Effects of Intravenous Lipid Emulsion Administration in Acute Tramadol Poisoning: A Randomized Controlled Trial.

BACKGROUND: As the prevalence of tramadol toxicity is increasing, managing these patients with the aim of treatment and complete recovery has become a major challenge for health care professionals. OBJECTIVE: This study evaluated the short-term effects of IV lipid emulsion (ILE) administration in cases of tramadol poisoning. METHODS: In this double-blind, randomized controlled trial, 120 patients with pure tramadol poisoning and a Glasgow Coma (GCS) score ≤ 12 referred to a poisoning center in Tehran, Iran were selected and randomly assigned 1:1 to receive ILE 20% (intervention) or 0.9% saline (control) after admission and primary stabilization. The patient's vital signs, GCS score, hospitalization duration, and rate of seizure occurrence were recorded and compared between the two groups. RESULTS: Mean (SD) age of participants was 25.3 (5.4) years and 84 (70%) were male. Mean (SD) ingested dose of tramadol was 3118 (244) mg, which was not different between the groups. Compared with controls, the ILE group had a higher level of consciousness after treatment (median [interquartile range] GCS score 12 [10-13] vs. 10 [8-12]; p = 0.03). In addition, length of hospitalization (median [interquartile range] (2 [1-3] days vs. 4 [4-6] days; p < 0.01) and rate of seizure occurrence were lower in the intervention group (16/60 vs. 30/60; p < 0.01). CONCLUSIONS: In the setting of tramadol poisoning with a decreased level of consciousness and based on our study's findings, administration of ILE is suggested to help manage patients in hospital emergency departments. However, larger trials might be needed to confirm these findings before entering the guidelines.

Spatio-temporal analysis of deaths from carbon monoxide poisoning in Iran between 2011 and 2018: An ecological study.

Background and Aims: Mortality caused by carbon monoxide every year threatens the lives of Iranian people, whose spatial and temporal distribution is not known for formulating prevention policies and interventions. This study was conducted to determine the trend of mortality rate changes due to carbon monoxide CO poisoning by Spatio-temporal analysis in Iran from 2011 to 2018. Methods: An ecological study was conducted based on data from the reports at the National Center for Statistics of Iran for 8 years from 21 March 2011 to 21 March 2018. The number of deaths due to CO poisoning and the annual mortality rates of CO poisoning per 100,000 populations were calculated. To determine the geographical and temporal distribution of death caused by carbon monoxide, spatiotemporal statistical analysis was used. Results: A total of 6078 deaths were reported due to CO poisoning 4497 deaths were male (74%) and 1596 were female (26%) from 2011 to 2018. Both sexes' mortality rate due to CO poisoning was 1.26 from 2011 to 0.91 in 2018. According to the results, the overall male-to-female ratio was 2.8. The mortality rate due to CO Poisoning had a decreasing trend. However, this trend did not have a linear trend (p = 0.37). The highest mortality due to CO poisoning was seen in the northern and western provinces of Iran. Conclusion: Our results showed that the mortality rate due to CO poisoning had a decreasing trend during the understudied period. Also, most of the deaths due to CO poisoning occurred in the northern and western provinces of Iran. So, designing prevention programs as well as increasing people's awareness in these regions is recommended.

Is single point HbA1c a reliable predictor for death in severe COVID-19?

Introduction: The severity of COVID-19 infection is affected by several risk factors such as Diabetes Mellitus (DM). The current study aimed to determine the effect of single-point HbA1c on the severity and mortality of hospitalized COVID-19 patients. Methods: This cross-sectional study was conducted among hospitalized moderate and severe COVID-19 patients in Baharloo Hospital in Iran between December 23rd and February 23rd, 2021. The patients have been diagnosed by Polymerase Chain Reaction (PCR) and Chest Computed Tomography (CT) imaging as COVID-19. Demographic data, clinical presentation, laboratory results, and treatments along with the HbA1c data were included. Results: 165 COVID-19 cases were included in this study; 126 (76.4%) of which were severe cases. 89 (53.9%) patients were male, with a mean age of 59.89 ± 16.59 years. Severe COVID-19 patients were more prone to a longer hospital stay, and a higher level of inflammatory mediators, compared to the moderate COVID-19 patients (p < 0.05). No significant association was found between single point HbA1c, FBS, and severity and mortality of COVID-19 cases (p > 0.05). Conclusions: Single point HbA1c was not a reliable mediator for the prediction of severity or death in hospitalized COVID-19 patients.

