Effect of lipid-lowering therapy on carotid plaque burden in older adults.

BACKGROUND: Little is known about the benefits of lipid-lowering medications in those age ≥ 75 years. We assessed the effect of lipid-lowering medications on progression to severe atherosclerosis in patients age > 75. METHODS: Data was retrospectively obtained from the Stroke Prevention & Atherosclerosis Research Centre, Canada. Atherosclerosis burden was measured as carotid total plaque area (TPA), a powerful predictor of cardiovascular risk. Survival time free of severe atherosclerosis (SFSA) was defined as the period when TPA remained <1.19 cm2. Kaplan-Meier, multiple Cox proportional hazard and hierarchical mixed-effect models were used to determine the effects of lipid-lowering medications on progression to severe atherosclerosis. RESULTS: In total 1404 cases (mean age 81 ± 4 years; women 52%) were included. Those taking lipid-lowering medications were more likely to have a history of diabetes and a higher burden of atherosclerosis at baseline. In Kaplan-Meier analysis, the SFSA was significantly longer in those receiving lipid-lowering therapy. In multivariable-adjusted analyses, those not receiving lipid lowering therapy (irrespective of their vascular disease at baseline) were more likely to have TPA > 1.19 cm2 (hazard ratio (HR) = 1.37, 95% confidence interval (CI): 1.09,0.71). Similar findings were observed in mixed effects models when plaque progression was defined as any change >0.05 cm2 per year (odds ratio (OR):2.17, 95% CI:1.38,3.57). CONCLUSION: Lipid-lowering therapy is effective in controlling the burden of atherosclerosis among older adults with and without vascular disease. The measurement of plaque burden can guide selection and follow-up of those who may benefit from treatment.

Assessment of microbial quality of household water output from desalination systems by the heterotrophic plate count method.

Point-of-use household water desalination systems (HWDSs) are becoming popular in Iran because of the deterioration of drinking water. This study aimed to determine the microbial quality of output water from HWDSs in Qom, Iran by using the heterotrophic plate count (HPC) method. Samples of input and output water from 30 HWDSs were collected over a six-month period. Heterotrophic bacteria were tested using the pour plate technique. At the first sampling stage, the HPC level in 23% of samples exceeded the 500 CFU/ml threshold level. On average, for 50% of samples, the HPC level of input samples was 0-10 CFU/ml, for 42% it was 10-100 CFU/ml and for 8% it was 100-500 CFU/ml. For output samples, for 25%, the level of HPC was 0-10 CFU/ml, for 43% it was 10-100 CFU/ml, for 24% it was 100-500 CFU/ml and for 8% it exceeded 500 CFU/ml. For total coliforms the most probable number test was positive for the first and third stages of sampling (3% input samples). The comparison of the averages with national standard values shows that in some cases, the contamination of output water from HWDSs in the city of Qom has been above the standard values.

Efficacy of nicorandil treatment for prevention of contrast-induced nephropathy in high-risk patients undergoing cardiac catheterization: A prospective randomized controlled trial.

BACKGROUND: Contrast-induced nephropathy (CIN) remains to be a potentially serious complication of radiographic procedures and is the third leading cause of the acute kidney injury (AKI) among hospitalized patients. This clinical trial was performed to assess the preventive effect of oral nicorandil on CIN in high-risk patients undergoing cardiac catheterization. METHODS: In this prospective, randomized, controlled trial, 128 patients with at least two risk factors for CIN undergoing elective percutaneous coronary intervention (PCI) were randomly assigned to either the nicorandil group or the control group. Patients in the nicorandil group (n = 64) received 10 mg nicorandil, daily from 30 min before and up to 3 days after procedure and intravenous hydration for 2 h before and 6 h after the procedure, whereas patients in the control group (n = 64) just received intravenous hydration. Serum creatinine (SCr) was measured before contrast exposure and at 72 h. CIN was defined as an increase of 25% in SCr or > 0.5 mg/dL 72 h after contrast administration. RESULTS: Contrast-induced nephropathy occurred in 14 out of 64 (21.9%) patients in the control group and in 3 out of 64 (4.7%) patients in the nicorandil group. There was a significant difference in the incidence of CIN between the two groups at 72 h after administering the radiocontrast agent (p = 0.008). Moreover, there were significant differences between the two groups in SCr and estimated glomerular filtration rate 72 h after radiocontrast administration (p < 0.05). CONCLUSIONS: The findings revealed that oral nicorandil had substantial efficacy over hydration protocol for the development of CIN in high-risk patients undergoing cardiac catheterization.

Investigation of educational intervention based on Theory of Planned Behavior on breakfast consumption among middle school students of Qom City in 2012.

BACKGROUND: Eating breakfast is crucial for adolescents to be healthy. It also improves students' capacity of learning and doing school homework. Although healthy habits such as eating breakfast, weight control, and regular sleep increase the lifespan in adults, the effects of healthy habits on school-age children have not been studied much. The present study aimed at investigating the impact of an educational program based on Theory of Planned Behavior (TPB) on eating breakfast among middle school students. MATERIALS AND METHODS: This interventional study was conducted on sixth-grade students in Qom City during the academic year 2012-2013. First, 97 students were randomly assigned to the experimental group and 97 other students were assigned to the control group. Then, a questionnaire was developed on eating breakfast by the researchers according to the TPB. A pilot study was conducted to assess the reliability of the questionnaire. To assess the validity of the questionnaire, advice by a panel of experts was sought. To carry out a pre-test, both groups answered the questions. After analyzing the pre-test results, the required content was developed for the experimental group. Educational methods included delivering speech, discussion groups, pamphlets, and posters. The required educationalcontent was provided for students during five sessions and for parents in one session. To determine the effect of educational intervention, a post-test study was carried out 2 months after the intervention. Collected data were analyzed using independent t-test, χ,([2]) and repeated measures. RESULTS: In the experimental group, 36.7% of students were eating breakfast at least in a day of a week, before educational intervention. After implementation of the educational program, only 32.7% of them were continuing their past habit. There was a significant difference between themean scores of attitudes, perceived behavioral control, intention, and practice of eating breakfast in the experimental and control groups (P < 0.05), while there was no significant difference between the mean scores of subjective norms after implementing the educational program in both groups (P < 0.26). CONCLUSION: Using the TPB improved students' intentions and behavior of eating breakfast. Thus, it seems necessary to consider all effective environmental factors on the subjective norms in the education of healthy eating behaviors or improving breakfast-eating practice among students.