138 research outputs found

    Bayesian analysis for categorical survey data

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    In this thesis, we develop Bayesian methodology for univariate and multivariate categorical survey data. The Multinomial model is used and the following problems are addressed. Limited information about the design variables leads us to model the unknown design variables taking into account the sampling scheme. Random effects are incorporated in the model to deal with the effect of sampling design, that produces the Multinomial GLMM and issues such as model comparison and model averaging are also discussed. The methodology is applied in a true dataset and estimates for population counts are obtaine

    Modelling HIV incidence and survival from age-specific seroprevalence after antiretroviral treatment scale-up in rural South Africa

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    Objective: Our study uses sex-specific and age-specific HIV prevalence data from an ongoing population-based demographic and HIV survey to infer HIV incidence and survival in rural KwaZulu-Natal between 2003 and 2011, a period when antiretroviral treatment (ART) was rolled out on a large scale.Design: Catalytic mathematical model for estimating HIV incidence and differential survival in HIV-infected persons on multiple rounds of HIV seroprevalence.Methods: We evaluate trends of HIV incidence and survival by estimating parameters separately for women and men aged 15-49 years during three calendar periods (2003-2005, 2006-2008, 2009-2011) reflecting increasing ART coverage. We compare model-based estimates of HIV incidence with observed cohort-based estimates from the longitudinal HIV surveillance.Results: Median survival after HIV infection increased significantly between 2003-2005 and 2009-2011 from 10.0 [95% confidence interval (CI) 8.8-11.2] to 14.2 (95% CI 12.6-15.8) years in women (P &lt; 0.001) and from 10.0 (95% CI 9.2-10.8) to 14.0 (95% CI 10.6-17.4) years in men (P = 0.02). Our model suggests no statistically significant reduction of HIV incidence in the age-group 15-49 years in 2009-2011 compared with 2003-2005. Age-specific and sex-specific model-based HIV incidence estimates were in good agreement with observed cohort-based estimates from the ongoing HIV surveillance.Conclusion: Our catalytic modelling approach using cross-sectional age-specific HIV prevalence data could be useful to monitor trends of HIV incidence and survival in other African settings with a high ART coverage.<br/

    Primary gestational choriocarcinoma of the uterine cervix. Report of a case and review of the literature

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    Kairi-Vassilatou E, Papakonstantinou K, Grapsa D, Kondi-Paphiti A, Hasiakos D. Primary gestational choriocarcinoma of the uterine cervix. Report of a case and review of the literature. Int J Gynecol Cancer 2007;17:921-925. Gestational choriocarcinoma usually arises in the uterine cavity and is associated with coincident or antecedent pregnancy. Extrauterine choriocarcinomas are very rare entities, and most of these are located in the uterine cervix. In our case, a 43-year-old woman was admitted in our hospital because she had amenorrhea for 2 months and elevated serum beta-human chorionic gonadotropin levels. The patient was considered to have an ectopic pregnancy. Initially, she was treated with methotrexate, but since there was a continuous rise in human chorionic gonadotropin levels, the patient underwent a laparoscopy, along with dilatation and curettage (D&amp;C) of the uterine cavity. Histopathologic findings, including immunohistochemical study, led to the diagnosis of choriocarcinoma of the cervix. Finally, the patient underwent a transabdominal hysterectomy and received single agent chemotherapy with methotrexate. Our case represents a primary choriocarcinoma of the cervix, which was initially misdiagnosed as an ectopic pregnancy. The difficulties in differential diagnosis are discussed. Immunohistochemical evaluation remains the mainstay of the diagnosis in most cases. Choriocarcinoma has a very good prognosis even in advanced stages, since it is a very chemosensitive tumor

    Echocardiographic findings on aortic stenosis: an observational, prospective, and multi-center registry

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    Background: The aim of this aortic stenosis registry was to investigate the changes of routine echocardiographic indices and strain in patients with moderate-to-severe aortic stenosis over a 6-month follow-up period. Methods: Our aortic stenosis registry is observational, prospective, multicenter registry of nine countries, with 197 patients with aortic valve area less than 1.5 cm2. The enrolment took place from January to August 2017. We excluded patients with uncontrolled atrial arrhythmias, pulmonary hypertension or cardiomyopathies, as well as those with hemodynamically significant valvular disease other than aortic stenosis. We included patients who did not require intervention and who had a complete follow-up study. Results: In patients with preserved ejection fraction, left ventricular mass has significantly increased between baseline and follow-up studies (218 ± 34 grams vs 253 ± 29 grams, p = 0.02). However, when indexed to body surface area, there was no significant difference. Left ventricular global longitudinal strain significantly decreased (-19.7 ± -4.8 vs (-16.4 vs -3.8, p = 0.01). Left atrial volume was significantly higher at follow-up (p = 0.035). Right ventricular basal diameter and mid-cavity diameter were greater at the follow-up (p = 0.04 and p = 0.035, respectively). Patients with low-flow low-gradient aortic stenosis had significantly lower global longitudinal strain (-12.3% ± -3.9% vs -19.7% ± -4.8%, p = 0.01). Conclusion: Left atrial dilatation is one of the first changes to take place in low-flow low-gradient aortic stenosis patients even when left ventricular dimensions and function remains intact. Global longitudinal strain is an important determinant of left ventricular systolic and diastolic dysfunction and right ventricular function is an important parameter of aortic stenosis assessment. Accordingly, our registry has further shed the light on these indices role as multisite follow-up of aortic stenosis

    Women's perspective on the COVID-19 pandemic: Walking into a post-peak phase

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    The pandemic of Novel Coronavirus Disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has provoked hundreds of thousands of deaths, resulting in catastrophe for humans. Although some insights have been garnered in studies on women, children and young adults infected with COVID-19, these often remain fragmented in literature. Therefore, we discussed the impact of COVID-19 pandemic on women, children and young patients, particularly those with underlying cardiovascular comorbidities or congenital heart disease. Furthermore, we gathered and distilled the existing body of literature that describes their cardiovascular complications and the recommended actions in favour of those patients toward the post-peak pandemic period. Although many questions still require answers, this article is sought to help the practicing clinician in the understanding and management of the threatening disease in special populations
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