Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 9.922
Filtrar
1.
Allergol Immunopathol (Madr) ; 49(5): 9-15, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34476916

RESUMO

INTRODUCTION: Allergic diseases could play a role of a predisposing factor for coronavirus disease 2019 (COVID-19). The aim of this study was to investigate allergic comorbidity and its association in COVID-19 patients. METHODS: Demographic data, clinical manifestations, laboratory reports, and radiologic findings, together with underlying comorbidity of patients, were studies. Allergic diseases were identified by using the standard GA2LEN questionnaire. The severity of COVID-19 was assessed by a visual analog scale (VAS) and an intensive care unit (ICU) report. RESULTS: Out of 400 COVID-19 patients admitted in the hospital, 158 (39.5%) presented with different allergic diseases, and a reverse association was observed between having allergic comorbidity and severity of COVID-19 infection (P = 0.005, relative risk = 0.96; 95% Confidence Interval (95% CI): 0.77-1.19). The respective frequency of asthma, allergic rhinitis (AR), chronic rhinosinusitis (CRS), atopic dermatitis, chronic urticaria, and food or drug allergy was 7.3%, 16%, 1.8%, 5%, 10% and 13.3%. Significantly, only AR was reversely associated with the severity of COVID-19 (P = 0.02, relative risk = 0.45; 95% CI: 0.77-1.19). Additionally, 43% of the patients presented hypoxemia, and 93.5% had chest CT scan involvement. Interestingly, patients with allergic diseases had significantly lower hypoxemia and chest CT involvement as compared with non-allergic patients (P = 0.002 and 0.003, respectively). CONCLUSION: The results of this study established that allergic diseases were not determined to be a predisposing factor for the severe acute respiratory syndrome (SARS) due to coronavirus 2 (SARS-CoV-2) infection. Significantly, AR patients developed mild clinical manifestations of COVID-19 and admitted to ICU as compared to non-AR patients.


Assuntos
COVID-19/epidemiologia , Hipersensibilidade/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/diagnóstico , Teste para COVID-19 , Comorbidade , Feminino , Humanos , Hipersensibilidade/diagnóstico , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Índice de Gravidade de Doença , Adulto Jovem
2.
J Res Health Sci ; 21(2): e00514, 2021 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-34465637

RESUMO

BACKGROUND: This study aimed to determine the secondary attack rate (SAR) and its determinants to describe the clinical features and epidemiological aspects of patients and determine the risk factors of COVID-19 among household contacts in Hamadan Province, west of Iran. STUDY DESIGN: A cohort study. METHODS: In this cohort study, a total of 323 index cases and 989 related close contacts ages more than 15 years old (family members, relatives, and co-workers) were enrolled using a manual contact tracing approach, and all participants were tested by reverse transcription polymerase chain reaction test. In this research, the frequency of symptoms was assessed, the SAR among contacts of index cases was calculated, and the risk factors of COVID-19 were evaluated by the logistic regression model. RESULTS: The secondary attack rate for total household members of index cases was estimated at 31.7% (95% CI: 28.8-34.7). It was found that among household contacts, the highest SARs were related to spouses 47.1% (95% CI: 38.7-55.7) and grandparents/parents 39.3% (95% CI: 29.4, 49.9) of index cases, who had also higher risks to become secondary cases (adjusted odds ratio [OR]=2.98, 95% CI: 1.31-6.75 and adjusted OR=2.76, 95% CI: 1.18-6.44, respectively). Considering the occupation of contacts, unemployed and retired people and housewives were most susceptible for transmission of COVID-19. It was revealed that cough was the most prevalent symptom among index and secondary cases. CONCLUSION: Our findings indicated that spouses and grandparents/parents of index cases were the most susceptible individuals for COVID-19 transmission. Prolonged exposure with index case before COVID-19 diagnosis raised the chance of infection among secondary cases.


Assuntos
COVID-19/transmissão , Busca de Comunicante , Características da Família , Família , Pandemias , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/epidemiologia , Teste para COVID-19 , Estudos de Coortes , Tosse/etiologia , Emprego , Feminino , Humanos , Incidência , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Razão de Chances , Fatores de Risco , SARS-CoV-2 , Adulto Jovem
3.
J Res Health Sci ; 21(2): e00515, 2021 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-34465638

RESUMO

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a contagious disease caused by a newly identified coronavirus. Our knowledge about the survival rate and prognostic factors of the disease is not established well. Therefore, this study aimed to identify the risk factors associated with the survival of COVID-19 cases in Hamadan province, West of Iran. STUDY DESIGN: A retrospective cohort study METHODS: This retrospective cohort study was performed in Hamadan province, West of Iran. The study included patients that referred to the provincial hospitals from February 20 to September 20, 2020. The follow-up of each subject was calculated from the date of onset of respiratory symptoms to the date of death. Demographic and clinical characteristics were extracted from patients' medical records. Kaplan-Meier method, Flemington-Harrington test, and Cox regression were used for data analysis. RESULTS: The overall 1, 5, 10, 20, 30 and 49-day survival rates were estimated at 99.57%, 95.61%, 91.15%, 87.34%, 86.91%, and 86.74%, respectively. Furthermore, survival time showed a significant association with age, gender, history of traveling to contaminated areas, co-morbidity, neoplasms, chronic diseases, and hospital units. CONCLUSION: In conclusion, elderly people, male gender, and comorbidities presented a greater risk of death. Therefore, it is important to pay more attention to this group of people to reduce the incidence and consequences after infection.


