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Propose: Nutritional requirements are often escalated following major trauma. Underfeeding and adverse outcomes were seen in critically ill trauma patients. The aim of the study was to quantify actual amount of calories and protein intakes, and extent to which those clinical factors may affect adequate intake. MATERIAL AND METHODS: An observational study carried out in a medical intensive care unit (ICU) of Tabriz University of medical science during April 2017 and December 2018. A total of 85 adult trauma patients with a 7 days ICU length of stay and who received Enteral nutrition (EN) were included in this study. The data on estimated and actual intake of energy and protein, severity of illness (i.e., Acute Physiology and Chronic Health Evaluation II (APACHE II), The Glasgow Coma Scale (GCS) and markers of nutritional status (i.e., serum albumin level and body mass index) were recorded. RESULTS: In this study, sixty-six patients (77%) were underfed in terms of energy and 19 patients (23%) had adequate energy intake. Logistic regression showed that only GCS possibly predict energy status. For every one-unit additional decrease in GCS scores, the odds of being underfed in terms of energy were increased by 1.32 times, after controlling for other factors (95% CI, 1.07 to 1.75, P-value = 0.044). No association was observed between nutritional status and clinical outcomes. CONCLUSIONS: The definite nutritional intake did not coverage the calculated requirements during ICU stay. The current study proposed that there was an inverse association between some clinically important factors (APACHE II score, intubation time) and mean energy intake. Nutritional support was not associated with any complications.
RESUMEN
BACKGROUND: Addiction is the repeated use of a chemical substance which affects the biological function of the brain and endangers physical health of the addicted person. Prevalence and pattern of taking drugs were assessed in the current study in a Special Cares Trauma Center. So the specialized physician could manage the medical procedure more easily through identification of addicted patients and type of their narcotics. METHODS: This cross-sectional study was conducted on 545 patients admitted to the Special Cares Center of Shahid Bahonar Hospital, Kerman, Iran, during 2010-2012. The data were collected by special information collection forms and then analyzed using SPSS software. FINDINGS: Among the total studied samples, around 55% of admitted patients were addicts. Opium was the most frequently used narcotic among the addicted patients with a percentage of 62%. Smoking was the most common method of taking the narcotics. 90% of addicted persons were male and 95% of them held diploma and under-diploma educational degrees. Among the reasons for admission of addicted patients to the Special Cares Clinic of Trauma Center, head trauma was the dominant cause (51%). CONCLUSION: Addiction is considerably more prevalent among the population admitted to the Special Cares Center compared to the society, indicating greater vulnerability of addicted individuals in the society. Addiction to traditional and indigenous drugs are still the most prevalent, and fortunately, these drugs are easier to substitute and medicate compared to the new industrial narcotics.
RESUMEN
Although sport-physiologists have repeatedly analyzed respiratory gases through exercise, it is relatively new in the cardiovascular field and is obviously more acceptable than standard exercise test, which gives only information about the existence or absence of cardiovascular diseases (CVDs). Through the new method of exercise test, parameters including aerobic and anaerobic are checked and monitored. 22 severe cases of heart failure, who were candidates of heart transplantation, referring to Massih Daneshvari Hospital in Tehran from Nov. 2007 to Nov. 2008 enrolled this study. The study was designed as a cross-sectional performance and evaluated only patients with ejection fraction less than 30%. O2 mean consumption was 6.27±4.9 ml/kg/min at rest and 9.48±3.38 at anaerobic threshold (AT) exceeding 13 ml/kg/min in maximum which was significantly more than the expected levels. Respiratory exchange ratio (RER) was over 1 for all patients. This study could not find any statistical correlations between VO2 max and participants' ergonomic factors such as age, height, weight, BMI, as well as EF. This study showed no significant correlation between VO2 max and maximum heart rate (HR max), although O2 maximum consumption was rationally correlated with expiratory ventilation. This means that the patients achieved maximum ventilation through exercise in this study, but failed to have their maximum heart rate being led probably by HF-induced brady-arrhythmia or deconditioning of skeletal muscles.