Iranian Journal of Public Health最新文献

Background: A meta-analysis study was conducted to measure how to forecast the effect of treatment of hypokinetic dysarthria in Parkinson's-disease with speech and language therapy.

Methods: Until October 2024, a comprehensive literature research was conducted, and 1665 related studies were reviewed. The 14 selected studies encompassed 948 participants with hypokinetic dysarthria in Parkinson's disease. The odds ratio (OR) mean difference (MD) and 95% confidence intervals (CIs) were used to look at the outcome of treatment of hypokinetic dysarthria in Parkinson's disease with speech and language therapy using dichotomous or continuous methods with a fixed- or random-effects model.

Results: In individuals with hypokinetic dysarthria in Parkinson-disease, speech and language therapy had significantly higher sound pressure level, phonation (MD, 7. 51; 95% CI, 3. 81-11. 20, p<0. 001), reading (MD, 8. 83; 95% CI, 4. 96-12. 69, p<0. 001), monologue (MD, 4. 28; 95% CI, 2. 47-6. 10, p<0. 001), and picture description (MD, 3. 64; 95% CI, 1. 78-5. 50, p<0. 001), and lower Voice Handicap Index (MD, -5. 61; 95% CI, -9. 05- -2. 17, p=0. 001) compared to control treatment.

Conclusion: In individuals with hypokinetic dysarthria in Parkinson's disease, speech and language therapy had significantly higher sound pressure level, phonation, reading, monologue, and picture description, and lower Voice Handicap Index compared to control treatment. To validate these finding more studies are required, caution is needed when interpreting these results, since many comparisons had a limited number of selected studies.

Background: This study aimed to evaluate the efficacy and safety of intravenous immunoglobulin (IVIG) therapy for recurrent miscarriage (RMC) using meta-analysis.

Methods: Literature from Jan 1990 to Feb 2024 was searched in PubMed, etc., using keywords such as "IVIG", "repetitive miscarriage", and "RMC". Two authors independently assessed the literature quality and risk of via Cochrane handbook, and extracted basic information and outcome indicator data. Meta-analysis was performed employing Review Manager 5.3.

Results: Eleven studies were involved, comprising 842 patients, of which 391 received IVIG therapy and 451 received placebo treatment. Relative to placebo group, IVIG group had a notably higher overall live birth rate (OR=2.24, 95% CI=1.68~2.98, Z=5.51, P<0.00001) and a greatly lower miscarriage rate (OR=0.46, 95% CI=0.22~0.95, Z=2.09, P=0.04). Subgroup analysis revealed that both primary and secondary RMC patients in IVIG group had markedly higher live birth rates versus placebo group (OR=2.13, 95% CI=1.18~3.83, Z=2.51, P=0.01; OR=1.50, 95% CI=0.98~2.30, Z=1.96, P=0.04). Nevertheless, the adverse reaction (AR) rate in IVIG group was superior to that in placebo group (OR=4.47, 95% CI=1.01~19.81, Z=1.97, P=0.05).

Conclusion: IVIG can markedly increase the live birth rate, reduce the miscarriage rate, and enhance pregnancy outcomes in patients with RMC. Nevertheless, the rate of ARs with IVIG therapy is relatively high, thus large-scale, multicenter, randomized controlled trials are needed for validation.

Background: This study investigates the role of exosomal integrin beta-2 (ITGB2) from triple-negative breast cancer (TNBC) cells in modulating immune responses, with a focus on its interaction with Toll-like receptor 4 (TLR4) in dendritic cells (DCs). This study aimed to understand how ITGB2 contributes to the immunosuppressive tumor microenvironment in TNBC.

Methods: ITGB2 expression in TNBC tissues and cell lines was analyzed using qPCR and Western blot at the Affiliated Cancer Hospital of Xinjiang Medical University between 2013 and 2015. Knockdown and overexpression models of ITGB2 were established in MDA-MB-231 cells to explore their effects on TLR4 expression in DCs. Exosomes were isolated from these cells, and DCs were co-cultured with exosomes to measure TLR4 expression and cytokine secretion using flow cytometry and ELISA.

Results: ITGB2 was overexpressed in TNBC tissues, correlating with poor prognosis. Exosomal ITGB2 from TNBC cells suppressed TLR4 expression in DCs, leading to impaired DC maturation and reduced cytokine secretion, thus promoting an immunosuppressive microenvironment.

Conclusion: Targeting the ITGB2-TLR4 axis could enhance anti-tumor immunity in TNBC. ITGB2 holds potential as a biomarker and therapeutic target, suggesting that inhibition of exosomal ITGB2 or restoration of DC function may improve therapeutic outcomes in TNBC.

Background: Perioperative care plays an unparalleled role in the management of strabismus. However, there is still a lack of adequate understanding of the perioperative care and guidelines on nursing measures for strabismus surgery. This article provides a comprehensive review of perioperative care for strabismus, focusing on psychological intervention and rehabilitative nursing.

Methods: To comprehensively collect research related to perioperative nursing, we employed a systematic literature retrieval strategy. The databases searched included PubMed, EMBASE, Web of Science, CNKI (China National Knowledge Infrastructure), WanFang, and VIP (Weipu). We read, summarized and review the literatures obtained from databases.

Results: We summarized the conclusions in the retained literature and elaborated from two aspects: Psychological intervention and Rehabilitation Nursing. Psychological intervention can be carried out from the following aspects: cognitive behavior intervention, psychological and emotional intervention, social support intervention. Perioperative rehabilitation can be carried out from the following aspects: postoperative nausea and vomiting management, prevention of postoperative infection, visual care, preventing recurrent strabismus post-surgery, avoiding diplopia.

