Publications by authors named "Mohsen Sadeghi"

30 Publications

  • Page 1 of 1

Clinical Manifestations of Patients with Coronavirus Disease 2019 (COVID-19) in a Referral Center in Iran.

Tanaffos 2020 Nov;19(2):122-128

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

Background: Following the recent epidemic of coronavirus disease 2019 (COVID-19) in Wuhan, China, a novel betacoronavirus was isolated from two patients in Iran on February 19, 2020. In this study, we aimed to determine the clinical manifestations and outcomes of the first confirmed cases of COVID-19 infection (n=127).

Materials And Methods: This prospective study was conducted on all COVID-19-suspected cases, admitted to Masih Daneshvari Hospital (a designated hospital for COVID-19), Tehran, Iran, since February 19, 2020. All patients were tested for COVID-19, using reverse transcription-polymerase chain reaction (RT-PCR) assay. Data of confirmed cases, including demographic characteristics, clinical features, and outcomes, were collected and compared between three groups of patients, requiring different types of admission (requiring ICU admission, admission to the general ward, and transfer to ICU).

Results: Of 412 suspected cases, with the mean age of 54.1 years (SD=13.4), 127 (31%) were positive for COVID-19. Following the patients' first visit to the clinic, 115 cases were admitted to the general ward, while ten patients required ICU admission. Due to clinical deterioration in the condition of 25 patients (out of 115 patients), ICU admission was essential. Based on the results, the baseline characteristics of the groups were similar. Patients requiring ICU admission were more likely to have multiorgan involvement (liver involvement, P<0.001; renal involvement, P<0.001; and cardiac involvement, P=0.02), low O saturation (P<0.001), and lymphopenia (P=0.05). During hospital admission, 21 (16.5%) patients died, while the rest (83.5%) were discharged and followed-up until March 26, 2020. Also, the survival rate of patients, who received immunoglobulin, was higher than other patients (60.87% vs. 39.13%).

Conclusion: The mortality rate of COVID-19 patients was considerable in our study. Based on the present results, this infection can cause multiorgan damage. Therefore, intensive monitoring of these patients needs to be considered.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7680520PMC
November 2020

Promising effects of tocilizumab in COVID-19: A non-controlled, prospective clinical trial.

Int Immunopharmacol 2020 Nov 4;88:106869. Epub 2020 Aug 4.

Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address:

Background: The clinical presentation of SARS-CoV-2 infection ranges from mild symptoms to severe complications, including acute respiratory distress syndrome. In this syndrome, inflammatory cytokines are released after activation of the inflammatory cascade, with the predominant role of interleukin (IL)-6. The aim of this study was to evaluate the effects of tocilizumab, as an IL-6 antagonist, in patients with severe or critical SARS-CoV-2 infection.

Methods: In this prospective clinical trial, 76 patients with severe or critical SARS-CoV-2 infection were evaluated for eligibility, and ultimately, 42 patients were included. Tocilizumab was administered at a dose of 400 mg as a single dose via intravenous infusion. Primary outcomes included changes in oxygenation support, need for invasive mechanical ventilation, and death. Secondary outcomes included radiological changes in the lungs, IL-6 plasma levels, C-reactive protein levels, and adverse drug reactions. The data were analyzed using SPSS software.

Results: Of the 42 included patients, 20 (48%) patients presented the severe infection stage and 22 (52%) were in the critical stage. The median age of patients was 56 years, and the median IL-6 level was 28.55 pg/mL. After tocilizumab administration, only 6 patients (14%) required invasive ventilation. Additionally, 35 patients (83.33%) showed clinical improvement. By day 28, a total of 7 patients died (6 patients in the critical stage and 1 patient in the severe stage). Neurological adverse effects were observed in 3 patients.

Conclusions: Based on the current results, tocilizumab may be a promising agent for patients with severe or critical SARS-CoV-2 infection, if promptly initiated during the severe stage.
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http://dx.doi.org/10.1016/j.intimp.2020.106869DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7402206PMC
November 2020

Large-scale simulation of biomembranes incorporating realistic kinetics into coarse-grained models.

Nat Commun 2020 06 11;11(1):2951. Epub 2020 Jun 11.

Department of Mathematics and Computer Science, Freie Universität Berlin, Arnimallee 6, 14195, Berlin, Germany.

Biomembranes are two-dimensional assemblies of phospholipids that are only a few nanometres thick, but form micrometre-sized structures vital to cellular function. Explicit molecular modelling of biologically relevant membrane systems is computationally expensive due to the large number of solvent particles and slow membrane kinetics. Coarse-grained solvent-free membrane models offer efficient sampling but sacrifice realistic kinetics, thereby limiting the ability to predict pathways and mechanisms of membrane processes. Here, we present a framework for integrating coarse-grained membrane models with continuum-based hydrodynamics. This framework facilitates efficient simulation of large biomembrane systems with large timesteps, while achieving realistic equilibrium and non-equilibrium kinetics. It helps to bridge between the nanometer/nanosecond spatiotemporal resolutions of coarse-grained models and biologically relevant time- and lengthscales. As a demonstration, we investigate fluctuations of red blood cells, with varying cytoplasmic viscosities, in 150-milliseconds-long trajectories, and compare kinetic properties against single-cell experimental observations.
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http://dx.doi.org/10.1038/s41467-020-16424-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7289815PMC
June 2020

Evaluation of CCR5-Δ32 mutation among individuals with high risk behaviors, neonates born to HIV-1 infected mothers, HIV-1 infected individuals, and healthy people in an Iranian population.

J Med Virol 2020 08 17;92(8):1158-1164. Epub 2020 Jan 17.

