Female Incidence Ratio Research Articles

Genetic and Epigenetic Association of FOXP3 with Papillary Thyroid Cancer Predisposition.

Papillary thyroid cancer (PTC) is the most common type of thyroid malignancy with an increased female incidence ratio. The specific traits of X chromosome inheritance may be implicated in gender differences of PTC predisposition. The aim of this study was to investigate the association of two X-linked genes, Forkhead Box P3 (FOXP3) and Protein Phosphatase 1 Regulatory Subunit 3F (PPP1R3F), with PTC predisposition and gender disparity. One hundred thirty-six patients with PTC and an equal number of matched healthy volunteers were enrolled in the study. Genotyping for rs3761548 (FOXP3) and rs5953283 (PPP1R3F) was performed using polymerase chain reaction-restriction fragment length polymorphism assay (PCR-RFLP). The methylation status of FOXP3 was assessed using the combined bisulfite restriction analysis (COBRA) method. The SPSS software was used for statistical analyses. Gender stratification analysis revealed that the CA and AA genotypes and the A allele of FOXP3 rs3761548 variant are associated with PTC predisposition only in females. Moreover, different methylation status was observed up to the promoter locus of FOXP3 between PTC female patients, carrying the CA and CC genotype, and controls. Both revealed associations may explain the higher PTC incidence in females through reducing FOXP3 expression as reported in immune related blood cells.

Increase in Registered Acute Kidney Injuries in German Hospitals.

Currently, the development of the incidence of acute kidney injury (AKI) and the influence of age and gender on the condition in Germany is unclear. Data were extracted from the national database of Federal Health Reporting. It was then normalized for demographic changes. Poisson regression was performed on 933,684 cases to quantify the correlation between age, years, and AKI incidence. Analysis of variance was performed on the same collection to evaluate gender disparities in different age groups. In absolute numbers, registered AKI increased almost sevenfold from 11,964 to 77,719 between 2000 and 2019. After adjusting for demographic changes, the most AKI - 6300.5 per million person-years - occur in the elderly (>79 years old). Males have a higher risk for the development of an AKI. The male and female AKI incidence ratio varies significantly between different age groups, and it is the lowest in people <20 and >79 years old. The registered incidence of AKI has risen substantially in the first 20 years of the millennium. The increase can partly be attributed to an increased diagnostic sensitivity provided by changes in the classification of AKI. It could also be shown that men suffer from AKI more often than women, particularly in the younger age groups.

EPCO-29. KLF5 IS REQUIRED FOR THE SEX-DIFFERENCES ACROSS MULTIPLE TUMORIGENIC PHENOTYPES IN PEDIATRIC GLIOBLASTOMA (GBM)

Abstract High-grade glioblastoma (GBM) is a highly heterogeneous, malignant cancer with no cure to date. A sex-biased incidence and therapeutic response is reported (1) for GBM with a male to female incidence ratio of 1.6:1 and female patients having a 4-6 month survival advantage (2) compared to male patients. In our current work, we sought to determine the molecular basis for the sex-bias in incidence and therapeutic response using an isogenic murine model of GBM with dual loss of neurofibromin 1 (NF1) and P53 (DNP53) in astrocytes. Our model yielded GBM from the murine astrocytes in a sex-biased manner, with male GBM cells exhibiting a highly significant proliferative, migratory, in-vivo tumorigenicity, stem-cell enrichment rate and therapeutic resistance compared to female GBM cells. Using transposon calling cards, we mapped Brd4 enhancer usage across the genome in male, compared to female GBM cells and identified key transcription factors that differentially enriched at male-biased, compared to female-biased Brd4 bound enhancers. Interestingly, female-biased Brd4-bound enhancers were enriched for transcription factors with tumor suppressor roles including P53 and SMAD4, whereas male-biased Brd4-bound enhancers were enriched for transcription factors with oncogenic roles, including Oct4, MYC and KLF5. Genetic or chemical silencing of KLF5 reduced the tumorigenic potential in male GBM with rates of cellular proliferation, survival, migration and stem-cell frequency significantly reduced to levels that resemble female GBM. Using transposon calling cards, we mapped KLF5 genomic localization in male and female GBM cells and identified significant peaks that affiliated with differentially expressed genes between the sexes. Interestingly, genes induced by KLF5 in the male cells were affiliated with poor survival in patients with various cancers, whereas those induced by KLF5 in the female cells were affiliated with favorable prognosis. This signifies the need to explore molecular mechanisms by which KLF5 drives these sex differences in GBM.

