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Dive into the research topics where Mohammad Otahbachi is active.

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Featured researches published by Mohammad Otahbachi.


American Journal of Forensic Medicine and Pathology | 2010

Excited delirium, restraints, and unexpected death: a review of pathogenesis.

Mohammad Otahbachi; Cihan Cevik; Satish Bagdure; Kenneth Nugent

Unexpected deaths periodically occur in individuals held in police custody. These decedents usually have had significant physical exertion associated with violent and/or bizarre behavior, have been restrained by the police, and often have drug intoxication. Autopsy material from these cases may not provide a satisfactory explanation for the cause of death, and these deaths are then attributed to the excited delirium syndrome. The pathogenesis of excited delirium deaths is likely multifactorial and includes positional asphyxia, hyperthermia, drug toxicity, and/or catecholamine-induced fatal arrhythmias. We suggest that these deaths are secondary to stress cardiomyopathy similar to the cardiomyopathy seen in older women following either mental or physical stress. This syndrome develops secondary to the toxic effects of high levels of catecholamines on either cardiac myocytes or on the coronary microvasculature. Patients with stress cardiomyopathy have unique ventricular morphology on echocardiograms and left ventricular angiography and have had normal coronary angiograms. People who die under unusual circumstances associated with high catecholamine levels have contraction bands in their myocardium. Consequently, the pathogenesis of the excited delirium syndrome could be evaluated by using echocardiograms in patients brought to the emergency centers, and by more careful assessment of the myocardium and coronary vessels at autopsy. Treatment should focus on prevention through the reduction of stress.


International Journal of Cardiology | 2009

Acute stress cardiomyopathy and deaths associated with electronic weapons.

Cihan Cevik; Mohammad Otahbachi; Elizabeth Miller; Satish Bagdure; Kenneth Nugent

Deaths associated with the use of electronic weapons almost always occur in young men involved in either civil disturbances or criminal activity. These situations are associated with high levels of circulating catecholamines and frequently associated with drug intoxication. The mechanism for these deaths is unclear. Clinical studies indicate that these high voltage electrical pulses do not cause cardiac arrhythmia. Acute stress cardiomyopathy provides an alternative explanation for deaths associated with electronic weapons and may provide a better explanation for the usual time course associated with taser deaths. Patients with acute stress cardiomyopathy usually have had an emotional or physical stress, have high circulating levels of catecholamines, present with an acute coronary syndrome but have normal coronary vessels without significant thrombus formation. They have unusual left ventricular dysfunction with so-called apical ballooning. This presentation has been attributed to the direct effects of catecholamines on myocardial cell function. Alternative explanations include vasospasm in the coronary microcirculation and/or acute thrombosis followed by rapid thrombolysis. Similar events could occur during the high stress situations associated with the use of electronic weapons. These events also likely explain restraint-related deaths which occur in independent of any use of electronic weapons. Forensic pathologists have the opportunity to provide important details about the pathogenesis of these deaths through histological studies and careful evaluation of coronary vessels.


Cardiovascular Revascularization Medicine | 2009

Coronary artery aneurysms in Behçet's disease

Cihan Cevik; Mohammad Otahbachi; Kenneth Nugent; Leigh Ann Jenkins

Behçets disease is a rare chronic autoimmune vasculitis with characteristic skin findings. Vascular involvement generally affects veins more than arteries, and coronary arterial involvement is extremely uncommon. Here we report the significant coronary artery aneurysms detected in a 41-year-old man with Behçets disease who had been in remission for 13 years. Our case illustrates the necessity of initial non-invasive cardiac assessment of patients with Behçets disease.


Journal of Cardiovascular Medicine | 2008

Effect of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibition on serum matrix metalloproteinase-13 and tissue inhibitor matrix metalloproteinase-1 levels as a sign of plaque stabilization.

