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Article ; Online: Sepsis Criteria and Revision in Toxicological Intensive Care Unit

Haleh Talaie / Maryam Nazari / Habib Emami

International Journal of Medical Toxicology and Forensic Medicine, Vol 10, Iss

2020 Volume 4

Abstract: Background: Sepsis is one of the significant causes of mortality in hospitalized patients. This cross-sectional study was performed to determine the frequency of positive blood culture and assess sepsis criteria based on Third International Consensus ... ...

Abstract	Background: Sepsis is one of the significant causes of mortality in hospitalized patients. This cross-sectional study was performed to determine the frequency of positive blood culture and assess sepsis criteria based on Third International Consensus Definitions (related to Sequential Organ Failure Assessment score) and clinical and paraclinical findings (i.e., on-admission leukocytosis, increased lactate level, and fever) in poisoned patients admitted to the Toxicological Intensive Care Unit (TICU). Methods: Medical records of a total of 2000 poisoned patients admitted to the TICU of Loghman Hakim Hospital from 2016 to 2018 were assessed. Among them, 189 cases (9.45%) with suspected sepsis were considered eligible to be enrolled in the study. Results: Of 189 cases, 146 (77.24%) had possible signs and symptoms of sepsis as well as SOFA score higher than two with positive blood culture in 81 cases (55%). The Mean±SD serum level of lactate was 25.97±16.32 on admission. The most common pathogen detected in blood culture was coagulase-negative Staphylococci in 35 (24.0%) out of 146 cases. Glasgow Coma Scale (GCS) less than 12, age older than 50 years, and bilirubin more than 1.2 mg/dL were found as independent predictors of sepsis on multivariate analysis. Conclusion: Based on our findings, it is proposed that the sepsis definition should not be restricted to the guidelines. The patients’ poisoning background and presence of many confounding factors, including poisoning-induced on-admission increased lactate levels, leukocytosis, and disturbed arterial blood gas provide a critical decision-making situation to confirm sepsis according to guidelines.
Keywords	blood culture ; intensive care unit ; lactate ; sepsis ; toxicity ; Medicine (General) ; R5-920 ; Toxicology. Poisons ; RA1190-1270
Subject code	610
Language	English
Publishing date	2020-11-01T00:00:00Z
Publisher	Shaheed Beheshti University of Medical Sciences
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Bidirectional Association Between COVID-19 and Mental Health Disorders

Haleh Talaie / Sayed Masoud Hosseini / Maryam Nazari / Farzad Nazemi

International Journal of Medical Toxicology and Forensic Medicine, Vol 11, Iss 3, p

A Narrative Review

2021 Volume 34101

Abstract: Background: Fear, anxiety, and stress are natural reactions of the human body to unpredictable and potentially threatening conditions. Currently, individuals are encountering Coronavirus Disease 2019 (COVID-19) pandemic; it is caused by a virulent, ... ...

Abstract	Background: Fear, anxiety, and stress are natural reactions of the human body to unpredictable and potentially threatening conditions. Currently, individuals are encountering Coronavirus Disease 2019 (COVID-19) pandemic; it is caused by a virulent, partially unknown pathogen with high transmissibility, recognized as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). It is conceivable to experience anxiety, stress, and subsequent mental health disorders during the pandemic. This narrative review provided a brief overview of mechanisms involved in COVID-19 and mental health disorders as well as the bidirectional association between them. Methods: Scientific electronic databases, such as PubMed, Scopus, Web of Science, and Google Scholar were thoroughly searched, based on different keywords in this study. Results: Lifestyle changes and isolation for breaking the chain of infection facilitate mental health disorders development more than before. Since the onset of the pandemic, the prevalence of mental health disorders has significantly increased. Moreover, studies suggested that the incidence of COVID-19 and the progression of the disease to a severe and life-threatening stage is higher in individuals with a history of mental health disorders. Inflammation is caused by, also may cause mental health disorders. Besides, COVID-19 is associated with cytokine storm and subsequent inflammation. Conclusion: There seems to be a bidirectional association between COVID-19 and mental health disorders, in which inflammation acts as an adaptor.
Keywords	coronavirus disease 2019 (covid-19) ; severe acute respiratory syndrome coronavirus 2 (sars-cov- 2) ; mental disorders ; cytokine release syndrome ; inflammation ; Medicine (General) ; R5-920 ; Toxicology. Poisons ; RA1190-1270
Subject code	150
Language	English
Publishing date	2021-08-01T00:00:00Z
Publisher	Shaheed Beheshti University of Medical Sciences
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The Low Prevalence of Hepatitis C Virus and Human Immunodeficiency Virus Coinfection and Hepatitis C Virus Mono-Infection Among Methadone Toxicity Patients

Haleh Talaie / Atieh Mousavizadeh / Behjat Barari

International Journal of Medical Toxicology and Forensic Medicine, Vol 10, Iss 1, p

2020 Volume 28457

Abstract: the incidence of Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV) coinfection in People Who Inject Drugs (PWIDs) is a public health issue; it presents various contentions to the healthcare providers. Although antiretroviral therapy improved ...

