Estudio epidemiológico de cáncer de piel del Hospital Regional de Iquique, Región de Tarapacá de Chile (2006 – 2010) / Epidemiological study of skin cancer in the Hospital of Iquique (2006-2010)

Introducción: El cáncer de piel es actualmente una patología de alta prevalencia y ha llegado a constituir un real problema de salud pública. El objetivo de este trabajo fue analizar las tasas de incidencia y características clínicas e histopatológicas del Carcinoma Basocelular (CBC), Espinocelular (CEC) y Melanoma Maligno (MM) en el hospital Regional de Iquique en el período 2006-2010. Metodología: Se analizaron 25.338 informes histopatológicos correspondientes a biopsias realizadas en el Servicio de Anatomía Patológica del Hospital Regional de Iquique, durante los años 2006-2010. Se obtuvieron 257 informes compatibles con cáncer de piel. Para cada tipo de tumor se analizaron las variables de sexo, edad, raza, localización anatómica, servicio de derivación y tipo histológico. El análisis estadístico se realizó a través de STATA®. Resultados: Se obtuvo un 65 por ciento de CBC, 28 por ciento de CEC y un 7 por ciento de MM. Las tasas de incidencia del total de cáncer cutáneo fueron fluctuantes, CBC (entre 11.07 y 22.10/ 100.000 habitantes), CEC (entre 5.03 y 9.33)/ 100.000 habitantes), MM ( 5-9/100.000). En relación con la edad, la edad promedio de CBC fue de 69.8+/- 14.9, CEC fue de 76.9+/-10.3 y MM fue de 64.7+/-15 años. En cuanto a la localización anatómica se encontró CBC, 75 por ciento en cabeza; 14 por ciento en tronco, 3 por ciento en extremidades. En el caso del CEC, 32 por ciento en cabeza, 30 por ciento en tronco, 34 por ciento en extremidades. MM se localizaba en un 38,8 por ciento en extremidades, 33,3 por ciento en cabeza y 11 por ciento en tronco. Discusión: En nuestro estudio se observaron similitudes en la clínica y en las características histopatológicas del cáncer de piel con otras regiones de Chile (Santiago, Concepción); sin embargo, se observó un mayor porcentaje de CEC y la localización anatómica del CEC de esta población difiere de análisis tanto de estudios nacionales como internacionales, encontrando...

Introduction: Skin cancer incidence rates have increased in the last decades. The purpose of this investigation was to study the incidence rates and the clinical and histopathological pattern of Basal Cell Carcinoma (BCC), Squamous cell Carcinoma (SCC) and Malignant Melanoma (MM) in the National Health Service Hospital of Iquique, Chile. Methodology: 25.338 histopathological reports from the Anatomical Pathology Department were analyzed during the period 2006-2010. 257 skin tumors were found. The variables: sex, age, race, anatomical localization and histopathological types of each tumour were also studied. The statistical analysis was performed by STATA®. Results: 65 percent of BCC, 28 percent SCC, 7 percent of MM were found. The skin cancer incidence rates obtained in our study changed from year to year. BCC (changed between 11.07 and 22.1 / 100.000 inhabitants), SCC ( changed between 5.03 and 9.33/ inhabitants), MM ( changed between 5 and 9 /100.000 inhabitants). Regarding the age, the average age of BCC was 69.8+/- 14.9, of SCC was 76.9+/-10.3 and of MM was 64.7+/-15 years old. Concerning the anatomical location of the tumours, 75 percent of BCC were located in the head; 14 percent in trunk, 3% in lower and upper extremities. In the case of SCC, 32 percent were located in the head, 30 percent in the trunk, and 34 percent in lower and upper extremities. Furthermore, a 38.8 percent of MM percent were located in the lower and upper extremities, 33.3 percent of MM in the head and 11 percent in the trunk. Discussion: In this study, the clinical and histopathological pattern of the cutaneous tumours were similar to those found in other cities of Chile (Santiago, Concepción); however; we found a different anatomical location of SCC in this study, different of national and international results. We observed a higher location of SCC in trunk and extremities. Also, it is important to establish that in this study, we observed a higher percentage of SCC...

Clinical utility of SPECT-CT co-registration imaging

The interpretation of nuclear medicine studies is largely based on function. However, this interpretation becomes more accurate and reliable when there is a corresponding precise anatomical localization. Hybrid systems are opening up a new era in SPECT imaging. A tertiary hospital in the Philippines has acquired the country's first hybrid imaging device combining a dual-detector, variable angle gamma camera with a low dose X-ray tube attached to the same gantry. This study evaluates the clinical utility of a hybrid imaging system, SPECT/CT for functional mapping with selected radiotracers. SPECT data were first interpreted alone and then re-assessed with the addition of SPECT/CT co-registered images. Patients referred for various nuclear medicine procedures with SPECT components in the first six months of operation studied for various clinical situations were evaluated in the study. Our study included sixty-four (64) patients in the first year of operation of SPECT/CT co-registered imaging systems. This included 23 with I-131, six with sulfur colloid, four with Gallium 67, five with Tc99m Sestamibi and 26 with Tc99m HOP. The pathologic sites in 28 out of 64 (44 percent) patients were noted in both SPECT and SPECT/CT co-registered images. Additionally, SPECT/CT co-registered images provided the precise anatomical localization in 12 (19 percent) patients not clearly evident in SPECT images alone and enabled the exclusion of disease in sites of physiologic tracer deposition in 16 (25 percent) patients found suspicious in SPECT alone leading to a change in the therapeutic approach. SPECT/CT allows a more precise interpretation of scintigraphic studies using selected radiotracers for various clinical situations. It provides additional information that improves diagnostic accuracy of SPECT and impacts on patient management indicating that SPECT/CT co-registered systems are suited for routine use in clinical practice.

Reappraisal and Practical Application of International League Against Epilepsy ( ILAE 1989 ) Classification of Localization-Related Epilepsies in Adult

BACKGROUND: Since 1985 when ILAE proposed its first classification system of epilepsy, many studies have reported the practical applicability of the system. However, its limitations have been elucidated. In order to find out the applicability and limitations of the ILAE classification system and the role that diagnostic parameters (semiology, EEG and MRI) take in the anatomical localization of localization-related epilepsies (LREs), we investigated the clinical data of adult patients with LRE in step-wise way. METHOD: We recruited 173 patients with newly-referred/diagnosed LRE from our departmental data registry. Idiopathic epilepsies were excluded. We evaluated the anatomical localization rate(LR) according to each diagnostic parameter, the concordant localization rate(CLR) between two parameters and between three parameters. LR in total patients by any one of three diagnostic parameters was also evaluated. MRI abnormalities were evaluated in those patients showing concordant localization between semiology and EEG. RESULTS: The highest anatomical LR(67.1%) was reported in the semiological parameter. CLR between semiology and EEG was 28.9%. CLR between three parameters was 16.2%. MRI abnormalities were seen in 60% of patients with concordant localization between semiology and EEG. Fifty six percent of electroclinically concordant patients showed concordant localization with an MRI and 79% of them were concordantly localized in the temporal lobe. The LR in total patients was 71.7%. In each of the evaluation steps, the temporal lobe LR was the highest. CONCLUSIONS: Total lobar LR by any one diagnostic parameter in all the patients was high according to the ILAE diagnostic criteria. Semiology was the best localizing parameter, however, combined evaluation with either EEG or MRI reduced the localizability. Even though the MRI study showed a significant discordance rate in patients with electroclinical localizations, it could identify the underlying etiology in a major proportion of the patients. This study showed the importance of an imaging study in the lobar localization of LREs combined with an electroclinical localization by the ILAE classification system.