Epidemiological studies to develop a regional melanoma prevention strategy

Az általános és középiskolás diákok körében végzett vizsgálat azt mutatta, hogy bár sokan használnak fényvédőkrémet, mégis a tanulók igen nagy százaléka számolt be napégésről, valamint a szolárium használat is viszonylag magasnak bizonyult mindkét korosztályú csoportban. A multinomiális regresszió analízis kimutatta, hogy a világos bőrtípussal rendelkezők, illetve a szoláriumot használók körében nagyobb eséllyel volt magas a naevus szám. A melanoma incidencia trendjét megvizsgálva azt tapasztaltuk, hogy mind az országos, mind a Hajdú-Bihar megyei standardizált incidencia a 2001 és 2014 közötti időszakban emelkedett. A 2012-2014-es időszakban nőtt a vastagabb Breslow értékkel és a III-as, illetve a már IV-es stádiumban diagnosztizált melanomák aránya. Eredményeink azt mutatják, hogy szükséges a prevenciós stratégiák javítása hazánkban. Egyrészt fontos lenne a primer prevenció fejlesztése érdekében az iskolaorvosok bevonása, annak érdekében, hogy a diákok és szüleik tájékozottabbak legyenek a kockázati tényezőkről, másrészt bőrgyógyászati tréningek után megfelelően rendszeresen ellenőrizhetnék a diákok bőrét. A melanoma esetében célzott populáció szintű szűrés lenne a szükségszerű és költséghatékony. A célpopuláció, azaz a 60 év felettiek szűrésében a háziorvosok hatékonyan tudnának részt venni.A study among primary and secondary school students found that although many people use sunscreen, a high percentage of students reported sunburn, and the use of solarium was also relatively high in both age groups. Multinomial regression analysis showed that those with light skin types and those using sunbeds were more likely to have high nevi numbers. Examining the trend in the incidence of melanoma, we found that both the national and Hajdú-Bihar County standardized incidence increased between 2001 and 2014. The proportion of melanomas diagnosed with higher tumour thickness and those diagnosed in Stage III and Stage IV increased in 2012-2014. Our results showed the need to improve prevention strategies in Hungary. On the one hand, it would be important to involve school physicians to improve primary prevention in order to make students and their parents more aware of the risk factors, and, on the other hand after dermatological training they will be able to appropriately and regularly check students' skin. For melanoma, targeted population-level screening would be necessary and cost-effective. General practitioners could effectively participate in screening the target population, i.e. those over the age of 60

Secukinumabbal szerzett klinikai tapasztalataink krónikus plakkos psoriasisban szenvedő betegek terápiájában

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Is the Definition of Roma an Important Matter? The Parallel Application of Self and External Classification of Ethnicity in a Population-Based Health Interview Survey

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Melanoma incidencia Hajdú-Bihar megyében a 2000-2014 közötti időszakban

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Primary tumour category, site of metastasis, and baseline serum S100B and LDH are independent prognostic factors for survival in metastatic melanoma patients treated with anti-PD-1

BackgroundPrognostic classification of metastatic melanoma patients treated with anti-PD-1 is of great interest to clinicians.ObjectiveWe aimed to determine the anti-PD-1 treatment related prognostic performance of demographics, clinical and histological prognostic markers and baseline serum S100B and LDH levels in advanced melanoma.MethodsA total of 200 patients with unresectable metastatic melanoma were included in this retrospective study. 34.5% had stage M1c disease and 11.5% had stage M1d disease at the start of therapy. 30% had pT4b primary melanoma. 55.5% had elevated baseline serum S100B levels and 62.5% had elevated baseline serum LDH levels. We analysed the risk of death using univariate and multivariate Cox proportional-hazards models and the median overall (OS) and progression-free (PFS) survival using the Kaplan-Meier estimator.ResultsThe median follow-up time from the start of anti-PD-1 treatment in patients who were alive at the end of the study (N=81) was 37 months (range: 6.1–95.9). The multivariate Cox regression analysis showed that M1c stage (vs. M1a, p=0.005) or M1d stage at the start of therapy (vs. M1a, p=0.001), pT4b category (vs. pT1a, p=0.036), elevated baseline serum S100B levels (vs. normal S100B, p=0.008) and elevated LDH levels (vs. normal LDH, p=0.049) were independently associated with poor survival. The combination of M1d stage, elevated baseline serum S100B and LDH levels and pT4b category was associated with a very high risk of death (HR 4.72 [1.81; 12.33]). In the subgroup of patients with pT4b primary melanoma, the median OS of patients with normal serum S100B levels was 37.25 months [95% CI 11.04; 63.46]), while the median OS of patients with elevated serum S100B levels was 8.00 months [95% CI 3.49; 12.51]) (p<0.001); the median OS of patients with normal serum LDH levels was 41.82 months [95% CI 11.33; 72.32]), while the median OS of patients with elevated serum LDH levels was 12.29 months [95% CI 4.35; 20.23]) (p=0.002).ConclusionOur real-world study indicates that the prognostic role of primary melanoma parameters is preserved in anti-PD-1 treated stage IV patients. Furthermore, there seems to be perspective in combining clinical, histological and serum prognostic markers in a prognostic model

Circulating epithelial-mesenchymal transition-associated miRNAs are promising biomarkers in ovarian cancer

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The prevalence of ADH1B and OPRM1 alleles predisposing for alcohol consumption are increased in the Hungarian psoriasis population

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Cyclobutane Pyrimidine Dimers from UVB Exposure Induce a Hypermetabolic State in Keratinocytes via Mitochondrial Oxidative Stress

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