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

Heavy metals (HMs) in the environment threaten food safety and human health. In this study, the health risks of HMs caused by the consumption of commonly consumed vegetables in the central part of Mazandaran province were evaluated.

In this study, 42 vegetable samples were analyzed for concentration of HMs, and estimated daily intake (EDI), target hazard quotients (THQ), hazard index (HI), and target carcinogenic risk (TCR) were calculated.

The mean content of lead (Pb), cadmium (Cd), and zinc (Zn) in the studied areas were obtained 28.45, 0.26, and 79.20 mg/kg, respectively. The concentration of Pb, Cd, and Zn in the studied vegetables was found to be 1.76 ± 0.2, 0.09 ± 0.07, and 11.53 ± 1.20 mg/kg, respectively. The EDI average of Pb, Cd, and Zn in adults was 0.0064, 0.0003, and 0.0412 mg/kg day−1; and in children were 0.0099, 0.0005, and 0.0686 mg/kg day−1, respectively. The present study showed that the THQ for Pb in all vegetables consumed by children faces much higher risks than adults. The TCR for Pb in total vegetables was less than 10-4 and for Cd was identified as more than 10-4 in some vegetables in the adults and the children’s population.

The concentration of Cd and Zn in the soil and related vegetables is less than the permissible limit, but the amount of Pb in the vegetables is higher than the permissible limit. Therefore, continuous care and monitoring of agricultural soils in these areas, such as the proper use of chemical fertilizers, pesticides, and treated wastewater sludge, is necessary.

Diabetes mellitus (DM) has different prevalence by region. This study aimed to identify the differences in the effects of obesity and depression on DM in South Korean adults by region.

The participants were 14,343 adults (≥30 yr) from Ulsan (regions with the lowest prevalence of DM) and Jeonbuk (regions with the highest prevalence of DM), and data were extracted from the Community Health Survey 2019. We applied a complex sampling design analysis to reflect the stratified, clustering and weights. The data were analyzed using the unweighted frequencies, weighted percentage, mean, standard error, Chi-Square test and multiple logistic regression analysis (SPSS 25.0).

Regarding the main result for Ulsan, the odds ratio of DM increased by 1.94, 2.52,1.57, and 4.87 times for obesity(25-29.9kg/m²), high obesity(≥30kg/m²), depression, and receipt of psychological counseling for depression, respectively. In Jeonbuk, the odds ratio of DM increased by 1.79, 2.84, and 3.59 times for obesity, high obesity, and unmet medical experience, respectively. On the other hand, depression-related variables were found to not influence DM

We provided the rationale for conducting a health project that interventions for obesity and depression should be included in DM management programs differently in Ulsan and Jeonbuk regions.

 Long COVID syndrome (LCS) is characterized by chronic symptoms of fatigue, cough, etc. after contracting COVID-19. This study aimed to identify the longevity of the symptoms of adults who reported suffering from LCS in our previous study which was conducted in 2021. The study population included patients who were referred to healthcare facilities (55 centers) in Fars province, Iran.

 This longitudinal retrospective and follow-up cohort study was conducted on adult patients who were hospitalized with COVID-19. We inquired about their current health status and obtained the information after they consented to participate and answer questions over the phone.

 In total, 2383 people participated in the study, 543 of whom (27.3%) reported experiencing symptoms of LCS. Fatigue (12.2%) and exercise intolerance (10%) were the two most common symptoms of persistent LCS. On the other hand, 240 people (12.1%) who did not report any symptoms of LCS in phase 1 of the study reported experiencing problems that are compatible with the diagnosis of LCS. Patients with persistent LCS (long-LCS) had longer hospital stays during their initial illness (7 days vs. 5 days) and were more frequently admitted to ICUs (15.8% vs. 8.9%) compared with those without long-LCS.

 More than one-quarter of adults will continue to suffer from the symptoms of long-COVID for more than one year after their initial infection. The scientific community should develop validated measures and biomarkers to objectively diagnose and follow up this condition.

Hazardous alcohol use is the most prevalent form of alcohol misuse, distinct from harmful or dependent use. This drinking behavior is a widespread practice among males, leading to a myriad of health and social challenges. Preventing hazardous alcohol use is crucial to reducing negative consequences and avoiding more severe forms of alcohol misuse. There has been no systematic review of its risk factors. This study aims to provide comprehensive information on hazardous alcohol use risk factors in adultmales by systematically summarizing current evidence.

