Cigarette smoking and risk of pressure ulcer in adult intensive care unit patients.

The objective of this study was to assess relationship between smoking, some other risk factors and ulcers development in intensive care unit. This prospective cohort study was performed in two university-affiliated hospitals. The sample consisted of adult male patients who were admitted to medical-surgical intensive care units. All eligible patients were grouped according to their cigarette smoking status as smoker and non-smoker. The final sample included 160 smokers and 192 non-smokers. Pressure ulcer occurred in 62 smoker patients and 28 of non-smoker who showed significant difference. Also number of pack-year of cigarettes smoking showed significant association with ulcer development. Ulcer stage was significantly different between the two groups. Besides of smoking, age, length of stay, faecal incontinency, diabetes mellitus, anaemia and trauma were significantly associated with pressure ulcers. Our study showed significant association between smoking and development of pressure ulcers.

Asymptomatic bacteriuria in users of low-dose combined oral contraceptives.

OBJECTIVES: To investigate the association between oral contraceptive use and the prevalence of asymptomatic bacteriuria in women. METHODS: The study was conducted on healthy women of childbearing age who either used low-dose combined oral contraceptives (COCs; cases) or applied the withdrawal method (controls). A positive urine culture with a colony count of more than 10(5)/ml, with the same bacteria on two consecutive specimens, was defined as asymptomatic bacteriuria. Pyuria was defined as the presence of ≥ 10 leukocytes per mm3 of urine. RESULTS: Overall, 369 women in the COC group and 364 in the control group were evaluated. The mean ages of women in the COC group and of controls were 29.9 ± 5.4 years and 30.4 ± 6.0 years, respectively (p = 0.280). Asymptomatic bacteriuria was detected in 2.4% of COC users and 1.9% of the controls (p = 0.633). Pyuria was found in 16% of the cases and 18.1% of the controls (p = 0.441). None of these differences was statistically significant. There was no significant association between duration of COC usage (< 1 year vs. ≥ 1 year) and asymptomatic bacteriuria. CONCLUSION: Use of low-dose COCs (even long-term) does not increase the risk of asymptomatic bacteriuria.

Previous Atorvastatin Treatment and Risk of Diabetic Foot Infection in Adult Patients: A Case-control Study.

OBJECTIVE: In addition to their lipid-lowering abilities, statins have anti-inflammatory and immunomodulatory properties. Increasing recent evidence suggests the possible role of pretreatment with statins in preventing or decreasing morbidity and mortality from infection. Diabetic foot infection (DFI) is a common complication of diabetes mellitus. The aim of this study was to determine whether previous atorvastatin use is associated with reduced risk of DFI and better outcomes of these infections. MATERIALS AND METHODS: One hundred ten adult patients admitted with a diagnosis of DFI were enrolled in the experimental group. For the control group, 123 adult patients with diabetes mellitus in an outpatient setting and without a history of DFIs were accepted. Participants in both groups were classified as statin users or non-statin users depending on history of atorvastatin treatment. For all individuals, the demographic, clinical, and laboratory findings were registered. RESULTS: Atorvastatin was used in 49.1% of the experimental group cases and in 66.7% of the control, and it showed a statistically significant difference (P = .007). Logistic regression analysis also showed that previous atorvastatin use significantly reduces the risk of DFI (odds ratio = 0.36; 95% confidence interval, 0.19-0.71; P = .003). Severe DFI, bone involvement, and the need for surgical intervention was lower in the experimental group, but this difference was not statistically significant. CONCLUSION: Prior therapy with atorvastatin considerably reduces the onset of DFIs. In addition to other effects, statins may be useful in preventing DFIs.

The Effect of Statins Use on the Risk and Outcome of Acute Bacterial Infections in Adult Patients.

