Geographical Pathology Research Articles

Spatial distribution and temporal trend of drug-related deaths in the Islamic Republic of Iran during 2014-2017.

Research suggests that there is an increasing trend in drug-related deaths worldwide: an estimated 69 000 individuals lose their lives due to substance abuse annually. To determine the geographical pathology of drug-related deaths in the Islamic Republic of Iran and to evaluate incidence trends, with a focus on identifying high- and low-risk regions. For this ecological study, we collected data from the 2 main sources (the Legal Medicine Organization and the Ministry of Health and Medical Education) responsible for registering substance-related deaths during 2014-2017. Data analysis was conducted using Joinpoint regression analysis, Global Moran's I and Anselin Local Moran's I. Of the 12 386 drug-related deaths in 2014-2017, most occurred during the summer months; 7162 of these were among middle-aged individuals. The mean age of children and adolescents who died of substance abuse was 5.2 [standard deviation (SD) 4.6] years. In the young adult group, mean age at death was 20.7 (SD 2.5) years; it was 34.2 (SD 5.4) years for adults and 55.6 (SD 9.8) years for older adults. Changes in mortality rate peaked in 2017 (annual percentage change = 0.52); in the last months of the study period there was a nonsignificant decrease (annual percentage change = -6.99) in the incidence (average annual percentage change = -0.5; 95% confidence interval: -3.2, 2.3). Deaths due to substance abuse will remain a huge public health problem unless policy- and decision-makers determine why this problem continues to increase despite the extensive efforts on regulation and find ways to mitigate it.

COVID-19 incidence and local average rainfall: An analysis from a tropical monsoon area.

Sir, COVID-19 pandemic is an important global problem that has affected more than 30,000,000 people worldwide. The disease is a viral respiratory infection. The effect of climate on the incidence of COVID-19 is interesting. There are a few reports on the climate–geographical pathology of COVID-19. It is mentioned that there might be an association between COVID-19 incidence and environmental background.[1] Here, the authors analyze the data to assess the relationship between COVID-19 incidence and local average rainfall in a tropical monsoon area in Indochina where the second area of the world affected by COVID-19 after China is. The official data from the local Public Health Ministry on the incidence of COVID-19 and the data from the local Metrological Department are collected as primary data for further analysis. The focus area is on 20 provinces in the northeastern region of the country, which is not an international tourist destination and is not affected by the importation of disease by foreign tourists. The incidence is the case with local transmission and the imported case from aboard are excluded. The period of the analysis is from March to September 2020. The relationship between COVID-19 incidence and local average rainfall is shown in Figure 1. There was no statistically significant correlation (r = −0.227, P = 0.336) between COVID-19 incidence and local average rainfall in the studied tropical area. This is in contrast to other local endemic diseases such as malaria and dengue that have a significant correlation between disease incidence and local average rainfall in the study setting.[23] Because this study was on a limited area in the tropical zone, a further comparative study between tropical and non-tropical countries should be done for further conclusion on the interrelationship between COVID-19 epidemiology and background rainfall.Figure 1: Figure showing the relationship between COVID-19 incidence and local average rainfallFinancial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

The Development of Global Cancer Research at the United States National Cancer Institute.

International research and collaboration has been a part of the National Cancer Institute's (NCI) mission since its creation in 1937. Early on, efforts were limited to international exchange of information to ensure that US cancer patients could benefit from advances in other countries. As NCI's research grant portfolio grew in the 1950s, it included a modest number of grants to foreign institutions, primarily in the United Kingdom and Europe. In the 1960s, the development of geographic pathology, which aimed to study cancer etiology through variations in cancer incidence and risk factors, led to an increase in NCI-funded international research, including research in low- and middle-income countries. In this paper, we review key international research programs, focusing particularly on the first 50 years of NCI history. The first NCI-led overseas research programs, established in the 1960s in Ghana and Uganda, generated influential research but also struggled with logistical challenges and political instability. The 1971 National Cancer Act was followed by the creation of a number of bilateral agreements with foreign governments, including China, Japan, and Russia, to support cooperation in technology and medicine. Although these agreements were broad without specific scientific goals, they provided an important mechanism for sustained collaborations in specific areas. With the creation of the NCI Center for Global Health in 2011, NCI's global cancer research efforts gained sustained focus. Because the global cancer burden has evolved over time, increasingly impacting low- and middle-income countries, NCI's role in global cancer research remains more important than ever.

