19 research outputs found
Efficacy of Octacalcium Phosphate and Octacalcium Phosphate/Gelatin Composite on the Repair of Critical-Sized Calvarial Defects in Rats
No full textObjectives: The healing of bone defects in the craniofacial region is an important clinical issue. We aimed to compare the effects of octacalcium phosphate (OCP) and the combination of OCP/gelatin (OCP/Gel) on calvarial bone regeneration in rats.
Materials and Methods: In this study, 72 male Sprague Dawley rats were randomly assigned to the OCP (n=24), OCP/Gel (n=24), and control groups (n=24). Lesions with a diameter of 9 mm were created in the parietal bone and were filled with 9-mg OCP and OCP/Gel disks. In the control group, no substance was implanted in the defect. Sampling was performed on days 10, 14, 21, and 28 after the implantation. After tissue processing, 5-µm sections were prepared and stained by hematoxylin and eosin (H&E) stain. The sections were studied, and the volume fraction of the newly formed bone was assessed by Kruskal-Wallis test at a significance level of 0.05.
Results: In the experimental groups, new bone formation was detected at the margins of the defects 10 days after the implantation. With the progression of the healing process, the newly formed bone covered greater areas of the defects and developed a more mature structure. In the control group, the defects were primarily filled with a dense connective tissue with small islands of new bone. The results of histomorphometric assessments showed that the volume of the newly formed bone in the experimental groups had a significant statistical difference with that in the control group (P<0.001).
Conclusions: The OCP/Gel composite can be useful in the healing process of calvarial bone defects
Salt Intake Among the Iranian Population and Public Attitudes Toward Salt Consumption: National and Subnational Report From STEPS 2021
No full textAbstract
High salt intake is a significant risk factor for non-communicable diseases globally. This study aimed to assess salt intake and attitude to salt consumption in Iran in 2021 using STEPS data. Data were analyzed from a population-based survey with a nationally and sub-nationally representative sample of Iranian adults. A systematic cluster sampling approach was employed. In total, 17,910 participants were included in the salt intake analyses, and 27,838 participants were included in the attitude and practice analyses. Spot urine samples were collected to estimate 24-h urine sodium and daily sodium intake. Participants also completed questionnaires, and anthropometric and physical measurements were taken. The mean daily salt intake in Iran in 2021 was 9.71 g/day, with 97.98% of participants exceeding the WHO-recommended limit of 5 g/day. Salt intake was higher in men than in women (9.95 vs. 9.51 g/day), and higher among rural compared to urban residents (10.02 vs. 9.6 g/day). Married and obese individuals had elevated salt intake. Participants with hypertension consumed more salt than those without (9.83 vs. 9.64 g/day). However, among hypertensive individuals, those aware of their condition consumed less salt. 91.96% of participants thought that excessive dietary salt could cause health problems and 57.93% considered reducing salt intake “very important.” Participants who added salt in their last meal had 1.77 times higher odds of excessive salt intake. Men (OR = 1.48) and those with higher BMI (OR = 1.67 for overweight, 2.26 for obesity) were more likely to exceed recommended salt levels. Our results underscore an urgent public health challenge, as salt intake among Iranian adults is nearly twice the recommended threshold. Habits such as using salt shakers, adding salt during cooking, and consuming salty processed foods were more common among individuals with higher estimated intake. These associations underscore the need for continued national attention to salt reduction efforts.Abstract
High salt intake is a significant risk factor for non-communicable diseases globally. This study aimed to assess salt intake and attitude to salt consumption in Iran in 2021 using STEPS data. Data were analyzed from a population-based survey with a nationally and sub-nationally representative sample of Iranian adults. A systematic cluster sampling approach was employed. In total, 17,910 participants were included in the salt intake analyses, and 27,838 participants were included in the attitude and practice analyses. Spot urine samples were collected to estimate 24-h urine sodium and daily sodium intake. Participants also completed questionnaires, and anthropometric and physical measurements were taken. The mean daily salt intake in Iran in 2021 was 9.71 g/day, with 97.98% of participants exceeding the WHO-recommended limit of 5 g/day. Salt intake was higher in men than in women (9.95 vs. 9.51 g/day), and higher among