Changing pattern of infective endocarditis in Iran: a 16 years survey

To investigate the changes in characteristics of patients with infective endocarditis in Iran and comparing the results with the changing profiles of Infection Endocarditis [IE] in other countries. We studied all patients with definite or possible IE seen at four referral teaching hospitals in Iran from Jan. 1995 to Dec. 2010. The data was analyzed both collectively and separately in two consecutive eight-year periods, i.e. 1995-2003 and 2004-2010. A total of 286 episodes of IE, 172 males and 114 females, were reviewed from which 162 ones were in the first eight-year time period and 124 episodes in the second one. Mean age of the patients was significantly increased in the second eight-year period [24.2 +/- 11 vs 39.4 +/- 15 years old, p value = 0.01]. Increase in the episodes caused by Staphylococcus aureus was significant [40.7% vs 22.8%, p value = 0.01]. The mean size of the vegetation was noticeably higher among IDUs than non-IDUs [1.53 +/- 0.1cm vs 0.76 +/- 0.2cm, p value < 0.001]. As well as extra cardiac complications, mortality rate was noticeably higher among the patients with vegetation size >/= 1cm [34.4% vs 16.3%, p value = 0.003]. There was not a significant difference regarding the mortality rate between the conservatively and surgically treated patients [20.7% vs 22.9%, p value = 0.07]. The most important changing characteristic of IE which influences the outcome of the disease seems to be vegetation size which can account for as the outcome predictor

Associations of demographic and socioeconomic factors with complete treatment and follow up of colon cancer

Cancer is the second cause of death in the world, and colon cancer is the third cause of death and is one of the most common cancers which will cure with early diagnosis, treatment and sufficient follow up. Assessing factors which affect this cancer is important for prolonging patient survival. Socioeconomic factors are among effective factors of cancer morbidity and mortality. Because mortality rates for colon cancers vary by socioeconomic characteristics, this study has been performed to recognize the relationship between socioeconomic factors with treatment and follow up of colon cancer. This was a cross-sectional, descriptive study for patients with colon cancer registered in Cancer Research Center of Shahid Beheshti University of Medical Sciences from April 2005 to November 2006. Patients were selected randomly, and the study was conducted using questionnaires filled by interviewing the patients via phone [if a patient was dead, the questions were asked from their family members]. Data analysis was done using SPSS [version 19] software. The study was performed on 520 colon cancer patients with age range of 23-88 years. The mean age of the patients was 63 [S.D. = 11.8] and the median age was 64.Two hundred thirty seven [45.4%] patients were female and 283[54.4%] were male. Using Chi- square test, age< 60 [P=0.002] and female gender [P=0.034] had a significant correlation with complete treatment and there was a significant relationship between complete follow up and age< 60 [P=0.037], academic education [P=0.02] and having insurance [P=0.021]. Multiple logistic regression tests were used to evaluate concurrent effects of variables on treatment and follow up. Correlated variables to complete treatment include: age< 60 [P=0.001], and female gender [P = 0.023].The Odds Ratio [OR] of completing treatment for patients under 60 years of age versus patients above 60 years was 3.13 [95% C.I. 1.55 to 6.34], and the OR of completing treatment for women versus men was 1.91[95% C.I. 1.33 to 2.74]. Correlated variables to follow up were academic education [P = 0.018] and having insurance [P = 0.046]. The OR of cancer follow up in illiterate patients versus college-educated patients was 0.45[95% C.I. 0.24 to 0.82], and the OR of cancer follow up in patients without insurance versus patients with health was 0.46[95% C.I. 0.21 to 0.98]. Age is a correlated factor on completing colon cancer treatment. Women have more complete colon cancer treatment than men. Academic education and having insurance were the most important factors among socioeconomic factors observed in a five-year follow up after treatment. As the population of the old is increasing, executing effective interventions to improve treatment and follow up procedures for old patients is of prime importance. It seems that increasing the insurance contribution in follow up measures may lead to increase in the regular follow up and may affect patients' survival.