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1.
Acta Derm Venereol ; 102: adv00751, 2022 Jul 26.
Artículo en Inglés | MEDLINE | ID: mdl-35535641

RESUMEN

Electrical impedance spectroscopy has clinical relevance in diagnosing malignancy in melanocytic lesions. Sixty-eight lesions with changes during digital follow-up of patients at very high risk of developing melanoma were prospectively included in this study from February to December 2016. Electrical impedance spectroscopy and reflectance confocal microscopy were performed to evaluate their performance in this subset of difficult lesions. Forty-six lesions were considered suspicious on reflectance confocal microscopy and were excised, of these, 19 were diagnosed as melanoma. Fifteen melanomas were detected by electrical impedance spectroscopy, while 4 received a score lower than 4, which suggested no malignancy. The addition of reflectance confocal microscopy improves accuracy while maintaining the same sensitivity. In the case of electrical impedance spectroscopy scores <4, lesions exhibiting changes in follow-up may need short-term monitoring or excision if dermoscopy shows criteria for melanoma. Results of electrical impedance spectroscopy in this subset of very early lesions should be carefully considered due to the risk of false negatives.


Asunto(s)
Melanoma , Neoplasias Cutáneas , Dermoscopía/métodos , Espectroscopía Dieléctrica/métodos , Estudios de Seguimiento , Humanos , Melanoma/patología , Microscopía Confocal/métodos , Neoplasias Cutáneas/patología , Síndrome
2.
J Am Acad Dermatol ; 85(5): 1151-1160, 2021 11.
Artículo en Inglés | MEDLINE | ID: mdl-32147389

RESUMEN

BACKGROUND: Pigmented labial macules (PLMs) are clinical, dermoscopic, and histopathologic challenges. OBJECTIVE: To describe and evaluate the utility of reflectance confocal microscopy (RCM) in PLMs and to establish a correlation between dermoscopy, RCM, histopathology, and immunohistochemistry. METHODS: Prospective study of PLMs from 4 tertiary referral dermatology centers. The study included 51 biopsy specimen-proven PLMs. Dermoscopic, RCM images, and histopathologic preparations were evaluated for malignant criteria. Diagnostic accuracy of RCM for melanoma diagnosis, RCM Lip Score previously reported, and κ values between techniques were calculated. RESULTS: Included were 5 melanomas and 46 benign PLMs. Dermoscopically, melanomas exhibited more frequently ≥3 colors and ≥3 structures. With RCM, pagetoid spreading, epithelial disarray, continuous proliferation of atypical cells around papillae, nonhomogeneously distributed papillae, marked cellular atypia, and a higher number of dendritic cells per papillae were more frequent in melanomas. The RCM Lip Score was significantly higher in malignant lesions. Good κ values were observed in most of the evaluated features. A perfect sensitivity and specificity was obtained combining dermoscopy and RCM. LIMITATIONS: A low number of melanomas were obtained. CONCLUSIONS: RCM improves lip melanoma diagnosis, and the RCM Lip Score represents a useful tool for the evaluation of a PLM.


Asunto(s)
Melanoma , Neoplasias Cutáneas , Dermoscopía , Diagnóstico Diferencial , Humanos , Melanoma/diagnóstico por imagen , Microscopía Confocal , Estudios Prospectivos
3.
J Am Acad Dermatol ; 83(4): 1057-1063, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31202873

RESUMEN

BACKGROUND: Reflectance confocal microscopy (RCM) allows accurate, noninvasive, in vivo diagnosis for skin cancer. However, its impact on physicians' diagnostic confidence and management is unknown. OBJECTIVES: We sought to assess the physicians' diagnostic confidence and management before and after RCM of equivocal skin lesions. METHODS: Prospective, 2-center, observational study. During clinical practice, 7 dermatologists recorded their diagnostic confidence level (measured in a scale from 0 to 10), diagnosis, and management before and after RCM of clinically/dermoscopically equivocal lesions that raised concern for skin cancer. We also evaluated the diagnostic accuracy before and after RCM. RESULTS: We included 272 consecutive lesions from 226 individuals (mean age, 53.5 years). Diagnostic confidence increased from 6.2 to 8.1 after RCM (P < .001) when RCM confirmed or changed the diagnosis. Lesion management changed in 33.5% cases after RCM (to observation in 51 cases and to biopsy/excision in 31 cases). After RCM, the number needed to excise was 1.2. Sensitivity for malignancy before and after RCM was 78.2% and 85.1%, respectively. Specificity before and after RCM was 78.8% and 80%, respectively. LIMITATIONS: Small sample size, real-life environment, and different levels of expertise among RCM users. CONCLUSION: Physicians' diagnostic confidence and accuracy increased after RCM when evaluating equivocal tumors, frequently resulting in management changes while maintaining high diagnostic accuracy.


