International Journal of Preventive Medicine最新文献

Background: Stevens-Johnson syndrome (SJS) as a dermatological emergency, is a severe condition with a 5% mortality rate. Antiepileptic drugs (AEDs) are linked to an increased risk of SJS, but the magnitude of this risk varies between studies, so comprehensive investigations are needed to evaluate the prevalence of SJS complications associated with AEDs.

Methods: Based on PRISMA guidelines, Online databases including PubMed/Medline, CINAHL (EBSCO), Web of Science (ISI), Scopus, and Embase were searched using related MeSH-term. Studies reporting SJS as a complication of AEDs or considering AEDs suspected of inducing SJS were included. The Studies which not published in English mentioned other complications instead of skin manifestations were excluded. The data was analyzed using the STATA 14 software. To investigate heterogeneity, the Q Cochrane test and I² test were used, and the random effects model was used for combining articles.

Results: Of 1630 studies, 24 studies were included in meta-analysis. The overall pooled prevalence of SJS was 23.22% (95% CI: 17.32-29.11). The pooled prevalence of SJS was 22.56% (95% CI: 16.55-28.57) in the Retrospective Cohort; 30.90% (95% CI: 5.32-56.48) in perspective Cohort, 24.84% (95% CI: 18.02-31.67) in Asia, 11.20% (95% CI: 6.10-18.4) in America, and 11.70% (95% CI: 2.77-20.63) in Europe. The I² index for the overall pooled prevalence of SJS was 93.6%. The results of the meta-regression exhibited that the sample size, publication year, age, design study, and place showed no significant effect on heterogeneity (P > 0.05). This review found a significant prevalence of Stevens-Johnson syndrome (SJS) linked to antiepileptic drugs (AEDs) at 23.22%.

Conclusions: Clinicians should be cautious when prescribing AEDs, especially to high-risk populations. More research is needed to understand SJS mechanisms and identify genetic markers for personalized treatment approaches.

Background: Family-based digital interventions have been shown to be effective in helping children and families adopt healthier lifestyles. This study aims to assess the efficacy of virtual educational programs in promoting lifestyle modification, with a focus on improving dietary habits, increasing physical activity, and reducing tobacco use among families in Isfahan, Iran.

Methods: This study was carried out in two stages from 2023 to 2024. The initial phase involved a comprehensive review of the existing literature, alongside consultations with health experts, to standardize and develop intervention programs tailored to the cultural context of Iranian society. The second phase was a randomized intervention survey conducted in parallel and double-blind (participants and statistics specialist) manner in two groups. Eligible participants included families registered at health centers, with at least one child aged 6-15 years and access to the internet and electronic devices. Participants were randomly assigned to either the intervention or control group. In the intervention group, each family member received virtual educational content via a website or mobile app. The program was delivered weekly for the first 8 weeks, followed by biweekly sessions for the next 8 weeks. The content focused on improving dietary habits, increasing physical activity, and reducing tobacco use and smoking exposure. The control group received no educational interventions but was given access to the recorded sessions after the study concluded. Participants were followed up at 2- and 6-month post-intervention.

Results: The primary outcomes include changes in body mass index (BMI), physical activity levels in both children and parents, dietary habits, smoking status, and exposure to indoor air pollutants. Conclusions: The rigorous design, incorporating cultural adaptation and a double-blind randomized controlled trial with follow-up assessments, provides a strong methodological framework for evaluating the effectiveness of virtual health interventions in a specific cultural context.

Background: This study's objective was to assess the adverse events (AEs) of rituximab (RTX) therapy in people with multiple sclerosis (pwMS).

Methods: This observational study was conducted on clinical data of pwMS who visited an MS center in Iran from January 2015 to January 2018 and underwent RTX therapy. The primary efficacy outcomes assessed were disability progression and the annual relapse rate. Initially the patients received 2 g of RTX (Zytux AryoGen Pharmed Company Iran) delivered in four 500-mg doses via an intravenous line each of which took 6 hours to avoid unwanted reactions. Afterward two 500-mg doses of RTX were administered every 6 months. we administered each dose within 4-6 hours to minimize unwanted reactions.

Results: A total of 307 RTX-treated patients were included in the study. Around 75.2% of patients were female. The mean (standard deviation (SD)) age was 37.9 (9) years, and the mean (interquartile range (IQR)) disease duration was 7 (7) years. During treatment, the Expanded Disability Status Scale (EDSS) remained unchanged for patients with shorter disease duration (<3 years), and it was significantly improved for patients with longer disease duration (>3 years, P value = 0.015). Around 39.4% of the patients had at least one side effect, most of which were minor infections of the urinary and respiratory tract, all mild in nature.

