Non‑melanoma skin cancer (NMSC) comprises squamous cell carcinoma (SCC), basal cell carcinoma (BCC), and severalrare skin tumors (i.e., Extramammary Paget’s disease), being the most common malignancy-affecting people worldwide. Itrepresents the majority of skin cancers and a significant percentage of all malignancies. Despite increasing public awarenessand scientific interest, the incidence of NMSC is constantly increasing. Even though most NMSC`s are associated with lessaggressive behavior, they can still be invasive locally and cause extensive damage to neighboring structures, inducingsignificant morbidity. In addition, different types and subtypes of NMSC tend to have frequent recurrences and may have significantmetastatic potential. As a direct consequence, NMSC has become an important issue for healthcare systems with a significantsocio‑economic impact.
The “volatile” international context requires the strengthening of the national security measures, including in the field of CBRN and public health. The medical countermeasures for the defense are based ultimately on the prophylactic treatment (pre-exposure, intra-exposure and post-exposure) and on the curative treatment (of emergency, maintenance and recovery) of the contaminated and the sick. Depending on the rapid and correct etiological diagnosis, the appropriate treatment is immediately applied. Although in times of peace this scenario is almost non-existent, during war or terrorist attack it can be a mass pathology, like an explosive epidemic, that requires specific therapeutic means. Military medicine had and has the conceptual capacity to make antidotes for CBRN medical protection; some have been patented and/or produced as experimental models, but it has no manufacturing capacity anymore.
Background and Aim: This study aimed to investigate the expression level of Sine oculis homeobox homolog 1(SIX1) in normal and cancerous cervical tissues. Methods: Real-time PCR was used to evaluate SIX1 expression level in fresh surgically obtained cervical biopsies. Also, cervical specimens were tested for HPV DNA detection by MY09/11, GP5+/6+ nested PCR method. Results: The expression level of SIX1 mRNA in Cervical cancer was markedly higher than in normal cervical tissue (p<0.0001). Moreover, HPV DNA was detected in 100% of cases and 21.05% of controls (P<0.0001). Conclusions: This finding indicates that increased SIX1 expression might be of relevance to the pathogenesis of cervical cancer. Perhaps, studies to find agents that specifically target SIX1, develop novel anti-cancer and anti-metastasis drugs. This idea has to be investigated in future clinical studies.
Obesity correlates with a higher risk of fractures in some sites as vertebras, upper arm, and legs. This is a narrative mini-review focused on several key points that link obesity with osteoporosis. Waist circumference may a better predictor of fractures than body mass index (BMI) in obese females. Even obese menopausal women have an extra source of estrogens in fat tissue this actually is not enough to offer a complete protection against osteoporotic fractures. Low levels of testosterone in males induce a higher risk of fall dependent or independent of sarcopenia (which is more evident in elderly). High BMI is correlated with vitamin D deficiency. Obesity is a contributor to muscle damage and decline due to fat accumulation and inefficient fuel utilisation by the muscle, namely sarcopenic obesity, regardless the age. Associated type 2 diabetes mellitus involves bone damage and fracture risk due to glycated proteins of the matrix, the changes of adipokines, increased cortical porosity, high risk of fall because of blood pressure and glycaemia anomalies, visual disturbances, renal and peripheral nerves diabetes-associated conditions etc. The fracture risk is also augmented via fat derived cytokines and chronic inflammation. Even it seems logical that the weight correction though bariatric surgery reduces the fracture risk in obesity, actually data from longitudinal studies pointed that, despite the procedure is life saving, it does not actually protect against osteoporosis which is regarded as a potential long-term complication. A high fracture burden in obesity should increase the level of awareness for practitioners of different medical areas due to multiple levels of complications and to the epidemiological impact of obesity.
Purpose: Cancers are one of the main causes of mortality in the world. The incidence of cancers in the world and mainly in developing countries is increasing. Due to the importance of this issue, the purpose of the current study was to assess the trend of incidence and death of Bladder Cancer among Iranian Military Community (MC) from 2007 to 2019. Methods: This is a cross-sectional study using time series data. All registered bladder cancer in Iranian Military community from March 2007 to February 2017 entered in this study. The future trend predicted using ARIMA (p,d,q) model. All analyzes were performed using ITSM and Excel (2010) software. Results: According to ARIMA (2, 2, 1) model, the bladder cancer among the Iranian military community had an increasing trend. The AR (12, 2, 0) model showed an increasing trend of this cancer among males but it seems the trend of bladder cancer among females will have a constant trend AR (12, 2, 1). The death due to bladder cancer was showed a decreasing trend using AR (14, 2, 1) model. Conclusion: In spite of decreasing trend in death due to bladder cancer, the trend of incidence of the Bladder cancer among the Iranian Military Community was increasing. However, it is necessary to adjust the effect of many factors that may have an important role in this trend.
The treatment of diseases is based on pharmacological and non-pharmacological means, but adequate devices are needed for their application. Medicine uses a wide range of medical devices. Currently, many medical devices are used, many of them being disposable. As recognition of the importance of medical devices, the national authority of the drug is the ANMDM (National Agency for Medicines and Medical Devices). Medical devices are indispensable for therapy, and their evolution has led to an extraordinary diversification of the field and the emergence of industry related to the pharmaceutical industry, with specific laws and regulations.