Analysis of the epidemiological characteristics between 2004 and 2017 and prediction of the changing pattern of other infectious diarrhea (OID) under COVID-19 in China.

The study describes epidemiological features and transmission of other infectious diarrhea (OID) before and during the epidemic of COVID-19 in China, which lays a foundation for OID prevention and control. Incidence rate and mortality data of OID containing detailed epidemiological information such as date, age and region from 2004 to 2017, and total OID case number from 2018 to 2020 were obtained from the Data Center of China’s Public Health Science and the National Bureau of Statistics’ statistical yearbook. The Joinpoint regression model and Z test was used to analyze, while R language and ArcGIS 10.5 for drawing. The autoregressive integrated moving average model was used to predict the influence of COVID-19 on OID. The OID incidence rate increased from 31.69/10 million in 2004 to 92.42/10 million in 2017, and the mortality rate decreased from 1.82/10,000 to 0.14/10,000. The male to female incidence ratio was 1.39:1 (P < .001). The patients’ age showed a decreased trend with age (P < .001). The scattered children devoted the most OID incidence rate. The bimodal distribution of OID incidence was summer peak in northern China, 2 apparent peaks in central and eastern, and winter peak in southern. The autoregressive integrated moving average model predicted 1,406,557 in 2020, comparing the actual OID cases in 2020 to 1,062,277. Affected by the epidemic control measures of COVID-19, the number of OID cases declined by 32.4% (Absolute percentage error = 32.4%). The OID incidence rate in China continuously increased and showed a bimodal distribution in summer and winter with inconspicuous regional characteristics, gender and age susceptibility differences, and occupational differences. Meanwhile, COVID-19 significantly reduced OID incidence in 2020. The discoveries might bring a beneficial effect on OID prevention and control policies.

Three Years Study Of Unusual Hydatid Cysts: From Head To Toe

Hydatidosis is a zoonotic infection due to larval stage of the tapeworm echinococcus. In adults’ liver represents the prevalent site and lungs are the second commonest site. Although these are common sites, it can occur at any site including spleen, pancreas, peritoneum, retroperitoneum, central nervous system, soft tissues, and breast. We present the histopathological spectrum of hydatid cyst at unusual sites in our hospital over a period of three years. The present retrospective study was conducted in the department of Pathology, SKIMS during a period of 3years from July 2019 to June 2022 where a total of 12cases were diagnosed as Hydatid Cyst at unusual sites on HPE during study period were included. Male and female ratio of incidence found to be 1:1:4. Maximum no of cases i.e., 3 occurred in brain, 2 in spleen,2 in thigh,1 each in breast, omentum, kidney, sacral ala and mediastinum.The hydatid cyst can be present in any part of the body and there is no natural immunity that inhibit the development &amp; growth of it. These unusual locations frequently result in nonspecific symptoms. To avoid life-threatening complications and unnecessary radical surgeries, hydatid cystic disease should always be suspected in all cystic lesions of radio imaging investigations, especially in endemic areas.

Epidemiological investigation and prevention and control strategies of rubella in Anhui province, China, from 2012 to 2021.

BackgroundRubella is a highly contagious viral infection with mild manifestations that occurs most often in children and young adults. Infection during pregnancy, especially during the first trimester, can result in an infant born with congenital rubella syndrome (CRS). The purpose of this paper is to analyze the characteristics of rubella epidemics in Anhui province from 2012 to 2021 and explore the prevention and control strategies of rubella.MethodsA descriptive epidemiological approach was used to examine the epidemiological characteristics of rubella in Anhui Province between 2012 and 2021.ResultsFrom 2012 to 2021, a total of 4,987 cases of rubella were reported in Anhui province, with an average annual incidence of 8.11 per million, demonstrating an overall downward trend (χ2 trend =3141.06, P < 0.01). The average yearly incidence of rubella in southern Anhui, central Anhui, and northern Anhui were 9.99 per million, 11.47 per million, and 4.50 per million, respectively, with statistically significant differences (χ2 =792.50, P < 0.01). The male to female incidence ratio was 1.67:1, and the male incidence rate was higher than the female incidence rate. Most cases occurred among students, accounting for 56.59% of all cases, and the 10–34 age group accounted for ~73.71% of all cases. Regarding immunization history, 3.57% of cases had two doses or more, 6.62% had one dose, 16.40% had none, and the remainder were uncertain.ConclusionThe incidence of rubella in Anhui province from 2012 to 2021 continued to decline, with regional variations observed. The 10–34-year-old population without a history of rubella vaccination is at high risk for the disease. It is suggested to carry out rubella vaccination and congenital rubella syndrome monitoring according to the actual situation.

