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BACKGROUND: Breast cancer is a prevalent cancer characterized by its aggressive nature and potential to cause mortality among women. The rising mortality rates and women's inadequate perception of the disease's severity in developing countries highlight the importance of screening using conventional methods and reliable scales. Since the validity and reliability of the breast cancer perception scale (BCPS) have not been established in the Iranian context. Therefore, this study aimed to determine the measurement properties of the BCPS in women residing in Tabriz, Iran. METHODS: The present study comprised a cross-sectional design, encompassing a sample of 372 Iranian women. The participants were selected through a multi-stage cluster random sampling technique conducted over a period spanning from November 2022 to February 2023. The measurement properties of the Iranian version of BCPS were assessed following the guidelines outlined in the COSMIN checklist. This involved conducting various steps, including the translation process, reliability testing (internal consistency, test-retest reliability, and measurement error), and methodological tests for validity (content validity, face validity, construct validity, and hypothesis testing). The study also investigated the factors of responsiveness and interpretability. The presence of floor and ceiling effects was assessed. RESULTS: The internal consistency of the scale was assessed using Cronbach's alpha, yielding a satisfactory value of 0.68. Additionally, McDonald's omega (95% CI) was computed, resulting in a value of 0.70 (0.66 to 0.74). Furthermore, the test-retest reliability was evaluated, revealing a high intraclass correlation coefficient (ICC) of 0.97 (95% CI: 0.94 to 0.99). The CVI, CVR, and impact scores of the BCPS were determined to be 0.98, 0.95, and 3.70, respectively, indicating favorable levels of content and face validity. To assess construct validity, an examination of the Exploratory Factor Analysis (EFA) was conducted on a set of 24 items. This analysis revealed the presence of six distinct factors, which collectively accounted for 52% of the cumulative variance. The fit indices of the validity model (CFI = 0.91, NFI = 0.96, RFI = 0.94, TLI = 0.90, χ2/df = 2.03, RMSEA = 0.055 and SRMR = 0.055) were confirmed during the confirmatory factor analysis (CFA). The overall score of BCPS exhibited a ceiling effect of 0.3%. The floor effect observed in the overall score (BCPS) was found to be 0.5%. Concerning the validation of the hypothesis, Spearman's correlation coefficient of 0.55 was obtained between the BCPS and the QLICP-BR V2.0. This correlation value signifies a statistically significant association. Furthermore, it is worth noting that the minimum important change (MIC) of 3.92 exhibited a higher value compared to the smallest detectable change (SDC) of 3.70, thus suggesting a satisfactory level of response. CONCLUSIONS: The obtained findings suggest that the Iranian version of the BCPS demonstrates satisfactory psychometric properties for assessing the perception of breast cancer among Iranian women. Furthermore, it exhibits favorable responsiveness to clinical variations. Consequently, it can serve as a screening instrument for healthcare professionals to comprehend breast cancer and as a reliable tool in research endeavors.
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Neoplasias da Mama , Lista de Checagem , Psicometria , Humanos , Feminino , Neoplasias da Mama/psicologia , Neoplasias da Mama/diagnóstico , Irã (Geográfico) , Estudos Transversais , Adulto , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Psicometria/métodos , Inquéritos e Questionários/normas , Percepção , Idoso , Adulto JovemRESUMO
BACKGROUND: Human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) is still among the leading causes of disease burden and mortality in sub-Saharan Africa (SSA), and the world is not on track to meet targets set for ending the epidemic by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United Nations Sustainable Development Goals (SDGs). Precise HIV burden information is critical for effective geographic and epidemiological targeting of prevention and treatment interventions. Age- and sex-specific HIV prevalence estimates are widely available at the national level, and region-wide local estimates were recently published for adults overall. We add further dimensionality to previous analyses by estimating HIV prevalence at local scales, stratified into sex-specific 5-year age groups for adults ages 15-59 years across SSA. METHODS: We analyzed data from 91 seroprevalence surveys and sentinel surveillance among antenatal care clinic (ANC) attendees using model-based geostatistical methods to produce estimates of HIV prevalence across 43 countries in SSA, from years 2000 to 2018, at a 5 × 5-km resolution and presented among second administrative level (typically districts or counties) units. RESULTS: We found substantial variation in HIV prevalence across localities, ages, and sexes that have been masked in earlier analyses. Within-country variation in prevalence in 2018 was a median 3.5 times greater across ages and sexes, compared to for all adults combined. We note large within-district prevalence differences between age groups: for men, 50% of districts displayed at least a 14-fold difference between age groups with the highest and lowest prevalence, and at least a 9-fold difference for women. Prevalence trends also varied over time; between 2000 and 2018, 70% of all districts saw a reduction in prevalence greater than five percentage points in at least one sex and age group. Meanwhile, over 30% of all districts saw at least a five percentage point prevalence increase in one or more sex and age group. CONCLUSIONS: As the HIV epidemic persists and evolves in SSA, geographic and demographic shifts in prevention and treatment efforts are necessary. These estimates offer epidemiologically informative detail to better guide more targeted interventions, vital for combating HIV in SSA.
