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1.
Cell Biochem Funct ; 42(4): e4025, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38845083

RESUMO

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease. Metabolic and mitochondrial dysregulation are critical causal factors in the pathogenesis and progression of RA. Mitochondrial dysfunction include abnormal energy metabolism, and excessive production of reactive oxygen species (ROS). This study aimed to investigate the adenosine triphosphate (ATP), mitochondrial membrane potential (ΔΨm), ROS, and mRNA expression level of ROMO1 (as ROS modulator) and OMA1 (as regulator mitochondrial dynamics) of peripheral blood mononuclear cells (PBMC) in RA patients. The study participants were 50 patients with RA and 50 sex- and age-matched healthy volunteers. PBMC of all participant were isolated by Ficoll-Paque. Alteration in ΔΨm and cellular ROS were measured using flow cytometry, ATP level was also assessed via luminometry, and ROMO1 and OMA1 mRNA expression via qRT-PCR assay. A significant decrease in ATP (p = .005) and ΔΨm (p < .001) was observed in the PBMC of RA compared to control. The ROS levels were significantly higher in the PBMC of RA compared to the control (p < .001). ROMO1 and OMA1 mRNA expression was also significantly increased in RA patients compared to control (p < .001). The decrease in ATP is strongly associated with ROS increasing in PBMC of RA patients, denoting an inverse and negative relationship between ATP and ROS production. Also, a decrease in ΔΨm was observed. It seems that in line with mitochondrial dysfunction in PBMC, increased expression of ROMO1 and OMA1 genes could also be involved in the development of RA.


Assuntos
Artrite Reumatoide , Leucócitos Mononucleares , Mitocôndrias , Espécies Reativas de Oxigênio , Humanos , Artrite Reumatoide/metabolismo , Artrite Reumatoide/patologia , Leucócitos Mononucleares/metabolismo , Feminino , Masculino , Espécies Reativas de Oxigênio/metabolismo , Mitocôndrias/metabolismo , Pessoa de Meia-Idade , Biomarcadores/metabolismo , Biomarcadores/sangue , Trifosfato de Adenosina/metabolismo , Proteínas Mitocondriais/metabolismo , Proteínas Mitocondriais/genética , Adulto , Potencial da Membrana Mitocondrial , Proteínas de Membrana/metabolismo , Proteínas de Membrana/genética , RNA Mensageiro/metabolismo , RNA Mensageiro/genética
2.
BMC Pregnancy Childbirth ; 24(1): 316, 2024 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-38664680

RESUMO

BACKGROUND: In this umbrella review, we systematically evaluated the evidence from meta-analyses and systematic reviews of maternal factors associated with low birth weight. METHODS: PubMed, Scopus, and Web of Science were searched to identify all relevant published studies up to August 2023. We included all meta-analysis studies (based on cohort, case-control, cross-sectional studies) that examined the association between maternal factors (15 risk factors) and risk of LBW, regardless of publication date. A random-effects meta-analysis was conducted to estimate the summary effect size along with the 95% confidence interval (CI), 95% prediction interval, and heterogeneity (I2) in all meta-analyses. Hedges' g was used as the effect size metric. The effects of small studies and excess significance biases were assessed using funnel plots and the Egger's test, respectively. The methodological quality of the included studies was assessed using the AMSTAR 2 tool. RESULTS: We included 13 systematic Review with 15 meta-analysis studies in our study based on the inclusion criteria. The following 13 maternal factors were identified as risk factors for low birth weight: crack/cocaine (odds ratio [OR] 2.82, 95% confidence interval [CI] 2.26-3.52), infertility (OR 1.34, 95% CI 1.2-1.48), smoking (OR 2.00, 95% CI 1.76-2.28), periodontal disease (OR 2.41, 95% CI 1.67-3.47), depression (OR 1.84, 95% CI 1.34-2.53), anemia (OR 1.32, 95% CI 1.13-1.55), caffeine/coffee (OR 1.34, 95% CI 1.14-1.57), heavy physical workload (OR 1.87, 95% CI 1.00-3.47), lifting ≥ 11 kg (OR 1.59, 95% CI 1.02-2.48), underweight (OR 1.79, 95% CI 1.20-2.67), alcohol (OR 1.23, 95% CI 1.04-1.46), hypertension (OR 3.90, 95% CI 2.73-5.58), and hypothyroidism (OR 1.40, 95% CI 1.01-1.94). A significant negative association was also reported between antenatal care and low birth weight. CONCLUSIONS: This umbrella review identified drug use (such as crack/cocaine), infertility, smoking, periodontal disease, depression, caffeine and anemia as risk factors for low birth weight in pregnant women. These findings suggest that pregnant women can reduce the risk of low birth weight by maintaining good oral health, eating a healthy diet, managing stress and mental health, and avoiding smoking and drug use.


