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1.
Middle East J Dig Dis ; 11(4): 218-224, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31824625

RESUMEN

BACKGROUND Gastric outlet obstructions (GOO) is a disabling complication of peptic ulcer disease (PUD). The introduction of endoscopic through the scope balloon dilatation (EBD) has eased the management but there are few reports on the long term results of this modality of treatment on patients' symptoms. METHODS Over a period of 4 years from January 2012 to December 2015 in two major referral hospitals affiliated to Shiraz university, medical endoscopy reports were reviewed retrospectively to identify those who received EBD for the treatment of GOO due to PUD .All of these patients were recalled and their current status were evaluated. RESULTS 22 consecutive patients with symptomatic GOO secondary to benign stricture underwent endoscopic balloon dilatation by a single operator. Of them, 14 had balloon dilatation twice and 6 had ballooning three times. The interval between the first referral and the last follow-up was 25.2 ± 10.3 (min: 4.8 max:43.4) months. The averages of maximum balloon size were 14.4 ± 5 mm in the first session, 14.3 ± 3.1mm in the second session, and 16 ± 2.4 mm in the third session. 73% of the patients had a significant improvement in clinical symptom with two sessions of EBD and did not require repeat dilatation. CONCLUSION EBD is a safe and efficient method in the management of GOO with good long term results.

2.
Croat Med J ; 60(4): 361-368, 2019 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-31483122

RESUMEN

AIM: To investigate the genetic factors involved in the development of non-alcoholic fatty liver disease (NAFLD) and its sequelae in a Middle Eastern population. METHODS: This genetic case-control association study, conducted in 2018, enrolled 30 patients with NAFLD and 30 control individuals matched for age, sex, and body mass index. After quality control measures, entire exonic regions of 3654 genes associated with human diseases were sequenced. Allelic association test and enrichment analysis of the significant genetic variants were performed. RESULTS: The association analysis was conducted on 27 NAFLD patients and 28 controls. When Bonferroni correction was applied, NAFLD was significantly associated with rs2303861, a variant located in the CD82 gene (P=2.49×10-7, adjusted P=0.0059). When we used Benjamini-Hochberg adjustment for correction, NAFLD was significantly associated with six more variants. Enrichment analysis of the genes corresponding to all the seven variants showed significant enrichment for miR-193b-5p (P=0.00004, adjusted P=0.00922). CONCLUSION: A variant on CD82 gene and a miR-193b expression dysregulation may have a role in the development and progression of NAFLD and its sequelae.


Asunto(s)
Proteína Kangai-1/genética , Enfermedad del Hígado Graso no Alcohólico/genética , Adulto , Anciano , Alelos , Índice de Masa Corporal , Estudios de Casos y Controles , Femenino , Estudios de Asociación Genética , Humanos , Masculino , MicroARNs/biosíntesis , Persona de Mediana Edad , Polimorfismo Genético
3.
Int J Endocrinol Metab ; 17(2): e81822, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-31372168

RESUMEN

Background: Chronic kidney disease (CKD) can potentially be associated with metabolic syndrome (MetS). Objectives: We aimed to determine the association of MetS and the number of metabolic syndrome components with the risk of CKD in the Iranian population in southern Iran. Methods: A total of 819 subjects aged 18 - 88 years were enrolled using weight-based random cluster sampling. We constructed a logistic regression model to determine the adjusted odds ratios (ORs) and 95% confidence intervals (CI) of the association of MetS individual components and the number of these components with CKD. Results: The prevalence rate of MetS was 25.9% (30.9% in women and 18.8% in men). CKD was present in 16.6% of the participants (men: 14% and women: 19.4%). The most prevalent component was abdominal obesity (63.6%), followed by low HDL cholesterol (36.7%), high triglyceride level (31.7%), hypertension (25.6%) and high fasting blood sugar (21.9%). Central obesity and low HDL level were observed to be more prevalent among women (P < 0.001). The presence of MetS was associated with CKD with an increased OR for CKD (OR: 3.07, 95% CI 2.09 - 4.50; P < 0.001). The adjusted ORs (95% CI) were 1.189 (0.554 - 2.555), 2.025 (0.990 - 4.141) and 4.769 (2.413 - 9.424) as the number of risk factors increased from 1 to ≥ 3. Individuals with hypertension and abdominal obesity had a higher OR of increased susceptibility to CKD in multivariate analysis. Conclusions: Our study indicated a strong association between CKD and MetS in the Iranian population. It is also suggested that individuals with metabolic risk factors should be detected earlier; they should also undergo multidisciplinary interventions to hinder worsening of the individual components of MetS and development of CKD.

