Trends and Correlates of Mean Lung Dose in Patients Receiving Breast Radiotherapy in a Single Institution from 2014 to 2018.

AIMS: Higher mean lung dose (MLD) in breast cancer patients has been associated with pneumonitis, pulmonary fibrosis and secondary lung cancer primaries. This study examined MLD in a single institution from 2014 to 18 to assess trends in median MLD (Gy) over time and factors associated with higher MLD to determine best practices for limiting lung toxicity. MATERIALS AND METHODS: General linear regressions were analysed to determine significant change in median MLD over time in patients receiving conventional or hypofractionated schedules for whole breast/chest wall (WB) radiotherapy with or without sequential boost or simultaneous integrated boost, WB tangential radiotherapy only and WB locoregional radiotherapy. Univariate and multivariable linear regression analysed identified factors associated with MLD. RESULTS: In total, 3894 patients were included in the analysis. The total median MLD across all years was 6.8 Gy in patients treated with conventional fractionation and 3.4 Gy in patients treated with hypofractionation. A significant increase in MLD was observed between 2014 and 2018 in patients receiving conventional or hypofractionation, conventional WB treatment with locoregional radiotherapy, conventional WB radiotherapy with simultaneous integrated boost and hypofractionated WB radiotherapy with sequential boost. Increased MLD was significantly correlated with lower lung volume and larger treatment volume due to locoregional radiotherapy, inclusion of a boost, chest wall treatment and reverse decubitus or supine positioning (P < 0.0001). CONCLUSION: A significant increase in MLD was observed over the years in patients receiving conventional and hypofractionated radiotherapy. Techniques such as prone positioning should be considered to lower MLD, particularly for patients with predisposing pulmonary risk.

Serological evidence of bluetongue and a preliminary entomological study in southern Croatia.

In December 2001, bluetongue (BT) was confirmed serologically by the Croatian Veterinary Institute using the competitive enzyme-linked immunosorbent assay (c-ELISA). Results of the serological testing of blood samples from ruminants in the Dubrovacko-Neretvanska County are presented (3,318 sera of ruminants from 53 herds were examined). In total, 357 bovine sera (178 or 49.9% positive), 1,268 ovine sera (174 or 13.7% positive) and 1,693 caprine sera (270 or 15.9% positive) were tested. Antibodies to BT virus serotype 9 were detected in 212 of the positive sera by serum neutralisation. A preliminary light-trap survey for midges of the Culicoides genus was also performed in the Dubrovacko-Neretvanska County. Fourteen light-trap collections from seven locations were examined and yielded a total of 4,872 Culicoides of which 4,492 (92%) belonged to the Obsoletus Complex (including C. obsoletus and C. scoticus).

Spatial distribution of bluetongue in cattle in southern Croatia in the last quarter of 2002.

The domestic ruminant population of southern Croatia was affected by bluetongue (BT) in late 2001. A sentinel cattle scheme was developed to detect the presence of bluetongue virus (BTV) activity in the domestic cattle population in the protection zone (based on the distribution of BT in 2001: Dubrovacko-Neretvanska County and the southern area of the Splitsko-Dalmatinska County) as well as in the surveillance zone (the northern area of the Splitsko-Dalmatinska County). Twenty-five villages were selected to serve as sentinel locations during the observation period which lasted from 15 September to 15 December 2002. Seroconversion was not detected in cattle in sentinel locations in the surveillance zone. However, in the protection zone, serum antibodies to BTV serotype 9 were detected in eight cattle in five of the ten sentinel locations. Although no clinical case of BT disease was detected in sheep on mainland Croatia in late 2002, BTV activity was present in sentinel cattle in the protection zone. When compared with 2001, spatial distribution of the locations in which cattle seroconverted to BTV-9 in the last quarter of the 2002 suggests a northward trend to the spread of BTV in the cattle of southern Croatia.

The age and sex composition of the population.

PIP: The age and sex distributions of the population of Yugoslavia are analyzed based on 1981 census data. The author selects as highlights the facts that the proportion of women in the total population, while declining, is still greater than that of men; that demographic aging is proceeding; that the ratio of the young to those of working age has decreased, while the ratio of the young to the elderly population has increased; and that regional differences are declining. An attempt is made to forecast future trends concerning age and sex distribution^ieng