated. Of 123 study subjects, 33 (26.8%) had high-risk NAFLD and were found to have a lower VPI than the other 90 subjects (0.19 vs 0.32; < 0.001). VPI, NAFLD FS, FIB-4, and APRI had statistically significant diagnostic values for high-risk NAFLD. VPI had the highest optimism-corrected AUC (VPI, 0.84 [95% CI, 0.77-0.91]; NAFLD FS, 0.74 [95% CI, 0.63-0.83]; FIB-4, 0.81 [95% CI, 0.72-0.89]; APRI, 0.73 [95% CI, 0.61-0.82]). Addition of VPI to any of the four scoring systems significantly improved the diagnostic value of the score for high-risk NAFLD. VPI may be an accurate noninvasive biomarker for diagnosis of high-risk NAFLD.
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http://dx.doi.org/10.2214/AJR.19.21963DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7474554PMC
April 2020

Age, period and cohort analysis of high cholesterol levels in Iranian adults over a 20-year period.

J Diabetes Metab Disord 2019 Dec 25;18(2):289-299. Epub 2019 Jun 25.

1Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Poursina Ave, Tehran, Iran.

Purpose: Hypercholesterolemia is one of the most important modifiable risk factors of non-communicable diseases and data on their values in different societies and their trend of changes should be updated every couple of years. Many studies have focused on assessing the prevalence of high cholesterol. We must emphasise that most of these studies were cross-sectional and did not directly investigate the temporal trends of change for age, period and birth cohort (APC). The aim of this study is to evaluate the effect of age, period and birth cohort on the prevalence of borderline to high cholesterol levels in Iranian adult population.

Methods: The data were collected from 110,302 subjects between 25 and 69 years of age over the period of 1990-2011. Data from these subjects were collected by using five national cross-sectional surveys conducted in 1990-91, 1999, 2003, 2007 and 2011. The APC effect on the prevalence of borderline and high cholesterol levels was assessed using the Intrinsic Estimator model.

Results: The overall prevalence of borderline cholesterol level among male subjects was found to be lower than that of females (39.8% vs. 46.3%). Similarly, the prevalence of high cholesterol level in men was reported to be 13.1%, which was lower than the 18.0% calculated in women. The prevalence of borderline and high cholesterol levels increased with age in men between the ages of 45-49. Then it stayed quite steady and eventually declined. Then it stayed quite steady and eventually declined. The prevalence in women also increased with age, with its maximum rise after the ages of menopause and a slight decline at the ages of 65-69. As for the birth cohorts, the prevalence of borderline and high cholesterol levels followed a declining trend by going from earlier birth cohorts to the later ones.

Conclusion: The present study provides evidence that age, period and birth cohort affect the prevalence of borderline and high cholesterol levels. Thus, these factors should be considered when developing and implementing care plans for people with hypercholesterolemia.
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http://dx.doi.org/10.1007/s40200-019-00410-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6915163PMC
December 2019

Effect of vitamins C and E on recovery of motor function after spinal cord injury: systematic review and meta-analysis of animal studies.

Nutr Rev 2020 06;78(6):465-473

Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran, and with the Brain and Spinal Injuries Research Center (BASIR), Neuroscience Institute, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Context: Many animal studies have evaluated the role of vitamins in the recovery of motor function after spinal cord injury, but their results have been contradictory and no consensus has been reached.

Objective: This meta-analysis aimed to investigate the effects of vitamin C and vitamin E on recovery of motor function after spinal cord injury in animal models.

Data Sources: Two authors independently collected the records of relevant articles published in MEDLINE, Embase, Scopus, and Web of Science through November 2018.

Study Selection: All studies conducted in animal models to evaluate the therapeutic effects of vitamin C or vitamin E or both on recovery of motor function after spinal cord injury were included. Studies that lacked a control group or a standard treatment, lacked an assessment of motor function, included genetically modified/engineered animals, included animals pretreated with vitamin C or vitamin E, or combined vitamin treatment with other methods, such as cell therapies, were excluded.

Data Extraction: Data from 10 articles met the inclusion criteria for meta-analysis, conducted in accordance with PRISMA guidelines.

Results: Daily supplementation with vitamin C (P < 0.0001) and vitamin E (P < 0.0001) significantly improved the recovery of motor function in animals affected by spinal cord injury. Vitamin C supplementation is effective only when administered intraperitoneally (P < 0.0001). Concurrent supplementation with both vitamins does not show better efficacy than treatment with either one alone.

Conclusion: Administration of vitamin C and vitamin E in animal models of spinal cord injury significantly improves the recovery of motor function.
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http://dx.doi.org/10.1093/nutrit/nuz076DOI Listing
June 2020

Hemangioblastoma of the Central Nervous System: A Case Series of Patients Surgically Treated at Shohada-e-Tajrish Hospital, Tehran, Iran during 2004-2014.

