scholarly journals Method of determining the degree of radicalism removal of pigment skin nevuses in children

2020 ◽  
pp. 57-62
Author(s):  
V.S. Konoplitskiy ◽  
◽  
O.V. Pasechnyk ◽  
V.V. Motygin ◽  
Y.Ye. Korobko ◽  
...  

Nevi are benign melanocytic tumors. Congenital melanocytic nevus is detected at birth or shortly after birth in 1% of infants. The nevus cells of simple nevican spread into the deep layers of the dermis. So incompletely excised nevus cells may at times continue to grow when the conventional excising technique is applied. A small pigment focus may therewith be detectable in the presence of a scar. These foci usually repeat the histological pattern of the primary nevus without any signs of malignization. The article presents an analysis of the data surgical approaches in the treatment nevus of the dermis. There are ways of improving surgical method of treatment of primary tumor based on research in the field of microarchitectonics of the skin. The aim: to increase the effectiveness of determining the degree of radicalism of removal of pigmental nevi in children, taking into account the thickness of the hypoderma in different anatomical areas of the body. Materials and methods of research. The work was carried out on the basis of the department of oncohematology of Vinnytsia Regional Children’s Clinical Hospital in the period from 2018 to 2020. Clinical distribution of features of surgical interventions in pigmented skin nevi involved analysis of data of medi cal cards of patients (120 documents). The age of patients of both sexes was between 3 and 16 years old. Patients with localization of pigmented neoplasms in different areas of the extremities (68 observations) and the trunk (52 children) were subject to analysis. Conclusions. The proposed methodology for determining the radicalism of removing pigmented skin nevi by mathematically calculating the ratios of the areas of the removed tissues at the skin level and at the level of aponeurosis, taking into account the thickness of the hypoderma in different parts of the body, allow you to clearly calculate the individual parameters of the operating wound. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies. Key words: children, surgical treatment, nevus, skin, primary tumor.

2021 ◽  
pp. 2021028
Author(s):  
Maristela Andrade ◽  
Giuseppe Argenziano ◽  
Vincenzo Piccolo ◽  
Eugenia Veronica Di Brizzi ◽  
Elvira Moscarella

2021 ◽  
pp. 002436392198947
Author(s):  
Monique Robles

Since the establishment of the first transgender clinic in the United States in 2007, over sixty clinics associated with children’s hospitals have opened across the nation and are seeing very young children and adolescents with a diagnosis of gender dysphoria (GD). Once known as gender identity disorder, GD has been redefined by the latest version of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition ( DSM-5) not as a mental illness but as the distress experienced by individuals related to their biological sex. The widely accepted practice of gender-affirming therapy (GAT) to treat a vulnerable population despite the associated health risks, the lack of supportive scientific evidence for the pharmacological and surgical interventions, along with the unqualified claim that these interventions will decrease the rate of suicide in these individuals presents a significant bioethical dilemma. The growing trend of GD not only impacts the individuals diagnosed but also society, culture, and the integrity of the profession of medicine. This article utilizes the five-box method, an ethical decision-making framework, to address the implications of the proposed treatment. Once applied, it becomes clear that the hormonal and surgical approaches used are not scientifically or ethically justified. The patient’s autonomy and preferences should be respected, yet constrained, if there exists a considerable risk to the well-being of the individual without proven benefits. The quality of life of those receiving this treatment has not been shown to be significantly improved long term, and the mental, physical, and spiritual health of individuals with GD is not thoroughly addressed in these clinics. The important social and contextual factors, on both microcosmic and macrocosmic scales, are minimized in favor of promoting an ideology. Ultimately, Catholic moral teaching reveals that this widely recommended treatment violates the body–soul union, disregards the principle of totality and integrity, and debases the dignity of humanity. Summary: This article examines GAT, the paradigm used in treating individuals identifying as transgender, through the lens of an EDMF. Each stage of this widely proposed treatment - social affirmation, pubertal blockade, administration of cross-sex hormones, and sex reassignment surgery - poses harms and risks that are not fully disclosed to minors and families, creating a bioethical dilemma. Dialogue utilizing science and reasoning must be encouraged to assist individuals who experience a gender identity that rejects their biological sex. This approach would also contribute to the well-being of society.


