Can we rely on public data as a source of information for cancer registry in developing countries?

BACKGROUND/AIMS: Although a "hospital-based cancer registry" is important in improving patient care, a "population-based cancer registry" with emphasis on epidemiology is important in allocating health care resources and prioritizing public health programs. Because of its reliance on retrieved clinical and para-clinical documents, there is some limitation in registering all cancer incidents in this system, especially in developing countries. In this study we examined the possibility of using public data as a complementary source of information for recording cancers in a population-based cancer registry. METHODS: Along with the annual census in rural areas, a survey was performed in Golestan province in March 2004 to identify public awareness about cancer incidents in the community. Individuals were questioned about history of cancer in their close relatives during the last two years. Those who reported cancer in their relatives were also asked to name the main organ of involvement. A similar list was retrieved from the cancer registry at the Ministry of Health in Gorgan, and cases with upper GI (esophagus and gastric) cancer diagnosis from 21 March 2002 through 20 March 2004 were selected for this study. Finally, these two lists were compared for examining accuracy of the collected data. RESULTS: We included 137 cases in our study with rural residence and known addresses. Only 35 (25.5%) cases were reported by the relatives and among them only 20 (57.1%) relatives correctly reported the tumor location. Although we found a difference in accurate reporting of cancer incidents by year of diagnosis (more correct cases reported during the second versus the first year), the difference was not statistically significant between the two years. CONCLUSION: In this study, we examined the possibility of using public awareness about cancer incidents as a complementary source of information for a population-based cancer registry. We found that this approach is not ideal for reducing limitations. Therefore, we recommend a nationwide cancer registry to record all cancer-related information at the time of diagnosis. This strategy will reduce the need for performing retrospective surveys in collecting cancer-related information.     

Myocardial Infarction Type 2: Avoiding Pitfalls and Preventing Adverse Outcomes

Myocardial infarction type 2 (MI type 2) is an elevation of cardiac biomarkers in a physiologically stressful state leading to demand-supply mismatch of oxygen. This type of myocardial infarction is commonly seen in hospitalized patients. Since the introduction of clear definition, diagnostic criteria and International Classification of Disease (ICD) codes, the diagnosis has become increasingly common. There still remains plenty to learn about MI type 2 especially prevention and treatment strategies. Studies have shown that there is increased mortality and morbidity associated with MI type 2 when compared to MI type 1, and there may be benefit in having a multi-disciplinary approach including cardiology when treating such patients. Secondary prevention therapies may also play a role in decreasing adverse events from MI type 2. However, randomized control trials are insufficient, and results of studies are cautiously interpreted. In this article we have assessed the current evidence on MI type 2 and the gap in literature that will potentially be the focus of future analyses.     

The Springer Model for Lifetime Prediction of Wind Turbine Blade Leading Edge Protection Systems: A Review and Sensitivity Study

The wind energy sector is growing rapidly. Wind turbines are increasing in size, leading to higher tip velocities. The leading edges of the blades interact with rain droplets, causing erosion damage over time. In order to mitigate the erosion, coating materials are required to protect the blades. To predict the fatigue lifetime of coated substrates, the Springer model is often used. The current work summarizes the research performed using this model in the wind energy sector and studies the sensitivity of the model to its input parameters. It is shown that the Springer model highly depends on the Poisson ratio, the strength values of the coating and the empirically fitted a2 constant. The assumptions made in the Springer model are not physically representative, and we reasoned that more modern methods are required to accurately predict coating lifetimes. The proposed framework is split into three parts—(1) a contact pressure model, (2) a coating stress model and (3) a fatigue strength model—which overall is sufficient to capture the underlying physics during rain erosion of wind turbine blades. Possible improvements to each of the individual aspects of the framework are proposed.     

Axillary lymph‐node metastases as the primary presentation of high‐grade serous ovarian carcinoma: A case report

We reported a female presented with an initial diagnosis of metastatic axillary lymph‐node carcinoma that comprehensive assessments revealed a definitive diagnosis of high‐grade serous ovarian carcinoma as the primary tumor.     

IMPACT OF HEPARIN LOCKING FREQUENCY ON PREVENTING TEMPORARY DIALYSIS CATHETER DYSFUNCTION IN HAEMODIALYSIS PATIENTS

A prospective analysis was conducted comparing dysfunction attributable to catheter thrombosis in subjects who received a heparin catheter lock three times a week (n = 15) to those who received a heparin lock six times a week (n = 15) immediately after the insertion of a temporary haemodialysis catheter. Thrombus related catheter removal occurred in two patients in control but no patients in the experiment group. Heparin locking six times a week was found to be effective in prolonging the mean of the first day where difficulty was experienced in aspiration. It also prevented any possible difficulty in catheter flushing. Increased locking frequency prevents any thrombus accumulation within the temporary catheter, while it has limited but significant preventive effect on thrombus accumulated around the catheter.     

Children's consumption of beverages in Singapore: knowledge, attitudes and practice

Aim: To examine the beverage consumption habits of Singaporean children and to investigate knowledge and attitudes of parents and children with regard to beverage consumption. Methods: A total of 800 respondents were randomly surveyed using face‐to‐face household interviews conducted between 10 March and 23 April 2009. The survey included mothers aged 25 to 44 years, of 400 children aged three to six years and 400 children aged seven to 10 years. Results: Children aged three to six and seven to 10 years typically consume milk on a daily basis. Younger children consume a greater number of servings of milk, whereas a significantly greater proportion of children aged seven to 10 years consume malted energy drinks and non‐gassy and gassy soft drinks (P ≤ 0.005 for all). In older children, a decline in the proportion consuming milk on a typical weekday (69% vs. 92% for three‐ to six‐year‐olds) is accompanied by a reduction in mean calcium intake (733 mg vs. 1032 mg for three‐ to six‐year‐olds). On a typical weekday, 26% of children aged three to six years did not meet the recommended daily dietary allowance (RDDA) of 600 mg of calcium. Of children aged seven to 10 years, 61% also did not meet the age‐appropriate RDDA of 700 g mg of calcium. Conclusions: Milk consumption decreases with age while the consumption of beverages such as malted energy drinks, gassy and non‐gassy soft drinks and syrups increases markedly. Educational programmes may aid in the selection of appropriate nutrient‐dense beverages and other calcium‐rich foods to ensure that children achieve the recommended daily dietary nutrient intake.