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Navid Sadeghi

Publications and source records attributed to Navid Sadeghi.

5 recordsLinked to original sources
PubMed2005

A Bayesian model for triage decision support.

OBJECTIVE: To compare triage decisions of an automated emergency department triage system with decisions made by an emergency specialist. METHODS: In a retrospective setting, data extracted from charts of 90 patients with chief complaint of non-traumatic abdominal pain were used as input for triage system and emergency medicine specialist. The final disposition and diagnoses of the physicians who visited the patient in Emergency Department (ED) as reflected in the medical records were considered as control. Results were compared by chi(2)-test and a binary logistic regression model. RESULTS: Compared to emergency medicine specialist, triage system had higher sensitivity (90% versus 64%) and lower specificity (25% versus 48%) for patients who required hospitalization. The triage system successfully predicted the Admit decisions made in the ED whereas the emergency medicine specialist decisions could not predict the ED disposition. Both triage system and emergency medicine specialist properly disposed 56% of cases, however, the emergency medicine specialist in this study under-disposed more patients than the triage system considering Admit disposition (p=0.004) while he appropriately discharged more patients compared to the triage system (p=0.017). CONCLUSION: The triage system studied here shows promise as a triage decision support tool to be used for telephone triage and triage in the emergency departments. This technology may also be useful to the patients as a self-triage tool. However, the efficiency of this particular application of this technology is unclear.

Abdominal Pain↗
PubMed2002

Determinants of operative mortality following primary coronary artery bypass surgery.

BACKGROUND: The purpose of this study was to determine the factors which can help to predict operative mortality before performing the operation, and afterwards. METHODS: The study population consisted of 504 patients (91 women and 413 men) who underwent primary isolated coronary artery bypass surgery from December 1997 to September 1999 by the same surgeon in a referral center in Tehran, Iran. Perioperative data were gathered and analyzed both in a univariate and multivariate model. RESULTS: After the operation patients spent 7.3 +/- 4.0 days in hospital. The total operative morbidity was 20.5%. Arrhythmias were the most common complication, with atrial fibrillation as the predominant feature. Major complications of the operation were: low cardiac output (4.2%); prolonged ventilatory support (2.4%); hemorrhage and exploratory reoperation (2.0%); postoperative myocardial infarction (1.4%); postoperative renal failure in (1.4%); and postoperative cerebrovascular accident (0.8%). Operative mortality rate in this study was 2.98%. Factors associated with high operative mortality in univariate analysis were: recent myocardial infarction, low ejection fraction, non-elective operation, left main coronary artery disease and prolonged cardiopulmonary bypass time. CONCLUSION: Our data suggest that prior to operation, operative mortality can be best predicted by urgency of operation and left ventricle ejection fraction. After performing the operation, prognostic factors include preoperative LVEF < or = 35%, non-elective operation, and prolonged cardiopulmonary bypass time. Further study is required to assess the generalization of our findings to Iranian patients.

Adult↗
PubMed2002

Mitral valve recurrence of a left atrial myxoma.

Recurrence of intracardiac myxoma is unusual, and heart valves are extremely rare locations for this tumor to originate, either as the primary site or the site of recurrence. We present a case of non-familial cardiac myxoma, which after successful resection of the tumor mass from the left atrium, recurred in the atrial surface of anterior leaflet of the mitral valve, along with a review of similar cases in the literature. Myxoma was originally believed to recur due to inadequate resection, but recent data suggest the multicentric disease to be the reason. Mitral valve myxoma mainly presents with symptoms of embolization and appears to affect women more often. It involves both leaflets with the same frequency and usually originates from the atrial side. Transesophageal echocardiography is the gold standard for non-invasive diagnosis and localization. Operative resection of the tumor along with the underlying tissue followed by suture repair of the valve and annuloplasty is recommended as the most appropriate treatment option. Long-term follow-up of patients by echocardiography is advised for early detection of any recurrence.

Female↗
PubMedDate not supplied

Prospective, randomized, paired comparison of laser epithelial keratomileusis and photorefractive keratectomy for myopia less than -6.50 diopters.

PURPOSE: We compared predictability, efficacy, safety, and patient satisfaction following laser epithelial keratomileusis (LASEK) and photorefractive keratectomy (PRK) for low to moderate myopia with either the Nidek EC-5000 excimer laser or the Technolas 217C excimer laser. METHODS: Forty-two patients with spherical equivalent refraction in the range -1.00 to -6.50 D were enrolled in this prospective study, each randomized for choice and sequence of LASEK and PRK on each of their eyes. Patients were examined daily for 7 days, and at 1 and 3 months. Patient satisfaction and quality of vision were assessed using a subjective questionnaire. RESULTS: Mean baseline refraction was -3.57 +/- 1.25 D in LASEK eyes and -3.44 +/- 1.13 D in PRK eyes. Follow-up rates were 100% up to 1 month and 76% at 3 months. At 3 months, 32 (100%) of LASEK eyes and 31 (97%) of PRK eyes had uncorrected visual acuity > or = 20/40, 25 (79%) of LASEK eyes and 26 (82%) of PRK eyes had uncorrected visual acuity > or = 20/20, mean refraction was 0.08 +/- 0.53 D in LASEK eyes and 0.12 +/- 0.50 D in PRK eyes, 26 (81%) of LASEK eyes and 23 (72%) of PRK eyes had a refraction within +/- 0.50 D and 29 (91%) of LASEK eyes and 30 (94%) of PRK eyes had refraction within +/- 1.00 D. Epithelial healing time and pain in LASEK and PRK eyes were not statistically different, and patients were equally satisfied. CONCLUSION: LASEK had similar predictability, efficacy, safety, and patient satisfaction to PRK in the treatment of low to moderate myopia.

Adolescent↗