Iran J Child Neurol 2019 ;13(2):163-169

Cancer Research Center, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Objectives: Hemangioblastoma refers to a benign vascular neoplasm that comprises stromal and capillary cells. Based on the classification of nervous system tumors proposed by WHO, hemangioblastomas are classified as Grade I meningeal tumors of uncertain origin. These tumors are found almost exclusively in the central nervous system (CNS) and account for 0.9% to 2.1% of all primary CNS tumors.

Materials & Methods: In this descriptive retrospective study, the archives of pathology reports were reviewed in the Department of Pathology of Shohada-e-Tajrish Hospital, Tehran, Iran and patients with definite diagnosis of hemangioblastoma made through histopathological examinations during 2004-2014 were identified. Age, gender and the location of tumor were extracted from the medical records and entered into SPSS statistical software v.22 for analysis.

Results: Thirty patients including 16 males (53.3%) and 14 females (46.7%) were identified. The mean age of the patients was calculated to be 41.2±13.47 yr, ranging from 19 to 62 yr old. The majority of lesions had been found in the cerebellum of the patients (93.3%); only one had occurred in the cerebrum (3.3%) and another in the fourth ventricle (3.3%).

Conclusion: Cerebellum is the most commonly affected location in patients with CNS hemangioblastomas, and a male preponderance is observed in these cases.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6451852PMC
January 2019

Differentiation of Benign from Malignant Adnexal Masses by Dynamic Contrast-Enhanced MRI (DCE-MRI): Quantitative and Semi-quantitative analysis at 3-Tesla MRI

Asian Pac J Cancer Prev 2019 Apr 29;20(4):1073-1079. Epub 2019 Apr 29.

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

Background: To evaluate the utility of the pharmacokinetic modeling derived from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in differentiating benign from malignant adnexal masses. Methods: A total of 43 patients with 49 complex adnexal masses (27 benign, 3 borderline, and 19 malignant lesions) underwent preoperative DCE-MRI examinations on a 3 Tesla MRI. Using extended Tofts’ model, quantitative analysis was performed in the solid components of all tumors. Three pharmacokinetic parameters were defined as volume transfer coefficient (Ktrans), the rate constant (Kep), and the plasma volume (Vp). Semi-quantitative analysis was also performed and the values of relative signal intensity (SI rel) wash-in-rate (WIR), the initial area under the curve (iAUC60), time-to-peak (TTP) and wash-out-rate (WOR) were calculated. Receiver operating characteristic (ROC) curve analysis was performed to evaluate diagnostic characteristics of each DCE-MRI parameter in differentiating borderline/malignant tumors from benign lesions and to provide the optimal cutoff values for these variables. Results: SI rel had the highest diagnostic value (AUC=0.872; p<0.001; cut-off=121.4 associated with an overall accuracy=79.6%, sensitivity=95.5%, specificity=66.7%, NPV=94.8% and PPV=70.0%). Ktrans had the second highest AUC=0.836 (p<0.001; cut-off=0.034 associated with an overall accuracy=79.6%, sensitivity=86.4%, specificity=74.1%, NPV=87.0% and PPV=73.1%). The other factors found to be acceptable diagnostic parameters for borderline/malignant lesions included WIR (AUC=0.816; p<0.001), iAUC60 (AUC=0.808; p<0.001), Vp (AUC=0.795; p<0.001), SI max (AUC=0.737, p=0.005), SI peak (AUC=0.737; p=0.005) and Kep (AUC=0.681; p=0.031). Conclusion: Quantitative DCE-MRI is a relevant tool for differentiating benign from malignant adnexal masses. Among all the DCE parameters, SI rel and Ktrans are the most accurate discriminators.
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http://dx.doi.org/10.31557/APJCP.2019.20.4.1073DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6948906PMC
April 2019

Response to the Letter on the Gap of Cigarette and Hookah Smoking between Socioeconomic Groups in Iran: Effect of Inequalities in Socioeconomic Position.

Arch Iran Med 2019 03 1;22(3):166-167. Epub 2019 Mar 1.

Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

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March 2019

Clinical application of ultrasound-guided percutaneous microwave ablation for benign breast lesions: a prospective study.

BMC Cancer 2019 Apr 11;19(1):345. Epub 2019 Apr 11.

Department of Ultrasound, Beijing Tian Tan Hospital, Capital Medical University, No. 119, West Road of South 4th Ring Road, Fengtai District, Beijing, 100160, China.

Background: Background: Benign breast lesions are the most common diseases in adult women, which have been treated with minimally invasive therapies in recent years. Little is known about the feasibility of Microwave ablation (MWA) for benign breast lesion treatment. The primary aim of this prospective study was to evaluate the safety and efficiency of MWA as a potential therapeutic option for benign breast lesions in a single-center cohort study.

