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2.
Clin Nutr ESPEN ; 60: 195-202, 2024 04.
Artículo en Inglés | MEDLINE | ID: mdl-38479910

RESUMEN

BACKGROUND: Colorectal cancer (CRC) is one of the most common cancers and is currently the third leading cause of cancer-related deaths worldwide. This study aimed to evaluate whether the dietary approach to stop hypertension (DASH) and Mediterranean (MED) diets are associated with CRC in Iranian adults. METHODS: This hospital-based case-control study was conducted on 71 cases and 142 controls (40-75 years old) in three general hospitals in Tehran, Iran. The dietary intakes of individuals were collected through face-to-face interviews using a semi-quantitative food frequency questionnaire (FFQ) that included 125 food items. The DASH and MED diet scores were calculated according to food items based on guidelines. Two logistic regression models were applied to evaluate the association between DASH and MED score adherence. RESULTS: After adjusting for confounding factors, a negative association between DASH diet adherence and CRC risk was observed in the second and last tertile compared to the first tertile (T) (T2: odds ratio (OR) = 0.33; 95% confidence interval (CI): 0.14-0.77 - T3: OR = 0.09; 95% CI: 0.03-0.27). There was no significant association between the MED diet and the risk of CRC. CONCLUSIONS: In conclusion, the current study's findings presented that adherence to a DASH diet could reduce the odds of CRC.


Asunto(s)
Neoplasias Colorrectales , Dieta Mediterránea , Hipertensión , Adulto , Humanos , Persona de Mediana Edad , Anciano , Estudios de Casos y Controles , Irán/epidemiología , Hipertensión/prevención & control , Hipertensión/complicaciones , Modelos Logísticos , Neoplasias Colorrectales/prevención & control
3.
BMC Geriatr ; 24(1): 244, 2024 Mar 11.
Artículo en Inglés | MEDLINE | ID: mdl-38468213

RESUMEN

BACKGROUND: Sarcopenia is a progressive disease with age-related loss of skeletal muscle mass, strength, and function. No study has investigated the association between healthy beverage index (HBI) and sarcopenia in older adults. Therefore, the present study aimed to investigate the association between HBI and sarcopenia in Iranian older adults. METHODS: In the present case-control study, 80 sarcopenic and 80 non-sarcopenic participants matched in sex were included. Body composition was measured using bioelectrical impedance analysis. Handgrip strength (HGS), skeletal muscle mass index (SMI), and gait speed were utilized to confirm sarcopenia. Also, a food frequency questionnaire was used to evaluate food intake. HBI score was calculated based on ten sub-components of the total beverages. Moreover, logistic regression was applied to assess the association between HBI and sarcopenia. RESULTS: In the crude model, we observed no significant association between HBI and the odds of sarcopenia. Still, after adjusting the confounders, the odds of developing sarcopenia decreased significantly in the second and last tertiles (T) (T2- odds ratio (OR) = 0.04, 95% confidence interval (CI): 0.01-0.25 and T3- OR = 0.10, 95% CI: 0.01-0.60). CONCLUSIONS: Our findings indicated that HBI is inversely related to the chance of sarcopenia. Therefore, to reduce the odds of sarcopenia, it is recommended to consume healthy drinks such as fruit juices and milk.


Asunto(s)
Sarcopenia , Anciano , Humanos , Bebidas , Estudios de Casos y Controles , Fuerza de la Mano , Irán/epidemiología , Músculo Esquelético , Sarcopenia/diagnóstico , Sarcopenia/epidemiología
4.
Clin Cardiol ; 47(2): e24239, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38402566

