Objective：We assessed the trends in lung cancer incidence over a 25-year period by socioeconomic groups for men in New South Wales（NSW）,Australia.Methods：Men diagnosed with lung cancer between 1987 and 2011 were d...Objective：We assessed the trends in lung cancer incidence over a 25-year period by socioeconomic groups for men in New South Wales（NSW）,Australia.Methods：Men diagnosed with lung cancer between 1987 and 2011 were divided into five quintiles according to an Index of Education and Occupation（IEO）.We assessed relative socioeconomic differences over time by calculating age-standardized incidence ratios（SIRs）by 5-year period of diagnosis,and estimated absolute differences by comparing the observed and expected numbers of cases using the highest IEO quintile as the reference.Results：Lung cancer incidence for men decreased from 1987 to 2011 for all IEO quintiles,with a greater rate of decline for men living in the highest IEO areas.Thus,the relative disparity increased significantly over the 25-year period（P=0.0006）.For example,the SIR for the lowest IEO quintile increased from 1.28 during 1987–1991 to 1.74during 2007–2011.Absolute differences also increased with the proportion of＂potentially preventable＂cases doubling from 14.5% in 1987–1991 to 30.2% in 2007–2011.Conclusions：Despite the overall decline in lung cancer incidence among men in NSW over the past 25 years,there was a significant increase in disparity across socioeconomic areas in both relative and absolute terms.展开更多
Background: Urticarial dermatitis may represent a useful term for a subset of a reaction pattern designated most commonly as dermal hypersensitivity by pathologists. The term is not commonly used, and requires definit...Background: Urticarial dermatitis may represent a useful term for a subset of a reaction pattern designated most commonly as dermal hypersensitivity by pathologists. The term is not commonly used, and requires definition to determine whether it is clinically relevant. Objectives: To define urticarial dermatitis and distinguish it from other urticarial reaction patterns and to review the frequency with which dermatologists can recognize clinical settings that match the biopsy findings of urticarial dermatitis. Design: Retrospective analysis of clinical and/or histological diagnosis of urticarial dermatitis, applying strict histological criteria in a center using urticarial dermatitis as a diagnostic term in 190 archived reports. Setting: Tertiary referral dermatopathology service reporting for dermatological practices in Sydney, Australia. Main Outcome Measures: The correlation between clinical and histological diagnoses of urticarial dermatitis and alternate diagnoses was analyzed. The frequency of positive immunofluorescence findings for bullous pemphigoid was determined in a subset of patients with urticarial dermatitis in whom this test was ordered to exclude prodromal bullous pemphigoid. Results: Urticarial dermatitis was the histological diagnosis in at least 1 biopsy result in 148 patients, and matched the provisional clinical diagnosis in 49 (33.1% ) patients. Urticarial dermatitis was the only diagnosis provided in 21 patients. The main alternate clinical diagnoses provided were early bullous pemphigoid or dermatitis herpetiformis (47 patients [31.8% ]), dermatitis (39 patients [26.4% ]),drug reaction (35 patients [23.6% ]), urticarial vasculitis (24 patients [16.2% ]), and urticaria (12 patients [8.1% ]). In 91 patients with a clinical diagnosis of urticarial dermatitis, the histological diagnosis in at least 1 biopsy result was matched in 49 patients (53.8% ); other histological diagnoses included dermatitis (21 patients [23.1% ]), papular urticaria (12 patients [13.2% ]), drug reaction (6 patients [6.6% ]), and urticaria (3 patients [3.3% ]). Review of 38 direct immunofluorescent results for prodromal bullous pemphigoid and a biopsy finding of urticarial dermatitis revealed only 3 positive results (7.9% ).Conclusions: Urticarial dermatitis seems to be a useful histological and clinical term for a subset of the dermal hypersensitivityreaction pattern. Although the clinical presentation is not restricted to a specific entity, eczema and drug reactions seem to be the most frequent clinical associations; and in a subset of patients, urticarial dermatitis remains as a recognizable reaction pattern. Urticarial dermatitis without eosinophilic spongiosis is not a reliable indicator for bullous pemphigoid, because the findings of immunofluorescence are often negative.展开更多
