Epidemiology of malignant melanoma (Clinical experience at the National Institute of Oncology in Hungary)

2011 ◽  
Vol 152 (25) ◽  
pp. 1000-1006 ◽  
Author(s):  
Tímea Balatoni ◽  
Gabriella Liszkay ◽  
Zoltánné Miklós ◽  
Miklós Kásler
Keyword(s):  
Malignant Melanoma ◽  
Early Recognition ◽  
Neck Region ◽  
Lower Limbs ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Test Results ◽  
The Mean ◽  
The Difference

The National Cancer Registry, which has been running since 1999 in Hungary, supplies more and more precise data about the growing incidence of malignant melanoma although nationwide melanoma database currently does not exist. As in the National Institute of Oncology a notable percentage of patients (20-25%) were treated with newly diagnosed melanoma, conclusions may be drawn for the efficacy of primary prevention for the whole country. Methods: The recent study compares the data of patients presented in the Institute with cutaneous malignant melanoma in 1998 and ten years later, in 2008. The histology parameters of tumors were also analyzed. The two groups were compared according to age, gender, localization and histology parameters (histological types Breslow and Clark numbers). In case of continuous variables the Mann-Whitney test were used to determine significant differences. Categorical variables were checked by χ2 test. Results: 149 and 377 cutaneous melanomas were diagnosed in 1998 and in 2008, respectively, which accounts for 153% increase in ten years. The mean age of patients was 56.3 and 57.2 years in 1998 and in 2008, respectively. The per cent of males was 43% in 1998 and 49% in 2008. Trunk was the most frequent localization in both years: 39% and 46%, then lower limbs (28% and 22%), upper limbs (21% and 18%) and the head and neck region (12% and 14%). Superficial melanoma was found the most frequent histological type (52 and 54%) followed by nodular melanoma (31% and 23%). Rate of in situ melanoma changed from 10% to 15%. The mean of Breslow numbers was 2.2 mm in 1998 and 1.6 mm in 2008, the difference was highly significant (p = 0.0002). Clark numbers were also decreasing, although the difference was not significant (p = 0.08). The majority of patients were presented with Clark III depth melanoma in both years (38% and 32%). Conclusions: It seems that forces emphasizing the importance of early recognition in medical education and in media are not futile considering that principally the early diagnosis can improve the melanoma’s prognosis – which is represented mainly by Breslow tumor depth. Orv. Hetil., 2011, 152, 1000–1006.

scholarly journals In-situ Desaturation Tests by Electrolysis for Liquefaction Mitigation

2021 ◽  
Author(s):  
Runze Chen ◽  
Yumin Chen ◽  
Hanlong Liu ◽  
Kunxian Zhang ◽  
Ying Zhou ◽  
...  
Keyword(s):  
Minimum Degree ◽  
Electricity Consumption ◽  
Potential Method ◽  
Economic Benefits ◽  
Degree Of Saturation ◽  
Test Results ◽  
Liquefaction Resistance ◽  
The Difference ◽  
Maximum And Minimum Degree

Electrolytic desaturation is a potential method for improving the liquefaction resistance of the liquefiable foundation by reducing the soil saturation. In this study, in-situ desaturation tests were performed to investigate the resistivity of soil at different depth and the water level of the foundation under different current. The test results show that at constant currents of 1 A (Ampere, unit of the direct current), 2 A and 3 A, the saturation of the treated foundation reached 87%, 83% and 80%. During the electrolysis process, the generated gas migrates vertically and horizontally under the influence of buoyancy and gas pressure. In the end of electrolysis, the gas inside the sand foundation basically migrates vertically only. The higher current intensity employed for electrolysis will affect the uniformity and stability of the gas. At constant currents of 1 A, 2 A and 3 A, the difference between the maximum and minimum degree of saturation in the treated foundation was 14%, 18% and 19%; and after electrolysis halted for 144 h, the saturation in the treated foundation was 90%, 85% and 87%. The electricity consumption analysis indicates that the desaturation method has excellent economic benefits in the treatment of saturated sand foundations.

scholarly journals Clinical and functional outcomes of tarsal coalition resection to correct rigid flat foot

