جستجوی مقالات مرتبط با کلیدواژه « تشخیص زودرس » در نشریات گروه « پزشکی »

Congenital heart disease is one of the most common birth defects. This study aims to examine the process of clinical guideline implementation to identify strengths and weaknesses.

In this cross-sectional study, healthy term and term neonates born from January 2023 to July 2023 were evaluated at Shahid Beheshti Hospital in Isfahan. The data collection tool was a checklist. The pulse oximetry (POX) was performed for healthy newborns within the first 24 hours after birth and before discharge from the hospital. Oxygen saturation (SpO2) < 89% in the baby's hand and foot was considered positive screening. If the SpO2 level was between 90-94%, the screening was repeated one hour later and if in the case of the same results, the newborn was referred to a specialist for further assessment. Healthy neonates with positive test results were followed up two months after primary POX screening.

Out of 500 neonates, 472 (94.4%) had a SpO2 level ³ 95%. Among the 21 cases who had a positive screening, one case had cardiac diseases (i.e., complete atrioventricular septal defect/pulmonary hypertension). Two healthy neonates with a positive screening were diagnosed with PFO after two months of follow-up. The assessment of the implementation process of newborn screening based on the checklist recommendations of clinical guidelines increased from 58.3 % to 91.6 % within six months.

The implementation of the critical congenital heart disease clinical guideline was found to be favorable and acceptable in this study and recommended for other hospitals to implement.

Lung cancer is the most common cancer worldwide with high mortality rates in male and female. In Iran, lung cancer is the third most common type of cancer and its prevalence is increasing rapidly. This disease has a high mortality rate because patients with lung cancer are diagnosed at an advance stage of the disease. Therefore, the presence of tumor markers is essential for treatment and early diagnosis of lung cancer. Studies have shown that there are many genetic variants that are significantly related to the incidence of lung cancer. The present study aimed to investigate the role of key genes in the occurrence of lung cancer.

Methods and Materials: 

This review article has been performed by searching lung cancer, key genes, clinical biomarker, and early diagnosis keywords in various data bases such as NCBI, PubMed, Scopus, Science Direct, and Google Scholar.

EGFR, KRAS and TP53 genes have the highest importance and role in the occurrence of lung cancer; therefore, the identification of mutations in the mentioned genes can play an important role in the diagnosis and treatment of lung cancer as a clinical biomarker.

Identification of genetic variants involved in lung cancer can be used as clinical biomarkers for early diagnosis and appropriate treatment of this disease. Molecular biomarkers can have the potential to improve the current state of early lung cancer detection and treatment methods. Recognizing genetic variants as clinical biomarkers for early diagnosis and evaluation of response to treatment for lung cancer can play an important role in facilitating the treatment process, increasing response to treatment, reducing mortality, and reducing material and spiritual damages caused by this disease.

According to the report of the World Health Organization (WHO), almost one-third of the world’s population is infected with tuberculosis (TB). The delay in TB diagnosis, in addition to increasing mortality, can increase the duration of disease transmission. This study aims to identify the factors affecting the early detection of smear-positive pulmonary TB in Patients in Qom Province, Iran.

In this case-control study, 120 patients with smear-positive pulmonary TB (60 with a diagnosis delayed for more than three months and 60 with a timely diagnosis) diagnosed from 2018 to 2021 in Qom Province participated. To determine the factors effective in early diagnosis of pulmonary TB, the odds ratio of each factor was calculated, and logistic regression analysis was used for data analysis.

The prescription of the sputum test at the first visit had the most significant effect on the early diagnosis of pulmonary TB (odds ratio=161, P<0.001). The TB in patients who visited the clinics and those visited by general practitioners was diagnosed with a higher delay. The lack of knowledge of existing TB diagnosis and treatment services in health centers had increased the diagnosis delay by 2.3. Occupation, gender, and place of residence were not found to be effective factors.

It seems that most doctors in Iran neglect to prescribe a sputum test for patients suspected of pulmonary TB and only prescribe chest x-rays. Training and informing doctors, private medical centers, and pharmacies in referring patients suspected of pulmonary TB to the health centers where the patients live can cause timely diagnosis of pulmonary TB.

