Journal of Research in Medical Sciences1735-1995221020171101Comparing Cox regression and parametric models in the analysis of factors influencing event time of neuropathy in patients with type 2 diabetes1070810708EN20171003Background: Cox proportional hazard model is the most common method for analyzing the effects of several variables on survival time. However, under certain circumstances, parametric models give more precise estimates to analyze survival data than Cox. The purpose of this study was to investigate the comparative performance of Cox and parametric models in a survival analysis of factors affecting the event time of neuropathy in patients with type 2 diabetes. Materials and Methods: This study included 371 patients with type 2 diabetes without neuropathy who were registered at Fereydunshahr diabetes clinic. Subjects were followed up for the development of neuropathy between 2006 to March 2016. To investigate the factors influencing the event time of neuropathy, significant variables in univariate model (P < 0.20) were entered into the multivariate Cox and parametric models (P < 0.05). In addition, Akaike information criterion (AIC) and area under ROC curves were used to evaluate the relative<br />goodness of fitted model and the efficiency of each procedure, espectively. Statistical computing was performed using R software<br />version 3.2.3 (UNIX platforms, Windows and MacOS). Results: Using Kaplan–Meier, survival time of neuropathy was computed 76.6 ± 5 months after initial diagnosis of diabetes. After multivariate analysis of Cox and parametric models, ethnicity, high?density lipoprotein and family history of diabetes were identified as predictors of event time of neuropathy (P < 0.05). Conclusion: According to AIC, “log?normal” model with the lowest Akaike’s was the best?fitted model among Cox and parametric models.<br />According to the results of comparison of survival receiver operating haracteristics curves, log?normal model was considered as the most efficient and fitted model.http://jrms.mui.ac.ir/index.php/jrms/article/view/10708http://jrms.mui.ac.ir/index.php/jrms/article/download/10708/5558Journal of Research in Medical Sciences1735-1995221020171101The relationship between food insecurity with cardiovascular risk markers and metabolic syndrome components in patients with diabetes: A population?based study from Kerman coronary artery disease risk study1070910709EN20171003Aim: We sought the prevalence of food insecurity and whether cardiovascular risk markers and metabolic syndrome components are significantly different in categories of food insecurity in patients with type 2 diabetes. Materials and Methods: In this cross?sectional study, 520 patients with type 2 diabetes from the Kerman coronary artery disease risk study aged between 23 and 87 years (60.8 ± 11.4) who selected by one?stage cluster sampling were assigned into four groups of “food secure” and “mild,” “moderate,” and “severe” food insecure. Household food insecurity was assessed by a 9?item household food insecurity access scale questionnaire. Results: The prevalence of food security and mild, moderate, and severe food insecurity in patients with diabetes was 24.4%, 33.1%, 28.9%, and 13.6%, respectively. There was a significant difference among the food?secure/insecure sex groups (P = 0.001). The prevalence of food insecurity and risk factors such as total cholesterol, high low?density lipoprotein cholesterol, and visceral obesity in mild food?insecure females was significantly higher than males (P < 0.001, 0.001, and 0.001, respectively). The fasting blood sugar significantly increased (P = 0.020) in diabetic females with food security than the other female groups. Diastolic blood pressure significantly increased (P = 0.028) in diabetic females with severe food insecurity than the other female groups. The glycosylated hemoglobin significantly increased (P = 0.013) in diabetic males with severe food insecurity than the other male groups. Food insecurity odds<br />ratio in females was 1.74 (95% confidence interval [CI]: 1.10–2.70), 2.39 (95% CI: 1.48–3.88), and 2.73 (95% CI: 1.49–5.01) times higher than in males for mild, moderate, and severe food insecurity, respectively. onclusions: Food insecurity may deteriorate some cardiometabolic biomarkers in type 2 diabetes. Improving food security in patients with diabetes may help reduce cardiovascular disease.http://jrms.mui.ac.ir/index.php/jrms/article/view/10709http://jrms.mui.ac.ir/index.php/jrms/article/download/10709/5559Journal of Research in Medical Sciences1735-1995221020171101Compliance with continuous positive airway pressure in Persian patients with obstructive sleep apnea1071110711EN20171003Background: Obstructive sleep apnea (OSA) is defined by recurrent apnea and hypopnea during sleep. The main treatment of OSA is continuous positive airway pressure (CPAP). Adherence to CPAP is challenging and depends on multiple factors. This study was designed to evaluate the compliance with CPAP in patients with OSA. Materials and Methods: This was a prospective observational study including 106 patients with confirmed OSA by a standard polysomnography. We recorded CPAP usage hours after 7 and 90 days by a smart card. We compared the adherence of the patients with respect to body mass index (BMI), gender, smoking status, living