Background: Retinoids have the capacity to accelerate the involution ofmultiple keratoacanthomas, including unusual variants such as keratoacanthoma marginatum centrifugum and keratoacanthoma en plaque that may persis...Background: Retinoids have the capacity to accelerate the involution ofmultiple keratoacanthomas, including unusual variants such as keratoacanthoma marginatum centrifugum and keratoacanthoma en plaque that may persist and be associated with progressive growth and provide difficulties in diagnosis and management. Observations: We describe 3 patients who had unusual infiltrated and keratotic plaques affecting the lower legs or nasolabial area that persisted or recurred that may be related to this group of unusual keratoacanthomas. The 3 patients had differing clinical lesions that did not resemble classic keratoacanthomas, but were linked by their biopsy findings of hypertrophic lichen planus-like reaction and pseudoepitheliomatous hyperplasia with a prominent infundibulocystic component that progressed to multiple keratoacanthomas or infundibulocystic squamous cell carcinoma. Polymerase chain reaction analysis of biopsy material from 2 patients failed to detect human papillomavirus. All 3 presentations provided a therapeutic dilemma, but responded rapidly to acitretin treatment at a dosage of 10 to 25 mg daily, which was continued for 15 to 24 months. Conclusions: These cases illustrate an unusual reaction pattern that is hypertrophic lichen planus-like but, instead of evolving to classic lichen planus, progresses to infundibulocystic hyperplasia and the development of multiple keratoacanthomas or infundibulocystic squamous cell carcinomas. Retinoids represent a therapeutic option for this difficult clinical problem and may obviate repeated and extensive surgery.展开更多
Cancer outcomes in Australia are among the best in the world,but this is not the story for all Australians,with sig-nificant disparities in cancer outcomes and experiences among specific groups in Australian society.T...Cancer outcomes in Australia are among the best in the world,but this is not the story for all Australians,with sig-nificant disparities in cancer outcomes and experiences among specific groups in Australian society.The Australian Government developed the Australian Cancer Plan(the Plan)as a national approach to improve cancer outcomes and experience for all.The Plan identifies six strategic objectives that require nationally coordinated effort,to achieve the Plan’s vision of world class cancer outcomes and experience for all Australians affected by cancer.The Plan empha-sises person-centred approaches to cancer care,underpinned by a Health Equity in Cancer Outcomes Framework.As the Australian Government’s national cancer control agency,Cancer Australia is driving the Plan’s reform agenda through five implementation policy priorities:the development and establishment of an Australian Comprehensive Cancer Network;the development of a National Optimal Care Pathways Framework;the development of a National Comprehensive Cancer Data Framework and minimum dataset;the development of a National Genomics in Cancer Control Framework;and initiatives to improve cancer outcomes for Aboriginal and Torres Strait Islander people.These priorities will lay the foundation to deliver an integrated,accessible,and equitable cancer control system to deliver the Plan’s vision over the next decade.展开更多
文摘Objective：We assessed the trends in lung cancer incidence over a 25-year period by socioeconomic groups for men in New South Wales（NSW）,Australia.Methods：Men diagnosed with lung cancer between 1987 and 2011 were divided into five quintiles according to an Index of Education and Occupation（IEO）.We assessed relative socioeconomic differences over time by calculating age-standardized incidence ratios（SIRs）by 5-year period of diagnosis,and estimated absolute differences by comparing the observed and expected numbers of cases using the highest IEO quintile as the reference.Results：Lung cancer incidence for men decreased from 1987 to 2011 for all IEO quintiles,with a greater rate of decline for men living in the highest IEO areas.Thus,the relative disparity increased significantly over the 25-year period（P=0.0006）.For example,the SIR for the lowest IEO quintile increased from 1.28 during 1987–1991 to 1.74during 2007–2011.Absolute differences also increased with the proportion of＂potentially preventable＂cases doubling from 14.5% in 1987–1991 to 30.2% in 2007–2011.Conclusions：Despite the overall decline in lung cancer incidence among men in NSW over the past 25 years,there was a significant increase in disparity across socioeconomic areas in both relative and absolute terms.
