32 results on '"Omid Moradi Moghaddam"'
Search Results
2. Relation between nutritional status on clinical outcomes of critically ill patients: emphasizing nutritional screening tools in a prospective cohort investigation
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Omid Moradi Moghaddam, Masoumeh Hosseinzadeh Emam, Pardis Irandoost, Mahdi Hejazi, Zeinab Iraji, Leila Yazdanpanah, Seyedeh Farnaz Mirhosseini, Abolfazl Mollajan, and Mohammad Niakan Lahiji
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Malnutrition ,Intensive care unit ,Nutritional risk assessment ,Clinical outcome ,Nutrition. Foods and food supply ,TX341-641 ,Food processing and manufacture ,TP368-456 ,Medicine (General) ,R5-920 - Abstract
Abstract Background Malnutrition is a significant concern reported in adult critically ill patients, yet there is no gold standard to assess nutritional status in this population. This study examines the association between nutritional status and clinical outcomes in intensive care unit (ICU) patients using nutritional risk assessment tools and aims to look for the best tool. Method In a single-center prospective cohort study among 165 patients, the predictive performance of high or low malnutrition risk assessed by Nutritional Risk Screening (NRS), Modified Nutrition Risk in Critically Ill (m-NUTRIC), Mini-Nutritional-Assessment Short-Form (MNA-SF), Controlling Nutritional status (CONUT), and Prognostic Nutritional Index (PNI) were evaluated and compared for mortality, organ failure, length of hospitalization, and mechanical ventilation (MV). Results Different assessment tools showed various nutritional statuses. m-NUTRIC and NRS-2002 were found to be associated more strongly relative to other tools with mortality (RR = 1.72; 95% CI, 1.42–2.08) and (RR = 1.37; 95% CI, 1.08–1.72), organ failure (RR = 1.69; 95% CI, 1.44–1.96) and (RR = 1.22; 95% CI, 0.99–1.48), MV (RR = 1.46; 95% CI, 1.27–1.65) and (RR = 1.21; 95% CI, 1.04–1.39) respectively. There was no correlation between malnutrition levels assessed by mentioned tools except for NRS-2002 and length of hospitalization. In predicting mortality or illness severity, the cut points were different for some tools like NUTRIC-score and all assessed outcomes (3.5), MNA-SF and mortality (6.5), CONUT with mortality, and MV (6.5). Conclusions A considerable proportion of patients admitted to the ICU are at high risk for malnutrition. Compared to other tools, m-NUTRIC and NRS-2002 proved superior in predicting clinical outcomes in critically ill patients. Other tools overestimated the risk of malnutrition in the ICU so couldn’t predict clinical outcomes correctly.
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- 2024
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3. Effect of omega-3 supplementation on lipid profile in children and adolescents: a systematic review and meta-analysis of randomized clinical trials
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Masoud Khorshidi, Zohreh Sajadi Hazaveh, Malek Alimohammadi-kamalabadi, Sanaz Jamshidi, Omid Moradi Moghaddam, Beheshteh Olang, Sayeh Hatefi, Amirhossein Hosseini, Parsa Jamilian, Meysam Zarezadeh, Parichehr Kohansal, Javad Heshmati, Parmida Jamilian, and Aliakbar Sayyari
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Omega-3 ,Lipid profile ,Children ,Systematic review ,Meta-analysis ,Nutrition. Foods and food supply ,TX341-641 ,Nutritional diseases. Deficiency diseases ,RC620-627 - Abstract
Abstract Purpose Dyslipidemia is considered as a known risk factor for cardiovascular disease. Yet various trials with wide ranges of doses and durations have reported contradictory results. We undertook this meta-analysis of randomized controlled trials (RCTs) to determine whether omega-3 supplementation can affect lipid profile in children and adolescents. Methods Cochrane Library, Embase, PubMed, and Scopus databases were searched up to March 2021. Meta-analysis was performed using random-effect method. Effect size was expressed as weighted mean difference (WMD) and 95% confidence interval (CI). Heterogeneity was assessed using the I 2 index. In order to identification of potential sources of heterogeneity, predefined subgroup and meta-regression analysis was conducted. Results A total of 14 RCTs with 15 data sets were included. Based on the combination of effect sizes, there was a significant reduction in TG levels (WMD: -15.71 mg/dl, 95% CI: -25.76 to -5.65, P=0.002), with remarkable heterogeneity (I2=88.3%, P
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- 2023
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4. Relationship of Vitamin D level with insulin dosage required based on insulin therapy protocol
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Mohammad Niakan Lahiji, Omid Moradi Moghaddam, Forough Ameri, Alireza Pournajafian, and Farnaz Mirhosseini
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Vitamin D ,insulin ,hyperglycemia ,intensive care unit (ICU) ,Medicine ,Human anatomy ,QM1-695 - Abstract
The deficiency of vitamin D amongst Iranian people is high and also is related on hyperglycemia. This study aims to evaluate the association of vitamin D levels with the required dose of insulin prescribed based on an insulin therapy protocol in critical condition patients admitted to intensive care unit (ICU), in an investigation based in Iran. This cross-sectional study was performed on patients who required insulin due to hyperglycemia. The relationship between serum vitamin D level and the required dose of insulin prescribed based on insulin therapy protocol in this group of patients was investigated. A total of 172 patients with a mean age of 46.93 ± 31.9 years were included in this study. Across the included participants, 78.8% of patients had vitamin D deficiency, 11.9% had insufficient vitamin D and 9.3% had normal vitamin D levels. There was a significant difference in mean blood sugar between the vitamin D deficiency group and the normal group. Vitamin D levels were also significantly higher in men than women. Furthermore, the HbA1C hemoglobin level in patients with Vitamin D deficiency was significantly higher compared to the group with normal levels of vitamin D. Our findings suggest that decreased vitamin D is associated with increased blood sugar and insulin requirements in patients admitted to ICU. Women are at a higher risk for vitamin D deficiency. We hope that these findings may help inform relevant treatment strategies.
