Showing 75 results for Neoplasm
Shahrbanoo Keihanian , Nafiseh Koochaki , Majid Pouya , Maryam Zakerihamidi ,
Volume 77, Issue 8 (11-2019)
Abstract
Background: Breast cancer is the most commonly diagnosed and the leading cause of cancer death among females worldwide. The rate of breast cancer incidence among Iranian women is 17% of all cancers, it has been ranked first in Iran. This study aimed to investigate the factors affecting axillary lymph node involvement in female patients with breast cancer.
Methods: A cross-sectional study was conducted on 167 patients with breast cancer diagnosed between March 2012 and March 2015 at Shahid Beheshti of Babol, Shahid Rajaei of Tonekabon and Imam Sajad of Ramsar hospitals. A researcher-made questionnaire was used to collect information on the patients and pathology report of tumor and lymph nodes was completed.
Results: The rate of axillary lymph node involvement was observed in 117 patients (70.1%). Mean age was 49.64±11.62 years in the patients with breast cancer. The highest frequency of lymph node involvement was observed in the 40-49 age group (24%). The average size of tumor was 3.39 cm and the majority of patients had a tumor 2-5 cm (T2) but the most involvement was related to T3 (>5cm). The most common type of cancer and grading were invasive ductal carcinoma (93.4%) and tumor grade 2 (52.1%), respectively. Most lymph node involvement was observed in invasive ductal carcinoma and 85.1% of patients had tumor degree 3. 22.2% of patients with vessels involvement had axillary lymph node involvement. 63% of patients’ tumors had receptors of estrogen and progesterone. A statistically significant association was observed between axillary lymph node involvement and tumor size (P=0.031), tumor type (P=0.007), tumor grade (P=0.011), estrogen receptor (P=0.008) and progesterone receptor (P=0.038).
Conclusion: There was a statistically significant association between axillary lymph node involvement and tumor size, type and grade, estrogen and progesterone receptor status, but there was no statistically significant association between axillary lymph node involvement and age and estrogen as well as progesterone receptor status.
Solmaz Ohadian Moghadam , Erfan Amini , Mohsen Ayati , Hassan Jamshidian , Seyed Ali Moemeni , Farshad Sheybaee Moghaddam , Mohammad Reza Nowroozi ,
Volume 77, Issue 10 (1-2020)
Abstract
Background: Prostate cancer has been reported as a worldwide important kind of cancer and the second most common cause of cancer-related mortality among men. Prostate-specific antigen (PSA) serum level is one of the most important markers of prostate cancer diagnosis. While PSA level helps predict the risk of prostate cancer development, researchers still looking for ways to increase the accuracy of prognostic models. To increase the specificity of PSA and decrease of unnecessary biopsies and morbidity, PSA-related parameters such as PSA doubling time (PSADT) have been used. In this study, the relationship between this factor and the severity of prostate cancer was evaluated.
Methods: In this retrospective study, the data of patients who were subjected to transrectal ultrasound-guided (TRUS) biopsy of the prostate and referred to Imam Khomeini Hospital, Tehran, between 2009 and 2017 were reviewed. We enrolled the men with at least two consecutive elevated PSA level within three months to calculate PSADT. Based on the pathology report, primary and secondary Gleason score (GS) were determined. Correspondingly, considering GS, the patients were divided into two groups with high-grade and low-grade tumor (GS<7 considered as low-grade and GS>7 considered as high-grade tumor).
Results: Totally, 1712 cases of TRUS biopsy of the prostate were studied. Among them, 547 (32.3%) had prostate cancer, of whom 73 cases were eligible based on inclusion criteria and were consented to enroll in the study. According to the data obtained, we found a significant difference in PSADT between the two groups of patients with high-grade and low-grade malignancy (mean±SD PSADT, 9.8±14.2 vs. 16.1±14.9 respectively, P=0.004). Considering the seven months as the cut-off point for PSADT in determining malignancy, there was a significant difference between the two groups according to Fisher's exact test (P=0.01).
Conclusion: In our study, PSADT cut-off of 7 months provided the greatest accuracy for differentiation between low-grade and high-grade malignancy, and PSADT has acceptable accuracy for the diagnosis of high-grade tumors.
