CONTEXTO E OBJETIVO: Acredita-se que a presença de fraturas escapulares esteja associada a alta freqüência de outras lesões e morbidades relacionadas. O objetivo foi avaliar o padrão de lesões e os desfechos gerais em pacientes com fraturas escapulares. DESENHO E LOCAL: Trabalho transversal com pacientes apresentando trauma, tratados em seis hospitais gerais em Teerã. MÉTODOS: Registros de trauma foram obtidos em seis hospitais gerais no período de um ano. Entre estes pacientes, 41 sofreram fratura escapular e foram incluídos no estudo. RESULTADOS: A faixa etária predominante para fratura escapular foi 20-50 anos, sendo 78%. Acidentes automobilísticos (AAs) foram a maior causa de lesão, em 73,2% (30/41). Observou-se também que os acidentes com pedestres correspondiam a 46,7% (14/30) das lesões devidas a AAs. Quedas foram a segunda causa mais freqüente, com sete casos (17,1%). Fraturas do corpo estavam o tipo mais freqüente das fraturas escapulares (80%). Dezoito pacientes (43,9%) apresentaram apenas fratura escapular. Fraturas de extremidades foram as lesões mais comumente associadas, observadas em 18 (43,9%). Três pacientes (7,3%) tiveram lesões graves (escala de gravidade das lesões > 16), o que resultou em um caso (2,4%) de óbito. A maioria dos pacientes foi tratada de forma conservadora (87,8%). CONCLUSÕES: Pacientes com fraturas escapulares tiveram lesões torácicas e fraturas de clavícula basicamente mais graves. Porém, não houve correlação com maiores índices da escala de gravidade das lesões, admissão na unidade de terapia intensiva ou mortalidade.

CONTEXT AND OBJECTIVE: The presence of scapular fracture is believed to be associated with high rates of other injuries and accompanying morbidities. The aim was to study injury patterns and their overall outcomes in patients with scapula fractures. DESIGN AND SETTING: Cross-sectional study of trauma patients treated at six general hospitals in Tehran. METHODS: One-year trauma records were obtained from six general hospitals Among these, forty-one had sustained a scapular fracture and were included in this study. RESULTS: Scapular fracture occurred predominantly among 20 to 50-year-old patients (78%). Road traffic accidents (RTAs) were the main cause of injury (73.2%; 30/41). Pedestrians accounted for 46.7% (14/30) of the injuries due to RTAs. Falls were the next most common cause, accounting for seven cases (17.1%). Body fractures were the most common type of scapular fractures (80%). Eighteen patients (43.9%) had isolated scapular fractures. Limb fracture was the most common associated injury, detected in 18 cases (43.9%). Three patients (7.3%) had severe injuries (injury severity score, ISS > 16) which resulted in one death (2.4%). The majority of the patients were treated conservatively (87.8%). CONCLUSIONS: Patients with scapula fractures have more severe underlying chest injuries and clavicle fractures. However, this did not correlate with higher rates of injury severity score, intensive care unit admission or mortality.

OBJECTIVE: Since the introduction of percutaneous nephrolithotomy (PCNL), many changes have been added regarding the entrance to pyelocalyceal system such as insertion of the needle pointed to an opaque stone as a guided landmark. We aim at comparing the outcomes of managing renal calculi with and without retrograde pyelography. MATERIALS AND METHODS: In a randomized clinical trial, 55 cases with opaque renal calculi candidates for PCNL with stone in one calyce, in the pelvis or both in one calyce and the pelvis simultaneously were included in a nine-month study. They were randomized into 2 groups, noncatheterized (n = 28) and catheterized (n = 27), called intervention and control groups, respectively. RESULTS: The 2 groups had similar distributions regarding gender, age, duration of operation, length of hospital stay, past history of any surgical procedures on kidney, and stone size. Outcome (residual stone based on aforementioned management) was evaluated with plain X-ray on the morning following the operation. Postoperative hemoglobin decrease was significantly higher in controls than in the intervention group (p < 0.001) (with no clinical significance). No difference in outcome, postoperative fever, duration of surgery, duration of hospital stay and radiation exposure was observed between the 2 groups. CONCLUSION: Our findings showed no differences in major clinical outcomes between the 2 groups (with and without catheter insertion for retrograde pyelography).

INTRODUCTION: The exact mechanism of chronic nonbacterial prostatitis has not been yet elucidated and the outcome with the current management is dismal. In this trial, we studied the effect of allopurinol in the treatment of this disease. MATERIALS AND METHODS: In this randomized double blind controlled trial, a calculated sample size of 56 were grouped into "intervention group" who received allopurinol (100 mg tds for 3 months) with ofloxacin (200 mg tds) for 3 weeks (n = 29) and "control group" who received placebo tablets with ofloxacin (n = 27). Patients’ scores based on the National Institute of Health Chronic Prostatitis Symptom Score were recorded before therapy and then every month during the study. A four-glass study was performed before intervention and after 3 months. RESULTS: The 2 groups were similar regarding outcome variables. In the first month of study, a significant but similar improvement in symptom scores was observed in both groups. Microscopic examination of prostate massage and post-massage samples were also similar in both groups. No side effects due to allopurinol were observed in patients. CONCLUSION: We did not find any advantage for allopurinol in the management of chronic prostatitis versus placebo in patients receiving routine antibacterial treatment.