rural compared to urban residents (10.02 vs. 9.6 g/day). Married and obese individuals had elevated salt intake. Participants with hypertension consumed more salt than those without (9.83 vs. 9.64 g/day). However, among hypertensive individuals, those aware of their condition consumed less salt. 91.96% of participants thought that excessive dietary salt could cause health problems and 57.93% considered reducing salt intake “very important.” Participants who added salt in their last meal had 1.77 times higher odds of excessive salt intake. Men (OR = 1.48) and those with higher BMI (OR = 1.67 for overweight, 2.26 for obesity) were more likely to exceed recommended salt levels. Our results underscore an urgent public health challenge, as salt intake among Iranian adults is nearly twice the recommended threshold. Habits such as using salt shakers, adding salt during cooking, and consuming salty processed foods were more common among individuals with higher estimated intake. These associations underscore the need for continued national attention to salt reduction efforts
Mortality and disability-adjusted life years in North Africa and Middle East attributed to kidney dysfunction : a systematic analysis for the Global Burden of Disease Study 2019
No full textThe authors would like to thank the hard work of the staff of the Institute for Health Metrics and Evaluation (IHME) for providing the best possible epidemiologic estimation of diseases in almost all regions and countries of the world, trying to reduce and eliminate poverty of knowledge and information about the diseases globally. Also, the core team authors sincerely thank all the collaborators of the GBD 2019 study who contributed to this study by providing data or a precise review of the manuscript. Publisher Copyright: © The Author(s) 2023. Published by Oxford University Press on behalf of the ERA. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.Peer reviewe
[S] Mortality and disability-adjusted life years in North Africa and Middle East attributed to kidney dysfunction: a systematic analysis for the Global Burden of Disease Study 2019
No full textBackground. The study aimed to estimate the attributable burden to kidney dysfunction as a metabolic risk factor in the North Africa and Middle East (NAME) region and its 21 countries in 1990-2019. Methods. The data used in this study were obtained from the Global Burden of Diseases (GBD) 2019 study, which provided estimated measures of deaths, disability-adjusted life years (DALYs), and other epidemiological indicators of burden. To provide a better insight into the differences in the level of social, cultural, and economic factors, the Socio-Demographic Index (SDI) was used. Results. In the NAME region in 2019, the number of deaths attributed to kidney dysfunction was 296 632 (95% uncertainty interval: 249 965-343 962), which was about 2.5 times higher than in the year 1990. Afghanistan, Egypt, and Saudi Arabia had the highest, and Kuwait, Turkey, and Iran (Islamic Republic of) had the lowest age-standardized rate of DALYs attributed to kidney dysfunction in the region in 2019. Kidney dysfunction was accounted as a risk factor for ischemic heart disease, chronic kidney disease, stroke, and peripheral artery disease with 150 471, 111 812, 34 068, and 281 attributable deaths, respectively, in 2019 in the region. In 2019, both low-SDI and high-SDI countries in the region experienced higher burdens associated with kidney dysfunction compared to other countries. Conclusions. Kidney dysfunction increases the risk of cardiovascular diseases burden and accounted for more deaths attributable to cardiovascular diseases than chronic kidney disease in the region in 2019. Hence, policymakers in the NAME region should prioritize kidney disease prevention and control, recognizing that neglecting its impact on other diseases is a key limitation in its management. © The Author(s) 2023. Published by Oxford University Press on behalf of the ERA. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.kz
The burden of neurological conditions in north Africa and the Middle East, 1990-2019: a systematic analysis of the Global Burden of Disease Study 2019