Research Center of Pediatric Infectious Diseases, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran.

One of the important genetic factors related to resistance to HIV-1 infection is the presence of the C-C chemokine receptor type 5 delta 32 (CCR5-Δ32) homozygous genotype (Δ32/Δ32). The aim of this study was to evaluate the CCR5-Δ32 mutation among individuals with high-risk behaviors, neonates born to HIV-1-infected mothers in the prevention of mother-to-child transmission (PMTCT) project, HIV-1-infected individuals, and healthy people. The frequency of the CCR5-Δ32 genotype was assessed in a cross-sectional survey carried out from March 2014 to March 2019 among four different groups of the Iranian population. Genomic DNA was extracted from peripheral blood mononuclear cells of 140 Iranian healthy people, 84 neonates born to HIV-1-infected mothers in the PMTCT project, 71 people with high-risk behaviors, and 76 HIV-1-infected individuals. The polymerase chain reaction method was used for the amplification of the CCR5 gene. The CCR5-Δ32 heterozygous deletion was detected in five (6.6%) HIV-1-infected individuals, four (4.7%) neonates born to HIV-1 positive mothers, two (1.4%) healthy people, and also three (4.2%) people with high-risk behaviors whereas the CCR5-Δ32 homozygous deletion was absent in all the groups (Fisher's exact test, P = .0242). The allele of CCR5-Δ32 homozygous was not detected in the four study groups, and no significant difference was seen in the frequency of the CCR5Δ32 heterozygous allele between HIV seropositive and seronegative individuals. Therefore, it seems that this allele alone cannot explain the natural resistance to HIV-1 infection and probably several mechanisms are responsible for these processes and it should be further investigated.
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http://dx.doi.org/10.1002/jmv.25658DOI Listing
August 2020

A Randomized Double Blind Placebo Controlled Trial Examining the Effects of Pentoxifylline on Contrast Induced Nephropathy Reduction after Percutaneous Coronary Intervention in High Risk Candidates.

Iran J Pharm Res 2019 ;18(2):1040-1046

Department of Biostatistics and Epidemiology, School of Medicine, Babol University of Medical Sciences, Babol, Iran.

Contrast-induced nephropathy (CIN) (known as contrast-induced acute kidney injury) occurs as a result of acute worsening of renal function following a procedure with administration of iodine contrasts agent and remains a substantial concern in clinical practices. The purpose of this study is to investigate the preventive effect of Pentoxifylline supplementation on reduction of CIN occurrence after percutaneous coronary intervention among patients who were high risk of CIN according to Mehran score. In randomized, double-blind clinical trial patients who undergo coronary angiography with Mehran Score ≥ 11 consisted of our population. Patients in a ratio 1:1, divided into two groups received saline 0.9% plus N-acetyl cysteine and Pentoxifylline 400 mg three times per day 24 h before angiography until 48 h after angiography. In control group, the patients received placebo instead of PTX in a same manner as the control group. The endpoint was the incidence of CIN defined as creatinine increase of 0.5 mg/dL within 2 days after contrast. There were no significant differences in baseline characteristics. CIN occurred in 3 (5.5%) and 4 (7.3%) patients of the both groups (Pentoxifylline and control), respectively ( 0.69; incidence odds ratio 1.36; 95% CI 0.29-6.38). No significant differences were seen in secondary outcome measures and changes in the level of creatinine ( 0.54). In high-risk patients undergoing coronary angiography pentoxifylline supplementation had protection effect against contrast-induced nephropathy greater than placebo based hydration, but, not supported by our data.
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http://dx.doi.org/10.22037/ijpr.2019.12557.10977DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6706721PMC
January 2019

Abdominal Compartment Syndrome in Critically Ill Patients.

Open Access Maced J Med Sci 2019 Apr 13;7(7):1097-1102. Epub 2019 Apr 13.

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

Background: Abdominal compartment syndrome patients suffer severe obstacles such as kidney failure and shock. To evade further complications, identifying the abdominal compartment syndrome (ACS) and Intra-abdominal hypertension (IAH), in critically ill individuals and hospitalised in the intensive care unit (ICU) is obligated.

Aim: The current study intended to study the abdominal compartment syndrome and the concomitant risk factors among hospitalised patients in ICU, by using the Intra-abdominal pressure test.

Material And Methods: One hundred and twenty-five hospitalised patients at ICU entered the current survey. Abdominal pressure was measured by standard intravesical technique. The SPSS 21 analysed the preoperative and intraoperative factors such as demographic records and comorbidities.

Results: Seventy-three (58.4%) participants were males and 52 (41.6%) were women in the mean age of 55.1 ± 18.3 years. Eighty-nine patients (71.2%) showed normal intra-abdominal pressure since 31 patients (24.8%), and 5 patients (4%) developed IAH and ACS. The intra-abdominal pressure (IAP) applied to Glasgow Coma Scale (GCS), Acute Physiology, shock, Systemic Inflammatory Response Syndrome (SIRS), central venous oxygen saturation and Chronic Health Evaluation (APACHE II) score (P < 0.05). Patients with high IAP have shown a higher mortality frequency, compared to others (P < 0.05).

Conclusion: Current findings showed a correlation between IAP hospitalised patients in ICU and shock, SIRS, APACHE II, central venous oxygen saturation and GCS. Intra-abdominal pressure test, as a valuable prognosis test for the abdominal compartment syndrome (ACS) and Intra-abdominal hypertension (IAH), may offer better results when added to the routine medical checkup of ICU patients.
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http://dx.doi.org/10.3889/oamjms.2019.228DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6490480PMC
April 2019

The visual geometry of a tool modulates generalization during adaptation.

