Publications by authors named "Parnian Shobeiri"

4 Publications

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Neuronal and glial CSF biomarkers in multiple sclerosis: a systematic review and meta-analysis.

Rev Neurosci 2021 Feb 16. Epub 2021 Feb 16.

Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.

Multiple sclerosis (MS) is a neurodegenerative disease associated with inflammatory demyelination and astroglial activation, with neuronal and axonal damage as the leading factors of disability. We aimed to perform a meta-analysis to determine changes in CSF levels of neuronal and glial biomarkers, including neurofilament light chain (NFL), total tau (t-tau), chitinase-3-like protein 1 (CHI3L1), glial fibrillary acidic protein (GFAP), and S100B in various groups of MS (MS versus controls, clinically isolated syndrome (CIS) versus controls, CIS versus MS, relapsing-remitting MS (RRMS) versus progressive MS (PMS), and MS in relapse versus remission. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, we included 64 articles in the meta-analysis, including 4071 subjects. For investigation of sources of heterogeneity, subgroup analysis, meta-regression, and sensitivity analysis were conducted. Meta-analyses were performed for comparisons including at least three individual datasets. NFL, GFAP, t-tau, CHI3L1, and S100B were higher in MS and NFL, t-tau, and CHI3L1 were also elevated in CIS patients than controls. CHI3L1 was the only marker with higher levels in MS than CIS. GFAP levels were higher in PMS versus RRMS, and NFL, t-tau, and CHI3L1 did not differ between different subtypes. Only levels of NFL were higher in patients in relapse than remission. Meta-regression showed influence of sex and disease severity on NFL and t-tau levels, respectively and disease duration on both. Added to the role of these biomarkers in determining prognosis and treatment response, to conclude, they may serve in diagnosis of MS and distinguishing different subtypes.
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http://dx.doi.org/10.1515/revneuro-2020-0145DOI Listing
February 2021

A systematic review of ECG findings in patients with COVID-19.

Indian Heart J 2020 Nov-Dec;72(6):500-507. Epub 2020 Nov 13.

School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Electronic address:

Introduction: Since the epidemic of COVID-19 attracted the attention, reports were surrounding electrocardiographic changes in the infected individuals. We aimed at pinpointing different observed ECG findings and discussing their clinical significance.

Methods: We conducted a systematic search in PubMed, Embase, and Scopus databases. We included eligible original papers, reports, letters to the editors, and case reports published from December 2019 to May 10, 2020.

Results: The team identified 20 articles related to this topic. We divided them into articles discussing drug-induced and non-drug-induced changes. Studies reported an increased risk of QTc interval prolongations influenced by different therapies based on chloroquine, hydroxychloroquine, and azithromycin. Although these medications increased risks of severe QTc prolongations, they induced no arrhythmia-related deaths. In the non-drug-induced group, ST-T abnormalities, notably ST elevation, accounted for the most observed ECG finding in the patients with COVID-19, but their relation with myocardial injuries was under dispute.

Conclusion: This systematic review suggests that identifying ECG patterns that might be related to COVID-19 is vital. Provided that physicians do not recognize these patterns, they might erroneously risk the lives of their patients. Furthermore, important drug-induced ECG changes provide awareness to the health-care workers on the risks of possible therapies.
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http://dx.doi.org/10.1016/j.ihj.2020.11.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7661958PMC
January 2021

VEGF levels in patients with glioma: a systematic review and meta-analysis.

Rev Neurosci 2021 Feb 2;32(2):191-202. Epub 2020 Nov 2.

School of Medicine, Tehran University of Medical Sciences (TUMS), Children's Medical Center Hospital, Dr. Qarib St., Keshavarz Blvd, Tehran14194, Iran.

Vascular endothelial growth factor (VEGF) has a crucial role in the angiogenesis of various tumors, including glioma. As the levels of VEGF would change in patients with glioma, we conducted the current systematic review and meta-analysis to more clearly determine the VEGF level alterations in different grades of glioma. PubMed and Scopus databases were sensitively searched for all the possible keywords addressing glioma and VEGF. Case-control and cohort studies on human subjects, which measured VEGF levels were eligible to be included in the study. Out of a total number of 3,612 studies, 22 studies were included and 12 studies entered the meta-analysis. This review revealed that serum levels of VEGF in glioma patients were 1.56 pg/dL higher compared to healthy controls ( = 0.05). Besides, immunohistochemistry (IHC) measurement of VEGF in surgical biopsies indicated significant difference in these two groups as well ( = 0.02). Yet, there was not a significant difference between patients with low-grade gliomas (World Health Organization (WHO) grades I-II, LGG) and those with high-grade gliomas (WHO grades III-IV, HGG) ( = 0.43). The results of this systematic review and meta-analysis demonstrate that VEGF levels would significantly increase in glioma, and therefore, could be potentially considered as a biomarker for this cancer.
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http://dx.doi.org/10.1515/revneuro-2020-0062DOI Listing
February 2021

Cardiovascular disease in COVID-19: a systematic review and meta-analysis of 10,898 patients and proposal of a triage risk stratification tool.

Egypt Heart J 2020 Jul 13;72(1):41. Epub 2020 Jul 13.

Tehran University of Medical Sciences, Tehran, Iran.

Background: Coronavirus disease 2019 (COVID-19) pandemic has drastically affected global health. Despite several studies, there is yet a dearth of data regarding the mechanisms of cardiac injury, clinical presentation, risk factors, and treatment of COVID-19-associated cardiovascular disease. This systematic review and meta-analysis is aimed at defining the clinical, electrocardiographic, and pathologic spectrum of cardiovascular disease (CVD), frequency of elevated cardiac and inflammatory biomarkers, and their frequency and relationship with severity of the disease and mortality in COVID-19 patients and to develop a triage risk stratification tool (TRST) that can serve as a guide for the timely recognition of the high-risk patients and mechanism-targeted therapy. We conducted an online search in databases of PubMed and Embase to identify relevant studies. Data selection was in concordance with PRISMA guidelines. Results were presented as pooled frequencies, odds ratio, standardized mean difference (SMD), and forest and funnel plots.

Results: We gathered a total of 54 studies and included 35 of them in our meta-analysis. Acute cardiac injury occurred in more than 25% of cases, mortality was 20 times higher, and admission to intensive care unit increased by 13.5 times. Hypertension was the most common pre-existing comorbidity with a frequency of 29.2%, followed by diabetes mellitus (13.5%). The deceased group of patients had higher cardiac and inflammatory biomarkers, with statistically significant SMD, compared with survivors. Pediatric patients were predominantly mildly affected. However, less frequently, the presentation was very similar to Kawasaki disease or Kawasaki shock syndrome. This latter presentation hass been called as multisystem inflammatory syndrome in children (MIS-C).

Conclusions: There is a wide spectrum of cardiac involvement in COVID-19 patients, and hence a Triage Risk Stratification Tool can serve as a guide for the timely recognition of the high-risk patients and mechanism-targeted therapy.
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http://dx.doi.org/10.1186/s43044-020-00075-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7356124PMC
July 2020