Iranian Journal of Public Health最新文献

Background: According to World Health Organisation data, on the top ten causes of death in the world in 2019, ischemic heart diseases ranked first, followed by stroke and chronic respiratory diseases. This study aimed to make cross-section of the current mortality rates of indicators of circulatory diseases, ischemic heart diseases and cerebrovascular diseases, access the trends of indicators in Serbia more than two decades and to find the correlation of these observed indicators between males and females.

Methods: Medical indicators were taken from the publicly available Health for all databases that deals with long-term evaluation and monitoring of indicators obtained from national authorities. In this epidemiological study, following indicators were analysed: indicator of standardized circulatory diseases, ischemic heart disease, and cerebrovascular diseases. SPSS was used for statistical analysis.

Results: Between 1998 and 2021 all of the mortality indicators were decreasing in Serbia. Between 2002 and 2005 observed indicators had almost constant decreasing trend. The standardized mortality for circulatory disease along with indicators for mortality from ischemic diseases and cerebrovascular disease was more prevalent among males than females.

Conclusion: Continuing the follow of indicators is of the great importance for public health and macroeconomic of countries. This decreasing trend in Serbia must remain constant and that can be effectively done through continuous improvement of health systems, focusing on the primary health care and conducting pharmacoeconomic studies and epidemiological studies.

Background: Phlebotomy has been used as a non-pharmacological treatment for different types of diseases, regarding the philosophy of humors in traditional medicines, such as Persian Medicine. However, according to the narrow-approved indications for phlebotomy in Western Medicine, we aimed to systematically summarize high-level of evidence on safety and efficacy of phlebotomy in treatment of human diseases.

Methods: In this umbrella review, to identify meta-analysis studies of clinical trials on phlebotomy, four electronic databases, including PubMed, web of science, Scopus, and Cochran library were searched until Jun 18, 2022 with relevant keywords for 'phlebotomy' and 'meta-analysis' according to PRISMA guidelines and PICO questions. After excluding irrelevant studies, data on subject characteristics, method of intervention, and adverse events were extracted. To evaluate the quality of the methodology of the systematic reviews, AMSTAR2 scale was utilized.

Results: From 327 identified studies, 7 full texts met the inclusion criteria, consisting of 56 clinical trials on 5648 subjects. These meta-analysis studies reported effects of phlebotomy on hypertension, acute gouty arthritis, skin disease (chronic urticaria and porphyria), and liver diseases (non-alcoholic fatty liver disease, chronic hepatitis C, and liver surgery). Our results showed significant improvements in different outcomes, while the most common adverse event was hematoma.

Conclusion: The level of evidence on the efficacy and safety of phlebotomy in some specific health conditions was substantial; however, to investigate the efficacy and safety of phlebotomy in management of other health problems more clinical studies with high sample sizes are needed.

Background: Salivary compounds can be used as diagnostic markers for changes in the oral cavity that cause oral problems in type 2 diabetes mellitus (T2DM).

Methods: This meta-analysis searched PubMed/Medline, EMBASE, Scopus and Cochrane Library, and the Web of Science until Nov 2023. The observational studies included patients with T2DM and healthy controls aged > 18 yr with no oral health problems or systematic or periodontal diseases. The Quality in Prognostic Studies (QUIPS) tool was used to evaluate the risk of bias. The random-effects model was constructed using standardized mean differences (SMD).

Results: The meta-analysis analyzed 13 observational studies that included 519 patients with T2DM and 356 healthy controls. Non-fasting periods of 30 min to 8 h were used to measure salivary profiles. Overall, salivary proinflammatory mediators favored patients with T2DM (SMD: 1.66; CI_95%: 0.42, 2.91, P<0.01) compared with healthy subjects. Subgroup analysis revealed that interleukin-6 (SMD: 1.33; CI_95%: -0.04, 2.69, P<0.05), followed by interleukin-8 (SMD: 0.92; CI_95%: -0.71, 2.55, P<0.13), was greater in patients with T2DM than in healthy subjects. Among patients with T2DM, network analysis identified salivary factors most closely associated with male sex (i.e., tumor necrosis factor), female sex (i.e., interleukin-8), fasting plasma glucose (i.e., C-reactive protein), HbA1c (i.e., IL-8), and age (i.e., C-reactive protein).

Conclusion: Overall, salivary IL-6 levels were greater in patients with T2DM and might be considered for monitoring oral changes. Moreover, network analysis could identify different salivary components that were most closely associated with patient characteristics.

Background: The aim was to explore the relationships among employment pressure, ego depletion, negotiable fate, and recent graduates' suicidal ideation during the COVID-19 pandemic.

Methods: A total of 2703 recent graduates completed two times questionnaires that measured employment pressure, ego depletion, negotiable fate and suicidal ideation in the current study.

Results: 1) employment pressure positively predicts suicidal ideation among recent graduates; 2) ego depletion mediates the association between employment pressure and recent graduates' suicidal ideation; and 3) negotiable fate moderates the associations of employment pressure with ego depletion and suicidal ideation, while the relationships of employment pressure with ego depletion and suicidal ideation are stronger for recent graduates with a strong belief in negotiable fate.

Conclusion: Ego depletion and negotiable fate play a significant role between employment pressure and recent graduates' suicidal ideation during the COVID-19 pandemic. This still needs to be noted in the post-epidemic era.