RESUMEN

BACKGROUND: Heart failure (HF) is a global problem, affecting more than 26 million people worldwide. This study evaluated the performance of 10 machine learning (ML) algorithms and chose the best algorithm to predict mortality and readmission of HF patients by using The Fasa Registry on Systolic HF (FaRSH) database. HYPOTHESIS: ML algorithms may better identify patients at increased risk of HF readmission or death with demographic and clinical data. METHODS: Through comprehensive evaluation, the best-performing model was used for prediction. Finally, all the trained models were applied to the test data, which included 20% of the total data. For the final evaluation and comparison of the models, five metrics were used: accuracy, F1-score, sensitivity, specificity and Area Under Curve (AUC). RESULTS: Ten ML algorithms were evaluated. The CatBoost (CAT) algorithm uses a series of decision tree models to create a nonlinear model, and this CAT algorithm performed the best of the 10 models studied. According to the three final outcomes from this study, which involved 2488 participants, 366 (14.7%) of the patients were readmitted to the hospital, 97 (3.9%) of the patients died within 1 month of the follow-up, and 342 (13.7%) of the patients died within 1 year of the follow-up. The most significant variables to predict the events were length of stay in the hospital, hemoglobin level, and family history of MI. CONCLUSIONS: The ML-based risk stratification tool was able to assess the risk of 5-year all-cause mortality and readmission in patients with HF. ML could provide an explicit explanation of individualized risk prediction and give physicians an intuitive understanding of the influence of critical features in the model.


Asunto(s)
Insuficiencia Cardíaca , Readmisión del Paciente , Humanos , Estudios Retrospectivos , Insuficiencia Cardíaca/diagnóstico , Insuficiencia Cardíaca/terapia , Aprendizaje Automático , Factores de Riesgo
5.
BMC Pediatr ; 24(1): 20, 2024 01 05.
Artículo en Inglés | MEDLINE | ID: mdl-38183026

RESUMEN

BACKGROUND: Allergic rhinitis is the most common allergic disease. It can accompany psychological disorders such as tic disorders due to the prolonged course of the symptoms of allergic rhinitis. This pioneer case-control study aims to investigate tic disorders in children and adolescents under 18 years of age diagnosed with allergic rhinitis. METHOD: The case group in this study consisted of patients who had both allergic rhinitis and tic disorders. Patients with allergic rhinitis without tic disorders were also enrolled as the control group with matched gender and age. Demographic characteristics, tic classifications, and contributing factors for allergic rhinitis and tic disorders were studied among the cases. Tic disorders were evaluated using DSM-5 criteria for the classification of tic disorders. RESULTS: 47 patients in the case group and 47 patients in the control group were included in this study. 53.2% and 46.8% were males and females in the case group, respectively. The mean age of the patients was 10.46 ± 3.97 years old. Sound tics were more common among the patients compared to motor tics. Patients with concomitant AR and tic disorders had more days per week with AR symptoms (P-value ≤ 0.001; OR (every day vs. three days a week = 11.02(2.98, 40.76))). Most patients with sound tick were women (p: 0.026), and most patients with motion tic were in the Provisional tic disorder group (p: 0.001). The history of infantile eczema was seen more in patients without sound tic (p: 0.025), and otitis media was significantly less common among patients with sound tics (p: 0.026). Provisional tic disorder was the most common class among the patients. In the case group (coexistence between allergic rhinitis and tic) compared to the control group, patients had significantly more days with AR symptoms per week. CONCLUSION: This preliminary study indicates that Provisional tic disorder was the most common classification of tic among patients with allergic rhinitis, especially in patients with motor tics. Asthma in motor tics, a history of food allergy in infancy, and a history of infantile eczema were also common among patients with vocal tics. Also, patients with allergic rhinitis and tic had more severe disease (more symptoms per week) than those with rhinitis alone. These findings emphasize the association of tic disorders with immunological pathways.


Asunto(s)
Dermatitis Atópica , Rinitis Alérgica , Trastornos de Tic , Tics , Niño , Masculino , Humanos , Adolescente , Femenino , Estudios de Casos y Controles , Rinitis Alérgica/complicaciones , Trastornos de Tic/complicaciones
6.
Int J Dent Hyg ; 22(1): 15-23, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-37466282

