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  1. Article ; Online: Overuse of computed tomography for mild head injury

    Maryam Saran / Morteza Arab-Zozani / Meysam Behzadifar / Mehrdad Gholami / Samad Azari / Nicola Luigi Bragazzi / Masoud Behzadifar

    PLoS ONE, Vol 19, Iss 1, p e

    A systematic review and meta-analysis.

    2024  Volume 0293558

    Abstract: Background Computed tomography (CT) scan is a common imaging technique used to evaluate the severity of a head injury. The overuse of diagnostic interventions in the health system is a growing concern worldwide. Objectives: The aim of this systematic ... ...

    Abstract Background Computed tomography (CT) scan is a common imaging technique used to evaluate the severity of a head injury. The overuse of diagnostic interventions in the health system is a growing concern worldwide. Objectives: The aim of this systematic review is to investigate the rate of CT scan overuse in cases of mild head injury. Methods Eligibility criteria: We encompassed observational studies-either designed as cohort, case-control, or cross-sectional investigations-that reported on CT scan overuse rates for mild head injuries. Studies had to be published in peer-reviewed, English-language sources and provide full content access Information sources: Web of Sciences, Scopus, Medline via PubMed, the Cochrane Library and Embase were searched from inception until April 1, 2023. Studies were included if reporting the overuse of CT scans for mild head injuries using validated criteria. Risk of bias: We used the Risk Of Bias In Non-randomised Studies - of Interventions (ROBINS-I) tool to evaluate the risk bias assessment of included studies. Two independent reviewers evaluated the eligibility of studies, extracted data, and assessed study quality by using the Newcastle-Ottawa Scale. Synthesis of results: Overuse estimates were calculated using a random-effects model. Subgroup analyses were performed to investigate any sources of heterogeneity. Point rate of overuse of CT scans for mild head injuries was the main outcome measured as percentage point estimates with corresponding 95% CIs. Results Included studies: Of the 913 potentially relevant studies identified, eight studies were selected for the final analysis. Synthesis of results: The pooled rate of CT scan overuse in patients with mild head injury was found to be 27% [95% CI: 16-43; I2 = 99%]. The rate of CT scan overuse in mild head injury cases varied depending on the criteria used. The rate of CT scan overuse was 37% [95% CI: 32-42; I2 = 0%] with the Glasgow Coma Scale (GCS), 30% [95% CI: 16-49; I2 = 99%] with the Canadian computed tomography head rule, ...
    Keywords Medicine ; R ; Science ; Q
    Subject code 610
    Language English
    Publishing date 2024-01-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Overuse of computed tomography for mild head injury

    Maryam Saran / Morteza Arab-Zozani / Meysam Behzadifar / Mehrdad Gholami / Samad Azari / Nicola Luigi Bragazzi / Masoud Behzadifar

    PLoS ONE, Vol 19, Iss

    A systematic review and meta-analysis

    2024  Volume 1

    Keywords Medicine ; R ; Science ; Q
    Language English
    Publishing date 2024-01-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: The impact of the Iranian health transformation plan policy on equitable access to medical imaging services in West Iran

    Maryam Saran / Banafsheh Darvishi Teli / Aziz Rezapour / Soraya Nouraei Motlagh / Meysam Behzadifar / Payam Haghighatfard / Nicola Luigi Bragazzi / Masoud Behzadifar

    BMC Research Notes, Vol 16, Iss 1, Pp 1-

    2023  Volume 6

    Abstract: Abstract Objective Equity in the delivery of health services, including diagnostic imaging, is crucial to achieving universal health coverage. The Health Transformation Plan (HTP), launched in 2014, represents a major healthcare policy to improve the ... ...

