Mohammad Reza Masjedi

Publications (68)100.77 Total impact

• Article: The totally drug resistant tuberculosis (TDR-TB).

  Ali Akbar Velayati, Parissa Farnia, Mohammad Reza Masjedi
  International journal of clinical and experimental medicine 01/2013; 6(4):307-9.
• Article: Risk factors affecting the survival rate in patients with symptomatic pericardial effusion undergoing surgical intervention.

  Seyed Mohsen Mirhosseini, Mohammad Fakhri, Amirhossein Mozaffary, Mojtaba Lotfaliany, Neda Behzadnia, Zahra Ansari Aval, Seyed Mohammad Saeed Ghiasi, Mohammad Reza Boloursaz, Mohammad Reza Masjedi
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  ABSTRACT: OBJECTIVES The optimal management and treatment of pericardial effusion are still controversial. There is limited data related to the risk factors affecting survival in these patients. The aim of this study was to determine the risk factors affecting the survival rate of patients with symptomatic pericardial effusion who underwent surgical interventions.METHODS From 2004 to 2011, we retrospectively analysed 153 patients who underwent subxiphoid pericardial window as their surgical intervention to drain pericardial effusions at the National Research Institute of Tuberculosis and Lung diseases (NRITLD). To determine the effects of risk factors on survival rate, demographic data, clinical records, echocardiographic data, computed tomographic and cytopathological findings and also operative information of patients were recorded. Patients were followed annually until the last clinical follow-up (August 2011). To determine the prognostic factors affecting survival, both univariate analysis and multivariate Cox proportional hazards model were utilized.RESULTSThere were 89 men and 64 women with a mean age of 50.3 ± 15.5 years. The most prevalent symptom was dyspnoea. Concurrent malignancies were present in 66 patients. Lungs were the most prevalent primary site for malignancy. The median duration of follow-up was 15 (range 1-85 months). Six-month, 1-year and 18-month survival rates were 85.6, 61.4 and 36.6%, respectively. In a multivariate analysis, positive history of lung cancer (hazard ratio [HR] 2.894, 95% confidence interval [CI] 1.362-6.147, P = 0.006) or other organ cancers (HR 2.315, 95% CI 1.009-50311, P = 0.048), presence of a mass in the computed tomography (HR 1.985, 95% CI 1.100-3.581, P = 0.023), and echocardiographic findings compatible with tamponade (HR 1.745, 95% CI 1.048-2.90 P = 0.032) were the three independent predictors of postoperative death.CONCLUSIONS In the surgical management of pericardial effusion, patients with underlying malignant disease, especially with lung cancer, patients with a detectable invasion of thorax in computed tomography and those with positive echocardiographic findings compatible with tamponade have a poor survival. Therefore, minimally invasive therapies could be considered as a more acceptable alternative for these high-risk patients.
  Interactive cardiovascular and thoracic surgery 12/2012;
• Source

  Available from: Shadi Asadollahi

  Article: Continuous renal replacement therapy versus furosemide for management of kidney impairment in heart transplant recipients with volume overload.