2013 ◽  
Vol 88 (6) ◽  
pp. 863-878 ◽  
Author(s):  
Ana Carolina Leite Viana ◽  
Bernardo Gontijo ◽  
Flávia Vasques Bittencourt

Giant congenital melanocytic nevus is usually defined as a melanocytic lesion present at birth that will reach a diameter ≥ 20 cm in adulthood. Its incidence is estimated in <1:20,000 newborns. Despite its rarity, this lesion is important because it may associate with severe complications such as malignant melanoma, affect the central nervous system (neurocutaneous melanosis), and have major psychosocial impact on the patient and his family due to its unsightly appearance. Giant congenital melanocytic nevus generally presents as a brown lesion, with flat or mammilated surface, well-demarcated borders and hypertrichosis. Congenital melanocytic nevus is primarily a clinical diagnosis. However, congenital nevi are histologically distinguished from acquired nevi mainly by their larger size, the spread of the nevus cells to the deep layers of the skin and by their more varied architecture and morphology. Although giant congenital melanocytic nevus is recognized as a risk factor for the development of melanoma, the precise magnitude of this risk is still controversial. The estimated lifetime risk of developing melanoma varies from 5 to 10%. On account of these uncertainties and the size of the lesions, the management of giant congenital melanocytic nevus needs individualization. Treatment may include surgical and non-surgical procedures, psychological intervention and/or clinical follow-up, with special attention to changes in color, texture or on the surface of the lesion. The only absolute indication for surgery in giant congenital melanocytic nevus is the development of a malignant neoplasm on the lesion.


2015 ◽  
Vol 3 (4) ◽  
pp. 22-28
Author(s):  
Anna Sergeevna Usoltseva ◽  
Yulia Vladimirovna Stepanova ◽  
Ivan Nikolaevich Krasnogorskiy ◽  
Margarita Sergeevna Tsyplakova

Background. Congenital melanocytic nevus is a benign pigmented neoplasm composed of nevus cells that clinically manifest at birth. When choosing a treatment for nevi, the possibility of recurrence as well as the threat of tumor malignancy should be considered. The aim of this work is to justify the surgical removal of a large and giant nevi of the face as a method of treatment justified by the pathomorphological structure. Materials and Methods. In 40 children of different ages born with large and giant nevi of the face, we used various types of plastic surgery to eliminate any defects formed after the excised nevi. We accounted for the features of the maxillofacial area: local plasty, expander dermotension, and transplantation of free skin grafts. We performed a total of 68 surgical interventions. Sixteen patients underwent the surgery once and 24 patients underwent secondary surgery (from 2 to 4). We also developed a scheme of the staged surgical treatments and conservative methods. Results. All patients had stable positive results that were studied by comparing the outcomes of different surgical treatment options and accounting for various morphological characteristics of the removed nevi.


2001 ◽  
Vol 40 (01) ◽  
pp. 31-37 ◽  
Author(s):  
U. Wellner ◽  
E. Voth ◽  
H. Schicha ◽  
K. Weber

Summary Aim: The influence of physiological and pharmacological amounts of iodine on the uptake of radioiodine in the thyroid was examined in a 4-compartment model. This model allows equations to be derived describing the distribution of tracer iodine as a function of time. The aim of the study was to compare the predictions of the model with experimental data. Methods: Five euthyroid persons received stable iodine (200 μg, 10 mg). 1-123-uptake into the thyroid was measured with the Nal (Tl)-detector of a body counter under physiological conditions and after application of each dose of additional iodine. Actual measurements and predicted values were compared, taking into account the individual iodine supply as estimated from the thyroid uptake under physiological conditions and data from the literature. Results: Thyroid iodine uptake decreased from 80% under physiological conditions to 50% in individuals with very low iodine supply (15 μg/d) (n = 2). The uptake calculated from the model was 36%. Iodine uptake into the thyroid did not decrease in individuals with typical iodine supply, i.e. for Cologne 65-85 μg/d (n = 3). After application of 10 mg of stable iodine, uptake into the thyroid decreased in all individuals to about 5%, in accordance with the model calculations. Conclusion: Comparison of theoretical predictions with the measured values demonstrated that the model tested is well suited for describing the time course of iodine distribution and uptake within the body. It can now be used to study aspects of iodine metabolism relevant to the pharmacological administration of iodine which cannot be investigated experimentally in humans for ethical and technical reasons.


2020 ◽  
Vol 11 (SPL1) ◽  
pp. 1477-1481
Author(s):  
Ishwari Gaikwad ◽  
Priyanka Shelotkar

The current world situation is both frightening and alarming due to the massive disruption caused by the Covid-19 pandemic. The next few days are censorious as we need to be very precautious in our daily regimen as well as dietary habits. Ayurveda offers knowledge about food based on certain reasoning. Indecent food custom is the chief cause for the rising development of health disorders in the current era. In classical texts of Ayurveda, the concept of diet explained well, ranging from their natural sources, properties and specific utility in pathological as well as physiological manner. In this work, the review of the relevant literature of Ahara (Diet) was carried out from Charak Samhita and other texts, newspapers, articles, web page related to the same.  Every human being is unique with respect to his Prakriti (Physical and mental temperament), Agni (Digestive capacity), Koshtha  (Nature of bowel) etc. For that reason, the specificity of the individual should be kept in mind. Ahara, when consumed in the appropriate amount at the right moment following all Niyamas (Guidelines) given in Ayurveda texts, gives immunity and keeps the body in a healthy state during pandemics such as Covid-19. Ultimately, this will help the human body to maintain its strength for life. This article reviews the concept of diet viz. combination of foods, their quantity and quality, methods of preparation and processing, which are to be followed during pandemics and are essential in maintenance and endorsement of health and preclusion of diseases.