Sci Rep 2019 02 25;9(1):2731. Epub 2019 Feb 25.

Department of Engineering, University of Cambridge, Trumpington Street, Cambridge, CB2 1PZ, UK.

Knowledge about a tool's dynamics can be acquired from the visual configuration of the tool and through physical interaction. Here, we examine how visual information affects the generalization of dynamic learning during tool use. Subjects rotated a virtual hammer-like object while we varied the object dynamics separately for two rotational directions. This allowed us to quantify the coupling of adaptation between the directions, that is, how adaptation transferred from one direction to the other. Two groups experienced the same dynamics of the object. For one group, the object's visual configuration was displayed, while for the other, the visual display was uninformative as to the dynamics. We fit a range of context-dependent state-space models to the data, comparing different forms of coupling. We found that when the object's visual configuration was explicitly provided, there was substantial coupling, such that 31% of learning in one direction transferred to the other. In contrast, when the visual configuration was ambiguous, despite experiencing the same dynamics, the coupling was reduced to 12%. Our results suggest that generalization of dynamic learning of a tool relies, not only on its dynamic behaviour, but also on the visual configuration with which the dynamics is associated.
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http://dx.doi.org/10.1038/s41598-019-39507-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6389992PMC
February 2019

Adaptive coupling influences generalization of sensorimotor learning.

PLoS One 2018 29;13(11):e0207482. Epub 2018 Nov 29.

Department of Engineering, University of Cambridge, Cambridge, United Kingdom.

Sensorimotor learning typically shows generalization from one context to another. Models of sensorimotor learning characterize this with a fixed generalization function that couples learning between contexts. Here we examine whether such coupling is indeed fixed or changes with experience. We examine the interaction between motor memories for novel dynamics during reciprocating, back and forth reaching movements. Subjects first experienced a force field for one movement direction and we used channel trials to assess generalization on the reciprocal movements. This showed minimal coupling such that errors experienced for one movement direction did not lead to adaptation for the other. However, after subjects had experienced a force field for both movement directions concurrently, a coupling developed between the corresponding motor memories. That is, on re-exposure for one direction there was a significant adaptation for movements in the other direction. The coupling was specific to the errors experienced, with minimal coupling when the errors had the opposite sign to those experienced during adaptation. We developed a state-space model in which the states for the two movement directions are represented by separate, yet potentially coupled learning processes. The coupling in the model controlled the extent to which each learning process was updated by the errors experienced on the other movement direction. We show that the coupling relies on a memory trace of the consecutive errors experienced for both movement directions. Our results suggest that the generalization of motor learning is an adaptive process, reflecting the relation between errors experienced across different movements.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0207482PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6264158PMC
April 2019

Single event visualization of unconventional secretion of FGF2.

J Cell Biol 2019 02 23;218(2):683-699. Epub 2018 Nov 23.

Heidelberg University Biochemistry Center, Heidelberg, Germany

FGF2 is exported from cells by an unconventional secretory mechanism. Here, we directly visualized individual FGF2 membrane translocation events at the plasma membrane using live cell TIRF microscopy. This process was dependent on both PI(4,5)P-mediated recruitment of FGF2 at the inner leaflet and heparan sulfates capturing FGF2 at the outer plasma membrane leaflet. By simultaneous imaging of both FGF2 membrane recruitment and the appearance of FGF2 at the cell surface, we revealed the kinetics of FGF2 membrane translocation in living cells with an average duration of ∼200 ms. Furthermore, we directly demonstrated FGF2 oligomers at the inner leaflet of living cells with a FGF2 dimer being the most prominent species. We propose this dimer to represent a key intermediate in the formation of higher FGF2 oligomers that form membrane pores and put forward a kinetic model explaining the mechanism by which membrane-inserted FGF2 oligomers serve as dynamic translocation intermediates during unconventional secretion of FGF2.
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http://dx.doi.org/10.1083/jcb.201802008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6363455PMC
February 2019

Particle-based membrane model for mesoscopic simulation of cellular dynamics.

J Chem Phys 2018 Jan;148(4):044901

Department of Mathematics and Computer Science, Freie Universität Berlin, Arnimallee 6, 14195 Berlin, Germany.

We present a simple and computationally efficient coarse-grained and solvent-free model for simulating lipid bilayer membranes. In order to be used in concert with particle-based reaction-diffusion simulations, the model is purely based on interacting and reacting particles, each representing a coarse patch of a lipid monolayer. Particle interactions include nearest-neighbor bond-stretching and angle-bending and are parameterized so as to reproduce the local membrane mechanics given by the Helfrich energy density over a range of relevant curvatures. In-plane fluidity is implemented with Monte Carlo bond-flipping moves. The physical accuracy of the model is verified by five tests: (i) Power spectrum analysis of equilibrium thermal undulations is used to verify that the particle-based representation correctly captures the dynamics predicted by the continuum model of fluid membranes. (ii) It is verified that the input bending stiffness, against which the potential parameters are optimized, is accurately recovered. (iii) Isothermal area compressibility modulus of the membrane is calculated and is shown to be tunable to reproduce available values for different lipid bilayers, independent of the bending rigidity. (iv) Simulation of two-dimensional shear flow under a gravity force is employed to measure the effective in-plane viscosity of the membrane model and show the possibility of modeling membranes with specified viscosities. (v) Interaction of the bilayer membrane with a spherical nanoparticle is modeled as a test case for large membrane deformations and budding involved in cellular processes such as endocytosis. The results are shown to coincide well with the predicted behavior of continuum models, and the membrane model successfully mimics the expected budding behavior. We expect our model to be of high practical usability for ultra coarse-grained molecular dynamics or particle-based reaction-diffusion simulations of biological systems.
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http://dx.doi.org/10.1063/1.5009107DOI Listing
January 2018

An error-tuned model for sensorimotor learning.

