Iranian Journal of Public Health最新文献

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.

Background: Air pollution is one of the major environmental risk factors for health. Children are vulnerable to the negative health consequences of air pollution. We aimed to determine the effect of PM10 levels on postneonatal mortality in Istanbul, the most populous city in Türkiye.

Methods: In this cross-sectional study, the relationship between PM10 levels and postneonatal deaths occurring in Istanbul, Türkiye in 2015-2019 was examined. PM10 levels for Istanbul were calculated by taking the average of daily PM10 measurements between 01.01.2015 and 31.12.2019, made available from Istanbul Air Quality Monitoring Stations. Data were analyzed using Microsoft Office Excel 2016 and AIRQ+ 2.2.3 software.

Results: If the PM10 value in Istanbul province had been reduced to 20 μg/m³, the limit value recommended by the WHO; in 2019; 36(19-61) postneonatal infant deaths could have been prevented; 7.73% (3.98-12.95) of postneonatal infant deaths were attributed to PM10. During this period, the PM10 value in Istanbul was above the limit value recommended by WHO, the European Union and Turkish legislation.

Conclusion: Infant mortality due to air pollution is an important public health problem.

Background: In the present review, we carried out a systematic review and meta-analysis to analyze possible lymph node metastasis (LNM) hazards in individuals with endoscopic resection of gastric cancer.

Methods: Relevant literature was selected by evaluating the PubMed, Cochrane Library, and Google Scholar electronic databases since from inception to March 2022. Corresponding clinicopathological outcomes were summarized, and pooled log odds ratios and 95% confidence intervals were assessed. The random effect model was preferred if variations among studies is high otherwise fixed effect model was preferred.

Results: Overall, 12 associated papers, including 4808 early gastric cancer individuals who endured more surgery after noncurative endoscopic resection, were entered into this analysis. The outcomes showed that submucosal invasion (log odd ratio 1.75, 95% (CI): 0.77-3.95, I² = 80.0%); vertical margin (log odd ratio 6.53, 95% (CI): 2.81-15.17, I² = 65%); horizontal margin (log Odd ratio 0.69 95% (CI): 0.22-2.14, I² = 52%), lymphatic invasion (Odd ratio 6.33 95% (CI): 1.98-20.24, I² = 91%), and vascular invasion (Odd ratio 3.55, 95% (CI): 1.31-9.58, I² = 92%) was significantly related to metastasis of lymph node for these patients.

Conclusion: There was a significant association of LNM hazards in individuals with endoscopic resection of gastric cancer. Therefore, invasion to lymph, vascular, submucosa and positive vertical margin should be strongly noticed when selecting surgical treatment factors.

Background: We aimed to assess the likelihood of cause-specific death and other causes of death after gastrectomy for gastric cancer (GC). Additionally, a competing-risk nomogram was developed for patient counseling and decision-making.

Methods: Eligible GC patients who had gastrectomy between 2007 and 2015 were included in the study from the Surveillance, Epidemiology, and End Results (SEER) database. Death from gastric cancer and death from other causes were considered as separate competing events. Cumulative incidence functions (CIF) were calculated for each event, and a competing-risk nomogram was developed.

Results: Overall, 8,808 patients who underwent gastrectomy were analyzed. Among them, 4,659 (52.90%) died from gastric cancer and 1,284 (14.58%) died from other causes. The five-year cumulative incidence of cause-specific death for gastric cancer was 50.4%, and 10.2% for deaths from other causes. Several independent factors, such as age at diagnosis, tumor site, grade, size, lymph node examination results, pathological T status, pathological N status, metastatic status, Lauren classification, radiation, and chemotherapy, were found to be associated with gastric cancer-specific death. The nomogram, based on results from the competing risk regression model, demonstrated good performance.

Conclusion: We have developed a nomogram aimed at predicting gastric cancer-specific mortality in patients following gastrectomy. The model has undergone internal validation, demonstrating good accuracy and reliability. It serves as useful tool that can assist physicians and patients in making more informed clinical decisions.

Background: With the intensification of population aging globally, the mental health of the elderly is not only related to their personal well-being but also directly affects family harmony and social stability. However, few studies have been conducted on interventions for mental health issues in the elderly.

Methods: From September to December 2023, a total of 164 elderly individuals were recruited from Ronghui Shanshui community in Fuzhou City of China through random cluster sampling and randomly divided into the control and experiment groups. The experiment group was given a three-month intervention based on general adaptation syndrome model, whereas the control group was given no intervention. At the end of the intervention period, an effect comparison was conducted between the two groups using the Physical Activity Rating Scale, University of California at Los Angels (UCLA) Loneliness Scale, and Memorial University of Newfoundland Scale of Happiness.

Results: After the intervention, the well-being of the experiment group increases significantly and is significantly higher than that of the control group (P < 0.05). After the intervention, the loneliness of the experiment group decreases significantly and is significantly lower than that of the control group (P < 0.05). Exercise participation significantly mediates the relationship between the intervention and psychological experience (P < 0.001).

Conclusion: This intervention model is not only beneficial for improving positive psychological experience in the elderly but can also effectively reduce their negative psychological experience. This study provides valuable reference for scientific intervention in the mental health of the elderly.

Background: We aimed to explore the prediction value of disulfidptosis-related long noncoding RNAs (lncRNAs) on the prognosis and immunotherapy efficiency of patients with head and neck squamous carcinoma (HNSCC).

Methods: Clinical and RNA-seq information were collected from The Cancer Genome Atlas (TCGA) and Genome Data Sharing (GDC) portal. The Pearson correlation analysis, univariate COX regression analysis, the least absolute shrinkage and selection operator (LASSO) COX regression were employed to construct the disulfidptosis-related lncRNAs (DRLs) prognostic model. The Kaplan-Meier survival curve, principal component analysis (PCA), receiver operating characteristic (ROC) curves and areas under the curves (AUCs) were used to examine the accuracy of the prognostic model. ssGSEA, mutation and functional and gene set enrichment analysis was performed to quantify the immune cell infiltration, immune function and functional enrichments. Finally, the mRNA expression of the DRLs was verified by real-time PCR (RT-PCR) in HNSCC cells.

Results: A new DRLs prognostic model (AC083967.1, AC106820.5, AC245041.2, AL590617.2, AP002478.1, and VPS9D1-AS1) with an independent prognostic value of HNSCC patients was successfully identified. In addition, the DRLs prognostic model was related with immune signature and drug therapy response. Meanwhile, the mRNA expression level of the 6 DRLs detected by RT-PCR was consistent with the results of bioinformatic analysis.

Conclusion: We developed a new DRLs prognostic model of HNSCC, which could effectively predicate the prognosis and therapy response of HNSCC patients and provide insights into personalized therapeutics.