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Síndrome da Imunodeficiência Adquirida , Infecções por HIV , Masculino , Feminino , Adulto , Humanos , Gravidez , Adolescente , Adulto Jovem , Pessoa de Meia-Idade , HIV , Síndrome da Imunodeficiência Adquirida/epidemiologia , Prevalência , Estudos Soroepidemiológicos , Infecções por HIV/prevenção & controle , África Subsaariana/epidemiologiaRESUMO
Background: Today, cardiovascular disease (CVD) is the leading cause of mortality in both sexes. There are several risk factors for heart diseases; some controllable, others not. However, socioeconomic, technological, and environmental factors can impact CVD as well as exclusive risk factors. Accurate identification and assessment of these factors are often difficult. In the present systematic review, we aimed to explore factors affecting CVD. Methods: Multiple databases (MEDLINE, Scopus, ISI Web of Science, and Cochrane) and gray literature were searched. The included studies described at least one determinant of CVD. The framework method was applied to analyze the qualitative data. Results: A total of 64 studies from 26 countries were included. The contextual determinants of CVD were categorized into 45 determinants, 15 factors, and 4 main social, economic, technological, and environmental categories. The 15 potentially reversible factors were identified as sociodemographic, violence, smoking, occupation, positive childhood experience, social inequalities, psychological distress, eating habits, neighborhood, family income, rapid technology, environmental pollution, living environments, noise, and disaster. Conclusions: Devolution and more efficient health policies are required to achieve further sustained reduction in CVD mortality, increase life expectancy, and reduce its associated risk factors. Policymakers should fully address the value of social, economic, technological, and environmental factors. In fact, a prevention agenda should be developed and updated collaboratively in terms of the determinant factors.
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Background: Colorectal cancer (CRC) is the third most common cancer and the second leading cause of death worldwide. However, CRC is considered as one of the most preventable cancers by which the mortality rates reduce about 60% through implementing the screening programmes. The present study aimed to evaluate the main barriers of CRC screening in a defined population. Method: Healthy individuals from all regions of the state were invited to participate in different healthcare centres. They were assessed by a provided online risk assessment tool, which was completed for all recruited subjects, and has been developed to assess the CRC risk based on personal and family history of adenoma, CRC, and other high-risk diseases. Research team staff assessed all individuals by this tool and then eligible people according to their lifetime risk of CRC were included in the study. There was not any age restriction in this study. Colonoscopy and three stool-based tests including faecal occult blood test, faecal immunochemical test and stool DNA tests were performed. Results: Overall, 725 cases including 425 (58.6%) males and 300 (41.4%) females participated in the study. Lack of knowledge and attitude about screening programmes was the most common barrier, especially among women (68% for women versus 58% for men) and those from rural areas (88% in rural versus 55% in urban areas). Fear of colonoscopy and procedure complications and pain (48%), discomfort and anxiety from inserting a tube into the bowel (65% among females versus 43% among males) were reported commonly. Embarrassment and dignity were other complaints, especially in women (62% in females versus 35% in males). Conclusion: Increasing knowledge and attitude about the aims and benefits of screening programmes, acceptable and convenient communication of health systems with the general population are considered to be the key elements in the success and implementation of any screening programme.
