Effects of pre-injury anti-platelet agents on short-term outcome of patients with mild traumatic brain injury: a cohort study

Objective: To determine the effects of pre-injury consumption of anti-platelet agents on the 30-day outcomes of patients with mild traumatic brain injury [TBI]

Methods: This prospective cohort study was conducted at three general hospitals in Tehran, Iran between July 2013 and July 2014. The study population included all patients with mild TBI aged over 18 years that medicated with aspirin or clopidogrel before occurring trauma. Within hospitalization, all patients were assessed with respect to in-hospital conditions especially complications and adverse events. After discharge, the individuals were followed for 30 days by telephone to assess mortality and disability using the Glasgow outcome scale [GOS]

Results: Of 1140 patients with mild TBI, only 135 had previously received aspirin and/or clopidogrel. The mean age was dramatically higher in those who were taking aspirin or clopidogrel [p<0.001]. The patients with previously use of anti-platelets were more transferred by ambulance when compared to another group [p=0.006]. The patients on anti-platelets had significantly lower GCS on admission when compared to others [p<0.001]. Length of hospitalization was significantly longer in those receiving anti-platelets [p=0.003]. In follow-up, 30- day mortality and disability was revealed in 2.8% of patients that received only aspirin and 7.5% in aspirin with clopidogrel and in 1.6 % of those who did not receive drugs without any significant difference between aspirin and control group [p=0.208] and significant difference in aspirin with clopidogrel group [p<0.001]

Conclusion: The premedication by anti-platelets [aspirin and/or clopidogrel] in patients with mild TBI leads to prolonged hospital stay, and increase rate of disability. Age and on admission GCS are the independent risk factors for predicting the outcome in patients with mild TBI receiving anti-platelet agents

Naloxone inhibits human serum albumin Glycation

Advanced glycation end-products [AGEs] are formed by non-enzymatic reaction between reducing sugar and protein. AGEs play important roles in pathogenesis of diabetic, aging complications, endothelial dysfunction and neurological diseases such as the Alzheimer's disease. Therefore compounds that prevent the glycation reaction are purported to have therapeutic effect on patients with diabetes and age-related complication. In this study, the Human serum albumin at concentration of 10 mg/ml was incubated in PBS with 40 mM Glucose, and in different concentrations of Naloxone [25,100,250micro M] for 42 days at 37[degree sign]. HSA with no additives and with Glucose 40mM were incubated as control and as glycated sample, respectively. Following the incubation, the samples were prepared for Circular Dichroism, Fluorescence and absorbance techniques. It was shown different Naloxone concentration can prevent Human serum albumin glycation

Report on takayasu arteritis in three iranian children

Takayasu arteritis [TA] or giant cell vasculitis is the third common vasculitis after Henoch-Schoenline purpura and Kawasaki disease in children. This vasculitis usually affects large vessels and is more common in females during the childhood. Aim of this report is to present three Iranian children [two boys, one girl] with TA. Mean age of our cases on admission was 10 years. Patients most commonly presented with episodes of systemic symptoms including, fever, headache, increased arterial blood pressure in one limb and convulsion. Other related symptoms were myalgia, limb pain, chest pain, and abdominal pain. Supra sternal, and abdominal bruit was noted in all patients. Angiography was performed in all cases. This revealed stenosis of the left subclavian artery and common carotid artery in one patient, generalized aortitis in one case and stenotic right renal artery in one patient. One boy was diagnosed as having systemic onset of juvenile idiopathic arthritis. One case was referred with hand pain and headache, and one case for control of hypertension. Follow-up ranged from 2 to 7 years since diagnosis. All patients were treated with prednisone, azathioprine, aspirin, and antihypertensive drugs. Each patient received either methotrexate, or hydroxychloroquine or mycofenolate mofetil. Although TA is uncommon before 10th year of life, it should be considered in patients presenting with hypertension and systemic symptoms such as fever, limb pain and pulseless limb