Fatemeh Nevisi , Marjan Yaghmaie , Hossein Pashaiefar , Kamran Alimoghaddam , Masoud Iravani, Gholamreza Javadi , Ardeshir Ghavamzadeh ,
Volume 77, Issue 11 (2-2020)
Abstract
Background: Gastric cancer (GC) is considered as one of the most common types of cancer worldwide with poor prognosis and generally limited treatment options. Recent studies have indicated that HER2, MDM2, MYC, MET, and TP53 play an important role in the development of gastric cancer. Therefore, the aim of this study was to evaluate the incidence of amplification/deletion of these genes in patients with gastric cancer.
Methods: In this descriptive study, a total of 37 gastric cancer tissue samples from GC patients including 23 males (62.2%) and 14 females (37.8%) referred to the Hematology-Oncology and Stem Cell Research Center of Shariati Hospital, Tehran, from March 2015 to February 2016 were evaluated. The patient's age at diagnosis ranged from 33 to 85 years (median: 65 years). The amplification pattern of HER2, MDM2, MYC and MET genes and TP53 deletion were investigated by fluorescence in situ hybridization (FISH) technique performed on 3 to 5 micron section obtained from formalin-fixed and paraffin-embedded cancer tissues.
Results: The tumors were preferably identified at the distal stomach (54.05%) in comparison to tumors arising from the gastric cardia. The tumor size varied between 2 and 5 cm (average, 3.5 cm). Seven of the cases (19%) had advanced tumors at the time of diagnosis. HER2, MDM2, MYC, MET and TP53 copy number alteration were successfully determined in all samples obtained from the GC patients. HER2, MDM2, and c-MYC genes were amplified in 2 (5.41%), 1 (2.7%) and 3 (8.11%) of 37 patient samples, however, MET gene amplification and TP53 deletion were not observed in the obtained GC tissue samples. Co-amplification of HER2, MDM2, and MYC genes, and co-amplification of HER2 and MYC genes were detected in one patient.
Conclusion: The results of this study indicate the low frequency of MDM2, HER2 and MYC genes in gastric cancer patient and their copy number alterations may provide diagnostic and prognostic marker for GC patients.
Sama Rezasoltani , Hamid Asadzadeh Aghdaei , Hossein Dabiri , Abbas Akhavan Sepahi , Mohammad Hossein Modarressi , Ehsan Nazemalhosseini Mojarad ,
Volume 78, Issue 3 (6-2020)
Abstract
Background: Colorectal cancer is the second most common cancer in the world which is mainly caused by epigenetic and environmental factors. Among these epigenetic factors, gut microbiota is an important one. Although it has not been proved a unique group of bacteria correlated with colorectal cancer, these findings have generally demonstrated differences between healthy and disease gut microbiome in population. Actually, the identification and investigation of intestinal microbiota in early detection of colorectal cancer have been highlighted in new researches and studies. Herein, in the current study, we aimed to evaluate the number of selected gut bacteria including Lactobacillus and Escherichia coli and Prevotella in the fecal specimens of adenomatous polyposis patients, colorectal cancerous cases in compared to normal participants in terms of estimating important role of gut microbiota during colorectal cancer initiation and progression.
Methods: The current research was a case-control study. Fecal samples were provided from 31 healthy individuals, 42 adenomatous polyposis patients and 20 colorectal cancer cases that were referred to Taleghani Hospital, Tehran, Iran, from August 2016 to August 2017 for colorectal cancer screening tests. Fecal samples were collected to analyze intestinal bacteria including, Lactobacillus, Escherichia coli, and Prevotella by absolute quantitative real-time polymerase chain reaction (PCR). The number of these gut bacteria was precisely determined by this method of real-time PCR.
Results: Higher number of Prevotella with 24.6 CT number (P<0.005) and E.coli with 20.4 CT number (P<0.015) were achieved in colorectal cancer cases and adenomatous polyposis patients in contrast to samples from normal individuals. On the contrary, the opposite range was observed for the quantification of Lactobacillus and greater numbers of bacteria (CT=28.6) were detected in normal, compared to the colorectal cancer cases and adenomatous polyposis (P<0.001).
Conclusion: The gut microbiota composition of individuals with colorectal cancer and adenomatous polyposis differs from that of healthy individuals, and the higher numbers of pathogenic microbiota versus beneficial microbiota present in those with colorectal cancer and adenomatous polyposis. In contrast, healthy individuals have higher numbers of beneficial gut microbiota than pathogenic microbes. These findings need more experimental analysis and investigation to better clarify.