2021 ◽  
Vol 15 (2) ◽  
pp. 115-119
Author(s):  
Rodrigo Guimarães Huyer ◽  
Mário Sérgio Paulillo Cillo ◽  
Carlos Daniel Cândido Castro Filho ◽  
Hallan Douglas Bertelli ◽  
Marcelo Morelli Girondo ◽  
...  
Keyword(s):  
Case Series ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Tarsal Coalition ◽  
Retrospective Case ◽  
Aofas Score ◽  
Level Of Evidence ◽  
Flat Foot ◽  
Flat Feet ◽  
The Mean

Objective: This study used the AOFAS score to assess the clinical functional results of patients who underwent tarsal coalition resection. Methods: This was a retrospective case series of patients who underwent tarsal coalition resection to correct rigid flat foot. Clinical and functional assessment was performed with the AOFAS score before and 6 months after surgical treatment. Descriptive analysis was performed for 7 patients (11 operated feet) using measurements of position and dispersion (mean, standard deviation, minimum, median and maximum value) for continuous variables and frequency tables (absolute and relative) for categorical variables. Results: The mean patient age was 10 years, 7 months, and the majority (71.43%) were male. The most affected joint was the calcaneonavicular. The right side was affected in 54.55% of the cases. The most frequent type of coalition was osseous (81.82% of the cases). The mean pre- and postoperative AOFAS scores were 32.7 and 70.2 points, respectively, which was a significant increase. Conclusion: The increased scores after coalition resection was considered the main change between the two assessments. Thus, it can be concluded that in rigid flat feet without severe hind- or forefoot deformities for which conservative treatment failed, bar resection should be the surgical procedure of choice. Level of Evidence IV; Therapeutic Studies; Case Series.

scholarly journals Investigation of Burnout Levels of Anaesthesiologists and Technicians in Covid-19 Pandemic Period

Acta Medica ◽  
2021 ◽  
pp. 1-5
Author(s):  
Gülsüm Kavalci ◽  
Selvi Ceran Kayipmaz
Keyword(s):  
Pearson Correlation ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Research Hospital ◽  
Pearson Correlation Test ◽  
Training And Research ◽  
The Mean ◽  
Questionnaire Method ◽  
High Level ◽  
The Relationship

Objective: The ongoing Covid-19 pandemic further increased this stress of employees. This disease, which did not have a cure and a vaccine at the beginning, increased the anxiety of the employees and forced them to live separately due to the risk of infecting family members. This study aimed to investigate the burnout levels of doctors and technicians working in Yenimahalle Training and Research Hospital Anaesthesiology and Reanimation Clinic. Materials and Methods: This study was conducted prospectively by using a questionnaire method in the Yenimahalle Training and Research Hospital. Maslach Burnout questionnaire applied to the participants. Quantitative data were expressed as %, the number of subjects as (n). The distribution of continuous variables was evaluated with the Kolmogorov-Smirnow test. Qualitative data were expressed in mean±SD (standard deviation). X2 test was used for comparison of categorical variables. Independent Student T-test was used for comparison of continuous variables. The relationship between burnout level and variables was determined by Pearson Correlation Test. The value of p<0.05 was considered statistically significant. Results: A total of 52 volunteers participated in the study. The average emotional exhaustion score of the volunteers participating in the study was 31.13±4.6, the average depersonalization score was 15.06±3.3, and the mean personal achievement score was 23.60±3.7. There was no statistically significant relationship between any of the variables and the burnout level (p>0.05). Conclusion: The high level of burnout in a clinic that is at the forefront of the fight against Covid-19, such as anesthesiology and reanimation, is important in terms of determining the situation.

VOMITING

2018 ◽  
Vol 25 (12) ◽  
pp. 1887-1891
Author(s):  
Malik Jamil Ahmed ◽  
Muhammad Nasir ◽  
Aamir Furqan
Keyword(s):  
Computer Software ◽  
Outcome Variable ◽  
Categorical Variables ◽  
P Value ◽  
Continuous Variables ◽  
Postoperative Vomiting ◽  
Hospital Data ◽  
Chi Square ◽  
Oral Ketamine ◽  
The Difference

