Iranian Journal of Medical Sciences最新文献

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Defensive Driving and Iran's "No to Road Accidents" Campaign: The Pivotal Role of Occupational Health and Safety Professionals in Reducing Fatalities. 防御性驾驶和伊朗的“拒绝道路事故”运动:职业健康和安全专业人员在减少死亡人数方面的关键作用。
IF 1.5
Iranian Journal of Medical Sciences Pub Date : 2025-08-01 DOI: 10.30476/ijms.2025.106351.4048
Rosanna Cousins, Vahid Gharibi
{"title":"Defensive Driving and Iran's \"No to Road Accidents\" Campaign: The Pivotal Role of Occupational Health and Safety Professionals in Reducing Fatalities.","authors":"Rosanna Cousins, Vahid Gharibi","doi":"10.30476/ijms.2025.106351.4048","DOIUrl":"https://doi.org/10.30476/ijms.2025.106351.4048","url":null,"abstract":"","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"50 8","pages":"586-587"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Effects of Prebiotic Dietary Fibers, Probiotics, and Synbiotics on Gut Permeability and Immunity: A Systematic Review. 益生元膳食纤维、益生菌和合成菌对肠道通透性和免疫力的影响:系统综述。
IF 1.5
Iranian Journal of Medical Sciences Pub Date : 2025-08-01 DOI: 10.30476/ijms.2024.102363.3525
Leila Maghsoumi-Norouzabad, Alireza Bagherzadeh-Karimi, Shabnam Aliakbari Majd, Leila Hosseini, Fatemeh Shahi
{"title":"The Effects of Prebiotic Dietary Fibers, Probiotics, and Synbiotics on Gut Permeability and Immunity: A Systematic Review.","authors":"Leila Maghsoumi-Norouzabad, Alireza Bagherzadeh-Karimi, Shabnam Aliakbari Majd, Leila Hosseini, Fatemeh Shahi","doi":"10.30476/ijms.2024.102363.3525","DOIUrl":"10.30476/ijms.2024.102363.3525","url":null,"abstract":"<p><strong>Background: </strong>Modulation of intestinal barrier, which function through zonulin pathway downregulation, represents a promising therapeutic strategy for chronic diseases. This systematic review aimed to evaluate the effects of prebiotic dietary fibers, probiotics, and synbiotics on intestinal permeability and immunity.</p><p><strong>Methods: </strong>A systematic literature search of the EMBASE, PubMed, Web of Science, and Scopus electronic databases was conducted from database inception up to May 2024, supplemented by manual reference list searches. Included studies met the following criteria: (a) English language publications; (b) clinical trials; (c) investigated each factor of serum or fecal zonulin levels, serum or fecal calprotectin, glucagon-likepeptide-2 (GLP-2), short chain fatty acids (SCFAs), long chain fatty acids (LCFAs), fecal bile acid (BA), LPS-binding protein (LBP), lipopolysaccharide (LPS), intestinal microbiota composition, or inflammatory factors such as interleukin 6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP); (d) supplemented prebiotic dietary fibers, probiotics, or symbiotics. Studies were excluded if they contained insufficient data or involved supplementation alongside other interventions. The study quality and risk of bias were assessed using Jadad's Score.</p><p><strong>Results: </strong>A total of 36 studies were included in this review. Of these, 14 articles (n=580 participants) evaluated the effect of dietary prebiotics, 18 articles (n=1502 participants) evaluated the effect of probiotics, and six articles (n=517 participants) examined the effect of synbiotics on intestinal health and immunity markers. According to the evidence presented in this study, prebiotic whole foods or food enriched with prebiotics, probiotics, and synbiotics might have favorable effects on the serum levels of zonulin as a measure of intestinal permeability. The effects on GLP-2, gut microbiota, and their metabolites (e.g., LCFAs/SCFAs and BA) were contradictory and inconclusive. Some studies indicated increased levels of <i>Bifidobacteria</i> and SCFA with prebiotic supplementation or prebiotics-enriched food products. Fecal calprotectin (as an important marker of the local gut inflammation), tumor necrosis factor-α (TNF-α), and hs-CRP were unaffected in most studies.