Translational Health Reports

Abstract Urosepsis is a severe, life-threatening condition caused by the rapid dissemination of urinary-tract pathogens into the bloodstream and an uncontrolled host inflammatory response. The emergence of multidrug-resistant organisms and the variability of immune activation in critically ill patients have made its management increasingly complex. Targeted antimicrobial therapy (TAT)—defined as the selection of antibiotics based on microbiological identification and susceptibility testing—embodies the principles of precision medicine, aiming to optimize treatment effectiveness while minimizing broad-spectrum exposure and the spread of resistance.

This review synthesizes the current evidence regarding the role of TAT in urosepsis, highlighting its effects on systemic inflammation, organ function, and clinical outcomes. Special attention is given to novel biomarkers such as Presepsin, neutrophil CD64 index, and Copeptin, examined alongside classical inflammatory mediators including tumour necrosis factor-α (TNF-α), interleukin-6 (IL-6), and C-reactive protein (CRP). Collectively, these markers provide valuable insights into the interplay between pathogen control and immune modulation. The review also discusses diagnostic and operational barriers to implementing TAT, the variability of antimicrobial stewardship across institutions, and future research directions aimed at integrating biomarker-guided targeted therapy into individualized sepsis management.

Abstract Background: Spinal injuries are a significant cause of morbidity and mortality globally. Trauma-related spinal fractures contribute to the burden on healthcare systems and significantly affect the quality of life. Although substantial progress has been made in trauma care, spinal fractures, particularly those associated with spinal cord injuries (SCI), remain a leading cause of long-term disability. The epidemiology of spinal fractures varies regionally due to demographic, trauma mechanisms, and healthcare factors. In Iran, motor vehicle accidents and falls from heights are prominent causes of spinal injuries, but regional data on the epidemiology of these injuries, particularly from smaller cities, is scarce.


Materials and Methods: This retrospective cohort study was conducted at Imam Khomeini Hospital in Sari, Mazandaran province, Iran, reviewing the records of 288 patients with spinal fractures treated between March 2014 and March 2018. Data collected included demographic characteristics (age and gender), injury mechanisms, fracture locations, fracture types, presence of spinal cord injuries, and clinical outcomes. The analysis also included the association between injury mechanisms and fracture types using statistical tests.


Results: The study included 288 patients, with 75% being male and a mean age of 39.21 years. The most common mechanisms of injury were motor vehicle accidents (47.2%) and falls from height (35.4%). Cervical spine fractures were the most common, accounting for 49% of cases. Burst fractures were the most prevalent type of fracture (40.5%). Spinal cord injuries were present in 21.2% of the patients, with a higher incidence in those injured by vehicle accidents. The mortality rate was 3.1%, and 42.4% of patients underwent surgical intervention. The average hospital stay was 7.53 days.


Conclusion: This study provides a comprehensive epidemiological profile of spinal fractures in a regional Iranian hospital. It highlights the high incidence of spinal fractures due to motor vehicle accidents and falls from height, with cervical spine fractures and burst fractures being the most common. The presence of spinal cord injury is significant and underscores the need for early diagnosis and effective treatment. . Further studies, particularly prospective ones, are needed to better understand the long-term outcomes of spinal injuries and SCI in Iran.