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Collatuzzo G, Rashidian H, Hadji M, Naghibzadeh A, Alizadeh-Navaei R, Boffetta P, Zendehdel K. Cigarettes and waterpipe use and risk of colorectal cancer in Iran: the IROPICAN study. Eur J Cancer Prev 2024:00008469-990000000-00156. [PMID: 38870041 DOI: 10.1097/cej.0000000000000902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
We aimed to investigate the association between cigarettes and waterpipe use and colorectal cancer (CRC) in an Iranian population. We analyzed data from a multicenter hospital-based case-control study in Iran (IROPICAN). Data on tobacco smoking, including cigarettes, and waterpipe smoking, were collected in detail. Multivariate logistic regressions estimated the odds ratios (ORs) and 95% confidence intervals (CIs) for the association between cigarette and waterpipe smoking and CRC, accounting for confounders including age, sex, socioeconomic status, opium use, marital status, family history of cancer, red meat, fiber, body shape at age 15 and perceived physical workload, and each other of the two exposures. The study population consisted of 3215 controls and 848 cases, including 455 colon and 393 rectum cancers. We found no association between CRC and cigarette smoking (OR, 0.8; 95% CI, 0.6-1.0) or waterpipe smoking (OR, 1.1; 95% CI, 0.9-1.5). Analysis by categories of cigarette pack-year and frequency of waterpipe smoking (head-year) did not show associations. We observed an inverse association between colon cancer and cigarette smoking (OR, 0.6; 95% CI, 0.5-0.9). There was, however, no significant association by pack-year categories. Cigarette and waterpipe smoking was not associated with CRC in the Iranian population. Further studies are needed to better understand the role of waterpipe on CRC.
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Affiliation(s)
- Giulia Collatuzzo
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Hamideh Rashidian
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Hadji
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Ahmad Naghibzadeh
- Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences
- Department of Biostatistics and Epidemiology, Kerman University of Medical Sciences, Kerman
| | - Reza Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Stony Brook Cancer Center, Stony Brook University
- Department of Family, Population and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Kazem Zendehdel
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
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Mansour R, Al-Ani A, Al-Hussaini M, Abdel-Razeq H, Al-Ibraheem A, Mansour AH. Modifiable risk factors for cancer in the middle East and North Africa: a scoping review. BMC Public Health 2024; 24:223. [PMID: 38238708 PMCID: PMC10797965 DOI: 10.1186/s12889-024-17787-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 01/16/2024] [Indexed: 01/22/2024] Open
Abstract
PURPOSE This scoping review examines controllable predisposing factors attributable to cancer in the Middle East and North Africa (MENA) region's adult population, highlighting opportunities to enhance cancer prevention programs. DESIGN We systematically searched the PubMed, Science Direct, and CINAHL, EMBASE, and Cochrane Library databases from 1997 to 2022 for articles reporting on the impact of modifiable risk factors on adult patients with cancer in the MENA region. RESULTS The review identified 42 relevant articles, revealing that tobacco consumption, obesity, physical inactivity, and diet are significant modifiable risk factors for cancer in the region. Tobacco smoking is a leading cause of lung, bladder, squamous cell carcinoma, and colorectal cancer. A shift towards a westernized, calorie-dense diet has been observed, with some evidence suggesting that a Mediterranean diet may be protective against cancer. Obesity is a known risk factor for cancer, particularly breast malignancy, but further research is needed to determine its impact in the MENA region. Physical inactivity has been linked to colorectal cancer, but more studies are required to establish this relationship conclusively. Alcohol consumption, infections, and exposure to environmental carcinogens are additional risk factors, although the literature on these topics is limited. CONCLUSION The review emphasizes the need for further research and the development of targeted cancer prevention strategies in the MENA region.
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Affiliation(s)
- Razan Mansour
- Department of Internal Medicine, University of Kansas Medical Center, Kansas, USA
| | - Abdallah Al-Ani
- Department of Pathology and Laboratory Medicine, King Hussein Cancer Center, Amman, Jordan
| | - Maysa Al-Hussaini
- Department of Pathology and Laboratory Medicine, King Hussein Cancer Center, Amman, Jordan
| | - Hikmat Abdel-Razeq
- Department of Internal Medicine, King Hussein Cancer Center, Amman, Jordan
| | - Akram Al-Ibraheem
- Department of Nuclear Medicine, King Hussein Cancer Center, Amman, Jordan
| | - Asem H Mansour
- Department of Diagnostic Radiology, King Hussein Cancer Center, Amman, Jordan.
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Al Awadh AA, Sakagami H, Amano S, Sayed AM, Abouelela ME, Alhasaniah AH, Aldabaan N, Refaey MS, Abdelhamid RA, Khalil HMA, Hamdan DI, Abdel-Sattar ES, Orabi MAA. In vitro cytotoxicity of Withania somnifera (L.) roots and fruits on oral squamous cell carcinoma cell lines: a study supported by flow cytometry, spectral, and computational investigations. Front Pharmacol 2024; 15:1325272. [PMID: 38303989 PMCID: PMC10830635 DOI: 10.3389/fphar.2024.1325272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 01/02/2024] [Indexed: 02/03/2024] Open
Abstract
Oral cancer is a severe health problem that accounts for an alarmingly high number of fatalities worldwide. Withania somnifera (L.) Dunal has been extensively studied against various tumor cell lines from different body organs, rarely from the oral cavity. We thus investigated the cytotoxicity of W. somnifera fruits (W-F) and roots (W-R) hydromethanolic extracts and their chromatographic fractions against oral squamous cell carcinoma (OSCC) cell lines [Ca9-22 (derived from gingiva), HSC-2, HSC-3, and HSC-4 (derived from tongue)] and three normal oral mesenchymal cells [human gingival fibroblast (HGF), human periodontal ligament fibroblast (HPLF), and human pulp cells (HPC)] in comparison to standard drugs. The root polar ethyl acetate (W-R EtOAc) and butanol (W-R BuOH) fractions exhibited the strongest cytotoxicity against the Ca9-22 cell line (CC50 = 51.8 and 40.1 μg/mL, respectively), which is relatively the same effect as 5-FU at CC50 = 69.4 μM and melphalan at CC50 = 36.3 μM on the same cancer cell line. Flow cytometric analysis revealed changes in morphology as well as in the cell cycle profile of the W-R EtOAc and W-R BuOH-treated oral cancer Ca9-22 cells compared to the untreated control. The W-R EtOAc (125 μg/mL) exerted morphological changes and induced subG1 accumulation, suggesting apoptotic cell death. A UHPLC MS/MS analysis of the extract enabled the identification of 26 compounds, mainly alkaloids, withanolides, withanosides, and flavonoids. Pharmacophore-based inverse virtual screening proposed that BRD3 and CDK2 are the cancer-relevant targets for the annotated withanolides D (18) and O (12), and the flavonoid kaempferol (11). Molecular modeling studies highlighted the BRD3 and CDK2 as the most probable oncogenic targets of anticancer activity of these molecules. These findings highlight W. somnifera's potential as an affordable source of therapeutic agents for a range of oral malignancies.
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Affiliation(s)
- Ahmed Abdullah Al Awadh
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Najran University, Najran, Saudi Arabia
| | - Hiroshi Sakagami
- Meikai University Research Institute of Odontology (M-RIO), Saitama, Japan
| | - Shigeru Amano
- Meikai University Research Institute of Odontology (M-RIO), Saitama, Japan
| | - Ahmed M. Sayed
- Department of Pharmacognosy, Faculty of Pharmacy, Nahda University, Beni-Suef, Egypt
- Department of Pharmacognosy, Collage of Pharmacy, Almaaqal University, Basra, Iraq
| | - Mohamed E. Abouelela
- Pharmacognosy Department, Faculty of Pharmacy (Boys), Al-Azhar University, Cairo, Egypt
| | - Abdulaziz Hassan Alhasaniah
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Najran University, Najran, Saudi Arabia
| | - Nayef Aldabaan
- Department of Pharmacology, College of Pharmacy, Najran University, Najran, Saudi Arabia
| | - Mohamed S. Refaey
- Department of Pharmacognosy, Faculty of Pharmacy, University of Sadat City, Sadat City, Menoufiya, Egypt
| | - Reda A. Abdelhamid
- Department of Pharmacognosy, Faculty of Pharmacy, Al-Azhar University, Assiut-Branch, Assiut, Egypt
| | - Heba M. A. Khalil
- Department of Veterinary Hygiene and Management, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt
| | - Dalia I. Hamdan
- Department of Pharmacognosy and Natural Products, Faculty of Pharmacy, Menoufia University, Shibin Elkom, Egypt
| | - El-Shaymaa Abdel-Sattar
- Department of Medical Microbiology and Immunology, Faculty of Pharmacy, South Valley University, Qena, Egypt
| | - Mohamed A. A. Orabi
- Department of Pharmacognosy, College of Pharmacy, Najran University, Najran, Saudi Arabia
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Bhandari D, Zhu Y, Zhang C, Zhu W, Alexandridis A, Etemadi A, Freedman ND, Chang C, Abnet CC, Dawsey SM, Inoue-Choi M, Poustchi H, Pourshams A, Boffetta P, Malekzadeh R, Blount B. Smoke exposure associated with higher urinary benzene biomarker muconic acid (MUCA) in Golestan Cohort Study participants. Biomarkers 2023; 28:637-642. [PMID: 37878492 DOI: 10.1080/1354750x.2023.2276030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 10/22/2023] [Indexed: 10/27/2023]
Abstract
Background. Benzene is a known human carcinogen. Human exposure to benzene can be assessed by measuring trans, trans-muconic acid (MUCA) in urine. Golestan Province in northeastern Iran has been reported to have high incidence of esophageal cancer linked to the use of tobacco products. This manuscript evaluates the urinary MUCA concentrations among the participants of the Golestan Cohort Study (GCS).Methods. We analyzed MUCA concentration in 177 GCS participants' urine samples and performed nonparametric pairwise multiple comparisons to determine statistically significant difference among six different product use groups. Mixed effects model was fitted on 22 participants who exclusively smoked cigarette and 51 participants who were classified as nonusers. The urinary MUCA data were collected at the baseline and approximately five years later, and intraclass correlation coefficient (ICC) was calculated from the model.Results. Compared with nonusers, tobacco smoking was associated with higher urinary MUCA concentrations. Based on the nonparametric test of pairwise multiple comparisons, MUCA concentrations among participants who smoked combusted tobacco products were statistically significantly higher compared to nonusers. Urinary MUCA collected five years apart from the same individuals showed moderate reliability (ICC = 0.41), which was expected given the relatively short half-life (∼6 h) of MUCA.Conclusion. Our study revealed that tobacco smoke was positively associated with increased levels of urinary MUCA concentration, indicating that it is a significant source of benzene exposure among GCS participants.