Ali Ameri ,
Volume 78, Issue 3 (6-2020)
Abstract
Background: Skin cancer is one of the most common forms of cancer in the world and melanoma is the deadliest type of skin cancer. Both melanoma and melanocytic nevi begin in melanocytes (cells that produce melanin). However, melanocytic nevi are benign whereas melanoma is malignant. This work proposes a deep learning model for classification of these two lesions.
Methods: In this analytic study, the database of HAM10000 (human against machine with 10000 training images) dermoscopy images, 1000 melanocytic nevi and 1000 melanoma images were employed, where in each category 900 images were selected randomly and were designated as the training set. The remaining 100 images in each category were considered as the test set. A deep learning convolutional neural network (CNN) was deployed with AlexNet (Krizhevsky et al., 2012) as a pretrained model. The network was trained with 1800 dermoscope images and subsequently was validated with 200 test images. The proposed method removes the need for cumbersome tasks of lesion segmentation and feature extraction. Instead, the CNN can automatically learn and extract useful features from the raw images. Therefore, no image preprocessing is required. Study was conducted at Shahid Beheshti University of Medical Sciences, Tehran, Iran from January to February, 2020.
Results: The proposed model achieved an area under the receiver operating characteristic (ROC) curve of 0.98. Using a confidence score threshold of 0.5, a classification accuracy of 93%, sensitivity of 94%, and specificity of 92% was attained. The user can adjust the threshold to change the model performance according to preference. For example, if sensitivity is the main concern; i.e. false negative is to be avoided, then the threshold must be reduced to improve sensitivity at the cost of specificity. The ROC curve shows that to achieve sensitivity of 100%, specificity is decreased to 83%.
Conclusion: The results show the strength of convolutional neural networks in melanoma detection in dermoscopy images. The proposed method can be deployed to help dermatologists in identifying melanoma. It can also be implemented for self diagnosis of photographs taken from skin lesions. This may facilitate early detection of melanoma, and hence substantially reduce the mortality chance of this dangerous malignancy.
Ali Ameri,
Volume 78, Issue 4 (7-2020)
Abstract
Background: The most common types of non-melanoma skin cancer are basal cell carcinoma (BCC), and squamous cell carcinoma (SCC). AKIEC -Actinic keratoses (Solar keratoses) and intraepithelial carcinoma (Bowen’s disease)- are common non-invasive precursors of SCC, which may progress to invasive SCC, if left untreated. Due to the importance of early detection in cancer treatment, this study aimed to propose a computer-based model for identification non-melanoma malignancies.
Methods: In this analytic study, 327 AKIEC, 513 BCC, and 840 benign keratosis images from human against machine with 10000 training dermoscopy images (HAM10000) were extracted. From each of these three types, 90% of the images were designated as the training set and the remaining images were considered as the test set. A deep learning convolutional neural network (CNN) was developed for skin cancer detection by using AlexNet (Krizhevsky, et al., 2012) as a pretrained network. First, the model was trained on the training images to discriminate between benign and malignant lesions. In comparison with conventional methods, the main advantage of the proposed approach is that it does not need cumbersome and time-consuming procedures of lesion segmentation and feature extraction. This is because CNNs have the capability of learning useful features from the raw images. Once the system was trained, it was validated with test data to assess the performance. Study was carried out at Shahid Beheshti University of Medical Sciences, Tehran, Iran, in January and February, 2020.
Results: The proposed deep learning network achieved an AUC (area under the ROC curve) of 0.97. Using a confidence score threshold of 0.5, a classification accuracy of 90% was attained in the classification of images into malignant and benign lesions. Moreover, a sensitivity of 94% and specificity of 86% were obtained. It should be noted that the user can change the threshold to adjust the model performance based on preference. For example, reducing the threshold increase sensitivity while decreasing specificity.
Conclusion: The results highlight the efficacy of deep learning models in detecting non-melanoma skin cancer. This approach can be employed in computer-aided detection systems to assist dermatologists in identification of malignant lesions.