4.
Int J Occup Environ Med ; 10(3): 111-123, 2019 07.
Artículo en Inglés | MEDLINE | ID: mdl-31325294

RESUMEN

BACKGROUND: Nurses are more likely to be exposed to violence at their workplace in comparison with other employees. OBJECTIVE: To determine various aspects of violence against nurses in Shiraz public hospitals. METHODS: This cross-sectional study was conducted from 2017 to 2018, using a multistage random sampling method. Violence including verbal threats, verbal abuse, physical and sexual abuse as well as ethnical types, violence from patients, patients' companions and coworkers, and causes of violence were investigated using a checklist. RESULTS: 405 nurses with a mean age of 30.2 (SD 7.1) years and female to male ratio of 4.2 were interviewed. 363 (89.6%) nurses had experienced at least one kind of violence; 68.4% suffered from more than one type of violence. Verbal abuse (83.9%), verbal threats (27.6%), physical violence (21.4%), sexual abuse (10.8%), and ethnical harassment (6.1%) were the most common types of violence experienced by the nurses. Patients' companions, patients, and physicians were reported as the sources of violence in 70.6%, 43.1%, and 4.1% of cases, respectively. Nurses with non-official employment status and non-Farsi ethnicity, having a disease, with non-evening shift work, and those with short or long employment period were more affected. Unrealistic expectations by patients' companions and long working hours were the most common attributing factors. CONCLUSION: Violence against nurses, as a strenuous and health-threatening crisis, has become epidemic in public hospitals in our region. Effective interventions are warranted to sort out these problems.


Asunto(s)
Personal de Enfermería en Hospital/estadística & datos numéricos , Delitos Sexuales/estadística & datos numéricos , Violencia Laboral/estadística & datos numéricos , Adulto , Estudios Transversales , Femenino , Hospitales Públicos/estadística & datos numéricos , Humanos , Irán , Masculino , Persona de Mediana Edad , Universidades , Armas/estadística & datos numéricos , Adulto Joven
5.
Diabetes Metab Syndr ; 13(3): 1949-1955, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31235120

RESUMEN

OBJECTIVE: The current systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to summarize the effect of mobile health (m-health) interventions on lipid profiles among patients with metabolic syndrome and related disorders. METHODS: Cochrane Library, EMBASE, PubMed, and Web of Science databases were searched to indentify the relevant randomized clinical trials published up April 30th, 2018. Two reviewers examined study eligibility, extracted data, and assessed risk of bias of included clinical trials, individually. Heterogeneity was measured using I-square (I2) statistic and Cochran's Q test. Data were pooled the standardized mean difference (SMD) effect size by the random-effect model. RESULTS: 18 trials of 1681 citations were identified to be appropriate for the current meta-analysis. Findings random-effects model indicated that m-health interventions significantly decreased total- (SMD -0.54; 95% CI, -1.05, -0.03) and LDL-cholesterol levels (SMD -0.66; 95% CI, -1.18, -0.15). M-health interventions had no significant effect on triglycerides (SMD -0.14; 95% CI, -0.56, 0.28) and HDL-cholesterol levels (SMD -0.35; 95% CI, -0.81, 0.11). CONCLUSION: Overall, the current meta-analysis demonstrated that m-health interventions resulted in an improvement in total- and LDL-cholesterol, but did not affect triglycerides and HDL-cholesterol levels.


