Effects of human erythropoietin on functional outcome of patients with traumatic cervical cord injury; a pilot randomized clinical trial

Objective: To determine the effects of recombinant human erythropoietin [rhEPO] on functional outcome and disability of patients with traumatic cervical spinal cord injury [SCI]

Methods: This was a randomized, double blind, placebo controlled clinical trial being performed in Nemazee and Shahid Rajaei hospitals of Shiraz during a 3-year period from 2011 to 2014. A total number of 20 patients with acute traumatic cervical SCI less than 8 hours after injury were included. We excluded those with anatomic cord dissection, penetrating cord injury and significant concomitant injury. Patients were randomly assigned to receive rhEPO in 500IU/mL dosage immediately and 24-hour later [n=11] or placebo [n=9]. All the patient received standard regimen of methylprednisolone. Neurological function was assessed on admission, 1, 6 and 12 months after the injury according to the American Spinal Cord Injury Association [ASIA]

Results: Overall we include a total number of 20 patients. The mean age of the patients was found to be 40.1 +/- 9.5 [ranging from 19 to 59] years. There were 18 [90.0%] men and 2 [10.0%] women among the patients. There was no significant difference between two study groups regarding the baseline characteristics. The baseline ASIA score was comparable between two study groups. The motor and sensory ASIA scores were comparable between two study groups after 1, 6 and 12 months follow-ups. We also found that there was no significant difference between two study groups regarding the motor and sensory outcome in complete cord injury and incomplete cord injury subgroups

Conclusion: Administration of rhEPO does not improve the functional outcome of patients with traumatic cervical SCI

Associations between self-reported anxiety and serum lipid, lipoprotein concentrations and platelets in healthy men

Objective: High blood cholesterol is one of the signifi cant risk factors for cardiovascular diseases. Increased cholesterol levels contribute to atherosclerosis, which causes platelet aggregation and increases the risk of blood clots in the arteries. Previous research has investigated relationships of elevated serum cholesterol with anxiety disorders. The current study aims to assess levels of serum lipid, lipoprotein concentrations and platelets in individuals with high and low anxiety. Methods: Of a total of 1,038 subjects, 142 healthy men were randomly selected. All participants were asked to complete the Spielberger’s self-reported state-trait anxiety inventory (STAI). Participants with scores higher than 46 and lower than 34 were included in high anxiety group (n=28) and low anxiety group (n=69), respectively. Levels of fasting serum lipids, including total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides and platelets were compared between the two groups. The data were analyzed using independent samples t-test and correlation coeffi cient test. Results: The levels of total cholesterol and LDL cholesterol were signifi cantly higher in the high anxiety group (P<0.001). There were no signifi cant differences in the levels of triglycerides, HDL cholesterol, and platelets. Conclusion

Lumbar radicular pain caused by epidural varices

Low back pain and sciatica are mainly caused by herniated lumbar disc and spondylotic lumbar canal stenosis. However, some rare entities such as lumbar epidural venous anomalies can result in acute low back pain and sciatica, among which epidural varices are less encountered. It can be not only idiopathic but also secondary to some vascular malformations. In this study, we report two cases of lumbar epidural varices presenting with low back pain and acute severe sciatica

Evaluation of contributive factors on recurrence of intracranial meningioma

Meningiomas are common benign tumors of the central nervous system. Patients with meningiomas achieve postoperative optimal functional recovery, but there is a probability of tumor recurrence months or years after surgical resection. This study aims to evaluate the prevalence of recurrent meningioma and the correlation between tumor recurrence and certain factors. We performed a retrospective descriptive-analytical study of patients with meningiomas who underwent surgical treatment in hospitals affiliated with Shiraz University of Medical Sciences during a 20-year period [1988 to 2008]. Factors including sex, age, bone changes, peritumoral edema, histological subtypes, tumor size, shape, location and resection degree, and recurrence time were evaluated in each patient. The recurrence rate of intracranial meningioma in a total of 644 patients included in the study was 10%. Statistical analysis of data showed a correlation between edema, bone changes, tumor size and shape, and histological subtypes. No relationship was found between age, sex and tumor location. This study has shown a statistical correlation between radiotherapy and a reduced probability of tumor recurrence or growth after surgical resection. Although the majority of meningiomas are benign, they can have malignant presentations. Recurrence occurs after a shorter period of time in patients with malignant and atypical meningiomas than in patients with benign meningiomas. Edema, bone changes, large size, special tumor shape and malignant histological subtypes are important prognostic factors that predict the probability of tumor recurrence or growth. Findings show a statistical correlation between the degree of tumor resection and its recurrence. This study recommends a more complete tumor resection along with adjuvant therapy and closer follow-up to decrease the risk of tumor recurrence