  Seyed Mohsen Mirhosseini, Mohammad Fakhri, Shadi Asadollahi, Zargham Hossein Ahmadi, Farin Rashid Farokhi, Mohammad Reza Boloursaz, Mohammad Reza Masjedi
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  ABSTRACT: OBJECTIVES It is unknown whether continuous renal replacement therapy or furosemide therapy is superior in heart transplant recipients who are in postoperative kidney insufficiency and volume overload. This prospective non-randomized, controlled trial investigated the efficacy of the two methods after transplantation.METHODS We assigned heart transplant recipients 18 years of age or older who were oliguric (urine output < 400 mL/day); had volume overload and estimated glomerular filtration rate <60 mL/min/1.73 m(2) of body surface area calculated with the use of the Modification of Diet in Renal Disease equation, to designed initiation of intervention. We followed 30 patients for up to 30 days. The primary outcome was estimated glomerular filtration rate status after intervention.RESULTSBetween January 2010 and April 2012, a total of 30 adults (mean age: 37 years; 18 men and 12 women) were assessed for entry in this trial. Continuous renal replacement therapy, when compared with furosemide, was associated with a significant increase in estimated glomerular filtration rate of patients after intervention 61 ± 4.5 vs 55 ± 8.5l mL/min/1.73 m(2) (P = 0.02). Moreover, the mean glomerular filtration rate at discharge time for the continuous renal replacement therapy group was 72 ± 7.3 and 58 ± 7.4 mL/min/1.73 m(2) for the furosemide group (P < 0.001). During the follow-up period, 6 of 15 patients in the continuous renal replacement therapy group (40%) and 4 of 15 in the furosemide group (26.6%) died (P = 0.43).CONCLUSIONS In this study, continuous renal replacement therapy in heart transplant recipients with reduced kidney function was associated with an improvement in estimated glomerular filtration rate status in comparison with furosemide.
  Interactive cardiovascular and thoracic surgery 12/2012;
• Article: A nonlinear model for estimating respiratory volume based on thoracoabdominal breathing movements.

  Mohammad Reza Raoufy, Sohrab Hajizadeh, Shahriar Gharibzadeh, Ali R Mani, Parivash Eftekhari, Mohammad Reza Masjedi
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  ABSTRACT: SUMMARY AT A GLANCE: The reliability of nonlinear models compared with routine linear methods for estimation of respiratory volume, based on thoracoabdominal breathing movements, was evaluated. Nonlinear models accurately predicted respiratory volume during normal and asynchronous breathing, and may be useful during prolonged respiratory monitoring. ABSTRACT: Background and objective:  Respiratory inductive plethysmography (RIP) is a non-invasive technique for measuring respiratory function. However, there are challenges associated with using linear methods for calibration of RIP. In this study, we developed two nonlinear models, artificial neural network (ANN) and adaptive neuro-fuzzy inference system (ANFIS), to estimate respiratory volume based on thoracoabdominal movements, and compared these models with routine linear approaches, including qualitative diagnostic calibration (QDC) and multiple linear regression (MLR). Methods:  Recordings of spirometry (SP) volume and RIP were obtained for 10 normal subjects and 10 asthmatic patients, during asynchronous breathing for seven minutes. The first five minutes of recording were used to develop the models; the remaining data was used for subsequent validation of the results. Results:  The results from the nonlinear models fitted the SP volume curve significantly better than those obtained by linear methods, particularly during asynchrony (P <0.05). On a breath-by-breath analysis, estimates of tidal volume, total cycle time, and sigh values using the ANN model were accurate by comparison with QDC. In contrast to the ANN model, there was a significant correlation between values for thoracoabdominal asynchrony and increased error of QDC (P <0.05). Conclusions:  These results indicate that the nonlinear methods can be adapted to closely simulate variable conditions and used to study the patterns of volume changes during normal and asynchronous breathing. © 2012 The Authors. Respirology © 2012 Asian Pacific Society of Respirology.
  Respirology 08/2012; · 2.42 Impact Factor
• Article: Wells' prediction rules for pulmonary embolism: valid in all clinical subgroups?