Although breast cancer is one of the biggest threats to women's health, preventive behaviors among women are not desirable, especially in vulnerable populations. This study aimed to assess the effect of an educational intervention on promoting breast cancer preventive behaviors in middle-aged women. It was performed on the outskirts of Mashhad, Iran

In this quasi-experimental study in 2017, women referring to comprehensive health service centers in the suburbs of Mashhad were randomly selected and divided into intervention (n = 60) and control (n = 60) groups. The educational intervention was performed in 4 sessions based on the structures of PEN-3 model. A self-designed questionnaire was completed immediately and two months after the educational intervention by the target group.

The mean of constructs of perceptual, empowering, and reinforcing factors were significantly higher in women with higher education. Despite the lack of statistically significant differences between the two groups before the educational intervention, but immediately and two months after the intervention, the mean scores of PEN-3 model constructs and preventive behaviors in the intervention group were significantly higher than the control group (P<0.05).

The findings showed that educational intervention based on PEN-3 model constructs was effective on improving preventive behaviors among marginalized women.

Congenital heart defects (CHD) are the most common type of birth defects. The main screening tests used to identify babies with congenital heart defects include prenatal echocardiography and postnatal clinical assessment. Routine pulse oximetry has been reported as an additional screening test that can potentially improve the early diagnosis of critical congenital heart disease (CCHD).

This study is a multi-stage evolutionary study that was conducted for 12 months from March 2021 to March 2022 at Pediatric Cardiovascular Research Center in Cardiovascular Institute, Isfahan, Iran. In the first phase, after identifying the topic and aims of the present study, questions were designed through the PICO method including (population, intervention, control, and outcomes). Then conducting systematic searches, the quality of all existing clinical guidelines (CG) of this field were evaluated using the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument and a committee consisting of pediatric cardiologists and neonatologists in the field. Next, based on the opinions of experts, the quality of 1 out of 6 clinical guidelines for early detection of critical congenital heart disease at birth by pulse oximetry was assessed as optimal. Finally, the clinical guidelines draft was evaluated using the Delphi method and the panel of experts. After expert panel meetings and consensus between members, the final version of the guideline for early detection of critical congenital heart diseases at birth by pulse oximetry was developed.

In the present study, criteria of clinical practice regarding the stages of newborn screening by pulse oximetry at birth were determined based on the evidence and health conditions and were presented in twenty-eight recommendations and six sections. The final recommendations were presented in the results section.

The finding of the present study showed that physicians, nurses, and midwives can apply the recommendations of this clinical guideline for the early detection and referral of neonates with critical congenital heart disease.

Congenital heart diseases (CHDs) are the most common type of birth defect. Success in the early detection of critical congenital heart diseases (CCHDs) using pulse oximetry technology depends on a large extent on physicians’ awareness of neonatal clinical examinations. The aim of this study was to investigate physicians’ awareness of newborn pulse oximetry screening for early detection of CCHD in Isfahan City, Iran.

A total of 65 physicians participating in the meeting at the continuing education programs at Isfahan University of Medical Sciences were enrolled in this descriptive-analytical, cross-sectional study in 2019-2020. Data were collected by a questionnaire, developed by the researchers, which validity and reliability were confirmed. Data analysis was conducted using SPSS software.

Of physicians participated to this study, 51 were pediatricians (78.5%). The most physicians (49.2%) had a moderate level of awareness of neonatal screening at birth by pulse oximetry. The results of linear regression analysis showed that only the doctors' workplace (hospital or office) was significantly associated with their awareness of neonatal screening at birth by pulse oximetry (P = 0.01, β = -0.31). In total, 7% of the variations in physicians’ awareness about neonatal screening at birth by pulse oximetry were predicted by this variable.

Physicians, particularly pediatricians, as the first line of health care providers to the newborns at birth, need more knowledge about the neonatal pulse oximetry screening, for early detection and referral of neonates with CHDs.

Correct and timely detection of the outbreaks of diseases with a short incubation period is of great importance in the health system. The aim of this study was to determine the detection of dysentery outbreaks using the cumulative sum method.

This time series study was conducted using the data of the National Surveillance System between 2014 and 2017. The outbreak alert threshold of each season and province was determined separately using the average of three years (1393 to 1395) in the same season and province. The dysentery outbreak in each season was exclusively predicted for Isfahan, Khuzestan, and Hamadan provinces in 2017 using the CUSUM method.