文摘Background: Urticarial dermatitis may represent a useful term for a subset of a reaction pattern designated most commonly as dermal hypersensitivity by pathologists. The term is not commonly used, and requires definition to determine whether it is clinically relevant. Objectives: To define urticarial dermatitis and distinguish it from other urticarial reaction patterns and to review the frequency with which dermatologists can recognize clinical settings that match the biopsy findings of urticarial dermatitis. Design: Retrospective analysis of clinical and/or histological diagnosis of urticarial dermatitis, applying strict histological criteria in a center using urticarial dermatitis as a diagnostic term in 190 archived reports. Setting: Tertiary referral dermatopathology service reporting for dermatological practices in Sydney, Australia. Main Outcome Measures: The correlation between clinical and histological diagnoses of urticarial dermatitis and alternate diagnoses was analyzed. The frequency of positive immunofluorescence findings for bullous pemphigoid was determined in a subset of patients with urticarial dermatitis in whom this test was ordered to exclude prodromal bullous pemphigoid. Results: Urticarial dermatitis was the histological diagnosis in at least 1 biopsy result in 148 patients, and matched the provisional clinical diagnosis in 49 (33.1% ) patients. Urticarial dermatitis was the only diagnosis provided in 21 patients. The main alternate clinical diagnoses provided were early bullous pemphigoid or dermatitis herpetiformis (47 patients [31.8% ]), dermatitis (39 patients [26.4% ]),drug reaction (35 patients [23.6% ]), urticarial vasculitis (24 patients [16.2% ]), and urticaria (12 patients [8.1% ]). In 91 patients with a clinical diagnosis of urticarial dermatitis, the histological diagnosis in at least 1 biopsy result was matched in 49 patients (53.8% ); other histological diagnoses included dermatitis (21 patients [23.1% ]), papular urticaria (12 patients [13.2% ]), drug reaction (6 patients [6.6% ]), and urticaria (3 patients [3.3% ]). Review of 38 direct immunofluorescent results for prodromal bullous pemphigoid and a biopsy finding of urticarial dermatitis revealed only 3 positive results (7.9% ).Conclusions: Urticarial dermatitis seems to be a useful histological and clinical term for a subset of the dermal hypersensitivityreaction pattern. Although the clinical presentation is not restricted to a specific entity, eczema and drug reactions seem to be the most frequent clinical associations; and in a subset of patients, urticarial dermatitis remains as a recognizable reaction pattern. Urticarial dermatitis without eosinophilic spongiosis is not a reliable indicator for bullous pemphigoid, because the findings of immunofluorescence are often negative.
文摘Background: Retinoids have the capacity to accelerate the involution ofmultiple keratoacanthomas, including unusual variants such as keratoacanthoma marginatum centrifugum and keratoacanthoma en plaque that may persist and be associated with progressive growth and provide difficulties in diagnosis and management. Observations: We describe 3 patients who had unusual infiltrated and keratotic plaques affecting the lower legs or nasolabial area that persisted or recurred that may be related to this group of unusual keratoacanthomas. The 3 patients had differing clinical lesions that did not resemble classic keratoacanthomas, but were linked by their biopsy findings of hypertrophic lichen planus-like reaction and pseudoepitheliomatous hyperplasia with a prominent infundibulocystic component that progressed to multiple keratoacanthomas or infundibulocystic squamous cell carcinoma. Polymerase chain reaction analysis of biopsy material from 2 patients failed to detect human papillomavirus. All 3 presentations provided a therapeutic dilemma, but responded rapidly to acitretin treatment at a dosage of 10 to 25 mg daily, which was continued for 15 to 24 months. Conclusions: These cases illustrate an unusual reaction pattern that is hypertrophic lichen planus-like but, instead of evolving to classic lichen planus, progresses to infundibulocystic hyperplasia and the development of multiple keratoacanthomas or infundibulocystic squamous cell carcinomas. Retinoids represent a therapeutic option for this difficult clinical problem and may obviate repeated and extensive surgery.
文摘Cancer outcomes in Australia are among the best in the world,but this is not the story for all Australians,with sig-nificant disparities in cancer outcomes and experiences among specific groups in Australian society.The Australian Government developed the Australian Cancer Plan(the Plan)as a national approach to improve cancer outcomes and experience for all.The Plan identifies six strategic objectives that require nationally coordinated effort,to achieve the Plan’s vision of world class cancer outcomes and experience for all Australians affected by cancer.The Plan empha-sises person-centred approaches to cancer care,underpinned by a Health Equity in Cancer Outcomes Framework.As the Australian Government’s national cancer control agency,Cancer Australia is driving the Plan’s reform agenda through five implementation policy priorities:the development and establishment of an Australian Comprehensive Cancer Network;the development of a National Optimal Care Pathways Framework;the development of a National Comprehensive Cancer Data Framework and minimum dataset;the development of a National Genomics in Cancer Control Framework;and initiatives to improve cancer outcomes for Aboriginal and Torres Strait Islander people.These priorities will lay the foundation to deliver an integrated,accessible,and equitable cancer control system to deliver the Plan’s vision over the next decade.
