Could the mitotic count improve personalized prognosis in melanoma patients?

A number of studies have indicated that the mitotic rate may be a predictive factor for poor prognosis in melanoma patients. The aim of this study was to investigate whether the mitotic rate is associated with other prognostic clinical and anatomopathological characteristics. After adjusting for other anatomopathological characteristics, we then verified the prognostic value of the number of mitoses, determining in which population subgroup this variable may have greater prognostic significance on 3-year mortality. The Veneto Cancer Registry (Registro Tumori del Veneto-RTV), a high-resolution population-based dataset covering the regional population of approximately 4.9 million residents, served as the clinical data source for the analysis. Inclusion criteria included all incident cases of invasive cutaneous malignant melanoma recorded in the RTV in 2015 (1,050 cases) and 2017 (1,205 cases) for which the number of mitoses was available. Mitotic classes were represented by Kaplan-Meier curves for short-term overall survival. Cox regression calculated hazard ratios in multivariable models to evaluate the independent prognostic role of different mitotic rate cut-offs. The results indicate that the mitotic rate is associated with other survival prognostic factors: the variables comprising the TNM stage (e.g., tumor thickness, ulceration, lymph node status and presence of metastasis) and the characteristics that are not included in the TNM stage (e.g., age, site of tumor, type of morphology, growth pattern and TIL). Moreover, this study demonstrated that, even after adjusting for these prognostic factors, mitoses per mm2 are associated with higher mortality, particularly in T2 patients. In conclusion, these findings revealed the need to include the mitotic rate in the histological diagnosis because it correlates with the prognosis as an independent factor. The mitotic rate can be used to develop a personalized medicine approach in the treatment and follow-up monitoring of melanoma patients.

Association between religiosity or spirituality and internet addiction: A systematic review.

Introduction: The literature provides evidence of religiosity being associated with physical and mental health, and also with behavioral addictions. This systematic review examines the data on the link between religiosity or spirituality and the emerging internet addictions. Methods: A systematic literature review was conducted in the PubMed and Scopus databases to identify observational (cross-sectional, cohort, and case-control) studies conducted on adolescents and young adults to investigate the association between religiosity or spirituality and internet addiction. Of the 854 articles identified in the databases, 13 met our inclusion criteria and were included in our systematic review. Results: Eleven of the 13 studies reviewed specifically investigated religiosity and internet addiction: six found an inverse association between religiosity and internet addiction; three found no evidence of any association; and one found a direct association. One study examining both religiosity and spirituality generated mixed results. Only one study investigated spirituality unrelated to religion, and found a direct association with internet addiction. Two of three studies specifically considering internet gaming addiction found it inversely associated with high levels of religiosity, while the third found no association. Conclusion: This review supports a possible role for religiosity as a protective factor, as emerged from the majority of the studies examined. Religiosity also seemed to be associated with lower internet gaming rates among adolescents.