No full textBackground The burden of neurological conditions in north Africa and the Middle East is increasing. We aimed to assess the changes in the burden of neurological conditions in this super-region to aid with future decision making. Methods In this analysis of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 data, we examined temporal trends of disability-adjusted life-years (DALYs; deaths and disabilities combined), deaths, incident cases, and prevalent cases of 14 major neurological conditions and eight subtypes in 21 countries in the north Africa and the Middle East super-region. Additionally, we assessed neurological DALYs due to 22 potentially modifiable risk factors, within four levels of classification, during the period 1990-2019. We used a Bayesian modelling estimation approach, and generated 95 uncertainty intervals (UIs) for final estimates on the basis of the 2.5th and 97.5th percentiles of 1000 draws from the posterior distribution. Findings In 2019, there were 441. 1 thousand (95 UI 347 .2-598 .4) deaths and 17.6 million (12.5-24.7) neurological DALYs in north Africa and the Middle East. The leading causes of neurological DALYs were stroke, migraine, and Alzheimer's disease and other dementias (hereafter dementias). In north Africa and the Middle East in 2019, 85.8 (82.6-89.1) of stroke and 39.9 (26.4-54.7) of dementia age-standardised DALYs were attributable to modifiable risk factors. North Africa and the Middle East had the highest age-standardised DALY rates per 100 000 population due to dementia (387.0 172 .0-848 .5), Parkinson's disease (84.4 74.7-103.2), and migraine (601.4 107.0-1371.8) among the global super-regions. Between 1990 and 2019, there was a decrease in the age-standardised DALY rates related to meningitis (-75.8% -81.1 to -69.5), tetanus (-88.2% -93.9 to -76.1), stroke (-32.0% -39.1 to -23.3), intracerebral haemorrhage (-51.7% -58.2 to -43.8), idiopathic epilepsy (-26.2% -43.6 to -1. 1), and subarachnoid haemorrhage (-62.8% -71.6 to -41.0), but for all other neurological conditions there was no change. During 1990-2019, the number of DALYs due to dementias, Parkinson's disease, multiple sclerosis, ischaemic stroke, and headache disorder (ie, migraine and tension-type headache) more than doubled in the super-region, and the burden of years lived with disability (YLDs), incidence, and prevalence of multiple sclerosis, motor neuron disease, Parkinson's disease, and ischaemic stroke increased both in agestandardised rate and count. During this period, the absolute burden of YLDs due to head and spinal injuries almost doubled. Interpretation The increasing burden of neurological conditions in north Africa and the Middle East accompanies the increasing ageing population. Stroke and dementia are the primary causes of neurological disability and death, primarily attributable to common modifiable risk factors. Synergistic, systematic, lifetime, and multi-sectoral interventions aimed at preventing or mitigating the burden are needed. Copyright (c) 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Global burden of peripheral artery disease and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019
No full textBackground: Peripheral artery disease is a growing public health problem. We aimed to estimate the global disease burden of peripheral artery disease, its risk factors, and temporospatial trends to inform policy and public measures. Methods: Data on peripheral artery disease were modelled using the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2019 database. Prevalence, disability-adjusted life years (DALYs), and mortality estimates of peripheral artery disease were extracted from GBD 2019. Total DALYs and age-standardised DALY rate of peripheral artery disease attributed to modifiable risk factors were also assessed. Findings: In 2019, the number of people aged 40 years and older with peripheral artery disease was 113 million (95% uncertainty interval [UI] 99·2–128·4), with a global prevalence of 1·52% (95% UI 1·33–1·72), of which 42·6% was in countries with low to middle Socio-demographic Index (SDI). The global prevalence of peripheral artery disease was higher in older people, (14·91% [12·41–17·87] in those aged 80–84 years), and was generally higher in females than in males. Globally, the total number of DALYs attributable to modifiable risk factors in 2019 accounted for 69·4% (64·2–74·3) of total peripheral artery disease DALYs. The prevalence of peripheral artery disease was highest in countries with high SDI and lowest in countries with low SDI, whereas DALY and mortality rates showed U-shaped curves, with the highest burden in the high and low SDI quintiles. Interpretation: The total number of people with peripheral artery disease has increased globally from 1990 to 2019. Despite the lower prevalence of peripheral artery disease in males and low-income countries, these groups showed similar DALY rates to females and higher-income countries, highlighting disproportionate burden in these groups. Modifiable risk factors were responsible for around 70% of the global peripheral artery disease burden. Public measures could mitigate the burden of peripheral artery disease by modifying risk factors. Funding: Bill & Melinda Gates Foundation. © 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens
Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020