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Mohammadreza Amirsadri , Amir Houshang Zargarzadeh , Farimah Rahimi, Fatemeh Jahani,
Volume 78, Issue 4 (7-2020)
Abstract
Background: Cancer is the third leading cause of death in Iran. Cancer treatment is very costly and chemotherapy drugs are one of the main causes of the high cost of cancer treatment. The purpose of this study was to evaluate the cost of chemotherapy drugs of five most common cancers and identifying the factors might affect the costs of chemotherapy drugs in a one of the large provinces of Iran, located in the center of the country.
Methods: In a cross-sectional study, the data of all patients with five common cancer diagnosed from March 2015 to March 2016 in Isfahan Province in Iran were collected from the Cancer Registry Center of Isfahan, as well as the pharmacies which distribute chemotherapy drugs. The required information (including, patient characteristics, type of cancer, and the costs of chemotherapy) of patients was obtained by linking the information of patients registered in the distributor pharmacies with the patients registered at the Isfahan Cancer Registry Center through the national code of the patients.
Results: Breast, skin, colorectal, stomach and thyroid cancers were the most common cancers within the evaluated period of time in Isfahan Province. Colorectal cancer with an annual average total cost of 110,510,720 IRR (Rials) per patient was the most expensive cancer during the evaluated time period while thyroid cancer with an annual average total cost of 40,791,123 IRR per patient was the least costly cancer within the evaluated time period in Isfahan among the five most common cancers, considering the chemotherapy medicines cost. The highest cost in the colorectal cancer was due to the drug cetuximab distributed under the trade name Erbitux®. Regardless of the cancer type, the mean annual total cost of chemotherapy drugs per patient within the considered period of time calculated to be 96,307,145 IRR.
Conclusion: The chemotherapy cost of the common cancers was high with an annual average of more than 96 million IRR (Rials) per patient, within the considered time period. This was particularly true for colorectal cancer with an annual average cost of more than 110 million Rials. |
Mahdi Ghoncheh, Narges Nazeri ,
Volume 78, Issue 10 (1-2021)
Abstract
Background: Granular cell tumor (Abrikossoff’s tumor) is a rare and slow-growing tumor of the soft tissue. Originated from the Schwann cells, it is often a benign tumor, but it can be malignant in 1-3% of the cases. Malignant cases can cause significant morbidity and mortality. It may develop in many anatomic locations, especially in the head and neck region, and also in skin and subcutaneous tissue.
Case Presentation: The patient was a 27 years old female who was referred to the Imam-Reza Hospital of Birjand because of a subcutaneous mass in the left inguinal region. The tumor was appeared six months ago as a painless slow-growing nodule. In physical examination, there was a 3×4 cm subcutaneous tumor in the left inguinal region. The tumor was attached to the skin but not to the deep and surrounding tissues. There was not any evidence of lymphadenopathy or distant metastasis. The patient was admitted in September 2017. The tumor was excised surgically with a one cm safe margin. The post-operative course was uneventful. In histopathology examination, there was a non-encapsulated neoplasm containing polygonal cells with round to oval nuclei and abundant fine pas-positive granules in the eosinophilic cytoplasm. There were fibrous bands between the tumoral cells. Overlying epithelium shows foci of pseudoepitheliomatous hyperplasia. This finding was compatible with granular cell tumor. Immunohistochemistry (IHC) staining of the cytoplasm and the nucleus for s-100 protein and cytoplasm for CD68 was also positive. The patient is symptom-free and without any sign of local recurrence or distant metastasis for 1.5 years post-operation.
Conclusion: Although it’s a rare tumor, the granular cell tumor must be considered in the differential diagnosis of soft tissue tumors. Surgical excision with a safe margin is the treatment of choice for the tumor. It is recommended that the patients must be observed for two years postoperatively.