Asunto(s)
Suplementos Dietéticos , Lípidos/sangre , Síndrome Metabólico/prevención & control , Telemedicina/métodos , Humanos , Síndrome Metabólico/sangre , Ensayos Clínicos Controlados Aleatorios como Asunto
6.
SAGE Open Med ; 7: 2050312118813680, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31105937

RESUMEN

Objective: With regard to limitation in national budget, the relevant authorities of healthcare and treatment throughout the globe are seeking the use of available resources in a way that no wastage of money or time-which is, of course, convertible to money-is acceptable. This study sought the opinions of hospital doctors and nurses on those activities at work that wasted their time. Methods: A questionnaire designed to identify activities that waste time during hospital care was completed based on the review of previous studies and including hospital wastes items. The authors designed a questionnaire, which was filled out by 209 nurses and 30 doctors in the surgery wards in hospitals affiliated to Shiraz University of Medical Sciences (SUMS). The items for time wasting activities were extracted from previous studies, and the reliability of the questionnaire was more than 0.785 using Cronbach's alpha. The response rate was more than 60%. Results: The mean age of the participating nurses and doctors was 30.24 ± 6.85 and 32.77 ± 7.05 years. In all aspects, more time was wasted during the morning and evening shifts in comparison with the night shifts. The activity that was thought to waste time in hospital care the most was paper-based documentation. Preventable wasted time during the shift was 16%-30% in the nurses' view and 18%-34% in the doctors' view. For both nurses and doctors, the highest-rated preventable wasted time was related to time spent waiting in ward for lab data responses, transfer of patients, or delivery of care. Conclusion: Hospital working environment is complex, and opportunities for improvement of the efficiency of the nurses' and doctors' workload should be analyzed, case by case, in each hospital and work group. Process change (for the decrease in the wasted time for waiting in wards), simple innovative ways (for the decrease in the wasted time for searching the needed equipment), using hospital information system technology for documentation, communication, and the better design of the wards (to decrease the wasted time due to transfer between the ward and restroom) could be helpful for improving efficiency and for a safer and acceptable delivery of care.

7.
Exp Clin Transplant ; 2019 Apr 17.
Artículo en Inglés | MEDLINE | ID: mdl-30995894

RESUMEN

OBJECTIVES: We aimed to determine outcomes and predictors of intraoperative-detected portal vein thrombosis in liver transplant recipients. MATERIALS AND METHODS: We retrospectively analyzed 806 adult liver transplant recipients from Shiraz, Iran, to determine those with intraoperative-detected portal vein thrombosis. Patients with this complication were compared with age- and sex-matched patients without this complication. Background diseases, surgery parameters, hospital admission, reoperation, rethrombosis, acute rejection, and use of antico-agulants were assessed. Cox proportional hazards, logistic regression, and random classification forest and random survival forest plots were used for data analyses. RESULTS: Mean age of patients was 44.7 ± 13.2 years. Patients with intraoperative-detected portal vein thrombosis (n = 91; 11.3%) had mortality ratio of 2.9 (range, 1.0-8.6) and 2-year survival of 78% versus 2-year survival rate of 92% in patients without this disease. Median time of survival in patients with this complication who died was 2 weeks versus 10 months in patients who died and did not have this complication. Random classification forest plots showed that high fasting blood sugar, autoimmune hepatitis, low prothrombin time, and cryptogenic cirrhosis were (in order) the main predictors of this complication. Random survival forest plots revealed that low prothrombin time, having intraoperative-detected portal vein thrombosis, Model for End Stage Liver Disease score, primary sclerosing cholangitis, diabetes mellitus, and hepatocellular carcinoma were (in order) the main predictors of death in liver transplant recipients. Low body mass index was associated with mortality in patients with intraoperative-detected portal vein thrombosis (by Cox proportional hazards). CONCLUSIONS: One of every 9 liver transplant patients had intraoperative-detected portal vein thrombosis. Hazard of death was 2.9, and death occurred far earlier in patients with this complication. Improvements in diabetes mellitus care, prothrombin time, Model for End-Stage Liver Disease score, and body mass index may improve outcomes of these patients.

