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Biomedical subjects

Bagher Larijani

Publications and source records attributed to Bagher Larijani.

51 records · Page 3Linked to original sources
PubMed2004

Craniopharyngioma: a clinicopathological study of 141 cases.

Craniopharyngioma is a tumor of the suprasellar region that histologically has two distinct variants with some differences in clinical behavior. The papillary type is almost always seen in adults and has a more indolent course compared with the adamantinomatous type, which is more common in childhood. In the present study, surgical specimens of craniopharyngiomas from 141 patients were reviewed. Their histomorphologic types were determined and the clinical features and prognosis of each group were assessed. The sizes of papillary type tumors were smaller and during the follow-up period there was no recurrence in the squamous papillary group. Aside from surgical resection (total vs subtotal), the recurrence rate for papillary type craniopharyngioma was lower than for adamantinomatous type. Histologic typing of craniopharyngioma especially in adults is useful for decision making with regard to treatment and follow-up.

Craniopharyngioma↗
PubMed2004

A school-based intervention to teach 3-4 grades children about healthy heart; the Persian Gulf healthy heart project.

BACKGROUND: Cardiovascular health promotion in children has the potential to reduce the risk of atherosclerosis in both the individual child and the population at large. It thus seems eminently reasonable to initiate healthful lifestyle training in childhood to promote improved cardiovascular health in adult life. AIMS: To test the hypothesis that a year long, classroom-based education for the third and fourth graders could change their knowledge scores about healthy heart. SETTINGS AND DESIGN: A randomized, controlled trial in elementary schools of Bushehr/Iran. METHODS AND MATERIALS: A total of 14 elementary schools, categorized by socioeconomic types and male and female setting were selected and randomized into control or intervention groups. Subjects were 1128 third and fourth graders, aged 9 to 10 years (49.1% boys and 50.9% girls). Over a course of 8 weeks, health educators and sport teachers of the elementary schools presented two hours sessions per week on heart function, nutrition, and exercise for healthy heart and living tobacco free for the intervention group. The education program was based on HeartPower! Program, an American Heart Association program. STATISTICAL ANALYSIS: Mann-Whitney U test and Wilcoxon matched-pairs signed rank test and Bonferroni correction for the two pair wise comparisons were used. RESULTS: Total heart knowledge at posttest was 25% correct higher in the intervention than in the control group (p< 0.001). Difference in means of total healthy heart knowledge scores between control and intervention group increased from 1.43 points in baseline to 4.02 points in posttest (p< 0.001). CONCLUSION: It can be concluded that the classroom-based cardiovascular health promotion had a significant effect on the heart healthy knowledge. Therefore, schools provide an excellent setting for introducing comprehensive healthy heart education and promotion of cardiovascular health to the general population.

Cardiovascular Diseases↗
PubMed2003

Metabolic and endocrinologic complications in beta-thalassemia major: a multicenter study in Tehran.

ABSTRACT : BACKGROUND : The combination of transfusion and chelation therapy has dramatically extended the life expectancy of thalassemic patients. The main objective of this study is to determine the prevalence of prominent thalassemia complications. METHODS : Two hundred twenty patients entered the study. Physicians collected demographic and anthropometric data and the history of therapies as well as menstrual histories. Patients have been examined to determine their pubertal status. Serum levels of 25(OH) D, calcium, phosphate, iPTH were measured. Thyroid function was assessed by T3, T4 and TSH. Zinc and copper in serum were determined by flame atomic absorption spectrophotometry. Bone mineral density (BMD) measurements at lumbar and femoral regions have been done using dual x-ray absorptiometry. The dietary calcium, zinc and copper intakes were estimated by food-frequency questionnaires. RESULTS : Short stature was seen in 39.3% of our patients. Hypogonadism was seen in 22.9% of boys and 12.2% of girls. Hypoparathyroidism and primary hypothyroidism was present in 7.6% and 7.7% of the patients. About 13 % of patients had more than one endocrine complication with mean serum ferritin of 1678 +/- 955 micrograms/lit. Prevalence of lumbar osteoporosis and osteopenia were 50.7% and 39.4%. Femoral osteoporosis and osteopenia were present in 10.8% and 36.9% of the patients. Lumbar BMD abnormalities were associated with duration of chelation therapy. Low serum zinc and copper was observed in 79.6% and 68% of the study population respectively. Serum zinc showed significant association with lumbar but not femoral BMD. In 37.2% of patients serum levels of 25(OH) D below 23 nmol/l were detected. CONCLUSION : High prevalence of complications among our thalassemics signifies the importance of more detailed studies along with therapeutic interventions.

