Publications by authors named "Iraj Mohebbi"

34 Publications

Establishing the Status of Patients With Non-Communicable Diseases in Disaster: A Systematic Review.

Disaster Med Public Health Prep 2021 Feb 15:1-8. Epub 2021 Feb 15.

Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, Iran.

Objective: People with NCDs are particularly vulnerable to disasters. This research systematically reviewed reports describing studies on the status of patients with NCDs before, during and after disasters.

Method: Relevant articles published from 1997 to 2019 were collected by searching the Scopus, PubMed, and Science Direct databases. We specifically examined reports describing NCDs and including the key words 'Non-Communicable Disease and Disasters.' NCDs include cardiovascular, respiratory, diabetes and cancer diseases.

Results: The review identified 42 relevant articles. Most of the included studies were found to have described the conditions of patients with NCDs after disasters - 14 (13.3%), during disasters - 11 (26.2%), before disasters - 6 (14.3%), within all stages of disasters: before, during and after - 6 (14.3%), only during and after disasters - 4 (9.5%), and includes before and during disasters - 1 (2.4%).

Conclusion: NCDs pose major health issues in disasters. Development of strong counter measures against the interruption of treatment, as well as surveillance systems to ascertain medical needs for NCDs are necessary as preparation for future disasters.
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http://dx.doi.org/10.1017/dmp.2020.364DOI Listing
February 2021

Non-communicable diseases in disasters: a protocol for a systematic review.

J Inj Violence Res 2021 Jan 18;13(1). Epub 2021 Jan 18.

Workplace Health Promotion Research Center, Department of Health in Emergencies and Disasters, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Email:

Background: NCDs require an ongoing management for optimal outcomes, which is challenging in emergency settings, because natural disasters increase the risk of acute NCD exacerbations and lead to health systems' inability to respond. This study aims to develop a protocol for a systematic review on non-communicable diseases in natural disaster settings.

Methods: This systematic review protocol is submitted to the International Prospective Register of Systematic Reviews (Registration No. CRD42020164032). The electronic databases to be used in this study include: Medline, Scopus, Web of Science, Clinical Key, CINAHL, EBSCO, Ovid, EMBASE, ProQuest, Google Scholar, Cochrane Library (Cochrane database of systematic reviews; Cochrane central Register of controlled Trials). Records from 1997 to 2019 are subject to this investigation. Three independent researchers will review the titles, abstracts, and full texts of articles eligible for inclusion, and if not matched, they will be reviewed by a final fourth reviewer. The proposed systematic review will be reported in accordance with the reporting guideline provided in the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) statement. We select studies based on: PICOs (Participants, Interventions, Comparators, and Outcomes).

Results: This systematic review identifies any impacts of natural disasters on patients with NCDs in three stages i.e. before, during and in the aftermath of natural disasters.

Conclusions: A comprehensive response to NCD management in natural disasters is an important but neglected aspect of non-communicable disease control and humanitarian response, which can significantly reduce the potential risk of morbidity and mortality associated with natural disasters.
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http://dx.doi.org/10.5249/jivr.v13i1.1512DOI Listing
January 2021

SARS-CoV-2 antibody seroprevalence in the general population and high-risk occupational groups across 18 cities in Iran: a population-based cross-sectional study.

Lancet Infect Dis 2021 04 15;21(4):473-481. Epub 2020 Dec 15.

Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran; Digestive Diseases Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Electronic address:

Background: Rapid increases in cases of COVID-19 were observed in multiple cities in Iran towards the start of the pandemic. However, the true infection rate remains unknown. We aimed to assess the seroprevalence of antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 18 cities of Iran as an indicator of the infection rate.

Methods: In this population-based cross-sectional study, we randomly selected and invited study participants from the general population (from lists of people registered with the Iranian electronic health record system or health-care centres) and a high-risk population of individuals likely to have close social contact with SARS-CoV-2-infected individuals through their occupation (from employee lists provided by relevant agencies or companies, such as supermarket chains) across 18 cities in 17 Iranian provinces. Participants were asked questions on their demographic characteristics, medical history, recent COVID-19-related symptoms, and COVID-19-related exposures. Iran Food and Drug Administration-approved Pishtaz Teb SARS-CoV-2 ELISA kits were used to detect SARS-CoV-2-specific IgG and IgM antibodies in blood samples from participants. Seroprevalence was estimated on the basis of ELISA test results and adjusted for population weighting (by age, sex, and city population size) and test performance (according to our independent validation of sensitivity and specificity).

Findings: From 9181 individuals who were initially contacted between April 17 and June 2, 2020, 243 individuals refused to provide blood samples and 36 did not provide demographic information and were excluded from the analysis. Among the 8902 individuals included in the analysis, 5372 had occupations with a high risk of exposure to SARS-CoV-2 and 3530 were recruited from the general population. The overall population weight-adjusted and test performance-adjusted prevalence of antibody seropositivity in the general population was 17·1% (95% CI 14·6-19·5), implying that 4 265 542 (95% CI 3 659 043-4 887 078) individuals from the 18 cities included were infected by the end of April, 2020. The adjusted seroprevalence of SARS-CoV-2-specific antibodies varied greatly by city, with the highest estimates found in Rasht (72·6% [53·9-92·8]) and Qom (58·5% [37·2-83·9]). The overall population weight-adjusted and test performance-adjusted seroprevalence in the high-risk population was 20·0% (18·5-21·7) and showed little variation between the occupations included.

Interpretations: Seroprevalence is likely to be much higher than the reported prevalence of COVID-19 based on confirmed COVID-19 cases in Iran. Despite high seroprevalence in a few cities, a large proportion of the population is still uninfected. The potential shortcomings of current public health policies should therefore be identified to prevent future epidemic waves in Iran.

Funding: Iranian Ministry of Health and Medical Education.

