ABSTRACT
This review aimed to examine trends in cancer research in the Arab world and identify existing research gaps. A search of the MEDLINE[registered] database [National Library of Medicine, Bethesda, Maryland, USA] was undertaken for all cancer-related publications published between January 2000 and December 2013 from seven countries, including Bahrain, Kuwait, Iraq, Lebanon, Morocco, Palestine and Sudan. A total of 1,773 articles were identified, with a significant increase in yearly publications over time [P <0.005]. Only 30.6% of the publications included subjects over the age of 50 years old. There was a dearth of cross-sectional/correlational studies [8.8%], randomised controlled trials [2.4%] and systematic reviews/meta-analyses [1.3%]. Research exploring cancer associations mainly considered social and structural determinants of health [27.1%], followed by behavioural risk factors [14.1%], particularly tobacco use. Overall, more cancer research is needed in the Arab world, particularly analytical studies with high-quality evidence and those focusing on older age groups and associations with physical activity and diet
ABSTRACT
This study investigates the association of wartime stress variables and coronary artery disease as determined by coronary angiography in Lebanon in 1986, a country with an ongoing civil war for ever a decade. A total of 127 patients who underwent coronary angiography at the American University of Beirut Medical Center were individually matched o age and sex with visitor controls free from any evidence of clinical coronary artery disease. Arteriographic cases [>/= 70% maximal stenosis] were compared with two control groups: arteriographic controls [entirely normal coronaries] and visitor controls. Findings suggest that there is a relation between exposure to both acute and chronic war events and coronary artery disease in this patient population. The reporting of exposure to acute war events was significantly higher in cases compared with both visitor controls [odds ratio [OR] = 2.4, 95% confidence interval [CI] 1.17- 4.90] and arteriographic controls [OR = 2.8, 95% CI 0.93- 8.47]. Crossing the [green-lines] that separate two belligerent sides, considered as an attribute of war-related chronic stress, was more frequent in cases compared with visitor controls [OR = 3.25, 95% CI 1.54-6.89] and arteriographic controls [OR = 5.38, 95% CI 1.65- 17.6]. The relation observed between wartime stress and coronary artery disease could not be explained by possible overreporting of stressful events in patients with suspected coronary artery disease or by an increase in clinical awareness for the disease for those under continuous stress. Adjusting for the effect of the well-established coronary artery disease risk factors did not alter the above findings