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1. Mining hypertension predictors using decision tree: Baseline data of Kharameh cohort study

Author

abbas Rezaianzadeh, Samane Nematolahi, maryam jalali, Shayan Rezaeianzadeh, Masoumeh Ghoddusi Johari, and Seyed Vahid Hosseini

Subjects
Decision tree, Hypertension, Kharameh cohort, Biology (General), QH301-705.5, Probabilities. Mathematical statistics, QA273-280
Abstract

Background: Hypertension is a serious chronic disease and an important risk factor for many health problems. this study aimed to investigate the factors associated with hypertension using a decision-tree algorithm. Methods: this cross-sectional study was conducted in Kharameh city between 2014-2017 through census. The study included 2510 hypertensive and 7840 non-hypertensive individuals. 70% of the cases were randomly allocated to the training dataset for establishing the decision tree, while the remaining 30% were used as the testing dataset for performance evaluation of the decision-tree. Two models were assessed. In the first model (model I), 15 variables including age, gender, body mass index, years of education, Occupation status, marital status, family history of hypertension, physical activity, total energy, number of meals, salt, oil type, drug use, alcohol use and smoke entered in to the model. in the second model (model II) 16 variables including age, gender, BMI and Blood factors as HCT, MCHC, PLT, FBS, BUN, CERAT, TG, CHOL, ALP, HDL, GGT, LDL and SG were considered. a receiver operating characteristic (ROC) curve was applied to assess the validation of the models. Results: The accuracy, sensitivity, specificity, and area under the ROC curve (AUC) are important metrics to evaluate the performance of a decision tree model. For model I, the accuracy, sensitivity, specificity and area under the ROC curve (AUC) value were 79.24%, 82.41%, 78.24% and 0.80, respectively. for model II, the corresponding values were 79.50%, 81.03%, 79.02% and 0.80, respectively. Conclusion: We have suggested a decision tree model to identify the risk factors associated with hypertension. This model can be useful for early screening and improving preventive and curative health services in health promotion.

Published
2024
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2. Survivability Prediction of Breast Cancer Patients Using Three Data Mining Methods: A Comparative Study

Author

Maryam Jalali, Navid Reza Ghasemi, Samane Nematolahi, and Najaf Zare

Subjects
breast neoplasm, data mining techniques, prognostic factors, Medicine
Abstract

Background and aims: Breast cancer (BC) is the leading cause of mortality among women. Early diagnosis is crucial for effective treatment. This study applied suitable data mining methods that provide rules and present influential prognostic factors on the survival time of BC patients. Methods: The dataset consisted of 1574 women diagnosed between January 2002 and December 2012 at the Cancer Registry Center of Nemazi hospital in Fars Province, Iran. Patients were classified based on prognostic factors using three popular data mining methods, including decision tree (J48), Naïve Bayes (NB), and nominal logistic regression (NLR). The Weka software was considered to compare these methods using sensitivity, specificity, and accuracy metrics. The outcome of the study was the median survival time, which was categorized into three classes. Results: In total, 212 women (13.5%) died of BC, whose mean age was 49.74 years old. Overall survival rates at 2, 3, 5, and 10 years were 0.98, 0.94, 0.87, and 0.76, respectively. The mean and median survival times were 4.81 and 4.27 years. Sensitivity, specificity, and accuracy for J48 and NB were 0.480, 0.570, and 0.572, as well as 0.483, 0.610, and 0.584, respectively. In addition, the corresponding values were 0.488, 0.584, and 0.579 for NLR, respectively. Further, J48 showed that the Nottingham Prognostic Index (NPI) was the most influential prognostic factor. Conclusion: This paper sought to improve the accuracy of BC classification using data mining methods. Comparing multiple prediction models gave us an insight into the relative prediction abilities of different data mining methods. The results suggested NB as the best classifier due to its higher accuracy and specificity. Finally, J48 identified the NPI as the most effective prognostic factor.

