[Computed tomographic features of coronavirus disease-2019 (COVID-19) pneumonia in three groups of Iranian patients: A single center study]. / Características en tomografía computarizada de la neumonía por coronavirus-2019 (COVID-19) en tres grupos de pacientes iraníes: estudio de un solo centro.

Introduction and Objectives: The pivotal role of chest computed tomographic (CT) to diagnosis and prognosis coronavirus disease-2019 (COVID-19) is still an open field to be explored. This study was conducted to assess the CT features in confirmed cases with COVID-19. Materials and Methods: Retrospectively, initial chest CT data of 363 confirmed cases with COVID-19 were reviewed. All subjects were stratified into three groups based on patients' clinical outcomes; non-critical group (n=194), critical group (n=65), and death group (n=104). The detailed of CT findings were collected from patients' medical records and then evaluated for each group. In addition, multinomial logistic regression was used to analyze risk factors according to CT findings in three groups of patients with COVID-19. Results: Compared with the non-critical group, mixed ground-glass opacities (GGO) and consolidation lesion, pleural effusion lesion, presence of diffuse opacity in cases, more than 2 lobes involved and opacity scores were significantly higher in the critical and death groups (P<0.05). Having more mixed GGO with consolidation, pleural effusion, lack of pure GGO, more diffuse opacity, involvement of more than 2 lobes and high opacity score identified as independent risk factors of critical and death groups. Conclusion: CT images of non-critical, critical and death groups with COVID-19 had definite characteristics. CT examination plays a vital role in managing the current COVID-19 outbreak, for early detection of COVID-19 pneumonia. In addition, initial CT findings may be useful to stratify patients, which have a potentially important utility in the current global medical situation.

Computed tomographic features of coronavirus disease-2019 (COVID-19) pneumonia in three groups of Iranian patients: A single center study.

INTRODUCTION AND OBJECTIVES: The pivotal role of chest computed tomographic (CT) to diagnosis and prognosis coronavirus disease-2019 (COVID-19) is still an open field to be explored. This study was conducted to assess the CT features in confirmed cases with COVID-19. MATERIALS AND METHODS: Retrospectively, initial chest CT data of 363 confirmed cases with COVID-19 were reviewed. All subjects were stratified into three groups based on patients' clinical outcomes; non-critical group (n=194), critical group (n=65), and death group (n=104). The detailed of CT findings were collected from patients' medical records and then evaluated for each group. In addition, multinomial logistic regression was used to analyze risk factors according to CT findings in three groups of patients with COVID-19. RESULTS: Compared with the non-critical group, mixed ground-glass opacities (GGO) and consolidation lesion, pleural effusion lesion, presence of diffuse opacity in cases, more than 2 lobes involved and opacity scores were significantly higher in the critical and death groups (P<0.05). Having more mixed GGO with consolidation, pleural effusion, lack of pure GGO, more diffuse opacity, involvement of more than 2 lobes and high opacity score identified as independent risk factors of critical and death groups. CONCLUSION: CT images of non-critical, critical and death groups with COVID-19 had definite characteristics. CT examination plays a vital role in managing the current COVID-19 outbreak, for early detection of COVID-19 pneumonia. In addition, initial CT findings may be useful to stratify patients, which have a potentially important utility in the current global medical situation.

Prognostic factors in gastric cancer using log-normal censored regression model.

BACKGROUND & OBJECTIVE: Gastric cancer is one of the most common cancers in the world. It is rarely detected early, and the prognosis remains poor. Cox proportional hazard model is used to examine the relationship between survival and covariates. Parametric survival models such as log normal regression model can also be used for this analysis. We used log normal regression model in this study to evaluate prognostic factors in gastric cancer and compared with Cox model. METHODS: We retrospectively studied the 746 patients diagnosed with gastric cancer admitted in a referral hospital in Tehran, Iran, from February 2003 through January 2007. Age at diagnosis, sex, extent of wall penetration, histology type, tumour grade, tumour size, pathologic stage, lymph node metastasis and presence of metastasis were entered into a log normal model. Hazard rate (HR) was employed to interpret the risk of death and the results were compared with Cox regression. The AIC (Akaike Information Criterion) was employed to compare the efficiency of models. RESULTS: Univariate analysis indicated that with increasing age the risk of death increased significantly in both log normal and Cox models. Patients with greater tumour size were also in higher risk of death followed by those with poorly differentiated and moderately differentiated in tumour grade and advanced pathologic stage. The presence of metastasis was significant prognostic factor only in log normal analysis. In final multivariate model, age was still a significant prognostic factor in Cox regression but it was not significant in log normal model. Presence of metastasis followed by histology type were other prognostic features found significant in log normal results. Based on AIC, log normal model performed better than Cox. INTERPRETATION & CONCLUSION: Our results suggest that early detection of patients in younger age and in primary stages and grade of tumour could be important to decrease the risk of death in patients with gastric cancer. Comparison between Cox and log normal models indicated that log normal regression model can be a useful statistical model to find prognostic factors instead of Cox.

