Cancer incidence in a cohort of Danish firefighters: An extended long-term follow-up 1968-2021.

OBJECTIVES: To update and extend the examination of cancer incidence in a cohort of Danish firefighters, now adding 7 years of follow-up and 2766 additional firefighters. The primary focus was directed toward cancer sites that recently contributed to the hazard evaluation conducted by the International Agency for Research on Cancer (IARC). METHODS: The updated cohort consisted of 11,827 male Danish firefighters who were followed up for cancer from 1968 to 2021. Cohort cancer morbidity was compared with a working population reference group, and standardized incidence ratios (SIR) were used for estimation of relative risks, along with 95% confidence intervals (95% CI). RESULTS: Among full-time firefighters, SIR of skin melanoma was 1.30 (95% CI: 1.02-1.66), and SIR = 1.37 (95% CI: 1.02-1.85) for over 5 years of employment. Slightly positive associations were also observed for cancer of the urinary bladder (SIR = 1.16; 95% CI: 0.93-1.45), prostate (SIR = 1.11; 95% CI: 0.97-1.28), and testis (SIR = 1.11; 95% CI: 0.75-1.63). CONCLUSIONS: This updated study provides evidence indicating an elevated risk of skin melanoma in firefighters. Consistent with IARC's evaluation, we also identified positive associations for urinary bladder, prostate, and testis cancer. In contrast, our findings did not suggest an increased risk of colon cancer, non-Hodgkin lymphoma, and mesothelioma. The latter may be due to small numbers in our still relatively young cohort. Continuous follow-up for cancer in firefighters is warranted, including assessment of influence from surveillance bias.

Survey of Danish Head and Neck Cancer Patients' Positions on Personalized Medicine, Gene Tests, and Personalized Follow-Up.

The field of personalized medicine (PM) has grown rapidly because of the "omics revolution", but PM may be difficult for patients to comprehend. This study sought to explore head and neck cancer (HNC) patients' positions and knowledge of PM, gene tests, and follow-up and to compare HNC patients' positions to a sample from a national Danish questionnaire. To do this, patients with prior HNC were invited to participate in a questionnaire. Initial interviews revealed a heterogenic understanding of PM between patients. A total of 226 patients were included in the survey and 177 patients with complete data were included for analysis. Most patients were more positive than negative towards gene tests and gene research (83% and 93%, respectively), but 72% had little or no knowledge of the subject. Almost all patients, 98%, were satisfied with their follow-up. Significantly more patients with HNC were positive towards gene research compared to a sample from a national Danish questionnaire (p < 0.001). Patients with HNC were positive towards gene tests and PM, but patients may not understand or comprehend the information given, and it is important to inform and educate patients and health professionals to establish common ground in PM.

Low-dose acetylsalicylic acid for the prevention of pre-eclampsia.

Pre-eclampsia affects 3-4% of pregnancies and is associated with maternal and infant mortality and morbidity. High-risk pregnancies in Denmark are recommended prophylactic low-dose acetylsalicylic acid (LDA). If new screening algorithms are implemented, LDA will be recommended to around 10% of pregnant women. The use of LDA may slightly increase the risk of minor bleeding disturbances. Otherwise, there is a lot of promising data regarding the safety of LDA use during pregnancy, as argued in this review.

Online SPE-LC-MS-MS method for eight hydroxylated metabolites of polycyclic aromatic hydrocarbons in urine and determination of optimal sampling time after firefighter training.

Polycyclic aromatic compounds (PAHs) are formed during incomplete combustion and firefighters are inadvertently at risk of being exposed to these and other hazardous compounds. Exposure to PAHs is often estimated by measuring their hydroxylated metabolites (OH-PAH) in urine. Here, an online-SPE LC-MS-MS method was set up for eight OH-PAHs thus increasing sample throughput and minimizing manual handling. The method was validated over a 5-month period and showed good reproducibility with intra- and inter-day variation of 2.4-8.1 % and 1.6-6.5 %, respectively, of low-level samples and accuracy (91.6-104.8 %) for a standard reference material. The method was applied to urine samples from conscripts training to become firefighters to determine the optimal sampling time for this training activity before a large intervention study. In total, six conscripts sampled urine 6-8 times over a 40-hr period during a 3-day training course. All eight metabolites were detected in ≥ 97 % of the samples and showed peak excretion 4-6 hrs after the training corresponding to 8-10 hrs after first exposure. Samples taken the morning after the exercise contained low levels of most metabolites. Consequently, 4-6 hrs post exposure is recommended as the optimal sampling time for quantification of PAH exposure and monitoring of potential differences in exposure.

High-dose loco-regional pattern of failure after primary radiotherapy in p16 positive and negative head and neck squamous cell carcinoma - A DAHANCA 19 study.