RESUMEN

OBJECTIVES: Knowledge and awareness gained from mass media can prepare people for lifestyle changes and impact their health and well-being. Considering the differences in the results of primary studies, we decided to conduct this study to evaluate the effect of mass media campaigns on oral health knowledge as a systematic meta-analysis and review. METHOD: The databases such as the Web of Sciences (ISI), Scopus, PubMed/Medline, and the Cochrane Library were searched systematically until February 2022. Data pooling was performed using a random effects model. The effect sizes were estimated as odds ratios (ORs) with their 95% confidence intervals (CIs). Additional analyses, including sensitivity, subgroup, and publication bias analyses, were also conducted. RESULTS: Our meta-analysis comprised a total number of seven articles. The pooled results indicated significant increases in oral health knowledge among included studies (OR = 1.64, 95% CI: 1.20-2.24, p < 0.001). In subgroup analyses, the effects of mass media campaigns on oral health knowledge remained significant for the studies with follow-up of less than 150 weeks (OR = 1.69, 95% CI: 1.49-1.91) and working-age populations (OR = 1.80, 95% CI: 1.40-2.32) compared to other categories. CONCLUSION: In general, this study showed that mass media campaigns may have positive effects on oral health knowledge, especially in the working-age population; it seems that for improving health knowledge among children, more initiatives are needed. Besides, the effects of these campaigns seem to be time-dependent and higher in shorter follow-up periods.


Asunto(s)
Promoción de la Salud , Salud Bucal , Niño , Humanos , Promoción de la Salud/métodos , Medios de Comunicación de Masas
7.
BMC Womens Health ; 23(1): 671, 2023 12 14.
Artículo en Inglés | MEDLINE | ID: mdl-38098009

RESUMEN

OBJECTIVE: Cancer is one of the main causes of death, and cervical cancer is the fourth most common cancer and the fourth leading cause of death from malignancy among women. Knowing the survival rate is used to evaluate the success of current treatments and care. This study was conducted to assess the survival rate of cervical cancer in Asia. METHODS: This systematic survey was conducted on four international databases, including Medline/PubMed, ProQuest, Scopus, and Web of Knowledge, and includes manuscripts that were published until the end of August 2021. Selected keywords were searched for international databases including cervical neoplasms [mesh], survival analysis or survival or survival rate, Asian countries (name of countries). The Newcastle-Ottawa Qualitative Evaluation Form was used for cohort studies to evaluate the quality of the articles. The analysis process was performed to evaluate the heterogeneity of the studies using the Cochran test and I2 statistics. Additionally, a meta-regression analysis was performed based on the year of the study. RESULTS: A total of 1956 articles were selected and reviewed based on their title. The results showed that 110 articles met the inclusion criteria. According to the randomized model, the 1, 3, 5, and 10-year survival rates of cervical cancer were 76.62% (95% Confidence Interval (CI), 72.91_80.34), 68.77% (95% CI, 64.32_73.21), 62.34% (95% CI, 58.10_66.59), and 61.60% (95% CI, 52.31_70.89), respectively. Additionally, based on the results of meta-regression analysis, there was an association between the year of the study and the survival rate, elucidating that the survival rate of cervical cancer has increased over the years. CONCLUSIONS: Results can provide the basic information needed for effective policy making, and development of public health programs for prevention, diagnosis, and treatment of cervical cancer.


Asunto(s)
Neoplasias del Cuello Uterino , Humanos , Femenino , Neoplasias del Cuello Uterino/diagnóstico , Tasa de Supervivencia , Asia/epidemiología , Análisis de Supervivencia
8.
Ann Med Surg (Lond) ; 85(11): 5577-5583, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-37920653

RESUMEN

Introduction: Vaginal cancer is one of the major causes of mortality in women, which mostly takes place in low- and middle-income countries. Assessing the survival rate of vaginal cancer is essential to investigate the success rate of current treatments and screening tools. This study aims to determine the survival rate of vaginal cancer in Asia. Methods: This systematic review was carried out using four international databases, including Medline/Pubmed, ProQuest, Scopus, Web of Knowledge, and also Google Scholar. Articles were investigated up to the end of August 2021. The authors utilized the Newcastle-Ottawa Scale to evaluate the quality of the articles. Evaluating the papers for heterogeneity was performed using the Cochrane test and I² statistic. Meta-regression analysis was also applied based on the year of the study. Results: Three articles (13 records) fulfilled the inclusion criteria. Based on the random model, the overall 5-year survival rate was 74.63%. Also, the rates of survival in relation to the type of treatment including chemotherapy, radiotherapy, or other modalities, were 78.53, 78.44, and 68.54%, respectively. According to meta-regression analysis, no correlation was found between the survival rate and the year of the study. Conclusion: The vaginal cancer survival rate is lower in Asian countries compared to that of developed countries. Increasing patient survival rates in such countries is crucial by implementing newer diagnostic tools, advanced surgical techniques, and goal-oriented treatments. Early diagnosis in lower stages and educating the populations about risk factors and preventative measures are also necessary for raising the rate of survival.