Assuntos
COVID-19/mortalidade , Doença Crônica/epidemiologia , Hospitalização , Neoplasias/epidemiologia , Pandemias , Viagem , Adulto , Fatores Etários , Idoso , COVID-19/diagnóstico , COVID-19/epidemiologia , Comorbidade , Mortalidade Hospitalar , Hospitais , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Sistema de Registros , Estudos Retrospectivos , Fatores de Risco , SARS-CoV-2 , Fatores Sexuais , Análise de Sobrevida , Taxa de Sobrevida
4.
J Res Health Sci ; 21(2): e00517, 2021 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-34465640

RESUMO

BACKGROUND: The basic reproduction number (R0) is an important concept in infectious disease epidemiology and the most important parameter to determine the transmissibility of a pathogen. This study aimed to estimate the nine-month trend of time-varying R of COVID-19 epidemic using the serial interval (SI) and Markov Chain Monte Carlo in Lorestan, west of Iran. STUDY DESIGN: Descriptive study. METHODS: This study was conducted based on a cross-sectional method. The SI distribution was extracted from data and log-normal, Weibull, and Gamma models were fitted. The estimation of time-varying R0, a likelihood-based model was applied, which uses pairs of cases to estimate relative likelihood. RESULTS: In this study, Rt was estimated for SI 7-day and 14-day time-lapses from 27 February-14 November 2020. To check the robustness of the R0 estimations, sensitivity analysis was performed using different SI distributions to estimate the reproduction number in 7-day and 14-day time-lapses. The R0 ranged from 0.56 to 4.97 and 0.76 to 2.47 for 7-day and 14-day time-lapses. The doubling time was estimated to be 75.51 days (95% CI: 70.41, 81.41). CONCLUSION: Low R0 of COVID-19 in some periods in Lorestan, west of Iran, could be an indication of preventive interventions, namely quarantine and isolation. To control the spread of the disease, the reproduction number should be reduced by decreasing the transmission and contact rates and shortening the infectious period.


Assuntos
Número Básico de Reprodução , COVID-19/epidemiologia , Epidemias , COVID-19/prevenção & controle , COVID-19/transmissão , COVID-19/virologia , Estudos Transversais , Humanos , Irã (Geográfico)/epidemiologia , Funções Verossimilhança , Cadeias de Markov , Método de Monte Carlo , Pandemias , SARS-CoV-2
5.
BMC Public Health ; 21(1): 1633, 2021 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-34493239

RESUMO

BACKGROUND: Waterpipe is one of the oldest methods of tobacco smoking, which has become the public health challenge, especially in the Eastern Mediterranean countries such as Iran. This study aimed to investigate the waterpipe smoking (WPS) in the young people of Kermanshah in 2020, using a qualitative method. METHODS: This was a qualitative study conducted with the approach of content analysis. Participants were young waterpipe user aged 17 to 25 years selected by purposeful sampling method in Kermanshah city, located in the west of Iran. Data were collected through semi-structured interviews in face-to-face and audio-recorded methods based on an interview guideline during June to August 2020. Then researchers transcribed verbatim and analyzed the content of the interviews thematically. RESULTS: In this study, 23 young people who were waterpipe users at the time of the study participated. The results showed that social aspects in three sub-categories were involved in WPS including "socio-cultural aspects", "socio-environmental aspects", and "social relations". Individual aspects of waterpipe use as second category also consisted of two sub-categories including "motivational aspects" and "lack of psycho-protective aspects". CONCLUSIONS: It seems that the implementation of the policy of reducing access to waterpipe in public environments is effective in reducing waterpipe consumption. It is suggested that educational and interventions, based on targeted models and theories be implemented in order to increase young people's belief and perception on dangers of WPS, and to improve their self-efficacy to smoking cessation.


