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BACKGROUND: It is not clear whether changes in body composition induced by androgen deprivation therapy (ADT) in prostate cancer (PC) patients are uniform or vary in the different body districts and whether regional lean body mass (LBM) and fat body mass (FBM) could have an impact on bone health. OBJECTIVE: To prospectively evaluate the regional changes in LBM and FBM in PC patients submitted to degarelix; to explore the relationship of regional body composition and bone mineral density (BMD) and bone turnover markers. DESIGN, SETTING, AND PARTICIPANTS: 29 consecutive non metastatic PC patients enrolled from 2017 to 2019. FBM, LBM and bone mineral density (BMD) evaluated by dual-energy x-ray absorptiometry (DXA) at baseline and after 12-month of ADT. Alkaline phosphate (ALP) and C-terminal telopeptide of type I collagen (CTX) assessed at baseline, 6 and 12 months. INTERVENTION: All patients underwent degarelix administration. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: T-test or sign test and Pearson or Spearman test for continuous variables were used when indicated. RESULTS AND LIMITATIONS: Median percent increase in FBM ranged from + 14.5% in trunk to + 25.4% in the left leg after degarelix. LBM changes varied from + 2% in the trunk to - 4.9% in the right arm. LBM in both arms and legs and their variations after degarelix directly correlated with ALP and inversely correlated with CTX. Lean mass of limbs, trunk and legs significantly correlated with BMD of the hip, lean mass of the trunk significantly correlated with spine BMD. These are post-hoc analysis of a prospective study and this is the main limitation. CONCLUSIONS: an heterogeneous change in body composition among body district is observed after ADT and bone turnover is influenced by lean mass and its variation. A supervised physical activity is crucial to maintain general physical performance and preserving bone health.
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Neoplasias da Próstata , Masculino , Humanos , Neoplasias da Próstata/tratamento farmacológico , Densidade Óssea , Antagonistas de Androgênios/efeitos adversos , Androgênios , Estudos Prospectivos , Composição Corporal , Absorciometria de FótonRESUMO
PURPOSE: The aim of the study was to analyze the modification of total and regional body composition in early breast cancer patients treated with aromatase inhibitors (AIs). METHODS: This is a prospective, single-center, observational, longitudinal study. Four-hundred and twenty-eight patients treated with adjuvant aromatase inhibitors were enrolled at the Medical Oncology and Breast Unit of Spedali Civili Hospital in Brescia from September 2014 to June 2022. Several body composition parameters including total and regional fat and lean body mass were investigated with dual-energy X-ray absorptiometry (DXA) scan at baseline and after 18 months of treatment with aromatase inhibitors. RESULTS: A significant increase in fat body mass (mean + 7.2%, 95% confidence interval [CI]: 5.5;8.9%) and a reduction in lean body mass (mean -3.1%, 95% CI -3.9; -2.4) were documented in this population. The changes in fat and lean body mass varied considerably according to different body districts ranging between + 3.2% to + 10.9% and from-1.3% to -3.9%, respectively. CONCLUSION: Aromatase inhibitor adjuvant therapy in early breast cancer is associated with changes in body composition, with a wide variability among different body districts, leading to a risk of sarcopenic obesity. Supervised physical exercise that focuses on single body parts that may display detrimental variations may be beneficial for AIs treated patients.
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BACKGROUND: Among the various types of basal cell carcinoma, the sclerodermiform variant has a high risk of recurrence and local invasiveness. A systematic description of the dermatoscopic features associated with specific body localization is lacking. OBJECTIVES: To describe the clinical and dermoscopic features of sclerodermiform basal cell carcinoma (BCC) according to localization in the body confronting with superficial and nodular types. METHODS: Clinical and dermoscopic images of sclerodermiform, nodular and superficial BCCs were retrospectively evaluated to study the location in the various body districts, maximum diameter, clinical appearance of the lesion, features of edges and presence or absence of specific dermatoscopic criteria of BCCs. RESULTS: We examined 291 histopathologically proven BCCs showing that in nodular BCCs, classical arborizing vessels were more frequently found in the body macro-area (trunk and limbs; n = 46, 97.9%) than in the head/neck area (n = 43, 82.7%); within sclerodermiform BCCs, short arborizing vessels were found more frequently in the head/neck district (n = 35, 49.3%) than in the body (n = 6, 23.1%; P-value 0.02); within nodular BCCs, multiple blue-grey dots and globules were more frequently found on the trunk (n = 23, 48.9%) than in the head/neck district (n = 12, 23.1%; P-value 0.01). In sclerodermiform BCCs, ulceration was found more frequently in the head/neck district (n = 38, 53.5%) than in the body (n = 4, 15.4%; P-value > 0.01), and in superficial BCCs, ulceration was found more frequently in the head/neck district (n = 5, 38.5%) than in the body (n = 8, 9.8%; P-value 0.02). CONCLUSION: Our study shows that superficial BCC are found frequently in the head/neck district dermoscopically characterized by ulceration and arborizing vessels; nodular BCCs are more frequently found in the body than in the head/neck district, and the dermoscopic pattern is characterized by the combination of three features: (i) classical arborizing vessels, (ii) multiple blue-grey dots and (iii) globules. Instead, sclerodermiform BCC is preferentially located in areas at high-moderate risk of recurrence; if pink-white areas and/or fine arborizing vessels are seen, clinicians should consider this diagnosis. Furthermore, location-specific dermatoscopic criteria have been described.