PLoS Comput Biol 2017 12 18;13(12):e1005883. Epub 2017 Dec 18.

Department of Engineering, University of Cambridge, Trumpington Street, Cambridge, United Kingdom.

Current models of sensorimotor control posit that motor commands are generated by combining multiple modules which may consist of internal models, motor primitives or motor synergies. The mechanisms which select modules based on task requirements and modify their output during learning are therefore critical to our understanding of sensorimotor control. Here we develop a novel modular architecture for multi-dimensional tasks in which a set of fixed primitives are each able to compensate for errors in a single direction in the task space. The contribution of the primitives to the motor output is determined by both top-down contextual information and bottom-up error information. We implement this model for a task in which subjects learn to manipulate a dynamic object whose orientation can vary. In the model, visual information regarding the context (the orientation of the object) allows the appropriate primitives to be engaged. This top-down module selection is implemented by a Gaussian function tuned for the visual orientation of the object. Second, each module's contribution adapts across trials in proportion to its ability to decrease the current kinematic error. Specifically, adaptation is implemented by cosine tuning of primitives to the current direction of the error, which we show to be theoretically optimal for reducing error. This error-tuned model makes two novel predictions. First, interference should occur between alternating dynamics only when the kinematic errors associated with each oppose one another. In contrast, dynamics which lead to orthogonal errors should not interfere. Second, kinematic errors alone should be sufficient to engage the appropriate modules, even in the absence of contextual information normally provided by vision. We confirm both these predictions experimentally and show that the model can also account for data from previous experiments. Our results suggest that two interacting processes account for module selection during sensorimotor control and learning.
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http://dx.doi.org/10.1371/journal.pcbi.1005883DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5749863PMC
December 2017

Synthesis and application of magnetite dextran-spermine nanoparticles in breast cancer hyperthermia.

Prog Biomater 2017 Sep 17;6(3):75-84. Epub 2017 Jun 17.

Biomedical Engineering Group, Faculty of Chemical Engineering, Tarbiat Modares University, Tehran, Iran.

Cancer treatment has been very challenging in recent decades. One of the most promising cancer treatment methods is hyperthermia, which increases the tumor temperature (41-45 °C). Magnetic nanoparticles have been widely used for selective targeting of cancer cells. In the present study, magnetic dextran-spermine nanoparticles, conjugated with Anti-HER2 antibody to target breast cancer cells were developed. The magnetic dextran-spermine nanoparticles (DMNPs) were prepared by ionic gelation, followed by conjugation of antibody to them using EDC-NHS method. Then the Prussian blue method was used to estimate the targeting ability and cellular uptake. Cytotoxicity assay by MTT showed that antibody-conjugated MNPs (ADMNPs) have no toxic effect on SKBR3 and human fibroblast cells. Finally, the hyperthermia was applied to show that synthesized ADMNPs, could increase the cancer cells temperature up to 45 °C and kill most of them without affecting normal cells. These observations proved that Anti-HER2 conjugated magnetic dextran-spermine nanoparticles can target and destroy cancer cells and are potentially suitable for cancer treatment.
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http://dx.doi.org/10.1007/s40204-017-0068-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5597569PMC
September 2017

Preparation and Characterization of Rivastigmine Transdermal Patch Based on Chitosan Microparticles.

Iran J Pharm Res 2016 ;15(3):283-294

Department of Toxicology, Faculty of Medical Science, Tarbiat Modares University, Tehran, Iran.

Here we report a novel approach for preparation of a 6-day transdermal drug delivery system (TDDS) as treatment for mild to moderate Alzheimer's disease. The spray drying method was used to prepare microparticles containing the anti-Alzheimer drug, Rivastigmine, in combination with the natural polymer, chitosan, for transdermal drug delivery applications. The content of the drug was determined by High Performance Liquid Chromatography (HPLC) method which was validated as per FDA guidelines. The morphology and size range of the microparticles were determined; and the effect of drug concentration in the solution injected into the spray dryer on the particles characterizations was studied. The stability of Rivastigmine at high temperature was confirmed using FTIR analysis as well as a validate HPLC assay. The obtained results show that the drug was stable at high temperatures with 7 to 42% loading in the microparticles, and the higher drug concentrations of the solution injected into the spray dryer resulted in increase of the drug loading, surface drug and microparticles distortion. The TDDS containing the microparticles was also prepared with microparticle to dry adhesive ratios of 5, 10 and 15% using acrylic adhesive. Based on adhesion properties of the patches, gained from the probe tack and the peel adhesion 180° tests, and the 15% patch by having more drug content per unit area of the patch, and still having similar adhesion properties was compared to the microparticles-free patch of 5.1% Rivastigmine salt (equivalent to the drug content of the 15% patch) from the permeation point of view by using Franz cell diffusion over 6 days. The drug permeation rate from the microparticle-free patch was slower than the 15% microparticles patch, which is the result of crystallization of Rivastigmine salt in the acrylic adhesive. The 6-day-prepared TDDS can be considered as an alternative for one-week application of 6 Exelon patches.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5149014PMC
January 2016

Integron types, gene cassettes and antimicrobial resistance profile of Acinetobacter baumannii isolated from BAL samples in Babol, north of Iran.

Microb Pathog 2017 Aug 4;109:35-38. Epub 2017 May 4.