Published
2024
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3. Mobile Cellular Data and Wi-Fi Use Are Not Associated with Adverse Health Effects

Author

Marziyei Rabie, Seyed Jalil Masoumi, Seyed Mohammad Javad Mortazavi, Samane Nematolahi, and Masoud Haghani

Subjects
smartphone, internet, cellular data, wi-fi, health, Medical physics. Medical radiology. Nuclear medicine, R895-920
Abstract

Background: Smartphone users frequently connect to the Internet via mobile data or Wi-Fi. Over the past two decades, the worldwide percentage of people who connect to the Internet using their mobile phones has increased drastically.Objective: This study aimed to evaluate the potential link between mobile cellular data/ and Wi-Fi use and adverse health effects.Material and Methods: This cross-sectional study was conducted on 2,796 employees (52% female and 48% male) of Shiraz University of Medical Sciences (SUMS), Shiraz, Iran. The sociodemographic data (e.g., gender, age, nationality, and education level) were collected for all the participants. They were also requested to provide information about their smartphone use including the characteristics of the connection to the Internet using their smartphones (mobile data and Wi-Fi). In addition, the participants’ history of diabetes, hypertension, cardiac ischemia, myocardial infarction, renal failure, fatty liver, hepatitis, chronic lung disease, thyroid disease, kidney stone, gall bladder stone, rheumatoid disease, epilepsy, and chronic headache was recorded through face-to-face interviews.Results: 94% of people participating in this study reported using mobile/Wi-Fi internet. The mean (±SD) Internet usage per day was 117.85±122.70 minutes including 76±98 minutes of mobile data and 42±81 minutes of Wi-Fi use. Conclusion: Our findings showed no link between mobile phone Internet usage and the risk of the above-mentioned health problems. As in 2021, the global average daily time spent on the Internet using mobile phones was 155 minutes, the participants’ lower use time could explain the failure to show any detrimental effects. Considering the study limitations, further large-scale studies are warranted.

Published
2023
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4. Bloodstream infections in adult patients with malignancy, epidemiology, microbiology, and risk factors associated with mortality and multi-drug resistance

Author

Ali Amanati, Sarvin Sajedianfard, Somayeh Khajeh, Shabnam Ghasempour, Salma Mehrangiz, Samane Nematolahi, and Zahra Shahhosein

Subjects
Bloodstream infection, Carbapenem-resistant isolates, Extended-Spectrum Beta-lactamase producing pathogens, Multidrug-resistant gram-negative infection, Mortality, Cancer, Infectious and parasitic diseases, RC109-216
Abstract

Abstract Background This study aimed to investigate the epidemiology, microbiology, and risk factors associated with mortality and multi-drug resistance bacterial bloodstream infections (BSIs) among adult cancer patients in Shiraz, Iran. We also report a four-year trend of antimicrobial resistance patterns of BSIs. Methods We conducted a retrospective study at a referral oncology hospital from July 2015 to August 2019, which included all adults with confirmed BSI. Results 2393 blood cultures tested during the four-year study period; 414 positive cultures were included. The mean age of our patients was 47.57 ± 17.46 years old. Central Line-Associated BSI (CLABSI) was more common in solid tumors than patients with hematological malignancies. Gram-negative (GN) bacteria were more detected (63.3%, 262) than gram-positive bacteria (36.7%, 152). Escherichia coli was the most common gram-negative organism (123/262, 47%), followed by Pseudomonas spp. (82/262, 31%) and Klebsiella pneumoniae (38/262, 14.5%). Coagulase-negative staphylococci (CoNS) was the most frequently isolated pathogen among gram-positive bacteria (83/152, 54.6%). Acinetobacter spp., Pseudomonas spp., E. coli, and K. pneumoniae were the most common Extended-Spectrum Beta-Lactamase (ESBL) producers (100, 96.2, 66.7%, and 60.7, respectively). Acinetobacter spp., Pseudomonas spp., Enterobacter spp., E. coli, and K. pneumoniae were the most common carbapenem-resistant (CR) isolates (77.8, 70.7, 33.3, 24.4, and 13.2%, respectively). Out of 257 Enterobacterales and non-fermenter gram-negative BSIs, 39.3% (101/257) were carbapenem-resistant. Although the incidence of multi-drug resistance (MDR) gram-negative BSI increased annually during 2015–2018, the mortality rate of gram-negative BSI remains unchanged at about 20% (p-value = 0.55); however, the mortality rate was significantly greater (35.4%) in those with resistant gram-positive BSI (p-value = 0.001). The overall mortality rate was 21.5%. Early (7-day mortality) and late mortality rate (30-day mortality) were 10 and 3.4%, respectively. Conclusions The emergence of MDR gram-negative BSI is a significant healthcare problem in oncology centers. The high proportion of the most frequently isolated pathogens were CR and ESBL-producing Enterobacterales and Pseudomonas spp. We have few effective choices against MDRGN BSI, especially in high-risk cancer patients, which necessitate newer treatment options.