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Hossein Bagherian, Shaghayegh Haghjooy Javanmard, Mehran Sharifi, Mohammad Sattari,
Volume 79, Issue 3 (6-2021)
Abstract
This review was conducted between December 2018 and March 2019 at Isfahan University of Medical Sciences. A review of various studies revealed what data mining techniques to predict the probability of survival, what risk factors for these predictions, what criteria for evaluating data mining techniques, and finally what data sources for it have been used to predict the survival of breast cancer patients. This review is based on the Prism statement consisting of published studies in the field of predicting the survival of breast cancer patients using data mining techniques from 2005 to 2018 in databases such as Medline, Science Direct, Web of Science, Embase data and Scopus. After searching in these databases, 527 articles were retrieved. After removing duplicates and evaluating the articles, 21 articles were used. The three techniques of logistic regression, decision tree, and support vector machine have been most used in articles. Age, tumor grade, tumor stage, and tumor size are used more than other risk factors. Among the criteria, the accuracy criterion was used in more studies. Most of the studies used the Surveillance, Epidemiology, and End Results Program (SEER) dataset. Typically, in the field of survival probability prediction, data mining techniques in the field of classification are given more attention due to their adaptation to this field. Accordingly, data mining techniques such as decision tree techniques, logistic regression, and support vector machine were used in more studies than other techniques. The use of these techniques can provide a good basis for clinicians to evaluate the effectiveness of different treatments and the impact of each of these methods on patients' longevity and survival. If the output of these techniques is used to provide the data input required by a decision support system, clinicians can provide risk factors related to the patient, the patient's age, and the patient's physical condition when providing services to breast cancer patients. Through the outputs provided by the decision support system, they provided the most optimal decision to choose the best treatment method and consequently increase patient survival.
Negar Abdi, Iraj Abedi, Mozafar Naserpour , Masoud Rabbani,
Volume 79, Issue 6 (9-2021)
Abstract
Background: Prostate cancer is the most common malignancy in men and the second leading cause of death in all countries of the world. The exact mechanism of prostate cancer is not known. On the other hand, early detection of prostate cancer can lead to a complete cure. Several clinical experiments including Digital Rectum Examination (DRE), biochemistry such as Prostate Specific Antigen (PSA), and pathology such as Trans Rectal Ultra Sonography (TRUS) are used to assess the size and spread of prostate cancer. In this study, the relationship between mean serum PSA and Gleason score as a standard method in patients with prostate cancer was compared using the parameters extracted from DCE MRI.
Methods: This applied-fundamental study was performed on 90 patients with prostate cancer, according to McDonald's criteria who were referred to Shafa Imaging Center in Isfahan, from March 2020 to October 2020. Quantitative analysis is based on modeling the change of concentration of the contrast agent using pharmacokinetic modeling techniques. The pathologist then determined the Gleason score using anatomical landmarks (such as prostate urethra) in the same areas suspected of being cancerous. Existing commercial software captures DCE-MRI data and creates parametric maps such as Ktrans and Kep maps that can be used for diagnostic purposes.
Results: Kep and Ktrans maps showed a significant difference between healthy and cancerous tissue. Kep and Ktrans in prostate cancer were significantly higher than in healthy tissue (P<0.05). Pearson correlation coefficient was used to investigate the relationship between DCE-MRI parameters and histopathological findings. No significant relationship was observed between Gleason score and DCE MRI parameters.
Conclusion: DCE MRI parameters significantly improve the accurate diagnosis of prostate cancer and are useful and effective for diagnosis, management, and evaluation of men with prostate cancer, but should not be considered as a substitute for tissue biopsy.
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Mohammad Ali Damghani , Fatemeh Fani Molky , Soheil Motamed ,
Volume 79, Issue 6 (9-2021)
Abstract
Background: Neck mass is one of the most common clinical findings in all age groups. Differential diagnosis of masses includes a range of pathologies from congenital to infectious or neoplasm. Understanding the risk factors of neck masses can help us to assess them properly. The purpose of this study is to obtain the epidemiological and clinical features of different neck masses in Kerman, Iran.
Methods: This research was a descriptive, retrospective and cross-sectional study. 120 Patients that have been biopsied from neck masses during March 2014 to March 2018 in the otorhinolaryngology department of Shafa hospital of Kerman (referral center of otorhinolaryngology disease of southeastern Iran), were the participants of the study. Data regarding age, sex, history of addiction, smoking and definite pathologic diagnosis were collected and analyzed with SPSS 20th version.
Results: Of 120 cases, 57.5 % were male and 42.5% were female. In the malignant masses group, the male to female ratio was 4.1 to 1. The average age of patients was 39.44 years old. From them, 20.83 percent had a history of smoking but 79.17 percent had never experienced smoking. In addition, 77.5% of the patients have not experienced opium consumption and 22.5% were addicted to opium regularly. There was a significant relationship between smoking and opium consumption and the incidence of malignant cervical masses (P<0.05). In the pathological study, inflammatory and infectious masses with 48.33 percent were in the head of pathology; malignant neoplasm with 25 percent, benign neoplasms with a prevalence of 12.5 percent and congenital masses with a prevalence of 9.7 percent were in the next ranks.
