Investigation of cancers incidence relevant to radiation in Chaharmahal and Bakhtiari province during five years (1998-2002

زمینه و هدف: پرتوهای یونیزان با دوزهای پایین (پرتوهای زمینه طبیعی) یکی از عوامل شیوع برخی از سرطان ها می باشد. در کشورهای در حال توسعه مثل ایران، 94 پرتوگیری انسان از منابع طبیعی پرتو می باشد. در نواحی مرتفع همانند استان چهارمحال و بختیاری که دارای سطح اشعه زمینه طبیعی بالا (بالاتر از میانگین جهانی) می باشد، بررسی میزان شیوع سرطان های مرتبط با اشعه حائز اهمیت است که هدف این تحقیق می باشد. مواد و روشها: در این مطالعه تعداد 751 مورد بیمار مبتلاء به سرطان در مدت 5 سال (81-1377) که برابر با معیارهای ICD10 لفظ بدخیم به آنها اطلاق می شد و در این استان به ثبت رسیده بودند، مورد بررسی قرار گرفتند. از این تعداد، 362 بیمار که مبتلاء به سرطان های پوست، پستان، ریه، تیروئید و لوسمی بودند، انتخاب شدند. اطلاعاتی نظیر جنس، سن و دیگر اطلاعات لازم از مرکز بهداشت و بخش های پاتولوژی بیمارستان های استان جمع آوری گردید و داده ها توسط آزمون آماری Chi-square مورد تجزیه و تحلیل قرار گرفت. نتایج: در نتیجه این بررسی، شیوع سرطان های پوست، پستان، تیروئید، ریه و لوسمی نسبت به کل سرطان های ثبت شده به ترتیب 5/20، 5/7، 6/2، 1/1 و 2/16 تعیین گردید. از کل موارد بررسی شده 3/48 موارد مرد و 7/51 موارد زن بودند. ارتباط آماری معنی داری بین جنس و نوع سرطان ها وجود داشت (05/0

C-reactive protein: associations with haematological variables, cardiovascular risk factors and prevalent cardiovascular disease

C-reactive protein (CRP) has been proposed as a risk factor for cardiovascular disease; however, this association is confounded by mutual relationships with both classical and haematological cardiovascular risk factors. We, therefore, measured CRP with a high-sensitivity assay in stored plasma samples from 414 men and 515 women in the north Glasgow MONICA (MONItoring trends in CArdiovascular diseases) survey, to study its correlation with haematological variables, classical risk factors and prevalent cardiovascular disease. CRP correlated with age, oral contraceptive use, menopause and most classical cardiovascular risk factors (except blood pressure). CRP also correlated with plasma levels of the pro-inflammatory cytokine interleukin 6, and haematocrit, viscosity, red cell aggregation, white cell count, and coagulation factors [fibrinogen, factor (F) VII in women, FVIII, FIX] and inhibitors (antithrombin and protein C in women; protein S) but not coagulation activation markers. CRP was significantly associated with prevalent cardiovascular disease in both men (P = 0.03) and women (P = 0.009), however, the association became non-significant after adjustment for firstly classical risk factors, then fibrinogen. We conclude that correlations with classical and haematological risk factors account for a substantial component of the association of CRP with prevalent cardiovascular disease, but there is evidence of a residual, independent effect among women

Can we rely on public data as a source of information for cancer registry in developing countries?

Background/aims: Although a "hospital-based cancer registry" is important in improving patient care, a "population-based cancer registry" with emphasis on epidemiology is important in allocating health care resources and prioritizing public health programs. Because of its reliance on retrieved clinical and para-clinical documents, there is some limitation in registering all cancer incidents in this system, especially in developing countries. In this study we examined the possibility of using public data as a complementary source of information for recording cancers in a population-based cancer registry. Methods: Along with the annual census in rural areas, a survey was performed in Golestan province in March 2004 to identify public awareness about cancer incidents in the community. Individuals were questioned about history of cancer in their close relatives during the last two years. Those who reported cancer in their relatives were also asked to name the main organ of involvement. A similar list was retrieved from the cancer registry at the Ministry of Health in Gorgan, and cases with upper GI (esophagus and gastric) cancer diagnosis from 21 March 2002 through 20 March 2004 were selected for this study. Finally, these two lists were compared for examining accuracy of the collected data. Results: We included 137 cases in our study with rural residence and known addresses. Only 35 (25.5%) cases were reported by the relatives and among them only 20 (57.1%) relatives correctly reported the tumor location. Although we found a difference in accurate reporting of cancer incidents by year of diagnosis (more correct cases reported during the second versus the first year), the difference was not statistically significant between the two years. Conclusion: In this study, we examined the possibility of using public awareness about cancer incidents as a complementary source of information for a population-based cancer registry. We found that this approach is not ideal for reducing limitations. Therefore, we recommend a nationwide cancer registry to record all cancer-related information at the time of diagnosis. This strategy will reduce the need for performing retrospective surveys in collecting cancer-related information