Published
2021
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5. Impact of antifungal stewardship interventions on the susceptibility of colonized Candida species in pediatric patients with malignancy

Author

Ali Amanati, Parisa Badiee, Hadis Jafarian, Fatemeh Ghasemi, Samane Nematolahi, Sezaneh Haghpanah, and Seyedeh Sedigheh Hamzavi

Subjects
Medicine, Science
Abstract

Abstract There is a worldwide concern regarding the antimicrobial resistance and the inappropriate use of antifungal agents, which had led to an ever-increasing antifungal resistance. This study aimed to identify the antifungal susceptibility of colonized Candida species isolated from pediatric patients with cancer and evaluate the clinical impact of antifungal stewardship (AFS) interventions on the antifungal susceptibility of colonized Candida species. Candida species colonization was evaluated among hospitalized children with cancer in a tertiary teaching hospital, Shiraz 2017–2018. Samples were collected from the mouth, nose, urine, and stool of the patients admitted to our center and cultured on sabouraud dextrose agar. The isolated yeasts identified by polymerase chain reaction–restriction fragment length polymorphisms (PCR–RFLP). DNA Extracted and PCR amplification was performed using the ITS1 and ITS4 primer pairs and Msp I enzyme. The broth microdilution method was used to determine the minimum inhibitory concentrations (MICs) for amphotericin B, caspofungin, and azoles. The prevalence of Candida albicans in the present study was significantly higher than other Candida species. Candida albicans species were completely susceptible to the azoles. The susceptibility rate of C. albicans to amphotericin B and caspofungin was 93.1% and 97.1%, respectively. The fluconazole MIC values of Candida albicans decreased significantly during the post-AFS period (P

Published
2021
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6. Alteration in hematological and biochemical parameters following the long-term consumption of Zataria multiflora essential oil in patients infected with liver hydatid disease

Author

Arash Jafari, Mohammad Moazeni, Seyed Vahid Hosseini, Hajar Khazraei, Samane Nematolahi, and Seyed Mohammad Kazem Tadayon

Subjects
zataria multiflora, essential oil, hematological parameters, biochemical parameters, clinical study, Medicine
Abstract

Abstract Background: Zataria multiflora Boiss is a well-known medicinal plant and its’ essential oil (EO) is traditionally used for treatment of respiratory and digestive disorders and/or bacterial, viral, fungal, and parasitic infections. Objective: This study was undertaken to evaluate the effect of long-term consumption of Z. multiflora EO on hematological and biochemical parameters in patients infected with liver hydatid disease. Materials and Methods: Fifteen patients were administered orally with Z. multiflora EO (60 mg daily) for six months. Hematological and biochemical analysis were performed on the blood samples of patients before the start of treatment and after completion of the treatment course. In hematological analysis, WBC, RBC, Hb, hematocrit, MCV, MCH, MCHC and platelets were measured. In biochemical analysis, FBS, BUN, creatinine, cholesterol, triglycerides, HDL, LDL, Na, K, Cl, AST, ALT, and ALK were assessed. Results: No apparent changes were observed in the values of hematological parameters of the patients after treatment. No significant changes also occurred in the values of FBS, BUN, creatinine, cholesterol, triglycerides, HDL, LDL, Na, and K. The mean values of AST, ALT and ALK enzymes decreased significantly after treatment (P ˂ 0.05). No adverse clinical event was noticed in the patients during the course of study. Conclusions: Long-term consumption of Z. multiflora EO induced no adverse effect on the hematological and biochemical parameters of patients infected with liver hydatid disease. Since Z. multiflora EO reduced the level of liver transaminases (AST, ALT and ALK), this herbal product may be considered as a hepatoprotective agent in human beings.