Translation: For the Farsi translation of the abstract see Supplementary Materials section.
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http://dx.doi.org/10.1016/S1473-3099(20)30858-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7833828PMC
April 2021

Neurological effects of long-term exposure to low doses of pesticides mixtures in male rats: Biochemical, histological, and neurobehavioral evaluations.

Chemosphere 2021 Feb 30;264(Pt 2):128464. Epub 2020 Sep 30.

Department of Toxicology and Neurophysiology Research Center, Faculty of Health, Urmia University of Medical Sciences, Urmia, Iran. Electronic address:

Humans are usually exposed to multiple pesticides in real life, but little is known as yet about the safety of low-dose pesticides mixtures. This study was conducted to evaluate the effects of long-term exposure to very low doses of pesticide mixtures on biochemical, histological, and neurobehavioral alterations in the rat model. For 90 days, four groups of male Wistar rats were given a mixture of five pesticides (in drinking water) in doses of 0, 0.25, 1 and 5 times the legally permitted levels (mg/kg body weight/day). After three-month exposure, the neurobehavioral effects of pesticide mixtures were evaluated by the Morris water maze, elevated plus maze and the open field tests. Then the biochemical and histopathological alterations in the hippocampus of studied animals were evaluated. Results showed that long-term exposure to a combination of five pesticides affected the nervous system in dose-dependent manner. As expected, nearly all of the parameters determined in this study were adversely changed in the high dose group. Exposure to medium dose (permitted level of pesticides mixture) was also able to induce oxidative stress and impaired memory and learning ability, although not all parameters were significantly changed in this group. It means that pesticides may behave differently when mixed. Interestingly, the administration of low doses of these chemicals induced an adaptive response by stimulating the redox system. In conclusion, it seems that the prolonged exposure to pesticide mixtures may cause adverse neurobehavioral effects, even at permitted levels.
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http://dx.doi.org/10.1016/j.chemosphere.2020.128464DOI Listing
February 2021

Schwannoma and Neurofibroma, Originating from the Ulnar Nerve in Neurofibromatosis: A Case Report and Review of the Literature.

Surg J (N Y) 2020 Jul 10;6(3):e139-e144. Epub 2020 Sep 10.

Department of Orthopedics, Imam Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran.

Schwannomas and neurofibromas are rare benign tumors originating from the peripheral nerve sheath. Tumors in neurofibromatosis are mostly neurofibromas and often appear in the soft tissue of peripheral nerves. In this report, a patient presented with two large adjacent soft tissue tumors in the right wrist and distal forearm which originated from a common nerve. A schwannoma had formed beside a neurofibroma from the ulnar nerve and induced numbness and paresthesia in the little and ring fingers. Although the patient had café au lait spots on the skin, neurofibromatosis was not suspected due to lack of symptoms. The patient was referred to the current research clinic suffering from two soft tissue masses in the wrist and ulnar nerve dysfunction. In neurofibromatosis patients, two tumors of a different nature originating from a common nerve close together have rarely been described in the literature. The patient was treated by en bloc excision of the mass while protecting the nerve fascicles. The follow-up results indicated no neurological symptoms and complete restoration of ulnar nerve function.
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http://dx.doi.org/10.1055/s-0040-1712536DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7487326PMC
July 2020

Predictors of coronavirus disease 19 (COVID-19) pneumonitis outcome based on computed tomography (CT) imaging obtained prior to hospitalization: a retrospective study.

Emerg Radiol 2020 Dec 8;27(6):653-661. Epub 2020 Aug 8.

Department of Radiology, Neuro-Intervention and Neurologic Surgery, Urmia University of Medical Sciences, Urmia, Iran.

Purpose: Computed tomography (CT) has been utilized as a diagnostic modality in the coronavirus disease 19 (COVID-19), while some studies have also suggested a prognostic role for it. This study aimed to assess the diagnostic and prognostic value of computed tomography (CT) imaging in COVID-19 patients.

Methods: This was a retrospective study of fifty patients with COVID-19 pneumonia. Twenty-seven patients survived, while 23 passed away. CT imaging was performed in all of the patients on the day of admission. Imaging findings were interpreted based on current guidelines by two expert radiologists. Imaging findings were compared between surviving and deceased patients. Lung scores were assigned to patients based on CT chest findings. Then, the receiver operating characteristic curve was used to determine cutoff values for lung scores.

Results: The common radiologic findings were ground-glass opacities (82%) and airspace consolidation (42%), respectively. Air bronchogram was more commonly seen in deceased patients (p = 0.04). Bilateral and multilobar involvement was more frequently found in deceased patients (p = 0.049 and 0.014, respectively). The mean number of involved lobes was 3.46 ± 1.80 lobes in surviving patients and 4.57 ± 0.60 lobes in the deceased patients (p = 0.009). The difference was statistically significant. The area under the curve for a lung score cutoff of 12 was 0.790.

Conclusion: Air bronchogram and bilateral and multilobar involvement were more frequently seen in deceased patients and may suggest a poor outcome for COVID-19 pneumonia.
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http://dx.doi.org/10.1007/s10140-020-01833-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7414287PMC
December 2020

Clinical and radiological characteristics of pediatric patients with COVID-19: focus on imaging findings.

Jpn J Radiol 2020 Oct 13;38(10):987-992. Epub 2020 Jun 13.

Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.

Purpose: CT imaging has been a detrimental tool in the diagnosis of COVID-19, but it has not been studied thoroughly in pediatric patients and its role in diagnosing COVID-19.

Methods: 27 pediatric patients with COVID-19 pneumonia were included. CT examination and molecular assay tests were performed from all participants. A standard checklist was utilized to extract information, and two radiologists separately reviewed the CT images.

Results: The mean age of patients was 4.7 ± 4.16 (mean ± SD) years. Seventeen patients were female, and ten were male. The most common imaging finding was ground-glass opacities followed by consolidations. Seven patients had a single area of involvement, five patients had multiple areas of involvement, and four patients had diffuse involvement. The sensitivity of CT imaging in diagnosing infections was 66.67%. Also, some uncommon imaging findings were seen, such as a tree-in-bud and lung collapse.