Conclusion: In this study, we investigated the epidemiological and clinical features of neck masses in Kerman. It is obvious that smoking is an important risk factor for neck mass malignancies. Also, the present study revealed that the incidence of malignant tumors increased with age.
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Malihe Hasanzadeh, Marjaneh Farazestanian, Afrooz Azad, Parnian Malakuti, Maryam Esmaeilpour,
Volume 80, Issue 4 (7-2022)
Abstract
Background: Aggressive angiomyxoma is a rare mesenchymal tumor with extensive local invasion. It often presents with a lump in the perineal area and pelvic. Since it often does not involve adjacent organs such as the urethra and anus, does not cause obstructive symptoms. Its incidence is 6 times higher in women than men. This tumor grows slowly and has a slight tendency to metastasize. However, the rate of local recurrence is high. MRI is the most widely used diagnostic method. Ultrasound and CT scan are also used for diagnosis. Due to the rarity of this tumor, it is difficult to diagnose before surgery and pathology assessment. Due to the penetrating nature of the tumor and the lack of a clear capsule, incomplete surgical resection is common. Local recurrence is common even after complete mass resection. Therefore, patients need a long follow-up. The main treatment is surgery but non-surgical interventions such as hormonal therapy, radiotherapy, arterial embolization, etc. have been associated with variable success rates.
Case Presentation: A 54-year-old female patient presented with a vulvar mass in February 2021. The patient mentioned that the mass had existed for ten years and had increased in size in the last two years. After discussion on the tumor board, she underwent surgery. The pathology of the mass was reported to be aggressive angiomyxoma. The patient was treated with a GNRH agonist after surgery. The patient is currently under follow-up and has not had a recurrence so far (March 2020).
Conclusion: Aggressive angiomyxoma is a rare mesenchymal tumor. It has extensive local invasion and a high recurrence rate, but distant metastasis is rare. Estrogen receptors or Progesterone receptors are commonly positive in aggressive angiomyxoma. The best treatment for aggressive angiomyxoma remains unknown. Extensive local resection of the tumor has been reported as an important therapeutic measure. In cases of mass recurrence, reoperation and hormone therapy have been effective. It is important for gynecologists to consider this tumor as a differential diagnosis when dealing with vulvar masses.
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Seyed Mostafa Seyedmardani , Pooya Sedighiany, Yousef Roosta ,
Volume 80, Issue 5 (8-2022)
Abstract
Background: Non-traumatic bone fractures are considered a pathologic condition with various etiologies, including cancer metastases, osteoporosis, and long-term corticosteroid consumption, which can affect people's quality of life. The main aim of this study was to investigate the etiology of pathological bone fractures in patients who were referred to the Hospital.
Methods: In this cross-sectional study, all patients with non-traumatic pathological fractures were included from March 2015 to February 2019 at Imam Khomeini hospital in Urmia city. Data analysis was calculated by chi-square test using SPSS.ver.17.
Results: A total of 168 patients participated in this study, of which 108 patients (64.3%) were female, and 60 patients (35.7%) were male with a mean age of 58.6±21.1 with a minimum and maximum age of 7 and 90 years old, respectively. According to the results, the most common etiologies consist of osteoporosis (33.3%), metastatic carcinoma (28.6%), and primary tumor (11.3%), respectively. Regarding the anatomical site involved, vertebrae (57.1%) and the neck of the proximal femur (27.4%) were detected as the most frequent sites with fractures, respectively. Moreover, a significant relationship was found between the fracture etiologies and demographics data (age and gender) (p<0.001). In this regard, osteoporosis and metastatic carcinoma were reported as the most common fracture etiologies in females and males. In addition, intertrochanteric-subtrochanteric (7.7%), distal femur (4.8%), intertrochanteric (1.2%), and acetabulum (1.2%) were considered other sites of fracture with less frequency. It is worth noting that for patients with ages less than fifty years old (<50 years old), commonly reported fracture etiology was the primary osteosarcoma, while in patients with ages more than fifty (>50 years old), osteoporosis was defined as the main fracture etiology.