9.
Appl Health Econ Health Policy ; 16(6): 837-846, 2018 12.
Artículo en Inglés | MEDLINE | ID: mdl-30123949

RESUMEN

OBJECTIVE: This study was aimed at estimating the value of the general population's willingness-to-pay (WTP) for one quality-adjusted life-year (QALY) in Iran. METHODS: Using multistage randomized cluster sampling, we recruited and interviewed 651 adult residents of Shiraz, south Iran. The mean age of the interviewees was 43.9 ± 16.3 years, and 326 (50.1%) of them were male. To each interviewee, we presented one of the hypothetical health scenarios that were used in the European value of a QALY project. Questionnaires, which were validated for the Persian language, were administered in digitally-assisted format, and a gray block questionnaire was used for special cases. The data were then analyzed using STATA and SPSS. RESULTS: The overall mean value of payment for one QALY of respondents who expressed WTP was US$2847, which is equal to 0.57 of the GDP per capita of Iran's population. Under the end-of-life (terminal illness) scenario, this value was 13% higher than health-gain scenarios. WTP was also associated with high educational level, household income, and household expenditure. CONCLUSION: Our results provided a threshold range of WTP and insights into rigorous scientific decision making about healthcare technology for the future.


Asunto(s)
Financiación Personal/estadística & datos numéricos , Años de Vida Ajustados por Calidad de Vida , Adolescente , Adulto , Anciano , Escolaridad , Femenino , Costos de la Atención en Salud , Gastos en Salud/estadística & datos numéricos , Humanos , Renta/estadística & datos numéricos , Irán , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Adulto Joven
10.
BMC Public Health ; 18(1): 1049, 2018 Aug 22.
Artículo en Inglés | MEDLINE | ID: mdl-30134910

RESUMEN

BACKGROUND: The synanthropic house fly, Musca domestica (Diptera: Muscidae), is a mechanical vector of pathogens (bacteria, fungi, viruses, and parasites), some of which cause serious diseases in humans and domestic animals. In the present study, a systematic review was done on the types and prevalence of human pathogens carried by the house fly. METHODS: Major health-related electronic databases including PubMed, PubMed Central, Google Scholar, and Science Direct were searched (Last update 31/11/2017) for relevant literature on pathogens that have been isolated from the house fly. RESULTS: Of the 1718 titles produced by bibliographic search, 99 were included in the review. Among the titles included, 69, 15, 3, 4, 1 and 7 described bacterial, fungi, bacteria+fungi, parasites, parasite+bacteria, and viral pathogens, respectively. Most of the house flies were captured in/around human habitation and animal farms. Pathogens were frequently isolated from body surfaces of the flies. Over 130 pathogens, predominantly bacteria (including some serious and life-threatening species) were identified from the house flies. Numerous publications also reported antimicrobial resistant bacteria and fungi isolated from house flies. CONCLUSIONS: This review showed that house flies carry a large number of pathogens which can cause serious infections in humans and animals. More studies are needed to identify new pathogens carried by the house fly.


Asunto(s)
Moscas Domésticas/patogenicidad , Insectos Vectores/patogenicidad , Animales , Humanos
11.
Int J Prev Med ; 9: 41, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29899879