Methods & Materials: 

The protocol was registered with PROSPERO. PubMed, Scopus, Science Direct, EBSCOhost (APA PsycArticles), and Google Scholar were searched. The inclusion criteria were English-language observational studies published between 2012 and 2022 with male participants aged 18 to 65. Two reviewers carried out the quality assessment. A narrative synthesis was conducted to synthesize the findings.

Out of 6,842 records yielded from the systematic search, 20 studies were included. All of these were cross-sectional studies with 19 out of 20 classified as high quality and one as moderate. The included studies identified several factors that increased the risk of hazardous alcohol use including lower education level, positive family history of alcohol use, smoking, high alcohol density neighborhoods, depressive symptoms, drinking motives, and negative life events. Little research has been done on other variables thatmay also play a role.

Several risk factors for hazardous alcohol use were identified. Future research, particularly longitudinal studies, is recommended to validate these findings.

Growing evidence indicates that adolescent substance abuse is now an alarming concern that imposes a considerable socio-economic burden on societies. On the other hand, numerous studies have shown that due to specific neurophysiological features, the brain is more vulnerable to the adverse effects of psychoactive drugs at an early age. Unfortunately, these negative effects are not limited to the period of drug use, but can persistently affect the brain’s responsiveness to future exposures to the same or other types of drug. For researchers to develop pharmacological strategies for managing substance abuse disorders, they need to gain a deep understanding of the differences in behavioral outcomes associated with each type of drug across different age groups. The present study was conducted to review the experimental evidence revealing the mentioned differential effects with an emphasis on common drugs of abuse, including cocaine, nicotine, cannabis, and opioids. Although the cellular mechanisms underlying age-related effects have not been exclusively addressed for each drug, the most recent results are presented and discussed. Future studies are required to focus on these mechanisms and reveal how molecular changes during brain development can result in differential responses to drugs at the behavioral level.

This guideline is the first Iranian guideline developed for the diagnosis, management, and treatment of hyperlipidemia in adults. The members of the guideline developing group (GDG) selected 9 relevant clinical questions and provided recommendations or suggestions to answer them based on the latest scientific evidence. Recommendations include the low?density lipoprotein cholesterol (LDL?C) threshold for starting drug treatment in adults lacking comorbidities was determined to be over 190 mg/dL and the triglyceride (TG) threshold had to be >500 mg/dl. In addition to perform fasting lipid profile tests at the beginning and continuation of treatment, while it was suggested to perform cardiovascular diseases (CVDs) risk assessment using valid Iranian models. Some recommendations were also provided on lifestyle modification as the first therapeutic intervention. Statins were recommended as the first line of drug treatment to reduce LDL?C, and if its level was high despite the maximum allowed or maximum tolerated drug treatment, combined treatment with ezetimibe, proprotein convertase subtilisin/kexin type 9 inhibitors, or bile acid sequestrants was suggested. In adults with hypertriglyceridemia, pharmacotherapy with statin or fibrate was recommended. The target of drug therapy in adults with increased LDL?C without comorbidities and risk factors was considered an LDL?C level of <130 mg/dl, and in adults with increased TG without comorbidities and risk factors, TG levels of <200 mg/dl. In this guideline, specific recommendations and suggestions were provided for the subgroups of the general population, such as those with CVD, stroke, diabetes, chronic kidney disease, elderly, and women.

Uncovering the roles and characteristics of pathogenesis-related molecules can help us develop novel management methods in parasitology. In this study, we studied the expression levels of Strongyloides stercoralis heat shock protein70 (HSP70) (Sst-hsp-70) and astacin (Sst-ast) as pathogenesis-related genes as well as the expression of S. ratti HSP70 and HSP17.1 (Sra-hsp-70, Sra-hsp-17.1) in the larvae and adult stages of S. stercoralis.

A hyperinfection isolate of S. stercoralis from Gilan Province, northern Iran was cultivated on nutrient agar. After a couple of days, parasites in different stages of life were collected, and total RNA was extracted. The expression levels of astacin and HSP genes were compared by real-time PCR.

Statistically higher expression levels of Sst-ast, Sst-hsp-70, and Sra-hsp-70 genes in L3 larvae than in adults were observed. However, the expression level of Sra-hsp-17.1 was non-significantly lower in the larval stage than in adult worms.

