[Risk factors of cancer in children under 14 years old]

Recognition of the risk factors of childhood cancer has been important. However, there is little identification about these risk factors. The aim of this study was to determine the risk factors of cancer in children under14 years old. The present study has been a case-control study of 14-year-old children. 98 childhood cancer cases and 100 controls were matched on age and sex. Data were collected using a questionnaire with some of the known and suspected risk factors of cancer via the parent, and were analyzed with two independent samples t-tests, chi-square and logistic regression models. In this study, low- educational status in mothers and fathers increased risk of childhood cancer [p<0.05]. Children lived in low-income families [500000-1500000 Rails per month], and had a significantly higher risk of cancer [Odds ratios=3.08; 95% CI=4-6.00]. Fathers smoking during pregnancy [odds ratio=3.00] and living near high voltage power lines [Odds ratios=1.5] were significantly related to an increased risk of cancer in children. In addition, there was a higher risk of cancer particularly among heavy [>/= 11 cigarettes per days] smokers [odds ratio= 2.7]. The results of this study indicated that some risk factors such as living conditions, smoking fathers during pregnancy, parental educational level and financial status were associated with the risk of childhood cancer. Therefore, public health should aim at improving environmental and familial socioeconomic status for all children; efforts should be concentrated on planning preventive and educational campaigns

Parental smoking and risk of childhood cancer: hospital-based case-control study in Shiraz

This case-control study in Shiraz aimed to determine the relationship betwterl parental smoking and childhood cancer. A questionnaire was completed by the mothers of 98 children newly diagnosed with cancer before the age of 14 years and 100 age- and sex-matched controls. Maternal smoking [prior to and during pregnancy and after the birth], and the numbers of maternal cigarettes smoked were not associated with an increased risk of childhood cancer. However, maternal exposure to passive smoke during pregnancy increased the risk of cancer childhood [OR - 3.6, 95% Cl: 1.3-5.0]. Father's smoking prior to [OR - 1.8, 95% Cl: 1.4-6.0] and during pregnancy [OR - 3.0, 95% Cl: 1.4-5.0] was significantly associated with an increased risk of cancer and this increased with heavy smoking. There were no relationship between an enhanced risk of childhood cancer and father's smoking after the child's birth

[ relationship between adherence to treatment regimen and prayer in hemodialysis patients]

Adherence is important for the health and well-being of patients on long-term hemodialysis therapy. Many factors such as spirituality and prayer have been hypothesized to have an effect on adherence in these patients. Therefore the aim of this study was to determine relationship between adherence and prayer in hemodialysis patients. A descriptive - correlational, cross-sectional design was used in this study. Two hundred patients with renal failure on hemodialysis, being treated at educational centers of Iran University of medical sciences, participated in the study. The subjects were selected by census method. Data were collected using the Adapted Prayer Scale [APS] based on Poloma and Pendleton's [1991] prayer scale, a demographic form and reviewing medical charts. Validity of the questionnaire was determined by content validity method and reliability of this instrument was demonstrated by a Cronbach's alpha [r = 0.80]. The data were analyzed by SPSS-14. Overall patients had dietary and medication adherence [> 50%]. But less than half had compliance to fluid restriction [44%]. Many of them used prayer [62%]. There were relationship between blood urea nitrogen and intra-dialytic weight gain with prayer p<0.05]. But, prayer was not correlated with potassium and phosphorus [p>0.05]. This study indicated the association between dietary and fluid adherence with prayer. Therefore nurses and health worker for should encourage patients to practice prayer to improve adherence and quality of life

[Dietary and fluid adherence in hemodialysis patients]