Background and Aim: Information on patients' experiences with and evaluations of health care is considered an essential outcome indicator to assess the quality of health care. This study aims to evaluate patient satisfaction with primary health care in a military setting. Methods: This cross-sectional study was conducted at the primary health care center located in a military setting, in Ankara, Turkey. A total of 3080 military personnel who received primary care in the last 12 months formed the population of the study. Turkish version of the European task force on patient evaluations of general practice care (EUROPEP) questionnaire was administered to the participants. Results: In the study, 2677 participants were reached with a response rate of 86.9%. The mean satisfaction rate (MSR) of clinical behaviour (69.3%) was higher than the MSR of the organization of care (58.4%). The MSR of the overall questionnaire was 67.1%. Significant differences were observed in the mean satisfaction scores of patients according to their descriptive characteristics including gender, age level, troop type, and the doctor providing the care. Conclusions: This study highlights the low patient satisfaction levels, which may have resulted from the fact that the study population was young and relatively healthy, and that there was no possibility of choosing the general practitioner. The EUROPEP questionnaire, which is an internationally validated and standardized instrument, can also be used to improve primary health care in military settings.
The pandemic called COVID-19 disease has an exponential course since the first cases were reported showing in 9th of May, 2020, more than 4 million cases of COVID-19. United States and European Council (EC), together with other European Union institutions, were closely monitoring the situation in order to take quick action. Objective: The aim of this article is to analyze the response to COVID 19 pandemic outbreak in term of strategy and money flow of Romanian health system in order to identify the strength and weakness and prepare for other similar provocative challenges. Global and national strategy: United States Government is delivering a comprehensive package of services to support international partners around the world in combatting this disease adding American expertise for global benefit, saving lives by improving international partners abilities to respond to the COVID-19, and reducing secondary impacts. Meanwhile European Union is focused on 6 major coordinates limit the spread of the virus, ensure and provide medical supplies, decrease negative economic impact, support jobs, promoting research and help European citizens to repatriate. Despite all negative elements a proper and relatively quick response of Romanian Public Health System was noticed and the taken measures were harmonized and synchronized with the European coordinates, prioritize initiatives, build an action plan, establish a communication plan, workforce optimization and management strategy. Conclusion: Global shock needs global response, with little or no government interventions, economic costs will be huge.
Background and Aim: Digital skills of healthcare professionals are recognized as critical for the successful digital transformation of healthcare. The present study aims to examine the relationship between the digital skills of healthcare professionals and the organizational structures of hospitals. Methods: In this cross-sectional study, using the convenience sampling method, 857 healthcare professionals, working in Greek military and civilian hospitals, voluntarily participated. Data were collected between July and November 2021 through a structured questionnaire, based on the Digital Competence framework. Digital skills were categorized into five subscales: information, communication, content creation, problem solving, and safety skills. Statistical analysis was performed with SPSS 26.0, with p-values 0.8, indicating high reliability. Younger participants showed higher scores (p<0.001). The mean scores for information, communication, content creation, problem solving and safety skills in military hospitals were calculated as 52.1 (SD=32.3), 50.6 (SD=31.8), 48.4 (SD=33.3), 49.8 (SD =30.8) and 52.8 (SD=34.1) respectively, while in civilian hospitals they were calculated as 45.1 (SD=32.2), 44.5 (SD=29.5), 41.8 (SD=32.4), 41.5 (SD=30.8) and 47.1 (SD=34.5) respectively. Conclusions: Healthcare professionals in military hospitals exhibit higher digital competence compared to their counterparts in civilian hospitals. Identifying the organizational factors that promote greater digital competence among healthcare professionals provides essential information to policymakers and healthcare managers for implementing targeted organizational improvements.
Background: Nonmelanoma skin cancers (NMSCs), including basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC), often occur in high-risk areas like the face, ears, and scalp. Surgical excision is standard, but achieving tumor-free margins while preserving function and appearance is challenging. This study evaluates the adequacy of arbitrary surgical margins versus histopathological clearance. Methods: A retrospective analysis was conducted on 147 patients with BCC or cSCC in high-risk areas treated at Elias Emergency University Hospital (2020–2024). Data included demographics, tumor type, size, location, excision margins, and histological clearance. Margins were grouped from 0 mm to >10 mm. Results: Most patients were male (59.2%) with a mean age of 70.6 years. BCC accounted for 70.7% of cases. Arbitrary margins averaged 5.4 mm; mean histological margins were ~2.5 mm. Complete excision was achieved in 91.2%; positive margins were most common on the nose and scalp. Discussion: Arbitrary margins in high-risk areas are often narrower than guidelines recommend, especially where tissue is limited, increasing the risk of incomplete excision. Conclusion: While aesthetic and functional considerations often necessitate smaller margins, improved intraoperative margin assessment could enhance oncological outcomes in high-risk NMSC.
