Tehran University of Medical Sciences

About: Tehran University of Medical Sciences is a education organization based out in Tehran, Iran. It is known for research contribution in the topics: Population & Cancer. The organization has 35661 authors who have published 57234 publications receiving 878523 citations. The organization is also known as: TUMS.

Penalization, bias reduction, and default priors in logistic and related categorical and survival regressions

Abstract: Penalization is a very general method of stabilizing or regularizing estimates, which has both frequentist and Bayesian rationales We consider some questions that arise when considering alternative penalties for logistic regression and related models The most widely programmed penalty appears to be the Firth small-sample bias-reduction method (albeit with small differences among implementations and the results they provide), which corresponds to using the log density of the Jeffreys invariant prior distribution as a penalty function The latter representation raises some serious contextual objections to the Firth reduction, which also apply to alternative penalties based on t-distributions (including Cauchy priors) Taking simplicity of implementation and interpretation as our chief criteria, we propose that the log-F(1,1) prior provides a better default penalty than other proposals Penalization based on more general log-F priors is trivial to implement and facilitates mean-squared error reduction and sensitivity analyses of penalty strength by varying the number of prior degrees of freedom We caution however against penalization of intercepts, which are unduly sensitive to covariate coding and design idiosyncrasies

Behcet's disease: epidemiology, clinical manifestations, and diagnosis.

Abstract: Behcet's Disease (BD) is classified among vasculitides. The aim of this review was to put together different known reports in order to help the reader to better understand the disease, to avoid the frequent misdiagnosis, and to decide the best treatment. Areas covered: a) Epidemiology: BD is rare, and is seen along the Silk Road, from 20 to 420/100,000 in Turkey and 80/100,000 in Iran, to 0.64/100,000 in the UK. b) Clinical manifestations: oral aphthosis is seen in more than 95% of patients, genital aphthosis (60-90%), skin (pseudofolliculitis/erythema nodosum, 40-90%), eyes (uveitis/retinal vasculitis, 45-90%), gastrointestinal (diarrhea/hemorrhage/perforation/pain, 4-38%), vascular (venous/arterial thrombosis, aneurysm, 2.2-50%), neurological (all kinds, especially meningo-encephalitis, 2.3-38.5%), and articular (arthralgia/arthritis/ankylosing spondylitis, 11.6-93%). c) Pathergy test is positive in some patients: 8.6% (in India) to 70.7% (in China). This data was extracted from the five nationwide surveys and the largest case series from BD conference reports and a Pubmed search. Expert commentary: Diagnosis is clinical but classification/diagnosis criteria may help. The best criteria for BD is the International Criteria for Behcet's Disease (ICBD). BD is a multisystem disease progressing by attacks and remissions. Each attack may resemble the preceding or it may be different in duration, severity, and the systems involved.

Strategies toward rheumatoid arthritis therapy; the old and the new.

Abstract: Currently, medications used to treat rheumatoid arthritis (RA) are glucocorticoids (GCs) and nonsteroidal anti-inflammatory drugs (NSAIDs), predominantly used for controlling the pain and inflammation, disease-modifying antirheumatic drugs (DMARDs), administered as first-line medication for newly diagnosed RA cases, and biological therapies, used to target and inhibit specific molecules of the immune and inflammatory responses. NSAIDs and other GCs are effective in alleviating the pain, inflammation, and stiffness due to RA. DMARDs that are used for RA therapy are hydroxychloroquine, methotrexate, leflunomide, and sulfasalazine. The biological therapies, on the contrary, are chimeric anti-CD20 monoclonal antibody, rituximab, inhibitors of tumor necrosis factor-α (TNF-α) like etanercept, infliximab, and adalimumab, a recombinant inhibitor of interleukin-1 (IL-1), anakinra, and costimulation blocker, abatacept. Moreover, newly under evaluation biological therapies include new TNF-α inhibitors, JAK inhibitors, anti-interleukin-6-receptor monoclonal antibodies (mABs), and antibodies against vital molecules involved in the survival and development of functional B cells. The new strategies to treat RA has improved the course of the disease and most of the patients are successful in remission of the clinical manifestations if the diagnosis of the disease occur early. The probability of remission increase if the diagnosis happens rapidly and treat-to-target approach are implemented. In this review article, we have attempted to go through the treatment strategies for RA therapy both the routine ones and those which have been developed over the past few years and currently under investigation.