Introduction: Patients with failure after primary radiotherapy (RT) for head and neck squamous cell carcinoma (HNSCC) have a poor prognosis. This study investigates pattern of failure after primary curatively intended IMRT in a randomized controlled trial in relation to HPV/p16 status. Material and methods: Patients with HNSCC of the oral cavity, oropharynx (OPSCC), hypopharynx or larynx were treated with primary curative IMRT (+/-cisplatin) and concomitant nimorazole between 2007 and 12. Of 608 patients, 151 had loco-regional failure within five years, from whom 130 pairs of scans (planning-CT and diagnostic failure scan) were collected and deformably co-registered. Point of origin-based pattern of failure analysis was conducted, including distance to CTV1 and GTV, and estimated dose coverage of the point of origin. Results: Of 130 patients with pairs of scans, 104 (80 %) had at least one local or regional failure site covered by 95 % of prescribed dose and 87 (67 %) of the failures had point of origin within the high-dose CTV (CTV1). Of failures from primary p16 + OPSCC, the majority of both mucosal (84 %) and nodal (61 %) failures were covered by curative doses. For p16- tumors (oral cavity, OPSCC p16neg, hypopharynx and larynx), 75 % of mucosal and 66 % of nodal failures were high-dose failures. Conclusion: Radioresistance is the primary cause of failure after RT for HNSCC irrespective of HPV/p16 status. Thus, focus on predictors for the response to RT is warranted to identify patients with higher risk of high-dose failure that might benefit from intensified treatment regimens.

Tumor volume and cancer stem cell expression as prognostic markers for high-dose loco-regional failure in head and neck squamous cell carcinoma - A DAHANCA 19 study.

BACKGROUND AND PURPOSE: Reliable and accessible biomarkers for patients with Head and Neck Squamous Cell Carcinoma (HNSCC) are warranted for biologically driven radiotherapy (RT). This study aimed to investigate the prognostic value of putative cancer stem cell (CSC) markers, hypoxia, and tumor volume using loco-regional high-dose failure (HDF) as endpoint. MATERIALS AND METHODS: Tumor tissue was retrieved from patients treated with primary chemo-(C-)RT and nimorazole for HNSCC in the Danish Head and Neck Cancer Study Group (DAHANCA) 19 study. Tumor volume, hypoxic classification, and expression of CSC markers CD44, SLC3A2, and MET were analyzed. For patients with eligible data on all parameters (n = 340), the risk of HDF following primary chemo-(C-)RT were analyzed by these biomarkers as a whole and stratified for p16-positive oropharynx (p16 + OPSCC) vs p16-negative (p16-) tumors (oral cavity, p16- oropharynx, hypopharynx and larynx). RESULTS: Higher risk of HDF was seen for patients with larger primary and nodal volume (>25 cm3, Hazard Ratio (HR): 3.00 [95 % CI: 1.73-5.18]), high SLC3A2 (HR: 2.99 [1.28-6.99]), CD44 (>30 % positive, HR: 2.29 [1.05-5.00]), and p16- tumors (HR: 2.53 [1.05-6.11]). p16- tumors had a higher CSC marker expression than p16 + OPSCC. The factors associated with the highest risk of HDF were larger volume (HR: 3.29 [1.79-6.04]) for p16- tumors (n = 178) and high SLC3A2 (HR: 6.19 [1.58-24.23]) for p16 + OPSCC (n = 162). CONCLUSION: Tumor volume, p16, and CSC markers are potential biomarkers for HDF for patients with HNSCC treated with (C-)RT. Lower expression of CSC in p16 + OPSCC may contribute to better tumor control.

Diagnóstico clínico en el síndrome de Kabuki: fenotipo y anomalías asociadas en dos casos nuevos / Clinical diagnosis of Kabuki syndrome: phenotype and associated abnormalities in two new cases

El síndrome de Kabuki es una entidad génica caracterizada por discapacidad intelectual asociada con múltiples anomalías sistémicas. El diagnóstico es fundamentalmente clínico y se basa en dismorfas faciales típicas, anomalías esqueléticas menores, persistencia de las almohadillas del pulpejo de los dedos y défcit de crecimiento posnatal. Otros hallazgos incluyen cardiopatía congénita, anomalías genitourinarias, fisura de paladar y/o labial, atresia anal y défcits funcionales, como mayor susceptibilidad a infecciones, enfermedades autoinmunes y endocrinológicas e hipoacusia. El objetivo de este trabajo es describir dos pacientes con diagnóstico clínico de síndrome de Kabuki, destacando los hallazgos fenotípicos y malformaciones asociadas.