Journal Article↗
PubMed2003

Diagnostic value of frozen section examination in thyroid nodule--surgery at the Shariati Hospital (1997-2000).

INTRODUCTION: There is controversy regarding the use and accuracy of frozen section (FS) in managing thyroid nodules. We compared the diagnostic value of FS with that of permanent histopathology examination and fine needle aspiration (FNA). MATERIALS AND METHODS: Permanent, FS, and FNA sample reports were compared in 214 patients between 1997 and 2000. FS, FNA, and permanent pathology (gold standard) results were compared using McNemar's test. RESULTS: 160 women and 54 men (mean age: 42.3 +/- 5.4 yr) took part in the study; 163 patients (76%) had benign and 51 (24%) malignant lesions; 76% of our thyroid cancer cases were papillary, 13.5% follicular, 6% medullary carcinoma, 4% Hürthle cell carcinoma, and 0.5% anaplastic carcinoma. FNA yielded definite results in 150 patients (sensitivity 72%, specificity 96%, and precision 90%). In 64 patients with equivocal FNA, FS was performed (sensitivity 36%, specificity 73%, and precision 85%). The observed difference between FNA and FS was not statistically significant. DISCUSSION: When FNA results are inconclusive, FS does not provide any further information. In suspected cases of papillary, undifferentiated, or medullary carcinomas, FS can confirm FNA findings and guide surgical therapy.

Adolescent↗
PubMed2003

Adjunctive estrogen treatment in women with chronic schizophrenia: a double-blind, randomized, and placebo-controlled trial.

The estrogen hypothesis of schizophrenia postulates that estrogen exerts a protective effect against schizophrenia and that this partly explains the observed sex differences in premorbid adjustment, onset age, treatment response, and illness course. It has been suggested that estrogen supplementation can augment the treatment effects of antipsychotics. The purpose of the present investigation was to access the efficacy of ethinyl estradiol as an adjuvant agent in the treatment of premenopausal women with chronic schizophrenia in an 8-week, double-blind, and placebo-controlled trial. Eligible participants in the study were 32 women of childbearing age with schizophrenia. All patients were inpatients, in the active phase of illness, and met DSM-IV criteria for chronic schizophrenia. Patients were allocated in a random fashion, 16 to haloperidol 15 mg/day plus ethinyl estradiol 0.05 mg/day and 16 to haloperidol 15 mg/day plus placebo for an 8-week, double-blind, placebo-controlled study. Although both protocols significantly decreased the score of the positive, negative, and general psychopathological symptoms over the trial period, the combination of haloperidol and ethinyl estradiol showed a significant superiority over haloperidol alone in the treatment of positive and general psychopathology symptoms as well as Positive and Negative Syndrome Scale (PANSS) total scores. Although the means Extrapyramidal Symptoms Rating Scale (ESRS) for the placebo group were higher than ethinyl estradiol group, the differences were not significant over the trial. A significant difference was observed between the overall mean biperiden dosages in the two groups. The results of this study suggest that estrogen may be an effective adjuvant agent in the management of women of childbearing age with chronic schizophrenia. Nevertheless, results of larger controlled trials are needed before recommendation for a broad clinical application can be made.

Adult↗
PubMed2003

Clinico-pathological features of thyroid cancer as observed in five referral hospitals in Iran--a review of 1177 cases.

In this study some of the clinical and pathological aspects of thyroid carcinomas in Iran are defined. Until fairly recently, Iran was an area of endemic iodine deficiency. The medical records of 1177 confirmed cases of thyroid cancer treated over a 15-year period at 5 tertiary referral centers were reviewed. The female/male ratio was 1.8/1. Mean age was 42.8 +/- 0.9 years, male patients being significantly older. The most common clinical presentation (initial manifestation) was a central neck mass; 28.6% of the tumors had metastasized, usually to the cervical lymph nodes, by the time the patient presented with disease. The mean size of non-metastatic tumors was 5.0 cm at their longest diameter. The distribution of tumors in our study did not reflect the expectations for an iodine-deficient area, where follicular thyroid carcinoma is common, but rather what is seen in iodine-rich areas. Papillary and follicular types accounted for79.7% and 8.8% of cases, respectively.