Predicting the probability of mortality of gastric cancer patients using decision tree.

BACKGROUND: Gastric cancer is the fourth most common cancer worldwide. This reason motivated us to investigate and introduce gastric cancer risk factors utilizing statistical methods. AIM: The aim of this study was to identify the most important factors influencing the mortality of patients who suffer from gastric cancer disease and to introduce a classification approach according to decision tree model for predicting the probability of mortality from this disease. METHODS: Data on 216 patients with gastric cancer, who were registered in Taleghani hospital in Tehran,Iran, were analyzed. At first, patients were divided into two groups: the dead and alive. Then, to fit decision tree model to our data, we randomly selected 20% of dataset to the test sample and remaining dataset considered as the training sample. Finally, the validity of the model examined with sensitivity, specificity, diagnosis accuracy and the area under the receiver operating characteristic curve. The CART version 6.0 and SPSS version 19.0 softwares were used for the analysis of the data. RESULTS: Diabetes, ethnicity, tobacco, tumor size, surgery, pathologic stage, age at diagnosis, exposure to chemical weapons and alcohol consumption were determined as effective factors on mortality of gastric cancer. The sensitivity, specificity and accuracy of decision tree were 0.72, 0.75 and 0.74 respectively. CONCLUSIONS: The indices of sensitivity, specificity and accuracy represented that the decision tree model has acceptable accuracy to prediction the probability of mortality in gastric cancer patients. So a simple decision tree consisted of factors affecting on mortality of gastric cancer may help clinicians as a reliable and practical tool to predict the probability of mortality in these patients.

Population prevalence of first- and second-degree family history of breast and ovarian cancer.

BACKGROUND: Family cancer history is an important risk factor for common cancers, thus, recognizing pattern of familial cancer can help us to identify individuals who may have higher chance to develop specified cancers. METHODS: This cross-sectional survey assessed family history of cancer in first- and second degree relatives. Totally, 7,300 persons aged > or = 20 years selected by random sampling from Tehran general population. Age- and sex-specified prevalence of breast and ovarian cancer in respondent's family was calculated. RESULTS: Of all, 279(4.3%) individuals reported a history of breast or ovarian cancer in their relatives. The prevalence of breast cancer family history was 1.8% among first-degree relatives and 2.5% among second- degree relatives. For ovarian cancer, first- and second-degree prevalence ranged from 0.05 to 0.12%. Those with family history of cancer were more often young and female. CONCLUSIONS: Overall, the estimates of prevalence presented here are likely to be conservative compared with actual current prevalence because of some limitations. While family history is an important risk factor for common cancers such as breast cancer, recognizing pattern of familial cancer that signify increased risk can help us to identify individuals who may have higher chance to develop specified cancers.

Risk of colorectal cancer in relatives: a case control study.

BACKGROUND: In around 10 to 15% of all colorectal cancer (CRC) cases, a positive family history of colorectal cancer is observed . Although increased risk of colorectal cancer in individuals with a family history of the disease has been observed consistently in the past studies, limited information is available on colorectal cancer associated with family history in Iran. AIMS: The purpose of this study is to define the risk of colorectal cancer associated with a family history of cancer. SETTING AND DESIGN: The present study was designed as an unmatched case control study. The cases were 393 patients with histologically confirmed colorectal carcinomas and there were 393 controls, randomly selected from among the healthy participants in a health survey. METHODS: The family history was extracted from a standard history form completed by the patient or from the record created by a health care provider. STATISTICAL ANALYSIS: Mantel-Heanszel Odds Ratio was computed for removing the confounding effect of age and sex. RESULTS: A positive family history of cancer was reported by 36.4 and 24.4% among the cases and controls, respectively. Colorectal cancer risk increased two-fold in subjects who reported having first degree relatives with cancer. The adjusted odds ratio was 4.76, indicating that having a positive family history of colorectal cancer among relatives increased one's risk of colorectal cancer about 4.5-fold. CONCLUSION: According to our findings, a family history of cancer increased the risk of CRC. Due to this fact that there is no current colorectal cancer screening program in Iran, it is recommended that first degree relatives of patients with colorectal cancer should be considered as a priority group for screening programs.

Relationship between uninvestigated dyspepsia and body mass index: a population-based study.