The Global, Regional, and National Burden of Adult Lip, Oral, and Pharyngeal Cancer in 204 Countries and Territories: A Systematic Analysis for the Global Burden of Disease Study 2019.

Importance: Lip, oral, and pharyngeal cancers are important contributors to cancer burden worldwide, and a comprehensive evaluation of their burden globally, regionally, and nationally is crucial for effective policy planning. Objective: To analyze the total and risk-attributable burden of lip and oral cavity cancer (LOC) and other pharyngeal cancer (OPC) for 204 countries and territories and by Socio-demographic Index (SDI) using 2019 Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study estimates. Evidence Review: The incidence, mortality, and disability-adjusted life years (DALYs) due to LOC and OPC from 1990 to 2019 were estimated using GBD 2019 methods. The GBD 2019 comparative risk assessment framework was used to estimate the proportion of deaths and DALYs for LOC and OPC attributable to smoking, tobacco, and alcohol consumption in 2019. Findings: In 2019, 370 000 (95% uncertainty interval [UI], 338 000-401 000) cases and 199 000 (95% UI, 181 000-217 000) deaths for LOC and 167 000 (95% UI, 153 000-180 000) cases and 114 000 (95% UI, 103 000-126 000) deaths for OPC were estimated to occur globally, contributing 5.5 million (95% UI, 5.0-6.0 million) and 3.2 million (95% UI, 2.9-3.6 million) DALYs, respectively. From 1990 to 2019, low-middle and low SDI regions consistently showed the highest age-standardized mortality rates due to LOC and OPC, while the high SDI strata exhibited age-standardized incidence rates decreasing for LOC and increasing for OPC. Globally in 2019, smoking had the greatest contribution to risk-attributable OPC deaths for both sexes (55.8% [95% UI, 49.2%-62.0%] of all OPC deaths in male individuals and 17.4% [95% UI, 13.8%-21.2%] of all OPC deaths in female individuals). Smoking and alcohol both contributed to substantial LOC deaths globally among male individuals (42.3% [95% UI, 35.2%-48.6%] and 40.2% [95% UI, 33.3%-46.8%] of all risk-attributable cancer deaths, respectively), while chewing tobacco contributed to the greatest attributable LOC deaths among female individuals (27.6% [95% UI, 21.5%-33.8%]), driven by high risk-attributable burden in South and Southeast Asia. Conclusions and Relevance: In this systematic analysis, disparities in LOC and OPC burden existed across the SDI spectrum, and a considerable percentage of burden was attributable to tobacco and alcohol use. These estimates can contribute to an understanding of the distribution and disparities in LOC and OPC burden globally and support cancer control planning efforts.

Performance of discrete wavelet transform-based method in the detection of influenza outbreaks in Iran: An ecological study.

Background and Aim: Timely detection of outbreaks is one of the main purposes of the health surveillance system. The presence of appropriate methods in the detection of outbreaks can have an important role in the timely detection of outbreaks. Because of the importance of this issue, this study aimed to assess the performance of discrete wavelet transform (DWT) based methods in detecting influenza outbreaks in Iran from January 2010 to January 2020. Methods: All registered influenza-positive virus cases in Iran from January 2010 to January 2010 were obtained from the FluNet web base tool, the World Health Organization website. The combination method that includes DWT and Shewhart control chart was used in this study. All analyses were performed using MATLAB software version 2018a Stata software version 15. Results: The Mean ± SD and median of reported influenza cases from January 2010 to January 2020 was 36 ± 108 and four cases per week. The combination of the DWT and Shewhart control chart with K = 0.25 had the most sensitivity. The most specificity in the detection of nonoutbreak days was seen in the combination of DWT and Shewhart control chart with K = 1.5, K = 1.75, and K = 2, respectively. The combination of DWT and Shewhart control chart with K = 0.5 had the best performance in the detection of outbreaks (sensitivity = 0.64, specificity: 0.90, Youden index: 0.54, and area under the curve [AUC]: 0.77). Conclusion: The DWT-based method in detecting influenza outbreaks has acceptable performance, but it is recommended that this method's performance be assessed in detecting outbreaks of other infectious diseases.

