Short-term effects of air pollution on hospital admissions of respiratory diseases in Hamadan, Iran, 2015 to 2021.

The short-term effects of air pollution on respiratory diseases have been reported in many countries. Urban areas are most affected because of the many sources of pollution and the large number of people living there. This study aims to investigate the effect of short-term exposure to air pollutants on respiratory hospital admissions in the city of Hamadan. In this ecological study, daily hospital admission data were collected from Shahid Beheshti Hospital in Hamadan. Daily information on air pollutants (CO, SO2, NO2, O3, PM2.5 and PM10) from Hamadan Department of Environment (DoE) organization and of climate factors from Hamadan Meteorological Office were collected. A negative binomial regression model was used to examine the effect of air pollution on daily respiratory hospitalizations. The effect of exposure to pollutants was measured whit different time lags (0-7 days). Furthermore, the effect of meteorological variables was controlled. Subgroup analyses were performed by sex and age group. A total of 12,454 hospitalizations for respiratory diseases were recorded. Results showed a strong and immediate effect of CO on respiratory hospital admissions with highest association at lag 7 (relative risk (RR) = 1.38, 95% CI: 1.33, 1.42). The effects of CO and SO2 on respiratory hospitalizations are greater for men than women. Regarding the short-term effects of PM2.5, SO2 and O3, adults (aged less than 65) were more prone to hospitalization for respiratory diseases. These results show that exposure to air pollution, particularly CO, may increase hospital admissions due to respiratory illness. So reducing the concentration of these pollutants can reduce the number of hospital admissions.

Relationship between long-term use of Ritalin and semen parameters in patients referred to psychiatric centres.

Some studies have shown that Ritalin can interfere with the growth and development of the reproductive system and can also have a serious and harmful effect on sperm parameters, so we decided to conduct studies in this field on the human sample. In a case-control study, 100 adult men aged 21-31 years with hyperactivity were divided into two groups of 50 past users and 50 current users and, 50 patients who had not used Ritalin before were included as the control group. Data were analysed using SPSS software, version 20. Analysis of variance, Pearson correlation coefficient, and regression analysis was used to assess the correlation between variables. The results also showed that there was a statistically significant difference between the current users and the control group in terms of sperm count, abnormality, and motility (p < .47). Comparison of the user group in the past and the control group showed that there was no statistically significant difference in terms of sperm count (p < .59), but there was a significant difference in terms of sperm motility and abnormality between the two groups (p < .001). The present study showed that long-term use of Ritalin can have negative effects on sperm parameters in humans.

The spectrum of ATM gene mutations in Iranian patients with ataxia-telangiectasia.

BACKGROUND: Ataxia-telangiectasia (A-T) is a rare genetic disorder characterized by a distinct range of clinical manifestations, including progressive ataxia, immunodeficiency, and radiosensitivity. METHODS: Clinical data, laboratory results, and genetic data were collected from forty-three A-T patients. Whole-exome sequencing and Sanger sequencing were done for the patients clinically diagnosed as suffering from A-T. Based on the phenotype severity of the disease, patients were divided into severe and mild subgroups. RESULTS: The median (IQR) age of diagnosis in this cohort was 5 (3-7) years, and various types of clinical manifestations, including fever (P =.005), lower respiratory tract infection (P = .033), diarrhea (P = .014), and hepatosplenomegaly (P = .032), were significantly higher among patients diagnosed with the severe phenotype. Our results showed a correlation between phenotype severity and mutation type. The chance of having severe phenotype in patients who have severe mutations, including frameshift and nonsense, was 7.3 times higher than in patients who were categorized in the mild genotype group (odds ratio = 7.3, P = .006). Thirty-four types of mutations including 9 novel mutations were observed in our study. CONCLUSION: Molecular analysis provides the opportunity for accurate diagnosis and timely management in A-T patients with chronic progressive disease, especially infections and the risk of malignancies. This study characterizes for the first time the broad spectrum of mutations and phenotypes in Iranian A-T patients, which is required for carrier detection and reducing the burden of disease in the future using the patients' families and for the public healthcare system.

Clinical, immunological and genetic findings in patients with UNC13D deficiency (FHL3): A systematic review.