Published
2020
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7. A comparison of breast cancer survival among young, middle-aged, and elderly patients in southern Iran using Cox and empirical Bayesian additive hazard models

Author

Samane Nematolahi and Seyyed Mohammad Taghi Ayatollahi

Subjects
Breast neoplasm, Prognosis, Additive hazards model, Bayesian inference, Cox regression analysis, Iran, Medicine
Abstract

OBJECTIVES A survival analysis of breast cancer patients in southern Iran according to age has yet to be conducted. This study aimed to quantify the factors contributing to a poor prognosis, using Cox and empirical Bayesian additive hazard (EBAH) models, among young (20-39 years), middle-aged (40-64 years), and elderly (≥ 65 years) women. METHODS Data from 1,574 breast cancer patients diagnosed from 2002 to 2012 in the cancer registry of Fars Province (southern Iran) were stratified into 3 age groups. The Kaplan-Meier method was used to estimate the overall survival rates. Cox and EBAH models were applied to each age category, and the Akaike information criterion was used to assess the goodness-of-fit of the 2 hazard models. RESULTS As of December 2012, 212 women (13.5%) in our study population had died, of whom 43 were young (15.3%), 134 middle-aged (11.8%), and 35 elderly (22.3%). The 5-year survival probability by age category was 0.83 (standard error [SE], 0.03), 0.88 (SE, 0.01), and 0.75 (SE, 0.04), respectively. CONCLUSIONS The Nottingham Prognostic Index was the most effective prognostic factor. The model based on Bayesian methodology performed better with various sample sizes than the Cox model, which is the most widely used method of survival analysis.

Published
2017
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10. Impact of antifungal stewardship interventions on the susceptibility of colonized Candida species in pediatric patients with malignancy

Author

Samane Nematolahi, Fatemeh Ghasemi, Parisa Badiee, Ali Amanati, Sezaneh Haghpanah, Hadis Jafarian, and Seyedeh Sedigheh Hamzavi

Subjects
Male, 0301 basic medicine, Antifungal Agents, food.ingredient, Adolescent, Science, 030106 microbiology, Colony Count, Microbial, Microbial Sensitivity Tests, Microbiology, Article, Antimicrobial Stewardship, 03 medical and health sciences, chemistry.chemical_compound, food, Antibiotic resistance, Caspofungin, Drug Resistance, Fungal, Amphotericin B, Neoplasms, medicine, Humans, Agar, Child, Candida albicans, Fluconazole, Candida, Cancer, Multidisciplinary, biology, business.industry, Broth microdilution, Triazoles, biology.organism_classification, Corpus albicans, 030104 developmental biology, chemistry, Child, Preschool, Medicine, Female, Disease Susceptibility, business, medicine.drug
Abstract

