[Prerequisites for a successful lung cancer screening program]. / Voraussetzungen für ein erfolgreiches Lungenkrebsscreeningprogramm.

The American national lung cancer screening trial (NLST) has provided the first confirmation of a reduction in lung cancer mortality by using low-dose multislice computed tomography (MSCT). Preliminary evaluations of smaller European trials could not confirm such a reduction. The final evaluation of the larger Dutch-Belgian NELSON trial and five other European trials are expected within the next 1-2 years. The results of the completed rounds of screening in all these studies indicate that the margin between a positive and a negative benefit-to-harm balance will be narrow. In such a scenario it will be crucial to optimize the definition of the target population for screening as a high-risk group for lung cancer, the quality of screening in terms of high sensitivity and specificity as well as high quality treatment and an effective ongoing control of program quality. Not all healthcare systems are suitable to fulfill these prerequisites.

Large cell carcinoma of the lung: LDCT features and survival in screen-detected cases.

PURPOSE: To investigate the early radiological features and survival of Large Cell Carcinoma (LCC) cases diagnosed in low-dose computed tomography (LDCT) screening trials. METHODS: Two radiologists jointly reviewed the radiological features of screen-detected LCCs observed in NLST, ITALUNG, and LUSI trials between 2002 and 2016, comprising a total of 29,744 subjects who underwent 3-5 annual screening LDCT examinations. Survival or causes of death were established according to the mortality registries extending more than 12 years since randomization. RESULTS: LCC was diagnosed in 30 (4 %) of 750 subjects with screen-detected lung cancer (LC), including 15 prevalent and 15 incident cases. Three additional LCCs occurred as interval cancers during the screening period. LDCT images were available for 29 cases of screen-detected LCCs, and 28 showed a single, peripheral, and well-defined solid nodule or mass with regularly smooth (39 %), lobulated (43 %), or spiculated (18 %) margins. One case presented as hilar mass. In 9 incident LCCs, smaller solid nodules were identified in prior LDCT examinations, allowing us to calculate a mean Volume Doubling Time (VDT) of 98.7 ± 47.8 days. The overall five-year survival rate was 50 %, with a significant (p = 0.0001) difference between stages I-II (75 % alive) and stages III-IV (10 % alive). CONCLUSIONS: LCC is a fast-growing neoplasm that can escape detection by annual LDCT screening. LCC typically presents as a single solid peripheral nodule or mass, often with lobulated margins, and exhibits a short VDT. The 5-year survival reflects the stage at diagnosis.

Integrated assessment of eutrophication in the southern Black Sea waters, using the Nested Environmental Status Assessment Tool.

This research deals with the land-based pressures on the southern Black Sea coast (Turkey), with the objective of assessing their eutrophication impacts. In this context, reference values of some of the eutrophication indicators were calculated, and eutrophication assessment was carried out for this area using the holistic approach NEAT (Nested Environmental Status Assessment Tool). In addition, correlations between NEAT results of coastal regions and pressure-impact analysis methods were investigated. In the determined Spatial Assessment Unit (SAU) areas, 9 indicators were evaluated according to the SAU surface, both with and without weighting by their size the overall assessment of the Turkish Black Sea coast is good (0.70) and moderate (0.57) environmental status, for non-weighting and weighting by SAUs, respectively, with a high confidence level. With this study, we concluded that the sensitivity of the assessment tool needs to be increased. Despite these results, an appropriate number of indicators to represent the water column should be added. It is important to include the phytoplankton variable in the evaluation in future studies. In addition, this study, which uses NEAT allows identifying problematic environmental areas that require attention and action from managers and policymakers.

Effect of smoking cessation counseling within a randomised study on early detection of lung cancer in Germany.

INTRODUCTION: In the German lung cancer screening trial LUSI, smoking cessation counseling (SCC) was offered to all participants at time of randomization, and smoking habits were asked for within annual questionnaire inquiries. We analyzed the smoking habits of the participants within the first 2 years of follow-up and especially the potential effect of the SCC on these habits. MATERIALS AND METHODS: We used the smoking data of the initial inquiry on which the decision on invitation to the study was based, the socio-economic data of the questionnaire filled-in at time of randomization, the psycho-social data obtained during the SCC, and the annual questionnaire data of the first two annual follow-up screening rounds. RESULTS: Smoking prevalence decreased in the entire cohort significantly by 4 %, whereby the decrease was with 4.5 % statistically not significantly higher in the control arm than in the screening arm with 3.4 %. The decline was much stronger in the subgroup of attendees to stop-smoking counseling and mounted up therein to 10 %. In some participants, an increase of readiness to quit smoking was observed during the counseling hour, but did not show effects on smoking status 2 years later. DISCUSSION: We did not see a tendency to increased smoking among participants of the intervention arm or the entire study. The decline of smoking prevalence among the attendees of the counseling might be due to self-selection. Since the issue of effectiveness of smoking cessation counseling is important, further research with randomization into offering counseling or no intervention should be taken into consideration.

Effect of high sedimentation rates on surface sediment dynamics and mangrove growth in the Porong River, Indonesia.

Large quantities of mud from the LUSI (Lumpur Sidoarjo) volcano in northeastern Java have been channeled to the sea causing high rates of sediment delivery to the mouth of the Porong River, which has a cover of natural and planted mangroves. This study investigated how the high rates of sediment delivery affected vertical accretion, surface elevation change and the growth of Avicennia sp., the dominant mangrove species in the region. During our observations in 2010-2011 (4-5years after the initial volcanic eruption), very high rates of sedimentation in the forests at the mouth of the river gave rise to high vertical accretion of over 10cmy(-1). The high sedimentation rates not only resulted in reduced growth of Avicennia sp. mangrove trees at the two study sites at the Porong River mouth, but also gave rise to high soil surface elevation gains.

Cellular immune responses and phagocytic activity of fishes exposed to pollution of volcano mud.

Since May 29, 2006, a mud volcano in the Brantas Delta of the Sidoarjo district has emitted mud that has inundated nearby villages. Pollution in this area has been implicated in detrimental effects on fish health. In fishes, leukocyte and phagocytic cells play a vital role in body defenses. We report for the first time the effect of "LUSI" volcano mud on the immune systems of fish in the Brantas Delta. The aim of this study was to find biomarkers to allow the evaluation of the effects of volcanic mud and anthropogenic pollution on fish health in the Brantas Delta. The study took places at the Brantas Delta, which was polluted by volcano mud, and at reference sites in Karangkates and Pasuruan. Leukocyte numbers were determined using a Neubauer hemocytometer and a light microscope. Differential leukocyte counts were determined using blood smears stained with May Grunwald-Giemsa, providing neutrophil, lymphocyte and monocyte counts. Macrophages were taken from fish kidney, and their phagocytic activity was measured. In vitro analyses revealed that leukocyte and differential leukocyte counts (DLC) were higher in Channa striata and Chanos chanos caught from the polluted area. Macrophage numbers were higher in Oreochromis mossambicus than in the other species, indicating that this species is more sensitive to pollution. In areas close to volcanic mud eruption, all specimens had lower phagocytic activity. Our results show that immune cells were changed and phagocytic activity was reduced in the polluted area indicating cytotoxicity and alteration of the innate immune system in fishes exposed to LUSI volcano mud and anthropogenic pollution.