Assuntos
Abandono do Hábito de Fumar , Fumar Cachimbo de Água , Adolescente , Humanos , Irã (Geográfico)/epidemiologia , Pesquisa Qualitativa , Fumar Tabaco , Fumar Cachimbo de Água/epidemiologia
6.
BMC Public Health ; 21(1): 1643, 2021 09 08.
Artigo em Inglês | MEDLINE | ID: mdl-34496805

RESUMO

BACKGROUND: Female household heads are faced with more problems than men due to their multiple concurrent roles. The present study was conducted to determine the relationship of supportive roles with mental health and satisfaction with life in female household heads in Karaj, Iran using a structural equations model. METHODS: The present descriptive-analytical study was conducted on 286 eligible female household heads in Karaj, Iran, in 2020, who were selected by convenience sampling. Data were collected using Vaux's Social Support, the perceived social support scale, the general health questionnaire (GHQ), and the satisfaction with life questionnaire plus a socio-demographic checklist, and were analyzed in SPSS-16 and Lisrel-8.8. RESULTS: The participants' mean age was 43.1 ± 1.7 years. According to the path analysis results, satisfaction with life had the highest direct positive relationship with perceived social support (B = 0.33) and the highest indirect positive relationship with age (B = 0.13) and the highest direct and indirect positive relationship with education and social support (B = 0.13). Also, mental health had a direct negative relationship with satisfaction with life (B = -0.29), an indirect negative relationship with social support, and both a direct and indirect negative relationship with perceived support (B = -0.26). CONCLUSION: Based on the results, supportive roles had a negative relationship with mental health; in other words, mental health problems increase as supportive roles decrease. They also had a positive relationship with satisfaction with life in female household heads. Accordingly, given the status and role of women in the health of family members and the community and their greater vulnerability, further attention and support should be directed toward these women by the government and relevant organizations like establishment of counseling-support centers.


Assuntos
Saúde Mental , Satisfação Pessoal , Adulto , Estudos Transversais , Características da Família , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Masculino
7.
BMC Med Educ ; 21(1): 471, 2021 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-34482821

RESUMO

BACKGROUND: Psychological disorders have negative consequences on students' learning and academic performance. In addition, academic burnout is one of the common challenges that affects students' motivation and academic eagerness; however, the determinant is not clear. Medical students, meanwhile, demand special attention due to their professional responsibilities. In this regard, this study is conducted to investigate the academic burnout, rate of depression, anxiety and stress as well as related factors among undergraduate medical students at the Tehran Medical Sciences Islamic Azad University. METHODS: This cross-sectional and descriptive study was performed on medical students of Islamic Azad University of Tehran in 2017. In phase I, conducted on all stager students, Maslach Burnout questionnaire was used. In phase II, the DASS-42 questionnaire was provided for 123 students, 120 of whom met the inclusion criteria. In addition, another questionnaire including gender, age, lifestyle, marital and financial status, nutrition style, vitamin D deficiency, smoking, study hours per week, work efficiency and distance from the place of residence to the teaching hospital was used. Finally, the data extracted by SPSS version 23 was analyzed at the significance level of 0.05. RESULTS: In phase I of the study, 17 subjects showed academic burnout (16.3%). Out of all, 76.5% of students with academic burnout did not focus on the study and students' academic burnout was associated with a decrease in their focus (P < 0.05). However, the relationship between academic burnout and other factors was not significant. In phase II, the prevalence of depression, anxiety and stress was 37.5, 41.1 and 30.3%, respectively. The prevalence of severe and very severe degrees that required psychiatric follow-up were 10.5, 10.5 and 7% for depression, anxiety and stress, respectively. According to statistical analyzes, there is a significant direct relationship between anxiety and the distance from the place of residence to the teaching hospital (P = 0.040). CONCLUSION: The present study estimated the prevalence of academic burnout to be between 9.2 and 23.4%, considering the 5% error in the calculation, and the level of anxiety was related to the distance from the place of residence to the hospital.


Assuntos
Esgotamento Profissional , Estudantes de Medicina , Ansiedade/epidemiologia , Esgotamento Profissional/epidemiologia , Esgotamento Psicológico/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Humanos , Irã (Geográfico)/epidemiologia , Prevalência , Inquéritos e Questionários , Universidades
8.
BMC Musculoskelet Disord ; 22(1): 651, 2021 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-34332559

RESUMO

BACKGROUND: Osteoporotic fractures impose significant costs on society. The objective of this study was to estimate the direct costs of the hip, vertebral, and forearm fractures in the first year after fracture incidence in Iran. METHODS: We surveyed a sample of 300 patients aged over 50 years with osteoporotic fractures (hip, vertebral, and forearm) admitted to four hospitals affiliated to Tehran University of Medical Sciences, Iran, during 2017 and were alive six months after the fracture. Inpatient cost data were obtained from the hospital patient records. Using a questionnaire, the data regarding outpatient costs were collected through a phone interview with patients at least six months after the fracture incidence. Direct medical and non-medical costs were estimated from a societal perspective. All costs were converted to the US dollar using the average exchange rate in 2017 (1USD = IRR 34,214) RESULTS: The mean ± standard deviation (SD) age of the patient was 69.83 ± 11.25 years, and 68% were female. One hundred and seventeen (39%) patients had hip fractures, 56 (18.67%) patients had vertebral fractures, and 127 (42.33%) ones had forearm fractures. The mean direct cost (medical and non-medical) during the year after hip, vertebral and forearm fractures were estimated at USD5,381, USD2,981, and USD1,209, respectively. CONCLUSION: The direct cost of osteoporotic fracture in Iran is high. Our findings might be useful for the economic evaluation of preventive and treatment interventions for osteoporotic fractures as well as estimating the economic burden of osteoporotic fractures in Iran.


