No abstract

Background: Breast cancer (BC) is the leading cause of oncological death for women, in both developed and developing countries. In Iran, breast cancer ranks first among cancers diagnosed in women. The aim of this study was to present the burden of this cancer including incidence, mortality and years life lost (YLL) due to breast cancer in Iranian women. Materials and Methods: National incidence data from the Iranian annual National Cancer Registration reports from 2003 to 2009 and national death statistics reported by the Ministry of Health and Medical Education from 1995 to 2010, stratified by age group, were included in this analysis. Also calculated YLLs provided by the Institute for Health Metrics and Evaluation (IHME) for the years 1990, 1995, 2000, 2005 and 2010 were employed to express the years lost due to BC for Iranian women. Results:The general mortality rate of breast cancer increased during these years from 0.96 to 4.33 per 100,000 and incidence increased from 16.0 to 28.3 per 100,000 for the years under study. YLLs calculated by IHME showed both increasing and decreasing patterns, with a tendency for stabilization. Conclusions: The burden of breast cancer for Iranian women is still increasing. Thus, health education programs to inform women regarding the signs and risk factors, and national screening to facilitate early diagnosis are needed for the female community in Iran.

Urolithiasis is relatively common in children, and identifiable predisposing factors for stone formation, including metabolic and structural derangements, can be established in most cases. Vesicoureteral reflux (VUR) is a common cause of kidney stone formation. The pathophysiological mechanism of urolithiasis in reflux is related to urinary tract infection and urinary stasis, both of which promote urinary crystal formation, but metabolic causes, such as crystallurias (mostly hypercalciuria), may also be involved in this process. However, few studies on urinary calcium and uric acid excretion in children with VUR have been conducted. We have studied the frequency of hypercalciuria and hyperuricosuria in children with VUR and compared the results with those from a control group. The VUR group comprised 108 children with VUR (19 boys, 89 girls; age range 3 months to 12 years), and the control group comprised 110 healthy children without any history of reflux or urinary tract infection (30 boys, 80 girls; age range 2 months to 12 years). Fasting urine was analyzed for the calcium/creatinine (Ca/Cr) and uric acid/creatinine (UA/Cr) ratios. Hypercalciuria was more frequently diagnosed in the VUR patients than in the control group (21.3 vs. 3.6%; P = 0.0001). Significant differences between the two groups were also found for the mean Ca/Cr and UA/Cr ratios (P = 0.0001 and P = 0.0001, respectively). No differences were found in the urinary Ca/Cr or UA/Cr ratios related to VUR grading or unilateral/bilateral VUR in the patient group, with the exception of those for hypercalciuria and mild VUR (P = 0.03). The association of urinary stones and microlithiasis in the VUR group was 29.6%. Our results demonstrate that the frequency of hypercalciuria and hyperuricosuria was higher in pediatric patients with VUR than in healthy children. Knowing this relationship, preventive and therapeutic interventions for stone formation in VUR could be greatly expanded.

This study provides considerable information on the high prevalence of excess weight in families with higher socioeconomic status at national and provincial levels. These findings can be used for international comparisons and for healthcare policies, improving their programming by considering differences at provincial levels.

Fractional excretion of sodium (FENa) has been said to be the most sensitive index for differentiating prerenal failure (PRF) from intrinsic renal failure (IRF). However, there are several instances of high FENa (>2%) in cases of PRF and low FENa (<1%) in IRF patients. In contrast, the fractional excretion of urea nitrogen (FEUN) is primarily dependent on passive forces, and many confounding variables that affect FENa have little effect on FEUN, if any. To compare FEUN with FENa, pediatric patients with acute kidney injury (AKI) were prospectively evaluated by history, physical examination, and obtaining appropriate laboratory data during a 1-year interval. Diagnosis of PRF or IRF was made in each patient, and renal failure indices were compared between two groups using chi-square and t test, as appropriate. Probability value (P value) <0.05 was considered significant. Receiver operating characteristic (ROC) plots for FEUN and FENa were drawn to compare the discriminative power of each index. Forty-three patients were enrolled in the study. There were 27 patients in the PRF and 16 in the IRF group. FENa was 2+/-0.4 in PRF and 4.5+/- 1% in IRF patients (P<0.05), and low FENa (<1%) was only seen in 44.4% of PRF patients, which was not statistically different from those with IRF (P>0.05). FEUN was 23.6+/- 4.9% in PRF and 41.6+/-4.8% in IRF patients (P<0.05), and low FEUN (<35%) was seen in 77.8% of the PRF group (P<0.05). Cutoff values of 30% and 1.6% were reached for FEUN and FENa, respectively. In conclusion, FEUN <35% had higher sensitivity and specificity than FENa <1% for differentiation of PRF from IRF.

The objective of this study was to determine the clinical and histopathological features and outcome of children with lupus nephritis (LN). Of 84 children with systemic lupus erythematosus (SLE), we retrospectively studied 58 children (69%) under 15 years of age with biopsy-proven LN who had been followed between October 1989 and January 2005. The mean age at diagnosis or initial referral was 10.6±2.25 years, and the mean followup was 5.3±4.1 years. Class IV LN was observed in 34 (58.6%) patients. The 5-year patient and renal survival rates were 82.5 and 78.5%, respectively, in the total group, and 75 and 85.8%, respectively, in patients with Class IV LN. No independent predictor of unfavorable outcome, including renal histology, was detected by multivariate analysis. The mid-term patient and the renal survival rates of Iranian children with biopsy-proven LN are high. Within 5 years of follow-up, renal histology was not a predictor for survival.

AIMTo correct the misclassification in registered gastric cancer incidence across Iranian provinces in cancer registry data.METHODSGastric cancer data is extracted from Iranian annual of national cancer registration report 2008. A Bayesian method with beta prior is implemented to estimate the rate of misclassification in registering patient’s permanent residence in neighboring province. Each time two neighboring provinces with lower and higher than 100% expected coverage of cancer cases are selected to be entered in the model. The expected coverage of cancerous patient is reported by medical university of each province. It is assumed that some cancer cases from a province with a lower than 100% expected coverage are registered in their neighboring province with more than 100% expected coverage.RESULTSThe condition was true for 21 provinces from a total of 30 provinces of Iran. It was estimated that 43% of gastric cancer cases of North and South Khorasan provinces in north-east of Iran was registered in Razavi Khorasan as the neighboring facilitate province; also 72% misclassification was estimated between Sistan and balochestan province and Razavi Khorasan. The misclassification rate was estimated to be 36% between West Azerbaijan province and East Azerbaijan province, 21% between Ardebil province and East Azerbaijan, 63% between Hormozgan province and Fars province, 8% between Chaharmahal and bakhtyari province and Isfahan province, 8% between Kogiloye and boyerahmad province and Isfahan, 43% Golestan province and Mazandaran province, 54% between Bushehr province and Khozestan province, 26% between Ilam province and Khuzestan province, 32% between Qazvin province and Tehran province (capital of Iran), 43% between Markazi province and Tehran, and 37% between Qom province and Tehran.CONCLUSIONPolicy makers should consider the regional misclassification in the time of programming for cancer control, prevention and resource allocation.

No abstract