Conclusions: RTX treatment is well-tolerated and safe, with a minor risk of mild infusion reactions and minor side effects for MS patients.

Background: Opium users are at risk of lead poisoning. Therefore, this study aimed to compare opium users with healthy controls in terms of blood lead levels (BLLs), blood biochemistry, and liver function tests.

Methods: A total of 100 people participated in the study. Biological samples (blood and urine) obtained from participants were prepared before analysis for the detection of opium alkaloids (morphine, codeine, papaverine, noscapine,…), amphetamine-type stimulants, and other licit and illicit drugs. Atomic absorption spectroscopy was used to calculate BLLs. We evaluated biochemical parameters and function tests. All statistical analysis was performed by using SPSS. In addition, biochemical parameters and liver function tests were evaluated.

Results: The BLLs of opium addicts living in Tehran and healthy controls were 18.8 and 7.1 g/dL, respectively. A strong correlation was observed between the route of opium consumption and the average amount of BLL ± SEM (P = 0.037). As compared with the control group, opium users showed a statistically significant (p 0.001) association between the serum levels of the enzyme's aspartate aminotransferase, gamma-glutamyl transferase, lactate dehydrogenase, alanine aminotransferase, alkaline phosphatase, and total bilirubin and an increase in white blood cell and hematocrit levels.

Conclusions: Results of the present study showed that opium users had elevated BLLs in comparison to the control group, which profoundly affected biochemical parameters and liver enzymes.

Background: Infection prevention and control (IPC) is a major component of health systems and affects both the health and safety of people who use health services and those who provide them. The Infection Prevention and Control Assessment Framework (IPCAF) is a tool for the assessment of IPC in healthcare centers.

Methods: In the present study, we examined the hospitals of Tehran from this point of view.

Results: Thirty-one hospitals were examined through IPCAF form. All the data were analyzed in SPSS version 25. Twenty-three centers (74.1%) were at the advanced level; 7 centers (22.5%) were at the intermediate level and only one center (3.2%) was at the minimum level. The lowest score was related to the field of education. There was no significant difference between private and public hospitals in terms of IPC score (P > 0.05).

Conclusions: Hospitals of Tehran are at advanced level in terms of IPC, and the lowest score is related to the field of education, which needs more investigation and effort to improve it.

Background: The effectiveness of warning labels on tobacco products in conveying health risks and promoting smoking cessation has been extensively studied. However, with the rise in electronic cigarette (E-cigarette) usage, there is a need to assess the impact of warning labels specifically tailored to this emerging market. This study aims to fill this gap by examining the effectiveness of warning labels on E-cigarette packaging in influencing smokers' perceptions and intentions to quit.

Method: A laboratory experiment was conducted, involving 180 participants comprising both conventional smokers and E-cigarette users. There are three experimental designs used in this research, which are subjected to conventional smokers and E-cigarette smokers. Participants were randomly located within each of the six cells. Each cell was given a different stimulus.

Results: The study revealed that warning labels on E-cigarette products significantly influenced participants' perceptions and intentions to quit smoking. Specifically, E-cigarette users perceived packaging with warning labels differently from those without. Moreover, visual warning labels were found to be more effective than textual ones in eliciting perceptions and intentions to quit smoking.

Conclusions: These findings underscore the importance of warning labels in conveying health risks and promoting smoking cessation intentions among E-cigarette users, offering valuable insights for public health strategies.

This study compares muscle damage levels in individuals with and without the ACTN3 R577X polymorphism after engaging in aerobic or strength exercises. A systematic review was performed using articles from PubMed, SciELO, ScienceDirect, Cochrane Library, Medline, and Lilacs. The keywords were "muscle damage" and "muscle injury" combined with "ACTN3," "R577X," and "alpha-actinin-3," following the guidelines of the Preferred Reporting Items for Systematic Reviews (PRISMA). A total of 421 articles were identified, of which 10 were considered eligible. In total, 411 individuals were investigated considering all studies included in this review. Of the five studies with strength exercises, four found no differences between genotypes post exercise. On the contrary, of the five studies that evaluated muscle damage in aerobic exercise, three (that monitored this aspect in long-duration and strenuous sporting events: marathon, half ironman, and ultra-endurance adventure race) observed that individuals with the ACTN3 R577X polymorphism presented higher levels of muscle damage (measured by creatine kinase, myoglobin, and lactate dehydrogenase). To conclude, the ACTN3 R577X polymorphism can make an individual more susceptible to muscle damage after more high-volume aerobic exercise. As far as strength exercises are concerned, such a relationship does not appear to be observed. In this sense, individuals with this polymorphism require a longer recovery time from aerobic training sessions with long duration, as well as specific strategies for distributing training throughout the week.