Assuntos
Fraturas do Quadril , Fraturas por Osteoporose , Fraturas da Coluna Vertebral , Idoso , Idoso de 80 Anos ou mais , Feminino , Antebraço , Custos de Cuidados de Saúde , Humanos , Irã (Geográfico)/epidemiologia , Pessoa de Meia-Idade , Fraturas por Osteoporose/diagnóstico , Fraturas por Osteoporose/epidemiologia , Fraturas por Osteoporose/terapia , Fraturas da Coluna Vertebral/diagnóstico , Fraturas da Coluna Vertebral/epidemiologia , Fraturas da Coluna Vertebral/terapia
9.
BMC Health Serv Res ; 21(1): 896, 2021 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-34461877

RESUMO

BACKGROUND: Facing limited health resources, healthcare providers need to rely on health service delivery models that produce the best clinical outcomes and patient experience. We aimed to contribute to developing a patient experience-based type 2 diabetes service delivery model by identifying operational structures and processes of care that were associated with clinical outcome, health experience, and service experience. METHODS: We conducted a cross-sectional survey of type 2 diabetes patients between January 2019 to February 2020. Having adjusted for demand variables, we examined relationships between independent variables (behaviours, services/processes, and structures) and three categories of dependent variables; clinical outcomes (HbA1c and fasting blood glucose), health experience (EuroQol quality of life (EQ-5D), evaluation of quality of life (visual analgene scale of EQ-5D), and satisfaction with overall health status), and service experience (evaluation of diabetes services in comparison with worst and best imaginable diabetes services and satisfaction with diabetes services). We analysed data using multivariate linear regression models using Stata software. RESULTS: After adjusting for demand variables; structures, diabetes-specific health behaviours, and processes explained up to 22, 12, and 9% of the variance in the outcomes, respectively. Based on significant associations between the diabetes service operations and outcomes, the components of an experience-based service delivery model included the structural elements (continuity of care, redistribution of task to low-cost resources, and improved access to provider), behaviours (improved patient awareness and adherence), and process elements (reduced variation in service utilization, increased responsiveness, caring, comprehensiveness of care, and shared decision-making). CONCLUSIONS: Based on the extent of explained variance and identified significant variables, health services operational factors that determine patient-reported outcomes for patients with type 2 diabetes in Iran were identified, which focus on improving continuity of care and access to providers at the first place, improving adherence to care at the second, and various operational process variables at the third place.


Assuntos
Diabetes Mellitus Tipo 2 , Estudos Transversais , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/terapia , Serviços de Saúde , Humanos , Irã (Geográfico)/epidemiologia , Qualidade de Vida
10.
BMC Res Notes ; 14(1): 338, 2021 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-34461988

RESUMO

OBJECTIVES: There are limited studies on the psychological issues and sleep problems among the Iranian people living with HIV (HIV). In this study, we aimed to assess sleep disorders, psychiatric characteristics, and employment status among Iranian PLWH. RESULTS: In total, 304 PLWH with a mean age of 40.01 (SD = 9.60) years participated in the study. About 72% of the participants had a global PSQI score of more than 5, with a mean score of 7.71 (SD = 3.31). About 55.6%, 50%, and 67.4% of subjects had abnormal scores for depression, anxiety, and stress. Unemployed participants had 2.13 times more chance (95% CI 1.01-4.53) of having poor sleep quality compared to employed patients, and stress increased its likelihood by 3.18 times (95% CI 1.47-5.88).


Assuntos
Infecções por HIV , Transtornos do Sono-Vigília , Adulto , Depressão/epidemiologia , Emprego , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Humanos , Irã (Geográfico)/epidemiologia , Sono , Transtornos do Sono-Vigília/epidemiologia
11.
Front Public Health ; 9: 714971, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34422753

RESUMO

Background: In the face of COVID-19, healthcare workers need to cope with the ongoing stressors at play and keep psychological distress at a minimum level. This study examined the psychosocial and demographic factors associated with nurse's resilience in the hospitals of Ahvaz that is one of the top cities infected with COVID-19 in Iran. Methods: The present cross-sectional study was conducted on 387 Iranian nurses in Ahvaz city. For data collection purposes, three online questionnaires (including Copenhagen Psychosocial, Demographic, and Connor-Davidson Resilience Scale) were distributed among the participants. Results: The mean resilience score was equal to 61.8 ± 14.8 for 387 nurses. Resilience had a statistically significant negative correlation with quantitative demand (r = -0.273, P < 0.008), work pace (r = -0.262, P < 0.011), emotional demand (r = -0.226, P < 0.030), stress (r = -0.458, P < 0.000), and burnout (r = -0.287, P < 0.005). Multiple linear regression analysis indicated that stress, job satisfaction, burnout and age were the main predictors of nurses' resilience during the (COVID-19) pandemic (R 2 = 0.45). Conclusions: We identified psychosocial and demographic predictive factors that may contribute to greater resilience among nurses during the COVID-19 outbreak. The findings of this study can be used to implement psychosocial interventions to amplify the resilience of medical staff during the COVID-19 outbreak.