Assuntos
Recém-Nascido de Baixo Peso , Humanos , Feminino , Fatores de Risco , Gravidez , Recém-Nascido , Complicações na Gravidez/epidemiologia , Metanálise como Assunto , Revisões Sistemáticas como Assunto
3.
J Res Med Sci ; 29: 18, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38808220

RESUMO

This guideline is the first Iranian guideline developed for the diagnosis, management, and treatment of hyperlipidemia in adults. The members of the guideline developing group (GDG) selected 9 relevant clinical questions and provided recommendations or suggestions to answer them based on the latest scientific evidence. Recommendations include the low-density lipoprotein cholesterol (LDL-C) threshold for starting drug treatment in adults lacking comorbidities was determined to be over 190 mg/dL and the triglyceride (TG) threshold had to be >500 mg/dl. In addition to perform fasting lipid profile tests at the beginning and continuation of treatment, while it was suggested to perform cardiovascular diseases (CVDs) risk assessment using valid Iranian models. Some recommendations were also provided on lifestyle modification as the first therapeutic intervention. Statins were recommended as the first line of drug treatment to reduce LDL-C, and if its level was high despite the maximum allowed or maximum tolerated drug treatment, combined treatment with ezetimibe, proprotein convertase subtilisin/kexin type 9 inhibitors, or bile acid sequestrants was suggested. In adults with hypertriglyceridemia, pharmacotherapy with statin or fibrate was recommended. The target of drug therapy in adults with increased LDL-C without comorbidities and risk factors was considered an LDL-C level of <130 mg/dl, and in adults with increased TG without comorbidities and risk factors, TG levels of <200 mg/dl. In this guideline, specific recommendations and suggestions were provided for the subgroups of the general population, such as those with CVD, stroke, diabetes, chronic kidney disease, elderly, and women.

4.
Arch Virol ; 168(2): 53, 2023 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-36609722

RESUMO

The prevalence of coinfection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and influenza virus among referred patients in Hamadan province, Iran, from November 2, 2021, to January 30, 2022, was evaluated. Samples were obtained from 14,116 individuals with COVID-19 symptoms and screened for SARS-CoV-2 and influenza viruses using a multiplex real-time PCR panel assay. Of these patients, 14.19%, 17.11%, and 1.35% were infected with influenza virus, SARS-CoV-2, and both viruses, respectively. The majority of the coinfected patients were female outpatients aged 19-60 years.


Assuntos
COVID-19 , Coinfecção , Influenza Humana , Orthomyxoviridae , Humanos , Feminino , Masculino , COVID-19/epidemiologia , SARS-CoV-2 , Coinfecção/epidemiologia , Pandemias , Orthomyxoviridae/genética
5.
Environ Monit Assess ; 195(7): 899, 2023 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-37380884

RESUMO

This study aimed to evaluate the occurrence and likelihood of health risks related to arsenic in drinking water of all counties of the Hamadan province in the northwest of Iran. In this work, 370 samples were collected from all of the water resources of urban and rural regions, during 5 years (2017 to 2021). Oracle Crystal Ball software was used to perform the Monte Carlo simulation and investigate the potential health risks. According to the results, the average values of arsenic in the nine counties were in the order Kabudarahang (40.1 ppb), Malayer (13.1 ppb), Nahavand (6.1 ppb), Bahar (2.05 ppb), Famenin (0.41 ppb), Asadabad (0.36 ppb), Tuyserkan (0.28 ppb), Razan (0.14 ppb), and Hamadan (< 0.1 ppb). The highest concentration of arsenic occurred in Kabudarahang with a maximum value of 185 ppb. In the spring season, the average concentration of the cations, including calcium, magnesium, sodium, lead, cadmium, and chromium, obtained 109.51 mg/l, 44.67 mg/l, 20.50 mg/l, 88.76 ppb, 0.31 ppb, and 0.02 ppb, respectively. Based on the Delphi classification, the P 90% of oral lifetime cancer risk, in Hamadan province, were within level II (low risk) to VII (extremely high risk). The risk analysis revealed there was a possible carcinogenic risk to humans from oral exposure to As-contaminated groundwater, especially in Kabudarahang county. Therefore, there is an urgent need for management and precise measures in contaminated areas to reduce and prevent the adverse health effects of arsenic.


