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Article: Invasive aspergillosis in liver transplant recipients, an infectious complication with low incidence but significant mortality.

Farahani, Azam / Ghiasvand, Fereshteh / Davoudi, Setareh / Ahmadinejad, Zahra

World journal of transplantation

2023 Volume 13, Issue 5, Page(s) 264–275

Abstract: Background: Infections, including invasive fungal infections (IFIs), are among the leading causes of mortality in liver transplant recipients during the first year post-transplantation.: Aim: To investigate the epidemiology, clinical manifestations, ... ...

Abstract	Background: Infections, including invasive fungal infections (IFIs), are among the leading causes of mortality in liver transplant recipients during the first year post-transplantation. Aim: To investigate the epidemiology, clinical manifestations, risk factors, treatment outcomes, and mortality rate of post-liver transplantation invasive aspergillosis (IA). Methods: In this case-control study, 22 patients with IA were identified by reviewing the archived and electronic medical records of 850 patients who received liver transplants at the Imam Khomeini Hospital complex in Tehran, Iran, between 2014 and 2019. The control group comprised 38 patients without IA infection matched for age and sex. The information obtained included the baseline characteristics of liver transplant patients, operative reports, post-transplantation characteristics of both groups and information about the fungal infection of the patient group. Results: The prevalence rate of IA among liver transplant recipients at Imam Khomeini Hospital was 2.7%. The risk factors of IA among studied patients included high serum creatinine levels before and post-transplant, renal replacement therapy, antithymocyte globulin induction therapy, post-transplant bile leakage, post-transplant hepatic artery thrombosis, repeated surgery within 30 d after the transplant, bacterial pneumonia before the aspergillosis diagnosis, receiving systemic antibiotics before the aspergillus infection, cytomegalovirus infection, and duration of post-transplant hospitalization in the intensive care unit. The most prevalent form of infection was invasive pulmonary aspergillosis, and the most common chest computed tomography scan findings were nodules, pleural effusion, and the halo sign. In the case group, prophylactic antifungal therapy was administered more frequently than in the control group. The antifungal therapy response rate at 12 wk was 63.7%. The 3- and 12- mo mortality rates of the patients with IA were 36.4% and 45.4%, respectively (compared with the mortality rate of the control group in 12 mo, which was zero). Conclusion: In this study, the prevalence of IA among liver transplant recipients was relatively low. However, it was one of the leading causes of mortality following liver transplantation. Targeted antifungal therapy may be a factor in the low incidence of infections at our facility. Identifying the risk factors of IFIs, maintaining an elevated level of clinical suspicion, and initiating early antifungal treatment may significantly improve the prognosis and reduce the mortality rate of liver transplant recipients.
Language	English
Publishing date	2023-09-07
Publishing country	United States
Document type	Journal Article
ISSN	2220-3230
ISSN	2220-3230
DOI	10.5500/wjt.v13.i5.264
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Article ; Online: Correlation of clinical, laboratory, and short-term outcomes of immunocompromised and immunocompetent COVID-19 patients with semi-quantitative chest CT score findings: A case-control study.

Ghadery, Abdolkarim Haji / Abbasian, Ladan / Jafari, Fatemeh / Yazdi, Niloofar Ayoobi / Ahmadinejad, Zahra

Immunity, inflammation and disease

2024 Volume 12, Issue 4, Page(s) e1239

Abstract: Background: As the effects of immunosuppression are not still clear on COVID-19 patients, we conducted this study to identify clinical and laboratory findings associated with pulmonary involvement in both immunocompromised and immunocompetent patients.!# ...