There is a worldwide concern regarding the antimicrobial resistance and the inappropriate use of antifungal agents, which had led to an ever-increasing antifungal resistance. This study aimed to identify the antifungal susceptibility of colonized Candida species isolated from pediatric patients with cancer and evaluate the clinical impact of antifungal stewardship (AFS) interventions on the antifungal susceptibility of colonized Candida species. Candida species colonization was evaluated among hospitalized children with cancer in a tertiary teaching hospital, Shiraz 2017–2018. Samples were collected from the mouth, nose, urine, and stool of the patients admitted to our center and cultured on sabouraud dextrose agar. The isolated yeasts identified by polymerase chain reaction–restriction fragment length polymorphisms (PCR–RFLP). DNA Extracted and PCR amplification was performed using the ITS1 and ITS4 primer pairs and Msp I enzyme. The broth microdilution method was used to determine the minimum inhibitory concentrations (MICs) for amphotericin B, caspofungin, and azoles. The prevalence of Candida albicans in the present study was significantly higher than other Candida species. Candida albicans species were completely susceptible to the azoles. The susceptibility rate of C. albicans to amphotericin B and caspofungin was 93.1% and 97.1%, respectively. The fluconazole MIC values of Candida albicans decreased significantly during the post-AFS period (P C. albicans were azole-resistant before AFS implementation, while only 1.5% (2/102) of the isolates were resistant after implementation of the AFS program (P C. albicans fluconazole and caspofungin resistant rate also decreased significantly (P p Candida species after the implementation of the AFS program. C. albicans and C. glabrata exhibited a significant increase in susceptibility after the execution of the AFS program.

Published
2021

11. Improved Kaplan-Meier Estimator in Survival Analysis Based on Partially Rank-Ordered Set Samples

Author

Ali Amanati, Sahar Nazari, Samane Nematolahi, Seyyed Mohammad Taghi Ayatollahi, and Zahra Shayan

Subjects
Independent and identically distributed random variables, Databases, Factual, Article Subject, Computer science, Computer applications to medicine. Medical informatics, R858-859.7, Asymptotic distribution, Kaplan-Meier Estimate, 01 natural sciences, Sampling Studies, Statistics, Nonparametric, General Biochemistry, Genetics and Molecular Biology, 010104 statistics & probability, 0502 economics and business, Sampling design, Statistics, Humans, Computer Simulation, 0101 mathematics, Child, Kaplan–Meier estimator, Probability, 050205 econometrics, Models, Statistical, General Immunology and Microbiology, Applied Mathematics, 05 social sciences, Nonparametric statistics, Computational Biology, Estimator, Mathematical Concepts, General Medicine, Simple random sample, Survival Analysis, Ranking, Hematologic Neoplasms, Modeling and Simulation, Algorithms, Research Article
Abstract

This study presents a novel methodology to investigate the nonparametric estimation of a survival probability under random censoring time using the ranked observations from a Partially Rank-Ordered Set (PROS) sampling design and employs it in a hematological disorder study. The PROS sampling design has numerous applications in medicine, social sciences and ecology where the exact measurement of the sampling units is costly; however, sampling units can be ordered by using judgment ranking or available concomitant information. The general estimation methods are not directly applicable to the case where samples are from rank-based sampling designs, because the sampling units do not meet the identically distributed assumption. We derive asymptotic distribution of a Kaplan-Meier (KM) estimator under PROS sampling design. Finally, we compare the performance of the suggested estimators via several simulation studies and apply the proposed methods to a real data set. The results show that the proposed estimator under rank-based sampling designs outperforms its counterpart in a simple random sample (SRS).

Published
2020
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12. Bloodstream infections in adult patients with malignancy, epidemiology, microbiology, and risk factors associated with mortality and multi-drug resistance

Author

Samane Nematolahi, Shabnam Ghasempour, Ali Amanati, Salma Mehrangiz, Somayeh Khajeh, Sarvin Sajedianfard, and Zahra Shahhosein

Subjects
Male, 0301 basic medicine, Carbapenem-resistant isolates, medicine.medical_specialty, 030106 microbiology, Bacteremia, Infectious and parasitic diseases, RC109-216, Drug resistance, Bloodstream infection, Iran, Microbiology, 03 medical and health sciences, 0302 clinical medicine, Antibiotic resistance, Medical microbiology, Risk Factors, Neoplasms, Sepsis, Drug Resistance, Bacterial, Epidemiology, medicine, Humans, 030212 general & internal medicine, Mortality, Cancer, Retrospective Studies, Bacteria, biology, business.industry, Incidence (epidemiology), Mortality rate, Enterobacter, Middle Aged, Acinetobacter, biology.organism_classification, Combined Modality Therapy, Drug Resistance, Multiple, Klebsiella pneumoniae, Infectious Diseases, Multidrug-resistant gram-negative infection, Female, Extended-Spectrum Beta-lactamase producing pathogens, business, Research Article
Abstract

