Iranian Journal of Public Health

Prehabilitation Interventions for Cardiac Surgery to Prevent Postoperative Pulmonary Complications: Systematic Review and Meta-Analysis

Junhua Wang, Hui Li, Wenjuan Yan, Na Xue, Jin Yin, . Nawsherwan, Sha Yin — Sun, 13 Oct 2024 07:46:01 +0000

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.

Association of ADIPOQ Single Nucleotide Polymorphisms (SNPs) with Obesity Risk in Different Populations: A Systematic Review and Analysis

Nurgul Sikhayeva, Akmaral Nursafina, Aidana Satayeva, Talgat Utupov — Tue, 15 Oct 2024 04:12:13 +0000

Background: Thirty-two single nucleotide polymorphisms (SNPs) are commonly found in ADIPOQ. APN levels are decreased in obesity, and SNPs of the ADIPOQ gene affecting APN have varying associations with the development of obesity in different populations. This systematic review and meta-analysis aimed to investigate the association of SNPs in ADIPOQ with the risk of obesity development in various populations.

Methods: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist date up to Feb 2023. We used the Newcastle–Ottawa scale to find out if a study fit the main criteria for submission and to assess the data quality of the articles included in the systematic review and meta-analysis. Odds ratios (OR) and 95% confidence intervals (CI) were calculated via Review Manager (RM) V.5.4 to estimate the connection between ADIPOQ polymorphic qualities of a gene and the risk of developing obesity.

Results: The present study analysed the association between ADIPOQ polymorphisms (rs1501299, rs2241766, rs266729, rs822393, and rs822396) and obesity risk and suggested that APN is partially responsible for the emergence of obesity and increases its risk.

Conclusion: It is important to take into account several limitations of this meta-analysis when evaluating the findings. First off, even though we looked through numerous databases for all relevant papers, there is a chance we overlooked some. Our capacity to arrive at more firm conclusions was further hampered by the small number of papers that made up our meta-analysis. The most current data, however, are presented in this study since it used newly published data to perform a meta-analysis and evaluate the relationship between ADIPOQ polymorphisms and obesity.

Lymph Node Metastasis and its Risk Factors for Early Gastritis Individuals Who Underwent Noncurative Endoscopic Resection: A Systematic Review and Meta-Analysis

Na Xu, Yuejun Zhang, Xiaoxia Ma, Wei Meng — Tue, 15 Oct 2024 04:16:31 +0000

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.

The Benefits and Applications of Lactobacillus plantarum in Food and Health: A Narrative Review

Davood Zare, Hadis Aryaee, Saeed Mirdamadi, Faezeh Shirkhan — Tue, 15 Oct 2024 04:43:04 +0000

Lactobacillus plantarum is a type of gram-positive lactic acid bacteria. This bacterium is considered a safe probiotic and, many applications and benefits including prolonging food shelf-life, enhancing antioxidant activity, improving food flavor characteristics and antimicrobial activities in the food industry, and application as a potential starter for dairy products have been attributed to it. Various studies have also emphasized its health-giving properties. As a result, the features and wide application of this bacterium, as well as the safety of L. plantarum and its strains, have made it a popular probiotic in the food and medical industries. Thus, in the present study keywords including L. plantarum and Lactiplantibacillus plantarum along with application, benefits, food, health, anti-oxidant, anti-diabetic, anti-obesity, anti-inflammatory, antiviral, and anti-depression were searched in databases of PubMed, Scopus, Web of Science, Sience direct and Google Scholar with no time restriction. Then, important features, benefits, and uses of L. plantarum were categorized and discussed. The ability of L. plantarum on the food such as prolonging food shelf-life, enhancing antioxidant activity, improving food flavor characteristics and antimicrobial activities in the food industry, and as a potential starter for dairy products is effective. In addition, several studies have emphasized of L. plantarum health-giving properties

Evaluation of Reporting Quality of Systematic Reviews on Health Economic Evaluation Studies Based on the CHEERS Statement: An Overview of Reviews

Fakhraddin Daastari, Maryam Tajvar, Amin Mohammadi, Badriyeh Karami — Tue, 15 Oct 2024 04:50:44 +0000

Background: Economic evaluations in healthcare are designed to inform decisions by the estimation of cost and effect trade-off of two or more interventions. We aimed to evaluate the standards of systematic reviews on health economic evaluation studies using the CHEERS (Consolidated Health Economic Evaluation Report Standards) tool.

