Sex differences in conventional and some behavioral cardiovascular risk factors, Analysis of the prevention clinic database

Background: An increase in Cardiovascular Disease (CVD) frequency was observed over the past three decades in low- and middle income countries, especially in Iran. The purpose of the present study was to review and compare the frequencies of conventional and some non-conventional CVD risk factors between men and women in a tertiary level referral cardiovascular teaching hospital in a six month period in the North of Iran.  Methods: A descriptive cross-sectional study was conducted using medical databases including conventional risk factors: opium consumption, physical inactivity, high salt diet, and serum vitamin D level. The chi-square and independent t tests were used to assess the differences between groups.  Results: A total of 740 (55% women) who had available full medical history data were recruited in the study. Approximately 62% of the participants were older than 45 years with the mean age of 54 (14.2) years old. Percentages of hypertension, diabetes, dyslipidemia, and obesity in women were significantly higher than those of men (P<0.05). A total of 50% of all the participants were physically inactive. Men had higher frequency of opium and saltshaker use than women (P<0.05).  Conclusion: The current study indicated that despite the importance of conventional CVD risk factors like diabetes, hypertension, dyslipidemia, and obesity, educational programs should be considered to improve physical activity and reducing salt consumption and awareness about opium use complications

Brachial endothelial function and carotid intima-media thickness in patients with coronary artery disease

     Endothelial dysfunction and carotid intima-media thickness are 2 indicators of subclinical cardiovascular disease. The aim of study was to analyze brachial flow mediated dilation(FMD)and carotid intima media thickness (CIMT)in patients with coronary artery disease, and investigate the relationship between endothelial function, CIMT and coronary artery disease risk factors.56 men and women aged between 25 to 75 years with coronary artery disease were recruited. FMD and CIMT was measured by B-mode ultrasonography. Data were presented  as  mean  ±  SE.  Pearson correlation  coefficients  were  used  to  evaluate associations   and  T-test  and  Chi-square  tests  were  used  for  quantitative  and qualitative variables. P-values  <  0.05  were considered  to  indicate  statistically  significant  differences. The mean age of subjects was 59.37±1.28 years. The frequencies of one, two and three-vessel coronary artery disease were 61%, 35.1% and 3.9%, respectively. The mean of CIMT in patients was 0.79±0.02 mm, and 65.5% of patients had CIMT more than 0.8 mm.The mean of FMD was 4.79±0.55% and 65.4% of patients had FMD lower than 5.3%. CIMT was correlated directly with number of diseased vessels, age andtotal cholesterol and was correlated inversely with HDL-C.Non-invasive measurement of FMD and CIMT are interrelated techniques that probably assess the same atherosclerotic process from functional and anatomic viewpoints.In these patients an increase in CIMT and decrease in FMD may warrant more aggressive risk factor control through the beginning of effective medical treatment

Evaluation of Brain Natriuretic Peptide, Tumor Necrosis Factor and Interleukin-6 Plasma Levels in Infants and Children with Congenital Heart Disease

Background Congenital heart disease (CHD) is the most common cause of major congenital birth defect. The aim of this study was to investigate the association of CHD with serum levels of Tumor necrosis factor-α (TNFα), Interleukin 6 (IL-6), and B-type Natriuretic Peptide (BNP) in infant and children. Materials and Methods The present study was conducted in Heshmat heart hospital and 17 Shahrivar hospital Rasht city, Iran. In 50 children, 25 with CHD and 25 age and sex-matched healthy children (were selected from companions or patients without heart disease), 3 ml vein blood samples of right hand were taken by a trained nurse and samples were sent to a private laboratory. After separation, the plasma placed at temperature of -20 °c. ELISA kits used for measuring BNP and eBioscience Bender MedSystems GmbH kit for measuring IL-6 and TNF-α. The results were entered into SPSS software (version 20.0). Results Serum levels of TNF-α and IL-6 and BNP in the healthy and patient groups were evaluated and by comparing results of the two groups there was no significant difference in serum levels of TNF-α and IL-6, but the serum levels of BNP has significant difference between two groups (80.7 ± 52.5 pg/ml vs. 455.4 ± 550.4 pg/ml, P=0.003). There was no significant relationship between BNP changes with changes in serum TNF-α, IL-6 levels. Conclusion Our study provided conclusive evidence BNP level is elevated in children with CHD; and significant relationship was observed between incidents of CHD respect to changes in serum BNP level