RESUMEN

Introduction: Urban family physician program (UFPP) was launched in Fars province of Iran in 2012. We aimed to assess the knowledge and practice of people toward this 5-year-old program. Methods: In this population-based study, through a multistage random sampling from 6 cities of Fars province, 1350 people older than 18 years were interviewed. For data collection, a questionnaire consisting of sociodemographic characteristics and items about knowledge and practice toward UFPP was used. Results: The mean age of the interviewees was 42.4 ± 14.2 years; male (674; 49.9%)-to-female (651; 48.2%) ratio was 1.03. Mean score of knowledge was 4.2 ± 1.7 (out of 14), while 961 (71.1%) had < 50% of the desirable knowledge. Mean score of practice was 4.4 ± 1.3 (out of 9), while only 443 (32.8%) had a good performance toward this program. Knowledge and practice did not show a significant correlation (r = 0.06, P = 0.05). Among cities, the highest and the lowest mean of knowledge belonged to Pasargad (5.6 ± 2.1) and Lar (3.0 ± 1.0) (P < 0.001), respectively. Pasargad (4.8 ± 1.4) had also the highest level of practice compared to Farashband (3.8 ± 1.4) which had the lowest score (P < 0.001). Multivariable analysis showed that supplemental insurance coverage (odds ratio [OR] = 2.5, %95 confidence interval [CI]: 1.6-3.9), female gender (OR = 1.9, %95 CI: 1.2-2.9) and higher level of education (OR = 1.7, %95 CI: 1.1-2.5) were the significant determinants of knowledge, while practice in those who were not covered by supplemental insurance was better (OR = 1.6, 95% CI: 1.2-2.5). Conclusions: After 5 years of implementation of UFPP, knowledge and practice of people toward UFPP are not satisfactory. This finding calls for a serious revision in some aspects of UFFP.

12.
Sci Rep ; 8(1): 4788, 2018 03 19.
Artículo en Inglés | MEDLINE | ID: mdl-29555959

RESUMEN

Non-alcoholic fatty liver disease (NAFLD) is an example of pathological fat accumulation in the liver and one of the major health conditions in the world. This study aimed to examine the independent role of dietary patterns in the development of NAFLD. In a cross-sectional study, 1500 individuals referred to a nutrition clinic were randomly selected, their demographic, anthropometric and blood metabolic indices were obtained, and food frequency questionnaires were completed for them. Liver stiffness was calculated using the NAFLD score formula and fibroscan. The two dominant dietary patterns identified were the "healthy" and "unhealthy dietary patterns". A significant percentage of those with NAFLD (45%) were in the upper quartile of the unhealthy model; however, only 10% had the healthy pattern (p < 0.001). In this study, 32.9 and 13.9% of the healthy and unhealthy participants were in the upper quartile of the healthy diet pattern. Also, it was shown that waist circumference is a strong mediator of dietary patterns and NAFLD relationship, and the indirect effect of diet through abdominal circumference is 28 times greater than the direct effect on NAFLD. The results suggested that healthy and unhealthy dietary patterns are respectively associated with lower- and higher-risk of NAFLD but the role of waist circumference as a mediator deserves more consideration.


Asunto(s)
Dieta , Enfermedad del Hígado Graso no Alcohólico/epidemiología , Circunferencia de la Cintura , Adulto , Dieta/efectos adversos , Femenino , Humanos , Masculino , Enfermedad del Hígado Graso no Alcohólico/inducido químicamente
13.
Diabetes Metab Syndr ; 12(3): 423-430, 2018 May.
Artículo en Inglés | MEDLINE | ID: mdl-29279272

RESUMEN

BACKGROUND AND OBJECTIVE: Although several studies have assessed the effect of folate supplementation on lipid profiles among patients with metabolic diseases, findings are inconsistent. This review of randomized controlled trials (RCTs) was conducted to summarize the evidence on the effects of folate supplementation on lipid profiles among patients with metabolic diseases. METHODS: Randomized-controlled trials (RCTs) published in PubMed, EMBASE, Web of Science and Cochrane Library databases up to until 20 August 2017 were searched. Two review authors independently assessed study eligibility, extracted data, and evaluated risk of bias of included studies. Heterogeneity was measured with a Q-test and with I2 statistics. Data were pooled by using the fix or random-effect model based on the heterogeneity test results and expressed as standardized mean difference (SMD) with 95% confidence interval (CI). RESULTS: A total of thirteen randomized controlled trials were included. Folate supplementation did not affect systolic blood pressure (SMD -0.87; 95% CI, -1.83, 0.09) and diastolic blood pressure (SMD -0.59; 95% CI, -1.55, 0.37), and lipid profiles including triglycerides (SMD 0.10; 95% CI, -0.42, 0.63), total- (SMD 0.06; 95% CI, -0.31, 0.43), HDL- (SMD 0.04; 95% CI, -0.36, 0.44), VLDL- (SMD 0.08; 95% CI, -0.24, 0.41), and LDL-cholesterol (SMD -0.14; 95% CI, -0.55, 0.28). CONCLUSIONS: Folate supplementation did not affect blood pressures and lipid profiles among patients with metabolic diseases. Additional prospective studies regarding the impact of folate supplementation on blood pressures and lipid profiles in patients with metabolic diseases are necessary.