In Isfahan Province, the outbreak alert was higher in the spring and summer and lower in the autumn and winter using the current method compared to the CUSUM method. For Khuzestan Province, the current outbreak alert was significantly higher in all seasons compared to the CUSUM method, while the current outbreak alert was lower than the alert predicted by the CUSUM method in Hamadan Province in all the seasons.

Compared to constant threshold-based methods, using the CUSUM method seems to be a better way for reporting outbreaks, especially in areas with a high incidence.

Investigating the changes in CT scans of patients is one of the most important methods to determine the prognosis of patients with head trauma, which has been considered by researchers. The aim of this study was to determine the findings of delayed CT scan in blunt head trauma patients referred to Shahid Bahonar Hospital of Kerman in 2020.

This was a descriptive-analytical study. All patients with blunt head trauma underwent the initial Brain CT based on indications according to the guideline after six Hour of monitoring in the emergency room if they hadnchrt any discharge conditions based on the indications in the guideline The brain controls CT was performed. Findings were analyzed by SPSS25 software. Chi-square, Independent T test, ANOVA and logistic regression were used.

  The results showed that 98.5% of the participants had no changes in their control CT scan. In the change group, 40% of cases had decreased hemorrhage, 35% of cases had increased hemorrhage and 25% of them had new intracranial hemorrhage. There was not also a statistically significant relationship between gender, drug history, outcome, initial CT-Scan findings, age, GCS score, systolic blood pressure, heart rate and duration with CT changes (in unchanged, exacerbated, recovered groups) (P> 0.05). But the results showed that the frequency of exacerbation of symptoms in people with underlying cranial disease was significantly higher than other groups (P=0.05).

According to the results, it is possible that performing a primary CT scan in patients with head trauma in EDs is a good method for assessing the general condition of patients with mild to moderate trauma. However, evaluation of the necessity of control CT scan requires research with a larger sample size and longer follow-up.

Colorectal cancer is one of the most common gastrointestinal cancers among human beings and the most important cause of death in the world. Based on the risk of colorectal cancer for individuals, using an appropriate screening program can help to prevent the disease. Therefore, the purpose of this study was to design a model for screening colorectal cancer based on risk factors to increase the survival rate of the disease on the one hand and to reduce the mortality rate on the other.

By reviewing articles and patients' records, 38 risk factors were detected. To determine the most important risk factors clinically, CVR(content validity ratio) was used; and considering the collected data, Spearman correlation coefficient and logistic regression analysis were applied for statistical analyses. Then, four algorithms -- J-48, J-RIP, PART and REP-Tree -- were used for data mining and rule generation. Finally, the most common model was obtained based on comparing the performance of the algorithms.

After comparing the performance of algorithms, the J-48 algorithm with an F-Measure of 0.889 was found to be better than the others.

The results of evaluating J-48 data mining algorithm performance showed that this algorithm could be considered as the most appropriate model for colorectal cancer risk prediction.

Herpes simplex virus (HSV) encephalitis is the most common cause of sporadic encephalitis, with significant morbidity and mortality that are effectively reduced by antiviral treatment. Herpes simplex infection in pregnant women rarely results in encephalitis. The most common symptoms of a pregnant woman with herpes simplex infection are colds and skin vesicles. Herpetic encephalitis occurs during pregnancy in the third trimester in 60% of cases and with less prevalence in the second trimester. Among HSVs most, HSV-1 causes encephalitis. Early diagnosis and timely treatment are important as mortality decreases from 70% to 20-30%. This case report, reviews a pregnant woman with a diagnosis of herpes encephalitis due to seizure and consciousness disorder, which was negative in polymerase chain reaction (PCR) assay and diagnostic studies.

The patient was a 23-year-old woman with a gestational age of 29 weeks who presented with fever, headache, delirium, and cognitive impairment three days prior to admission following seizure. Early magnetic resonance imaging (MRI) showed an increase in the cortical signal in the temporal lobe and PCR assay for the detection of herpes virus was negative. Magnetic resonance venography also showed an increase in the left maxillary sinus with differential diagnosis of herpetic encephalitis. Considering the symptoms of the patient with a strong suspicion of herpes simplex encephalitis, the patient was treated with acyclovir, which was associated with improvement of clinical symptoms. Finally, normal delivery was performed after 36 weeks of gestation.