Abstract	Background: As the effects of immunosuppression are not still clear on COVID-19 patients, we conducted this study to identify clinical and laboratory findings associated with pulmonary involvement in both immunocompromised and immunocompetent patients. Methods: A case-control of 107 immunocompromised and 107 immunocompetent COVID-19 patients matched for age and sex with either positive RT-PCR or clinical-radiological findings suggestive of COVID-19 enrolled in the study. Their initial clinical features, laboratory findings, chest CT scans, and short-term outcomes (hospitalization time and intensive care unit [ICU] admission) were recorded. In addition, pulmonary involvement was assessed with the semi-quantitative scoring system (0-25). Results: Pulmonary involvement was significantly lower in immunocompromised patients in contrast to immunocompetent patients, especially in RLL (p = 0.001), LUL (p = 0.023), and both central and peripheral (p = 0.002), and peribronchovascular (p = 0.004) sites of lungs. Patchy (p < 0.001), wedged (p = 0.002), confluent (p = 0.002) lesions, and ground glass with consolidation pattern (p < 0.001) were significantly higher among immunocompetent patients. Initial signs and symptoms of immunocompromised patients including dyspnea (p = 0.008) and hemoptysis (p = 0.036), respiratory rate of over 25 (p < 0.001), and spo2 of below 93% (p = 0.01) were associated with higher pulmonary involvement. Total chest CT score was also associated with longer hospitalization (p = 0.016) and ICU admission (p = 0.04) among immunocompromised patients. Conclusions: Pulmonary involvement score was not significantly different among immunocompromised and immunocompetent patients. Initial clinical findings (dyspnea, hemoptysis, higher RR, and lower Spo
MeSH term(s)	Humans ; COVID-19 ; Case-Control Studies ; Hemoptysis ; Immunocompromised Host ; Tomography, X-Ray Computed ; Dyspnea
Language	English
Publishing date	2024-04-05
Publishing country	England
Document type	Journal Article
ZDB-ID	2740382-8
ISSN	2050-4527 ; 2050-4527
ISSN (online)	2050-4527
ISSN	2050-4527
DOI	10.1002/iid3.1239
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Article ; Online: Cycle Threshold Values Predict COVID-19 Severity and Mortality but Are not Correlated with Laboratory Markers.

Esmaeili, Behnaz / Khoshnevis, Hoda / Alirezaee, Atefe / Shakoori, Abbas / Pourpak, Zahra / Chegini, Hamid / Ahmadinejad, Zahra

Iranian journal of allergy, asthma, and immunology

2023 Volume 22, Issue 5, Page(s) 468–481

Abstract: Many studies have evaluated the possible utility of cycle threshold (Ct) values as a predictor of Coronavirus disease 2019 (COVID-19) severity and patient outcome. Given the inconsistent results, we aimed to evaluate the association between severe acute ... ...

Abstract	Many studies have evaluated the possible utility of cycle threshold (Ct) values as a predictor of Coronavirus disease 2019 (COVID-19) severity and patient outcome. Given the inconsistent results, we aimed to evaluate the association between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Ct values and disease severity, inflammatory markers, and outcomes in Iranian patients with COVID-19. A retrospective study of 528 patients with COVID-19 hospitalized from September 2020 to October 2021 was conducted. Demographic, clinical, and laboratory data of patients were retrieved from electronic medical records. Ct values were analyzed as a continuous variable after subcategorizing into 3 groups: low (Ct values<20), medium (Ct values 20 to 30), and high (Ct values>30). Of the 528 patients (45.1% female) aged 13 to 97 years, 109 patients had low Ct values, 312 patients had medium, and 107 patients had high Ct values. Patients with low Ct values were more likely to present with critical COVID-19, require invasive mechanical ventilation and develop complications such as acute respiratory distress syndrome and pneumonia. Furthermore, patients with low or medium Ct values were more likely to die compared to patients with high Ct values. Multivariate analysis showed that patients with low or medium Ct values were more likely to have severe COVID-19 compared with patients with high Ct values. The multivariate analysis also showed a higher risk of mortality in patients with low Ct values compared to patients with high Ct values, although this was not statistically significant. Our findings revealed that Ct values were an independent predictor of COVID-19 severity. The risk of mortality was higher in patients with low Ct values. However, further investigation is needed to address the correlation between Ct values and inflammatory factors.
MeSH term(s)	Humans ; Female ; Male ; COVID-19 ; SARS-CoV-2 ; Retrospective Studies ; Iran/epidemiology ; Biomarkers
Chemical Substances	Biomarkers
Language	English
Publishing date	2023-10-29
Publishing country	Iran
Document type	Journal Article
ZDB-ID	2488724-9
ISSN	1735-5249 ; 1735-1502
ISSN (online)	1735-5249
ISSN	1735-1502
DOI	10.18502/ijaai.v22i5.13996
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Article ; Online: Discovering associations between radiological features and COVID-19 patients' deterioration.

Ahmadinejad, Nasrin / Ayyoubzadeh, Seyed Mohammad / Zeinalkhani, Fahimeh / Delazar, Sina / Javanmard, Zohreh / Ahmadinejad, Zahra / Mohajeri, Amirhassan / Esmaeili, Marzieh

Health science reports

2023 Volume 6, Issue 9, Page(s) e1257

Abstract: Background and aims: Data mining methods are effective and well-known tools for developing predictive models and extracting useful information from various data of patients. The present study aimed to predict the severity of patients with COVID-19 by ... ...

