A systematic review of worldwide incidence of nonmelanoma skin cancer.

BACKGROUND: Nonmelanoma skin cancer (NMSC) is the most common cancer affecting white-skinned individuals and the incidence is increasing worldwide. OBJECTIVES: This systematic review brings together 75 studies conducted over the past half century to look at geographical variations and trends worldwide in NMSC, and specifically incidence data are compared with recent U.K. cancer registry data. METHODS: Following the development of a comprehensive search strategy, an assessment tool was adapted to look at the methodological quality of the eligible studies. RESULTS: Most of the studies focused on white populations in Europe, the U.S.A. and Australia; however, limited data were available for other skin types in regions such as Africa. Worldwide the incidence for NMSC varies widely with the highest rates in Australia [>1000/100, 000 person-years for basal cell carcinoma (BCC)] and the lowest rates in parts of Africa (< 1/100, 000 person-years for BCC). The average incidence rates in England were 76·21/100, 000 person-years and 22·65/100, 000 person-years for BCC and squamous cell carcinoma (SCC), respectively, with highest rates in the South-West of England (121·29/100, 000 person-years for BCC and 33·02/100, 000 person-years for SCC) and lowest rates by far in London (0·24/100, 000 person-years for BCC and 14·98/100, 000 person-years for SCC). The incidence rates in the U.K. appear to be increasing at a greater rate when compared with the rest of Europe. CONCLUSIONS: NMSC is an increasing problem for health care services worldwide. This review highlights a requirement for prevention studies in this area and the issues surrounding incomplete NMSC registration. Registration standards of NMSC should be improved to the level of other invasive disease.

Tabaquismo y otras formas de fumar entre los estudiantes de Medicina / Smoking and other forms of smoking among medical students

Introducción. El tabaco es la segunda sustancia psicoactiva más consumida en España y cuyo consumo es causa de la principal tasa de mortalidad evitable en el mundo, además de producir enfermedades muy graves en muchos sistemas como el respiratorio, cardiovascular y ser factor de riesgo para gran número de tumores. Objetivo. Conocer la prevalencia del consumo de tabaco y otras sustancias asociadas entre los estudiantes de 1º, 4º y 6º de la Facultad de Medicina de Albacete. Material y métodos. Estudio trasversal utilizando una encuesta anónima y voluntaria entre los estudiantes de 1º, 4º y 6º de la Facultad de Medicina de Albacete. Resultados. El 66% de los estudiantes han probado el tabaco, de los cuales al 97% fueron sus amigos los que se lo ofrecieron. El 100% cree que el tabaco es perjudicial.Entre los que han probado el tabaco, el 9,5% son fumadores habituales y entre ellos, el 57,9% son de sexto curso de Medicina. Hay una relación estadísticamente significativa entre ser varón y ser fumador. Un estudiante fuma IQOS y otro utiliza vapeadores, a diferencia de los 54 estudiantes (27%) que consumen cachimba, siendo lo más frecuente el consumo en finde semana. El 6% de los estudiantes consume marihuana, con una relación estadísticamente significativa entre ser de sexto curso y su consumo. Conclusión. Hay una prevalencia bastante alta de consumo de tabaco y productos relacionados entrelos estudiantes, a pesar de que todos ellos tienen conocimiento de los efectos perjudiciales para la salud. (AU)

Introduction. Tobacco is the second most consumed psychoactive substance in Spain and whose use is the cause of the main avoidable mortality rate in the world, as well as producing very serious diseases in many systems such as the respiratory, and cardiovascular ones and being a risk factor for a large number of tumors. Objective. To know the prevalence of tobacco consumption and other associated substances among 1st,4th and 6th year students of the Medical Faculty of Albacete. Material and methods. Cross-sectional study usingan anonymous and voluntary survey among 1st, 4th and 6th year students of the Medical Faculty of Albacete. Results.Sixty-six percent of the students have tried smoking, 97% of whom were offered it by their friends. A total of 100% believe that tobacco is harmful.Among those who have tried smoking, 9.5% are regular smokers and among them 57.9% are in the sixth year of medicine. There is a statistically significant relationship between being male and being a smoker. One student smoked IQOS and another one used vapers, unlike 54 students (27%) who consumed hookah, with weekend consumption being the most frequent. Six percent of the students consumed marihuana, there being a statistically significant relationship between being in the sixth year and its consumption. Conclusion. The prevalence of consumption of tobacco and related products is fairly high among the students, even though all of them are aware of its harmful effects on health. (AU)

The past, present and future in scaffold-based tendon treatments.