</p><p><strong>Conclusion: </strong>The lack of consistent replication across studies made it difficult to draw definitive conclusions about the effects of prebiotics, probiotics, and synbiotics on gut-related health and immunity. Therefore, further evidence is required before definitive recommendations can be established.</p>","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"50 8","pages":"500-529"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Serous and Exosomal LDH-C4 as a Potential Diagnostic and Prognostic Biomarker of Cervical Carcinoma. 浆液和外泌体LDH-C4作为宫颈癌的潜在诊断和预后生物标志物。
IF 1.5
Iranian Journal of Medical Sciences Pub Date : 2025-08-01 DOI: 10.30476/ijms.2025.103065.3620
Fengxia Zhang, Zengguang Ma, Fengqin Zhang, Yucui Li, Xiaojie Liu, Jiandong Zhang
{"title":"Serous and Exosomal LDH-C4 as a Potential Diagnostic and Prognostic Biomarker of Cervical Carcinoma.","authors":"Fengxia Zhang, Zengguang Ma, Fengqin Zhang, Yucui Li, Xiaojie Liu, Jiandong Zhang","doi":"10.30476/ijms.2025.103065.3620","DOIUrl":"https://doi.org/10.30476/ijms.2025.103065.3620","url":null,"abstract":"<p><strong>Background: </strong>Exosomal molecules derived from cancer cells have been recognized as candidate biomarkers for cancer diagnosis and prognosis. This study aimed to evaluate the potential of the LDH-C4 expression level in cervical carcinoma.</p><p><strong>Methods: </strong>A retrospective study was conducted on patients with cervical carcinoma at the Third Hospital of Hebei Medical University, in Shijiazhuang, China, between July 2021 to September 2023. Peripheral blood was obtained, and serum and exosomes were extracted. Lactate dehydrogenase (LDHC) gene expression levels were quantified using reverse transcription-quantitative polymerase chain reaction (PCR), and these were compared with protein expression levels in cervical carcinoma tissues. Statistical analyses, including independent t tests, Chi square tests, receiver operator characteristic (ROC) curves, Kaplan-Meier analysis, and subsequent log-rank tests, were performed with the SPSS software version 21. Univariate and multiple analyses were used to analyze independent prognostic risk factors. P<0.05 was considered statistically significant.</p><p><strong>Results: </strong>A total of 220 individuals were recruited, including 120 with cervical carcinoma and 100 healthy controls. In patients with cervical carcinoma, the LDHC gene expression levels were 5.58% and 11.28% in serum and exosomes of healthy donors and were 79.38% and 66.27% in patients with cervical carcinoma. There was a statistically significant difference in the LDHC expression between the patient group and the control group (P=0.008, in serum; P=0.011, in exosomes). In addition, LDH-C4 protein expression was associated with histology grade (P=0.022), tumor stage (P=0.019), and lymph node metastasis (P=0.016). The overall survival of patients with cervical carcinoma with positive LDH-C4 expression was 83.54%; patients with a higher LDH-C4 expression exhibited a poorer overall survival rate than those with lower LDH-C4 expression. Multiple Cox regression analysis demonstrated that LDH-C4 expression is a poor independent prognostic factor for patients with cervical carcinoma.</p><p><strong>Conclusion: </strong>LDH-C4 levels in serum and exosomes may exhibit potential in identifying patients with cervical carcinoma, thus providing a novel approach for the early screening of cervical carcinoma.</p>","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"50 8","pages":"539-547"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Septic Gangrene and Thrombophlebitis Following Leech Therapy in a Patient with Undiagnosed Arterial Occlusive Disease: A Case Report. 脓毒性坏疽和血栓性静脉炎在水蛭治疗后未确诊的动脉闭塞性疾病:1例报告。