Methods: Women with possibly benign breast lesions based on an ultrasound (US) assessment who were scheduled to undergo MWA between November 2014 to July 2018 were included in the study. The patients underwent conventional US to measure the size of the lesion, Doppler US to assess the vascularity of the lesion, elastography to evaluate the stiffness of the mass, core needle biopsy of suspicious lesions, contrast-enhanced US to help determine the treatment plan and eventually MWA of the lesion. Lesions were followed at one, three, six, twelve and eighteen months after treatment to with the same imaging modalities.

Results: A total of 314 women aged 17 to 69 years old (mean = 36.9 ± 9.9 years) with 725 benign breast lesions (mean of maximum diameter = 10.86 ± 5.40 mm) were included. The frequency of palpable mass, pain and nipple discharge significantly decreased after treatment. Complete ablation rate was 97.8%, immediately after ablation, which increased to 100% after supplementary ablation of the 15 cases with incomplete ablation. Blood flow classification and lesion's volume also showed a significant decrease, while both volume reduction ratio and disappearance rate significantly increased following treatment. The elasticity score of the lesions showed fluctuations across different follow-up intervals. None of the patients experienced major complications and the 1% who had mild symptoms were successfully treated.

Conclusion: MWA treatment is shown to be safe and efficient and has the potential to be considered as an alternative first line treatment for benign breast lesions.
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http://dx.doi.org/10.1186/s12885-019-5523-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6458746PMC
April 2019

A Low-Cost Highly Configurable Phantom for Simulation of Imaging-Guided Endocavitary Procedures.

Ultrasound Q 2019 Mar;35(1):61-67

Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.

We developed a method to create customizable phantoms suitable for endocavitary imaging and interventional research, based on the fabrication of an acrylic phantom mold, and development of a phantom matrix composed of gelatin, agar, graphite particles, and propanol. Our phantom was mechanically stable, easily fabricated, and highly adjustable, and its ultrasound (US) and magnetic resonance imaging (MRI) scans showed the qualification for the procedure guidance compared with the human prostate image using the same US system. To test the feasibility of the phantom for the research, the seeds placement guided by MRI/US fusion was performed, and the overall test error (distance from the seed center to the virtual lesion center in olives) was 2.59 ± 0.59 mm. We have created a simple, low-cost, configurable, gelatin-based phantom and tested its feasibility for simulating endorectal interventional US procedures. The design of the phantom mold and matrix is likely to be useful to the broader medical training community, and the preliminary data from the experiment of MRI/US-guided seeds placement showed its potential to test the clinical hypothesis in US research.
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http://dx.doi.org/10.1097/RUQ.0000000000000413DOI Listing
March 2019

Potential diagnostic and prognostic value of serum and cerebrospinal fluid biomarkers in traumatic spinal cord injury: A systematic review.

J Neurochem 2019 05 15;149(3):317-330. Epub 2019 Jan 15.

Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.

It remains unclear whether biomarkers in the serum or CSF can be used for diagnosis or prognosis of spinal cord injuries (SCI). Therefore, a systematic review was undertaken to evaluate the prognostic or diagnostic value of serum and CSF biomarkers in assessing the severity of SCI and the outcome of patients. Two independent reviewers summarized the human studies retrieved from the electronic databases of Medline, Embase, Scopus and ISI Web of Science until April 2018. Seventeen studies were included (1065 patients aged 16-94 years old). Although the findings of the included studies suggest that inflammatory and structural proteins may be useful in assessing the severity of SCI and prediction of neurological outcome, the level of evidence is generally low. Given limitations to the available evidence, further investigation in this field is required using large prospective data sets with rigorous analysis of sensitivity, specificity and prediction.
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http://dx.doi.org/10.1111/jnc.14637DOI Listing
May 2019

The Gap of Cigarette and Hookah Smoking Between Socioeconomic Groups in Iran: Effect of Inequalities on Socioeconomic Position.

Arch Iran Med 2018 09 1;21(9):418-424. Epub 2018 Sep 1.

Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Background: Hookah and cigarette smoking have adverse effects on individuals' health and therefore place a great burden on public health. The aim of this study was to measure inequalities in socioeconomic position to determine contributing factors on cigarette and hookah smoking in Iran.

Methods: In this study, secondary analysis of the Iran's sixth national Surveillance of Risk Factors of Non-Communicable Diseases (SuRFNCD-2011) was conducted for 10,572 individuals aged 15 to 70 years old. Subjects were categorized into three groups according to their socioeconomic status (low, middle and high) in order to assess their inequalities using principal component analysis. At the end, the gap between the low and high socioeconomic groups was decomposed using Blinder-Oaxaca decomposition technique.

Results: The prevalence of cigarette and hookah smoking in high, middle, and low socioeconomic groups was 11.8%, 13.2%, and 13.1% (P=0.158), and 2.6%, 3.3% and 4.3%, (P<0.001), respectively. Blinder-Oaxaca decomposition technique showed a lower prevalence of hookah smoking in high socioeconomic group compared to low socioeconomic group (P<0.001). The gap between the two mentioned groups was measured to be 1.7%. However, this gap for cigarette smoking (1.5%) was not significant (P=0.093).