Occupational needle stick injuries and related factors among healthcare workers in military hospitals in Tehran.

AIM: Healthcare workers (HCWs) are always at risk of experiencing occupational needle stick injuries (NSIs). The primary aim of this study was to assess the prevalence of NSIs among Iranian HCWs in military hospitals in Tehran. DESIGN: This cross-sectional study was conducted in four military hospitals in the summer of 2019 in Tehran. METHOD: By Census, 802 HCWs were included. Data were collected through a questionnaire consisting of vaccination history, safety equipment, use of safety box, history of NSIs and demographic variables. The logistics regression was used to estimate the odds ratios (OR) and 95% confidence interval (CI). The statistical significance level was set at 5%. The data were analysed using the SPSS software version 23. RESULTS: A total of 203 (25.3%, CI: 22.3-28.4) of the participants reported a history of NSIs at least once during the past year. Single HCWs had a higher risk of NSIs compared to married HCWs (OR: 1.59, 95% CI (1.09, 2.30)). Also, the night shift working (OR: 1.91, 95% CI (1.18, 3.12)), higher educational degree (OR: 2.25, 95% CI (1.21, 4.20)), working overtime (OR: 1.50, 95% CI: (1.07, 2.12)), older age (OR: 1.02, 95% CI (1.01, 1.04)) and needle recapping (OR: 2.90, 95% CI: (1.98, 4.22)) were identified as significant associated factors. The study draws attention to a relatively high prevalence of NSIs as well as high-risk activities among military HCWs. The primary source of NSIs is needle recapping. Measures such as setting up training courses for the military HCWs are needed to be planned.

Forty-seven year trend of measles in Iran: An interrupted time series analysis.

Background and Aim: Measles is an acute viral infectious disease usually characterized by erythematous maculopapular rash and sometimes pneumonia, diarrhea, and Central Nervous System disturbance. The current study aimed to describe the trend of measles in Iran before and after the 1978 revolution and COVID-19 pandemic. Methods: In the current quasi-experimental study, we used annual data on confirmed cases of measles in Iran, from 1974 to 2021. Data were extracted from the World Health Organization website. An interrupted time series model was used to assess the effect of different events on the incidence of measles. Results: The trend of new cases increase every year until 1980 according to the preintervention slope of 2040 (95% confidence interval [CI] = -1965-2045; p < 0.31). After Iran's revolution, the occurrence of new cases significantly decreased (-845 [95% CI = -1262 to -432; p = 0.001]). After the COVID-19 pandemic, the trend of new cases significantly increased (41 [95% CI = 12-70; p = 0.006]). Conclusion: It seems that social or health-related events are among the effective factors on the incidence of measles. But with maintaining vaccination coverage in the community and vaccination of immigrants, this fluctuation in the disease trend can be decreased.

Prevalence of Amiodarone Induced Hypothyroidism and Hyperthyroidism in Patients with Heart Diseases: A Systematic Review and Meta-Analysis.

BACKGROUND: Due to the importance of amiodarone-induced hyperthyroidism in patients with heart failure, the purpose of the present systematic review and metaanalysis was to determine the prevalence of thyroid dysfunction (hypothyroidism and hyperthyroidism) in patients with heart disease who received amiodarone. METHODS: Electronic databases including Scopus, PubMed, Web of Science, and Science Direct were searched by two investigators. To assess the heterogeneity between the included studies, the chi-square χ2 test (α=0.05) and I2 index were used. Additionally, a random-effects model with 95% CI was used to estimate the pooled prevalence of thyroid dysfunction due to the heterogeneity of the studies. To identify the cause of heterogeneity, a meta-regression analysis was employed. All analyses were performed using Stata ver13 (Stata Corporation, College Station, TX, USA). RESULTS: The pooled prevalence of hypothyroidism was 23.43% (95% CI: 11.54-35.33) and hyperthyroidism was 11.61% (95% CI: 7.20-16.02). There was no significant association between the prevalence of hypothyroidism and the year of the study (p=0.152), sample size (p=0.805), and mean age of subjects in the sample groups (p=0.623). However, there was a significant association between the prevalence of hyperthyroidism and the year of the study (p=0.037), but no statistically significant association between either the prevalence of hyperthyroidism and sample size (p=0.425), or the prevalence of hyperthyroidism and the mean age of subjects in the sample groups (p=0.447). CONCLUSION: The prevalence of thyroid dysfunction in patients with cardiac arrhythmias receiving amiodarone was considerable. Extreme care should be exercised to improve the monitoring of any thyroid abnormalities that may arise in patients receiving amiodarone.

