International Journal of Preventive Medicine
Volume:3 Issue: 6, jun 2012

The salt hypothesis was revived in 1904 by Ambard and Beaujard[1] and since then, many researches around the world have been studying this aspect.[2] The salt hypothesis states that salt is necessary for the genesis of essential hypertension.[3] Moreover, the mortality rates of stomach cancer and stroke were found to decrease in a similar way over a given time in different countries.[4] Based on an observation in 1965—that stomach cancer mortality and stroke mortality were strongly correlated—the hypothesis was presented that salt could be involved in the etiology of both the diseases, although by different mechanisms.[5] While salt intake could have an influence on blood pressure and thus increasing the risk of stroke mortality,[4] it can also have a caustic influence on the stomach mucosa, stimulating atrophic gastritis leading to stomach cancer.[6]

Preventive Medicine in the elderly is often regarded as a redundant concept and pre-existing opinions are barriers in the provision of this service. This article explores the concepts of preventive medicine in the elderly from a United Kingdom perspective and examines current trends، opinions and sets out a path for the future. In particular it focusses on the theories of morbidity associated with ageing، economic viability of of providing preventive medicine care for the older person and attempts to seek redress for the current situation.

Community-based participatory research (CBPR) has been applied by health researchers and practitioners to address health disparities and community empowerment for health promotion. Despite the growing popularity of CBPR projects, there has been little effort to synthesize the literature to evaluate CBPR projects. The present review attempts to identify appropriate elements that may contribute to the successful or unsuccessful interventions. A systematic review was undertaken using evidence identified through searching electronic databases, web sites, and reference list checks. Predefined inclusion and exclusion criteria were assessed by reviewers. Levels of evidence, accounting for methodologic quality, were assessed for 3 types of CBPR approaches, including interventional, observational, and qualitative research design as well as CBPR elements through separate abstraction forms. Each included study was appraised with 2 quality grades, one for the elements of CBPR and one for research design. Of 14,222 identified articles, 403 included in the abstract review. Of these, 70 CBPR studies, that 56 intervention studies had different designs, and finally 8 studies met the inclusion criteria. The findings show that collaboration among community partners, researchers, and organizations led to community-level action to improve the health and wellbeing and to minimize health disparities. It enhanced the capacity of the community in terms of research and leadership skills. The result provided examples of effective CBPR that took place in a variety of communities. However, little has been written about the organizational capacities required to make these efforts successful. Some evidences were found for potentially effective strategies to increase the participant’s levels of CBPR activities. Interventions that included community involvement have the potential to make important differences to levels of activities and should be promoted.

A school-based surveillance system entitled the childhood and adolescence surveillance and prevention of Adult Noncommunicable disease (CASPIAN) Study is implemented at national level in Iran. This paper presents the methods and primary findings of the third survey of this surveillance system. This national survey was performed in 2009–2010 in 27 provinces of Iran among 5570 students and one of their parents. In addition to physical examination, fasting serum was obtained. Body mass index was categorized based on the World Health Organization growth charts. Data of 5528 students (2726 girls, 69.37% urban, mean age 14.7 ± 2.4 years) were complete and are reported. Overall, 17.3% (17.3% of girls and 17.5% of boys) were underweight, and 17.7% (15.5% of girls and 19.9% of boys) were overweight or obese. Abdominal obesity was documented in 16.3% of students (17.8% of girls and 15% of boys). 57.6% of families consumed breads, the staple food for Iranians, prepared with white flour. Most families (43.8% in urban areas and 58.6% in rural areas) used solid hydrogenated fats. 22.7% of students did not add salt to the table food. 14.2% of students reported to have a regular daily physical activity for at least 30 min a day. Overall, 10.4% of students (11.7% in urban areas and 7.3% in rural areas) reported that they used tobacco products, often waterpipe. 32.8% of students experienced at least three times of bullying in the previous 3 months. During the year prior to the survey, 14.46% of students had an injury needing the interference by school health providers. This survey is confirmatory evidence on the importance of establishing surveillance systems for risk behaviors to implement action-oriented interventions.

