Nonvisualized sentinel node on preoperative lymphoscintigraphy in primary cutaneous melanoma: an 11-year retrospective survey.

BACKGROUND: Sentinel lymph node (SLN) biopsy in cutaneous melanoma patients evaluates the regional draining basin for occult micrometastatic disease. Occasionally, nonidentification of SLN impairs the acquisition of this important prognostic factor. OBJECTIVES: To investigate the outcomes of melanoma patients with negative lymphoscintigraphic findings and patients who underwent SLN biopsy from 2004 to 2015 ( n = 1200) were retrospectively reviewed for tumor characteristics and clinical outcomes. METHODS: Patients with nonvisualized lymph nodes (NV group) who underwent only preoperative lymphoscintigraphy were separated and compared with a cohort drawn from all melanoma patients who completed the surgical procedure within the same period (V group). RESULTS: A negative lymphoscintigraphic scan was observed in 38 cases (3.2% of all patients). The NV group showed a significantly older age (median 66.0 vs. 48.3 years; P < 0.0001). Head and neck melanomas were more frequent in the NV group compared to the control group (25.1 vs. 7.8%; P = 0.009). Tumor characteristics such as ulceration and Breslow thickness do not influence the lymphoscintigraphy result. No differences were found in overall survival (OS) and disease-free survival (DFS) between the groups. CONCLUSIONS: The nonvisualization of regional lymph nodes by lymphoscintigraphy is more frequent in older patients with head and neck melanomas. From the clinical point of view, no specific recommendation emerged for patients' management because the nonvisualization of the SLN did not show a significant influence on DFS and OS rates. However, lack of knowledge of lymph node status suggests performing a tighter follow-up eventually by ultrasound evaluation of all potential lymph node drainage basins.

Adipose tissue stromal vascular fraction and adipose tissue stromal vascular fraction plus platelet-rich plasma grafting: New regenerative perspectives in genital lichen sclerosus.

Lichen sclerosus (LS) is a chronic relapsing, inflammatory skin disorder usually involving the anogenital region of both sexes lacking a resolutive therapy. This study compared adipose tissue derived-stromal vascular fraction (AD-SVF) and AD-SVF-enriched platelet-rich plasma (PRP) therapy in the management of genital LS patients. Additionally, in vitro evaluation of cells and growth factors contained in the injected SVF has been evaluated as possible predictive factors for treatment outcome. The study population was 40 patients diagnosed with LS who were symptomatic despite medical treatment. Patients (age 43-78 years) randomized into two groups using a 1:1 allocation ratio, were evaluated clinically and assessing dermatology life quality index (DLQI) before and 6 months after treatment. Both procedures demonstrated a strong safety profile with no complications linked to the therapy. After 6 months, both treatments allowed for a significant improvement respect to baseline. Combinatory therapy demonstrated decreased efficacy in late stage patients. No correlations have been found between clinical and biological findings. AD-SVF and AD-SVF plus PRP are safe and effective regenerative approaches for genital LS patients. Clinical results support the preferential use of combinatory therapy for early stage patients confirming a synergic effect of AD-SVF and PRP. In contrast, AD-SVF plus PRP is discouraged for late stage patients.

Locus DFNB4 -acueducto vestibular dilatado- comportamiento audio-vestibular / Locus DFNB4 -enlarged vestibular aqueduct- behavior audio vestibular / Locus DFNB4 - aqueduto vestibular dilatada - comportamentoaudio-vestibular

Introducción: el acueducto vestibular dilatado, denominado en la literatura internacional EVA, porEnlarged Vestibular Aqueduct, ha sido reportadopor afectar hasta el 15% de la población pediátrica con hipoacusia neurosensorial. En su génesis compartecon Pendred en el Locus DFNB4, el Gen SLC26A4en el cromosma 7q22-31.1. No se conoce bienel comportamiento y la evolución de esta entidad,debido a la gran variabilidad genotípica y fenotípicaque presenta...

Introduction: Dilated Vestibular Aqueduct, known in the international literature Enlarged Vestibular Aqueduct (EVA) has been reported to affect up to 15% of the pediatric population with hearing loss Sensory Neuro. In its genesis shares with pendred in the locus DFNB4 the SLC26A4 gene in the cromosma 7q22-31.1. It is not well understood and evolution behavior of this entity, due to the great variability genotypic and phenotypic presented...

Introdução: Aqueduto vestibular dilatada conhecido na literatura internacional Enlarged Vestibular Aqueduct (EVA) tem sido relatada a afetar até 15% da população pediátrica com perda auditiva sensorial neuro. Em suas ações genesis com Pendred no Locus DFNB4 o gene SLC26A4 na 7q22-31.1 cromosma. Elenão é bem compreendida e o comportamento de evolução dessa entidade, devido à grande variabilidade genotípica e fenotípica apresentada...