9.
BMC Res Notes ; 16(1): 326, 2023 Nov 09.
Artículo en Inglés | MEDLINE | ID: mdl-37946292

RESUMEN

BACKGROUND: Few studies assess the link between plant-based diets and colorectal cancer (CRC) incidence. To our knowledge, no study has examined the association between pro-vegetarian dietary pattern (PDP) and CRC globally or among Iranians. Therefore, the objective of our matched case-control study was to evaluate the association between PDP and CRC in the Iranian population. METHODS: The present research was a hospital-based case (n = 71)-control (n = 142) study conducted in the same hospitals in Tehran, Iran. This study used a reliable and valid semi-quantitative food frequency questionnaire to evaluate the participants' dietary intake. According to the residual method, the selected plant and animal foods have been adjusted in the total energy intake to calculate the PDP index. Odds ratios (ORs) and 95% confidence intervals (CIs) adjusted for confounding variables were also expressed using logistic regression by SPSS software. RESULTS: In the crude and adjusted models, we observed that the odds of CRC decreased significantly in the 3rd and last quartile of PDP compared to the 1st quartile (Q) (Crude model: Q3: OR = 0.36, 95% CI: 0.17 - 0.79, P-value = 0.011 and Q4: OR = 0.33, 95% CI: 0.14 - 0.79, P-value = 0.012 - Adjusted model: Q3: OR = 0.41, 95% CI: 0.18 - 0.94, P-value = 0.035 and Q4: OR = 0.35, 95% CI: 0.14 - 0.87, P-value = 0.025). CONCLUSIONS: Based on the results of the present case-control study in the Iranian population, it was concluded that PDP, which involves consuming vegetables, fruits, cereals, dairy products, and low meat consumption, reduces the odds of CRC. In conclusion, adherence to PDP is associated with a decreased odds of CRC.


Asunto(s)
Neoplasias Colorrectales , Animales , Humanos , Irán/epidemiología , Factores de Riesgo , Estudios de Casos y Controles , Neoplasias Colorrectales/epidemiología , Dieta , Encuestas y Cuestionarios
10.
BMC Womens Health ; 23(1): 469, 2023 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-37658410

RESUMEN

BACKGROUND: Diet quality is a significant determinant in the etiology of breast cancer (BrCa), but further studies are required to explore this relationship. Therefore, we tried to assess if diet quality, assessed using the Diet Quality Index-International (DQI-I), was related to BrCa among the Iranian population. METHODS: In the present case-control research, 134 women with a recent diagnosis of BrCa and 267 without BrCa were selected as case and control groups. Individual food intake data from a food frequency questionnaire was used to compute DQI-I. Also, the multivariable logistic regression models were utilized to evaluate the association between DQI-I and BrCa odds . RESULTS: We found a significant association between the last tertile of DQI-I and BrCa odds in the fully adjusted model (odds ratio (OR) = 0.30; 95% confidence interval (CI): 0.15-0.56). The subgroup analysis based on menopausal status also showed a significant decrease in BrCa odds in pre-and post-menopausal women (pre-menopausal: OR = 0.27; 95% CI: 0.10-0.70 - post-menopausal status: OR = 0.35; 95% CI: 0.13-0.92). CONCLUSIONS: Our findings indicated that a higher DQI-I score was related to a lower chance of BrCa. According to our research, a healthy diet pattern is crucial for BrCa prevention.


