The Incidence of Skin Squamous Cell Carcinoma in Osijek-Baranja County – An Epidemiological Study

The aim of this study is to show the incidence of squamous cell carcinoma of the skin in Osijek Baranja County, Eastern Croatia, in period from 2004 to 2009. This is the first report of epidemiological features of squamous cell skin carcinoma in this region. In this period we registred 469 patients with SCC of the skin, from which 237 females (50.5%) and 232 males (49.5%). World age-standardised rates (ASRW per 100,000) incidence in this period was 11.8/100,000 (16.8/ 100,000 for men and 9.0/100,000 for women). SCC of the skin occur in elderly commonly after 70 years. Most common localization is on the photoexposed areas, for example head, neck and backs of the hands. These localization varied in males and females (in females 2.5 times more in the nose area than males while 6 times more on the ear). The relation between photoexposed and photo non-exposed areas is 5:1. These results will serve as reference for studying the patterns of descriptive epidemiology of squamous cell carcinoma of the skin in the Osijek-Baranja County and the surrounding region

The Incidence of Skin Squamous Cell Carcinoma in Osijek-Baranja County – An Epidemiological Study

The aim of this study is to show the incidence of squamous cell carcinoma of the skin in Osijek Baranja County, Eastern Croatia, in period from 2004 to 2009. This is the first report of epidemiological features of squamous cell skin carcinoma in this region. In this period we registred 469 patients with SCC of the skin, from which 237 females (50.5%) and 232 males (49.5%). World age-standardised rates (ASRW per 100,000) incidence in this period was 11.8/100,000 (16.8/ 100,000 for men and 9.0/100,000 for women). SCC of the skin occur in elderly commonly after 70 years. Most common localization is on the photoexposed areas, for example head, neck and backs of the hands. These localization varied in males and females (in females 2.5 times more in the nose area than males while 6 times more on the ear). The relation between photoexposed and photo non-exposed areas is 5:1. These results will serve as reference for studying the patterns of descriptive epidemiology of squamous cell carcinoma of the skin in the Osijek-Baranja County and the surrounding region

Incidence of orbital, conjunctival and lacrimal gland malignant tumors in USA from Surveillance, Epidemiology and End Results, 1973-2009

AIM: To determine the types and incidence of tumors affecting the orbit, conjunctiva and lacrimal glands and to study the trend line of these tumors in the United States from 1973 to 2009. METHODS: We used the publicly available Surveillance, Epidemiology and End Results (SEER) database registries to determine the incidence rates. Age was adjusted to the 2000 US Standard Population. Patients were stratified according to age group, gender, race and histological grouping of tumor lesions. Three age groups were defined: 0-19, 20-49 and ≥50y. Annual percentage changes were calculated to examine trends. RESULTS: The overall age adjusted incidence rate was 3.39 (95%CI: 3.27-3.52) per million person-years. The tumors were more prevalent in age group ≥50 counting 9.51 (95%CI: 9.11-9.92) per million person-years. Most of the soft tissue sarcomas occurred in the young age with incidence rate of 0.35 (95%CI: 0.28-0.42) per million person-years. Lymphomas were the dominant subtype in the adult population with incidence rate of 5.74 (95%CI: 5.43-6.06) per million person-years. Incidence rates were higher in males than females with an overall rate ratio of 1.31 (95%CI: 1.21-1.41) mainly caused by the increase in carcinoma subtypes. White race had a higher tumor incidence with a rate ratio of 1.47(95%CI: 1.25-1.73) driven by the higher incidence of most histological subtypes. Orbital tumors showed a higher incidence rate followed by conjunctival and lacrimal gland tumors with incidence rates of 1.59, 1.37 and 0.43 per million person-years respectively. The trend line of overall incidence of tumors showed a significant increase (APC=3.11, 95%CI: 2.61-3.61) mainly due to increase of lymphomas. This increase was higher than the increase of lymphomas at other sites. CONCLUSION: Orbital, conjunctival and lacrimal gland malignant tumors differ among children and adults. Over the years there has been a noticeable increase in incidence rates of orbital and lacrimal gland tumors mainly caused by an increase in lymphomas and an apparent increase due to advances in diagnostic techniques. ICD-O-3 topographical coding should be improved to consider the different orbital bones and ocular structures

THE EFFECT OF HEAT AND MOISTURE EXCHANGER ON MORPHOLOGICAL AND FUNCTIONAL STATE OF LOVER AIRWAYS IN LARYNGECTOMIZED PERSONS