Assuntos
Arsênio , Água Potável , Humanos , Qualidade da Água , Monitoramento Ambiental , Cádmio
6.
Arch Psychiatr Nurs ; 36: 1-6, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-35094819

RESUMO

PURPOSE: Globally mental disorders affect a large number of adolescents. The unmet need for health care of mental health problems is common among adolescents. The aim of this systematic review and meta-analysis was to estimate the global prevalence of unmet needs of mental health care among adolescents. METHODS: PubMed, Web of Sciences and Scopus, were searched by June 2018 using a pre-designed search strategy. The summary measure was the prevalence of unmet need for mental health care. The inverse variance method was used in meta-analysis, and the results were reported using the random-effects model at a 95% confidence interval (CI). RESULTS: Out of 30,154 retrieved studies, 15 cross-sectional studies met the eligibility criteria and included in the meta-analysis. The included studies involved 51,309 participants, which 34,476 of them required the mental health care services. The overall pooled prevalence of unmet need for mental health care was 54.0% (95% CI: 41.0, 67.0; I2 = 99.9%). Prevalence among adolescents with any mental disorder, general population of adolescents, and high-risk adolescents were 58.1 (46.8, 69.5), 51.4 (30.2, 72.7), and 31.0 (29.0, 33.0) respectively. CONCLUSION: Based on the results of this systematic review a considerable proportion of adolescents with mental health problems, have not received the required mental health care.


Assuntos
Serviços de Saúde Mental , Saúde Mental , Adolescente , Estudos Transversais , Atenção à Saúde , Humanos , Prevalência
7.
Surgeon ; 19(1): 37-48, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32209308

RESUMO

BACKGROUND: The aim of this review was to compare the available treatments of esophageal cancer, in terms of pulmonary, cardiovascular complications, anastomotic leakage, and esophagitis after treatment in patients with esophageal squamous cell carcinoma (SCC). METHODS: Medline, Web of Science, Scopus, the Cochrane Library and Embase were searched. The randomized controlled trials (RCT) that had compared the treatment -related complications of treatments for esophageal SCC were included. We included 39 randomized control trials in a network meta-analysis. The Chi2-test was used to assess of heterogeneity. The loop-specific and design-by-treatment interaction methods were used for assessment of consistency assumption. The risk ratio with 95% confidence interval (CI) was used to report the effect-sizes in the network meta-analysis. RESULTS: The pulmonary complication, cardiac complication, anastomotic leakage, and esophagitis were reported in 31, 11, 17, and 15 RCTs respectively. Video-assisted thoracoscopy + laparoscopy (VATS) was rank as the first and second treatment in terms of lower risk for pulmonary complication and anastomotic leakage. There was no statistically significant difference between treatments in terms of lower risk of cardiovascular complications. However, Surgery + Cisplatin + Fluorouracil (SCF) was ranked as better treatment. 3-dimensional conformal radiotherapy + Docetaxel + Cisplatin (3DCRTDC) was the best treatment in terms of lower risk for esophagitis. CONCLUSION: According to the results of this study, it seems the risk of pulmonary, cardiovascular, anastomotic leakage and esophagitis complications for VATS, SCF, surgery + radiotherapy (SRT), and 3DCRTDC was lower than other treatments respectively in the networks.


Assuntos
Neoplasias Esofágicas , Fístula Anastomótica/epidemiologia , Fístula Anastomótica/etiologia , Neoplasias Esofágicas/cirurgia , Humanos , Metanálise em Rede
8.
BMC Womens Health ; 20(1): 186, 2020 08 31.
Artigo em Inglês | MEDLINE | ID: mdl-32867777

