• Asian Pacific Journal of Cancer Prevention
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• v.15 no.1
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• pp.441-447
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• 2014

Background: Multi-state models are appropriate for cancer studies such as gastrectomy which have high mortality statistics. These models can be used to better describe the natural disease process. But reaching that goal requires making assumptions like Markov and homogeneity with time. The present study aims to investigate these hypotheses. Materials and Methods: Data from 330 patients with gastric cancer undergoing surgery at Iran Cancer Institute from 1995 to 1999 were analyzed. To assess Markov assumption and time homogeneity in modeling transition rates among states of multi-state model, Cox-Snell residuals, Akaikie information criteria and Schoenfeld residuals were used, respectively. Results: The assessment of Markov assumption based on Cox-Snell residuals and Akaikie information criterion showed that Markov assumption was not held just for transition rate of relapse (state 1 ${\rightarrow}$ state 2) and for other transition rates - death hazard without relapse (state 1 ${\rightarrow}$ state 3) and death hazard with relapse (state 2 ${\rightarrow}$ state 3) - this assumption could also be made. Moreover, the assessment of time homogeneity assumption based on Schoenfeld residuals revealed that this assumption - regarding the general test and each of the variables in the model- was held just for relapse (state 1 ${\rightarrow}$ state 2) and death hazard with a relapse (state 2 ${\rightarrow}$ state 3). Conclusions: Most researchers take account of assumptions such as Markov and time homogeneity in modeling transition rates. These assumptions can make the multi-state model simpler but if these assumptions are not made, they will lead to incorrect inferences and improper fitting.

• Journal of Trauma and Injury
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• v.28 no.4
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• pp.248-255
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• 2015

Purpose: study of the mutual influence of the individual anatomical regions damage in patients associated with falls from heights. Methods: 561 medical reports of patients associated with falls from heights admitted to Republican Research Center of Emergency Medicine (RRCEM), in period of 2010-2013 yy, were analyzed retrospectively. Patient's age range was from 15 to 89. Treatment of these patients held in three stages: period of acute disorders of vital functions; relative stabilization period; stabilization of vital functions. The scope and content of medical diagnostic procedures performed on pre-hospital and intensive care stages. The severity of each injury was scored according to the AIS scale, the total severity of lesions was scored by points due to ISS. Digital material is treated by methods of mathematical statistics. Results: Falls from heights leads to associated injuries for 4 times more than isolated trauma, and increases according to height of fall and falling surface. Patients with TBI+chest trauma, are most serious contingent that has highest mortality and complications (36.8%). TBI+musculoskeletal system trauma are characterized by high blood loss, traumatic shock and fat embolism, forming a vicious circle. Conclusion: in patients associated with falls from heights clinical manifestations of injuries mutual aggravation syndrome will be seen. TBI leads to complication of chest trauma, delayed diagnostics of abdominal and chest trauma, aggravation of coma condition. Developing of high blood loss and fat embolism in musculoskeletal system trauma leads to shock and pulmonary embolism, which increases probability of death in the presence of abdominal or chest trauma, but abdominal trauma or chest trauma has no significant effect on the severity of the musculoskeletal system trauma.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.2
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• pp.787-792
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• 2015

Background: Non-Hodgkins lymphoma (NHL) is a heterogeneous group of malignancies, originating in the lymphatic organs, whose incidence is increasing in developed as well as developing countries. Epidemiological evidence suggests that aspirin may reduce the incidence and mortality of several cancers. The main objective of this study was to evaluate the potential relationship between using aspirin and development of NHL with a meta-analysis. Materials and Methods: A total of 7 studies were included. Outcome was calculated and reported as odds ratios (ORs). Heterogeneity was assessed with Cochrane Q and $I^2$ statistics. Dissemination bias was evaluated by funnel plot visualization and trim-and-fill analysis. Results: Our analysis showed OR of developing NHL overall of 1(95% CI: 0.87-1.16, p=0.9), and in females this was 0.81 (95%CI: 0.72-.92, p=0.001) and in males 1.01 (95%CI: 0.82-1.26, p=0.86). The odds ratio (OR) of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) was 0.85 (95%CI: 0.75-0.97, p=0.02), The ORs of follicular lymphoma (FL) and large B-cell lymphoma (DLBCL) in individuals exposed to aspirin were 1.12 (95%CI: 0.86-1.45, p=0.37) and 1.03 (95%CI: 0.9-1.19, p=0.6) respectively. Conclusions: In conclusion, individuals taking aspirin do not demonstrate any change in risk of Non-Hodgkins lymphoma.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.8
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• pp.3849-3854
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• 2016