BACKGROUND: Beyond their lipid-lowering abilities, statins have anti-inflammatory and immunomodulatory properties. In view of these effects, a growing interest has emerged in the possible role of statins, in preventing or decreasing morbidity and mortality from infection. OBJECTIVES: The aim of this study was to determine whether previous statin use is associated with reduced risk of acute bacterial infections and better outcome of these infections. MATERIALS AND METHODS: In this historical cohort study, consecutive adult patients admitted with acute bacterial infection were enrolled. Control group were selected from adult outpatient and without history of acute bacterial infections. Acute bacterial infections included in this study were; pneumonia, acute pyelonephritis, cellulitis and sepsis with unknown origin. Data about baseline characteristics, co-morbidities and statins use of two groups was obtained. RESULTS: Finally 144 patients met inclusion criteria and were enrolled. Same numbers of controls were selected. Two groups were matched based on most baseline characteristics and co-morbidities. The patients' categories were as follows: pneumonia 42.3%, acute pyelonephritis 23.6%, cellulitis 16% and sepsis 18%. From all participants 29.9% of patients and 45.8% controls were statin users. There was significant association between previous statin use and reduced risk of acute bacterial infections (Mantel Haenszel Weighted Odds Ratio=0.51, 95% CI: 0.30-0.85, p=0.009). Duration of hospitalization was significantly shorter in statin users (p=0.002). Hospital mortality rate was lower (14.6%) in statins users when compared with non-users (18.8%) with significant difference (p=0.028). CONCLUSION: Prior therapy with statins is associated with considerably reduced onset of acute bacterial infections and better outcome in adult patients.

Association between quality of life, menopausal status, and sociodemographic factors among middle-aged women in Iran.

OBJECTIVE: Assessment of overall health, well-being, and quality of life (QoL) during middle age and menopause deserves special attention. The aim of this study was to investigate the effect of menopausal status and some sociodemographic variables on QoL among middle-aged women in Semnan, Iran. PARTICIPANTS AND METHODS: This cross-sectional survey was conducted in 2012 in Semnan, Iran. The participants included 770 women aged 45-60 years. The data were collected by interview using a structured questionnaire that included sociodemographic characteristics, data on menopausal status, and QoL measurement using the Menopause-Specific Quality of Life questionnaire. RESULTS: The mean±SD age of the women was 50.9±4.7 years. The overall unadjusted mean scores obtained for each domain were as follows: vasomotor: 1.83±1.86; psychosocial: 1.62±1.41; physical: 1.98±1.28; and sexual: 1.63±1.87. Logistic regression analysis showed that menopausal status was significantly associated with QoL in all domains, except the psychosocial domain. Age, BMI, household income, and number of children were significantly associated with impairment in QoL. Marital status, educational level, and residential area did not show any association with QoL in multivariate analysis. CONCLUSION AND RECOMMENDATIONS: Our findings confirm previous literature on the negative impact of menopausal symptoms on QoL, and show the interaction of some sociodemographic characteristics including age, number of children, household income, and BMI, on QoL. Health professionals should ensure that they consider a range of factors in middle-aged women's lives and provide insight into possible treatment strategies and lifestyle interventions for improving QoL.

Association between body mass index and urinary tract infection in adult patients.

BACKGROUND: Overweight and obesity have become a global public health over the last decades. Obesity has been suggested to be a risk factor for some infections, but studies often showed controversial findings. Few studies examined the relationship between body mass index (BMI) and urinary tract infection (UTI), showing inconsistent results. OBJECTIVES: The purpose of this study was to determine the relationship between BMI and UTI in adult patients. PATIENTS AND METHODS: Adult patients (≥ 18 years old) who were referred to clinics or admitted in hospital with diagnosis of UTI were considered for participation in the study. Control group were selected from healthy adult normal population whom underwent medical check-ups at the same hospital and without history of UTI. Data about age, gender, history of diabetes mellitus and BMI were registered for individuals who met inclusion criteria. RESULTS: A total of 116 patients with UTI and 156 people as the control group were included in the study. Two groups were matched for age, gender and history of diabetes mellitus. Mean BMI ± SD of patients was 25.2 ± 4.0 kg/m(2) and the controls was 25.1 ± 3.6 kg/m(2). There was no significant correlation between BMI and UTI (P = 0.757). Mean BMI ± SD of patients with upper UTI was 25.6 ± 4.1 kg/m(2) and for lower UTI was 24.9 ± 4.0 kg/m(2). There was no significant difference between BMI of controls and patients with any type of UTI (P = 0.573). CONCLUSIONS: Our findings did not found an association between BMI and UTI and does not support obesity as a risk factor for UTI in adult patients.

