Depression and Suicidal Ideation among Patients Receiving Opioid Maintenance Treatments Considering Cognitive Flexibility

Objective: Cognitive flexibility is associated with psychiatric disorders. Drug addicts experience more psychiatric disorders. This research aimed to examine depression and suicidal ideation among those receiving opioid maintenance treatment (OMT), taking into account the mediating role of cognitive flexibility. Method: This cross-sectional research was conducted on patients who were enrolled in the OMT program in Semnan in 2021 and abstained from opioid use for at least one year. 126 participants (115 males and 11 females) were randomly selected from among patients in three therapeutic groups (42 from each of the methadone, buprenorphine, and opium tincture groups). The main data collection tools were the Beck Scale for Suicide Ideation (BSSI), Cognitive Flexibility Inventory (CFI), and Beck Depression Scale (BDI-II). Data analysis was done through logistic regression models. Results: Correlation analysis between depression scores, suicidal ideation, and cognitive flexibility showed a significant correlation between each of them. Adjusting for the type of treatment, the increase in cognitive flexibility was associated with a decreasing chance of depression (odds ratio [OR] = 0.87; 95% CI [0.82, 0.92]), and the use of buprenorphine (OR = 15.1) and opium tincture (OR = 9.3), compared to methadone, were associated with a depression increase. Yet, multivariate analysis did not show an independent and significant association between cognitive flexibility and the risk of suicide. Conclusion: Based on the results, patients receiving maintenance treatments are in different conditions in terms of depression and suicide, and psychological flexibility is in correlation with depression and suicidal thinking and behavior in them. This suggests that these patients seem to benefit from cognitive training, at least in reducing their depression

Estimating the Net Survival of Patients with Gastric Cancer in Iran in a Relative Survival Framework

Background: Iran is an Eastern Mediterranean region country with the highest rate of gastric cancer. The present study aimed to evaluate the 5-year net survival of patients with gastric cancer in Iran using a relative survival framework. Methods: In a cross-sectional study, using life-table estimation of relative survival, we reported 1- to 5-year relative survival regarding age, sex, disease stage, pathology, and adjuvant therapies via modeling excess mortality. All the analyses were done applying Stata 11.2 with a confidence level of 95%. Results: Data on 330 patients (aged 32–96 y), who were comprised of 228 (69.1%) men and 102 (30.1%) women with gastric cancer and were followed up for 10 years, were analyzed. Adenocarcinoma was the most common malignancy (281 [85.2%] patients), and 248 (75.1%) patients were at stage 3 or stage 4. The 1- and 5-year net survival rates after surgery were 67.96 (95% CI: 62.35–72.98) and 23.35 (95% CI: 17.94–29.28), respectively. Higher stages (P=0.001), older ages (P=0.007), and less use of adjuvant therapies (P<0.001) were independently associated with excess mortality. Conclusion: It is recommended to use the relative survival framework to analyze the survival of cancer patients as an alternative approach not only to eliminate biases due to competing risks and their dependencies but also to estimate the cure at the population level concerning the most important individual characteristics. Our findings showed that the survival rate of gastric cancer in Iran is lower than that in most developed countries in terms of net survival

Clinical Effectiveness of Modified SOFA (MSOFA) scoring system for predicting mortality and length of stay in patients hospitalized in intensive care unit

Background: The ability to recognize the severity of the disease in those who their survival depend entirely on admission to the intensive care unit, is very valuable clinically. This study aimed to evaluate the clinical effectiveness of MSOFA scale to predict mortality and length of stay in ICU patients respectively. Methods: This was a retrospective cross-sectional study conducted on hospital records of patients admitted to the intensive care unit of Kowsar Hospital of Semnan. The data collection tool was a demographic questionnaire and MSOFA scale. Finally, data were analyzed using SPSS version 16 by logistic regression and ROC curve. Results: The study of 105 patients' records of the intensive care unit in 2015 showed that 45/7% of patients were died, 15/2% and 39% were discharged and moved to other wards respectively. The results of logistic regression analysis and ROC curve showed that this criterion had moderate sensitivity and specificity for prediction of mortality and length of stay in ICU patients (Area=0/635, CI= 0/527-0/743( and each unit increase in MSOFA score is accompanied by increasing 32 percent chance of death (OR=1.325; 95% CI:1.129,1.555; P=0.001(. Also each unit increase in MSOFA score accompanied by increasing 19% length of stay in ICU (OR=1.191; 95% CI: 1.034, 1.371; P=0.015(. Conclusion: The results of this study showed that the MSOFA scale is not useful tool to predict the length of stay and mortality of patients admitted to the intensive care unit

Association between C-reactive protein and high-density lipoprotein of cholesterol among adults in Tehran city

Introduction: In the present research, the association between C-reactive protein (CRP) and high-densitylipoprotein of cholesterol (HDL-C) is studied among healthy adults in Tehran city.Materials and Methods: It is performed as a cross-sectional study using data of adults with age 18 andmore enrolled in the first phase of the "Evaluation of novel risk factors of NCD" project in the ResearchInstitute for Endocrine Sciences (Tehran,Iran) in 2001. Analyses were done by logistic regression modelsusing crude and adjusted odds ratio (OR) to demonstrate the associations between CRP and HDL-Cregarding their age, gender, body mass index and smoking status as underlying variables. To get finalreduced logistic model we used backward elimination strategy with likelihood ratio test.Results: Based on the findings of analysis on data of 126 men and 208 women, it was reported asignificant association between blood concentration of CRP and HDL-C (P<0.001). Logistic regressionanalysis revealed that increasing the concentration of CRP to 0.2 mg/l and more in serum, increased thelikelihood of decreasing the serum concentration of HDL-C to 40 and 50 mg/dl and less about two folds inmen and women respectively (adjusted OR: 2.25, 95% CI: 1.49-3.41).Conclusion: In apparently healthy adults from Tehran city, independent of age, sex, body mass index,blood pressure, fasting blood sugar, and smoking, serum concentrations of CRP and HDL-C are reverselyassociated while both of them are considered as independent factors related with cardiovascular disordersand complications