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INTRODUCTION: This study aimed to collect and summarize test data and conduct a meta-analysis, with respect to the Multitarget Stool DNA test sensitivity and specificity, compared to colonoscopy. MATERIAL AND METHODS: All manuscripts were screened for eligibility according to inclusion criteria. Participants were a normal population at an average risk of developing CRC. Intervention was Stool based and DNA panel tests compared with colonoscopy, and outcome was detection of CRC and any pre-cancerous lesions. Inter-study and inconsistency (using the I-squared test) were assessed. RESULTS: Meta-analyses of the Mt-sDNA test showed a combined sensitivity of 89%, 51%, and 76% for the detection of CRC, advanced adenoma (AA), and combined CRC and AA, respectively. The overall specificity was 91%, 89%, and 90% for the detection of CRC, AA, and combined CRC and AA, respectively. CONCLUSION: Mt-sDNA had significantly acceptable diagnostic accuracy for CRC and AA diagnosis, but still has lower sensitivity and specificity than colonoscopy.
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Adenoma , Neoplasias Colorretais , Humanos , Detecção Precoce de Câncer/métodos , Programas de Rastreamento/métodos , Sangue Oculto , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/genética , Adenoma/diagnóstico , Adenoma/genética , DNA/análiseRESUMO
This updated meta-analysis sought to determine whether the pro-inflammatory potential of diet is a risk factor for breast cancer (BrCa) development, for the first time focusing on the effects of design heterogeneity. The search was performed using Scopus, PubMed, and Embase databases. Data were extracted from twenty-one eligible studies, including eleven cohorts (336,085 participants/20,033 incidence cases), and ten case-control studies (9,833 cases/12,752controls). The random-effect was used to calculate the relative risk (RR) using STATA 16 software. The highest dietary inflammatory index (DII) vs. the lowest category showed 16% increased risk of BrCa (95% CI: 1.06-1.26; I2 = 62.8%, P (I2) < 0.001). This was notable in post-menopausal status (RR = 1.13, 95% CI: 1.04-1.22), women with body mass index (BMI) ≥ 30 kg/m2 (RR = 1.35, 95% CI: 1.07-1.63), and study populations from developing countries (RR = 1.79, 95% CI: 1.12-2.47). Methodological covariates were subject to subgroup meta-analyses and showed stronger results among case-control studies (RR = 1.50, 95% CI: 1.20-1.80), studies considered age-matched controls (RR = 1.56, 95% CI: 1.19-1.93) and hospital-based controls (RR = 2.11, 95% CI: 1.58-2.64), and cohort studies identified by prolong follow-up durations (RR = 1.13, 95% CI: 1.03-1.22). This updated meta-analysis highlighted the pro-inflammatory diet as a risk factor for BrCa, especially among women in post-menopausal status, obese groups, and developing countries. Meta-analysis in methodological subgroups could improve results, less affected by heterogeneity, and suggested subclassification with important implications for future epidemiological designs and even clinical management.
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Neoplasias da Mama , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/etiologia , Estudos de Casos e Controles , Dieta/efeitos adversos , Feminino , Humanos , Incidência , Fatores de RiscoRESUMO
One of the major smoking prevention strategies has been to educate the public and increase people's awareness, using health-warning messages. However, many young people continue smoking without paying attention to health risk messages on cigarette packets in Iran. Hence, this study was conducted to examine the processing route of anti-smoking messages and influencing cognitive factors based on the Elaboration Likelihood Model. This cross-sectional study was correlational in nature. The non-probability sample consisted of 387 tobacco smokers in the age range of 18 to 30 years old. The study was conducted between July and November of 2018 in Tabriz, Iran. A researcher-designed questionnaire was used for the purpose of data collection. No causal inferences were drawn due to the non-experimental nature of the investigation. It was found that tobacco smokers often processed the health warning messages through the central route. Perceived severity, smoking abstinence self-efficacy, and psychological dependence were predictors of message processing through the central route. The results supported the conceptual model of cognitional predictors of the processing route. To design and execute effective health warning messages to quit smoking, it is recommended to consider cognitive factors as a means to enhance critical thinking about the content of the health-warning message.
