Prospective Acid Reflux Study of Iran (PARSI): Methodology and study design

<p>Abstract</p> <p>Background</p> <p>Gastroesophageal reflux disease is a common and chronic disorder but long term, prospective studies of the fate of patients seeking medical advice are scarce. This is especially prominent when looking at non-erosive reflux disease (NERD) patients.</p> <p>Methods</p> <p>We designed a prospective cohort to assess the long term outcome of GERD patients referring to gastroenterologists. Consecutive consenting patients, 15 years of age and older, presenting with symptoms suggestive of GERD referring to our outpatient clinics undergo a 30 minute interview. Upper gastrointestinal endoscopy is performed for them with protocol biopsies and blood samples are drawn. Patients are then treated according to a set protocol and followed regularly either in person or by telephone for at least 10 years.</p> <p>Discussion</p> <p>Our data show that such a study is feasible and follow-ups, which are the main concern, can be done in a fairly reliable way to collect data. The results of this study will help to clarify the course of various subgroups of GERD patients after coming to medical attention and their response to treatment considering different variables. In addition, the basic symptoms and biological database will fuel further molecular epidemiologic studies.</p

Initial Experience with Brain Mapping under Awake Craniotomy for Resection of Insular Gliomas of the Dominant Hemisphere

Background & Importance: Insular lobe is located at the depth of sylvian fissure and is hidden by frontal, temporal and parietal lobes in close vicinity of internal capsule and basal ganglia and adjacent to the speech centers in the dominant hemisphere. Thus, radical resection of insular gliomas can be even more difficult. Brain mapping techniques can be used to maximize the extent of tumor removal and minimize postoperative morbidities. Case Presentation: Patients with newly diagnosed gliomas of dominant insula were enrolled. The exclusion criteria were severe cognitive and/or psychological disturbances, those with difficulty in communication, older than 65 years, severely obese patients, those with difficult airways for intubation and severe cardiovascular or respiratory diseases. All patients were evaluated by contrast enhanced brain MRI, functional brain MRI and diffusion tensor tractography of language and motor systems preoperatively. All were operated under awake craniotomy with the same anesthesiology protocol. Intraoperative monitoring included continuous motor evoked potential, electromyography, electrocorticography, direct electrical stimulation of cortex and subcortical tracts. They were followed with serial neurological examination and imaging. Conclusion: Seven patients were enrolled including 3 man and 4 women with mean age of 44.4 years. 5 patients suffered from low grade and 2 from high grade glioma. The most common clinical presentation was seizure followed by speech disturbance, hemiparesis and memory loss. Extent of tumor resection ranged from 73 to 100%. No mortality or major postoperative neurological deficit was encountered. Seizure control improved in 3/4 of patients with medical refractory epilepsy. One patient suffered from permanent deterioration of speech after surgery. Brain mapping under awake craniotomy may be considered a safe method to maximize the extent of tumor resection, while preserving neurological function in patients with gliomas of the dominant insular lobe

Prospective Acid Reflux Study of Iran (PARSI): Methodology and study design-1

<p><b>Copyright information:</b></p><p>Taken from "Prospective Acid Reflux Study of Iran (PARSI): Methodology and study design"</p><p>http://www.biomedcentral.com/1471-230X/7/42</p><p>BMC Gastroenterology 2007;7():42-42.</p><p>Published online 20 Nov 2007</p><p>PMCID:PMC2212633.</p><p></p> junction across the z-line, C: Cardia, D: Body, E: Antrum

Prospective Acid Reflux Study of Iran (PARSI): Methodology and study design-2

<p><b>Copyright information:</b></p><p>Taken from "Prospective Acid Reflux Study of Iran (PARSI): Methodology and study design"</p><p>http://www.biomedcentral.com/1471-230X/7/42</p><p>BMC Gastroenterology 2007;7():42-42.</p><p>Published online 20 Nov 2007</p><p>PMCID:PMC2212633.</p><p></p> after one week. If patient is better with the previous prescription, patient should back to the previous dosage and continue till the next visit

Prospective Acid Reflux Study of Iran (PARSI): Methodology and study design-0

<p><b>Copyright information:</b></p><p>Taken from "Prospective Acid Reflux Study of Iran (PARSI): Methodology and study design"</p><p>http://www.biomedcentral.com/1471-230X/7/42</p><p>BMC Gastroenterology 2007;7():42-42.</p><p>Published online 20 Nov 2007</p><p>PMCID:PMC2212633.</p><p></p>Presenting just by minor symptoms