IF 1.5
Iranian Journal of Medical Sciences Pub Date : 2025-08-01 DOI: 10.30476/ijms.2025.105450.3922
Mohadeseh Ostovar, Ahmad Hosseinzadeh, Mojtaba Heydari, Mahsa Moghadam, Mesbah Shams
{"title":"Septic Gangrene and Thrombophlebitis Following Leech Therapy in a Patient with Undiagnosed Arterial Occlusive Disease: A Case Report.","authors":"Mohadeseh Ostovar, Ahmad Hosseinzadeh, Mojtaba Heydari, Mahsa Moghadam, Mesbah Shams","doi":"10.30476/ijms.2025.105450.3922","DOIUrl":"https://doi.org/10.30476/ijms.2025.105450.3922","url":null,"abstract":"<p><p>Different side effects have been reported for leech therapy, such as local itching, skin reactions, infection, bleeding disorders, and anemia. The present study described a rare and lethal adverse event following leech therapy. A 63-year-old man was referred to Nemazee Teaching Hospital (Shiraz, Iran) in December 2020 with a two-week history of progressive right lower extremity swelling, erythema, and ecchymosis. One week before symptom onset, he had undergone leech therapy on the lateral calf and upper thigh of the right lower extremity, administered by a traditional healer. Physical examination revealed gangrene of the right leg and absence of all pulses. Color Doppler sonography of the leg and computed tomography angiography (CTA) of the thoracic aorta to the lower extremities revealed complete thrombosis of all right lower extremity arteries, extending to the right iliac artery and abdominal aorta. With a diagnosis of arterial occlusive disease and septic thrombophlebitis, the patient received intravenous antibiotics and anticoagulant therapy. Due to the inadequacy of medical treatments, a right lower extremity amputation was performed. The patient expired 5 days postoperatively due to septic shock and multiorgan failure.</p>","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"50 8","pages":"581-585"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cost-Effectiveness Analysis of Crizanlizumab in Sickle Cell Disease in Iran. 克里赞单抗治疗伊朗镰状细胞病的成本-效果分析
IF 1.5
Iranian Journal of Medical Sciences Pub Date : 2025-08-01 DOI: 10.30476/ijms.2025.102567.3573
Marzieh Nosrati, Shadi Izadidehkordi, Shekoufeh Nikfar, Fatemeh Sadat Heydari
{"title":"Cost-Effectiveness Analysis of Crizanlizumab in Sickle Cell Disease in Iran.","authors":"Marzieh Nosrati, Shadi Izadidehkordi, Shekoufeh Nikfar, Fatemeh Sadat Heydari","doi":"10.30476/ijms.2025.102567.3573","DOIUrl":"https://doi.org/10.30476/ijms.2025.102567.3573","url":null,"abstract":"<p><strong>Background: </strong>Sickle cell disease (SCD) prevalence is predicted to rise dramatically in the upcoming years. Although several medications have received Food and Drug Administration (FDA) approval in recent years, low- and middle-income countries (LMICs) still struggle to access these medications due to their remarkably high prices. Crizanlizumab, owing to its clinical and economic privileges, appears to be the most suitable option for addition to pharmacotherapy guidelines. However, no study has yet investigated its cost-effectiveness in Iran's healthcare system.</p><p><strong>Methods: </strong>This cost-effectiveness evaluation was conducted in 2022 at the Pharmacoeconomic and Pharmaceutical Administration Department of the Faculty of Pharmacy at Tehran University of Medical Sciences, Tehran, Iran. A decision-tree model was designed, followed by a cost-utility analysis for crizanlizumab in two separate scenarios, targeting not only monotherapy with crizanlizumab in SCD compared with placebo, but also crizanlizumab's concomitant use with hydroxyurea compared with hydroxyurea. The study reports the outcomes from Iran's healthcare system perspective. Direct medical costs, quality-adjusted life years related to vaso-occlusive crisis, hospitalizations, and adverse effects were calculated. Incremental cost-effectiveness ratios were compared. SUSTAIN trial was the main clinical source for modeling crizanlizumab's effectiveness in SCD. A sensitivity analysis was performed to measure the sensitivity of outcomes to changes in medication costs. Microsoft Excel 2020 was utilized for calculations and modeling.