Predictors of Self-Care Behaviors in Heart Failure Patients: A Cross-Sectional Study

Abstract Introduction: Adherence to self-care behaviors and determining its related factors in patients with chronic illnesses are mandatory. The objective of the present study was two-fold: first, to examine the self-care behaviors adherence among heart failure patients and second, to determine its predictors in a comprehensive study of various factors in patients with heart failure. Methods: This descriptive cross-sectional study was conducted on 239 patients with heart failure referred to Dr.Heshmat hospital as the only heart center in Guilan province (Northern Iran). The consecutive sampling method was used. Data were collected by Self-Care Heart Failure Index, Cardiac Depression Scale, Mini-Mental State Examination, and Charlson Comorbidity Index and were analyzed by descriptive statistics and analytical statistics in SPSS. Results: Results showed educational level, history of receiving information, and cognitive function as predictors of self-care maintenance. Also, monthly income, history of receiving information, and ventricular dysfunction were predictors of self-care management. Monthly income, admission status, number of hospitalizations, history of receiving information, and cognitive function are mentioned as predictors of self-confidence. Predictors of total self-care were monthly income, history of receiving information, and cognitive function. (P . 0.05). Conclusions: Promoting self-care behaviors could prevent the adverse effects of diseases such as readmission, prolonged hospitalization, and bed occupancy ratio. The majority of the participants had non-adherent self-care, and, according to the results, it is recommended that assessing predictors in these patients and planning. Also, it is suggested that more observational, qualitative, and mixed-method studies be done in the future

Medication Adherence and its Related Factors in Patients Undergoing Coronary Artery Angioplasty

Introduction: Percutaneous Coronary Intervention (PCI) has no effect on coronary artery atherosclerosis, thus the modification of physiological risk factors seems essential to prevent coronary artery disease (CAD). Then PCI patients have to receive multiple drug therapies in an attempt to prevent the recurrence of cardiac events. In spite of the evidence based on medication adherence to prevent post-PCI CAD development, medication adherence is the main concern for health care system. Accordingly, this study aims to determine the medication adherence and its related factors among these patients. Methods: In this cross-sectional study, the statistical community was the patients undergoing PCI at medical educational hospital of Dr. Heshmat in Rasht, Iran. 269 patients were selected by convenient sampling method. The data were collected by a questionnaire consisting of 4 parts, namely the socio-individual factors, Morisky medication adherence scale, hospital anxiety and depression scale and cardiac patient’s self-efficacy scale. Data analysis was done by descriptive statistics and the significance variables in univariate analysis were examined in a multi logistic regression model through considering co-linearity. Results: The results showed that 75 patients (28%) didn’t adhere to the medication. In addition, the majority of them were reported to have clinical anxiety (44.2%) and mild depression (55.8%). Also, based on the results derived from multiple logistic regressions, only the spouse's educational level and family history of coronary artery disease were significant predictors of medication adherence. Conclusion: The current study findings display lack of complete post-PCI medication adherence, which underscores the importance of the existence of cardiac rehabilitation systems in the society. Therefore, it is recommended that cardiac rehabilitation centers be built in the society

The relationship between ultra processed food consumption and premature coronary artery disease: Iran premature coronary artery disease study (IPAD)

BackgroundUltra-processed foods (UPF) consumption may affect the risk of PCAD through affecting cardio metabolic risk factors. This study aimed to evaluate the association between UPFs consumption and premature coronary artery disease (PCAD).MethodsA case–control study was conducted on 2,354 Iranian adults (≥ 19 years). Dietary intake was assessed using a validated 110-item food frequency questionnaire (FFQ) and foods were classified based on the NOVA system, which groups all foods according to the nature, extent and purposes of the industrial processes they undergo. PCAD was defined as having an stenosis of at least single coronary artery equal and above 75% or left main coronary of equal or more than 50% in women less than 70 and men less than 60 years, determined by angiography. The odds of PCAD across the tertiles of UPFs consumption were assessed by binary logistic regression.ResultsAfter adjustment for potential confounders, participants in the top tertile of UPFs were twice as likely to have PCAD compared with those in the bottom tertile (OR: 2.52; 95% CI: 1.97–3.23). Moreover, those in the highest tertile of the UPFs consumption had more than two times higher risk for having severe PCAD than those in the first tertile (OR: 2.64; 95% CI: 2.16–3.22). In addition, there was a significant upward trend in PCAD risk and PCAD severity as tertiles increased (P-trend < 0.001 for all models).ConclusionHigher consumption of UPFs was related to increased risk of PCAD and higher chance of having severe PCAD in Iranian adults. Although, future cohort studies are needed to confirm the results of this study, these findings indicated the necessity of reducing UPFs intake