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- 2023
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5. The outcome of using intravenous immunoglobulin (IVIG) in critically ill COVID-19 patients’: a retrospective, multi-centric cohort study
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Mohammadreza Salehi, Mahdi Barkhori Mehni, Mohammadmehdi Akbarian, Samrand Fattah Ghazi, Nasim Khajavi Rad, Omid Moradi Moghaddam, SaeedReza Jamali Moghaddam, Masoumeh Hosseinzadeh Emam, Sayed Hamidreza Abtahi, Maryam Moradi, and Fereshteh Ghiasvand
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COVID-19 ,Intravenous immunoglobulin ,IVIG ,Pneumonia ,Coronavirus ,Pandemic ,Medicine - Abstract
Abstract Background During the COVID-19 pandemic, different treatments have been used in critically ill patients. Using intravenous immunoglobulin (IVIG) has been suggested in various studies as an effective option. Our study aims to access the efficacy of IVIG in critically ill COVID-19 patients. Methods In this retrospective matched cohort study, records of three tertiary centers with a large number of COVID-19 admissions were evaluated and used. Based on treatment options, patients were divided into two groups, standard COVID-19 treatment (109 patients) and IVIG treatment (74 patients) patients. Also, the effect of IVIG in different dosages was evaluated. Patients with IVIG treatment were divided into three groups of low (0.25 gr/kg), medium (0.5 gr/kg), and high (1 gr/kg) dose. Data analysis was performed using an independent t test and one-way analysis of variance (ANOVA) to compare the outcomes between two groups, including duration of hospitalization, intensive care unit (ICU) length of stay, and mortality rate. Results The duration of hospitalization in the IVIG group was significantly longer than standard treatment (13.74 days vs. 11.10 days, p 0.05). Also, initial outcomes in IVIG subgroups were compared separately with the standard treatment group. The results indicated that only the duration of hospitalization in the IVIG subgroup with medium dose is significantly longer than the standard treatment group (p
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- 2022
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6. Evaluation of the effects of pycnogenol (French maritime pine bark extract) supplementation on inflammatory biomarkers and nutritional and clinical status in traumatic brain injury patients in an intensive care unit: A randomized clinical trial protocol
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Mahsa Malekahmadi, Omid Moradi Moghaddam, Sheikh Mohammed Shariful Islam, Kiarash Tanha, Mohsen Nematy, Naseh Pahlavani, Safieh Firouzi, Mohammad Reza Zali, and Abdolreza Norouzy
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Traumatic brain injury ,Critical care ,Pycnogenol ,Inflammation ,Nutrition support ,French maritime pine bark extract ,Medicine (General) ,R5-920 - Abstract
Abstract Background Traumatic brain injury (TBI) is one of the major health and socioeconomic problems in the world. Immune-enhancing enteral formula has been proven to significantly reduce infection rate in TBI patients. One of the ingredients that can be used in immunonutrition formulas to reduce inflammation and oxidative stress is pycnogenol. Objective The objective of this work is to survey the effect of pycnogenol on the clinical, nutritional, and inflammatory status of TBI patients. Methods This is a double-blind, randomized controlled trial. Block randomization will be used. An intervention group will receive pycnogenol supplementation of 150 mg for 10 days and a control group will receive a placebo for the same duration. Inflammatory status (IL-6, IL- 1β, C-reactive protein) and oxidative stress status (malondialdehyde, total antioxidant capacity), at the baseline, at the 5th day, and at the end of the study (10th day) will be measured. Clinical and nutritional status will be assessed three times during the intervention. The Sequential Organ Failure Assessment (SOFA) questionnaire for assessment of organ failure will be filled out every other day. The mortality rate will be calculated within 28 days of the start of the intervention. Weight, body mass index, and body composition will be measured. All analyses will be conducted by an initially assigned study arm in an intention-to-treat analysis. Discussion We expect that supplementation of 150 mg pycnogenol for 10 days will improve clinical and nutritional status and reduce the inflammation and oxidative stress of the TBI patients. Trial registration This trial is registered at clinicaltrials.gov (ref: NCT03777683) at 12/13/2018.
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- 2020
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7. The content of plasma selenium in early admitted septic patients
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Omid Moradi Moghaddam, Mohammad Niakan Lahiji, Azadeh Moghaddas, Maryam Farasatinasab, and Somayyeh Nasiripour
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Critical ill patients ,intensive care unit ,Selenium ,sepsis ,Pharmacy and materia medica ,RS1-441 - Abstract
Objective: Selenium depletion has been reported in critical illness correlates with an increase in mortality and morbidity. In this study, we aimed to access the selenium plasma levels of septic patients early at the Intensive Care Unit (ICU) admission in order to compare with reference range. Methods: We conducted a cross-sectional study in a university affiliated hospital aiming to assess the early plasma level of selenium in ICU admitted patients. eighty patients diagnoses with sepsis were included and considered for characteristic evaluation, monitoring criteria assessment and also blood sampling. All blood sampling was performed during 48 hours of the ICU admission in order to determined the plasma Selenium level by atomic absorption method. Findings: The mean plasma levels of selenium in male and female was 98.14 ± 23.52 and 78.1 ± 24.46 μ/L, respectively. Although selenium plasma levels was higher in the ICU male patients significantly, both had near normal range (80 μ/L). Conclusion: In this study we found that in early admitted Iranian ICU patients in Tehran, selenium deficiency has not routinely seen but probably will happen during ICU hospitalization.
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- 2017
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8. Relationship between type of brain injury with Bispectral Index monitoring in intubated ICU trauma patients
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Omid Moradi Moghaddam, Mohammad Niyakan Lahiji, Valiollah Hassani, Farid Kazemi Gezik, and Ehsan Farazi
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consciousness monitors ,craniocerebral trauma ,frontal lobe ,intensive care units ,Medicine (General) ,R5-920 - Abstract
Background: Bispectral Index (BIS) may be used in traumatic brain injured patients with different anatomical sites of injury to evaluate the level of consciousness. The objective of this study is to evaluate the relation between type of brain injury and the presence or absence of frontal lobe damage based on brain CT-scan with BIS monitoring in intubated acute head trauma patients admitted to the intensive care unit (ICU). Methods: Participants of this cross-sectional study consisted of 30 intubated head trauma patients over the age of 15 years old, without any known history of visual or hearing impairments, neurologic disorders, mental retardation, or frontal skin laceration, who were admitted to the ICU in Rasool Akram University Hospital, Tehran. Patients who needed muscle relaxant administration, or those who showed instability of vital signs, hypoxemia, disorders of the blood biochemistry, or blood gases, liver or kidney failure, convulsion or hypoxic encephalopathy during the study were excluded. In the first three days of admission, each patient underwent monitoring of BIS every sixty minutes for just six hours a day. All the hypnotic drugs were discontinued six hours prior to the start of monitoring and fentanyl was the only opioid, which was administered if an analgesic was required. Statistical analysis were used to evaluate the data and p-value less than 0.05 was considered statistically significant. Results: Mean age of all patients was 43.6 years with a Standard Deviation (SD) of 18.96. Presence or absence of frontal lobe injury, had no statistically significant correlations with mean BIS in each three days of study and the mean BIS total. However, mean BIS in the second and third days had statistically significant differences in different types of cranial lesions (contusion, subdural hemorrhage, subarachnoid hemorrhage, etc) which usually have different prognoses. Conclusion: Different kinds of acute traumatic cranial lesions with different prognosis may have different values in BIS monitoring. Presence or absence of frontal lobe injury, had no statistically significant correlations with BIS values.
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- 2015
9. Obesity Paradox
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Razieh Khalooeifard, Amirhossein Hemmati, Neda Izadi, Cain Clark, Seyed Mohammad Reza Hashemian, Masoumeh Hosseinzadeh Emam, Omid Moradi Moghaddam, and Ali Amirsavadkouhi
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Nutrition and Dietetics - Published
- 2022
10. Linear mixed model analysis to evaluate correlations between remdesivir adverse effects with age and gender of patients with mild Covid‐19 pneumonia
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Mohsen Sedighi, Alireza Amanollahi, Omid Moradi Moghaddam, Hamed Basir Ghafouri, Seyede Elham Hoseini, and Nader Tavakoli
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Male ,Alanine ,Infectious Diseases ,Drug-Related Side Effects and Adverse Reactions ,Creatinine ,Virology ,Humans ,Female ,Adenosine Monophosphate ,COVID-19 Drug Treatment - Abstract
We aimed to assess longitudinal changes in clinical indexes of corona disease 2019 (Covid-19) patients with mild pulmonary infection during 5 days of remdesivir therapy and determine the effect of age and gender on remdesivir adverse effects (AE). Patients' clinical data including inflammatory markers, liver and renal function tests, and heart rate (HR) were extracted from medical records. Linear mixed model (LMM) was used to analyze longitudinal changes in patients' clinical indexes. Gender and age were inserted in LMM as covariates to find their correlation with AE and clinical indexes. Of 84 patients, 35 patients met our criteria for the study. There were significant increases in mean levels of white blood cell (WBC; p = 0.005), alanine aminotransferase (ALT; p = 0.001), aspartate aminotransferase (p = 0.001), blood urea nitrogen (BUN; p = 0.001), and creatinine (p = 0.006), whereas mean levels of erythrocyte sedimentation rate (p = 0.005), C-reactive protein (p = 0.001), alkaline phosphatase (p = 0.001), and potassium (p = 0.003) decreased significantly. Estimated glomerular filtration rate (p = 0.001) and HR (p = 0.001) showed a notable decline over the course of treatment. LMM analysis showed that mean changes in WBC (β = 0.94, p = 0.029), creatinine (β = 0.12, p = 0.020), and HR (β = 6.47, p = 0.008) were greater in males than in females. Also, age of patients had a significant effect on the mean changes of WBC (β = -0.02, p = 0.023), sodium (β = -0.06, p = 0.010), BUN (β = 0.23, p = 0.001), and HR (β = -0.29, p = 0.001). Despite no renal and liver dysfunction, Covid-19 patients with mild pulmonary infection may develop some remdesivir AE and attributed side effects might be affected by gender and age of patients.
