Background: The incidence rates of lip and oral cancer have continued to increase, and prognosis is associated with a country’s socioeconomic status. The mortality-to-incidence ratio (MIR) is a reasonable indicator of disparities in cancer screening and treatment. In this study, we aimed to understand the association between economic status and cancer prognosis. Methods: Data were obtained from the Global Cancer Observatory (GLOBOCAN) and the World Health Organization (WHO). The MIRs were compared to evaluate the correlation with the human development index (HDI), the current health expenditure (CHE), and the ratio of CHE over gross domestic product (CHE/GDP) disparities via Spearman’s rank correlation coefficient. Results: The results showed that Asia had the most cases and deaths. In addition, they showed a significant association (p < 0.001, p = 0.005, and p < 0.001, respectively) of the crude rate (CR) of incidence with the HDI, the CHE, and the CHE/GDP. However, their associations with mortality rate (p = 0.303, p = 0.997, and p = 0.101) were not significant. Regarding the correlation of the MIRs, the results revealed a significant association with the HDI, the CHE, and the CHE/GDP (p < 0.001, p < 0.001, and p < 0.001, respectively). Conclusion: Countries with higher HDI, CHE per capita, and CHE/GDP tend to have lower MIRs, which indicates favorable clinical outcomes.

Lung ventilation (LV) and alveolar permeability (AP) were measured in 24 male chronic renal failure (CRF) patients on regular hemodialysis (HD). LV and AP were determined by Tc-99m DTPA aerosol inhalation lung scintigraphy using commercial lung radioaerosol delivery units. The equilibrium LV images were visually interpreted by two independent and experienced nuclear medicine physicians. The degree of AP damage to the total right lung was presented as the clearance rate (k value; %/min) of the time-activity curve from dynamic total right lung images. The results showed 10/24 (42%) cases with inhomogeneous distribution and 8/24 (33%) cases with hypoventilation on equilibrium LV images. In comparison with 10 male normal controls, the k value of the CRF patient group was larger (1.14 + 0.36%/min vs 0.75 + 0.14%/min, p value <0.05). In addition, there was no significant correlation for k value and albumin level (r 2 = 0.008) or for k value and HD duration (P = 0.228). In conclusion, CRF can predispose patients to LV change and AP damage. However, the degree of AP damage is not related to serum albumin level or HD duration.

Diffuse alveolar hemorrhage (DAH) secondary to anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis is rare in clinical practice and may present as severe acute respiratory distress syndrome (ARDS) with high mortality. Extracorporeal membrane oxygenation (ECMO) has been reported to be a salvage treatment providing the time necessary for immunosuppressive treatment in cases accompanied by severe ARDS. Prone positioning (PP) has been proven to reduce the mortality in patients with severe ARDS. However, there is no consensus about choosing PP or ECMO in severe ARDS due to DAH secondary to ANCA-associated vasculitis. We reported a case of microscopic polyangiitis (MPA)-related DAH and severe ARDS treated with PP successfully providing the time necessary for early glucocorticoids and plasma exchange to control the underlying disease. Since anticoagulation therapy is not necessary in PP, it does not increase the risk of bleeding tendency unlike ECMO. PP has a life-saving role in the management of patients with severe ARDS due to ANCA-associated pulmonary vasculitis.

Background: The incidence rate of lip and oral cancer is increasing in recent years, the prognosis of which is associated with a country’s socioeconomic status. The mortality-to-incidence ratio (MIR) is a reasonable indicator of disparities in cancer screening and treatment. We aim to understand the association between economic status and cancer prognosis.Methods: Data were obtained from the Global Cancer Observatory (GLOBOCAN) and the World Health Organization (WHO). The MIR was applied to evaluate the correlation to healthcare expenditures and the human development index (HDI) disparities via Spearman's rank correlation coefficient.Results: The results showed that Asia has the most cases and deaths. The association of the HDI, current health expenditure (CHE), and ratio of CHE to the percentage of gross domestic product (CHE/GDP) to the crude rate (CR) of incidence show significant results (p<0.001, p=0.005, and p<0.001, respectively). However, their association with the mortality rate (p=0.303, p=0.997, and p=0.101) is not significant. In the correlation of the MIRs, the results revealed a significant association with the HDI, CHE, and CHE/GDP with the MIR (p<0.001, p<0.001, and p<0.001, respectively).Conclusion: Countries with a higher HDI, more CHE per capita, and higher CHE/GDP tend to have a lower MIR, which indicates a favorable clinical outcome.

Lupus nephritis (LN) is a common and severe manifestation of pediatric-onset systemic lupus erythematosus (pSLE). It is one of the major causes of long-term glucocorticoid/immune suppressants use in pSLE. It causes long-term glucocorticoid/immune suppressants use and even end-stage renal disease (ESRD) in pSLE. It is now well known that high chronicity, especially the tubulointerstitial components in the renal biopsy, predicts a poor renal outcome. Interstitial inflammation (II), a component of activity in LN pathology, can be an early predictor for the renal outcome. With the advent of 3D pathology and CD19-targeted CAR-T cell therapy in the 2020s, the present study focuses on detailed pathology and B cell expression in II. We recruited 48 pSLE patients with class III/IV LN to analyze the risk of ESRD based on different II scores. We also studied 3D renal pathology and immunofluorescence (IF) staining of CD3, 19, 20, and 138 in patients with a high II score but low chronicity. Those pSLE LN patients with II scores of 2 or 3 showed a higher risk for ESRD (p = 0.003) than those with II scores of 0 or 1. Excluding patients with chronicity >3, high II scores still carried a higher risk for ESRD (p = 0.005). Checking the average scores from the renal specimens from different depths, the II, and chronicity showed good consistency between 3D and 2D pathology (interclass correlation coefficient [ICC], II = 0.91, p = 0.0015; chronicity = 0.86, p = 0.024). However, the sum of tubular atrophy plus interstitial fibrosis showed no good consistency (ICC = 0.79, p = 0.071). The selected LN patients with negative CD19/20 IF stains showed scattered CD3 infiltration and a different IF pattern of Syndecan-1 expression. Our study provides unique data in LN, including 3D pathology and different in situ Syndecan-1 patterns in LN patients.