Methods: We searched the PubMed database with keywords CHEERS and its complete form in combination with keywords related to cost or economic evaluation without language and time limits until November 17, 2021. The CHEERS tool was then used to include systematic reviews.

Results: Overall, 32 systematic reviews, included 610 primary studies were included. Of the 32 included studies, only 1 study (3.1%) had poor quality, 5 studies (15.6%) had good quality, remaining studies had very good and excellent quality.

Conclusion: Some studies still have problems in expressing the standards. The necessity of standards for reporting economic evaluation studies in the field of health is very serious, and Cheers is one of the most important tools.

Implementation of the Package of Essential Non-Communicable (PEN) Disease Interventions in Low-Resource Settings: A Systematic Review

Mina Aminpour, Aidin Aryankhesal, Asgar Aghaei Hashjin, Hamid Pourasghari — Tue, 15 Oct 2024 04:56:11 +0000

Background: To deal with the rising prevalence and death rate of non-communicable diseases, the WHO designed a package of essential interventions for non-communicable diseases for low- and middle-income countries. This review aimed to identify the barriers and facilitators of the implementation of this program.

Methods: The electronic databases of PubMed, Scopus, Web of Science, Cochrane Library, and Scientific Information Database (SID) were searched for papers without a time limit at the end of Dec 2020. Only English and Persian languages were considered. The PRISMA guideline was consulted.

Results: Overall, 15 articles were selected for the final analysis out of 404 initially retrieved ones, based on inclusion/exclusion criteria and quality assessment. Thirteen articles had good quality, while 2 articles were of fair quality. Studies were published during 2014-2020. Thematic analysis was used to make sense of papers so that barriers and facilitators were categorized within 2 main themes and 7 sub-themes. Certain organizational factors including human resources, service delivery, structure, leadership/governance, data and information, resources, and financing were identified as barriers and facilitators. Knowledge and culture, and economic and social factors were identified as contextual factors.

Conclusion: By considering the factors identified in this study, policymakers and health system managers can be more successful in implementing this WHO PEN and similar packages.

Assessment of the Effect of Community-Based Health Insurance Scheme on Health-Related Outcomes in Ethiopia: A Systematic Review

Abraham Gebrehiwot Yihdego, Maryam Tajvar, Ali Akbari Sari — Tue, 15 Oct 2024 04:58:56 +0000

Background: We aimed to review the effect of community-based health insurance on health-related outcomes in Ethiopia.

Methods: A systematic review was undertaken utilizing a major relevant published literature review from September 2017 to June 15, 2023. PubMed, Scopus, Web of Science, Science Direct, Google Scholar, Semantic Scholar, EMBASE, ProQuest, Hinari, and the Cochrane Library were used to search for relevant literature. Moreover, the Prisma flow model was used to select eligible findings.

Results: Overall, 72% of the articles employed cross-sectional comparative study designs and procedures, and 36% of them employed samples ranging in size from 501 to 1000 participants. Furthermore, 76% were studied using descriptive statistics and logistic regression, whereas fewer utilized a random model, a probity model, or a correlation model. Similarly, 32% of the research used two-stage stratified sampling methods, and around 40% of the data revealed that the scheme increased healthcare utilization services. About 72 % of the reviewed study results showed that the scheme reduced catastrophic health expenditure and increases utilization of healthcare services. And the 20% reviewed studies stated that the CBHI boosts household satisfaction level. Moreover 12% of the reviewed studies stated that, CBHI increased QoL (quality of life).