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Affiliation(s)
- Deepak Bhandari
- Tobacco and Volatiles Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Yuyang Zhu
- Tobacco and Volatiles Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Can Zhang
- Tobacco and Volatiles Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Wanzhe Zhu
- Tobacco and Volatiles Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Arash Etemadi
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran
| | - Neal D Freedman
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Cindy Chang
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Christian C Abnet
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Sanford M Dawsey
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Maki Inoue-Choi
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Hossein Poustchi
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran
| | - Akram Pourshams
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran
| | - Paolo Boffetta
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY, USA
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran
| | - Benjamin Blount
- Tobacco and Volatiles Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Pahlavanzadeh B, Kolagari S, Ebrahimi Kalan M, Taleb ZB, Ward KD, Zare S, Charkazi A. Psychometric properties of Fagerström Tolerance Questionnaire among Turkmen Nass (Naswar) users. Addict Sci Clin Pract 2023; 18:32. [PMID: 37217987 DOI: 10.1186/s13722-023-00390-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 05/08/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND Smokeless tobacco (SLT) products are gaining popularity around the globe, particularly in Asia, Africa, and the Middle East. Among these products, Nass (aka Naswar) is popular among the Turkmen ethnicity in Iran. Although several studies reported nicotine dependence (ND) among SLT users, psychometric instruments have never been utilized to specifically measure ND among Nass users. Therefore, in this study, we aimed to evaluate the reliability and validity of the Fagerström Tolerance Questionnaire (FTQ) among Turkmen Nass users. METHODS A cross-sectional, descriptive study was conducted in June-December 2018 among 411 Turkmen adults who currently (past 30 days) used Nass. Two bilinguals (Persian English) individuals translated and back-translated the FTQ-SLT, which maintained both the questionnaire's accuracy and cultural sensitivity. Construct validity was assessed using exploratory and confirmatory factor analysis. RESULTS The mean age and standard deviation for initiating Nass were 22.5 ± 11.81 years. Exploratory and confirmatory factor analysis indicated a single-factor solution with 8-items that captured several important ND components. Using Nass frequently, soon after waking, when sick, and experiencing a craving were some of the main components. Subgroups comparison revealed that higher scores occurred among those who were married, had Nass user(s) in their immediate family, and consumed bulk form of Turkmen Nass directly without using a tissue. CONCLUSION Our findings show that the FTQ- SLT is a fairly reliable and valid scale to measure ND among Turkmen Nass users and warrants further testing to accommodate cross-cultural differences in other populations.
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Affiliation(s)
| | - Shohreh Kolagari
- Faculty of Nursing & Midwifery, Golestan University of Medical Sciences, Gorgan, Iran
| | | | - Ziyad Ben Taleb
- Department of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, 411 S. Nedderman Drive Box 19407, Arlington, TX, 76019-0407, USA
| | - Kenneth D Ward
- School of Public Health, University of Memphis, 3720 Alumni Ave, Memphis, TX, 38152, USA
| | - Samane Zare
- School of Medicine, Department of Social Medicine, Population, & Public Health, University of California Riverside, 3333 14th Street, Riverside, CA, 92501, USA
| | - Abdurrahman Charkazi
- Environmental Health Research Center, Faculty of Health, Golestan University of Medical Sciences, Late Falsefi University Complex, KM 5of Gorgan-Sari Road, Gorgan, Iran.
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Shafiee A, Oraii A, Jalali A, Alaeddini F, Saadat S, Masoudkabir F, Tajdini M, Ashraf H, Omidi N, Heidari A, Shamloo AS, Sadeghian S, Boroumand M, Vasheghani-Farahani A, Karimi A, Franco OH. Epidemiology and prevalence of tobacco use in Tehran; a report from the recruitment phase of Tehran cohort study. BMC Public Health 2023; 23:740. [PMID: 37085856 PMCID: PMC10122292 DOI: 10.1186/s12889-023-15629-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 04/07/2023] [Indexed: 04/23/2023] Open
Abstract
INTRODUCTION Tobacco use is a major health concern worldwide, especially in low/middle-income countries. We aimed to assess the prevalence of cigarette smoking, waterpipe, and pipe use in Tehran, Iran. METHODS We used data from 8272 participants of the Tehran Cohort Study recruitment phase. Tobacco use was defined as a positive answer to using cigarettes, waterpipes, or pipes. Participants who did not report tobacco use during the interview but had a previous smoking history were categorized as former users. Age- and sex-weighted prevalence rates were calculated based on the national census data, and characteristics of current and former tobacco users were analyzed. RESULTS Age- and sex-weighted prevalence of current tobacco users, cigarette smokers, waterpipe, and pipe users in Tehran was 19.8%, 14.9%, 6.1%, and 0.5%, respectively. Current tobacco use was higher in younger individuals (35-45 years: 23.4% vs. ≥ 75 years: 10.4%, P < 0.001) and men compared to women (32.9% vs. 7.7% P < 0.001). The prevalence of tobacco use increased with more years of education (> 12 years: 19.3% vs. illiterate: 9.7%, P < 0.001), lower body mass index (< 20 kg/m2: 31.3% vs. ≥ 35 kg/m2: 13.8%, P < 0.001), higher physical activity (high: 23.0% vs. low: 16.4%, P < 0.001), opium (user: 66.6% vs. non-user: 16.5%, P < 0.001), and alcohol use (drinker: 57.5% vs. non-drinker: 15.4%, P < 0.001). Waterpipe users were younger (46.1 vs. 53.2 years) and had a narrower gender gap in prevalence than cigarette smokers (male/female ratio in waterpipe users: 2.39 vs. cigarette smokers: 5.47). Opium (OR = 5.557, P < 0.001) and alcohol consumption (OR = 4.737, P < 0.001) were strongly associated with tobacco use. Hypertension was negatively associated with tobacco use (OR = 0.774, P = 0.005). CONCLUSION The concerning prevalence of tobacco use in Tehran and its large gender gap for cigarette and waterpipe use warrant tailored preventive policies.
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Affiliation(s)
- Akbar Shafiee
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Oraii
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Jalali
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Farshid Alaeddini
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheil Saadat
- Department of Emergency Medicine, University of California, Irvine, CA, USA
| | - Farzad Masoudkabir
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Masih Tajdini
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Haleh Ashraf
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Omidi
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirhossein Heidari
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Alireza Sepehri Shamloo
- Department of Electrophysiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany
| | - Saeed Sadeghian
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohamamdali Boroumand
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Vasheghani-Farahani
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbasali Karimi
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Oscar H Franco
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
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Ansari Ramandi MM, Valizadeh N, Moezzi A, Ghoddusi M, Hatami F. Chest Pain in a Young Male with Carbon Monoxide Poisoning and Substance Abuse: A Case Report and Literature Review. ARYA ATHEROSCLEROSIS 2023; 19:58-62. [PMID: 38883570 PMCID: PMC11066783 DOI: 10.48305/arya.2023.11795.2447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 07/08/2023] [Indexed: 06/18/2024]
Abstract
BACKGROUND Carbon monoxide (CO) poisoning is the leading cause of poisoning-related deaths in the United States. In addition, myocardial infarction (MI) due to CO poisoning in a young, healthy adult is rare. On the other hand, smokeless tobacco, processed in various forms, is a controversial coronary heart disease (CHD) risk factor. CASE REPORT In this study, we describe a 29-year-old man who presented with acute chest pain following a night of smoking tobacco and using smokeless tobacco in the presence of carbon monoxide poisoning. ST-segment elevation was observed on an electrocardiogram, and echocardiography revealed akinesia. In addition, cardiac markers were elevated. In this particular instance, thrombolytic therapy demonstrated successful outcomes. CONCLUSIONS We believe the case and discussion could shed light on the emergency department management of such individuals. We advise clinicians to consider the possibility of coronary heart disease in carbon monoxide poisoning patients and to obtain a baseline electrocardiogram and cardiac markers.
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Affiliation(s)
- Mohammad Mostafa Ansari Ramandi
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Niloufar Valizadeh
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Ali Moezzi
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Mohamadyousef Ghoddusi
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Farbod Hatami
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
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Factors Predicting Dependence on Waterpipe Smoking Among Waterpipe Exclusive Smokers. J Addict Nurs 2023; 34:23-29. [PMID: 36857545 DOI: 10.1097/jan.0000000000000509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
ABSTRACT The current study targeted a sample of waterpipe (WP) exclusive smokers to identify the levels and predictors of dependence on this smoking pattern and to examine the relationship between WP smoking (WPS) dependence and depressive symptoms. A cross-sectional research design was employed with a community sample of 270 subjects who are currently WP exclusive smokers. Assessment of WPS dependence and depressive symptoms was performed using self-report measures. About 62.6% of the subjects were WPS dependent. The unique significant predictors of WPS dependence were age, depression levels, age of starting WPS, duration of WPS, income, smoking WP daily, the belief of being attracted to WPS, and the desire to stop WPS. These predictors explained 35% of the variance in WPS dependence. WPS dependence was associated with increased depressive symptoms. Although few studies have been conducted, the WPS dependence prevalence appears to be alarmingly high among WP exclusive smokers. Factors associated with WPS dependence provide useful information that can be used to tailor WP prevention interventions.
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Motamed-Gorji N, Hariri S, Masoudi S, Sharafkhah M, Nalini M, Oveisgharan S, Khoshnia M, Motamed-Gorji N, Gharavi A, Etemadi A, Poustchi H, Zand R, Malekzadeh R. Incidence, early case fatality and determinants of stroke in Iran: Golestan Cohort Study. J Stroke Cerebrovasc Dis 2022; 31:106658. [PMID: 35973398 DOI: 10.1016/j.jstrokecerebrovasdis.2022.106658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 06/20/2022] [Accepted: 07/14/2022] [Indexed: 10/15/2022] Open
Abstract
OBJECTIVES While few studies investigated the incidence of stroke in Iran, no Iranian cohort has estimated the standardized-incidence rate and early fatality of first-ever-stroke subtypes along with associated factors. METHODS Golestan Cohort Study is a prospective study launched in northeastern Iran in 2004, including 50,045 individuals aged 40-75 at baseline. Age-standardized incidence rate of first-ever-stroke was calculated per 100,000 person-years, according to World Standard Population. The 28-day case fatality was calculated by dividing the number of fatal first-ever-stroke during the first 28 days by total events. Cox proportional hazard models were conducted to assess incidence and fatality risk factors. We used Population Attributable Fractions to estimate the incidence and early fatality proportions reduced by ideal risk factor control. RESULTS 1,135 first-ever-strokes were observed during 8.6 (median) years follow-up. First-ever-stroke standardized incidence rate was estimated 185.2 (95% CI: 173.2-197.2) per 100,000 person-years. The 28-day case fatality was 44.1% (95% CI: 40.4-48.2). Hypertension and pre-stroke physical activity were the strongest risk factors associated with first-ever-stroke incidence (Hazard ratio: 2.83; 2.47-3.23) and 28-day case fatality (Hazard ratio: 0.59; 0.44-0.78), respectively. Remarkably, opium consumption was strongly associated with hemorrhagic stroke incidence (Hazard ratio: 1.52; 1.04-2.23) and ischemic stroke fatality (Hazard ratio: 1.44; 1.01-2.09). Overall, modifiable risk factors contributed to 83% and 61% of first-ever-stroke incidence and early fatality, respectively. CONCLUSION Efficient risk factor control can considerably reduce stroke occurrence and fatality in our study. Establishing awareness campaigns and 24-hour stroke units seem necessary for improving the stroke management in this area.
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Affiliation(s)
- Nazgol Motamed-Gorji
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sanam Hariri
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Masoudi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Sharafkhah
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Nalini
- Cardiovascular Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shahram Oveisgharan
- Rush Alzheimer Disease Research Center, Rush University Medical Center, Chicago, IL, USA
| | - Masoud Khoshnia
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Abdolsamad Gharavi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Etemadi
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Hossein Poustchi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Zand
- Neuroscience Institute, Penn State University, Hershey, PA, USA; Neuroscience Institute, Geisinger, Danville, PA, USA.
| | - Reza Malekzadeh
- Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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10
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Hajat C, Stein E, Ramstrom L, Shantikumar S, Polosa R. The health impact of smokeless tobacco products: a systematic review. Harm Reduct J 2021; 18:123. [PMID: 34863207 PMCID: PMC8643012 DOI: 10.1186/s12954-021-00557-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 10/12/2021] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION The objective was to systematically review studies on health outcomes from smokeless tobacco (SLT) products. METHODS We analysed published literature on the health outcomes from SLT use between 01/01/2015 to 01/02/2020, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol using PubMed, Embase, Scopus, and Google Scholar. RESULTS Of 53 studies included, six were global, 32 from Asia, Middle East and Africa (AMEA), nine from USA and six from Europe. 'Poor'-rated studies predominated (23;43%), in particular, for global (4;66%) and AMEA (16;50%). Health outcomes differed between SLT-products and regions; those in AMEA were associated with higher mortality (overall, cancer, Coronary heart disease (CHD), respiratory but not cardiovascular disease (CVD)), and morbidity (CVD, oral and head and neck cancers), with odds ratios up to 38.7. European studies showed no excess mortality (overall, CVD, from cancers) or morbidity (ischemic heart disease (IHD), stroke, oral, head and neck, pancreatic or colon cancers) from several meta-analyses; single studies reported elevated risk of rectal cancer and respiratory disorders. Pooled study data showed protection against developing Parkinson's disease. US studies showed mixed results for mortality (raised overall, CHD, cancer and smoking-related cancer mortality; no excess risk of respiratory or CVD mortality). Morbidity outcomes were also mixed, with some evidence of increased IHD, stroke and cancer risk (oral, head and neck). No studies reported on switching from cigarettes to SLT-products. CONCLUSION Our review demonstrates stark differences between different SLT-products in different regions, ranging from zero harm from European snus to greatly increased health risks in AMEA. The literature on the safety profile for SLT-products for harm reduction is incomplete and potentially misinforming policy and regulation.
