ABSTRACT
Diabetic retinopathy is a complication of diabetes, caused by high blood sugar levels damaging the eye. Globally, diabetic retinopathy affects more than 103.12 million people. Diabetic retinopathy is among the leading causes of vision loss at the global level, including in Ethiopia. Therefore, the study aimed to assess the time to develop diabetic retinopathy and identify factors associated with diabetic retinopathy among diabetes patients. METHODS: A retrospective study was conducted from September 1, 2021, to January 30, 2022. Data was collected using semi structured questionnaire. The Cox proportional hazard model were used to determine the median time to develop diabetic retinopathy and identify predictors of diabetic retinopathy. Data was analyzed using R software. RESULTS: A total of 373 diabetes patients were included in this study. The prevalence of diabetic retinopathy was 41.3%. The median time was 41 months, ranging from 39 to 73 months. Elder age (HR=3.17, 95%CI: 1.53, 6.58), being male (HR=2.34, 95%CI: 1.35,6.15), previous family history of diabetes (HR=4.16, 95%CI: 2.19, 8.37), longer duration of diabetes (HR=2.86, 95%CI: 1.41, 5.31) received only insulin therapy (HR=3.91, 95%CI: 1.36, 7.94), and high systolic blood pressure (HR=2.32; 95%CI: 1.12, 4.39) were statistically significant factors related to development of diabetes retinopathy. CONCLUSIONS: More than half of diabetic patinets in this study were developed retinopathy diabetes within a few months of being diagnosed. As a result, we advocate that the best way to preserve our vision from diabetic retinopathy is to maintain our diabetes under control, and the high-risk population receive early screening for diabetes
Subject(s)
Proportional Hazards Models , Retrospective Studies , Diabetic Retinopathy , Median Neuropathy , Diabetes Complications , HypertensionABSTRACT
@#[Abstract] Objective: To investigate the expression of zinc-α2-glycoprotein 1 (AZGP1) in osteosarcoma tissue and its relationship with clinicopathological features and prognosis of patients. Methods: A total of 62 pairs of cancer tissue and adjacent normal tissue samples from patients with osteosarcoma treated in the Department of Orthopedics, Second People's Hospital of Nanyang City were collected from August 2012 to August 2014. The expressions of AZGP1 in osteosarcoma tissues and adjacent tissues were detected by using immunohistochemical staining. All patients were followed up on the second day after the operation. The deadline was August 31, 2019. All patients were followed up for 5 years, with death as the end event. The number of end events within 5 years and overall survival (OS) time of the patients were recorded. Kaplan-Meier method was used for survival analysis, and Cox proportional hazard model was used for multivariate analysis of factors affecting patients’ survival. Results: The positive expression rate of AZGP1 in the osteosarcoma tissues was significantly higher than that in the adjacent tissues (77.42% vs 32.26%, P<0.01). There were significant differences in the positive expression rates of AZGP1 in patients with different Eneeking stages, soft tissue infiltration or not and lung metastasis conditions (all P<0.05). Kaplan-Meier survival analysis showed that the average OS time and 5-year OS rate of patients in the AZGP1 positive expression group were significantly lower than those in the negative expression group [(24.19±2.68) months vs (43.07±3.70) months, P<0.01; 18.75% vs 64.29%, P<0.01]. The lung metastasis and positive expression of AZGP1 were risk factors affecting the prognosis of patients with osteosarcoma (HR=3.407, 3.647, all P<0.05). Conclusion: AZGP1 is highly expressed in osteosarcoma tissues, and it is related to the malignant indicators and prognosis of patients. It may be a potential marker for evaluating the prognosis of osteosarcoma patients.
ABSTRACT
BACKGROUND: To investigate the impact of national health screening on all-cause mortality risk, aged over 45.METHODS: Data from Korean Longitudinal Study of Aging 2006–2014 were assessed. A total of 10,254 participants were included at baseline, and survival rate was assessed biennially. Using cox proportional hazards model, the effect of health screening on mortality risk was investigated. Covariates were gender, depression, education, marital status, co-habitants, house income, social engagement, economic satisfaction, private health insurance, residence location, chronic diseases, and health behaviors (smoking, alcohol intake, regular exercise).RESULTS: At baseline 2006, 54.4% of participants didn't undergo health screening. A hazard ratio (HR) for mortality risk of non-participants were 1.36 (95% confidence interval [CI], 1.21–1.53) after adjusting age and gender. Adding marital status and co-habitants to model 1 as covariates, HR was 1.34 (95% CI, 1.18–1.50) (model 2). Adding depression scores and socioeconomic vulnerabilities to model 2, HR was 1.29 s (95% CI, 1.14–1.45) (model 3). Adding chronic diseases to model 3, HR was 1.26 (95% CI, 1.14–1.48) (model 4). Finally, health behaviors have been added to model 4, HR was 1.24 (95% CI, 1.10–1.40) (model 5). In addition, the mortality risk increased as the cumulative number of missing health screenig increased accordingly.CONCLUSION: Health screening was an independent factor to reduce mortality risk. Therefore, active encouragement to participate the health screening should be implemented to reduce all-cause mortality.
