National Spinal Cord Injury Registry of Iran (NSCIR-IR) - a critical appraisal of its strengths and weaknesses / 中华创伤杂志(英文版)

The National Spinal Cord Injury Registry of Iran (NSCIR-IR) is a not-for-profit, hospital-based, and prospective observational registry that appraises the quality of care, long-term outcomes and the personal and psychological burden of traumatic spinal cord injury in Iran. Benchmarking validity in every registry includes rigorous attention to data quality. Data quality assurance is essential for any registry to make sure that correct patients are being enrolled and that the data being collected are valid. We reviewed strengths and weaknesses of the NSCIR-IR while considering the methodological guidelines and recommendations for efficient and rational governance of patient registries. In summary, the steering committee, funded and maintained by the Ministry of Health and Medical Education of Iran, the international collaborations, continued staff training, suitable data quality, and the ethical approval are considered to be the strengths of the registry, while limited human and financial resources, poor interoperability with other health systems, and time-consuming processes are among its main weaknesses.

Skin Metastasis, An Uncommon Course Of Prostate Carcinoma: A Report Of Two Cases

Prostate cancer is one of the most common cancers among men worldwide and in the USA. Most prostate cancer progression either locally invades to seminal vesicles or metastasizes distally to bone. Skin is not a common site of metastasis for the majority of malignancies including prostate cancer. This paper reports two extremely rare cases of prostate carcinoma metastatic to the skin: a 74-year-old man previously treated with radiation for prostate cancer with cutaneous metastases to the shoulder and a 68-year-old man with prostate adenocarcinoma and cutaneous metastases to the groin. Both patients were diagnosed with skin punch biopsy and later confirmed with immunohistochemical staining for PSA and prostate specific acid phosphatase, specific for prostatic carcinoma. Although unusual, development of multiple skin lesions in patients with prostate adenocarcinoma should raise the flags of cutaneous metastases.

effect of timing of decompression on neurologic recovery and histopathologic findings after spinal cord compression in a rat model

Prior animal models have shown that rats sustaining 3-second immediate spinal cord compression had significantly better functional recovery and smaller lesion volumes than rats subjected to compression times of 1 hour, 6 hours, 3 weeks, and 10 weeks after spinal cord injury. We compare locomotor rating scales and spinal cord histopathology after 3 seconds and 10 minute compression times. Ten rats were assigned into two early [3-second] and late [10-minute] compressive surgery groups. Compressive injury was produced using an aneurysmal clip method. Rats were followed-up for 11 weeks, and behavioral assessment was done by inclined plane test and tail-flick reflex. At the end of the study, the rats were sacrificed, and spinal cord specimens were studied in light and EM. Basso, Beattie and Bresnahan [BBB] locomotor rating scales were significantly better in the early compression group after the 4th week of evaluation [P<0.05] and persisted throughout the remainder of the study. Histopathology demonstrated decreased normal tissue, more severe gliosis and cystic formation in the late group compared to the early group [P<0.05]. In EM study, injuries in the late group including injury to the myelin and axon were more severe than the early compression group, and there was more cytoplasmic edema in the late compression group. Spinal cord injury secondary to 3-second compression improves functional motor recovery, spares more functional tissue, and is associated with less intracellular edema, less myelin and axon damage and more myelin regeneration in rats compared to those with 10 minutes of compression. Inclined plane test and tail-flick reflex had no significant difference

Situation of medical sciences in 50 top countries from 1996 to 2010-based on quality and quantity of publications

In research outputs both quality and quantity are of critical value and evaluation of both aspects is required for best evaluation. Several studies have worked on single or two-dimensional methods that provide the assessment of quality, quantity or both simultaneously in different branches of sciences, but none of them have played a role in a particular area of medicine. This study has been conducted to compare countries worldwide in the field of medical researches. Measuring both quality and quantity of researches is performed separately. In order to evaluate countries from both aspects of quantity and quality of research outputs, a modified form of the citation per publication [CPPm] and publication per population [PPPm] were used to make these indices comparable through different years and nations by normalizing the values according to the world average standards. When countries are ranked by CPPm, Iceland ranks the 1[st] with the score of 1.98, Faroe Islands and Gambia rank the 2[nd] and the 3[rd] with scores of 1.84 and 1.63, respectively. In PPPm Switzerland, Sweden and Denmark ranked the top three with scores of 13.34, 11.67 and 10.32, respectively. Iran ranked 71 in CPPm and 141 in PPPm. Ranking countries makes it possible to identify countries which have performed better in research outcomes by means of quality and quantity; thus, reforming policies can be taken into action to lower the waste of money, higher quality and quantity of outputs while providing helpful tip[s] for institutions to improve