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Background: Cryosurgery is a common destructive treatment method for intraepidermal carcinoma (IEC) above the knee. Curettage alone is a simple, non‐aggressive and inexpensive treatment method commonly used on benign skin lesions. However, only one study has assessed curettage for treatment of IEC. Objective: We aimed to (1) compare the effectiveness of cryosurgery (standard method) to curettage (experimental method) for treatment of IEC in regard to overall clearance rates at 1‐year follow‐up, and (2) investigate whether wound healing times differed between the treatment groups. Methods: In this randomized and controlled, non‐inferiority trial, adult patients with one or more IEC with a diameter of 5–20 mm, located above the knee and suitable for destructive treatment were recruited from Sahlgrenska University Hospital (Gothenburg, Sweden). Lesions were randomized to treatment with either cryosurgery or curettage. Wound healing was assessed by a nurse after 4–6 weeks and through self‐report forms. Overall clearance was assessed by a dermatologist after 1 year. Results: In total, 183 lesions in 147 patients were included, with 93 lesions randomized to cryosurgery and 90 to curettage. Eighty‐eight (94.6%) of the lesions in the cryosurgery group and 71 (78.9%) in the curettage group showed an overall clearance at the 1‐year follow‐up visit (p = 0.002). The non‐inferiority analysis was inconclusive. Curettage resulted in both shorter self‐reported wound healing times (mean time 3.1 vs. 4.8 weeks, p < 0.001) and a larger proportion of healed wounds after 4–6 weeks (p < 0.001). Conclusions: Cryosurgery and curettage both result in high clearance rates for treatment of IEC, but cryosurgery is significantly more effective. On the other hand, curettage may result in shorter wound healing times. [ABSTRACT FROM AUTHOR]

5 d Including acral lentiginous melanoma, melanoma in junctional nevus, malignant melanoma not otherwise specified, etc. 6 e As per the study design, fatal and non-fatal cases were similar regarding median thickness. While the individual case fatality rate from thin melanoma is low, overall, thin melanomas contribute a large proportion of total melanoma deaths. [Extracted from the article]

Summary: Background: Thin cutaneous melanomas (≤ 1·00 mm) are increasing worldwide, causing around a quarter of all melanoma deaths in the U.S.A. and Australia. Identification of predictive factors for potentially fatal thin melanomas could allow better use of resources for follow‐up. Objectives: To identify the clinicopathological factors associated with fatal thin melanomas. Methods: This large, nested case–case study extracted data from the population‐based Queensland Cancer Registry, Australia. Our cohort consisted of Queensland residents aged 0–89 years who were diagnosed with a single, locally invasive thin melanoma (≤ 1·00 mm) between 1995 and 2014. Fatal cases (eligible patients who died from melanoma) were individually matched to three nonfatal cases (eligible patients who were not known to have died from melanoma) according to sex, age, year of diagnosis and follow‐up interval. Using conditional logistic regression, we calculated odds ratios (ORs) for melanoma‐specific death, adjusting for all collected clinicopathological variables. Results: In the cohort, 27 660 eligible patients were diagnosed with a single, thin melanoma. The final case–case series included 424 fatal cases and 1189 nonfatal cases. Fatal cases were sixfold as likely to arise on the scalp as on the back [OR 6·39, 95% confidence interval (CI) 2·57–15·92] and six times as likely to be of thickness 0·80–1·00 mm as of < 0·30 mm (OR 6·00, 95% CI 3·55–10·17). Conclusions: Scalp location is a strong prognostic factor of death from thin melanoma. Further, this study provides support that melanomas with a thickness of 0·80–1·00 mm are the more hazardous thin lesions. Patients with these tumour characteristics require specific attention during follow‐up. What's already known about this topic? Thin invasive melanomas (≤ 1·00 mm) contribute a substantial proportion of melanoma fatalities, owing to the high volume of disease.There is a need to find prognostic factors that will better identify fatal thin melanomas at the time of diagnosis. What does this study add? In this large population‐based study, fatal thin tumours were sixfold as likely to be located on the scalp as on the back.Thin melanomas of 0·80–1·00 mm thickness were six times as likely to be associated with death as tumours < 0·30 mm.Scalp location and increasing thickness are strong predictive factors of fatal thin melanomas, indicating that patients with these tumour characteristics require close follow‐up. Respond to this article Linked Comment:Cust. Br J Dermatol 2020; 182:827–828. Plain language summary available online [ABSTRACT FROM AUTHOR]

