Histologic Distribution of Lung and Bronchus Tumors: A Population-Based Study in the Upper Peninsula of Michigan.

INTRODUCTION: Lung cancer remains the leading cause of cancer-related mortality in the United States, with cigarette smoking recognized as the most important modifiable risk factor. The distinct smoking rates and occupational landscape in the Upper Peninsula of Michigan underscore the necessity of investigating the multifactorial influences on the prevalence and distribution of lung and bronchus cancer within this population. METHODS: This study, conducted from January 2012 to December 2022, included 1035 patients diagnosed with lung or bronchus tumors who were first seen and/or received the first course of treatment at Upper Peninsula Health Systems (UPHS) - Marquette, the largest hospital system in the Upper Peninsula of Michigan and one of only two radiation oncology treatment centers in the Upper Peninsula. RESULTS: This study demonstrated that the histologic trend of lung and bronchus cancers in a sample of 1035 patients in the Upper Peninsula of Michigan closely resembles that of national averages. Participants with a lifetime history of smoking made up 943 (91.1%) cases of patients diagnosed with lung or bronchus cancers in this study. Lifetime non-smokers only made up 53 (5.1%) cases of patients diagnosed with lung or bronchus cancers. The median age at diagnosis of participants in this study was 70 years. CONCLUSION: Our study provides significant insights into the histologic distribution of lung and bronchus cancers within the Upper Peninsula of Michigan, addressing a notable gap in the current literature for this rural and medically underserved population. The histologic distribution of lung and bronchus cancers in this region aligns with national trends. Furthermore, the distinct rates of cigarette smoking in the Upper Peninsula emphasize the critical role of smoking cessation efforts in reducing the burden of lung and bronchus cancers in this region.

A Case of a Testicular Tumor Histologically Described as a Seminoma in a Patient With an Elevated Serum Alpha-Fetoprotein.

Seminomas and non-seminomas are distinct categories of germ cell tumors arising from the testicles. This case report describes a rare occurrence of a testicular tumor exhibiting histologic characteristics of a seminoma in a 39-year-old male patient who simultaneously has an elevated serum alpha-fetoprotein (AFP). The staging characteristics of this tumor was pT1bNxM0, stage IS. This patient was treated with a right radical orchiectomy and adjuvant chemotherapy with bleomycin, etoposide, and cisplatin. This case report describes the histologic, laboratory, and imaging findings as well as the treatment and surveillance of this patient.

Incidentally Discovered Aortic Thrombosis in a Patient Undergoing Capecitabine and Oxaliplatin Chemotherapy for Colon Cancer.

This case report describes a 68-year-old male who presented to the emergency department (ED) with nausea, vomiting, abdominal pain, diarrhea, and fatigue after starting adjuvant combination chemotherapy with capecitabine and oxaliplatin two weeks prior. Further evaluation of this patient in the ED revealed an incidentally discovered aortic thrombosis, of which this patient did not exhibit any specific symptoms. This case, among a few others, has described the development of arterial thrombosis in patients with cancer undergoing combination chemotherapy with capecitabine and oxaliplatin.

Necrotizing Pneumonia Secondary to Pulmonary Blastomycosis: A Case Report.

Necrotizing pneumonia is a rare but potentially life-threatening complication of pulmonary blastomycosis, a fungal infection caused by inhaling spores of the fungus Blastomyces dermatitidis. This case report describes a 56-year-old male who presented with worsening malaise, subjective fevers and chills, night sweats, and a productive cough. Further evaluation revealed a right upper lobe necrotizing pneumonia secondary to pulmonary blastomycosis.

Bronchial Schwannoma Incidentally Discovered via Bronchoscopy: A Case Report.

Bronchial schwannomas are rare tumors that arise from Schwann cells and account for a very small percentage of primary lung tumors. This case report describes a rare incidental finding of a bronchial schwannoma discovered in the left lower lobe secondary carina via bronchoscopy in a 71-year-old female who presented with minimal symptoms.

Cutaneous Squamous Cell Carcinoma: A Review of High-Risk and Metastatic Disease.