  Babak Sharif-Kashani, Bavand Bikdeli, Solmaz Ehteshami-Afshar, Mandana Chitsazan, Neda Behzadnia, Ehsan Chitsaz, Saeid Kermani-Randjbar, Leila Saliminejad, Mohammad-Reza Masjedi, Behnood Bikdeli
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  ABSTRACT: Pulmonary embolism is major cause of hospital death. Clinical prediction rules such as Wells' prediction rules can help in selection of at-risk patients who need further testing for pulmonary embolism. We evaluated the usefulness of such criteria for detection of patients with diagnosed pulmonary embolism. Patients enrolled in National Research Institute of Tuberculosis and Lung Disease (NRITLD) deep venous thrombosis (DVT) registry were evaluated and those with objective data about presence or absence of pulmonary embolism were selected for this study. Diagnosis of pulmonary embolism was based on computed tomography pulmonary angiography (CTPA). We calculated the embolic burden in those with CTPA-confirmed pulmonary embolism. Eighty-six patients entered the study (58 males, 28 females, mean age = 54.39 ± 1.74 years). Fifty-four cases had coexisting pulmonary embolism (embolic burden score: 10.77 ± 1.181). Embolic burden score was correlated to presence of massive pulmonary embolism (Pearson rho: 0.43, P = 0.002). There was no association between Wells' pulmonary embolism score and the occurrence of pulmonary embolism (Spearman's rho: 0.085, P = 0.51). Dividing the patients into two, or three, risk groups according to Wells' model did not reveal an association with occurrence of pulmonary embolism either (P = 0.99 and P = 0.261, respectively). Tachycardia and hemoptysis were the only parameters from the Wells' pulmonary embolism score correlated to presence of pulmonary embolism (Spearman's rho: 0.373, P < 0.000 and Spearman's rho: 0.297, P = 0.005, correspondingly). Wells' pulmonary embolism score could not predict the occurrence of pulmonary embolism in DVT patients suspected of having coexisting pulmonary embolism. Until further studies shed light on this patient subset, overreliance on Wells' prediction rules as the solo decision making tool should be cautioned.
  Blood coagulation & fibrinolysis: an international journal in haemostasis and thrombosis 08/2012; 23(7):614-618. · 1.25 Impact Factor
• Article: Novel mutation of the activation-induced cytidine deaminase gene in a Tajik family: special review on hyper-immunoglobulin M syndrome.

  Seyed Alireza Mahdaviani, Armin Hirbod-Mobarakeh, Ning Wang, Asghar Aghamohammadi, Lennart Hammarström, Mohammad Reza Masjedi, Qiang Pan-Hammarström, Nima Rezaei
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  ABSTRACT: The hyper-immunoglobulin M (HIGM) syndrome comprises a group of primary immunodeficiency disorders characterized by normal or elevated serum levels of IgM and low levels of other immunoglobulin classes. Patients with HIGM usually suffer from a variety of recurrent infections. Herein, we report two siblings of a Tajik family with a HIGM phenotype in which a novel missense mutation in the activation-induced cytidine deaminase (AICDA) gene was detected. Mutations in this gene are responsible for an autosomal recessive form of HIGM. We have also reviewed and summarized all published cases with HIGM due to defects in AICDA.
  Expert Review of Clinical Immunology 08/2012; 8(6):539-46. · 2.07 Impact Factor
• Article: Opium Could Be Considered an Independent Risk Factor for Lung Cancer: A Case-Control Study.

  Mohammad Reza Masjedi, Parisa Adimi Naghan, Shervin Taslimi, Mahmoud Yousefifard, Seyyed Meisam Ebrahimi, Adnan Khosravi, Shirin Karimi, Mostafa Hosseini, Esmaeil Mortaz
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  ABSTRACT: Background: Lung cancer is the leading cause of cancer-related death worldwide, and half of all incident lung cancers are believed to occur in the developing countries, including Iran. Objective: We investigated the association of opium with the risk of lung cancer in a case-control study. Methods: We enrolled 242 cases and 484 matched controls in this study. A questionnaire was developed, containing questions on basic demographic characteristics, as well as lifelong history of smoking cigarettes, exposure to passive smoking, opium use and alcohol consumption. For smoking cigarettes and opium and also oral opium intake frequency, duration and cumulative use were categorized into three groups: no use, low use and high use. Conditional logistic regression was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs). Results: Multivariate analysis in men showed that after adjusting for the effect of ethnicity, education and pack years of smoking cigarettes, smoking opium remained as a significant independent risk factor with an OR of 3.1 (95% CI 1.2-8.1). In addition, concomitant heavy smoking of cigarettes and opium dramatically increased the risk of lung cancer to an OR of 35.0 (95% CI 11.4-107.9). Conclusion: This study demonstrated that smoking opium is associated with a high risk of lung cancer as an independent risk factor.
  Respiration 07/2012; · 2.26 Impact Factor
• Article: Uremic pleuritis in chronic hemodialysis patients.