Determining the risk factors in developing or increasing the relapses of acute lymphoblastic leukemia (ALL) may help health and preventive systems to launch new programs. Up to 90% of normal population changes to seropositive for BK virus by the age of 10 years. Whether this oncogenic virus is responsible for evolving ALL is unclear. In this study, we evaluated the excretion of urinary BK virus in newly diagnosed children with ALL compared with normal population. This case–control study was carried out on 62 participants (32 ALL patients and 32 normal subjects), aged 1–18 years, in Saint Al-Zahra and Sayyed-Al-Shohada University Hospitals, Isfahan, Iran. A polymerase chain reaction (PCR) method was used to detect the BK virus in specimens. PCR amplification was performed using specific primers of PEP-1 (5′-AGTCTTTAGGGTCTTCTACC-3′) and PEP-2 (5′-GGTGCCAACCTATGGAACAG-3′). Thirty-five out of 62 participants (54.8%) were males and the remaining were females. The mean duration of disease was 9.6 ± 9.69 months. Central nervous system (CNS) relapse was seen in 29% of the patients. Positive PCR for urine BK virus was seen in three children with ALL (9.7%). No positive result for urine BKV was achieved in the control group. However, Fisher’s exact test did not show any significant difference between the two groups (P > 0.05). In addition, there was no significant correlation between BKV positivity and frequency of relapses. To demonstrate the role of BK virus in inducing ALL or increasing the number of relapses, prospective studies on larger scale of population and evaluating both serum and urine for BK virus are recommended.

Iran, similar to other countries, had faced H1N1 flu outbreak in 2009. In order to assess its transmission dynamic, we estimated its force of infection (β) and basic reproductive number (R0). Within a middle size primary school in Iran, we actively followed students and detected flu‑like syndrome among students and their families in the first three months of academic year; October through December 2009. We estimated the probability of disease transmission within families (β) fitting random effects Poisson regression model. Moreover, R0 within the school was computed based on the number of detected cases. In 452 students, 204 influenza‑like syndromes were detected. The estimated β within families was 0.10; increasing one infectious member within each family was associated with 30% increase in this number. The estimated R0 for the first month was 1.21 (95% C.I.: 0.99, 1.47); corresponding numbers for the first two and first three months were 1.28 (95% C.I.: 1.05, 1.54) and 1.32 (95% C.I.: 1.11, 1.59), respectively. It seems that the dynamic transmission of H1N1 virus was more or less comparable with that in other seasonal species. Our findings showed that the virus mainly circulated among students within schools. In addition, it seems that the transmission rate within families was relatively high.

This study aims to identify the differences between Injecting Drug Users (IDUs) and non‑IDUs, with regard to some potential factors. This could be useful to design effective interventions for harm reduction, which is one of the priority areas in reducing the burden of addiction. Sixty cases and 60 controls participated in this pair‑matched case‑control study, which was conducted in Tehran. The cases were IDUs who were asked to introduce two friends; one IDU and the other non‑IDU as the paired control. In addition to demographic variables, onset age of cigarette smoking, dropping out of school, imprisonment, history of being sexually abused for money, and family history of using illegal drugs were obtained from the cases and controls via an interview. Pair Odds Ratio (OR) was estimated through McNemar and conditional multivariable logistic regression analysis. Eighty‑three % of the IDUs and 92% the controls were male. The mean for onset age of cigarette smoking was 16 in the cases and 20 in the controls, which was significantly different between cases and controls (P<0.001). In the multivariate analysis, dropping out from school was significantly different between cases and controls (OR=4.22 95% CI: 2.23 – 14.0). Imprisonment was more frequent in IDUs compared to non‑IDUs (OR=3.70 95% CI: 1.09 – 11.08). The cases had more sexual relationship for earning money compared to the controls (OR=3.14 95% CI: 1.24 – 13.70). Onset age of cigarette smoking was significantly (P<0.001) sooner in the IDUs compared to the non‑IDUs (15.9 and 20.1 years, respectively). IDUs reported 5.5 times more that non‑IDUs of having an addict in their family (P value=0.04). The finding of this study can be useful in identifying the persons who are at risk of IDU. Therefore, people who involve with risk factors recognized in this study should be triggered for harm reduction prevention strategies.

