International Journal of Preventive Medicine
Volume:2 Issue: 2, Apr 2011

Mortality from Ischemic Heart Disease (IHD) 1, stroke 2, 3, and stomach cancer 4, 5 have fallen over recent decades, especially in developed countries; however, IHD and stroke remain among the leading causes of death in Europe 6, 7. Furthermore, wide geographic variations in rates and trends of mortality from these diseases have been shown since the early 1950s 8, 9 and for incidence and case fatality from IHD by the WHO MONICA Project in the mid-1980s 10.There is a controversy in the relationship between early life conditions and mortality at later life. Several studies have shown the association between IHD and adverse living conditions in early life 11-15, but not always 16, 17. For stroke, some studies have observed this relationship 14, 18, whereas others have not 12, 15. Time trends of stomach cancer also differ between populations and the role of living conditions on trends is not yet fully understood 19.In this paper, the results of my previous population-based time-series studies will be discussed that aimed to describe trends in mortality between subsequent cohorts in relation to living conditions in early life of these cohorts 20, 21. Cohort-wise trends of IHD, stroke, and stomach cancer mortality of populations in seven European countries –i.e., Denmark, England and Wales, Finland, France, the Netherlands, Norway and Sweden- have been assessed and it has been determined whether these trends were correlated with developments in infant mortality rate (IMR) at the time of birth of the subsequent cohortsGenerally, an overall decline in mortality from these three diseases from 1950 to 2005 in all countries, for all ages and both men and women have been observed, with the important exception of a period epidemic of IHD in 1950 to 1970. From a cohort perspective, we observed steady declines for between cohorts born between 1860 and 1939 in most causes, again with the exception of IHD.

Based on observations of 20 years of follow-up of the Turkish Adult Risk Factor (TARF) study, this review summarizes the distribution of risk factors among Turks which is dominated by components of the metabolic syndrome (MetS), especially by abdominal obesity and atherogenic dyslipidemia. The adoption of a 95 cm cutoff for male abdominal obesity was crucial in the understanding of factors for cardiometabolic risk. The prevalence of MetS, type-2 diabetes and coronary heart disease (CHD) are high, alike in Iranians. The TARF study demonstrated that systemic low-grade inflammation and oxidative stress are a major determinant of cardiometabolic risk in the population at large, and involves the female sex to a greater extent than the male. As a result of this, impaired anti-inflammatory and atheroprotective function developed in large segments of middle-aged and elderly obese individuals emerging as dysfunction of apolipoprotein A-I and HDL particles. This dysfunction is currently a major driver cardiometabolic risk in Turkish adults leading to substantial excess diabetes and CHD. Separate algorithms for diabetes and CHD were derived that improved the risk prediction of these diseases.

Myocardial infarction (MI) is a leading cause of death in both the industrialized and developing countries globally. The economic evaluation of MI is undertaken to rationale the allocation of scarce healthcare resource. The objective is to review cost-effectiveness analysis of treatment of myocardial infarction (MI) with medications. We searched PubMed using the key words: “cost effectiveness analysis” and “myocardial infarction”. After applying the selection criteria, eight articles were selected for the present study. Out of eight articles five articles had studied thrombolytic agents. All of these papers clearly explain the costs and benefits of different drugs for MI. ICER was assessed in six out of the eight articles to compare the costs and health effects between alternative medications. ICER was expressed in different effect units. This study found that various medications including thrombolytic agents, ACEI and heparin are administered to treat MI in many countries. It is also found that five of eight studies focus on thrombolytic therapies. It implies that thrombolytic is generally very cost effective for MI to the whole society.

Infertility affects about 6.1 million women ages 15-44 in the United States. The leading cause of infertility in women is quantitative and qualitative defects in human germ-cell development. Human embryonic stem cell (hESC) lines are derived from the inner cell mass (ICM) of developing blastocysts and have a broad clinical potential, and they can be used to obtain germ cells. hESCs have been classified in to three classes based on their epigenetic state. The goal of this project is to epigenetically reprogram Class II and Class III cell lines to Class I (naïve state), and to in vitro differentiate potent hESCs to primordial germ cells (PGCs). Recent evidence suggests that 3-deazaneplanocin A (DZNep) is a global histone methylation inhibitor which selectively inhibits trimethylation of lysine 27 on histone H3K27, and it is an epigenetic therapeutic for cancer. The characteristics of DZNep lead us to hypothesize that it is a good candidate to epigenetically reprogram hESC cells to the Class I. Also, we used sodium butyrate, shown in previous studies to up-regulate the expression of germ cell specific markers. We used these two drugs to produce epigenetically stable hESC lines. X-Chromosome inactivation has been used as a tool to follow the reprogramming process. We have used immunostaining and western blot as methods to follow this re-programming qualitatively and quantitatively. The preliminary results showed that hESC cells treated with these two drugs showed dramatic tendency to lose H3K27me3 marker

Current international guidelines recommend 6-9 months of Isoniazid (INH) preventive chemotherapy to prevent the development of active tuberculosis in children exposed to smear positive tuberculosis patients. The purpose of this study was to determine adherence to six months of supervised INH prophylaxis and outcome in children with household exposure to an adult pulmonary tuberculosis index case in Varamin city, Tehran, Iran. A descriptive study (Cross-sectional) was conducted among household contacts in Varamin city, between 1997- 1998. All children <6 years old in household contact with an adult pulmonary tuberculosis index case were screened for tuberculosis and given supervised INH preventive chemotherapy once active tuberculosis was excluded. Adherence and outcome were monitored. In total, 31 index cases and 128 household contact cases were identified; 23 (18%)children <6 years old experienced household exposure, who were fully evaluated. two children were treated for active tuberculosis and 15 (12%)children received preventive chemotherapy. Positive smear results in index cases were as follow: 19 cases, 1+; 5 cases, 2+; 7 cases, 3+. A comparisons of positive smears in the index cases with need for prophylaxis of contact cases shows that the majority of contacts requiring prophylaxis had close contact with the 1+ index cases. All children who received preventive chemotherapy, completed 6 months of supervised INH prophylaxis. Strategy of six months of supervised INH chemoprophylaxis is successful, particularly in children who are at high risk to progress to disease following exposure.