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- 2022
11. The effect of French maritime pine bark extract supplementation on inflammation, nutritional and clinical status in critically ill patients with traumatic brain injury: A randomized controlled trial
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Sheikh Mohammed Shariful Islam, Mahdi Shadnoush, Mohsen Nematy, Jenna McVicar, Abdolreza Norouzy, Jamshid Gholizadeh Navashenaq, Omid Moradi Moghaddam, Safieh Firouzi, Armin Shirvani, Mohammad Reza Zali, Naseh Pahlavani, and Mahsa Malekahmadi
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medicine.medical_specialty ,Traumatic brain injury ,Critical Illness ,Nutritional Status ,Placebo ,Gastroenterology ,law.invention ,Randomized controlled trial ,law ,Internal medicine ,Intensive care ,Brain Injuries, Traumatic ,Humans ,Medicine ,Survival rate ,Flavonoids ,Inflammation ,Pharmacology ,Plant Extracts ,business.industry ,Mortality rate ,Pinus ,medicine.disease ,Confidence interval ,Parenteral nutrition ,Dietary Supplements ,Plant Bark ,business - Abstract
Inflammation plays an important role in the pathophysiology of traumatic brain injury (TBI). Based on the anti-inflammatory properties of French maritime pine bark extract and the neuroprotective effects, we aimed to evaluate the effects of its supplementation on TBI. Sixty-seven TBI patients admitted to the intensive care units (ICUs) were enrolled. After stabilizing the hemodynamic status, the intervention group received 150 mg of French maritime pine bark extract supplementation (Oligopin) with enteral nutrition for 10 days. The control group received a placebo. Inflammatory status and oxidative stress markers were measured three times. Also, clinical and nutritional statuses were assessed. Supplementation, significantly decreased IL-6 (β = -53.43 pg/ml, 95% confidence interval [CI] = -91.74, -15.13, p = .006), IL-1β (β = -111.66 pg/ml, 95% CI = -183.79, -39.5402, p = .002) and C-reactive protein (β = -19.99 mg/L, 95% CI = -27.23, -12.76, p ˃ .001) in the intervention group compared to control group after 10 days. Clinical scores including acute physiology and chronic health evaluation II and sequential organ failure assessment were reduced (β = -3.72, 95% CI = -5.96, -1.49, p = .001and β = -2.07, 95% CI = -3.23, -0.90, p < .001, respectively), and Nutric score was reduced compared to control group (β = -.60, 95% CI = -1.08, -0.12, p = .01). The survival rate was higher by 15% in the intervention group compared to control group. Oligopin supplementation in TBI patients in ICU reduced inflammation and improved the clinical status and malnutrition score and thereby reducing the mortality rate.
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- 2021
12. Cerebral Venous Sinus Thrombosis in a Young Body Builder Man With Androgen Use
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Omid Moradi Moghaddam, Moghaddam Nasiripour, Masoumeh Hosseinzadeh Emam, and Maryam Farasatinasab
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Male ,Sinus Thrombosis, Intracranial ,Androgens ,Humans ,Pharmacology (medical) - Published
- 2022
13. Promising impacts of mesenchymal stem cell therapy in treatment of SARS-CoV-2 (COVID-19)
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Beheshteh Olang, Meysam Zarezadeh, Mohammadreza Emami, Masoud Khorshidi, and Omid Moradi Moghaddam
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Pulmonary and Respiratory Medicine ,2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Mesenchymal stem cell ,Medicine ,Cardiology and Cardiovascular Medicine ,Critical Care and Intensive Care Medicine ,business ,Virology ,Article - Published
- 2020
14. An Open-Label, Single-Arm, Pilot Intervention Study to Assess the Efficacy and Safety of Apixaban in Heparin-Induced Thrombocytopenia
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Maryam Farasatinasab, Saeedeh Balouchzehi, Omid Moradi Moghaddam, Nafiseh Ansarinejad, Mahmonir Mohammadi, and Somayyeh Nasiripour
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Pharmacology ,Heparin ,Pyridones ,Anticoagulants ,Humans ,Pyrazoles ,Pharmacology (medical) ,Hemorrhage ,Pilot Projects ,Thrombosis ,Enoxaparin ,Thrombocytopenia ,Factor Xa Inhibitors - Abstract
Heparin-induced thrombocytopenia (HIT) is a serious adverse drug reaction due to its related risk of life- and limb-threatening thrombosis. Apixaban is a direct factor Xa inhibitor that may be intended as an ideal alternative for the management of HIT. In this open-label, single-arm, pilot intervention study, the efficacy and safety of apixaban were evaluated in 30 patients aged18 years with clinically suspected HIT (4Ts score ≥4 points). Patients with mechanical heart valves, chronic kidney disease, hepatic impairment, and active bleeding were excluded. In all patients with inclusion criteria, heparin or enoxaparin was discontinued and apixaban was started. The dose of apixaban for HIT suspected patients was defined on the basis of the reason for anticoagulant therapy. End points included confirmed thrombosis, mortality, and adverse treatment-related events. After apixaban therapy, platelet counts normalized in all patients; none of the 30 subjects developed new, progressive, or recurrent thrombosis; and only 1 of 30 patients developed a hemorrhagic event. Five patients (16.7%) died, but the reason for death was not linked to thrombosis, hemorrhage, or adverse effects of apixaban. Along with the available emerging data, our results propose that apixaban could be a safe and effective drug for the management of suspected HIT in clinically stable patients.