Asunto(s)
Neoplasias de la Mama , Femenino , Humanos , Neoplasias de la Mama/genética , Estudios de Casos y Controles , Irán/epidemiología , Dieta , Dieta Saludable
11.
Int Ophthalmol ; 43(12): 4719-4728, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37713146

RESUMEN

PURPOSE: The purpose of this study was to investigate the prevalence of cataracts, refractive disorders, age-related macular disease (AMD), and glaucoma, as well as their trends from 1990 to 2019 in Iran, in comparison with high-middle socio-demographic index (HMSDI) countries and the world, using the Global Burden of Disease (GBD) 2019 study. METHODS: The GBD study provided data on the prevalence of blindness and visual impairment (VI), as well as four of their causes including cataracts, refractive disorders, age-related macular disease (AMD), and glaucoma. Using Joinpoint analysis, the annual percent change (APC) was calculated to assess the trend of change in prevalence in each category of diseases from 1990 to 2019, stratified by sex and age, for Iran, HMSDI countries, and the world. RESULTS: In 2019, refractive errors and cataracts were the most common causes of blindness and VI for both genders in Iran, HMSDI countries and the world. Iran had a higher age-standardized prevalence in all four categories of ophthalmologic disorders compared to HMSDI countries and the world for both genders in 2019. Additionally, the age-specific prevalence of all four disorders in 2019 was higher in Iran compared to HMSDI countries. However, in terms of trends of prevalence from 1990 to 2019, the rate of reduction for the four ophthalmologic disorders in Iran was higher than in HMSDI and the world for both males and females. Furthermore, Iran had a greater percentage of reduction in prevalence for all age groups in all four disorders compared to HMSDI countries. CONCLUSION: The prevalence of cataracts, refractive errors, AMD, and glaucoma in Iran was higher compared to HMSDI countries in 2019 for both sexes and all age groups, but the trends of prevalence for all four disorders from 1990 to 2019 in Iran had a higher slope of reduction compared to HMSDI countries for all ages and sexes.


Asunto(s)
Catarata , Glaucoma , Degeneración Macular , Errores de Refracción , Baja Visión , Humanos , Masculino , Femenino , Carga Global de Enfermedades , Irán/epidemiología , Prevalencia , Ceguera/epidemiología , Ceguera/etiología , Baja Visión/epidemiología , Baja Visión/etiología , Errores de Refracción/complicaciones , Errores de Refracción/epidemiología , Glaucoma/complicaciones , Glaucoma/epidemiología , Catarata/complicaciones , Catarata/epidemiología , Degeneración Macular/complicaciones
12.
BMC Nutr ; 9(1): 99, 2023 Aug 17.
Artículo en Inglés | MEDLINE | ID: mdl-37592349

RESUMEN

BACKGROUND: The current research aimed to evaluate the relationship between fruit, vegetable (FV), and dairy consumption with the odds of developing hypertension based on nationwide Stepwise approach to surveillance (STEPS) data in Iran. METHODS: This cross-sectional study was accomplished by the research center of non-communicable diseases (NCDs) in Tehran. In total, 29,378 individuals' data were analyzed. Participants were classified into normal, elevated BP, stage I, and stage II hypertension according to systolic blood pressure (SBP) and diastolic blood pressure (DBP) examinations. Based on the STEPS questionnaire, the consumption of FVs and dairy products was evaluated. Multinomial logistic regression was applied to assess the relationship between the consumption of FVs and dairy products with hypertension. RESULTS: The findings revealed that only fruit consumption (≥ 2 servings/day) was negatively related to stage I hypertension (odds ratio (OR) = 0.81; 95% confidence interval (CI): 0.69-0.95) in two servings per day and OR = 0.81; 95% CI: 0.68-0.96 in > two servings per day) in the adjusted model. There was no significant relationship between consuming vegetables and dairy products with elevated BP and hypertension. CONCLUSION: Our study showed that increasing fruit consumption was related to reducing hypertension odds. Regarding the consumption of dairy products and vegetables, no significant relationship was found with the odds of hypertension. More studies, especially cohorts, are needed to evaluate the impacts of FV and dairy products on the risk of hypertension.