Background This study aimed to investigate the epidemiology, microbiology, and risk factors associated with mortality and multi-drug resistance bacterial bloodstream infections (BSIs) among adult cancer patients in Shiraz, Iran. We also report a four-year trend of antimicrobial resistance patterns of BSIs. Methods We conducted a retrospective study at a referral oncology hospital from July 2015 to August 2019, which included all adults with confirmed BSI. Results 2393 blood cultures tested during the four-year study period; 414 positive cultures were included. The mean age of our patients was 47.57 ± 17.46 years old. Central Line-Associated BSI (CLABSI) was more common in solid tumors than patients with hematological malignancies. Gram-negative (GN) bacteria were more detected (63.3%, 262) than gram-positive bacteria (36.7%, 152). Escherichia coli was the most common gram-negative organism (123/262, 47%), followed by Pseudomonas spp. (82/262, 31%) and Klebsiella pneumoniae (38/262, 14.5%). Coagulase-negative staphylococci (CoNS) was the most frequently isolated pathogen among gram-positive bacteria (83/152, 54.6%). Acinetobacter spp., Pseudomonas spp., E. coli, and K. pneumoniae were the most common Extended-Spectrum Beta-Lactamase (ESBL) producers (100, 96.2, 66.7%, and 60.7, respectively). Acinetobacter spp., Pseudomonas spp., Enterobacter spp., E. coli, and K. pneumoniae were the most common carbapenem-resistant (CR) isolates (77.8, 70.7, 33.3, 24.4, and 13.2%, respectively). Out of 257 Enterobacterales and non-fermenter gram-negative BSIs, 39.3% (101/257) were carbapenem-resistant. Although the incidence of multi-drug resistance (MDR) gram-negative BSI increased annually during 2015–2018, the mortality rate of gram-negative BSI remains unchanged at about 20% (p-value = 0.55); however, the mortality rate was significantly greater (35.4%) in those with resistant gram-positive BSI (p-value = 0.001). The overall mortality rate was 21.5%. Early (7-day mortality) and late mortality rate (30-day mortality) were 10 and 3.4%, respectively. Conclusions The emergence of MDR gram-negative BSI is a significant healthcare problem in oncology centers. The high proportion of the most frequently isolated pathogens were CR and ESBL-producing Enterobacterales and Pseudomonas spp. We have few effective choices against MDRGN BSI, especially in high-risk cancer patients, which necessitate newer treatment options.

Published
2021
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13. Relationship between mental workload and salivary cortisol levels: A field study

Author

Ali Akbar Saboor-Yaraghi, Reza Kazemi, Samane Nematolahi, Mojgan Zoaktafi, Alireza Choobineh, and Seyed Abolfazl Zakerian

Subjects
Psychomotor learning, NASA-TLX, Hydrocortisone, 05 social sciences, Rehabilitation, Public Health, Environmental and Occupational Health, Workload, Cognition, Pilot Projects, Iran, 03 medical and health sciences, 0302 clinical medicine, Task Performance and Analysis, Task analysis, Humans, 0501 psychology and cognitive sciences, Psychology, Association (psychology), Cortisol level, 050107 human factors, 030217 neurology & neurosurgery, Salivary cortisol, Clinical psychology
Abstract

BACKGROUND: Mental workload (MW) assessment is a key point in research and development of human-machine interfaces in the workplace. OBJECTIVE: This study aimed to examine the relationship between mental workload and the amount of salivary cortisol amongst technicians of an Iranian combined cycle power plant. METHODS: A total of 18 technicians participated in this pilot study. First, task analysis was carried out to determine operation steps that forced us to separate them in to two groups. Next, the Visual, Auditory, Cognitive, and Psychomotor (VACP) technique and NASA Task Load Index (NASA-TLX) questionnaire were used to examine their mental workload. Then, the operator’s salivary samples were collected at four specific times of both off and working days. Finally, the relationship between mental workload and salivary cortisol was examined with the analysis of Pearson correlation. RESULTS: The results of mental workload assessment with subjective methods showed a high level of mental workload amongst all technicians. No significant association was observed between the NASA-TLX questionnaire and VACP technique with concentration of salivary cortisol (p = 0.081). CONCLUSION: Based on the results, it can be concluded that salivary cortisol might not be an appropriate physiological method to assess mental workload, since cortisol levels are highly dependent on individuals’ circadian rhythm.