Global COVID-19 vaccine acceptance rate: a systematic review and meta-analysis.

Aim: Achieving high COVID-19 vaccination coverage rates is essential as soon as a vaccine is available to deal with and end this pandemic. Due to the different amounts of COVID-19 vaccine acceptance rates in different regions, the pooled estimation of this rate is essential. Therefore, we conducted a systematic review and meta-analysis to investigate worldwide COVID-19 vaccine acceptance rates. Subject and methods: International databases (including, Web of sciences, PubMed, and Scopus) were searched to identify related studies. The heterogeneity among studies was assessed using the I2 index, the Cochran Q test, and T2. A random-effects model was used to pool estimate vaccine acceptance rates. Results: The overall pooled estimate of COVID-19 vaccine acceptance rate was 65.1 (95% CI 60.1-70.1; P < 0.001, I2 = 99.8). The vaccine acceptance rate in the general population was 68.5 (95% CI 62.5-74.5; P < 0.001, I2 = 99.8) and among healthcare workers (HCWs) was 55.9 (95% CI 47.8-64.1; P < 0.001, I2 = 99.6). The lowest COVID-19 vaccine acceptance rate was in the Middle East (46.1% (35.1-57.0)), and the highest coverage rate was (85% (71-99.1)) in South America. Conclusion: COVID-19 vaccine acceptance rate among HCWs is lower than the general population. More studies are recommended to identify related factors to the COVID-19 vaccine acceptance rate.

Hospital length of stay for COVID-19 patients: a systematic review and meta-analysis.

The length of stay in the hospital for COVID-19 can aid in understanding the disease's prognosis. Thus, the goal of this study was to collectively estimate the hospital length of stay (LoS) in COVID-19 hospitalized individuals. To locate related studies, international databases (including Google Scholar, Science Direct, PubMed, and Scopus) were searched. The I2 index, the Cochran Q test, and T2 were used to analyze study heterogeneity. The mean LoS in COVID- 19 hospitalized patients was estimated using a random-effects model. COVID-19's total pooled estimated hospital LoS was 15.35, 95%CI:13.47-17.23; p<0.001, I2 = 80.0). South America had the highest pooled estimated hospital LoS of COVID-19 among the continents, at 20.85 (95%CI: 14.80-26.91; p<0.001, I2 = 0.01), whereas Africa had the lowest at 8.56 8 (95%CI: 1.00-22.76). The >60 age group had the highest pooled estimated COVID-19 hospital LoS of 16.60 (95%CI: 12.94-20.25; p<0.001, I2 = 82.6), while the 40 age group had the lowest hospital LoS of 10.15 (95% CI: 4.90-15.39, p<0.001, I2 = 22.1). The metanalysis revealed that COVID-19's hospital LoS was more than 10 days. However, it appears that this duration varies depending on a number of factors, including the patient's age and the availability of resources.

Platelet-rich plasma in the treatment of scars, to suggest or not to suggest? A systematic review and meta-analysis.