Tendon injuries represent a significant clinical burden on healthcare systems worldwide. As the human population ages and the life expectancy increases, tendon injuries will become more prevalent, especially among young individuals with long life ahead of them. Advancements in engineering, chemistry and biology have made available an array of three-dimensional scaffold-based intervention strategies, natural or synthetic in origin. Further, functionalisation strategies, based on biophysical, biochemical and biological cues, offer control over cellular functions; localisation and sustained release of therapeutics/biologics; and the ability to positively interact with the host to promote repair and regeneration. Herein, we critically discuss current therapies and emerging technologies that aim to transform tendon treatments in the years to come.

Note: Geiger tube coincidence counter for lower atmosphere radiosonde measurements.

Atmospheric profiles of cosmic rays and radioactivity can be obtained using adapted meteorological radiosondes, for which Geiger tubes remain widely used detectors. Simultaneous triggering of two tubes provides an indication of energetic events. As, however, only small volume detectors can be carried, the event rate is small, which, due to the rapid balloon ascent, cannot be circumvented using long averaging periods. To derive count rates at low altitudes, a microcontroller is used to determine the inter-event time. This yields estimates of the coincidence rate below 5 km, where the coincidence rate is too small to determine solely by event counting.

Medullary thyroid carcinoma and duodenal calcitonin-secreting neuroendocrine tumour: more than coincidence?

UNLABELLED: Neuroendocrine tumours (NETs) are a heterogeneous group of neoplasms whose management can be problematic. In many cases, multiple tumours may occur in the same patient or his or her family, and some of these have now been defined genetically, although in other cases the underlying gene or genes involved remain unclear. We describe a patient, a 63-year-old female, who was diagnosed with a medullary thyroid carcinoma (MTC), which was confirmed pathologically after thyroidectomy, but whose circulating calcitonin levels remained elevated after thyroidectomy with no evidence of metastatic disease. Subsequently, an entirely separate and discrete duodenal NET was identified; this was 2.8 cm in diameter and was removed at partial duodenectomy. The tumour stained immunohistochemically for calcitonin, and its removal led to persistent normalisation of the circulating calcitonin levels. There was no germline mutation of the RET oncogene. This is the first identification of a duodenal NET secreting calcitonin and also the first demonstration of a second tumour secreting calcitonin in a patient with MTC. We suggest that where calcitonin levels remain high after removal of a MTC a search for other NETs should be conducted. LEARNING POINTS: NETs are a complex and heterogeneous group of related neoplasms, and multiple tumours may occur in the same patient.Calcitonin can be produced ectopically by several tumours outside the thyroid.Persistently elevated calcitonin levels after removal of a MTC may not necessarily indicate persisting or metastatic disease from the tumour.The real prevalence of calcitonin-producing NETs may be underestimated, as serum determination is only recommended in the diagnosis of pancreatic NETs.

Note: Programmable data acquisition system for research measurements from meteorological radiosondes.

A programmable data acquisition system to allow novel use of meteorological radiosondes for atmospheric science measurements is described. In its basic form it supports four analogue inputs at 16 bit resolution, and up to two further inputs at lower resolution, configurable instead for digital instruments. It also provides multiple instrument power supplies (+8 V, +16 V, +5 V, and -8 V) from the 9 V radiosonde battery. During a balloon flight encountering air temperatures from +17 °C to -66 °C, the worst case voltage drift in the 5 V unipolar digitisation circuitry was 20 mV. The system liberates a new range of low cost atmospheric research measurements, by utilising radiosondes routinely launched internationally for weather forecasting purposes. No additional receiving equipment is required. Comparisons between the specially instrumented and standard meteorological radiosondes show negligible effect of the additional instrumentation on the standard meteorological data.

Evolution of organic matter fractions after application of co-compost of sewage sludge with pruning waste to four Mediterranean agricultural soils. A soil microcosm experiment.