Internet dependency and its predictors among faculty members

Background: Extensive use of the internet has resulted in the emergence of a phenomenon called internet dependency. Internet dependency is turning into a major global concern due to its growing prevalence. It can negatively affect different personal, familial, occupational, and social aspects of life. Objectives: This study aimed to assess internet dependency and its predictors among faculty members. Methods: This cross-sectional study was conducted in 2014_2015 on 211 faculty members of Guilan University of Medical Sciences, Rasht, Iran. Internet dependency was measured using the Internet Addiction Inventory, an instrument which consists of items on factors related to Internet use. Data analysis was performed using the Kolmogorov_Smirnov, the Chi-square, the Fisher's exact, and the Kruskal_Wallis tests as well as the Spearman's correlation and the logistic regression analysis. Results: Seventy-five participants (35.5) were at risk for internet dependency and the rest were in normal condition. The significant predictors of internet dependency were gender, main goal of internet use, and main type of internet use. Conclusion: As more than one-third of the faculty members are at risk for internet dependency, educational interventions are needed to broaden their knowledge about the negative effects of internet overuse and to help them modify their internet use behaviors

Neuroimaging of corpus callosum in central nervous system demyelinating disorders

Corpus callosum (CC) is the largest white matter structure in the brain, consisting of 200-250 million contralateral axonal projections. It is the major commissural pathway connecting the hemispheres of human brain. The pathology of CC includes wide variety of entities that arise from different causes such as congenital, inflammatory, tumoral, degenerative, infectious, etc. This study reviews the most reliable neuroimaging data of human CC in central nervous system (CNS) demyelinating diseases to facilitate the understanding of different pathological entities of the CC and their role in anticipation of probable prognostic findings. After a brief description of normal anatomy and functions of CC, this review examines the most valuable findings obtained using conventional and functional magnetic resonance imaging. It also demonstrates the most well organized findings of how CC features influence prognostic factors of demyelinating disorders, which could have a great value for choosing proper therapy methods. The authors also provided a brief review of other demyelinating disorders which are primarily caused by other pathological factors other than autoimmunity. As a conclusion, the authors showed the importance of CC as an critical part of the brain, which should be explored by different methods of imaging, correspondent to clinical evaluation of CNS demyelinating disorder to widen our knowledge on pathology and clinical patterns of such disorders

The Diet Adherence in Cardiovascular Disease Risk Factors Patients in the North of Iran Based on the Mediterranean Diet Adherence

Background and objectives: Before any nutritional intervention, it is necessary to have the prospect of eating habits of people with cardiovascular risk factors. In this study, we assessed the adherence of healthy diet based on Mediterranean dietary pattern and related factors in adults in the north of Iran. Methods: This study was conducted on 550 men and women with cardiovascular risk factors that referred to Heshmat hospital in Rasht, northern Iran. Information was collected by interview and reading medical history and measuring anthropometric indexes. The Mediterranean Diet Adherence Screener was used for assessing dietary adherence, this screener was modified according to religious beliefs and culture of Iran. Results: The mean age of participants was 58±0.38 years. The mean of body mass index was 27±0.01 kg/m2, and the mean of waist circumference was 98±0.2 cm. The mean of dietary adherence was 5.76±0.07. 45% of participants had low adherence, and just 4% had suitable adherence. The mean of dietary adherence in men was significantly higher than women (p=0. 07). Participants in rural area and high educational participants insignificantly had an unsuitable dietary Adherence. There was no significant association between some cardiovascular disease risk factors and dietary adherence. Conclusion: Education to different group about dietary intake correction and using a Mediterranean dietary pattern that is similar to dietary intake in the north of Iran, for controlling cardiovascular disease is necessary