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Abandono do Hábito de Fumar , Produtos do Tabaco , Adolescente , Adulto , Estudos Transversais , Humanos , Rotulagem de Produtos , Fumantes , Adulto JovemRESUMO
BACKGROUND: There is a lack of scientific literature on the application of fear appeals theories to evaluate lung cancer risk perception among smokers. The aim of the present study is to apply the Extended Parallel Process Model (EPPM) to discover the perception of the smokers about their lifetime risk of developing lung cancer (perceived susceptibility), their perception of lung cancer survival (perceived severity), response efficacy, self-efficacy, and readiness to quit. METHODS: In this cross-sectional study, 215 eligible smokers (aged 45 years and over who have smoked at least 1 pack per day in the last 5 years) were recruited. The data collection tool was designed using validate self-report questionnaires and it was contained items on the perceived risk of a smoker contracting lung cancer and perceived lung cancer survival rate. It also had questions to measure the main constructs of the EPPM and Readiness to quit ("Low_Readiness", and "High_Readiness"). To test how the data support conceptual EPPM to data, Generalized Structural Equation Modeling (GSEM) was used. RESULTS: Findings showed a significant relationship between Perceived_Susceptibility and Perceived_Response Efficacy; (B = 1.16, P < 0.001); between Perceived_Susceptibility and Perceived_Self Efficacy, (B = -0.93, P < 0.001), Perceived_Severity, and Perceived_Response Efficacy (B = 1.07, P < 0.001). There was also a significant relationship between Perceived_Threat and Perceived_Response Efficacy; between Perceived_Threat and Perceived_Self Efficacy. The relationship between High_Readiness and Perceived_Self Efficacy, and between High_Readiness and Perceived_Severity also were significant. However, the relationships between High_Readiness and Perceived_Threat were not significant (P > 0.05). CONCLUSION: Perceived_threat and Perceived_efficacy were important for smokers with low readiness to quit, while Perceived_efficacy was most important for smokers with high readiness to quit. These findings could be used in promoting lung cancer awareness and designing smoking cessation programs based on smokers' stages of change.
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Neoplasias Pulmonares , Abandono do Hábito de Fumar , Estudos Transversais , Humanos , Percepção , FumantesRESUMO
Particulate air pollutants are known contributors to global cardiorespiratory mortality through several pathways. We examined the effects of varied exposure to PM2.5 and trace metals on biological markers of airway inflammation, oxidative stress, and hemodynamic function of young individuals living in two different exposure settings. We enrolled and followed a panel of 97 healthy nonsmoking participants aged 15-18 years living in a highly polluted metropolitan city of Tabriz (TBZ) and a much less polluted semi-urban town of Hadishahr (HDS). For five consecutive months, the subjects were examined by a physician, and fractional exhaled nitric oxide levels (FENO) were measured. Samples of exhaled breath condensation (EBC) were obtained for measuring interleukin 6 (IL-6), tumor necrosis factor α (TNF-α), and total nitric oxide (NOx). We measured daily outdoor PM2.5 mass concentration in a fixed station in each location for all this period. The PM-metal content was analyzed by ICP-MS. The linear mixed-effects regression models were applied for data analysis. The averages of PM2.5 mass and total metals in TBZ were nearly two and four times higher than in HDS, respectively. In TBZ, an increased IQR of PM2.5 mass during 0-5 days was -correlated with a significant rise in diastolic blood pressure, heart rate, TNF-α, FENO, and NOx and reduction of IL-6. Moreover, exposure to low PM2.5 concentration is significantly -correlated with an elevation in diastolic blood pressure in HDS. We also observed that exposure to metal constituents in the highly polluted region is correlated with increased TNF-α and IL-6 with 131.80% (95% CI: 56.01, 244.39) and 47.51% (95% CI: 33.01, 62.05) per IQR of Hg, respectively. This study suggests that exposure to ambient PM2.5 and their metal contents in highly polluted areas may incite significant changes in airway inflammation, oxidative stress, and hemodynamic parameters in healthy subjects.
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Poluentes Atmosféricos , Poluição do Ar , Adolescente , Poluentes Atmosféricos/análise , Biomarcadores/metabolismo , Exposição Ambiental/análise , Hemodinâmica , Humanos , Inflamação , Estresse Oxidativo , Material Particulado/análiseRESUMO
[This corrects the article DOI: 10.1155/2020/1963814.].