area, and education level. Results: Patients in the 18–45 years’ age group had higher compliance in mean (standard deviation) daily use of CPAP (0.93 [0.40] h) compared to the other age groups (P < 0.001). Patients with BMI >35 had better compliance (1.13 [0.44]) than the other patients (P < 0.001). Furthermore, nonsmokers and highly educated patients had better compliance compared to the others (P < 0.001). Conclusion: Age, BMI, education, and smoking are important factors in<br />adherence to CPAP in patients with OSA <br />http://jrms.mui.ac.ir/index.php/jrms/article/view/10711Journal of Research in Medical Sciences1735-1995221020171101Evaluation of response to hepatitis B vaccine in Iranian 6–18?year?old students1071310713EN20171003Background: Hepatitis B is a dangerous disease with high morbidity and mortality rates all around the world. Vaccination is the most important way to its prevention and control. This cross?sectional study was carried out to study the levels of immunogenicity to hepatitis B vaccine in students. Materials and Methods: Six hundred and forty?four students aged 6–18 years including 316 girls and 328 boys were selected from the Chaharmahal Va Bakhtiari province. Selected students had been received three doses of recombinant vaccine (0, 1, and 6 months). Blood samples were taken and the titers of hepatitis B surface antigen were studied. esults: From a total of 644 students, 396 (61.5%) had a titer lesser than 10 mIu/ml and 248 (38.5%) had a titer higher than 10 mIu/ml. Therefore, the level of respond to vaccine with 95% confidence was 38.5% (34.7%–42.4%). Levels of respond to vaccine were related to age, body mass index (BMI), and educational level and were not related to sex and habit of students. Conclusions: Reverse significant relation was seen between the respond to vaccine and age and BMI in a way which the titers of antibody were lower in students with higher age and BMI.http://jrms.mui.ac.ir/index.php/jrms/article/view/10713http://jrms.mui.ac.ir/index.php/jrms/article/download/10713/5562Journal of Research in Medical Sciences1735-1995221020171101Acquired tumor resistance to antiangiogenic therapy: Mechanisms at a glance1071210712EN20171003Angiogenesis is critical for oxygen and nutrient delivery to proliferating tumor cells. Th erefore, as angiogenesis is required and<br />vital for the tumor growth and metastasis. Antiangiogenic therapy is considered to be benefi cial for tumor growth prevention due<br />to starvation of tumor of oxygen and nutrients, but in some cases, the benefi ts are not permanent. Tyrosine kinase inhibitors and many other agents often target angiogenesis through inhibition of the vascular ndothelial growth factor (VEGF) pathway. Although preclinical studies showed satisfactory outcomes in tumor growth inhibition, antiangiogenic therapy in the clinical setting may not be eff ective.Th e resistance bserved in several tumor types through alternative angiogenic “escape” pathways contributes to restoration of tumor growth and may induce rogression, enhancement of invasion, and metastasis. Th erefore, tivation of major compensatory angiogenic pathways, sustaining tumor angiogenesis during VEGF blockade contributing to the recurrence of tumor<br />growth overcome antiangiogenic strategies. In this review, we summarize the novel mechanisms involved in evasive resistance to antiangiogenic therapies and represent diff erent cancer types which have the ability to adapt to VEGF inhibition achieving resistance to antiangiogenic therapy through these adaptive mechanisms.http://jrms.mui.ac.ir/index.php/jrms/article/view/10712http://jrms.mui.ac.ir/index.php/jrms/article/download/10712/5561Journal of Research in Medical Sciences1735-1995221020171101Myocardial bridge over the left anterior descending coronary artery: A case report and review of the literature1071610716EN20171003Myocardial bridging (MB) is considered as a topic of high interest since its occurrence in diff erent studies is statistically signifi cant, and the clinical manifestations of this phenomenon are complicated with cardiovascular diseases. Whether the MB participates in heart diseases and has a decisive eff ect to life-threatening situations is still under research, and many studies have been conducted to clarify the abovementioned question. A case report with a MB on the left anterior descending coronary artery is presented in the<br />current study, and a review of the literature is provided as well. Cardiologists as well thoracic surgeons and radiologists should bear in their mind the otential presence of such variant during interpretation of angiographies and multidetector-computed tomography.http://jrms.mui.ac.ir/index.php/jrms/article/view/10716http://jrms.mui.ac.ir/index.php/jrms/article/download/10716/5565Journal of Research in Medical Sciences1735-1995221020171101Does zinc possess renoprotective properties in patients under cardiac surgery?1071410714EN20171003...http://jrms.mui.ac.ir/index.php/jrms/article/view/10714http://jrms.mui.ac.ir/index.php/jrms/article/download/10714/5563Journal of Research in Medical Sciences1735-1995221020171101Opium, an important risk factor for deep vein thrombosis patients1071510715EN20171003...http://jrms.mui.ac.ir/index.php/jrms/article/view/10715http://jrms.mui.ac.ir/index.php/jrms/article/download/10715/5564