Conclusion: Together, the present study results showed that osteoporosis and metastatic carcinoma were the most critical etiology of fractures, and there was a statistical correlation between demographic characteristics (such as gender and age) and pathological fracture etiologies. According to the statistical results, the most common sites exposed for fractures were also the vertebral and proximal femur.
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Majid Zamani, Masoudeh Babakhanian , Farhad Heydari , Mohammad Nasr-Esfahani , Mohammad Mahdi Zarezadeh ,
Volume 80, Issue 7 (10-2022)
Abstract
Background: In addition to heart disease, ECG also changes in non-heart disease, which due to its similarity, can lead to misdiagnosis of heart disease in patients. ECG changes in brain lesions such as ischemic and hemorrhagic strokes, brain traumas, etc. and have been studied in many articles, but the effects of brain midline shift on ECG changes have not been studied. In this study, we want to examine these changes.
Methods: This is a prospective cross-sectional descriptive study. Patients with brain tumors who were referred to Al-Zahra and Kashani hospitals in Isfahan from April 2019 to March 2021 were selected. Patients with a history of heart disease, patients receiving medications that cause ECG changes, patients with ECG changes due to non-cardiac and cerebral causes, and individuals under 15 years of age were not included in the study. Patients whose ECG changes were due to electrolyte disturbances or acute heart problems were also excluded from the study. After obtaining informed consent from patients, a CT scan or brain MRI was taken and patients were divided into two groups with and without midline shift. Then the ECG was taken and ECG changes (T wave, ST segment, QTc Interval, QRS prolongation) were compared in two groups of brain tumors with and without midline shift.
Results: 136 patients were included in the study. Of these, 69 patients were in the without midline shift group and 67 patients were in the midline shift group. In the midline shift group, 3% of patients had ST segment changes and 23.9% had T wave changes, which were 1.4% and 10.1% in the without midline shift group, respectively. The mean QTc Interval in the two groups without and with midline shift was 338.26 (4 28.438) and 388.66 (37.855), respectively, and the mean QRS in the without midline shift group was 86.09 (88.9.88) ms and in the midline shift group was 94.63 (±12.83) ms.
Conclusion: Brain midline shifts can cause QRS widening, QTc interval prolongation, and T-wave changes in patients' ECGs.
Yasser Hasanzadeh, Zahra Sagheb Movafagh , Atena Sahrabeygi , Hamid Heidarian Miri , Masoumeh Gharib ,
Volume 81, Issue 10 (1-2024)
Abstract
Background: Identifying the epidemiological aspects of central nervous system (CNS) tumors is the first step in implementing management protocols to control the condition of these tumors. We aimed to examine the epidemiology and histopathology of both benign and malignant tumors of the CNS in one of the referral and university centers in the east of Iran.
Methods: This cross-sectional study was conducted on all files of patients admitted to Qaem Hospital in Mashhad City, Iran, in a period of 10 years from March 2009 to February 2018 with a definitive diagnosis of benign or malignant tumors of the CNS, including tumors of the brain, cerebellum, spinal cord, or meningeal membranes. Information sources included the patients' physical files and the hospital information system (HIS). The statistical software SPSS version 28.0 for Windows (IBM SPSS, Armonk, New York, USA) was used for the statistical analysis.
Results: In total, 775 patients with benign and 771 patients with malignant CNS tumors were included in the study. Regarding epidemiological aspects of benign tumors, the incidence rate of women was almost twice that of men (68.47% versus 31.53%), with an overall average age of 45.31±19.81 years. The most common benign tumors were meningioma (72.77%), followed by schwannoma (13.67%). Regarding malignant brain tumors, the mean age of affected patients was 36.64±19.67 years, with males accounting for 53.04% of cases and females for 46.96%. The most frequent type of tumor was glioblastoma (32.68%), followed by diffuse astrocytoma (16.47%). Both benign and malignant CNS tumors were associated with significant hospital mortality; in-hospital mortality rates for benign and malignant tumors were 10.1% and 17.5%, respectively. Tumor type and its grade were the main determinants of early death in malignant CNS tumors.
Conclusion: The epidemiological characteristics of benign and malignant tumors in our study community were similar to the reports presented in other communities. Knowledge of these characteristics provides the possibility of managing patients and reducing morbidity and mortality related to these tumors.
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