Objectives: To investigate whether the addition of dexamethasone and chloropheniramine to oral ketamine premedication affects the incidence of postoperative vomiting. Study Design: Randomized control trail. Setting: Department of Anesthesia and Intensive Care Nishtar Hospital, Multan. Period: March 2016 to March 2017. Methodology: After obtaining ethical approval ethical and review board of hospital. Data was entered in a computer software SPSS version 23.1 and analyzed for possible variables. Continuous variables were presented as mean and standard deviation like age, weight, sedation time, anesthesia time, admission time and PACU time. Categorical variables were presented as gender, ASA statusand postoperative vomiting. Student test and chi square test was applied to see association of outcome variable. P value of 0.05 was taken as significant. Results: Overall, 100% (n=80) patients were included in this study, both genders. The study group was further divided into twoequal groups, 50% (n=40) in each, i.e. Group K (Ketamine) group and group KD (Ketamine-Dexamethasone). The main outcome variable of this study was postoperative vomiting. In this study, Postoperative vomiting observed in 35% (n=10) and 10% (n=4) patients, for group K and group KD respectively. The difference was statistically significant (p=0.007). Conclusion: Addition of dexamethasone and chloropheniramine with ketamine as premedication reduce the incidence of postoperative vomiting.

scholarly journals Comparison of Exposure in the Kaplan Versus the Kocher Approach in the Treatment of Radial Head Fractures

Hand ◽  
2018 ◽  
Vol 14 (2) ◽  
pp. 253-258 ◽  
Author(s):  
Leslie Fink Barnes ◽  
Joseph Lombardi ◽  
Thomas R. Gardner ◽  
Robert J. Strauch ◽  
Melvin P. Rosenwasser
Keyword(s):  
Surface Area ◽  
Radial Head ◽  
Lateral Collateral Ligament ◽  
Radial Head Fractures ◽  
3 Dimensional ◽  
Average Surface Area ◽  
The Mean ◽  
The Difference ◽  
Head Neck

Background: The aim of this study was to compare the complete visible surface area of the radial head, neck, and coronoid in the Kaplan and Kocher approaches to the lateral elbow. The hypothesis was that the Kaplan approach would afford greater visibility due to the differential anatomy of the intermuscular planes. Methods: Ten cadavers were dissected with the Kaplan and Kocher approaches, and the visible surface area was measured in situ using a 3-dimensional digitizer. Six measurements were taken for each approach by 2 surgeons, and the mean of these measurements were analyzed. Results: The mean surface area visible with the lateral collateral ligament (LCL) preserved in the Kaplan approach was 616.6 mm2 in comparison with the surface area of 136.2 mm2 visible in the Kocher approach when the LCL was preserved. Using a 2-way analysis of variance, the difference between these 2 approaches was statistically significant. When the LCL complex was incised in the Kocher approach, the average visible surface area of the Kocher approach was 456.1 mm2 and was statistically less than the Kaplan approach. The average surface area of the coronoid visible using a proximally extended Kaplan approach was 197.8 mm2. Conclusions: The Kaplan approach affords significantly greater visible surface area of the proximal radius than the Kocher approach.

A SEVERITY SCORING SYSTEM FOR OUTCOME PREDICTION IN CATS WITH PANCREATITIS

2017 ◽  
Vol 43 (04) ◽  
pp. 269-275
Author(s):  
Bi-Ling Su ◽  
Shu-Yu Wang ◽  
Pin-Chen Liu
Keyword(s):  
Disease Severity ◽  
Scoring System ◽  
Outcome Prediction ◽  
Clinical Signs ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Laboratory Findings ◽  
Severity Scoring ◽  
Imaging Results ◽  
The Mean

In order to develop a clinically applicable severity scoring system in cats with pancreatitis, 41 cats diagnosed with pancreatitis and hospitalized between 2011 and 2013 with their complete medical history were selected for analysis. Clinical signs, physical examination findings, laboratory findings, diagnostic imaging results, complications and concurrent diseases were analyzed to evaluate potential prognostic factors and further establish the severity scoring system. The mortality of cats selected in this study due to pancreatitis was 48.8%. Abnormalities in hemoglobin, albumin, blood urea nitrogen, total bilirubin, phosphorous and blood pressure were significantly associated with disease severity and prognosis and were selected for constructing the system. The abnormal range for each variable was further partitioned into quartiles, which were recorded into categorical variables. The weighting factors were calculated from the odds ratios (OR) between each of the quartiles and the normal range category. The area under curve (AUC) of the six continuous variables system at presentation and after rehydration of the cats was 0.873 and 0.976, respectively. The scores of 41 cats after rehydration ranged from 7 to 36 points. The mean score was [Formula: see text], the median 17 points and the mode 32 points. The optimal cut-off point for outcome prediction was 17.5 with a sensitivity of 95.2% and specificity of 95.5%. The mortality was 95% with a [Formula: see text], whereas 4.8 % had a [Formula: see text]. The severity scoring system provides a reliable and clinically applicable method to predict disease severity in cats with pancreatitis.