Given that herpes simplex virus encephalitis is a rare and potentially dangerous and complicated disease, it is imperative for a pregnant patient with atypical symptoms to be identified with an appropriate diagnostic and therapeutic measures.

Cerebral aneurysm disease causes intracranial hemorrhage by rupturing, which can eventually, lead to organ failure or death. For this reason, it is important to anticipate the reasons for rupturing of a cerebral aneurysm from biomechanical point of view. Investigating this disease may even help the physicians to find treatments and predict the patient’s situation. This research was conducted to understand risks of development and rupture of a patient-specific cerebral aneurysm.

In a computational simulation, fluid-structure interaction method has been used for a patient-specific case. Also, considering the speed of the systole as the initial condition of the problem, the blood fluid domain has been solved in three types of fluid mathematical models (Newtonian, non-Newtonian Carreau, and non-Newtonian power-law). Then, the pressure results on the wall have been transmitted to ANSYS software, version 15.0 (ANSYS Inc., Canonsburg, PA, USA) and the structure has been solved based on three material models (linear elastic, hyperplastic Neo-Hookean and hyperplastic Mooney-Rivlin, with 5 parameters). The study was done in University of Tehran, Iran, from October 2016 to September 2018.

Shear stress, pressure, flow velocity, wall displacement and von-Mises stress have been extracted from the simulations. The average wall displacement of the aneurysm was 1.8 mm. Also, no significant difference was found in the amount of arterial wall displacement, with constant wall material model and different blood models. However, a significant difference has been observed in the case of considering constant blood model and different wall material models in the value of displacement.

With regard to the amount of displacement of the aneurysm wall in this particular patient, with the geometry and location of the specific aneurysm, the brain nerves 3 and 6 were under stress and exposed to damage. The minimum shear stress was in the aneurysm neck, which stimulates the endothelial cells in the area of aneurysm. In addition, the blood model didn’t had a significant effect on the displacement calculations, while the wall material model played a more decisive role.

Cancer of the endometrium is the most common gynecologic malignancy in western and industrial countries, and is the second most common in developing countries, therefore it is of special importance. Adenocarcinoma of the endometrium is the most common type of uterine cancer. The prevalence of endometrial cancer in young women under the age of 40 in western country is very low and about 5 percent. The aim of this study was to determine the prevalence of endometrial cancer at age ≤40 years in our center during 4 years.
In a cross-sectional study, all medical records of patients with endometrial cancer in Ghaem University Hospital, Mashhad, Iran was reviewed to identify women A total of 119 patients with endometrial cancer that was admitted in our genecology oncology center were evaluated. 19 patients (15.9%) were younger than 40 years old. 16 cases (84.2%) with endometrial adenocarcinoma and 3 (15.7%) had endometrial stromal sarcoma. The youngest patient was 27 years old and the oldest was 39 years. Seven patients (8/36%) had infertility and we don’t know about fertility condition in 3, because they were single. 12 cases (63%) were overweight (BMI≥35) and 6 cases (5/31%) had polycystic ovarian disease (PCOD). In 2 patients, there was concomitant ovarian and endometrial cancer. Histology report of both ovaries was endometrioid and both patients were overweight. Obesity, poly cystic ovary syndrome (PCOD) and Infertility were the most important risk factors for endometrial cancer in young patients.
The prevalence of endometrial cancer in young women under the age of 40 in our country is so higher than the statistics provided in industrial countries.

As the most prevalent malignant neoplastic cancer among women, breast cancer stands as the second common cause of mortality inducted by cancer worldwide. Since people’s awareness affects their attitude and in turn positively affects the prevention of breast cancer and its timely prognosis, it helps to cut down on the mortality rate. This latter issue motivated the present study which aimed to investigate the awareness and practice of Nursing, Midwifery and Paramedicine students concerning breast cancer at Bandar Abbas University.
As a cross-sectional research, the present study was conducted among university students in the second semester of 2015-16. The sample was selected through a randomized method and finally included 253 subjects. The data collection instrument was a questionnaire whose reliability and validity were already established in some other research. SPSS ver19.0 was used for the statistical analysis of the data.
The majority of subjects (61%) had an average score and only a few (2.3%) achieved a good score. No statistically significant correlation was found between the family background of breast cancer and the awareness score. Half of the subjects (51%) were aware of the breast self-test method but only 37% did it regularly every month. 41.6% visited a doctor annually for a test. Negligence comprised the highest percentage of refraining from the self-test. Feeling no pain (29.2%) was the most common cause of not visiting a doctor. The internet played a key role among the information sources.
Raising awareness contributes to positive behavior and affects the performance of self-test and visiting a doctor. Students’ low level of awareness of how to diagnose breast cancer requires that healthcare staff as well as academics take a step to increase this awareness and practice through proper education and strategies.