Subject(s)
Aging , Chronic Disease , Depression , Education , Health Behavior , Insurance, Health , Korea , Longitudinal Studies , Marital Status , Mass Screening , Mortality , Proportional Hazards Models , Survival RateABSTRACT
Background and purpose: Osteosarcoma is a tumor originated from mesenchymal tissue, which often occurs in teenagers. It often occurs in long bones, rarely in maxillofacial regions. The present treatment is mainly in surgery followed by chemotherapy and radiation. It is an infrequent disease and hardly reported. In this study, we compared clinical differences in 32 maxillofacial osteosarcoma patients and identified the prognostic factors in the disease. Methods: The clinical data of 32 osteosarcoma patients were retrospectively reviewed. The data covered the period from Jan. 2010 to Jan. 2017, and included sex, age, tumor site. The mean follow-up time was 75 months (ranging from 7 to 90 months). The Kaplan-Meier method was used to measure the overall survival rate. A log-rank univariate analysis was used to determine the prognostic factors related to the survival rate. The Cox model multivariate analysis was used to identify independent prognostic factors. Results: The median survival time of 32 patients in the present study was (47.6±8.4) months (95％CI: 31.1-64.1). The 1-and 2-year cumulative survival rates were 84％ and 72％, respectively. The 5-year cumulative survival rate was 44％. Log-rank univariate analysis showed that the significant factors were size, surgical margin and frequency of adjuvant chemotherapy. Surgical margin and frequency of adjuvant chemotherapy were closely related to recurrence. Cox regression analysis revealed that surgical margin and frequency of adjuvant chemotherapy were the prognostic factors. Conclusions: Maxillofacial osteosarcoma has unique features and prognosis. Surgical margin and frequency of adjuvant chemotherapy were the prognostic factors in osteosarcoma.
ABSTRACT
Conditional logistic regression analysis and unconditional logistic regression analysis are commonly used in case control study,but Cox proportional hazard model is often used in survival data analysis.Most literature only refer to main effect model,however,generalized linear model differs from general linear model,and the interaction was composed of multiplicative interaction and additive interaction.The former is only statistical significant,but the latter has biological significance.In this paper,macros was written by using SAS 9.4 and the contrast ratio,attributable proportion due to interaction and synergy index were calculated while calculating the items of logistic and Cox regression interactions,and the confidence intervals of Wald,delta and profile likelihood were used to evaluate additive interaction for the reference in big data analysis in clinical epidemiology and in analysis of genetic multiplicative and additive interactions.
ABSTRACT
Conditional logistic regression analysis and unconditional logistic regression analysis are commonly used in case control study,but Cox proportional hazard model is often used in survival data analysis.Most literature only refer to main effect model,however,generalized linear model differs from general linear model,and the interaction was composed of multiplicative interaction and additive interaction.The former is only statistical significant,but the latter has biological significance.In this paper,macros was written by using SAS 9.4 and the contrast ratio,attributable proportion due to interaction and synergy index were calculated while calculating the items of logistic and Cox regression interactions,and the confidence intervals of Wald,delta and profile likelihood were used to evaluate additive interaction for the reference in big data analysis in clinical epidemiology and in analysis of genetic multiplicative and additive interactions.
ABSTRACT
Background & objectives: Persistent infections with high-risk (HR) human papillomaviruses such as HPV 16, 18, 31, 33 and 45 have been identified as the major aetiological factor for cervical cancer. The clinical outcome of the disease is often determined by viral factors such as viral load, physical status and oncogene expression. The aim of the present study was to evaluate the impact of such factors on clinical outcome in HPV16 positive, locally advanced cervical cancer cases. Methods: One hundred and thirty two pretreatment cervical tumour biopsies were selected from patients undergoing radiotherapy alone (n=63) or concomitant chemo-radiation (n=69). All the samples were positive for HPV 16. Quantitative real time-PCR was carried out to determine viral load and oncogene expression. Physical status of the virus was determined for all the samples by the ratio of E2copies/E7copies; while in 73 cases, the status was reanalyzed by more sensitive APOT (amplification of papillomavirus oncogene transcripts) assay. Univariate analysis of recurrence free survival was carried out using Kaplan-Meier method and for multivariate analysis the Cox proportional hazard model was used. Results: The median viral load was 19.4 (IQR, 1.9- 69.3), with viral integration observed in 86 per cent cases by combination of the two methodologies. Both univariate and multivariate analyses identified viral physical status as a good predictor of clinical outcome following radiation treatment, with episomal form being associated with increased recurrence free survival. Interpretation & conclusions: The present study results showed that viral physical status might act as an important prognostic factor in cervical cancer.
