Paraclinical findings in Iranian veterans exposed to sulfur mustard gas: A literature review / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>Sulfur mustard (SM) causes various systemic disturbances in human beings. This study aimed to assess paraclinical changes caused by exposure to SM gas in Iranian veterans during the war between Iraq and Iran.</p><p><b>METHODS</b>A literature review was carried out in international and national medical databases including ISI, Medline, Scopus, Iranmedex and Irandoc. Both Farsi and English literature were searched.</p><p><b>RESULTS</b>Search of the literature yielded 422 medical articles related to SM poisoning. Among them, 30 relevant articles were thoroughly reviewed. The most important reported complications were leukopenia, neutropenia, lymphopenia, eosinophilia, thrombocytopenia, increased bleeding time, positive C-reactive protein (CRP), rheumatoid factor (RF), antinuclear antibody (ANA), decreased T helper cells, natural killer cells, IL6, and IL8 levels, elevation of serum immunoglobulins, decreased levels of T3, T4 and cortisol, increased level of adrenocorticotropic hormone (ACTH), proteinuria, hematuria, and elevated liver enzymes. Also, there were some changes in chest assessments.</p><p><b>CONCLUSIONS</b>SM causes profound systemic complications in victims, even years after exposure. The paraclinical changes can be observed in hematology, immune system, biochemistry, hormonal profile and some imaging studies.</p>

Survival after in-hospital cardiopulmonary resuscitation in a major referral center during 2001-2008

Despite efforts to save more people suffering from in-hospital cardiac arrest, rates of survival after in-hospital cardiopulmonary resuscitation [CPR] are no better today than they were more than a decade ago. This study was undertaken to assess the demographics, clinical parameters and outcomes of patients undergoing CPR by the code blue team at our center during 2001 to 2008. Data were collected retrospectively from adult patients [n=2262] who underwent CPR. Clinical outcomes of interest were survival at the end of CPR and survival at discharge from the hospital. Factors associated with survival were evaluated using binomial and Chi Square tests. Of the patients included [n=2262], 741 patients [32.8%] had successful CPR. The number of male patients requiring CPR was more than females in need of the procedure. The majority of patients requiring CPR were older than 60 years [56.4 +/- 17.9]. The number of successful CPR cases in long-day shift [7:00 to 19:00] was more than that in the night shift [19:00 to 7:00]. Furthermore, 413 [18.4%] cases were resuscitated on holidays and 1849 [81.7%] on the working days. The duration of CPR was 10 min or less in 710 [31.4%] cases. Cardiopulmonary resuscitations which lasted less than 10 minutes were associated with better outcomes. The findings of the present study indicate that some manageable factors including the duration of CPR, working shift, working day [holiday or non-holiday] could affect the CPR outcomes. The findings might also be taken as evidence to suggest that the allocation of more personnel in each shift especially in night shifts and holidays, planning to increase the personnel's CPR skills, and decreasing the waste time would result in the improvement of CPR outcome

Hospital admission due to nephrological conditions during hajj causes, healthcare use, and short-term outcomes

In this retrospective study, records of Iranian Hajj pilgrims who were hospitalized in 2 Iranian hospitals in Mecca and Medina, Saudi Arabia, from 2005 to 2007, were reviewed of 600 patients who were hospitalized, 12 [2.0%] were admitted due to nephrological causes, which included kidney calculi [n = 7; 58.4%], acute kidney failure [n = 2; 16.7%], urinary tract infection [n = 1; 8.3%], urinary tract infection and urinary calculus [n = 1; 8.3%], and renal malignancy [n = 1; 8.3%]. None of the patients needed referral to other healthcare centers, and all of them were discharged with good condition. Length of hospital stay was 1 to 4 days. There was no association between hospitalization due to nephrological causes and sociodemographic data, healthcare use, and outcome. This inpatient epidemiological study showed 2% of total admissions were related to nephrological conditions in Iranian Hajj pilgrims, most commonly due to easily treated conditions

Survival after in-hospital cardiopulmonary resuscitation in a major referral center

This study was undertaken to assess the demographics, clinical parameters and outcomes of patients undergoing cardiopulmonary resuscitation [CPR], by the code blue team at our center to compare with other centers. Data were collected retrospectively from all adult patients who underwent CPR at our hospital from 2007 to 2008. CPR was performed on 290 patients and it was given 313 times. Clinical outcomes of interest were survival at the end of CPR and survival at discharge from the hospital. Factors associated with survival were evaluated via binomial and chi square-tests. Of the 290 patients included, 95 patients [30.4%] had successful CPR. However, only 35 patients [12%] were alive at discharge. The majority requiring CPR were above 60 years of age [61.7%]. Males required CPR more than females. There were 125 women [43.1%] and 165 males [56.9%] aged 3 to 78 [average 59.6] years. Majority [179] of the cases [61.7%] were above 60 years of age. Regarding the various wards, 54 cases [17.3%] were in the internal medicine ward, 63 cases [20.1%] in the surgery ward, 1 case [0.3%] in the clinic, 11 cases [3.5%] in the paraclinic, 116 cases [37.1%] in the emergency [ER], 55 cases [17.5%] in the Intensive Care Unit [ICU] and Coronary Care Unit [CCU], and 13 cases [4.2%] were in other wards. Cardiac massage was done in 133 cases [42.5%], defibrillation only via electroshock 3 cases [1%], and both were used in177 cases [56.5%]. The ER had the most cases of CPR. Both cardiac massage and electroshock defibrillation were needed in most cases. In-hospital CPR for cardiopulmonary arrest was associated with 30.4% success at our center at the end of CPR but only 12% were alive at discharge. Duration of CPR >10 minutes was predictive of significantly decreased survival to discharge