Foreign body aspiration and ingestion in dental clinic: a seven-year retrospective study.

BackgroundThis retrospective study investigated the incidence rate of accidental foreign body aspiration and ingestion according to patient sex, age, and dental department. This study aimed to verify whether the incidence rate is higher in geriatric than in younger patients and whether it is different among dental departments.MethodsAccidental foreign body aspiration and ingestion cases were collected from electronic health records and the safety report system of Yonsei University Dental Hospital from January 2011 to December 2017. The collected data included patients’ age, sex, medical conditions, treatment procedures, and foreign objects that were accidentally aspirated or ingested. The incidence rate was calculated as the number of accidental foreign body aspirations and ingestions relative to the total number of patient visits. Differences depending on the patients’ sex, age, and dental department were statistically identified.ResultsThere were 2 aspiration and 37 ingestion cases during the 7-year analysis period. The male to female incidence ratio was 2.8:1. The incidence rate increased with age and increased rapidly among those aged 80 years or older. Seven of the 37 patients with accidental foreign body ingestion had intellectual disability, Lou Gehrig’s disease, dystonia, or oral and maxillofacial cancer. The incidence rate was highest in the Predoctoral Student Clinic and the Department of Prosthodontics. The most frequently swallowed objects were fixed dental prostheses and dental implant components.ConclusionThe incidence rate of accidental foreign body aspiration and ingestion differed according to patient sex, age, and dental department. Dental practitioners must identify high-risk patients and apply various methods to prevent accidental foreign body aspiration and ingestion in dental clinics. Inexperienced practitioners should be particularly careful.

The incidence of lung cancer in Northern Ireland: 1991–1992

IntroductionLung cancer is the leading cause of cancer deaths in many Western countries, but its incidence has never been studied in Northern Ireland.AimsAccordingly, the present study was mounted to determine, for the first time, the incidence of the condition in Northern Ireland and to compare the findings with other regions in the British Isles.MethodsA notification study of the incidence of lung cancer (ICD 162) was conducted in Northern Ireland during 1991/1992. Notifications from 6 sources were computerised and linked. Incident cases were identified and analysed in relation to Age, Sex and Geographical region—Northern Ireland, England and Wales, Scotland and the Republic of Ireland.ResultsSome 900 incident cases of lung cancer were identified. The incidence rate per 100,000 population was found to be 57.04. Mortality underestimated incidence by 12.5%. (p<0.05). The male to female incidence ratio was 2.1: 1, and this ratio was similar in other regions, except Scotland, where the ratio was 1.7:1. The null hypothesis of a common incidence distribution across regions was formally rejected. A variety of models were fitted and a model in which the log-odds on incidence was a quadratic function of age fitted most of the regional data.ConclusionsNorthern Ireland had the lowest incidence of lung cancer in the UK, but its overall rate was still 40% higher than that observed in the Republic of Ireland which had the lowest rate in the British Isles. Across regions, the pattern of incidence by age and sex was complicated, but a linear logistic model fitted all of the Irish data and the female data in Scotland, satisfactorily.

Human brucellosis epidemiology in the pastoral area of Hulun Buir city, Inner Mongolia autonomous region, China, between 2003 and 2018.