Assuntos
COVID-19 , Enfermeiras e Enfermeiros , Resiliência Psicológica , Estudos Transversais , Surtos de Doenças , Humanos , Irã (Geográfico)/epidemiologia , SARS-CoV-2
12.
BMC Med Res Methodol ; 21(1): 161, 2021 08 09.
Artigo em Inglês | MEDLINE | ID: mdl-34372764

RESUMO

BACKGROUND: Non-participation in cohort studies, if associated with both the exposure and occurrence of the event, can introduce bias in the estimates of interest. This study aims to identify factors associated with follow-up participation in Tehran Lipid and Glucose Study, a large-scale community-based prospective study in West Asia. METHODS: A sample of 10,368 adults from TLGS was included in the analysis. All analyses were split according to sex and age groups (20-39, 40-59, and 60 years). The associations between socio-demographic, health, and lifestyle factors with response rate were identified using the Generalized Estimating Equations model. RESULTS: Over the median of 15.7 years of follow up the response rate was 64.5%. The highest response rate was observed in those aged 40-59 years for both sexes. Current smokers had lower odds of response in both sexes for all age groups, ranging from 0.51 to 0.74, p < 0.01. In young adults, being single (OR = 0.79, OR = 0.57, p ≤ 0.01, respectively for men and women) and unemployed (OR = 0.73, OR = 0.76, p ≤ 0.01, respectively for men and women) in both sexes, high physical activity in men (OR = 0.77, p < 0.01), high education (OR = 0.75, p = 0.02) and obesity (OR = 0.85, p = 0.05) in women were associated with lower response rate. For the middle-aged group, diabetes in men (OR = 0.77, p = 0.05) and hypertension (OR = 0.84, p = 0.05), and having a history of cancer (OR = 0.43, p = 0.03) in women were factors associated with lower response rates. Finally, interventions for both sexes (OR = 0.75, OR = 0.77, p ≤ 0.05, respectively for men and women) and being divorced/widow in women (OR = 0.77, p = 0.05) were the factors associated with the lower response rate in the elderly. CONCLUSIONS: Long-term participation was influenced by socio-demographic, health, and lifestyle factors in different sex- and age-specific patterns in TLGS. Recruitment strategies targeting these factors may improve participant follow-up in longitudinal studies.


Assuntos
Glucose , Lipídeos , Adulto , Idoso , Causalidade , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto Jovem
13.
BMC Health Serv Res ; 21(1): 763, 2021 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-34340702

RESUMO

BACKGROUND: The structure of the Iranian health system has raised this hypothesis that a part of the Knee Replacement Surgery (KRS) services are provided due to Physician-Induced Demand (PID). METHODS: This paper used an unbalanced individual panel data covering the steady-state 15,729 KRSs performed by 995 surgeons provided by the Armed Forces Insurance Organization at the provincial level over the 60 months (2014-2018). We use a generalized method of moment's system (GMM-SYS) to obtain consistent and asymptotically efficient estimates, which provide a vital instrument for our dynamic panel data. RESULTS: The outcomes show that with unequal increasing orthopedic surgeons to population ratio, both the number and size of KRS services were increased significantly at a 1 % level. Given that the positive elasticity obtained for the service size was significantly larger than the number of services, the findings give strong support for the existence of PID in the Iran system for KRS care. Also, the raw and population-adjusted number of KRS, cost, and the surgery per active physician increased significantly at the monthly province level. CONCLUSIONS: This is the first time that the existence of PID in the Iranian health system is investigated using approved econometric models. The findings indicate that the health system structure has been provided the conditions for aggressive, costly, and high-risk services such as KRS to be exposed to PID.


Assuntos
Artroplastia do Joelho , Cirurgiões , Humanos , Demanda Induzida , Irã (Geográfico)/epidemiologia , Modelos Econométricos
14.
Front Cell Infect Microbiol ; 11: 693522, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34336717