2020 ◽  
Vol 5 (5) ◽  
pp. 386-393
Author(s):  
L. M. Gunina ◽  
◽  
Kazys Mylashyus ◽  
Voitenko V. L. ◽  
◽  
...  

Under high-intensity loads, the athlete's bodies take place a number of biochemical reactions and physiological processes that can lead to hyperbilirubinemia. The factors that can initiate the onset of this phenomenon include the syndrome of micro-damage muscle, violation of the integrity of erythrocyte membranes, decreased blood pH, malnutrition and increase oxygen demand of the body. Degree of expression of manifestations of physiological bilirubinemia depends on the level of adaptation of the athlete to the physical activities offered. Hyperbilirubinemia in athletes can be one of the components of the deterioration of the functional state, forming the symptoms of endogenous intoxication. The relevance of this problem in sport lies in the relatively low detection rate of hyperbilirubinemia due to the lack of regular screening studies. However, in drawing up a plan of nutritional- metabolic support for training and competitive activity and recovery measures, must not only the individual reaction of the athlete body to physical activity, but also the severity of shifts in the indicators of bilirubin metabolism and their ratio. The article describes the reasons for the increase in bilirubin levels, which can be caused by both the effect of physical activity and by the presence of pathological processes in athletes. The factors influencing the blood serum’s bilirubin content are also highlighted, which include the state of erythrocyte cell membranes and the rate of hemoglobin destruction, the functional state of the liver, the specifics of physical loads and the use of ergogenic pharmacological agents by athletes. Particular accent has been placed on the illumination of hereditary hyperbilirubinemias, which may have been detected at the stage of selection of athletes. The most common phenomenon is Gilbert's syndrome, which occurs in 2-5% of cases in the general population, is characterized in the clinic by a benign flow and is manifested by episodes of jaundice and an increase in total bilirubin content to moderate values due to indirect. The frequency of detection of hyperbilirubinemias in the population of athletes is 4.68%, among which Gilbert's disease accounts for almost half (48.7%). Conclusion. The work highlighted the pathogenesis and diagnostic algorithm of Gilbert's disease, and also emphasized that its drug prevention and correction in athletes to maintain functional and physical fitness should be carried out taking into account anti-doping rules, which requires upon diagnosis timely receipt of a therapeutic exclusion


Author(s):  
Rajendra Pai N. ◽  
U. Govindaraju

Ayurveda in its principle has given importance to individualistic approach rather than generalize. Application of this examination can be clearly seem like even though two patients suffering from same disease, the treatment modality may change depending upon the results of Dashvidha Pariksha. Prakruti and Pramana both used in Dashvidha Pariksha. Both determine the health of the individual and Bala (strength) of Rogi (Patient). Ayurveda followed Swa-angula Pramana as the unit of measurement for measuring the different parts of the body which is prime step assessing patient before treatment. Sushruta and Charaka had stated different Angula Pramana of each Pratyanga (body parts). Specificity is the characteristic property of Swa-angula Pramana. This can be applicable in present era for example artificial limbs. A scientific research includes collection, compilation, analysis and lastly scrutiny of entire findings to arrive at a conclusion. Study of Pramana and its relation with Prakruti was conducted in 1000 volunteers using Prakruti Parkishan proforma with an objective of evaluation of Anguli Pramana in various Prakriti. It was observed co-relating Pramana in each Prakruti and Granthokta Pramana that there is no vast difference in measurement of head, upper limb and lower limb. The observational study shows closer relation of features with classical texts.


Author(s):  
Joshua S. Walden

The book’s epilogue explores the place of musical portraiture in the context of posthumous depictions of the deceased, and in relation to the so-called posthuman condition, which describes contemporary changes in the relationship of the individual with such aspects of life as technology and the body. It first examines Alfred Hitchcock’s Vertigo to view how Bernard Herrmann’s score relates to issues of portraiture and the depiction of the identity of the deceased. It then considers the work of cyborg composer-artist Neil Harbisson, who has aimed, through the use of new capabilities of hybridity between the body and technology, to convey something akin to visual likeness in his series of Sound Portraits. The epilogue shows how an examination of contemporary views of posthumous and posthuman identities helps to illuminate the ways music represents the self throughout the genre of musical portraiture.


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