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Parham Mardi, Sorour Shojaeian, Nooshin Taherzadeh-Ghahfarokhi, Ghazaleh Molaverdi, Maedeh Amiri Roudy , Ali Salahshour, Mahmood Bakhtiyari, Sayed-Hamidreza Mozhgani ,
Volume 78, Issue 11 (February 2021)
Abstract

  SARS-CoV-2 emerging from Wuhan, China is a member of the Coronaviridae family, which has so far infected and killed many people. The SARS-CoV-2 pandemic affected various aspects of life in Iran and Worldwide, and governments have imposed quarantines and travel bans on an unprecedented scale. The virus causes COVID-19, which can spread through close contact with the infected person, contaminated equipment, and suspended air droplets. The most common symptoms of the disease include fever, cough, shortness of breath, gastrointestinal symptoms, and diarrhea. In severe cases, the lung infection can occur, which causes Severe Acute Respiratory Syndrome that leads to ICU admission and even death.
  Besides, this infection can cause gastrointestinal, neurological, and renal impairments. Not merely, this new coronavirus has infected many more people worldwide in comparison to MERS and SARS, but also it has killed more people. Patients with underlying diseases such as hypertension, diabetes, respiratory problems, kidney disease, heart disease and Immunodeficiency are at higher risk of infection and potential death. Also, the risk of death and complication increases in older adults, while most of the infected children are asymptomatic. Some infected people may have mild or no symptoms but can still transmit the disease and spread it to others.
To diagnose COVID-19, serology tests, and level of ESR, CRP and other acute-phase reactants are helpful, whereas molecular tests, such as RT-PCR tests, that detect the virus’s genetic material are still the golden standard. Also, CT scan detects lung involvement; Ground-glass opacification, especially in lower lobes and subpleural region, is the most common CT characteristic, although it is not specific for COVID-19. Because the disease is difficult to diagnose, hard to prevent and challenging to treat, it has become a major concern for many countries. This review aims to gather existing information in the fields of virology, molecular pathogenesis, disease symptoms, epidemiology, clinical presentations, diagnosis, treatment, and the spread of the disease. This study also provides evidence-based prevention and treatment strategies for health policymakers, doctors, nurses, and practitioners in the field of public health, including researchers and students.
 

Mohsen Ayati, Mohammad Reza Nowroozi, Amirreza Fotovat, Erfan Amini, Faeze Salahshour, Laleh Sharifi ,
Volume 79, Issue 2 (May 2021)
Abstract

Background: Ewing's sarcoma/Primitive neuroectodermal tumor (PNET) is a group of tumors with small round cells that originate from nerve stem cells. They are generally more common in children and often occur in the soft or bony tissues of the limbs, trunk, head, and neck. Ewing's sarcoma is a rare disease in the kidney and its tumor thrombosis into Inferior Vena Cava (IVC) is assumed as a very rare condition.
Case Presentation: The patient was a 14-year-old boy who underwent an MRI of the thoracic and lumbar vertebrae due to paresthesia of the lower limbs, which showed the presence of the mass in the vertebrae of T3, T4, T5, and concurrently right kidney. The pathology report confirmed the diagnosis of Ewing’s sarcoma, PNET. The patient underwent T4 laminectomy and bone mass resection and then received 4 courses of chemotherapy with VAC + IE. In the next stage of treatment, the patient had abdominal MRI and MR Venography (MRV) that demonstrated a mass in the middle of the upper right kidney with a 10 cm length tumor thrombosis into IVC with extension to the suprahepatic area and involvement of several aortocaval lymph nodes. In January 2020, the patient was operated in Imam Khomeini Hospital Complex, Tehran by a midline incision, at first, the kidney artery and vein were controlled, and without thrombectomy, the IVC was controlled from above and below the liver, then the tumor thrombosis was removed. The right kidney underwent a radical nephrectomy. Three days later, the patient was discharged in good general condition and referred for chemotherapy.
Conclusion: Because Ewing's sarcoma is a rare condition in the kidney, this case is considered a very rare case due to its tumor thrombosis. This case study showed that despite the advanced stage of the disease, early diagnosis and treatment of patients with Ewing's sarcoma, along with adjuvant treatments can play an important role in the survival of these patients.


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