Infectious Diseases and Tropical Medicine Research Center, Babol University of Medical Sciences, Babol, Islamic Republic of Iran. Electronic address:

Multi-drug resistant isolates of Acinetobacter baumannii have created therapeutic problems worldwide. This current study was intended to determine the Integron types, gene cassettes and antimicrobial resistance profile of A. baumannii isolated from BAL samples in Babol, north of Iran. During a 15-month period, 35 A. baumannii isolates were studied. Different classes of antimicrobial agents were used to determine the resistance ratios. Multiplex-PCR was used to detect different types of integrons and associated gene cassettes. The resistance rates to GM, FEP, AK, TOB, CP, PIP, SAM, IPM, SXT, CTX, CAZ, CL, TIM, MEM, and TZP were 85.7%, 100%, 91.4%, 68.5%, 94.3%, 88.5%, 97.1%, 94.3%, 100%, 100%, 100%, 0.0%, 91.4%, 94.3% and 91.4%, respectively. The distribution analysis of int genes showed that 25.7%, 88.6% and 28.6% of isolates carried the intI, intII and intIII genes, respectively. The prevalence of aadB, dfrA1, bla-OXA and aadA1 genes were 94.3%, 77.1%, 40% and 5.7%, respectively. The current study showed that a high level of A. baumannii isolates harbor integrons in our therapeutic center, which may lead to distribution of multiple antimicrobial resistance. The different types of gene cassette arrays in the present study highlight the important role of geographical features in MDR isolates dissemination which could be credited to different profiles of drug consumption in different areas. The findings emphasized that the need for continuous surveillance to prevent distribution of multidrug resistance among A. baumannii strains in Iran.
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http://dx.doi.org/10.1016/j.micpath.2017.05.005DOI Listing
August 2017

Efficacy of olanzapine in symptom relief and quality of life in gastric cancer patients receiving chemotherapy.

J Res Med Sci 2016 18;21:88. Epub 2016 Oct 18.

Health Research Institute, Babol University of Medical Sciences, Babol, Iran.

Background: Considering the incidence and prevalence rates of gastric cancer in Mazandaran Province of Iran, this research was performed to evaluate the efficacy and safety of olanzapine in symptom relief and quality of life (QOL) improvement of gastric patients receiving chemotherapy.

Materials And Methods: This clinical trial was conducted on thirty new cases of gastric cancer patients whose treatment protocol was planned on chemotherapy and were allocated into two groups by simple random sampling. Intervention group (15 patients) received olanzapine tablets (2.5-10 mg/day) a day before the beginning of chemotherapy; in the 1 day of chemotherapy to 8 weeks after chemotherapy, besides the routine treatment regimens. The control group received only the routine treatment regimens. The patients were followed for 8 weeks after intervention. All of the patients were assessed with Hospital Anxiety and Depression Scale (HADS) and WHO-QOL-BREF questionnaires; further, Rhodes index was used to evaluate nausea and vomiting (N/V) status.

Results: All the recruited patients continued the allocated interventions (no lost to follow-up). N/V decreased in the case group, but the difference was not statistically significant ( = 0.438). The patients' appetite and body mass index increased ( = 0.006). Anxiety and depression subscales of HADS had significant differences between the two groups ( < 0.001) in the 4 and 8 week after treatment. Among the different subdomains of QOL, only physical health improved significantly after intervention ( < 0.05), but no significant difference was observed in other subdomains and also total QOL score ( > 0.05). No significant increase was observed in fasting and 2-h postprandial blood glucose and lipid profile ( > 0.05).

Conclusion: Olanzapine can be considered as an effective drug to increase appetite and decrease anxiety and depression in patients with gastric cancer.
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http://dx.doi.org/10.4103/1735-1995.192504DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5244650PMC
October 2016

Nanoscopic compartmentalization of membrane protein motion at the axon initial segment.

J Cell Biol 2016 Oct 3;215(1):37-46. Epub 2016 Oct 3.

Institute for Chemistry and Biochemistry, Free University Berlin, 14195 Berlin, Germany Randall Division of Cell and Molecular Biophysics, King's College London, London SE1 1UL, England, UK Institute for Biochemistry, ETH Zurich, 8093 Zurich, Switzerland

The axon initial segment (AIS) is enriched in specific adaptor, cytoskeletal, and transmembrane molecules. During AIS establishment, a membrane diffusion barrier is formed between the axonal and somatodendritic domains. Recently, an axonal periodic pattern of actin, spectrin, and ankyrin forming 190-nm-spaced, ring-like structures has been discovered. However, whether this structure is related to the diffusion barrier function is unclear. Here, we performed single-particle tracking time-course experiments on hippocampal neurons during AIS development. We analyzed the mobility of lipid-anchored molecules by high-speed single-particle tracking and correlated positions of membrane molecules with the nanoscopic organization of the AIS cytoskeleton. We observe a strong reduction in mobility early in AIS development. Membrane protein motion in the AIS plasma membrane is confined to a repetitive pattern of ∼190-nm-spaced segments along the AIS axis as early as day in vitro 4, and this pattern alternates with actin rings. Mathematical modeling shows that diffusion barriers between the segments significantly reduce lateral diffusion along the axon.
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http://dx.doi.org/10.1083/jcb.201603108DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5057285PMC
October 2016

Giant left anterior descending coronary artery aneurysm in an adult male patient with ST elevation myocardial infarction.

J Surg Case Rep 2016 Mar 28;2016(3). Epub 2016 Mar 28.