Adherences to fluid restriction and dietary and medication guidelines are essential for adequate management of hemodialysis patients. The aim of this study was to assess the blood urea nitrogen [BUN], serum potassium [K] and serum phosphorus [PO[4]] levels and interdialytic weight gain [IWG] accounted for adherence of uremic patients on hemodialysis. It was a descriptive - correlational study in which 200 patients with renal failure and on hemodialysis, being treated at teaching hospitals of Iran University of medical sciences, participated in the study. The subjects were selected by census sampling method. Blood urea nitrogen, serum potassium and phosphorus levels and interdialytic weight gain of uremic patients were collected from medical charts and were analyzed by SPSS, version 14. Most of the patients [56%] had non-adherence with fluid restrictions. The levels of phosphorus, potassium, and blood urea nitrogen were higher than expected levels in 25.5%, 5.5% and 4.5% of patients, respectively. In addition, there were relationships between blood urea nitrogen, serum potassium, serum phosphorus levels and interdialytic weight gain with educational status [p _ 0.05], however, there were no statistically significant correlation between the levels of these variables with gender, age, financial status, marital status and duration of dialysis [p > 0.05]. According to the findings, most patient had adherence to dietary and medication regimen and educational level of patient was associated with adherence. Dietary compliance may be improved by dietary counseling and education may motivates patients to change and comply with dietary recommendations. Therefore, another study to evaluate effect of dietary counseling techniques on adherence in dialysis patients is suggested

Identifying isolated impaired glucose tolerance using common clinical data Tehran lipid and glucose study

To determine the clinical traits of subjects with isolated impaired glucose tolerance [isolated-IGT] defined as fasting plasma glucose [FPG]<100 mg/dl and 2-hour plasma glucose [2h-PG] between 140 mg/dl and 200 mg/dl. In this cross-sectional study, we evaluated the data and results of oral glucose tolerance test [OGTT] from 8212 participants of the Tehran Lipid and Glucose Study [4742 women and 3470 men] aged >/= 20 years, without diabetes. Logistic regression models for having isolated-IGT were developed among 7012 subjects with FPG<100 mg/dl to predict isolated-IGT. The overall prevalence of IGT was 13.6% [n=1120] of these subjects, 59.6% [n=668] were isolated-IGT. In the clinical model, the adjusted odds ratios [OR] for having isolated-IGT were statistically significant for age >/= 40 years [2.6], hypertension [1.9], overweight [1.7] or obesity [2.2], family history of diabetes [1.3], and female gender [1.2]. Adding the lipid profiles to the clinical model increased the area under the receiver-operating characteristics curve [AUC] only slightly [72.5% vs. 71.4%, P=0.001]. The other clinical model including waist circumference had similar predictive power compared to the clinical This analysis showed that in Tehranian adults with FPG<100 mg/dl, female gender, older age, family history of diabetes, overweight and obesity, and hypertension were significantly associated with a higher likelihood of isolated-IGT OGTT should hence be recommended in subjects with the above mentioned characteristics

[Perceived social support in hemodialysis patients]

Physical and psychosocial problems along with the changes in life style, put hemodialysis patients under pressure. It seems that social support decreases psychological stresses and improves quality of life. This study aimed to describe hemodialysis patients' perceptions on their social supports and related factors. This descriptive-correlational study is a part of a larger study. All patients [n=202] referred to the hemodialysis units of Iran University of Medical Sciences were recruited to the study during a four-months period. Data were collected using "Personal Resources Questionnaire" [PRQ 85-PART 2] and analyzed using SPSS v.14. Findings revealed that the most patients [64.9%] had perceived social support at high levels. There were significant relationships between social support with economic status, gender and marital status [P<0.05]. Findings also indicated that the statements of "I enjoy doing little extra things that make another person's life more pleasant" and, "I belong to a group in which I feel important" had the highest and lowest scores respectively. Regarding the variety of perceptions in hemodialysis patients on social support and its related factors, nurses can prevent social isolation of these patients through identification of high risk groups and can also reduce their stresses and help them to improve their quality of life by providing adequate supportive interventions

[Parental smoking and risk of childhood cancer]

Cigarette smoke increases risk of adult cancer. However, the association between parental smoking and cancer in childhood is unclear. Therefore, the present study was designed to determine the relationship between parental smoking and childhood cancer. A case-control study was conducted comparing 98 childhood cancer cases with 100 matched controls on age and sex. Data were gathered through face to face interviews using a questionnaire, in 2007-2008. All statistics were computed by the SPSS software [version 14] using chi-square, independent f-test and odds ratios. It was revealed that maternal smoking [before, during and after pregnancy] was not associated with an increased risk of cancer childhood. Although, maternal exposure to passive smoke during pregnancy was associated with cancer childhood [odds ration=3.6, 95% confidence interval: 0.4-5.0]. Postnatal smoking of fathers was not associated with risk of cancer but fathers smoked more than 11 cigarettes during pregnancy, increased the risk of cancer [odds ratio=2.7; 95% CI, 0.3-4.4]. The study indicated that paternal smoking increases the risk of childhood cancer. Therefore, nurses can help to have healthy children by educating parents to quiet smoking or smoke outside children's rooms and their environment