Despite the rising trend for applying platelet-rich plasma (PRP) in the management of various types of scars, there is no convincing evidence supporting its use. This motivated us to review the randomized clinical trials that examine the effectiveness and safety of PRP, alone or in combination with other methods, for the management of atrophic or hypertrophic/keloidal scars. The Web of Science, Scopus, Google Scholar, and Cochrane Library databases were systematically searched until September 1st , 2020. Thirteen clinical trials were enrolled in the meta-analysis, and 10 more were reviewed for their results. The random effect meta-analysis method was used to assess the effect size of each outcome for each treatment type, and I2 was used to calculate the statistical heterogeneity between the studies. Patients treated with PRP experienced an overall response rate of 23%, comparable to the results seen with laser or micro-needling (22% and 23%, respectively) When used alone, moderate improvement was the most frequently observed degree of response with PRP (36%) whereas, when added to laser or micro-needling, most patients experienced marked (33%, 43%, respectively) or excellent (32% and 23%, respectively) results. Concerning the hypertrophic/keloid scars, the only study meeting the required criteria reported a better improvement and fewer adverse effects when PRP was added to the intralesional corticosteroids. Platelet-rich plasma appears to be a safe and effective treatment for various types of atrophic scars. In addition, when added to ablative lasers or micro-needling, it seems to considerably add to the efficacy of treatment and reduce the side effects.

Effect of whey protein supplementation on weight and body composition indicators: A meta-analysis of randomized clinical trials.

BACKGROUND & AIM: Whey protein (WP) is one of the well-known dairy driven products to help people to change their weight and body composition (BC). This study aimed to investigate the effect of WP on weight and BC on every published RCT on all populations. METHODS: A systematic review of the literature was undertaken to identify RCTs that examined the effect of WP on weight, body fat, lean body mass, fat-free mass, and waist circumference. To create weighted-group-mean differences for within- and between-group comparisons, random effects models were used. Subgroup analyses were also done to determine the effect of potential sources of heterogeneity. RESULTS: Thirty-five RCTs, with a total of 1902 adult participants were included in pooled analysis. The effect of WP supplementation on BMI (-0.156, 95% CI: -0.31, 0.00, P < 0.05), body fat mass (-0.144, 95% CI: -0.28, 0.00, P < 0.05), and waist circumference (-0.448, 95% CI: -0.86, -0.03, P < 0.05) in within group analysis, and BMI (-0.769, 95% CI: -1.54, 0.00, P < 0.05) and lean body mass (0.741, 95% CI: 0.07, 1.41, P < 0.05) in the between group analysis was indicated. Resistance training, WP dosage, sex, age group, the type of control group (placebo, different proteins, etc.), the control group dosage, and energy intake before and during the trial, as well as between the WP and control groups, were recognized as the main sources of heterogeneity. CONCLUSION: The data from trials currently available supports the use of WP to improve BC indicators. The benefits of WP on BC are expected to be greatest when combined with resistance training and a reduction in overall calorie consumption.

Effect of epidemic management and control plan on COVID-19 mortality in Iran: an interrupted time series analysis.

Background: Globally, several measures have been taken to decrease COVID-19 mortality. However, the effectiveness of preventive measures on the mortality related to COVID-19 has not been fully assessed. Thus, the present study aimed the present study aimed to assess the success of COVID-19 epidemic management and control plan on the mortality associated with COVID-19 in Iran from February 19, 2020, to February 5, 2021. Methods: In the current quasi experimental study an interrupted time series analysis of daily collected data on confirmed deaths of COVID-19 occurred in Iran and in the world, were performed using Newey ordinary least squares regression-based methods. Results: In Iran, the trend of new deaths increased significantly every day until 24 November 2020 according to pre-intervention slope of [(OR 1.14, 95% CI 0.96-1.32,); P < 0.001]. The occurrence of new deaths had a decreasing trend after November 24, 2020, with a coefficient of [(OR -5.12, 95% CI -6.04 - -4.20), P < 0.001)]. But in the global level daily new deaths was increasing before [(OR 18.66, 95% CI 14.41-2292; P < 0.001)] and after the 24 November 2020 [(OR 57.14, 95% CI 20.80-93.49); P: 0.002]. Conclusions: Iranian COVID-19 epidemic management and control plan effectively reduced the mortality associated to COVID-19. Therefore, it is essential to continue these measures to prevent the increase in the number of deaths.

COVID-19: Clinical features, case fatality, and the effect of symptoms on mortality in hospitalized cases in Iran.