Cihan Cevik; Mohammad Otahbachi; Kenneth Nugent; Chokesuwattanaskul Warangkana; Gary Meyerrose

Atherosclerotic plaques are composed of a lipid rich core, which is covered by a collagen rich fibrous cap. Rupture of the atherosclerotic plaque with superimposed thrombosis is the main cause of acute coronary syndromes, including acute myocardial infarction and unstable angina. The stability of the plaque depends on its collagen content; degradation of the collagen leads to a vulnerable plaque that is prone to rupture. Recent studies have demonstrated a critical role for matrix metalloproteinases (MMPs) in the degradation of the collagen content and the reduction of mechanical stability of the atherosclerotic plaques. Increased expression of various MMPs has been shown in the tissue sections of atherosclerotic plaques. The increased expression of MMPs in the atheroma also leads to increased MMP levels in the circulation. The cholesterol lowering drugs - 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) - decrease the tissue expression of various MMPs in atheromatous plaques by attenuating the inflammatory process that promotes MMP expression during the course of atherosclerosis. However, the effect of statin treatment on the serum levels of MMP-13, which has a critical role in the initiation of collagen degradation, is unknown. On the basis of these previous studies, we discuss the need for studies on the effect of statin treatment on the serum levels of MMP-13 and tissue inhibitor of matrix metalloproteinase (TIMP-1) levels in hypercholesterolemic patients.


Heart & Lung | 2012

Aortic stenosis and angiodysplastic gastrointestinal bleeding: Heyde's disease.

Sameer Islam; Ebtesam Islam; Cihan Cevik; Hosam Attaya; Mohammad Otahbachi; Kenneth Nugent

Obscure gastrointestinal (GI) bleeding can be a perplexing and difficult problem in elderly patients, especially if they are hemodynamically unstable. If aortic stenosis is also present, the cause of the GI bleeding may be explained. We present a 66-year-old man with a medical history of coronary artery disease who presented with acute GI bleeding. During his hospital course, the patient had a colonoscopy showing diffuse angiodysplasia and an echocardiogram showing severe aortic stenosis. This combination of angiodysplasia and aortic stenosis is known as Heydes syndrome. It has been hypothesized that the aortic stenosis causes an acquired von Willebrand factor deficiency that leads to GI bleeding. Aortic valve replacement, when possible, can prevent recurrent GI bleeding in these cases, but medical decisions in these cases are complex and difficult.


Journal of Cardiac Surgery | 2009

Successful endovascular stenting of total juxtarenal aortic occlusion performed through brachial and femoral access.

Mohammad Otahbachi; Ashwani Kumar; Cihan Cevik; Alex Suarez

A 64-year-old man presented to the hospital with right foot pain. He had history of diabetes mellitus, hypertension, and smoking. There was a black eschar on the tip of the right fourth toe. Posterior tibial and dorsal pedal pulses were not palpable bilaterally. Ankle brachial index at rest was 0.13 and 0.2 in the right and left lower extremities, respectively. A Doppler ultrasound study confirmed the presence of an aorto-iliac disease. Cardiology was consulted to evaluate for possible revascularization. Abdominal aortic angiography was performed through the right brachial artery because an initial femoral arterial attempt had failed. Aortography revealed total juxtarenal aortic occlusion (Fig. 1). Balloon angioplasty was performed to the occlusion using a 6.0 × 100-mm AGIL/TRACTM Balloon (Abbott Vascular, Abbott Park, IL, USA). A 14 × 40-mm self-expanding stent (PROTÉGÉTM, ev3, Plymouth, MN, USA) was deployed across the occlusion below the renal arteries through the right femoral artery. Postdeployment inflation was done with a 9.0 × 40-mm AGIL/TRAC Balloon. Then, two 9.0 × 59-mm i-CAST stents (Atrium Medical Corporation, Hudson, NH, USA) were placed in the abdominal aorta distal to the previous stent in the form of a double barrel, with successful postdeployment inflations. The final angiographic view revealed the restoration of blood flow in the aorto-iliac system (Fig. 2). At follow-up, the peripheral pulses were appreciated and the patient’s symptoms resolved.


Journal of Investigative Medicine | 2011

Conductive energy devices: a review of use and deaths in the United States.

Kenneth Nugent; Satish Bagdure; Mohammad Otahbachi; Cihan Cevik

Background Conductive energy devices (CEDs) have been temporally associated with morbidity and mortality in police work, but the frequency of use and of complications is not certain. Methods This is a literature review using PubMed and Google Scholar searches to identify population-based CED studies, studies reporting morbidity and mortality with CEDs, and studies in healthy volunteers. Results Recent studies indicate that CEDs are used approximately 83 to 338 times per million population per year in the United States. The subjects have a typical profile, including young men with belligerent or bizarre behavior who often have a psychiatric disorder or are intoxicated with drugs. The mortality estimates range from 0.0% to 1.4% of subjects controlled with CEDs. Limited information from autopsy studies indicates that death is frequently associated with confounding factors, especially intoxication with illicit drugs. Conclusions Conductive energy devices are used frequently during police work and are associated with a low but definite mortality rate. The use of CEDs and the management of at-risk subjects need more study.


