جستجوی مقالات مرتبط با کلیدواژه « causality » در نشریات گروه « پزشکی »

Ischemic stroke (IS) is the leading cause of disability and mortality worldwide. Low-density lipoprotein cholesterol (LDL-C) levels hadno potential risk on ischemic stroke. However, higher LDL-C levels were closely related to IS. Based on two antagonistic viewpoints, a Mendelian randomization (MR) study was designed to evaluate the causal effects of LDL-C levels on IS.

Datasets of LDL-C levels and ischemic stroke were acquired from genome-wide association studies (GWAS). Weighted median method was conducted for main analysis, and MR-Egger and inverse-variance weighted (IVW) methods were performed for auxiliary analyses. Heterogeneity and pleiotropic tests were utilized to confirm the reliability of this study.

A total of 359 single nucleotide polymorphisms (SNPs) were associated with LDL-C levels (P < 5 × 10−8) and 337 SNPs were available in ischemic stroke with eliminating outliers. LDL-C levels were significantly associated with ischemic stroke (OR = 1.104, 95%CI = 1.019 - 1.195, P = 1.52 × 10-2). MR-Egger and IVW showed directionally similar estimates (MR-Egger: OR = 1.120, 95%CI = 1.040 - 1.207, P = 3.12 × 10-3; IVW: OR = 1.120, 95%CI = 1.064 - 1.178, P = 1.17 × 10-5).

LDL-C levels had causal effects on IS, providing insights into the design of future interventions to reduce the burden of ischemic stroke.

The significance of diagnosing the root reason for syncope and taking therequired preventive or treatment measures cannot be overlooked when it comes tooutcome prediction. This study endeavors to examine the role of proBNP in differentiatingcardiogenic and non-cardiogenic syncope in patients presenting to the emergencydepartment (ED).

We prospectively performed a cross-sectional study on patients presentingwith acute syncope. All the patients for this investigation were followed up until thedefinite cause of their syncope (cardiac or non-cardiac) was diagnosed and the screeningperformance characteristics of proBNP in differentiation of cardiogenic and noncardiogenic syncope were evaluated.

Three hundred patients with syncope were studied (64.7% male). In the end,the cause of syncope was determined to be cardiogenic in 133 cases (44.3%). The areaunder the ROC curve of proBNP in the differentiation of cardiogenic syncope from noncardiogenic was estimated to be 78.9 (95% CI: 73.5 – 84.3). The optimal cut-off point forproBNP in this regard was 143.5 pg/mL point. Sensitivity, specificity, positive and negativepredictive values, and positive and negative likelihood ratios of proBNP in the mentionedcut-off point were 75.39% (95% CI: 67.61–82.73), 75.44% (95% CI: 68.07–81.62), 71.12%(95% CI: 62.82–78.26), 79.74% (95% CI: 72.46–85.54), 2.46 (95% CI: 1.86–3.25), and 0.25(95% CI: 0.18–0.34), respectively.

The accuracy of proBNP in differentiation of cardiogenic and non-cardiogenicsyncope is fair. ProBNP concentration equals to or higher than 143.5 pg/mL can differentiatecardiogenic syncope from non-cardiogenic with 75% sensitivity and 76% specificity. Itseems that its use for this purpose should be considered with caution and along with othertools

The objective of this study was to record and analyze the adverse drug reactions (ADRs) due to psychotropic drugs and the potential drug-drug interactions (pDDIs) amongst different psychotropic drugs as well as pDDIs between psychotropic drugs and other co-prescribed drugs by using Medscape software (online).

A cross sectional study was carried out in patients visiting the Psychiatric Outpatient Department of a Tertiary Care Teaching Hospital. Total 500 prescriptions were analysed for the ADRs and pDDIs.

Total 37 ADRs were observed in 32 (6.4%) patients. Antipsychotics was the most common group and olanzapine was the most common psychotropic drug suspected of causing ADRs. Tremors was the most common ADR observed. All of the ADRs were nonserious and were in a “Recovering” state when the data was collected. Total 1051 pDDIs were observed in all the 500 prescriptions surveyed, out of which 361 prescriptions were showing at least one pDDI.

The overall incidence of ADRs was not very high (6.4%), which reiterates the judicious use of the drugs in the study setting. Majority of prescriptions had only 1-2 pDDIs per prescription.

The relationship between cadmium (Cd) exposure and depression remains unclear. This nationwide study aimed to compare the levels of blood Cd with the presence of depressive mood in Korean adults.

From the 2008–2013 Korea National Health and Nutrition Examination Survey, 10,968 individuals over 20 yr old were identified. Data on demographics, health behaviors, depressive mood, and blood Cd (B-Cd) levels were used in the analysis. Estimated levels of B-Cd were drawn from multivariate regression models.

Higher age-adjusted B-Cd levels were noted among women, rural residents, people who have a low economic or educational status, smoke currently, drink frequently, or have depressive mood than the counterpart groups. In fully adjusted models, men with depressive mood exhibited significantly higher B-Cd levels than those without depressive mood, and these levels were strongly mediated by smoking status.

Our results suggest a need for Cd accumulation screening among individuals with depressive mood.

Chemotherapy-induced adverse drug reactions (ADRs) are one of the major consequences of cancer therapy that affects patients’ quality of life, outcomes of the treatment, morbidity, and mortality and increases the economic burden. The study’s objective was to evaluate the incidence, causality, severity, and preventability and to calculate the direct medical cost of chemotherapy-induced ADRs among cancer patients.