Kabuki syndrome is a genetic entity with multiple anomalies associated with intellectual disability. The clinical diagnosis is based on typical facial features, minor skeletal abnormalities, fnger pads, and postnatal growth defcit. Other fndings may include congenital heart disease, genitourinary anomalies, oral clefts, anal atresia, increased susceptibility to infections, autoimmune and endocrine disease and hearing loss. The objective of this paper is to describe two patients with clinical diagnosis of Kabuki syndrome, highlighting the phenotypic fndings and associated malformations.

Diagnóstico clínico en el síndrome de Kabuki: fenotipo y anomalías asociadas en dos casos nuevos / Clinical diagnosis of Kabuki syndrome: phenotype and associated abnormalities in two new cases

El síndrome de Kabuki es una entidad génica caracterizada por discapacidad intelectual asociada con múltiples anomalías sistémicas. El diagnóstico es fundamentalmente clínico y se basa en dismorfas faciales típicas, anomalías esqueléticas menores, persistencia de las almohadillas del pulpejo de los dedos y défcit de crecimiento posnatal. Otros hallazgos incluyen cardiopatía congénita, anomalías genitourinarias, fisura de paladar y/o labial, atresia anal y défcits funcionales, como mayor susceptibilidad a infecciones, enfermedades autoinmunes y endocrinológicas e hipoacusia. El objetivo de este trabajo es describir dos pacientes con diagnóstico clínico de síndrome de Kabuki, destacando los hallazgos fenotípicos y malformaciones asociadas.(AU)

Kabuki syndrome is a genetic entity with multiple anomalies associated with intellectual disability. The clinical diagnosis is based on typical facial features, minor skeletal abnormalities, fnger pads, and postnatal growth defcit. Other fndings may include congenital heart disease, genitourinary anomalies, oral clefts, anal atresia, increased susceptibility to infections, autoimmune and endocrine disease and hearing loss. The objective of this paper is to describe two patients with clinical diagnosis of Kabuki syndrome, highlighting the phenotypic fndings and associated malformations.(AU)

Diagnóstico clínico en el síndrome de Kabuki: fenotipo y anomalías asociadas en dos casos nuevos. / [Clinical diagnosis of Kabuki syndrome: phenotype and associated abnormalities in two new cases].

Kabuki syndrome is a genetic entity with multiple anomalies associated with intellectual disability. The clinical diagnosis is based on typical facial features, minor skeletal abnormalities, finger pads, and postnatal growth deficit. Other findings may include congenital heart disease, genitourinary anomalies, oral clefts, anal atresia, increased susceptibility to infections, autoimmune and endocrine disease and hearing loss. The objective of this paper is to describe two patients with clinical diagnosis of Kabuki syndrome, highlighting the phenotypic findings and associated malformations.

Violência nos desenhos animados exibidos pela televisão: uma ponderação necessária

Pretende descrever e caracterizar o conteúdo de uma amostra de desenhos animados exibidos nas emissoras de São Paulo. De acordo com o que consta na literatura, inclui algumas categorias que levam em consideração o ponto de vista do público infanto-juvenil a respeito desse tipo de material televisivo. Identifica as personagens principais, secundárias e figurantes e descreve suas características gerais. Verifica o envolvimento das personagens principais em episódios de perseguição e a ocorrência de agressão física contra ser humano ou animal, identificando o instrumento da agressão. Avalia como reais ou irreais as conseqüências dos comportamentos agressivos das personagens, classificando-os como reativos ou provocativos. Caracteriza como aliadas, opositoras ou neutras, as personagens secundárias em relação às principais e verifica a utilização de superpoderes por parte das personagens principais. Analisa o tempo e o lugar onde os enredos se desenvolvem. Avalia os desenhos como realistas ou fantasiosos e registra a duração dos desenhos (5 a 10 minutos). Os dados são apresentados em termos de freqüência simples e conjunta, e, sobre uma parte das distribuições conjuntas, é calculado o valor da estatística qui-quadrado com o objetivo de testar hipóteses de existência de relação entre pares de variáveis envolvidas. Os resultados mostram que as personagens principais e secundárias são, em sua maioria, figuras humanas ou animais com comportamento humanizado e pertencentes à categoria masculino/macho; personagens principais são adultas e muitas delas dotadas de superpoderes; a temática básica dos desenhos analisados é a perseguição; os comportamentos agressivos das personagens não causam geralmente danos reais. Situações de ataque e defesa marcam as relações entre as personagens e os contextos onde os enredos se desenvolvem são urbanos ou rurais contemporâneos. Os desenhos na dimensão realidade-fantasia mostram-se predominantemente fantasiosos, desafiadores da lógica. Discute os resultados considerando-se as peculiaridades do gênero desenho animado, as características do pensamento infantil e o desenvolvimento da compreensão, por parte da criança e da natureza fictícia do conteúdo dos desenhos animados (AU)