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Affiliation(s)
- C Hajat
- Public Health Institute, UAE University, Abu Dhabi, 15551, UAE.
| | - E Stein
- Independent Researcher, New York, USA
| | - L Ramstrom
- Independent Researcher, Institute for Tobacco Studies, Stockholm, Sweden
| | - S Shantikumar
- Warwick Medical School, University of Warwick, Coventry, UK
| | - R Polosa
- Center of Excellence for the Acceleration of HArm Reduction (CoEHAR), University of Catania, Catania, Italy
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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11
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Wu Z, Han Y, Caporaso JG, Bokulich N, Mohamadkhani A, Moayyedkazemi A, Hua X, Kamangar F, Wan Y, Suman S, Zhu B, Hutchinson A, Dagnall C, Jones K, Hicks B, Shi J, Malekzadeh R, Abnet CC, Pourshams A, Vogtmann E. Cigarette Smoking and Opium Use in Relation to the Oral Microbiota in Iran. Microbiol Spectr 2021; 9:e0013821. [PMID: 34523990 PMCID: PMC8557864 DOI: 10.1128/spectrum.00138-21] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 07/26/2021] [Indexed: 12/27/2022] Open
Abstract
Cigarettes and opium contain chemicals and particulate matter that may modify the oral microbiota. This study aimed to investigate the association between cigarette and opium use with the oral microbiota. A total of 558 participants were recruited from Iran between 2011 and 2015. Individuals were categorized as never cigarette nor opium users, ever cigarette-only smokers, ever opium-only users, and ever both cigarette and opium users. Participants provided saliva samples for 16S rRNA gene sequencing. Logistic regression, microbiome regression-based kernel association test (MiRKAT), and zero-inflated beta regression models were calculated. For every increase in 10 observed amplicon sequence variants (ASVs), the odds for being a cigarette-only smoker, opium-only user, and both user compared to never users decreased by 9% (odds ratio [OR] = 0.91; 95% confidence interval [95% CI] = 0.86 to 0.97), 13% (OR = 0.87; 95% CI = 0.75 to 1.01), and 12% (OR = 0.88; 95% CI = 0.80 to 0.96), respectively. The microbial communities differed by cigarette and opium use as indicated by MiRKAT models testing the three beta-diversity matrices (P < 0.05 for all). Three genera were less likely and one genus was more likely to be detected in cigarette-only smokers or opium-only users than in never users. The relative abundance of the phylum Actinobacteria (never, 14.78%; both, 21.20%) was higher and the phyla Bacteroidetes (never, 17.63%; both, 11.62%) and Proteobacteria (never, 9.06%; both, 3.70%) were lower in users of both cigarettes and opium, while the phylum Firmicutes (never, 54.29%; opium, 65.49%) was higher in opium-only users. Cigarette and opium use was associated with lower alpha-diversity, overall oral microbiota community composition, and both the presence and relative abundance of multiple taxa. IMPORTANCE Cigarette smoking and opium use are associated with periodontal disease caused by specific bacteria such as Porphyromonas gingivalis, which suggests a link between cigarette smoking and opium use and the oral microbiota. Alterations of the oral microbiota in cigarette smokers compared to nonsmokers have been reported, but this has not been studied across diverse populations. Additionally, the association of opium use with the oral microbiota has not been investigated to date. We conducted this study to investigate differences in the oral microbiota between ever users of cigarettes only, opium only, and both cigarettes and opium and never users of cigarettes and opium in Iran. Lower alpha-diversity, distinct overall oral microbial communities, and the presence and relative abundance of multiple taxa have been found for users of cigarettes and/or opium.
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Affiliation(s)
- Zeni Wu
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Yongli Han
- Biostatistics Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - J. Gregory Caporaso
- Center for Applied Microbiome Science, Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, Arizona, USA
| | - Nicholas Bokulich
- Center for Applied Microbiome Science, Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, Arizona, USA
| | - Ashraf Mohamadkhani
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Moayyedkazemi
- Department of Internal Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Xing Hua
- Biostatistics Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Farin Kamangar
- Department of Biology, School of Computer, Mathematical, and Natural Sciences, Morgan State University, Baltimore, Maryland, USA
| | - Yunhu Wan
- Biostatistics Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Shalabh Suman
- Cancer Genomics Research Laboratory, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, Maryland, USA
- Leidos Biomedical Research Laboratory, Inc., Frederick National Laboratory for Cancer Research, Frederick, Maryland, USA
| | - Bin Zhu
- Cancer Genomics Research Laboratory, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, Maryland, USA
- Leidos Biomedical Research Laboratory, Inc., Frederick National Laboratory for Cancer Research, Frederick, Maryland, USA
| | - Amy Hutchinson
- Cancer Genomics Research Laboratory, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, Maryland, USA
- Leidos Biomedical Research Laboratory, Inc., Frederick National Laboratory for Cancer Research, Frederick, Maryland, USA
| | - Casey Dagnall
- Cancer Genomics Research Laboratory, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, Maryland, USA
- Leidos Biomedical Research Laboratory, Inc., Frederick National Laboratory for Cancer Research, Frederick, Maryland, USA
| | - Kristine Jones
- Cancer Genomics Research Laboratory, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, Maryland, USA
- Leidos Biomedical Research Laboratory, Inc., Frederick National Laboratory for Cancer Research, Frederick, Maryland, USA
| | - Belynda Hicks
- Cancer Genomics Research Laboratory, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, Maryland, USA
- Leidos Biomedical Research Laboratory, Inc., Frederick National Laboratory for Cancer Research, Frederick, Maryland, USA
| | - Jianxin Shi
- Biostatistics Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Christian C. Abnet
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Akram Pourshams
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Emily Vogtmann
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, Maryland, USA
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12
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Afrashteh S, Ansarifar A, Vali M, Nami Nazari L, Keshtkar N, Memar S, Mohebbi E, Hadji M, Ostovar A, Zendehdel K, Marzban M. Geographic distribution and time trends of water-pipe use among Iranian youth and teenage students: A meta-analysis and systematic review. J Ethn Subst Abuse 2021; 22:285-315. [PMID: 34486927 DOI: 10.1080/15332640.2021.1943097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Water-pipe tobacco smoking is harmful to health, yet its rate of prevalence remains uncertain. Recent evidence has shown that the prevalence of water-pipe smoking among students is higher than in the general population. In this study, a systematic review of related literature on water-pipe use was conducted, and for this purpose, 76 articles were examined in the study. In this vein, geographic distribution and time trends of water-pipe consumption in Iran were considered. The results of this study showed that lifetime, last-year, and last-month prevalence of water-pipe smoking use among Iranian students were 28.78 (25.07-32.49), 20.84 (16.01-25.66), and 16.36 (11.86-20.85), respectively. The results also showed a wide variation by the region and sex in Iran. This study has shown the importance of addressing public prevention and alerting programs in schools and universities.
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Affiliation(s)
- Sima Afrashteh
- Department of Public Health, School of Public Health, Bushehr University of Medical Sciences, Bushehr, Iran
| | | | - Mohebat Vali
- Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | | - Sara Memar
- Bushehr University of Medical Sciences, Bushehr, Iran
| | - Elham Mohebbi
- Tehran University of Medical Sciences, Tehran, Iran.,Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Hadji
- Health Unit, Faculty of Social Science, Tampere University, Tampere, Finland
| | | | | | - Maryam Marzban
- Department of Epidemiology, School of Public Health, Bushehr University of Medical Sciences, Bushehr, Iran.,The Persian Gulf Martyrs, Bushehr University of Medical Sciences, Bushehr, Iran
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13
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Hashemian M, Merat S, Poustchi H, Jafari E, Radmard AR, Kamangar F, Freedman N, Hekmatdoost A, Sheikh M, Boffetta P, Sinha R, Dawsey SM, Abnet CC, Malekzadeh R, Etemadi A. Red Meat Consumption and Risk of Nonalcoholic Fatty Liver Disease in a Population With Low Meat Consumption: The Golestan Cohort Study. Am J Gastroenterol 2021; 116:1667-1675. [PMID: 33767101 PMCID: PMC8460710 DOI: 10.14309/ajg.0000000000001229] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 02/08/2021] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Nonalcoholic fatty liver disease (NAFLD), as the most common liver disease in the world, can range from simple steatosis to steatohepatitis. We evaluated the association between meat consumption and risk of NAFLD in the Golestan Cohort Study (GCS). METHODS The GCS enrolled 50,045 participants, aged 40-75 years in Iran. Dietary information was collected using a 116-item semiquantitative food frequency questionnaire at baseline (2004-2008). A random sample of 1,612 cohort members participated in a liver-focused study in 2011. NAFLD was ascertained through ultrasound. Total red meat consumption and total white meat consumption were categorized into quartiles based on the GCS population, with the first quartile as the referent group. Multivariable logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS The median intake of total red meat was 17 and total white meat was 53 g/d. During follow-up, 505 individuals (37.7%) were diagnosed with NAFLD, and 124 of them (9.2%) had elevated alanine transaminase. High total red meat consumption (ORQ4 vs Q1 = 1.59, 95% CI = 1.06-2.38, P trend = 0.03) and organ meat consumption (ORQ4 vs Q1 = 1.70, 95% CI = 1.19-2.44, P trend = 0.003) were associated with NAFLD. Total white meat, chicken, or fish consumption did not show significant associations with NAFLD. DISCUSSION In this population with low consumption of red meat, individuals in the highest group of red meat intake were at increased odds of NAFLD. Furthermore, this is the first study to show an association between organ meat consumption and NAFLD (see Visual Abstract, http://links.lww.com/AJG/B944).