The effect of co-compost application from sewage sludge and pruning waste, on quality and quantity of soil organic carbon (SOC) in four Mediterranean agricultural soils (South Spain), was studied in soil microcosm conditions. Control soil samples (no co-compost addition) and soils treated with co-composts to a rate equivalent of 140 Mg ha(-1) were incubated for 90 days at two temperatures: 5 and 35 degrees C. The significances of incubation temperature and the addition of co-compost, on the evolution of the different fractions of SOC, were studied using a 2(3) factorial design. The co-compost amendment increased the amounts of humic fractions: humic acids (HA) (1.9 times), fulvic acids (FA) (3.3 times), humin (1.5 times), as well as the free organic matter (1.4 times) and free lipids (21.8 times). Incubation of the soils enhanced its biological activity mainly in the amended soils and at 35 degrees C, leading to progressive SOC mineralization and humification, concomitant to the preferential accumulation of HA. The incubation results show large differences depending on temperature and soil types. This fact allows us to select suitable organic amendment for the soil when a rapid increase in nutrients through mineralization is preferred, or in cases intending the stabilization and preservation of the SOC through a process of humification. In soils with HA of more than 5 E(4)/E(6) ratio, the incubation temperature increased rates of mineralization and humification, whereas lower temperatures limited the extent of both processes. In these soils the addition of co-compost in spring or summer is the most recommendable. In soils with HA of lower E(4)/E(6) ratio (<5), the higher temperature favoured mineralization but not humification, whereas the low temperature maintained the SOC levels and even increased the HA/FA ratio. In these soils the moment of addition of organic amendment should be decided depending on the effect intended. On the other hand, the lower the SOC content in the original soil, the greater are the changes observed in the SOC after amendment with co-compost. The results suggest that proper recommendations for optimum organic matter evolution after soil amendment is possible after considering a small set of characteristics of soil and the corresponding soil organic matter fractions, in particular HA.

Kinetic analysis of a general model of activation of aspartic proteinase zymogens involving a reversible inhibitor. I. Kinetic analysis.

Starting from a simple general reaction mechanism of activation of aspartic proteinases zymogens involving a uni- and a bimolecular simultaneous activation route and a reversible inhibition step, the time course equation of the zymogen, inhibitor and activated enzyme concentrations have been derived. Likewise, expressions for the time required for any reaction progress and the corresponding mean activation rates as well as the half-life of the global zymogen activation have been derived. An experimental design and kinetic data analysis is suggested to estimate the kinetic parameters involved in the reaction mechanism proposed.

Kinetic analysis of a general model of activation of aspartic proteinase zymogens involving a reversible inhibitor. II. Contribution of the uni- and bimolecular activation routes.

From the kinetic study carried out in part I of this series (preceding article) an analysis quantifying the relative contribution to the global process of the uni- and bimolecular routes has been carried out. This analysis suggests a way to predict the time course of the relative contribution as well as the effect on this relative weight of the initial zymogen, inhibitor and activating enzyme concentrations.

[Postoperative results of stapes revision]. / Postoperative Ergebnisse nach Stapesrevision.

BACKGROUND: In this retrospective study indications, intraoperative findings, reconstruction techniques and postoperative hearing results in revision stapes surgery were evaluated. PATIENTS: Between March 1988 and January 1996, 150 patients underwent stapes revision. Indications for surgery were the presence of conductive hearing loss (132), dizziness (12), sensorineural hearing loss (3), deafness (2), and tinnitus (1). RESULTS: Intraoperative findings were lateral migration of the implant, regrowth of bone in the oval window niche, erosion of incus, cholesteatoma, and others. In most cases a new prosthesis (gold piston) was inserted between incus and vestibulum. In cases with incus erosion, a malleovestibulopexy was performed. Seventy-three percent of patients who underwent revision stapes surgery because of conductive hearing loss showed a hearing improvement of 20 dB or more. All patients who underwent revision stapes surgery because of dizziness reported an improvement of their symptoms postoperatively. CONCLUSIONS: Revision stapes surgery should be approached by experienced surgeons, because the risk of severe sensorineural hearing loss is higher than at the time of primary stapedectomy. Informed consent is mandatory.

Critical fusion frequency in the central visual field.

The critical fusion frequency (CFF) was measured across the central visual field. Stimulus parameters were adjusted to ensure an increase in CFF at the fovea. Comparison was made between the foveal and extra-foveal CFF values. The study showed that, while the CFF may be highest at the fovea when the CFF values are generally low, stimulus parameter changes that increase the CFF result in a greater increase extra-foveally. Ultimately, then, the CFF maximum shifts from the fovea to an extra-foveal area. Under the experimental conditions used in the study, the maximum occurred approximately 10 degrees from fixation.