RESUMO

Background: Onychomycosis is one of the most common and recurrent dermatological diseases worldwide. The antimycotic activity of prescribed medications varies according to the causative agents, and treatment failure rates exceeding 30%. This study aimed to assess the epidemiological profile of onychomycosis in Iran. Also, the susceptibilities to conventional and new antifungals were investigated. Methods: In this descriptive cross-sectional study, during the period of 18 months starting from September 2019 until March 2020, 594 nail specimens were obtained from patients who presented nail changes compatible with a clinical diagnosis of onychomycosis. The patients were referred from different cities, including Tehran, Kermanshah, Arak, Kashan, Rasht, Qom, Urmia, Zahedan, Hamadan, Zanjan, Borujerd, Bushehr, and Yazd. All the samples were subjected to microscopic examination and fungal culture. Fungi identified were confirmed through the PCR-sequencing method. The susceptibility to itraconazole, fluconazole, terbinafine, griseofulvin, posaconazole, ravuconazole, efinaconazole, luliconazole, and tavaborole was evaluated according to the Clinical and Laboratory Standards Institute (CLSI) guidelines, document M38-A2 for filamentous fungi, and document M27-A3 for yeasts. Results: 594 patients were included. Of these, in 179 cases (30.1%) (95% CI:0.3 ± 0.037) onychomycosis was confirmed. The majority of patients were ≥ 60 years of age (n=58, 32.6%) and female (n=113, 63.1%). Saprophytic fungi accounted for the vast majority of the nail isolates (n=92, 51.4%) (95% CI:0.051 ± 0.0.073), followed by dermatophytes (n=45, 25.1%) (95% CI:0.25 ± 0.063), and yeasts (n=42, 23.5%) (95% CI:0.23 ± 0.061). Diabetes mellitus (77.3%), hypothyroidism (18.2%), and solid tumors (4.5%) were documented as the most prevalent underlying conditions. Antifungal susceptibility testing was performed against 60 fungal isolates (20 each of Candida species, saprophytic fungi, and dermatophytes). Efinaconazole, ravuconazole, and luliconazole were the most active agents against Candida species. Also, luliconazole, posaconazole, and efinaconazole were most potent against dermatophytes. Luliconazole had the greatest antifungal activity against saprophytic fungi. Conclusions: The prevalence of onychomycosis in Iranian patients was relatively high. LUL exhibited potent antifungal activity against the three groups of fungi tested, determining its broad-spectrum antimycotic activity and its probable use as the first-line therapy for onychomycosis.


Assuntos
Antifúngicos , Onicomicose , Antifúngicos/farmacologia , Antifúngicos/uso terapêutico , Estudos Transversais , Feminino , Fungos/genética , Humanos , Irã (Geográfico)/epidemiologia , Testes de Sensibilidade Microbiana , Onicomicose/tratamento farmacológico , Onicomicose/epidemiologia
15.
J Indian Soc Pedod Prev Dent ; 39(2): 147-153, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34341233

RESUMO

Background and Aim: Tooth decay as a significant but preventable public health priority continues to be a common disease in developing countries, including Iran, which is particularly prevalent among children. The present study aims to determine dental caries prevalence among elementary school students and its relationship with body mass index and oral hygiene in Ardabil, Iran in 2019. Materials and Methods: This cross-sectional study was conducted on 581 elementary school students selected through cluster random sampling method in Ardabil city in 2019. Demographic data was collected using questionnaire and anthropometric indices (height, weight) were measured using the weighing scale and stadiometer, and dental caries was evaluated using the decayed, missing, or filled teeth index (dmft for primary teeth and DMFT for permanent). Results: The mean age of students was 9.61 ± 1.76 years, and 50.8% of them were female. 20.7% (n = 120) were obese, and 19.1% (n = 111) were overweight. The overall prevalence of caries was 74.9% (n = 435) in primary teeth, 72.8% (n = 423) in permanent teeth, and 96.6% (n = 561) in all teeth. The average dmft and DMFT scores were 4.16 ± 3.72 and 1.96 ± 1.76, respectively. There was a significant inverse relationship between body mass index and dmft (r = -0.146, P < 0.0001) and DMFT (r = -0.111, P = 0.004). Conclusion: The findings showed that prevalence of dental caries in elementary school children in Ardabil city is higher than global standards, obese and over-weight children experience fewer caries compared to normal-weight children, and there is a significant relation between not brushing the teeth and dental caries.


Assuntos
Cárie Dentária , Higiene Bucal , Índice de Massa Corporal , Criança , Estudos Transversais , Índice CPO , Cárie Dentária/epidemiologia , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Prevalência , Instituições Acadêmicas , Estudantes
16.
East Mediterr Health J ; 27(7): 656-664, 2021 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-34369579

RESUMO

Background: Efforts to reduce inappropriate hospital stay, including alternatives such as homecare, are important to improve patient care and reduce health care costs. Aims: This study evaluated inappropriate hospital stay in Shiraz, Islamic Republic of Iran and the extent to which these stays were due to lack of homecare services and others factors needed for homecare. Methods: This cross-sectional study was conducted between January 2018 and September 2019 at two public hospitals in Shiraz. All adult patients hospitalized in these two hospitals in the study period were included, except patients in mental care wards. Appropriateness of patients' hospital stay was assessed on a daily basis using the Iranian version of the Appropriateness Evaluation Protocol. The chi-squared test was used to assess association between need for homecare and patient characteristics. Results: Of 6458 hospitalization days assessed (for 1954 patients), 710 (11.0%) days were inappropriate. The greatest proportion of causes of inappropriate stay were physician-related (32.9%). Of the 710 inappropriate hospitalization days, 231 were due to lack of homecare services. Most patients who were inappropriately hospitalized because of lack of homecare services were insured through Salamat insurance (64.0%). A statistically significant relationship was found between the need for homecare services and the type of health insurance (P = 0.01). Of the patients admitted to hospital because of lack of homecare services, 36.8% had endocrine diseases, especially diabetes, and 21.8% needed oxygen services. Conclusion: Institutionalizing home health care in the Iranian health system could encourage more home health care referral and reduce inappropriate hospitalization, especially for diabetes.


