جستجوی مقالات مرتبط با کلیدواژه « Prospective Studies » در نشریات گروه « پزشکی »

This study investigates the effectiveness of mammographic screening for women aged 40 to 49 in Brazil's Steel Valley Region. Despite a Ministry of Health recommendation to start screenings at 50, 25% of breast cancer cases occur in the 40-49 age group.

The retrospective analysis, spanning 2008-2019 at Marcio Cunha Hospital, compared two groups: cancer diagnosed via screening mammography (277) and diagnostic mammography (229).

The results showed delayed diagnoses for non-screened women, with a 4.16 times higher mortality rate. Screening facilitated earlier detection of less malignant cancers (85.9% vs. 43.7%). Women diagnosed through screening were more likely to preserve their breasts (28.9% vs. 55.5% for Radical Breast Surgery and 71.1% vs. 28.9% for Breast-Sparing Surgery), and fewer axillary lymphadenectomies were performed. All statistical tests performed returned a P-value lower than 0.05, showing high statistical significance.

The findings support extending screening mammography access to all women over 40 in the Steel Valley region and underscore the need for broader-scale research in other areas. Recommendations include enhancing public awareness and establishing a breast cancer surveillance service.

 Despite the health benefits of smoking cessation on patients with cardiovascular diseases (CVDs), some resume smoking even after their discharge from hospital with acute coronary syndrome (ACS).

 This study aimed to determine the predictors of smoking resumption after ACS in western Iran.

 This prospective cohort study was performed on 175 patients admitted to the Imam Ali Cardiovascular Center, Kermanshah, Iran, with a diagnosis of ACS from January 2018 to December 2018. Data were collected by a trained interviewer using a checklist developed based on the study objectives. Differences between groups were evaluated by independent t-test, chi-square, and Fisher’s exact tests. The relationship between smoking resumption and predicting variables was assessed using univariate and multivariate logistic regression models (Forward LR).

 All participants were male with a mean age of 56.30 ± 8.91 (mean ± SD) years. Three months post-discharge, 137 (78.3%) patients quit smoking, and 38 (21.7%) patients resumed it. The patients who resumed smoking were more likely to be divorced (20.6% vs. 0.7%), unemployed or retired (73.7% vs. 63.5%), have smokers in household (86.8% vs. 50.4%), and have history of depression (52.7% vs. 20.4%) (P-values < 0.05). The independent predictors of smoking resumption were divorce (OR 4.2, 95% CI: 1.31 - 19.01), having smokers in household (OR 12.08, 95% CI: 3.45 - 40.81), and history of depression (OR 12.16, 95% CI: 3.68 - 39.04).

 Divorce, having smokers in household, and history of depression were identified as the independent predictors of smoking resumption in ACS patients. Those who have these characteristics should be viewed as having a high risk of smoking relapse and be provided with more support to quit smoking.

The outcomes of acute ischemic stroke (AIS) are highly affected by time-to-treatment. Thepresent study aimed to determine the factors affecting in-hospital and pre-hospital delays in treatmentof AIS.

This prospective study was carried out on 204 AIS patients referring to the stroke care unit in Zanjan(Iran) in 2019. The required data were collected by interviewing the patients and families and using patients’records and observations.

The maximum delay was related to onset-to-arrival time (288.19 ± 339.02minutes). The logistic regression analysis indicated a statistically significant decline in the treatment delay viaconsultation after the initiation of symptoms (p< 0.001), transferring the patient through emergency medicalservice to the hospital (p<0.001), and patients’ perception regarding AIS symptoms (P< 0.001).

It isessential to inform people regarding AIS symptoms and referring to AIS treatment units to reduce the treatmenttime.

Due to the controversial effects of mental health disorders during pregnancy on infant health, the present study aimed to evaluate the effect of gestational depression, stress, and anxiety on the growth of offspring at six months of age in disadvantaged communities in South of Iran.

The sample comprised of 470 pregnant women (response rate=98%) who are participated in the Bandar Abbas Pregnancy Cohort study. Maternal mental health was measured by the DASS-21 questionnaire during pregnancy. Data on infant growth was collected based on infant`s growth chart at six months of age. The relative risk of suboptimal infant growth was calculated by Modified Poisson regression models at 5% significant level.

The prevalence of depression, anxiety, and stress was 19.0%, 26.1% and 6.5%, respectively. At six months of age, the mean (SD) of infant`s weight (gram), height (cm) and head circumference (cm) were 7287.30 (1019.85), 63.23 (5.62) and 41.39 (2.70), respectively. Compared to normal mothers, the risk of suboptimal weight at six months of age significantly increased by 71% in mothers who were classified as having depression (Adjusted RR: 1.71, 95% CI: 1.07, 2.09). The presence of anxiety significantly increased the risk of suboptimal height at six months of age by 43% (ARR: 1.43, 95% CI: 1.07, 1.92). There were no statistically significant effects of ‎either depression anxiety or stress on the suboptimal head circumference at six months of age.

Our results showed that mental health disorders of pregnant women might adversely influence the weight and height growth of offspring within the first six months of age. Screening protocols to early diagnose of mental health disorders during pregnancy, and to strict follow up of diagnosed cases postpartum are proposed.

The effect of maternal mental health during pregnancy on Cesarean section through implications of pre- and postnatal birth have narrowly been investigated. The aim of the present study was to investigate the effect of maternal mental health during pregnancy on the type of delivery in the suburbs of Bandar Abbas. 

This study used data of 200 mothers registered in a prospective cohort study on pregnant women in the suburbs of Bandar Abbas, South of Iran, during 2016-18. The presence of depression, anxiety, or stress in expecting mothers were measured by DASS-21 questionnaire and the outcome defined as having Cesarean section (Cesarean section) was measured at postpartum. The relative risk (95% CI) was calculated using Cox regression models. All analyses were performed using STATA statistical package, with a significance level of 5%.

Information of 196 mothers were collected (98% response rate); the mean age of the participants was 27.28 (±5.62) years. The prevalence of depression, anxiety, and stress was 13.8% (27), 40.4% (40), and 7.6% (15), respectively. Nearly 40% of mothers went through Cesarean section. Compared to mothers with good mental health, the risk of Cesarean section was 96% higher in depressed mothers (RR=2, 95% CI: 1.43–2.74) (p=0.001), 81% higher in anxious mothers (RR=1.81, 95% CI: 1.29-2.53) (p=0.003), and 75% higher in stressed mothers (RR=1.75, 95% CI: 0.86-3.56) (p=0.121).

The findings of this study showed that poor mental health, especially anxiety and depression, during pregnancy could increase the risk of Cesarean section. Accordingly, screening protocols for mental health status and prenatal counseling sessions are suggested for pregnant mothers to increase their informed decision on types of delivery.