No full textBackground The health risks associated with moderate alcohol consumption continue to be debated. Small amounts of alcohol might lower the risk of some health outcomes but increase the risk of others, suggesting that the overall risk depends, in part, on background disease rates, which vary by region, age, sex, and year. Methods For this analysis, we constructed burden-weighted dose-response relative risk curves across 22 health outcomes to estimate the theoretical minimum risk exposure level (TMREL) and non-drinker equivalence (NDE), the consumption level at which the health risk is equivalent to that of a non-drinker, using disease rates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020 for 21 regions, including 204 countries and territories, by 5-year age group, sex, and year for individuals aged 15-95 years and older from 1990 to 2020. Based on the NDE, we quantified the population consuming harmful amounts of alcohol. Findings The burden-weighted relative risk curves for alcohol use varied by region and age. Among individuals aged 15-39 years in 2020, the TMREL varied between 0 (95% uncertainty interval 0-0) and 0.603 (0.400-1.00) standard drinks per day, and the NDE varied between 0.002 (0-0) and 1.75 (0.698-4.30) standard drinks per day. Among individuals aged 40 years and older, the burden-weighted relative risk curve was J-shaped for all regions, with a 2020 TMREL that ranged from 0.114 (0-0.403) to 1.87 (0.500-3.30) standard drinks per day and an NDE that ranged between 0.193 (0-0.900) and 6.94 (3.40-8.30) standard drinks per day. Among individuals consuming harmful amounts of alcohol in 2020, 59.1% (54.3-65.4) were aged 15-39 years and 76.9% (7.0-81.3) were male. Interpretation There is strong evidence to support recommendations on alcohol consumption varying by age and location. Stronger interventions, particularly those tailored towards younger individuals, are needed to reduce the substantial global health loss attributable to alcohol. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd.AuthorOverflow(574
Global, regional, and national burden of colorectal cancer and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019
No full textBackground Colorectal cancer is the third leading cause of cancer deaths worldwide. Given the recent increasing trends in colorectal cancer incidence globally, up-to-date information on the colorectal cancer burden could guide screening, early detection, and treatment strategies, and help effectively allocate resources. We examined the temporal patterns of the global, regional, and national burden of colorectal cancer and its risk factors in 204 countries and territories across the past three decades. Methods Estimates of incidence, mortality, and disability-adjusted life years (DALYs) for colorectal cancer were generated as a part of the Global Burden of Diseases, Injuries and Risk Factors Study (GBD) 2019 by age, sex, and geographical location for the period 1990-2019. Mortality estimates were produced using the cause of death ensemble model. We also calculated DALYs attributable to risk factors that had evidence of causation with colorectal cancer. Findings Globally, between 1990 and 2019, colorectal cancer incident cases more than doubled, from 842 098 (95% uncertainty interval [UI] 810 408-868 574) to 2.17 million (2.00-2.34), and deaths increased from 518 126 (493 682-537 877) to 1.09 million (1.02-1.15). The global age-standardised incidence rate increased from 22.2 (95% UI 21.3-23.0) per 100 000 to 26.7 (24.6-28.9) per 100 000, whereas the age-standardised mortality rate decreased from 14.3 (13.5-14.9) per 100 000 to 13.7 (12.6-14.5) per 100 000 and the age-standardised DALY rate decreased from 308.5 (294.7-320.7) per 100 000 to 295.5 (275.2-313.0) per 100 000 from 1990 through 2019. Taiwan (province of China; 62.0 [48.9-80.0] per 100 000), Monaco (60.7 [48.5-73.6] per 100 000), and Andorra (56.6 [42.8-71.9] per 100 000) had the highest age-standardised incidence rates, while Greenland (31.4 [26.0-37.1] per 100 000), Brunei (30.3 [26.6-34.1] per 100 000), and Hungary (28.6 [23.6-34.0] per 100 000) had the highest age-standardised mortality rates. From 1990 through 2019, a substantial rise in incidence rates was observed in younger adults (age <50 years), particularly in high Socio-demographic Index (SDI) countries. Globally, a diet low in milk (15.6%), smoking (13.3%), a diet low in calcium (12.9%), and alcohol use (9.9%) were the main contributors to colorectal cancer DALYs in 2019. Interpretation The increase in incidence rates in people younger than 50 years requires vigilance from researchers, clinicians, and policy makers and a possible reconsideration of screening guidelines. The fast-rising burden in low SDI and middle SDI countries in Asia and Africa calls for colorectal cancer prevention approaches, greater awareness, and cost-effective screening and therapeutic options in these regions. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd.AuthorOverflow(404
