Evaluation of prognostic factors effect on survival time in patients with colorectal cancer, based on weibull competing-risks model

Aim: The aim of this study was to assess the association between survival of patients with colorectal cancer and prognostic factors in a competing risk parametric model using Weibull distribution

Background: The prognosis of colorectal cancer is relatively good in terms of survival time. In many prognostic studies, patients may be exposed to several types of competing events. These different causes of death are called competing risks

Methods: Data was recorded from 372 patients with colorectal cancer who registered in the Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences [Tehran, Iran] from 2004 to 2015 in a retrospective study. Analysis was performed using competing risks model and Weibull distribution. Software used for data analysis was R, and significance level was regarded as 0.05

Results: The result indicated that, at the end of follow-up, 111 [29.8%] deaths were from colorectal cancer and 14 [3.8%] deaths were due to other diseases. The average body mass index [BMI] was 24.61[SD 3.98]. The mean survival time for a patient in 372 was 62.05[SD 48.78] month with median equals to 48 months. According to competing-risks method, only stageIII [HR, 1.69; 95% CI, 1.246-2.315], stageIV[HR, 4.51; 95% CI,2.91-6.99 ] and BMI[HR, 0.96; 95% CI, 0.96-0.975] have a significant efect on patient's survival time

Conclusion: This study indicated pathologic stage[III,IV] and BMI as the prognosis, using a Weibull model with competing risks analysis, while other models without the competing events lead to significant predictors which may be due to over-estimation

Biomarkers in inflammatory bowel diseases: insight into diagnosis, prognosis and treatment

Inflammatory bowel disease [IBD] is a chronic disease of unknown etiology which mostly involves the intestine and requires a personalized approach for treatment. IBD represents a heterogeneous group of patients with inherently variable disease courses. Hence, the heterogeneity of patient populations may delay the diagnosis, clinical practice and initiation of appropriate treatment. Use of biomarkers for diagnosis and management of IBD is still necessary. Descriptions of the immunological pathway abnormalities in IBD improve assessment to identify the patient's disease status, and relative risk of progression to complicated disease behaviors, and this information may ultimately influence therapeutic decisions. In this study, we try to explain the role of biomarkers in early diagnosis, estimating prognosis, and target agents for correct managements of IBD's patients. This information might be important to provide insight into emerging panels of multiple IBD biomarkers and highlighting the essential role of personalizes panel for each patient

Clinical and histological presentation of helicobacter pylori and gluten related gastroenteropathy

Celiac disease has been reported to be associated with gastric abnormalities. The aim of this study was to assess the relationship between the prevalence of celiac disease and Helicobacter pylori infection in an Iranian population of 250 patients. Biopsies were taken from the gastric antrum and duodenum. Morphology and histology were evaluated using the updated Sydney system and modified Marsh criteria, respectively. To simplify the interpretation of gastric lesions we classified gastritis in macroscopic and microscopic stages. Serology for anti-tissue transglutaminase antibody was performed to determine the presence of celiac disease. Among 250 patients, 232 [93%] had histological evidence of Helicobacter pylori infection. Histological abnormalities [Marsh I to IIIc] were present in 24 [10%]. Of 24 patients, 20 [83%] with histological abnormalities were infected with Helicobacter pylori. Of 250 patients, 25 [10%] had a positive anti-tissue transglutaminase antibody. Of 25 anti-tissue transglutaminase antibody positive patients, 9 [3.6%] had microscopic and macroscopic enteritis [Marsh I to IIIc]. Clinical presentation of celiac disease was not distinguishable from cases infected with Helicobacter pylori. Histology, even in patients with positive serology, was non-specific and unhelpful. We found a high prevalence of Helicobacter pylori infection and chronic gastritis, but neither was associated with celiac disease, in agreement with studies in Western populations

Peginterferon alfa-2a [pegasys] and ribavirin in the treatment of chronic Hepatitis C

Background and aims: pegylation of interferon alfa-2a is a new modality for treatment of chronic hepatitis C. This clinical trial was conducted to evaluate the efficacy and safety of PEG IFN in combination with ribavirin in CHC patients

Methods: fifty-seven patients with HGV RNA in serum, persistently elevated ALT and chronic C hepatitis on liver biopsy enrolled to this study. The patients received PEG IFN 180 micg per week plus ribavirin 10- 15 mg/kg per day

Results: HCV RNA was negative in 37 patients [74%] after three months of beginning of study [EVR] and SVR occurred in 50% of all patients

Conclusion: peginterferon alfa-2a plus ribavirin is safe and effective in treatment of naive patients and relapses