Background: First‑ degree relatives (FDRs) of hypertensive (HT) are predisposed to hypertension (HTN) which accelerates cardiovascular aging. Same can be studied noninvasively by pulse wave analysis (PWA), encompassing central hemodynamics such as central blood pressure (cBP), cardiac output, and stroke work (SW) and vascular stiffness parameters such as pulse wave velocity (PWV) and augmentation index at HR 75 (AIx@75). We studied PWA‑ derived cardiovascular parameters in FDRs of HT compared to controls. Materials and Methods: We conducted a case– control study in 119 FDRs of HT and 119 matched controls. Oscillometric PWA was performed by Mobil‑ o‑ Graph (IEM, Germany) and cardiovascular parameters were compared. P < 0. 05 was considered statistically significant. Results: Groups were comparable with gender, age, height, weight, body mass index, and physical activity. FDRs of HT had significantly higher brachial and cBPs, SW (101. 41 ± 25. 44 vs. 88. 31 ± 20. 25, P = 0. 001), rate pressure product‑ 119. 40 ± 25. 34 vs. 108. 34 ± 18. 17, P < 0. 0001), PWV (5. 22 ± 0. 46, P < 0. 0001), and AIx@75 (31. 48 ± 9. 01 vs. 27. 95 ± 9. 4, P = 0. 002) than control. Dependent study variables correlated with brachial blood pressure more in magnitude and significance level than age or anthropometric variables. PWA results of FDR with maternal inheritance did not differ significantly from those with paternal inheritance. Conclusion: PWA reveals early cardiovascular aging in young FDRs of HTs. It clues to future cardiovascular disease including HTN itself, need for primary prevention, and further study for consolidation of these results.

BACKGROUND: Colorectal cancer (CRC) is the fourth most common cancer among men and the second among women in Iran. First-Degree Relatives (FDRs) of patients with CRC are known to be at higher risk of CRC. The aim of this study was to identify the most cost-effective strategy for CRC screening in Iranian high risk individuals. METHODS: A Markov model was developed to assess the cost-effectiveness of six colonoscopy screening strategies for individuals at increased risk of CRC because of positive history of the disease in at least one first-degree relative in their family. Our strategies included five-yearly or ten-yearly colonoscopy starting from the age of 40 or 50 and colonoscopy once at 50 or 55 years. Data were extracted from the published literature, Globocan 2012 database, and national cancer registry reports. The Markov model contained 11 mutually exclusive health states. Time horizon of model was life time and cycle duration was 1 year. Outcomes included life year gains, Quality Adjusted Life Years (QALYs) and costs. The TreeAge Pro software was used for data modeling. RESULTS: All six screening strategies increased the life expectancy and QALY and were costlier than no screening. The incremental cost per QALY gained for CRC screening varied from $489 for one colonoscopy screening per lifetime at 55 years to $3, 135 for colonoscopy screening every five years starting at the age of 40, compared with no screening. When strategies were compared with the next best strategy, dominated strategies were removed from analysis, one colonoscopy screening per lifetime at 55 years old; or every ten years starting at the age 40; or every five years starting at age 40 remained with incremental cost effective ratios of $489, $2, 505, and $26, 080 per QALY gained, respectively. CONCLUSIONS: CRC colonoscopy screening in high-risk individuals is cost-effective in Iran. Colonoscopy screening every 10 years starting at the age of 40 was the most cost-effective strategy.

Background: Otosclerosis (OS) is the most common cause of conductive hearing loss in young population, and we determined incidence of OS among 1st and 2 nd degree relatives of surgically proved otosclerotic patients. Methods: In a cross sectional study among 43 surgically proved otosclerotic patients, positive family history of OS was determined. In suspicious cases, physical exam, tunning fork tests, and eudiometry were performed. We also reviewed medical sheaths of admitted OS patients from 1995 to 2003 in Isfahan university hospitals for family history of OS. Results: Among 15 otosclerotic patients (34.88%) with positive family history of OS, 14 individuals of their first and second degree relatives had clinical and audiometric otosclerosis. Among 85 medical record sheaths of otosclerotic patients, 12 patients (27.9 %) had positive family history for OS. Conclusions: The incidence of clinical and audiometric otosclerosis among first and second degree relatives of OS patients is nearly similar to the rate of positive family history of our patients, which is relatively lower than other studies.

Background: Sleep apnea is associated with increased risk of diabetes mellitus. However, no studies have compared sleep apnea symptoms in diabetic patients and their first degree relatives. The purpose of our study was to investigate high risk for sleep apnea syndrome, in diabetics and their first degree relatives for prevention of diabetes in family.Methods: As a part of a cohort study, all of diabetic and their first degree relatives who came for glucose control in diabetes clinic were invited to take part in the survey. Two thousand, four hundred and sixty-two individuals (82% of invited) agreed to fill out the Berlin and Epworth sleep questionnaire. Participants consisted of 2462 subjects of 15–70 years of age, both males and females with diabetes and family history of type 2 diabetes mellitus. A total of 1234 participants had diabetes and 11, 231 were relatives of diabetic patients. High risk for sleep apnea regarding Berlin questionnaire and Epworth sleepiness scale, diabetic and relative were analyzed.Results: Prevalences of high risk for sleep apnea were higher among diabetics than relatives (P -value<0.001). In a multiple regression analysis, ‘‘age, body mass index, education, high blood pressure’’ were risk factor for sleep apnea symptoms while isolated blood glucose level was not by Berlin questionnaire. By Epworth sleep scale only education level was a risk factor for sleep apnea symptoms while isolated blood glucose level was not risk factor.Conclusions: Sleep apnea symptoms may not have significant difference between diabetics and their relatives. We need more study on sleep apnea in the family of diabetic patients. We hope that more studies on mentioned field may help prevention of diabetes in their family.