ABSTRACT
Objective To study the prognosis of gastroesophageal reflux disease ( GERD) in children, and explore the factors which impacts on the prognosis of GERD. Methods One hundred and thirteen children with GERD were enrolled on the basis of positive result of 24-hour pH-monitoring between January 2007 and November 2011. The number of patients who were followed up was 87,and the parents of children were contacted with the telephone. The prognosis was evaluated by comparing the degree of patients′symptom relief,and the cumulative symptom relief rate was calculated by Kaplan-meier product limit method. The univariate Log-rank test and the COX proportional hazardmodel multivariate analysis were applied to detect the factors impacting on the prognosis,including age,gender,the regularity of treatment,reflux index,and Boix-Ochoa standard score,with esophageal hiatal hernia or without,receiving surgical treatment or not,the diet and lifestyle improved or not,receiving anti-acid treatment or not,as well as with allergies his-tory or without. Results At last,76 out of 87 children had symptom relieved. Survival curve showed the cumulative symptom relief rate at different time points,the median cumulative symptom relief rate reached 6 months,the final relief rate was close to 90. 0%,and the continuous treatment time was 44 months. The study showed that 14. 9% (13/87 ca-ses) of children′s growth and development were affected and the life and learning in 16. 1% (14/87 cases) of children were impacted. Age (P=0. 012,Wald=6. 376) and the regularity of treatment (P=0. 000,Wald=13. 059) were the risk factors in the prognosis of GERD. Conclusions Age and the treatment regularity were the factors in the prognosis. The children aged more than 1-year old have poor prognosis compared with those less than 1-year old,and the irregular treatment is the risk factor in the prognosis.
ABSTRACT
Incubation period of HIV to AIDS is a vital tool that plays an important role in estimating the longevity or survivability of the HIV infected patients. However, death of AIDS patients when considered as end point becomes meaningful while finding the actual survivability of an individual. The present study is focused in analyzing the data on 343 AIDS patients who were recommended to undergo treatment in the ART centre followed up for a period of 6 years. The study included a cohesive treatment of censored observations based on lost to follow-up, deaths, recovered and alive cases till the end of study as well as uncensored observations. On the basis of diagnosed AIDS cases, the estimates of survivability under various conditions have been obtained. This paper also incorporates the trend of survivability for the reported AIDS patients with respect to age, sex, stages and mode of transmission across these 6 years. Kaplan Meier estimation method and Cox proportional hazard model were applied to determine the effect of various covariates that may be responsible for the death of the AIDS patients, survival pattern.
ABSTRACT
The growth of Protestantism in Brazil has been associated with changes in mortality and health-related outcomes. Recent research has suggested that affiliation with Protestant churches may positively influence their members' well being by: 1) providing moral directives, 2) creating formal or informal sanctions, and 3) promoting social networks and support. This article uses data from the 1996 and 2006 Brazilian Demographic Health Surveys (DHS) and Cox's proportional hazard models to examine the relationship between infant mortality and mothers' religious involvement. Unadjusted results show that differences in the hazard ratios of infant mortality by mothers' religious involvement are considerable and statistically significant. When one controls demographic and socioeconomic variables in the 1996 DHS, the baseline relationship disappears, supporting the hypothesis of selectivity. Results using the 2006 DHS are somewhat different and suggest that the association between religious involvement and infant mortality was stronger in Brazil in 2006 than in 1996. This research should encourage future studies on religious involvement and health-related outcomes in Brazil. This topic deserves further consideration from Brazilian demographers not simply because this country has undergone enormous changes in its religious landscape over recent decades, but also because religion can affect believers' lifestyles and behaviors, and this can indirectly influence their health and well-being.