Conclusion: CT imaging shows less involvement in pediatric compared to adult patients, due to pediatric patients having a milder form of the disease. CT imaging also has a lower sensitivity in detecting abnormal lungs compared to adult patients. The most common imaging findings are ground-glass opacities and consolidations, but other non-common imaging findings also exist.
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http://dx.doi.org/10.1007/s11604-020-01003-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7293432PMC
October 2020

The risk factors associated with MERS-CoV patient fatality: A global survey.

Diagn Microbiol Infect Dis 2020 Mar 31;96(3):114876. Epub 2019 Jul 31.

Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, Iran. Electronic address:

Risk factors associated with Middle East respiratory syndrome coronavirus (MERS-CoV) infection outcome were established by analyses of WHO data from September 23, 2012 to 18 June 2018. Of the 2220 reported cases, 1408 cases, including 451 MERS-CoV deaths, were analyzed. The case fatality rate was 32% (95% CI: 29.4-34.5). Compared to MERS patients ≤30 years old, those with >30 years had the adjusted odds ratio estimate for death of 2.38 [95% CI: 1.75-3.22]. This index was 1.43 [95% CI: 1.06-1.92] for Saudi patients in comparison to non-Saudi; 1.76 [95% CI: 1.39-2.22] for patient with comorbidity in comparison to those without comorbidity; 0.58 [95% CI: 0.44-0.75] for those who had close contact to a camel in the past 14 days and 0.42 [95% CI: 0.31-0.57] for patients with >14 days with onset of signs and hospital admission compared to patients with ≤14 days.
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http://dx.doi.org/10.1016/j.diagmicrobio.2019.114876DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7126953PMC
March 2020

The risk factors associated with MERS-CoV patient fatality: A global survey.

Diagn Microbiol Infect Dis 2020 Mar 31;96(3):114876. Epub 2019 Jul 31.

Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, Iran. Electronic address:

Risk factors associated with Middle East respiratory syndrome coronavirus (MERS-CoV) infection outcome were established by analyses of WHO data from September 23, 2012 to 18 June 2018. Of the 2220 reported cases, 1408 cases, including 451 MERS-CoV deaths, were analyzed. The case fatality rate was 32% (95% CI: 29.4-34.5). Compared to MERS patients ≤30 years old, those with >30 years had the adjusted odds ratio estimate for death of 2.38 [95% CI: 1.75-3.22]. This index was 1.43 [95% CI: 1.06-1.92] for Saudi patients in comparison to non-Saudi; 1.76 [95% CI: 1.39-2.22] for patient with comorbidity in comparison to those without comorbidity; 0.58 [95% CI: 0.44-0.75] for those who had close contact to a camel in the past 14 days and 0.42 [95% CI: 0.31-0.57] for patients with >14 days with onset of signs and hospital admission compared to patients with ≤14 days.
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http://dx.doi.org/10.1016/j.diagmicrobio.2019.114876DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7126953PMC
March 2020

Assessing the ergonomic exposure for construction workers during construction of residential buildings.

Work 2019 ;62(3):411-419

Social Determinants of Health Research Center, Occupational Medicine Center, Urmia University of Medical Sciences, Urmia, Iran.

Background: Construction workers are at greater risk of musculoskeletal disorders due to their exposure to physical ergonomic risk factors.

Objectives: The purpose of this study is to quantify the ergonomic hazards for workers in the construction of residential buildings.

Methods: In this cross-sectional study, PATH method, a work-sampling observation method, was applied to study the working postures, handled loads, and manual material handling activities in construction workers. A total of 5832 observations were made on 10 workers involved in tasks of three jobs including reinforcing bar, formwork, and pouring concrete. The ergonomic exposure was characterized in terms of percentage of observations made for each task.

Results: Non-neutral trunk postures, especially mild and severe flexions, were frequently observed in all job tasks. High-strain leg postures of squatting, kneeling, and leg(s) bent were mostly observed in floor formwork (39%), concrete finishing (5%), and floor rebar construction (52.3%), respectively. The highest proportion of work time with one (5.8%) and two hands (9%) at/above shoulder was observed in column rebar construction. In concrete pouring and rebar cutting, workers were observed in 39.45% and 23.1% of work time doing carry and push/pull activities, respectively. Heavy loads (>15 kg) were mostly observed in concrete pouring and floor formwork tasks.

Conclusion: In the construction of residential buildings with the concrete structure, workers perform their task with non-neutral postures of trunk and leg and handling heavy loads. The recommended controls could reduce the musculoskeletal stress in rebar tying, concrete pouring, and concrete finishing tasks.
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http://dx.doi.org/10.3233/WOR-192876DOI Listing
May 2019

Ovarian cancer stem cell: A potential therapeutic target for overcoming multidrug resistance.

J Cell Physiol 2019 04 14;234(4):3238-3253. Epub 2018 Oct 14.

Molecular Medicine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

The cancer stem cell (CSC) model encompasses an advantageous paradigm that in recent decades provides a better elucidation for many important biological aspects of cancer initiation, progression, metastasis, and, more important, development of multidrug resistance (MDR). Such several other hematological malignancies and solid tumors and the identification and isolation of ovarian cancer stem cells (OV-CSCs) show that ovarian cancer also follows this hierarchical model. Gaining a better insight into CSC-mediated resistance holds promise for improving current ovarian cancer therapies and prolonging the survival of recurrent ovarian cancer patients in the future. Therefore, in this review, we will discuss some important mechanisms by which CSCs can escape chemotherapy, and then review the recent and growing body of evidence that supports the contribution of CSCs to MDR in ovarian cancer.
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http://dx.doi.org/10.1002/jcp.26768DOI Listing
April 2019

Serum vitamin D level and its relation to thyroid hormone, blood sugar and lipid profiles in Iranian sedentary work staff.