Conclusion: Most of the studies provide evidence of the positive effect of CBHI in Ethiopia. Mainly, its membership improved the utilization of health services and decreased the incidence of catastrophic health expenditures. Thus, all actors should cooperate to strengthen it to solve the effective attribute of the deprived value of health care and continuity of care delivery system related to the country's new policy.

Socioeconomic and Health Characteristics as Predictors of Social Support in Elderly People with Visual Impairment: Evidence from Serbia

Tue, 15 Oct 2024 05:06:45 +0000

Background: Social networks and support have an independent and strong influence on health and quality of life at all stages of the life cycle, especially in the elderly. We aimed to determine the level of social support among the elderly population of the Republic of Serbia.

Methods: The survey is part of the fourth Health survey of the population of Serbia, which was conducted in 2019 by the Republic Institute of Statistics with the Institute for Public Health of Serbia "Dr. Milan Jovanović Batut" and the Ministry of Health of the Republic of Serbia. The research instrument was standardized questionnaires constructed in accordance with the European Health Interview Survey (EHIS, wave3) and the social support score (Oslo-3 Social Support Scale). For the purposes of this research, data on the population aged 65 and over were used.

Results: In terms of social support, 85.8% of respondents had bad , 13.9% moderate and 0.3% strong. Univariate regression analysis determined that respondents from the territory of Vojvodina had a 1.6 times higher chance of poor social support compared to respondents from southern and eastern Serbia. The probability of bad social support was 1.5 times higher in persons who were never married/cohabiting, persons with secondary education were at 1.6 times higher risk of poor social support compared to persons with higher education. Inactive persons had poor social support 1.4 times more often than employed persons, as well as persons with comorbidities (OR=1.218).

Conclusion: These researches are of great importance for public health because it provides valuable data for the creation of interventions that will intensify activities related to providing adequate social support to the elderly.

MiR-21-5p Promotes Osteogenic Differentiation and Calcification of Valvular Interstitial Cells by Targeting TGFBI in Calcific Aortic Valve Disease

Tue, 15 Oct 2024 05:14:22 +0000

Background: Calcific aortic valve disease (CAVD) is the most common heart relating disease with high morbidity and mortality, especially in elderly population. While extensive investigations have been devoted to the study of mechanistic pathways related to CAVD, the key factors and mechanisms mediating valve mineralization remain unclear. The aim of this study is to investigate the role of mirnas and their downstream targets in CAVD disease progression. A previous recent multi-omics study suggested a novel CAVD molecular interaction network contained miR-21-5p.

Methods: CAV and their pair-matched adjacent normal tissues were obtained from 15 patients pathologically diagnosed as CAVD and admitted in Yancheng Third People's Hospital (The Sixth Affiliated Hospital of Nantong University) from 2019-2021. RT-qPCR was utilized for detection of miR-21-5p and related protein expression levels to confirm the related factors in CAVD progression. Western blotting was applied to strengthen the results of RT-qPCR and confirm osteogenic differentiation of VICs via biomarker detection. The staining of alkaline phosphatase (ALP) and alizarin red was performed to assess the degree of VIC mineralization.

Results: We found that miR-21-5p was remarkably increased (P<0.0001) in calcified aortic valves (AVs) whereas TGFBI was diminished (P<0.01) in CAVD samples compared to the paired normal tissues from CAVD patients. Additionally, TGFBI was targeted by miR-21-5p. Furthermore, overexpressing TGFBI could block VIC osteogenic differentiation mediated by miR-21-5p. To sum up, miR-21-5p promotes VIC osteogenic differentiation and calcification via TGFBI in CAVD progression.

Conclusion: Our work might bring a sight on underlying mechanisms of CAVD progression and provide a possible therapeutic target for diagnosis and treatment.

The Influence of Cyber Victimization, Internet Use, and Perception of Cyberbullying-on-Cyberbullying Perpetration among Korean Adults: A National Sample-Based Study

Se-Ri Park, Sung-Man Bae — Tue, 15 Oct 2024 05:22:23 +0000

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.