O crescimento do Protestantismo no Brasil tem sido associado a mudanças em variáveis de mortalidade e saúde. Estudos recentes sugerem que a afiliação com igrejas Protestantes pode positivamente influenciar o bem-estar de seus membros a partir: 1) do ensinamento de diretrizes morais; 2) da criação de sanções formais e informais; e 3) da promoção de redes sociais e de suporte. Este trabalho utiliza dados da Pesquisa Nacional de Demografia e Saúde (PNDS) de 1996 e 2006 e modelos de risco proporcional de Cox para examinar a associação entre mortalidade infantil e envolvimento religioso da mãe. Resultados bivariados mostram que as diferenças nas razões de risco da mortalidade infantil por envolvimento religioso materno são consideráveis e estatisticamente significativas. Ao controlar por variáveis demográficas e socioeconômicas na amostra de 1996, esta associação inicial desaparece, o que corrobora a hipótese de seletividade. Resultados usando a PNDS de 2006 mostram, no entanto, que os diferenciais na mortalidade infantil por participação em cultos religiosos ou missas ainda são observados no modelo multivariado. Tal constatação sugere que a associação entre envolvimento religioso materno e mortalidade infantil no Brasil é mais forte em 2006 do que era em 1996. Este trabalho deve encorajar novos estudos sobre a relação entre religião e variáveis de saúde no Brasil. Este tema merece maior consideração dos demógrafos no Brasil não somente porque este país tem passado por profundas mudanças religiosas, mas também porque a religião pode afetar o comportamento e o estilo de vida de seus fiéis, o que, por sua vez, pode influenciar o bem-estar e a saúde destes indivíduos.
El crecimiento del protestantismo en Brasil ha sido asociado a cambios en variables de mortalidad y salud. Estudios recientes sugieren que la afiliación a iglesias protestantes puede influenciar positivamente en el bienestar de sus miembros por: 1) la enseñanza de directrices morales; 2) la creación de sanciones formales e informales; y 3) la promoción de redes sociales y de apoyo. Este trabajo utiliza datos de la Investigación Nacional de Demografía y Salud (PNDS) de 1996 y 2006 y modelos de riesgo proporcional de Cox para examinar la asociación entre mortalidad infantil e implicación religiosa de la madre. Resultados bivariados muestran que las diferencias en las razones de riesgo de la mortalidad infantil por implicación religiosa materna son considerables y estadísticamente significativas. Al controlar por variables demográficas y socioeconómicas en la muestra de 1996, esta asociación inicial desaparece, lo que corrobora la hipótesis de selectividad. Resultados usando la PNDS de 2006 muestran, no obstante, que los diferenciales en la mortalidad infantil por participación en cultos religiosos o misas se observan incluso en el modelo multivariado. Tal constatación sugiere que la asociación entre implicación religiosa materna y mortalidad infantil en Brasil es más fuerte en 2006 de lo que era en 1996. Este trabajo debe animar nuevos estudios sobre la relación entre religión y variables de salud en Brasil. Este tema merece mayor consideración de los demógrafos en Brasil, no solamente porque este país ha pasado por profundos cambios religiosos, sino también porque la religión puede afectar el comportamiento y el estilo de vida de sus fieles, lo que a su vez, puede influenciar en el bienestar y la salud de estos individuos.
Subject(s)
Health Behavior , Demography , Health Education , Infant Mortality , Protestantism , Religion and Medicine , Social Support , BrazilABSTRACT
Objective To investigate the prognostic factors affecting the postoperative survival of patients with invasive bladder cancer,and to predict the survival time of the patients.Methods We retro- spectively analyzed the clinical and follow-up data of 178 patients with invasive bladder cancer treated by radical cystectomy and urinary diversion from 1991 to 2004.A multivariate analysis was performed in these patients by the Cox proportional hazard model.A prognostic index(PI)based on the Cox regression was con- structed.According to the individualized PI,the patients were classified into different hazard groups and the expected survival curve of each patient was calculated.Results Cox regression analysis showed that the factors which influenced the postoperative survival included tumor stage(RR=1.982,P=0.000),grade (RR=1.978,P =0.042),lymph node metastasis(RR=2.142,P=0.048),Tis(RR=6.177,P= 0.000),tumor shape(RR=0.416,P=0.003),number of tumors( RR=1.820,P=0.035),pathological type(RR=2.228,P=0.032),patient age(RR=0.672,P=0.025)and neoadjuvant chemotherapy (RR=0.257,P=0.016).Based on the percentile of PI,patients were classified into 3 prognostic groups; the median survival time of 3 groups were 42.5,22.5 and 7.0 months,respectively.There were significant differences between each 2 among the 3 groups(P＜0.01).Conclusions Neoadjuvant chemotherapy, tumor stage,grade,lymph node metastasis,Tis,shape and number of tumors,pathological type,patient age were important prognostic factors.PI value can be used to predict the prognosis of patients with invasive blad- der cancer.