RESUMO

BACKGROUND: Our knowledge on the prevalence of high-risk behaviors among women of Alborz is not reliable due to the sensitivity of the issue. This study aimed to estimate the prevalence of seven risk behaviors among the reproductive age women in Alborz Province, Iran. METHOD: In this cross-sectional study, 2000 women were randomly selected from a registered healthcare system in 2019. A researcher-made questionnaire was used to collect the required data. The prevalence of the risk behaviors including drug abuse, hookah, alcohol drinking, tobacco smoking, extramarital intercourse, and gambling was estimated using the unmatched count technique, and the prevalence rate was reported at a 95% confidence interval. RESULTS: The response rate for this study was 95%. The estimated prevalence for drug abuse, hookah, alcohol drinking, tobacco smoking, extramarital intercourse, and gambling were 3% (95%CI: 2.78 to 3.22), 10.5% (95%CI: 10.29 to 10.71), 7% (95%CI: 6.78 to 7.22), 10% (95%CI: 9.78 to 10.22), 8.7% (95%CI, 8.29 to 8.71), and 7.5% (95%CI, 4.71 to 7.28), respectively. CONCLUSION: High risk behaviors are highly prevalent among Iranian women. Enforcing laws, prohibition, marketing restrictions, increasing taxation, expanding treatment, promoting condom distribution and providing community-based service are recommended to reduce the effects of high risk behaviors among women.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Jogo de Azar/epidemiologia , Assunção de Riscos , Fumar/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Pessoa de Meia-Idade , Prevalência , Fumar/psicologia , Saúde da Mulher , Adulto Jovem
9.
East Mediterr Health J ; 24(11): 1088-1097, 2019 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-30701524

RESUMO

BACKGROUND: Ageing is a major known risk factor that is a threat to human health. To date, many studies have investigated quality of life (QOL) among the elderly population in the Islamic Republic of Iran. However, their results were inconsistent. AIMS: We designed this systematic review and meta-analysis to estimate the overall mean score of QOL based on the Short Form 36 Health Survey Questionnaire (SF-36) among the Iranian elderly population. METHODS: We searched international databases (Medline, Scopus and Science Direct) and national databases (Science In-formation Database, MagIran, IranMedex and Irandoc) up to February 2015. We included all cross-sectional studies that evaluated QOL among the Iranian elderly population using SF-36. RESULTS: Of 2150 studies identified, 15 were included in the meta-analysis. The mean scores for QOL in the 8 scales were: 47.58, 51.75, 55.42, 55.78, 59.55, 51.54, 47.85 and 51.31 for physical-role, physical function, mental health, bodily pain, social functioning, emotional-role, general health, and vitality, respectively. CONCLUSIONS: Our results indicated that health-related QOL decreased with increasing age. QOL was worse in women than in men, especially in physical-role and general health scales. Elderly people who lived in a nursing home had lower QOL than those who lived in their own home. So, health policy-makers should design comprehensive programmes to improve health-related QOL for the Iranian elderly population.


Assuntos
Idoso/psicologia , Qualidade de Vida , Idoso/estatística & dados numéricos , Humanos , Irã (Geográfico) , Qualidade de Vida/psicologia , Inquéritos e Questionários
10.
Med J Islam Repub Iran ; 33: 45, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31456969

RESUMO

Background: Tuberculosis (TB) is one of the ten leading causes of death, especially in developing countries. We aimed to assess the inequality in the incidence and prevalence of TB and TB/HIV based on the human development index (HDI) globally. Methods: In this ecological study, the data on the incidence and prevalence of TB, HIV, and TB/HIV co-infection in 168 countries were obtained from the World Health Organization (WHO). The HDI of these countries in 2000, 2005, 2010, and 2015 was also obtained from the United Nations Development Program (UNDP). The concentration index was used to assess the inequality of the incidence and prevalence of TB and TB/HIV based on the HDI globally. Results: The concentration index for the incidence of TB according to the HDI was -0.32 (95% CI: -0.46, -0.17), -0.36 (95% CI: -0.49, -0.23), -0.37 (95% CI: -0.52, -0.22), and -0.36 (-0.52, -0.21) in 2000, 2005, 2010, and 2015, respectively. The same pattern was observed for the incidence and prevalence of TB/HIV. The results showed that TB and TB/HIV mainly concentrated in countries with a lower HDI. Conclusion: According to the results of this study, the incidence of TB and TB/HIV and the prevalence of TB/HIV concentrated in the countries with a lower HDI. In addition, inequality in TB and HIV based on the HDI did not change from 2000 to 2015. Therefore, it seems that public health programs, especially in low-income countries, should be revised and the World Health Organization and the United Nations should provide more technical and financial help for these countries.

11.
Horm Metab Res ; 50(11): e6, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30452070

RESUMO

In the article, the name of the co-author was given incorrectly. The correct name of the author is Mohammad Ali Mansournia. In the abstract section the correct abbreviation of "mean difference" is MD.

