ЭПИДЕМИОЛОГИЧЕСКИЕ АСПЕКТЫ ОСНОВНЫХ ЛОКАЛИЗАЦИЙ ГИНЕКОЛОГИЧЕСКОГО РАКА В ТОМСКОЙ ОБЛАСТИ

The purpose of the study was to evaluate the epidemiological aspects of the three major gynecologic cancers (cervical, endometrial and ovarian cancers) in Tomsk region. Material and methods. The data collected by the population-based cancer registry and the territorial body of the Federal State Statistics were analyzed. The epidemiological situation in Tomsk region between 2007 and 2015 was studied. Results. Gynecologic cancer is one of the most common cancers affecting women in Tomsk region. Cervical cancer is the 4-th most frequent cancer in Siberian Federal District. The incidence of gynecologic cancer has been steadily rising over time. Early diagnosis of endometrial and ovarian cancers remains a significant clinical challenge. The one-year mortality rate is still high. We recognize that unlike cervical cancer, screening benefits have not been shown for endometrial and ovarian cancer. To improve the specialized care for gynecological cancer patients, the screening programs in the region were approved.Статья посвящена анализу эпидемиологической ситуации по таким локализациям, как рак шейки матки, рак тела матки, рак яичников, на территории Томской области. Цель работы – изучить эпидемиологическую ситуацию по гинекологическому раку (рак шейки матки, рак тела матки, рак яичников) в Томской области. Материал и методы. Проанализированы данные официальных отчетных форм, базы популяционного областного ракового регистра и территориального органа государственной статистики. Изучена ситуация с 2007 по 2015 г. Результаты. Гинекологический рак занимает одно из лидирующих мест в структуре онкопатологии женского населения области. По заболеваемости раком шейки матки Томская область занимает 4-е место среди территорий Сибирского федерального округа. В динамике наблюдается рост показателей заболеваемости раком шейки и тела матки. Ряд показателей, характеризующих онкологическую помощь при гинекологическом раке, хуже, чем в среднем по региону (ранняя диагностика тела матки и яичника, низкий уровень активной выявляемости рака шейки, тела матки и яичника, высокий показатель одногодичной летальности). Для улучшения специализированной помощи больным гинекологическим раком в онкологическом диспансере утвержден план мероприятий по реализации скрининга рака шейки матки в женской популяции области

Absolute charge calibration of scintillating screens for relativistic electron detection

We report on new charge calibrations and linearity tests with high-dynamic range for eight different scintillating screens typically used for the detection of relativistic electrons from laser-plasma based acceleration schemes. The absolute charge calibration was done with picosecond electron bunches at the ELBE linear accelerator in Dresden. The lower detection limit in our setup for the most sensitive scintillating screen (KODAK Biomax MS) was 10 fC/ mm 2. The screens showed a linear photon-to-charge dependency over several orders of magnitude. An onset of saturation effects starting around 10-100 pC/ mm2 was found for some of the screens. Additionally, a constant light source was employed as a luminosity reference to simplify the transfer of a one-time absolute calibration to different experimental setups

ОСОБЕННОСТИ И ХАРАКТЕРИСТИКА ПОКАЗАТЕЛЕЙ ЗАБОЛЕВАЕМОСТИ РАКОМ ЩИТОВИДНОЙ ЖЕЛЕЗЫ У ЖИТЕЛЕЙ Г. ТОМСКА И ТОМСКОЙ ОБЛАСТИ

The analysis of thyroid cancer incidence and its structure among different populations of Tomsk region is presented. We studied the report documents, the database of the Tomsk regional oncologic dispensary for the period 2008 to 2012. The clinical characteristics of patients with thyroid cancer were summarizes according to sex, age and place of residence. The papillary cancer was the most often diagnosed. It was found that in young patients, thyroid cancer was diagnosed more often in the stage 1 and 2. On the other hand, in elderly patients (above 60 years), thyroid cancer diagnosed at stage 3 and 4. In the Tomsk region, as elsewhere in the world, thyroid cancer is detected more often in women.Представлены результаты анализа заболеваемости раком щитовидной железы среди жителей Томской области, особенности ее структуры среди различных контингентов населения. Были изучены база данных и отчетные документы Томского областного онкологического диспансера за период 2008–2012 гг. Обобщена клиническая характеристика больных раком щитовидной железы в зависимости от пола, возраста и места проживания. В результате анализа установлено, что лидирующее место в морфологической структуре рака щитовидной железы принадлежит папиллярному раку. Выявлено увеличение количества вновь выявленных больных, установлено, что рак щитовидной железы в молодом возрасте чаще диагностируется на ранних стадиях, стадии 3 и 4 при первичной диагностике встречаются преимущественно у лиц старше 60 лет. В Томской области, как и во всем мире, среди больных раком щитовидной железы превалируют женщины