Published
2020

14. Impact of antifungal stewardship interventions on the susceptibility of Candida species in pediatric patients with malignancy

Author

Ali Amanati, Parisa Badiee, Hadis Jafarian, Fatemeh Ghasemi, Samane Nematolahi, Sezaneh Haghpanah, and Seyedeh Sedigheh Hamzavi

Abstract

Background There is a worldwide concern with respect to the antimicrobial resistance and the inappropriate use of antifungal agents, which had led to an ever-increasing antifungal resistance. This study aimed to identify the antifungal susceptibility of Candida species isolated from the pediatric patients with cancer and also to evaluate the clinical impact of antifungal stewardship (AFS) ‎interventions on antifungal susceptibility of Candida species. Methods In this study, Candida species colonization were evaluated among hospitalized children with cancer in a tertiary teaching hospital, Shiraz 2017-18. The broth microdilution method was used to determine the minimum inhibitory concentrations (MICs) for polyenes (amphotericin B), echinocandins (caspofungin), and azoles (voriconazole, fluconazole, posaconazole, and itraconazole). Antifungal susceptibility of Candida species was compared with our previous study results to determine the clinical impact of AFS interventions on the antifungal susceptibility. Results The prevalence of Candida albicans in the present study was significantly higher than other Candida species. Candida albicans species were completely susceptible to the azoles. The sensitivity rate of C. albicans to amphotericin B and caspofungin was 93.1% and 97.1%, respectively. The results confirm the positive effect of optimized antifungal usage and bedside intervention on the susceptibility of Candida species after the implementation of the AFS program. C. albicans and C. glabrata exhibited significant increase in sensitivity after the execution of AFS program. Conclusions Improving the antifungal agent usage can improve antifungal ‎susceptibility and reduce resistance. The AFS is recommended to be addressed, applied, and regularly assessed in centers.

Published
2020
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16. Prognostic Factors of Breast Cancer Survival in the Islamic Republic of Iran: an Additive Empirical Bayesian Approach

Author

Abbas Rezaianzadeh, Sedighe Tahmasebi, Najaf Zare, Majid Akrami, and Samane Nematolahi

Subjects
Oncology, Adult, medicine.medical_specialty, Breast Neoplasms, Iran, Bayes' theorem, Breast cancer, Internal medicine, medicine, Humans, Neoplasm Invasiveness, Stage (cooking), Survival analysis, Aged, Neoplasm Staging, business.industry, Public health, Age Factors, Cancer, Bayes Theorem, General Medicine, Middle Aged, medicine.disease, Prognosis, Survival Analysis, Cancer registry, Tumor Burden, Socioeconomic Factors, Lymphatic Metastasis, Nottingham Prognostic Index, Female, business, Receptors, Progesterone
Abstract