Tremendous global efforts have been made to collect data on the HIV/AIDS epidemic. Yet, significant challenges remain for generating and analysing evidence to allocate resources efficiently and implement an effective AIDS response. India offers important lessons and a model for intelligent and integrated use of data on HIV/AIDS for an evidence-based response. Over the past 15 years, the number of data sources has expanded and the geographical unit of data generation, analysis and use for planning has shifted from the national to the state, district and now subdistrict level. The authors describe and critically analyse the evolution of data sets in India and how they have been utilised to better understand the epidemic, advance policy, and plan and implement an increasingly effective, well-targeted and decentralised national response to HIV and AIDS. The authors argue that India is an example of how 'know your epidemic, know your response' message can effectively be implemented at scale and presents important lessons to help other countries design their evidence generation systems. [ABSTRACT FROM AUTHOR]

Cochlear implantation (CI) rates vary between countries, depending on identification routines and economic restrictions. The present study aimed at determining the prevalence of CIs in postlingually deafened, aged 20–69 years old, in Göteborg, Sweden. Three patient databases with information on PTA, a questionnaire, medical records and consultations identified 88 subjects with sensorineural hearing loss &nvge;80 dB HL (PTA of 500, 1000, 3000 Hz), PB word score of ≤30% (better ear), regular use of hearing-aid, and oral language. The prevalence of CIs was 11.8 per 100&VeryThinSpace;000 population, and of subjects fulfilling the audiometric candidacy criteria 18.6 per 100&VeryThinSpace;000. The mean PTA (op. ear) of subjects awaiting operation was 97 dB HL (SD 12.3), and of already implanted subjects 106 dB HL (SD 10.2). Mean PB word score was 9% (SD 8.9) and 3% (SD 4.9) respectively. Subjects awaiting operation had significantly better residual hearing, emphasizing recent changes in candidacy criteria. Comparing with prevalence from other countries demonstrated that more patients could be candidates for cochlear implantation.SumarioLa tasa de implantes cocleares (CI) varía según los países, dependiendo de las rutinas de identificación y de las restricciones económicas. Este estudio pretende determinar la prevalencia de los CI en adultos ensordecidos de 20 a 69 años en Goteborg, Suecia. Mediante una base de datos con información sobre PTA, un cuestionario, antecedentes médicos y de consulta se identificaron 88 sujetos con hipoacusia sensorineural &nvge;80 dB HL (PTA de 0.5, 1.0, 3.0 kHz), calificación en palabras PB&VeryThinSpace;≤&VeryThinSpace;30% (mejor oído), uso regular de auxiliares auditivos y de lenguaje oral. La prevalencia de CI fue de 11.8 por 100,000 personas y de 18.6 por 100,000 la de los sujetos que reunían los criterios audiométricos para ser candidatos. El promedio de PTA del oído propuesto en los sujetos que esperaban la operación fue de 97dB HL (SD 12.3) y en los sujetos ya implantados de 106 dB HL (SD 10.2). La calificación promedio de la prueba con palabras PB fue de 9% (SD 8.9) y 3% (SD 4.9) respectivamente. Los sujetos que estaban esperando la cirugía tenían una audición residual significativamente mejor, con énfasis en los recientes cambios en los criterios de candidatura. Comparando la prevalencia de otros países, queda demostrado que más pacientes podrían ser candidatos para implante coclear. [ABSTRACT FROM AUTHOR]