Asunto(s)
Suplementos Dietéticos , Ácido Fólico/administración & dosificación , Lípidos/sangre , Enfermedades Metabólicas/sangre , Enfermedades Metabólicas/tratamiento farmacológico , Ensayos Clínicos Controlados Aleatorios como Asunto , Complejo Vitamínico B/administración & dosificación , Humanos , Pronóstico
14.
Curr Med Mycol ; 4(4): 37-44, 2018 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-30815616

RESUMEN

Invasive fungal infections (IFIs) are among the life-threatening issues in patients with impaired immune system. High administration of antifungals in these patients imposes a heavy economic burden on the national health system. In addition, despite the usually expensive antifungal regimens, the mortality rate due to fungal infections is still high, resulting in the loss of hundreds of lives per year. Survival rate is an indicator of the success of national healthcare policies. Early diagnosis of IFI is critical because any delays may be fatal. The weakness of the old-fashioned culture-based diagnostic methods lies in their time-consuming laboratory procedures. To overcome this problem, several diagnostic approaches have been developed to facilitate the early diagnosis of invasive candidiasis as the most prevalent IFI. These methods are based on the detection of serologic and molecular footprints. However, nowadays, antibiotic resistance and proper and cost-effective use of antibiotics are given special attention in national healthcare policies. The instructions for controlling these indices have been collected under the name of antibiotic stewardship. The present review study was targeted toward providing insight into novel diagnostic biomarkers and antifungal stewardship programs. The simultaneous investigation of these two issues facilitates the achievement of a novel health policy for the treatment of systemic candidiasis in immunocompromised patients.

16.
Tanaffos ; 16(4): 251-259, 2017 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-29849681

RESUMEN

Helicobacter pylori, a gram negative pathogen, infects the stomach and gastrointestinal tract and causes pathological damage to these organs. H. pylori infection is more prevalent among people living in developing countries. Allergic asthma is a chronic inflammatory disease of the airways. Hyperinflation, hyperresponsiveness, and abnormal immunological and inflammatory processes in respiratory airways typically occur during an asthma attack. The results of recent studies have suggested an association between H. pylori and asthma risk. However, the role of H. pylori infection in the pathophysiology of asthma is still a matter of debate. The results of some studies indicate an association between H. pylori infection and protection against allergic asthma. Exposure to infectious agents might educate the immune system and provide protection against allergic diseases. H. pylori inflammation also changes gastric hormonal levels and could influence the autonomic nervous system. T-regs could be influenced by the immunological response to H. pylori and then inhibit the Th-2-mediated allergic response. Therefore, H. pylori might play a protective role against asthma. H. pylori can also reduce gastro-esophageal reflux, which is an asthma stimulator. High loads of H. pylori are not always present during infection. It is not definitely clear whether H. pylori is a pathogen or simply an opportunist. It has been suggested that early exposure to H. pylori prevents development of pediatric asthma. Therefore, it is possible that therapeutic products made from H. pylori can be used for the treatment or prevention of asthma.