Abstract	the incidence of Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV) coinfection in People Who Inject Drugs (PWIDs) is a public health issue; it presents various contentions to the healthcare providers. Although antiretroviral therapy improved the life expectancy of HIV-infected people, HCV-related mortality turned into a greater concern among these individuals [1]. AccFurthermore, they mentioned, “injecting drug users in the Taipei methadone maintenance treatment program had a very high prevalence of HIV/ HBV coinfection and HCV mono-infection”[2]. Besides, a systematic review and meta-analysis results suggested a high frequency of HIV/HBV coinfection (>80%) in Intravenous (IV) drug users [3]. Although the incidence of HIV among IV drug users has been decreased, HCV is still endemic in this population [4]. We aimed to estimate HCV/HIV coinfection frequency and its related risk factors among methadone poisoned patients who were admitted to the Loghman Hakim poisoning center between March 2012 and March 2017. Loghman-Hakim Hospital is a unique poisoning referral center in Tehran, Iran, that admits patients from all cities in Tehran Province, Iran. Annually, around 20000 hospitalized patients are observed and treated in this center, with 80-100 patients daily turn-over. The required data were collected using a questionnaire, clinical examinations, and laboratory findings. The patients with a history of infectious diseases, like hepatitis B or C, HIV, and IV drug consumption, were excluded from the present research. The obtained blood samples were screened for antibodies to HCV and HIV using a commercially available Enzyme-Linked Immunosorbent Assay (ELISA). Furthermore, the relevant urine samples were analyzed for the presence of methadone with a rapid test. Among 200 participants, 134 (67%) were male, and 66 (33%) were female with the age range of 1 to 83 years. The methadone serum levels of 129 (64.5%) patients were positive, 39 (19.5%) were negative, and 32 (16%) patients were not examined due to ...
Keywords	methadone toxicity ; co-infection ; hiv ; hcv ; Medicine (General) ; R5-920 ; Toxicology. Poisons ; RA1190-1270
Subject code	360
Language	English
Publishing date	2020-01-01T00:00:00Z
Publisher	Shaheed Beheshti University of Medical Sciences
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Hepatotoxicity Among Poisoned Patients

Arezou Mahdavinejad / Haleh Talaie / Ali Saffaei / Mitra Rahimi / Sayed Masoud Hosseini

International Journal of Medical Toxicology and Forensic Medicine, Vol 12, Iss 4, Pp 38931-

A Cross-sectional Study

2022 Volume 38931

Abstract: Background: Drug-induced liver injury is a major cause of hepatitis worldwide. In patients diagnosed with acute poisoning, drug-induced liver injury is a critical challenge. This study aims to evaluate the pattern of hepatotoxicity in poisoned patients ... ...

Abstract	Background: Drug-induced liver injury is a major cause of hepatitis worldwide. In patients diagnosed with acute poisoning, drug-induced liver injury is a critical challenge. This study aims to evaluate the pattern of hepatotoxicity in poisoned patients admitted to Loghman Hakim Hospital. Methods: In this cross-sectional study that was conducted at Loghman Hakim hospital, the clinical records of poisoned patients were evaluated and patients with hepatotoxicity were selected for final analysis. The clinical and para-clinical information of these patients was recorded. The SPSS software, version 23. was used for statistical analysis. Results: A total of 260 cases were included in this study. The Mean±SD age of patients was 38.24±16.29 years and most of them were male (79.2%). Patients with narcotics poisoning had the highest prevalence (38.5%), especially when they were taken together with acetaminophen or benzodiazepine. In addition, among the patients studied, those with underlying cardiovascular disease are more likely to develop hepatotoxicity. Conclusion: In conclusion, among people with various types of poisoning, it seems that narcotics (opium, heroin, methadone, etc.), particularly when taken together with acetaminophen or benzodiazepines, cause hepatotoxicity and increase serum levels of liver aminotransferases. Also, in the study population, patients with underlying cardiovascular disease had a higher chance of liver injury. Therefore, clinicians are recommended to accurately monitor the sign and symptoms of hepatotoxicity in these populations.
Keywords	drug-induced hepatotoxicity ; poisoning ; overdose ; liver ; Medicine (General) ; R5-920 ; Toxicology. Poisons ; RA1190-1270
Subject code	610
Language	English
Publishing date	2022-10-01T00:00:00Z
Publisher	Shaheed Beheshti University of Medical Sciences
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Risk Factors of Hospital-acquired Thrombocytopenia in Toxicological Intensive Care Unit