  Farin Rashid-Farokhi, Guitti Pourdowlat, Mohammad-Reza Nikoonia, Neda Behzadnia, Shahram Kahkouee, Amir-Ahmad Nassiri, Mohammad-Reza Masjedi
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  ABSTRACT: Chronic hemodialysis (HD) patients are predisposed to several complications associated with pleural effusion. In addition, uremia can directly cause pleuritis. However, there are inadequate data about pathogenesis and natural course of uremic pleuritis. In this study, 76 chronic HD patients with pleural effusion admitted to the Respiratory Center of Masih Daneshvari Hospital, in Tehran, Iran between June 2005 and May 2011 were evaluated to figure out the etiology of their pleural disease. Among these patients, patients with uremic pleuritis were identified and studied. The rate of uremic pleuritis was 23.7%. Other frequent etiologies of pleural effusion were parapneumonic effusion (23.7%), cardiac failure (19.7%), tuberculosis (6.6%), volume overload, malignancy, and unknown. In patients with uremic pleuritis, dyspnea was the most common symptom, followed by cough, weight loss, anorexia, chest pain, and fever. Compared to patients with parapneumonic effusion, patients with uremic effusion had a significantly higher rate of dyspnea and lower rate of cough and fever. Pleural fluid analysis showed that these patients had a significantly lower pleural to serum lactic dehydrogenase ratio, total pleural leukocytes, and polymorphonuclear count compared to patients with parapneumonic effusion. Improvement was achieved in 94.1% of patients with uremic pleuritis by continuation of HD, chest tube insertion or pleural decortication; an outcome better than the previous reports. Despite the association with an exudative effusion, inflammatory pleural reactions in patients with uremic pleuritis may not be as severe as infection-induced effusions. Owing to the advancement in HD technology and other interventions, outcome of uremic pleuritis may be improved.
  Hemodialysis International 06/2012; · 1.54 Impact Factor
• Article: Relationship between angiogenic squamous dysplasia and bronchogenic carcinoma in patients undergoing white light bronchoscopy.

  Shirin Karimi, Forouzan Mohammadi, Kian Khodadad, Makan Sadr, Leila Seyfollahi, Mohammad Reza Masjedi
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  ABSTRACT: To better understand the characteristic morphology of angiogenic squamous dysplasia (ASD) and its association with different types of common bronchogenic carcinomas using routine white light bronchoscopy. Using a case-control design, 186 formalin-fixed paraffin-embedded blocks of bronchial tissue (136 cases, 50 controls) obtained from patients who underwent routine nonfluorescence bronchoscopy between 2004 and 2005 were studied. ASD occurred at a higher frequency in patients with neoplastic lesions compared with those without neoplastic lesions (28 of 136 versus one of 50). ASD was also more prevalent in patients with squamous cell carcinoma compared with other neoplasms. Seventy six per cent of the ASD patients (22 of 29) smoked cigarettes. The morphology of ASD on hematoxylin and eosin- and CD31-stained sections was characterized by prominent microvasculature and capillary projections closely juxtaposed to variable degrees of dysplasia in all of the bronchogenic carcinoma specimens, and to metaplasia in one case in the control group. ASD is a unique morphological entity that should be considered by pathologists even on bronchoscopic biopsies from patients who undergo white light bronchoscopy. The presence of ASD may represent a risk biomarker of bronchogenic carcinoma in screening programs and in chemoprevention of lung cancer.
  Canadian respiratory journal: journal of the Canadian Thoracic Society 05/2012; 19(3):201-6. · 1.56 Impact Factor
• Article: Efficacy of Harm Reduction Programs among Patients of a Smoking Cessation Clinic in Tehran, Iran.