Human brucellosis represents a serious public health concern in Hulun Buir and requires a comprehensive epidemiologic analysis to define adapted control measures. The present study describes the case numbers, constituent ratios and incidence rate of human brucellosis. Conventional biotyping, that is abortus, melitensis, ovis and suis (AMOS)-PCR and multi-locus variable-number tandem repeat analysis (MLVA) were used to characterize the Brucella strains. Between 2003 and 2018, a total of 23,897 human brucellosis cases were reported, with an incidence rate of 56.03/100,000, which is 20 times higher than the country's average incidence. This incidence rate increased year after year, culminating in 2005 and decreased between 2011 and 2018. Because Hulun Buir relies on a nomadic livestock rearing system, brucellosis spreads easily among different animal species and humans. In Xin Barag Left Banner and Xin Barag Right Banner, the incidence rates were, respectively, 226.54/100,000 and 199.10/100,000, exceeding those observed in other areas. Most of the cases occurred in the 25- to 45-year-old group, accounting for 65.74% of the cases (15,709/23,897), and among farmers, accounting for 66.71% (15,942/23,897). The male to female incidence ratio was 2.67:1. The higher incidence in younger people and the large gender ratio reflected the unique traditional production and lifestyle of nomads. Most reported cases were observed from April to June, indicating that more than 40% of the cases were related to the delivery of domestic livestock. The biotyping showed that the 44 isolated strains were all B.melitensis, including 12 Brucella melitensis biovar (bv) 1 and 32 B.melitensis bv. 3. The strains displayed a genetic similarity of 80%-100%. Our hypothesis is that human brucellosis outbreak in this region may be originating from a limited source of infection, so further investigation is necessary. The epidemic situation of human brucellosis in Hulun Buir is extremely serious, strengthened surveillance and control in animals' brucellosis should be priority.

Analysis of the Epidemiological Characteristics of Rabies in Jingxi City, Guangxi from 2000 to 2020

Objective Analyze the epidemiological characteristics of rabies in Jingxi City to provide a basis for formulating rabies control measures. Methods Descriptive epidemiological methods were used to analyze the surveillance data of rabies in Jingxi City from 2000 to 2020. Results A total of 73 rabies cases and 73 cases of rabies were reported in Jingxi City from 2000 to 2020, with an average annual incidence rate of 0.55/100,000, and a case fatality rate of 100%; cases were reported in 19 towns and townships; it occurred frequently in Summer and autumn, with 56.16% of cases from May to September. Mainly farmers, the incidence accounted for 84.93%; male incidence rate was 0.70/100,000, female incidence rate was 0.38/100,000, male and female incidence ratio was 2.04:1; the main wonding animals were dogs, accounting for 95.89%; humans No history of vaccination after exposure accounted for 97%. Conclusion The rural area Jingxi City is a key area for rabies Prevention and control. It is necessary to strengthen the propaganda of rabies prevention knowledge, standardize post-exposure treatment, and carry out large-scale dog immunization. Comprehensive prevention measures such as immunization and hunting to effectively curb the epidemic of rabies. Background: Jingxi, Guangxi is located on the border of China and Vietnam. The border with Vietnam to the south is 152.5km long. It has a subtropical monsoon climate. It has 19 villages and towns under its jurisdiction and has a total population of 670,000. Among them, ethnic minority imports account for 99.40%. The port was expanded to an international port with the approval of the state council, and the Yuexu port was also upgraded to a national first-level port. Border trade increased. Residents in rural areas have the habit of raising domestic dogs and eating dog meat. There are a large number of dogs, dog registration management, and immunization. The implementation of hunting and killing measures is not in place, the standardized disposal rate after exposure is low, and rabies epidemics occur from time to time.