Conclusion: The finding indicates the importance of socioeconomic status in hookah smoking. After decomposition of the gap between the 2 socioeconomic groups, age, gender and education level were reported to be the major contributors to the differences observed between the 2 groups.
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September 2018

Comparison of inter- and intra-observer variability of breast density assessments using the fourth and fifth editions of Breast Imaging Reporting and Data System.

Eur J Radiol Open 2018 20;5:67-72. Epub 2018 Apr 20.

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

Background: Breast density is a well-known independent risk factor for breast cancer and can significantly affect the sensitivity of screening mammograms.

Objective: We aimed to evaluate the intra- and inter-observer consistencies of breast density assessments using methods outlined in the fourth and fifth editions of the American College of Radiology (ACR) Breast Imaging Reporting and Data System (BI-RADS) guidelines to determine which method is more reliable.

Materials And Methods: Three radiologists with subspecialties in breast imaging defined breast density in 72 mammograms four times each: twice using the fourth edition of the ACR BI-RADS guidelines and twice using the fifth edition. The intra- and inter-observer agreements were calculated and compared for each method.

Results: The weighted kappa values for the overall intra-observer agreement were 0.955 (95% confidence interval [CI]: 0.931-0.980) and 0.938 (95% CI: 0.907-0.968) when breast densities were assessed according to criteria outlined in the fourth and fifth ACR BI-RADS editions, respectively. The difference between these values was not statistically significant (p = .4). The overall Fleiss-Cohen (quadratic) weighted kappa for inter-observer agreement were 0.623 (95% CI: 0.517-0.729) and 0.702 (95% CI: 0.589-0.815) when breast densities were assessed according to criteria outlined in the fourth and fifth ACR BI-RADS editions, respectively. The difference between these values was not statistically significant (p = .32). Similarly, there were no significant differences in the evaluation of breast density (overall) when comparing breast density assignment using criteria outlined in the fourth and fifth ACR BI-RADS edition (p = .582).

Conclusion: The ACR BI-RADS guideline is an acceptable method to classify breast density, resulting in substantial inter-observer agreements using criteria outlined in both the fourth and fifth editions. The intra-observer agreement was nearly perfect for radiologists using criteria outlined in both sets of guidelines. Moreover, although the percentage of women who were classified as having dense breasts was higher when radiologists used the fifth edition of ACR BI-RADS guidelines than when they used the fourth edition, this difference was not statistically significant.
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http://dx.doi.org/10.1016/j.ejro.2018.04.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5918175PMC
April 2018

Correlation Between Mammographic Breast Density, Breast Tissue Type in Ultrasonography, Fibroglandular Tissue, and Background Parenchymal Enhancement in Magnetic Resonance Imaging.

Breast Cancer (Auckl) 2018 18;12:1178223418771971. Epub 2018 Apr 18.

Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran.

Objective: Breast cancer is the most common malignancy in the female population, and imaging studies play a critical role for its early detection. Mammographic breast density (MBD) is one of the markers used to predict the risk stratification of breast cancer in patients. We aimed to assess the correlations among MBD, ultrasound breast composition (USBC), fibroglandular tissue (FGT), and the amount of background parenchymal enhancement (BPE) in magnetic resonance imaging, after considering the subjects' menopausal status.

Methods: In this retrospective cross-sectional study, the medical records' archives in a tertiary referral hospital were reviewed. Data including age, menopausal status, their mammograms, and ultrasound assessments were extracted from their records. All of their imaging studies were reviewed, and MBD, USBC, FGT, and BPE were determined, recorded, and entered into SPSS software for analysis.

Results: A total of 121 women (mean age = 42.7 ± 11.0 years) were included, of which 35 out of 115 (30.4%) had reached menopause. Using the Jonckheere-Terpstra test for evaluating the trends among above mentioned 4 radiologic characteristics in the total sample population, a significant positive relation was found between each of these paired variables: (1) USBC-MBD ( = .006), (2) FGT-MBD ( = .001), (3) USBC-BPE ( = .046), (4) USBC-FGT ( = .036), and (5) BPE-FGT ( < .001). These trends were not found to be significant among premenopausal subjects.

Conclusions: Considering the trends between different measures of breast density in the 3 radiologic modalities, these factors can be used interchangeably in certain settings.
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http://dx.doi.org/10.1177/1178223418771971DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5912268PMC
April 2018

Neck Circumference Percentiles of Iranian Children and Adolescents: The Weight Disorders Survey of CASPIAN IV Study.

Int J Endocrinol Metab 2017 Oct 29;15(4):e13569. Epub 2017 Jul 29.

Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Neck circumference (NC), emerging as a key morphological index for pediatric obesity, is associated with obesity- and overweight-related detrimental conditions in children. In this study, we aimed to provide the age- and sex-specific percentile reference values for neck circumference of the Iranian children and adolescents.

