The risk profile of patients with COVID-19 as predictors of lung lesions severity and mortality-Development and validation of a prediction model.

Objective: We developed and validated a prediction model based on individuals' risk profiles to predict the severity of lung involvement and death in patients hospitalized with coronavirus disease 2019 (COVID-19) infection. Methods: In this retrospective study, we studied hospitalized COVID-19 patients with data on chest CT scans performed during hospital stay (February 2020-April 2021) in a training dataset (TD) (n = 2,251) and an external validation dataset (eVD) (n = 993). We used the most relevant demographical, clinical, and laboratory variables (n = 25) as potential predictors of COVID-19-related outcomes. The primary and secondary endpoints were the severity of lung involvement quantified as mild (≤25%), moderate (26-50%), severe (>50%), and in-hospital death, respectively. We applied random forest (RF) classifier, a machine learning technique, and multivariable logistic regression analysis to study our objectives. Results: In the TD and the eVD, respectively, the mean [standard deviation (SD)] age was 57.9 (18.0) and 52.4 (17.6) years; patients with severe lung involvement [n (%):185 (8.2) and 116 (11.7)] were significantly older [mean (SD) age: 64.2 (16.9), and 56.2 (18.9)] than the other two groups (mild and moderate). The mortality rate was higher in patients with severe (64.9 and 38.8%) compared to moderate (5.5 and 12.4%) and mild (2.3 and 7.1%) lung involvement. The RF analysis showed age, C reactive protein (CRP) levels, and duration of hospitalizations as the three most important predictors of lung involvement severity at the time of the first CT examination. Multivariable logistic regression analysis showed a significant strong association between the extent of the severity of lung involvement (continuous variable) and death; adjusted odds ratio (OR): 9.3; 95% CI: 7.1-12.1 in the TD and 2.6 (1.8-3.5) in the eVD. Conclusion: In hospitalized patients with COVID-19, the severity of lung involvement is a strong predictor of death. Age, CRP levels, and duration of hospitalizations are the most important predictors of severe lung involvement. A simple prediction model based on available clinical and imaging data provides a validated tool that predicts the severity of lung involvement and death probability among hospitalized patients with COVID-19.

WHO-ILAR COPCORD study (stage 1, urban study) in Sanandaj, Iran.

This study aims to conduct an urban Community Oriented Program for Control Of Rheumatic Diseases (COPCORD) study in Sanandaj (Kurdistan, Iran). Sanandaj with a population of 311,446 (2006 census), Caucasian of Kurdish subgroup, was selected as the field. Sanandaj was divided into 100 clusters and subjects were randomly selected from them (50 subjects from each cluster). The COPCORD study started on July 2011 and ended on June 2012. Of the households, 1,631 was visited and 5,830 persons were interviewed. The male to female ratio was 0.8-1 (44.5% males, 55.5% females). Musculoskeletal complaints during the past 7 days were detected in 42.8% of the interviewed subjects (36.3% males, 48.1% females). The distribution was 16.7% shoulder, 10% wrist, 9.7% hands and fingers, 7.7% hip, 26.3% knee, 9.9% ankle, 6.4% toes, 9.5% cervical spine, and 21.5% dorsal and lumbar spine. Degenerative joint diseases were detected in 19.4% of the subjects: 1.8% neck, 18.9% knee, 3.9% hands, and 0.51% hip. Low back pain was detected in 16.5%, sciatica in 1.2%, cervical nerve root pain in 0.24%, and soft tissue rheumatism in 5.5%. Inflammatory disorders were 0.51% rheumatoid arthritis, 0.22% seronegative spondyloarthropathy, 0.10% ankylosing spondylitis, 0.05% systemic lupus erythematosus, and 0.10% Behcet's disease . Fibromyalgia was detected in 0.62% and gout in 0.12% of the studied population. Disability was reported by 28.3%. It was present at the study time in 21.4%. Comparing the four COPCORD studies of Iran, the figures (numbers) obtained by COPCORD Sanandaj are much the same as the COPCORD study in Tehran. Joint complaints were seen less frequently than in the COPCORD urban study of Zahedan and rural study of Tuyserkan. Osteoarthritis was higher than in Tehran, but the same as the two others. Soft tissue rheumatism was rather the same. Rheumatoid arthritis was higher than Tehran and Tuyserkan, but lower than Zahedan.

Cancer during pregnancy: a review of 10 years of experience.

Cancer is the second most common cause of death among women who are in reproductive ages; however it is not common during pregnancy. There are few numbers of documents concerning cancer and its related treatment outcomes and prognosis during pregnancy. The aim of this study was to review our experience about gestational cancer. In this retrospective chart review study, 25 pregnant women with any kind of diagnosed malignancy who attended hospitals in Uremia and Sanandaj city since 10 years ago were assessed. Cancer cases were verified by a pathologist using pathology and TNM system for tumors staging. Then survival duration was analyzed using Kaplan-Maier plot. From all, 10 women had gynecologic cancers and 15 had non-gynecologic cancers. Ovarian cancer was the most common malignancy. The mean of survival was 67 months for all patients (CI95%: 23.7-110.3), 67 months for gynecologic cancer group (CI95%: 40.2-93.8) and 69 months for non-gynecologic cancer group (CI95%: 0-159) (p = 0.51). According to the results, the cancer complaints and symptoms must be examined thoroughly and do not take them as pregnancy complications since delays in prognosis leads to more severe problems and makes treatment difficult. If cancer is treated carefully after three months of gestation, probably it won't have severe side effects for fetus.

Prevalence of asthma and rhinitis in bakery workers in the city of Sanandaj, Iran.

Baker's asthma is one of the most common forms of occupational asthma. This study was conducted to determine prevalence of asthma and rhinitis among bakery workers in the city of Sanandaj, the provincial center of Kurdistan province in the west of Iran in the in Summer 2006. In this study 776 bread bakery workers were included. These subjects were selected randomly among 1620 bakery workers. The diagnosis of asthma was based on a medical history of episodic symptoms of cough, chest tightness, and dyspnea and spirometry. Airflow obstruction was determined with spirometry, the definition of airflow obstruction which was used in this study was an FEV1/FVC ratio < 0.8, and FEV1 or FVC increases of > or = 12 percent and at least 200 mL after using a short-acting inhaled beta2-agonist. Rhinitis was diagnosed by typical history of work related symptoms. Analyses were performed on 776 subjects (all were men) without missing data for asthma and rhinitis. All of subjects were male with mean age of 33.69+/-11.09 years. Mean duration of bakery working for these subjects was 13.91+/-9.37 years. Prevalence of asthma at the time of study was 11.9%. 93 subjects were diagnosed as asthma with history, physical and spirometry findings. 31 (33.3%) of asthmatic workers were diagnosed as asthma previously and 62 (66.6%) workers were known as new asthmatic patients which were diagnosed in this study program. The prevalence of rhinitis was (9.9%). Subjects with asthma had longer history of working at bakery than others (P=0.001). Asthma prevalence among these bakery workers that were included in our study was similar and in some instances the prevalence was lower than other studies.