Background Previous studies report on smoking in Iran but recent national data on tobacco use (including cigarette, water-pipe and pipe) have not been reported. Methods In 2007, 5287 Iranians aged 15–64 years were sampled from all provinces as part of a national cross-sectional survey of non-communicable disease (NCD) risk factors. Data were collected using the standardised stepwise protocol for NCD risk factor surveillance of the World Health Organization. Use of tobacco products was calculated as the sum of smoking cigarettes/cigars (smoking currently or daily any amount of factory/hand-made cigarettes or cigars), pipes (daily) and water pipes (daily). Results Total current and daily tobacco use was 14.8% (burden 7.3 million) and 13.7% (burden 6.7 million) when extrapolated to the Iranian population aged 15–64. The prevalence of current and daily cigarette smoking was 12.5% (6.1 million; 23.4% males and 1.4% females) and 11.3% (5.6 million; 21.4 males and 1.4 females); former smokers comprised 1.7 million or 3.4% of the Iranian population (6.2% males and 0.6% females; mean cessation age 34.1). The mean age of starting to smoke was 20.5 years (24.2 males and 20.4 females). The prevalence of water-pipe smoking was 2.7% (burden 1.3 million; 3.5% males and 1.9% females). Water-pipe smokers used the water-pipe on average 3.5 times a day (2.8 males and 4.5 females). Conclusion The prevalence of tobacco use has not escalated over the past two decades. Nonetheless, the burden is high and therefore warrants preventive public health policies.
Purpose Skin cancers are the most common human malignancy with increasing incidence. Currently, surgery is standard of care treatment for non-melanoma skin cancers. However, brachytherapy is a growing modality in the management of skin cancers. Therefore, we aimed to assess the outcome of...
Glioblastoma multiforme (GBM) is the most common malignant primary brain tumor in adults. Despite several investigations in this field, maximal safe resection followed by chemoradiotherapy and adjuvant temozolomide with or without tumor-treating fields remains the standard of care with poor survival outcomes. Many endeavors have failed to make a dramatic change in the outcomes of GBM patients. This study aimed to review the available strategies for newly diagnosed GBM in the neoadjuvant setting, which have been mainly neglected in contrast to other solid tumors.
Colorectal cancer is becoming an increasing concern in the middle-aged population of Iran. This study aimed to compare the preliminary results of short-course and long-course neoadjuvant chemoradiotherapy treatment for rectal cancer patients. In this clinical trial we recruited patients with rectal adenocarcinoma located from 5 cm to 15 cm above the anal verge. Patients in group I (short-course) received three-dimensional conformational radiotherapy with a dose of 25 Gy/5 fractions in 1 week plus concurrent XELOX regimen (capecitabine 625 mg/m2 from day 1–5 twice daily and oxaliplatin 50 mg/m2 on day 1 once daily). Patients in group II (long-course) received a total dose of 50–50.4 Gy/25–28 fractions for 5 to 5.5 weeks plus capecitabine 825 mg/m2 twice daily. Both groups underwent consolidation chemotherapy followed by delayed surgery at least 8 weeks after radiotherapy completion. The pathological response was assessed with tumor regression grade. In this preliminary report on complications and pathological response, 66 patients were randomized into two study groups. Mean duration of radiotherapy in groups I and II was 5 ± 1 days (range, 5 to 8 days) and 38 ± 6 days (range, 30 to 58 days). The median follow-up was 18 months. Pathological complete response was achieved in 32.3% and 23.1% of patients in the short-course and long-course groups, respectively (p = 0.558). Overall, acute grade 3 or higher treatment-related toxicities occurred in 24.2% and 22.2% of patients in group I and II, respectively (p = 0.551). No acute grade 4 or 5 adverse events were observed in either group except one grade 4 hematologic toxicity that was seen in group II. Within one month of surgery, no significant difference was seen regarding grade ≥3 postoperative complications (p = 0.333). For patients with rectal cancer located at least 5 cm above the anal verge, short-course radiotherapy with concurrent and consolidation chemotherapy and delayed surgery is not different in terms of acute toxicity, postoperative morbidity, complete resection, and pathological response compared to long-course chemoradiotherapy.
7 June 2017 in Journal of Diabetes & Metabolic Disorders
Non-HDL-C as a valuable predictor of premature atherosclerosis, coronary events like first Myocardial infarction and cardiovascular mortality has a high accuracy of measurement both in fasting and non-fasting individuals. Metabolic syndrome (MetS) can promote the development of diabetes mellitus, endothelial dysfunction and atherosclerosis. A common pathway for cross linking of metabolic abnormalities and non-HDL-C has been suggested. In this study we aimed to describe the potential association between non-HDL cholesterol fractions and metabolic syndrome. Data of third national surveillance of the risk factors of non-communicable diseases (SuRFNCD-2007) were analyzed. We defined metabolic syndrome (MetS) according to the Adult Treatment Panel III (ATPIII) and International Diabetes Federation (IDF) criteria for 2125 subjects aging 25–64 years. The receiver operating characteristic (ROC) curves were used to determine the optimal cut-points for the diagnosis of MetS. The curves were depicted for non–high-density lipoprotein cholesterol (non-HDL-C) and difference of total non-HDL-C and LDL-C (Differential cholesterol or Diff-C) as predictors of MetS. Logistic regression was also performed in a complex sample analysis scheme. The area under the curve (AUC) with 95% Confidence intervals of total non-HDL-C was computed. Values were 0.693 (0.670-0.715) for IDF-defined MetS and 0.719 (0.697-0.740) for ATPIII criteria. The optimal non-HDL-C cut-point we recommend for both criteria is 153.50 mg/dl (sensitivity: 75.7%, specificity: 57.2%, with ATPIII; sensitivity: 73.2%, specificity: 57.1%, with IDF). Using IDF criteria, the accuracy of predictors were greater in non-diabetic subjects. AUC of Diff-C in DM (−) vs. DM (+) were 0.786 (0.765-0.807) vs. 0.627(0.549-0.705). Adults with high non–HDL-C were 4.42 times more likely to have ATPIII-defined MetS (≥190 vs. < 190 mg/dL). Elevated Diff-C corresponded to increased risk of the MetS (ORs: 10.71 and 26.29 for IDF and ATP III criteria, respectively. All P-values <0.001). A significant robust association exists between non-HDL-C and MetS whether applying conventional or new thresholds.