Congenital hypothyroidism is a major but preventable cause of mental backwardness in infants. In case of hypothyroidism in fetuses, certain complications will occur in vital organs like the central nervous system and the skeleton. Before screening programs were introduced, congenital hypothyroidism was diagnosed with delay due to its few and non-specific symptoms during the first days of life. Given the difference in reference range for various races and populations, this study was aimed to determining a natural range for thyroid hormones used in the screening of infants. In a descriptive cross-sectional study at Vali-asr Hospital, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran, from March 2013 to 2014. The level of T4, FT4 and TSH hormones was measured in all natural childbirth, without any complications and with one-minute Apgar score above 7 while this study was underway. A group of 249 infants (male and female), including 35 (14.1%) aged between 0 and 4 days, 102 (41%) aged between 5 and 7 days and 112 (45%) aged between 7 and 30 days, were examined. The average TSH, T4 and FT4 amounts in infants, aged 0 to 30 days, were respectively 5.35 µU/ml, 10.77 µg/dl and 1.33 ng/dl. The interval was 4.76-6.01 µU/ml for TSH, 10.36-11.17 µg/dl for T4 and 1.29-1.37ng/dl for FT4. The difference between age groups with average TSH concentration is not meaningful (P=0.7) and the average T4 amount in different age groups was meaningfully different (P=0.05). The average FT4 in different age groups is meaningfully different (P=0.007). The thyroid hormone amounts calculated for males and females were not significantly different. Given the difference in the reference range in race, population and geographical zones, it is necessary to determine a range for screening in Iran. According to the findings of the present study, lower cut-offs, compared with western countries, should be envisaged for TSH in congenital hypothyroidism screening programs that could speed up the diagnosis of minor cases of the disease and prevent complications.

Breast cancer is the most common cancer among women and the second cause of death due to women’s cancer after the lung cancer. Early detection is very crucial in improving the outcomes and survival rates. The purpose of this study was to determine to what extent educational program based on health belief model (HBM) can change women’s health beliefs and behaviors of breast cancer screening. In a quasi-experimental study, 219 women referred to Health Care Centers in Tabriz were divided into case and control groups through cluster random sampling. Data were collected by using a self-administered questionnaire consisted of 4 sections: demographic characteristics, knowledge of the breast cancer and related screening methods, health beliefs and behaviors of screening. Three months after the intervention, the two groups sat for posttest. Post intervention, there was a remarkable increase within the experimental group in perceived seriousness (P=0.02), threat (P=0.01) and benefit (P<0.001). However, within the control group there was a significant increase in perceived sensitivity (P=0.01) and a decrease in perceived seriousness (P=0.01). Moreover, there was a 15.4% increase in the frequency of breast screening examination in the experimental group. Overall, the screening behaviors in post intervention was significantly different between the two groups (P=0.03). The culturally-sensitive educational intervention based on HBM was to some extent effective in alteration of the health beliefs and screening behaviors. In future educational programs, it seems that focusing on perceived sensitivity enhancement and reducing the perceived barriers would have an important effect on mammography practice in long time follow up.

Secondary prevention, as defined by early diagnosis, has very important role in response to treatment and reduction of complication of bladder cancer. In this study we sought to investigate the interval between onset of symptoms and definite diagnosis and their related factors. This study was done on 82 patients extracted from cancer registry. Mean interval between onset of symptoms and definite diagnosis was 3.8 months. Mean delay from onset of symptoms to first medical visit was 2.76 months and mean GPs delay in making a patient refer to urologist was 0.98 months. The present study revealed patient's late referral to physicians and general physician's delay in referring the patients as two major factors in delayed diagnosis. This finding emphasizes the importance of public information provision about early referral after the onset of symptoms, as well as promoted education for general physicians.