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11.
Hojjat SP Won E Hardisty MR Akens MK Wise-Milestone LM Whyne CM 《Annals of biomedical engineering》2011,39(11):2816-2822
Skeletal metastases most frequently affect the vertebral column and may lead to severe consequences including fracture. Clinical
management of skeletal metastases often utilizes a multimodal treatment approach, including bisphosphonates (BPs). Previous
work has demonstrated the synergistic potential of photodynamic therapy (PDT) in combination with BP in treating osteolytic
disease through structural, histologic, and destructive mechanical testing analyses. Recent work has developed and validated
image-based methods that may be used to non-destructively determine mechanical stability in whole bones, and enable their
use for additional (i.e. histologic) analysis. In this work we use an intensity-based 3D image registration technique to compare
the strain patterns throughout untreated control and BP + PDT treated rnu/rnu rat spinal motion segments with osteolytic metastases.
It was hypothesized that the combination treatment will reduce average and maximum strain values and restore the pattern of
strain to that of healthy vertebrae. Mean, median, and 90th percentile strains in the control group were significantly higher
than the treatment group. High strain areas in both groups were observed around the endplates; in the control group, large
areas of high strains were also observed around the lesions and adjacent to the dorsal wall. Absence of high strains adjacent
to the dorsal wall (similar to healthy vertebrae) may correspond to a reduced risk of burst fracture following BP + PDT therapy.
This study demonstrates the application of non-destructive image analysis to quantify the positive mechanical effects of combined
BP + PDT treatment in the metastatic spine. 相似文献
12.
Ahmadzadehfar H Palmedo H Strunk H Biersack HJ Habibi E Ezziddin S 《Lung cancer (Amsterdam, Netherlands)》2007,58(3):418-421
A 61-year-old man presented with spontaneous pneumothorax. After diagnosis of emphysemic bullae, the patient underwent talc pleurodesis and had no further complaints. Five years later a routine chest X-ray showed suspicious pleural lesions in addition to the emphysema, which was deemed compatible with the known history of talc pleurodesis. Subsequent chest CT, however, revealed one lesion in the right lung that appeared not typical for this condition in addition to multiple lesions in pleural proximity. FDG-PET/CT demonstrated high glucose uptake in all the lesions. Subsequent needle biopsy of the suspicious intrapulmonary and also of one mediastinal lesion yielded the histopathological diagnosis of talcum granuloma with long-standing calculous fibrotic changes and no evidence of malignancy. This report on PET/CT after talc pleurodesis addresses the potential pitfalls caused by this condition, as chronic granulomatous reactions, like other inflammatory lesions, may account for highly increased FDG uptake which should be interpreted with caution and not simply read as a sign of malignancy. PET/CT offers the opportunity to exactly localize the areas of increased FDG uptake within regions of pleural thickening caused by talc deposition, however, the dilemma of misleading FDG accumulation cannot be solved by this hybrid imaging modality. 相似文献
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14.
Marziye Hadian Alireza Jabbari Hojjat Sheikhbardsiri 《Ethiopian journal of health sciences》2020,30(6):1027
BackgroundTraditional medicine is a complete system, including diagnostic methods, etiology and treatment based on interpersonal differences.Owing to a lack of investigations in the field of Iranian traditional medicine as well as its many present challenges, certain studies in this area can prove quite practical in identifying and solving ongoing challenges. This study investigates the challenges of the health system in Iranian traditional medicine in the context of control levers.MethodsThe study was qualitative content analysis. A framework analysis, “Control Knob Approach”, was considered appropriate to promote apprehension of challenges of health systems in Iranian traditional medicine. Data were collected by purposeful sampling through in-depth and semi-structured individual interviews with 35 experts of Iranian traditional medicine. Directed content analysis was used to analyze the data, which extracted the initial codes after performing the recorded interviews on paper and immersing them in the data analysis.ResultsUpon analysis of data by Iranian medicine experts, five main categories including financing, payment system, regulations, behavior and organization were defined alongside 13 subcategories.ConclusionAccording to current challenges and the tendency of society to receive traditional medicine services, as well as the long history of traditional medicine in Iran, fair access to traditional medicine services should be provided. This access must be through the production of indigenous knowledge and the formulation of regulatory and educational policies and guidelines and the empowerment of relevant, healthy, effective, evidence-based and cost-effective forces. 相似文献
15.
Sabet A Ahmadzadehfar H Schäfer N Wilhelm K Schüller H Ezziddin S 《Cardiovascular and interventional radiology》2012,35(4):954-957
We present the acute management and outcome of a patient after an accidental mesenteric distribution of Y90 microspheres during radioembolization (RE). This report describes and highlights: (1) the incidence of a significant reflux during a RE session while injecting into a replaced right hepatic artery from the superior mesenteric artery, (2) the appearance of diffuse mesenteric Y90 distribution in bremsstrahlung-imaging, (3) the management protocol with the radiation protection agent amifostine, (4) the development of typical adverse effects in the expected time window, and (5) survival of the patient without long-term sequelae. This report should sensitize physicians to this particular problem and may help to avoid as well as manage similar radioembolization incidences. 相似文献
16.