BACKGROUND: Familial hemophagocytic lymphohistiocytosis (FHL) is a rare autosomal recessive immune disorder that is caused by mutations in 6 different genes related to the formation and function of secretory lysosomes within cytotoxic T lymphocytes and natural killer (NK) cells. Thus, defect in these genes is associated with the accumulation of antigens due to defective cytotoxic function. FHL type 3 (FHL3) accounts for nearly 30-40% of FHL, and its underlying reason is mutation in UNC13D gene which encodes Munc13-4 protein. METHODS: For the first time, we aimed to systematically review clinical features, immunologic data, and genetic findings of patients with FHL3. We conducted electronic searches for English-language articles in PubMed, Web of Science, EMBASE, and Scopus databases to collect comprehensive records related to patients with UNC13D mutations. RESULTS: A total of 279 abstracts were initially reviewed for inclusion. Among them, 57 articles corresponding to 322 individual FHL3 patients fulfilled our selection criteria. Finally, 73 and 249 patients were considered as severe and mild feature groups, respectively. Our results confirmed that fever, hepatosplenomegaly, and hemophagocytosis are common clinical features in the disease. Moreover, reduced fibrinogen and NK cell activity, as well as increased ferritin and triglycerides, are important markers for early diagnosis of the FHL3 disease. Investigation of genotype showed that the most prevalent type and zygosity of UNC13D are splice-site errors and compound heterozygous, respectively. CONCLUSION: FHL3 patients have a wide range of clinical manifestations, which makes it difficult to diagnose. Therefore, it seems that the sequencing of the entire UNC13D gene (coding and non-coding regions) is the most appropriate way to accurate diagnosis of FHL3 patients.

Patterns of clustering of the metabolic syndrome components and its association with coronary heart disease in the Multi-Ethnic Study of Atherosclerosis (MESA): A latent class analysis.

BACKGROUND: The Metabolic syndrome (MetS), refers to one of the most challenging public health issues across the world. The aim of this study was to explore the clusters of participants on the basis of MetS components and determine its effect on coronary heart disease (CHD). METHODS: This study used the information from Multi-Ethnic Study of Atherosclerosis (MESA). MESA was performed at 6 US sites and was a population-based cohort study of 6776 adults (3576 females; 3200 males), aged 45 to 84 years. The participants were free of clinical cardiovascular disease at baseline. Latent class analysis (LCA) was conducted to achieve the study's objectives. The outcome variable was CHD during the study period (2000-2012). RESULTS: The prevalence of all Mets components (except triglyceride (TG) and fasting blood glucose (FBS)) is more common in females than in males. Three latent classes were recognized: (1) Non-MetS, (2) low risk, and (3) MetS. Notably, MetS latent class included 29.88% and 35.38% in females and males, respectively. After adjustment for covariates (e.g. demographic, biomarker etc.), MetS latent class showed a positive association with CHD events in both genders. CONCLUSIONS: Results showed that clustering pattern of the MetS components, as well as the association between latent classes and risk of incident CHD events, are different in females and males. Notable percentages of individuals are in the MetS class, which emphasizes the necessity of implementing preventive interventions for this sub-group of the population.

Evaluation of prognostic factors effect on survival time in patients with colorectal cancer, based on Weibull Competing-Risks Model.

AIM: The aim of this study was to assess the association between survival of patients with colorectal cancer and prognostic factors in a competing risk parametric model using Weibull distribution. BACKGROUND: The prognosis of colorectal cancer is relatively good in terms of survival time. In many prognostic studies, patients may be exposed to several types of competing events. These different causes of death are called competing risks. METHODS: Data was recorded from 372 patients with colorectal cancer who registered in the Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences (Tehran, Iran) from 2004 to 2015 in a retrospective study. Analysis was performed using competing risks model and Weibull distribution. Software used for data analysis was R, and significance level was regarded as 0.05. RESULTS: The result indicated that, at the end of follow-up, 111 (29.8%) deaths were from colorectal cancer and 14 (3.8%) deaths were due to other diseases. The average body mass index (BMI) was 24.61(SD 3.98). The mean survival time for a patient in 372 was 62.05(SD 48.78) month with median equals to 48 months. According to competing-risks method, only stageIII (HR, 1.69; 95% CI, 1.246-2.315 ), stageIV( HR, 4.51; 95% CI,2.91-6.99 ) and BMI( HR, 0.96; 95% CI, 0.96-0.975) have a significant effect on patient's survival time. CONCLUSION: This study indicated pathologic stage (III,IV) and BMI as the prognosis, using a Weibull model with competing risks analysis, while other models without the competing events lead to significant predictors which may be due to over-estimation.