4-Methyl-N-(Piperidin-1-Ylmethylene) Benzenesulfonamide (PMSA) Promotes Ferroptosis of Tumor Cells by Targeting the KEAP1-NRF2-GPX4 Axis

Bingchun Sun, Guangyu Zhao, Ligang Zhang, Jianji Hou, Binhua Wu — Tue, 15 Oct 2024 00:00:00 +0000

Background: We aimed to investigate the effect of 4-methyl-N-(piperidin-1-ylmethylene) benzenesulfonamide (PMSA) on tumor cell proliferation, migration, ferroptosis, and the potential molecular mechanism of ferroptosis in tumor cells.

Methods: PMSA was produced in the marine biomedical research institute of Guangdong Medical University (Zhanjiang, China) and used for tumor cells treatment. MTT and cell colony formation assays were used to measure the inhibition of tumor cell proliferation, the scratch assay was used to identified the suppression of tumor cell migration, the death of tumor cells was measured by Annexin-V-FITC/PI staining, the level of ferroptosis-relative lipid ROS in tumor cells was measured by flow cytometry and MDA detection kit, and the expression of ferroptosis-relative protein was measured by Western blot. The Discovery Studio system was used for molecular docking and the binding ability was measured by cellular thermal shift assay.

Results: The PMSA we produced inhibited tumor cell proliferation, colony formation, migration and triggered cell death, and Fer-1 could reverse these effects. The amount of ROS and MDA levels in tumor cells was also markedly raised by PMSA. PMSA treatment significantly reduced the expression of SLC7A11/XCT, NRF2, and GPX4 in tumor cells. The phosphorylation level of NRF2 was also decreased. Through molecular docking, it was discovered that PMSA could bind to NRF2 and thereby block its activity.

Conclusion: The KEAP1-NRF2-GPX4 axis was the target of PMSA’s anti-tumor action, which results in ferroptosis of tumor cells. This demonstrated that the compound has the potential to be used as a candidate for anti-tumor drugs.

The Effect of PM10 Pollutant Levels on the Postneonatal Mortality Rate: Application of the AirQ+ Model in Istanbul, Türkiye

Sumeyye Nur Aydin, Ugurcan Sayili, Busra Kara, Gunay Can — Sat, 19 Oct 2024 04:45:23 +0000

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.

Effect of an Exercise Intervention Based on General Adaptation Syndrome Model on Psychological Experience in Community-Dwelling Elderly

Liping Dai , Bingjin Su , Kun Ma — Sat, 19 Oct 2024 04:47:56 +0000

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 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.

Causal Relationships between Circulating Immune Cell Traits and the Risk of Rheumatoid Arthritis and Osteoarthritis: A Bidirectional Two-Sample Mendelian Randomization Study

Sat, 19 Oct 2024 04:54:39 +0000

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.

Evaluation of Mortality Statistics in Turkey from 2017 to 2022: An Analysis of the Impact of COVID-19

Cemil Çelik , Uğur Ata , Naile Esra Saka — Sat, 19 Oct 2024 04:57:13 +0000

Background: Examining death statistics at regular intervals is highly useful for assessing public health. This study aimed to analyze cause-specific mortality statistics, to ascertain their distribution over the years, and to offer remedial solutions to enhance public health outcomes.

Methods: In this retrospective descriptive study, an analysis was conducted on data sourced from the "Death and Cause of Death Statistics" provided by the Turkish Statistical Institute between 2017 and 2022.

Results: While the crude mortality rate remained stable from 2017 to 2019, a discernible increase in mortality rates has been observed since 2020, attributed to the impact of the pandemic. The crude death rate was the highest in the <5 yr and ≥65 yr age groups. Approximately 70% of the total mortality cases in Turkey were attributed to cardiovascular diseases, cancers, respiratory diseases, and diabetes.

Conclusion: Given the world's rapidly aging population, an increase in deaths related to the four major noncommunicable diseases is foreseen. Therefore, there is an imperative need to enhance efforts aimed at preventing and controlling these diseases.