Does sticky blood predict a sticky end? Associations of blood viscosity, haematocrit and fibrinogen with mortality in the West of Scotland

There is increasing evidence that blood viscosity and its major determinants (haematocrit, plasma viscosity and fibrinogen) are associated with an increased risk of incident cardiovascular events; however, their associations with mortality are not established. We therefore studied the associations of these variables with cardiovascular events and total mortality in 1238 men and women aged 25-64 years, followed for 13 years in the first North Glasgow MONICA (MONItoring CArdiovascular disease) survey and West of Scotland centres in the Scottish Heart Health Study. After adjustment for age and sex, increasing whole blood viscosity, plasma viscosity, haematocrit and fibrinogen (analysed by both von Clauss and heat precipitation assays) were significantly associated with mortality. Only the association for fibrinogen (von Clauss assay) remained significant after adjustment for major cardiovascular risk factors. We conclude that clottable fibrinogen may be independently associated with mortality. However, the significance of this association, and the extent to which viscosity is associated with mortality, remain to be established in larger studies and meta-analyses

Hepatitis B/C virus co-infection in Iran: A seroepidemiological study

Background/aims: As hepatitis B and C virus have the same transmission routes, dual infection may occur. The aim of this study was to determine the seroprevalence of HCV in HBsAg-positive subjects. Methods: 139 HBsAg-positive subjects were enrolled in the study. Serum samples were tested using ELISA method for anti-HCV antibodies. Chi-square and Fisher's exact tests were used to compare the proportions. Results: There were 68 (48.9%) males and 71 (51.1%) females. The mean age was 41.89±11.30 years. One case was excluded because of inadequate blood sampling. Anti-HCV antibody was positive in 17 (12.3%) of the 138 remaining subjects. Seropositivity of HCV was similar between female and male patients (p=0.69). Conclusion: The seroprevalence of co-infection with hepatitis B virus and hepatitis C virus in our study was higher than such reports from some countries (Italy), but was in line with worldwide prevalence (>10%)

False alarm reduction in critical care

High false alarm rates in the ICU decrease quality of care by slowing staff response times while increasing patient delirium through noise pollution. The 2015 PhysioNet/Computing in Cardiology Challenge provides a set of 1250 multi-parameter ICU data segments associated with critical arrhythmia alarms, and challenges the general research community to address the issue of false alarm suppression using all available signals. Each data segment was 5 minutes long (for real time analysis), ending at the time of the alarm. For retrospective analysis, we provided a further 30 seconds of data after the alarm was triggered. A total of 750 data segments were made available for training and 500 were held back for testing. Each alarm was reviewed by expert annotators, at least two of whom agreed that the alarm was either true or false. Challenge participants were invited to submit a complete, working algorithm to distinguish true from false alarms, and received a score based on their program's performance on the hidden test set. This score was based on the percentage of alarms correct, but with a penalty that weights the suppression of true alarms five times more heavily than acceptance of false alarms. We provided three example entries based on well-known, open source signal processing algorithms, to serve as a basis for comparison and as a starting point for participants to develop their own code. A total of 38 teams submitted a total of 215 entries in this year's Challenge. This editorial reviews the background issues for this challenge, the design of the challenge itself, the key achievements, and the follow-up research generated as a result of the Challenge, published in the concurrent special issue of Physiological Measurement. Additionally we make some recommendations for future changes in the field of patient monitoring as a result of the Challenge.National Institutes of Health (U.S.) (Grant R01-GM104987)National Institute of General Medical Sciences (U.S.) (Grant U01-EB-008577)National Institutes of Health (U.S.) (Grant R01-EB-001659

HBV/HCV co-infection in Iran: A seroepidemiological based study

The aim of this study was to determine the seroprevalence of HCV in HBsAg positive subjects. In a population based single stage cluster sampling in Golestan province of Iran, 139 HBsAg positive subjects were detected and enrolled in the study. Serum samples were tested using ELISA method for anti-HCV antibodies. Chi-square and Fishers exact tests were used to compare the proportions. There were 68(48.9%) male and 71(51.1 %) female. The mean age was 41.89±11.30 years (25-64 years). One case was excluded because of inadequate blood sampling. Anti-HCV antibody was positive in 17(12.3%) of 138 remaining subjects. Seropositivity of HCV in female was higher than male (14.1% versus 10.4%, respectively) but the difference was not statistically significant (p = 0.52). No significant relationship was seen between Anti-HCV seroprevalence and demographic factors such as age, place of residence and marital status. The seroprevalence of co-infection with HBV and HCV in our study was higher than such reports from some countries (Italy); but it was in line with worldwide prevalence (>10%). A careful longitudinal evaluation of the viremia levels of both HBV/HCV viruses is essential for making a correct diagnosis and tailoring the appropriate therapeutic schedule in co-infected patients. © 2006 Asian Network for Scientific Information

Genetically determined height and coronary artery disease.