</p><p><strong>Results: </strong>Concomitant therapy with low-dose crizanlizumab added to hydroxyurea led to the lowest Incremental Cost Effectiveness Ratio (ICER) of 398,881 United States dollars (USD), exceeding Iran's accepted cost-effectiveness threshold. Sensitivity analysis results demonstrate that even a 20% reduction in the price of crizanlizumab does not lead to its cost-effectiveness in Iran.</p><p><strong>Conclusion: </strong>Crizanlizumab administration in sickle cell disease is not found cost-effective in Iran, neither as a monotherapy nor added to hydroxyurea.</p>","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"50 8","pages":"548-555"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical Predictive Factors for Reproductive Organ Involvement in Females with Muscle Invasive Bladder Cancer: A Retrospective Review of Radical Cystectomy Cases from Two Tertiary Centers. 女性肌性浸润性膀胱癌累及生殖器官的临床预测因素:两个三级中心根治性膀胱切除术病例的回顾性分析。
IF 1.5
Iranian Journal of Medical Sciences Pub Date : 2025-08-01 DOI: 10.30476/ijms.2025.104015.3746
Nastaran Mahmoudnejad, Mohammad Hamidi Madani, Parham Montazeri, Kimia Vakili, Mohammad Nasri, Sajjad Imen, Navid Masoumi
{"title":"Clinical Predictive Factors for Reproductive Organ Involvement in Females with Muscle Invasive Bladder Cancer: A Retrospective Review of Radical Cystectomy Cases from Two Tertiary Centers.","authors":"Nastaran Mahmoudnejad, Mohammad Hamidi Madani, Parham Montazeri, Kimia Vakili, Mohammad Nasri, Sajjad Imen, Navid Masoumi","doi":"10.30476/ijms.2025.104015.3746","DOIUrl":"https://doi.org/10.30476/ijms.2025.104015.3746","url":null,"abstract":"<p><strong>Background: </strong>The preservation of reproductive organs in females with muscle-invasive bladder cancer (MIBC) might improve reproductive and sexual function. This study aimed to identify potential clinical risk factors for reproductive organ involvement (ROI) using preoperative data from transurethral resection of tumor (TURT) reports and imaging findings.</p><p><strong>Methods: </strong>This retrospective analysis was conducted on 143 women with bladder cancer who underwent radical cystectomy (RC) at Modarres and Labafinejad Medical Centers in Tehran, Iran, between 2010 and 2019. Demographic, clinical, and pathological data, along with follow-up reports, were collected from medical records and analyzed.</p><p><strong>Results: </strong>The mean age of the participants was 69.17±10.62 years, with an ROI rate of 16.8%. The vagina was the predominantly involved organ. Significant independent risk factors for ROI included clinical T stage (P=0.042), bladder neck or trigonal location of the tumor (P<0.001), tumor size> 5 cm (P=0.002), presence of carcinoma <i>in situ</i> (CIS) (P=0.014), lymphovascular invasion in TURT reports (P=0.002), and preoperative hydronephrosis in imaging (P<0.001). Patients with ROI demonstrated significantly lower 5-year survival rates than those without ROI, with overall survival rate of 20.8% versus 63.9% and cancer-specific survival rate of 19% versus 64.8%, respectively.</p><p><strong>Conclusion: </strong>This study represented a comprehensive analysis of preoperative TURT and imaging predictors of ROI. Clinical T stage, tumor location, maximum tumor size, concomitant CIS, presence of lymphovascular invasion, and hydronephrosis were identified as significant preoperative clinical factors associated with ROI. These findings might help guide surgical planning for organ preservation in female MIBC patients.</p>","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"50 8","pages":"530-538"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
