Predicting mortality, hospital length of stay and need for surgery in pediatric trauma patients / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>Pediatric trauma is one of the major health problems around the world which threats the life of children. The survival of injured children depends upon appropriate care, accurate triage and effective emergent surgery. The objective of this study was to determine the predictive values of injury severity score (ISS), new injury severity score (NISS) and revised trauma score (RTS) on children's mortality, hospitalization and need for surgery.</p><p><b>METHODS</b>In this study, records of trauma patients under 15 years old transported from a trauma scene to emergency department of Poursina hospital from 2010 to 2011 were included. Statistical analysis was applied to determine the ISS, NISS and RTS ability in predicting the outcomes of interest.</p><p><b>RESULTS</b>There were 588 records in hospital registry system. The mean age of the patients was (7.3 ± 3.8) years, and 62.1% (n = 365) of patients were male. RTS was the more ability score to predict mortality with an area under curve (AUC) of 0.99 (95% CI, 0.99-1). In the hospital length of stay (LOS), ISS was best predictor for both the hospital LOS with AUC of 0.72 (95% CI, 0.67-0.76) and need for surgical surgery with AUC of 0.94 (95% CI, 0.90-0.98).</p><p><b>CONCLUSION</b>RTS as a physiological scoring system has a higher predicting AUC value in predicting mortality. The anatomic scoring systems of ISS and NISS have good performance in predicting of hospital LOS and need for surgery outcomes.</p>

Increased likelihood of arrhythmic events associated with increased anxiety in patients with implanted cardiac defibrillators after the Ahar-Varzegan Earthquake in East Azarbaijan, 2012

Objective: To determine the type and pattern of arrhythmic events following the 2012 Ahar-Varzegan Earthquake among patients implanted with cardiac defibrillators [ICDs] in East Azarbaijan province

Methods: In a prospective cohort study, conducted in East Azerbaijan Province of Iran, 132 patients were enrolled in two comparison groups according to the region of residence i.e., earthquake region [n=98] and non-earthquake [n=34] region in 2012. Data were collected for those meeting standard criteria for sustained ventricular arrhythmias [Vas], or supraventricular tachycardias [SVTs] and triggered ICD therapies, either shock or anti-tachycardia pacing [ATP]. The state version of the State-Trait Anxiety Inventory [STAI-S] was used to assess general symptoms of anxiety in both groups

Results: Males comprised 81.1% of the participants. Mean age of the participants was 59.7+/-15 years

The frequency of patients with sustained VAs increased significantly after the earthquake [p=0.008]

There were more VAs [mean 2.16 vs. 6.23; p=0.008] and they occurred earlier [6th vs. 16th day; p=0.01] in the earthquake area

The mean frequency of SVTs and the total number of delivered ICD therapies were similar between groups

Differences in anxiety levels were not significant between groups but there was a trend for presence of greater number of patients with anxiety [p=0.07] and the relative severity of anxiety [p=0.08] in the earthquake area

Conclusion: In the earthquake area, the mean frequency of VAs increased and they occurred earlier in the earthquake area. The stress of anxiety might have served as a trigger for these events

Association of adult attention deficit/hyperactivity disorder and traffic injuries in Tabriz - Iran

Nowadays, it is well known that the attention-deficit/hyperactivity disorder [ADHD] is not confined to children and adolescents. Recent data showed that a considerable portion of the general adult population may be affected by ADHD. On the other hand, the impact of ADHD on driving performance, a major area of adult life, has gained enthusiasm. More recent studies revealed an association between adult ADHD and undesirable driving problems. This study was performed to determine the association between presence of adult ADHD and traffic injuries. In this case-control study, in a 13 month period, 140 subjects [70 drivers/riders injured in traffic accidents, and 70 age- and sex-matched non traumatic controls] were selected to participate in the study and were placed in two groups. Subjects with psychiatric comorbidities were excluded. The Conners' Adult ADHD Rating Scale [CAARS] self-report [screening version] was used for screening adult ADHD in both groups. Finally, the occurrence of this condition was compared between the case and control groups. Sixty- nine males and one female were recruited in each group with a mean age of 29.31 +/- 9.32 [18-61] years in the case and 29.03 +/- 9.07 [range: 18-60] years in the control groups [P > 0.05]. Previous history of traffic accident was significantly higher in the case group [15.7% vs. 4.3%, P=0.024]. The mean driving time in a day was also significantly higher in the case group. In the case group, the scores of CAARS [the ADHD index, ADHD symptoms total, inattentive subscale and hyperactive/impulsive subscale] were positive [higher than 70] in 4.3, 10, 7.1 and 10 percent of patients respectively. Among the controls, the corresponding proportions were 4.3, 14.3, 8.6 and 8.6 percent respectively. The two groups were comparable for the mentioned rates. The results of this study revealed no significant association between ADHD and traffic injuries in Tabriz- Iran