Department of Cardiology, Sina Heart Center, Isfahan, Iran

Coronary artery aneurysm is a rare clinical entity encountered incidentally 0.3-5% among patients who undergo coronary angiography. Even giant coronary artery aneurysm is much rarer with an incidence of 0.02% among all atherosclerotic cases. Due to rare occurrence and lack of controlled trials, clinical presentation, prognosis and management of giant coronary artery aneurysm are under controversies in the literature. We report a 43-year-old male patient admitted to our hospital with a typical chest pain associated with ST elevation changes in anterior chest leads and elevated cardiac enzymes. Coronary angiography of the patient revealed a large (1.5 cm × 3 cm) aneurysm of proximal left anterior descending coronary artery. We performed a successful surgical excision and coronary bypass surgery. The patient had an uncomplicated course.
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http://dx.doi.org/10.1093/jscr/rjw023DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4809239PMC
March 2016

Detrimental predictive effect of metabolic syndrome on postoperative complications in patients who undergoing coronary artery bypass grafting.

Acta Biomed 2015 Apr 27;86(1):86-91. Epub 2015 Apr 27.

Isfahan Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: The present study came to address the value of metabolic syndrome (MetS) in predicting postoperative outcome following coronary artery bypass grafting (CABG).

Methods: In a retrospective study, a consecutive series of patients including 2010 subjects who underwent isolated CABG were reviewed. Baseline information and intraoperative details were collected by reviewing hospital-recorded files. The composite outcome of major adverse cardiac and cerebrovascular events (postoperative morbidity) was generated from the occurrence of myocardial infarction, cardiac arrhythmias, stroke, renal failure, and other cardiac-related problems.

Results: Overall, 2010 patients who underwent isolated CABG were studied that among them 24.7% suffered from MetS. No difference was found in the prevalence of postoperative arrhythmias, brain stroke, multi-organ failure, and dialysis between the two groups with and without MetS. Early morbidity rate was 27.4% in MetS group and 27.8% in non-MetS group with no significant discrepancy. Using multivariable logistic regression modeling, we showed that MetS status could not predict postoperative morbidity; however, advanced age, history of congestive heart failure, higher Canadian Cardiovascular Society (CCS) scale, and longer cross-clamp time were main indicators of postoperative morbidity. 

Conclusion: MetS has no detrimental predictive effect on early postoperative morbidity in CABG patients. (www.actabiomedica.it).
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April 2015

Which technique is suitable for management of acute myocardial infarction following coronary artery bypass surgery, rescue percutaneous coronary intervention or open heart surgery? A case-series studies.

Acta Biomed 2014 Dec 17;85(3):277-80. Epub 2014 Dec 17.

Cardiac Surgery; Hypertension Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran;.

One of the serious complications followingcoronary artery bypass surgery is postoperative acute myocardial infarction commonly due to graft thrombosis, kinking, or spasm. Two recommended approaches for management of this event includeRescue percutaneous coronary intervention (PCI) and urgent open heart surgery. In the present case series, we described and compared early and long-term results of rescue PCI and reoperation in patients with three-vessel coronary artery disease undergoing CABG postoperatively and suffered acute myocardial infarction.
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December 2014

Obstructive sleep apnea and postoperative complications in patients undergoing coronary artery bypass graft surgery: a need for preventive strategies.

Int J Prev Med 2014 Nov;5(11):1446-51

Department of Cardiology and Pulmonology, Center of Sleep Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany.

Background: Obstructive sleep apnea (OSA) is very frequent and often unrecognized in surgical patients. OSA is associated with perioperative complications. We evaluated the effects of OSA on postoperative complications and hospital outcomes in patients undergoing coronary artery bypass graft (CABG) surgery.

Methods: Candidates of elective CABG were evaluated by the Berlin questionnaire for OSA. After surgery, patients were assessed for postoperative complications, re-admission to the Intensive Care Unit (ICU), duration of intubation, re-intubation, days spent in the ICU and the hospital.

Results: We studied 61 patients who underwent CABG from which 25 (40.9%) patients had OSA. Patients with OSA had higher body mass index (29.5 ± 3.9 vs. 26.0 ± 3.7 kg/m(2), P = 0.003) and higher frequency of hypertension (68.0% vs. 30.5%, P = 0.003), dyslipidemia (36.0% vs. 5.5%, P = 0.004), and pulmonary disease (16.0 vs. 2.7%, P = 0.08). Regarding the surgical outcomes, OSA patients had longer intubation duration (0.75 ± 0.60 vs. 0.41 ± 0.56 days, P = 0.03).

Conclusions: Obstructive sleep apnea is frequent, but unrecognized among patients undergoing CABG. In these patients, OSA is associated with prolonged intubation duration. Preventing these problems may be possible by early diagnosis and management of OSA in cardiac surgery patients. Further studies with larger sample of patients and longer follow-ups are required in this regard.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4274552PMC
November 2014

Sensorineural hearing loss in patients with coronary artery bypass surgery.

Adv Biomed Res 2013 6;2. Epub 2013 Mar 6.

Department of Cardiac Surgery, Chamran Hospital, Isfahan, Iran.

Background: This study is planned to obtain a better understanding of the correlation between sudden sensorineural hearing loss and cardiopulmonary bypass. There are many causes for sudden hearing loss which include infectious, circulatory, inner ear problems like meniere's disease, neoplastic, traumatic, metabolic, neurologic, immunologic, toxic, cochlear, idiopathic (unknown cause) and other causes. One of the less common cause is surgery include cardiopulmonary bypass procedures.

Materials And Methods: This study is a self controlled clinical trial on 105 patients that was carried out in chamran Hospital, Esfahan, Iran. Participants were including all those patients undergoing coronary artery bypass surgery in the hospital who fell under the criteria for inclusion. Patients underwent audiometric testing at our hospital on three or two different occasions during the course of this study, Initially before the procedure to test the baseline hearing capacity; then two week after the procedure to assess any changes in hearing ability following the surgery. Data analysis performed by co-variance analysis.