Emamian MH Zeraati H Majdzadeh R Shariati M Hashemi H Fotouhi A 《International ophthalmology》2012,32(4):329-336
Uncorrected refractive error plays a significant role in poor vision and blindness, and its correction is the most cost-effective intervention in eye care. In this study, we report the status of the unmet refractive need and the role of economic inequality in determining the level of this need in Shahroud, Iran. This cross-sectional nested case-control study was performed on 5,190 individuals aged 40-64 years. Cases and controls were individuals with uncorrected visual acuity worse than 0.3 LogMAR in the better eye who showed at least 0.2 LogMAR improvement after correction. Cases were individuals whose presenting vision was worse than 0.3 in the better eye but improved by at least 0.2 LogMAR after correction. Controls were individuals in whom the difference between the presenting and corrected vision was less than 0.2 LogMAR. The prevalence of the unmet need was 5.7 % and it was more prevalent in women (6.5 %) than in men (4.6 %) (p = 0.003). There was a gap of 19.6 % between the two groups of high and low economic status. The Oaxaca-Blinder decomposition method revealed that differences in the education level of the two groups accounted for half of this gap. Spectacle usage is better in Iran than in some other developing countries; however, in this study, about 40 % of those who required spectacles did not have them. 相似文献
17.
Ali Arhami Dolatabadi Afshin Amini Hamidreza Hatamabadi Parisa Mohammadi Sara Faghihi-Kashani Hojjat Derakhshanfar Seyed Morteza Tabatabaee Mehrdad Moghimi Ali Kabir 《Ultrasound in medicine & biology》2014
We compared the diagnostic accuracy of emergency medicine residents (EMRs) and radiology residents (RRs) in performing focused abdominal sonography for trauma (FAST). The cohort in this prospective study comprised 200 unstable patients (163 males and 37 females; mean ± standard deviation of age, 34.3 ± 16.4 y) who presented with trauma. These patients were evaluated using FAST, first by EMRs and subsequently by RRs. Patients with positive FAST results underwent further diagnostic procedures such as computed tomography, diagnostic peritoneal lavage and laparotomy. Those with negative FAST results underwent clinical follow-up for 72 h until their condition deteriorated or they were discharged. Sensitivity, specificity, positive and negative predictive values and accuracy in evaluating free intraperitoneal fluid were 80%, 95%, 57%, 98% and 94% when FAST was performed by EMRs and 86%, 95%, 59%, 98% and 94% when FAST was performed by RRs. The level of agreement between EMRs and RRs was moderate (κ = 0.525). FAST is a useful screening tool for initial assessment of free abdominal fluid in patients with trauma. Our results indicate that EMRs can perform sonography on trauma patients as successfully as RRs. 相似文献
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19.
Nikolaus A. Haas Axel Moysich Ulrich Neudorf Hojjat Mortezaeian Mohamed Abdel-Wahab Heike Schneider Daniel De Wolf Jerome Petit Sreeram Narayanswami Kai Thorsten Laser Eugen Sandica 《Clinical research in cardiology》2013,102(2):119-128
Background
Percutaneous pulmonary valve implantation (PPVI) was introduced in 2000 as an interventional procedure for the treatment of right ventricular outflow tract (RVOT) dysfunction. The new Edwards SAPIEN? pulmonic valve has reached CE certification at the end of 2010 thus offering an attractive alternative with extended sizes (23 and 26 mm) to the conventional Melody® valve (sizes 18, 20 and 22 mm).Patients
Over a 1-year period, PPVI using the Edwards SAPIEN? pulmonic valve was performed in 22 patients using a standardized procedure. Primary diagnosis was tetralogy of Fallot (n = 11), pulmonary atresia (n = 2), Truncus arteriosus (n = 3), TGA/PS-Rastelli (n = 1), Ross surgery (n = 2), double outlet right ventricle (n = 2) and absent pulmonary valve syndrome (n = 1). The character of the RVOT for PPVI was transannular patch (n = 4), bioprosthesis (n = 2), homograft (n = 5) and Contegra® conduit (n = 11). The leading hemodynamic problem consisted of a pulmonary stenosis (PS) (n = 2), pulmonary regurgitation (PR) (n = 11) and a combined PS/PR lesion (n = 9).Results
In 21/22 patients, PPVI was performed successfully (10 × 23 and 11 × 26 mm). There were 9 female and 13 male patients; the mean age was 21.7 years (range 6–83 years), the mean length was 162 cm (range 111–181 cm) and the weight 56.5 kg (range 20–91 kg). Invasive data showed a decrease of RV-systolic pressure from 61.2 mmHg (±23.1) to 41.2 mmHg (±8.6) and reduction of RV–PA gradient from 37.3 mmHg (±23.2) to 6.9 mmHg (±5.3). The PA-systolic pressure increased from 25.8 mmHg (±8.6) to 33.9 mmHg (±9.3) as did the PA diastolic pressure (from 6.0 mmHg (±5.6) to 14.6 mmHg (±4.3). There was a substantial reduction of pulmonary regurgitation from before (none/trivial n = 0, mild n = 2, mode rate n = 9, severe n = 11) to after PPVI (none/trivial n = 20, mild n = 1). During the short-term follow-up of 5.7 months there was no change in the immediate results.Conclusion
PPVI using the Edwards SAPIEN? pulmonic valve can be performed safely in a wide range of patients with various diagnoses and underlying pathology of the RVOT and enables the restoration of an adult-size RVOT diameter. Although the immediate and short-term results seem promising, the long-term effects and safety have to be assessed in further clinical follow-up studies. 相似文献20.