Geographical spread of gastrointestinal tract cancer incidence in the Caspian Sea region of Iran : spatial analysis of cancer registry data

BACKGROUND: High incidence rates of gastrointestinal tract cancers have been reported in the Caspian region of Iran. This study aimed to: 1) describe the geographical spatial patterns of gastrointestinal tract cancer incidence based on cancer registry data and, 2) determine whether geographical clusters of statistical significance exist. METHODS: The Babol Cancer Registry, which covers the two major northern Iranian provinces of Mazandaran and Golestan (total population = 4,484,622) was used to identify new gastrointestinal tract cancer cases during 2001 to 2005. Age-specific cancer incidence rates were calculated for 7 gastrointestinal tract cancer sites in 26 wards of the Mazandaran and Golestan provinces. Spatial autocorrelation indices, hierarchical Bayesian Poisson models, and spatial scan statistics were used in measuring the geographic pattern and clusters. RESULTS: There were non-random spatial patterns in esophageal and stomach cancers that were similar for both sexes. Clusters of high incidence were identified in esophageal, stomach, colorectal and liver cancer for both sexes, as well as a possible cluster of pancreas cancer in males. CONCLUSION: Gastrointestinal tract cancers exhibit significant spatial clustering of risk in northern Iran. Further work is needed to relate these geographical patterns to information on potential life-style and environmental factors

A Multilevel Latent Class Analysis of Smoking Stages in Adolescents and Its Predictors

Adolescent smoking status were powerful predictors for adult smoking where the most people who started smoking at lower ages continueed to smoke later. The smoking process is complicated and is not limited to smokers and non-smokers, but includes patterns and different stages that need to be identified and evaluated . The main objectives of the current study is to identify stages of smoking in adolescents and to assess factors influencing the patterns of smoking in this population. Using the multistage random sampling, 56 high schools with a total of 205 classrooms were randomly selected. The total number of 4907 high school students in Tabriz, Iran participated in the current study and completed a self-administered questionnaire. Multilevel latent class analysis was used in smoking stage determination. Three stages of smoking were identified non-smokers, moderate, and heavy smokers with prevalence 71.3%, 22.4%, and 6.3%, respectively. In gender specific analysis, such figures were 82.6%, 14.5%, and 2.7% for girls and 77.3%, 15.6%, and 7% for boys, respectively. Age, the grade point average, living with parents, having smoking friends and family, risk taking behaviors, self-injury, attitude and positive thinking about smoking were significantly associated with smoking stages in students. The social-economic status did not have significant association with smoking stage. Using multilevel classification technique that consider the hierarchal construct of data, a more reliable stages of smoking was measured in male and female adolescents

Effect of Family Structure and Behavioral and Eyesight Problems on Caries Severity in Pupils by Using an Ordinal Logistic Model

Background: Dental caries is one of the most preventable yet prevalent chronic diseases worldwide. Our objective was to evaluate the effect of family structure and behavioral and eyesight problems as they relate to caries severity in schoolchildren. Methods: This research was carried out on 845 primary schoolchildren aged 9 yr in Kerman, Iran, in 2012. Ten variables, including health records, family structure information and a dmft/DMFT index, were collected. Children were categorized into three groups based on the WHO caries severity classification. Low caries level was defined as dmft/DMFT4.4. The Cochran–Armitage test and ordinal logistic regression were employed for data analysis. Results: Almost half of pupils had moderate or high caries severity. The odds of being in a higher caries severity category in pupils with behavioral problems (OR=2.37, 95% CI: 1.29-4.38) and girls (OR=1.6, 95% CI: 1.22-2.06) were higher than in other categories. In addition, pupils with eyesight problems (OR=0.58, 95% CI: 0.37-0.90) and overweight pupils (OR=0.46, 95% CI: 0.31-0.71) had lower caries severity than others. The effects of parents’ education, birth rank, living with parents and consanguineous relationship between parents were not significant on caries severity (P>0.05). Conclusions: Female pupils with behavioral problems were at a higher risk of caries severity than other pupils. These pupils need to be educated and coached on proper dental care. In addition, overweight pupils and those with eyesight problems ha

Correction the Bias of Odds Ratio resulting from the Misclassification of Exposures in the Study of Environmental Risk Factors of Lung Cancer using Bayesian Methods