Higher expression levels of Sst-ast, Sst-hsp-70, and Sra-hsp-70 genes in the larval stages of S. stercoralis suggest the potential role of these enzymes in parasite cutaneous invasion and pathogenesis. However, higher expression of Sra-hsp-17.1 in adult forms is probably involved in resistance and survival mechanisms. The similarity in gene expression between S. stercoralis and S. ratti can provide helpful hints to better understand strongyloidiasis from various perspectives, including pathogenesis, proper diagnosis, and targeted treatment.

The objective is to compare the impact of clear aligner treatment (CAT) versus conventional fixed appliance treatment (FAT) on oral health‑related quality of life (OHRQoL) among adults at five‑time points: pretreatment (T0), 1 week (T1), 1 month after (T2), and 6 months after (T3) treatment initiation, and in the long‑term follow‑up (T4).

Search terms were based on Medical Subject Headings (MeSH) and non‑MeSH. Potentially eligible studies compared OHRQoL in clear aligner (CA) and fixed appliance (FA) patients. In February 2023, Scopus, Web of Science, Cochrane, and PubMed were searched for published studies. Nine out of 94 shortlisted papers were eligible for a systematic review. Of these nine papers, five studies were considered for a meta‑analysis.

At T0, CA and FA patients had similar oral health impact profile (OHIP)‑14 questionnaire scores with a standard mean difference (SMD) of 0.105 (confidence interval [CI]: −1.029–1.48). The SMD of the OHRQoL related to T1, T2, and T3 was −3.119 (CI: −0.145, 0.355), −1.527 (CI: −5.597, −0.64), and − 2.331 (CI: −1.906, −1.148). T4 showed no difference between groups (SMD = 0.007, CI: CI: −4.286, −0.376). Regarding the OHIP‑14 domains, functional limitations remained consistent in both groups across all time intervals. Psychological discomfort exhibited a notable difference only at T2. Throughout the treatment, CAT showed significantly lower levels of physical, psychological, and social disability, as well as handicap, though these differences did not persist beyond T4. Notably, physical pain was the sole domain that remained elevated in the FAT group up to T4.

During the 1st day of the orthodontic treatment, both the CA and FA groups had comparable OHRQoL statuses. However, as time passed, the CA group notably improved their OHRQoL compared to the FA group. Interestingly, after a year or the completion of treatment, both groups eventually reached similar OHRQoL levels. Nevertheless, it is worth noting that FA patients continued to experience more physical pain even a year later.

Fluent speech requires executive functions for identification, inhibition, and modification of speech interruptions to continuously regulate the speech process. The current study examined the executive functions in adults who stutter (AWS) and adults who do not stutter (AWNS). We also examined the relationship between executive functions and stuttering severity.

This research is a descriptive-analytic cross-sectional study. The participants included 32 AWS (mean age = 28 years; SD = 6.79 years) who were divided into three groups of mild, moderate, and severe severity and 32 AWNS (mean age = 28.57 years; SD = 6.53 years; 28). Selected tests from Delis-Kaplan executive function system (D-KEFS) were used to assess executive function domains.

The results of this study showed that AWS performed significantly lower than AWNS in working memory (p = 0.009), problem solving and planning (p < 0.001), verbal cognitive flexibility (shifting) (p < 0.001), and verbal inhibitory control (p < 0.001). The results also showed no difference between AWS and AWNS in non-verbal inhibition, shifting, and reasoning. Furthermore, there was a significant relationship between stuttering severity and executive function domains.

Together, this study showed that executive function skills are affected in AWS and should be considered in the rehabilitation programs of AWS.

 Attention Deficit Hyperactivity Disorder (ADHD) in adulthood is associated with significant impairment in occupational, academic, and social functioning. The aim of this study is to survey the frequency of ADHD in adults referred to psychiatric clinics.

 The present cross-sectional descriptive study includes 300 patients referred to psychiatric clinics affiliated to Babol University of Medical Sciences with an age range of 18-45 years who were selected and included in the study. It is used the Adults Attention Deficit Hyperactivity Disorder self-report scale (ASRS V1.1) to diagnose Adult ADHD in these individuals. Logistic regression and P-Paired test were used to analyze the data.

 The mean age of the subjects was 30.21 ± 7 7.94. Of these, 181 (60.3%) were men and 119 (39.7%) were women. The overall prevalence of Adult ADHD in the study samples was 39.3%. In the logistic regression analysis of crude and adjusted data of study variables, no significant relationship was seen between Adult ADHD and age, education, employment status and marital status (P ≥ 0.05), but a significant relationship between Adult ADHD and consumption of Cigarettes, alcohol and drugs were observed (P ≤ 0.05).

