Tehran Universities of Medical Science

Tehrān, Iran

Tehran Universities of Medical Science

Tehrān, Iran
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Forouzanfar M.H.,University of Washington | Liu P.,University of Washington | Roth G.A.,University of Washington | Ng M.,University of Washington | And 82 more authors.
JAMA - Journal of the American Medical Association | Year: 2017

IMPORTANCE Elevated systolic blood (SBP) pressure is a leading global health risk. Quantifying the levels of SBP is important to guide prevention policies and interventions. OBJECTIVE To estimate the association between SBP of at least 110 to 115mmHg and SBP of 140mmHg or higher and the burden of different causes of death and disability by age and sex for 195 countries and territories, 1990-2015. DESIGN A comparative risk assessment of health loss related to SBP. Estimated distribution of SBP was based on 844 studies from 154 countries (published 1980-2015) of 8.69 million participants. Spatiotemporal Gaussian process regression was used to generate estimates of mean SBP and adjusted variance for each age, sex, country, and year. Diseases with sufficient evidence for a causal relationship with high SBP (eg, ischemic heart disease, ischemic stroke, and hemorrhagic stroke) were included in the primary analysis. MAIN OUTCOMES AND MEASURES Mean SBP level, cause-specific deaths, and health burden related to SBP (≤110-115mmHg and also≤140mmHg) by age, sex, country, and year. RESULTS Between 1990-2015, the rate of SBP of at least 110 to 115mmHg increased from 73 119 (95%uncertainty interval [UI], 67 949-78 241) to 81 373 (95%UI, 76 814-85 770) per 100000, and SBP of 140mmHg or higher increased from 17 307 (95%UI, 17 117-17 492) to 20526 (95%UI, 20283-20746) per 100000. The estimated annual death rate per 100000associated with SBP of at least 110 to 115mmHg increased from 135.6 (95%UI, 122.4-148.1) to 145.2 (95%UI 130.3-159.9) and the rate for SBP of 140mmHg or higher increased from 97.9 (95%UI, 87.5-108.1) to 106.3 (95%UI, 94.6-118.1). Loss of disability-adjusted life-years (DALYs) associated with SBP of at least 110 to 115mmHg increased from 148 million (95%UI, 134-162 million) to 211 million (95% UI, 193-231 million), and for SBP of 140mmHg or higher, the loss increased from 95.9 million (95%UI, 87.0-104.9 million) to 143.0million (95%UI, 130.2-157.0million). The largest numbers of SBP-related deathswere caused by ischemic heart disease (4.9 million [95%UI, 4.0-5.7 million]; 54.5%), hemorrhagic stroke (2.0million [95%UI, 1.6-2.3 million]; 58.3%), and ischemic stroke (1.5 million [95%UI, 1.2-1.8 million]; 50.0%). In 2015, China, India, Russia, Indonesia, and the United States accounted for more than half of the globalDALYs related to SBP of at least 110 to 115mmHg. CONCLUSIONS AND RELEVANCE In international surveys, although there is uncertainty in some estimates, the rate of elevated SBP (≤110-115 and≤140mmHg) increased substantially between 1990 and 2015, and DALYs and deaths associated with elevated SBP also increased. Projections based on this sample suggest that in 2015, an estimated 3.5 billion adults had SBP of at least 110 to 115mmHg and 874 million adults had SBP of 140mmHg or higher. © 2017 American Medical Association.


Pelucchi C.,Irccs Instituto Of Ricerche Farmacologiche Mario Negri | Lunet N.,University of Porto | Boccia S.,Catholic University of the Sacred Heart | Zhang Z.-F.,University of California at Los Angeles | And 39 more authors.
European Journal of Cancer Prevention | Year: 2015

Gastric cancer affects about one million people per year worldwide, being the second leading cause of cancer mortality. The study of its etiology remains therefore a global issue as it may allow the identification of major targets, besides eradication of Helicobacter pylori infection, for primary prevention. It has however received little attention, given its comparatively low incidence in most high-income countries. We introduce a consortium of epidemiological investigations named the 'Stomach cancer Pooling (StoP) Project'. Twenty-two studies agreed to participate, for a total of over 9000 cases and 23 000 controls. Twenty studies have already shared the original data set. Of the patients, 40% are from Asia, 43% from Europe, and 17% from North America; 34% are women and 66% men; the median age is 61 years; 56% are from population-based case-control studies, 41% from hospital-based ones, and 3% from nested case-control studies derived from cohort investigations. Biological samples are available from 12 studies. The aim of the StoP Project is to analyze the role of lifestyle and genetic determinants in the etiology of gastric cancer through pooled analyses of individual-level data. The uniquely large data set will allow us to define and quantify the main effects of each risk factor of interest, including a number of infrequent habits, and to adequately address associations in subgroups of the population, as well as interaction within and between environmental and genetic factors. Further, we will carry out separate analyses according to different histotypes and subsites of gastric cancer, to identify potential different risk patterns and etiological characteristics. © 2015 Lippincott Williams & Wilkins, Inc.


Zarafshan H.,Iranian Autism Center | Mohammadi M.R.,Tehran Universities of Medical Science | Ahmadi F.,Newcastle University | Arsalani A.,Special Education Office of Tehran
Iranian Journal of Psychiatry | Year: 2013

Objective: Teachers often experience burnout and challenges during their active career. Different studies have shown that those directly involved with teaching children with special needs are more subject to burnout. Due to advance screening tools, more children with autism are now diagnosed and involved in special education. The aim of the present study was to investigate the professional burnout in teachers of children with autism compared to teachers of other children with special needs . Methods: Casual Comparative study design was used for this research. Three self-reported measures (Maslach Burnout Inventory, Job Descriptive Index, and General Health Questionnaire) were distributed; clustered sampling selection was conducted to select participants. Ninety three female teachers (32 teachers of children with autism, 30 teachers in schools for deaf and 31 for teachers of children with mental retardation) from 12 schools located in 4 districts of Tehran were selected. Pearson's and Spearman's correlation statistical tests, analysis of variances and regression were used to analyze the results. Results: Results of the current study revealed a significant difference in criterion validity between the three groups of teachers The three groups were different in terms of general health (p=0.010), emotional exhaustion (p=0.005) and depersonalization (p<0.001); however considering other variables no significant differences were observed. Comparison between groups showed that the average scores of teachers of children with autism were significantly higher than teachers of deaf and hard of hearing and mentally retarded children in general health, fatigue, and depersonalization variables. No significant differences were observed in average scores of teachers for mentally retarded and deaf children. Conclusions: Female teachers' of children with autism are experiencing significantly higher levels of burnout and general mental health problems compared to teachers of children with other disabilities requiring special education.

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