hsa-miR-520d-3p and hsa-miR-449a are Candidate MicroRNA Regulators in Multiple Sclerosis. hsa-miR-520d-3p和hsa-miR-449a是多发性硬化症的候选MicroRNA调节因子。
IF 1.5
Iranian Journal of Medical Sciences Pub Date : 2025-07-01 DOI: 10.30476/ijms.2024.103243.3647
Nafiseh Karimi, Majid Motovali Bashi, Mostafa Ghaderi-Zefrehei, Bluma J Lesch
{"title":"<i>hsa-miR-520d-3p</i> and <i>hsa-miR-449a</i> are Candidate MicroRNA Regulators in Multiple Sclerosis.","authors":"Nafiseh Karimi, Majid Motovali Bashi, Mostafa Ghaderi-Zefrehei, Bluma J Lesch","doi":"10.30476/ijms.2024.103243.3647","DOIUrl":"10.30476/ijms.2024.103243.3647","url":null,"abstract":"<p><strong>Background: </strong>An incapacitating chronic inflammatory neurodegenerative illness, known as multiple sclerosis (MS), is characterized by lymphocyte infiltration into the central nervous system. We aimed to identify specific miRNAs whose altered expression correlates with MS diagnosis and therapy selection, which could be biomarkers for these aspects of the disease.</p><p><strong>Methods: </strong>The GSE21079 dataset was obtained for this study using Geoquery version 2.50.5 from the Gene Expression Omnibus database. The miRNAs exhibiting the highest variance were selected, and a miRNA-miRNA interaction network was constructed through a Bayesian network utilizing the bnlearn R package (version 4.7.1). The adjacency matrix generated from the learned network was subsequently analyzed in the Cytoscape environment. For the workbench lab, whole blood samples were collected from the MS Research Center and Al-Zahra Hospital in Isfahan, Iran, between June 2019 and October 2019. RNA extraction was conducted in the laboratory at Isfahan University. Real-time PCR (RT-PCR) was employed to validate the expression changes of the candidate mirRNAs (<i>hsa-miR-520d-3p</i>, <i>hsa-miR-449a</i>). The results were analyzed using REST 2009 software.</p><p><strong>Results: </strong>The Notch1 signaling pathway was targeted by <i>hsa-miR-520d-3p</i> and <i>hsa-miR-449a</i> in MS patients, which led to downregulation of critical genes, such as <i>LIM</i> and <i>SH3 protein 1 (LASP1)</i>, <i>Tubulin Alpha1c (TUBA1C)</i>, and <i>S100 calcium binding protein A6 (S100A6)</i>. Furthermore, the results from RT-PCR among 50 whole blood samples, comprising 30 cases of MS and 20 control cases, indicated that the expression levels of miRNA in patients with MS exhibited a statistically significant difference compared to those in healthy individuals, with values of 0.324 for <i>hsa-miR-520d-3p</i> and 0.075 for <i>hsa-miR-449a</i>. These values correspond to a downregulation of 3.1-fold and 13.3-fold, respectively.</p><p><strong>Conclusion: </strong>The findings indicate that MS patients have lower expression levels of <i>hsa-miR-520d-3p</i> and <i>hsa-miR-449a</i>.</p>","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"50 7","pages":"472-480"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12334791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Outcome of Ischemic Stroke Patients Following Decompressive Craniectomy: A Cohort Study. 缺血性脑卒中患者颅骨减压切除术后的预后:一项队列研究。
IF 1.5
Iranian Journal of Medical Sciences Pub Date : 2025-07-01 DOI: 10.30476/ijms.2024.102797.3589
Mohammad Jamali, Mahyar Noorollahi, Ehsan Mohammad Hosseini, Abdolkarim Rahmanian, Mohammad Sayari, Sulmaz Ghahramani