12.
Horm Metab Res ; 50(11): 783-790, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30396207

RESUMO

This systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to clarify the effect of melatonin supplementation on glycemic control. Databases including PubMed, MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials were searched until July 30th, 2018. Two reviewers independently assessed study eligibility, extracted data, and evaluated the risk of bias for included trials. Heterogeneity among included studies was assessed using Cochran's Q test and I-square (I2) statistic. Data were pooled using random-effect models and standardized mean difference (MD) was considered as the overall effect size. Twelve trials out of 292 selected reports were identified eligible to be included in current meta-analysis. The pooled findings indicated that melatonin supplementation significantly reduced fasting glucose (SMD=-6.34; 95% CI, -12.28, -0.40; p=0.04; I2: 65.0) and increased the quantitative insulin sensitivity check index (QUICKI) (SMD=0.01; 95% CI, 0.00, 0.02; p=0.01; I2: 0.0). However, melatonin administration did not significantly influence insulin levels (SMD=-1.03; 95% CI, -3.82, 1.77; p=0.47; I2: 0.53), homeostasis model assessment of insulin resistance (HOMA-IR) (SMD=-0.34; 95% CI, -1.25, 0.58; p=0.37; I2: 0.37) or HbA1c levels (SMD=-0.22; 95% CI, -0.47, 0.03; p=0.08; I2: 0.0). In summary, the current meta-analysis showed a promising effect of melatonin supplementation on glycemic control through reducing fasting glucose and increasing QUICKI, yet additional prospective studies are recommended, using higher supplementation doses and longer intervention period, to confirm the impact of melatonin on insulin levels, HOMA-IR and HbA1c.


Assuntos
Glicemia/metabolismo , Diabetes Mellitus/tratamento farmacológico , Melatonina/administração & dosagem , Diabetes Mellitus/metabolismo , Suplementos Nutricionais/análise , Humanos , Resistência à Insulina , Ensaios Clínicos Controlados Aleatórios como Assunto
13.
Horm Metab Res ; 50(6): 429-440, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29883970

RESUMO

In this systematic review and meta-analysis of randomized controlled trials (RCTs), the effects of vitamin D supplementation on biomarkers of inflammation and oxidative stress in diabetic patients are summarized. The following databases were searched up to December 2017: MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials. The quality of the relevant extracted data was assessed according to the Cochrane risk of bias tool. Data were pooled using the inverse variance method and expressed as mean difference with 95% Confidence Intervals (95% CI). Heterogeneity between studies was assessed by the Cochran Q statistic and I-squared tests (I2). Overall, 33 studies were included in the meta-analyses. Vitamin D supplementation were found to significantly reduce serum high-sensitivity C-reactive protein (hs-CRP) (WMD 0.27; 95% CI, - 0.35, - 0.20; p<0.001) and malondialdehyde (MDA) levels (WMD - 0.43, 95% CI - 0.62, - 0.25, p<0.001) in diabetic patients. In addition, vitamin D supplementation were found to increase markers of nitric oxide (NO) release (WMD 4.33, 95% CI 0.96, 7.70), total serum antioxidant capacity (TAC) (WMD 57.34, 95% CI 33.48, 81.20, p<0.001) and total glutathione (GSH) levels (WMD 82.59, 95% CI 44.37, 120.81, p<0.001). Overall, this meta-analysis shows that in diabetic patients, taking vitamin D had significant effects on hs-CRP and MDA levels, and significantly increased NO, TAC and GSH levels.


Assuntos
Biomarcadores/metabolismo , Diabetes Mellitus/tratamento farmacológico , Diabetes Mellitus/patologia , Suplementos Nutricionais , Inflamação/patologia , Estresse Oxidativo , Vitamina D/uso terapêutico , Adulto , Idoso , Antioxidantes/metabolismo , Proteína C-Reativa/metabolismo , Glutationa/metabolismo , Humanos , Malondialdeído/metabolismo , Pessoa de Meia-Idade , Óxido Nítrico/metabolismo , Viés de Publicação , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento , Vitamina D/farmacologia
14.
Med Microbiol Immunol ; 206(6): 463-470, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29032460