Abstract	Background and aims: Data mining methods are effective and well-known tools for developing predictive models and extracting useful information from various data of patients. The present study aimed to predict the severity of patients with COVID-19 by applying the rule mining method using characteristics of medical images. Methods: This retrospective study has analyzed the radiological data from 104 COVID-19 hospitalized patients diagnosed with COVID-19 in a hospital in Iran. A data set containing 75 binary features was generated. Apriori method is utilized for association rule mining on this data set. Only rules with confidence equal to one were generated. The performance of rules is calculated by support, coverage, and lift indexes. Results: Ten rules were extracted with only X-ray-related features on cases referred to ICU. The Support and Coverage index of all of these rules was 0.087, and the Lift index of them was 1.58. Thirteen rules were extracted from only CT scan-related features on cases referred to ICU. The CXR_Pleural effusion feature has appeared in all the rules. The CXR_Left upper zone feature appears in 9 rules out of 10. The Support and Coverage index of all rules was 0.15, and the Lift index of all rules was 1.63. the CT_Adjacent pleura thickening feature has appeared in all rules, and the CT_Right middle lobe appeared in 9 rules out of 13. Conclusion: This study could reveal the application and efficacy of CXR and CT scan imaging modalities in predicting ICU admission to a major COVID-19 infection via data mining methods. The findings of this study could help data scientists, radiologists, and clinicians in the future development and implementation of these methods in similar conditions and timely and appropriately save patients from adverse disease outcomes.
Language	English
Publishing date	2023-05-08
Publishing country	United States
Document type	Journal Article
ISSN	2398-8835
ISSN (online)	2398-8835
DOI	10.1002/hsr2.1257
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Article: Prevalence of hepatitis B infection in the Gambian population: A narrative review of recent developments.

Camara, Muhammed / Tantuoyir, Marcarious M / SeyedAlinaghi, SeyedAhmad / Ghiasvand, Fereshteh / Ahmadinejad, Zahra

Preventive medicine reports

2023 Volume 36, Page(s) 102401

Abstract: Hepatitis B is a "silent epidemic", fifty to a hundred (50-100) times more infectious than HIV, a potentially life-threatening liver infection caused by the hepatitis B virus (HBV). HBV can cause acute and chronic infection and subsequently results in a ... ...

Abstract	Hepatitis B is a "silent epidemic", fifty to a hundred (50-100) times more infectious than HIV, a potentially life-threatening liver infection caused by the hepatitis B virus (HBV). HBV can cause acute and chronic infection and subsequently results in a high risk of death from cirrhosis and liver cancer. Despite the availability of a safe and effective vaccine, HBV continues to be a global burden including in The Gambia. This study reviewed the recent trends in the epidemiological characteristics of HBV in the Gambia. The researchers conducted an online literature search for primary studies on HBV prevalence published in the past two decades from Jan 1992 to Feb 2022 inclusive on Google Scholar, PubMed, and Scopus. All retrieved studies were assessed for eligibility according to specific inclusion/exclusion criteria, data completeness, and methodological coherence. We found that HBV infection prevalence is above 8% in The Gambia. Moreover, HBV is the most common cause of hepatocellular carcinoma (HCC) in Gambia. Liver cirrhosis and HCC have the highest mortality contribution among hepatitis patients, with occult HBV carriers as major culprits. Also, vaccination coverage has declined from 91% to 88% according to reports from current literature. To achieve the WHO goal of eliminating HBV by 2030, policies targeting infection transmission control among risk groups, community awareness programs, research, price reduction of drugs, mass vaccinations, and diagnostics should be urgently instituted.
Language	English
Publishing date	2023-09-07
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2785569-7
ISSN	2211-3355
ISSN	2211-3355
DOI	10.1016/j.pmedr.2023.102401
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Article: Brucella

Mehrabian, Fatemeh / Abdi Layaee, Zahra / Ahmadinejad, Zahra

Case reports in infectious diseases

2019 Volume 2019, Page(s) 7291482

Abstract: Brucellosis, as a systemic infection with potential to involving virtually all organ systems, is an endemic zoonosis in Iran. This is the history of a 17-year-old boy with a ventriculoperitoneal (VP) shunt who presented with prolonged fever, constipation, ...

Abstract	Brucellosis, as a systemic infection with potential to involving virtually all organ systems, is an endemic zoonosis in Iran. This is the history of a 17-year-old boy with a ventriculoperitoneal (VP) shunt who presented with prolonged fever, constipation, and abdominal pain. Laboratory studies, including cerebrospinal fluid (CSF) and blood tests, revealed a VP shunt infection with
Language	English
Publishing date	2019-01-21
Publishing country	Egypt
Document type	Case Reports
ZDB-ID	2627642-2
ISSN	2090-6633 ; 2090-6625
ISSN (online)	2090-6633
ISSN	2090-6625
DOI	10.1155/2019/7291482
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Article ; Online: A bimodal BI-RADS-guided GoogLeNet-based CAD system for solid breast masses discrimination using transfer learning.