Identification and Verification of a Novel Disulfidptosis-Related lncRNAs Prognostic Signature to Predict the Prognosis and Immune Activity of Head and Neck Squamous Carcinoma

Zi Yin , Jue Wang , Changqing Zhu , Chenli Xu , Juan Fang , Qiaoqin Li — Sat, 19 Oct 2024 05:15:26 +0000

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.

Impact of Acne on the Quality of Life of Adolescents in the Territory of the Northern and Southern Regions of Montenegro

Sat, 19 Oct 2024 05:23:16 +0000

Background: Acne vulgaris is a chronic inflammatory disease predominantly known as a disease of adolescents. We aimed to assess the quality of life of adolescents with acne in the territory of northern and southern regions of Montenegro.

Methods: This cross-sectional study was conducted in 2024, in four secondary schools in the north and south of Montenegro with total number of 561 subjects. To assess the quality of life of adolescents with acne we used the Children's Dermatology Life Quality Index and to measure acne-related disability we used The Cardiff Acne Disability Index.

Results: The average value of the total CDLQI score among adolescents from the northern region of Montenegro was 4.45±3.31, and 4.03±3.50 among southern region. The average value of the total CADI score among adolescents from the northern region of Montenegro was 3.56±1.77, and 3.50±1.98 among adolescents from the southern region. A statistically significantly higher mean value of sub scores in adolescents from the northern region compared to adolescents from the southern region existed in the domain of symptoms and feelings, vacation and treatment (P< 0.05). The regression analysis was also performed.

Conclusion: This study confirms the negative impact of acne on the quality of life of Montenegrin adolescents, especially those in the northern region. It is necessary to give more attention to the acne problems from doctors, and to increase awareness among adolescents and provide them early and the most effective therapy.

A Predictive Model for Gastric Cancer-Specific Death after Gastrectomy: A Competing-Risk Nomogram

Lai Wang, Xiaojun Lou — Sat, 19 Oct 2024 05:28:48 +0000

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.

Maternal Fasting Plasma Glucose, Age and Body Mass Index as Prediction of Gestational Diabetes Mellitus in Iran

Sat, 19 Oct 2024 00:00:00 +0000

Background: Gestational diabetes mellitus (GDM) is a common complication of pregnancy that can lead to adverse outcomes. In this retrospective cohort study, maternal fasting blood sugar (FBS) in the second trimester of pregnancy, body mass index (BMI), and age were assessed as potential screening indicators of later GDM.

Methods: The study population included information on 4007 Iranian pregnant women documented by the Integrated Health Record System (SIB) record system (2019-2020).

Results: In the adjusted analysis, FBS maintained a significant relationship with GDM (P ≤0.001). In the simple ROC analysis, the AUC (SE) of FBS for the prediction of GDM was 0.905(0.09), and considering the cut-off point as 85.95, sensitivity (Se) and specificity (Sp) were equal to 0.81 and 0.71, respectively, but by stillbirth, abortion, prematurity, neonatal weight, height, and head circumference not obtained acceptable AUC (≥.60) for detection of FBS cut-off point. The cut-off point of FBS in the presence of maternal age (AUC>0.6) and BMI (AUC>0.6) by GDM was 83.75(Se= 86.4%, Sp= 80.0%).

Conclusion: Based on the evidence presented, maternal weight and BMI are important in predicting hyperglycemia leading to GDM. It is necessary to conduct more precise national studies to standardize the FBS cut-off point by controlling age and BMI variables.

Sclerostin as a Genetic Determinant of Trabecular Bone Score in Postmenopausal Women: The Bushehr Elderly Health (BEH) Program

Sat, 19 Oct 2024 05:50:47 +0000

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.

The Relationship between Sleep and Competitive Anxiety in Paralympic Medalists

Sang-Hyuk Park , Seung-Taek Lim — Sat, 19 Oct 2024 05:53:41 +0000