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METHODS: Data were obtained from East Azerbaijan cancer registry database for the 10-year period between 2007 and 2016. Survival analysis was performed to calculate the breast cancer-specific survival proportions and mortality rates. Joinpoint trend analysis was performed to estimate the incidence trend of the cancer. RESULTS: A total number of 4989 patients were recorded with primary diagnosis of breast cancer. Of them, we collected follow-up data for 1335 (1309 female and 26 male). The 10-year crude mortality rate was 3.34 (per 100,000). The one-, two-, three-, five-, and ten-year breast cancer-specific survival proportions were 0.92 (95% CI 0.91-0.93), 0.88 (95% CI 0.86-0.90), 0.84 (95% CI 0.83-0.86), 0.77 (95% CI 0.74-0.80), and 0.65 (95% CI 0.60-0.70), respectively. Over the study period, the age-standardized incidence rates increased from 21.68 to 36.99 (per 100,000) with an annual percentage change of 5.5 percent. Older individuals and males patients had significantly worse survival, and patients with high-grade tumors had significantly higher risk of mortality. CONCLUSION: A relatively better survival for breast cancer in East Azerbaijan, Iran, was observed compared to the overall breast cancer-specific survival proportions and mortality rates in the country. However, it is still poor compared to the developed countries indicating that inappropriate treatment modalities might have played a role on this.
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INTRODUCTION: In this study, the authors aimed to perform a novel and extensive analysis, based on the most applicable correlations between the mandibular and upper airway parameters, using cone beam computed tomography across all malocclusion classes. The authors also focused on gender-dependent differences in an Iranian population. MATERIALS AND METHODS: Images were acquired from adult patients using cone beam computed tomography. The patients were classified into three groups of malocclusion classes (class I: 13 males and 27 females, class II: 13 males and 27 females, and class III: 25 males and 15 females). For each patient, 10 parameters for the mandible and 23 parameters for the pharynx, pyriform aperture, and nasal cavity were evaluated in the images. RESULTS: Pearson's correlation coefficient showed significant correlations between the mandibular morphology and upper airway dimensions in each malocclusion class. In females, the menton angle had a significant correlation with pharyngeal dimensions in all malocclusion classes. In males, the bigonial width, bicondylar width, and symphyseal height of the mandible were correlated with pharyngeal dimensions in all classes. The greatest correlation between the mandible and upper airways was observed in class III malocclusions, and the lowest correlation was observed in class I malocclusions. In addition, the mandibular parameters had relationships with the nasal cavity and pyriform aperture. CONCLUSION: It is important to consider the knowledge of the relationship between some characteristics of the mandible and airways in various clinical approaches.
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Mandíbula/diagnóstico por imagem , Cavidade Nasal/diagnóstico por imagem , Faringe/diagnóstico por imagem , Adulto , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Imageamento Tridimensional , Masculino , Má Oclusão Classe I de Angle , Má Oclusão Classe III de AngleRESUMO
Return to work after completion of cancer treatments has many benefits for patients, families, and society. Readiness for return to work (RRTW) seems to be an effective factor for return to work in cancer survivors. Therefore, the present study was to investigate return to work and its relation to RRTW among Iranian survivors of cancer. This descriptive-correlational study examined a total of 227 survived cancer patients with completed primary treatments and without active cancer symptoms. Data were collected by the return to work and RRTW questionnaires and analyzed with descriptive statistics and inferential statistics using SPSS software. Upon completion of initial treatment, 166 (73.2%) of survivor participants returned to work, of which 78 (34.4%) and 88 (38.4%) participants returned to full-time and part-time works, respectively. ANOVA test showed a significant difference between RRTW and the type of return to work. In addition, results of regression analysis revealed that there was a positive significant relationship between RRTW and the rate of return to work before and after the adjustment of variables (p ≤ 0.05). Considering the findings of the study, there is a necessary need planning for rehabilitation programs by nursing managers concerning these patients to facilitate their return to work.
