Survival analysis modeling with hidden censoring

There are well-established survival analysis methodologies for data sets that are complete, with accurate information on censoring. But what if they are not complete? In this article we consider how to analyze cases where “hidden censoring” occurs, where individuals have effectively left the study but the hospital is unaware of this. We develop a new Markov chain-based methodology for generating survival curves and hazard functions, and demonstrate this using a breast cancer data set from the Kurdistan region of Iraq

Parasite infection in Serranus cabrilla (Perciformes, Serranidae): histopathological aspects and new host record for nematode genus Philometra from Aegean Sea, Turkey

ΔΕΝ ΔΙΑΤΙΘΕΤΑΙ ΠΕΡΙΛΗΨΗThis study was conducted to determine infection with nematode parasite Philometra sp. in gonads of Serranus cabrilla recorded in Izmir Gulf between October 2016 and July 2017. The overall prevalence was 14.46% and the mean intensity of infection 1.2 parasites per fish. The occurrence of philometrid infection on comber hosts was assessed according to several risk factors (fish length class, sex and season). Our findings suggest that the highest rates of parasite infection occur in larger sized fish, hermaphrodite individuals and during April month. The present report also revealed that marked hyperemia was the major findings of infected gonads of S. cabrilla, where parasitic nematodes caused a marked inflammatory reaction at the histopathological examination. As far as we know, this paper represents the first mention of genus Philometra in S. cabrilla from Turkey and the first presence of philometrid parasites in Aegean coast of Turkey. Furthermore, the present work is the first record of the effects of Philometra sp. parasitism on a serranid species in Izmir Gulf

Occurrence of black spot disease induced by Posthodiplostomum cuticola (Nordmann, 1832) (Digenea: Diplostomatidae) in endemic and native fish of Turkey: seven new host records

ΔΕΝ ΔΙΑΤΙΘΕΤΑΙ ΠΕΡΙΛΗΨΗThis study was conducted to determine parasite infection with Posthodiplostomum cuticola in eight fish species collected from five Rivers Basins of Turkey (Aras, Çoruh, Sakarya, Marmara and Susurluk River Basins). Five of eight fish species are endemic to Turkey. The highest values of prevalence and mean intensity (60.87%; 4.86) of cysts with metacercaria of P. cuticola were recorded in Alburnus filippii, a native fish species in Ağıl Creek. At the gross examination numerous black lesions were observed at the skin of the fishes. Microscopically black-spot disease was revealed by melanin pigmentation and atrophy of fish muscles in lesioned areas. Parasites were covered by thing connective tissue capsule. Alburnus escherichii, Alburnus filippii, Capoeta tinca, Chondrostoma angorense, Chondrostoma colchicum, Squalius pursakensis and Squalius turcicus were found as new host records for P. cuticola

Occurrence of black spot disease induced by Posthodiplostomum cuticola (Nordmann, 1832) (Digenea: Diplostomatidae) in endemic and native fish of Turkey: seven new host records

ΔΕΝ ΔΙΑΤΙΘΕΤΑΙ ΠΕΡΙΛΗΨΗThis study was conducted to determine parasite infection with Posthodiplostomum cuticola in eight fish species collected from five Rivers Basins of Turkey (Aras, Çoruh, Sakarya, Marmara and Susurluk River Basins). Five of eight fish species are endemic to Turkey. The highest values of prevalence and mean intensity (60.87%; 4.86) of cysts with metacercaria of P. cuticola were recorded in Alburnus filippii, a native fish species in Ağıl Creek. At the gross examination numerous black lesions were observed at the skin of the fishes. Microscopically black-spot disease was revealed by melanin pigmentation and atrophy of fish muscles in lesioned areas. Parasites were covered by thing connective tissue capsule. Alburnus escherichii, Alburnus filippii, Capoeta tinca, Chondrostoma angorense, Chondrostoma colchicum, Squalius pursakensis and Squalius turcicus were found as new host records for P. cuticola

A retrospective evaluation of traumatic dental injury in children who applied to the dental hospital, Turkey

Objective: The purpose of this study was to analyze traumatic dental injuries in children visiting the dental hospital emergency department in Samsun of Turkey, in the period from 2007 to 2011.Materials and Methods: Data of age, gender, causes of dental trauma, injured teeth, type of dental injuries, the application period, the dental treatments, and traumatic dental injuries according to the seasons were obtained from the records at dental hospital.Results: Of all 320 patients with traumatic dental injury, 205 were boys and 115 were girls with a boys/girls ratio 1.78:1. Traumatic dental injury was observed more frequently in the 7.12 age groups: 52.5% in girls and 67.8% in boys. Falls are the major cause of traumatic dental injury in the age group 6.12 (51.4%). Sport activities are a common cause of traumatic dental injury in the 7.12 age group (34.2%). Patients visited a dentist within approximately 2 h (57.1%). The upper anterior teeth were subjected to trauma more frequently than the lower anterior teeth. The maxillary central incisors were the most commonly affected teeth, and the  mandibular canins were the least affected teeth. In primary teeth, avulsion was the most common type of dental injury (23%); on the other hand, enamel fractures were the most common type of dental injury (30.6%) observed in permanent teeth. In the primary dentition, the most commonly performed treatments were dental examination and prescribing (70%). The most common treatment choices in permanent teeth were restoration and dental examination (49.7 and 15.8%, respectively).Conclusion: The results of the study show that the emergency intervention to traumatized teeth is important for good prognosis of teeth and oral tissues. Therefore, the parents should be informed about dental trauma in schools, and dental hospital physicians should be subjected to postgraduate training.Key words: Classification, emergency treatment, teeth, traum

Interaction of inflammatory cytokines and erythropoeitin in iron metabolism and erythropoiesis in anaemia of chronic disease

In chronic inflammatory conditions increased endogenous release of specific cytokines (TNFα, IL-1, IL-6, IFNγ and others) is presumed. It has been shown that those of monocyte lineage play a key role in cytokine expression and synthesis. This may be associated with changes in iron metabolism and impaired erythropoiesis and may lead to development of anaemia in patients with rheumatoid arthritis. Firstly, increased synthesis of acute phase proteins, like ferritin, during chronic inflammation is proposed as the way by which the toxic effect of iron and thereby the synthesis of free oxy-radicals causing the damage on the affected joints, may be reduced. This is associated with a shift of iron towards the mononuclear phagocyte system which may participate in the development of anaemia of chronic disease. Secondly, an inhibitory action of inflammatory cytokines (TNFα, IL-1), on proliferation and differentiation of erythroid progenitors as well as on synthesis of erythropoietin has been shown, thereby also contributing to anaemia. Finally, chronic inflammation causes multiple, complex disturbances in the delicate physiologic equilibrium of interaction between cytokines and cells (erythroid progenitors, cells of mononuclear phagocyte system and erythropoietin producing cells) leading to development of anaemia of chronic disease (Fig. 1)

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication