ABSTRACT
Objective: to determine the incidence of deep vein thrombosis [DVT] in patients undergoing spinal surgeries receiving prophylactic doses of Deltaparin in a single center in central Iran
Methods: this cross-sectional study was conducted in Shariatee hospital of Isfahan during a 12-month period. We included all the patients undergoing elective spinal surgeries in our center during the study period who received prophylactic dosages of subcutaneous Dalteparin [5000 unit daily] the first postoperative day. Those with absolute contraindications of anticoagulation therapy were not included in the study. Patients were followed for 3 months clinically and the incidence of DVT was recorded. DVT was suspected clinically and was confirmed by color Doppler sonography
Results: overall we included 120 patients with mean age of 44.8 +/- 12.6 years among whom there were 54 [45%] men and 66 [55%] women. Lumbar discectomy [32.9%] and laminectomy [20.2%] were the most common performed procedures. DVT was detected in 1 [0.83%] patient in postoperative period. None of the patients developed pulmonary embolism and none hemorrhagic adverse event was recorded. The patient was treated with therapeutic unfractionated heparin and was discharged with warfarin
Conclusion: our results shows the efficacy of LMWH [Dalteparin] in reducing the incidence of DVT to 0.83%. These results also show the safety of Dalteparin in spine surgery because of lack of bleeding complication
ABSTRACT
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
ABSTRACT
Background: Ruptured cerebral aneurysms [ICAs] are the most common non-traumaticcause of subarachnoid hemorrhage [SAH] that is associated with life threateningcomplications such as Vasospasm, Infarction, and Hydrocephalus [HCP]. The activeparticipation of macrophage/monocyte-mediated inflammatory response in thepathogenesis of cerebral aneurysm as labeled with Monocyte ChemoattractantProtein-1[MCP-1] is suggested
Objective: To measure the serum level of MCP-1 in rupturedCAs in different time intervals
Methods: We measured the serum levels of MCP-1 inSAH patients who had CAs and compared it with that of MCP-1 in two control groups:including patients with SAH without CAs, and the normal population of blood donors.We also measured the MCP-1 levels in patients with CAs one week afterward toevaluate the effect of treatment. Serum level of MCP-1 was measured by a commercial ELISA assay
Results: Mean serum MCP-1 level in patients with SAH and CAs was188.2168 Pg/ml and 331.3982 Pg/ml in the normal population. There was nostatistically significant difference between serum levels of MCP-1 on the first[mean=188.2168 Pg/ml] and 7th days after SAH onset [mean=171.8450 Pg/ml][p=0.739]. Serum level of MCP-1 increased significantly as Glasgow Coma Scaledecreased [p=0.078] and Hunt and Hess score increased [p=0.089]
Conclusion: Ourresults did not show an increasing MCP-1 serum level in patients with aneurysmalSAH. There was a relationship between poor clinical grade and MCP-1 levels inpatients with CAs. MCP-1 may be a local inflammatory marker for cerebral aneurysmswithout systemic manifestation