Anticoagulation in cancer patients in hospice

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e20509-e20509
Author(s):  
H. M. Holmes ◽  
K. T. Bain ◽  
R. Luo ◽  
A. Zalpour ◽  
E. Bruera ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Patient Characteristics ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Length Of Service ◽  
Chi Square ◽  
Patients With Cancer ◽  
Hospice Patients ◽  
The Mean ◽  
The Impact

e20509 Background: Low-molecular weight heparin (LMWH) is preferred over warfarin in patients with thromboembolic disease and active cancer, but no guidelines exist in hospice. Although warfarin may be less safe in hospice patients, hospices may prefer to provide warfarin due to lower cost and less invasiveness compared to LMWHs. We sought to identify disparities in the use of warfarin vs. LMWHs in cancer patients enrolled in hospice. Methods: We analyzed a dataset from a national pharmacy provider for more than 800 hospices. We identified patients with a terminal diagnosis of cancer who were enrolled and died in hospice in 2006 and who were prescribed warfarin or LMWH. Patient characteristics included age, gender, race, cancer diagnosis, length of hospice service, and number of comorbidities. For descriptive comparisons, the Kruskal-Wallis test was used for continuous variables, and the Chi-square test was used for categorical variables. Results: Of 54,764 patients with cancer admitted and deceased in 2006, 3874 (7.1%) were prescribed warfarin, and 1137 (2.1%) were prescribed LMWH. Patients prescribed warfarin (n=576) or enoxaparin (n=5) for treatment of atrial arrhythmias were excluded. The mean age was 70.6 years for warfarin and 64.8 years for LMWH (p<0.0001). The mean and median lengths of service, respectively, were 43.6 days and 23.0 days for warfarin and 35.0 and 18.0 days for LMWH, (p<0.0001). There were no differences for gender, and a higher proportion of white patients were prescribed warfarin. Patients prescribed warfarin had an average of 2.1 comorbid conditions, versus 1.6 conditions for LMWH (p<0.0001). Cancer diagnoses were significantly different between the two groups, with a higher proportion of patients with lung and prostate cancer taking warfarin. Conclusions: Patients prescribed warfarin were older, had more comorbidities, and a longer length of service than patients prescribed LMWHs. Further research is needed to determine the impact of anticoagulation on outcomes, especially cost and quality of life, for cancer patients in hospice. This study raises the need to establish guidelines for the appropriateness of anticoagulation in hospice patients with cancer. No significant financial relationships to disclose.

Interspecific differences in the burrow morphology between the sympatric mud shrimps, Austinogebia narutensis and Upogebia issaeffi (Crustacea: Thalassinidea: Upogebiidae)

2005 ◽  
Vol 85 (4) ◽  
pp. 943-947 ◽  
Author(s):  
Kyoko Kinoshita ◽  
Gyo Itani
Keyword(s):  
Size Effects ◽  
Interspecific Differences ◽  
The Family ◽  
The Mean ◽  
The Difference ◽  
Burrow Structure ◽  
Shaped Pattern ◽  
Burrow Morphology ◽  
Shaped Section

The morphology of burrows constructed by the upogebiid mud shrimps Austinogebia narutensis and Upogebia issaeffi was studied using resin castings of burrows in situ on Mukaishima Island, Seto Inland Sea, Japan, where the two species occurred sympatrically. The burrow structure of both shrimps is a relatively simple Y-shaped pattern, which is typical of the family Upogebiidae. Total burrow length, and length and overall width of the U-shaped section of A. narutensis were greater than those of U. issaeffi, possibly because A. narutensis is the larger species. When the ratios of the burrow measurements to the mean burrow diameter were compared to exclude possible size effects, the burrows of A. narutensis had a wider and shallower U-shaped section than those of U. issaeffi. Because the casts were made where the two species occurred sympatrically, the differences in the burrow morphology were not due to the differences in environmental factors but to the difference in the shrimp species, whether they are adaptive or not.

scholarly journals Salbutamol nebulization for management of transient tachypnea of newborn (TTN).