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Affiliation(s)
- Maryam Hashemian
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Departments of Biology, School of Art and Sciences, Utica College, Utica, New York, USA
| | - Shahin Merat
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Poustchi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Jafari
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir-Reza Radmard
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farin Kamangar
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Biology, School of Computer, Mathematical, and Natural Sciences, Morgan State University, Baltimore, Maryland, USA
| | - Neal Freedman
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Azita Hekmatdoost
- Departments of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahdi Sheikh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Genetic Epidemiology Group, Section of Genetics, International Agency for Research on Cancer, the World Health Organization, Lyon, France
| | - Paolo Boffetta
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York, USA
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Rashmi Sinha
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Sanford M Dawsey
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Christian C Abnet
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Etemadi
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
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14
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Rostron BL, Wang J, Etemadi A, Thakur S, Chang JT, Bhandari D, Botelho JC, De Jesús VR, Feng J, Gail MH, Inoue-Choi M, Malekzadeh R, Pourshams A, Poustchi H, Roshandel G, Shiels MS, Wang Q, Wang Y, Xia B, Boffetta P, Brennan P, Abnet CC, Calafat AM, Wang L, Blount BC, Freedman ND, Chang CM. Associations between Biomarkers of Exposure and Lung Cancer Risk among Exclusive Cigarette Smokers in the Golestan Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7349. [PMID: 34299799 PMCID: PMC8306295 DOI: 10.3390/ijerph18147349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/02/2021] [Accepted: 07/05/2021] [Indexed: 11/17/2022]
Abstract
Biomarkers of tobacco exposure are known to be associated with disease risk but previous studies are limited in number and restricted to certain regions. We conducted a nested case-control study examining baseline levels and subsequent lung cancer incidence among current male exclusive cigarette smokers in the Golestan Cohort Study in Iran. We calculated geometric mean biomarker concentrations for 28 matched cases and 52 controls for the correlation of biomarker levels among controls and for adjusted odds' ratios (ORs) for lung cancer incidence by biomarker concentration, accounting for demographic characteristics, smoking quantity and duration, and opium use. Lung cancer cases had higher average levels of most biomarkers including total nicotine equivalents (TNE-2), 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), and 3-hydroxyfluorene (3-FLU). Many biomarkers correlated highly with one another including TNE-2 with NNAL and N-Acetyl-S-(2-cyanoethyl)-L-cysteine (2CYEMA), and N-Acetyl-S-(4-hydroxy-2-buten-1-yl)-L-cysteine (t4HBEMA) with N-Acetyl-S-(3-hydroxypropyl-1-methyl)-L-cysteine (3HMPMA) and N-Acetyl-S-(4-hydroxy-2-methyl-2-buten-1-yl)-L-cysteine (4HMBEMA). Lung cancer risk increased with concentration for several biomarkers, including TNE-2 (OR = 2.22, 95% CI = 1.03, 4.78) and NNN (OR = 2.44, 95% CI = 1.13, 5.27), and estimates were significant after further adjustment for demographic and smoking characteristics for 2CYEMA (OR = 2.17, 95% CI = 1.03, 4.55), N-Acetyl-S-(2-carbamoylethyl)-L-cysteine (2CAEMA) (OR = 2.14, 95% CI = 1.01, 4.55), and N-Acetyl-S-(2-hydroxypropyl)-L-cysteine (2HPMA) (OR = 2.85, 95% CI = 1.04, 7.81). Estimates were not significant with adjustment for opium use. Concentrations of many biomarkers were higher at the baseline for participants who subsequently developed lung cancer than among the matched controls. Odds of lung cancer were higher for several biomarkers including with adjustment for smoking exposure for some but not with adjustment for opium use.
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Affiliation(s)
- Brian L. Rostron
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD 20993, USA; (J.W.); (S.T.); (J.T.C.); (C.M.C.)
| | - Jia Wang
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD 20993, USA; (J.W.); (S.T.); (J.T.C.); (C.M.C.)
| | - Arash Etemadi
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA; (A.E.); (M.I.-C.); (C.C.A.); (N.D.F.)
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran 1411713135, Iran; (R.M.); (A.P.)
| | - Sapna Thakur
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD 20993, USA; (J.W.); (S.T.); (J.T.C.); (C.M.C.)
| | - Joanne T. Chang
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD 20993, USA; (J.W.); (S.T.); (J.T.C.); (C.M.C.)
| | - Deepak Bhandari
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (D.B.); (J.C.B.); (V.R.D.J.); (J.F.); (Y.W.); (B.X.); (A.M.C.); (L.W.); (B.C.B.)
| | - Julianne Cook Botelho
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (D.B.); (J.C.B.); (V.R.D.J.); (J.F.); (Y.W.); (B.X.); (A.M.C.); (L.W.); (B.C.B.)
| | - Víctor R. De Jesús
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (D.B.); (J.C.B.); (V.R.D.J.); (J.F.); (Y.W.); (B.X.); (A.M.C.); (L.W.); (B.C.B.)
| | - Jun Feng
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (D.B.); (J.C.B.); (V.R.D.J.); (J.F.); (Y.W.); (B.X.); (A.M.C.); (L.W.); (B.C.B.)
| | - Mitchell H. Gail
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA;
| | - Maki Inoue-Choi
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA; (A.E.); (M.I.-C.); (C.C.A.); (N.D.F.)
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran 1411713135, Iran; (R.M.); (A.P.)
| | - Akram Pourshams
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran 1411713135, Iran; (R.M.); (A.P.)
| | - Hossein Poustchi
- Liver and Pancreaticobilliary Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran 1411713135, Iran;
| | - Gholamreza Roshandel
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan 4917867439, Iran;
| | - Meredith S. Shiels
- Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA;
| | - Qian Wang
- Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
| | - Yuesong Wang
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (D.B.); (J.C.B.); (V.R.D.J.); (J.F.); (Y.W.); (B.X.); (A.M.C.); (L.W.); (B.C.B.)
| | - Baoyun Xia
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (D.B.); (J.C.B.); (V.R.D.J.); (J.F.); (Y.W.); (B.X.); (A.M.C.); (L.W.); (B.C.B.)
| | - Paolo Boffetta
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY 11794, USA;
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
| | - Paul Brennan
- International Agency for Research on Cancer, 69372 Lyon, France;
| | - Christian C. Abnet
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA; (A.E.); (M.I.-C.); (C.C.A.); (N.D.F.)
| | - Antonia M. Calafat
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (D.B.); (J.C.B.); (V.R.D.J.); (J.F.); (Y.W.); (B.X.); (A.M.C.); (L.W.); (B.C.B.)
| | - Lanqing Wang
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (D.B.); (J.C.B.); (V.R.D.J.); (J.F.); (Y.W.); (B.X.); (A.M.C.); (L.W.); (B.C.B.)
| | - Benjamin C. Blount
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (D.B.); (J.C.B.); (V.R.D.J.); (J.F.); (Y.W.); (B.X.); (A.M.C.); (L.W.); (B.C.B.)
| | - Neal D. Freedman
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA; (A.E.); (M.I.-C.); (C.C.A.); (N.D.F.)
| | - Cindy M. Chang
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD 20993, USA; (J.W.); (S.T.); (J.T.C.); (C.M.C.)
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15
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Gasana J, Vainio H, Longenecker J, Loney T, Ádám B, Al-Zoughool M. Identification of public health priorities, barriers, and solutions for Kuwait using the modified Delphi method for stakeholder consensus. Int J Health Plann Manage 2021; 36:1830-1846. [PMID: 34176157 DOI: 10.1002/hpm.3270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 06/17/2021] [Accepted: 06/18/2021] [Indexed: 11/05/2022] Open
Abstract
The rapid modernization and economic developments in Kuwait, have been accompanied by substantial lifestyle changes such as unhealthy diet and physical inactivity. These modifiable behaviours have contributed to increased rates of non-communicable diseases including diabetes and cardiovascular diseases. Delphi Consensus Method was implemented in the current study to draw stakeholders from all sectors together to develop a consensus on the major public health priorities, barriers and solutions. The process involves administration of a series of questions to selected stakeholders through an iterative process that ends when a consensus has been reached among participants. Results of the iteration process identified obesity, diabetes, cardiovascular diseases along with lack of enforcement of laws and regulation as priority health issues. Results also identified lack of national vision for the development of a public health system, lack of multidisciplinary research investigating sources of disease and methods of prevention and improving efficiency with existing resources in implementation and efficiency as the main barriers identified were. Solutions suggested included investing in healthcare prevention, strengthening communication between all involved sectors through intersectoral collaboration, awareness at the primary healthcare setting and use of electronic health records. The results offer an important opportunity for stakeholders in Kuwait to tackle these priority health issues employing the suggested approaches and solution.
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Affiliation(s)
- Janvier Gasana
- Department of Environmental and Occupational Health, Faculty of Public Health, Kuwait University, Kuwait, Kuwait
| | - Harri Vainio
- Department of Environmental and Occupational Health, Faculty of Public Health, Kuwait University, Kuwait, Kuwait
| | - Joseph Longenecker
- Department of Epidemiology, Faculty of Public Health, Kuwait University, Kuwait, Kuwait
| | - Tom Loney
- College of Medicine, Mohammed Bin Rashid University for Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Balázs Ádám
- Department of Public Health and Preventive Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Mustafa Al-Zoughool
- Department of Environmental and Occupational Health, Faculty of Public Health, Kuwait University, Kuwait, Kuwait
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Gupta R, Gupta S, Sharma S, Sinha DN, Mehrotra R. Association of smokeless tobacco and cerebrovascular accident: a systematic review and meta-analysis of global data. J Public Health (Oxf) 2021; 42:e150-e157. [PMID: 31067304 DOI: 10.1093/pubmed/fdz054] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 03/14/2019] [Accepted: 04/24/2019] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND The association of smokeless tobacco (SLT) with stroke has been dealt with in only a few reviews. The present meta-analysis aims to present the updated comprehensive summary risk of stroke in adult SLT users along with sub group analysis. METHODS A systematic literature search for articles evaluating risk of stroke in SLT users was conducted. The study characteristics and risk estimates were extracted independently by two authors (RG and SG). Random-effect model was used to estimate the summary relative risks. RESULTS The overall risk of stroke in SLT users was found to be significantly higher (1.17, 95% CI 1.04–1.30) compared to non-users, especially for users in Southeast Asian region. The results remained unchanged even after strict adjustment for smoking (1.18, 95% CI 1.04–1.32). SLT users had 1.34 times or 13.4% higher risk of fatal stroke, though risk of nonfatal stroke was not enhanced. Significantly higher risk of stroke was seen in users of chewing tobacco (1.35, 95% CI 1.20–1.50) in comparison to non-chewers. Gender-based analysis showed enhanced risk of fatal stroke in both male and female users. SLT-attributable fraction of fatal stroke was highest for India at 14.8%. CONCLUSION The significant higher risk of stroke with SLT use, even after adjustment for smoking, emphasizes the imperative need to include SLT cessation advice for control and prevention of stroke.
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Affiliation(s)
- R Gupta
- Division of Cytopathology, ICMR-National Institute for Cancer Prevention and Research, I-7, Sector-39, Noida (U.P), India
| | - S Gupta
- Division of Cytopathology, ICMR-National Institute for Cancer Prevention and Research, I-7, Sector-39, Noida (U.P), India
| | - S Sharma
- Division of Epidemiology & Biostatistics, ICMR-National Institute for Cancer Prevention and Research, I-7, Sector-39, Noida (U.P), India
| | - D N Sinha
- School of Preventive Oncology, Patna & Ex-Consultant, WHO FCTC Global Knowledge Hub on Smokeless Tobacco, ICMR-National Institute for Cancer Prevention and Research, I-7, Sector-39, Noida (U.P), India
| | - R Mehrotra
- ICMR-National Institute for Cancer Prevention and Research and Director, WHO FCTC Global Knowledge Hub on Smokeless Tobacco, I-7, Sector-39, Noida (U.P), India
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Wang Q, Hashemian M, Sepanlou SG, Sharafkhah M, Poustchi H, Khoshnia M, Gharavi A, Pourshams A, Malekshah AF, Kamangar F, Etemadi A, Abnet CC, Dawsey SM, Malekzadeh R, Boffetta P. Dietary quality using four dietary indices and lung cancer risk: the Golestan Cohort Study (GCS). Cancer Causes Control 2021; 32:493-503. [PMID: 33611724 PMCID: PMC10667988 DOI: 10.1007/s10552-021-01400-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 01/28/2021] [Indexed: 02/06/2023]
Abstract
PURPOSE The lung cancer incidence in Iran has increased almost ten times over the past three decades. In addition to the known causes such as smoking and certain occupational exposure, dietary quality has been suggested to play a role in lung cancer. We aim to explore the association between dietary pattern and lung cancer risk among a Middle East population. METHODS Data came from Golestan Cohort Study which included 48,421 participants with 136 lung cancer cases diagnosed during a median follow-up of 12 years. Multivariable Cox proportional hazards regression models were used to calculate the HRs and 95% CI of lung cancer risk by tertile of the four dietary index scores-the Health Eating Index (HEI)-2015, the Alternative Health Eating Index (AHEI)-2010, the Alternative Mediterranean Diet (AMED), and the Dietary Approach to Stop Hypertension (DASH)-Fung. RESULTS A higher DASH-Fung score was inversely associated with risk of lung cancer after adjusting for potential confounders (tertile three vs. tertile one: HR = 0.59 (0.38-0.93); p for trend = 0.07), and pinteraction with smoking was 0.46. Similar findings were observed among current smokers with the HEI-2015 score (tertile three vs. tertile one: HR = 0.22 (0.08-0.60): p for trend < 0.01), and pinteraction between smoking and the HEI-2015 score was 0.03. CONCLUSION In the GCS, consuming a diet more closely aligned with the DASH diet was associated with a reduced risk of lung cancer, which appeared to be independent of smoking status. There was also an inverse link between the HEI-2015 score and lung cancer risk among current smokers. Our finding is particularly important for the Middle East population, as diet may play an important role in cancer prevention and overall health.