Nutr Hosp 2018 Oct 5;35(5):1107-1114. Epub 2018 Oct 5.

Introduction: the sedentary lifestyle is related to the incidence of various diseases and metabolic disorders. The aim of the current study was to understand the link between serum vitamin D levels, thyroid hormones and lipid profiles among Iranian sedentary staff.

Material And Methods: in this cross-sectional study, 300 healthy subjects with normal body mass index (BMI) and age between 18 and 65 years, with sedentary lifestyles, were included. Serum levels of 25-hydroxyvitamin D, thyroid stimulating hormone (TSH), fasting blood sugar, plasma total cholesterol, and high-density lipoprotein (HDL) and triglycerides (TG) were measured with qualified laboratory methods. Low-density lipoprotein (LDL) concentration was calculated based on the Friedewald equation. A self-made questionnaire with different questions was used to assess physical activity.

Results: the means of BMI and age were 25.63 ± 10.25 and 36.69 ± 7.14 years, respectively. The prevalence of vitamin D deficiency was 65.7%. Results showed significant differences for TG, HDL, and thyroxine (T4) between subgroup categories. Serum levels of 25-hydroxyvitamin D had a negative significant correlation with triiodothyronine (T3) and T4, and a positive correlation with HDL. Linear regression analysis showed a significant association of 25-hydroxyvitamin D concentrations with HDL and T4 after adjustments based on the sex.

Conclusion: finally, the results of this study show that with the improvement in vitamin D status, the decrease in the levels of TG, T3 and T4, with an increase in HDL can be expected. So, verification and detection of true causality through the interventional studies will be valuable, scientifically.
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http://dx.doi.org/10.20960/nh.1719DOI Listing
October 2018

Quality of observational studies in prestigious journals of occupational medicine and health based on Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: a cross-sectional study.

BMC Res Notes 2018 May 2;11(1):266. Epub 2018 May 2.

Social Determinants of Health Research Center, Occupational Medicine Center, Urmia University of Medical Sciences, Resalat Street, Urmia, Iran.

Objective: The present study applied the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement to observational studies published in prestigious occupational medicine and health journals.

Results: A total of 60 articles was evaluated. All sub-items were reported in 63.74% (95% confidence interval [CI], 56.24-71.24%), not reported in 29.70% (95% CI, 20.2-39.2%), and not applicable in 6.56% (95% CI, 4.86-8.26%) of the studies. Of the 45 sub-items investigated in this survey, eight were reported 100% of the time, 13 were addressed in more than 90% of the articles, 22 were included in more than 75% of the studies, and 27 sub-items were applied in more than 50% of the articles published in the journals included in this study.
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http://dx.doi.org/10.1186/s13104-018-3367-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5932818PMC
May 2018

Epidemiological factors and worldwide pattern of Middle East respiratory syndrome coronavirus from 2013 to 2016.

Int J Gen Med 2018 6;11:121-125. Epub 2018 Apr 6.

Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, Iran.

Background: Middle East respiratory syndrome coronavirus (MERS-CoV) is an emerging threat to global health security with high intensity and lethality. This study was conducted to investigate epidemiological factors and patterns related to this disease.

Methods: Full details of MERS-CoV cases available on the disease outbreak news section of the World Health Organization official website from January 2013 to November 2016 were retrieved; demographic and clinical information, global distribution status, potential contacts, and probable risk factors for the mortality of laboratory-confirmed MERS-CoV cases were extracted and analyzed by following standard statistical methods.

Results: Details of 1,094 laboratory-confirmed cases were recorded, including 421 related deaths. Significant differences were observed in the presentation of the disease from year to year, and all studied parameters differed during the years under study (all -values <0.05). Evaluation of the effects of various potential risk factors of the final outcome (dead/survived) revealed that two factors, namely, the morbid case being native and travel history, are significant based on a unifactorial analysis ( <0.05). From 2013 to 2016, these factors remained important. However, factors that were significant in predicting mortality varied in different years.

Conclusion: These findings point to interesting potential dimensions in the dynamic of this disease. Furthermore, effective national and international preparedness plans and actions are essential to prevent, control, and predict such viral outbreaks; improve patient management; and ensure global health security.
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http://dx.doi.org/10.2147/IJGM.S160741DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5896642PMC
April 2018

Quercetin: A functional dietary flavonoid with potential chemo-preventive properties in colorectal cancer.

J Cell Physiol 2018 09 16;233(9):6544-6560. Epub 2018 Apr 16.

Solid Tumor Research Center, Urmia University of Medical Sciences, Urmia, Iran.

Recently, an intense attention has been paid to the application of natural compounds as a novel therapeutic strategy for cancer treatment. Quercetin, a natural flavonol present in many commonly consumed food items, is widely demonstrated to exert inhibitory effects on cancer progression through various mechanisms. Since there is a strong association with diets containing abundant vegetables, fruits, and grains, and significant decline in the risk of colon cancer, accumulation studies have focused on the anticancer potential of quercetin in colorectal cancer. Cell cycle arrest, increase in apoptosis, antioxidant replication, modulation of estrogen receptors, regulation of signaling pathways, inhibition of and metastasis and angiogenesis are among various mechanisms underlying the chemo-preventive effects of quercetin in colorectal cancer. This review covers various therapeutic interactions of Quercetin as to how targets cellular involved in cancer treatment.
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http://dx.doi.org/10.1002/jcp.26595DOI Listing
September 2018

The multiple functions of melatonin in regenerative medicine.

Ageing Res Rev 2018 Aug 6;45:33-52. Epub 2018 Apr 6.

Stem Cell and Regenerative Medicine Institute, Tabriz University of Medical Sciences, Tabriz, Iran. Electronic address:

Melatonin research has been experiencing hyper growth in the last two decades; this relates to its numerous physiological functions including anti-inflammation, oncostasis, circadian and endocrine rhythm regulation, and its potent antioxidant activity. Recently, a large number of studies have focused on the role of melatonin in the regeneration of cells or tissues after their partial loss. In this review, we discuss the recent findings on the molecular involvement of melatonin in the regeneration of various tissues including the nervous system, liver, bone, kidney, bladder, skin, and muscle, among others.
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http://dx.doi.org/10.1016/j.arr.2018.04.003DOI Listing
August 2018

The PERSIAN Cohort: Providing the Evidence Needed for Healthcare Reform.

Arch Iran Med 2017 Nov 1;20(11):691-695. Epub 2017 Nov 1.

Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.

In the past, communicable diseases caused the highest mortality in Iran. Improvements in socioeconomic status and living standards including access to safe drinking water, along with the inception of Health Houses in the 1980s, have changed disease patterns, decreasing the spread of and deaths from infectious and communicable diseases. The incidence and prevalence of non-communicable diseases (NCD), however, have now increased in Iran, accounting for nearly 80% of deaths and disabilities. Without interventions, NCD are predicted to impose a substantial human and economic burden in the next 2 decades. However, Iran's health system is not equipped with the necessary policies to combat this growth and must refocus and reform. Therefore, in the year 2013, the Ministry of Health and Medical Education funded a well-designed nationwide cohort study-Prospective Epidemiological Research Studies in IrAN (PERSIAN)-in order to assess the burden of NCD and investigate the risk factors associated with them in the different ethnicities and geographical areas of Iran. The PERSIAN Cohort, which aims to include 200000 participants, has 4 components: Adult (main), Birth, Youth and Elderly, which are being carried out in 22 different regions of Iran. Having an enormous dataset along with a biobank of blood, urine, hair and nail samples, the PERSIAN Cohort will serve as an important infrastructure for future implementation research and will provide the evidence needed for new healthcare policies in order to better control, manage and prevent NCD.
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November 2017

Environmental and biological measurements of isoflurane and sevoflurane in operating room personnel.

Int Arch Occup Environ Health 2018 Apr 15;91(3):349-359. Epub 2017 Dec 15.

Department of Occupational Health, Health Faculty, Urmia University of Medical Sciences, Pardis-e Nazloo, Serow Rd Km 11, Urmia, Iran.

Purpose: The present study aimed to compare the concentration of isoflurane and sevoflurane in the individual's breathing zone and ambient air of operating rooms (ORs), to investigate the correlation between breathing zone levels and urinary concentrations, and to evaluate the ORs pollution in the different working hours and weeks.

Methods: Environmental and biological concentrations of isoflurane and sevoflurane were evaluated at 9ORs. Air samples were collected by active sampling method and urine samples were collected from each subject at the end of the work shift. All samples were analyzed using gas chromatography.

Results: The geometric mean ± GSD concentration of isoflurane and sevoflurane in breathing zone air were 1.41 ± 2.27 and 0.005 ± 1.74 ppm, respectively, while in post-shift urine were 2.42 ± 2.86 and 0.006 ± 3.83 µg/l, respectively. A significant positive correlation was found between the urinary and environmental concentration of isoflurane (r  = 0.724, P < 0.0001). The geometric mean ± GSD values of isoflurane and sevoflurane in ambient air were 2.30 ± 2.43 and 0.004 ± 1.56 ppm, respectively. The isoflurane concentration was different for three studied weeks and significantly increased over time in the ambient air of ORs.

Conclusions: The occupational exposure of OR personnel to isoflurane and sevoflurane was lower than national recommended exposure limits. The urinary isoflurane could be a good internal dose biomarker for monitoring of occupational isoflurane exposure. Considering the accumulation of anesthetic waste gases in the studied ORs, real-time air monitoring is better to be done at the end of the work shift.
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http://dx.doi.org/10.1007/s00420-017-1287-yDOI Listing
April 2018

Cause-specific mortality among women of reproductive age: Results from a population-based study in an Iranian community.

Sex Reprod Healthc 2017 Dec 18;14:7-12. Epub 2017 Aug 18.

Reproductive Health Research Center, School of Public Health, Urmia University of Medical Sciences, Urmia, Iran. Electronic address:

Purpose Of Study: This study was conducted to evaluate the levels, patterns, and causes of mortality among women of reproductive age in Northwestern Iran.

Methods: Deaths were determined for females resident in West Azerbaijan Province of Iran and who died between March 2013 to February 2014 using reproductive age mortality survey (RAMOS). Causes of death were ascertained by verbal autopsy (VA) and classified based on the International Classification of Diseases, tenth revision (ICD-10). Overall and cause-specific mortality rates (MRs) per 100,000 women with 95% confidence intervals were calculated.

Results: A total of 510 deaths were detected, and VA interviews were conducted with the relatives of the deceased Cases; overall MR was 56.59 per 100,000 women (95% CI: 56.49-56.69). The highest MR was observed in suicide cases (MR=10.21per 100,000women, 95% CI: 10.15-10.27), accounting for 18% of all deaths. The most common method of suicide was self-inflicted burns (45.6%), followed by deaths due to breast cancer (MR=4.22per 100,000women, 95% CI: 4.18-4.26), which accounted for the most cancer-related mortality. All-cause mortality was associated with age, area of residence, marital status, level of education, and ethnic (religious) status relationship (P<0.001).

Conclusion: Suicide, especially self-immolation, was the main cause of death among women of reproductive age, and both suicides and breast cancer are major public health problems for this group of women.
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http://dx.doi.org/10.1016/j.srhc.2017.08.003DOI Listing
December 2017

Association between metabolic syndrome and sensorineural hearing loss: a cross-sectional study of 11,114 participants.

Diabetes Metab Syndr Obes 2017 6;10:459-465. Epub 2017 Nov 6.

Social Determinants of Health Research Center, Occupational Medicine Center, Urmia University of Medical Sciences, Urmia.

Background/objectives: Hearing loss (HL) is associated with certain diseases and affects health, resulting in a low quality of life. Some components of the metabolic syndrome (MetS) coincide with the risk factors for sensorineural hearing loss (SNHL). To date, very few studies have examined the link between MetS and HL. The aim of the current study was to try to understand the potential association between MetS and HL.