[Self-efficacy in hemodialysis patients and its related factors]

End-stage-renal-disease [ESRD] patients treated by hemodialysis require major lifestyle changes and self-efficacy in the treatment regimen to comply with their chronic illness. Clients' perception of being self-efficient results in increased self-care activities and adherence to medical regimen. Although client's self-efficiency can affect on outcomes of the disease, few study is available in this regard. This descriptive correlational study was carried out to identify self-efficacy of hemodialysis patients and its related factors. 200 patients referring to health care setting affiliated with Iran Medical University were selected by convenience sampling method. A tool, Guidelines for Health Promotion, was used to assess self-efficacy in the treatment regimen. The tool was made reliable by test-retest method. Findings showed that self-efficacy was correlated with educational level, dialysis duration and weight difference between 2 dialysis sessions. In contrast, no correlation was found between self-efficacy and age as well as sex. The study showed a significant relationship between self-efficacy and some personal characteristics of patients. Thus, it is necessary for nurses to assess self-efficacy of their patients. In addition, nurses are in a key position to influence on self-efficacy of their patients and improve self-care activities of them. To achieve these, they can provide necessary instructions for their clients to control stress and emotional as well as physical stimulations

Quality of life in patients with end stage renal disease

Recent studies suggest that patients' perceptions might be more important than objective clinical assessments in determining quality of life [QOL] in patients with End Stage Renal Disease [ESRD]. The aim of this study was to determine QOL in patients experiencing ESRD and its related factors. In this descriptive-correlational study, we recruited 202 hemodialysis patients from Iran University of medical sciences' hemodialysis units using convenience sampling method. Data were collected using [Ferrans and Powers quality of life Index- dialysis version] instrument and analyzed using SPSS-14. Findings showed that the patients had a high perceived QOL. Lowest satisfaction mean scores were for the items [your health] [M=3.80, SD=1.74], [being able to take care of your financial needs] [M=3.31, SD=1.85], [achieving your personal goals] [M=4.02, SD=1.63], and your family's happiness [M=4.96, SD=1.27]. It was reported that [probably you will get a kidney transplant] [M=4.22, SD=2.15], [neighborhood] [M=4.32, SD=2.09], personal appearance [M=5.67, SD=0.91], and [your spouse] [M=5.84, SD=0.61] also had lowest mean score for importance from patients point of view. Financial status, educational levels, marital status and number of children were all associated with the QOL [P 0.05]. This study denoted financial status, educational levels, marital status and number of children is related to QOL of hemodialysis patients. So, these factors that affect quality of life may promote health and wellbeing and may increase survival in hemodialysis patients. The findings of this study can assist providers in planning and implementing educational and support programs for patients and their family

[Relationship between perceived social support and quality of life in hemodialysis patients]

Quality of life in hemodialysis patient can be affected by Physical, psychosocial and lifestyle disturbances. It seems that perceived social support can improve quality of life in these patients. Therefore, this study aimed at determining the relationship between perceived social support and quality of life in hemodialysis patients. This descriptive- correlational study was conducted with 202 patients with chronic renal failure, recruited through consensus method. They have been under hemodialysis treatment in one of the hemodialysis care units, affiliated to Iran University of Medical Sciences. Data were collected using the [Personal Resources Questionnaire 85] [PRQ-85] part 2 and The [Ferrans and Powers quality of life Index-dialysis version]. All statistics were computed using the SPSS software [version 14]. Finding indicated that patients had a high perceived social support [64.9%], good quality of life [54.0%] and socio-economic condition [P

[ association between vitamin D and bone mineral density in postmenopausal women]

