ABSTRACT
Objectives: To investigate the determinants of mortality and the lethal area 50 [LA50] in large series of Iranian burn patients admitted to a single burn center
Methods: This cross-sectional study was conducted in Shahid Motahari burn center of Tehran, Iran during a 1-year period from 2011 to 2012. We included all the burn patients who were admitted to our center during the study period. Those with incomplete medical records and those referred to other centers were excluded from the study. The medical records of the included patients were reviewed and the demographic, clinical, laboratory and outcome measures were recorded. The mortality rate was recorded and the determinants of LA50 were analyzed in a univariate and stepwise multivariate model
Result: Overall we included a total number of 1200 subjects with mean age of 30.8+/-18 years. There were 907 [75.6%] men and 293 [24.4%] women among the patients. The total LA50 was 55.5% [95% CI: 52.98%-58.3 %]. There was a significant difference between age group >61 years and two 11-20 and 21-30 groups regarding LA50. The advanced age [p<0.001], female gender [p=0.002], inhalational injury [p<0.001] and burn extension determined by TBSA% [p<0.001] were significantly associated with mortality. In addition, male gender [p=0.087], flame [p=0.156], scald [p=0.088] and chemical injuries [p=0.071] were not associated with mortality
Conclusion: The LA50 determine din our study is still much lower than that reported in developed countries, as a result, the quality of medical care is lower. Female gender, age, inhalational injury and extension of burn determined by TBSA% were found to be the independent risk factors of mortality in burn patients in our series
ABSTRACT
The clinical relevance of bone marrow micrometastasis [BMM] in non-small-cell lung cancer is undetermined, and the value of such analyses in advanced stage patients has not been clearly assessed previously. This study was conducted to estimate the accuracy of both polymerase chain reaction [PCR] and immunohistochemistry [IHC] in micrometastases detection and determine the best site for bone marrow biopsy in order to find micrometastasis. This prospective cross-sectional study was performed in the Department of Thoracic Surgery, Alzahra University Hospital from September 2008 to June 2009. To evaluate the bone marrow, a 3-cm rib segment and an aspirated specimen from the iliac bone prior to tumor resection were taken. PCR and IHC were performed for each specimen to find micrometastasis. Of 41 patients, 14 [34%] were positive for BMM by PCR compared with two positive IHC [4.8%]. All BMMs were diagnosed in rib segments, and iliac specimens were all free from metastatic lesion. Our data showed no significant association between variables such as age, sex, histology, tumor location, side of tumor, involved lobe, smoking, or weight loss and presence of BMM. PCR could use as a promising method for BMM detection. BMM in a sanctuary site [rib] is not associated with advanced stages of lung cancer. In addition, when predictor variables such as age, sex, histology, tumor location, smoking, or weight loss are analyzed, no correlation can be found between micrometastasis prevalence and any of those variables