Aboriginal status is a prognostic factor for mortality among antiretroviral naïve HIV-positive individuals first initiating HAART

Affiliation: Mark Daniel: Département de médecine sociale et préventive, Faculté de médecine, Université de Montréal et Centre de recherche du Centre hospitalier de l'Université de Montréal

A Study on the Kerridge's Inaccuracy Measure and Related Conceptss

Department of Statistics, Cochin University of Sciene ans Technology

Supervivencia en pacientes con trasplante hepático realizado en la Fundación Cardioinfantil entre 2005 y 2013

Introducción: El trasplante hepático es la terapia de elección para los pacientes con enfermedad hepática terminal, logrando mejorar su expectativa y calidad de vida, de acuerdo a estudios realizados en otros países. En la Fundación Cardioinfantil – Instituto de Cardiología (FCI-IC) se han realizado 332 trasplantes hepáticos hasta el 2014, pero no se conoce la supervivencia y los factores pronósticos propios de los pacientes intervenidos. Objetivo Principal: Estimar la supervivencia a 1, 3 y 5 años e identificar los principales factores pronósticos de los pacientes a quienes se les realizó trasplante hepático en el periodo 2005-2013 en la FCI-IC. Método: Estudio observacional y retrospectivo, basado en revisión de historias clínicas de los pacientes adultos a quienes se les realizó trasplante hepático en el periodo 2005-2013 en la FCI-IC. Resultados: La supervivencia al año fue de 90.91% (IC95% 86.40-93.98), a los 3 años 83.64% (IC95% 77.89-88.01) y a los 5 años de 79.18% (IC95% 72.54-84.39). Los principales factores pronósticos fueron el antecedente de ascitis (HR 2.449, IC 1.252 – 4.792), la edad del donante (HR 1.040, IC 1.009 – 1.071) y el receptor (HR 1.037, IC 1.014 – 1.060). Se encontró una mayor supervivencia en los pacientes con cirrosis alcohólica (HR 0.099, IC 0.021 – 0.467). Conclusiones: El estudio mostró una supervivencia mayor a la reportada en estudios realizados en Estados Unidos (67.4-73.0% a los 5 años) y España (73,3% a los 3 años) y similar a la de Chile (80.0% a los 5 años). Cabe resaltar que estos estudios incluyeron series más grandes de pacientes.

Timing and the holding periods of institutional real estate

Literature on investors' holding periods for securities suggests that high transaction costs are associated with longer holding periods. Return volatility, by contrast, is associated with shorter holding periods. In real estate, high transaction costs and illiquidity imply longer holding periods. Research on depreciation and obsolescence suggests that there might be an optimal holding period. Sales rates and holding periods for U.K. institutional real estate are analyzed, using a proportional hazards model, over an 18-year period. The results show longer holding periods than those claimed by investors, with marked differences by type of property and over time. The results shed light on investor behavior.

Timing and the holding periods of institutional real estate

The literature on investors’ holding periods for equities and bonds suggest that high transaction costs are associated with longer holding periods. Return volatility, by contrast, is associated with short-term trading and hence shorter holding periods. High transaction costs and the perceived illiquidity of the real estate market leads to an expectation of longer holding periods. Further, work on depreciation and obsolescence might suggest that there is an optimal holding period. However, there is little empirical work in the area. In this paper, data from the Investment Property Databank are used to investigate sales rate and holding period for UK institutional real estate between 1981 and 1994. Sales rates are investigated using the Cox proportional hazards framework. The results show longer holding periods than those claimed by investors. There are marked differences by type of property and sales rates vary over time. Contemporaneous returns are positively associated with an increase in the rate of sale. The results shed light on investor behaviour.