CILJ ISTRAŽIVANJA: proširenje dosadašnjih spoznaja o terapijskoj vrijednosti i učinkovitosti kazeta za održavanje vlažnosti i temperature zraka čija je uporaba jedini nefarmaceutski način liječenja i prevencije tegoba nastalih nakon totalne laringektomije. NACRT STUDIJE: prospektivna opservacijska studija ISPITANICI I METODE: U studiju je bilo uključeno 70 ispitanika - laringektomiranih osoba obaju spolova liječenih u KBC-u Osijek. Skupinu ispitanika činilo je 35 ispitanika koji se redovito koriste kazetama za održavanje vlažnosti i temperature zraka, a kontrolnu skupinu 35 ispitanika koji se njima ne koriste. Svim ispitanicima uzet je bioptat proksimalnog dijela traheje te su analizirane histološke promjene sluznice. Svi su podvrgnuti spirometriji, a na temelju dobivenih podataka procijenjen je i uspoređen morfološki i funkcionalni status donjih dišnih putova za obje ispitivane skupine. Ispitanici su potom ispunili posebno osmišljen upitnik na osnovi kojega je procijenjen utjecaj kazeta na neke aspekte kvalitete života laringektomiranih osoba. Statistička obrada podataka provedena je pomoću statističkog paketa SPSS (verzija 17.0.0, SPSS Inc., Chicago, IL, SAD). REZULTATI: Blago zadebljanje bazalnih stanica epitela nađeno je u 8 (11 %), srednje zadebljanje bazalnih stanica epitela u 7 (10 %), a jako zadebljanje bazalnih stanica epitela u 2 (3 %) ispitanika. Najveći broj ispitanika imao je nalaz pločaste metaplazije 35 (50 %). Blaga displazija nađena je u 5 (7 %), a umjerena u 4 (6 %) od 70 ispitanika. Postoji statistički značajna razlika u pojavnosti najtežih, prekanceroznih promjena (displazije) u bioptatu sluznice traheje u promatranim skupinama. Displazija I. i II. stupnja nalazi se u 1 (1 %) ispitanika u skupini koja se koristi kazetama, a u 8 (11 %) ispitanika kontrolne skupine. Ispitivani spirometrijski parametri za sve kategorije pokazuju bolji rezultat nalaza u kategoriji ispitanika koji nose kazetu u usporedbi s onima oni ju koji ne nose, no ni za jedan parametar nije nađena statistički značajna razlika u ispitivanim skupinama. Svi su ispitanici ocijenili ukupno 10 obilježja vezanih uz dišne putove, osjetilne funkcije i gornji dio probavnog sustava (bol u vratu, problemi vezane uz usnu šupljinu, osjet okusa i mirisa, tegobe s disanjem i nosnom sekrecijom, problemi s gutanjem, govor, kašalj i iskašljavanje). Od ukupno 10 ocijenjenih kategorija, postoji statistički značajna razliku u pojavnosti osjećaja boli u području vrata te osjeta okusa. Od ukupno osam obilježja vezanih uz psihosocijalno funkcioniranje u vlastitom okruženju, statistički značajna razlika nađena je u ocjeni kvalitete komunikacije, socijalne interakcije i koncentracije. ZAKLJUČAK: Kazete za održavanje vlažnosti i temperature zraka mogle bi imati ulogu u očuvanju staničnog integriteta respiratornog epitela. Rezultate spirometrije koji ne pokazuju statistički značajnu razliku za dvije ispitivane skupine moglo bi se pripisati malom uzorku, no ipak predstavljaju značajan temelj za buduća istraživanja. Kazete za održavanje vlažnosti i temperature zraka povoljno utječu na neke simptome koji su uobičajeni nakon totalne laringektomije te na neke aspekte kvalitete života laringektomiranih osoba.OBJECTIVES. Expansion of previous cognitions on therapeutic values and effectiveness of the heat and moisture exchanger as its use is the only non-pharmaceutical way of treatment and prevention of pulmonary complications after total laryngectomy. STUDY DESIGN. Prospective observational study. PATIENTS AND METHODS. The study included 70 respondents – laryngectomized persons of both genders who were treated at Clinical Hospital Center Osijek. There were 35 respondents who regularly used heat and moisture exchangers and 35 respondents in control group who didn't use them. Biopsy specimen of the proximal part of the trachea has been taken in all respondents, and histological changes of the tracheal epithelium have been analysed. All of them have undergone spirometry. According to the obtained data morphological and functional status of lower respiratory tract has been evaluated and compared in both groups of respondents. Subsequently, the respondents have filled in a questionnaire according to which the influence of the heat and moisture exchanger onto some aspects in life quality of patients after laryngectomy could be evaluated. Statistical analysis was performed with SPSS Statistics (Version 17.0.0, SPSS Inc.,Chicago, IL, USA). RESULTS. Mild basal cell hyperplasia has been found in 8 (11 %), moderate basal cell hyperplasia in 7 (10 %), and advanced basal cell hyperplasia in 2 (3 %) respondents. Squamous metaplasia was the most common finding (50 %). Mild dysplasia was found in 5 (7 %), and moderate dysplasia in 4 (6 %) of 70 respondents. There is a statistically significant difference in manifestation of most severe, precancerous changes (dysplasia) in tracheal biopsy specimen in both groups. Mild and moderate squamous dysplasia has been found in 1 (1 %) user, and in 8 (11 %) non-users. Although the examined spirometric parameters for all categories show a better result in experimental group, statistical comparison has not detected any significant differences between the experimental and control group. All respondents graded 10 characteristics connected to respiratory system, sensory functions and the upper part of digestive system (neck pain, dry mouth, taste and smell, breathing problems, nose secretion, swallowing problems, speech, cough and expectoration). Out of 10 categories evaluated three were statistically significant difference in neck pain and taste. Out of eight characteristics connected to psychosocial functioning in the environment, statistically significant difference was found in communication, social interaction and concentration. CONCLUSION. Heat and moisture exchanger could have an important role in protection of respiratory epithel cell integrity. Spirometry results which didn't show statistically significant difference for the two examined groups could be explained by small sample, but they represent an important basis for future research. Heat and moisture exchanger positively influences some symptoms that are frequent after total laryngectomy, as well as some aspects of the life quality in patients after total laryngectomy

Cancer Management

Cancer remains a major clinical challenge as a cause of death due to its frequent poor prognosis and limited treatment options in many cases. Cancer management book addresses various cancer management related topics including new approaches for early cancer detection and novel anti-cancer therapeutic strategies. This book is a collection of studies and reviews written by experts from different parts of the world to present the most up-to-date knowledge on cancer management