BACKGROUND AND AIM: Recent studies have shown inconsistent results about the association between body mass index and symptoms of gastrointestinal disorders. The aim of this study was to assess the association between body mass index (BMI) and symptoms of uninvestigated dyspepsia in patients with gastrointestinal symptoms and their relations with age. METHODS: This study was designed as a cross-sectional and population based evaluation that was conducted in Iran. The patients were interviewed by using questionnaire which was arranged on the basis of Rome III criteria for functional dyspepsia. The association between body mass index, age and dyspepsia symptoms was determined. RESULTS: A total of 790 patients with gastrointestinal symptoms (249 men, mean +/- SD of age, 49.9 +/- 19 years; mean +/- SD of BMI, 25.4 +/- 4.7) were included and among them 681 (86.2%) had symptoms of dyspepsia. The prevalence of dyspepsia symptoms among females younger and older than 50 years were 83% and 93.8% ,respectively, but these percentages among males younger and older than 50 years were 84.5% and 81.5%.In males younger and older than 50 years 42.9% and 37.6% had BMI over than 25, but these percentages were 51.3% and 54.8% for females. Among overweight and obese patients the prevalence of dyspepsia symptoms were 82.7% and 78%, respectively, compared with normal weight (90.7%). CONCLUSION: After the age of 50, the prevalence of dyspepsia symptoms and high body mass index were increased in females, but were decreased in males. No relation between symptoms of dyspepsia and body mass index in both genders was found.

Diagnosis and prevalence of enteropathogenic bacteria in children less than 5 years of age with acute diarrhea in Tehran children's hospitals.

INTRODUCTION: Acute diarrhea disease is the second cause of death among all infectious diseases in children younger than 5 years of age worldwide. The aim of this study was to employ a combination of biochemical, microbiological and molecular diagnostic techniques to investigate the stools of Iranian children with acute diarrhea for bacterial enteropathogens. METHOD: Diarrheagenic Escherichia coli, Shigella spp., Salmonella spp., Campylobacter spp. and Yersinia spp., were investigated from June 2003 to June 2005, in 1087 children less than 5 years old with acute diarrhea. Stool specimens from children were studied for enteropathogens both by standard culturing and molecular methods. This study was designed on hospital based. RESULT: The highest incidence values were found in the summer and in children less than 1-year-old (42.7%). The Pathogenic bacteria recovered out from fecal samples of 555 (55.1%) patients had the following profile: Shigella spp. (26.7%) was the most prevalent bacterial pathogen and Shiga-like toxin producing E. coli (STEC) and Enteroaggregative E. coli (EAEC) 105 (18.9%) and 92 (16.6%) had the second and third highest prevalence, respectively. Enteropathogenic E. coli (EPEC), Campylobacter, Salmonella and Enterotoxigenic E. coli (ETEC) were found in 70 (12.6%), 60 (10.8%), 42 (7.6%), and 38 (6.8%) positive samples, respectively. In this study neither Yersinia nor E. coli O157:H7 were found. Of the 30 co-infections detected, Shigella flexneri and Campylobacter jejuni accounted for more than 50%. CONCLUSION: Information about the prevalence of wide-range Shigella and STEC may facilitate the control and management of infant diarrhea diseases in Iran. The results of this study suggest that comprehensive surveys are needed in different parts of the country in order to identify the incidence of different enteropathogenic diarrhea, especially diarrheagenic E. coli in children in Iran.

Colorectal cancer in Iran: an epidemiological study.

BACKGROUND: Colorectal cancer (CRC) is one of the most common cancers worldwide. But information regarding CRC in Iran is limited; the aim of this study was to investigate the epidemiologic features of CRC in Iran, using 5-year data from cancer registry. METHODS: This survey is a descriptive-analytic study consists of 1138 colorectal cancer patients who registered in Cancer Registry Center of Research Center for Gastroenterology and Liver Disease, Tehran, Iran. These data gathered using interview and pathology reports that registered in cancer registry forms. Data analysis was performed with descriptive and univariate methods. RESULTS: Of 1138 patients, 696 cases were male and 442 female. There was no significant difference between males and females regarding age at diagnosis. 400 patients (35.1%) had a family history of cancer. The most common histology type of tumor was adenocarcinoma, NOS. In most cases (39.1%) tumor grading was well differentiated and there was no significant difference between males and females. CONCLUSION: Colorectal cancer is a disease with nonspecific symptoms. Family history of cancer was evident in 35.1% of our cases and also 42.9% of patients were below the age of 50 years old, suggests that genetic factors may be play an important role in the development of this disease in our country.