Objective: Identifying the epidemiological characteristics of COVID-19 could help to control the pandemic. The aim of this study was to characterize the epidemiological features of hospitalized COVID-19 patients in Iran. Methods: Data were collected on patients admitted to a military referral hospital in Tehran, Iran, from February 8, 2020 to July 28, 2021. Sex, age, clinical symptoms, outcome, type of comorbidities, level of blood Spo2, time of admission, and time of discharge were investigated. Sex ratio, case fatality rate (CFR), and daily trends of hospital admissions and deaths were also determined. Descriptive statistics and multiple logistic regression with 95% confidence intervals were used for data analysis. The statistical significance level was set at 0.05. STATA16.0 and Excel 2010 were used for data analysis. Results: The median hospital length of stay (LOS) was 6 days. The following symptoms were most common: cough (63.5%), fever (50%), respiratory distress (46.1%), and muscular pain (40.8%). Hypertension (29.5%), diabetes (24.7%), and cardiovascular diseases (21.8%) were the most prevalent comorbidities. The CFR was calculated at 8.30%. Respiratory symptoms increased the odds of death by 45% (OR 1.45, 95% CI 1.03-2.06). Gastrointestinal symptoms were associated with a reduction in the mortality of COVID-19 cases, but this association was not statistically significant (OR 0.94, 95% CI 0.73-1.21). Conclusions: The results of this study emphasize higher mortality rates among older age groups, male patients, and patients with underlying diseases.

High dose melatonin as an adjuvant therapy in intubated patients with COVID-19: A randomized clinical trial.

Objective: In the COVID-19 pandemic, the SARS-CoV-2 virus has infected millions of people worldwide. Mortality primarily results from the inflammation state and its complications. High-dose melatonin has been established as an anti-inflammatory agent. This study evaluated high-dose melatonin as an adjuvant therapy in critically ill patients with SARS-CoV-2 infection. Methods: We conducted a double-blinded, randomized clinical trial of 21 mg of melatonin per day compared with a placebo in 67 patients with COVID-19. We enrolled patients older than 18 years of age with documented SARS-CoV-2 infection, who were admitted to the intensive care unit and underwent invasive mechanical ventilation. Administration of melatonin and placebo through a nasogastric tube continued for 5 days. The main outcomes were mortality rate, duration of mechanical ventilation, changes in oxygenation indices, and C-reactive protein (CRP) levels. Results: No significant differences were observed in mortality and duration of mechanical ventilation between the control and intervention groups. After 5 days of the intervention, the mean (±standard deviation) CRP and platelet count were 47.28 (±38.86) mg/L and 195.73 (±87.13) × 1000/µL, respectively, in the intervention group and 75.52 (±48.02) mg/L and 149.62 (±68.03) × 1000/µL, respectively, in the control group (P < 0.05). Conclusion: High-dose melatonin in intubated patients with COVID-19 was associated with a decrease in CRP levels. However, this treatment did not apparently affect patient outcomes.

xsGastrointestinal symptoms are associated with a lower risk of hospitalization and mortality and Outcomes in COVID-19.

BACKGROUND: We aimed to find the association between gastrointestinal (GI) and respiratory symptoms with mortality and hospitalization among COVID-19 patients. METHODS: We analyzed the registered data of COVID-19 patients from February 20, 2020, to March 10, 2021. Depending on the patients' disease symptoms, four categories were defined: patients with only GI symptoms, patients with only respiratory symptoms, patients with both symptoms, and patients with other symptoms. Logistic regression analysis was used to assess the association of groups with outcomes. RESULTS: A total of 42,964 patients from 23 hospitals were included, of which 26.5% patients had at least one or more GI symptoms. Of total patients, 51.58% patients were hospitalized among which 22.8% had at least one or more GI symptoms. GI symptoms significantly decreased the odds of mortality (OR 0.72, 95% CI 0.56-0.92), but respiratory symptoms increased the odds for mortality (1.36: 1.24-1.50), compared with patients with other symptoms. Moreover, the odds ratio of patients who had both respiratory and GI symptoms increased (1.52: 1.31-1.78) compared with patients with other symptoms. The same results were observed for hospitalization as the outcome. CONCLUSIONS: Our study showed that the presence of GI symptoms in COVID-19 at the time of admission was associated with a lower odds of hospitalization and mortality; however, this association had higher odds for respiratory symptoms.