  Hooman Sharifi, Roghieh Kharaghani, Habib Emami, Zahra Hessami, Mohammad Reza Masjedi
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  ABSTRACT: Recently, harm reduction programs have been used to reduce mortality and morbidity among smokers. The main objective of this study was to evaluate the effect of harm reduction programs on the smoking patterns of subjects who presented to a smoking cessation clinic in Tehran, Iran. This observational study was conducted between September 2008 - September 2009 on 132 patients who were unable to quit smoking. Patients were enrolled by the first come first service method. During the study period, subjects were assigned to either group or individual visits every 15 days in conjunction with the use of nicotine gum. The main objective of this study was to evaluate at the third and sixth months of follow-up: the number of smoked cigarettes, level of expired carbon monoxide (CO), and numbers of nicotine gum used. Data were analyzed by the Wilcoxon rank, Fisher's exact, and Pearson's chi-square tests and SPSS version 17 software. A total of 87.1% of the subjects were males. We noted decreases in the number of cigarettes smoked daily and the level of expired CO, whereas the amount of nicotine gum used significantly increased during the time interval between the first session and the third and sixth month follow-up visits (p < 0.001 for all variables). During the follow up sessions, 64.4% of subjects reduced the number of cigarettes they smoked daily by at least 50% and 12.9% of subjects quit smoking. Behavioral and pharmacological therapy in harm reduction programs result in a decrease in the number of cigarettes smoked daily and a reduction in the amount of expired CO. Therefore, these methods can be beneficial in achieving complete smoking cessation.
  Archives of Iranian medicine 05/2012; 15(5):283-9. · 0.97 Impact Factor
• Article: Diagnostic yield of post-bronchoscopy sputum smear in pulmonary tuberculosis.

  Majid Malekmohammad, Majid Marjani, Payam Tabarsi, Parvaneh Baghaei, Zahra Sadr, Parisa Adimi Naghan, Davoud Mansouri, Mohammad Reza Masjedi, Ali Akbar Velayati
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  ABSTRACT: The early definitive diagnosis of pulmonary tuberculosis (TB) is important for control of the disease in the community. We performed this study to evaluate the additional gain of post-bronchoscopy sputum in the diagnosis of pulmonary TB. Bronchoscopy and bronchoalveolar lavage were performed for 126 patients suspected of pulmonary TB who either had 3 negative sputum smears for acid-fast bacilli or could not expectorate. After bronchoscopy the patients were asked to give sputum samples for 3 consecutive days. All of the obtained specimens were investigated for Mycobacterium tuberculosis by smear and culture. Pulmonary TB was confirmed in 56 patients. Among all confirmed cases, the sensitivity of bronchoalveolar lavage smear was 57.1% (32 of 56), sensitivity of post-bronchoscopy smear was 76.7% (43 of 56), and the yield of a combination of the 2 methods was 83.9% (47 of 56). Results of post-bronchoscopy sputum smears were not significantly related to sex, age, human immunodeficiency virus (HIV) infection, presence of cavitary lesions on chest X-ray, or the ability to expectorate before bronchoscopy (p > 0.05). Evaluation of post-bronchoscopy sputum smears is helpful for earlier diagnosis of pulmonary TB and is an inexpensive and accessible assay.
  Scandinavian Journal of Infectious Diseases 05/2012; 44(5):369-73. · 1.72 Impact Factor
• Article: AssessMent of ProphylAxis for VenouS ThromboembolIsm in Hospitalized Patients: The MASIH Study.

  Babak Sharif-Kashani, Payman Shahabi, Sasan Raeissi, Neda Behzadnia, Alireza Shoaraka, Mahan Shahrivari, Leila Saliminejad, Saviz Pozhhan, Mohammad-Reza Hashemian, Mohammad-Reza Masjedi, Behnood Bikdeli
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  ABSTRACT: Background: Venous thromboembolism (VTE) accounts for several cases of in-hospital mortality (over 100 000 deaths annually in the West). Despite the existence of effective prophylaxis guidelines for at-risk patients, the guidelines adherence is missing. Methods: We evaluated the thromboprophylaxis reception and appropriateness based on the eighth edition of the American College of Chest Physicians (ACCP) guidelines on VTE prophylaxis, among hospitalized patients of a World Health Organization (WHO)-collaborating teaching hospital in a 3-month period. Results: From the 904 evaluated cases, 481 entered the study. Appropriate decision on whether to prophylaxe or not, was made in 305 (63.40%), however, complete appropriateness (considering correct regimen type, dosing, and duration) was seen only in 229 patients (47.60%). The ACCP risk for VTE was the strongest predictor of thromboprophylaxis prescription (odds ratio [OR]: 2.62, 95% confidence interval [CI]: 1.35-5.05). Conclusions: Our thromboprophylaxis results were comparable to that of Western countries. Improved thromboprophylaxis appropriateness, which requires improving the physicians' thromboprophylaxis awareness and knowledge, could reduce the rate of in-hospital VTE and translate into better patient care.
  Clinical and Applied Thrombosis/Hemostasis 03/2012; 18(5):462-8. · 1.33 Impact Factor
• Article: Diagnostic yield of post-bronchoscopy sputum smear in pulmonary tuberculosis.