    Abstract Abstract Objective Equity in the delivery of health services, including diagnostic imaging, is crucial to achieving universal health coverage. The Health Transformation Plan (HTP), launched in 2014, represents a major healthcare policy to improve the quality and accessibility of healthcare services. This study aimed to explore the impact of the HTP on equity in the access to medical imaging in Lorestan province, located in west Iran, from 2014 to 2023. Annual growth rates (AGR) of imaging devices were calculated, whilst equity assessment of medical imaging distribution was carried out by means of the Gini coefficient and the Lorenz curve per 100,000 population. The latter was generated using the cumulative distribution of imaging devices, as well as the cumulative population ratio. Results Between 2014 and 2023, the number of imaging devices has increased threefold. The AGR of installing CT and MRI scanners in Lorestan province increased between 2014 and 2023. The Gini coefficients increased from 0.12 for CT and 0.16 for MRI in 2014 to 0.33 in 2023 for both devices. This indicates a decrease in equity in access to these fundamental health technologies despite the increase in their figures. Policymakers should better allocate medical equipment based on the specific health needs of different regions throughout Iran.
    Keywords Diagnostic imaging ; Equity in Healthcare ; Gini Coefficient ; Health Economics ; Health Policy ; Health Transformation Plan ; Medicine ; R ; Biology (General) ; QH301-705.5 ; Science (General) ; Q1-390
    Subject code 360
    Language English
    Publishing date 2023-11-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Magnetic resonance mammography in comparison with mammography in the discovery of multifocal, multicentric and bilateral lesions of breast cancer

    Khadijeh Bakhtavar / Maryam Saran / Masoud Behzadifar / Maryam Farsi

    Electronic Physician, Vol 9, Iss 8, Pp 5083-

    2017  Volume 5087

    Abstract: Background: Breast cancer is one of the health system problems and important diseases that is rising in developing and advanced countries. Objective: This study aimed to determine the difference of Magnetic Resonance Mammography (MRM) findings versus ... ...

    Abstract Background: Breast cancer is one of the health system problems and important diseases that is rising in developing and advanced countries. Objective: This study aimed to determine the difference of Magnetic Resonance Mammography (MRM) findings versus mammography in detecting multifocal, multi-centric and malignant bilateral lesions in patients with known breast cancer in Tehran. Methods: This cross-sectional study was conducted in Iran and Tehran among breast cancer patients between January 2015 and February 2016. Patients were included in the study prior to surgery, at the request of a surgeon with the aim of detecting multifocal, multi-centric and bilateral lesions. Demographic information was also collected from patients. The results for quantitative variables were expressed as mean and standard deviations, and for qualitative variables, were expressed as relative and absolute frequency. Chi-square test was used to compare the two methods. SPSS Ver.24 (IBM) software was used to analyze the data. Results: Thirty-nine patients were enrolled in the study. The mean age of patients in this study was 48.46±6.836. In mammography, 13 (33.3%) had Composition C and 26 (66.7%) had Composition D according to the type of Composition. In total, 25 patients (89.3%) had one lesion and 3 patients (10.7%) had more than two lesions. In MRM, all lesions observed were mass (54 masses). The number of lesions found in MRM was 27 patients with one lesion (58.9%), 6 patients with two lesions (20.5%) and 5 patients with three lesions (20.6%). MRM detected more lesions compared to mammography (p<0.0001). The value of Chi-square test with a degree of freedom and error level of 0.05 was 3.71 and p<0.0001 that showed a significant relationship between the number of MRM findings in comparison with mammography. Conclusion: The results of our study showed that two or more lesions and bilateral lesions in MRM were more than mammography in women with B Breast Composition C, D; the findings showed that MRM has a better ability to detect ...
    Keywords Breast cancer ; Mammography ; MRM ; Multifocal ; Multi-centric ; Medicine (General) ; R5-920
    Subject code 616
    Language English
    Publishing date 2017-08-01T00:00:00Z
    Publisher Electronic Physician
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: The challenges of implementation of clinical governance in Iran