The specific role of relationship life events in the onset of depression during pregnancy and the postpartum

Background The precipitating role of life events in the onset of depression is well-established. The present study sought to examine whether life events hypothesised to be personally salient would be more strongly associated with depression than other life events. In a sample of women making the first transition to parenthood, we hypothesised that negative events related to the partner relationship would be particularly salient and thus more strongly predictive of depression than other events. Methods A community-based sample of 316 first-time mothers stratified by psychosocial risk completed interviews at 32 weeks gestation and 29 weeks postpartum to assess dated occurrence of life events and depression onsets from conception to 29 weeks postpartum. Complete data was available from 273 (86.4%). Cox proportional hazards regression was used to examine risk for onset of depression in the 6 months following a relationship event versus other events, after accounting for past history of depression and other potential confounders. Results 52 women (19.0%) experienced an onset of depression between conception and 6 months postpartum. Both relationship events (Hazard Ratio = 2.1, p = .001) and other life events (Hazard Ratio = 1.3, p = .020) were associated with increased risk for depression onset; however, relationship events showed a significantly greater risk for depression than did other life events (p = .044). Conclusions The results are consistent with the hypothesis that personally salient events are more predictive of depression onset than other events. Further, they indicate the clinical significance of events related to the partner relationship during pregnancy and the postpartum.

A utilização de modelos de duração para gerenciar risco de crédito

Os modelos hazard, também conhecidos por modelos de tempo até a falência ou duração, são empregados para determinar quais variáveis independentes têm maior poder explicativo na previsão de falência de empresas. Consistem em uma abordagem alternativa aos modelos binários logit e probit, e à análise discriminante. Os modelos de duração deveriam ser mais eficientes que modelos de alternativas discretas, pois levam em consideração o tempo de sobrevivência para estimar a probabilidade instantânea de falência de um conjunto de observações sobre uma variável independente. Os modelos de alternativa discreta tipicamente ignoram a informação de tempo até a falência, e fornecem apenas a estimativa de falhar em um dado intervalo de tempo. A questão discutida neste trabalho é como utilizar modelos hazard para projetar taxas de inadimplência e construir matrizes de migração condicionadas ao estado da economia. Conceitualmente, o modelo é bastante análogo às taxas históricas de inadimplência e mortalidade utilizadas na literatura de crédito. O Modelo Semiparamétrico Proporcional de Cox é testado em empresas brasileiras não pertencentes ao setor financeiro, e observa-se que a probabilidade de inadimplência diminui sensivelmente após o terceiro ano da emissão do empréstimo. Observa-se também que a média e o desvio-padrão das probabilidades de inadimplência são afetados pelos ciclos econômicos. É discutido como o Modelo Proporcional de Cox pode ser incorporado aos quatro modelos mais famosos de gestão de risco .de crédito da atualidade: CreditRisk +, KMV, CreditPortfolio View e CreditMetrics, e as melhorias resultantes dessa incorporação

Câncer de boca e orofaringe: tendências e análise de sobrevida em Natal (RN)

Introduction: Mouth cancer is classified as having one of the ten highest cancer incidences in the world. In Brazil, the incidence and mortality rates of oral cancer are among the highest in the world. Intraoral cancer (tongue, gum, floor of the mouth, and other non-specified parts of the mouth), the accumulated survival rate after five years is less than 50%. Objectives: Estimate the accumulated survival probability after five years and adjust the Cox regression model for mouth and oropharyngeal cancers, according to age range, sex, morphology, and location, for the city of Natal. Describe the mortality and incidence coefficients of oral and oropharyngeal cancer and their tendencies in the city of Natal, between 1980 and 2001 and between 1997 and 2001, respectively. Methods: Survival data of patients registered between 1997 and 2001 was obtained from the Population-based Cancer Record of Natal. Differences between the survival curves were tested using the log-rank test. The Cox proportional risk model was used to estimate risk ratios. The simple linear regression model was used for tendency analyses of the mortality and incidence coefficients. Results: The probability after five years was 22.9%. The patients with undifferentiated malignant neoplasia were 4.7 times more at risk of dying than those with epidermoid carcinoma, whereas the patients with oropharyngeal cancer had 2.0 times more at risk of dying than those with mouth cancer. The mouth cancer mortality and incidence coefficients for Natal were 4.3 and 2.9 per 100 000 inhabitants, respectively. The oropharyngeal cancer mortality and incidence coefficients were, respectively, 1.1 and 0.7 per 100 000 87 inhabitants. Conclusions: A low survival rate after five years was identified. Patients with oropharyngeal cancer had a greater risk of dying, independent of the factors considered in this study. Also independent of other factors, undifferentiated malignant neoplasia posed a greater risk of death. The magnitudes of the incidence coefficients found are not considered elevated, whereas the magnitudes of the mortality coefficients are high