17.
Dent Res J (Isfahan) ; 13(5): 387-395, 2016 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-27857763

RESUMEN

BACKGROUND: The high prevalence of malocclusion is a public health problem in the world and the third priority in oral care. Numerous primary studies have presented reports on the prevalence of malocclusion among Iranian children. In combination, the results of these studies using meta-analysis are highly valuable for health policy-making. Similarly, this study aimed at determining the prevalence of different types of malocclusion among Iranian children. MATERIALS AND METHODS: Using relevant keywords, national and international databases were explored. After narrowing down the search strategy and leaving out the duplicates, the remaining articles were screened based on titles and abstracts. To increase search sensitivity, reference lists of the papers were examined. To identify unpublished articles and documentations, a set of negotiations were done with the people involved and research centers. Finally, the heterogeneity index between the studies was determined using Cochran (Q) and I2 tests. According to the results of heterogeneity, the random effects model was used to estimate the prevalence of malocclusion in Iran. RESULTS: In total, 25 articles were included in the meta-analysis process. The prevalence of dental malocclusion was estimated in 28,693 Iranian children aged 3-18 years. The total prevalence of Class I, II, and III malocclusion was 54.6% (46.5-62.7), 24.7% (20.8-28.7), and 6.01% (4-7.1), respectively. The prevalence of Class I, II, and III malocclusion was 44.6% (32.9-56.2), 21.5% (18.01-25.1), and 4.5% (3.2-5.9) in boys and 48.8% (36.8-60.8), 21.5% (16.9-25.1), and 5.5% (3.9-7.1) in girls, respectively. CONCLUSION: This study showed a high prevalence of malocclusion among Iranian children. Also, the results indicated that the prevalence is higher in girls.

18.
PLoS One ; 11(5): e0155669, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27219458

RESUMEN

We have evaluated the ever changing epidemiology of cancers in Fars province, Iran since the re-establishment of Fars cancer registry. Based on the collected data from all related sources in Fars province from 2007-2010 we calculated the cancer age-standardized rates per 100,000 person-years (ASRs). The results are presented as incidence rates of cases by site according to the International Classification of Diseases for Oncology (ICD-O), sex, age, crude rate, and ASRs. In women the total ASR was 41.70 per 100,000 from 1985-1989 which had increased to 55.50 and 95.46 during 1998-2002 and 2007-2010. The incidence of breast cancer in women during 2007-2010 was about two and four times higher than 1998-2002 and 1985-1989. The incidence of colorectal cancer in women during 2007-2010 was about three and five times higher than 1998-2002 and 1985-1989. In men the total ASR was 62.9 per 100,000 in 1985-1989 that increased to 64.50 and 101.48 during 1998-2002 and 2007-2010. Although stomach cancer was the most common cancer among men during 1985-1989 and 1998-2002, but in recent study bladder cancer was the most common cancer among men in Fars province. The incidence of colorectal cancer in men during 2007-2010 was about three times higher than 1998-2002 and 1985-1989. This study shows growing incidence of cancer in southern Iran. The colorectal cancer in both genders had increased and its pattern is similar to western countries. In men, bladder and prostate cancers had a growing rate and the incidences of these cancers in the present study were greater than stomach cancer.


Asunto(s)
Neoplasias de la Mama/epidemiología , Neoplasias Colorrectales/epidemiología , Neoplasias de la Próstata/epidemiología , Neoplasias Gástricas/epidemiología , Neoplasias de la Vejiga Urinaria/epidemiología , Estudios Transversales , Femenino , Humanos , Incidencia , Irán/epidemiología , Masculino , Sistema de Registros , Caracteres Sexuales
19.
Asian Pac J Cancer Prev ; 17(S3): 81-6, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27165213