13.
Sci Rep ; 13(1): 11763, 2023 07 20.
Artículo en Inglés | MEDLINE | ID: mdl-37474604

RESUMEN

Older people spend most of their time indoors. Limited evidence demonstrates that exposure to indoor air pollutants might be related to chronic complications. This study aimed to estimate the correlation between household air pollution (HAP)'s long-term exposure and the prevalence of elevated hypertension, diabetes mellitus (DM), obesity, and low-density lipoprotein (LDL) cholesterol. From the Global Burden disease dataset, we extracted HAP, hypertension, DM, body mass index, and LDL cholesterol data from Iran from 1990 to 2019 to males and females in people over 50 years. We present APC and AAPC and their confidence intervals using Joinpoint Software statistical software. R software examined the correlation between HAP and hypertension, DM2, Obesity, and high LDL cholesterol. Our finding showed a significant and positive correlation between HAP exposure and prevalence of high low-density lipoprotein cholesterol (p ≤ 0.001, r = 0.70), high systolic blood pressure (p ≤ 0.001, r = 0.63), and high body mass index (p ≤ 0.001, r = 0.57), and DM2 (p ≤ 0.001, r = 0.38). The analysis results also illustrated a positive correlation between indoor air pollution and smoking (p ≤ 0.001, r = 0.92). HAP exposure might be a risk factor for elevated blood pressure, DM, obesity, and LDL cholesterol and, consequently, more serious health problems. According to our results, smoking is one of the sources of HAP. However, ecological studies cannot fully support causal relationships, and this article deals only with Iran. Our findings should be corroborated in personal exposure and biomonitoring approach studies.


Asunto(s)
Contaminantes Atmosféricos , Contaminación del Aire Interior , Contaminación del Aire , Hipertensión , Masculino , Femenino , Humanos , Anciano , LDL-Colesterol , Exposición a Riesgos Ambientales/efectos adversos , Exposición a Riesgos Ambientales/análisis , Contaminación del Aire/efectos adversos , Contaminación del Aire/análisis , Contaminación del Aire Interior/efectos adversos , Contaminación del Aire Interior/análisis , Contaminantes Atmosféricos/efectos adversos , Contaminantes Atmosféricos/análisis , Hipertensión/epidemiología , Hipertensión/etiología , Colesterol/análisis , Obesidad , Culinaria , Material Particulado/análisis
14.
BMC Cancer ; 23(1): 558, 2023 Jun 16.
Artículo en Inglés | MEDLINE | ID: mdl-37328812

RESUMEN

BACKGROUND: Ovarian cancer is amongst one of the most commonly occurring cancers affecting women, and the leading cause of gynecologic related cancer death. Its poor prognosis and high mortality rates can be attributed to the absence of specific signs and symptoms until advance stages, which frequently leads to late diagnosis. Survival rate of patients diagnosed with ovarian cancer can be used in order to better assess current standard of care; the aim of this study is to evaluate the survival rate of ovarian cancer patients in Asia. METHODS: Systematic review was performed on articles that were published by the end of August 2021 in five international databases, including Medline / PubMed, ProQuest, Scopus, Web of Knowledge, and Google Scholar. The Newcastle-Ottawa quality evaluation form was used for cohort studies to evaluate the quality of the articles. The Cochran-Q and I2 tests were used to calculate the heterogeneity of the studies. The Meta-regression analysis was also done according to when the study was published. RESULTS: A total of 667 articles were reviewed, from which 108 were included in this study because they passed the criteria. Based on a randomized model, the survival rates of ovarian cancer after 1, 3 and 5 years were respectively 73.65% (95% CI, 68.66-78.64), 61.31% (95% CI, 55.39-67.23) and 59.60% (95% CI, 56.06-63.13). Additionally, based on meta-regression analysis, there was no relationship between the year of study and survival rate. CONCLUSIONS: The 1-year survival rate was higher than that of 3- and 5-year for ovarian cancer. This study provides invaluable information that can not only help establish better standard of care for treatment of ovarian cancer, but also assist in development of superior health interventions for prevention and treatment of the disease.