A COMPARATIVE STUDY ON OUTCOMES OF OPEN & LAPAROSCOPIC REPAIR IN INGUINAL HERNIA IN A TERTIARY CARE CENTRE

Background: Over the last decade, the field of hernia surgery got a new transformation, with exponential growth in mesh technology. Laparoscopic hernia repair has remained a contentious issue since its inception. Though a variety of procedures performed; none can be termed as an ideal procedure as each one is accompanied by varied early and late complications. The most scientific way to conclude the superiority of one method over others is evidence-based medicine. Hence, we have conducted a study in our institute, to compare Lichtenstein tension-free open hernioplasty with Transabdominal pre-peritoneal repair (TAPP) comparing the intraoperative and early postoperative complications. Methods: Our study was a single-centre, prospective comparative study conducted on sixty-one patients, over a period of 2 years from August 2018 to August 2020. All the cases included in the study were uncomplicated inguinal hernias. A detailed history of the symptoms, thorough clinical examination and investigations were done, which were analysed. Results: Most of the patients presented in the 5th decade. Male to female ratio of incidence of inguinal hernia was 11.2:1. Majority of the patients presented with unilateral hernia with right inguinal hernia being the most frequent presentation. The mean duration of surgery for TAPP is more when compared to Lichtenstein operation. The mean duration of hospital stay for open hernioplasty is more when compared to the laparoscopic hernia repair. TAPP is associated with lesser complications when compared to Lichtenstein's hernioplasty. Seroma, hematoma, and wound infection were the common complications noted. Conclusion: TAPP repair is a better procedure when compared to Lichtenstein operation in terms of hospital stay, post- operative recovery, intra-operative and post-operative complications.

Population-based epidemiological data of follicular lymphoma in Poland: 15\xa0years of observation

Available epidemiological reports on follicular lymphoma (FL) often highlight a significant discrepancy between its high and low incidence rates in Western and Eastern Europe, respectively. The reasons behind that difference are not fully understood, but underreporting is typically presumed as one of the main factors. This study aimed to assess FL epidemiology in Poland based on 2000–2014 data from the Polish National Cancer Registry, which has 100% population coverage and over 90% completeness of the registration. All cases were coded according to ICD-10 and ICD-O-3 recommendations. The total number of registered FL cases was 3,928 with crude (CR) and standardized (SR) incidence rates of 0.72/105 and 0.87/105, respectively. The median age of FL diagnosis was 61 years, with the male to female incidence ratio of 1.06. The distribution of morphological types of FL: not otherwise specified (NOS), grades 1, 2, or 3 were 72.58, 4.81, 12.88, and 9.73%, respectively. Among all reported mature B-cell non-Hodgkin lymphomas, FL was ranked the fourth in incidence, just after chronic lymphocytic leukemia/small lymphocytic lymphoma (CR 3.62/105, SR 4.99/105), plasma cell neoplasms (CR 3.78/105, SR 4.97/105) and diffuse B-cell lymphoma, NOS (CR 2.13/105, SR 2.65/105). The systematic increase in FL incidence among females was observed. Our study confirms a lower FL incidence rate in Poland as compared to other European countries. Moreover, as our analysis was based on a registry with high data completeness, it provides evidence that reasons other than underreporting are responsible for FL incidence discrepancies between Eastern and Western Europe.

Epidemiological characteristics of human brucellosis in Tongliao city of Inner Mongolia Autonomous Region, 2004-2018

Objective: To analyze the epidemiological characteristics of human brucellosis (HB), evolution and origin feature of Brucella strains in Tongliao city, Inner Mongolia Autonomous Region during 2004-2018, and to provide evidence for strategy development against the disease. Methods: Data from the reports on HB in Tongliao during 2004-2018 were extracted from the China Information System for Disease Control and Prevention before being analyzed with software Excel 2016. Epidemiologic feature was described, using the number of cases, constituent ratio and related rates. Conventional biotypes methods were used for identification of species/biovars strains while species of six Brucella strains were further verified by AMOS-PCR. Cluster analyze on six Brucella strains were performed with Bio-Numerics 5.0 software and for examining and revealing the genetic characteristics of the related strains. Results: During 2004-2018, a total of 16 704 HB cases were reported, with the incidence rate as 35.41/100 000. The incidence rates appeared as 110.51/100 000 in Jarud Banner and 67.84/100 000 in Kulun flag, which were both higher than the other areas. Most of the cases were reported in the 40-54 year olds, which accounted for 48.75% (8 143/16 704). The number of HB in farmers appeared as 14 873, which counted for 89.04% (14 873/16 704) of all the cases. Male to female ratio of incidence was 2.40∶1. Most of the reported cases appeared between March to May, which accounted for 56.30% (9 405/16 704). Peak of the disease was seen in April. Using the conventional identification method, results showed that the available six strains all belonged to B. melitensis, including three of them as B. melitensis bv.1 and others three strains as B. melitensis bv. 3. Results from the amplified AMOS-PCR showed that all the strains were B. melitensis. The six strains clustered in two MLVA-11 genotypes (111 and 116) and all belonged to the Eastern Mediterranean lineage. Based on the MLVA-16 cluster analysis, results suggested that strains from this study were having close genetic relationship with B. melitensis strains that were from Jilin and Heilongjiang provinces. Conclusions: Human brucellosis identified in Tongliao area was with greater risk in spreading the disease to the vicinity. Our findings indicated that the programs on detection and control of the disease should be strengthened.