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Affiliation(s)
- Qian Wang
- Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1079, New York, NY, 10029, USA.
| | - Maryam Hashemian
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Biology Department, Utica College, Utica, NY, USA
| | - Sadaf G Sepanlou
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Disease Research Center, Digestive Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Sharafkhah
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Poustchi
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Liver and Pancreatobiliary Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Khoshnia
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Abdolsamad Gharavi
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Akram Pourshams
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Liver and Pancreatobiliary Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Akbar Fazeltabar Malekshah
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Arash Etemadi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Christian C Abnet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Sanford M Dawsey
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Liver and Pancreatobiliary Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Disease Research Center, Digestive Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Alomari MA, Khabour OF, Alzoubi KH. Gender-specific relationship of circulatory measures with waterpipe smoking: The Irbid WiHi project. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2021. [DOI: 10.1016/j.ijans.2021.100379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Solhi M, Fattahi E, Barati H, Mohammadi M, Kasmaei P, Rastaghi S. Smokeless Tobacco Use in Iran: A Systematic Review. ADDICTION & HEALTH 2020; 12:225-234. [PMID: 33244399 PMCID: PMC7679486 DOI: 10.22122/ahj.v12i3.274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background Smokeless tobacco (ST) use is one of the most important public health problems in Southeast Asia. The use of these substances increases the incidence of some cancers and other diseases. The purpose of this review study was to investigate on ST use in Iran. Methods A literature search was conducted on PubMed, Google Scholar, and three national databases [Scientific Information Database (SID), IranMedex, and IranDoc] based on the standard search strategy. Findings Most consumer people lived in Sistan and Baluchestan Province (Zahedan and Chabahar Cities) and Golestan Province, Iran. ST use rates ranged from 11.0% to 45.7% among college students in Sistan and Baluchestan (Zahedan and Chabahar) and Golestan. There are various types of ST consumed in Iran that have been mentioned in various articles, including Pan, Gutka, Nass, Naswar, Biti, and Supari. Conclusion Most studies on ST have been conducted in Sistan and Baluchestan and Golestan Provinces and we need more research for other provinces. Consumption by women is a warning and a threat to women's health in the future. Further studies will be needed to find out more precisely the prevalence of consumption in Iran.
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Affiliation(s)
- Mahnaz Solhi
- Department of Education and Health Promotion, School of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Esmaeil Fattahi
- Department of Education and Health Promotion, School of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Hadis Barati
- Student Research Committee AND Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoud Mohammadi
- Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Parisa Kasmaei
- Department of Health Education and Promotion, School of Health AND Research Center of Health and Environment, Guilan University of Medical Sciences, Rasht, Iran
| | - Sedighe Rastaghi
- Student Research Committee AND Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
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20
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Bifari AE, Sulaimani RK, Khojah YS, Almaghrabi OS, AlShaikh HA, Al-Ebrahim KE. Cardiovascular Risk Factors in Coronary Artery Bypass Graft Patients: Comparison Between Two Periods. Cureus 2020; 12:e10561. [PMID: 33101808 PMCID: PMC7577304 DOI: 10.7759/cureus.10561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Background Information showing risk factor trends in patients undergoing coronary artery bypass graft in Saudi Arabia is scarce. Thus, we aimed to compare cardiovascular risk factors among coronary artery bypass graft patients between two periods: 2012 and 2018. Methods This was a cross-sectional study based on hospital records at a tertiary center in Saudi Arabia. The medical records of 72 patients in 2012 and 111 patients in 2018 were reviewed. The study included all patients who underwent coronary artery bypass grafting for the first time. The chi-square test and independent t-test were used for statistical analysis; P-values less than 0.05 were considered statistically significant. Results The mean (SD) of the patient age was 61.21 (9.74) years in the first period and 58.01 (11.14) years in the second period. The number of patients who smoked was significantly higher in the second period of the study (14.3% in the first period; 27.0% in the second period; P < 0.001). The study also showed an increase in hypertension and diabetes mellitus in the second period compared to the first (70% vs 71.2% and 68.6% vs 72.1%, respectively), and a reduction in the percentage of patients with hypercholesterolemia (18.3% vs 17.1%). However, these findings were non-significant. Conclusions The percentage of smokers was significantly higher in the second period of this research as a consequence of cultural variation and because of the popularity of water-pipe smoking in the society. We recommend the need for increased awareness regarding smoking and the implementation of smoking-cessation programs.
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Affiliation(s)
- Anas E Bifari
- Medicine, College of Medicine, King Abdulaziz University, Jeddah, SAU
| | - Rakan K Sulaimani
- Medicine, College of Medicine, King Abdulaziz University, Jeddah, SAU
| | - Yaser S Khojah
- Medicine, College of Medicine, King Abdulaziz University, Jeddah, SAU
| | | | - Hesham A AlShaikh
- Medicine, College of Medicine, King Abdulaziz University, Jeddah, SAU
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21
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Homaie Rad E, Pulok MH, Rezaei S, Reihanian A. Quality and quantity of price elasticity of cigarette in Iran. Int J Health Plann Manage 2020; 36:60-70. [PMID: 32840879 DOI: 10.1002/hpm.3062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 08/09/2020] [Accepted: 08/13/2020] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE Effectiveness of tax policies to control cigarette consumption largely depends on the sensitivity of cigarette demand due to price change. Price elasticity is the measurement of this responsiveness. The main objective of this study is to measure quantity, and quality price elasticity of demand (PED) and cross-price elasticity of demand (XED) for Iranian and non-Iranian cigarette brands in Iran. METHODS This study used data from the 2017 Iranian household income and expenditures survey conducted in all 31 provinces of Iran. A total of 39,864 households were included in the survey. PED of quantity and quality and XED were estimated using restricted, unrestricted and quintile regression models. RESULTS Our results s show that the Iranian and non-Iranians brands cigarettes were price inelastic and elastic, respectively. XED between Iranian and non-Iranian brands was positive suggesting households' preference for Iranian brands of cigarettes over non-Iranian brands. Quintile regression results suggest that PED varied between -1.20 and -0.91 across the distribution of quantity demanded. CONCLUSION Imposing tax could be a useful policy tool to control smoking initiation and intensity in Iran. However, the effectiveness of such policy would depend on the better governance of taxation imposed on different brands of cigarettes.
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Affiliation(s)
- Enayatollah Homaie Rad
- Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | | | - Satar Rezaei
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Anita Reihanian
- Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran
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22
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Roshandel G, Ferlay J, Semnani S, Fazel A, Naeimi-Tabiei M, Ashaari M, Amiriani T, Honarvar M, Sedaghat S, Hasanpour-Heidari S, Salamat F, Mansoury M, Ghasemi-Kebria F, Mirkarimi H, Jafari-Delouei N, Shokoohifar N, Vignat J, Weiderpass E, Malekzadeh R, Bray F. Recent cancer incidence trends and short-term predictions in Golestan, Iran 2004-2025. Cancer Epidemiol 2020; 67:101728. [PMID: 32554298 DOI: 10.1016/j.canep.2020.101728] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 04/22/2020] [Accepted: 04/24/2020] [Indexed: 01/12/2023]
Abstract
BACKGROUND We examine recent trends in the major cancers occurring in the Golestan province, a high-risk region for upper gastrointestinal cancers in Northern Iran, and provide short-term cancer predictions of the future cancer burden. METHODS New cancer cases diagnosed in Golestan 2004-2016 were obtained from the Golestan population-based cancer registry (GPCR) database, and age-standardized rates by cancer site, year and sex calculated per 100,000 person-years. Using IARC's DepPred package we fitted time-linear age-period models to the available GPCR data to predict the cancer incidence burden in the year 2025. We calculated the contribution of demographic changes versus changes in risk to the overall changes in incidence from 2016 to 2025. RESULTS The number of new cancer cases (excluding non-melanoma skin cancers) in 2025 is predicted to increase by 61.3% from 2678 cases in 2016 to 4319 cases. While a 17.6% reduction in the number of esophageal cancer cases is predicted by 2025, the number of new cases for each of the remaining major cancers is predicted to increase over the next decade, including cancers of the stomach (a 36.1% increase from 2016 to 2025), colorectum (56.2%), lung (67.8%), female breast (93.2%), prostate (101.8%) and leukemia (96.1%). The changes in the population structure and risk contributed 37.8% and 23.5% respectively, to the overall increase in incidence. CONCLUSION Other than for the major upper gastrointestinal cancer types, the incidence rates of common cancers observed in the province are on the rise, reinforcing the need for continuous surveillance, as well as the design and implementation of effective cancer control programs.
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Affiliation(s)
- Gholamreza Roshandel
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Jacques Ferlay
- Section for Cancer Surveillance, International Agency for Research in Cancer, Lyon, France
| | - Shahryar Semnani
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Abdolreza Fazel
- Cancer Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | | | - Mohammad Ashaari
- Department of Pathology, Sayyad Shirazi Hospital, Golestan University of Medical Sciences, Gorgan, Iran
| | - Taghi Amiriani
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mohammadreza Honarvar
- Deputy of Research and Technology, Golestan University of Medical Sciences, Gorgan, Iran
| | - SeyedMehdi Sedaghat
- Deputy of Public Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - Susan Hasanpour-Heidari
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Faezeh Salamat
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mohsen Mansoury
- Statistics and Information Technology Office, Golestan University of Medical Sciences, Gorgan, Iran
| | - Fatemeh Ghasemi-Kebria
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Honeyehsadat Mirkarimi
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Nastaran Jafari-Delouei
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Nesa Shokoohifar
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Jérôme Vignat
- Section for Cancer Surveillance, International Agency for Research in Cancer, Lyon, France
| | - Elisabete Weiderpass
- International Agency for Research in Cancer, World Health Organization, Lyon, France
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Freddie Bray
- Section for Cancer Surveillance, International Agency for Research in Cancer, Lyon, France.
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23
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Etemadi A, Poustchi H, Calafat AM, Blount BC, De Jesús VR, Wang L, Pourshams A, Shakeri R, Inoue-Choi M, Shiels MS, Roshandel G, Murphy G, Sosnoff CS, Bhandari D, Feng J, Xia B, Wang Y, Meng L, Kamangar F, Brennan P, Boffetta P, Dawsey SM, Abnet CC, Malekzadeh R, Freedman ND. Opiate and Tobacco Use and Exposure to Carcinogens and Toxicants in the Golestan Cohort Study. Cancer Epidemiol Biomarkers Prev 2020; 29:650-658. [PMID: 31915141 PMCID: PMC7839071 DOI: 10.1158/1055-9965.epi-19-1212] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 11/19/2019] [Accepted: 12/30/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND There is little information on human exposure to carcinogens and other toxicants related to opiate use, alone or in combination with tobacco. METHODS Among male participants of the Golestan Cohort Study in Northeast Iran, we studied 28 never users of either opiates or tobacco, 33 exclusive cigarette smokers, 23 exclusive users of smoked opiates, and 30 opiate users who also smoked cigarettes (dual users; 21 smoked opiates and 9 ingested them). We quantified urinary concentrations of 39 exposure biomarkers, including tobacco alkaloids, tobacco-specific nitrosamines, polycyclic aromatic hydrocarbons (PAH), and volatile organic compounds (VOC), and used decomposition to parse out the share of the biomarker concentrations explained by opiate use and nicotine dose. RESULTS Dual users had the highest concentrations of all biomarkers, but exclusive cigarette smokers and exclusive opiate users had substantially higher concentrations of PAH and VOC biomarkers than never users of either product. Decomposition analysis showed that opiate use contributed a larger part of the PAH concentrations than nicotine dose, and the sum of 2- and 3-hydroxyphenanthrene (∑2,3-phe) resulted almost completely from opiate use. Concentrations of most VOC biomarkers were explained by both nicotine dose and opiate use. Two acrylamide metabolites, a 1,3-butadiene metabolite and a dimethylformamide metabolite, were more strongly explained by opiate use. Acrylamide metabolites and ∑2,3-phe were significantly higher in opiate smokers than opiate eaters; other biomarkers did not vary by the route of opiate intake. CONCLUSIONS Both cigarette smokers and opiate users (by smoking or ingestion) were exposed to many toxicants and carcinogens. IMPACT This high exposure, particularly among dual opiate and cigarette users, can have a substantial global public health impact.