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Carcinoma Basocelular , Neoplasias Cutâneas , Carcinoma Basocelular/diagnóstico por imagem , Demografia , Dermoscopia , Humanos , Recidiva Local de Neoplasia , Estudos Retrospectivos , Neoplasias Cutâneas/diagnóstico por imagemRESUMO
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.
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Exposição Ambiental , Neoplasias Cutâneas/prevenção & controle , Luz Solar , Protetores Solares/administração & dosagem , Feminino , Humanos , Itália , Masculino , Estudos Prospectivos , Inquéritos e QuestionáriosAssuntos
Carcinoma de Células Escamosas , Neoplasias Cutâneas , Anticorpos Monoclonais Humanizados/uso terapêutico , Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma de Células Escamosas/patologia , Humanos , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/patologiaAssuntos
Antineoplásicos , Sarda Melanótica de Hutchinson , Neoplasias Cutâneas , Aminoquinolinas/uso terapêutico , Antineoplásicos/uso terapêutico , Humanos , Sarda Melanótica de Hutchinson/tratamento farmacológico , Sarda Melanótica de Hutchinson/cirurgia , Imiquimode/uso terapêutico , Uso Off-Label , Neoplasias Cutâneas/tratamento farmacológicoAssuntos
Dermatite/parasitologia , Infestações por Ácaros/complicações , Adulto , Humanos , MasculinoAssuntos
Vacinas contra COVID-19 , COVID-19 , Administração Cutânea , Humanos , Itália , RNA , SARS-CoV-2Assuntos
Anilidas/administração & dosagem , Antineoplásicos/administração & dosagem , Carcinoma Basocelular/tratamento farmacológico , Piridinas/administração & dosagem , Neoplasias Cutâneas/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Anilidas/efeitos adversos , Antineoplásicos/efeitos adversos , Feminino , Proteínas Hedgehog/antagonistas & inibidores , Humanos , Masculino , Pessoa de Meia-Idade , Piridinas/efeitos adversos , Estudos RetrospectivosRESUMO
BACKGROUND: The last melanoma staging system of the 2009 American Joint Committee on Cancer takes into account, for stage IV disease, the serum levels of lactate dehydrogenase (LDH) and the site of distant metastases. OBJECTIVE: Our aim was to compare the significance of metastatic volume, as evaluated at the time of stage IV melanoma diagnosis, with other clinical predictors of prognosis. METHODS: We conducted a retrospective multicentric study. To establish which variables were statistically correlated both with death and survival time, contingency tables were evaluated. The overall survival curves were compared using the Kaplan-Meier method. RESULTS: Metastatic volume and number of affected organs were statistically related to death. In detail, patients with a metastatic volume >15 cm(3) had a worse prognosis than those with a volume lower than this value (survival probability at 60 months: 6.8 vs. 40.9%, respectively). The Kaplan-Meier method confirmed that survival time was significantly related to the site(s) of metastases, to elevated LDH serum levels and to melanoma stage according to the latest system. CONCLUSION: Our results suggest that metastatic volume may be considered as a useful prognostic factor for survival among melanoma patients.
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Melanoma/patologia , Melanoma/secundário , Neoplasias Cutâneas/patologia , Carga Tumoral , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Estimativa de Kaplan-Meier , L-Lactato Desidrogenase/sangue , Masculino , Melanoma/sangue , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Curva ROC , Estudos Retrospectivos , Neoplasias Cutâneas/sangue , Taxa de SobrevidaRESUMO
AIM: Sleep could be severely affected in psoriasis because of skin symptoms and psychological repercussions of the disease. The aim of this study was to investigate the influence of psoriasis on sleep. METHODS: A total of 202 patients with psoriasis and 202 healthy volunteers have completed a self-rated questionnaire, the Pittsburgh Sleep Quality Index, which assesses sleep quality and disturbances over a 1-month time interval. The severity of the dermatoses has been evaluated utilizing the PASI score. RESULTS: In psoriatic patients the Pittsburgh Sleep Quality Index resulted between 0 and 17 (5.56±3.93), in the controls between 0 and 18 (5.13±4.16). No statistically significant correlation was observed between the score of Pittsburgh Sleep Quality Index and PASI. The anti-psoriatic therapy, while causing a marked improvement of lesions and itching, does not affect the quality of sleep. CONCLUSION: Although literature indicated that psoriasis negatively affects the quality of sleep, in this study this correlation was not observed.