Background & Objective: Inability to measure exact exposure in epidemiological studies is a common problem in many studies, especially cross-sectional studies. Depending on the extent of misclassification, results may be affected. Existing methods for solving this problem require a lot of time and money and it is not practical for some of the exposures. Recently, new methods have been proposed in 1:1 matched case–control studies that have solved these problems to some extent. In the present study we have aimed to extend the existing Bayesian method to adjust for misclassification in matched case–control Studies with 1:2 matching. Methods: Here, the standard Dirichlet prior distribution for a multinomial model was extended to allow the data of exposure–disease (OR) parameter to be imported into the model excluding other parameters. Information that exist in literature about association between exposure and disease were used as prior information about OR. In order to correct the misclassification Sensitivity Analysis was accomplished and the results were obtained under three Bayesian Methods. Results: The results of naïve Bayesian model were similar to the classic model. The second Bayesian model by employing prior information about the OR, was heavily affected by these information. The third proposed model provides maximum bias adjustment for the risk of heavy metals, smoking and drug abuse. This model showed that heavy metals are not an important risk factor although raw model (logistic regression Classic) detected this exposure as an influencing factor on the incidence of lung cancer. Sensitivity analysis showed that third model is robust regarding to different levels of Sensitivity and Specificity. Conclusion: The present study showed that although in most of exposures the results of the second and third model were similar but the proposed model would be able to correct the misclassification to some extent

Meta-analysis of type-specific human papillomavirus prevalence in Iranian women with normal cytology, precancerous cervical lesions and invasive cervical cancer:Implications for screening and vaccination

To predict the impact of current vaccines on cervical cancer and for the improvement of screening programs, regional data on distribution of human papillomavirus (HPV) types in women with or without cervical cancer is crucial. The present meta-analysis intend to comprehensively evaluate the HPV burden in women with invasive cervical cancer, high-grade squamous intraepithelial lesion (cervical intraepithelial neoplasia 2 and 3), low-grade squamous intraepithelial lesion (cervical intraepithelial neoplasia 1), atypical squamous cells of undetermined significance and normal cytology, as these data will help decision making in regards with screening programs and HPV vaccination in Iran. To determine the HPV prevalence and type distribution in Iranian women with or without cervical cancer, 20 published studies were included in this meta-analysis. In total, 713, 124, 104, 60, and 2577 women invasive cervical cancer, high-grade squamous intraepithelial lesion (cervical intraepithelial neoplasia 2 and 3), low-grade squamous intraepithelial lesion (cervical intraepithelial neoplasia 1), atypical squamous cells of undetermined significance and normal were reviewed, respectively. Overall HPV prevalence in women with invasive cervical cancer, high-grade squamous intraepithelial lesion (cervical intraepithelial neoplasia 2 and 3), low-grade squamous intraepithelial lesion (cervical intraepithelial neoplasia 1), atypical squamous cells of undetermined significance and normal cytology were 77.4%, 71.8%, 65.3%, 61.7%, and 8.4%, respectively. The six most common types were HPV 16, 18, 6/11, 31, and 33; among them HPV 16 was the most frequent type in all five different groups. According to this study, it was estimated that HPV vaccines could have a great impact on prevention of cervical cancer in Iran. In conclusion, this meta-analysis highlights the necessity of introducing vaccination program in Iran. J. Med. Virol. 87:287-295, 2015.</p

Meta-analysis of type-specific human papillomavirus prevalence in Iranian women with normal cytology, precancerous cervical lesions and invasive cervical cancer:Implications for screening and vaccination

