مجله طب نظامی
سال نهم شماره 3 (پیاپی 29، پاییز 1386)

Bachground. In spite of decrease in burden of stomach cancer in the ‎developed world, the incidence of this disease is still high in the developing ‎countries including Iran. Due to the slow progression of the cancer within ‎stomach, the cancer is usually diagnosed in advanced stage leading to a high ‎mortality rate. The stomach cancer is the second cause of death due to ‎cancer after lung cancer. In this study, we studied the survival rate of ‎stomach cancer among patients hospitalized in Baghiatollah hospital in ‎Tehran, Iran between 2000 and 2005. Patients and Methods. In overall, we studied the survival rate of 209 ‎patients hospitalized for stomach cancer in Baghiatollah hospital. We used ‎patient files and abstracted demographic data as well as information about ‎stomach tumor, i.e. histopathology, stage of the disease. Crude survival rates ‎were studied by of stomach cancer using Kaplan-Meier and Life Table ‎methods. Cox regression model estimated the effect of demographic ‎information and tumor characteristics on death due to stomach cancer.‎ Results. we found a poor prognosis for our stomach cancer patients. More ‎than 20 percent of patients died of stomach cancer in the first three months ‎and only half of patients were still alive after nine months of follow-up. One, ‎three, and five years survival were 44, 19, and 11 percents, respectively. ‎Stage of tumor was the most important prognostic factor in this study, ‎although patients diagnosed with a stomach cancer staged IB, II, IIIA, and ‎IIIB had almost similar prognosis. Study of 13 patients with stomach ‎lymphoma showed a better survival rate compared to adenocarcinoma in ‎overall. Discussion. stomach cancer patients had a considerably poor prognosis in ‎Iran. Further studies are needed to improve the diagnostic and therapeutic ‎approached to improve the prognosis of these patients.

Background. Readmission of injured veterans imposes heavy financial burdens on the health system in different countries thus, determining its controllable risk factors can result in lowering such costs. This study was designed to evaluate the risk factors associated with readmission due to exacerbation in chemical injured patients who suffer from chronic pulmonary diseases. Material and Methods. In this prospective study that was carried out in 2006, 96 chemical injured veterans from Sardasht were chosen in a simple randomized fashion. They were followed up for readmission (2 times or more within 6 months) due to exacerbation in signs and symptoms. Demographic data (age, sex, marital status, monthly income and level of education), spirometric findings (Predicted VC, Predicted FVC, and Predicted FEV1), somatic comorbidities (Ifudu), scale of anxiety and depression (HADS) and Body Mass Index (BMI) were recorded for each participant. Risk factors of readmission due to exacerbation of pulmonary signs and symptoms were analyzed using the multivariate regression test. Finding. Of all 96 individuals, 23 (24%) were readmitted due to aggravation of signs and symptoms within 6 months which showed a significant relationship with age (P=0.016), sex (P=0.05), comorbidity score (P=0.008), level of anxiety (P=0.05) and depression (P=0.05) while reevaluation with Predicted VC (P=0.717), Predicted FVC (P=0.664) and Predicted FEV1 (0.353) was not statistically significant. Predicting factors of readmission in patients suffering from chronic pulmonary diseases were comorbidity scale (P=0.007) and anxiety (P=0.040) which predicted readmission as follows: Logit (readmission) = 0.19 8* comorbidity (unit) * anxiety (unit)-3.93 Discussion. According to this study, comorbid somatic conditions and level of anxiety are risk factors of readmission due to aggravation of signs and symptoms in chemical injured patients who suffer from chronic pulmonary diseases. Considering such variables would assist decision makers in lowering heavy costs of readmissions in such patients.