Background: Breast cancer is the most prevalent malignancy in women worldwide; lack of awareness of symptoms and delay on diagnosis of breast cancer are the main causes of mortality among women. This study was conducted with the purpose of assessing the effect of educational consulting for breast self-examination (BSE) based on the health belief model (HBM) on the knowledge and performance of women over 40 years attending health care centers in Hamadan, Iran. Materials and Methods: In this quasi-experimental study, eligible women admitted to health centers in Hamadan city in 2015 were randomly assigned to intervention and control groups (n=75 in each group). The intervention group received 4 weekly sessions of breast cancer screening consulting based on the HBM. Control group received only routine care. Knowledge, HBM constructs, and BSE practice were compared between the groups before, immediately after and three months after the consultation. Results: Before the intervention, no significant differences were observed in knowledge, health belief and practice between two groups. However, after the intervention a significant difference was observed between two groups in mean scores of perceived benefits, perceived barriers, self-efficacy and the health motivations (p <0.05). Significant differences were also observed in terms of knowledge and BSE practice (p <0.01). Conclusions: The results indicate the importance of consultation on knowledge and beliefs to improve BSE performance and prevention of breast cancer in Iranian women.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.21
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• pp.9411-9416
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• 2014

Background: Cancer registration data is used to understand the nation's cancer burden, and to provide significant baseline data for cancer control efforts, as well as, research on cancer incidence, mortality, survival, and prevalence. A system that approves, assesses, and manages the qualification of specialists, responsible for performing cancer registration, has not been developed in Korea. This study presents ways to implement a certification system designed for the qualification of tumor registrars in Korea. Materials and Methods: Requirements for implementing a certified tumor registrar qualification system were determined by reviewing the system for establishing qualifications in Korea and the American qualification system via the National Cancer Registrars Association (NCRA). Moreover, a survey was conducted on Korean medical records administrators, who had taken the U.S. Certified Tumor Registrar (CTR) examination, in order to review their opinions regarding these requirements. Results: This study verified the feasibility of a qualification examination based on the opinions of CTR specialists by determining the following: items, and the associated ratings, of the qualifications necessary to register individuals as certified tumor registrars in a private qualification system; status of human resources required for the examination or training processes; plans regarding the organization needed for management, and operation of qualifications, examination standards, subject areas, examination methods, examination qualifications, or education and training programs. Conclusions: The implementation of a certified tumor registrar qualification system will lead to enhanced job competency for specialists and a qualitative improvement of cancer registration data. It will also reliably foster human resources that will lay the groundwork needed to establish scientific and reasonable national cancer management policies.

• Journal of Physiology & Pathology in Korean Medicine
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• v.23 no.5
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• pp.1167-1171
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• 2009

Ischemic stroke has been the leading cause deaths and the critical disability. In addition, the clinical problem of ischemic stroke have the poor prognosis and high mortality rate. The study aim was to identify the incidence variation of ischemic stroke by days of the week and its relationship with residences in males. We analyzed 607 males patients with ischemic stroke diagnosed by magnetic resonance image or computerized tomography. They were admitted to the oriental hospital of Kyunghee, Daejeon, Wonkwang university. We analyzed the onset of ischemic stroke using a ${\chi}2$ test. The results showed significant weekly variation of ischemic stroke onset and the differences of weekly variation according to residences. A deeper knowlegde of the underlying weekly variation could be provide more effective insights for preventive approach.

• Journal of Trauma and Injury
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• v.19 no.1
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• pp.35-40
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• 2006

Purpose: Injuries are the third leading cause of death in Korea. Isolated chest injury is not uncommon and shows high mortality and morbidity. Several scoring systems are used for triage and stratification for trauma patients, but no standard system is accepted. We aimed to analyze the accuracy of identification of isolated chest injury by using several scoring systems. Methods: We reviewed a total of 75 patients admitted with isolated chest injury between January 2005 and October 2005. Medical records were reviewed by using the Injury Severity Score (ISS), the Revised Trauma Score (RTS), and the Trauma and Injury Severity Score (TRISS). The scoring systems were compared by using statistics methods. Results: The overall predictive accuracy of the TRISS was 12.5%, 12.0% greater than those of the RTS and the ISS. By using the area under the receiver operating characteristic (AUROC) curve, the TRISS showed an excellent discriminative power (AUROC 0.931) compared to the ISS (AUROC 0.926) and the RTS (AUROC 0.872). Conclusion: Compared with the RTS and the ISS, the TRISS is an easily applied tool with excellent prognostic abilities for isolated chest trauma patients. However, the TRISS, the ISS, and the RTS showed high specificity and low sensitivity, so another scoring system is required for triage and stratification of isolated chest injury patients.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.5
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• pp.2225-2229
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• 2014