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Sobreviventes de Câncer/psicologia , Neoplasias/psicologia , Retorno ao Trabalho/psicologia , Retorno ao Trabalho/estatística & dados numéricos , Adulto , Emprego , Feminino , Humanos , Irã (Geográfico) , Masculino , Inquéritos e QuestionáriosRESUMO
OBJECTIVES: There is a higher rate of mortality from cardiovascular disease (CVD) in Iran and the mortality rate increases even after coronary artery bypass grafting (CABG). The aim of this study was to evaluate the association between mortality and survival in patients 10 y after CABG, using the dietary inflammatory index (DII) and dietary antioxidant indices. METHODS: In the current prospective cohort study, 450 patients with CVD who were referred to the Tehran Heart Center and who underwent an isolated CABG during the 6-mo period between April and September 2006 were enrolled. Anthropometric measurements and clinical assessments were performed. Biochemical assay, including hemoglobin A1c, serum lipids, creatinine, blood urea nitrogen, lipoprotein(a), albumin, and C-reactive protein, were also measured. DII, dietary antioxidant quality (DAQ) scores, and dietary Mediterranean quality index (MEDQI) were measured using the data obtained from a semi-quantitative food frequency questionnaire. Survival analysis was performed using the Kaplan-Meir method followed by log-rank test. The association between all-cause mortality and study parameters was performed with Cox proportional hazard model. RESULTS: According to the present results, older ages, male sex, lower educational attainment, opium use, previous history of diabetes and myocardial infarction, and higher hematocrit and creatinine concentrations were associated with higher mortality rates. Among nutritional indices, a high inflammatory diet was a positive predictor of mortality, whereas a higher DAQ score was a negative predictor (P < 0.05). No association was found between the MEDQI score and mortality rate among patients. CONCLUSION: According to the present findings, a diet high in inflammatory foods and low in antioxidant content is a potent predictor of mortality 10 y post-CABG. Therefore, reducing the inflammatory potential of the diet and improving its antioxidant content will be a preventive strategy for reducing mortality after CABG.
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Antioxidantes/análise , Ponte de Artéria Coronária/mortalidade , Doença da Artéria Coronariana/mortalidade , Dieta Saudável/estatística & dados numéricos , Dieta Mediterrânea/estatística & dados numéricos , Idoso , Doença da Artéria Coronariana/cirurgia , Estudos Transversais , Feminino , Humanos , Inflamação , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Avaliação Nutricional , Estudos Prospectivos , Taxa de Sobrevida , Resultado do TratamentoRESUMO
BACKGROUND: Health literacy has been considered as a predictor of starting, maintaining, and stop smoking. However, such relations have not been well documented in previous texts. Therefore, the purpose of this study was to investigate the relation between health literacy and changes in the behavior of smoking in Tabriz University of Medical Sciences. METHODS: In this correlational descriptive study, a total of 297 employees of Tabriz health centers were examined. To collect data, a demographic-social questionnaire, Iranian Health Literacy Questionnaire, and DiClemente's behavior change questionnaire were used. Besides, SPSS 13 software (significance level = 0.05) was employed to analyze the data. RESULTS: The average health literacy rate of participants was 70, and most respondents had adequate health literacy. Nearly 41.1% were in the precontemplation phase which is one of the stages of behavior change. There was a positive and significant statistical relation between behavior change variable with all health literacy areas (except the scope of understanding) and total health literacy score (P = 0.011 and r = 0.147). The results of ordinal regression analysis demonstrated that there is a significant positive relationship between the score of health literacy and behavioral change (b = 0.019, 95% confidence interval = (0.010-0.029), P < 0.001). CONCLUSIONS: Improving the level of health literacy can lead to change people's behavior in relation to tobacco consumption. However, due to the lack of relevant texts, there is a need for further studies in this field.
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BACKGROUND: Health knowledge is a requirement in healthcare and having a higher level of health knowledgehelps to promote a satisfactory health status. Also, patients have specific rights within the healthcaresystem, but sometimes they are not aware of their rights. These issues are highly affected by social determinants. OBJECTIVES: The goal of this study was to assess the social determinants of oral health knowledge and theawareness of patient's rights. MATERIAL AND METHODS: This was a cross-sectional study conducted on patients referred to private officesand dental clinics in Tabriz, Iran. The study sample consisted of 500 patients and was selected by randomsampling. A researcher-made questionnaire was used to collect data. RESULTS: The highest number of the patients (31.9%) were 25-34 years old; 62.2% of the participantswere female and 37.8% were male. Regarding religion, on a 1-10 scale, the majority of the respondents(26.6%) had scored themselves 8. As for oral health knowledge, 84.8% believed that reducing sugar consumptionprevents tooth decay and 96.9% declared that stopping smoking is effective in reducing oral diseases.Regarding patients' awareness of the right to access their medical records, only 40% stated that theyhave such right and 34.2% declared "I don't know", while 25.8% believed they have no right to access theirmedical records.