RESUMEN

Globally, the burden of breast cancer (BC) continues to increase. BC related lymphedema (BCRL) is currently non curable and as a life time risk it affects at least 25% of BC patients. Knowing more about BCRL and appropriate control of its modifiable risk factors can improve quality of life (QOL) of the affected patients. In this case control study to detect factors, 400 women with BCRL (as the case group) and 283 patients with BC without lymphedema (as the control group) that were referred to Shiraz University of Medical Sciences affiliated BC clinic center were assessed. The data were analyzed in SPSS. The mean age of the case group was 52.3±11.0 years and of the control group was 50.1±10.9 years. In patients with BCRL, 203(50.7%) had left (Lt) side BC and in non- lymphedema group 151 (53.3%) had Lt side BC. Out of all BCRL patients, 204 (51%) had lymphedema in all parts of their affected upper extremities, 100 (25%) had swelling in the arm and forearm and 23 (5.7%) had edema in both the upper extremity and trunk. Edema, heaviness, concern about changing body image, pain and paresthesia were the most common signs/symptoms among patients with BCRL. In BCRL patients, the difference of circumference between the affected upper limb and non-affected limb was 4.4±2.5 cm and the difference in volume displacement was 528.7±374.4 milliliters. Multiple variable analysis showed that moderate to severe activity (OR; odds ratio =14, 95% CI: 2.6-73.3 ), invasiveness of BC (OR =13.7, 95% CI: 7.3-25.6), modified radical mastectomy (OR=4.3, 95% CI: 2.3-7.9), BMI =>25 (OR=4.2, 95% CI: 2-8.7), radiotherapy (OR=3.9, 95% CI: 1.8-8.2 ), past history of limb damage (OR=1.7, 95% CI: 0.9-3.1) and the number of excised lymph nodes (OR=1.06, 95% CI: 1.02-1.09) were the significant predictors of lymphedema in women with BC. Modifiable risk factors of BCRL such as non-guided moderate to severe physical activity, high BMI and trauma to the limb should be controlled as early as possible in BC patients to prevent development of BCRL and improve QOL of these patients.


Asunto(s)
Neoplasias de la Mama/cirugía , Linfedema/etiología , Mastectomía/efectos adversos , Calidad de Vida , Extremidad Superior/patología , Neoplasias de la Mama/patología , Estudios de Casos y Controles , Femenino , Estudios de Seguimiento , Humanos , Irán , Escisión del Ganglio Linfático , Metástasis Linfática , Linfedema/diagnóstico , Persona de Mediana Edad , Invasividad Neoplásica , Estadificación de Neoplasias , Pronóstico , Factores de Riesgo , Sobrevivientes
20.
Int J Prev Med ; 7: 3, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-26941904

RESUMEN

BACKGROUND: A national project of extending a family physician program to urban areas has been started since May 2013 in Iran. The present study aimed to detect correlates of people's satisfaction and dissatisfaction about urban family physician program. METHODS: This cross-sectional and population-based study was conducted in Shiraz, Southern Iran. Multistage and proportional to size random sampling were used. Different items about satisfaction and dissatisfaction toward urban family physician program were queried. Single variable and then multiple variable analyses of data were done using SPSS software (Chicago, IL. USA). RESULTS: Mean age of 1257 participants in the study was 38.1 ± 13.2 years. Respondents included men (634; 50.4%), married (882; 70.2%), those who were educated at universities (529; 42%) and self-employed groups (405; 32.2%). One thousand fifty-eight (84.1%) were covered by the family physician program. Mean of referral times to a family physician was 2.2 ± 2.9 during the year before the study. Satisfaction toward urban family physician program was high in 198 (15.8%), moderate in 394 (31.3%), and low in 391 (31.1%). Dissatisfaction about this program was more among younger than 51-year-old groups (for 31-50 years odds ratio [OR] =2.3, 95% confidence interval [CI] =1.4-3.7, P < 0.001 and for 18-30 years OR = 2, 95% CI = 1.2-3.4, P = 0.005), less knowledgeable ones (OR = 2.2, 95% CI = 1.3-3.6, P = 0.001), singles (OR = 2.1, 95% CI = 1.2-3.4, P = 0.003), and those with more than 4 of family members (OR = 1.3, 95% CI = 1-1.7, P = 0.05). CONCLUSIONS: Overall, the majority of the people are not very satisfied with the urban family physician program. This shows the need for a multi-disciplinary approach including training, improvement of infrastructures and referral system, continuous supervision, and frequent monitoring of user's and provider's feedback about this program. According the results, the family physician program should be improved prior to extending this program to other provinces in Iran.

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