There are inconsistent data regarding the role of vitamin-D in determining bone mineral density [BMD] especially in less severe vitamin-D deficiency. The aim of this study was to investigate the possible association between 25[OH]D and BMD in healthy free-living postmenopausal women in a population-based study. We enrolled 245 postmenopausal women, aged between 40 to 80 years, randomly selected from the Tehran Lipid and Glucose Study. Measurements of BMD were taken at the lumbar spine and upper femur by dual X-ray absorptiometry; additional to demographic and anthropometric data, serum 25[OH]D, PTH, calcium, phosphorus and alkaline phosphatase were measured according to the currently used laboratory methods. Bivariate and multivariate analyses were used to explore the association between 25[OH]D, BMD and other clinical and biochemical variables. Mean age and duration of menopause were 58 +/- 7 and 9.4 +/- 6.8 years, respectively; 25[OH]D [29.3 +/- 24.9 ng/ml] was <10 ng/ml and 11-20 ng/ml in 5.2% [n=13] and 37.6% [n=92] of women, respectively; 25[OH]D correlated inversely with LnPTH [r=-0.25, p<0.01]. However no association was found between 25[OH]D level and BMD at any of the skeletal scanning sites in bivariate analysis or multiple linear regression analyses, after adjusting for age, years since menopause, body mass index [BMI], calcium and LnPTH. In the multivariate analyses, BMD correlated inversely with LnPTH, in addition to age and BMI [R2=20%, p=0.03] only in femoral neck, but not at any other sites. This study showed no association between 25[OH]D and BMD in postmenopausal women

[ association study of pre-pregnancy BMI and parity with weight change and BMI at 6 months postpartum in Javaheri hospital and the other related centers to Islamic Azad University in 1385]

The relation between postpartum weight retention and pre-pregnancy BMI and parity is controversial. Pregnancy has been cited as a contributor to overweight in women. Retention of gestational weight can be a significant contributor to obesity related complications. This study was performed to identify the impact of pre-pregnancy BMI and parity on weight change and BMI at 6 months postpartum. In a prospective cohort study, 503 parous women, 15-45 years old who delivered full-term, without complication and exclusively breastfed till 6 months, were assessed at 6 months postpartum in Javaheri hospital and other related centers to Islamic Azad University in 1385. The participants filled out questionnaires. The survey measured woman's weight and height. The information was used to compute each woman's pregnancy BMI, pregnancy weight gain and postpartum weight loss. The samples were analyzed to assess the impact of pre-pregnancy BMI on weight change at 6 months postpartum in fixed parity and the impact of parity on weight change at 6 months postpartum in fixed pre-pregnancy BMI. There were no associations between parity, height, family income, contraception, mode of delivery, age and weight changes at 6 months postpartum. There were associations between pre-pregnancy BMI and weight changes at 6 months postpartum if parity fixed [p>2]. To our knowledge, overweight women before pregnancy have higher risk of postpartum weight retention if parity were 3 or more. These findings support the need of the guidelines for preventing major weight retention associated with pregnancy

[ effects of endotracheal suctioning on arterial blood gases in patients receiving mechanical ventilation: a before-after open clinical trial]

Endotracheal suctioning is one of the most frequently used methods for airway clearance in patients receiving mechanical ventilation but there are controversial findings regarding its effects on arterial blood gases in mechanically ventilated patients. This study was carried out to determine the effects of endotracheal suctioning on arterial blood gases in patients receiving mechanical ventilation. This research was a before-after open clinical trial study. The subjects consisted of 70 mechanically ventilated patients who were admitted to intensive care units and emergency department of Hazrat-Rasool Hospital in Tehran. Subjects were selected with purposive convenience sampling. The patients received endotracheal suctioning. Arterial blood gases were measured 5 minutes before and 25 minutes after endotracheal suctioning. Data were recorded on the data-recording sheet. Data were analyzed utilizing Wilcoxon and paired t-tests. There were significant differences in the ratio of arterial partial pressure of oxygen to fraction of inspired oxygen [Pao2/Fio2], Paco2, and arterial oxygen saturation [Sao2] between before and after endotracheal suctioning [p=0.000]. As findings showed that endotracheal suctioning improves arterial blood gases exchanges in patients receiving mechanical ventilation, so performing endotracheal suctioning in mechanically ventilated patients is recommended

[Prevalence of obesity in subjects aged 50 years and over in Tehran]