Assari, Zahra / Mahloojifar, Ali / Ahmadinejad, Nasrin

Computers in biology and medicine

2021 Volume 142, Page(s) 105160

Abstract: Numerous solid breast masses require sophisticated analysis to establish a differential diagnosis. Consequently, complementary modalities such as ultrasound imaging are frequently required to evaluate mammographically further detected masses. ... ...

Abstract	Numerous solid breast masses require sophisticated analysis to establish a differential diagnosis. Consequently, complementary modalities such as ultrasound imaging are frequently required to evaluate mammographically further detected masses. Radiologists mentally integrate complementary information from images acquired of the same patient to make a more conclusive and effective diagnosis. However, it has always been a challenging task. This paper details a novel bimodal GoogLeNet-based CAD system that addresses the challenges associated with combining information from mammographic and sonographic images for solid breast mass classification. Each modality is initially trained using two distinct monomodal models in the proposed framework. Then, using the high-level feature maps extracted from both modalities, a bimodal model is trained. In order to fully exploit the BI-RADS descriptors, different image content representations of each mass are obtained and used as input images. In addition, using an ImageNet pre-trained GoogLeNet model, two publicly available databases, and our collected dataset, a two-step transfer learning strategy has been proposed. Our bimodal model achieves the best recognition results in terms of sensitivity, specificity, F1-score, Matthews Correlation Coefficient, area under the receiver operating characteristic curve, and accuracy metrics of 90.91%, 89.87%, 90.32%, 80.78%, 95.82%, and 90.38%, respectively. The promising results indicate that the proposed CAD system can facilitate bimodal suspicious mass analysis and thus contribute significantly to improving breast cancer diagnostic performance.
MeSH term(s)	Breast/diagnostic imaging ; Breast Neoplasms/diagnostic imaging ; Female ; Humans ; Machine Learning ; Mammography/methods ; ROC Curve
Language	English
Publishing date	2021-12-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	127557-4
ISSN	1879-0534 ; 0010-4825
ISSN (online)	1879-0534
ISSN	0010-4825
DOI	10.1016/j.compbiomed.2021.105160
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Article: Factors affecting development of air ambulance base: A systematic review and thematic analysis.

Eskandari, Zahra / Ghomian, Zohreh / Sohrabizadeh, Sanaz / Alibabaei, Ahmad / Ahmadinejad, Hojjat

Journal of education and health promotion

2021 Volume 10, Page(s) 320

Abstract: Nowadays, air ambulances have been developed as part of advanced emergency medicine services with many countries employing these services for transferring patients in usual and emergency conditions. However, there are challenges concerning the optimal ... ...

Abstract	Nowadays, air ambulances have been developed as part of advanced emergency medicine services with many countries employing these services for transferring patients in usual and emergency conditions. However, there are challenges concerning the optimal development of air ambulance base. The present research aimed to identify factors affecting the development of air ambulance bases to provide the opportunity of planning to improve the quality of emergency medical services. In this systematic literature review, the peer-reviewed papers in fiv electronic databases, including Medline through PubMed, Scopus, Web of Science, ScienceDirect, and ProQuest, as well as available gray literature, were searched and selected. Two combinations of groups were used as keywords: the Health Planning and development factor, air ambulance base. The focus was on the PRISMA checklist, with no time limitations until from 1990 to January 2020. Finally, through 5156 related citations, 20 articles were included. Descriptive and thematic content analyses were evaluated. The factors affecting the development of the air ambulance base were classified in fiv categories and 14 subcategories as follows: navigation criteria, process indications and standards, sociopolitical factors, and current situation of the area. There are few studies on factors affecting the development of air ambulance bases. It is necessary to apply multidimensional models to consider various factors for development. The development of high populated cities, events and ceremonies with a crowd of participants, and increase of human-made disasters are making these services increasingly indispensable.
Language	English
Publishing date	2021-08-31
Publishing country	India
Document type	Journal Article ; Review
ZDB-ID	2715449-X
ISSN	2319-6440 ; 2277-9531
ISSN (online)	2319-6440
ISSN	2277-9531
DOI	10.4103/jehp.jehp_36_21
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Article ; Online: Barriers to hand hygiene compliance in intensive care units during the COVID-19 pandemic: A qualitative study.