A prospective observational study was conducted for 8 months in patients above 18 years and receiving chemotherapy. ADRs were evaluated for their causality, severity, and preventability using different ADR assessment scales, and the economic burden for different ADRs was based on their direct medical costs.

A total number of 230 patients were enrolled in the study, out of which 84 patients developed 148 ADRs. Patients who received chemotherapy showed a higher incidence of ADRs in 45–55 years of age group (30.95%), females (69.04%), solid tumors (92.85%), stage III (55.95%), and double regimen (61.90%). Paclitaxel and carboplatin were reported to cause most ADRs, such as anemia (14.18%) and leucopenia (6.75%). ADRs were assessed using scales. As per the WHO-UMC scale, 59.4% ADRs were possible, followed by probable (39.2%). The majority of the ADRs were mild (52%) in severity. About 41.9% reactions were probably preventable, and 3.4% were definitely preventable.

The overall incidence of ADRs was 36.52%. The direct medical cost incurred for the management of ADRs was 457.23 USD.

Context:

 Infantile Colic (IC) is an essential problem in infancy that is influenced by factors related to infants and parents. The parental factors associated with colic have not been comprehensively assessed. 

The present systematic review was conducted to investigate the parental factors affecting the incidence of IC.
Data Sources: Databases, including PubMed, Web of Science, Scopus, Science Direct, Google scholar, as well as Scientific Information Database (SID), and Magiran (Iranian websites) were searched to identify all eligible papers concerning parental factors affecting infantile CI. The registration number of this study was CRD42020163518 in the PROSPERO database.

Study Selection:

 A total of 423 relevant articles published up to the end of December 2019 were assessed. The selected articles were screened based on duplicated, eligibility criteria, and quality appraisal. The main inclusion criteria were observational studies and articles in Persian and English languages.

Data Extraction: 

The Mesh keywords and Boolean operators included (“risk factors” OR “causality”) AND (“parents” OR “fathers” OR “mothers”) AND (“infant”) AND (“colic”). Consequently, 18 papers were thoroughly studied and the related data were extracted. Two researchers independently performed the data extraction and quality assessment based on the STROBE checklist from the observational studies. The information of selected studies was recorded in a table, i.e. consisted of authors’ names, purpose, design, population, and main results.

Final articles consisted of 10 prospective, 6 cross-sectional, and 2 case-control studies. Eventually, the effective factors were placed in 6 categories, as follows: psychological factors, physical factors, taking medications, perinatal factors, family’s socioeconomic status, and maternal diet. The most important characteristics predisposing to IC were parental depression, anxiety, smoking, maternal history of migraine, young age, primiparity, low family support, high socioeconomic status, high-risk pregnancies, and delivery, taking antibiotics, as well as the consumption of celery, onions, and bananas.

Various parental factors affect the incidence of colic. Identifying these risk factors and accurate planning can be beneficial in the prevention and treatment of IC.

Identifying predisposing factors of seizure can be somewhat helpful in preventing it from occurring. 

The present study has been designed aiming to assess the frequency of predisposing factors of seizure in patients visiting the emergency department (ED). 

The present prospective cross-sectional study was performed on adult patients presenting to ED following seizure during 1 year. Known or probable predisposing risk factors for seizure were extracted from various studies and were asked from patients or their relatives during history taking and clinical examination. 

Finally, 246 seizure patients with the mean age of 38.8 ± 18.3 (18 – 92) years were included (68.7% male). Most patients were in the 18–29 years age group (41.1%), had an educational level less than high school diploma (59.8%), and were unemployed (47.8%). Among the predisposing factors of seizure, emotional stress with 107 (43.7%) cases, insomnia with 44 (17.9%), and irregular use of antiepileptic medications with 36 (14.6%) cases were the most common predisposing factors, respectively. In 43.5% of the patients, no identified predisposing factor was found. Insomnia (p = 0.002), stress (p < 0.001), and substance abuse (p < 0.001) were the most important predisposing factors of seizure in individuals less than 60 years old. In addition, being in the menstruation period was also shown to be a predisposing risk factor for women aged less than 60 years (p = 0.002). 

Emotional stress, insomnia, and irregular use of antiepileptic medication were the most important predisposing factors of seizure in the studied patients. In more than 40% of patients presenting to ED following seizure, no predisposing factor was found.

The etiologies and causal beliefs of heart disease are considered one of the 5 dimensions of health self-regulatory model. Thus, the present study aimed to review the literature and screen the appropriate tools for evaluating the causal beliefs and perceived heart risk factors (PHRFs).

The review samples encompassed all published articles from 1992 to March 2017. A systematic search was conducted across 6 databases: the Web of Science, Scopus, Medline, EBSCO, ProQuest, PsycINFO, and Google Scholar. The qualitative evaluation of the articles was examined using the checklists of the Critical Appraisal Skills Programme (CASP) by 2 independent investigators. After the application of the criteria for inclusion in the study, 22 studies were obtained according to the PRISMA guidelines.

A total of 10 504 (50.5% male) patients at an average age of 57.85±10.75 years participated in 22 studies under review. The results of the systematic review showed that 22 tools were available to measure PHRFs. The instruments were categorized into 4 groups of valid scales (6 studies), invalid questionnaires (6 studies), checklists (3 studies), and open-ended single items (7 studies). Only 23.2% of the measuring instruments were sufficiently valid.

The results of this systematic review showed that a limited number of valid tools were available to measure PHRFs. Considering the importance of studying cardiac patients’ perception of the etiology of disease and the paucity of standards and valid grading scales, it seems necessary to design and provide tools with broader content that can cover all aspects of patients’ beliefs.