Overweight and obesity are major health problems affecting communities worldwide and the prevalence is rapidly rising. Although the prevalence of obesity in Iran has been reported, there are no data available on the prevalence of these factors in individuals aged over 50 years, individuals who are naturally more prone to cardiovascular diseases and death. This study aims at determining the prevalence of overweight and obesity in this high risk age group. In this investigation, data for 3391 individuals aged >/= 50 y, participants of the Tehran Lipid and Glucose study, was collected and assessed. Overall 1566 men [46.2%] and 1825 women [53.8%] were studied. The mean age for women was 59.8 +/- 7.2y and that for men was 62 +/- 7.9y. Average weight for males was 73 +/- 11.9 kg. and for females was 68.6 +/- 11.8 kg. On the whole prevalence of abnormal BMI [>/= 25 kg/mg2] was 73.3% [CI 95%, 71.8-74.8%]; of these 44.1% [CI 95%, 42.4-45.8%] were overweight and 29.2% [CI 95%, 27.7-30.8%] were obese. Percentages for overweight were 82% and 63.2% for women and men respectively. To conclude the prevalence of obesity and overweight in those aged over 50 years are rapidly rising. It is highly recommended that interventions for lifestyle changes be implemented in this high risk age group

[Population attribtable risk for diabetes associated to obesity in Iranian adults]

Excess weight is a well known risk factor for Type 2 diabetes mellitus. Several studies have estimated the population attributable risk of diabetes associated with overweight and obesity in developed countries. However, little evidence exists regarding the contribution of excess weight to diabetes in the Middle East countries. This study aimed at quantification of the impact of overweight and obesity on a population level in Iran. Using data of a population-based short-term cohort study in Iran, which began in 1998 with 3.6-year follow-up, we calculated the adjusted odds ratios [OR] and population attributable risks [PAR] of developing diabetes, i.e. the proportion of diabetes that would have been avoided had overweight and/or obesity not been present in the population. Results: Of the 4728 subjects studied, during the 3.6- year follow-up period, 3.5% [n=164] developed diabetes. This proportion was 1.3%, 3.2%, and 7.0% for the normal, overweight, and obese subjects, respectively. When compared to normal BMI, the adjusted ORs for incident diabetes were 1.78 [95% confidence interval [CI] 1.05 to 3.02] for overweight and 3.61 [95% CI 2.13-6.10] for obesity. The adjusted-PAR was 23.8% for overweight and 37.6% for obesity. Relatively feasible lifestyle changes of preventing overweight and obesity could substantially lower population diabetes incidence

[Assessing predicting factors in non-alcoholic fatty liver disease [NAFLD] in type 2 diabetes]

Non-alcoholic fatty liver disease [NAFLD] is a relatively prevalent disorder with many suspected risk factors. The aim of this study was to assess the association between the suspected risk factors with the presence of NAFLD according to the ultrasonographic criteria in type II diabetic patients. The study was performed on 76 type 2 diabetic patients attending consecutively to endocrine clinic. Negative history of alcohol use and hepatitis Band C were our basic inclusion criteria. All candidates underwent thorough clinical and biochemical assays consist of height, weight, waist circumference, fasting blood sugar, HbA1c, triglyceride, total cholesterol, HDL and LDL, liver trans-aminases, alkaline phosphatase, thyroid function tests, serum iron and total iron binding capacity and liver sonography to detect the presence [stage I to III] or absence of steatosis. The score of metabolic syndrome was determined according to the latest ATP III criteria. Pearson and Spearman correlation coefficients and logistic regression were used to assess the relationship between suspected risk factors and the presence of NAFLD. Forty-nine patients [64.4%] were female. The mean age [+/-standard deviation] was 59.7+/-8.8 years. The mean BMI in patients with and without NAFLD were 29.4+/-4.5 and 24.8+/-3.8kg/m[2], respectively [p<0.001]. Prevalence of NAFLD was significantly higher among patients with metabolic syndrome [89% vs. 43%, p<0.05]. Age [r=-0.24, p<0.05], waist circumference [r=0.27, p<0.05] and triglyceride [r=0.28, p<0.05] had significant correlation with steatosis. However, in logistic regression analysis, only BMI [for each 5 unit increment] was independently associated with the presence of NAFLD [OR=4.25, 95% CI: 1.7-10.9, p<0.05]. In type 2 diabetic patients, only BMI had a significant role in predicting NAFLD. It seems that other metabolic factors will not give any additional information for predicting NAFLD