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Affiliation(s)
- Arash Etemadi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Poustchi
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Liver and Pancreaticobilliary Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Antonia M Calafat
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Benjamin C Blount
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Victor R De Jesús
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lanqing Wang
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Akram Pourshams
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Shakeri
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maki Inoue-Choi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Meredith S Shiels
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Gholamreza Roshandel
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Gwen Murphy
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Connie S Sosnoff
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Deepak Bhandari
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jun Feng
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Baoyun Xia
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Yuesong Wang
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lei Meng
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Farin Kamangar
- Department of Biology, School of Computer, Mathematical, and Natural Sciences, Morgan State University, Baltimore, Maryland
| | - Paul Brennan
- International Agency for Research on Cancer, Lyon, France
| | - Paolo Boffetta
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Sanford M Dawsey
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Christian C Abnet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Neal D Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
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Gupta R, Gupta S, Sharma S, Sinha DN, Mehrotra R. Risk of Coronary Heart Disease Among Smokeless Tobacco Users: Results of Systematic Review and Meta-Analysis of Global Data. Nicotine Tob Res 2020; 21:25-31. [PMID: 29325111 DOI: 10.1093/ntr/nty002] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 01/06/2018] [Indexed: 01/31/2023]
Abstract
Background Use of smokeless tobacco (SLT) products has been linked to multiple adverse effects, especially precancer and cancer of oral cavity. However, the association of SLT use with risk of coronary heart disease (CHD) is shrouded with controversy due to conflicting results in the literature. The present meta-analysis aimed to evaluate the risk of CHD among adult ever-users of SLT products along with sub-group analysis. Methods The analysis included studies retrieved from a systematic literature search for published articles assessing risk of CHD with SLT use. Two authors independently extracted risk estimates and study characteristics of the included studies. Summary relative risks were estimated using the random-effect model. Results Twenty studies from four WHO regions were included in the analysis. The summary risk of CHD in SLT users was not significantly positive (1.05, 95% CI = 0.96 to 1.15) although a higher risk of fatal CHD was seen (1.10, 95% CI = 1.00 to 1.20). The risk was significant for users in European Region (1.30, 95% CI = 1.14 to 1.47). The results remained unchanged even after strict adjustment for smoking. Product-wise analysis revealed a significant positive association of fatal CHD with snus/snuff use (1.37, 95% CI = 1.14 to 1.61). The SLT-attributable fraction of fatal CHD was calculated to be 0.3%, highest being for European region (5%). Conclusion A significant positive association was detected between SLT use and risk of fatal CHD, especially for European users and those consuming snus/snuff. In view of the positive association even after strict adjustment for smoking, these results underscore the need for inclusion of cessation efforts for smokeless tobacco in addition to smoking for control of fatal cardiovascular diseases. Implications The present meta-analysis demonstrates a global perspective of association between coronary heart disease (CHD) and use of smokeless tobacco (SLT), especially for fatal cardiac events, even with strict adjustment for smoking. There appears to be some difference in this effect based on the type of SLT product used. These results highlight the independent deleterious effect of SLT products on the outcome of CHD and might help to resolve the long-standing controversy regarding the association of SLT with the risk of CHD. Hence, we propose that in addition to smoking, cessation efforts should be directed towards SLT products as well, for control of cardiovascular diseases.
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Affiliation(s)
- Ruchika Gupta
- Division of Cytopathology, National Institute of Cancer Prevention and Research, India
| | - Sanjay Gupta
- Division of Cytopathology, National Institute of Cancer Prevention and Research, India
| | - Shashi Sharma
- Division of Epidemiology & Biostatistics, National Institute of Cancer Prevention and Research, India
| | - Dhirendra N Sinha
- WHO FCTC Global Knowledge Hub on Smokeless Tobacco, National Institute of Cancer Prevention and Research, India
| | - Ravi Mehrotra
- National Institute of Cancer Prevention and Research, India
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Islami F, Poustchi H, Pourshams A, Khoshnia M, Gharavi A, Kamangar F, Dawsey SM, Abnet CC, Brennan P, Sheikh M, Sotoudeh M, Nikmanesh A, Merat S, Etemadi A, Nasseri Moghaddam S, Pharoah PD, Ponder BA, Day NE, Jamal A, Boffetta P, Malekzadeh R. A prospective study of tea drinking temperature and risk of esophageal squamous cell carcinoma. Int J Cancer 2020; 146:18-25. [PMID: 30891750 PMCID: PMC7477845 DOI: 10.1002/ijc.32220] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 01/16/2019] [Accepted: 02/05/2019] [Indexed: 02/02/2023]
Abstract
Previous studies have reported an association between hot tea drinking and risk of esophageal cancer, but no study has examined this association using prospectively and objectively measured tea drinking temperature. We examined the association of tea drinking temperature, measured both objectively and subjectively at study baseline, with future risk of esophageal squamous cell carcinoma (ESCC) in a prospective study. We measured tea drinking temperature using validated methods and collected data on several other tea drinking habits and potential confounders of interest at baseline in the Golestan Cohort Study, a population-based prospective study of 50,045 individuals aged 40-75 years, established in 2004-2008 in northeastern Iran. Study participants were followed-up for a median duration of 10.1 years (505,865 person-years). During 2004-2017, 317 new cases of ESCC were identified. The objectively measured tea temperature (HR 1.41, 95% CI 1.10-1.81; for ≥60°C vs. <60°C), reported preference for very hot tea drinking (HR 2.41, 95% CI 1.27-4.56; for "very hot" vs. "cold/lukewarm"), and reported shorter time from pouring tea to drinking (HR 1.51, 95% CI 1.01-2.26; for <2 vs. ≥6 min) were all associated with ESCC risk. In analysis of the combined effects of measured temperature and amount, compared to those who drank less than 700 ml of tea/day at <60°C, drinking 700 mL/day or more at a higher-temperature (≥60°C) was consistently associated with an about 90% increase in ESCC risk. Our results substantially strengthen the existing evidence supporting an association between hot beverage drinking and ESCC.
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Affiliation(s)
- F. Islami
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Surveillance and Health Services Research, American Cancer Society, Atlanta, GA, United States
| | - H. Poustchi
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - A. Pourshams
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - M. Khoshnia
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Gastroenterology Research Center, Golestan University of Medical Science, Gorgan, Iran
| | - A. Gharavi
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Gastroenterology Research Center, Golestan University of Medical Science, Gorgan, Iran
| | - F. Kamangar
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Biology, School of Computer, Mathematical, and Natural Sciences, Morgan State University, Baltimore, MD, United States
| | - S. M. Dawsey
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States
| | - C. C. Abnet
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States
| | - P. Brennan
- International Agency for Research on Cancer, Lyon, France
| | - M. Sheikh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- International Agency for Research on Cancer, Lyon, France
| | - M. Sotoudeh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - A. Nikmanesh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - S. Merat
- Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - A. Etemadi
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States
| | - S. Nasseri Moghaddam
- Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - P. D. Pharoah
- Department of Oncology, Strangeways Research Laboratory, University of Cambridge, Worts Causeway, Cambridge, United Kingdom
| | - B. A. Ponder
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, United Kingdom
| | - N. E. Day
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - A. Jamal
- Surveillance and Health Services Research, American Cancer Society, Atlanta, GA, United States
| | - P. Boffetta
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - R. Malekzadeh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Dadkhah-Tirani H, Hasandokht T, Agostoni P, Salari A, Shad B, Soltanipour S. Comparison of cardiovascular risk factors among coronary artery bypass graft patients in 2010 and 2016: A single-center study in Guilan province, Iran. ARYA ATHEROSCLEROSIS 2019; 14:205-211. [PMID: 30783410 PMCID: PMC6368195 DOI: 10.22122/arya.v14i5.1740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND There has been a change in the risk factor profile of patients with coronary artery disease (CAD) in the western world. We sought to compare the risk factor profile of patients undergoing coronary artery bypass graft (CABG) surgery in northern part of Iran in 2010 and 2016. METHODS In a cross-sectional study, medical records of 296 CABG patients in 2010 and 500 patients in 2016 were collected from a referral university hospital in Guilan province, Iran. We compared the risk factor profile using chi-square test or independent t-test as needed in the two time points, 2010 and 2016. RESULTS The age of CABG patients significantly decreased from 62.49 ± 8.05 to 58.09 ± 9.20 over time. The frequency of hypertension (HTN) (66.2% vs. 59.1%, P = 0.045), diabetes mellitus (DM) (51.8% vs. 43.6%, P = 0.025), smoking (35.6% vs. 28.0%, P = 0.028), and patients with multimorbidity (31.8% vs. 26.7%, P = 0.001) increased in the second period compared to the first period of study. Whereas, the prevalence of hypercholesterolemia and positive family history of coronary heart disease (CHD) remained stable over time (49.6% vs. 49.0%, P = 0.870; 10.5% vs. 11.1%, P = 0.810, respectively). CONCLUSION We observed a dramatic increase in DM, HTN, and cigarette smoking as well as the multimorbidity prevalence in 2016 compared to 2010. Even with considering all study limitations, primary and secondary prevention program to decrease cardiovascular disease is required.
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Affiliation(s)
- Heidar Dadkhah-Tirani
- Assistant Professor, Cardiovascular Diseases Research Center AND Department of Cardiology, School of Medicine, Heshmat Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Tolou Hasandokht
- Assistant Professor, Cardiovascular Diseases Research Center AND Department of Cardiology, School of Medicine, Heshmat Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Piergiuseppe Agostoni
- Professor, Centro Cardiologico Monzino IRCCS AND Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milano, Milano, Italy
| | - Arsalan Salari
- Associate Professor, Cardiovascular Diseases Research Center AND Department of Cardiology, School of Medicine, Heshmat Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Bijan Shad
- Associate Professor, Cardiovascular Diseases Research Center AND Department of Cardiology, School of Medicine, Heshmat Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Soheil Soltanipour
- Associate Professor, Department of Community Medicine, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
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27
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Etemadi A, Poustchi H, Chang CM, Blount BC, Calafat AM, Wang L, De Jesus VR, Pourshams A, Shakeri R, Shiels MS, Inoue-Choi M, Ambrose BK, Christensen CH, Wang B, Murphy G, Ye X, Bhandari D, Feng J, Xia B, Sosnoff CS, Kamangar F, Brennan P, Boffetta P, Dawsey SM, Abnet CC, Malekzadeh R, Freedman ND. Urinary Biomarkers of Carcinogenic Exposure among Cigarette, Waterpipe, and Smokeless Tobacco Users and Never Users of Tobacco in the Golestan Cohort Study. Cancer Epidemiol Biomarkers Prev 2019; 28:337-347. [PMID: 30622099 PMCID: PMC6935158 DOI: 10.1158/1055-9965.epi-18-0743] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 09/27/2018] [Accepted: 10/17/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND How carcinogen exposure varies across users of different, particularly noncigarette, tobacco products remains poorly understood. METHODS We randomly selected 165 participants of the Golestan Cohort Study from northeastern Iran: 60 never users of any tobacco, 35 exclusive cigarette, 40 exclusive (78% daily) waterpipe, and 30 exclusive smokeless tobacco (nass) users. We measured concentrations of 39 biomarkers of exposure in 4 chemical classes in baseline urine samples: tobacco alkaloids, tobacco-specific nitrosamines (TSNA), polycyclic aromatic hydrocarbons (PAH), and volatile organic compounds (VOC). We also quantified the same biomarkers in a second urine sample, obtained 5 years later, among continuing cigarette smokers and never tobacco users. RESULTS Nass users had the highest concentrations of tobacco alkaloids. All tobacco users had elevated TSNA concentrations, which correlated with nicotine dose. In both cigarette and waterpipe smokers, PAH and VOC biomarkers were higher than never tobacco users and nass users, and highly correlated with nicotine dose. PAH biomarkers of phenanthrene and pyrene and two VOC metabolites (phenylmercapturic acid and phenylglyoxylic acid) were higher in waterpipe smokers than in all other groups. PAH biomarkers among Golestan never tobacco users were comparable to those in U.S. cigarette smokers. All biomarkers had moderate to good correlations over 5 years, particularly in continuing cigarette smokers. CONCLUSIONS We observed two patterns of exposure biomarkers that differentiated the use of the combustible products (cigarettes and waterpipe) from the smokeless product. Environmental exposure from nontobacco sources appeared to contribute to the presence of high levels of PAH metabolites in the Golestan Cohort. IMPACT Most of these biomarkers would be useful for exposure assessment in a longitudinal study.
