Background: First-degree relatives (FDRs) of people diagnosed with colorectal cancer (CRC) have a two-to three-fold increased risk of developing disease. Colonoscopy screening test can be effective in prevention and early treatment. Objectives: The purpose of this study was to determine the rate of participation in colonoscopy screening test and related factors in first degree relatives. Methods: 200 FDRs of CRC cases were interviewed by the researchers. A reliable and valid questionnaire about undergoing colonoscopy screening test and barriers was filled via phone. To report qualitative data results, we used percent and proportion. Full (bytotal variables) and final (Forward LR) multiple logistic regression analysis were used to make a model which was executed using spss19. Results: In total, 59% FDRs had undergone colonoscopy screening test to the time of interview. Major reasons for not participating were fear of pain (23%), concerns about complications and test positive result (21.5%), lack of health insurance (21.5%), not believing in the test effectiveness (17%), no need because of healthy feeling (13%), embarrassment (12%) and distrust to service provider skills (10%). Results of multiple logistic regression analysis indicated there is statistical significance between participating colonoscopy screening and variables "not affected with hypertension (95%CI: 0.4 -2.04, OR = 3.7), believe in test effectiveness in FDRs (95%CI: 1.8 -16.9, OR = 5.6), also age of
BackgroundApproximately 15% to 25% of colorectal cancer (CRC) cases have positive family history for disease. Colonoscopy screening test is the best way for prevention and early diagnosis. Studies have found that first degree relatives (FDRs) with low socioeconomic status are less likely to participate in colonoscopy screening program. ObjectivesThe aim of this study is to determine the association between socioeconomic status and participation in colonoscopy screening program in FDRs.Patients and MethodsThis descriptive cross-sectional, study has been conducted on 200 FDRs who were consulted for undergoing colonoscopy screening program between 2007 and 2013 in research institute for gastroenterology and liver disease of Shahid Beheshti University of Medical Sciences, Tehran, Iran. They were interviewed via phone by a valid questionnaire about socioeconomic status. For data analysis, chi-square, exact fisher and multiple logistic regression were executed by SPSS 19.ResultsThe results indicated 58.5% participants underwent colonoscopy screening test at least once to the time of the interview. There was not an association between participation in colonoscopy screening program and socioeconomic status to the time of the interview in binomial analysis. But statistical significance between intention to participate and educational and income level were found. We found, in logistic regression analysis, that high educational level (Diploma and University degree in this survey) was a predictor to participate in colonoscopy screening program in FDRs.ConclusionsAccording to this survey low socioeconomic status is an important factor to hinder participation of FDRs in colonoscopy screening program. Therefore, planned interventions for elevation knowledge and attitude in FDRs with low educational level are necessary. Also, reducing colonoscopy test costs should be a major priority for policy makers.
Background: Postoperative meningitis (POM) is the most dreaded cause of morbidity and mortality in neurosurgery patients. This study aimed to identify incidence and mortality rate as well as related factors to outcome in patients with POM. Methods: This descriptive longitudinal study conducted on patients with POM in duration of 2 years. Incidence and mortality rates as well as related factors were studied. Results: The incidence and mortality rates of POM was 8.9% and 50%, respectively. There were statistically significant association between male gender, as well as having mechanical ventilation, and death outcome in univariable analysis. In addition, in multivariable logistic regression analysis, length of intensive care unit (ICU) stay of more than 7 days [Odds ratio (OR): 1.2, confidence interval of 95% (95%CI): 1.02-6.2), mechanical ventilation (OR: 1.1, 95%CI: 1.05-5.1], positive cerebrospinal fluid (CSF) culture (OR: 2.4, 95%CI: 1.9-4.08) were predicting factors to death outcome. Finally, we found an inverse relationship between survival function and length of ICU stay in patients with POM. Conclusion: According to the high rates of incidence and mortality due to POM in this study, preventive studies to decrease this dreaded cause of morbidity and mortality in neurosurgery patients should be the planned.
Background: Platelet volume indices (PVIs) are inexpensive and readily available parameters in intensive care units (ICUs). However, their association with mortality has never been investigated in the post-neurosurgical meningitis (PNM). Objectives: This study was designed to investigate the association of PVIs with mortality in PNM patients. Methods: This retrospective study was conducted in the adult patients undergone various neurosurgical procedures in a neurosurgery department at a tertiary educational medical center in Tehran from 2016 to 2017. In this study, platelet indices including mean platelet volume (MPV), platelet distribution width (PDW), and platelet count were measured on ICU admission. Results: A total of 37 patients were included, 18 of whom survived (mortality rate: 50%). PDW and MPV values were significantly higher in non-survivors than in survivors. In non-survivor patients, platelet count was significantly lower and PDW was higher at diagnosis and discharge when compared to on admission. Also, there was no significant linear correlation between Charlson comorbidity index (CCI) and platelet indices. The means of these parameters showed no significant differences in CCI categories between the two patient subgroups. Conclusions: The obtained data revealed that the high levels of MPV and PDW in PNM are not associated with the increased risk of mortality, whereas the decrease in plateletcrit was not associated with increased risk of mortality.
Background:The first-degree relatives (FDRs) of patients with colorectal cancer (CRC) are at a 2 to 3-fold increased risk of developing the disease compared with the general population.Objectives: This study aimed to determine the relationship between the lifestyle of colorectal cancer patients' FDRs and their compliance in colonoscopy screening test. Methods: This cross-sectional study conducted on FDRs of patients with colorectal cancer in one educational hospital, Tehran, Iran in duration 2018. A total of 114 patients' FDRs were consulted face to face by preventive medicine specialist and data collecting forms were fully completed. Three months later the FDRs were followed for undergoing colonoscopy screening test or decision to do it soon. Next, the relationship between lifestyle [BMI (body mass index), cigarette smoking, diet, physical activity], socioeconomic status (job, income, health insurance), and comorbidities with a tendency to participate in colonoscopy screening program assessed. In multivariable logistic regression analysis, predictor factors for colonoscopy screening in FDRs were investigated. The data were analyzed using SPSS V. 18 software and the significance statistically was P < 0.05 in the all tests. Results: Overall, 57% of FDRs undergone colonoscopy tests up to time of study or they were tended to do it soon. In multivariable logistic regression, age < 50 years old (P = 0.01, OR = 1.08, 95%CI: 1.01 -1.8), higher income (equal and more than 20 million Rials) (P < 0.001, OR = 2.5, 95%CI: 1.8 -11), appropriate physical activity (≥ 150 minutes weekly) (P < 0.001, OR = 5.2, 95%CI: 4.6 -17.5) and normal diet (intake of carbohydrate, fat, protein, fruit and vegetables) (P = 0.006, OR = 3.02, 95%CI: 2.9 -6.6) were the predictor factors to compliance the FDRs for participation in colonoscopy screening program. Conclusions: Although in this study there was an association between lifestyle of FDRs and the compliance rate of colonoscopy screening test but according to the vulnerability of the relatives, more research in this field should be carried out.
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