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BACKGROUND: Various risk scoring systems have been recently developed to predict clinical outcomes in patients with upper gastrointestinal bleeding (UGIB). The two commonly used scoring systems include full Rockall score (RS) and the Glasgow-Blatchford score (GBS). Bleeding scores were assessed in terms of prediction of clinical outcomes in patients with UGIB. PATIENTS AND METHODS: Two hundred patients (age >18 years) with obvious symptoms of UGIB in the emergency department of Rasoul Akram Hospital were enrolled. Full RS and GBS were calculated. We followed the patients for records of rebleeding and 1-month mortality. A receiver operating characteristic curve by using areas under the curve (AUCs) was used to statistically identify the best cutoff point. RESULTS: Eighteen patients were excluded from the study due to failure to follow-up. Rebleeding and mortality rate were 9.34% (n=17) and 11.53% (n=21), respectively. Regarding 1-month mortality, full RS was better than GBS (AUC, 0.648 versus 0.582; P=0.021). GBS was more accurate in terms of detecting transfusion need (AUC, 0.757 versus 0.528; P=0.001), rebleeding rate (AUC, 0.722 versus 0.520; P=0.002), intensive care unit admission rate (AUC, 0.648 versus 0.582; P=0.021), and endoscopic intervention rate (AUC, 0.771 versus 0.650; P<0.001). CONCLUSION: We found the full RS system is better for 1-month mortality prediction while GBS system is better for prediction of other outcomes.
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The objective of this paper was that fine-needle aspiration (FNA) has become a well-liked modality in the diagnosis, staging, and follow-up of head and neck masses. Limited studies exist regarding the value of FNA in the diagnosis of head and neck masses. We aimed to evaluate the diagnostic value of head and neck lymphomas. This cross-sectional study method was performed in Imam Hospital and Cancer Institute affiliated to Tehran University of Medical Sciences. In a 5 years period between January 2006 and June 2010, we enrolled all patients with cervical mass (es) who had undergone FNA as the primary diagnostic modality and then underwent biopsy (excisional or open). Results of FNA were compared with histopathological study as a gold standard method. Finally, 47 patients were recruited. It was found that FNA had a sensitivity of 88% (CI 95% = 79-97), a specificity of 81.2% (CI 95% = 70-92), a positive predictive value of 84.6% (CI 95% = 75-95), a negative predictive value of 85.7% (CI 95% = 77-95) and an accuracy of 85.1% (CI 95% = 75-95) in the diagnosis of head and neck lymphoma. We conclude that FNA has a considerable value in differentiation of head and neck lymphoma from non-lymphoma etiologies and is recommended as a screening test for the diagnosis of head and neck lymphoma.
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BACKGROUND: Infection after transrectal ultrasound (TRUS) guided biopsy of the prostate is a major and potentially life-threatening problem. Using antibiotic premedication can not completely eliminate infection after biopsy. OBJECTIVES: We performed this study to determine the value of using povidone-iodine in prevention of post biopsy infection. PATIENTS AND METHODS: Totally, 280 patients who were referred for TRUS guided biopsy of the prostate were divided randomly into two equal groups. The case group received an intrarectal mixture of povidone-iodine and lidocaine gel before performing biopsy, while the control group received only lidocaine gel. Patients were followed up for 30 days for possible signs of infection including fever, chills and dysuria. RESULTS: The mean age in the case group was 68.7 ± 7 years and 68.1 ± 7 years in the control group (P = 0.78). Overall, there were signs and symptoms of infection in 78 patients (27.9%), of which 27 (19.3%) were in the case group, while 51 (36.4%) were in the control group (P = 0.001, OR = 2.4, 95% CI = 1.4-4.1). CONCLUSION: Simple use of widely available povidone-iodine for cleaning the rectum before TRUS guided prostate biopsy can reduce the infection rate.
