hamidreza jahanbani ardakani
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مجله دانشکده پزشکی دانشگاه علوم پزشکی تهران، سال هشتاد و یکم شماره 4 (پیاپی 267، تیر 1402)، صص 323 -329زمینه و هدف
هدف از این مطالعه انطباق فرا فرهنگی پرسشنامه کیفیت زندگی روتاتور کاف و تعیین پایایی و روایی پرسشنامه در جمعیت فارسی زبان مبتلا به بیماری روتاتور کاف بود.
روش بررسیاین مطالعه در شهر اصفهان و از اردیبهشت 1401 تا اسفند 1401 انجام شده است. شرکت کنندگان شامل 56 فرد مبتلا به پاتولوژی روتاتور کاف بودند. پایایی آزمون-بازآزمون با ضریب همبستگی درون کلاسی ایجاد شد. سازگاری درونی با استفاده از آلفا کرونباخ محاسبه گردید. تخمین خطا در اندازه گیری ها با خطای استاندارد اندازه گیری محاسبه شد. ارزیابی تکرارپذیری با فاصله سه روز بین تکمیل پرسشنامه آزمون -بازآزمون سنجیده شده است.
یافته هامیزان آلفا کرونباخ 971/0 بود که سازگاری درونی بالایی را نشان داد. ضریب همبستگی درون کلاسی 99/0 بود که نشان دهنده پایایی بالای آزمون-بازآزمون است. مقدار همبستگی با پرسشنامه DASH برابر با 907/0 و با پرسشنامه SPADI برابر با 941/0 بوده است.
نتیجه گیرینسخه فارسی پرسشنامه کیفیت زندگی روتاتور کاف ابزاری معتبر و قابل اعتماد برای ارزیابی کیفیت زندگی در بیماران با تشخیص آسیب روتاتور کاف است.
کلید واژگان: فارسی زبانان, کیفیت زندگی, تکرارپذیری نتایج, صدمات روتاتور کاف, پرسشنامهBackgroundThe objective of this study was the transcultural adaptation of the Rotator cuff quality of life (RC-QOL) questionnaire and the determination of the reliability and validity of the questionnaire in the Persian-speaking population with rotator cuff disease.
MethodsThis study was conducted in Isfahan from April 2022 to February 2023. The participants consisted of 56 people with rotator cuff pathology. The process of adapting and translating the questionnaire was done with the methodology presented previously by Beaton et al. Content validity was first tested by a group of orthopedic and physical medicine and rehabilitation specialists and then through a pilot study consisting of 15 Persian-speaking patients with rotator cuff disease. Test-retest reliability was established with an intraclass correlation coefficient. Internal consistency was calculated using Cronbach's alpha. The measurement's error estimation was calculated with the standard error of the measurement. Reproducibility evaluation was measured with a 3-day interval between the completion of the test-retest questionnaire.
ResultsThe age range of the participants was 34 to 68 years (55% men and 45% women). The mean (standard deviation) of the total score of the RC-QOL questionnaire was 44.33(10.81) and ranged from 17.35 to 70.88. Cronbach's alpha was 0.971, which showed high internal consistency. The intraclass correlation coefficient was 0.99, indicating high test-retest reliability. The mean values (standard deviations) of the DASH and SPADI questionnaires were equal to 77.66(13.69) and 66.66(18.25), respectively. The results of the study showed excellent and significant convergent validity of the RC-QOL questionnaire with both the DASH and SPADI questionnaires. The correlation value with the DASH and SPADI questionnaires was equal to 0.907 and 0.941, respectively.
ConclusionThe Persian version of the RC-QOL questionnaire is a valid and reliable tool to evaluate the quality of life in patients diagnosed with rotator cuff injuries.
Keywords: persian people, quality of life, reproducibility of results, rotator cuff injuries, surveys, questionnaires -
Purpose
To evaluate the changes in biomechanical properties of the cornea using the Corvis ST device after the treatment of keratoconus patients with ultraviolet‑A/riboflavin corneal cross‑linking (CXL).
MethodsThirty‑seven eyes from 37 consecutive patients with progressive keratoconus were included in this prospective observational case series. Corneal biomechanical parameters including the length of the applanated cornea (L1 and L2), corneal movement velocity during applanation (V1 and V2) at the moment of the first and second applanation, deformation amplitude (DA), distance between bending points of the cornea points of the cornea (PD), and concave radius of curvature (R) at the point of the highest concavity were recorded using the Corvis ST at baseline, 3 months, and 1 year after CXL.
ResultsThe mean age of the patients was 23.27 years (range, 19–31 years). Among CorVis ST corneal biomechanical parameters, L1, DA, PD, and R at the point of the highest concavity did not change significantly. The length of the applanated cornea at the moment of second applanation (L2) showed a significant change 3 months after CXL, but no significant difference was found between the 3‑month and 1‑year values of this parameter. Corneal movement velocity during applanation (V1 and V2) did not change 3 months after doing CXL, but the changes in these parameters were significant 1 year after CXL.