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- 2022
15. Nutritional status of patients hospitalized in the intensive care unit: A comprehensive report from Iranian hospitals, 2018
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Batoul Khoundabi, Omid Moradi Moghaddam, Zeinab Javid Mishamandani, Omid Pournik, Mohammad Taghi Beigmohammadi, Tannaz Jamialahmadi, Abdolreza Norouzy, Mohsen Nematy, Elham Shafiei, Alireza Sedaghat, Mohammad Rezaeisadrabadi, Masoum Khoshfetrat, Mohammad Safarian, Farid Zand, Mahdi Shadnoush, and Seyed Mohammadreza Hashemian
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Adult ,Male ,medicine.medical_specialty ,Critical Illness ,Nutritional Status ,Disease ,Iran ,Critical Care and Intensive Care Medicine ,Risk Assessment ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,law ,medicine ,Humans ,Sampling (medicine) ,Aged ,Nutritional Support ,Critically ill ,business.industry ,Malnutrition ,030208 emergency & critical care medicine ,Nutritional status ,Middle Aged ,medicine.disease ,Intensive care unit ,Intensive Care Units ,Regimen ,Nutrition Assessment ,030228 respiratory system ,Emergency medicine ,Female ,Complication ,business - Abstract
Introduction and aim Malnutrition is a complication of hospitalization in critically ill patients. This event is occurred because of disease and therapeutic processes for curing the patients. Determination of nutritional status helps physicians and clinical nutritionists decide on the best regimen which should be prescribed for a patient. In the current study, we aimed to report the nutritional status ofpatientshospitalizedin the intensive care unit (ICU). Method of study We used three standard tolls, including Subjective global assessment (SGA), Nutrition Risk in the Critically Ill (NUTRIC) Score and nutrition risk screening (NRS) questionnaires via a multi-stage sampling for different ICU wards of 32 university hospitals in Iran. Frequencies and rates of nutritional scores, comparative studies, and determined agreement of scoring systems and nutritional status in any ward of hospitals were evaluated. Results There were 771 males and 540 female Cancer and trauma patients had the best and worst nutritional scores, respectively. Using NRS and NUTRIC, the low-risk scores were more frequent than thehigh-riskscores among ICU patients. SGA showed that most patients were in grades A (well nutritional status) or B (moderate nutritional status), andfew caseswere in grade C (poor nutritional status).The high-risk nutritional score wasobtained for older patients. NUTRIC and NRS had better agreement for diagnosis and differentiation of malnutrition than NUTRIC-SGA or NRS-SGA pairs. However, there was no strong agreement between the mentioned pairs. Conclusion Nutritional status of patients hospitalized in ICU wards in Iran wassomewhat better than other countries that this could be due to the highly observed guidelines of patient's care in Iran. Anyway,it is suggested that a more precise tool of nutritional scoresto be validated for patients hospitalized in ICU·In addition, better medical care needs a well evaluation of nutritional insufficiencies and what is necessary for compensation using complementary regimens.
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- 2019
16. Outcome of Using Intravenous Immunoglobulin (IVIG) in Critically Ill COVID-19 Patients’: A Retrospective, Multi-Centric Cohort Study
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Mohammadreza Salehi, Nasim Khajavi Rad, Masoumeh Hosseinzadeh Emam, Mohammadmehdi Akbarian, Omid Moradi Moghaddam, Sayed Hamidreza Abtahi, Fereshteh Ghiasvand, Mahdi Barkhori Mehni, Maryam Moradi, Saeed Reza Jamali Moghaddam, and Samrand Fattah Ghazi
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Pediatrics ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,biology ,Critically ill ,business.industry ,biology.protein ,Medicine ,Antibody ,business ,Outcome (game theory) ,Cohort study - Abstract
Background: To access the effect of Intravenous immunoglobulin (IVIG) in critically ill corona virus disease 2019 (COVID-19) patients.Method: In this retrospective matched cohort study, records of three tertiary centers with large number of COVID-19 admissions were evaluated and used. Based on treatment options, patients were divided into two groups, standard COVID-19 treatment (109 patients) and IVIG treatment (74 patients) patients. Also, the effect of IVIG in different dosages was evaluated. Patients with IVIG treatment were divided into three groups of low (0.25 gr/kg), medium (0.5 gr/kg), and high (1 gr/kg) dose. Data analysis was performed using independent t-test and One-way analysis of variance (ANOVA) to compare the outcomes between two groups, including duration of hospitalization, intensive care unit (ICU) length of stay, and mortality rate.Result: The duration of hospitalization in the IVIG group were significantly longer than standard treatment (13.74 days vs. 11.10 days, p<0.05). There was not a significant difference between the two groups in ICU length of stay, number of intubated patients and duration of mechanical ventilation (P>0.05). Also initial outcomes in IVIG subgroups were compared separately with the standard treatment group. The results indicated that only the duration of hospitalization in the IVIG subgroup with medium dose is significantly longer than the standard treatment group (PConclusion: Using IVIG is not beneficial for COVID-19 patients based on no remarkable differences in duration of hospitalization, ICU length of stay, duration of mechanical ventilation and even mortality rate.
- Published
- 2021
17. Effect of enteral immunomodulatory nutrition formula on mortality and critical care parameters in critically ill patients: A systematic review with meta-analysis
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Sheikh Mohammed Shariful Islam, Omid Moradi Moghaddam, Naseh Pahlavani, Zachary S. Clayton, Safieh Firouzi, Sepideh Soltani, Mahsa Malekahmadi, and Sanaz Rezaei Zonooz
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ARDS ,medicine.medical_specialty ,Critical Care ,Critical Illness ,Lung injury ,Critical Care Nursing ,law.invention ,Enteral Nutrition ,Randomized controlled trial ,law ,Critical care nursing ,Internal medicine ,Intensive care ,medicine ,Humans ,Respiratory function ,Omega 3 fatty acid ,Aged ,Respiratory Distress Syndrome ,business.industry ,Length of Stay ,medicine.disease ,Intensive care unit ,Respiration, Artificial ,Intensive Care Units ,business - Abstract
BACKGROUND Enteral immunomodulatory nutrition is recommended as an adjuvant therapy for patients in intensive care units (ICU), but its effectiveness is incompletely understood. AIM The aim of this review was to examine the effect of a commonly used immunomodulatory formula-omega-3 fatty acids, γ-linolenic acid, and antioxidants-on clinical outcomes and mortality risk in critically ill patients. DESIGN Systematic review and meta-analysis of randomized controlled trials (RCTs). METHOD PubMed, Scopus, and Institute for Scientific Information (ISI) Web of Knowledge databases were searched until 18 February 2021. RCTs that used the immunomodulatory formula in the ICU were included. RESULTS Ten RCTs (1166 participants) were included in the meta-analysis. The immunomodulatory formula reduced the duration of ICU stay weighted mean difference [(WMD): -2.97 days; 95%CI: -5.59, -0.35)], mechanical ventilation (WMD = -2.20 days, 95%CI: -4.29, -0.10), sequential organ failure assessment and multiple organ dysfunction scores (Hedge's g: -0.42 U/L; 95% CI: -0.74, -0.11), decreased 8-day overall mortality risk (RR = 0.74, 95% CI: 0.58, 0.91), and extended the ICU-free days (WMD: 4.06 days, 95% CI: 0.02, 8.09). The improvement in respiratory function and reduction in mortality risk was more in patients with acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). Furthermore, the reduction in mechanical ventilation and mortality risk was more evident in older (>60 years) vs young adults. CONCLUSION AND RELEVANCE TO CLINICAL PRACTICE Taken together, the immunomodulatory formula may enhance clinical practice for critical care nurses, such that the prevalence and/or susceptibility to secondary conditions commonly encountered in the ICU (ie, ALI and ARDS) could be attenuated, ultimately allowing critical care nurses to focus their care on the primary reason for which a patient is in the ICU. The study protocol was registered in PROSPERO.
- Published
- 2021
18. Effect of bariatric surgery on endogenous sex hormones and sex hormone-binding globulin levels: a systematic review and meta-analysis
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Omid Moradi Moghaddam, Shimels Hussien Mohammed, Mohammad Reza Emami, Maryam Safabakhsh, Meysam Zarezadeh, Masoud Khorshidi, and Shahab Alizadeh
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Male ,endocrine system ,medicine.medical_specialty ,Dehydroepiandrosterone ,Bariatric Surgery ,030209 endocrinology & metabolism ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Dehydroepiandrosterone sulfate ,Sex hormone-binding globulin ,Sex Hormone-Binding Globulin ,medicine ,Humans ,Androstenedione ,Gonadal Steroid Hormones ,Testosterone ,biology ,business.industry ,Luteinizing Hormone ,Prolactin ,Surgery ,chemistry ,biology.protein ,030211 gastroenterology & hepatology ,Female ,Follicle Stimulating Hormone ,Luteinizing hormone ,business ,hormones, hormone substitutes, and hormone antagonists ,Hormone - Abstract
Background Most studies have shown beneficial effect of bariatric surgery (BS) on serum levels of sex hormones. Objective A systematic review and meta-analysis was conducted to examine the magnitude of possible changes in levels of sex hormones following BS. Settings Electronic databases were searched, including PubMed, Scopus, Web of Science, and Embase, for relevant studies. Methods The heterogeneity of the studies was examined by χ2 tests and the degree of heterogeneity was estimated using I2 statistic. Results The results of pooled analyses revealed that BS caused a significant increase in luteinizing hormone (LH), follicular stimulating hormone (FSH), total testosterone (TT), and sex hormone binding globulin (SHBG) levels and conversely, decreased dehydroepiandrosterone (DHEA) and estradiol (E2) levels in males. For females, BS significantly increased LH, FSH, and SHBG levels and conversely, decreased androstenedione (AE), E2 and TT levels. Additionally, the level of progesterone (P), prolactin (PRL), free testosterone (FT) and dehydroepiandrosterone sulfate (DHEA-S) showed no significant changes in patients who had undergone BS. Conclusion BS changed most sex hormones levels including LH, FSH, TT, SHBG, AE, DHEA, and E2. It seems that BS is able to exert substantial impacts on sex hormones levels and as well as sexual function, however, larger, and more precise trials are required to specifically focus on these claims.