In most countries, rates of mortality and malnutrition among children continue to decline, but large inequalities between poor and better-off children exist, both between and within countries. These inequalities, which appear to be widening, call into question the strategies for child mortality reduction relied upon to date. We review (1) what is known about the causes of socioeconomic inequalities in child health and where programs aimed at reducing inequalities may be most effectively focused and (2) what is known about the success of actual programs in narrowing these inequalities. We end with lessons learned: the need for better evidence, but most of all for a new approach to improving the health of all children that is evidence based, broad, and multifaceted. [ABSTRACT FROM AUTHOR]

The child survival revolution of the 1980s contributed to steady decreases in child mortality in some populations, but much remains to be done. More than 10 million children will die this year, almost all of whom are poor. Two-thirds of these deaths could have been prevented if effective child survival interventions had reached all children and mothers who needed them. Translation of current knowledge into effective action for child survival will require leadership, strong health systems, targeted human and financial resources, and modified health system to ensure that poor children and mothers benefit. A group of concerned scientists and policy-makers issues a call to action to leaders, governments, and citizens to translate knowledge into action for child survival. [ABSTRACT FROM AUTHOR]

Summary: 皮肤癌是西方人群中最常见的癌症。黑色素瘤是该病中最危险的一种。如果不及时治疗,黑色素瘤倾向于在"厚度"(侵入皮肤的深度)层面生长,较厚的肿瘤被认为比较薄的肿瘤更晚期,更难治疗。 然而,在澳大利亚昆士兰,约四分之一的黑色素瘤死亡是由薄肿瘤引起的,肿瘤侵入皮肤表面厚度为 1 mm 或以下(≤1.00 mm)。 这项研究旨在寻找一些在诊断时可以确定最终死于薄黑色素瘤的患者因素。对来自昆士兰癌症登记处的数据进行了分析,以比较导致患者死亡的 424 例薄黑色素瘤与未导致死亡的 1189 例薄黑色素瘤的特征。 位于头皮上的薄黑色素瘤与背部的薄黑色素瘤相比,导致患者死亡的可能性高至 6 倍。此外,较厚的薄黑色素瘤(穿透皮肤厚度为 0.80‐1.00 mm)导致死亡的可能性是厚度小于 0.30 mm 的微创(较薄)肿瘤的 6 倍。 这项研究表明,在诊断时,根据肿瘤发生在身体的哪个部位以及厚度不断增加,可以在薄黑色素瘤中识别出更危险的肿瘤类型。具有这些特征的黑色素瘤患者在诊断和治疗后可能需要更密切的随访。 本摘要涉及研究:与薄 (≤1.00 mm) 黑色素瘤死亡相关的临床病理因素 [ABSTRACT FROM AUTHOR]

Summary: Skin cancer is the most common cancer in Western populations. Melanoma is the most dangerous form of the disease. Melanoma tends to grow in 'thickness' (depth of invasion into the skin) if left untreated, and thicker tumours are considered more advanced and harder to treat than thinner tumours. However, around one quarter of all deaths from melanoma in Queensland, Australia are caused by thin tumours, invading the skin's surface to a thickness of 1mm or less (≤1.00 mm). This study aimed to find factors that, at diagnosis, can identify patients who will eventually die from thin melanoma. Data from the Queensland Cancer Registry were analysed to compare the characteristics of 424 thin melanomas that caused the patient to die to 1,189 thin melanomas that did not lead to death. Thin melanomas located on the scalp were six times more likely to cause the patient's death, when they were compared to thin melanomas on the back. Also, the thicker of the thin melanomas, which penetrated the skin to 0.80‐1.00 mm thickness, were six times as likely to cause death, when compared to minimally invasive (thinner) tumours with a thickness of less than 0.30mm. This study showed that where on the body the tumour occurs, and increasing thickness, could identify the more dangerous tumours among the thin melanomas, at diagnosis. Patients with melanomas with these characteristics may need closer follow‐up after diagnosis and treatment. This is a summary of the study: Clinicopathological factors associated with death from thin (≤ 1.00 mm) melanoma [ABSTRACT FROM AUTHOR]