Methods: Using Iranian health surveys of professional drivers, we enrolled 11,114 individuals aged 20-60 years, whose main job is to operate a motor vehicle. We examined participants for the presence and absence of SNHL and the components of the MetS. Additionally, we investigated the relationship between MetS and the pure tone air conduction hearing thresholds of participants with SNHL, including low-frequency and high-frequency thresholds.

Results: This cross-sectional study consisted of 11,114 participants: 3202 (28.81%) diagnosed with MetS and 7911 (71.18%) without and 2772 (24.94%) with SNHL and 8432 (75.86%) without. Participants with SNHL had a higher number of components of MetS (<0.001 for all components).

Conclusion: Our results demonstrated that an association possibly exists between different components of MetS (obesity, hypertension, hypertriglyceridemia, high fasting glucose levels, and waist circumference) and SNHL in a population of West Azerbaijan drivers. Therefore, it is important to schedule periodic checkups for drivers to detect and avoid the increase in MetS components at an early stage in this population.
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http://dx.doi.org/10.2147/DMSO.S150893DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5680967PMC
November 2017

Association between SNPs at IL-17A and IL-17F and susceptibility to accelerated silicosis.

Toxicol Ind Health 2017 Sep 8;33(9):673-680. Epub 2017 May 8.

3 Social Determinants of Health Research Center, Department of Occupational Medicine, Urmia University of Medical Sciences, Urmia, Iran.

The association between single nucleotide polymorphisms (SNPs) in the interleukin (IL)-17 gene and silicosis has been evaluated in different populations. The aim of the present study was to analyze the association between SNPs at IL-17A (-832A/G) and IL-17F (+7488A/G) and susceptibility to accelerated silicosis in the Iranian Kurdish population. We studied 48 patients with accelerated silicosis and 62 controls. Genomic DNA was isolated using the "salting out" method. PCR-RFLP was performed for all SNPs typing. The frequencies of A/A, A/G, and G/G genotypes at IL-17A (-832A/G) were 4 (8.33%), 23 (47.92%), and 21 (43.75%) in patients and 5 (8.06%), 35 (56.45%), and 22 (35.48%) in controls, respectively. The frequencies of A and G alleles at IL-17 (-832A/G) were 31 (32.29%) and 65 (67.71%) in patients, and 45 (36.29%) and 79 (63.71%) in the controls, respectively. The frequencies of A/A, A/G, and G/G genotypes at IL-17F (+7488A/G) were 1 (2.08%), 47 (97.92%), and 0 (0%) in patients, and 11 (17.74%), 51 (82.26%), and 0 (0%) in the controls, respectively. The frequencies of A and G alleles at IL-17F (+7488A/G) were 49 (51.04%) and 47 (48.96%) in patients, and 73 (58.87%) and 51 (41.13%) in the controls, respectively. IL-17F (+7488A/G) genotype was more frequent among the cases compared with controls (97.92% vs. 82.26%). The frequency of the IL-17F (+7488A/G) genotype was significantly greater in patients with accelerated silicosis (odds ratio = 10.13 95%; confidence interval = 1.2-81.5; p = 0.008). The IL-17F (+7488A/G) genotype revealed a significantly increased risk of accelerated silicosis ( p < 0.05). The IL-17F (+7488 G) allele was associated with an increased risk of accelerated silicosis, but in the case of the IL-17A (-832A/G) polymorphism, a significant association was not observed.
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http://dx.doi.org/10.1177/0748233717695431DOI Listing
September 2017

Anti-fatigue mats, low back pain, and electromyography: An interventional study.

Int J Occup Med Environ Health 2015 ;28(2):347-56

Urmia University of Medical Sciences, Urmia, Iran (Social Determinants of Health Research Center, Occupational Medicine Center).

Objectives: Increasing bilateral gluteus medius co-activation has been identified as one of the most important factors in developing low back pain due to prolonged standing in healthy people. This study aims to investigate the impact of an anti-fatigue mat on the bilateral gluteus medius co-activation pattern and to report the low back pain subjectively in 2 different standing positions on the normal rigid surface and on the anti-fatigue mat.

Material And Methods: While carrying out an easy simulated profession, 16 participants who had no low back pain background were requested to stand for 2 h in each position, with and without using the anti-fatigue floor mat, respectively. At the beginning of standing process and at every 15 min until the time of 120 min lapses, electric activities for the bilateral gluteus medius co-activation and subjective pain level in low back area were collected by the surface electromyogeraphy (EMG) and the visual analogue scale (VAS), respectively in each position.

Results: The obtained findings revealed that the anti-fatigue mat significantly decreased subjective pain level in low back area among 15 participants (p < 0.05). However, there was objectively no significant difference in the bilateral gluteus medius co-activation pattern among the participants between the position 1 and the position 2 (p > 0.05). The findings obtained under this study related to the impact of the anti-fatigue mat upon the low back pain based on the increase of > 10 mm on the VAS threshold, which showed that this intervention had no significant impact upon decreasing the number of patients suffering from the low back pain and also minimizing the bilateral gluteus medius co-activation in both pain developer groups (p > 0.05). However, 73% of the participants preferred to apply it.

Conclusions: It seems that the anti-fatigue mat may be useful in reducing the low back pain although it objectively didn't significantly change the gluteus medius co-activation pattern related to the low back pain.
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http://dx.doi.org/10.13075/ijomeh.1896.00311DOI Listing
December 2016

Association between the high risk occupations and bladder cancer in Iran: a case-control study.

Int J Occup Med Environ Health 2013 Apr 20;26(2):205-13. Epub 2013 May 20.

Department of Occupational Health, Faculty of Health, Kurdistan University of Medical Sciences, Kurdistan, Iran.

Objectives: The objective of this work was to identify the high-risk occupations in Iran and to re-inspect occupations that were related to bladder cancer.

