فهرست مطالب
Shiraz Emedical Journal
Volume:17 Issue: 7, Aug 2016
- تاریخ انتشار: 1395/06/21
- تعداد عناوین: 5
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Page 1BackgroundGiven the role of inflammation in tumor progression, as well as in diffuse large B-cell lymphoma (DLBCL), researchers are trying to identify easily applicable, easy accessible prognostic markers for individual risk assessment. The most frequently used inflammatory prognostic markers are the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), and the Glasgow prognostic score (GPS)..ObjectivesTo determine and compare the prognostic value of the baseline inflammatory biomarkers NLR, PLR, and GPS in patients with DLBCL..MethodsWe retrospectively analyzed data from 103 DLBCL patients treated with R-CHOP or R-CHOP-like regimens. We evaluated the significance of NLR, PLR, and GPS as a predictor of response to treatment, overall survival (OS), and event-free survival (EFS)..ResultsHigher NLR levels were found in patients with a poorer response to therapy (median [range] 2.87 [0.56 - 26.33] vs. 4 [0.62 - 29.66], P = 0.026). Patients with NLR values of > 2.63 (cutoff value calculated by receiver-operating characteristic) had significantly worse two-year OS (65.1% vs. 87.2%, P = 0.002) and two-year EFS (59.8% vs. 87.1%, P = 0.001). PLR values were not significant for survival. The two-year OS rates for patients with GPS = 0, GPS = 1, and GPS = 2 were 93.3%, 63.9%, and 33.3%, respectively (P 2.63 were an independent prognostic factor for OS (hazard ratio [HR] = 2.857; 95% confidence interval [CI] 1.022 - 8.699; P = 0.048] and EFS (HR = 4.06; 95% CI 1.357 - 12.151; P = 0.012)..ConclusionsOur research confirmed NLR as useful independent prognostic marker for survival. PLR and GPS did not show independent prognostic value, although they were also associated with the patients clinical features. The easy availability and inexpensiveness of inflammatory biomarkers should encourage their use in clinical practice..Keywords: Diffuse Large Cell Lymphoma, Prognosis, Neutrophil, to, Lymphocyte Ratio, Platelet, to, Lymphocyte Ratio, Glasgow Prognostic Score
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Page 2BackgroundSociologists regularly criticize the unbalanced doctor-patient interaction (DPI). A few previous studies have investigated DPI in developing countries..ObjectivesThis study aimed to explore the nature of DPI in one educational hospital in Shiraz, Iran, according to the views of patients and their relatives..MethodsThis is a critical ethnography study that was conducted using a triangulation strategy in 2014, including156 clinical consultations, 920 hours of participant observations, and 6 focus groups with 51 patients and their families using a critical ethnography method. Sampling was purposeful, and the data were interpreted according to an exploration of the power relationship between the doctor and the patient in the context of the study according to the opinions of patients and their relatives..ResultsThe study showed that participants faced unexpected interactions, which included four features: unequal, unprofessional, instrumental, and non-cooperative. Although this form of interaction was explored to examine the struggle between the voice of medicine and the voice of the lifeworld, the results showed that the DPI in the context of our study contains hegemonic features, which are related to physicians autonomy..ConclusionsThese four themes revealed that patients are criticized about this form of interaction. These themes not only are not in line with the responsibilities and ethics of medicine but also are in contrast to it. It seems that patient-centered approaches can help solve the problem. In addition, the health system should monitor DPIs and promote them by reforming their structure..Keywords: Doctor, Patient Interaction, Critical Ethnography, Iran
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Page 3BackgroundFamily is the first environment in which children grow up, and for this reason, it has a significant effect on their future behaviors. The encouragement, discouragement, premonitions, indifference, and behaviors that characterize the primary stages of childrens lives will influence their future lives..ObjectivesThis research aims to study the relationship between different parenting styles in order to identify aggression among adolescents in Zahedan city..MethodsThe present research is a cross-sectional, descriptive-analytical study. The research population consisted of 206 high school students and their parents in Zahedan city, and the study was carried out during the winter and spring of 2014. The respondents were selected through cluster sampling and were evaluated using Baumrinds parenting style questionnaire, as well as the AGQ aggression questionnaire..ResultsAccording to the 206 questionnaires completed, there was a significant inverse relationship between authoritative parenting, and aggression (P = 0.02) and spitefulness elements (P = 0.023). In addition, there was a significant relationship between permissive parenting and anger (P = 0.01), and a direct significant relationship was also found between despotic parenting, and anger (P = 0.01) and aggression (P = 0.008)..ConclusionsThe results suggest that the best parenting style to lower aggression and its elements is the authoritative style. Dominant parents place more emphasis on independent behaviors. While they are kind and friendly, they also impose boundaries, direct their children toward independence, and pave the way to safeguarding their mental health.Keywords: Parenting Style, Aggression, Adolescents
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Page 4BackgroundSeveral factors affect oral and dental hygiene and therefore general health..ObjectivesThis study used the health belief model (HBM) to explore factors influencing dental health behaviors of students in Teheran, Iran..MethodsA cross-sectional study design was used. The participants were 400 male high-school students in district 5 in Tehran selected through multistage stratified random sampling. A self-administered questionnaire was used to collect the data, which included the following measures of the HBM: perceived severity, perceived susceptibility, perceived benefits, perceived barriers, cues to action, and self-efficacy. A multiple regression analysis and Pearsons correlation were run to detect potential correlations between the independent variables and dependent variable..ResultsAll 400 students completed the study. The results of the linear regression analysis showed that perceived barriers, self-efficacy, and cues to action accounted for the highest percent of total variance observed in dental health behaviors. The total HBM constructs and demographic variables explained 29% of the variance in dental health behaviors..ConclusionsThe current study provides evidence that oral and dental hygiene can be promoted by reducing perceived barriers and enhancing oral and dental hygiene self-efficacy..Keywords: Perception, Oral Health, Health Behavior