    Masoud Behzadifar / Nicola Luigi Bragazzi / Morteza Arab-Zozani / Ahad Bakhtiari / Meysam Behzadifar / Tina Beyranvand / Negar Yousefzadeh / Samad Azari / Haniye Sadat Sajadi / Mandana Saki / Maryam Saran / Hasan Abolghasem Gorji

    Health Research Policy and Systems, Vol 17, Iss 1, Pp 1-

    a meta-synthesis of qualitative studies

    2019  Volume 14

    Abstract: Abstract Background Policy- and decision-makers seek to improve the quality of care in the health sector and therefore aim to improve quality through appropriate policies. Higher quality of care will satisfy service providers and the public, reduce costs, ...

    Abstract Abstract Background Policy- and decision-makers seek to improve the quality of care in the health sector and therefore aim to improve quality through appropriate policies. Higher quality of care will satisfy service providers and the public, reduce costs, increase productivity, and lead to better organisational performance. Clinical governance is a method through which management can be improved and made more accountable, and leads to the provision of better quality of care. In November 2009, the Iranian Ministry of Health and Medical Education implemented new clinical guidelines to standardise and improve clinical services as well as to increase efficiency and reduce costs. The purpose of this study was to assess the challenges of implementing clinical governance through a meta-synthesis of qualitative studies published in Iran. Methods Ten databases, including ISI/Web of Sciences, PubMed/MEDLINE, Embase, PsycINFO, the Cochrane Library, CINAHL, Scopus, Barakatns, MagIran and the Scientific Information Database, were searched between January 2009 and May 2018. The quality of the included studies was assessed using the Critical Appraisal Skills Programme tool. This study was reported according to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research guidelines. Thematic synthesis was used to analyse the data. Results Ten studies were selected and included based on the inclusion/exclusion criteria. In the first stage, 75 items emerged and were coded, and, following comparison and combination of the codes, 32 codes and 8 themes were finally extracted. These themes included health system structure, management, person-power, cultural factors, information and data, resources, education and evaluation. Conclusion The findings of the study showed that there exist a variety of challenges for the implementation of clinical governance in Iran. To successfully implement a health policy, its infrastructure needs to be created. Using the views and support of stakeholders can ensure that a policy is ...
    Keywords Clinical governance ; challenges ; Iran ; meta-synthesis ; Public aspects of medicine ; RA1-1270
    Subject code 360
    Language English
    Publishing date 2019-01-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Evaluation Efficacy and Safety of Vortioxetine 20 mg/d versus Placebo for Treatment Major Depressive Disorder

    Masoud Behzadifar / Hamidreza Dehghan / Korush Saki / Meysam Behzadifar / Abouzar Keshavarzi / Maryam Saran / Ali Akbari Sari

    Pharmacology & Pharmacy, Vol 06, Iss 04, Pp 221-

    A Systematic Review and Meta-Analysis of Randomized Controlled Trials

    2015  Volume 231

    Abstract: Major depressive disorder, a common debilitating illness, is one of the leading causes of disability and disease worldwide. Different drugs for the treatment of patients with major depression can be used. Vortioxetine for the treatment of major ... ...

    Abstract Major depressive disorder, a common debilitating illness, is one of the leading causes of disability and disease worldwide. Different drugs for the treatment of patients with major depression can be used. Vortioxetine for the treatment of major depressive disorder was approved by the Food and Drug Administration (FDA) in 2013. This study aimed to evaluation efficacy and safety Vortioxetine 20 mg/d compared placebo in major depressive disorder. To conduct this study, we searched Pub Med, Cochrane library, Scopus, and Central Register of Controlled Trials. This study by including randomized controlled trials (RCTs) that evaluated this study by including randomized controlled trials (RCTs) that evaluated Vortioxetine 20 mg/d in patients with major depressive disorder. Data analysis was conducted by standard mean different ratios (SMD) with 95% confidence intervals (CIs), P values and odds ratios (ORs) for adverse events with 95% confidence intervals (CIs) and P values; heterogeneity testing and sensitivity analysis was also performed in this study. We found that 4 articles met the inclusion criteria and were finally used for this meta-analysis. Results showed statistical significance in the MADRS (Montgomery-&Aringsberg Depression Rating Scale), SMD = -4.75 with 95% CI [-6.84, -2.65] and P value < 0.00001), for Clinical Global Impression Scale-Improvement (CGI-I) SMD was -4.34 with 95% CI [-6.41, -2.27] and P value < 0.00001, and for Sheehan Disability Scale (SDS) SMD was -2.62 with 95% CI [-3.99, -1.25] and P value < 0.00001. The pooled analysis for safety demonstrated for diarrhea OR = 0.92 with 95% CI [0.46, 1.83] , P value = 0.09, for dry mouth OR = 1.74 with 95% CI [1.07, 2.83] , P value = 0.80, for dizziness OR = 1.62 with 95% CI [0.72, 3.66] , P value = 0.05, for fatigue OR = 1.17 with 95% CI [0.34, 4.08], P value = 0.07, for headache OR = 1.28 with 95% CI [0.91, 1.79], P value = 0.60 and for nausea OR = 4.78 with 95% CI [3.43, 6.67], P value = 0.61. Vortioxetine 20 mg/d versus placebo showed a significant difference for nausea and dry mouth, but no significant differences were observed for the four adverse effects. In several studies of the drug Vortioxetine 20 mg/d, the treatment of major depressive illness has been more effective for evaluating the effectiveness of this drug, which must be more clinical studies of sound.
    Keywords Major Depressive Disorder ; Vortioxetine 20 mg ; Systematic Review ; Meta-Analysis ; Therapeutics. Pharmacology ; RM1-950 ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2015-03-01T00:00:00Z
    Publisher Scientific Research Publishing
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Article ; Online: The frequency of blood transfusion and its components in hospitalized patients in Shohada Ashayer hospital in Khorramabad, 2009

    sedighe nadri / seyede maryam saran / hosien Teimouri / mohammad Soltani / khatere Anbari

    Yafteh, Vol 13, Iss 4, Pp 5-

    2012  Volume 10

    Abstract: Background : Blood is a resusciate source of life which there is no replacement for it. Limited time of preserving, screening tests of blood health, group determining, and cross-matching, that necessitate personal and laboratory costs, increase the ... ...

    Abstract Background : Blood is a resusciate source of life which there is no replacement for it. Limited time of preserving, screening tests of blood health, group determining, and cross-matching, that necessitate personal and laboratory costs, increase the importance of correct request and suitable consumption. This study was conducted to determine the frequency of blood transfusion and its components and calculate the ratio of C/T. Materials and Methods: This descriptive-analytic study included 648 patients for whom blood and blood components were requested during the study. The data regarding the variables were recorded in a checklist and then were analyzed using the SPSS software. Results: The results showed that during the study 7746 patients were hospitalized and blood or blood components were requested for 648 (8%) of them. Out of these patients, 265 (40.9%) received transfusions of blood or its components. Packed cell was the most frequently transfused component (71.3%). The mean HB (hemoglobin) in the patients before transfusion was 9.49 gr/dl. Chronic anemia was the most prevalent indication of transfusion, and femoral fracture surgery was the most frequent operation needing blood transfusion. The C/T ratio was found to be 1.1. Conclusion: In this study, 59.1 % of the requested units were not used. Realizing requests based on scientific needs, and costs of production, preserving, separating components, transporting them to hospitals, and cross-matching including laboratory needs and manpower are recommended.
    Keywords Blood ; (Hemoglobin) ; Blood transfusion ; Cross-match ; Medicine ; R ; Medicine (General) ; R5-920
    Subject code 610
    Language Persian
    Publishing date 2012-03-01T00:00:00Z
    Publisher Lorestan University of Medical Science
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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