Background: Postoperative pulmonary complications (PPCs) are associated with a higher risk of morbidity and mortality in patients undergoing cardiac surgery. We aimed to investigate the effect of preoperative interventions on PPCs and length of intensive care unit and hospital stay in patients undergoing cardiac surgery.

Methods: A systematic review and meta-analysis was conducted on randomized or quasi-randomized trials by searching PubMed, Medline, ISI Web of Science, Science Direct, Physiotherapy Evidence Database (PEDro), and the Cochrane Library for all available years until December 2023. Our primary outcomes were PPCs including atelectasis and Pneumonia and secondary outcomes were length of intensive care unit and hospital stay.

Results: Twenty-one included trials provide data on 2895 participants. The preoperative intervention of inspiratory muscle training (IMT) significantly reduced the PPCs including atelectasis (OR: 0.49, 95%CI: 0.28, 0.86) and Pneumonia (OR: 0.41, 95%CI: 0.25, 0.67) in cardiac patients compared with the control group. Preoperative exercise training intervention is significantly associated with a lower risk (OR: 0.15, 95%CI: 0.06, 0.38) of composite PPCs (i.e. atelectasis and Pneumonia) in the intervention group. Preoperative IMT significantly reduced the postoperative hospital stay by -1.57 days (95% CI: -2.33, -0.81) in the intervention group. Preoperative exercise training significantly decreased the postoperative intensive care unit stay by -2.22 hours (95% CI: -3.05, -1.38) and hospital stay by -1.82 days (95% CI: -3.38, -0.27) in the intervention group.

Conclusion: Preoperative intervention of IMT and exercise training significantly reduce PPCs and hospital stay in patients undergoing cardiac surgery.

Background: Sclerostin, a protein encoded by the SOST gene, is an important genetic risk factor for osteoporosis in postmenopausal women. This study was conducted on the Iranian postmenopausal women, to investigate the association between this gene and the Trabecular Bone Score (TBS) as a novel index used for assessing osteoporosis.

Methods: The present study, conducted in 2024, was performed on 1071 women aged 60 years and older who participated in the Bushehr Elderly Health (BEH) program. The associations between seven independent Single Nucleotide Polymorphisms (SNPs) within the SOST gene and mean TBS of L1 to L4 were examined using the additive, dominant, and recessive models. Genetic risk scores (GRS) were calculated for each postmenopausal woman based on the coefficient regressions derived from the additive and dominant models. The relationship between the GRS quartiles and TBS was evaluated using a linear regression model.

Results: After adjusting for age and Body Mass Index (BMI), the associations between the rs2023794-C and TBS were significant in the additive (β = 0.03, P= 4.7×10^-5, PFDR= 0.0003) and dominant (β = 0.032, P= 5×10^-5, PFDR= 0.0003) models. The GRS derived from both additive and dominant models were related to TBS (P<0.05). For the additive model GRS, TBS showed an average increase of 0.022 score for the fourth quartile in comparison with the first quartile, adjusted for age, BMI, type 2 diabetes mellitus (T2DM), and smoking status (P=0.001).

Conclusion: SOST gene is associated with TBS and may have implications for personalized medicine. Targeting sclerostin through SOST could offer a therapeutic approach in managing osteoporosis in high-risk postmenopausal women.

Background: Rheumatoid arthritis (RA) and osteoarthritis (OA) are prevalent chronic joint disorders with immunological pathogenesis. However, the causal relationships between circulating immune cells and them remain largely unknown. Therefore, we conducted a bidirectional two-sample Mendelian randomization (MR) study to determine their causal relationship.

Methods: Genome-wide association study summary statistics were extracted from publicly available databases regarding immune cell phenotypes, RA, and OA. MR analysis was conducted using five MR methods, with inverse-variance-weighted (IVW) as the primary analysis method. False discovery rate correction (FDR) was used to reduce the likelihood of type 1 errors. We also conducted MR-Egger intercept tests to evaluate horizontal pleiotropy.

Results: After FDR adjustment of the P values for the IVW method, the CD27 expression on memory B cells was negatively related to the risk of RA (P < 0.001), and the human leukocyte antigen (HLA)--DR expression on CD14+ monocytes was negatively related to the risk of OA (P < 0.001). We also found that RA was negatively associated with the expression of HLA-DR on myeloid dendritic cells (P < 0.001), but significant horizontal pleiotropy was observed.

Conclusion: Our study demonstrates a causal relationship between specific immune cell traits and RA as well as OA, providing further insight into the role of immune cells in the pathogenesis of these disorders.

Background: Although cyberbullying has emerged as a serious problem even among adults, most researches have been conducted on the adolescents. We aimed to verify the independent effects of cyber victimization, internet use, and the perception of cyberbullying-on-cyberbullying perpetration in South Korea adults.

Methods: The data of 1500, 20s to 50s Korea adults from the 2019 Survey on the Cyberbullying conducted by the National Information Society Agency were used.

Results: A hierarchical multiple regression analysis indicated that cyber victimization and internet use were positively related to cyberbullying perpetration. In particular, the perception of cyberbullying was negatively associated with cyberbullying perpetration.

Conclusion: This study is an early effort to verify the influence of the perception of cyberbullying-on-cyberbullying perpetration. Educating that cyberbullying is an illegal and dangerous behavior is important to prevent cyberbullying perpetration.