Predictors of first-year survival in patients with advanced COPD treated using long-term oxygen therapy

Little evidence-based guidance is available to aid clinicians in determining short-term prognoses in very severe COPD patients. Therefore, the present study was designed to provide a prospective assessment (1) of the mortality rates and (2) whether the baseline measurements may be determinants of 1-year mortality in hypoxemic COPD patients receiving long-term oxygen therapy (LTOT).Seventy-eight clinically stable patients with advanced COPD treated using LTOT were enrolled in a prospective cohort study. Outcome variable: first-year mortality. Baseline measurements: categorical variables: age (<60 or >= 60 years); gender; body mass index (<20 or >= 20 kg/m(2)); fat-free mass (FFM) index (<16 [men] and <15kg/m(2) [women]; baseline dyspnea index (BDI) (<= 3 or >3); and corticosteroid use. Continuous variables: smoking history; lung function; FFM; fat mass; hemoglobin; hematocrit; arterial blood gases; forearm muscle strength; St. George's Respiratory Questionnaire (SGRQ); and comorbidity score. By the end of 1-year of follow-up, 12 patients (15.4%) had died. Kaplan-Meier curves showed that BDI <= 3 was the only variable associated with higher mortality. Cox proportional hazards analysis revealed that tower PaO2 and SPO2, higher PaCO2 and SGRQ scores were associated with reduced survival. In the multivariate analysis, BDI remained predictive of mortality (hazard ratio [HR], 0.50; 95% confidence interval [CI], 0.31-0.81), as did PaO2 (HR, 0.49; 95% CI, 0.26-0.95). These data suggest that readily available parameters as dyspnea intensity and hypoxemia severity may be useful in predicting first-year survival rates in advanced COPD patients receiving LTOT (C) 2007 Elsevier Ltd. All rights reserved.

Desigualdade da sobrevivência de trabalhadores de Botucatu, São Paulo, Brasil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Shorter CAG repeat length in the AR gene is associated with poor outcome in head and neck cancer

Objective: Alterations in the size of the [CAG](n) repeats of the AR gene have been described in several types tumors. The purpose of this study was to evaluate if there is an association between the AR [CAG](n) repeat alleles and the relative risk for head and neck cancer and to analyse microsatellite instability (MSI) and loss of heterozygosity (LOH) in these tumors.Design: Matched samples of blood and head and neck tumors were evaluated using two methodologies, silver-stained gels to perform the analyses of MSI and LOH, and automated analysis to confirm these results and for genotyping of the AR [CAG](n), repeat length. Sixty-nine individuals without cancer were used as a control group for both procedures. The Log-rank test was used to compare overall survival and disease-free survival curves. The Cox proportional hazards regression models were performed to determine the [CAG], repeats as an independent prognostic factor.Results: Patients with alleles <= 20 in the male group showed a correlation with lower disease-free survival (P = 0.0325) and with recurrence or metastasis (RR 2.52, CI 95%). in the female group, the allele 2 (longer allele) showed a significant lower mean of [CAG](n), repeat when compared to the control group. Microsatellite instability was detected in nine cases in both procedures. In six out of these nine cases, we observed a reduction of the AR [CAG](n) repeat length. LOH was detected in one out of 17 women informative for oral cancer in both procedures.Conclusion: These results suggest that short [CAG](n) repeat length (: 20) polymorphism is associated with poor prognosis in a subset of male patients with head and neck cancer and that AR gene microsatellite instability is uncommon in these tumors. (C) 2007 Elsevier Ltd. All rights reserved.

