ABSTRACT
Pelvic fracture is a result of devastating injuries and is usually encountered in conjunction with other life-threatening injuries. The aim of the current study was to determine the outcome determinants of patients with pelvic fractures referred to a large trauma center in southern Iran. This retrospective cross-sectional study was conducted in a level I trauma center over a period of three years from 2012 to 2015. We included all patients with pelvic fractures whose medical records had sufficient data. Data were compared between good condition and poor conditions. A total of 327 patients with mean age of 40.1 ± 19.7 years were included. Poor condition was defined as being associated with higher heart rate (p=0.002), lower systolic blood pressure (p<0.001), lower diastolic blood pressure (p=0.002) lower Glasgow Coma Scale (GCS) on admission (p<0.001) and higher Injury Severity Score (ISS) (p<0.001). Those with poor conditions had significantly higher admission to ICU (p<0.001), higher rate of surgical interventions (p<0.001) and higher mortality (p<0.001). The hospital length of stay (p<0.001) and ICU length of stay (p=0.025) were also longer in those with poor condition. Lower hemoglobin, lower pH, higher heart rate, lower systolic blood pressure, lower GCS on admission and higher ISS were important outcome determinants of traumatic pelvic fractures.
ABSTRACT
The ethanolic extract of a Malagasy species Euphorbia stenoclada (ES) (Euphorbiaceae), traditionally used as a herbal remedy against asthma and acute bronchitis, was tested to evaluate possible anti-proliferative activity on human airway smooth muscle cells (HASMC). The ES ethanolic extract totally abolished the interleukin-1beta (IL-1beta) induced proliferation of HASMC (IC(50)=0.73+/-0.08 microg/mL). No cytotoxic effect was observed up to 20 microg/mL. A bioassay-guided fractionation of the ethanolic extract was performed by reversed-phase (RP) flash chromatography, giving five fractions (FA to FE) where fraction FE was the only active one (IC(50)=0.38+/-0.02 microg/mL). The purification of this bioactive fraction FE was carried out by RP-HPLC affording six sub-fractions 1-6, and only sub-fraction 5 kept the anti-proliferative activity. Its major constituent was identified as quercetin (IC(50)=0.49+/-0.12 microg/mL) by means of HPLC/UV/MS and co-elution with the authentic standard. Quercitrin was also identified in the fraction FE but was inactive. A structure-activity relationship with flavonols determined that methylation reduced the anti-proliferative activity whereas glycosylation abolished it. The present study shows that the anti-proliferative properties of Euphorbia stenoclada are mediated through the presence of quercetin that may explain the traditional use of this plant as a remedy against asthma.