Asunto(s)
Neoplasias Ováricas , Humanos , Femenino , Tasa de Supervivencia , Neoplasias Ováricas/epidemiología , Asia/epidemiología
16.
Arch Acad Emerg Med ; 11(1): e29, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37215242

RESUMEN

Introduction: Altered immune responses, in particular neutrophil changes, are perceived to play a key role in immune responses to trauma. This study aimed to evaluate the association of neutrophil changes with patients' survival in severe multiple trauma cases. Methods: The current retrospective cohort study was conducted using data from patients admitted in the intensive care unit (ICU) of a trauma center in Shiraz, Iran, between 2016 and 2021. Patients were divided into three groups (i.e., normal, neutropenia, and neutrophilia) based on neutrophil count at the time of ICU admission, and the association of neutrophil count with in-hospital mortality was analyzed. Results: 2176 patients with the mean age of 37.90 ± 18.57 years were evaluated (84.04% male). The median trauma severity based on injury severity score (ISS) in this series was 9 (4 -17). Patients were divided in to three groups of neutrophilia (n = 1805), normal (n = 357), and neutropenia (n = 14). There were not any significant differences between groups regarding age distribution (p = 0.634), gender (p = 0.544), and trauma severity (p = 0.197). The median survival times for the normal, neutropenia, and neutrophilia groups were 49 (IQR: 33 -47) days, 51 (IQR: 8- 51) days, and 38 (IQR: 26 - 52) days, respectively (p = 0.346). The log-rank test showed a statistically significant difference between the three groups adjustment for ISS (p ≤ 0.001). For each unit increase in ISS, the hazard ratio increased by 2%. In ISS 9-17, the hazard ratio increased by 11% compared to ISS<4. Also, in ISS>17, the hazard ratio increased by 76% compared to ISS<4 in ICU-hospitalized patients. Conclusions: In general, the findings of the present study showed that the survival rate of patients in the normal group after ISS adjustment was higher than the other two groups. Also, the Cox model showed that the mortality risk ratio in the neutropenia group was 15 times higher than the normal group.

17.
Sci Rep ; 13(1): 5925, 2023 04 12.
Artículo en Inglés | MEDLINE | ID: mdl-37045979

RESUMEN

The goal of this study was to develop a predictive machine learning model to predict the risk of prolonged mechanical ventilation (PMV) in patients admitted to the intensive care unit (ICU), with a focus on laboratory and Arterial Blood Gas (ABG) data. This retrospective cohort study included ICU patients admitted to Rajaei Hospital in Shiraz between 2016 and March 20, 2022. All adult patients requiring mechanical ventilation and seeking ICU admission had their data analyzed. Six models were created in this study using five machine learning models (PMV more than 3, 5, 7, 10, 14, and 23 days). Patients' demographic characteristics, Apache II, laboratory information, ABG, and comorbidity were predictors. This study used Logistic regression (LR), artificial neural networks (ANN), support vector machines (SVM), random forest (RF), and C.5 decision tree (C.5 DT) to predict PMV. The study enrolled 1138 eligible patients, excluding brain-dead patients and those without mechanical ventilation or a tracheostomy. The model PMV > 14 days showed the best performance (Accuracy: 83.63-98.54). The essential ABG variables in our two optimal models (artificial neural network and decision tree) in the PMV > 14 models include FiO2, paCO2, and paO2. This study provides evidence that machine learning methods outperform traditional methods and offer a perspective for achieving a consensus definition of PMV. It also introduces ABG and laboratory information as the two most important variables for predicting PMV. Therefore, there is significant value in deploying such models in clinical practice and making them accessible to clinicians to support their decision-making.


Asunto(s)
Unidades de Cuidados Intensivos , Respiración Artificial , Adulto , Humanos , Estudios Retrospectivos , Aprendizaje Automático , Cuidados Críticos
18.
BMC Public Health ; 23(1): 490, 2023 03 14.
Artículo en Inglés | MEDLINE | ID: mdl-36918858