Conclusion: Comprehensive perioperative care for patients with strabismus can alleviate negative emotions, improve psychological status, reduce the incidence of postoperative complications, and enhance patients' quality of life. However, further research is still needed to establish detailed intervention strategies for comprehensive care.

Background: This article aimed to compare the value of infection related critical illness scores in predicting the risk of death in infected patients, and evaluate the predictive accuracy of three scoring indicators: SOFA score, APACHE II score, and NEWS score.

Methods: Through the established retrieval strategy, the relevant literature from January 2013 to December 2023 were searched on platforms such as CNKI, Wanfang, PubMed, Embase, and Cochrane Library, eight relevant literature were included for meta-analysis. Literature screening and data extraction were conducted according to predetermined standards, using a fixed effects model for data analysis.

Results: Among the 8 included literature (References (5-12)), the ratio of mortality to survival and 95% confidence interval for SOFA scores were 1.33 and (0.98, 1.75), respectively; The APACHE II score is 2.24 and (1.58, 2.97); The NEWS score is 1.64 and (1.45, 1.85). All three scoring indicators had significant value in predicting the risk of death in infected patients. In addition, comparing the AUC of the three scoring indicators, the SOFA score had the highest AUC, followed by the APACHE II score, and showed significant differences compared to the NEWS score, with P<0.001 and P<0.05 respectively.

Conclusion: The SOFA score has higher accuracy and predictive value in predicting the condition and risk of death of infected patients. However, further attention needs to be paid to the selection of scoring methods to comprehensively consider the clinical situation and research objectives. The results of this study are helpful in guiding the evaluation and prediction of infected patients in clinical practice, and providing a basis for optimizing treatment strategies.

Background: This study aimed to provide comprehensive information on translated versions of the 9-item shared decision-making questionnaire, widely used to measure patient involvement in shared decision-making, by combining psychometric validation information.

Methods: We searched various databases such as PubMed, Scopus, Google Scholar, along with developer website to gather pertinent literature published until Feb, 2024. This psychometric validation carried out based on item characteristics, content validity, and factor analysis results of individual studies. Our evaluation was based on predetermined cut-off values for item difficulty, discrimination index, Cronbach's alpha, Kaiser Meyer Olkin factor (KMO), Bartlett's test of sphericity, and factor extraction and rotation, confirmatory factor analysis range. The European Social Research Council guidance on the conduct of narrative synthesis in systematic reviews was employed for synthesis of validation results.

Results: The final analysis included nine studies with 3090 participants from various countries, and most participants had adequate literacy, and age range was 30-60 yr. Most model versions had a good fit, and all studies reported satisfactory results, except for one study's discrimination index values. The tool's validity was satisfactory. Most of the studies reported a convenient sample was the main limitation, along with recall bias in the final responses.

Conclusion: The 9-item shared decision-making tool can be used to measure patient involvement in shared decision-making in validated language-respected countries, as proper evaluation procedures reported satisfactory results in the confirmatory analysis models and reliability testing.

Background: Suicide is an intentional act that results in the death of a person. Clinical researchers show that a new era has begun in understanding suicide pathophysiology. Our study assessed serum minerals (Fe, Mg) and vitamins (D, B12) to see if they are related to suicide attempts.

Methods: This is a cross-sectional study conducted in Ali-ebn-Abi Taleb Hospital, Rafsanjan City Central District, Kerman Province, Iran in 2022. Prior to measuring the quantity of essential minerals and vitamins in the blood, the degree of depression was assessed using the Beck depression severity scale. Chi-square, Independent T-test, Kruskal-Wallis, and Mann Whitney U test were performed to ascertain the existence of an association between these substances within the body and suicide attempts.

Results: Thirty-two attempted suicides (24 women and 8 men, mean age 14-46 yr) were included in this study. The mean and standard deviation of depression scores for 32 candidates was 16.43 ± 26.74. Moreover, our results show nearly 46.7% (50% women and 37.5% men) of participants suffer from vitamin D deficiency and 6.7% from Mg deficiency, half of them have also severe depression.

Conclusion: One of the reasons for the cause of depression and suicide attempt could be the status of minerals and vitamins in the body. Therefore, it is likely that a suitable diet and checking blood factors might help to reduce suicide attempts in a society.

Background: Increasing healthcare spending is a significant issue, with the aging population contributing to a rise in patients needing renal replacement therapy. The cost of peritoneal dialysis (PD) is substantial, particularly in upper-middle-income countries like Serbia. We aimed to identify the direct costs and influencing factors of treating peritoneal dialysis-associated peritonitis (PD associate peritonitis) in Serbia.

Methods: A retrospective observational study was conducted on consecutive patients admitted due to PD-associated peritonitis in five tertiary care hospitals across Serbia in 2019-2022. The primary outcome was total cost of hospitalization. Potential predictors were determined using generalized linear model with a gamma probability distribution and a log link function.

Results: The study included 122 patients. The average total cost per patient was 1131.90±1538.67 USD, with the cost of hospitalization (348.17 ± 361.52 USD) and antibiotics (294.94±465.88 USD) being the most significant. The length of hospitalization (P<0.001) and treatment outcome (P<0.001) were found to be significant predictors of the total cost.

Conclusion: The costs of treating PD associate peritonitis in Serbia are substantial, with each additional day of hospitalization significantly increasing the cost. The importance of patient and doctor education about infection prevention is underscored by the health consequences and the lengthy, expensive treatment when an infection occurs.