Pressure ulcers and acute risk factors in individuals with traumatic spinal fractures with or without spinal cord injuries: A prospective analysis of the National Spinal Column/Cord Injury Registry of Iran (NSCIR-IR) data / 中华创伤杂志(英文版)

PURPOSE@#To identify risk factors for developing pressure ulcers (PUs) in the acute care period of traumatic spinal fracture patients with or without spinal cord injuries (SCIs).@*METHODS@#Data were collected prospectively in participating the National Spinal column/Cord Injury Registry of Iran (NSCIR-IR) from individuals with traumatic spinal fractures with or without SCIs, inclusive of the hospital stay from admission to discharge. Trained nursing staff examined the patients for the presence of PUs every 8 h during their hospital stay. The presence and grade of PUs were assessed according to the European Pressure Ulcer Advisory Panel classification. In addition to PU, following data were also extracted from the NSCIR-IR datasets during the period of 2015 - 2021: age, sex, Glasgow coma scale score at admission, having SCIs, marital status, surgery for a spinal fracture, American Spinal Injury Association impairment scale (AIS), urinary incontinence, level of education, admitted center, length of stay in the intensive care unit (ICU), hypertension, respiratory diseases, consumption of cigarettes, diabetes mellitus and length of stay in the hospital. Logistic regression models were used to estimate the unadjusted and adjusted odds ratio (OR) with 95% confidence intervals (CI).@*RESULTS@#Altogether 2785 participants with traumatic spinal fractures were included. Among them, 87 (3.1%) developed PU during their hospital stay and 392 (14.1%) had SCIs. In the SCI population, 63 (16.1%) developed PU during hospital stay. Univariate logistic regression for the whole sample showed that marital status, having SCIs, urinary incontinence, level of education, treating center, number of days in the ICU, age, and Glasgow coma scale score were significant predictors for PUs. However, further analysis by multiple logistic regression only revealed the significant risk factors to be the treating center, marital status, having SCIs, and the number of days in the ICU. For the subgroup of individuals with SCIs, marital status, AIS, urinary incontinence, level of education, the treating center, the number of days in the ICU and the number of days in the hospital were significant predictors for PUs by univariate analysis. After adjustment in the multivariate model, the treating center, marital status (singles vs. marrieds, OR = 3.06, 95% CI: 1.55 - 6.03, p = 0.001), and number of days in the ICU (OR = 1.06, 95% CI: 1.04 - 1.09, p < 0.001) maintained significance.@*CONCLUSIONS@#These data confirm that individuals with traumatic spinal fractures and SCIs, especially single young patients who suffer from urinary incontinence, grades A-D by AIS, prolonged ICU stay, and more extended hospitalization are at increased risk for PUs; as a result strategies to minimize PU development need further refinement.

Compare the effect of eicosapentaenoic acid and Ooxidized Low- density lipoprotein on the expression of CD36 and peroxisome proliferator-activated receptor gamma

Background: there is evidence that CD36 promotes foam cell formation through internalizing oxidized LDL [ox- LDL] into macrophages; therefore, it plays a key role in pathogenesis of atherosclerosis. In addition, CD36 expression seems to be mediated by nuclear receptor peroxisome proliferator-activated receptor gamma [PPAR-[gamma]]. The aim of the present study was to evaluate and compare the effect of PPAR-[gamma] ligands, eicosapentaenoic acid [EPA] as an anti-atherogenic factor and ox-LDL as an atherogenic factor on CD36 expression. Mechanism of PPAR-[gamma] action and its ligands in CD36 expression were also investigated

Methods: raw 264.7 macrophage cell line was treated with ox-LDL [100 and 150 [micro]g protein/LDL] and EPA [100 and 200 [micro]M] for 24 and 48 hours in absence or presence of PPAR-[gamma] inhibitor, T0070907. Quantitative real-time PCR and Western-blotting were used for analysis of gene and protein expression, respectively

Results: raw 264.7 exposures to ox-LDL and EPA resulted in increased expression of CD36 mRNA and protein; however, mRNA and PPAR-[gamma] protein were not upregulated significantly. Pre-incubation of cells with T0070907 led to decreased expression of CD36 when treated with ox-LDL and EPA

Conclusion: it was confirmed that both EPA and ox-LDL increased CD36 expression but not PPAR-[gamma], and also co-treatment with PPAR-[gamma] inhibitor decreased CD36 expression. We concluded that upregulation of CD36 depends on PPAR-[gamma] activation and is not related to increased expression of PPAR-[gamma]. Induction of CD36 by EPA showed that CD36 suppression is not the means by which [omega]-3 fatty acids [EPA] provide protection against formation of atherosclerotic plaque. Iran. Biomed. J. 17 [2]: 84-92, 2013