Background: Carcinoma of the tongue is the most common intra-oral malignancy in Western countries. Incidence and mortality rates have increased in recent years, and survival has not improved. This study aimed to determine etiologic factors for tongue cancer with age-sex matched case-control data. Materials and Methods: 47 patients with carcinoma of the tongue referred to our oral medicine clinic between years 2005-2006 were analyzed and compared with control group data. The medical records, including family history of cancer, dental trauma, and history of abuse of alcohol and tobacco products was recorded for all subjects. Chi square comparison tests and linear regression analysis were performed using the SPSS program for statistics. Results: Patient and randomly selected control groups each consisted of 30 male and 17 female subjects with mean ages 53.2 (${\pm}12.6$) and 52.6 (${\pm}11.5$) years respectively. Smoking and alcohol abuse proportions were significantly higher in the patient group (p=0.0001, p<0.0001 respectively). Chronic mechanical trauma was observed in 44.7% of the patients and 17.0% of the control group (p=0.004). Similarly, family history of cancer of any type (for the first degree relatives) was found to be more common in the patient group (p=0.009). On regression analysis, alcohol abuse, family history of cancer, smoking, chronic mechanical traumas appeared as significant etiologic factors (p=0.0001). Conclusions: We believe that field cancerization may become evident in oral and oropharyngeal mucosa with multiple steps of molecular changes starting from the first sign of dysplasia with chronic exposure to etiological factors. Chronic trauma cases need particular attention to search for very early signs of cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.14
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• pp.5611-5615
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• 2014

Context: Tobacco is the single largest cause of preventable death among adults globally, as it is in India. Despite this alarming situation, there is very minimal inclusion of tobacco in formal education systems, including the medical discipline, in India. Aims: The present study analyzed the extent of integration of tobacco control related content in Masters of Public Health (MPH) curricula of various institutes in India. Materials and Methods: This cross-sectional study was conducted during January 2011 to May 2011 in all colleges of the country offering a MPH course. The colleges were enlisted using various internet search engines (Google Scholar, Pubmed, Medline), other published literature and snowball technique. A 50 items semi-structured questionnaire was designed, posted and e-mailed (followed by hard copy) to the Person-In-Charge of the MPH program. Statistical Analysis: Descriptive statistics were used to profile the tobacco control content in respective institutions. All data entry and analysis was conducted using SPSS (version 16) for windows. Results: The duration of the MPH course was two years in all institutes and had accreditation with some affiliated body. Tobacco related diseases were covered under 'non communicable diseases' section by every institute. However, a mere 41.4% of institute's had faculty who had received specialized training in tobacco control. More coverage was given to health risks and effects of smoking as compared to cessation interventions (5 A's), symptoms of withdrawal and pharmacological treatments. Only 25% of institutes were in process of introducing tobacco courses into their curricula. Lack of expertise and administrative barriers were cited as perceived major problems in inclusion of tobacco control in MPH curricula. Conclusions: It can be concluded that tobacco control is not receiving adequate attention in public health curricula in India. There is a need for coordinated efforts in the area of tobacco control so as to reduce morbidity and mortality from tobacco induced diseases.

• The Korean Journal of Rehabilitation Nursing
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• v.1 no.1
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• pp.27-42
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• 1998

Osteoporosis is a major health problem in countries with aging populations, resulting in excess morbidity and mortality. This study was conducted to investigate knowledge and practices about osteoporosis in adults and to identify some factors which were influenced to that. 56-item questionnaire was developed including five domains(general characteristics, osteoporosis-related characteristics, knowledge of risk factors, knowledge of prevetion and practices). Subjects of this study were 368 adult ranged from 30 to 59. Data were collected during the period from June 15 to July 10, 1998 by means of a structured questionnare. The data were analyzed using descriptive statistics, t-test, ANOVA, Post Hoc, Pearson Correlation by SPSSWIN program. The results were as follows: 1. The mean knowledge score of risk factors for osteoporosis was 7.46(full score=15) and that of prevention of osteoporosis was 8,79(full score=12). 2. The mean practice score of osteoporosis was slightly higher than median value. 3. Women had better knowledge about osteoporosis risk factors and practiced more osteoporosis-prevention measures than men. Although the data demonstrated fairly good general knowledge about osteoporosis in the subjects, the older group(age 50-59), those at the highest risk of developing the disease, knew less about osteoporosis than the younger group(age 30-39) did. 4. The persons who had heard about osteoporosis and bone mineral density though mass media medical pratitioners and who didn't take any medicine for osteoporosis had better knowledge about osteoporosis and preventive measures. The practice score was significantly higer in the postmenopausal women and persons who were already diagnosed as osteoporosis patients, or who underwent bone mineral density measurements. 5. The relation between knowledge and practice was significant. In conclusion, there was a modest degree of general knowledge about osteoporosis and its consequences in adults. Further randomized studies are needed to evaluate the relationship between osteoporosis and risk factors. However, these results support the importance of education to prevent osteoporosis.