Adenocarcinoma, Follicular↗
PubMed2003

Comparison of fine-needle-nonaspiration with fine-needle-aspiration technique in the cytologic studies of thyroid nodules.

INTRODUCTION: Fine needle aspiration (FNA) has been adopted as a simple and cost effective technique for cytologic studies of thyroid nodules. The recently introduced fine needle nonaspiration (FNNA) technique, however, is claimed to be superior because it provides specimens with larger number of cells and better preserved cytomorphology and architecture of thyroid papillae and follicles. In this study, we compare the efficacy of the two methods. MATERIALS AND METHODS: Two hundred patients with thyroid nodules, 1-4 cm in size, were recruited. FNA and FNNA techniques were applied to each patient. In a single-blind setting, all specimens were examined by a single cytopathologist. The specimens were scored (0, 1, or 2) on the basis of background blood or clot, number of obtained cells, preserved architecture of papillae and follicles, and cellular degeneration. Nonparametric methods were then used to compare the scores of the two techniques. RESULTS: Two hundred patients (162 female, 38 male) were entered into the study. Specimens from 43 patients were inadequate. In the remaining 157 patients, no statistically significant difference was seen between FNNA and FNA average scores in each parameter (p > 0.05). CONCLUSION: We concluded that FNNA is not superior to FNA in the cytopathologic studies of thyroid nodules.

Biopsy, Fine-Needle↗
PubMed2002

Treatment of hyperfunctioning thyroid nodules by percutaneous ethanol injection.

BACKGROUND: Autonomous thyroid nodules can be treated by a variety of methods. We assessed the efficacy of percutaneous ethanol injection in treating autonomous thyroid nodules. METHODS: 35 patients diagnosed by technetium-99 scanning with hyperfunctioning nodules and suppressed sensitive TSH (sTSH) were given sterile ethanol injections under ultrasound guidance. 29 patients had clinical and biochemical hyperthyroidism. The other 6 had sub-clinical hyperthyroidism with suppressed sTSH levels (<0.24 &mgr;IU/ml) and normal thyroid hormone levels. Ethanol injections were performed once every 1-4 weeks. Ethanol injections were stopped when serum T3, T4 and sTSH levels had returned to normal, or else injections could no longer be performed because significant side effects. Patients were followed up at 3, 6 and, in 15 patients, 24 months after the last injection. RESULTS: Average pre-treatment nodule volume [18.2 PlusMinus; 12.7 ml] decreased to 5.7 PlusMinus; 4.6 ml at 6 months follow-up [P < 0.001]. All patients had normal thyroid hormone levels at 3 and 6 months follow-up [P < 0.001 relative to baseline]. sTSH levels increased from 0.09 PlusMinus; 0.02 &mgr;IU/ml to 0.65 PlusMinus; 0.8 &mgr;IU/ml at the end of therapy [P < 0.05]. Only 3 patients had persistent sTSH suppression at 6 months post-therapy. T4 and sTSH did not change significantly between 6 months and 2 years [P > 0.05]. Ethanol injections were well tolerated by the patients, with only 2 cases of transient dysphonia. CONCLUSION: Our findings indicate that ethanol injection is an alternative to surgery or radioactive iodine in the treatment of autonomous thyroid nodules.

Journal Article↗
PubMedDate not supplied

Bone mineral density is related to blood pressure in men.

The aim of this study was to determine the relationships between bone mineral density (BMD) and blood pressure in 214 men, age 20-76. BMD measurements were done by dual X-ray absorptiometry using a Lunar DPXMD densitometer at the lumbar spine (L2-L4) and different femoral regions. Systolic (SBP) and diastolic (DBP) blood pressure were measured using an MPC-350 sphygmomanometer. Physicians gathered demographic data and participants' dietary intake of calcium were determined by using food frequency questionnaires. After adjusting for age, body mass index, dietary calcium, and exercise history, multiple linear regression models showed that DBP was negatively related to femoral neck BMD (beta = -0.145, P = 0.032) and just shy of significant association with femoral neck BMC (beta = -0.114, P = 0.079). SBP was correlated with femoral neck (r = -0.171, P = 0.012) and Ward's (r = -0.186, P = 0.006) BMD but not after adjusting for possible confounders. Further studies are needed to determine whether elevated blood pressure is causally related to the development of low bone mass.