Haleh Talaie / Sayed Masoud Hosseini / Maryam Nazari / Mehdi Salavati Esfahani / Behjat Barari

International Journal of Medical Toxicology and Forensic Medicine, Vol 10, Iss

2020 Volume 3

Abstract: Background: Platelet count is a readily available biomarker predicting disease severity and risk of mortality in the intensive care units (ICU). This study aims to describe the frequency, to assess the risk factors, and to evaluate the impact of ... ...

Abstract	Background: Platelet count is a readily available biomarker predicting disease severity and risk of mortality in the intensive care units (ICU). This study aims to describe the frequency, to assess the risk factors, and to evaluate the impact of thrombocytopenia on patient outcomes in a Toxicological ICU (TICU). Methods: In this prospective observational Cohort study, we enrolled 184 patients admitted to our TICU from October 1st, 2019, to August 23rd, 2020. Mild/moderate and severe thrombocytopenia were defined as at least one platelet counts less than 150×103/µL and 50×103/µL during the ICU stay, respectively. Results: Of 184 enrolled patients, 45.7% had mild to moderate thrombocytopenia and 5.4% had severe thrombocytopenia. Old age (OR: 1.042, 95%CI: 1.01-1.075, P=0.01), male gender (OR: 4.348, 95%CI: 1.33-14.22, P=0.015), increased international normalized ratio (INR) levels (OR: 3.72, 95%CI: 1.15-112, P=0.028), and administration of some medications including heparin (OR: 3.553, 95%CI: 1.11-11.36, P=0.033), antihypertensive drugs (OR: 2.841, 95%CI: 1.081-7.471, P=0.034), linezolid (OR: 13.46, 95%CI: 4.75-38.13, P<0.001), erythromycin (OR: 19.58, 95%CI: 3.23-118.86, P=0.001), and colistin (OR: 10.29, 95% CI 1.44-73.69, P=0.02) were the risk factors of hospital-acquired thrombocytopenia. The outcomes of patients with normal platelet count were significantly better than those who developed thrombocytopenia (P<0.001). Conclusion: We found that thrombocytopenia could develop in almost 50% of patients admitted to TICU, which is associated with poor prognosis. Additionally, the platelet counts should be closely monitored to administer some medications (heparin, antihypertensive drug, and linezolid), especially in old patients.
Keywords	thrombocytopenia ; poisoning ; intensive care unit (icu) ; patient outcome assessment ; risk factors ; Medicine (General) ; R5-920 ; Toxicology. Poisons ; RA1190-1270
Subject code	610
Language	English
Publishing date	2020-09-01T00:00:00Z
Publisher	Shaheed Beheshti University of Medical Sciences
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Unexpected Treatment in a Severe Covid-19 Patient with Essential Thrombocythemia Who Received Oseltamivir and Hydroxychloroquine

Talaie, Haleh / Nazari, Maryam / Hosseini, Sayed Masoud / Ghanean, Helia

International Pharmacy Acta; Vol. 3 No.; 3e7:1-4 ; 2645-3266 ; 2645-3258

A Covid-19 Patient With Thrombocythemia

2020 Volume 1

Abstract: Introduction: Novel coronavirus disease (Covid-19) has been recognized as a new human infectious disease caused by a mutated type of coronavirus that might be associated with thrombocytopenia through different mechanisms. Moreover, the presence of ... ...

