International Journal of Preventive Medicine最新文献

Background: Human papillomavirus (HPV) is a known risk factor for cervical cancer, and currently, primary HPV typing is recommended for screening instead of cervical cytology. However, there are limited studies on the prevalence of HPV in Iran.

Methods: This cross-sectional study evaluated the liquid-based cervical smears of 700 women with no history of HPV vaccination and cervical dysplastic disease from 2017 to 2020 in Isfahan, Iran. Here, we compare the prevalence of HPV genotypes using COBAS with Pap smear cytology results in evaluating the most appropriate cervical cancer screening test.

Results: The prevalence of HPV infection was 23.3%, including 8.7% with HPV 16/18 and 14.6% with other HR (high-risk) HPVs. In cytology reports, 8 out of 16 individuals with high-risk lesions were negative for any type of HPV; on the other hand, there were 129 HR HPV-positive patients out of 570 negative or low-risk Pap smear results.

Conclusions: It assumed that there is no superiority for HPV genotyping over cytology or vice versa in detecting high-risk patients for cervical cancer; as only 26.8% of women with HPV show abnormal cytology; and from those with normal cytology, 17.9% were positive for HR HPV.

Background: Dietary micronutrient levels can influence glucose and insulin regulation. Studies show micronutrients can have a positive effect on blood sugar control. This study aimed to investigate the relationship between blood sugar levels and dietary antioxidant minerals (Cr, Mg, Cu, Se, Zn) in children with type 1 diabetes.

Methods: This cross-sectional study was conducted on 82 children aged 3-18 with type 1 diabetes. A three-day food record was used to collect dietary information. Fasting blood sugar and 2-hour postprandial glucose were recorded by parents. Dietary data were extracted by N4. SPSS Version 27 was used for all statistical analyses.

Results: The average age of subjects was 10/3 ± 3/3 years. According to the comparison of intake amounts of antioxidant minerals based on age and sex with Recommended Dietary Allowance (RDA), most children reported enough intake. A significant positive relationship was observed between the intake of copper and 2 hours of blood sugar after breakfast (P values < 0.05). We found a significant relationship between intake of chromium, magnesium, selenium, and zinc with blood sugar levels, after adjusting for confounding variables (P values < 0.05).

Conclusions: The amount of dietary antioxidant minerals in most children was within the appropriate range compared with the RDA. There is a significant relationship between dietary antioxidant minerals (chromium, magnesium, selenium, and zinc) and fasting and postprandial blood glucose after adjusting for confounding variables.

Background: DART (Disaster Assessment of Readiness and Training program) is one of the five Disaster Risk Reduction Management Programs (DRRMP) in Primary Health Care (PHC) of Iran. The guidelines for this program have not been revised in more than 10 years. The aim of this study is to critically evaluate the current guideline.

Methods: This was A qualitative research by Focus Group Discussion (FGD) using the Eisner's educational connoisseurship and criticism model performed in Isfahan Medical Sciences University, Iran during 2024. The study population included seven experts who are familiar with the DRRMP and Eisner's model. Sampling method was purposeful and the FGD group members were selected by the researcher. Data collection was done through 1) WHO handbook for guideline development, 2) WHO Health Emergency, Disaster Risk Management Framework (H-EDRM), 3) A new framework of Primary Health Care (PHC) disaster preparedness and 4) Comparison of DART guideline with Stanford, FEMA and British Columbia household preparedness guidelines.

Results: In this study, four main categories were found in the educational criticism of the DART guideline: simplicity in design and development, lack of layout in pages and lack of user-friendly features (descriptions), sharp visual and content criticism for the minimum essential context of a guideline (interpretation), Little conformity of visual criteria and relative conformity of content criteria with global samples (evaluation).Finally, Thematic phase indicated that current guidelines do not meet the expectations of health care providers (HCPs), effective educational promotion of guidelines is needed, and adaptation to lifestyle and cultural customs and actual educational needs were also issues that could be considered.

Conclusions: Visual and content criticism based on Eisner's model showed some of the basic components of the formulation and implementation of a guideline. Modifying and revising the DART guideline based on this information and scientific processes and continuous needs assessment can create an effective result in the development of improved guidelines.

Background: This study aims to explore the efficacy of unified protocols for a transdiagnostic treatment approach in enhancing detective thinking and reflective functioning in children diagnosed with type 1 diabetes (T1D).

Methods: This quasi-experimental study involved pre- and post-tests with two experimental groups and one control group, followed by a 2-month follow-up period. Participants, T1D children aged 8-12 years old, were recruited from specialized pediatric clinics. They were randomly assigned to either experimental or control groups. The experimental group underwent a 10-session unified protocol for transdiagnostic treatment intervention, each lasting 60 minutes, with an additional 30-minute session involving mothers, conducted weekly. The control group did not receive any intervention during this period and remained on a waiting list. After completing the treatment sessions, both groups completed research questionnaires assessing detective thinking and reflective functioning in the post-test phase for comparison.