2021 ◽  
Vol 28 (01) ◽  
pp. 52-59
Author(s):  
Fatima Maroof ◽  
Tehmina Maqbool ◽  
Hafiz Muhammad Irfan ◽  
Beenish Bashir Mughal ◽  
Ayesha ◽  
...  
Keyword(s):  
Placebo Group ◽  
Respiratory Rate ◽  
Test Results ◽  
Demographic Information ◽  
Significant Difference ◽  
Nebulized Salbutamol ◽  
The Mean ◽  
Randomized Control ◽  
The Difference ◽  
Trial Setting

Objective: To compare the mean change in respiratory rate with salbutamol nebulization versus placebo for treatment of transient tacyopnea of newborn. Study Design: Randomized Control Trial. Setting: Department of Neonatology, Federal Government Polyclinic (PGMI), Islamabad. Period: 8th August 2017 to 7th February 2018. Material & Methods: 100 neonates fulfilling selection criteria were enrolled in the study. Informed consent was obtained from parents. Demographic information was also noted. All baseline respiratory rate were noted. Neonates were divided into two groups by lottery method. Neonates in Treatment group were nebulized with Salbutamol. Placebo group was nebulized with Normal Saline. Then neonates were followed-up in N.I.C.U after 4 hours of second nebulization. After 4 hours, respiratory rates were assessed and change in respiratory rate was noted. Both groups were compared for mean reduction in respiratory rate by using independent sample t-test. Results: In nebulized salbutamol, group, mean respiratory rate was changed from 79.62±8.18bpm to 52.06±4.96bpm. This was a significant decrease (p<0.05). In placebo group, mean respiratory rate was changed from 81.88±8.86bpm to 62.50±6.75bpm. This was significant decrease (p<0.05). The difference between both groups at baseline was insignificant while after 4 hours was significant. The mean changed in respiratory rate with nebulized salbutamol was 27.56±6.83bpm while with placebo was 19.35±9.83bpm. There was significant difference in mean reduction in respiratory rate (p<0.05). Conclusion: It has been proved that nebulized salbutamol can be helpful in reducing respiratory rate significantly in neonates with TTN as compared to placebo.

scholarly journals Clear cell sarcoma of the nuchal region with metastasis in stomach

2011 ◽  
Vol 19 (3-4) ◽  
pp. 76-78
Author(s):  
Dragana Tegeltija ◽  
Aleksandra Lovrenski ◽  
Milana Panjkovic ◽  
Slavica Knezevic-Usaj ◽  
Zivka Eri ◽  
...  
Keyword(s):  
Malignant Melanoma ◽  
Soft Tissues ◽  
Clear Cell ◽  
Neck Region ◽  
Surgical Excision ◽  
Clear Cell Sarcoma ◽  
Lower Limbs ◽  
Medical Attention ◽  
Cell Sarcoma ◽  
Complete Surgical Excision

Clear cell sarcoma/malignant melanoma of soft parts is a rare malignant tumor that originates from the neural crest. It is most common in young men in the lower limbs, grows slowly in the form of deep localized nodes around the tendons, fascia, and aponeurosis. Prognosis is poor, local recurrences and metastases are common. We present a case of a 53-year-old patient who sought medical attention due to the presence of a tumefaction in the nuchal neck region, followed by pain, heightened sensitivity, and numbness in his right hand. After excision, histological examination, and application of immunohistochemical and histochemical methods, malignant melanoma of soft tissues was diagnosed. Fourteen months after the excision of the neck tumor, a metastatic stomach disease was diagnosed. Larger tumors with necrosis, expressed pleomorphisam, and increased mitotic activity give metastases before local recurrence. Diagnosis is set using immunohistochemical methods after surgical excision of the tumor and the prognosis of the disease depends on the size of tumor and complete surgical excision.

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