- Published
- 2020
19. Evaluation of the effects of pycnogenol (French maritime pine bark extract) supplementation on inflammatory biomarkers and nutritional and clinical status in traumatic brain injury patients in an intensive care unit: A randomized clinical trial protocol
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Sheikh Mohammed Shariful Islam, Omid Moradi Moghaddam, Mahsa Malekahmadi, Naseh Pahlavani, Mohsen Nematy, Abdolreza Norouzy, Safieh Firouzi, Mohammad Reza Zali, and Kiarash Tanha
- Subjects
Male ,Medicine (miscellaneous) ,Severity of Illness Index ,Enteral administration ,Antioxidants ,law.invention ,Study Protocol ,chemistry.chemical_compound ,Traumatic brain injury ,0302 clinical medicine ,Randomized controlled trial ,law ,Brain Injuries, Traumatic ,Pharmacology (medical) ,Randomized Controlled Trials as Topic ,lcsh:R5-920 ,0303 health sciences ,Clinical Trials, Phase I as Topic ,Mortality rate ,Middle Aged ,Malondialdehyde ,Intensive care unit ,Intensive Care Units ,Treatment Outcome ,Pycnogenol ,Female ,lcsh:Medicine (General) ,Adult ,medicine.medical_specialty ,Adolescent ,Nutritional Status ,Placebo ,Young Adult ,03 medical and health sciences ,Clinical Trials, Phase II as Topic ,Double-Blind Method ,Nutrition support ,Internal medicine ,medicine ,Humans ,Aged ,030304 developmental biology ,Flavonoids ,Inflammation ,Plant Extracts ,business.industry ,medicine.disease ,French maritime pine bark extract ,Oxidative Stress ,Critical care ,chemistry ,Dietary Supplements ,business ,Body mass index ,Biomarkers ,030217 neurology & neurosurgery - Abstract
Background Traumatic brain injury (TBI) is one of the major health and socioeconomic problems in the world. Immune-enhancing enteral formula has been proven to significantly reduce infection rate in TBI patients. One of the ingredients that can be used in immunonutrition formulas to reduce inflammation and oxidative stress is pycnogenol. Objective The objective of this work is to survey the effect of pycnogenol on the clinical, nutritional, and inflammatory status of TBI patients. Methods This is a double-blind, randomized controlled trial. Block randomization will be used. An intervention group will receive pycnogenol supplementation of 150 mg for 10 days and a control group will receive a placebo for the same duration. Inflammatory status (IL-6, IL- 1β, C-reactive protein) and oxidative stress status (malondialdehyde, total antioxidant capacity), at the baseline, at the 5th day, and at the end of the study (10th day) will be measured. Clinical and nutritional status will be assessed three times during the intervention. The Sequential Organ Failure Assessment (SOFA) questionnaire for assessment of organ failure will be filled out every other day. The mortality rate will be calculated within 28 days of the start of the intervention. Weight, body mass index, and body composition will be measured. All analyses will be conducted by an initially assigned study arm in an intention-to-treat analysis. Discussion We expect that supplementation of 150 mg pycnogenol for 10 days will improve clinical and nutritional status and reduce the inflammation and oxidative stress of the TBI patients. Trial registration This trial is registered at clinicaltrials.gov (ref: NCT03777683) at 12/13/2018.
- Published
- 2020
20. Evaluation the effects of pycnogenol (French maritime pine bark extract) supplementation on the inflammatory biomarkers, nutritional and clinical status in traumatic brain injury patients, in Intensive Care Unit; A Randomized Clinical Trial protocol
- Author
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Mahsa Malekahmadi, Omid Moradi Moghaddam, Sheikh Mohammed Shariful Islam, Kiarash Tanha, Mohsen Nematy, Naseh Pahlavani, Safieh Firouzi, Mohammad Reza Zali, and Abdolreza Norouzy
- Abstract
Background: Traumatic brain injury (TBI) is one of the major health and socioeconomic problems in the world. Immune-enhancing enteral formula has been proven to significantly reduce infection rate in TBI patient. One of the ingredients that can be used in immunonutrition formulas to reduce inflammation and oxidative stress is pycnogenol. Objective: surveying the effect of pycnogenol on the clinical, nutritional and inflammatory status of TBI patients. Methods: This is double-blind, randomized controlled trial . Block randomization will be used. Intervention group will receive pycnogenol supplementation of 150 mg for 10 days. Control group will receive placebo for the same duration. Inflammatory status (IL-6, IL- 1β, C-reactive protein) and oxidative stress status (Malondialdehyde, total antioxidant capacity), at the base line, at the 5 th day and at the end of the study (10 th day) will be measured. Clinical and nutritional status will be assessed three times during the intervention. SOFA (sequential organ failure assessment) questionnaire for assessment of organ failure will be filled out every other day. The mortality rate will be calculated within 28 days of the start of the intervention. Weight, body mass index and body composition will be measured. All analyses will be conducted by initially assigned study arm in an intention-to-treat analysis. Discussion: We expect that supplementation of 150 mg pycnogenol for 10 days will improve clinical and nutritional status and reduce the inflammation and oxidative stress of the TBI patients.
- Published
- 2019
21. Medical negligence according to the Islamic Penal Code in Iran: A case report
- Author
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Nahid Dadashzadeh Asl, Mohammad Niakan Lahiji, Azadeh Memarian, and Omid Moradi Moghaddam
- Subjects
Male ,medicine.medical_specialty ,Penal code ,Autopsy ,Iran ,Islam ,Postoperative Complications ,medicine ,Humans ,health care economics and organizations ,Aged ,business.industry ,General surgery ,Malpractice ,Medical jurisprudence ,Respiratory infection ,General Medicine ,Foreign Bodies ,Bandages ,humanities ,Chemical warfare ,Criminal law ,Medical negligence ,business - Abstract
Crimes against a person's physical integrity are a serious and consequential felony in the Islamic criminal law. A war veteran and victim of chemical warfare deceased at the age of 69 was referred to Kahrizak Legal Medicine Center, Tehran, Iran for autopsy. According to Iranian law, deceased war veterans should undergo autopsy to have the potential damage to their organs due to chemical warfare identified, so that due compensation can be awarded to their heirs. When the chest was opened and the pericardium was removed to separate the heart from arterial bases, a sterile gauze was astonishingly found in the mediastinal cavity. According to the history provided by his children, the veteran had undergone coronary artery bypass graft (CABG) 10 years before, which had caused him physical and mental frailty and ultimately led to his death following a respiratory infection.