Closed head injuries are a great burden of health care facilities in Iran, similar to many other developing countries. Cognitive dysfunction is of immense importance as a long term complication of brain injuries. Numerous studies are planned to investigate the effect of potential remedy on preventing or halting secondary post-traumatic brain damages,which results in cognitive as well as general function impairments.The current study aimed to provide reliable scales to gauge patient’s functional level in specific domain to ensure reliable results in Iran. We selected three general and cognitive function scales [Glasgow Outcome Scale Extended (GOSE), Galveston Amnesia and Orientation Test (GOAT), Disability Rating Scale (DRS)] used extensively worldwide, and converted them to Farsi language. To assess their validity and reliability, we implemented them on a group of head injured Iranian patients. Factor analysis revealed 5 independent factors for GOAT with total distribution variance of 80.2%. For DRS, 3 independent factors came out that consisted 92.3% of variance. GOAT and DRS Farsi versions in our study also had satisfactory correlation coefficient using Pierson correlation matrix. Regarding the reliability, the Cronbach’s alpha index was 78.2% for GOAT and 90.5% for DRS. Factor analysis was not feasible for GOSE. However, Kappa coefficient was used to estimate its validity, which was 68%. This study inferred that our Farsi version of DRS and GOAT functional scales are certainly appropriate for Iranian head injured patients. Our GOSE Farsi-converted scale showed good validity, though it is still required to be more evaluated for reliability in future attempts. This scale can help in prevention of secondary brain damages after trauma.

Maternal mortality, a preventable tragedy, is an indicator of development, poverty and democracy. Therefore, prevention of maternal deaths is one of the main goals in many countries. Iran is one of the developing countries which aim to reduce maternal mortality through introduction of a new policy at national level. This study aimed to explore the extent to which this policy is practiced at peripheral levels. The data were collected through interviews with relevant people, observation, and review of the documents. The results showed that there is a gap between policy and practice which can be explained by inadequate training programs, inadequate collaboration, lack of guidelines and instigation of a specific investigation into maternal deaths. This study suggests a number of considerations such as an initiative to collaborate, developing a guideline and presenting training programs before such policies are launched.

This study was conducted to evaluate the effects of apple consumption on lipid profile among hyperlipidemic and over weight men. We performed an experimental study on 46 hyperlipidemic men. Total Cholesterol (TC) 200-240 mg/dl, Triglyceride (TG) 150-350mg/dl and mean age of 41.4 ±3.9year) who were randomly divided into two (apple and control) groups. Apple group (23 subjects) received 300g of whole apple per day (Golden delicious) for 8 weeks. Control group (23 subjects) had the regular dietary pattern for the same period of time. Blood samples were collected at baseline and after intervention and analyzed for serum TG, TC, low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol(HDL-C), very low density lipoprotein-cholesterol(VLDL), apolipoprotein B (Apo B), lipoprotein a (Lp a) and LDL/HDL levels. Before study, education level and family size were compared. Before and after intervention, physical activity and dietary intake were compared, between two groups. Both total polyphenol and total fiber in consumed apple were measured. Total polyphenol and total fiber were 485 mg/kg fresh apple and 4.03 g/100g fresh apple, respectively. After 8 weeks, mean different TG and VLDL concentrations were increased statistically in apple group compared to control group, but, no significant differences were observed in regard of TC, LDL-C, HDL-C, Apo (B), Lp(a) and LDL/HDL levels, between two groups. Consumption of Golden delicious apple may be increased serum TG and VLDL concentrations in hyperlipidemic men. We need more studies to assay the effect of Golden delicious apple on serum TC, LDL-C, HDL-C, Apo (B), Lp(a) and LDL/HDL concentrations.

Stomach cancer mortality has been fallen throughout Europe during the past decades in terms of both incidence and mortality rates 1, 2, 3, mainly as a result of remarkable improvement of living conditions in European societies 4-7. Efforts to reduce global cancer disparities begin with an understanding of geographic patterns in cancer incidence, mortality and prevalence, by studies such as GLOBOCAN 8, 9, EUROCARE 10, and Five Continents databases 11. Survival increased and mortality decreased through the combination of earlier detection, better access to care and improved treatment 12. There has also been a concomitant change in lifestyle and environmental exposures over successive generations 13, including changes in exposures to risk factors in early life 14.Several studies conducted projections of future trends in stomach cancer mortality in European countries 7,12,14-17. Mortality rates were generally expected to decline further. Based on the cancer mortality trends in the European Union until 2000, one study projected a further fall by 11% in age-standardized cancer mortality from 2000 to 2015 15. A Dutch study also projected a substantial decline in stomach cancer mortality until 2015, based on trends until 2000 16. Similarly, an Irish study predicted mortality from stomach cancer to fall further in the near future, although at a slower rate than in the recent past 17.