Fatal childhood injuries in Finland between 1971 and 2017

BackgroundThe injury mortality rates around the globe show considerable country-to-country differences and the rates have decreased at very different speeds. In Finland, the proportion of total mortality attributed to injuries has been one of the highest in the European Union. The purpose of the present study was to examine the 47-year nationwide trend and the male to female ratio in the number and incidence of fatal injuries among 0 to 14-year-old children in Finland.MethodsThe data were obtained from the Official Cause-of-Death Statistics of Finland during 1971–2017. The main categories for unintentional injury deaths were road traffic injuries, water traffic injuries, falls, drownings, and poisonings. For intentional injury deaths, the main categories were suicides and homicides.ResultsIn 1971, there were 109 fatal injuries in girls and 207 in boys, while in 2017, these numbers had reduced to 9 and 12. The corresponding incidences (per 100,000 children per year) were 20.1 and 2.1 for girls, and 36.7 and 2.6 for boys, respectively. During the study period overall male to female injury incidence ratio decreased from 1.8 to 1.2. The greatest decline occurred in the number of fatal motor vehicle injuries. In 1971, the incidence of intentional deaths (suicides and homicides) was 2.6 in girls and 2.7 in boys, while in 2017 these numbers were 0.9 and 0.4, respectively.ConclusionsThis nationwide study confirms that the number and incidence rates of childhood injury deaths have reduced till current days and are already below the average in Europe.

Incidence of AChR Ab-positive myasthenia gravis in Israel: A population-based study.

The incidence of myasthenia gravis (MG) has traditionally been low, ranging between 2-6/106 . Several recent epidemiological studies have reported a higher incidence. We, therefore, aimed to assess and characterize the incidence of MG in Israel. We retrospectively reviewed the records of all four laboratories that performed the acetylcholine receptor antibody (AChR Ab) test in Israel between 1994 and 2013 and documented the number of newly diagnosed seropositive MG patients each year. To assure that data indeed reflect only newly diagnosed patients, patient's names and ID numbers were screened at the Hadassah medical center database since 1978, the year when the test was first performed in Israel. In order to calculate the annual incidence of the disease, the population at risk was derived from the annual publication of the Israeli Central Bureau of Statistics. The annual incidence of MG for this time period was 13.1/106 inhabitants. The mean incidence of MG between 1994 and 2003 was 7.695/106 /y, while the mean incidence between 2004 and 2013 was 18.49/106 (P<.0001). Mean age of diagnosis between 1994 and 2003 was 56.65±0.9351, while between 2004 and 2013, it was 59.89±0.5336 (P=.0012). Male to female (M:F) incidence ratio in the years 1994-2003 and 2004-2013 was 2:3.2 and 3:1.8, respectively, reflecting increased incidence among males (P<.0001). The incidence of MG in Israel has increased significantly during the last decade, especially among males of older age. These findings may reflect an etiological role of an environmental factor, increased awareness, and increased longevity in general.

Incidence in Ph-Negative Myeloproliferative Neoplasms in Armenia from 2005 to 2019

