Assuntos
Melanoma/patologia , Doenças da Unha/patologia , Neoplasias Cutâneas/patologia , Idoso , Feminino , Dedos , Grécia/epidemiologia , Humanos , Masculino , Melanoma/diagnóstico , Melanoma/epidemiologia , Pessoa de Meia-Idade , Doenças da Unha/diagnóstico , Doenças da Unha/epidemiologia , Estadiamento de Neoplasias , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/epidemiologia , Dedos do PéAssuntos
Carcinoma de Células Escamosas/diagnóstico , Herpes Simples/diagnóstico , Neoplasias Cutâneas/diagnóstico , Antibacterianos/uso terapêutico , Antivirais/uso terapêutico , Claritromicina/uso terapêutico , Diagnóstico Diferencial , Dedos , Herpes Simples/tratamento farmacológico , Herpes Simples/microbiologia , Herpes Simples/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Staphylococcus aureus/isolamento & purificação , Valaciclovir/uso terapêuticoAssuntos
Antineoplásicos/efeitos adversos , Face/patologia , Transtornos da Pigmentação/induzido quimicamente , Pirimidinas/efeitos adversos , Escroto/patologia , Sulfonamidas/efeitos adversos , Inibidores da Angiogênese/efeitos adversos , Inibidores da Angiogênese/uso terapêutico , Antineoplásicos/uso terapêutico , Humanos , Indazóis , Masculino , Pessoa de Meia-Idade , Pirimidinas/uso terapêutico , Receptores de Fatores de Crescimento do Endotélio Vascular/antagonistas & inibidores , Sulfonamidas/uso terapêuticoRESUMO
BACKGROUND: Knowledge of the factors that influence early detection of melanoma is important in developing strategies to reduce associated mortality. OBJECTIVES: To identify sociodemographic, behavioural and medical care-related factors associated with melanoma thickness in a low-incidence population but with a high case fatality. PATIENTS AND METHODS: In a multicentre, retrospective, survey-based study of 202 patients with a recent diagnosis of invasive melanoma (< 1 year), we collected data on demographic and behavioural factors, attitudes towards prevention, access to medical care, frequency of skin self-examination (SSE) and physician skin examination (PSE) in relation to melanoma thickness. RESULTS: Thinner tumours (≤ 1 mm, 80 melanomas) were associated with female sex (P ≤ 0.049), nonnodular (superficial spreading melanoma, lentigo maligna melanoma, acral lentiginous melanoma) histological subtypes (P < 0.001), absence of ulceration (P ≤ 0.001), and location other than lower extremity or trunk location (P ≤ 0.004). Patients married at the time of diagnosis or who performed SSE during the year prior to diagnosis were more likely to have thinner tumours than those who did not [odds ratio (OR) 3.45, 95% confidence interval (CI) 1.48-8.04 and OR 2.43, 95% CI 1.10-5.34, respectively]. Full-body skin examination by a physician was not significantly associated with thinner melanoma (OR 1.99, 95% CI 0.66-6.07). CONCLUSIONS: SSE was shown to be an important factor in the detection of thin melanoma, in contrast to partial or full-body PSE, which did not show any statistically significant effect on tumour thickness.
Assuntos
Detecção Precoce de Câncer/métodos , Melanoma/diagnóstico , Neoplasias Cutâneas/diagnóstico , Adulto , Idoso , Atitude Frente a Saúde , Detecção Precoce de Câncer/estatística & dados numéricos , Feminino , Grécia/epidemiologia , Acessibilidade aos Serviços de Saúde , Humanos , Masculino , Estado Civil , Melanoma/epidemiologia , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Exame Físico/métodos , Exame Físico/estatística & dados numéricos , Estudos Retrospectivos , Autoexame/métodos , Autoexame/estatística & dados numéricos , Fatores Sexuais , Neoplasias Cutâneas/epidemiologiaRESUMO
Previous work has examined potential links between the etiology of GH deficiency (GHD) and the baseline characteristics of the patients including biochemical and psychometric parameters. Using an update of the KIMS pharmaco-epidemiological database (Pfizer International Metabolic Database), we addressed the question how well such results can be generalized and whether regional differences may play a role. From 30 different countries, 13 167 GH-deficient patients were included in KIMS at the data close in December 2008. In order to explore country-specific differences of baseline characteristics documented in KIMS, separate analyses of baseline characteristics of adult-onset GHD patients (n=7708) were performed for the six largest contributing European countries and the United States. This analysis revealed striking regional variations in the pathogenesis of the disease, clinical characteristics such as body mass index, and in the classical features of the metabolic syndrome such as blood pressure or lipid status between countries. Moreover, the approach to endocrine function testing was widely different between countries, as well as the distribution of etiologies of GHD. These data suggest that a complex relation between biochemical and clinical signs of GHD exists, and that the spectrum of adult GHD syndrome is influenced by regional diagnostic and clinical particularities.
