Histopathological and patient-related characteristics of basal cell carcinomas of the head and neck influencing therapeutic management

The authors hypothesize that histopathological characteristics of basal cell carcinomas of the head and neck (BCCHN) have changed over time and the correlation of BCCHN localization and histological tumour type can help improving the number and quality of necessary therapeutic interventions. Information of 222 patients with 344 BCCHN was gained. Descriptive measures were compared to prior studies to prove whether or not characteristics of basal cell carcinomas or patients have changed over time. Afterwards descriptive measures were correlated with number of conducted operations to evaluate if tumour localization, histological tumour type and number of operations depend on one another. Aggravating factors which lead to a higher number of operations were older age, greater size of BCCHN, adjacent elastosis, the localizations eye, ear and nose and histological tumour types morpheaform and nodularulcerated. In comparison to earlier studies characteristics of BCCHN and patients showed positive developments because of grown awareness of BCCHN. Furthermore, our correlations demonstrate that therapeutic results of BCCHN treatment are continuously improving. Nevertheless, treatment of aggressive morpheaform BCCHN in combination with distinctive patient characteristics still needs improvement

Bilateral multifocal Warthin's tumors in upper neck lymph nodes. report of a case and brief review of the literature

Cystadenolymphomas (Warthin's tumors) are the second most frequent lesions of the parotid gland. Due to their benign clinical behavior, the low rates of recurrence and malignant transformation they were classified as tumor-like lesions. In addition, a polyclonal growth of the epithelial components of the tumor could be detected. Warthin's tumors occur bilateral in 7-10%, whereas a multifocal appearance is extremely rare. Even if the pathogenesis is still unclear a heterotopia of salivary tissue during embryogenesis is the most likely explanation for the origin of these tumors in the upper neck and periparotideal region. Here we present a rare case of bilateral, multifocal, extraglandular Warthin's tumors in lymph nodes of the upper neck and give a brief review of the literature. If a primary malignancy can be excluded by a careful staging procedure prior to the operation an isolated excision of the lesions of the neck is the adequate treatment

Fantasy Sports as Gaming or Gambling? Perception, Attitudes, and Engagement Behavior of College Students

Background: The current study was carried out owing to the projected increase in the fantasy sports market in India, the popularity of fantasy sports in the age group of 18–25 years, the gambling-related implications of engaging in fantasy sports, and the dearth of published data on the extent and pattern of engagement in fantasy sports among college students in India. We aimed to assess the attributes of engagement in fantasy sports among college students and explore their perceptions and attitudes toward fantasy sports. Methods: This was a cross-sectional observational study among students enrolled in undergraduate courses in an autonomous college in central India. The study questionnaire included a semi-structured proforma that asked for information on the sociodemographic details, questions to assess the gaming (both online and offline) pattern and participation in fantasy sports by the study participants, and a modified Motives for Online Gaming Questionnaire (MOGQ). The participants were also asked to express, on a 10-point scale, their agreement that fantasy sports are similar to gambling. Results: Around one-fifth of the participants had engaged in a fantasy sport at least once. Around 18% had gambled at least once. The participants who reported losing money from fantasy sports also engaged in a significantly greater number of fantasy sports ( p = .002). Those who engaged in fantasy sports with the main goal of making money agreed more with the statement that fantasy sports are similar to online gambling compared to those who did not ( p = .01). Conclusions: Those who engaged in fantasy sports to make money agreed more with the statement that fantasy sports are similar to gambling. The study helps understand the associations between various psychosocial motives, monetary motivations, and involvement in fantasy sports

TB or not TB? Diagnostic difficulties in HIV-positive versus HIV-negative tuberculosis patients with an immigration background in Germany

Patients immigrated or born to immigrated parents constitute an increasing proportion of TB in Germany. This study aimed to assess the clinical presentation and outcome of immigrated TB-monoinfected (TB/HIV–) patients versus TB patients with an HIV coinfection (TB/HIV+). Ninety-three patients (36 boys/men, 57 girls/women; age range, 2–59 years) were investigated of whom 47 were TB/HIV+ and 46 TB/HIV–. TB/HIV+ patients more frequently had an African background (76.6% [36/47], P <0.001), TB/HIV– patients (63.0% [29/46]) more often had an East-European or Asian background ( P <0.001). Most common symptoms included lymphadenopathy (37.6% [35/93]) and weight loss (35.5% [33/93]). In TB/HIV+ patients acute presentation was more frequent including fever (57.4% [27/47]), gastrointestinal (44.7% [21/47]), and respiratory symptoms (36.2% [17/47]). TB skin test was highly positive in all performed cases (20/20), IGRA was positive in 98.2% (55/56) cases applied. Pulmonary involvement was relatively rare (51/93 [54.8%]), especially in TB/HIV– patients (36.10% [17/46]) vs. TB/HIV+ (70.23% [36/47]; P <0.001). An infectious etiology was suspected in only 43.5% (20/46) TB/HIV– vs. 72.3% (34/47) TB/HIV+ patients ( P ⩽0.005); a malignancy was suspected in (21/46 [45.7%] TB/HIV– patients vs. 12/47 [25.5%] TB/HIV+; P ⩽0.043). The diagnostic delay between first presentation to a doctor and TB diagnosis was long in all cases, especially in TB/HIV– patients (range, 0–336 weeks; median, 8 weeks vs. TB/HIV+ patients; range, 0–288 weeks; median, 0 weeks; P <0.05). TB, especially in young immigrated HIV– patients frequently presents as an atypic extrapulmonary disease, which may end up in a delayed diagnosis of up to several years