- Published
- 2019
22. Effect of evening primrose oil supplementation on lipid profile: A systematic review and meta-analysis of randomized clinical trials
- Author
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Shahab Alizadeh, Hamed Kord-Varkaneh, Seyed Mohammad Mousavi, Javad Heshmati, Mohammad Reza Emami, Masoud Khorshidi, Beheshteh Olang, Meysam Zarezadeh, Naheed Aryaeian, and Omid Moradi Moghaddam
- Subjects
medicine.medical_specialty ,Cochrane Library ,law.invention ,Oenothera biennis ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Randomized controlled trial ,law ,Internal medicine ,Hyperlipidemia ,medicine ,Humans ,Plant Oils ,Evening Primrose Oil ,gamma-Linolenic Acid ,Randomized Controlled Trials as Topic ,Pharmacology ,0303 health sciences ,medicine.diagnostic_test ,Triglyceride ,business.industry ,030302 biochemistry & molecular biology ,medicine.disease ,Lipid Metabolism ,Lipids ,Endocrinology ,chemistry ,Linoleic Acids ,030220 oncology & carcinogenesis ,Meta-analysis ,lipids (amino acids, peptides, and proteins) ,Lipid profile ,business ,Lipoprotein - Abstract
Background: Studies have shown that evening primrose oil (EPO) supplementation might be effective in improving lipid profile, however, the results are inconsistent. This study was performed to determine the direction and magnitude of the EPO effect on the lipid profile. Methods: PubMed, Scopus, Cochrane Library, Embase and Web of Science databases and Google Scholar were searched up to September-2019. Meta-analysis was performed using the random-effects model. Lipid profile including high-density lipoprotein (HDL), total cholesterol (TC), triglyceride (TG), and low-density lipoprotein (LDL) was considered as the primary outcome. Results: A total of 926 articles were identified through database searching, of which, six RCTs were included in the meta-analysis. There were six studies on HDL, TC, and TG and four studies on LDL. EPO supplementation had no significant effect on TC, TG, LDL, and HDL. However, in subgroup analysis, a significant reduction in TG at a dose of �4 g/day (weighted mean difference WMD = �37.28 mg/dl; 95% CI: �73.53 to �1.03, p =.044) and a significant increase in HDL in hyperlipidemic subjects (WMD = 5.468 mg/dl; 95% CI: 1.323 to 9.614, p =.010) was found. Conclusion: Oral intake of EPO at a dose of �4 g/day significantly reduces serum TG levels and significantly increases HDL levels in hyperlipidemic subjects. © 2020 John Wiley & Sons, Ltd.
- Published
- 2019
23. Nutritional adequacy in critically ill patients: Result of PNSI study
- Author
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Mahdi Shadnoush, Arefe Sadat Taheri, Bahareh Jabbarzadeh Gangeh, Tannaz Jamialahmadi, Khatereh Babakhani, Seyed Hossein Ardehali, Fatemeh Mazaheri Eftekhar, Mehrnoush Meshkani, Mohsen Nematy, Majid Khadem-Rezaiyan, Omid Moradi Moghaddam, Masoum Khoshfetrat, Maryam Mohamadi Narab, Afshin Mohammad Alizadeh, Seyed Mohammadreza Hashemian, Zeinab Javid, Niyaz Mohammadzadeh Honarvar, Alireza Sedaghat, Fahime Kimiaee, Farid Zand, Mohammad Safarian, Mohammad Taghi Beigmohammadi, Mahboube Kosari Monfared, Abdolreza Norouzy, Omid Pournik, and Behnam Foroutan
- Subjects
0301 basic medicine ,Male ,medicine.medical_specialty ,Critical Care ,Critical Illness ,Nutritional Status ,030209 endocrinology & metabolism ,Iran ,Critical Care and Intensive Care Medicine ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,law ,Intensive care ,Odds Ratio ,Medicine ,Cluster Analysis ,Humans ,Critical Care Outcomes ,APACHE ,Aged ,030109 nutrition & dietetics ,Nutrition and Dietetics ,APACHE II ,business.industry ,Nutritional Support ,Medical record ,Malnutrition ,Nutritional Requirements ,Odds ratio ,Middle Aged ,medicine.disease ,Intensive care unit ,Confidence interval ,Intensive Care Units ,Cross-Sectional Studies ,Nutrition Assessment ,Dietary Reference Intake ,Emergency medicine ,Regression Analysis ,Female ,business ,Energy Intake - Abstract
Critically ill patients are provided with the intensive care medicine to prevent further complications, including malnutrition, disease progression, and even death. This study was intended to assess nutritional support and its' efficacy in the Intensive Care Units (ICUs) of Iran.This cross-sectional study assessed 50 ICU's patients out of 25 hospitals in the 10 major regions of Iran's health system and was performed using the multistage cluster sampling design. The data were collected from patient's medical records, ICU nursing sheets, patients or their relatives from 2017 to 2018. Nutritional status was investigated by modified NUTRIC score and food frequency checklist.This study included 1321 ICU patients with the mean age of 54.8 ± 19.97 years, mean mNUTRIC score of 3.4 ± 2.14, and malnutrition rate of 32.6%. The mean time of first feeding was the second day and most of patients (66%) received nutrition support, mainly through enteral (57.2%) or oral (37%) route during ICU stay. The patients received 59.2 ± 37.78 percent of required calorie and 55.5 ± 30.04 percent of required protein. Adequate intake of energy and protein was provided for 16.2% and 10.7% of the patients, respectively. The result of regression analysis showed that the odds ratio of mNUTRIC score was 0.85 (95% confidence interval [CI] = 0.74-0.98) and APACHE II was 0.92 (95%CI = 0.89-0.95) for the prediction of energy deficiency. Nutrition intake was significantly different from patient's nutritional requirements both in terms of energy (p 0.001) and protein (p 0.001). Also, mean mNUTRIC score varied notably (p = 0.011) with changing in energy intake, defined as underfeeding, adequate feeding, and overfeeding.The present findings shown that, provided nutritional care for ICU patients is not adequate for their requirements and nutritional status.
