Predictors of poor clinical outcome in patients with cervical spondylotic myelopathy undergoing cervical laminectomy and fusion.

BACKGROUND: Cervical spondylotic myelopathy (CSM) is a common degenerative disease that arises from spinal cord compression and injury. Laminectomy with posterior spinal fusion (LPSF) is one of the most common approaches used to treat patients with CSM. The present study aimed to evaluate predictors of poor clinical outcome in patients with CSM undergoing LPSF. METHODS: We retrospectively evaluated 157 patients with CSM who underwent LPSF at our center between April 2014 and June 2019. The neurological outcome was assessed using the modified Japanese Orthopaedic Association (mJOA) scale before the surgery and at the last follow-up visit. Based on the clinical outcomes, all patients were divided into two groups [the good group (recovery rates ≥ 75%) and the poor group (recovery rates < 75%)]. The following suggested variables as potential predictors for the poor clinical outcome were compared between the two groups:age, gender, body mass index (BMI), smoking, diabetes, number of laminectomy levels, presence of signal changes in Magnetic Resonance Imaging (MRI), duration of symptoms, preoperative JOA scale, preoperative Pavlov ratio, preoperative cervical curvature, and preoperative cervical range of motion (ROM). RESULTS: There were 86 males (54.8%) and 71 females (45.2%) with the mean follow-up time of 24.96 ± 1.67 months. Overall, 114 patients (72.6%) had a good clinical outcome. However, 43 subjects (27.4%) failed to achieve a good outcome. According to the binary logistic regression analysis, age (odds ratio [OR], 2.14; 95% confidence interval [95% CI], 1.87-2.63; P = 0.014) and preoperative JOA scale (OR, 3.73; 95% CI 2.96-4.87; p < 0.001) were independent predictors of poor clinical outcome. CONCLUSIONS: The results of the present study showed that age and preoperative JOA scale were predictors of poor clinical outcome in patients with CSM undergoing LPSF. These findings will be of great value in preoperative counseling and management of postoperative expectations.

The effect of cryoprecipitate on prevention of intra cerebral hemorrhage and brain contusion expansion in traumatic patients.

BACKGROUND: Traumatic brain injury (TBI) is a general and socioeconomic complication and is one of the important causes of mortality and disability among young people in the world. Falling and violence and sports injuries are the other cause. It causes for about ten million new patients, accounting for 9% of all deaths. This interventional study aims to investigate the effects of early administration of cryoprecipitate to prevent expansion of intracranial hemorrhage. METHODS: This randomized clinical trial recruited 54 non-pregnant patients. 27 patients in the control group and 27patients in the interventional group. For all patients, common and accepted procedures in scientific centers, including anticonvulsant drugs, normal saline and the other routine management was done and only for patients in the intervention group, 4 units of cryoprecipitate were added to their routine treatments; computed tomography scan (CT) scan was performed 48 hours later in both groups and finally the contusion size was compared in both groups. RESULTS: It was observed in the intervention group that by adding 4 units of cryoprecipitate to their treatments; they had no increased size of the brain parenchymal contusion according to the criteria defined in the study compared to the control group (OR: 0.08, 95% CI: 0.0102_0.6303). CONCLUSIONS: According to a clinical trial, it seems that cryoprecipitate can prevent of cerebral parenchymal hemorrhage expansion in traumatic patients.

Co-culture of Mouse Two-cell Embryos on Human Endometrial Stromal Cells in Proliferative and Secretory Phases / Co-cultivo de Dos Células Embrionarias de Ratón sobre Células Estromales Endometriales Humanos en Fases Proliferativa y Secretora

There were no significant differences in the distribution of embryos reaching to 2- cells, 4- cells, morula or blastocysts culturing on human endometrial stromal cells (Secretory or proliferative phases). The percent of morula in stage A (without fragmentation), stage B (<25% fragmentation), stage C (25-50% fragmentation) and stage D (>50% fragmentation) and did not showed significant differences between two coculture groups. Thus, the phase that the endometrial stromal cells were in thereby did not affect on the quality of embryos.

No hubo diferencias significativas en la distribución de los embriones en los cultivos que llegan a las 2 y 4 células, mórula o blastocistos sobre las células del estroma endometrial (fases proliferativa y secretora). El porcentaje de mórulas en etapa A (sin fragmentación), etapa B (<25% fragmentación), etapa C (25-50% de fragmentación) y etapa D (>50% fragmentación), y no mostraron diferencias significativas entre los dos grupos de co-cultivo. Así, la fase en la que se encontraban las células estromales endometriales no afectaron la calidad de los embriones.