ConclusionsAlthough the CorVis ST device may detect changes in some biomechanical properties of cornea after the treatment of keratoconus patients with CXL, many parameters remain unchanged, and this device cannot readily be used to find the effects of CXL.
Keywords: Corneal biomechanical properties, Corneal cross‑linking, CorVis ST, Dynamic imaging, Keratoconus -
Background
There are numerous sophisticated studies which have investigated risk factors of breast cancer (BC). The purpose of this paper is to use benefits of Bayesian modeling to involve such prior information in determining factors affecting the survival of women with BC in Yazd city.
Materials and MethodsThe checklist included the characteristics of the patients and the factors studied. Then, from the records of patients referred to Radiotherapy Center of Shahid Ramezanzadeh, who had BC, from April 2005 to March 2012, the survival of 538 persons was recorded in the census. Data were analyzed by R software version 3.4.2, and 0.05 was considered the significance level.
ResultsThe mean age of BC diagnosis was 48.03 ± 11016 years. The Bayesian Cox regression showed that surgery (hazard ratio [HR] =1.631 95% PI; 1.102–2.422), ki67 (HR = 3.260. 95% PI; 1.6308–6.372), stage (HR = 5.620, 95% PI; 4.079–7.731), lymph node (HR = 1.765, 95% PI; 1.127–2.790), and ER (HR = 2. 600 95% PI; 2.023–3.354) were significantly related to survival time.
ConclusionThe parametric and cox models were compared with standard error, and Cox model was selected as an optimal model. Accordingly, stage, ki67, lymph node, ER, and surgery variables had a positive effect on death hazard.
Keywords: Bayesian method, breast cancer, regression analysis, risk factors, survival analysis -
Purpose Ameloblastoma is a non-encapsulated and slow-growing tumor with high recurrence rate. Orbital involvement by this neoplasm is an extremely rare entity. In this study, we present a systematic review on this situation along with clinical and paraclinical features of a case.
Methods An electronic search was conducted on major medical sources. Data of the cases in the literature in addition to our own case were extracted, summarized, and statistically analyzed.
Results A total of 36 other cases from 20 relevant studies were also reviewed. Review topics included epidemiology, clinical presentation, pathologic features, differential diagnosis, imaging, treatment, and prognosis. We provided a five-year history of a 50-year-old man with orbital/skull base invasion of plexiform maxillary ameloblastoma.
Conclusions Maxillary ameloblastoma is a locally aggressive neoplasm, and physicians must be alert to the biologic behavior of this tumor to detect any invasion to critical structures such as orbit and cranium. Orbital ameloblastoma causes significant morbidity and mortality. We advocate meticulous patient follow-up with regular clinical examinations and paraclinical work-up for timely detection of any invasion or recurrence. The best must be done to avoid extensions by aggressive removal of maxillary ameloblastoma.Keywords: Ameloblastoma, Eye, Vision, Orbit, Review -
BackgroundTe aim of this study is to evaluate the results of photorefractive keratectomy (PRK) in the management of postoperative hyperopia and astigmatism in patients with history of radial keratotomy (RK).Materials And MethodsTis prospective nonrandomized noncomparative interventional case series enrolled consecutive eyes treated with PRK after RK. In cases, in which (1) wavefront (WF) scan was undetectable during primary examinations; and/or, (2) WF data were not transferable to the excimer laser device, patients were treated with the tissue-saving (TS) mode. Patients with detectable/transferable WF were assigned to WF-guided advanced personalized treatment (APT).ResultsTirty-two and 47 eyes were managed by APT and TS modes, respectively. Pooled analysis of both APT and TS groups showed improvement in uncorrected distant visual acuity and corrected distant visual acuity. Te amount of sphere, cylinder, corneal cylinder, spherical equivalent, defocus equivalent, and total aberration showed improvement as well.ConclusionPRK seems to bring favorable outcome and safety profile in the management of post-RK hyperopia and astigmatism. It is crucial for practitioners to warn their patients about the fact that they may still have progressive refractive instability regardless of their choice on the laser method of vision correction.Keywords: Astigmatism, hyperopia, mitomycin-C, photorefractive keratectomy, radial keratectomy
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BackgroundMultiple sclerosis (MS), a central nervous system (CNS) autoimmune disorder, affects 2.3 million people around the world. Cancer kills around 7.5 million people annually. Both diseases have similar risks and intertwining molecular causes. Most studies focusing on MS and cancer have found an insignificant difference or reduction in the amount of cancer found in the MS community.MethodsWe performed a cohort study using data from Isfahan Multiple Sclerosis Society (IMSS) and Isfahan cancer society and followed-up for 8 years on average (2006-2014). All of the 1718 MS patients were diagnosed according to McDonalds criteria, then standardized incidence ratio and the numbers of expected cancer case were calculated.ResultsWhile patients had an insignificant change in cancer prevalence, men had fewer cancer cases and women showed an increased prevalence of cancer. Certain types of cancer proved statistically significant. Breast cancer, nervous system cancers, and lymphoma were elevated in the cohort.ConclusionOur results support the hypothesis that MS significantly affects certain cancers in a protective or associative manner. All cancer rates, except breast cancer, cancers located in the nervous system, and lymphomas were reduced in cohort, suggesting that unregulated immune function may provide protective effects to MS patients against cancer.Keywords: Cancer, Multiple Sclerosis, Cohort, Isfahan, Iran