Cardiovascular Revascularization Medicine | 2009

Left circumflex coronary artery to hepatic vein fistula: a case report and brief review of coronary vasculogenesis.

Cihan Cevik; Kenneth Nugent; Veli K. Topkara; Mohammad Otahbachi; Leigh Ann Jenkins

Coronary artery fistulas are rare coronary artery anomalies. Their clinical significance varies from a long asymptomatic course to overt heart failure and death. They are often detected incidentally with diagnostic coronary angiograms. Cardiologists increasingly encounter coronary artery fistulas secondary to recent improvements in cardiovascular imaging modalities. Management is still controversial, especially in asymptomatic cases with less significant shunts. Here, we describe a 62-year-old woman with a left circumflex artery to hepatic vein fistula found on coronary angiography. The patient is being managed conservatively using nuclear imaging studies and echocardiographic evaluation.


The American Journal of the Medical Sciences | 2009

Advanced locally invasive squamous cell carcinoma.

Michal M. Pankratz; Rachel Chandler; Mohammad Otahbachi; Kenneth Nugent; Rishi Raj

Advanced Locally Invasive Squamous Cell Carcinoma A 60-year-old man who had never sought medical care presented with generalized weakness and dizziness. He was wearing a bandage that covered his left eye, ear, and head. Removal of the bandage showed a large 10 cm 12 cm fungating ulcer involving the left forehead and face. The inferior margin of the ulcer extended below the eye socket and the stump of the optic nerve was seen in the base of the socket. Superiorly, the ulcer had penetrated the skull and the pulsating brain covered by the soft tissue could be seen underneath. Laterally, the ulcer had destroyed the pinna and nose. This lesion was first noticed by the family 24 years ago as a small scaly red spot superior to the left eyebrow. The patient had consistently ignored the family’s advice to seek medical attention, and the lesion had slowly grown to its present size. Computed tomography at admission showed complete destruction of the left orbit, destruction of a 6 cm 6 cm section of frontal bone, and invasion of the nose and left external ear (Figures 1 and 2). Biopsy of the lesion showed it to be a squamous cell carcinoma. Differential diagnosis of “big skin lesions” includes malignancies like basal cell carcinoma, squamous cell carcinoma, amelanotic melanoma, and angiosarcoma, and benign disease like atypical fibroxanthoma, blastomycosis, leprosy, and cutaneous leishmaniasis. Our patient presented after a very long delay and could not be treated. Delays in treatment are often explained by psychiatric disorders, phobias, cognitive impairment, fear, ignorance about beliefs of medical care, unusual beliefs about medical care, and denial.


Journal of Cardiovascular Medicine | 2009

Aortic coarctation complicated with multiple saccular aortic aneurysms.

Cihan Cevik; Orhan Elonu; Kenneth Nugent; Mohammad Otahbachi; Leigh Ann Jenkins

Aortic coarctation is a congenital malformation of the aorta that should be diagnosed and corrected early in life. The natural history of unrepaired coarctation of the aorta includes the development of systemic hypertension and subsequent morbidity and death from cardiovascular disease. Here, we present a case with replacement of the aortic arch and its branches by tortuous multilobulated aneurysms as a result of untreated aortic coarctation.

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Kenneth Nugent

Texas Tech University Health Sciences Center

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Leigh Ann Jenkins

Texas Tech University Health Sciences Center

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Gary Meyerrose

Texas Tech University Health Sciences Center

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Ashwani Kumar

Texas Tech University Health Sciences Center

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Satish Bagdure

Texas Department of State Health Services

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Chanwit Roongsritong

Texas Tech University Health Sciences Center

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Grace Simoni

Texas Tech University Health Sciences Center

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Jan Simoni

Texas Tech University Health Sciences Center

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John F. Moeller

Texas Tech University Health Sciences Center

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A. Sadhu

Texas Tech University Health Sciences Center

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