Global, regional, and national incidence of six major immune-mediated inflammatory diseases: findings from the global burden of disease study 2019
No full textBackground: The causes for immune-mediated inflammatory diseases (IMIDs) are diverse and the incidence trends of IMIDs from specific causes are rarely studied. The study aims to investigate the pattern and trend of IMIDs from 1990 to 2019. Methods: We collected detailed information on six major causes of IMIDs, including asthma, inflammatory bowel disease, multiple sclerosis, rheumatoid arthritis, psoriasis, and atopic dermatitis, between 1990 and 2019, derived from the Global Burden of Disease study in 2019. The average annual percent change (AAPC) in number of incidents and age standardized incidence rate (ASR) on IMIDs, by sex, age, region, and causes, were calculated to quantify the temporal trends. Findings: In 2019, rheumatoid arthritis, atopic dermatitis, asthma, multiple sclerosis, psoriasis, inflammatory bowel disease accounted 1.59%, 36.17%, 54.71%, 0.09%, 6.84%, 0.60% of overall new IMIDs cases, respectively. The ASR of IMIDs showed substantial regional and global variation with the highest in High SDI region, High-income North America, and United States of America. Throughout human lifespan, the age distribution of incident cases from six IMIDs was quite different. Globally, incident cases of IMIDs increased with an AAPC of 0.68 and the ASR decreased with an AAPC of −0.34 from 1990 to 2019. The incident cases increased across six IMIDs, the ASR of rheumatoid arthritis increased (0.21, 95% CI 0.18, 0.25), while the ASR of asthma (AAPC = −0.41), inflammatory bowel disease (AAPC = −0.72), multiple sclerosis (AAPC = −0.26), psoriasis (AAPC = −0.77), and atopic dermatitis (AAPC = −0.15) decreased. The ASR of overall and six individual IMID increased with SDI at regional and global level. Countries with higher ASR in 1990 experienced a more rapid decrease in ASR. Interpretation: The incidence patterns of IMIDs varied considerably across the world. Innovative prevention and integrative management strategy are urgently needed to mitigate the increasing ASR of rheumatoid arthritis and upsurging new cases of other five IMIDs, respectively. Funding: The Global Burden of Disease Study is funded by the Bill and Melinda Gates Foundation. The project funded by Scientific Research Fund of Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital ( 2022QN38). © 2023 The Author(s
Prevalence, years lived with disability, and trends in anaemia burden by severity and cause, 1990–2021: findings from the Global Burden of Disease Study 2021
No full textBackground: Anaemia is a major health problem worldwide. Global estimates of anaemia burden are crucial for developing appropriate interventions to meet current international targets for disease mitigation. We describe the prevalence, years lived with disability, and trends of anaemia and its underlying causes in 204 countries and territories. Methods: We estimated population-level distributions of haemoglobin concentration by age and sex for each location from 1990 to 2021. We then calculated anaemia burden by severity and associated years lived with disability (YLDs). With data on prevalence of the causes of anaemia and associated cause-specific shifts in haemoglobin concentrations, we modelled the proportion of anaemia attributed to 37 underlying causes for all locations, years, and demographics in the Global Burden of Disease Study 2021. Findings: In 2021, the global prevalence of anaemia across all ages was 24·3% (95% uncertainty interval [UI] 23·9–24·7), corresponding to 1·92 billion (1·89–1·95) prevalent cases, compared with a prevalence of 28·2% (27·8–28·5) and 1·50 billion (1·48–1·52) prevalent cases in 1990. Large variations were observed in anaemia burden by age, sex, and geography, with children younger than 5 years, women, and countries in sub-Saharan Africa and south Asia being particularly affected. Anaemia caused 52·0 million (35·1–75·1) YLDs in 2021, and the YLD rate due to anaemia declined with increasing Socio-demographic Index. The most common causes of anaemia YLDs in 2021 were dietary iron deficiency (cause-specific anaemia YLD rate per 100 000 population: 422·4 [95% UI 286·1–612·9]), haemoglobinopathies and haemolytic anaemias (89·0 [58·2–123·7]), and other neglected tropical diseases (36·3 [24·4–52·8]), collectively accounting for 84·7% (84·1–85·2) of anaemia YLDs. Interpretation: Anaemia remains a substantial global health challenge, with persistent disparities according to age, sex, and geography. Estimates of cause-specific anaemia burden can be used to design locally relevant health interventions aimed at improving anaemia management and prevention. Funding: Bill & Melinda Gates Foundation. © 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens
