Aims: We conducted a systematic review of recent studies investigating trends in the epidemiology of heart failure (HF). Methods and results: We fitted simple linear regression models of rates against calendar year for mortality and hospital admission. Based on Population Attributable Fractions (PAFs) from the NHANES I Epidemiological Follow-up Study and self-reported prevalences of risk factors for HF, the estimated changes in numbers of new cases of HF in Australia were calculated from 1995 to 2005. A clear decline in mortality from HF and some data on decreases in admissions to hospitals for HF, as well as the lack of reports showing an increase in the incidence of HF, all argue against the existence of an ‘epidemic’ of HF. However, most reports on trends in HF survival have shown a secular improvement. The latter, together with population aging, are major factors that may increase the caseload of HF. Against this background of conflicting influences, we estimate that in Australia, the inflow into the caseload of HF decreased by 1.6% among people aged ≥55 years in 2005 relative to 1995. Conclusion: Available evidence does not support an increase in the caseload of HF over recent years. Taking all of the influences on the epidemiology of HF together, it is likely that the number of new cases of HF will rise over the next few years, even if the incidence rate falls, chiefly because the elderly population is expanding so quickly.

Background: The use of anthropometric indices is one of the new and low-cost diagnostic methods of metabolic syndrome (MetS). The present study aimed to determine optimal cutoff points for the visceral adiposity index (VAI), body roundness index (BRI), and a body shape index (ABSI) in the prediction of MetS. Methods: This cross-sectional study was performed on 10,000 individuals aged from 35 to 65 years, recruited in Ravansar Non-Communicable Diseases (RaNCD) cohort study, in the west region of Iran, in 2019. MetS was defined according to International Diabetes Federation (IDF) criteria. The receiver operating characteristic (ROC) curve analysis was used to assess predictive anthropometric indices and determine optimal cutoff values. Results: The optimal cutoff points for VAI were 4.11 (AUC: 0.82; 95% CI: 0.81– 0.84) in men and 4.28 (AUC: 0.86; 95% CI: 0.85– 0.87) in women to prediction of MetS. The optimal cutoff points for BRI were 4.75 (AUC: 0.75; 95% CI: 0.74– 0.77) in men and 6.17 (AUC: 0.62; 95% CI: 0.61– 0.64) in women to prediction of MetS. The optimal cutoff points for ABSI were 0.12 (AUC: 0.49; 95% CI: 0.47– 0.51) in men and 0.13 (AUC: 0.49; 95% CI: 0.47– 0.51) in women to prediction of MetS. The risk of MetS in men and women with a VAI higher than the optimal cutoff point was, respectively, 9.82 and 11.44 times higher than that in those with a VAI lower than the cutoff point. Conclusion: Although VAI might not be very cost-beneficial compared to IDF, our study showed VAI is a better predictor of MetS than BRI in adults. ABSI was not a suitable predictor for MetS.

Heart surgery patients are more at risk of poor peripheral perfusion, and peripheral capillary oxygen saturation (SpO2) measurement is regular care for continuous analysis of blood oxygen saturation in these patients. With regard to controversial studies on accuracy of the current pulse oximetry probes and lack of data related to patients undergoing heart surgery, the present study was conducted to determine accuracy of pulse oximetry probes of finger, toe, forehead and earlobe in detection of oxygen saturation in patients admitted to intensive care units for coronary artery bypass surgery. In this clinical trial, 67 patients were recruited based on convenience sampling method among those admitted to intensive care units for coronary artery bypass surgery. The SpO2 value was measured using finger, toe, forehead and earlobe probes and then compared with the standard value of arterial oxygen saturation (SaO2). Data were entered into STATA-11 software and analyzed using descriptive, inferential and Bland-Altman statistical analyses. Highest and lowest correlational mean values of SpO2 and SaO2 were related to finger and earlobe probes, respectively. The highest and lowest agreement of SpO2 and SaO2 were related to forehead and earlobe probes. The SpO2 of earlobe probes due to lesser mean difference, more limited confidence level and higher agreement ration with SaO2 resulted by arterial blood gas (ABG) analysis had higher accuracy. Thus, it is suggested to use earlobe probes in patients admitted to the intensive care unit for coronary artery bypass surgery. Registration of this trial protocol has been approved in Iranian Registry of Clinical Trials at 2018–03-19 with reference IRCT20100913004736N22 . “Retrospectively registered.”

