Spatial Evaluation of Oral Lichen Planus Patients Referred to Shiraz Dental School, Iran: a Medical Geography Approach.

Statement of the Problem: Oral lichen planus (OLP) is an important inflammatory disease concerning its tendency to malignancy. The etiopathogenesis of this disease is still unknown. Medical geography uses geographic techniques to study factors related to location that cause uneven distribution of disease. Purpose: This study was conducted to map OLP in patients referred to Shiraz Dental School with medical geography techniques and investigate any possible relationship between the number of dentists and health-centers in different regions of Fars province with the number of referrals. Materials and Method: In this cross-sectional study, we evaluated the records of OLP patients referred to Shiraz Dental School from 2007 to 2018. Age, sex, place of residence, occupation, level of education, location of involvement, duration, and cutaneous involvement were recorded. The number of dentists and healthcare centers was obtained from the statistical records of Fars province. A Geographic Information System was used for the assessment of the spatial distribution of OLP. Ordinary least squares (OLS) and geographically weighted regression (GWR) indices were used for evaluating the relationship between the number of dentists and health centers with the number of referrals. Results: From 1006 records, 457 were studied, from which 71% were female (age range of 41-60). The regression coefficient was 0.937 for the number of dentists in each county compared to OLP referrals indicating a strong relationship. The regression coefficient was 0.983 for the number of health-centers. According to GWR analyses in Shiraz neighboring counties like Marvdasht, Sepidan, and Sarvestan, there is a positive relationship between the number of dentists and OLP patients. Conclusion: The results revealed that dentists and health care centers had a good cognition of referring patients with OLP (as a premalignant lesion) for definite diagnosis in Fars counties. But both groups need more education in this matter. Moreover, referrals from settlements near Shiraz were more common because of their easier access.

Comparison of the Effect of Alpha and Hydrocortisone Ointments on Prevention of Acute Skin Complications Due to Radiotherapy in Breast Cancer Patients.

BACKGROUND: Radiotherapy in breast cancer patients is associated with acute and delayed side effects. This study aimed to compare the effect of alpha and hydrocortisone 1% (H1%) ointments on prevention of acute skin complications due to radiotherapy in breast cancer patients. METHODS: This clinical trial was conducted on 86 patients with breast cancer in the radiotherapy center of Imam Reza Hospital of Kermanshah, Iran. Using the records, the patients were selected and randomly divided into alpha and H1% groups after obtaining informed consent. The severity of dermatitis, complications, and patient complaints during treatment were evaluated weekly for up to 6 weeks by RTOG criteria. Data were analyzed using SPSS-16 software. RESULTS: At the end of the third, fourth, fifth, and sixth weeks, 10 (11.7%), 25 (29.1%), 53 (61.6%), and 28 (32.6%) patients had skin complications, respectively. In weeks 5 and 6 in the H1 group, the incidence of complications was higher (P = 0.001). The frequency of pain and burning complaints at the end of the third, fourth, fifth, and sixth weeks was 15 (17.4%), 37 (43.0%), 52 (60.5%), and 1(1.2%), respectively. Pain and burning intensity in the fourth and fifth weeks in the H1 group was lower than alpha (P = 0010). Complaints of skin itching at the end of the third, fourth, and fifth weeks were 16 (18.6%), 25 (29.1%), and 28 (32.6), respectively. This complication was lower in the H1% group during these weeks (P < 0.05). CONCLUSION: Alpha ointment is more effective than H1% in relieving pain and burning, preventing complications except itching. It seems using an alpha ointment or combining it with H1% is an appropriate strategy to reduce the rate of injuries and skin complications of radiotherapy.

A small number of objective function weight vectors is sufficient for automated treatment planning in prostate cancer.

Current practice for treatment planning optimization can be both inefficient and time consuming. In this paper, we propose an automated planning methodology that aims to combine both explorative and prescriptive approaches for improving the efficiency and the quality of the treatment planning process. Given a treatment plan, our explorative approach explores trade-offs between different objectives and finds an acceptable region for objective function weights via inverse optimization. Intuitively, the shape and size of these regions describe how 'sensitive' a patient is to perturbations in objective function weights. We then develop an integer programming-based prescriptive approach that exploits the information encoded by these regions to find a set of five representative objective function weight vectors such that for each patient there exists at least one representative weight vector that can produce a high quality treatment plan. Using 315 patients from Princess Margaret Cancer Centre, we show that the produced treatment plans are comparable and, for [Formula: see text] of cases, improve upon the inversely optimized plans that are generated from the historical clinical treatment plans.