- Published
- 2019
24. Response to letter 'Are we really sure about the pycnogenol antihypertensive effect?'
- Author
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Sheikh Mohammed Shariful Islam, Reza Daryabeygi-Khotbehsara, Abdolreza Norouzy, Safieh Firouzi, Sepideh Soltani, Omid Moradi Moghaddam, and Mahsa Malekahmadi
- Subjects
Flavonoids ,Pharmacology ,medicine.medical_specialty ,Cardiovascular Diseases ,Plant Extracts ,business.industry ,MEDLINE ,Humans ,Medicine ,business ,Intensive care medicine ,Antihypertensive Agents ,Randomized Controlled Trials as Topic - Published
- 2020
25. Effects of pycnogenol on cardiometabolic health: A systematic review and meta-analysis of randomized controlled trials
- Author
-
Abdolreza Norouzy, Sepideh Soltani, Omid Moradi Moghaddam, Mahsa Malekahmadi, Reza Daryabeygi-Khotbehsara, Safieh Firouzi, and Sheikh Mohammed Shariful Islam
- Subjects
Blood Glucose ,0301 basic medicine ,medicine.medical_specialty ,Free Radicals ,Cardiovascular System ,law.invention ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Randomized controlled trial ,law ,Internal medicine ,Humans ,Medicine ,Randomized Controlled Trials as Topic ,Flavonoids ,Pharmacology ,Plant Extracts ,business.industry ,Cholesterol ,Hemodynamics ,Lipids ,Confidence interval ,Blood Cell Count ,Clinical trial ,030104 developmental biology ,Blood pressure ,Liver ,chemistry ,Creatinine ,030220 oncology & carcinogenesis ,Meta-analysis ,Dietary Supplements ,Glycated hemoglobin ,business ,Body mass index - Abstract
Aim Clinical trials on the effect of pycnogenol supplementation on cardiometabolic health have been controversial. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the potential effect of pycnogenol supplementation on cardiometabolic profile. Methods PubMed, Scopus, and ISI Web of Science databases were searched until October 2018. RCTs that evaluated the effects of pycnogenol on cardiometabolic parameters were included. DerSimonian and Laird random-effect models were used to compute the weighted mean differences (WMDs) and 95% confidence intervals (CIs). Results Twenty-four RCTs including 1594 participants were included in the meta-analysis. Pycnogenol significantly reduced fasting blood glucose (WMD: −5.86 mg/dl; 95% CI: −9.56, −2.15), glycated hemoglobin (WMD = −0.29%, 95%CI: −0.56, −0.01), systolic blood pressure (WMD: −2.54 mmhg; 95% CI: −4.08, -0.99), diastolic blood pressure (WMD: −1.76 mmhg; 95% CI: −3.12, −0.41), body mass index (WMD: −0.47 kg/m2; 95% CI: −0.90, −0.03), LDL cholesterol (WMD: −7.12 mg/dl; 95% CI: −13.66, −0.58) and increased HDL cholesterol (WMD: 3.27 mg/dl; 95% CI: 0.87, 5.66). Conclusion This meta-analysis suggests that pycnogenol may have a role in preventing cardiometabolic disease. However, further well-designed RCTs are recommended to evaluate its long-term effects and explore the optimal duration of use and dosage.
- Published
- 2019
26. Color spectrographic respiratory monitoring from the external ear canal
- Author
-
Ala Saket, D. John Doyle, Omid Moradi Moghaddam, Kamal Jafarian, Farhad Izadi, Mahsa Majidi, Mohammad Niakan Lahiji, and Kamran Hassani
- Subjects
Adult ,Lung Diseases ,Male ,Sound Spectrography ,Time Factors ,Adolescent ,Computer science ,Respiratory monitoring ,Signal ,law.invention ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,030202 anesthesiology ,law ,Predictive Value of Tests ,medicine ,Humans ,Computer vision ,Ear canal ,Lung ,Aged ,Respiratory Sounds ,Sound (medical instrument) ,Electret microphone ,Miniaturization ,Amplifiers, Electronic ,business.industry ,Adapter (computing) ,Respiration ,Signal Processing, Computer-Assisted ,General Medicine ,Acoustics ,Equipment Design ,Middle Aged ,medicine.anatomical_structure ,030228 respiratory system ,Cardiovascular Diseases ,Case-Control Studies ,Personal computer ,Spectrogram ,Female ,Artificial intelligence ,business ,Ear Canal ,Preliminary Data - Abstract
The need for simple and reliable means of respiratory monitoring has existed since the beginnings of medicine. In the present study, we describe the use of color spectrographic analysis of breathing sounds recorded from the external ear canal as a candidate technology to meet this need. A miniature electret microphone was modified with the addition of an adapter to allow it to be placed comfortably in the external ear canal. The amplified signal was then connected to a real-time color spectrogram program running on a laptop personal computer utilizing the Windows operating system. Based on the results obtained, we hypothesize that the real-time display of color spectrogram breathing patterns locally or at a central monitoring station may turn out to be a useful means of respiratory monitoring in patients at increased risk of respiratory depression or other respiratory problems. Finally, we conducted a statistical analysis that suggests that significant spectrogram differences may exist among some groups investigated in the study.
- Published
- 2018
27. Effect of Support Program on Satisfaction of Family Members of ICU Patients
- Author
-
Hamid Afsaneh Abvali, Hamid Peyrovi, Omid Moradi-Moghaddam, and Mahmoodreza Gohari
- Subjects
lcsh:RT1-120 ,lcsh:Nursing ,family member ,support program ,satisfaction ,intensive care unit - Abstract
Background: This study has been conducted to investigate the effect of family-centered support program on satisfaction of the family members of patients in intensive care unit. Hospitalization of patient in intensive care unit causes crisis in family. It is very important to pay attention to the role of patient’s family in support and care of patients in intensive care unit, to pay attention to fulfillment of the family’s needs in order to increase their satisfaction. Methods: This study was a quasi-experimental study with control group. 76 family members of the patients hospitalized in medical and surgical intensive care units were recruited through purposeful sampling method and were divided in two groups (control and trial with 38 people in each groups). In the control group, action was taken according to routine way of the unit and in trial group, intervention was conducted within three days in three dimensions of support, information and reassurance. In the fourth day, satisfaction was measured using Family Satisfaction Intensive Care Unit (FS-ICU) questionnaire. Results: Mean and standard deviation of the satisfaction with care in the control and trial groups were 37.78(18.36) and 69.26(8.39), respectively, mean and standard deviation of satisfaction in information and decision-making domains were 25.65(17.48) and 61.84(12.21) and total satisfaction score were 32.73(16.92) and 66.17(9.07), respectively. These scores indicated significant increase of satisfaction after intervention (p< 0.001). Conclusion: This research showed that information, emotional support and reassurance of the family of patients in intensive care unit has considerable effect on increase of their satisfaction. It is suggested to educate intensive care nurses and other health care personnel about psychosocial and behavioral skills to support family members during hospitalization of their patients in intensive care unit.
- Published
- 2015
28. Early Administration of Selenium in Patients with Acute Traumatic Brain Injury: A Randomized Double-blinded Controlled Trial
- Author
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Valiollah Hassani, Mohammad Niakan Lahiji, Shakiba Mozari, and Omid Moradi Moghaddam
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Traumatic brain injury ,extended glasgow outcome scale ,Critical Care and Intensive Care Medicine ,Acute traumatic brain injury ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Clinical endpoint ,Medicine ,selenium ,business.industry ,Standard treatment ,Glasgow Outcome Scale ,Glasgow Coma Scale ,medicine.disease ,Intensive care unit ,Surgery ,030104 developmental biology ,Anesthesia ,Injury Severity Score ,business ,030217 neurology & neurosurgery ,Research Article - Abstract
Aim: The present study was carried out to examine this hypothesis that administration of selenium can prevent the development of injuries by brain trauma and thus can modulate patients' functional recovery and also improve posttraumatic outcome. Materials and Methods: This double-blinded controlled trial was carried out on 113 patients who were hospitalized following traumatic brain injury (TBI) with Glasgow Coma Scale score of 4–12 that were randomly assigned to receive selenium within 8 h after injury plus standard treatment group or routine standard treatment alone as the control. The primary endpoint was to assess patients' functional recovery at 2 months after the injury based on extended Glasgow Outcome Scale score (GOS-E). Secondary outcomes included the changes in Full Outline of Unresponsiveness score (FOUR) score, Sequential Organ Failure Assessment (SOFA) score, and acute physiology and chronic health evaluation (APACHE) III score, side effects of selenium, length of Intensive Care Unit (ICU) stay, and length of hospital stay. Results: There was no difference in the length of ICU and hospital stay, the trend of the change in FOUR and SOFA scores within 15 days of first interventions, and the mean APACHE III score on the 1 st and 15 th days between the two groups. Mortality was 15.8% in selenium group and 19.6% in control group with no between-group difference. No difference was revealed between the two groups in appropriate outcome according to GOS-E score at 60 ± 10 days and also 30 ± 5 days according to the severity of TBI. Conclusion: This human trial study could not demonstrate beneficial effects of intravenous infusion of selenium in the improvement of outcomes in patients with acute TBI.