[Parents' knowledge about the symptoms of substance abuse: a study on parents of students in Kerman high schools and secondary schools]

Three basic strategies against substance abuse are control of distribution, treatment of dependents and prevention. Recent years experiences have shown the significant importance of prevention. Considering the decrease in age of substance abuse onset, parents' knowledge about this phenomenon and consequently its early prevention and control in the family is very important. In this cross-sectional study performed in 2005, knowledge of 600 parents of Kerman highs schools' and secondary schools' students in relation to the symptoms of substance abuse was determined by using a researcher-made questionnaire. In whole, 20.1% of the participants had high school or higher educational level and 11.7% of them had history of substance abuse in their family members. The highest knowledge scores in physical symptoms belonged respectively to alcohol [23%], opium [17%] and cigarette [15%]. In relation to psychological symptoms, the highest scores were obtained for tranquilizers and analgesics [29%] and then cigarette, alcohol and opium [24%, 19% and 17% respectively]. Insufficient Knowledge scores, especially in regard to substances with increasing rate of use is a serious warning requiring serious attempts for increasing knowledge of all classes of society especially parents. This should be done continuously and by using the most efficient educational programs and cooperation of all related organizations

Effectiveness of Transcutaneous Electrical Nerve Stimulation [TENS] on the post cesarean section pain

Transcutaneous electrical nerve stimulation [TENS] has been a non-chemical effective method in reducing pain. The mechanism of TENS is not clear but gate control theory may explain it. The purpose of this study was to evaluate the analgesic effect of TENS on the post cesarean section pain. In a randomized clinical trial, in the year 2006, at Oncology Ward of Kerman Afzalipur Hospital 72 women with cesarean delivery, participated in this study and were assigned randomly to two groups. For the TENS group [36 patients] TENS was applied and for the control group [36 patients], placebo TENS. Intensity of pain before and after interventions was assessed by visual analogue scale [VAS]. Also the first request of analgesic by the patient was compared between the two groups. The individual, and VAS results were collected in a questionnaire, analyzed by SPSS, and statistical tests The mean scores of pain for TENS group and control group were 3.78 +/- 1.72 and 6.61 +/- 2.11 respectively [p=0.0001]. There was a significant statistical difference [p=0.0001], between the different mean scores for TENS group [2.25] and control group [0.22]. Reducing pain in the TENS group and control group were 91% and16.6% respectively]p=0.0001].This study demonstrated that, using the postoperative TENS can reduce the intensity of pain and it can also, be an effective and safe method in controlling the pain of patients with cesarean section

[Quality of care in airways of head injury patients in emergency ward of Bahonar Hospital in Kerman city]

Introduction: Head injury is an important problem in the community. Side effects of injury relates to nursing care quality. The first and important factor for study in these patients is the situation of airway. Often due to the airway obstruction and reduction of ventilation, hypoxia in brain tissue occurs. With increased number of patients with head injuries and the vital importance of this organ, the observance of the care and nursing points is necessary. For several consecutive years, Aden Brock anesthesiology institute has examined the condition of airway but in Iran, only in 1995, a study in Tehran has considered the nursing, condition of airways

Objective: The purpose of this study was to investigate the quality of care in the airways of head injury patients in emergency department of Bahonar Hospital in Kerman City

Materials and Methods: This research is a descriptive cross- sectional research carried out on 384 patients with head injury hospitalized in emergency department of Shahid Bahonar Hospital in winter 2003. Instrument for data collection was an observational checklist consisting of 15 care criteria that their validity and reliability were confirmed. It was for gathering demographic data

Results: Results showed that 86.5% of male patients presenting to the emergency department were the morning working shift. The patients were in the age group of 20-24 years. Their arrivals were due to the closed injuries and strokes that were consistent with study of Aden Brock Institute in 1997. The greatest rate of optimal care [98.5%] is related to the mode of oxygen therapy and the lowest correct application of sterile principles in pharynx and tracheal suction

Conclusion: It can be concluded that because of multiple traumas in men, quality of care for female patients was more favorable but among female patients, quality of care for natural airways, the conditions of head and neck, oxygen consumption, observation of safety issues, control of breathing counts and attention to the potency of tracheal tube were unfavorable and, thus, improvement for quality of care is suggested