  Majid Malekmohammad, Majid Marjani, Payam Tabarsi, Parvaneh Baghaei, Zahra Sadr, Parisa Adimi Naghan, Davoud Mansouri, Mohammad Reza Masjedi, Ali Akbar Velayati
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  ABSTRACT: Background: The early definitive diagnosis of pulmonary tuberculosis (TB) is important for control of the disease in the community. We performed this study to evaluate the additional gain of post-bronchoscopy sputum in the diagnosis of pulmonary TB. Methods: Bronchoscopy and bronchoalveolar lavage were performed for 126 patients suspected of pulmonary TB who either had 3 negative sputum smears for acid-fast bacilli or could not expectorate. After bronchoscopy the patients were asked to give sputum samples for 3 consecutive days. All of the obtained specimens were investigated for Mycobacterium tuberculosis by smear and culture. Results: Pulmonary TB was confirmed in 56 patients. Among all confirmed cases, the sensitivity of bronchoalveolar lavage smear was 57.1% (32 of 56), sensitivity of post-bronchoscopy smear was 76.7% (43 of 56), and the yield of a combination of the 2 methods was 83.9% (47 of 56). Results of post-bronchoscopy sputum smears were not significantly related to sex, age, human immunodeficiency virus (HIV) infection, presence of cavitary lesions on chest X-ray, or the ability to expectorate before bronchoscopy (p > 0.05). Conclusion: Evaluation of post-bronchoscopy sputum smears is helpful for earlier diagnosis of pulmonary TB and is an inexpensive and accessible assay.
  Scandinavian Journal of Infectious Diseases 01/2012; · 1.72 Impact Factor
• Article: Recurrence after treatment success in pulmonary multidrug-resistant tuberculosis: predication by continual PCR positivity.

  Ali Akbar Velayati, Parissa Farnia, Mohammad Reza Masjedi
  International journal of clinical and experimental medicine 01/2012; 5(3):271-2.
• Article: Pulmonary disease caused by Mycobacterium simiae in Iran's national referral center for tuberculosis.

  Parvaneh Baghaei, Payam Tabarsi, Parissa Farnia, Majid Marjani, Fatemeh Maryam Sheikholeslami, Mahsa Chitsaz, Pegah Gorji Bayani, Masoud Shamaei, Davood Mansouri, Mohammad Reza Masjedi, Ali Akbar Velayati
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  ABSTRACT: Several species of non-tuberculosis mycobacteria (NTM) can affect humans and can cause either symptomatic or asymptomatic infection. This study aimed to determine the clinical and radiological manifestation, as well as the treatment, of M. simiae in patients in Masih Daneshvari Hospital, a TB referral hospital in Iran. This retrospective study involved all patients presenting to our referral center from 2002 to 2009, with confirmation of M. simiae pulmonary infection. For all patients, sputum smear and culture for identification was performed, as was drug susceptibility testing. Additionally, PCR identification methods for NTM, and high-resolution CT scan were conducted. All patients were treated according to American Thoracic Society recommendations. In total, 26 cases of M. simiae were identified in our center. The mean age of the patients was 58.23 ± 16.9years. Only one patient was HIV positive, and all but one were Iranian. The most frequent symptom was coughing (92.3%), and 100% of the patients had nodular lesions. In addition, bronchiectasis and cavitation were present in 84.6% and 88.5% respectively. All the patients were resistant to every first-line drug. Two patients failed the treatment, and twenty-four were cured, after which no recurrence of the disease was observed. M. simiae may present with clinical and radiological manifestations consistent with tuberculosis, and be resistant to anti-TB agents. A more efficient treatment for NTMs such as M. simiae is needed, to shorten the period of treatment and proved fewer adverse effects than current therapies.
  The Journal of Infection in Developing Countries 01/2012; 6(1):23-8. · 1.19 Impact Factor
• Article: Morphological modification by Tubercle bacilli: no time for denial.