Abstract	Introduction: Novel coronavirus disease (Covid-19) has been recognized as a new human infectious disease caused by a mutated type of coronavirus that might be associated with thrombocytopenia through different mechanisms. Moreover, the presence of underlying disease is a risk of hospitalization and poor prognosis of Covid-19. Case report: Here, we describe a 77-year-old male Covid-19 patient with essential thrombocythemia. Although gastrointestinal symptoms (GI) were uncommon in the early stages of the pandemic, he presented to a clinic with GI symptoms and general weakness. He didn't have any respiratory involvement and laboratory tests revealed a hemoglobin and platelet reduction (810000/micL to 174000/micL), leukopenia, and elevated D-dimer. He received oseltamivir (75 mg twice daily) and hydroxychloroquine (200 mg twice daily) for five days. Discussion & Conclusions: Despite his underlying disease and severity of illness including one-month fever, malaise, and a weight loss of 11 kg in ten days, he was cured without any hospitalization.
Keywords	Covid-19 ; Essential thrombocythemia ; Gastrointestinal symptoms ; Platelet ; covid19
Language	English
Publishing date	2020-09-21
Publisher	International Pharmacy Acta
Publishing country	ir
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: High sensitivity versus low level of vancomycin needs to be concern for another alternative anti- Staphylococcus aureus as the first- line antibiotic.

Talaie, Haleh / Mousavizadeh, Atieh / Emami, Habib / Gachkar, Latif / Barari, Behjat / Alijanzadeh, Mohammad Hossein

Acta bio-medica : Atenei Parmensis

2019 Volume 90, Issue 4, Page(s) 498–503

Abstract: Background and aim: Vancomycin has been the first-line therapy for MRSA infection disease for many years. According to standard guidelines, the therapeutic vancomycin trough concentration should be above 10 mg/L and optimally between 15-20 mg/L. The aim ...

Abstract	Background and aim: Vancomycin has been the first-line therapy for MRSA infection disease for many years. According to standard guidelines, the therapeutic vancomycin trough concentration should be above 10 mg/L and optimally between 15-20 mg/L. The aim of this study was to evaluate vancomycin trough level concentration in patients infected with MRSA. Methods: This cross- sectional study included a sample of 170 patients admitted to the ICU of Loghman hospital. We used a standard questionnaire, then applied appropriate statistical tests. All collected data had been analyzed and interpreted by IBM SPSS Statistics 19.0. Results: Among this study population, 71.8% was male. Just 20.8% of the patients can reach the therapeutic level trough even after changing the dose. It should be noted that a significant percentage of toxicity was observed after increasing the dose. Conclusions: Even though high sensitivity against vancomycin disc has been seen in antibiogram tests, sufficient efficiency has not been distinguished, in the sense that, just a few patients by low trough level concentration, reached to therapeutic level after the dose change. Based on some sources, because of the side effects and limited safe range of vancomycin, we should consider a new approach to the alternative antibiotics. (www.actabiomedica.it).
MeSH term(s)	Anti-Bacterial Agents/administration & dosage ; Anti-Bacterial Agents/pharmacology ; Cross-Sectional Studies ; Female ; Humans ; Male ; Methicillin-Resistant Staphylococcus aureus/drug effects ; Microbial Sensitivity Tests ; Staphylococcal Infections/drug therapy ; Vancomycin/administration & dosage ; Vancomycin/pharmacology
Chemical Substances	Anti-Bacterial Agents ; Vancomycin (6Q205EH1VU)
Language	English
Publishing date	2019-12-23
Publishing country	Italy
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2114240-3
ISSN	2531-6745 ; 0392-4203
ISSN (online)	2531-6745
ISSN	0392-4203
DOI	10.23750/abm.v90i4.7646
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Article ; Online: Is there any potential management against COVID-19? A systematic review and meta-analysis.

Talaie, Haleh / Hosseini, Sayed Masoud / Nazari, Maryam / Fakhri, Yadollah / Mousavizadeh, Atieh / Vatanpour, Hossein / Firoozfar, Ali

Daru : journal of Faculty of Pharmacy, Tehran University of Medical Sciences

2020 Volume 28, Issue 2, Page(s) 765–777

Abstract: Purpose: A recent survey has shown that the COVID-19 pandemic has culminated in dramatical and critical treatment particularly in acute infected patients. In fact, this systematic review-meta-analysis was directly pertained to estimation at the ... ...