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Affiliation(s)
- Arash Etemadi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, Maryland.
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Poustchi
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Liver and Pancreaticobiliary Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Cindy M Chang
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland
| | - Benjamin C Blount
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Antonia M Calafat
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lanqing Wang
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Victor R De Jesus
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Akram Pourshams
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Shakeri
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Meredith S Shiels
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, Maryland
| | - Maki Inoue-Choi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, Maryland
| | - Bridget K Ambrose
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland
| | - Carol H Christensen
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland
| | - Baoguang Wang
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland
| | - Gwen Murphy
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, Maryland
| | - Xiaoyun Ye
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Deepak Bhandari
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jun Feng
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Baoyun Xia
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Connie S Sosnoff
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Farin Kamangar
- Department of Biology, School of Computer, Mathematical, and Natural Sciences, Morgan State University, Baltimore, Maryland
| | - Paul Brennan
- International Agency for Research on Cancer, Lyon, France
| | - Paolo Boffetta
- The Tisch Cancer Institute, Mount Sinai School of Medicine and Institute for Translational Epidemiology, New York, New York
| | - Sanford M Dawsey
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, Maryland
| | - Christian C Abnet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, Maryland
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Neal D Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, Maryland
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Pratiti R, Mukherjee D. Epidemiology and Adverse Consequences of Hookah/Waterpipe Use: A Systematic Review. Cardiovasc Hematol Agents Med Chem 2019; 17:82-93. [PMID: 31483237 DOI: 10.2174/1871525717666190904151856] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 08/15/2019] [Accepted: 08/15/2019] [Indexed: 06/10/2023]
Abstract
Hookah smoking is becoming a popular trend globally. Waterpipe smoking is the second most prevalent form of alternate tobacco products. The rapid increase in hookah use is because of the misconception prevalent in society that hookah smoking is less harmful than cigarette smoking. Smoking ban policies had given impetus of switching from cigarette smoking to alternate tobacco products like waterpipe. Hookah users regard hookah to be more socially acceptable, less stigmatizing with flavors and to alleviate cigarette craving symptoms. Newer basic science research on animal models and human cells has shown consistently mutagenic, oxidative, and inflammatory changes that could cause possible health effects of premalignant oral lesion and chronic diseases like atherosclerosis and chronic obstructive pulmonary disease. Studies on the chemistry of waterpipe smoke had shown alarming results with the smoke containing seven carcinogens, 39 central nervous system depressants, and 31 respiratory irritants. Enormous data exist showing waterpipe smoking causing various health effects. Hookah smoking effects on cardiovascular disease is additive with hookah containing a significant amount of nicotine, tar, and heavy metals causing both acute and chronic effects on the cardiovascular system. These effects include increased heart rate, blood pressure, prevalence of coronary heart disease, heart failure, ST-segment elevation myocardial ischemia, recurrent ischemia, and worse outcomes including mortality related to these diseases. The objectives of the review are to assess the factor associated with the increasing use of hookah, its health effects, options for hookah smoking cessation, and public health policy initiatives to mitigate waterpipe use.
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Affiliation(s)
- Rebecca Pratiti
- McLaren HealthCare, G-3245 Beecher Rd, Flint, MA 48532, United States
| | - Debabrata Mukherjee
- Texas Tech University Health Science Center, Department of Internal Medicine, El Paso, TX 79905, United States
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Salloum RG, Lee J, Mostafa A, Abu-Rmeileh NME, Hamadeh RR, Darawad MW, Kheirallah KA, Salama M, Maziak W, Nakkash R. Waterpipe Tobacco Smoking among University Students in Three Eastern Mediterranean Countries: Patterns, Place, and Price. Subst Use Misuse 2019; 54:2275-2283. [PMID: 31347433 DOI: 10.1080/10826084.2019.1645177] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Background: The objective of this study was to examine waterpipe tobacco smoking patterns, places of smoking, and prices paid among university students in the Eastern Mediterranean Region. Methods: A cross-sectional online survey was administered to a convenience sample of university students in three countries. Participants were young adults (18-29 years) who were ever waterpipe smokers, from Egypt (n = 728), Jordan (n = 790), and Palestine (n = 722). Measures included past-30-day waterpipe smoking, frequency, intensity, place of smoking, and prices paid per waterpipe smoking session and for packaged waterpipe tobacco. Logistic regression models evaluated the factors associated with past-30-day waterpipe smoking. Results: Past-30-day waterpipe smoking (prevalence) was observed among 60.7%, 67.7% and 63.1% of students from Egypt, Jordan, and Palestine, respectively. Among past-30-day smokers, past-5-day waterpipe smoking (frequency) was observed among 28.9%, 51.5%, and 48.6% of participants, respectively. Smoking in a café was highest among participants from Egypt (74.0%), followed by those from Palestine (44.8%), and Jordan (43.0%). Mean price paid per session was USD 0.99 (Egypt), USD 8.07 (Jordan), USD 6.05 (Palestine). The corresponding mean prices per packet were USD 0.86, USD 4.96, and USD 5.55, respectively. Predictors of past-30-day waterpipe smoking included younger age of initiation, male gender, employment, and smoking waterpipe alone. Conclusions: This study contributes to our understanding of waterpipe smoking patterns, places of smoking, and prices paid among young adults in a region with alarmingly high smoking rates. Understanding waterpipe smoking behaviors can inform the design of policy and educational interventions to curb its rising threat.
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Affiliation(s)
- Ramzi G Salloum
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA.,Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - JuHan Lee
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Aya Mostafa
- Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | - Randah R Hamadeh
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | | | - Khalid A Kheirallah
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohamed Salama
- Medical Experimental Research Center, Mansoura University, Mansoura, Egypt
| | - Wasim Maziak
- Department of Epidemiology, Florida International University, Miami, Florida, USA
| | - Rima Nakkash
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
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30
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Szyfter K, Napierala M, Florek E, Braakhuis BJM, Takes RP, Rodrigo JP, Rinaldo A, Silver CE, Ferlito A. Molecular and health effects in the upper respiratory tract associated with tobacco smoking other than cigarettes. Int J Cancer 2018; 144:2635-2643. [DOI: 10.1002/ijc.31846] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 06/14/2018] [Accepted: 07/26/2018] [Indexed: 12/12/2022]
Affiliation(s)
| | - Marta Napierala
- Laboratory of Environmental Research, Department of ToxicologyPoznan University of Medical Sciences Poznan Poland
| | - Ewa Florek
- Laboratory of Environmental Research, Department of ToxicologyPoznan University of Medical Sciences Poznan Poland
| | | | - Robert P. Takes
- International Head & Neck Scientific Group Padua Italy
- Department of Otolaryngology‐Head and Neck Surgery, Radboud University Medical CentreRadboud Institute for Health Sciences Nijmegen the Netherlands
| | - Juan P. Rodrigo
- International Head & Neck Scientific Group Padua Italy
- Department of Otolaryngology, Hospital Universitario Central de Asturias, IUOPAUniversity of Oviedo, CIBERONC Oviedo Spain
| | - Alessandra Rinaldo
- International Head & Neck Scientific Group Padua Italy
- Department of OtolaryngologyUniversity of Udine School of Medicine Udine Italy
| | - Carl E. Silver
- International Head & Neck Scientific Group Padua Italy
- Department of SurgeryUniversity of Arizona College of Medicine Phoenix AZ
| | - Alfio Ferlito
- Coordinator of the International Head & Neck Scientific Group Padua Italy
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Alomari MA, Al-Sheyab NA, Khabour OF, Alzoubi KH. Serum VEGF Level Is Different in Adolescents Smoking Waterpipe versus Cigarettes: The Irbid TRY. Biomolecules 2018; 8:E102. [PMID: 30274185 PMCID: PMC6316401 DOI: 10.3390/biom8040102] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 09/12/2018] [Accepted: 09/20/2018] [Indexed: 01/02/2023] Open
Abstract
Waterpipe (Wp) use is associated with most devastating diseases and particularly popular among adolescents. Vascular endothelium growth factor (VEGF) is essential for generating new vessels. The effect of smoking tobacco on VEGF is controversial and unknown among adolescents. Therefore, the current study compared serum VEGF in adolescents smoking cigarettes (Cg) only (9.3%), Wp only (19.6%), and dual (Wp and Cg) (36.4%) versus nonsmokers (34.6%) in adolescents. A self-reported questionnaire and enzyme-linked immunosorbent assay (ELISA) were used to obtain smoking status and serum VEGF, respectively, in 475 (age: 14.6 ± 1.0 years) boys (n = 263) and girls (n = 212) from Irbid, Jordan. The analysis showed that smoking status (R² = 0.021; p = 0.001) and gender (R² = 0.035; p = 0.000) can predict VEGF. Furthermore, 2-way-ANCOVA revealed that VEGF was lower in the dual cohort versus the Cg (33.4%; p = 0.04) and nonsmoker (29.6%; p = 0.003) cohorts; VEGF in smokers, was lower (33.6%; p = 0.04) in the Wp versus nonsmokers in the boys but not the girls. These results are unique and suggest that smoking lowers VEGF, which might adversely affect vascular growth and function. This is alarming given that adolescents are still in the development stage and smoking, particularly Wp, is popular among them. Therefore, interventions targeting smoking among schoolchildren are urgently needed to avoid the negative effects of smoking, especially on vascular health.
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Affiliation(s)
- Mahmoud A Alomari
- Division of Physical Therapy, Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan.
- Division of Physical Education, Department of Educational Sciences, Qatar University, Doha 2713, Qatar.
| | - Nihaya A Al-Sheyab
- Faculty of Applied Medical Sciences, Allied Medical Sciences Department, Jordan University of Science and Technology, Irbid 22110, Jordan.
- Faculty of Nursing, Maternal and Child Health Department, Jordan University of Science and Technology, Irbid 22110, Jordan.
| | - Omar F Khabour
- Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan.
| | - Karem H Alzoubi
- Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid 22110, Jordan.