Effect of preoperative information and reassurance in decreasing anxiety of patients who are candidate for coronary artery bypass graft surgery

Psychological problems like as anxiety in patients who are coronary artery bypass graft [CABGs] may increase mortality and morbidity. The effect of reassurance and preoperative information in decreasing of anxiety is uncertain. This study designed to address the effect of preoperative information and decreasing of anxiety of patients who are candidate for CABGs. With experimental study and randomize sampling 85 [55male and 30female] of 238 patients who were candidate for CABGs included and completed spilberger anxiety test on the day of admission. Preoperative information and reassurance done and test completed again on the day before surgery. Mean number of anxiety score in patients with mild anxiety disorder [21 patients] were 34 +/- 4.2 before and 39 +/- 5.8 after intervention. In patients with moderate anxiety disorder [39 patients] the number decreased to 53.88 +/- 7.6. All of differences were significant statistically. In patients with mild anxiety preparative information and reassurance resulted in increasing anxiety but in patients with moderate or server anxiety disorder, anxiety level decreased significantly

[Sexual dysfunction in couples and its related factors during pregnancy]

Pregnancy is one of the most critical periods in women's lives. Sexual and marital relationships could change due to physical and psychological alterations during this period. Disregarding sexual relationships during pregnancy may result in sexual dysfunction in couples. This study was performed to determine sexual dysfunction and some of its related factors in pregnant women and their spouses. In this descriptive-analytical study, sexual dysfunction and some of its related factors, prevalent during pregnancy, were studied in 350 couples, through stratified sampling. A three-part questionnaire was used for data gathering: 1] Demographic, 2] Couples' attitudes towards sexual activities during pregnancy, and 3] Arizona Sexual Experience Scale [ASEX]-both female and male versions. The results were statistically secrutimized. Sexual dysfunction was found in 12.5%, 11.3% and 21% of the couples in the first, second and third trimesters of pregnancy respectively. Altered sex drive in women and sexual dissatisfaction and inability to reach orgasm in men were the most prevalent sexual dysfunctions at each pregnancy trimester. A significant relationship was found between male sexual dysfunction and fear of injury to the fetus [P=0.009] and feeling of guilt [P<0.001] in the third trimester. Similarly, female sexual dysfunction was significantly associated with fear of injury to the fetus [OR=1.5], feeling of decreased sexual attractiveness [OR=1.43], discontent with family's financial situation [OR=2.67], unwanted pregnancy [OR=4.05] and low level of education [OR=2.49]. As couples' knowledge, beliefs and attitudes regarding sexual activity during pregnancy influence their sexual function, holding educational programs and providing consultation to address the issue during prenatal care are recommended

Relaxation therapy in the background of standard antihypertensive drug treatment is effective in management of moderate to severe essential hypertension

To evaluate the efficacy of relaxation technique as an adjunctive therapy for control of hypertension. From April 2004 to January 2005, with a single blinded randomized controlled design, 220 patients with newly diagnosed essential moderate to severe hypertension who needed drug therapy were included in the study. The study took place in the Hypertension Clinic, Sina Hospital, Tabriz, Iran. Patients were systematically randomized to receive standard plus relaxation therapy, 2 times per week, for 8 weeks, or standard therapy alone. We collected the demographic data, blood pressure measurements, and the data on prescribed drugs. The mean age of patients was 54 in the case group and 56 years in the control group. The mean blood pressure level [systolic and diastolic] was 192.86/105.16 and 192.09/102.25 mm Hg on admission in the case and the control groups, which decreased to 133.46/81.48 and 146.21/83.57 mm Hg, at the end of study. The difference of blood pressure on admission was not statistically significant, but became significant at the end of the study. Fifty-nine percent in the case group and 36% in the control group had good control of blood pressure. Relaxation therapy on the background of standard antihypertensive drug treatment results in better control of blood pressure

epidemiological survey of mental disorders among adults in the north, west area of Tabriz, Iran

To find out prevalence of mental disorders in the North West Area of Tabriz, Iran and their association with demographic factors such as gender, marital status, education and age. In this cross sectional study 1017 households were chosen using systematic randomized sampling and 2624 individuals above the age of seventeen years and above. We obtained information on psychiatric disorders by using Duke University Questionnaire. Four hundred fifty two people were interviewed by two psychiatrists based on the DSM-IV criteria. The SPSS-11 version was used for analysis. The probability of mental disorder was 19.4% in women and 8.59% in men. The overall prevalence of psychiatric disorders was 14.4%. Etiological studies provide usefull information for planning provision of mental health care. Further studies are needed to find out the prevalence of mental disorders in the community