  Ali Akbar Velayati, Parissa Farnia, Mohammad Reza Masjedi, Gennady Konstantinovich Zhavnerko, Jalaledin Ghanavi, Nikolai Nikolaevich Poleschuyk
  The Journal of Infection in Developing Countries 01/2012; 6(1):97-9. · 1.19 Impact Factor
• Article: Chest physicians' knowledge of appropriate thromboprophylaxis: insights from the PROMOTE study.

  Behnood Bikdeli, Babak Sharif-Kashani, Sasan Raeissi, Solmaz Ehteshami-Afshar, Neda Behzadnia, Mohammad-Reza Masjedi
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  ABSTRACT: Venous thromboembolism (VTE) is a major cause of in-hospital mortality. Several international guidelines provide thromboprophylaxis recommendations; however, guidelines adherence is missing worldwide. We evaluated the chest physicians' knowledge regarding VTE prophylaxis, using a systematically developed questionnaire. The Prophylaxis-foR-venOus-throMbOembolism-assessmenT-questionnairE (PROMOTE) questionnaire was developed using an algorithm encompassing the most important VTE prophylaxis topics and included 13 clinical scenarios. Responses were evaluated with reference to the eighth edition of American College of Chest Physicians guidelines for VTE prevention to assess thromboprophylaxis appropriateness. The questionnaires were distributed during the fourth International Congress on Pulmonary Disease, Intensive Care and Tuberculosis. From the 88 received questionnaires (response rate: 39.8%), 82 were acceptable (62 men, 20 women). The most commonly cited VTE risk factors were immobility (79.2%), surgery (68.2%), and cancer (60.9%). The mean correct response ratio to the questions was 67% [95% confidence interval (CI) 64-70%] with highest appropriateness ratios amongst cardiologists (77.1 ± 5.8%) and lowest ratios among thoracic surgeons (59.2 ± 5%). Physicians' specialty had a significant effect on the overall appropriateness (P = 0.04) and most of appropriateness subcategories. Thoracic surgeons had the lowest rate of over-prophylaxis (P = 0.02). Years passed from graduation were inversely associated with overall appropriateness (P = 0.006). Physicians with academic engagements had a higher overall appropriateness (P = 0.04). We found a wide gap between the guideline recommendations and the responses. PROMOTE is the first systematically developed questionnaire that addresses chest physicians' thromboprophylaxis knowledge and could be useful to strategies to improve VTE prophylaxis. Because of the dissimilar prophylaxis pitfalls of different specialists, distinct educational programs seem necessary to improve their knowledge of proper VTE prophylaxis.
  Blood coagulation & fibrinolysis: an international journal in haemostasis and thrombosis 12/2011; 22(8):667-72. · 1.25 Impact Factor
• Article: Utility of Gastric Lavage for Diagnosis of Tuberculosis in Patients who are Unable to Expectorate Sputum.