Attitudes toward menopause among middle-aged women in Semnan, Iran.

BACKGROUND AND OBJECTIVE: The menopause marks a major biological transition in the lives of all women. Understanding the attitude of women about menopause facilitates the implementation of public health policies that focus on improving women's health. This study was designed to determine the attitude of a group of Iranian women toward menopause with respect to sociodemographic variables and menopausal status. MATERIALS AND METHODS: A cross-sectional study was conducted at Primary Health Centers of Semnan during 2012. A total of 747 women aged 45-60 years were interviewed. Sociodemographic characteristics and attitude toward menopause were collected through a structured pretested questionnaire. The attitude scale consisted of 17 questions, each rated on a five-point Likert scale with a total score of 85 points. RESULTS: The mean (±SD) age of women was 51.3 (±4.5) years. Women were classified as premenopausal (38.4%), perimenopausal (16.9%), and postmenopausal (44.8%). The majority of respondents (63.5%) were illiterate or have had low level of education (<9 years), and 86.3% were unemployed. The mean (±SD) attitude score was 53.3 (±6.8). Most of the women (71%) had neutral attitude, 22.8% had positive, and only 6.3% had negative attitude toward menopause. Menopausal status, educational level, marital status, place of residency, and employment were not associated with women's attitude. CONCLUSION: In general, women's attitude toward menopause ranged from neutral to positive. The attitude did not differ significantly on the basis of menopausal status, educational level, marital status, place of residency, and employment.

Knowledge and attitude toward evidence-based medicine among medical students in Semnan, Iran.

OBJECTIVES: Evidence-based medicine (EBM) has gained widespread acceptance in medicine. Little is known about the attitudes, knowledge, and behavior of medical students toward EBM in developing countries. This study was designed to assess medical students' awareness and attitudes toward EBM and to obtain the basis required for developing appropriate teaching and learning opportunities. METHODS: This was a cross-sectional study in which medical students completed a questionnaire to determine their attitudes, knowledge, and perceptions regarding EBM. RESULTS: Completed questionnaires were received from 84% (143) of 170 medical students. Only 24.5% of respondents had good basic information and familiarity with the term of EBM. The majority (89.3%) of participants had positive attitude toward EBM and agreed that it was useful in the management of patients. Mostly were interested in learning the skills of EBM. Most of the respondents (80.2%) had no or little awareness of EBM resources especially the Cochrane, DARE, and Bandolier clinical evidence database. Forty-two (29%) reported having had formal training in search strategies. Most of the respondents did not understand but would like to learn about technical terms used in EBM, and about a third felt able to explain to others the meaning of some of these terms. CONCLUSIONS: This study demonstrates lack of adequate knowledge about basic concepts of EBM among medical student. On the other hands, there is an overall positive attitude toward EBM. There is need for educational interventions and incorporating formal teaching of EBM at medical education.

Cigarette smoking and nephrolitiasis in adult individuals.

BACKGROUND: Nephrolithiasis is a widespread multifactorial disorder. Constitutional, environmental and genetic factors play a role in stone formation. Although important advances have been made in understanding the pathophysiology of stone formation, none of the many theories have given a satisfactory explanation of this process. OBJECTIVES: The objective of study was to evaluate the probable relationship between cigarette smoking and nephrolitiasis in adult men. PATIENTS AND METHODS: A total of 102 cases diagnosed with nepholithiasis and 121 age-matched healthy controls were recruited from June 2010 to September 2011. Smoking status and resultant data was obtained from both groups. RESULTS: Twenty seven (26.5%) of the patients with stones and eighteen (14.9%) of the control group were current cigarette smokers. Our findings showed that smoking significantly increases the risk of nepholithiasis (OR = 2.06, 95% CI: 1.06-4.01, P = 0.034). There was no significant difference in the number of cigarettes smoked (P = 0.830) and years of smoking (P = 0.536) between subjects with and without stones (P = 0.536). CONCLUSIONS: This study suggests that cigarette smoking might be an independent risk factor for the development of nephrolithiasis.