 The findings of the present study show a relatively high prevalence of Adult ADHD among people with a history of psychiatric disorder, who are more likely to be exposed to smoking, alcohol and drug abuse.

Micronutrient interventions for Adult Attention-Deficit/Hyperactivity (ADHD) could be helpful. We used a naturally processed whole wheat grains supplement containing higher doses of micronutrients named Nutrition Bio Shield (NBS). We aimed to determine its effects on ADHD symptoms in adults. 

Fifty-two medication-free adults with ADHD were randomly assigned to receive 5 g of NBS supplement or placebo daily for eight weeks. 

Twenty-three participants in the NBS group and 24 participants in the placebo group completed the study. After 8 weeks, compared with the placebo, the ADHD scores significantly decreased (mean difference 95%CI): -4.9 (-8.6 to -1.1); p=0.01; Cohen’s d=0.74), and quality of life significantly improved (mean difference 95%CI): 5.6 (0.12 to 11.3); p=0.04; Cohen’s d=0.59) in the NBS group. The observed side effects were minimal and did not differ statistically between groups. 

Quality of life increased during consumption of the NBS supplement, compared to the placebo. However, despite the statistically significant findings, these changes in ADHD symptoms were small and the clinical significance may be low (about 5%).

Rhabdomyosarcoma (RMS) is a rareandaggressivemesenchymaltumorarising from skeletal muscle cells. Although it is predominantly seen in children, it can also affect adults. RMS typically presents as a rapidly growing mass in the head and neck region, genitourinary tract, or extremities. Among these sites, cervical RMS is exceedingly rare and has only been reported in a handful of cases.

In this report,wepresent a case of cervicalRMSin a 30-year-oldwomandiagnosedandtreated at the Salah Azaiez Institute. We describe the clinical presentation, imaging findings, histopathological characteristics, and treatment modalities used in this patient’s management. Additionally, we review the existing literature on cervical RMS to highlight the rarity of this entity and the challenges in its diagnosis and management. A 30-year-old woman with no pathological history suddenly presented with a cervical polyp with no other symptoms. On gynecological examination, a polypoid mass measuring 3 cm developed in the lower lip of the cervix. A surgery consisting of the cervical polyp removal was performed, showing at macroscopy several polypoid fragments measuring up to 1.5 cm, microscopically non-characterizable. Gynecologists opted for conization. Definitive histology concluded with an embryonic RMS with spindle cells (desmin+, myogenin+) of the uterine cervix with microscopically involved margins, resulting in the amputation of the whole cervix. The pelvic MRI showed no residual mass. The PET-CT did not find any hypermetabolic site. The tumor was classified as IA IRSG (Intergroup Rhabdomyosarcoma Study Group) favorable group (T1a according to the TNM classification), corresponding to the low risk of recurrence subgroup. Multidisciplinary reunion decided to treat with adjuvant chemotherapy based on 4 cycles of Doxorubicin and Ifosfamide and did not retain the indication of postoperative radiation therapy.

Given the rarity of RMS in adults and the absence of standardized protocols for managing these tumors, a multidisciplinary decision is essential, and case reports remain highly relevant.

Celiac disease (CeD) is a permanent immune-mediated enteropathy triggered by gluten. Patients with CeD have various clinical features. In the present study, we aimed to evaluate the clinical, laboratory, and histopathological features of 150 patients with CeD in Zahedan, Southeast Iran.

In a retrospective cross-sectional study, we investigated the characteristics of 150 patients with celiac in Zahedan from 2008 to 2018. In addition to the demographic characteristics of the patients, other parameters such as clinical symptoms, comorbidities, serum level of anti-tissue transglutaminase (IgA-TTG), liver function tests, and report of the intestinal biopsy were obtained from patients’ recorded files. Descriptive statistics were used for the collected data.

150 patients were included in the study. 72 (48%) were males, and 78 (52%) were females. The mean (±SD) age was 28.5 (±10.69) years (range 16-82 years). The most frequent symptom was abdominal pain (38%), followed by diarrhea (32%) and nausea (30%). Iron-deficiency anemia was found in 30% of patients. Immunoglobulin A, and anti-tissue transglutaminase antibodies (IgA anti-TTG) were found in 144 (96%) patients. The results of the biopsy showed 76% with Marsh I, 10% with Marsh II, and 52% with Marsh III histological changes according to the Marsh classification.

Most of our patients with CeD were oligo-symptomatic forms. It is essential for healthcare professionals to have the clinical features of patients diagnosed with CeD in their area.