Sun-protection and sun-exposure habits among sailors: results of the 2018 world's largest sailing race Barcolana' skin cancer prevention campaign.

BACKGROUND: Epidemiologic data suggest an increased risk of melanoma (MM) and non-melanoma skin cancer (NMSC) in persons with intense recreational sun-exposure such as marathon runners or surfers. Up to data little is known about the sun-exposure habits, sun-protection behaviours and risk factors for MM and NMSC among sailors. OBJECTIVE: The objective of this prospective, cross-sectional study was to investigate the sun-exposure and sun-protective habits and risk factors for skin cancer among sailors attending the 50° edition of Barcolana, the largest sailing race in of the world, which took place in October 2018 in Trieste, Italy as an integrative component of a public sun-prevention campaign. METHODS: The study consisted of 2 parts: (i) a self-administered questionnaire focusing on sun-exposure and protective habits and (ii) a free skin examination carried out by volunteer dermatologists. Participation was optional and anonymous, and open to visitors and sailors attending the event. RESULTS: Overall, 431 (52.4%) sailors and 391 (47.6%) visitors responded to the questionnaire, while a total of 437 individuals including 189 (43.3%) sailors and 248 (56.6%) visitors participated in the skin examination group. The majority of sailors reported a past history of severe sunburns (20.2%), applied sunscreen never (14.4%) to sometimes (45.7%) or only once daily (59%) on the face (55%) and shoulders (26%). Moreover, 14% of sailors had a personal history of non-melanoma skin cancer (NMSC). During the dermatological examination, suspicious lesions for skin cancer (including MM and NMSC) were identified in 37% of the sailors. CONCLUSION: Our findings support the need to develop and promote primary and secondary prevention strategies to improve the sun-exposure and sun-protective habits among sailors.

Evolving Role of Systemic Therapies in Non-melanoma Skin Cancer.

Keratinocyte cancers - basal and cutaneous squamous cell carcinoma (BCC, cSCC) - are the most common forms of non-melanoma skin cancer (NMSC) and there has been a significant increase in their incidence globally in recent decades. Although the majority of BCC and cSCC are cured with conventional surgery or radiotherapy, certain tumour or patient-determined factors may result in these modalities being inadequate or inappropriate, for example, locally advanced or metastatic disease, high tumour multiplicity, patient comorbidities and patient preferences. In these clinical circumstances, systemic treatment may be indicated, and over the past 10 years a number of new systemic agents have been approved. Nonetheless, effective systemic therapy for keratinocyte cancers remains an area of significant unmet clinical need. Improved understanding of the molecular and immune pathogenesis underlying tumour growth and development is critical for driving future advances and is a research priority. The aim of this review is to provide clinicians with an overview of systemic treatments for BCC and cSCC and will focus on current evidence for conventional chemotherapy, targeted therapies, immunotherapy, adjuvant and neoadjuvant therapy, chemoprevention and future prospects for novel systemic treatment approaches.

Angiotensin-converting enzyme gene polymorphism is associated with myocardial infarction but not with development of coronary stenosis.

BACKGROUND: Although both genetic and nongenetic factors contribute to the pathogenesis of coronary artery disease, the identification of specific genetic lesions has lagged behind the identification of critical environmental risk factors. A reported association between myocardial infarction (MI) and the insertion/deletion (I/D) polymorphism of the angiotensin-converting enzyme (ACE) gene in European men suggests a critical role for this genomic region. However, the generality of this association remains to be determined. It also is not clear at what stage in disease progression the association with the ACE I/D polymorphism becomes important. METHODS AND RESULTS: We evaluated the ACE I/D polymorphism in patients who had undergone coronary angiography (402 men and 295 women) and in 203 representative control subjects. After polymerase chain reaction amplification, genotypes were determined by agarose gel sizing and by hybridization with allele-specific oligonucleotides. After patients were categorized by the degree of coronary artery stenosis and the occurrence of an MI, the distribution of ACE I/D genotypes was evaluated by log linear analysis. Patients were genetically representative of the regional population, and patients with > 60% stenosis of their coronary arteries had the same distribution of ACE I/D genotypes as did patients with < 10% stenosis. However, among patients with stenosis, the occurrence of an MI was significantly associated with the D allele in all patients (odds ratio [OR], 1.59; P = .002) and in men alone (OR, 1.63; P = .006). The lack of significance in women (OR, 1.40; P = .263) is probably due to the fact that only 36 women in the present study had experienced an MI. Furthermore, the association between MI and the ACE I/D polymorphism was independent of blood pressure, smoking habits, and body mass index. CONCLUSIONS: Segregation of the ACE I/D polymorphism is a pervasive genetic risk factor for MI in whites but has no evident effect on the events leading to stenosis of the coronary arteries. This suggests that risk of MI is influenced by two independent processes--atherogenesis that leads to coronary stenosis followed by conversion to MI. The renin-angiotensin system appears to confer significant risk of infarction by influencing the conversion to MI but has no apparent effect on the development of atherostenosis.

[Echography and integrated imaging in the diagnosis of hyperparathyroidism]. / Ecografia e imaging integrato nella diagnosi dell'iperparatiroidismo.

The authors report their personal experience with US, CT, biopsy and, lately, MRI, to localize enlarged parathyroid glands in primary and secondary hyperparathyroidism. December 1986 through December 1993, sixty-four primary and 55 secondary hyperparathyroidism patients were examined--119 in all. At biopsy and surgery, US sensitivity appeared to be 72%, with 0.94 positive predictive value; CT sensitivity was 80% with 0.91 positive predictive value. The two methods combined had 87% sensitivity in all. In the authors' experience, US proved to be a sensitive, accurate and cost-effective technique, as well as the best method to guide biopsy thanks to its multiplanar capabilities. Even though it requires great operator's experience, US is the method of choice in the localization of abnormal parathyroid glands. Its combination with CT increased overall sensitivity mainly in ectopic localizations and postoperative recurrences. Finally, technologic progress and increased MR sensitivity are likely to make MRI the imaging technique of choice, replacing CT, in the diagnostic protocol of hyperparathyroidism.

Response of refractory Hodgkin's disease to monoclonal anti-CD30 immunotoxin.

In Hodgkin's disease, Hodgkin and Reed-Sternberg cells consistently express the antigen CD30. We investigated the possible therapeutic role of an immunotoxin prepared by covalent linking of an anti-CD30 monoclonal antibody (Ber-H2) to saporin (SO6), a type-1 ribosome-inactivating protein. The immunotoxin (0.8 mg/kg in one or two doses) was given to four patients with advanced refractory Hodgkin's disease. In three, there was rapid and substantial reduction in tumour mass (50% to greater than 75%). Clinical responses were transient (6-10 weeks). In-vivo binding of the immunotoxin to tumour cells was shown by immunohistology in two patients. Antibodies to both parts of the immunotoxin developed in all patients.