Assuntos
Serviços de Assistência Domiciliar , Hospitalização , Adulto , Estudos Transversais , Hospitais Públicos , Humanos , Irã (Geográfico)/epidemiologia , Tempo de Internação
17.
BMC Public Health ; 21(1): 1599, 2021 08 30.
Artigo em Inglês | MEDLINE | ID: mdl-34461857

RESUMO

BACKGROUND: Body image is the main element of an individual's personality that may be influenced by many factors during menopause. We aimed to assess the relationship between postmenopausal women's body image with the severity of menopausal symptoms. METHODS: This was a cross-sectional study on 300 postmenopausal women, aged 45 to 65 years old, in Tehran, Iran. We recruited the samples using the multi-stage sampling method. Tools for data collection were: 1) the Menopausal Rating Scale (MRS), 2) the Fisher's Body Image questionnaire and 3) a socio-demographic questionnaire. We analyzed data using the independent samples t-test, Pearson correlation coefficient, Spearman's correlation coefficient, and multiple linear regression tests. RESULTS: Three hundred women aged 55.11 ± 3.99 years old, participated in the study. Mean scores for body image and MRS were 163.07 ± 21.17 (Range: 46-230) and 16.45 ± 8.38 (Range: 0-44), respectively. About 50% of women had severe symptoms of menopause (MRS score ≥ 17). There was a negative correlation between the total score and the score of all dimensions of body image with the total score and all dimensions of MRS (P < 0.001). There were also significant relationships between women's body image with: their education (P < 0.001, r = 0.20) the spouse's education (P < 0.001, r = 0.26), adequacy of monthly household income (P < 0.001, r = 0.32), marital status (P = 0.36), their occupation (P = 0.007) and housing status (P = 0.012). There was also a significant negative correlation between women's lower body organs image with the number of children (P = 0.017, r = - 0.14). According to the multiple linear regressions model, severity of menopausal symptoms (Beta = - 0.45, P < 0.001) and adequacy of monthly household income (Beta = 0.15, P = 0.005) are the significant related factors with postmenopausal women's body image. CONCLUSIONS: Body image is correlated with menopausal symptoms of women during menopause. Therefore, it seems that interventions aimed at relieving the annoying symptoms of menopause can help to improve their body image. Also, body image could be influenced by some socio-demographic factors which should be considered in menopause health promotion programs.


Assuntos
Imagem Corporal , Pós-Menopausa , Idoso , Estudos Transversais , Feminino , Fogachos , Humanos , Irã (Geográfico)/epidemiologia , Menopausa , Pessoa de Meia-Idade , Inquéritos e Questionários
18.
Blood Adv ; 5(15): 2987-3001, 2021 08 10.
Artigo em Inglês | MEDLINE | ID: mdl-34351388

RESUMO

Type 3 von Willebrand disease (VWD3) is a rare and severe bleeding disorder characterized by often undetectable von Willebrand factor (VWF) plasma levels, a recessive inheritance pattern, and heterogeneous genotype. The objective of this study was to identify the VWF defects in 265 European and Iranian patients with VWD3 enrolled in 3WINTERS-IPS (Type 3 Von Willebrand International Registries Inhibitor Prospective Study). All analyses were performed in centralized laboratories. The VWF genotype was studied in 231 patients with available DNA (121 [115 families] from Europe [EU], and 110 [91 families] from Iran [IR]). Among 206 unrelated patients, 134 were homozygous (EU/IR = 57/77) and 50 were compound heterozygous (EU/IR = 43/7) for VWF variants. In 22 patients, no or only one variant was found. A total of 154 different VWF variants (EU/IR = 101/58 [5 shared]) were identified among the 379 affected alleles (EU/IR = 210/169), of which 48 (EU/IR = 18/30) were novel. The variants p.Arg1659*, p.Arg1853*, p.Arg2535*, p.Cys275Ser, and delEx1_Ex5 were found in both European and Iranian VWD3 patients. Sixty variants were identified only in a single allele (EU/IR = 50/10), whereas 18 were recurrent (≥3 patients) within 144 affected alleles. Nine large deletions and one large insertion were found. Although most variants predicted null alleles, 21% of patients carried at least 1 missense variant. VWD3 genotype was more heterogeneous in the European population than in the Iranian population, with nearly twice as many different variants. A higher number of novel variants were found in the Iranian VWD3 patients.


