ABSTRACT
BACKGROUND: COVID-19 was first identified in Iran in February 2020 and since then it spread rapidly through all over the country and soon after that it was reported as a pandemic. The current study presents a preliminary report of spine trauma management during COVID-19 pandemic. METHODS: A cross sectional study was designed to evaluate patients admitted for vertebral fractures with diagnosis of COVID-19 infection on February and March 2020. Analysis was made based on clinical and laboratory data along with the imaging findings from chest HRCT. RESULTS: Seven patients with spine trauma including five males and two females ranging from 14 to 59 years were diagnosed for COVID-19 infection through CT-scan findings. Except one, all other patients were asymptomatic for COVID-19 at the time of admission. In three cases the COVID diagnosis was made the day after arrival and in others after 10, 14 and 35 days. Five patients were treated surgically among whom four were admitted to ICU soon after the surgery. The mean ICU stay for operated patients were eight days and the mean hospital stay was 22.6 days. CONCLUSION: Proper diagnosis of COVID-19 is the keystone to protect both patients and health care providers. During the pandemic all admitted patients should be screened for COVID-19 infection. Unnecessary procedures for spine trauma patients should be avoided in order to reduce complications related to surgery and to preserve ICU beds.
ABSTRACT
BACKGROUND: Nasal polyposis (NP) treatment and pathophysiology have always been challenging for otolaryngologists. Among the medical treatments for NP, glucocorticoids (GCs) have been always one of the mainstays but the mechanisms of their action are not well defined. Identifying and comparing the protein profile of chronic rhinosinusitis (CRS) with NP before and after treatment with GCs can help to clarify NP pathogenesis and mechanisms of corticosteroid effects on NP. METHODS: Samples of nasal polyps were taken from selected NP patients in workup for endoscopic sinus surgery. None of the patients used local or systemic GCs within 30 days before the sampling. The patients were given prednisone, 30 mg/day, for 4 days before the surgery to shrink the NP tissue. Nasal polyp samples were collected during surgery. Proteins from samples were extracted and separated by immobilized pH gradient-based two-dimensional difference gel electrophoresis (2D DIGE). Resulting 2D-gel images were statistically analyzed using Delta2D software and differently expressed protein spots were identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. RESULTS: A reference map of 1963 proteins could be established. Expression of 20 proteins changed significantly (twofold, p<0.05) after treatment of NP with GCs. Heat shock proteins and retinoic acid were induced by GCs. Ingenuity pathway analysis of all identified proteins indicated that apoptosis pathway is triggered in NP after GC administration. CONCLUSION: Identifying the changes of NP proteome due to GCs and the biological functions of proteins can lead to new ways of treatment and open new fields in NP research.
