The Use of Artificial Intelligence in the Management of Neurodegenerative Disorders; Focus on Alzheimer's Disease.

Recent advances in artificial intelligence (AI) have shown great promise in the diagnosis, prediction, treatment plans, and monitoring of neurodegenerative disorders. AI algorithms can analyze huge quantities of data from numerous sources, including medical images, quantifiable proteins in urine, blood, and cerebrospinal fluid (CSF), genetic information, clinical records, electroencephalography (EEG) signals, driving behaviors, and so forth. Alzheimer's disease (AD) is one of the most common neurodegenerative disorders that progressively damage cognitive abilities and memory. This study specifically explores the possible application of AI in the diagnosis, prediction, monitoring, biomarker or drug discovery, and classification of AD.

Association of Serum Minerals, Vitamin D, Total Protein, and Inflammatory Mediators and Severity of Low Back Pain.

BACKGROUND: Low back pain (LBP) is a multifactorial disorder with multiple etiologies, which are not fully understood. In this study, we aimed to evaluate the relationship between serum levels of minerals, total protein, vitamin D (vit D), and inflammatory mediators with LBP and its severity. MATERIALS AND METHODS: This case-control study was derived from the study nested in the Fasa Cohort Study. Overall, 148 individuals with LBP were compared with 150 individuals without LBP. Blood samples were evaluated for serum protein, iron (Fe), aluminum (Al), copper (Cu), phosphorus, vit D, IL-1B, IL-6, high-sensitive C-reactive protein (HS-CRP), and TNF-alpha. Severity of pain was measured with the McGill and Oswestry questionnaires. RESULTS: The mean age of participants in the case and control groups was 49.2 ± 6.1 and 47.57 ± 5.85 years, respectively. In the case group, 61 patients (48.8%) were male. The mean serum levels of Fe, Al, vit D, Cu, IL-1B, IL-6, HS-CRP, and TNF-alpha were significantly different between case and control groups (P≤0.05). However, there were no significant differences between studied groups in the term of sex and serum phosphorus (P>0.05). Regarding pain severity, age was correlated with McGill score (r=0.18), body mass index with Oswestry (r=0.21), Fe with McGill (r=-0.15) and Oswestry (r=-0.13), protein with McGill (r=0.32) and Oswestry (r=-0.32), Al with McGill (r=0.56) and Oswestry (r=0.45), IL-1B with McGill (r=0.19) and Oswestry (r=0.13), TNF-alpha with McGill (r=0.34) and Oswestry (r=0.26), IL-6 with Oswestry (r=0.13), HS-CRP with McGill (r=0.60) and Oswestry (r=0.46), and vit D was correlated with McGill (r=0.21) and Oswestry scores (r=0.17). Higher Fe (odds ratio [OR]: 0.99), protein (OR: 0.47), Al (OR: 0.11), and vit D levels (OR: 0.97) were protective against LBP (P<0.001). Higher IL-1B (OR: 1.01), TNF-alpha (OR: 1.03), and HS-CRP (OR: 1.0003) presented as risk factors for LBP (P<0.001). CONCLUSION: Our study revealed except phosphorous, all the serum levels minerals and inflammatory markers was significantly different in LBP patients compared to healthy individuals. Also, in the LBP patients, serum levels of Fe, total protein, Al, and vit D aside to inflammatory mediators (i.e., IL-1B, TNF-alpha, and HS-CRP) shows a marked association with severity of LBP.

Anxiety but not depression is associated with metabolic syndrome: The Isfahan Healthy Heart Program.

BACKGROUND: Only a few studies have carried out to evaluate the association of depression and anxiety with metabolic syndrome (MetS). The aim of this study was to investigate whether the depression and anxiety are associated with MetS and its different components. MATERIALS AND METHODS: This cross-sectional study forms part of the prospective Isfahan Cohort Study. A total of 470 participants were chosen. Anxiety and depression symptoms were measured using hospital anxiety and depression scale (HADS). The MetS was diagnosed according to the American Heart Association and National Heart, Lung, and Blood Institute. One-way analysis of variance and binary logistic regression were used. RESULTS: The mean age of participants was 55.7 ± 9.3. The prevalence of MetS in female participants with symptoms of depression (P < 0.0001), concurrent anxiety and depression (P = 0.004), anxiety (P < 0.0001), and asymptomatic individuals (P = 0.001) was significantly different when compared to male participants. Moreover, the analysis showed that having anxiety symptoms is in a negative relationship with MetS (odds ratio [OR] = 0.31; 95% confidence interval [CI] = 0.12-0.78). In addition, with each 10-year increase in age, the probability of MetS will decrease 40% (OR = 0.59; 95%Cl = 0.53-0.72). Body mass index (OR = 1.29; 95%CI = 1.21-1.37), and gender (higher age for women) (OR = 0.34; 95%CI = 0.11-0.98) had positive relationship with MetS. CONCLUSION: The study findings revealed that the prevalence of MetS in patients with anxiety was lower than the healthy subjects, while no significant association was found between depression, concurrent depression, an anxiety with MetS.

Fasa Registry on Acute Myocardial Infarction (FaRMI): Feasibility Study and Pilot Phase Results.