Methods: We used the data gathered through the weight disorders survey of CASPIAN IV study conducted in 2011 - 2012 in Iran, including a total of 21954 Iranian children and adolescents, composed of 10750 girls and 11204 boys, aged 7 - 18 years old. We presented the interval of NC percentile in three age groups of 7 - 10 years, 11 - 14 years, and 15 - 18 years. Finally, age-specific nomograms of NC for both genders in the Iranian and Canadian populations were compared.

Results: The intervals of 90th percentile of NC for boys in the three periods of school age (7 - 10 years), pre-adolescence (11 - 14 years), and adolescence (15 - 18 years) were 24.2 - 30.0 cm, 26.6 - 33.2 cm, and 30.1 - 38.5 cm, respectively. These intervals for girls were 23.7 - 30.1 cm, 26.5 - 33.7 cm, and 28.5 - 36.0 cm, respectively. NC increased with age in both boys and girls and its variability showed an increasing trend with age.

Conclusions: We demonstrated for the first time the NC reference values for the Iranian children and adolescents aged 7 - 18 years old. Considering the significant differences between our national NC references and the values reported from the Canadian population, it seems logical to use these national percentiles not only for epidemiologic studies but also for routine clinical examinations.
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http://dx.doi.org/10.5812/ijem.13569DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5750675PMC
October 2017

Age-Period-Cohort Analysis of Obesity and Overweight in Iranian Children and Adolescents.

Int J Endocrinol Metab 2017 Oct 30;15(4):e13561. Epub 2017 Jul 30.

Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Background: To date, few studies looked upon obesity and overweight in children and adolescents through the 3 different temporal dimensions of age, period, and cohort. The current study aimed at evaluating the trends of these health issues among children under 19 years old using the age-period-cohort (APC) analysis.

Methods: Data gathered through 5 cross sectional studies including 2 national health surveillance (1990 - 91 and 1999), and 3 CASPIAN surveys (2003, 2009, and 2011). Subjects were classified by their body mass index (BMI) into 3 groups of normal (BMI < 85th percentile), overweight-obese (85th percentile < BMI < 95th percentile), and obese (95th percentile < BMI). Intrinsic estimator method was used to analyze the effects of age, period, and birth cohort on obesity and overweight among the subjects.

Results: A total of 80,698 children and adolescents under 19 years old, including 40,419 (50.09%) males and 40,279 (49.91%) females, were evaluated. The prevalence of obesity decreased progressively by age in males and females with minor discrepancies. It increased from 1990 to 2009 in both genders, but from that point on remained quite constant in males and dropped significantly in females. The prevalence of obesity was steady in earlier birth cohorts, but increased significantly after the birth cohorts from 1986 to 1990.

Conclusions: Environmental factors and social stresses during neonatal and infantile periods (birth cohort effect) along with other variables influencing the children later in their lives (period effect) affect the prevalence of overweight and obesity substantially. Moreover, a decrease in the prevalence of obesity and overweight was observed by age increase (age effect).
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http://dx.doi.org/10.5812/ijem.13561DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5750447PMC
October 2017

Transplantation of olfactory ensheathing cells on functional recovery and neuropathic pain after spinal cord injury; systematic review and meta-analysis.

Sci Rep 2018 01 10;8(1):325. Epub 2018 Jan 10.

Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

There are considerable disagreements on the application of olfactory ensheathing cells (OEC) for spinal cord injury (SCI) rehabilitation. The present meta-analysis was designed to investigate the efficacy of OEC transplantation on motor function recovery and neuropathic pain alleviation in SCI animal models. Accordingly, all related studies were identified and included. Two independent researchers assessed the quality of the articles and summarized them by calculating standardized mean differences (SMD). OEC transplantation was shown to significantly improve functional recovery (SMD = 1.36; 95% confidence interval: 1.05-1.68; p < 0.001). The efficacy of this method was higher in thoracic injuries (SMD = 1.41; 95% confidence interval: 1.08-1.74; p < 0.001) and allogeneic transplants (SMD = 1.53; 95% confidence interval: 1.15-1.90; p < 0.001). OEC transplantation had no considerable effects on the improvement of hyperalgesia (SMD = -0.095; 95% confidence interval: -0.42-0.23; p = 0.57) but when the analyses were limited to studies with follow-up ≥8 weeks, it was associated with increased hyperalgesia (SMD = -0.66; 95% confidence interval: -1.28-0.04; p = 0.04). OEC transplantation did not affect SCI-induced allodynia (SMD = 0.54; 95% confidence interval: -0.80-1.87; p = 0.43). Our findings showed that OEC transplantation can significantly improve motor function post-SCI, but it has no effect on allodynia and might lead to relative aggravation of hyperalgesia.
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http://dx.doi.org/10.1038/s41598-017-18754-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5762885PMC
January 2018

Blood Pressure Nomograms for Children and Adolescents by Age and Body Mass Index in Tehran, Iran.

Iran J Public Health 2017 Mar;46(3):368-379

Pediatric Chronic Kidney Disease Research Center, The Children's Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran.

