The Correlation Between Bladder Cancer and Obesity, Overweight, Physical Inactivity, and Tobacco Use: An Ecological Study in Asian Countries.

BACKGROUND: Bladder cancer is the ninth most common cancer in the world. OBJECTIVES: This study aimed to determine the correlation between age-standardized incidence rates of bladder cancer and some risk factors in Asian countries through an extensive ecological analysis. METHODS: This ecological study evaluated the correlation between age-standardized incidence rates of bladder cancer and obesity, overweight, physical inactivity, and tobacco use in 30 Asian countries. To determine the factors that were significantly related to age-standardized incidence rate of bladder cancer, a univariate analysis was performed using simple linear regression. In the next step, variables with p-values less than 0.25 were entered into a multivariate linear regression model. RESULTS: The incidence of bladder cancer was higher in countries with higher prevalence of overweight (r2 = 0.36, p < 0.001), obesity (r2 = 0.34, p = 0.001), current daily tobacco use (r2 = 0.17, p = 0.03), and physical inactivity (r2 = 0.13, p = 0.04). The results of multiple regression analysis indicated a direct correlation between the incidence of bladder cancer and overweight (ß = 0.15, p < 0.001) and current daily tobacco use (ß = 0.21, p = 0.001). CONCLUSIONS: There was a significant relationship between the incidence of bladder cancer and overweight and current daily tobacco use. Further epidemiological studies are needed to confirm this relationship.

Factors associated with extubation time in coronary artery bypass grafting patients.

Background and Objectives. Cardiovascular diseases are the leading cause of death worldwide, with coronary artery disease being the most common. With increasing numbers of patients, Coronary Artery Bypass Grafting (CABG) has become the most common operation in the world. Respiratory disorder is one of the most prevalent complications of CABG. Thus, weaning off the mechanical ventilation and extubation are of great clinical importance for these patients. Some post-operative problems also relate to the tracheal tube and mechanical ventilation. Therefore, an increase in this leads to an increase in the number of complications, length of hospital stay, and treatment costs. Since a large number of factors affect the post-operative period, the present study aims to identify the predictors of extubation time in CABG patients using casualty network analysis. Method. This longitudinal study was conducted on 800 over 18 year old patients who had undergone CABG surgery in three treatment centers affiliated to Shiraz University of Medical Sciences. The patients' information, including pre-operative, peri-operative, and post-operative variables, was retrospectively extracted from their medical records. Then, the data was comprehensively analyzed through path analysis using MPLUS-7.1 software. Results. The mean of extubation time was 10.27 + 4.39 h. Moreover, extubation time was significantly affected by packed cells during the Cardiopulmonary Bypass (CPB), packed cells after CPB, inotrope use on arrival at ICU, mean arterial pressure 1st ICU, packed cells 1st ICU, platelets 1st ICU, Blood Urea Nitrogen 1st ICU, and hematocrit 1st ICU. Conclusion. Considering all of the factors under investigation, some peri-operative and post-operative factors had significant effects. Therefore, considering the post-operative factors is important for designing a treatment plan and evaluating patients' prognosis.

Spatial analysis of common gastrointestinal tract cancers in counties of Iran.

BACKGROUND: Gastrointestinal tract cancers are among the most common cancers in Iran and comprise approximately 38% of all the reported cases of cancer. This study aimed to describe the epidemiology and to investigate spatial clustering of common cancers of the gastrointestinal tract across the counties of Iran using full Bayesian smoothing and Moran I Index statistics. MATERIALS AND METHODS: The data of the national registry cancer were used in this study. Besides, indirect standardized rates were calculated for 371 counties of Iranand smoothed using Winbug 1.4 software with a full Bayesian method. Global Moran I and local Moran I were also used to investigate clustering. RESULTS: According to the results, 75,644 new cases of cancer were nationally registered in Iran among which 18,019 cases (23.8%) were esophagus, gastric, colorectal, and liver cancers. The results of Global Moran's I test were 0.60 (P=0.001), 0.47 (P=0.001), 0.29 (P=0.001), and 0.40 (P=0.001) for esophagus, gastric, colorectal, and liver cancers, respectively. This shows clustering of the four studied cancers in Iran at the national level. CONCLUSIONS: High level clustering of the cases was seen in northern, northwestern, western, and northeastern areas for esophagus, gastric, and colorectal cancers. Considering liver cancer, high clustering was observed in some counties in central, northeastern, and southern areas.

Pathological profile of patients with breast diseases in Shiraz.

BACKGROUND: Around 200,000 breast disorders are annually diagnosed all over the world. Fibrocystic changes are the most common breast disorder and fibroadenoma is the most prevalent benign breast tumor. The present study aimed to determine the spectrum, type and prevalence of breast masses in women referred to Shiraz University of Medical Sciences between 2004 and 2012 . MATERIALS AND METHODS: A cross-sectional study was conducted on the diagnostic reports data. RESULTS: A total of 640 samples were studied. Most 57.3% of masses were detected in the left breast, 65%, 28.2% and 6.1% of cases presenting with benign, malignant, and inflammatory lesions, respectively. Among all the samples the most prevalent diagnosis (37.7%) was fibroadenoma and fibrocystic lesions (17%). 174 samples (96% of the malignant cases) were invasive. 6.5% of the benign, and 37% of the malignant cases occurred in post menopause women and the differences were statistically significant. Among those with malignant tumors lymph nodes were involved in 25.6% of menopausal women and 44.2% of non-menopausal ones, and the difference was statistically significant. CONCLUSIONS: Regular clinical breast examination beside mammographic follow-ups, especially during menopause, should be carried out as a priority and a national organized program should be designed for screening breast disorders.

Breast cancer risk factors in women participating in a breast screening program: a study on 11,850 Iranian females.

The incidence rate of breast cancer in developed countries is almost three-fold higher than in developing countries. Iran has had one of the lowest incidence rates for breast cancer in the world, but during the recent decades a marked increase has been seen. The purpose of this study was to investigate some established risk factors of breast cancer in Iranian women. A study of 11,850 women participating in abreast screening program was conducted. The 197 women diagnosed with breast cancer and 11,653 healthy women were compared. Logistic regression was performed to investigate associations of reproductive and anthropometric factors with breast cancer risk. Family history of breast cancer (OR=1.94 , 95%CI=1.35-2.78), occupation (OR= 1.65,95%CI=1.20- 2.25), education level (OR=0.50,95%CI=0.28-0.91), parity (OR=0.27, 95%CI=0.12-0.59), menopausal status (OR=3.15, 95%CI=2.35-4.21), age at menarche (OR=0.33, 95%CI=0.15-0.70), and age at the first pregnancy (OR=4.10 , 95%CI=1.13-14.77) were related to the risk of breast cancer. Decrease in parity may to some extent explain the rising trend of incidence of breast cancer incidence in Iranian women.