Breast cancer is a public health challenge in the Islamic Republic of Iran. Relatively few studies have dealt with large dataset and advanced statistical methods. Therefore, we aimed to investigate the role of prognostic factors on breast cancer survival using Additive Empirical Bayesian model with large data set. Breast cancer data set included 1574 women diagnosed with breast cancer from 2002 to 2012 that registered from Cancer Registry in Fars Province, Islamic Republic of Iran. Overall survival rates at 2, 3, 5 and 10 years were 0.98, 0.94, 0.87 and 0.76, respectively. Five years survival at stages 1, 2 and 3 were 0.94, 0.92 and 0.74, respectively. The younger patients with characteristics such as zero involved nodes, negative progesterone receptor, free skin and good prognostic level had a higher survival chance than others. The 5-year survival probability by stage in Fars Province was nearly the same as that reported by the American Cancer Society. The Nottingham prognostic index (NPI) related to nodal status, tumour size and nuclear grade was the main indicator of breast cancer mortality.العوامل التنبؤية للنجاة من سرطان الثدي في جنوب جمهورية إيران الإسامية: منهج باييز التجريبي الجمعي لحساب معدّل المخاطر.سمانة نعمت الله، عباس رضائيان زاده، نجف زارع، مجيد أكرمي، صديقه طهماسبي.يشكل سرطان الثدي تحديا للصحة العامة في جمهورية إيران الإسامية. وقد تصدى عدد قليل نسبياً من الدراسات لقواعد البيانات الكرى والطرق الإحصائية المتقدِّمة. ومن ثمَّ، هدفنا من هذه الدراسة إلى التحقيق في دور العوامل التنبؤية المتعلقة بالنجاة من سرطان الثدي باستخدام نموذج باييز التجريبي الجمعي القائم عى قاعدة بيانات كبرة. وتضمنت مجموعة البيانات المتعلقة بسرطان الثدي 1574 امرأة أثبت التشخيص إصابتهن بسرطان الثدي في الفرة من 2002 إلى 2012 وفقاً لسجل أمراض السرطان في مقاطعة فارس، جمهورية إيران الإسامية. وبلغت معدلات النجاة الكلية في السنوات 2 و 3 و 5 و 10 ما مقداره 0.98 و 0.94 و 0.87 و 0.76 عى التوالي. وبعد خمس سنوات، بلغت معدلات النجاة لمدة خمس سنوات في المراحل 1 و 2 و 3 ما مقداره 0.94 و 0.92 و 0.74 عى التوالي. وبالنسبة للمرضى الأصغر سناً الذين يتسمون بعدم وجود غجج مصابة وبمستقبِلات بروجستيرون سلبية وجلد غر مصاب ومستوى تشخيصي جيد، فظهر أن لديهم فرصة أكر للنجاة مقارنة بغيرهم. وتساوت تقريباً احتالات النجاة لخمس سنوات حسب مرحلة المرض في محافظة فارس وفقاً للتقارير الواردة من جمعية السرطان الأمريكية. وشكّل "مؤشر نوتنجهام التنبؤي" المتعلق بحالة الغدد الليمفاوية وحجم الورم والدرجة النووية المؤشر الرئيي لمعدل الوفيات الناجمة عن سرطان الثدي.Facteurs pronostiques du taux de survie du cancer du sein dans le sud de la République islamique d’Iran : approche empirique bayésienne de type additif.Le cancer du sein est un problème de santé publique en République islamique d’Iran. Relativement peu d’études ont traité la question en recourant à de larges jeux de données et à des méthodes statistiques avancées. Ainsi, nous avons voulu étudier le rôle des facteurs pronostiques de la survie du cancer du sein à l’aide d’une approche bayésienne de type additif et au moyen d’un large jeu de données. Le jeu de données sur le cancer du sein incluait 1574 femmes diagnostiquées avec un cancer du sein entre 2002 et 2012 inscrites au Registre du Cancer de la Province de Fars, en République islamique d’Iran. Au total, les taux de survie à deux, trois, cinq et 10 ans étaient de 0,98, 0,94, 0,87 et 0,76 respectivement. Les taux de survie à cinq ans aux stades 1, 2 et 3 étaient de 0,94, 0,92 et 0,74 respectivement. Les patients plus jeunes ayant des caractéristiques telles que l’absence d’implication ganglionnaire, la présence de récepteur négatif de la progestérone, l’absence d’atteinte cutanée, et un bon niveau pronostique avaient des chances de survie plus élevées que les autres. La probabilité de survie à cinq ans selon le stade dans la province de Fars était presque la même que celle rapportée par l'American Cancer Society. L’Index pronostique de Nottingham lié au statut ganglionnaire, à la taille de la tumeur et au grade nucléaire était l’indicateur principal de mortalité liée au cancer du sein.

Published
2016

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