Анализ заболеваемости инвазией Opisthorchis felineus и злокачественными новообразованиями гепатобилиарной системы в Российской Федерации

The purpose of this paper is to perform the pilot review of the official medical statistics on reported Opisthorchis felineus (O. felineus) infection and liver and intrahepatic bile duct cancer in Russian Federation, covering the period 2011–2013.Materials and methods. Statistical data collected from 81 regions of Russia, reflecting the incidence of opisthorchiasis over a period from the 1st of January 2011 to the 31st of December 2013 was analyzed. The analysis of official health statistics of malignant hepatic lesions and intrahepatic bile duct was conducted in 82 regions of Russia over the same period. The data was obtained from the annual reports of the Russian center of information technologies and epidemiological studies in the field of oncology.Results. The average annual incidence of O. felineus was 24,7 ± 9,0 cases per 100,000 population. The highest incidence was observed in Khanty-Mansiysk Autonomous Okrug, Yamalo-Nenets Autonomous Okrug, Tyumen Oblast, Tomsk Oblast, Omsk Oblast and Novosibirsk Oblast. We did not observe any significant change in O. felineus infection rates within last 20 years. However, we found that infection incidence had increased in some geographical units of Western Siberia. The incidence of liver and intrahepatic bile duct cancers was 4,8 ± 0,2 cases per 100,000 population; the highest rate was reported in Far East regions, Siberia and Volgograd Oblast. This study documents the importance of opisthorchiasis in certain endemic areas and presents the best available data on associations between O. felineus infection and liver/intrahepatic bile duct cancers in endemic areas of Russian Federation.Цель. Исследовать взаимосвязь заболеваемости инвазией Opisthorchis felineus (O. felineus) и злокачественными новообразованиями гепатобилиарной системы у населения Российской Федерации на основании анализа данных официальной медицинской отчетности за период 2011–2013 гг.Материал и методы. Проанализированы статистические данные 81 региона России, отражающие заболеваемость описторхозом за период с 1 января 2011 г. по 31 декабря 2013 г. Проведен анализ официальных медицинских статистических данных злокачественного поражения печени и внутрипеченочных желчных протоков в 82 регионах России за аналогичный период, полученный из годовых отчетов Российского центра информационных технологий и эпидемиологических исследований в области онкологии.Результаты. Заболеваемость инвазией O. felineus составила 24,7 ± 9,0 на 100 000 населения. К гиперэндемичным по описторхозу регионам (уровень заболеваемости > 100 на 100 000 населения) относятся Ханты-Мансийский автономный округ, Ямало-Ненецкий автономный округ, а также Тюменская, Томская, Омская и Новосибирская области (Западная Сибирь). Средний показатель заболеваемости инвазией O. felineus в динамике за последние 20 лет относительно стабилен, однако отмечается распространение инвазии на новые территории. Заболеваемость раком печени и внутрипеченочных желчных протоков составила 4,8 ± 0,2 случаев на 100 000 населения, при этом наиболее высокие показатели регистрируются на Дальнем Востоке, в Сибири и Волгоградской области. Получены пилотные данные о взаимосвязи заболеваемости инвазией O. felineus и онкологическими заболеваниями гепатобилиарной системы у населения эндемичных регионов Российской Федерации

Identifying patients with diabetes and the earliest date of diagnosis in real time: an electronic health record case-finding algorithm