RESUMEN

BACKGROUND: Vaccination is one of the best ways to stop the transmission of coronavirus disease 2019 (COVID-19). In this regard, uunderstanding the features related to the intention of different populations to receive the COVID-19 vaccine is essential for an effective vaccination program. This study aimed to investigate the vaccination intention predictors in the general adult population of Iran. METHODS: A cross-sectional, web-based survey was conducted on social networks, including Telegram, WhatsApp, LinkedIn, Instagram, and Facebook. Multinomial logistic regression models were used to investigate predictors associated with the intention to receive COVID-19 vaccines, including sociodemographic characteristics, trust, worry, sources of information, and conspiracy beliefs. The main outcomes included unwillingness, undecidedness, and intention to receive the COVID-19 vaccine. RESULTS: Out of 780 respondents, 481 (61.6%) reported an intention to be vaccinated, 214 (27.4%) expressed their undecided status, and 85 (10.9%) reported unwillingness to receive any type of COVID-19 vaccine. A higher age (OR undecided = 0.97, 95% CI (0.96-0.99)), (OR unwilling = 0.97, 95% CI (0.95-0.99)); exposure with COVID-19 (OR unwilling = 0.82, 95% CI (0.76-0.89)), (OR undecided = 0.87, 95% CI (0.83-0.93)) were positively associated with vaccination intentions. No/low trust in vaccines, institutions, concerns about the future of the pandemic, and conspiracy beliefs were strongly and negatively associated with COVID-19 vaccination intentions. CONCLUSION: Most Iranians intended to get a COVID-19 vaccine. Higher vaccine acceptance needs to consider demographic features, exposure history, confidence in vaccines, trust in institutions, concerns, and conspiracy beliefs of people.


Asunto(s)
Vacunas contra la COVID-19 , COVID-19 , Adulto , Humanos , Vacunas contra la COVID-19/uso terapéutico , Irán/epidemiología , COVID-19/epidemiología , COVID-19/prevención & control , Estudios Transversales , Programas de Inmunización , Intención , Vacunación
19.
BMC Womens Health ; 23(1): 42, 2023 01 31.
Artículo en Inglés | MEDLINE | ID: mdl-36721166

RESUMEN

BACKGROUND: Carbohydrates are the primary energy source in Asian countries, including Iran. An emerging method can be used to measure the quality of carbohydrates, including the carbohydrate quality index (CQI), which includes a variety of components. Low-carbohydrate diet score (LCDS) has been proposed as a new method of scoring micronutrient intake that could provide a reasonable explanation for the link between diet and the risk of chronic diseases. OBJECTIVE: This study aimed to investigate the relationship between CQI, LCDS, glycemic index (GI), glycemic load (GL), insulin load (IL), and insulin index (II) with bone mass density (BMD) in postmenopausal women. METHOD: In this case-control study, 131 postmenopausal women with osteoporosis/osteopenia and 131 healthy postmenopausal women aged 45-65 participated. The dual-energy X-ray absorptiometry (DEXA) method measured the BMD of the lumbar vertebrae and femoral neck. A validated semi-quantitative food frequency questionnaire was used to assess dietary intake. Logistic regression were used to evaluate the relation between GI, GL, II, IL, CQI, and LCDS with BMD. RESULTS: Diets with higher GI increased the risk of osteopenia and osteoporosis, but LCDS and CQI decreased the risk of osteopenia and osteoporosis. CONCLUSION: These findings suggest that a higher intake of fruits and vegetables and receiving various dietary vitamins, minerals, and antioxidant compounds may be a useful way to prevent osteopenia in Iranian women.


Asunto(s)
Densidad Ósea , Enfermedades Óseas Metabólicas , Carbohidratos de la Dieta , Osteoporosis , Femenino , Humanos , Estudios de Casos y Controles , Insulina , Irán , Posmenopausia
20.
J Ethn Subst Abuse ; 22(2): 285-315, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-34486927

RESUMEN

Water-pipe tobacco smoking is harmful to health, yet its rate of prevalence remains uncertain. Recent evidence has shown that the prevalence of water-pipe smoking among students is higher than in the general population. In this study, a systematic review of related literature on water-pipe use was conducted, and for this purpose, 76 articles were examined in the study. In this vein, geographic distribution and time trends of water-pipe consumption in Iran were considered. The results of this study showed that lifetime, last-year, and last-month prevalence of water-pipe smoking use among Iranian students were 28.78 (25.07-32.49), 20.84 (16.01-25.66), and 16.36 (11.86-20.85), respectively. The results also showed a wide variation by the region and sex in Iran. This study has shown the importance of addressing public prevention and alerting programs in schools and universities.


Asunto(s)
Instituciones Académicas , Fumar , Humanos , Adolescente , Irán/epidemiología , Fumar/epidemiología , Universidades , Estudiantes , Prevalencia
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