Modeling grouped survival data with time-dependent covariates

In this article, proportional hazards and logistic models for grouped survival data were extended to incorporate time-dependent covariates. The extension was motivated by a forestry experiment designed to compare five different water stresses in Eucalyptus grandis seedlings. The response was the seedling lifetime. The data set was grouped since there were just three occasions in which the seedlings was visited by the researcher. In each of these occasions also the shoot height was measured and therefore it is a time-dependent covariate. Both extended models were used in this example, and the results were very similar.

Estudo de sobrevivência de uma coorte de pessoas de 60 anos e mais no município de Botucatu (SP) - Brasil

O aumento proporcional do número de idosos na população tem motivado estudos no sentido de melhorar a qualidade de vida desta faixa etária através de políticas sociais e, entre elas, o planejamento em saúde. Com o objetivo de conhecer riscos de mortalidade para a população de sessenta anos e mais, um estudo de sobrevida foi realizado rastreando, no ano de 1992, os idosos participantes de um inquérito de morbidade referida realizado na cidade de Botucatu em 1983/84. Foram localizados 89,6% destes idosos. Curvas de sobrevivência foram calculadas com o método de Kaplan-Meier e a análise de riscos, utilizando-se a Regressão Múltipla de Cox ajustando-se o modelo agregando as variáveis por blocos. Para o sexo masculino foram encontradas associadas, independentemente, ao aumento da mortalidade as seguintes categorias de variáveis: idade de 70 anos e mais: Hazard Ratio (HR)=2,4 (1,6 - 3,7); salário menor que um salário mínimo: HR=2,2 (1,3 - 3,8); ter outras rendas: HR=2,2 (1,3 - 3,9); ser o chefe da família ou seu cônjuge: HR=2,3 (1,2 - 2,4); referência de doenças do aparelho circulatório: HR=1,6 (1,1 - 2,4); referência de diabetes mellitus: HR=3,0 (1,3 - 7,0). Para o sexo feminino, foram encontradas associadas a idade de 70 anos e mais: HR=4,6 (3,0 - 7,1); referência de diabetes mellitus: HR=3,0 (1,7-5,3) e ter outras rendas: HR=2,0 (1,1 - 4,0).

Anemia at one year is an independent risk factor of graft survival

Background Post-transplant anemia is multifactorial and highly prevalent. Some studies have associated anemia with mortality and graft failure. The purpose of this study was to assess whether the presence of anemia at 1 year is an independent risk factor of mortality and graft survival. Methods All patients transplanted at a single center who survived at least 1 year after transplantation and showed no graft loss (n = 214) were included. Demographic and clinical data were collected at baseline and at 1 year. Patients were divided into two groups (anemic and nonanemic) based on the presence of anemia (hemoglobin<130 g/l in men and 120 g/l in women). Results Baseline characteristics such as age, gender, type of donor, CKD etiology, rejection, andmismatches were similar in both groups. Creatinine clearance was similar in both anemic and nonanemic groups (69.32 ± 29.8 × 75.69 ± 30.5 ml/mim; P = 0.17). A Kaplan- Meier plot showed significantly poorer death-censored graft survival in the anemic group, P = 0.003. Multivariate analysis revealed that anemic patients had a hazard ratio for the graft loss of 3.85 (95% CI: 1.49-9.96; P = 0.005). Conclusions In this study, anemia at 1 year was independently associated with death-censored graft survival and anemic patients were 3.8-fold more likely to lose the graft. © 2010 Springer Science+Business Media, B.V.

Preditores de recidiva hemorrágica ou óbito na hemorragia digestiva alta por úlcera péptica ou lesão aguda da mucosa gastroduodenal

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)