Materials And Methods: In the study, 300 patients suffering from bladder cancer and 500 control individuals were interviewed. Demographic information, occupational history, and history of exposure to chemical compounds such as aromatic amines for each participant were collected. ORs and 95% CIs were calculated using unconditional logistic regression for each occupation.

Results: There was a significantly increased risk of bladder cancer among truck and bus drivers (OR = 11.3), skilled agricultural, forestry and fishery workers (OR = 6.0), metal industry workers (OR = 6.0), domestic housekeepers (OR = 5.9), and construction workers (OR = 3.8).

Conclusions: The study showed a strong correlation between truck and bus drivers, skilled agricultural, forestry and fishery workers, metal industry workers, domestic housekeepers, as well as construction workers and the increased risk of bladder cancer in these occupations.
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http://dx.doi.org/10.2478/s13382-013-0103-5DOI Listing
April 2013

Molecular Evaluation of the IFN γ +874, TNF α -308, and IL-1Ra VNTR Sequences in Silicosis.

Maedica (Bucur) 2012 Jan;7(1):20-4

Cellular and Molecular Research Center, Urmia University of Medical Sciences, Urmia, Iran.

Introduction: to assess whether single nucleotide variation within regulatory sequences of cytokine or chemokine genes is associated with silicosis, this study was conducted for molecular evaluation of the IFN γ +874, TNF α -308, and IL-1Ra VNTR sequences in the patients with the silicosis.

Materials And Methods: ASO-PCR technique was carried out for genotyping of IFN γ +874 and TNF α -308, and in the case of IL-1Ra VNTR, a PCR reaction was performed.

Results: our findings implied that: 1) IFN γ +874 T allele frequency was 0.44 in the cases and 0.48 in the controls; 2) IFN γ +874 A allele frequency was 0.56 in the cases and 0.52 in the controls; 3) TNF α -308 A allele frequency was 0.34 in the cases and 0.29 in the controls; 4) TNF α -308 G allele frequency was 0.66 in the cases and 0.71 in the controls; 5) the observed frequencies (%) of allele 1, allele 2, allele 3 and allele 4 were 65(72.2), 18(20), 2(2.22), 5(5.56) in the cases respectively, and 6) 68(75.6), 17(18.9), 2(2.22), 3(3.33) in the controls respectively. Genotypic and allelic frequencies were not significantly different between cases and controls (p value > 0.05).

Conclusions: it can be concluded that IFN γ +874, TNF α -308 and IL-1Ra VNTR are not associated with silicosis.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3484791PMC
January 2012

The relationship between working schedule patterns and the markers of the metabolic syndrome: comparison of shift workers with day workers.

Int J Occup Med Environ Health 2012 Sep 29;25(4):383-91. Epub 2012 Sep 29.

Occupational Medicine Department, Urmia University of Medical Sciences, Urmia, Iran.

Objectives: This study examined the effect of shift work on developing the metabolic syndrome by comparing groups of exposed and unexposed Iranian drivers.

Methods: We considered as night-shift drivers those drivers whose shifts included at least 15 h per week between 9:00 p.m. and 7:00 a.m. Daytime drivers were defined as drivers working regularly without shift work. 3039 shift work drivers were selected. These were matched with non-shift workers. The differences in baseline characteristics and the prevalence of the components of the metabolic syndrome were assessed with Student's t test, and chi-square tests.

Results: We found central adiposity in 52.0% of the shift workers versus 42.6% of the day workers (p < 0.0001). The hypertension component was not significantly related to shift work (p > 0.05); but there were significant differences as regards other components of the metabolic syndrome (p < 0.0001). Among the shift workers, the odds ratios of the increased FBS, low HDL-C, higher TG levels, as well as higher waist circumference were 1.992 (95% CI: 1.697-2.337), 1.973 (95% CI: 1.759-2.213), 1.692 (95% CI: 1.527-1.874), and 1.460 (95% CI: 1.320-1.616), respectively. The metabolic syndrome was more common among the shift workers (OR = 1.495; 95% CI: 1.349-1.657).

Conclusion: In evaluating such results, further consideration is needed to find pathophysiological clarification; in turn, stress linked to shift work must be considered to likely have had a relevant influence on the outcome. In our opinion, shift work acts as an occupational factor for the metabolic syndrome.
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http://dx.doi.org/10.2478/S13382-012-0051-5DOI Listing
September 2012

Interleukin-18, interleukin-8, and CXCR2 and the risk of silicosis.

Toxicol Ind Health 2013 Oct 1;29(9):830-7. Epub 2012 Jun 1.

1Occupational Medicine Center, Urmia University of Medical Sciences, Urmia, Iran.

Molecular mechanisms in the pathogenesis of silicosis are not fully understood. Exposure to crystalline silica leads to the activation of signaling pathways controlling the production and secretion of inflammatory mediators. Inflammatory cytokines are noted as important candidate genes for fibrotic lung diseases. Cytokines, chemokines, and variations of their genes have been associated with upregulation or downregulation of chronic inflammatory mediators. Variations in the interleukin (IL)-18, IL-8 and chemokine receptor CXCR2 genes are believed to influence the risk of silicosis in stone-grinding factory workers in Iran. Allele-specific oligonucleotide polymerase chain reaction (PCR) procedure was carried out for IL-18 -137 and IL-18 -607, meanwhile touchdown PCR was performed for IL-8 -251 and CXCR2 +1208 genotyping. Variation in genotypic and allelic frequencies was not statistically different among cases versus controls (p > 0.05). These findings indicated for the first time that IL-18 -137, IL-18 -607, IL-8 -251, and CXCR2 +1208 are suggested not to influence the risk of silicosis in tested occupational group.
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http://dx.doi.org/10.1177/0748233712445048DOI Listing
October 2013

Prevalence of metabolic syndrome in Iranian professional drivers: results from a population based study of 12,138 men.