Background: Normal standard references of blood pressure (BP) for children and adolescents should be constructed according to anthropometric indices. Therefore we aimed to produce BP reference percentiles by body mass index (BMI).

Methods: Data on demographic characteristics, anthropometric indices and BP values of 16246 3-18-year-old children and adolescents from 3 cross-sectional studies conducted in Tehran were included. To justify the need for BMI adjustment, quantile regression model was applied for different percentiles of systolic and diastolic BPs with age, sex, and the corresponding BMI percentiles. Then, Age- and sex-specific BP nomograms were constructed according to BMI.

Results: All regression coefficients for BMI percentiles were significant in quantile regression of BPs, confirming the necessity for BMI-adjusted nomograms of BP. The BP percentiles for each gender by age and BMI are presented. All the BP percentiles rose steadily in all BMI percentiles with minor discrepancies between the two genders. As observed, the prevalence of hypertension is estimated to be lower among the lean subjects and higher among overweighs when the BMI-adjusted BP curves are considered.

Conclusion: The reference database constructed in this survey is the first Iranian BP reference by age and BMI in children and adolescents, from it concluded that BMI-adjusted BP curves depict a more precise picture of the hypertension prevalence and present a more reliable classification standard for hypertension.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5395533PMC
March 2017

Accuracy of cystatin C in prediction of acute kidney injury in children; serum or urine levels: which one works better? A systematic review and meta-analysis.

BMC Nephrol 2017 04 3;18(1):120. Epub 2017 Apr 3.

Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Poursina Ave, Tehran, Iran.

Background: There is still an ongoing discussion on the prognostic value of cystatin C in assessment of kidney function. Accordingly, the present study aimed to conduct a meta-analysis to provide evidence for the prognostic value of this biomarker for acute kidney injury (AKI) in children.

Methods: An extensive search was performed in electronic databases of Medline, Embase, ISI Web of Science, Cochrane library and Scopus until the end of 2015. Standardized mean difference (SMD) with a 95% of confidence interval (95% CI) and the prognostic performance characteristics of cystatin C in prediction of AKI were assessed. Analyses were stratified based on the sample in which the level of cystatin C was measured (serum vs. urine).

Results: A total of 24 articles were included in the meta-analysis [1948 children (1302 non-AKI children and 645 AKI cases)]. Serum (SMD = 0.96; 95% CI: 0.68-1.24; p < 0.0001) and urine (SMD = 0.54; 95% CI:0.34-0.75; p < 0.0001) levels of cystatin C were significantly higher in children with AKI. Overall area under the curve of serum cystatin C and urine cystatin C in prediction of AKI were 0.83 (95% CI: 0.80-0.86) and 0.85 (95% CI: 0.81-0.88), respectively. The best sensitivity (value = 0.85; 95% CI: 0.78-0.90) and specificity (value = 0.61; 95% CI: 0.48-0.73), were observed for the serum concentration of this protein and in the cut-off points between 0.4-1.0 mg/L.

Conclusion: The findings of the present study showed that cystatin C has an acceptable prognostic value for prediction of AKI in children. Since the serum level of cystatin C rises within the first 24 h of admission in patients with AKI, this biomarker can be a suitable alternative for traditional diagnostic measures.
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http://dx.doi.org/10.1186/s12882-017-0539-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5379579PMC
April 2017

Early versus late spinal decompression surgery in treatment of traumatic spinal cord injuries; a systematic review and meta-analysis.

Emerg (Tehran) 2017 11;5(1):e37. Epub 2017 Jan 11.

Department of Neurology, School ofMedicine, Imam Khomeini Hospital, Tehran University ofMedical Sciences, Tehran, Iran.; Iranian Center of Neurological Research, Tehran University ofMedical Sciences, Tehran, Iran.

Introduction: Despite the vast number of surveys, no consensus has been reached on the optimum timing of spinal decompression surgery. This systematic review and meta-analysis aimed to compare the effects of early and latespinal decompression surgery on neurologic improvement and post-surgical complications in patients with traumatic spinal cord injuries.

Methods: Two independent reviewers carried out an extended search in electronic databases. Data of neurological outcome and post-surgery complication were extracted. Finally, pooled relative risk (RR) with a 95% confidence interval (CI) was reported for comparing of efficacy of early and late surgical decompression.

Results: Eventually 22 studies were included. The pooled RRwas 0.77 (95% CI: 0.68-0.89)for at least one grade neurological improvement, and 0.84 (95% CI: 0.77-0.92)for at least two grade improvement. Pooled RR for surgical decompression performed within 12 hours after the injury was 0.26 (95% CI: 0.13-0.52; p<0.001), while it was 0.75 (95% CI: 0.63-0.90; p=0.002) when the procedure was performed within 24 hours, and 0.93 (95% CI: 0.76-1.14; p=0.48) when it was carried out in the first 72 hours after the injury. Surgical decompression performed within 24 hours after injury was found to be associated with significantly lower rates of post-surgical complications (RR=0.77; 95% CI: 0.68-0.86; p<0.001).