BACKGROUND: Myocardial infarction (MI) is the leading cause of death in Iran. Every attempt to improve treatment patterns and patient outcomes needs a surveillance system to both consider the efficacy and safety measures. Fasa Registry on Myocardial Infarction (FaRMI) is the first population-based registry for acute MI in Iran targeted to provide meticulous description of patients' characteristics, to explore the management patterns of these patients, to discover the degree of adherence to the practice guidelines, and to investigate the determinants of poor in-hospital and later outcomes. METHODS: A diagnosis of acute MI (type I, II and III) was made upon the accepted criteria by the attending cardiologists and types IV and V MI were excluded. Two registrar nurses gathered data on demographics, place of residence and ethnicity, past medical history, risk factors, and the clinical course. Management patterns in the pre-hospital setting, during the hospital stay and at the discharge time were recorded. Routine laboratory results and cardiac biomarkers on three consecutive days were registered. RESULTS: pilot phase included the first 95 patients, 63.5% of whom were men and 31.5% were women. With a mean age of 62.89±13.75 years among participants, the rate of premature MI was 31.8%. ST segment elevation MI accounted for 68.2% cases and inferior wall was the most prevalent region involved followed by anterior and posterior walls. DISCUSSION: Obtained data on the characteristics of patients suffering an MI event revealed the major determinants of delay in initiation of therapies and contributors of poor outcome. Completeness of data was guaranteed upon involvement of multiple checkpoints and data quality was secured by means of automatic validation processes in addition to weekly physicians' roundups. CONCLUSION: Execution of FaRMI in the form presented is feasible and it will build up a comprehensive population-based registry for MI in the region.

Bilateral Vocal Cord Paralysis after Anterior Cervical Discectomy Following Cervical Spine Injury: A Case Report.

Bilateral vocal cord paralysis is a rare and preventable complication of anterior cervical discectomy and fusion. Herein, we report a fatal case of bilateral vocal cord paralysis after anterior cervical discectomy and fusion (ACD/F). A 65-year-old man with cervical spine trauma and anterior cord syndrome, following car overturn presented to our emergency department. The patient had C6-T10 prolapsed discs for which ACD/F was performed. In the recovery room he developed stridor and respiratory distress immediately after extubation, and was reintubated. Otolaryngological evaluation revealed bilateral vocal cord paralysis. He later required a tracheostomy but finally died in a rehabilitation center after an acute coronary event. Awake fibroptic intubation is recommended in patients at high risk for preoperative recurrent laryngeal nerve injury. Intraoperative tracheal tube cuff pressure monitoring and modification of surgical approach to neck are recommended to prevent bilateral nerve damage.

The impact of generic form of Clopidogrel on cardiovascular events in patients with coronary artery stent: results of the OPCES study.

BACKGROUND: To compare the early and late cardiovascular events as well as side effects of Osvix, a generic form of Clopidogrel versus Plavix regimens in patients with chronic stable angina, undergoing bare metal stent (BMS) or drug eluting stent (DES) placement, this study was carried out. METHODS: A total of 442 patients with chronic stable angina who were scheduled for elective percutaneous coronary intervention (PCI) were included in a randomized, double blind, multi-centric clinical trial being performed in 6 distinct university hospitals in 5 cities of Iran from March 2007 to November 2009. Baseline, demographic and history of risk factors were recorded using the patients' medical charts. Stenting procedure was performed via transfemoral approach using low osmolar contrast agents. Patients underwent BMS or DES placements based on the physician selection and were randomly assigned to Osvix or Plavix groups. Patients were followed by telephone in 0 and 6 months intervals regarding the major adverse cardiovascular events (MACE) including death, myocardial infarction, in-stent thrombosis, stroke, target lesion revascularization, and target vascular revascularization. Angina episodes, bleeding, liver enzymes, neutrophils and platelets count were also assessed in these intervals. RESULTS: There was not any significant difference between these two groups regarding the baseline characteristics. In the DES group, the 6-month mortality rate and the incidence of MACE in Osvix and Plavix groups were 0.9% and 1.9% (p = 0.61) and 1.8% and 4.9% (p = 0.26), respectively. During the follow up period after DES or BMS placement, there wasn't any significant difference regarding neutrophil and platelet counts or liver enzymes between study groups. CONCLUSIONS: Using Osvix and Plavix are followed by similar major cardiovascular events and side-effect profile in patients undergoing PCI.

Effect of oral clonidine on acute intraocular pressure rise after phacoemulsification: a prospective double-blind, randomized, clinical trial.

OBJECTIVE: To determine the efficacy and safety of oral clonidine in decreasing the prevalence and intensity of postoperative intraocular pressure (IOP) rise in those undergoing phacoemulsification. METHODS: This was a prospective randomized, double-blind, placebo-controlled, clinical trial including 62 patients (each with 1 affected aye) with senile cataract scheduled for phacoemulsification who were randomly assigned to receive preoperative oral clonidine (5 µg/kg, 31 patients) or placebo (1 tablet, 31 patients). The IOP was measured preoperatively and at 6, 12, and 24 h postoperatively. The prevalence and intensity of the acute postoperative IOP rise was compared between and within the groups. RESULTS: There was no significant difference between the 2 study groups regarding the baseline characteristics and the baseline IOP (P=0.628). Patients who received placebo as premedication had significantly higher IOP at 6 (17.96±5.49 vs. 13.61±4.09; P<0.001) and 12 (16.90±4.11 vs. 13.96±3.25; P=0.003) h postoperatively compared with those who received oral clonidine. However, there was no significant difference between the 2 groups regarding the IOP at 24 h after operation (15.41±3.96 vs. 16.01±3.41; P=0.0539). The prevalence of acute IOP rise (>21 mmHg) was significantly higher in placebo group compared with clonidine group (25.8% vs. 9.6%; P=0.091). CONCLUSION: Administering preoperative oral clonidine in a dosage of 5 µg/kg, 2 h before phacoemulsification, significantly decreases the prevalence and intensity of acute postoperative IOP rise in those undergoing general anesthesia. Oral clonidine is safe, cheap, and easily accessible and, thus, it is recommended for controlling the IOP after phacoemulsification, especially in high-risk patients.