Absorptiometry, Photon↗
PubMedDate not supplied

Total antioxidant capacity and levels of epidermal growth factor and nitric oxide in blood and saliva of insulin-dependent diabetic patients.

BACKGROUND: The aim of this study was to examine how type 1 diabetic patients have altered levels of lipid peroxidation, antioxidant defense, NO and EGF in their plasma and saliva. We tested the differences in lipid peroxidation level, antioxidant power, and concentrations of epidermal growth factor (EGF) and nitric oxide (NO) in saliva and blood of type 1 diabetic subjects in comparison to healthy control subjects. METHODS: Nineteen subjects with type 1 diabetes mellitus and 19 healthy age- and sex-matched control subjects were included in the study. Blood and saliva samples were obtained and analyzed for thiobarbituric reactive substances (TBARS) as a marker of lipid peroxidation, ferric reducing ability (total antioxidant power), EGF and NO levels. RESULTS: TBARS levels did not show a significant difference between the two groups. Analysis of antioxidant power revealed that saliva and plasma of diabetic patients had more antioxidant power (p <0.01) than the healthy control population (107 +/- 10.35 vs. 11.14 +/- 4.66 and 192 +/- 12.3 vs. 142 +/- 15.2 mmol/L, respectively). Concentration of EGF was increased (p <0.01) in saliva whereas it was reduced (p <0.01) in plasma of diabetic patients in comparison to those of healthy subjects (2423 +/- 322 vs. 1513 +/- 341 and 125 +/- 14 vs. 346 +/- 60 pg/mL, respectively). NO level increased in both saliva and plasma of diabetic patients in comparison to those of healthy subjects (46.61 +/- 7 vs. 72.89 +/- 13 and 62.11 +/- 4.6 vs. 76.25 +/- 5 micromol/L, respectively). Blood HbA1c (%) of patients was significantly higher than that of controls (8.3 +/- 0.32 vs. 5.4 +/- 0.24, p <0.01). CONCLUSIONS: Existence of increased total antioxidant power in the presence of normal lipid peroxidation in plasma and saliva of type 1 diabetic patients indicates the existence of oxidative stress. Increased salivary EGF and NO levels in association with elevated TAOP is interesting and should be further studied.

Adult↗
PubMedDate not supplied

Peak bone mass of Iranian population: the Iranian Multicenter Osteoporosis Study.

Osteoporosis is a major public health problem in the Western countries and is projected to have a similar impact in the Middle East. It has been suggested that peak bone mineral density (BMD), a major determinant of osteoporotic fractures later in life, may be lower in this part of the world compared with the Western world. The purpose of the Iranian Multicenter Osteoporosis Study was to determine peak bone mass in a randomly chosen sample of healthy Iranian subjects. A total of 5201 participants (2340 males, mean age 42.7+/-13.8) were recruited based on randomized clustered sampling from all regions of five major cities across the country. In women, peak lumbar BMD (1.182+/-0.127 g/cm2) occurred in the 29- to 33-yr age group, whereas peak total femur BMD (1.006+/-0.126 g/cm2) occurred in the 32- to 36-yr age group. In men, peak lumbar BMD (1.181+/-0.153 g/cm2) and femoral BMD (1.096+/-0.159 g/cm2) both occurred in the 20- to 24-yr age group. When standardized to mg/cm2 units using established formulas, Iranian peak bone mass values are comparable with that of Western countries and are generally higher than that of Eastern Asian and Middle Eastern countries.

Adult↗
PubMedDate not supplied

Primary thyroid malignancies in Tehran, Iran.