Geographical Pathology of Acute Lymphoblastic Leukemia in Iran with Evaluation of Incidence Trends of This Disease Using Joinpoint Regression Analysis.

The aim of present study is to determine the spatial-temporal epidemiology of acute lymphoblastic leukemia (ALL) in Iranian children. This ecological study was performed using an exploratory mixed design. The study population consists of 3769 children with ALL who were reported in the National Cancer Registry Program of Iran from 2006 to 2014. Data analysis was conducted using Mann-Whitney U, joinpoint regression analysis, Global Moran's I and Anselin Local Moran's I. The average annual incidence rate of ALL was 2.25 per 100000 children under 15 years of age during the study period, which was 1.37 times higher in males. The average annual percentage change (AAPC) of the disease was 7.1%, which is higher than that of developed countries. The incidence of ALL was higher in spring and summer and its peak incidence was at the age of 2-5. Spatial autocorrelation of the ALL was 0.358 and significant (P value <0.001). The high-risk cluster of ALL was identified in Fars and Kohgiluyeh and Boyer-Ahmad provinces and the low-risk cluster in Kermanshah, Zanjan and Kurdistan provinces. The incidence of ALL is on rise in Iranian children and appropriate healthcare services are required to prevent new cases of this disease in high-risk areas.

History of the Center of Morphological&#x0D; Research of the Kazakh Institute&#x0D; of Oncology and Radiology and its&#x0D; contribution to the development of cancer&#x0D; service in the Republic of Kazakhstan

The article is devoted to the history of the Сenter of morphological research at the Kazakh Institute of Oncology and&#x0D; Radiology (KazOIR). The initial Pathomorphology Laboratory&#x0D; was established in 1960 under the leadership of the Candidate&#x0D; of Medical Sciences I.A. Zakhvatkina. The Problem Laboratory&#x0D; of Pathomorphology and Geographic Pathology of Tumors was&#x0D; created later in 1964 and was headed by the Doctor of Medical&#x0D; Sciences, Professor N.I. Kolychev since 1972.&#x0D; Modern morphological diagnostics methods introduced&#x0D; into practice during the laboratory existence included an immunohistochemical examination of tumors, electron microscopic&#x0D; examination, and FISH (fluorescent in situ hybridization) diagnostics.&#x0D; Today, the Center for Morphological Studies provides methodological, organizational, and advisory assistance to oncological dispensaries and other medical institutions of the Republic&#x0D; of Kazakhstan in malignant neoplasms’ diagnostics.

Cancer in the tropics: geographical pathology and the formation of cancer epidemiology

Researchers have long been concerned with cancer in what has been called the tropics, developing world, and low- and middle-income countries. Global health advocates' recent calls to attend to an emergent cancer epidemic in these regions were only the latest effort in this long history. Researchers, known as geographical pathologists, sought to determine the etiologies of cancer and other non-infectious diseases between the 1920s and the 1960s by comparing their occurrence across different environments. The geographical pathologists used the concept of the environment to analyze the influences that natural and artificial surroundings had on health. While the international network of geographical pathology fostered medical thinking about environmental health in the early and mid-twentieth century, the very meaning of environment, alongside the scientific methods for studying the environment, changed in this period. In the 1960s, epidemiology, previously used for the study of infectious diseases, displaced geographical pathology as the cohesive framework of cancer research. This signaled a shift in research focus, from one dedicated to diagnostics and the environment to one centered on population and statistical studies. This article shows that it was not the lack of knowledge about cancer in the developing world but rather specific configurations of knowledge that shaped which cancer interventions in the developing world researchers and public health officials conceived.