BACKGROUND: Effective population management of patients with diabetes requires timely recognition. Current case-finding algorithms can accurately detect patients with diabetes, but lack real-time identification. We sought to develop and validate an automated, real-time diabetes case-finding algorithm to identify patients with diabetes at the earliest possible date. METHODS: The source population included 160,872 unique patients from a large public hospital system between January 2009 and April 2011. A diabetes case-finding algorithm was iteratively derived using chart review and subsequently validated (n = 343) in a stratified random sample of patients, using data extracted from the electronic health records (EHR). A point-based algorithm using encounter diagnoses, clinical history, pharmacy data, and laboratory results was used to identify diabetes cases. The date when accumulated points reached a specified threshold equated to the diagnosis date. Physician chart review served as the gold standard. RESULTS: The electronic model had a sensitivity of 97%, specificity of 90%, positive predictive value of 90%, and negative predictive value of 96% for the identification of patients with diabetes. The kappa score for agreement between the model and physician for the diagnosis date allowing for a 3-month delay was 0.97, where 78.4% of cases had exact agreement on the precise date. CONCLUSIONS: A diabetes case-finding algorithm using data exclusively extracted from a comprehensive EHR can accurately identify patients with diabetes at the earliest possible date within a healthcare system. The real-time capability may enable proactive disease management

Lancet

BACKGROUND: In 2015, the second cycle of the CONCORD programme established global surveillance of cancer survival as a metric of the effectiveness of health systems and to inform global policy on cancer control. CONCORD-3 updates the worldwide surveillance of cancer survival to 2014. METHODS: CONCORD-3 includes individual records for 37.5 million patients diagnosed with cancer during the 15-year period 2000-14. Data were provided by 322 population-based cancer registries in 71 countries and territories, 47 of which provided data with 100% population coverage. The study includes 18 cancers or groups of cancers: oesophagus, stomach, colon, rectum, liver, pancreas, lung, breast (women), cervix, ovary, prostate, and melanoma of the skin in adults, and brain tumours, leukaemias, and lymphomas in both adults and children. Standardised quality control procedures were applied; errors were rectified by the registry concerned. We estimated 5-year net survival. Estimates were age-standardised with the International Cancer Survival Standard weights. FINDINGS: For most cancers, 5-year net survival remains among the highest in the world in the USA and Canada, in Australia and New Zealand, and in Finland, Iceland, Norway, and Sweden. For many cancers, Denmark is closing the survival gap with the other Nordic countries. Survival trends are generally increasing, even for some of the more lethal cancers: in some countries, survival has increased by up to 5% for cancers of the liver, pancreas, and lung. For women diagnosed during 2010-14, 5-year survival for breast cancer is now 89.5% in Australia and 90.2% in the USA, but international differences remain very wide, with levels as low as 66.1% in India. For gastrointestinal cancers, the highest levels of 5-year survival are seen in southeast Asia: in South Korea for cancers of the stomach (68.9%), colon (71.8%), and rectum (71.1%); in Japan for oesophageal cancer (36.0%); and in Taiwan for liver cancer (27.9%). By contrast, in the same world region, survival is generally lower than elsewhere for melanoma of the skin (59.9% in South Korea, 52.1% in Taiwan, and 49.6% in China), and for both lymphoid malignancies (52.5%, 50.5%, and 38.3%) and myeloid malignancies (45.9%, 33.4%, and 24.8%). For children diagnosed during 2010-14, 5-year survival for acute lymphoblastic leukaemia ranged from 49.8% in Ecuador to 95.2% in Finland. 5-year survival from brain tumours in children is higher than for adults but the global range is very wide (from 28.9% in Brazil to nearly 80% in Sweden and Denmark). INTERPRETATION: The CONCORD programme enables timely comparisons of the overall effectiveness of health systems in providing care for 18 cancers that collectively represent 75% of all cancers diagnosed worldwide every year. It contributes to the evidence base for global policy on cancer control. Since 2017, the Organisation for Economic Co-operation and Development has used findings from the CONCORD programme as the official benchmark of cancer survival, among their indicators of the quality of health care in 48 countries worldwide. Governments must recognise population-based cancer registries as key policy tools that can be used to evaluate both the impact of cancer prevention strategies and the effectiveness of health systems for all patients diagnosed with cancer. FUNDING: American Cancer Society; Centers for Disease Control and Prevention; Swiss Re; Swiss Cancer Research foundation; Swiss Cancer League; Institut National du Cancer; La Ligue Contre le Cancer; Rossy Family Foundation; US National Cancer Institute; and the Susan G Komen Foundation

Dental Treatment in a State-Funded Primary Dental Care Facility: Contextual and Individual Predictors of Treatment Need?