Assuntos
Hormônio do Crescimento Humano/deficiência , Hipopituitarismo/sangue , Hipopituitarismo/etiologia , Adulto , Biomarcadores/sangue , Pressão Sanguínea , Índice de Massa Corporal , Bases de Dados Factuais , Europa (Continente) , Feminino , Glucagon/sangue , Humanos , Insulina/sangue , Fator de Crescimento Insulin-Like I/metabolismo , Metabolismo dos Lipídeos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Estados UnidosAssuntos
Antibióticos Antineoplásicos/administração & dosagem , Doxorrubicina/análogos & derivados , Polietilenoglicóis/administração & dosagem , Sarcoma de Kaposi/tratamento farmacológico , Neoplasias Cutâneas/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Relação Dose-Resposta a Droga , Doxorrubicina/administração & dosagem , Feminino , Humanos , MasculinoRESUMO
BACKGROUND: p53 has a common polymorphism at amino acid 72, encoding either arginine or proline. p53Arg and p53Pro exhibit differences in various biological activities, such as cell-cycle arrest and induction of apoptosis. Numerous epidemiological studies have examined the role of this polymorphism in several human malignancies, including cutaneous cancers, with contradictory results. OBJECTIVES: To investigate the germline frequency of p53 codon 72 polymorphism in malignant melanoma in a Mediterranean population, and to examine possible associations with various clinicopathological factors. METHODS: In this hospital-based case-control study we used allele-specific polymerase chain reaction for p53 codon 72 genotyping in blood specimens from 107 Greek patients with sporadic cutaneous melanoma and 145 healthy controls. RESULTS: After adjustment for age, sex and phototype the Pro/Pro genotype was associated with increased risk for cutaneous melanoma compared with the Arg/Arg genotype (adjusted odds ratio, OR 3.17, 95% confidence interval, CI 1.03-9.78). This correlation was more pronounced in subjects with phototypes III or IV (adjusted OR 9.56, 95% CI 1.56-58.46), dark skin (adjusted OR 10.96, 95% CI 1.64-73.28), dark eyes (adjusted OR 8.86, 95% CI 1.69-46.52) and dark hair (adjusted OR 3.17, 95% CI 1.01-9.95), and among noncarriers of melanocortin 1 receptor gene (MC1R) red hair polymorphisms (adjusted OR 2.99, 95% CI 1.02-8.78). CONCLUSIONS: p53 codon 72 Pro/Pro genotype could be a risk factor for the development of melanoma in the Greek population, especially in subgroups with darker skin pigmentation, as well as among noncarriers of the MC1R red hair polymorphic variants.
Assuntos
Genes p53/genética , Cor de Cabelo/genética , Melanoma/genética , Receptor Tipo 1 de Melanocortina/genética , Neoplasias Cutâneas/genética , Pigmentação da Pele/genética , Adulto , Idoso , Estudos de Casos e Controles , Códon/genética , Feminino , Genótipo , Homozigoto , Humanos , Masculino , Pessoa de Meia-Idade , Polimorfismo Genético/genética , Fatores de RiscoRESUMO
After administration of Adriamycin, bleomycin, vincristine (ABV) as palliative chemotherapy in advanced AIDS-related Kaposi's sarcoma (AIDS.KS) patients with low Karnosfsky performance scores, the authors attempted to estimate the overall biological cost/benefit relating to the disease. The authors analyzed data from 20 consecutive AIDS patients with advanced Kaposi's sarcoma presenting skin and visceral involvement treated with ABV every 3 weeks. An increased rate of infections, HIV and ABV-related side effects was observed. The performance amelioration (about 30%) was not significantly correlated with AIDS.KS clinical remission. CD4 count at baseline (p < 0.05), ABV therapy duration (p < 0.001), the achieved AIDS.KS clinical amelioration score (p < 0.01) and the improved Karnofsky score (p < 0.001) were significant predictors of life expectancy which was unrelated to the rate of side effects. The authors conclude that ABV palliative chemotherapy can assist in protracting life expectancy and improving the Karnofsky score.