Sanei Taheri

Amyloidosis is an extracellular deposition of abnormal serum proteins. Systemic amyloidosis could involve different organs such as the spleen, liver, and kidneys. Renal artery microaneurysm is very rare in renal amyloidosis. We report a 44-year-old woman who was referred to our general hospital for evaluation of rising serum creatinine level, anemia, and pathological fracture. Two hours following renal biopsy, she developed severe pain in the left flank during voiding and ultrasonography revealed a large perinephric hematoma. She underwent angiography that incidentally showed pseudoaneurysm with diffused renal artery microaneurysm. The feeding artery to the pseudoaneurysm was completely ligated by an interventional radiologist. The subsequent histopathological report of the kidney revealed amyloidosis.

The aim of this longitudinal study was to investigate the value of uterine artery Doppler sonography during the second and third trimesters in the prediction of adverse pregnancy outcome in low-risk women. From July 2011 to August 2012, a total of 205 singleton pregnant women presenting at our antenatal clinic were enrolled in this prospective study and were assessed for baseline demographic and obstetric data. They underwent ultrasound evaluation at the time of second and third trimesters, both included Doppler assessment of bilateral uterine arteries to determine the values of the pulsatility index (PI) and resistance index (RI) and presence of early diastolic notch. The endpoint of this study was assessing the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of Doppler ultrasonography of the uterine artery, for the prediction of adverse pregnancy outcomes including preeclampsia, stillbirth, placental abruption and preterm labor. The me...

The aim of this study was to identify and describe brain CT findings in patients with poisoning or drug overdose and altered mental status. In this study, 403 patients with some degree of loss of consciousness who referred due to poisoning or drug overdose were evaluated by brain CT. The most common cause of intoxication was suicide. Intoxication status was determined by the physician and was mainly based on a history of intoxication, positive toxicologic screen result, or physical evidence suggesting intoxication. Among 403 unconscious patients, 229 patients who were ingested or inhaled Benzodiazepine, Carbamazepine, Carbon Monoxide, Ethanol, Methanol, Opium, Tricyclic antidepressants, and Tramadol included in the study. Others had used multiple drugs and/or toxins, or their intoxication was unknown. Mean age of patients was 37.6 ± 17.7 years (14-95). Among them, 181 (79%) were male. Among all patients, 92 had consumed opium (40.2%), 47 had consumed Benzodiazepines (20.5%) and othe...

Since the diagnostic yield of chest X-ray (CXR) is not high enough, when it is ordered for all the multiple trauma patients, this study was aimed to evaluate the relationship between clinical and CXR findings in order to formulate a clinical decision rule to prevent unnecessary CXR in these patients. Stable multiple blunt trauma patients referring to the ED were included. The clinical and radiographic findings of all the patients were collected and the relationships between these variables analysed. Finally, based on the regression coefficients (β) of the variables, the Thoracic Injury Rule-out Criteria (TIRC) were designed. A total of 2607 patients were included (males: 78.9%, mean age: 34.1 ± 15.0 years). Age over 60 (β = 0.8; 95% CI: 0.27-1.34; P = 0.003), crepitation (β = 4.33; 95% CI: 1.65-7.0; P < 0.001), loss of consciousness (β = 3.16; 95% CI: 2.44-3.88; P < 0.001), decrease in pulmonary sounds (β = 2.67; 95% CI: 1.73-3.6; P < 0.001), chest wall pain (β = 2.12; 95% CI: 1.63-2.61; P < 0.001) and tenderness (β = 1.78; 95% CI: 1.26-2.27; P < 0.001), dyspnea (β = 1.3; 95% CI: 0.41-2.18; P = 0.004) and abrasion (β = 0.5; 95% CI: 0.22-0.83; P = 0.03) were independent factors predicting thoracic injury. CXR in stable conscious multiple blunt trauma patients under 60 years, without chest wall pain and tenderness, decrease in pulmonary sounds, crepitation, skin abrasion, and dyspnea did not provide any additional findings. Based on TIRC, it seems that CXR in stable multiple blunt trauma patients who are conscious and under 60 and have no decrease in pulmonary sounds, no dyspnea, no thoracic skin abrasion, and no crepitation can be ignored.

A 23-year-old male patient with right nasal Juvenile Nasopharyngeal Angiofibroma (JNA) developed Central Retinal Artery Occlusion (CRAO) during embolization of the tumor using polyvinyl alcohol particles before endoscopic excision. Classic CRAO management was initiated by an ophthalmologist after 12 h. Retrospective evaluation of the angiograms revealed a tiny communication between the external carotid and ophthalmic arteries which had not been noticed before embolization. During endoscopic excision, the tumor was found to originate extraordinarily from midline structures. It was concluded that CRAO might be a rare complication of JNA embolization. Careful preoperative angiographic evaluations to detect communicating arteries and immediate ophthalmologic consultation in case of developing visual symptoms during the procedure are necessary.