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Conhecimentos, Atitudes e Prática em Saúde , Saúde Bucal , Higiene Bucal , Direitos do Paciente , Determinantes Sociais da Saúde , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos de Amostragem , Inquéritos e Questionários , Adulto JovemRESUMO
Considering the pathologic importance of metabolic disturbances, advanced glycation end products (AGEs), and chronic inflammation in diabetes mellitus and ameliorating potentials of l-carnosine in hampering these detritions and because these effects have not been investigated in patients with type 2 diabetes (T2D) so far, we conducted the current study. We hypothesized that l-carnosine would improve glycemic control, lipid profile, AGE, soluble receptor of AGEs (sRAGE), and inflammatory markers. In a randomized, double-blind, placebo-controlled clinical trial, 54 patients with T2D were recruited and assigned into either intervention group (n=27, receiving 2 capsules of l-carnosine 500 mg each) or control group (n=27). Blood samples and dietary intakes information were collected at baseline and after 12 weeks of intervention. l-Carnosine supplementation resulted in significant decrease in fat mass and an increase in fat-free mass in the intervention group compared with the placebo group (1.5% and 1.7%, respectively) (P<.05). A significant reduction in fasting blood glucose (13.1 mg/dL); glycated hemoglobin (.6%); and serum levels of triglycerides (29.8 mg/dL), carboxymethyl lysine (91.8 ng/mL), and tumor necrosis factor-α was detected in the l-carnosine group compared with the placebo group (P<.05). In the l-carnosine group, a significant reduction in serum pentosidine levels (2.8 ng/mL) was observed compared with those at baseline (P<.05). No significant differences were observed in dietary intake, body mass index, systolic and diastolic blood pressure, fasting insulin levels, homeostasis model assessment of insulin resistance and secretion, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, sRAGE, interleukin (IL)-6, and IL-1ß levels between the groups after adjusting for baseline values and covariates (P>.05). Collectively, l-carnosine lowered fasting glucose, serum levels of triglycerides, AGEs, and tumor necrosis factor-α without changing sRAGE, IL-6, and IL-1ß levels in T2D patients.
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Glicemia/metabolismo , Carnosina/farmacologia , Diabetes Mellitus Tipo 2/sangue , Hemoglobinas Glicadas/metabolismo , Produtos Finais de Glicação Avançada/sangue , Triglicerídeos/sangue , Fator de Necrose Tumoral alfa/sangue , Tecido Adiposo/efeitos dos fármacos , Adulto , Arginina/análogos & derivados , Arginina/sangue , Composição Corporal/efeitos dos fármacos , Carnosina/uso terapêutico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Suplementos Nutricionais , Método Duplo-Cego , Jejum , Feminino , Humanos , Lisina/análogos & derivados , Lisina/sangue , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Mesoporous nanoparticles have a great potential in targeted therapy approaches due to their ideal properties for encapsulation of various drugs, proteins and also biologically active molecules. MATERIAL AND METHODS: We used mesoporous hydroxyapatite (HA) nanoparticles as a drug carrier and developed radiolabeled mesoporous HA containing of 2-deoxy-D-glucose (2DG) and Doxorubicin (DOX) with technetium-99m (99mTc) for imaging in in vitro and in vivo studies. RESULTS: 2DG and DOX in presence of mesoporous HA nanoparticles more reduced the fraction of viable cells in the MDA-MB-231, MCF-7 human and MC4-L2 Balb/c mice breast cancer cells. The radiochemical purity of the nano-2DG-DOX complex with 99mTc was calculated to 96.8%. The results of cellular uptake showed a 44.77% increase in uptake of the [99mTc]-nano-2DG-DOX compared to the complex without nanoparticles (p < 0.001). CONCLUSION: Radioisotopic imaging demonstrated a high biochemical stability for [99mTc]-nano-2DG-DOX complex. The results demonstrated that [99mTc]-nano-2DG-DOX, may be used as an attractive candidate in cancer imaging and treatment managing.