Conclusion: The findings of this study indicate that early spinal decompression surgery can improve neurologic recovery and is associated with less post-surgical complications. The optimum efficacy is observed when the procedure is performed within 12 hours of the injury.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5325907PMC
January 2017

Worthing Physiological Score vs Revised Trauma Score in Outcome Prediction of Trauma patients; a Comparative Study.

Emerg (Tehran) 2017 11;5(1):e31. Epub 2017 Jan 11.

Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Introduction: Awareness about the outcome of trauma patients in the emergency department (ED) has become a topic of interest. Accordingly, the present study aimed to compare the rapid trauma score (RTS) and worthing physiological scoring system (WPSS) in predicting in-hospital mortality and poor outcome of trauma patients.

Methods: In this comparative study trauma patients brought to five EDs in different cities of Iran during the year 2016 were included. After data collection, discriminatory power and calibration of the models were assessed and compared using STATA 11.

Results: 2148 patients with the mean age of 39.50±17.27 years were included (75.56% males). The AUC of RTS and WPSS models for prediction of mortality were 0.86 (95% CI: 0.82-0.90) and 0.91 (95% CI: 0.87-0.94), respectively (p=0.006). RTS had a sensitivity of 71.54 (95% CI: 62.59-79.13) and a specificity of 97.38 (95% CI: 96.56-98.01) in prediction of mortality. These measures for the WPSS were 87.80 (95% CI: 80.38-92.78) and 83.45 (95% CI: 81.75-85.04), respectively. The AUC of RTS and WPSS in predicting poor outcome were 0.81 (95% CI: 0.77-0.85) and 0.89 (95% CI: 0.85-0.92), respectively (p<0.0001).

Conclusion: The findings showed a higher prognostic value for the WPSS model in predicting mortality and severe disabilities in trauma patients compared to the RTS model. Both models had good overall performance in prediction of mortality and poor outcome.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5325901PMC
January 2017

Rapid Acute Physiology Score versus Rapid Emergency Medicine Score in Trauma Outcome Prediction; a Comparative Study.

Emerg (Tehran) 2017 10;5(1):e30. Epub 2017 Jan 10.

Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Introduction: Rapid acute physiology score (RAPS) and rapid emergency medicine score (REMS) are two physiologic models for measuring injury severity in emergency settings. The present study was designed to compare the two models in outcome prediction of trauma patients presenting to emergency department (ED).

Methods: In this prospective cross-sectional study, the two models of RAPS and REMS were compared regarding prediction of mortality and poor outcome (severe disability based on Glasgow outcome scale) of trauma patients presenting to the EDs of 5 educational hospitals in Iran (Tehran, Tabriz, Urmia, Jahrom and Ilam) from May to October 2016. The discriminatory power and calibration of the models were calculated and compared using STATA 11.

Results: 2148 patients with the mean age of 39.50±17.27 years were studied (75.56% males). The area under the curve of REMS and RAPS in predicting in-hospital mortality were calculated to be 0.93 (95% CI: 0.92-0.95) and 0.899 (95% CI: 0.86-0.93), respectively (p=0.02). These measures were 0.92 (95% CI: 0.90-0.94) and 0.86 (95% CI: 0.83-0.90), respectively, regarding poor outcome (p=0.001). The optimum cut-off point in predicting outcome was found to be 3 for REMS model and 2 for RAPS model. The sensitivity and specificity of REMS and RAPS in the mentioned cut offs were 95.93 vs. 85.37 and 77.63 vs. 83.51, respectively, in predicting mortality. Calibration and overall performance of the two models were acceptable.

Conclusion: The present study showed that adding age and level of arterial oxygen saturation to the variables included in RAPS model can increase its predictive value. Therefore, it seems that REMS could be used for predicting mortality and poor outcome of trauma patients in emergency settings.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5325900PMC
January 2017

Evaluating the Correlation Between the Survival Rate of Patients with Esophageal Squamous Cell Carcinoma and Expression of p53 and Cyclin D1 Biomarkers Along with Other Prognostic Factors.

J Gastrointest Cancer 2018 Mar;49(1):35-40

Medical Biotechnology Department, Iran University of Medical Sciences, Tehran, Iran.

Objective: In the present study, we aimed to evaluate the relationship between the survival rate of patients with esophageal squamous cell carcinoma (SCC) and expression of two biomarkers along with age, gender, tumor margin, depth of invasion, site of tumor, tumor diameter, tumor grade, number of involved nodes, and vascular invasion.

Materials And Methods: In this retrospective survey, medical records of patients referred to the Shohada-e Tajrish hospital during 2001 to 2005 were reviewed and subjects with definite diagnosis of SCC were included. Required data were extracted from the patients' records, and their prepared paraffin-embedded tissue blocks were collected under supervision of two pathologists. Immunohistochemistry (IHC) analysis was performed at the Firoozgar hospital in Tehran, Iran.