Introduction: Enhancements of laboratory diagnostics and the emergence of new therapies had a significant impact on the incidence, prevalence and survival of patients with myeloproliferative neoplasms (MPN). Published epidemiology data are scarce, and multiple sources are needed to assess the disease burden. The aim of our work was to identify the patterns and trends of incidence, prevalence and survival of patients with MPN in the Republic of Armenia (RA) for the period 2005-2019. Methods: The data from Hematology Center blood diseases register, Oncological Center cancer register, as well as the data from death registration were the basis of our research. Demographic data were obtained from National Statistical Office of RA. Results: Analysis of the data obtained has shown that during the reporting period the average annual incidence of MPN was 1.84 per 100.000 inhabitants, including 2.1 for males and 1.64 for females. Analysis of incidence rates of MPN in relation to sex and age in the period under study revealed high rates in patients in groups 65 - 74 (8.3) and 55 - 64 (5.12 per 100 thousand years), respectively. According to the data obtained in the group of patients with MPN, the high annual average incidence rates are noted in primary myelofibrosis (PMF) (1.09 in 2018) and polycythemia vera (PV) (0.89 in 2016), the lowest for essential thrombocythemia (ET) (0.7 in 2016) per 100.000 population, respectively. In comparing our data to those obtained for 1966-1971 and 1998-2004 periods, one may detect a statistically significant increase in the total incidence of PMF and PV (p < 0.001). Conclusions: Analysis of the incidence rate in MPNs adjusted for age and gender shown the prevalence in group 65 - 74 (8.3) and in group 55 - 64 (5.13) per 100,000 inhabitants. The peak of incidence rate for both males and females was the age 65 - 74 and the male female incidence ratio in this age group was 11.3:6.2. The increasing incidence rate in MPNs in Armenia depends on the improvement of laboratory diagnosis. Thrombotic complications are observed in patients with an MPN in 45.3% of cases. In most cases, thrombosis is the first clinical symptom of an MPN, which determines the need for the introduction into clinical practice of molecular genetic testing methods among patients with thrombosis, an increase in blood levels, splenomegaly for the early diagnosis of clonal hematopoiesis and the use of a targeted drug.

The Sex Ratio of Patients with Hematological Malignancies Enrolled Onto Clinical Trials for Investigational Medicinal Products Reported at ASH 2018 Reflects Male to Female Incidence Ratio

Introduction: It has previously been reported that there is a disparity in sex ratios (as well as ethnicity and education level) in subjects enrolled onto clinical trials for investigational medical products (CTIMPs) in oncological trials. This could have an impact for the individual as some reviews have suggested patients on clinical trials have better outcomes than those treated off trial. However, importantly this may have an impact on the analysis of the efficacy, adverse events and recommended dosing of the IMP under investigation due to sex differences in disease biology and drug metabolism. Given the significance of these potential differences, the FDA has established an Office of Women's Health with the specific mandate of ensuring women are represented adequately in trials. The sex ratios of subjects enrolled onto trials for hematological malignancies to the best of our knowledge has not been reviewed previously. We sought to analyse whether there was a difference in enrolment of men and women onto CTIMPs for hematological malignancies in all abstracts presented at the American Society of Haematology Congress in 2018. Methods: All abstracts that were presented either in oral or poster format at ASH in 2018 were accessed online and reviewed. Only abstracts that were reporting prospective clinical trials involving investigational medical products for hematological malignancies in adult patients were included in the analysis. The significance of the observed percentage of female subjects was analysed by Chi square with the null hypothesis (expected percentage) stated. Results: Of all abstracts reviewed, 398 were identified that fulfilled the criteria. If trial names or NCT numbers were specified, these were recorded and 16 were identified as "duplicates", abstracts reporting the same trial or different parts of the same trial and so if applicable only one abstract was included in the analysis. 204 abstracts reported the number of men and women enrolled onto the trial. In total there were 11,056 men (57%) compared to 8243 women (43%) on trial (p&lt;0.0001, H0=50%). The differences according to disease group and phase of trial where stated are shown in the tables. More men were enrolled onto trials then women in all disease groups (Table 1). This was compared to the expected ratio based on the national incidence of all new diagnoses made in the UK in 2016 (www.cancerresearchuk.org, accessed July 2019). In all disease categories, the ratio was as expected apart from trials for myeloma where there was a statistically significant ratio in favour of women being enrolled. Table 2 categorises the percentage of men and women enrolled according to phase of trial. The proportions in these categories were not equal, with the proportion of women entering early phase trials significantly lower than phase 3 trials (p&lt;0.0001). Conclusions: There was a significant difference in the number of men and women enrolled onto trials for IMPs in hematological malignancies that were presented at ASH 2018. The skew towards male subjects was consistent across disease groups and phase of trial. However this difference may reflect the underlying incidence of these diseases in men and women in the general population rather than represent a true bias in recruitment. However, the proportion of women recruited to early phase trials was significantly lower than those recruited to Phase 3 trials and the reasons for this difference should be investigated further. The data also highlights that a significant number of trials did not report the male to female ratio in the abstract consequently the dataset is not truly representative. Furthermore, the abstracts that have been reviewed only reflect those accepted for presentation which could be further skewing the data. The monitoring of subject recruitment to clinical trials should be performed at a national and international level by regulatory bodies to ensure that the complete trial population is captured and reflects the demographics of the general population. Disclosures No relevant conflicts of interest to declare.