{"title":"Outcome of Ischemic Stroke Patients Following Decompressive Craniectomy: A Cohort Study.","authors":"Mohammad Jamali, Mahyar Noorollahi, Ehsan Mohammad Hosseini, Abdolkarim Rahmanian, Mohammad Sayari, Sulmaz Ghahramani","doi":"10.30476/ijms.2024.102797.3589","DOIUrl":"10.30476/ijms.2024.102797.3589","url":null,"abstract":"<p><strong>Background: </strong>Decompressive craniectomy (DC) is effective in reducing mortality and improving outcomes in stroke patients. However, there is a need for a better understanding of the outcomes and complications of stroke, particularly in regions such as Iran, where comprehensive studies on DC outcomes are scarce. This study investigated the effects of DC in stroke patients.</p><p><strong>Methods: </strong>This cohort study was conducted at Nemazi Hospital in Shiraz, Iran, from 2018 to 2020. All patients aged over 18 years with ischemic stroke requiring DC were included using census sampling. Data on demographics, clinical history, and imaging findings were collected. Outcomes were assessed using the modified rankin scale (mRS), Glasgow outcome score extended (GOSE), and aphasia severity rating (ASR).</p><p><strong>Results: </strong>A total of 144 cerebral infarction patients underwent DC; 22 (15.3%) were lost to follow-up, and 67 (55%) of the remaining patients died either during hospitalization or within at least 6 months of follow-up. Patients over 60 years old (OR=0.152), those with a history of stroke (OR=0.227), and those with COVID-19 infection (OR=0.164) were associated with a decreased likelihood of survival. However, an increase in the Glasgow Coma Scale (GCS) score on admission was associated with an increased probability of survival (OR=1.199). The ordered logistic regression analysis showed that an increase in GCS score was associated with a higher probability of achieving better outcomes across all models: GOSE (OR=1.177), mRS (OR=0.839, with lower scores indicating better outcomes), and ASR (OR=1.354). The analysis showed that patients over 60 had a lower probability of achieving better outcomes in the GOSE model (OR=0.185) and were likely to have worse outcomes in the mRS model (OR=5.182).</p><p><strong>Conclusion: </strong>These findings underscored the critical role of comorbidities (such as COVID-19 and prior stroke) and GCS scores in predicting patient survival and functional outcomes following DC. In particular, the higher mortality rates and poorer functional outcomes observed in older patients highlighted the need for careful consideration in this age group.</p>","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"50 7","pages":"445-454"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12334788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Educational Challenges in Training Patient-Centered Communication in Senior Medical Students. 培养医学生以病人为中心的沟通能力的教育挑战。
IF 1.5
Iranian Journal of Medical Sciences Pub Date : 2025-07-01 DOI: 10.30476/ijms.2025.105331.3924
Lida Jarahi, Amirhossien Derakhshan Doghaei, Mehri Yavari, Seyed Masoud Hosseini
{"title":"Educational Challenges in Training Patient-Centered Communication in Senior Medical Students.","authors":"Lida Jarahi, Amirhossien Derakhshan Doghaei, Mehri Yavari, Seyed Masoud Hosseini","doi":"10.30476/ijms.2025.105331.3924","DOIUrl":"10.30476/ijms.2025.105331.3924","url":null,"abstract":"","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"50 7","pages":"496-497"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12334787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
An Unusual Etiology of Presyncopal Episodes: Dynamic Left Ventricular Outflow Tract Obstruction Secondary to an Elongated Anterior Mitral Valve Leaflet. 一种不寻常的晕厥前发作的病因:二尖瓣前叶拉长继发的动态左心室流出道阻塞。
IF 1.5
Iranian Journal of Medical Sciences Pub Date : 2025-07-01 DOI: 10.30476/ijms.2025.104916.3846
Stylianos Karvounaris, Ioannis Michaelides, Theodoros Ntoskas, Konstantinos Ritsatos, Georgios Papaetis
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