OBJECTIVE: The aim of this study was to present a descriptive epidemiology of primary thyroid cancer in Tehran, Iran, using cancer registry data. SUBJECTS AND METHODS: All cases of thyroid cancer registered from 1998 to 2001 in Tehran Metropolitan Area Population-Based Cancer Registry were used for this study. The incidence of thyroid cancer was estimated for the area covered by the cancer registry. Survival of patients was ascertained by telephone call to the patients or the patient's family and/or linkage of registry data to mortality data from the Bureau of Vital Statistics. Patient's survival was based on sex, age and morphological type of tumour. RESULTS: Four hundred and twenty-nine cases of primary thyroid cancer were registered in the Tehran Metropolitan Area Cancer Registry. The incidence of thyroid cancer was 3.5 and 1.0 per 100,000 population per year for females and males, respectively. Seventy percent of tumours were papillary, 11% follicular, 6.2% medullary, and the rest were other subtypes. The papillary and follicular variants occurred in younger age: 43 +/- 16 and 46 +/- 13 years, respectively; the medullary and anaplastic variants occurred in older age: over 50 years. A 5-year survival rate was 82.2%, with median survival of 66 months and 95% confidence interval of 63 and 69 months. Men and women had a similar survival experience. CONCLUSIONS: While the incidence of thyroid cancer was slightly high, the descriptive epidemiology of thyroid cancer in Tehran did not manifest a unique feature. Tehran patients experienced a high rate of survival, and the survival time for males and females was similar.

Adolescent↗
PubMedDate not supplied

Cost analysis of different screening strategies for gestational diabetes mellitus.

OBJECTIVE: To analyze the findings of a survey in Tehran, Iran, to determine the screening method for gestational diabetes mellitus (GDM) best suited to the local population. METHODS: In four university teaching hospitals in Tehran, 2,416 pregnant women were classified into high-, intermediate-, and low-risk groups, on the basis of criteria established by the American Diabetes Association, and then screened for GDM. A two-step approach was implemented, with use of blood glucose thresholds of 130 mg/dL and 140 mg/dL and the previously advocated diagnostic criteria of two or more abnormal results of an oral glucose tolerance test. RESULTS: The prevalence of GDM is increasing globally, and the major determinants of screening programs for GDM are the cost-to-benefit ratio and the prevalence in the target population. The prevalence of GDM in our study sample was 4.7%. Changing from the 130 mg/dL to the 140 mg/dL blood glucose threshold decreased case-detection sensitivity by 12%, to 88%. With this approach, however, the cost of screening for GDM per pregnancy decreased from US dollars 3.80 to US dollars 3.21 (-15.5%), and the cost per detected case of GDM declined from US dollars 80.56 to US dollars 77.44 (-3.9%). CONCLUSION: We recommend universal screening for GDM in populations, such as ours, that have a substantial baseline prevalence of GDM and variable health-care coverage. In such a setting, a considerable proportion of cases of GDM may be missed. Moreover, universal screening is less expensive in developing countries than in more developed economies and leads to clearer long-term savings for a health service stretched to the limit.

Adult↗
PubMedDate not supplied

Insulinoma in Iran: a 20-year review.

BACKGROUND: The time between onset of symptoms of insulinoma to diagnosis ranges from 10 days to more than 20 years. To help physicians make an earlier diagnosis, we defined the clinical, imaging and paraclinical characteristics of insulinoma in cases from seven referral hospitals in Iran over two decades. METHODS: The medical records of 68 cases with biochemical or histological evidences of insulinoma were reviewed. RESULTS: More males were affected (53%). The mean age at diagnosis was 39 +/- 15.3 years. The mean duration of symptoms was 39.9 +/- 59.3 months. Eighty-four percent of patients had been initially misdiagnosed as cereberovascular accident (CVA), epilepsy, conversion disorder, and others). Neuroadrenergic symptoms were observed in 89.6% and and neuroglycopenic symptoms in 97% of patients. Mean diameter of tumours was 2.9 cm (range, 1 cm to 8.5 cm). Of 52 pathologically confirmed cases of insulinoma, 43 tumours (87.8%) were single and 49 (94.2%) were benign. Fifty-five patients had undergone surgery, with a successful outcome in 44 (80%). CONCLUSION: The high incidence of neuroglycopenic symptoms suggest the clinical impression of insulinoma when patients present with a suggestive clinical syndrome. The clinical impression is essential to decrease the frequent delay in the diagnosis of insulinoma.

Adolescent↗