RESUMO

Killer cell immunoglobulin like receptors (KIRs) have a principal role in regulating the effector functions of NK cells, particularly in viral infections. The major ligands for KIRs are human leukocyte antigen (HLA) class I molecules. The aim of this study is to investigate the possible association of KIR genes, their known HLA ligands and compound KIR-HLA genotypes with hepatitis B virus (HBV) infection. Our study group consisted of 202 Iranian HBV-infected patients (52 spontaneously recovered, 50 asymptomatic carriers, 50 chronic sufferers and 50with liver cirrhosis) and 100 ethnic-matched healthy control subjects. KIR and HLA genotyping was performed by a polymerase chain reaction-sequence-specific primer (PCR-SSP). The frequencies of the KIR2DL5A, KIR2DS1, and KIR3DS1 genes were significantly elevated in recovered individuals when compared with both control and patient groups. Also, KIR2DL5, and KIR3DP1 full were escalated in recovered individuals in comparison with patient groups. In addition, HLA-Bw4 ligand and HLA-A Bw4 were highly frequent in recovered individuals compared with healthy controls. Furthermore, the KIR3DS1 + HLA-Bw4, KIR3DS1 + HLA-Bw4 Iso80 , and KIR3DS1 + HLA-A Bw4 genotypes were significantly more common in recovered individuals than both healthy control and patient groups. Interestingly, AA genotype had less frequency and Bx had higher frequency in recovered individuals compared with both healthy control and patient groups. Our findings suggest a potential impact of the NK cells' activating phenotype that leads to the HBV clearance in infected individuals.


Assuntos
Predisposição Genética para Doença , Genótipo , Hepatite B/genética , Fosfoproteínas/genética , Receptores KIR/genética , Adulto , Feminino , Frequência do Gene , Técnicas de Genotipagem , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Adulto Jovem
15.
Med J Islam Repub Iran ; 31: 75, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29445704

RESUMO

Background: Depression is the most common mental disorder in individuals with HIV and AIDS (PLWHA), and comorbidity with depression exacerbates the disease. Several studies have estimated the prevalence of depression in HIV and AIDS patients so far, but there is no consensus about the prevalence of depression among these patients. Thus, we aimed at estimating the overall prevalence of depression among Iranian PLWHA. Methods: The international and national databases including Web of Science, Scopus, Medline, Science Direct, MagIran, Scientific Information Database (SID), IranMedex, and Medlib were searched until June 2016. The quality of included studies was assessed using Newcastle-Ottawa Scale. Results: Out of 591 references, 9 cross-sectional studies met the eligibility criteria and were included in the review. The lowest and highest reported prevalence of depression among people with HIV was 22% (95% CI: (11, 33)) and 76% (95% CI: (71, 81)), respectively. Prevalence of depression in people with HIV in the north, west, and south of Iran was 45% (95% CI: (23, 67)), 30% (95% CI: (15, 45)), and 56% (95% CI: (35, 77)), respectively. Prevalence of depression among addict and non-addict patients was 25% (95% CI: (21, 30)) and 58% (95% CI: (40, 77)), respectively. Conclusion: According to the results of this systematic review, the prevalence of depression is considerable among Iranian PLWHA. Prevalence in the southern regions of Iran is more than the western and northern regions of Iran. This evidence may be useful for Iranian health policymakers to design suitable preventive and therapeutic interventions in PLWHA to prevent and control depression among these people in Iran.

16.
Am J Emerg Med ; 34(3): 558-69, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26809929

RESUMO

OBJECTIVE: This meta-analysis of trials was conducted to evaluate the analgesic and side effects of ketamine-propofol combination (ketofol) in comparison to propofol in procedural sedation and analgesia (PSA). METHODS: Medline, EMBASE, Scopus, CINHAL, and Cochrane Central Register of Controlled Trials were searched for clinical trial. The administration complications were the key outcomes of interest. RESULT: Eighteen clinical trials that met our criteria were included in the analysis. Pooling of data showed that ketofol is significantly effective for reduction of respiratory complication and with relative risk (RR) of 0.31 in 14 trials (95% confidence interval [CI], 0.47-0.7; P = .001). Ketofol was also effective in reducing cardiovascular complications with hypotension RR of 0.11 in 9 trials (95% CI, 0.17-0.97; P = .04) and bradycardia RR of 0.47 in 8 trials (95% CI, 0.28-0.72; P = .008). The present study also showed that the summary of RR for psychomimetic complications was 1.95 in 13 trials were (95% CI, 0.79-4.81; P = .15) and for muscle rigidity was 0.52 for 2 trials (95% CI, 0.06-4.67; P = .56), and both were insignificant. In regard to nausea and vomiting, the RR was 1.23 in 12 trials (95% CI, 0.39-3.88; P = .72) and insignificant. CONCLUSION: This meta-analysis demonstrates good safety profile in cardiorespiratory problems and comparable rate of other complications with propofol in adult procedural sedation and analgesia.