Ahmadipour, Maryam / Dehghan, Mahlagha / Ahmadinejad, Mehdi / Jabarpour, Maryam / Mangolian Shahrbabaki, Parvin / Ebrahimi Rigi, Zahra

Frontiers in public health

2022 Volume 10, Page(s) 968231

Abstract: Background: The practice of hand washing is an effective way to prevent contamination and disease transmission. Following the COVID-19 pandemic, hand washing has become increasingly important. Therefore, this qualitative study aimed to understand ... ...

Abstract	Background: The practice of hand washing is an effective way to prevent contamination and disease transmission. Following the COVID-19 pandemic, hand washing has become increasingly important. Therefore, this qualitative study aimed to understand barriers to hand hygiene compliance among healthcare workers during the COVID-19 pandemic. Materials and methods: Twenty-five healthcare workers from intensive care units were sampled using purposive sampling in a qualitative content analysis study. Data were collected through a semi-structured interview and field notes. Based on the Lundman and Graneheim approach, the data were analyzed. COREQ checklist was used to report the research. Results: According to the findings, there are three main categories of barriers to hand hygiene practice: barriers related to individuals (including two subcategories of lack of knowledge of healthcare workers and healthcare workers' improper attitude), barriers related to management (including two subcategories of wrong behavioral patterns and unsuitable training and planning), and barriers related to organizations (including four subcategories of heavy workloads, improperly designed wards, a lack of equipment, and lack of quality equipment). Conclusions: This research indicates that hand washing practice increased during the COVID-19 pandemic. Nevertheless, some barriers persist, resulting in a decline in hand washing compliance among health care workers. This finding can help managers and policymakers remove barriers to hand washing compliance and improve healthcare workers' adherence to hand washing.
MeSH term(s)	COVID-19/prevention & control ; Guideline Adherence ; Hand Hygiene/methods ; Humans ; Intensive Care Units ; Pandemics
Language	English
Publishing date	2022-08-18
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2711781-9
ISSN	2296-2565 ; 2296-2565
ISSN (online)	2296-2565
ISSN	2296-2565
DOI	10.3389/fpubh.2022.968231
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Article ; Online: Hospital challenges and managerial approaches to combat COVID-19 outbreak: a qualitative study in southeastern Iran.

Ebrahimi Rigi, Zahra / Namjoo, Zakieh / Jabarpour, Maryam / Ahmadinejad, Mehdi / Ahmadipour, Maryam / Mangolian Shahrbabaki, Parvin / Dehghan, Mahlagha

BMC health services research

2023 Volume 23, Issue 1, Page(s) 690

Abstract: Background: During the covid-19 pandemic, hospitals have faced several challenges, so they need to identify and address effective management strategies to cope with these challenges that enhance their current knowledge to deal with similar challenges in ...

Abstract	Background: During the covid-19 pandemic, hospitals have faced several challenges, so they need to identify and address effective management strategies to cope with these challenges that enhance their current knowledge to deal with similar challenges in the future. This study aimed to identify managerial strategies for dealing with Covid-19 pandemic challenges at a hospital in southeastern Iran. Methods: This qualitative content analysis study used purposive sampling to select eight managers, three nurses, and one worker from Shahid Bahonar Hospital. In this study, semi-structured interviews were used to collect data and Lundman and Graneheim's approach was used to analyze them. Results: Three hundred fifty codes remained after constant comparison, compression, and merging. The results demonstrated one theme "Managerial reengineering in the healthcare system during the Covid-19 crisis", two main categories, seven subcategories and, 19 sub- subcategories. The first main category was "The difficulty of managing challenges," including "Insufficient resources and physical space", "Socio-organizational challenges" and, "Incompetence and unpreparedness of managers." The second main category was "Reforming the management duties." This category included "Planning and decision-making," "Organization," "Leadership and motivation," and "Monitoring and control." Conclusions: Hospitals and managers were less prepared to cope with the Covid-19 crisis challenges due to health system organizations' less attention to biological crises. Healthcare organizations can carefully evaluate these challenges, and the strategies managers adopt to deal with these problems. They also can identify the strategies' strengths and weaknesses and propose more effective strategies. As a result, healthcare organizations will be better prepared for similar crises.
MeSH term(s)	Humans ; COVID-19/epidemiology ; Iran/epidemiology ; Pandemics ; Disease Outbreaks ; Hospitals
Language	English
Publishing date	2023-06-26
Publishing country	England
Document type	Journal Article
ZDB-ID	2050434-2
ISSN	1472-6963 ; 1472-6963
ISSN (online)	1472-6963
ISSN	1472-6963
DOI	10.1186/s12913-023-09631-0
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