Results: The studied population included 20 men (74%) and 7 women (26%). The mean age at diagnosis was 58 ± 22. Results showed significantly higher survival rates in women compared to men (85.7 vs. 40%) (p = 0.001) and in patients with well-differentiated tumors compared to poor-differentiated cases (20 vs. 5%) (p = 0.004). No significant relationship was found between p53 expression and prognostic factors like age, gender, the site, grade, and size of the tumor, depth of invasion, involvement of lymph nodes, and vascular invasion.

Conclusion: Positivity of p53 and cyclin D1 was not found to be predictive of survival in patients with esophageal SCC which might be due to the small sample size of the present survey. Further investigations with larger sample populations and longer follow-ups are required to evaluate this correlation.
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http://dx.doi.org/10.1007/s12029-016-9905-6DOI Listing
March 2018

The efficacy of Schwann cell transplantation on motor function recovery after spinal cord injuries in animal models: A systematic review and meta-analysis.

J Chem Neuroanat 2016 12 5;78:102-111. Epub 2016 Sep 5.

Department of Emergency Medicine, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran.

Aim: This article aimed to assess the efficacy of Schwann cell transplantation on motor function recovery in animal model of spinal cord injuries via meta-analysis.

Methods: An extended search was carried out in the electronic databases of Medline (via PubMed), EMBASE (via OvidSP), CENTRAL, SCOPUS, Web of Science (BIOSIS), and ProQuest. Finally, 41 eligible studies conducted on 1046 animals including 517 control animals and 529 transplanted animals were included in the meta-analysis. Pooled standardized mean difference (SMD) and odds ratio (OR) with 95% confidence interval (95% CI) were reported.

Results: The findings showed that treatment with Schwann cells leads to a modest motor function recovery after spinal cord injury (SMD=0.85; 95% CI: 0.63-1.07; p<0.001). Transplantation of these cells in acute phase of the injury (immediately after the injury) (OR=4.30; 95% CI: 1.53-12.05; p=0.007), application of mesenchymal/skin-derived precursors (OR=2.34; 95% CI: 1.28-4.29; p=0.008), and cells with human sources are associated with an increase in efficacy of Schwann cells (OR=10.96; 95% CI: 1.49-80.77; p=0.02). Finally, it seems that the efficacy of Schwann cells in mice is significantly lower than rats (OR=0.03; 95% CI: 0.003-0.41; p=0.009).

Conclusion: Transplantation of Schwann cells can moderately improve motor function recovery. It seems that inter-species differences might exist regarding the efficacy of this cells. Therefore, this should be taken into account when using Schwann cells in clinical trials regarding spinal cord injuries.
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http://dx.doi.org/10.1016/j.jchemneu.2016.09.002DOI Listing
December 2016

A randomized controlled trial of smoking cessation methods in patients newly-diagnosed with pulmonary tuberculosis.

BMC Infect Dis 2016 08 5;16:369. Epub 2016 Aug 5.

Department of Epidemiology and Biostatistics, School of Public Health and Institute of Public Health Research, Tehran University of Medical Sciences, Tehran, Iran.

Background: Tuberculosis (TB) and tobacco use are two major alarming global health issues that tend to be co-prevalent in many developing countries and various surveys have provided evidence on their entangled associations. Accordingly, it is strongly suggested that smoking cessation be incorporated in TB control programs. Therefore, we aimed to evaluate the effectiveness of two smoking cessation methods among newly-diagnosed pulmonary TB patients.

Methods: A total of 210 newly-diagnosed pulmonary TB patients from Tehran, Iran with smoking habits were included in this randomized clinical trial during 2012-2013. Patients were assigned to three groups of control (just TB medical treatment), brief advice (TB medical treatment plus individualized counseling sessions of quitting behavioral therapy) and combined intervention (TB medical treatment plus individualized counseling sessions of quitting behavioral therapy plus medical treatment with slow release bupropion). Patients' abstinence was followed at six time point during six months. Data were analyzed by SPSS v.22 using Generalized Estimating Equations (GEE) model.

Results: Abstinance rate at the end of six months were 71.7 % for combined intervention group, 33.9 % for brief advice group and 9.8 % for the control group (p < 0.001). Combined intervention group and brief advice group respectively had 35 times (p < 0.001, OR = 35.26, 95 % CI = 13.77-90.32) and 7 times (p < 0.001, OR = 7.14, 95 % CI = 2.72-18.72) more odds of not being an active smoker at each time point, compared to the control group.

Conclusion: Considering the prevalence and importance of TB and the substantial influence of these preventive measures on controlling tobacco use, application of such programs is recommended.

Trial Registration: The survey was registered in the Iranian registry of clinical trials website (irct.ir) in August 31, 2013 with IRCT ID: IRCT2013062613783N1 .
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http://dx.doi.org/10.1186/s12879-016-1727-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4974814PMC
August 2016