Non-melanoma skin cancer represents one-third of all malignancies and its incidence is expected to rise until the year 2040. Cutaneous squamous cell carcinoma (cSCC) represents 20 % of all non-melanoma skin cancer and is a deadly threat owing to its ability to metastasize to any organ in the body. Therefore, a better understanding of cSCC is essential to strengthen preventative measures and curable treatment options. Currently, research demonstrates that cSCC is diagnosed at a rate of 15-35 per 100,000 people and is expected to increase 2-4 % per year. With respect to metastatic cSCC, this disease is more common in men; people over the age of 75 years; and inhabitants of the south and mid-west USA. In 2010, the American Joint Committee on Cancer updated the Cancer Staging Manual's primary tumor designation to now include high-risk factors; however, factors such as immunosuppression and tumor recurrence were not included. Other staging systems such as Brigham and Women's Hospital have allowed for increased stratification of cSCC. High-risk cSCC is defined as a cSCC that is staged as N0, extends beyond basement membrane, and has high-risk features associated with sub-clinical metastasis. High-risk features are depth of invasion (>2 mm), poor histological differentiation, high-risk anatomic location (face, ear, pre/post auricular, genitalia, hands, and feet), perineural involvement, recurrence, multiple cSCC tumors, and immunosuppression. Epidermal growth factor receptor and nuclear active IκB kinase (IKK) expression are also predictive of metastatic capabilities. Clinically, the initial lesions of a cSCC tumor can present as a painless plaque-like or verrucous tumor that can ultimately progress to being large, necrotic, and infected. Tumors can also present with paresthesias or lymphadenopathy depending on the location involved. With respect to prognosis, metastatic cSCC is lethal, with several large studies demonstrating a mortality rate of >70 %. Therefore, treatment of metastatic cSCC is difficult and depends on the location involved and extent of metastasis. Treatment options include surgery, radiation therapy, chemotherapy, and any combination of the above. Surgery alone can be used for metastatic cSCC treatment, but is not as effective as surgery in conjunction with radiation therapy. Radiation therapy has some success as a monotherapy in low-risk or cosmetically sensitive areas such as the external ear, eyelid or nose. According to the 2013 National Comprehensive Cancer Network Guidelines, cisplatin as a single agent or combined with 5-fluorouracil hold the strongest support for the treatment of metastatic cSCC; however, the supporting evidence is inconsistent and a curative chemotherapeutic approach is still lacking. Epidermal growth factor receptor inhibitors are a newer class of agents being used in metastatic cSCC and hold some promise as a therapy for this disease. Other areas of interest in finding curative treatments for metastatic cSCC include p53, hypermethylation of specific genes, chromatin remodeling genes, and the RAS/RTK/PI3K pathway. This review addresses the epidemiology, staging, risk factors, clinical presentation, management, and new trends in the treatment of high-risk and metastatic cSCC.

Dermatology in Doximity.

Doximity, currently the largest online social networking service for United States (US) health care professionals and medical students, provides a wide variety of content to a large audience. In fact, its database includes 1,078,305 physicians in the US. It is therefore important to evaluate this content from time to time. Our objective is to analyze both the residency rankings and news content presented in Doximity, with respect to dermatology. The study compared the residency rankings created by Doximity to another dermatology residency ranking system that used a different algorithm. In terms of dermatology content, seven dermatology-related search terms were entered into the Doximity search query and data was collected on the first 20 "relevant" articles. Our study evaluated a total of 140 articles. The search term "skin cancer" yielded the most articles totaling 6,001. Informative articles were the most common type of article for each content item searched except for "dermatology", yielding research articles as the most common content type (70%). The search term "melanoma awareness" had the largest number of shares (19,032). In comparing dermatology residency rankings on Doximity with another ranking system that accounted for scholarly achievement, there was 50% overlap. In conclusion, it is vital to evaluate content on social media websites that are utilized by US medical students and health care professionals. We hope this information presented provides an up-to-date analysis on the quality of one particular social media platform.

Evaluating Dermatology Residency Program Websites.

BACKGROUND: Internet resources play an important role in how medical students access information related to residency programs.Evaluating program websites is necessary in order to provide accurate information for applicants and provide information regarding areas of website improvement for programs. To date, dermatology residency websites (D  WS) have not been evaluated.This paper evaluates dermatology residency websites based on availability of predefined measures. METHODS: Using the FREIDA (Fellowship and Residency Electronic Interactive Database) Online database, authors searched forall accredited dermatology program websites. Eligible programs were identified through the FREIDA Online database and had a functioning website. Two authors independently extracted data with consensus or third researcher resolution of differences. This data was accessed and archived from July 15th to July 17th, 2015.Primary outcomes measured were presence of content on education, resident and faculty information, program environment, applicant recruitment, schedule, salary, and website quality evaluated using an online tool (WooRank.com). RESULTS: Out of 117 accredited dermatology residencies, 115 had functioning webpages. Of these, 76.5% (75) had direct links found on the FRIEDA Online database. Most programs contained information on education, faculty, program environment, and applicant recruitment. However, website quality and marketing effectiveness were highly variable; most programs were deemed to need improvements in the functioning of their webpages. Also, additional information on current residents and about potential away rotations were lacking from most websites with only 52.2% (60) and 41.7% (48) of programs providing this content, respectively. CONCLUSIONS: A majority of dermatology residency websites contained adequate information on many of the factors we evaluated. However, many were lacking in areas that matter to applicants. We hope this report will encourage dermatology residencyprograms to improve their websites and provide adequate content to attract the top residents for their respective programs.

Skin infections among US high school athletes: A national survey.

BACKGROUND: Skin infections have long been a reported problem among high school athletes, particularly wrestlers. There has yet to be a national study describing the epidemiology of skin infections across multiple high school sports. OBJECTIVE: We sought to report the epidemiology of skin infections among US high school athletes. METHODS: High school sports-related skin infections resulting in time loss were reported by a convenience sample of US high schools from 2009/2010 through 2013/2014 via High School Reporting Information Online. RESULTS: During the study, 474 skin infections were reported among 20,858,781 athlete exposures, a rate of 2.27 per 100,000 athlete exposures. The largest number of skin infections occurred in wrestling (73.6%) followed by football (17.9%). The most common infections were bacterial (60.6%) and tinea (28.4%) infections. Body parts most often affected were the head/face (25.3%) followed by the forearm (12.7%). LIMITATIONS: The study included only high schools with National Athletic Trainers' Association-affiliated athletic trainers, which may limit generalizability. However, using athletic trainers as data reporters improved data quality. CONCLUSIONS: Skin infections are an important subset of high school sports-related adverse events. An understanding of the epidemiology of sports-related skin infections should promote awareness and drive evidence-based prevention efforts.