OBJECTIVE:This study examined individual and contextual factors which predict the dental care received by patients in a state-funded primary dental care training facility in England. METHODS:Routine clinical and demographic data were extracted from a live dental patient management system in a state-funded facility using novel methods. The data, spanning a four-year period [2008-2012] were cleaned, validated, linked by means of postcode to deprivation status, and analysed to identify factors which predict dental treatment need. The predictive relationship between patients' individual characteristics (demography, smoking, payment status) and contextual experience (deprivation based on area of residence), with common dental treatments received was examined using unadjusted analysis and adjusted logistic regression. Additionally, multilevel modelling was used to establish the isolated influence of area of residence on treatments. RESULTS:Data on 6,351 dental patients extracted comprised of 147,417 treatment procedures delivered across 10,371 courses of care. Individual level factors associated with the treatments were age, sex, payment exemption and smoking status and deprivation associated with area of residence was a contextual predictor of treatment. More than 50% of children (<18 years) and older adults (≥65 years) received preventive care in the form of 'instruction and advice', compared with 46% of working age adults (18-64 years); p = 0.001. The odds of receiving treatment increased with each increasing year of age amongst adults (p = 0.001): 'partial dentures' (7%); 'scale and polish' (3.7%); 'tooth extraction' (3%; p = 0.001), and 'instruction and advice' (3%; p = 0.001). Smokers had a higher likelihood of receiving all treatments; and were notably over four times more likely to receive 'instruction and advice' than non-smokers (OR 4.124; 95% CI: 3.088-5.508; p = 0.01). A further new finding from the multilevel models was a significant difference in treatment related to area of residence; adults from the most deprived quintile were more likely to receive 'tooth extraction' when compared with least deprived, and less likely to receive preventive 'instruction and advice' (p = 0.01). CONCLUSION:This is the first study to model patient management data from a state-funded dental service and show that individual and contextual factors predict common treatments received. Implications of this research include the importance of making provision for our aging population and ensuring that preventative care is available to all. Further research is required to explain the interaction of organisational and system policies, practitioner and patient perspectives on care and, thus, inform effective commissioning and provision of dental services

EPIDEMIOLOGICAL ASPECTS OF GYNECOLOGIC CANCER IN TOMSK REGION

The purpose of the study was to evaluate the epidemiological aspects of the three major gynecologic cancers (cervical, endometrial and ovarian cancers) in Tomsk region. Material and methods. The data collected by the population-based cancer registry and the territorial body of the Federal State Statistics were analyzed. The epidemiological situation in Tomsk region between 2007 and 2015 was studied. Results. Gynecologic cancer is one of the most common cancers affecting women in Tomsk region. Cervical cancer is the 4-th most frequent cancer in Siberian Federal District. The incidence of gynecologic cancer has been steadily rising over time. Early diagnosis of endometrial and ovarian cancers remains a significant clinical challenge. The one-year mortality rate is still high. We recognize that unlike cervical cancer, screening benefits have not been shown for endometrial and ovarian cancer. To improve the specialized care for gynecological cancer patients, the screening programs in the region were approved

Temporal and spectral evolution of runaway electron bursts in TEXTOR disruptions

Novel observations of the burst-like runaway electron losses in tokamak disruptions are reported. The runaway bursts are temporally resolved and first-time measurements of the corresponding runaway energy spectra are presented. A characteristic shape and burst to burst changes of the spectra are found. The runaway energy content of the disruptions and the conversion of the predisruptive magnetic energy are estimated. The radial decay of the runaways can be approximated by an exponential distribution. Deriving from the measurements, resistive tearing modes or kink modes are suggested to trigger the formation of the bursts