Early hyperglycemia is associated with poor outcome, and persistent hyperglycemia is a powerful and independent predictor of mortality in children and adolescents with severe TBI.

BackgroundNeurosurgical treatment and the severity of head injury (HI) can have remarkable effect on patients’ neuropsychiatric outcomes.ObjectivesThis research aimed to study the effect of these factors on cognitive functioning, general health and incidence of mental disorders in patients with a traumatic brain injury (TBI).Patients and MethodsIn this descriptive, longitudinal study, 206 TBI patients entered the study by consecutive sampling; they were then compared according to neurosurgery status and severity of their HI. Both groups underwent neurosurgical and psychological examinations. The mini mental state examination (MMSE) and general health questionnaire–28 items (GHQ-28) were administered to the study participants. At follow-up, four months later, the groups underwent a structured clinical interview by a psychiatrist based on the diagnostic and statistical manual of mental disorders, fourth edition (DSM-IV) diagnostic criteria regarding the presence of mental disorders.ResultsAnalysis of covariance (ANCOVA) and multivariate analysis of covariance (MANCOVA) were performed and adjusted for the effect of confounding variables (age, gender, Glasgow outcome scale (GOS) , and level of education). The severity of HI had the most significant effect for the following variables; cognitive functioning and physical symptoms (P < 0.05). The effect of the neurosurgical treatment factor was not significant; however, the interaction effect of the two variables on social dysfunction, and total score of the GHQ-28 questionnaire appeared to be significant (P < 0.05). Fisher's exact test indicated that after a four month follow-up period, no significant differences were seen between the two groups (with or without neurosurgery) in the incidence of mental disorders, while χ2 Test showed that having a more severe HI is significantly correlated with the incidence of mental disorders (P < 0.01).ConclusionsThe implications of this study should be discussed with an emphasis on negative, effective factors on the cognitive – behavioral and neuropsychiatric outcomes of a TBI.

Background: Breast cancer is the most common cancer in women in most areas of the world. In Iran and Guilan province, frequency of this type of cancer has shown an increasing rate according to statistics of health centers of province in recent years. Despite of efforts on early diagnosis and treatment, this type of cancer is still the second leading cause of deaths due to cancer in women. Objectives: This study aimed at obtaining protein biomarkers that may be useful in diagnosis and treatment of breast cancer. Patients and Methods: In this experimental study, 10 patients with proved breast cancer and 10 patients with healthy breast, healthy and cancerous tissue samples were obtained to perform proteomics. All tissue proteins were purified using standard separation methods and proteins were separated using two-dimensional electrophoresis. Healthy and tumorous tissue proteomes were compared and the extent of protein expression was analyzed. Results: Four hundred fifty four proteins were recognized, 138 of which were identified with changes in protein expression while cancerous. The expression of 61 proteins in tumorous group was suppressed. Three proteins showed increased expression while cancerous and 74 proteins showed decreased expression in cancerous tissue. Conclusions: It seems that in this disease, the expression of a large number of proteins in cancerous tissues changed, most of them decreased or not expressed at all. These changed proteins can be effective as biomarker in diagnosis and treatment of this disease.

Background: Mental disorders in patients with chronic medical disorders are associated with, performance degradation, poor quality of life, lack of cooperation with treatment and inappropriate use of medical services, and increased costs. The objective of this study was to determine the prevalence of mental disorders in the general population referring to an educational medical hospital in Rasht, Iran, in 2013. Materials and Methods: In this cross-sectional study, 1725 patients who referred to a medical educational center in Rasht were selected using convenience sampling method. Data were collected through clinical interviews and using inpatients' psychological condition analysis form. Data were analyzed using descriptive and inferential statistics. Results: Results showed that the prevalence of mental disorders in this population was 48.6%. The statistical test results showed age (P < 0.0001), marital status (P < 0.0001), occupation, history of substance abuse (P < 0.0001), psychiatric history (P < 0.0001), and a history of suicide attempt (P < 0.001) had significant relationships with presence of mental disorders. Conclusions: Given the high prevalence of mental disorders in this community, it is recommended that consultation and therapeutic services be provided in health centers for patients' health.

Introduction: Odontoid pathologies constitute a special category because they may lead to instability. Instability is defined by abnormal spinal alignment under physiologic conditions (loads) such as standing, walking, bending, or lifting. Since instability poses a risk of cord damage, surgical interventions may be required for durable long-term stabilization. This study demonstrates operative technique and results of endoscopic endonasal approach to the odontoid. Methods: We conducted a retrospective study involving 18 patients who underwent endoscopic endonasal odontoidectomy (EEO) due to Craniovertebral pathologies. Demographic data, clinical features of the patients, risk factors, intraoperative and postoperative complications were reported in this series. Results: Satisfactory outcomes achieved in 16 patients based on comparing modified Rankin scale before and after the surgery (P value= 0.0001). The mean duration for EEO was 232.6 ± 18.8 minutes. The mean blood loss during surgery was 386.67 ± 153.04 ml. The mean duration of hospital stay was seven days. All patients were extubated within a few hours after surgery. Against the backdrop of a successful anterior decompression in the aforementioned cases, intraoperative cerebrospinal fluid (CSF) leakage, postoperative meningitis, and pulmonary thromboembolism have emerged as devastating complications. However, two intraoperative CSF leakages were managed by direct dural repair and fat graft; two patients died due to postoperative meningitis and pulmonary thromboembolism 7 and 4 days after the second surgery. Conclusion: In conclusion, EEO can be effectively used for anterior decompression of the odontoid pathologies, despite the risk of complications.