Results: The study included 30 children with T1D across two groups. Repeated measures analysis of variance revealed that unified protocols for transdiagnostic treatment significantly enhanced detective thinking and reflective functioning in children with T1D (P < 0.05). The effects of the treatment persisted during the follow-up phase (P < 0.001).

Conclusions: Integrated transdiagnostic therapy demonstrated effectiveness in improving detective thinking and reflective functioning in children diagnosed with T1D. Notably, these positive effects were sustained beyond the intervention period, indicating the treatment's potential as an efficient intervention strategy to enhance the psychological well-being of children with T1D.

Background: To provide a detailed understanding and apply a comprehensive strategy, this study examines the association between COVID-19 vaccination and cardiovascular events. We conducted a Bayesian multivariate meta-analysis using summary data across multiple outcomes including myocardial infarction, stroke, arrhythmia, and CAD, considering potential dependencies in the data. Markov chain Monte Carlo (MCMC) methods were detected for easy implementation of the Bayesian approach. Also, the sensitivity analysis of the model was done by using different priors.

Methods: Fifteen studies were included in the systematic review, with eleven studies comparing the results between the vaccine group and the unvaccinated group. Additionally, six studies were used for further analysis to compare mRNA COVID-19 Vaccines (Pfizer-BioNTech and Moderna).

Results: Bayesian meta-analysis revealed a link between vaccines and CAD risk (OR, 1.70; 95% CrI: 1.11-2.57), particularly after BNT162b2 (OR, 1.64; 95% CrI: 1.06-2.55) and second dose (OR, 3.44; 95% CrI: 1.99-5.98). No increased risk of heart attack, arrhythmia, or stroke was observed post-COVID-19 vaccination. As the only noteworthy point, a protective effect on stroke (OR, 0.19; 95% CrI: 0.10-0.39) and myocardial infarction (OR, 0.003; 95% CrI: 0.001-0.006) was observed after the third dose of the vaccine.

Conclusions: Secondary analysis showed no notable disparity in cardiovascular outcomes between BNT162b2 and mRNA vaccines. The association of COVID-19 vaccination with the risk of coronary artery disease should be considered in future vaccine technologies for the next pandemic.

Background: Early identification of high-risk patients presenting with ST-segment elevation myocardial infarction (STEMI) helps prevent complications. The shock index (SI) is a bedside risk-stratification tool used in emergency departments. In this study, we aimed to assess the SI's predictive value for prognosticating in-hospital and one-year mortality, as well as one-year major cardiovascular events (MACEs). As secondary endpoints, we assessed the age SI's performance and the influence of prehospital transport factors on SI's predictive value.

Methods: This prospective cohort study is named SEMI-CI and enrolled patients with STEMI who were referred to a cardiology hospital in Isfahan. We analyzed data on 867 patients with STEMI. Systolic blood pressure (SBP) and heart rate (HR) upon admission were used to calculate SI. Patients were divided into two groups based on SI, and 277 patients had SI > 0.7.

Results: In-hospital death, one-year mortality, and MACE were more prevalent in those patients presenting with SI ≥ 0.7. However, after multivariate adjustment, SI was an independent predictor of in-hospital mortality and MACE, but it was not associated with one-year mortality. Furthermore, mortality rates increased from lower to higher age groups. Among patients transferred by emergency medical services to our hospital, SI showed prognostic implications for in-hospital mortality but not for one-year mortality.

Conclusions: The current study showed that a positive SI and age SI are valuable risk-stratification tools to identify high-risk patients presenting with STEMI.

Background: To compare characteristics of patients with multiple sclerosis (MS) between cigarette smokers and non-smokers.

Methods: A case-control study was performed on patients registered in the Kashani MS center from April 2019 to April 2020 in Isfahan, Iran. In total, 136 smoker patients and 220 non-smokers participated in the study and completed the questionnaire.

Results: The frequency of male gender in the smoker group was significantly higher than in the non-smokers (64.7% vs. 15%, P < 0.001). The mean age at MS onset was 31.5 ± 9.60 years among cigarette smokers and 29.7 ± 9.47 years among non-smokers (P = 0.794). Furthermore, 80% of cigarette smokers and 64% of non-smokers had at least one relapse per year (ARR ≥1, P < 0.001). The Expanded Disability Status Scale (EDSS) of more than 4.5 was significantly higher in smokers (26.5% vs. 18%, P = 0.023). There was a relation between an EDSS of more than 4.5 and an interval between smoking initiation and disease onset (P = 0.004). Long duration of smoking was associated with a higher disability scale (16.4 ± 9.5 vs. 9.8 ± 7.3, P = 0.008). Men smoked for a longer period of time before developing MS than women (9.24 ± 10.07 vs. 4.47 ± 7.61, P = 0.002). The average daily cigarette consumption was 7.74 ± 6.65 in women and 10.84 ± 9.44 in men (P = 0.024). Duration of smoking before the onset of the disease was 4.47 ± 7.61 years in women and 9.24 ± 10.07 in men (P = 0.002).

Conclusions: Our data suggest that there is a possible relationship between disability score and the duration of smoking before the onset of MS. It also revealed that the duration of smoking can affect the progression of the disease. Further studies are suggested to confirm these findings.