PLoS One 2012 22;7(2):e31790. Epub 2012 Feb 22.

Occupational Medicine Center, Urmia University of Medical Sciences, Urmia, Iran.

Background: It is evident that professional driving is associated with substantial changes in lifestyle habits. Professional drivers are prone to metabolic syndrome (MetS) and its complications because their working environment is characterized by numerous stress factors such as lack of physical activity due to working in a fixed position, disruption in diet, and irregular sleep habits. The aim of the present study was to estimate the prevalence of MetS among long distance drivers residing in West Azerbaijan province in Iran.

Materials: To assess the prevalence of metabolic syndrome among professional long distance drivers, 12138 participants were enrolled in this cross sectional study. The MetS was defined using International Diabetes Federation criteria.

Results: Among 12138 participants, 3697 subjects found to be MetS. The crude and age-adjusted rates of MetS were 30.5% and 32.4% respectively. Based on Body mass index (BMI), 5027 subjects (41.4%) were overweight (BMI ≥ 25.01-30 kg/m2), and 2592 (21.3%) were obese (BMI ≥ 30.01 kg/m2). The presence of central obesity was more common than other components. The associations of MetS with BMI, pack-year smoking, age, weekly driving duration and driving experiences were significant in the logistic regression. By increasing BMI, pack-year smoking, age, weekly driving duration and driving experiences, odds ratio of MetS was increased.

Conclusion: The study suggests that MetS has become a noteworthy health problem among Iranian long distance drivers. This might be due to the following facts: sitting in a fixed position for long hours while working, cigarette smoking, job stress, unhealthy diet and lack of physical activity. Educational programs should be established for promoting healthy lifestyle and also for early detection and appropriate interventions.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0031790PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3285171PMC
August 2012

Association of angiotensin-1-converting enzyme gene variations with silicosis predisposition.

Inhal Toxicol 2010 Nov;22(13):1110-5

Occupational Medicine Center, Urmia University of Medical Sciences, Urmia, Iran.

Interactions between several genes and environmental factors occur in silicosis and other dust-mediated pulmonary fibrosis. It has been suggested that several genes play role in individual susceptibility to silicosis. The aim of this study was to determine the angiotensin-1-converting enzyme (ACE) gene (I/D) variations in patients with silicosis and healthy controls in Iranian Kurdish population. Forty-one male workers with silicosis and 41 healthy male controls were entered in the study. Polymerase chain reaction (PCR) method was carried out for allele and genotype typing. Our finding showed that the frequencies of D and I alleles were 0.65 and 0.35 in the silicotic patients compared to 0.52 and 0.48 in the controls. The frequencies of ACE D/D, D/I, and I/I genotypes were 15 (36.59%), 23 (56.1%), and 3 (7.31%) in patients, and 14 (34.15%), 15 (36.59%), and 12 (29.27%) in the controls, respectively. The results indicate that the frequency of ACE D/D+D/I genotypes were higher in the patients group (92.7% vs. 70.73%) (OR: 5.24, 95% CI: 1.35-20.30, P = 0.01). Also, ACE I/I genotype frequency was lower in patients (7.32% vs. 29.27%) (OR: 0.19, 95% CI: 0.04-0.73, P = 0.01). It can be concluded that ACE D/D and I/D genotypes may play a role in the susceptibility to silicosis; on the contrary, ACE I/I genotype may have protective effect.
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http://dx.doi.org/10.3109/08958378.2010.526654DOI Listing
November 2010

Pericardial plaque: a unique complication of silicosis.

Ind Health 2011 1;49(1):122-5. Epub 2010 Sep 1.

Department of Occupational Medicine, Urmia University of Medical Sciences, Urmia, Iran.

The heart and the respiratory system are closely connected in such a way that disorders of one system would influence the function of the other. This unique case of silicosis complicated by corpulmonale associated with pericardial plaque formation in a young adult male is reported here due to an unknown complication of silicosis.
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http://dx.doi.org/10.2486/indhealth.ms1145DOI Listing
June 2011

Secondary spontaneous pneumothorax in rapidly progressive forms of silicosis: characterization of pulmonary function measurements and clinical patterns.

Toxicol Ind Health 2007 Apr;23(3):125-32

Department of Occupational Medicine, Urmia Medical Sciences University, Urmia, Iran.

Background: A secondary spontaneous pneumothorax is a complication of an underlying pulmonary disease. In recent years, there have been only a few scattered reports of patients with silicosis also having a pneumothorax. Silicosis, a form of disabling pulmonary fibrosis, is a well-known occupational disease resulting from high-level exposure to silica or silica-containing dusts. The objective of the present study was to elucidate any associations between the occurrence of a pneumothorax, and pulmonary function tests and clinical observations performed prior to the pneumothorax; these two factors may be predictors for a pneumothorax among workers exposed primarily to silica-containing respirable dust.

Methods: A diagnosis of silicosis was made on several factors: silica dust exposure, appropriate interval of time after exposure, clinical findings, pulmonary function tests and chest radiological findings. A checklist was designed for collecting data of occupational history, respiratory signs, and symptoms from onset of dust exposure to the occurrence of a pneumothorax. Spirometery was conducted in accordance to the recommendations of standard protocols and guidelines posited by the American Thoracic Society. Autopsies were performed in three cases where the patient had suffered a pneumothorax due to silicosis. Mann-Whitney U-tests and Fisher's exact tests were used to determine any associations between pneumothorax and predictor factors.

Results: An association between a progressive decrease in pulmonary function test values and a pneumothorax was observed. The occurrence of a pneumothorax was associated with complaints of pleuretic chest pain, resting dyspnea, respiratory distress, paroxysmal nocturnal dyspnea, orthopnea and crackle.

Conclusion: A characteristic decline in pulmonary function test values and the severity of respiratory impairment may facilitate the occurrence of a pneumothorax in silicosis.
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http://dx.doi.org/10.1177/0748233707078216DOI Listing
April 2007