To predict the impact of current vaccines on cervical cancer and for the improvement of screening programs, regional data on distribution of human papillomavirus (HPV) types in women with or without cervical cancer is crucial. The present meta-analysis intend to comprehensively evaluate the HPV burden in women with invasive cervical cancer, high-grade squamous intraepithelial lesion (cervical intraepithelial neoplasia 2 and 3), low-grade squamous intraepithelial lesion (cervical intraepithelial neoplasia 1), atypical squamous cells of undetermined significance and normal cytology, as these data will help decision making in regards with screening programs and HPV vaccination in Iran. To determine the HPV prevalence and type distribution in Iranian women with or without cervical cancer, 20 published studies were included in this meta-analysis. In total, 713, 124, 104, 60, and 2577 women invasive cervical cancer, high-grade squamous intraepithelial lesion (cervical intraepithelial neoplasia 2 and 3), low-grade squamous intraepithelial lesion (cervical intraepithelial neoplasia 1), atypical squamous cells of undetermined significance and normal were reviewed, respectively. Overall HPV prevalence in women with invasive cervical cancer, high-grade squamous intraepithelial lesion (cervical intraepithelial neoplasia 2 and 3), low-grade squamous intraepithelial lesion (cervical intraepithelial neoplasia 1), atypical squamous cells of undetermined significance and normal cytology were 77.4%, 71.8%, 65.3%, 61.7%, and 8.4%, respectively. The six most common types were HPV 16, 18, 6/11, 31, and 33; among them HPV 16 was the most frequent type in all five different groups. According to this study, it was estimated that HPV vaccines could have a great impact on prevention of cervical cancer in Iran. In conclusion, this meta-analysis highlights the necessity of introducing vaccination program in Iran. J. Med. Virol. 87:287-295, 2015.</p

PSORIASIS AND INCREASED PREVALENCE OF HYPERTENSION AND DIABETES MELLITUS

Background: Psoriasis is an autoimmune skin disease and associated with other diseases such as cardiovascular, hypertension, and diabetes mellitus. Aim: Our aim was to explore the prevalence of diabetes mellitus and hypertension in psoriatic patients. Materials and Methods: Between April 2008 and May 2010, a total of 304 psoriatic and 300 nonpsoriatic patients were enrolled in this cross sectional study. Data were obtained on age, sex, weight, heights, etc; documented medical history of diabetes mellitus and hypertension; family history of diabetes mellitus and hypertension in first relatives, history of smoking. Results: There was no significant difference in age and gender distribution between two groups. There was also no difference in body mass index between two groups. Within psoriatic group, 79.3% of patients present with plaque type of the disease and 20.7% present with other types. The results showed that within psoriatic patients, the prevalence of diabetes in women is significantly higher than in men (OR=1.93, CI95%: 1.1-3.6, P=0.004) but this difference is not present in nonpsoriatic patients. The results also showed that the prevalence of diabetes in psoriatic patients is significantly higher than nonpsoriatic patients (OR=1.76, CI95%: 1.11-2.8, P=0.015). The data showed that psoriatic patients were more likely to develop hypertension compared with nonpsoriatic patients (OR=2.2, CI95%: 1.2-4.6, P=0.003). According to results, although smoking rate within psoriatic patients is higher than the other group but the difference was not significant. Conclusion: Psoriatic patients have an increased risk of developing metabolic syndrome and hypertension in comparison to nonpsoriatic patients

MyoRing implantation in keratoconic patients: 3 years follow-up data

Purpose: To evaluate long-term follow-up data on implantation of a full-ring intra-corneal implant (MyoRing) for management of keratoconus. Methods: A total of 40 keratoconic eyes of 37 consecutive patients who had undergone MyoRing implantation using the Pocket Maker microkeratome (Dioptex, GmbH, Linz, Austria) and completed 3 years of follow-up appointments were included in this retrospective study. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refraction and keratometry (K) readings were measured and evaluated preoperatively, and 3 years, postoperatively. Results: No intraoperative complications were observed in this case series. Three years postoperatively, there was a significant improvement in UDVA, CDVA, K readings, spherical equivalent (SE), and manifest sphere and cylinder (P < 0.05 for all comparisons). UDVA was significantly improved from 1.14 ± 0.27 to 0.30 ± 0.21 LogMAR (P = 0.001), CDVA was also improved from 0.52 ± 0.23 to 0.18 ± 0.12 LogMAR (P = 0.001), SE was decreased by 4.35 diopters (D) and average keratometric values were reduced by 2.34 D (P = 0.001). Overall, 81% of subjects were moderately to highly satisfied 3 years after surgery and 64.90% agreed to have the fellow eye implanted with MyoRing. Conclusion: MyoRing implantation using the Pocket Maker microkeratome was found to be a minimally invasive procedure for improving visual acuity and refraction in the majority of the patients with keratoconus