Assuntos
Doença de von Willebrand Tipo 3 , Doenças de von Willebrand , Genótipo , Humanos , Irã (Geográfico)/epidemiologia , Estudos Prospectivos , Doença de von Willebrand Tipo 3/diagnóstico , Doença de von Willebrand Tipo 3/epidemiologia , Doença de von Willebrand Tipo 3/genética
19.
Brain Behav ; 11(8): e2304, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34333852

RESUMO

OBJECTIVES: The present study was conducted to assess 3(HCWs) during the COVID-19 pandemic. METHODS: A total number of 7626 HCWs were included in this web-based cross-sectional study, via the convenience sampling technique. To collect the required data, the sociodemographic characteristics information form, the Depression Anxiety Stress Scale-21 (DASS-21), and the Corona Disease Anxiety Scale (CDAS) were also employed. In addition, data analysis was performed using the SPSS Statistics software (ver. 24), as well as descriptive statistics, Chi-square test (χ2 ), and univariate/multivariate logistic regression models. RESULTS: The CDAS results revealed that 47.9% and 70.5% of the HCWs had experienced moderate levels of physical and psychological anxiety, respectively. Based on the DASS results, 44.8%, 43%, and 34.8% of the HCWs had been subjected to depression, anxiety, and stress symptoms during the COVID-19 pandemic, respectively. The logistic regression models correspondingly showed that depression among the HCWs was significantly correlated with risk factors, such as the age groups of 20-30 years (p = .001), 31-40 years (p = .006), female HCWs (p> .001), history of physical illnesses (p = .004), and history of psychiatric disorders (p> .001). Moreover, factors including the age groups of 20-30 years (p < .001), 31-40 years (p < .001), 41-50 years (p < .001), female HCWs (p> .001), history of physical illnesses (p < .001), and history of psychiatric disorders (p>.001) were assumed as significant predictors of anxiety in these individuals. Besides, factors such as the age groups of 20-30 years (p = .002), 31-40 years (p = .004), female HCWs (p>.001), occupation (p = .016), history of physical illnesses (p < .001), and history of psychiatric disorders (p> .001) could significantly predict the prevalence rate of stress in the HCWs in times of this crisis. CONCLUSION: Given the importance of mental health status among HCWs during the COVID-19 pandemic, health administrators and policymakers of the Ministry of Health and Medical Education in Iran are suggested to provide psychological screening and supportive care programs for HCWs with the aim of enhancing their mental health and successful coping with critical circumstances.


Assuntos
COVID-19 , Pandemias , Adulto , Ansiedade/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Feminino , Pessoal de Saúde , Nível de Saúde , Humanos , Internet , Irã (Geográfico)/epidemiologia , SARS-CoV-2 , Adulto Jovem
20.
Ann Glob Health ; 87(1): 79, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34434715

RESUMO

Introduction: The mental health of people working in Covid-19 wards (nurses, doctors, etc.) may be compromised due to the specific conditions of the workplace and patients. Therefore, the aim of this study was to investigate the relationship between mental burden and quality of work life in nurses in intensive care units of Covid-19 patients. Method: In this cross-sectional study, a sample of 200 people-100 nurses in care units for patients with COVID-19 (group 1) and 100 nurses in non-COVID-19 patient care units (group 2-in three university hospitals were obtained. These 200 samples were randomly extracted from the list of employees and selected. Data were collected using three questionnaires, including (1) a demographic, (2) the NASA-Task Load Index (1988) (Hart & Staveland, 1988) and (3) National Institute for Occupational Safety and Health (NIOSH) Quality of Life. Data were analyzed using SPSS-24 software and descriptive and analytical statistical methods. Results: The overall mean scores of nurses' quality of work life were significantly different between the two groups (P < 0.05). The average score of quality of life in nurses caring for patients with COVID-19 is 92.57, more than nurses caring for patients without COVID-19, 79.43. Among the dimensions of mental workload: Performance and efficiency, with an average score of 77.32 ± 15.85, had the highest score, while discouragement and failure, with an average score of 58.04 ± 26.72, had the lowest score of mental workload. There is a significant difference between the mental load of work in the two groups (P = 0.001). There is a significant inverse relationship between total quality of work life and total mental workload (r = -14 and P = 0.01). Conclusion: In this study, it was observed that nurses caring for Covid-19 patients are in a more unfavorable situation in terms of the studied characteristics. Due to the work period, these nurses have a high workload and a low quality of work life to compensate for the mental and physical deficiencies required by a long presence in the work environment.


Assuntos
COVID-19 , Enfermeiras e Enfermeiros , Qualidade de Vida , Carga de Trabalho , Adulto , COVID-19/epidemiologia , COVID-19/enfermagem , Estudos Transversais , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Enfermeiras e Enfermeiros/psicologia , Enfermeiras e Enfermeiros/estatística & dados numéricos , Inquéritos e Questionários , Carga de Trabalho/psicologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...