Malignant transformation of tailgut cysts is significantly higher than previously reported: systematic review of cases in the literature.

The best treatment for tailgut cysts has not been firmly established. We report a systematic review of the cases in the available literature in order to provide an evidence base for treatment. A systematic search of articles wholly or partly in English was made of PubMed, Embase and Google Scholar; additional studies were discovered by searching reference lists and contacting authors directly. Search terms 'tailgut cyst', 'tail gut cyst', 'retrorectal hamartoma' and 'retrorectal tumour' were used for case reports or case series; no publication date restrictions were imposed. Only studies with histological confirmation of diagnosis and reporting the age and gender of patients were included. Papers were excluded by consensus between the first two authors. A total of 196 individual cases were analysed in detail including 51 cases of neoplasia. The overall rate of neoplastic transformation was 26.6%. Although the male:female cyst incidence ratio was 1:4, men over 18 had a significantly greater relative risk of neoplasm at 1.94 (P=0.0055). Radiological evidence of nodular thickening of the cyst wall significantly increased the relative risk of the presence of cancer (P=0.0023). Current orthodoxy that these are not dangerous embryological remnants is unfounded and may be false. The available data suggest the risk of malignant transformation is high and will apply to any residual tissue after excision. The same rationale behind total mesorectal excision in rectal cancer applies to tailgut cysts. Consequently they should be resected with similar oncological margins.

The association between heavy metal soil pollution and stomach cancer: a case study in Hangzhou City, China

Stomach cancer (SC) is a severe health burden, with nearly half of the world's cases found in China. Noticeably, the emissions of heavy metals into the environment have increased alongside rapid urbanization and industrialization in China. However, as regards carcinogenic associations, the relationship between heavy metals and SC is yet unclear. Based on 9378 newly diagnosed SC cases in Hangzhou City from 2009 to 2012, this work is concerned with the quantitative characterization of the spatial distribution pattern of SC incidence and its geographical association with soil heavy metals by means of a novel geographical model. The results show that (a) Cd is one of the severe soil pollutants in Hangzhou; (b) higher SC incidence clusters are in central Hangzhou, whereas lower clusters are found in the northeast and southwest with a male to female incidence ratio about 2.2:1; (c) although when considered separately, the heavy metals in this work do not have a considerable impact on the distribution of SC incidence in Hangzhou City, nevertheless, the joint effects of multiple heavy metals have significant impacts on SC risk. The present work calls for a rigorous quantitative assessment of the integrated heavy metal soil pollution and its effects on SC incidence.

Clinical and prognostic factors in 98 patients with malignant melanoma in China.

ObjectiveTo investigate clinical and prognostic factors in patients with malignant melanoma (MM) in China.MethodsA total of 98 MM patients were enrolled in the study. Enumeration data were analyzed using Fisher’s exact probability tests or χ2 tests. Survival rates were calculated using log-rank tests. A Cox multivariate regression analysis was performed to determine independent prognostic factors.ResultsThe male: female incidence ratio was 1.88:1. The highest incidence rate was seen in the 45–65 year age group. Primary lesion ulceration was seen in 60.2% of patients. The 1-year, 3-year and 5-year survival rates were 85.7%, 34.7% and 13.3%, respectively. In univariate analyses, the 5-year survival rate in patients was significantly associated with ulceration (P < 0.01), clinical stage (P < 0.01) and surgical excision of the tumor (P < 0.01). Cox multivariate regression analysis confirmed that ulceration and clinical stage were independent prognostic factors.ConclusionsSome clinical characteristics of MM patients in China are significantly different from those of patients in Western countries. Ulceration and clinical stage are independent risk factors for poor survival in MM patients.