Assuntos
Neoplasias da Mama/patologia , Desoxiglucose/química , Doxorrubicina/química , Portadores de Fármacos/química , Durapatita/química , Nanopartículas/química , Tecnécio/química , Animais , Transporte Biológico , Neoplasias da Mama/tratamento farmacológico , Linhagem Celular Tumoral , Desoxiglucose/metabolismo , Desoxiglucose/farmacologia , Desoxiglucose/uso terapêutico , Doxorrubicina/metabolismo , Doxorrubicina/farmacologia , Doxorrubicina/uso terapêutico , Humanos , Marcação por Isótopo , Camundongos , Porosidade , Ensaios Antitumorais Modelo de XenoenxertoRESUMO
BACKGROUND: Coronary artery disease (CAD) is the leading causes of mortality and morbidity in worldwide. This nested case-control study investigated the predictors of death in long-term follow-up after coronary artery bypass graft surgery (CABG). METHODS: Cases were defined as CABG patients who died in the period of May 2006-March 2013. Controls were CABG patients who were alive in the same period. Cases and controls were derived from an existing cohort, Tehran Heart Center-Coronary Outcome Measurement. One hundred and fifty-nine patients in control group were randomly selected from 566 available patients in follow-up database. A series of simple and multiple logistic regressions was performed in the context of univariate and multivariate analyses, respectively, for computing unadjusted and adjusted odds ratios and their confidence intervals (CI). In the univariate analyses, demographic or cardiometabolic factors were entered separately, and for multivariate analysis, we got both significant risk factors from univariate analysis and the major risk factors. RESULTS: The results of multivariate analyses showed that for age, the likelihood of mortality increases in CABG patients (95%CI: 1.1; 1.03-1.2; P < 0.005). Other significant independent risk factors were peripheral vascular disease (PVD) (95%CI: 2.7; 1.06-6.8; P = 0.036), diabetics (95%CI: 2.49; 0.9-6.3; P = 0.039), smoking (95%CI: 4.38; 1.45-13.7; P = 0.011), length of stay in hospital after CABG surgery (95%CI: 1.14; 1.0-1.24; P = 0.001), total cholesterol (95%CI: 1.12; 1-1.2; P = 0.001), and C-reactive protein (CRP) (95%CI: 1.12; 0.99-1.27; P = 0.049) (all P < 0.05). CONCLUSIONS: The study results indicated that age, diabetes, cigarette smoking, PVD, long length of stay in hospital, elevated triglycerides, total cholesterol, CRP, and high-density lipoprotein cholesterol were significant contributing to increased mortality after CABG. It seems that vulnerable older patients continue to be at high risk with poor outcomes.
RESUMO
BACKGROUND: The aim of the present research was to evaluate the relationship between Mediterranean dietary quality index (Med-DQI) and dietary phytochemical index (DPI) with metabolic risk factors of cardiovascular disease in candidates for coronary artery bypass graft (CABG) surgery. METHODS: This was a cross-sectional study on 454 patients aged 35-80 years as candidates of CABG and hospitalized in Tehran Heart Center. Anthropometric and demographic characteristics were obtained from all participants and a 138-item semi-quantitative food frequency questionnaire (FFQ) was used to evaluate Med-DQI and DPI. Biochemical parameters including HbA1C, serum lipids, albumin, creatinine and C-reactive protein (CRP) were assessed by commercial laboratory methods. RESULTS: Patients with higher scores of "saturated fatty acids" had lower serum albumin concentrations (P < 0.05). High scores of "cholesterol" subgroup was also accompanied with higher serum Hb A1C percent (P = 0.04). Significantly higher concentrations of serum creatinine were also observed in categorizes with lower "fish" scores. Patients with lower phytochemical intakes had significantly higher Med-DQI scores. CONCLUSION: According to our findings, high dietary intakes of saturated fatty acids and cholesterol were associated with low serum albumin and Hb A1C concentration. Further studies are needed to better clarify these associations and possible underlying mechanisms.