Anatomía aplicada a fracturas de temporal: análisis de 10 casos / Applied anatomy of a temporary fracture: analysis of 10 cases / Anatomia aplicada a fraturas de temporal: análise de dez caso

Antecedentes: las lesiones en el hueso temporal ocurren en el 30 a 70% de los casos de traumatismo de cráneo cerrado, siendo los accidentes automovilísticos causa del 31%. En general, las líneas de fractura corren paralelas a la línea del golpe entregado y se extienden a través de los agujeros de la base del cráneo, puntos débiles del hueso temporal. Estas se denominan como longitudinal o transversal, a pesar de que la mayoría son en realidad mixtas. Las fracturas bilaterales tienen una incidencia menor de 8-29%. Objetivo: Analizar los tipos de fracturas temporales más frecuentes y las modificaciones de éstas sobre su anatomía en correlación con la clínica del paciente y los exámenes de TAC. Diseño: Retrospectivo de corte transversal. Población: Niños y adultos jóvenes de ambos sexos. Método: Es un trabajo retrospectivo transversal con revisión de historias clínicas de niños y adultos jóvenes, más disecciones microanatómicas en cadáveres adultos de ambos sexos, fijados en formol al 10%. Resultados: Se recolectaron 10 pacientes; 8 de sexo masculino y 2 femeninos, del total 2 son niños. Todos con procedencia de Córdoba, consultan por zumbido, hipoacusia y mareo o desequilibrio postraumático. Uno de ellos niño de 13 años con hipoacusia bilateral y supuración de oído. Al grupo se suma una parálisis facial recuperada con tratamiento clínico. Conclusiones: El conocimiento de la anatomía, con el apoyo de la tomografía computada de oído, y los estudios audiológicos son fundamentales para el diagnóstico clínico y topográfico de la lesión.

Background: lesions occur in the temporal bone in the 30 to 70% of cases of closed skull trauma. Being car accidents cause 31%. In general, the fracture lines run parallel to the line of blow delivered and extend through the holes to the skull base, temporal bone weak points. These are denominate as longitudinal or transverseal, though most are actually mixed. The bilateral fractures have a lower incidence of 8-29%. Objetive: analize the types of temporal fractures the most frequent and modifications of these on their anatomy correlated with the patient’s clinical and computed tomography exams. Design: transversal cut retrospective. Population: children and young adults of both sexes. Method: it is a transversal retrospective study with review of clinical records of children and young adults more microanatomic dissections in adult cadavers of both sexes, fixed in 10% formalin. Results: 10 patients were collected; 8 male and 2 female, total 2 are children. All of them are from Córdoba, complaining of tinnitus, hearing loss and dizziness or post traumatic imbalance. The age average is to 22 years old. The 50% is given by automobile accidents, also presented cases of labor accident, drop height and flattening. One of them, a child to 13 years old with bilateral hearing loss and ear drainage. The group adds a facial paralysis recovered with clinical treatment. Conclusions: knowledge of anatomy, with supported by computed tomography ear, and audiological studies are essential for clinical diagnosis and topographic of the lesion.

Antecedentes: as lesões no osso temporal ocorrem em 30% a 70% dos casos de traumatismo de crânio fechado, sendo os acidentes automobilísticos causa de 31%. Em geral, as linhas de fratura correm paralelas à linha do golpe e se estendem através dos orifícios da base do crânio, pontos frágeis do osso temporal. Estas são denominadas como longitudinal ou transversal, a pesar de, na verdade, a maioria ser mista. As fraturas bilaterais tem uma incidência menor de 8-29%. Objetivo: Analisar os tipos de fraturas temporais mais frequentes e as modificações destas sobre a sua anatomia em correlação com a clínica do paciente e os exames de TAC. Desenho: Retrospectivo de corte transversal População: Crianças e jovens adultos em ambos os sexos. Método: É um trabalho retrospectivo transversal com revisão de histórias clínicas de crianças e jovens adultos mais dissecações microanatômicas em cadáveres adultos de ambos os sexos, conservados em formol a 10%. Resultados: Foram coletados 10 pacientes: 8 do sexo masculino e 2 femininos, dos quais 2 são crianças. Todos oriundos de Córdoba, consultam por zumbido, hipoacusia e tontura ou desequilíbrio póstraumático. Um desses pacientes, um adolescente de 13 anos com hipoacusia bilateral e supuração do ouvido. Ao grupo, soma-se uma paralisia facial recuperada com tratamento clínico. Conclusões: O conhecimento da anatomia, com o apoio da tomografia computadorizada de ouvido e os estudos audiológicos, é fundamental para o diagnóstico clínico e topográfico da lesão.