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Introduction: Malignant melanoma may present a great variety of histopathological patterns. Besides the classic forms of melanoma, there are a number of variants that have been described, such as polypoid, verrucous, desmoplastic, myxoid, chondroid, balloon-cell, rhabdoid, animal-type, amelanotic, spitzoid, nevoid. The aim of this study was to characterize the rare histopathologic variants of malignant melanoma observed in a Dermatopathology Laboratory in a period of 15 years (1995-2009). Material and Methods: Analized data included: patient age and sex, clinical diagnosis, melanoma location, Breslow and Clark level, presence of ulceration and follow-up. These variants were grouped according to architectural, cytologic and/or stromal changes. Results: Eighty-seven rare histopathologic variants of melanoma were observed, corresponding t...
Objectives: To determine clinical and histopathological differences between melanoma associated with nevus (MAN) and de novo melanoma (MN). Methods: Retrospective study of all cases of cutaneous melanoma diagnosed between 2001 and 2009 in Centro de Dermatologia Médico-Cirúrgica de Lisboa. Results: Of the 397 melanomas included, 52.6% were of feminine sex and 47.4% of the masculine. Of these melanomas only 9.3% were histologically associated with nevus, with discrete predominance of cases in the feminine sex (54%, p=0,033). In the group of the MAN the average of ages was slightly inferior (56,5 vs 59,3 years, p=0,577). The trunk was the preferential localization of all the melanomas (42.1%, p=0,005). Histologically the superficial spreading subtype was more frequently associated with MAN. The MAN were thinner than the MN (1,42 versus 2,...
Introduction: Stress induced hyperglycaemia is prevalent in critical care. Tight glycaemic control is associated with significantly improved clinical outcomes. Providing tight control is difficult due to evolving patient condition and drug therapies. Model-based/derived methods (e.g. SPRINT) have shown significant mortality reductions. This research validates an improved metabolic control model and its parameters based on predictive capability for use in real-time glycaemic control.
Introduction: Severe sepsis and septic shock occur frequently in the Intensive Care Unit (ICU) and are a leading cause of admission, mortality and cost. Around 11-12% of all NZ and US ICU admissions are due to the more extreme cases of severe sepsis. Currently, the diagnosis of sepsis presents many challenges in a clinical setting. Sepsis treatment consists of antibiotic therapy with the use of fluid therapy and vasopressors. A positive blood culture for the specific sepsis type should precede the use of antibiotics and other therapies. Importantly, many of these therapies would be contra-indicated if sepsis wasn’t present. However, such blood culture results take 24-48 hours to process, by which time the disease may be advanced and more difficult to treat. Faster approximate diagnoses can be obtained in 4-8 hours using a variety of bi...
Study Type - Therapy (case series) Level of Evidence 4. What's known on the subject? and What does the study add? Until now, the transvaginal approach has been the only method of removing larger specimens from the abdominal cavity using natural orifice transluminal endoscopic surgery. There has been no means of extracting larger specimens in men and the means are restricted even in women, particularly in young women. The present study shows that the difficulty of large specimen retrieval can be overcome, irrespective of the diameter of the chosen port, through natural orifices using morcellation. OBJECTIVE: To show, in a porcine model, the feasibility of a complete transvesical natural orifice transluminal endoscopic surgery (NOTES) nephrectomy with kidney extraction after morcellation through the same port. MATERIALS AND METHODS: Tr...
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