Background: Drug use can lead to several psychological, medical and social complications. The current study aimed to measure and decomposes socioeconomic-related inequalities in drug use among adults in Iran. Methods: This was a cross-sectional study The PERSIAN Cohort is the largest and most important cohort among 18 distinct areas of Iran. This study was conducted on 130,570 adults 35 years and older. A structured questionnaire was applied to collect data. The concentration index (C) was used to quantify and decompose socioeconomic inequalities in drug use. Results: The prevalence experience of drug use was 11.9%. The estimated C for drug use was − 0.021. The corresponding value of the C for women and men were − 0.171 and − 0.134, respectively. The negative values of the C suggest that drug use is more concentrated among the population with low socioeconomic status in Iran (p < 0.001). For women, socioeconomic status (SES) (26.37%), province residence (− 22.38%) and age (9.76%) had the most significant contribution to socioeconomic inequality in drug use, respectively. For men, SES (80.04%), smoking (32.04%) and alcohol consumption (− 12.37%) were the main contributors to socioeconomic inequality in drug use. Conclusions: Our study indicated that drug use prevention programs in Iran should focus on socioeconomically disadvantaged population. Our finding could be useful for health policy maker to design and implement effective preventative programs to protect Iranian population against the drug use.

Background: The level of socioeconomic-related inequality in physical activity in Iran is largely unknown. This study investigates socioeconomic-related inequality in poor-physical activity (PPA) among Iranian adults. Methods: A total of 129,257 adult participants enrolled in the PERSIAN (Prospective Epidemiological Research Studies in IrAN) Cohort were included in this study. Physical activity of adults was measured using metabolic equivalent rates (METs). Physical activity less than 41 METs/hour/day was considered PPA. The Concentration index (C) was used to quantify socioeconomic-related inequality in PPA. Moreover, the C was decomposed to identify the relative contribution of explanatory variables to inequality in PPA. Results: There were significant regional variations in physical activity level among Iranian adults (29.8–76.5%). The positive value of C (0.098, 95% CI = 0.092 to 0.104) suggested that the higher concentration of PPA among higher socioeconomic status (SES) adults in Iran which was consistently observed in all cohort sites. Conclusions: The higher prevalence of PPA among Iranian adults, especially, women and older adults, warrant further public health attention. Since PPA is concentrated more among the high-SES population in Iran, strategies for the promotion of physical activity should focus more on economically well-off population.

OBJECTIVES: Unhealthy dietary patterns are the most important changeable risk factors for breast cancer. The aim of this study was to assess the relationship between dietary patterns and the risk of breast cancer among under-50 year women in the west of Iran.METHODS: All women under 50 years old with pathologically confirmed breast cancer between 2013 and 2015 who were referred to oncology clinics in the west of Iran, and 408 under-50 women referred to other outpatient clinics who were without breast or other cancers at the time of the study and 2 years later were selected as the control group. The data were collected using the middle-aged periodical care form of the Iranian Ministry of Health and analyzed using univariate and multivariate logistic regression in Stata.RESULTS: The most powerful risk factor for breast cancer was fried foods; the odds ratio of consuming fried foods more than once a month for breast cancer was 4.5 (95% confidence interval, 2.1 to 9.4). A dose-response model indicated that increasing vegetable and fruit consumption up to 90 servings per month decreased the odds of breast cancer, but consuming more than 90 servings per month increased the risk.CONCLUSIONS: Inadequate consumption of vegetables and consumption of soft drinks, industrially produced juices, fried foods, and sweets were identified as risk factors for breast cancer. In response to these findings, it is necessary to raise awareness and to provide education about healthy diets and the need to change unhealthy dietary patterns.