Postoperative delirium (POD) is one of the important complications of cardiac surgery and it is assumed to provoke inflammatory responses. Theoretically, anti-inflammatory effects of dexamethasone can have an influence on the incidence and outcomes of POD. The aim of our study was to assess POD predictors and outcomes of dexamethasone administration after cardiac surgery. Patients’ mental status was examined by mini-mental status examination and psychiatric interviewing to diagnose delirium. Subsequently, authors analyzed the patient variables for identification of predictors and outcomes of POD. Between 196 patients who met the inclusion criteria, 34 (17.34%) patients were delirious. History of chronic renal failure, obstructive pulmonary disease, smoking, and addiction strongly predicted development of POD. Other predictors were intra-aortic balloon pump insertion, transfusion of packed cells, and atrial fibrillation rhythm. In our study, the administration of dexamethasone significantly reduced the risk for POD. Furthermore, delirium was associated with longer intensive care unit (ICU) stay. Our study reports the predictors of POD, which patients commonly facing them in cardiac surgery ICU. Appropriate management and prevention of these predictors, especially modifiable ones, can decrease the incident of POD and improves cognitive outcomes of cardiac surgeries.

Chronic inflammation and oxidative stress are associated with health and the disease status. The objective of the present study was to investigate the association among white blood cell (WBC) counts, neutrophil counts as a WBC subpopulation, and diacron reactive oxygen metabolites (d-ROMs) levels in an asymptomatic population. The clinical data, including general cardiovascular risk variables and high-sensitivity C-reactive protein (hs-CRP), were collected from 100 female subjects (mean age, 62 years) in outpatient clinics. The correlation of the d-ROMs with hs-CRP, WBC, and neutrophil counts was examined. The mean/median levels were WBC counts 5.9 × 109/L, neutrophil counts 3.6 × 109/L, hs-CRP 0.06 mg/dL, and d-ROMs 359 CURR U. A simple correlation analysis showed a significant positive correlation of the d-ROMs with the WBC counts, neutrophil counts, or hs-CRP levels. The correlation between d-ROMs and neutrophil counts (β = 0.22, P < 0.05), as well as that between d-ROMs and hs- CRP (β = 0.28, P < 0.01), remained significant and independent in a multiple linear regression analysis adjusted for other variables. A multiple linear regression analysis showed that WBC counts had only a positive correlation tendency to the d-ROMs. Neutrophils may be slightly but more involved in the oxidative stress status, as assessed by d-ROMs, in comparison to the overall WBC. Further studies are needed to clarify the biologic mechanism(s) of the observed relationship.

Liver inflammatory pseudotumor (IPT) is considered a benign inflammatory lesion mostly presented as a solitary solid mass in the right hepatic lobe. It may clinically and radiologically mimic a malignant liver tumor or an abscess. Accordingly, diagnoses of most of the reported cases have been established after surgical resection. In this report, we describe a 52-year-old woman with a 1-year history of fever of unknown origin. In the following investigation, abdominal computed tomography (CT) scan showed infiltrative lesion in the right hepatic lobe. The patient underwent a CT-guided needle biopsy of the hepatic lesion. Histopathologic study of biopsy specimen revealed the features of IPT. The patient was discharged and followedup for 6 months. After 6 months she had no complaint of fever and control liver ultrasonography disclosed no lesion. As liver IPT has favorable response to conservative therapy and may also resolve spontaneously, precise recognition of this condition with the help of fine-needle biopsy may help to avoid unnecessary surgery.

Dear Editor, In the context of HIV, postexposure prophylaxis refers to the set of services that are provided to manage the specific aspects of exposure to HIV and to help prevent HIV infection in a person exposed to the risk of getting infected by HIV.[1] It includes first aid, counseling, risk assessment, laboratory investigations based on the informed consent of the exposed person, and source and depending on the risk assessment, the provision of short-term antiretroviral drugs with followup evaluation. [2] Needle prick and injury by sharp objects are common problems faced by many surgeons/health care workers. But in many situations, the exposed person may not be aware of the measures taken to prevent the disease. The importance of knowledge about postexposure prophylaxis increases in view of a study done by Wig, which showed that 62.8% of the participants were not aware of postexposure prophylactic measures to be taken if there is an occupational exposure to the blood of a HIV-positive patient.[3]