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BackgroundTe aim of this study is to evaluate the results of photorefractive keratectomy (PRK) in the management of postoperative hyperopia and astigmatism in patients with history of radial keratotomy (RK).Materials And MethodsTis prospective nonrandomized noncomparative interventional case series enrolled consecutive eyes treated with PRK after RK. In cases, in which (1) wavefront (WF) scan was undetectable during primary examinations; and/or, (2) WF data were not transferable to the excimer laser device, patients were treated with the tissue-saving (TS) mode. Patients with detectable/transferable WF were assigned to WF-guided advanced personalized treatment (APT).ResultsTirty-two and 47 eyes were managed by APT and TS modes, respectively. Pooled analysis of both APT and TS groups showed improvement in uncorrected distant visual acuity and corrected distant visual acuity. Te amount of sphere, cylinder, corneal cylinder, spherical equivalent, defocus equivalent, and total aberration showed improvement as well.ConclusionPRK seems to bring favorable outcome and safety profile in the management of post-RK hyperopia and astigmatism. It is crucial for practitioners to warn their patients about the fact that they may still have progressive refractive instability regardless of their choice on the laser method of vision correction.Keywords: Astigmatism, hyperopia, mitomycin-C, photorefractive keratectomy, radial keratectomy
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The hyperimmunoglobulin E syndromes (HIESs) are very rare immunodeficiency syndromes with multisystem involvement, including immune system, skeleton, connective tissue, and dentition. HIES are characterized by the classic triad of high serum levels of immunoglobulin E (IgE), recurrent staphylococcal cold skin abscess, and recurrent pneumonia with pneumatocele formation. Most cases of HIES are sporadic although can be inherited as autosomal dominant and autosomal recessive traits. A fundamental immunologic defect in HIES is not clearly elucidated but abnormal neutrophil chemotaxis due to decreased production or secretion of interferon ? has main role in the immunopathogenesis of syndrome, also distorted Th 1/Th 2 cytokine profile toward a Th 2 bias contributes to the impaired cellular immunity and a specific pattern of infection susceptibility as well as atopic-allergic constitution of syndrome. The ophthalmic manifestations of this disorder include conjunctivitis, keratitis, spontaneous corneal perforation,recurrent giant chalazia, extensive xanthelasma, tumors of the eyelid, strabismus, and bilateral keratoconus. The diagnosis of HIES is inconclusive, dependent on the evolution of a constellation of complex multisystemic symptoms and signs which develop over the years. Until time, no treatment modality is curative for basic defect in HIES, in terms of cytokines/chemokines derangement. Of note, bone marrow transplant and a monoclonal anti-IgE (omalizumab) are hoped to be successful treatment in future.Keywords: Autoimmune disease_eye_hyperimmunoglobulin E syndrome_immunodefi ciency_ocular_omalizumab_Staphylococcus aureus
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PurposeThe aim of the present study was to investigate the effect of subthreshold diode laser micropulse (SDM) in comparison with conventional laser photocoagulation in the treatment of the diabetic macular edema (DME).MethodsSixty-eight eyes from 68 patients with clinically significant DME were divided randomly into two equal groups. In the first group, SDM photocoagulation was employed, while conventional laser photocoagulation was performed on the eyes of the second group. Central macular thickness (CMT), central macular volume (CMV), and best corrected visual acuity (BCVA) were measured before, 2, and 4 months after intervention, and the results were compared.ResultsThe mean CMT was 357.3 and 354.8 microns before the treatment in Groups 1 and 2, respectively (P = 0.85), and decreased significantly to 344.3 and 349.8 after 4 months, respectively (P = 0.012 and P = 0.049). The changes in the central macular thickness was statistically higher in the first group (P = 0.001). The mean CMV significantly decreased in Group 1 (P = 0.003), but it was similar to pretreatment in Group 2 after 4 months (P = 0.31). The BCVA improved significantly in Group 1 (PConclusionsIn this study, SDM was more effective than conventional laser photocoagulation in reducing CMT and CMV and improving visual acuity in patients with DME.Keywords: Diabetic macular edema, Subthreshold diode laser micropulse, Conventional laser photocoagulation
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