Abstract	Purpose: A recent survey has shown that the COVID-19 pandemic has culminated in dramatical and critical treatment particularly in acute infected patients. In fact, this systematic review-meta-analysis was directly pertained to estimation at the efficient value of some clinical managements to confront the COVID-19 infection. Methods: Pubmed, Embase, Scopus, Cochrane, and Scholar databases were searched from inception to July 1, 2020, to identify studies reporting the current treatment process and medications (e.g. hydroxychloroquine, antiviral therapy, convalescent plasma, and immunomodulatory agents) for COVID-19. A random-effects model meta-analysis was performed to calculate the relative risk (RR) with 95% confidence intervals (CI). The outcomes of this study were the frequency of negative conversion cases, clinical improvements, mechanical ventilation demand, intensive care unit (ICU) entry, and mortality. The standard treatment refers to the published guidelines and specialist experience which varies in different articles, and the proposed treatment refers to the kind of interest suggested in the included studies. Results: A number of 45 articles met the eligibility criteria (out of 6793 articles). Among them, 26 articles involving 3263 patients were included in quantitative analysis. Anti-COVID-19 interventions could significantly increase clinical improvement (RR 1.17, 95% CI 1.08-1.27; I Conclusion: Based on our findings, all the included interventions significantly declined the mortality and enhanced clinical improvements with no effect on negative conversion and mechanical ventilation demand. Especially, immunomodulators and plasma therapy showed favorable outcomes. An evaluation on the efficacy of proposed treatment against COVID-19.
MeSH term(s)	Antiviral Agents/administration & dosage ; COVID-19/mortality ; COVID-19/therapy ; COVID-19/virology ; Humans ; Immunization, Passive/methods ; Immunologic Factors/therapeutic use ; Intensive Care Units ; Respiration, Artificial ; COVID-19 Serotherapy
Chemical Substances	Antiviral Agents ; Immunologic Factors
Keywords	covid19
Language	English
Publishing date	2020-08-18
Publishing country	Switzerland
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	2129183-4
ISSN	2008-2231 ; 1560-8115
ISSN (online)	2008-2231
ISSN	1560-8115
DOI	10.1007/s40199-020-00367-4
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Article ; Online: Is there any potential management against COVID-19? A systematic review and meta-analysis

Talaie, Haleh / Hosseini, Sayed Masoud / Nazari, Maryam / Fakhri, Yadollah / Mousavizadeh, Atieh / Vatanpour, Hossein / Firoozfar, Ali

DARU Journal of Pharmaceutical Sciences ; ISSN 2008-2231

2020

Keywords	covid19
Language	English
Publisher	Springer Science and Business Media LLC
Publishing country	us
Document type	Article ; Online
DOI	10.1007/s40199-020-00367-4
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The Impact of Current COVID-19 Therapeutics on Patients’ Clinical Improvements Based on Disease Severity; A Systematic Review.

Talaie, Haleh / Nazari, Maryam / Hosseini, Sayed Masoud / Mousavizadeh, Atieh / Alavi-Darazam, Ilad / Vatanpour, Hossein

International Pharmacy Acta; Vol. 3 No.; 3e10:1-16 ; 2645-3266 ; 2645-3258

The Evaluation of Current Anti-COVID-19 Medications

2020 Volume 1

Abstract: Introduction: COVID-19 pandemic is not a new issue that encompasses the entire world. It is becoming increasingly urgent to find effective medications. This systematic review was conducted to discuss the clinical impact of some proposed managements ... ...

Abstract	Introduction: COVID-19 pandemic is not a new issue that encompasses the entire world. It is becoming increasingly urgent to find effective medications. This systematic review was conducted to discuss the clinical impact of some proposed managements against COVID-19. Methods: PubMed, Scopus, Cochrane Library, Embase, and Google Scholar databases were searched from their inception to June 15, 2020, to identify studies reporting the current treatment process and medications for COVID-19. Results: After searching databases, a total of 5450 articles were assessed. A number of 42 relevant studies were identified as eligible for the review including a total of 5599 patients. The severity of illness was investigated in 5053 cases including 3169 mild or mild to moderate or moderate, 222 moderate to severe, and 1662 severe cases. Among the therapeutics reported in these studies, 15 medications besides convalescent plasma showed some evidence of antiviral activity. Antivirals (34%; 14/42), especially lopinavir/ritonavir, were the main classes of therapeutic agents evaluated against COVID-19. Approximately, 14.3% (6/42) of the studies which assessed the impact of hydroxychloroquine and azithromycin, convalescent plasma therapy, lopinavir/ritonavir plus azithromycin, methylprednisolone, and interferon α-2b, have reported clinical improvement in all cases. A number of 10 studies (23.81%) exhibited a negative conversion of SARS-CoV-2 in all cases. Conclusions: Based on our findings, considering the diverse and scattered effects of current medications on clinical outcomes and the rate of negative conversion of SARS-CoV-2, large clinical trials are required to evaluate the best treatment options for COVID-19.
Keywords	COVID-19 ; Clinical improvement ; Medications ; SARS-CoV-2 ; Systematic review ; covid19
Subject code	610
Language	English
Publishing date	2020-10-31
Publisher	International Pharmacy Acta
Publishing country	ir
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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