ALLERGY AND PSEUDO-ALLERGY: ECOLOGIC ASPECTS OF GEOGRAPHIC PATHOLOGY

Those problems of modern people, which are related to their lifestyle in terms of the formation of geographic pathology, are deep and multi-faceted. Organism adaptive reconstruction caused by environmental changes is taking practical significance both for evaluation of functional state of organs and systems as well as for working out scientifically grounded principles of primary prophylaxis of geographical pathology, caused by the influence of natural conditions and anthropogenic factors. In the structure of geographic pathology huge niche belongs to allergic diseases, which are qualified not only as genetically, but also as ecologically determined «civilization diseases». Differentiated approach to studying the prevalence of allergic diseases in the North is considered in terms of the main pathogenic mechanisms: true allergy and pseudo allergy. As an example the results of epidemiologic examination for Evenkia population are presented. Epidemiology of allergic diseases distinctively shows that mankind should not only enlarge the spectrum of new anthropogenic factors and create new so called «blessings of civilization», which negatively influence an organism, contributing to the diseases, but should know the laws of living in consonance with nature, following those laws and not disturb them with mindless and massive persistency. Specific of the allergy mechanisms triggering in extreme ecologic conditions of the North is calling for solutions.

GE-24 * CHARACTERIZING INTRATUMOR HETEROGENEITY AND TUMOR EXTENSION IN PEDIATRIC DIFFUSE INTRINSIC PONTINE GLIOMA

INTRODUCTION: Diffuse intrinsic pontine glioma (DIPG) is an understudied pediatric brain cancer. The validity of at-diagnosis tumor biopsy is currently under debate with no published studies investigating tumor heterogeneity within the same patient. METHODS: Two whole brains obtained at postmortem from patients with DIPG were studied. Frozen and formalin fixed paraffin embedded (FFPE) specimens were stained for H&E, GFAP and Ki67. Histologic analysis revealed a high-grade infiltrating astrocytoma with variable cellularity and mitotic activity. Core punches representing different tumor anatomical locations, as well as tumor grades were obtained, and used for DNA and RNA extractions. DNA was analyzed for methylation (Illumina 450), and mRNA for NanoString expression profiling. To investigate molecular disparities within each grade, specimens were reanalyzed based on geographic location and pathology. Each tumor grade was then designated as classic or non-classic (not fitting all criteria for a specific grade). RESULTS: We show that mRNA profiles (unsupervised clustering) correspond to tumor grade across the brainstem (n = 12 per case). The expression pattern of twelve genes is sufficient for accurate molecular grading (WHO II, III, IV) of tissue specimens when compared with neuropathological assessment. We show detectable differential mRNA expression patterns within each grade, helping to discriminate between classic and non-classic specimens. Methylation analysis (n = 24, 12/case) verified the heterogeneous nature of mRNA expression data (within tumor grades), where WHO grade III non-classic specimens clustered with WHO grade II classic specimens. The largest molecular changes were observed in tumors from distinct geographic locations (brainstem versus lateral ventricles). CONCLUSIONS: Significant intratumor heterogeneity may affect the accuracy of targeted diagnosis in small biopsy specimens. A better understanding of these differences will help in improving therapy and devising accurate molecular-based tumor grading.

Epstein - Barr Virus Associated Lymphoid Proliferations from Epidemiology to "Targeted" Therapies

Research during the two or three decades that followed this discovery, extended the geographic scope of Burkitt lymphoma from the high incidence of Sub-Saharan Africa, to North Africa, the Middle East [2] and South America as areas of intermediate incidence. A direct casual connection to nasopharyngeal carcinoma common in South East Asia was also discovered. In spite of the progress in understanding the geographic pathology of EBVrelated cancers, the oncogenic potential of EBV drew relatively little interest in the United States and Europe. However, when the HIV epidemic started to sweep these continents in the eighties, the role of EBV in lymphogenesis in immune compromised patients hit home, so to speak. HIV related, post transplant and post therapy associated EBV associated lymphoproliferative disorders were intensively investigated. It became clear that EBV, though remains dormant mostly in memory B cells escaping CD8+T cell elimination in immune competent individuals, it can be reactivated in some immune compromised patients. Not only Burkitt lymphoma was associated with EBV, but several other types of T, B, NK cells, plasmablastic and Hodgkin lymphomas [3]. EBV associated lymphoproliferative disorders are not uncommon in children, in the elderly, in therapy-related immune suppressed patients and in recent immigrants to the US.

Методологічні дослідження проблеми поширення вроджених вад у контексті історії її розвитку

This article dwells upon the main periods of development of medicine geographic research of innate vices on the territory of the Union of Soviet Socialist Republics (USSR) and independent Ukraine. Many works of foreign scientists, which concern this problem have been analyzed in this article. Methodological principles of proliferation of birth defects, including analysis of methodological significance of A. Avtsyna of geographical pathology. The methods of research dissemination of birth defects, in this context, particular attention is paid to systematic approaches and whose role in the medical-geographical nature is essential. Key words: methodological principles, methods, birth defects, geographic pathology, medical geography.