BACKGROUND: The nature and underlying mechanisms of an inverse association between adult height and the risk of coronary artery disease (CAD) are unclear. METHODS: We used a genetic approach to investigate the association between height and CAD, using 180 height-associated genetic variants. We tested the association between a change in genetically determined height of 1 SD (6.5 cm) with the risk of CAD in 65,066 cases and 128,383 controls. Using individual-level genotype data from 18,249 persons, we also examined the risk of CAD associated with the presence of various numbers of height-associated alleles. To identify putative mechanisms, we analyzed whether genetically determined height was associated with known cardiovascular risk factors and performed a pathway analysis of the height-associated genes. RESULTS: We observed a relative increase of 13.5% (95% confidence interval [CI], 5.4 to 22.1; P<0.001) in the risk of CAD per 1-SD decrease in genetically determined height. There was a graded relationship between the presence of an increased number of height-raising variants and a reduced risk of CAD (odds ratio for height quartile 4 versus quartile 1, 0.74; 95% CI, 0.68 to 0.84; P<0.001). Of the 12 risk factors that we studied, we observed significant associations only with levels of low-density lipoprotein cholesterol and triglycerides (accounting for approximately 30% of the association). We identified several overlapping pathways involving genes associated with both development and atherosclerosis. CONCLUSIONS: There is a primary association between a genetically determined shorter height and an increased risk of CAD, a link that is partly explained by the association between shorter height and an adverse lipid profile. Shared biologic processes that determine achieved height and the development of atherosclerosis may explain some of the association. (Funded by the British Heart Foundation and others.)

Natriuretic peptides and integrated risk assessment for cardiovascular disease. an individual-participant-data meta-analysis

BACKGROUND: Guidelines for primary prevention of cardiovascular diseases focus on prediction of coronary heart disease and stroke. We assessed whether or not measurement of N-terminal-pro-B-type natriuretic peptide (NT-proBNP) concentration could enable a more integrated approach than at present by predicting heart failure and enhancing coronary heart disease and stroke risk assessment. METHODS: In this individual-participant-data meta-analysis, we generated and harmonised individual-participant data from relevant prospective studies via both de-novo NT-proBNP concentration measurement of stored samples and collection of data from studies identified through a systematic search of the literature (PubMed, Scientific Citation Index Expanded, and Embase) for articles published up to Sept 4, 2014, using search terms related to natriuretic peptide family members and the primary outcomes, with no language restrictions. We calculated risk ratios and measures of risk discrimination and reclassification across predicted 10 year risk categories (ie, <5%, 5% to <7·5%, and ≥7·5%), adding assessment of NT-proBNP concentration to that of conventional risk factors (ie, age, sex, smoking status, systolic blood pressure, history of diabetes, and total and HDL cholesterol concentrations). Primary outcomes were the combination of coronary heart disease and stroke, and the combination of coronary heart disease, stroke, and heart failure. FINDINGS: We recorded 5500 coronary heart disease, 4002 stroke, and 2212 heart failure outcomes among 95 617 participants without a history of cardiovascular disease in 40 prospective studies. Risk ratios (for a comparison of the top third vs bottom third of NT-proBNP concentrations, adjusted for conventional risk factors) were 1·76 (95% CI 1·56-1·98) for the combination of coronary heart disease and stroke and 2·00 (1·77-2·26) for the combination of coronary heart disease, stroke, and heart failure. Addition of information about NT-proBNP concentration to a model containing conventional risk factors was associated with a C-index increase of 0·012 (0·010-0·014) and a net reclassification improvement of 0·027 (0·019-0·036) for the combination of coronary heart disease and stroke and a C-index increase of 0·019 (0·016-0·022) and a net reclassification improvement of 0·028 (0·019-0·038) for the combination of coronary heart disease, stroke, and heart failure. INTERPRETATION: In people without baseline cardiovascular disease, NT-proBNP concentration assessment strongly predicted first-onset heart failure and augmented coronary heart disease and stroke prediction, suggesting that NT-proBNP concentration assessment could be used to integrate heart failure into cardiovascular disease primary prevention