Spatial modeling of colonic lesions with geographic information systems.

BACKGROUND: Geographic information system (GIS) software has been used in health care systems to display and analyze spatial pattern of diseases and health services. OBJECTIVES: This study was performed to assess spatial patterns of colon's pathologic lesions based on the pathologic reports and assess whether it is possible to use GIS software in health services. PATIENTS AND METHODS: Archives of pathology of Namazi and Faghihi hospitals, two main referral centers of south-west of Iran, were obtained and reviewed between January 2009 and September 2011 for biopsy reports of patients who underwent colonoscopy. Abnormal biopsies were categorized into five different subgroups according to the type of pathologic specimens. By GIS, spatial patterns of colon biopsies were plotted in different maps and spatial auto-correlation of colon biopsies was calculated using the Moran's Index. RESULTS: A total of 4815 biopsies from 2663 different patients were reviewed, 53.8% of which were men. Abnormal biopsies were 2781 of all specimens (57.8%). Neoplastic lesions, inflammatory bowel diseases and polyps were 9.3%, 19.3% and 29.2% of total biopsies, respectively. Pathologic biopsies were more common in the distal colon. Maps of all biopsies and maps of specific pathologies were manifested in GIS. CONCLUSIONS: Our study showed that left-sided lesions are still more common in the Iranian population. On the other hand, surveying the right side of colon is as important as the distal part, which necessitates total colonoscopy.

The geographical clusters of gastrointestinal tract cancer in fars province, southern iran.

BACKGROUND: Gastrointestinal tract cancer (GI.C) is one of the common cancers in world-wide. The incidence rate of it is different in various geographical regions. This study was performed to assess spatial clusters of the occurrence of GI.C in Fars Province. METHODS: In this cross-sectional study, the new cases were 4569 cases from 2001 to 2009. The crude incidence rates were standardized based on world population for both sexes. The spatial analysis was conducted using the geographical information systems. We used the local Indicators of spatial association measure, in order to identify local spatial clusters. RESULTS: From a total of the new cases, 62.8% cases were male. The most common GI.Cs were stomach and colorectal cancer in men and women respectively. The significant cluster patterns were discovered from 2002 to 2007. The common type of spatial clustering was a high-high cluster, that to indicate from North-west to South-east of Fars Province. CONCLUSIONS: Analysis of the geographical distribution of GI.C will provide opportunities for policymakers for applying preventive measures. Furthermore, it could be helpful for researchers for future epidemiological studies for investigation of etiological agents in regions with significant spatial clustering of high incidence of cancer.

The Spatial Distribution of Cancer Incidence in Fars Province: A GIS-Based Analysis of Cancer Registry Data.

BACKGROUND: Cancer is a major health problem in the developing countries. Variations of its incidence rate among geographical areas are due to various contributing factors. This study was performed to assess the spatial patterns of cancer incidence in the Fars Province, based on cancer registry data and to determine geographical clusters. METHODS: In this cross sectional study, the new cases of cancer were recorded from 2001 to 2009. Crude incidence rate was estimated based on age groups and sex in the counties of the Fars Province. Age-standardized incidence rates (ASR) per 100,000 was calculated in each year. Spatial autocorrelation analysis was performed in measuring the geographic patterns and clusters using geographic information system (GIS). Also, comparisons were made between ASRs in each county. RESULTS: A total of 28,411 new cases were diagnosed with cancer during 2001-2009 in the Fars Province, 55.5% of which were men. The average age was 61.6 ± 0.5 years. The highest ASR was observed in Shiraz, which is the largest county in Fars. The Moran's Index of cancer was significantly clustered in 2004, 2005, and 2006 in total, men, and women. The type of spatial clustering was high-high cluster, that to indicate from north-west to south-east of Fars Province. CONCLUSIONS: Analysis of the spatial distribution of cancer shows significant differences from year to year and between different areas. However, a clear spatial autocorrelation is observed, which can be of great interest and importance to researchers for future epidemiological studies, and to policymakers for applying preventive measures.