Assuntos
Sedação Consciente/métodos , Manejo da Dor/métodos , Propofol/uso terapêutico , Adulto , Analgésicos/efeitos adversos , Analgésicos/uso terapêutico , Anestésicos Dissociativos/efeitos adversos , Anestésicos Dissociativos/uso terapêutico , Quimioterapia Combinada , Humanos , Hipnóticos e Sedativos/efeitos adversos , Hipnóticos e Sedativos/uso terapêutico , Propofol/efeitos adversos , Ensaios Clínicos Controlados Aleatórios como Assunto
17.
Am J Emerg Med ; 34(8): 1535-41, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27289437

RESUMO

OBJECTIVE: This meta-analysis of trials was conducted to evaluate the impact of desmopressin on renal colic pain relief in comparison to more typically used medications (opioids and nonsteroidal anti-inflammatory drugs [NSAIDs]). METHODS: PubMed, EMbase, Scopus, CINHAL, and Cochrane Central Register of Controlled Trials were searched for clinical trials. Pain reduction and need for rescue treatment were the outcomes of interest. RESULTS: Ten studies met our inclusion criteria and were analyzed. Pooling of data showed that, on a scale of 1-10, pain reduction after 30 minutes was significantly higher in NSAID in comparison to desmopressin (3.39 with a 95% confidence interval [CI] of 4.62-2.16; P<.01), but this reduction was not significantly different between NSAID and desmopressin-NSAID combination (-0.28 with 95% CI of -0.62 to 0.05; P=.01). Summary of relative risk (RR) for the need for rescue treatment in desmopressin in comparison to NSAID was 0.31 with a 95% CI of 0.13-0.74 and a significant RR (P<.04), but no difference was shown in desmopressin-NSAID combination in comparison to NSAID (0.70 with a 95% CI of 0.49-1.00; P<.19). On this outcome, desmopressin in comparison to opioid showed insignificant RR (1.82 with a 95% CI of 0.36-4.34; P=.72), but this need in desmopressin in comparison to desmopressin-opioid combination was 0.75 with a 95% CI of 0.56-0.99 and a significant RR (P=.042). CONCLUSION: In conclusion, the results of this systematic review suggest that, according to the present low-quality studies, desmopressin can be used as an adjuvant therapy in renal colic management in combination with opioids.


Assuntos
Desamino Arginina Vasopressina/uso terapêutico , Manejo da Dor/métodos , Cólica Renal/tratamento farmacológico , Antidiuréticos/uso terapêutico , Humanos , Resultado do Tratamento
20.
J Echocardiogr ; 2024 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-39014266

RESUMO

BACKGROUND: Hypertension is the most common reversible cause of cardiovascular disease worldwide and more than one billion individuals suffer from the disease. Constant heart exposure to increased afterload progresses to maladaptive remodeling, leading to cardiac dysfunction. In this study, we aimed to evaluate cardiac function in response to hypertension treatment. METHODS: One hundred patients diagnosed with hypertension were evaluated two times, with 3 to 6 months intervals, before and after antihypertensive therapy. Patients underwent clinical and echocardiographic evaluation in both visits and the interest effect of antihypertensive therapy on cardiac function was studied. RESULTS: 58 men and 42 women with a mean age of 60.81 ± 11.8 years were studied. Mean systolic and diastolic pressure in the first visit was 163.05 ± 20.6 and 95.40 ± 10.4, respectively. On the second visit, mean systolic and diastolic pressure was 129.95 ± 10.4 and 82.35 ± 7.2 respectively (P value for both < 0.001). The mean value of Global Longitudinal Strain as the main parameter for evaluating left ventricular systolic function was -15.54% on the first visit and changed to -16.95% on the second visit (P value 0.025). CONCLUSIONS: According to the results of this study, changes in parameters, indicator of systolic and diastolic function, after 3-6 months of antihypertensive therapy are significant. The most important point is that maladaptive remodeling of the heart is reversible if hypertension is diagnosed timely. To follow-up patients under antihypertensive therapy, GLS and parameters indicator of diastolic dysfunction, have the best diagnostic value in terms of detecting early stages of cardiac injury.

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