Dr. D. Nicasio Landa, official epidemic doctor during the cholera epidemic of 1854-1855

In this unpublished work from 1861, which we have transcribed, Dr. Nicasio Landa (1830-1891) is revealed to have been at the forefront in carrying out epidemiological studies in Spain. He traced the medical topography, or geographical pathology, of cholera by provinces, by means of calculating the incidence rate ("millesimal proportion of those infected") and lethality rates ("millesimal proportion of the dead") using the official data on the sick and deceased in the cholera epidemic of 1854-1855, published by the General Directorate of Health and Charity, as well as the data of the population census of 1857. He worked with an infectionist conception and, besides tracing the epidemiological map, he proposed an association of cholera with the geographical constitution of the terrain in order to explain the anomalous distribution of the disease. That same "anomalous" distribution was repeated in the cholera epidemic in Spain in 1885, and in that of 1971, which is in accordance with the environmental characteristics of certain terrains that make possible the maintenance and persistence of the vibrio cholerae, according to recent research explaining the varied endemo-epidemic distribution of cholera.

The geographic pathology of atherosclerosis.

The Geographic Pathology of Atherosclerosis Get access Nutrition Reviews, Volume 26, Issue 11, November 1968, Pages 327–330, https://doi.org/10.1111/j.1753-4887.1968.tb00836.x Published: 01 November 1968

Geographic pathology of brain tumors. 1. Distribution of deaths from primary tumors.

Geographic pathology of brain tumors. 1. Distribution of deaths from primary tumors.

The WFN comes of age

The WFN comes of age

A gathering of the dying

In our corporeal existence, all events occur at a time and place. From a clinical context, time measures are given the priority. Time before presentation of symptom onset, or door-to-needle or -balloon times are key factors influencing outcomes for acute ST segment elevation myocardial infarction. Perhaps our understanding of disease would be buttressed by also considering ‘place’. Geographical location of patients may reveal disease clusters. These data would be useful for everything from health resource allocation – placing cardiac rehabilitation clinics near those locations, for example – to planning the most efficient ambulance route for transfer to a tertiary care centre. This interaction of environment or place with health is known as medical geography. The ecology of human health and disease has also been studied under different banners: geographical pathology, medical topography, geographical epidemiology and geomedicine. The importance of location has been recognized for more than 2000 years:

Geographic Pathology of Helicobacter pylori Gastritis

Helicobacter pylori is etiologically associated with gastritis and gastric cancer. There are significant geographical differences between the clinical manifestation of H. pylori infections. The aim of this study was to compare gastric mucosal histology in relation to age among H. pylori-infected patients from different geographical areas using the same grading system. The prevalence of atrophy and intestinal metaplasia were also compared with the respective gastric cancer incidence in the different countries. A total of 1906 patients infected with H. pylori from seven countries were evaluated. Entry criteria included H. pylori positive cases with antral and corpus biopsies between the ages of 18 and 75 years. The minimum number of cases required from a country was 100. Hematoxylin-eosin stained biopsies from antrum and corpus were scored semiquantitatively using the parameters suggested by the Sydney Classification System. Statistical evaluation was performed using Kruskal-Wallis test and Spearman's rank correlation test. The severity of gastric atrophy varied among the different groups with the highest scores being present in Japan. The lowest scores were found in four European countries and in Thailand. The scores for intestinal metaplasia were low in general except for Xi-an, Japan, and Shanghai. For all the countries, the presence of atrophy in the antrum correlated well (r = 0.891) with the incidence of gastric cancer. Using a standardized grading system in a large study of H. pylori-related geographic pathology, we found major differences in the overall prevalence and severity of H. pylori gastritis in relation to age. These differences mirrored the respective incidences of gastric cancer in those geographical areas.