Evaluation the Possible Role of Interleukin-6 and Tumor Necrosis Factor- Alpha in Pathogenesis of Obstructive Sleep Apnea in Obese Patients: A Case-Control Study:.

BACKGROUND: According to a mounting body of evidence, recent observations have highlighted considerable association between obstructive sleep apnea (OSA) syndrome and patients' obesity and inflammation, however the exact underlying mechanisms remain to be fully understood. In this study, the relationship between OSA and Interleukin-6 and Tumor necrosis factor- alpha was assessed in obese patients and their serum concentrations were compared to non-OSA obese subjects. MATERIALS AND METHODS: This case-control study was conducted on forty-six obese OSA patients (body mass indices, BMI30) and 42 obese but otherwise healthy individuals who were admitted to the pulmonary or obesity clinics of the Hazrat-e Rasool General Hospital (Tehran, Iran) between November 2019 and May 2020 were included. The participants completed the NOSAS, EPWORTH and STOPBANG questionnaires. Tumor Necrosis Factor-Alpha (TNF-α) and Interleukin-6 (IL-6) serum concentrations were determined using the enzyme-linked immunosorbent assay (ELISA) method. RESULTS: Compared to the non-OSA group, OSA patients had higher systolic and diastolic blood pressure, pCO2, bicarbonate (HCO3) and hemoglobin and lower high-density lipoprotein (HDL) values. IL-6 and TNF-α serum levels were not significantly different between both groups. Univariate and multivariate linear regression models showed that BMI, systolic blood pressure, pCO2 and HCO3 can positively affect the serum TNF-α and systolic blood pressure and HCO3 can also positively affect the serum IL-6 values in patients with the OSA. CONCLUSION: This investigation suggests that among the OSA patients, the heightened inflammatory profile may be influenced by the high BMI. Furthermore, the exclusive relationship between different disease biomarkers and inflammatory agents in OSA patients is intriguing and needs further research.

Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life Years for 29 Cancer Groups From 2010 to 2019: A Systematic Analysis for the Global Burden of Disease Study 2019.

IMPORTANCE: The Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) provided systematic estimates of incidence, morbidity, and mortality to inform local and international efforts toward reducing cancer burden. OBJECTIVE: To estimate cancer burden and trends globally for 204 countries and territories and by Sociodemographic Index (SDI) quintiles from 2010 to 2019. EVIDENCE REVIEW: The GBD 2019 estimation methods were used to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life years (DALYs) in 2019 and over the past decade. Estimates are also provided by quintiles of the SDI, a composite measure of educational attainment, income per capita, and total fertility rate for those younger than 25 years. Estimates include 95% uncertainty intervals (UIs). FINDINGS: In 2019, there were an estimated 23.6 million (95% UI, 22.2-24.9 million) new cancer cases (17.2 million when excluding nonmelanoma skin cancer) and 10.0 million (95% UI, 9.36-10.6 million) cancer deaths globally, with an estimated 250 million (235-264 million) DALYs due to cancer. Since 2010, these represented a 26.3% (95% UI, 20.3%-32.3%) increase in new cases, a 20.9% (95% UI, 14.2%-27.6%) increase in deaths, and a 16.0% (95% UI, 9.3%-22.8%) increase in DALYs. Among 22 groups of diseases and injuries in the GBD 2019 study, cancer was second only to cardiovascular diseases for the number of deaths, years of life lost, and DALYs globally in 2019. Cancer burden differed across SDI quintiles. The proportion of years lived with disability that contributed to DALYs increased with SDI, ranging from 1.4% (1.1%-1.8%) in the low SDI quintile to 5.7% (4.2%-7.1%) in the high SDI quintile. While the high SDI quintile had the highest number of new cases in 2019, the middle SDI quintile had the highest number of cancer deaths and DALYs. From 2010 to 2019, the largest percentage increase in the numbers of cases and deaths occurred in the low and low-middle SDI quintiles. CONCLUSIONS AND RELEVANCE: The results of this systematic analysis suggest that the global burden of cancer is substantial and growing, with burden differing by SDI. These results provide comprehensive and comparable estimates that can potentially inform efforts toward equitable cancer control around the world.