- Published
- 2017
29. The Relationship Between Changes in Liver Enzymes and Mortality of Patients Admitted to a Surgical Intensive Care Unit
- Author
-
Mohammad Niakan Lahiji, Omid Moradi Moghaddam, Mahzad Alimian, Valiollah Hasani, and Ali Ahani Azari
- Subjects
medicine.medical_specialty ,business.industry ,Liver enzyme ,Emergency medicine ,General Earth and Planetary Sciences ,Medicine ,Surgical intensive care unit ,business ,General Environmental Science - Published
- 2016
30. Invasive candidiasis in critical care setting, updated recommendations from 'Invasive Fungal Infections-Clinical Forum', Iran
- Author
-
Farhad Soltani, Mohammad Ali Davarpanah, Farid Zand, Reza Shahrami, Ali Ghaziani, Behrooz Farzanegan Bidgoli, Ashraf Mahmoud Elhoufi, Malak El-Sobky, Farzad Shirazian, Mohammad Torabi-Nami, Amir Mohammad Hashem Asnaashari, Saeed Abbasi, Homeira Yazdinejad, Arezoo Ahmadi, Omid Moradi Moghaddam, and Mohammad Hossein Jarrahzadeh
- Subjects
Antifungal ,medicine.medical_specialty ,Pediatrics ,Local practice ,business.industry ,medicine.drug_class ,Critically ill ,Invasive candidiasis ,Review ,medicine.disease ,Intensive care unit ,law.invention ,Care setting ,law ,Intensive care ,Epidemiology ,medicine ,Intensive care medicine ,business - Abstract
Invasive candidiasis (IC) bears a high risk of morbidity and mortality in the intensive care units (ICU). With the current advances in critical care and the use of wide-spectrum antibiotics, invasive fungal infections (IFIs) and IC in particular, have turned into a growing concern in the ICU. Further to blood cultures, some auxiliary laboratory tests and biomarkers are developed to enable an earlier detection of infection, however these test are neither consistently available nor validated in our setting. On the other hand, patients' clinical status and local epidemiology data may justify the empiric antifungal approach using the proper antifungal option. The clinical approach to the management of IC in febrile, non-neutropenic critically ill patients has been defined in available international guidelines; nevertheless such recommendations need to be customized when applied to our local practice. Over the past three years, Iranian experts from intensive care and infectious diseases disciplines have tried to draw a consensus on the management of IFI with a particular focus on IC in the ICU. The established IFI-clinical forum (IFI-CF), comprising the scientific leaders in the field, has recently come up with and updated recommendation on the same (June 2014). The purpose of this review is to put together literature insights and Iranian experts' opinion at the IFI-CF, to propose an updated practical overview on recommended approaches for the management of IC in the ICU.
- Published
- 2014
31. Invasive candidiasis in intensive care unit; consensus statement from an Iranian panel of experts, July 2013
- Author
-
Amir Hossein Lotfi, Mahboubeh Hajiabdolbaghi, Seyed Mohammadreza Hashemian, Ali Amirsavadkouhi, Mohammad Niakan, Ali Majidpour, Mohammad Taghi Beigmohammadi, Seyed Hossein Ardehali, Farzad Shirazian, Arezoo Ahmadi, Mahshid Talebi Taher, Reza Nejat, Payam Tabarsi, Mohammad Torabi-Nami, Omid Moradi Moghaddam, Mehran Kouchek, Majid Mokhtari, and Atabak Najafi
- Subjects
Antifungal ,medicine.medical_specialty ,therapy ,business.industry ,medicine.drug_class ,High mortality ,Treatment options ,Invasive candidiasis ,Review ,invasive candidiasis ,Iran ,medicine.disease ,Intensive care unit ,intensive care unit ,local consensus ,law.invention ,Care setting ,Round table ,law ,Intensive care ,General Earth and Planetary Sciences ,Medicine ,business ,Intensive care medicine ,General Environmental Science - Abstract
Invasive candidiasis (IC) is associated with high mortality in intensive care unit (ICU) patients. Timely diagnosis of this potentially fatal condition remains a challenge; on the other hand, the criteria for initiating empirical antifungal therapy in critically ill patients are not well defined in different patient population and ICU settings. Alongside the international guidelines, reaching regional and local consensus on diagnosis and management of IC in ICU setting is essential. This report summarizes our present status of IC management in ICU, considered by a group of Iranian experts in the fields of intensive care and infectious diseases. A round table of 17 experts was held to review the available data and discuss the optimal treatment strategies for IC in critical care setting. Comparative published data on the management of IC were analytically reviewed and the commonly asked questions about the management of IC in ICU were isolated. These questions were interactively discussed by the panel and audience responses were taken to consolidate point-to-point agreement with the panel arriving at consensus in many instances. The responses indicated that patients’ risk stratification, clinical discretion, fungal diagnostic techniques and the empirical therapy for IC are likely to save more patients. Treatment options were recommended to be based on the disease severity, prior azole exposure, and the presence of suspected azole-resistant Candida species. This report was reviewed, edited and discussed by all participants to include further evidence-based insights. The panel expects such endorsed recommendations to be soon formulated for implementation across the country.
- Published
- 2014
32. Probiotics in Critically Ill Patients
- Author
-
Omid Moradi Moghaddam
- Subjects
Patients ,biology ,Synbiotics ,Colonisation resistance ,Gut flora ,Probiotic ,biology.organism_classification ,law.invention ,Microbiology ,Editorial ,Anesthesiology and Pain Medicine ,Immune system ,law ,Lactobacillus ,Immunology ,Intensive care unit ,Anaerobic bacteria ,Bifidobacterium - Abstract
The term ‘probiotic’ is derived from the Greek/Latin word “pro” and the Greek word “bios,” meaning “of life”. The concept of probiotics was first described by Metchnikoff in 1907 (1). The World Health Organization (WHO) and the Food and Agriculture Organization of the United Nations have defined probiotics as “live microorganisms, which, when administered in adequate amounts, confer a health benefit on the host” (1, 2). These agents are often administered concurrently with substances that promote bacterial colonization and growth (prebiotics); in this instance, they are referred to as synbiotics. Probiotics are bacteria or yeasts. Most probiotics come from two groups: Lactobacillus and Bifidobacterium. Each group comprises different species and strains. Some probiotics, such as Saccharomyces boulardi, are yeasts (3, 4). In a healthy individual, there is a homeostasis between commensal intestinal microbiota and pathogenic bacteria. The composition of colonic microbiota is fundamental to gut barrier function. Anaerobic bacteria are the predominant microorganisms in the gastrointestinal tract, preventing the overgrowth of pathogenic bacteria in a phenomenon termed “colonization resistance” (2). When this homeostatic mechanism is altered, an ecological imbalance occurs, and gut barrier function is impaired. Gut barrier and immune dysfunction is associated with the onset of systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS) in critically ill patients (5). Several mechanisms by which probiotics exert their beneficial activity have been proposed, including competitive exclusion of bacterial adherence; release of bacteriocins to inhibit the growth of pathogens; production of butyrate; antioxidative effects; stimulation of mucus and SIgA production; enhancement of macromolecular degradation, which reduces antigen load; suppression of immune cell proliferation; inhibition of epithelial cell nuclear factor kappa B (NFκB) activation; modulation of epithelial apoptosis; maintenance of epithelial barrier; and modulation of immune function (2, 5, 6). There is substantial evidence that during periods of critical illness, significant alterations occur in the gut microflora due to several factors, including changes in circulating stress hormones, gut ischemia, immunosuppression, the use of antibiotics, and a lack of nutrients (6, 7). ICU and surgical patients are now believed to be at high risk of bacterial translocation, resulting in exacerbation of the disease state. Intestinal microbes can have a major role in such patients.
- Published
- 2011
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