Results: In our study the changes in the threshold of hearing in frequency of 1000 in right ear and in frequencies of 2000 and 4000 in left ear were significant, but this changes were about 2-3 db and were not noticeable. The difference in degree of SNHL, before and after surgery in different frequencies were been shown.

Conclusion: As loss of the patients with symptomatic sensory neural hearing loss in this study, It isn't commanded the routin auditory assessment pre and post surgery was been done.
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http://dx.doi.org/10.4103/2277-9175.107966DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3732875PMC
August 2013

Infectious endocardial intracardiac defibrillator lead, infectious pericarditis, and delayed constrictive pericarditis.

J Res Med Sci 2013 Mar;18(3):260-3

Department of Cardiac Surgery, Chamran Hospital, Iran.

The usage of Implantable Cardiac Defibrillator (ICD) since 1980s is becoming more popular these days. The rate of both, endocarditis and constrictive pericarditis are low but it still needs attention. We are reporting a rare case of ICD endocarditis as a result of toe infection in a diabetic patient. This was followed by infectious pericarditis after device removal by open heart surgery and then delayed constrictive pericarditis.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3732911PMC
March 2013

Trajectory of human movement during sit to stand: a new modeling approach based on movement decomposition and multi-phase cost function.

Exp Brain Res 2013 Aug 27;229(2):221-34. Epub 2013 Jun 27.

Department of Mechanical Engineering, Isfahan University of Technology, 84156 Esfahān, Iran.

The purpose of this work is to develop a computational model to describe the task of sit to stand (STS). STS is an important movement skill which is frequently performed in human daily activities, but has rarely been studied from the perspective of optimization principles. In this study, we compared the recorded trajectories of STS with the trajectories generated by several conventional optimization-based models (i.e., minimum torque, minimum torque change and kinetic energy cost models) and also with the trajectories produced by a novel multi-phase cost model (MPCM). In the MPCM, we suggested that any complex task, such as STS, is decomposable into successive motion phases, so that each phase requires a distinct strategy to be performed. In this way, we proposed a multi-phase cost function to describe the STS task. The results revealed that the conventional optimization-based models failed to correctly predict the invariable features of STS, such as hip flexion and ankle dorsiflexion movements. However, the MPCM not only predicted the general features of STS with a sufficient accuracy, but also showed a potential flexibility to distinguish between the movement strategies from one subject to the other. According to the results, it seems plausible to hypothesize that the central nervous system might apply different strategies when planning different phases of a complex task. The application areas of the proposed model could be generating optimized trajectories of STS for clinical applications (such as functional electrical stimulation) or providing clinical and engineering insights to develop more efficient rehabilitation devices and protocols.
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http://dx.doi.org/10.1007/s00221-013-3606-1DOI Listing
August 2013

Coronary artery bypass and carotid endarterectomy with mild hypothermia.

Asian Cardiovasc Thorac Ann 2012 Apr;20(2):168-71

Department of Cardiovascular Surgery, Isfahan University of Medical Sciences, Isfahan, Iran.

The approach to treatment in patients with both coronary artery disease and major carotid disease is controversial. We analyzed our results of concomitant coronary artery bypass and carotid endarterectomy. Twenty-three patients aged 58 years or older underwent elective concomitant coronary artery bypass and carotid endarterectomy with mild hypothermia (32°C). Demographic characteristics and preoperative risk factors were recorded prospectively. Data were collected during a mean follow-up of 22 ± 9 months. The mean age of the patients was 71 ± 7 years. Twenty-one patients were in New York Heart Association class I to II, and 2 were in class III. Early mortality was 8.6%. There was no early postoperative stroke. Mean intensive care unit stay was 64.5 ± 30.5 h. One (4.3%) patient had a stroke one year later. One- and 2-year survival rates were estimated to be 86.9% and 73.9%, respectively. Although concomitant coronary and carotid artery surgery remains controversial, cooling to 32°C provided good results in this challenging group of patients managed by one team.
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http://dx.doi.org/10.1177/0218492311436081DOI Listing
April 2012

Effectiveness of massage therapy on the mood of patients after open-heart surgery.

Iran J Nurs Midwifery Res 2012 Feb;17(2 Suppl 1):S120-4

Department of Surgery, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Cardiovascular diseases have the highest death rates in human society. Coronary artery disease is among the most important of these diseases. No treatment of cardiovascular disease has as much impact on the quality of life of the patients as the heart surgery. The recovery from heart surgery is associated with symptoms of pain and psychological distress. In the early recovery period, the patients will face moderate symptoms of anxiety and depression. In this regard, various measures of nursing, as complementary therapy practices have been performed to help the patients for overcoming the physical and psychological needs. One of these methods, in recent years has been the use of complementary and alternative therapies, particularly massage therapy, after heart surgery. Thus, the aim of this study was to determine the effectiveness of massage therapy on the mood of patients after open-heart surgery in Isfahan Chamran Hospital during 2010-11.

Materials And Methods: In this study 72 patients, who underwent coronary artery bypass surgery, were selected. They were randomly assigned to the two case and control groups. The patients of the case group (n = 36) received Swedish massage for 20 minutes in 4 sessions in 4 consecutive days, 3 to 6 days after the open-heart surgery. The patients in the control group received only the routine care. The mood questionnaire (POMS) which was used in this study has been completed the day before the start of the study and intervention and again after the last day of the intervention. SPSS software version 12 and descriptive and inferential statistical methods were used for data analysis.