  Parvaneh Baghaei, Payam Tabarsi, Parisa Farnia, Amir Hoseyn Radaei, Mehdi Kazempour, Yazdan Ali Faghani, Mehdi Mirsaeidi, Atieh Novin, Ehsan Chitsaz, Davoud Mansouri, Mohammad Reza Masjedi, Ali Akbar Velayati
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  ABSTRACT: There are number of patients who are unable to expectorate sputum specimens. In this study, we used gastric lavage (GL) test for diagnosis of tuberculosis (TB) in patients who were unable to produce sputum. Patients who were unable to produce sputum specimens were included in the study to confirm TB disease. Gastric lavage sampling was performed and sent for acid fast bacillus smear and culture under special laboratory conditions and sterilized methods. Further bronchoscopy for broncho-alveolar lavage was done on patients with negative GL smear results. Drug susceptibility tests were performed on 48 GL culture positive cases. Eighty-five patients were included in the study; who were hospitalized at our referral center for suspected TB. GL smears were reported to be positive in 37 cases (66.07%) and culture in 85.7%. The total number of smear and culture-positive cases in this study was 48 (85.7%). Forty cases (87%) of drug-sensitive, 1 case (2.2%) of isoniazid and rifampin-resistant TB (multi-drug resistant; MDR), and 5 cases of resistant to one drug were detected. There have not been observed any complications after the GL method. It seems that regarding the high number of positive GL cultures (85.7%), GL can be effective for diagnosis of patients who have suspicious tuberculosis symptoms and are unable to produce sputum especially in resource limited areas.
  Journal of global infectious diseases 10/2011; 3(4):339-43.
• Source

  Available from: PubMed Central

  Article: Normal dimensions of trachea and two main bronchi in the Iranian population.

  Nina Zahedi-Nejad, Mehrdad Bakhshayesh-Karam, Shahram Kahkoei, Azizola Abbasi-Dezfoully, Mohammad Reza Masjedi
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  ABSTRACT: The purpose of this study was to determine the normal diameters of larger airways in the Persian population, since these demographic variables are essential for interpretation of chest CTs and/or plain X-rays. During a 6-month period, sagittal and coronal diameters of tracheas of all cases admitted for a chest CT to the radiology department of the National Research Institute of Tuberculosis and Lung Disease (NRITLD) were measured. The patients had to accept to take part in the study and had to fulfill the inclusion and exclusion criteria of the study. Ninety-nine percent confidence intervals (99% CI) were used to define the upper and lower limits of normal. Two hundred subjects, including 132 men and 68 women aged 20-85 years, were studied. CORONAL AND SAGITTAL DIAMETERS OF TRACHEAS IN THE UPPER PART WERE AS FOLLOWS: 1.8±0.24 and 2.06±0.27cm for men, and 1.48±0.20 and 1.49±0.24 for women, respectively. For the lower part that was: 1.8±0.23, 1.86±0.27, 1.51±0.18, and 1.46±0.23, respectively. For the right and left main-stem bronchi the values were as follows: 1.16±0.17 and 1.02±0.22 for men and 0.93±0.13 and 0.81±0.13 for women, respectively. The values determined by us had a narrower range of normality than the ones found in the previous reports, so they will stay more friendly for interpretation of individual cases.
  Polish journal of radiology / Polish Medical Society of Radiology. 10/2011; 76(4):28-31.
• Article: Predicting arterial blood gas values from venous samples in patients with acute exacerbation chronic obstructive pulmonary disease using artificial neural network.

  Mohammad Reza Raoufy, Parivash Eftekhari, Shahriar Gharibzadeh, Mohammad Reza Masjedi
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  ABSTRACT: Arterial blood gas (ABG) has an important role in the clinical assessment of patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD). Because of ABG complications, an alternative method is beneficial. We have trained and tested five artificial neural networks (ANNs) with venous blood gas (VBG) values (pH, PCO(2), HCO(3), PO(2), and O(2) saturation) as inputs, to predict ABG values in patients with AECOPD. Venous and arterial blood samples were collected from 132 patients. Using the data of 106 patients, the ANNs were trained and validated by back-propagation algorithm. Subsequently, data from the remainder 26 patients was used for testing the networks. The ability of ANNs to predict ABG values and to detect significant hypercarbia was assessed and the results were compared with a linear regression model. Our results indicate that the ANNs provide an accurate method for predicting ABG values from VBG values and detecting hypercarbia in AECOPD.
  Journal of Medical Systems 08/2011; 35(4):483-8. · 1.13 Impact Factor