Geographic pathology revisited: Development of an atlas of cancer in India

Information on 217,174 microscopically diagnosed cancers diagnosed in 2001-2002 was collected from pathology laboratories in 68 districts across India. Data collection took place primarily via the Internet. Average annual age-adjusted incidence rates for microscopically diagnosed cases (MAAR) by gender and site were calculated for each of the 593 districts in the country. The rates were compared to those from established population based cancer registries (PBCR). In 82 districts, the MAAR for 'all cancer sites' was above a "completeness" threshold of 36.2/100,000 (based on results of a rural PBCR). The results confirmed some known features of the geography of cancer in India, and brought to light new ones. Cancers of the mouth and tongue are particularly frequent in both genders in the southern states. Very high rates of nasopharynx cancer were found in the northeastern states (Nagaland, Manipur). There was clear geographic correlation between the rates of cervical and penile cancer, and a high rate of stomach and lung cancer (in both genders) in many districts of Mizoram State. The area of high risk for gallbladder cancer seems larger than suspected previously, involving a wide band of northern India. There is a belt of high incidence of thyroid cancer in females in southwest coastal districts. Other than identifying possible existence of high-risk areas of specific cancers, our study has recognized places where PBCR could be established. The study was remarkably cost-effective and the electronic data-capture methodology provides a model for health informatics in the setting of a developing country.

The Importance of Geographic Pathology in Understanding Causes and Approaches to Prevention of Chronic Diseases in the World

Geographic pathology provides information that a disease may have a quite different incidence and mortality as function of area of residence. Research in animals can model fairly precisely what is learned through geographic pathology, and provides the basis for understanding possible mechanisms of action. These approaches can yield public health recommendations and health promotion activities. Frequent intake of foods with saturated fats such as meat and dairy products raises the risk of coronary heart disease, especially so in smokers. The total mixed fat intake accounts for the high incidence of the nutritionally linked cancers, i.e. of the post-menopausal breast, distal colon, prostate, pancreas, ovary and endometrium, in Western countries, and of increasing impact in Asia, as people there adopt Western eating habits. Monounsaturated oils such as olive oil are low risk fats, as found in animal models, and through the fact that the incidence of coronary heart and neoplastic diseases is lower in the Mediterranean region, where such oils are customarily used. Fish and fish oils are protective, as is noted in countries with a high intake. The genotoxic carcinogens for a number of these cancers are heterocyclic amines that are produced during the broiling or frying of meaty foods that contain creatinine. Excessive salt intake can cause high blood pressure and with stomach cancer, especially with inadequate intake of potassium, from fruits and vegetables, and calcium from certain vegetables and low fat dairy products. Bran cereal fiber intake, especially with adequate calcium, yields an increased stool bulk, eliminating factors involved in colon and breast cancer. Vegetables and fruits, as well as soy products, are rich in antioxidants that are essential to lower disease risk stemming from reactive oxygen species in the body. Green and black tea are excellent sources of such beneficial antioxidants of a polyphenol nature, as is cocoa and chocolates. Antioxidants also extend healthy aging and may protect against Alzheimer's and Parkinson's diseases. Nutritional lifestyles can be described for most populations in the world that offer the possibility of a healthy long life.

S09.3: Malaria and Cancer ‐ A Lesson from Geographical Pathology

S09.3: Malaria and Cancer ‐ A Lesson from Geographical Pathology

Siberian Branch of the Russian Academy of Sciences, Medical Section. Assessment of development and progressing mechanisms of arterial hypertension in newly come population in the North

Arterial hypertension (AH) is the most widespread cardiovascular disease, meeting in 20–30 % of the adults both in Russia and abroad. AH and its high prevalence is especially urgent for the Far North and Siberia and it can be considered as a geographical pathology. Purpose of research. To conduct the combined research of character of adaptive reactions and their disorders in newly come population with AH in dependence on duration of residing in the North (according of the international program WHO/CINDI) and to obtain a theoretical substantiation for selection of rational correction AH. Results of research: Dynamics of prevalence AH is characterized by recurrence: the greatest frequency of cases AH is registered per the first years of stay in the North (30,2%) and repeated increase at term of residing 30 years and more (28,7%). Combined comparative examination of practically healthy people living in the North and the patients with AH, including study of a functional state of vegetative nervous system, hormonal, metabolic status, functional state of neutrophils, lysosomic enzymes, product of lipid peroxidation — malonic dialdehyde reflects a state of steady adaptation in the practically healthy people and state of a functional tension, unstable adaptation and disadaptation at the patients with AH depending on sex and duration of residing in the North. The earliest changes during adaptation are defined at a level of regulation of vegetative nervous system and cellular level, that opens the new trend for rational correction AH.