Findings: The comparison of study results showed that massage decreased the overall rating of the patients' mood after the surgery.

Conclusions: The use of massage therapy as an effective nursing intervention can improve the patients' mood after open-heart surgery. Due to the low cost and simplicity of this method, it can perhaps be used as a complement to drug therapy and postoperative interventions used in these patients.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3696961PMC
February 2012

Evaluation of accuracy of Euroscore risk model in prediction of perioperative mortality after coronary bypass graft surgery in Isfahan.

J Res Med Sci 2011 Jun;16(6):787-92

Assistant Professor of Cardiac Surgery, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: This study aimed to evaluate the accuracy of Euroscore (European System for Cardiac Operative Risk Evaluation) in predicting perioperative mortality after cardiac surgery in Iranian patient population.

Methods: Data on 1362 patients undergoing coronary bypass graft surgery (CABG) from 2007 to 2009 were collected. Calibration was assessed by Hosmer-Lemeshow goodness-of-fit. Area under the curve (AUC) was used to assess score validity. Odds ratios were measured to evaluate the predictive value of each risk factor on mortality rate.

Results: The overall perioperative in hospital mortality was 3.6% whereas the Euroscore predicted a mortality of 3.96%. Euroscore model fitted well in the validation databases. The mean AUC was 66%. Mean length of intensive care unit (ICU) stay was 2.5 ± 2.5 days. Among risk factors, only left ventricular dysfunction, age and neurologic dysfunction were found to be related to mortality rate.

Conclusions: Euroscore did not have acceptable discriminatory ability in perioperative in hospital mortality in Iranian patients. It seems that development of a local mortality risk scores corresponding to our patients epidemiologic characteristics may improve prediction of outcome.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3214397PMC
June 2011

Influence of the timing of cardiac catheterization and amount of contrast media on acute renal failure after cardiac surgery.

J Res Med Sci 2011 Apr;16(4):502-8

Assistant Professor, Department of Cardiac Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: There is limited data about the influence of timing of cardiac surgery in relation to diagnostic angiography and/or the impact of the amount of contrast media used during angiography on the occurance of acute renal failure (ARF). Therefore, in the present study the effect of the time interval between diagnostic angiography and cardiac surgery and also the amount of contrast media used during the diagnostic procedure on the incidence of ARF after cardiac surgery was investigated.

Methods: Data of 1177 patients who underwent different types of cardiac surgeries after cardiac catheterization were prospectively examined. The influence of time interval between cardiac catheterization and surgery as well as the amount of contrast agent on postoperative ARF were assessed using multivariable logistic regression.

Results: The patients who progressed to ARF were more likely to have received a higher dose of contrast agent compared to the mean dose. However, the time interval between cardiac surgery and last catheterization was not significantly different between the patients with and without ARF (p = 0.05). Overall, postoperative peak creatinine was highest on day 0, then decreased and remained significantly unchanged after this period. Overall prevalence of acute renal failure during follow-up period had a changeable trend and had the highest rates in days 1 (53.57%) and 6 (52.17%) after surgery. Combined coronary bypass and valve surgery were the strongest predictor of postoperative ARF (OR: 4.976, CI = 1.613-15.355 and p = 0.002), followed by intra-aortic balloon pump insertion (OR: 6.890, CI = 1.482-32.032 and p = 0.009) and usage of higher doses of contrast media agent (OR: 1.446, CI = 1.033-2.025 and p = 0.031).

Conclusions: Minimizing the amount of contrast agent has a potential role in reducing the incidence of postoperative ARF in patients undergoing cardiac surgery, but delaying cardiac surgery after exposure to these agents might not have this protective effect.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3214355PMC
April 2011

The efficacy of preventive parasternal single injection of bupivacaine on intubation time, blood gas parameters, narcotic requirement, and pain relief after open heart surgery: A randomized clinical trial study.

J Res Med Sci 2011 Apr;16(4):477-83

Assistant Professor, Department of Cardiac Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Postsurgical pain usually results in some complications in the patients. This study has tried to investigate the effects of parasternal single injection of bupivacaine on postoperative pulmonary and pain consequences in patients after open heart surgery.

Methods: In a prospective double blind clinical study, 100 consenting patients undergoing elective open heart surgery were randomized into two groups. In case group, bupivacaine was injected at both sides of sternum, immediately before sternal closure. In the control group, no intervention was performed. Then, the patients were investigated regarding intubation period, length of ICU stay, arterial blood gas (ABG) parameters, morphine requirement, and their severity of postoperative pain using a visual analogue scale (VAS) device.

Results: No differences were found between the two groups regarding to age, sex, pump time, operation time, and body mass index and preoperative cardiac ejection fraction. Mean intubation length in case group was much shorter than that in control group. Mean PaO(2) in case group was lower in different checking times in postoperative period. The patients in the case group needed less morphine compared to those in the control group during the 24-hour observation period in the ICU. Finally, mean VAS scores of pain in case group were significantly lower than those in control group at 6, 12, and 24 hours postoperatively.

Conclusions: Patients' pain relief by parasternal single injection of bupivacaine in early postoperative period can facilitate earlier ventilator weaning and tracheal extubation after open heart surgery as well as achieving lower pain scores and narcotic requirements.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3214351PMC
April 2011

Congenital coronary artery fistula between right coronary artery and the coronary sinus.

J Card Surg 2010 Jan-Feb;25(1):97. Epub 2009 Dec 7.

Department of Cardiac Surgery, Chamran Heart Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.

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http://dx.doi.org/10.1111/j.1540-8191.2009.00942.xDOI Listing
June 2011