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Etemadi A, Gandomkar A, Freedman ND, Moghadami M, Fattahi MR, Poustchi H, Islami F, Boffetta P, Dawsey SM, Abnet CC, Malekzadeh R. The association between waterpipe smoking and gastroesophageal reflux disease. Int J Epidemiol 2018; 46:1968-1977. [PMID: 29025018 DOI: 10.1093/ije/dyx158] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2017] [Indexed: 12/20/2022] Open
Abstract
Background Unlike cigarettes, there is little information about the association between other tobacco products and the risk of gastroesophageal reflux disease (GERD) and esophageal adenocarcinoma. Methods We used the baseline data from the Pars Cohort Study conducted in southern Iran. In 2012, 9264 local residents between 40 and 75 years old were enrolled, with detailed information about lifestyle, including duration and frequency of tobacco use. GERD was defined based on questions assessing heartburn and regurgitation in the past 12 months, frequency and severity. Associations were calculated by logistic regression models adjusted for age, sex, education, cigarettes and body mass index. Results In the study, 25.4% of the participants had severe GERD (interfering with participants' routines), 25.1% had frequent GERD (at least once a week) and 11.2% had both severe and frequent GERD, all more common among women (p < 0.001); 45.6% of women and 28.3% of men smoked waterpipes. Among people not using medications against reflux symptoms, there was an association between waterpipe smoking and severe [odds ratio (OR) = 1.18; 95% confidence interval (CI):1.04-1.35], frequent (OR = 1.16; 95% CI: 1.02-1.32) and severe and frequent reflux (OR = 1.30; 95% CI: 1.08-1.56). The associations increased with the duration of use, intensity and cumulative waterpipe-years, reaching an OR of 1.44 (95% CI: 1.12-1.86) for severe and frequent reflux in those who had smoked more than 48 waterpipe-years. There was effect modification by sex, and all the associations were only seen among women. Conclusion The increasing trend in the association between cumulative waterpipe use and reflux disease among women is particularly important given the growing waterpipe tobacco epidemic in many populations.
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Affiliation(s)
- Arash Etemadi
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Abdullah Gandomkar
- Non-Communicable Disease Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Neal D Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Mohsen Moghadami
- Non-Communicable Disease Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Reza Fattahi
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Poustchi
- Liver and Pancreaticobilliary Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farhad Islami
- Surveillance and Health Services Research, American Cancer Society, Atlanta, GA, USA
| | - Paolo Boffetta
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai and Institute for Translational Epidemiology, New York, NY, USA
| | - Sanford M Dawsey
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Christian C Abnet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Non-Communicable Disease Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Gupta R, Gupta S, Sharma S, Sinha DN, Mehrotra R. A systematic review on association between smokeless tobacco & cardiovascular diseases. Indian J Med Res 2018; 148:77-89. [PMID: 30264756 PMCID: PMC6172910 DOI: 10.4103/ijmr.ijmr_2020_17] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND & OBJECTIVES The association of smokeless tobacco (SLT) with cardiovascular diseases has remained controversial due to conflicting reports from various countries. Earlier meta-analyses have shown significantly higher risk of fatal myocardial infarction and stroke in SLT users. However, the risk of hypertension (HTN) with SLT products has not been reviewed earlier. This systematic review was undertaken to summarize the evidence available from global literature on the association of SLT with cardiovascular outcomes - heart disease, stroke and HTN. METHODS A systematic literature search was performed in PubMed and Google Scholar since their inception till October 2017 using pre-decided search terms and inclusion/exclusion criteria. Data were extracted from studies included independently by two authors and reviewed. RESULTS The review included 50 studies - 23 on heart disease, 14 on stroke and 14 on HTN. Majority of the studies evaluating heart disease or stroke were conducted in the European Region and most of these did not find a significant association between SLT use and either of these outcomes. On the other hand, 70 per cent of the studies on HTN were reported from South-East Asian Region and about half of the studies found a higher risk of HTN in SLT users. INTERPRETATION & CONCLUSIONS Current available evidence is insufficient to conclusively support the association of cardiovascular diseases with SLT use due to variability in results and methodological constraints in most of the studies. Region and product-specific well-designed studies are required to provide this evidence to the policymakers. However, advice on cessation of SLT products should be offered to patients presenting with cardiovascular diseases.
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Affiliation(s)
- Ruchika Gupta
- Division of Cytopathology, ICMR-National Institute of Cancer Prevention & Research, Noida, India
| | - Sanjay Gupta
- Division of Cytopathology, ICMR-National Institute of Cancer Prevention & Research, Noida, India
| | - Shashi Sharma
- Division of Epidemiology & Biostatistics, ICMR-National Institute of Cancer Prevention & Research, Noida, India
| | | | - Ravi Mehrotra
- WHO FCTC Global Knowledge Hub for Smokeless Tobacco, ICMR-National Institute of Cancer Prevention & Research, Noida, India
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Eskandarieh S, Nedjat S, Abdollahpour I, Azimi AR, Moghadasi AN, Asgari N, Sahraian MA. Environmental risk factors in neuromyelitis optica spectrum disorder: a case-control study. Acta Neurol Belg 2018; 118:277-287. [PMID: 29500680 DOI: 10.1007/s13760-018-0900-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 02/13/2018] [Indexed: 11/26/2022]
Abstract
Neuromyelitis optica spectrum disorder (NMOSD) has unknown risk factors. The aim of this study was to identify the environmental risk factors for NMOSD. A case-control study was conducted in Tehran from 2015 to 2016 among 100 patients with NMOSD. Sex-matched healthy controls (n = 400) were selected through random digit dialing (RDD). Logistic regression was used to estimate unadjusted and adjusted ORs (odds ratio) at 95% confidence intervals (CI) via SPSS. Compared with the control population, in NMOSD patients, the adjusted OR for low dairy consumption per week was (OR = 18.09; 95% CI 6.91, 47.37), following low sea food intake (OR = 13.91; 95% CI 6.13, 31.57) and low fruit and vegetable consumption (OR = 6.23; 95% CI 3.07, 12.62). The lower heavy physical activity (OR: 16.11, 95% CI 7.03, 36.91) among patients had risen the risk of NMOSD. A past history of head trauma was considered a risk for NMOSD (OR: 8.39, 95% CI 4.97, 14.16). The association between NMOSD and intentional abortion only among females (OR: 7.42, 95% CI 2.81, 19.55) was detected. This study indicates significant associations between dietary habits, life style, history of head trauma and intentional abortion in female and the later diagnosis of NMOSD.
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Affiliation(s)
- Sharareh Eskandarieh
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
- MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Saharnaz Nedjat
- Department of Epidemiology and Biostatistics, School of Public Health, Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ibrahim Abdollahpour
- Department of Epidemiology and Biostatistics, School of Public Health, Arak University of Medical Sciences, Arak, Iran
| | - Amir Reza Azimi
- MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Nasrin Asgari
- Department of Neurology, University of Southern Denmark, Odense, Denmark
| | - Mohammad Ali Sahraian
- MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Burden of cancer in the Eastern Mediterranean Region, 2005-2015: findings from the Global Burden of Disease 2015 Study. Int J Public Health 2018; 63:151-164. [PMID: 28776254 PMCID: PMC5973975 DOI: 10.1007/s00038-017-0999-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 06/02/2017] [Accepted: 06/13/2017] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES To estimate incidence, mortality, and disability-adjusted life years (DALYs) caused by cancer in the Eastern Mediterranean Region (EMR) between 2005 and 2015. METHODS Vital registration system and cancer registry data from the EMR region were analyzed for 29 cancer groups in 22 EMR countries using the Global Burden of Disease Study 2015 methodology. RESULTS In 2015, cancer was responsible for 9.4% of all deaths and 5.1% of all DALYs. It accounted for 722,646 new cases, 379,093 deaths, and 11.7 million DALYs. Between 2005 and 2015, incident cases increased by 46%, deaths by 33%, and DALYs by 31%. The increase in cancer incidence was largely driven by population growth and population aging. Breast cancer, lung cancer, and leukemia were the most common cancers, while lung, breast, and stomach cancers caused most cancer deaths. CONCLUSIONS Cancer is responsible for a substantial disease burden in the EMR, which is increasing. There is an urgent need to expand cancer prevention, screening, and awareness programs in EMR countries as well as to improve diagnosis, treatment, and palliative care services.
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Poustchi H, Eghtesad S, Kamangar F, Etemadi A, Keshtkar AA, Hekmatdoost A, Mohammadi Z, Mahmoudi Z, Shayanrad A, Roozafzai F, Sheikh M, Jalaeikhoo A, Somi MH, Mansour-Ghanaei F, Najafi F, Bahramali E, Mehrparvar A, Ansari-Moghaddam A, Enayati AA, Esmaeili Nadimi A, Rezaianzadeh A, Saki N, Alipour F, Kelishadi R, Rahimi-Movaghar A, Aminisani N, Boffetta P, Malekzadeh R. Prospective Epidemiological Research Studies in Iran (the PERSIAN Cohort Study): Rationale, Objectives, and Design. Am J Epidemiol 2018; 187:647-655. [PMID: 29145581 DOI: 10.1093/aje/kwx314] [Citation(s) in RCA: 351] [Impact Index Per Article: 58.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 08/30/2017] [Indexed: 12/15/2022] Open
Abstract
Noncommunicable diseases (NCDs) account for 76% of deaths in Iran, and this number is on the rise, in parallel with global rates. Many risk factors associated with NCDs are preventable; however, it is first necessary to conduct observational studies to identify relevant risk factors and the most appropriate approach to controlling them. Iran is a multiethnic country; therefore, in 2014 the Ministry of Health and Medical Education launched a nationwide cohort study-Prospective Epidemiological Research Studies in Iran (PERSIAN)-in order to identify the most prevalent NCDs among Iran's ethnic groups and to investigate effective methods of prevention. The PERSIAN study consists of 4 population-based cohorts; the adult component (the PERSIAN Cohort Study), described in this article, is a prospective cohort study including 180,000 persons aged 35-70 years from 18 distinct areas of Iran. Upon joining the cohort, participants respond to interviewer-administered questionnaires. Blood, urine, hair, and nail samples are collected and stored. To ensure consistency, centrally purchased equipment is sent to all sites, and the same team trains all personnel. Routine visits and quality assurance/control measures are taken to ensure protocol adherence. Participants are followed for 15 years postenrollment. The PERSIAN study is currently in the enrollment phase; cohort profiles will soon emerge.
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Affiliation(s)
- Hossein Poustchi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences
| | - Sareh Eghtesad
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences
| | - Farin Kamangar
- Department of Biology, School of Computer, Mathematical, and Natural Sciences, Morgan State University, Baltimore, Maryland
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran UMS, Tehran, Iran
| | - Arash Etemadi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Abbas-Ali Keshtkar
- Department of Health Sciences Education Development, School of Public Health, Tehran UMS, Tehran, Iran
| | - Azita Hekmatdoost
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Shahid Beheshti UMS, Tehran, Iran
| | - Zahra Mohammadi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences
| | - Zahra Mahmoudi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences
| | - Amaneh Shayanrad
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences
| | - Farzin Roozafzai
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences
| | - Mahdi Sheikh
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences
| | - Alireza Jalaeikhoo
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences
| | | | - Fariborz Mansour-Ghanaei
- Department of Gastroenterology, Gastrointestinal and Liver Diseases Research Center, Guilan UMS, Rasht, Iran
| | - Farid Najafi
- Research Center for Environmental Determinants of Health, School of Public Health, Kermanshah UMS, Kermanshah, Iran
| | - Ehsan Bahramali
- Noncommunicable Diseases Research Center, Fasa UMS, Fasa, Iran
| | | | | | - Ahmad Ali Enayati
- School of Public Health and Health Sciences Research Center, Mazandaran UMS, Sari, Iran
| | - Ali Esmaeili Nadimi
- Department of Cardiology, School of Medicine, Rafsanjan UMS, Rafsanjan, Iran
| | | | - Nader Saki
- Department of Otolaryngology, Head and Neck Surgery, Hearing and Speech Research Center, Ahvaz Jundishapur UMS, Ahvaz, Iran
| | - Fatemeh Alipour
- Eye Research Center, Farabi Eye Hospital, Tehran UMS, Tehran, Iran
| | - Roya Kelishadi
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Diseases, Isfahan UMS, Isfahan, Iran
| | | | - Nayyereh Aminisani
- Department of Statistics and Epidemiology, Faculty of Health Sciences, Tabriz UMS, Tabriz, Iran
| | - Paolo Boffetta
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran UMS, Tehran, Iran
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