Asunto(s)
Carcinoma Basocelular/diagnóstico por imagen , Carcinoma de Células Escamosas/diagnóstico por imagen , Toma de Decisiones Clínicas , Síndrome del Nevo Displásico/diagnóstico por imagen , Melanoma/diagnóstico por imagen , Neoplasias Cutáneas/diagnóstico por imagen , Biopsia , Carcinoma Basocelular/patología , Carcinoma Basocelular/terapia , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/terapia , Dermoscopía , Síndrome del Nevo Displásico/patología , Síndrome del Nevo Displásico/terapia , Femenino , Humanos , Masculino , Melanoma/patología , Melanoma/terapia , Microscopía Confocal/métodos , Persona de Mediana Edad , Nevo Pigmentado/diagnóstico por imagen , Nevo Pigmentado/patología , Nevo Pigmentado/terapia , Estudios Prospectivos , Sensibilidad y Especificidad , Piel/patología , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/terapia , Espera Vigilante
4.
Acta Derm Venereol ; 100(8): adv00106, 2020 Apr 06.
Artículo en Inglés | MEDLINE | ID: mdl-32110813

RESUMEN

Numerous dermoscopic structures for the early detection of melanoma have been described. The aim of this study was to illustrate the characteristics of dermoscopic structures that are similar to blotches, but smaller (termed microblotches), and to evaluate their association with other well-known dermoscopic structures. A cross-sectional study design, including 165 dermoscopic images of melanoma was used to define microblotches, and 241 consecutive images of naevi from the HAM10000 database, were studied to evaluate the prevalence of this criterion in both groups. Microblotches were defined as sharply demarcated structures ≤1 mm, with geographical borders visible only with dermoscopy. Microblotches were present in 38.7% of the melanomas and 6.7% of the naevi. Moreover, microblotches were associated with an odds ratio (OR) of malignancy of 5.79, and were more frequent in invasive melanoma than in the in-situ subtype (OR 2.92). Histologically, they correspond to hyperpigmented parakeratosis or epidermal consumption. In conclusion, microblotches are related to melanomas. This finding could help dermatologists to differentiate between naevi and melanomas.


Asunto(s)
Melanoma/diagnóstico por imagen , Nevo/diagnóstico por imagen , Neoplasias Cutáneas/diagnóstico por imagen , Anciano , Anciano de 80 o más Años , Estudios Transversales , Dermoscopía , Femenino , Humanos , Masculino , Melanoma/patología , Persona de Mediana Edad , Nevo/patología , Neoplasias Cutáneas/patología
5.
J Am Acad Dermatol ; 81(6): 1330-1338, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31163236

RESUMEN

BACKGROUND: There is no consensus on the imaging tests that should be performed at the initial staging of melanoma patients. OBJECTIVE: To evaluate the diagnostic accuracy of 4 imaging studies for the initial staging of melanoma patients. METHODS: Cross-sectional study with prospectively collected data, from January 2011 to April 2017, including patients with clinical stage T2b to T4b according to 2009 American Joint Committee on Cancer, without evidence of metastasis. RESULTS: Initial staging of 308 patients detected 16.6% of metastases and 5.8% false-positive results, overall. Regional lymph node ultrasonography showed a metastasis detection rate (MDR) of 12.8%, false-positive rate of 0.8%, and accuracy of 96.0%. Computed tomography (CT) and positron emission tomography-CT had the highest detection rates at stage T4b: MDR, 13.3%; false-positive rate, 8.9%; accuracy, 91.1%; and MDR, 6.9%; false-positive rate, 0%; and accuracy, 93.1%, respectively. Brain magnetic resonance imaging showed a MDR of 2.0% in T4b. LIMITATIONS: Single-center study. CONCLUSION: Performing ultrasound scans for assessing lymph node metastasis in patients with American Joint Committee on Cancer T2b stage and above is advisable. In patients with stage T4b, CT or positron emission tomography-CT are suitable for the detection of metastasis. Brain magnetic resonance imaging at T4b deserves further discussion, considering the ultimate clinical benefit in management and therapeutic options for asymptomatic patients.


Asunto(s)
Biomarcadores de Tumor/sangre , Ganglios Linfáticos/patología , Melanoma/diagnóstico por imagen , Melanoma/patología , Neoplasias Cutáneas/diagnóstico por imagen , Neoplasias Cutáneas/patología , Centros Médicos Académicos , Adulto , Anciano , Estudios Transversales , Reacciones Falso Positivas , Femenino , Humanos , Ganglios Linfáticos/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos , Masculino , Persona de Mediana Edad , Invasividad Neoplásica/patología , Metástasis de la Neoplasia/diagnóstico por imagen , Metástasis de la Neoplasia/patología , Estadificación de Neoplasias , Tomografía Computarizada por Tomografía de Emisión de Positrones/métodos , Sensibilidad y Especificidad , España , Tomografía Computarizada por Rayos X/métodos , Ultrasonografía Doppler/métodos
6.
Dermatology ; 233(6): 471-479, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-29502116

RESUMEN

BACKGROUND: Malignant melanomas mimicking seborrheic keratosis (SK-like MMs) carry the risk of delayed diagnosis and inadequate treatment. The value of dermoscopy to improve the correct detection of these mimickers has not been previously studied. OBJECTIVE: To evaluate the diagnostic accuracy of clinically SK-like MMs with and without dermoscopy. METHODS: Clinical and dermoscopic images of histopathologically proven SK-like MMs (n = 134) intermingled with other melanomas and benign tumors were randomly presented to clinicians with different levels of experience, blinded to the diagnosis and goal of the study. Each participant classified each lesion as melanoma or benign tumor. The clinical and clinical-dermoscopic diagnostic accuracies were measured separately. RESULTS: Overall, 54 participants with a mean clinical experience of 15.8 years (SD 11.8) evaluated 231 tumors. Almost 40% of SK-like melanomas were clinically misclassified as benign tumor. Dermoscopy improved diagnostic accuracy for all participants, independently of experience, from 60.9 to 68.1% (p < 0.001), mostly due to a significant increase in the sensitivity (clinical 61.9% vs. dermoscopic 74.5%) (p < 0.001). Dermoscopy did not significantly affect specificity among the experienced participants (≥6 years of experience) compared to clinical examination (61.1 vs. 59.6%, respectively); in contrast, dermoscopy was associated with a decrease in specificity compared to clinical diagnosis among novice participants (< 6 years) (45.6 vs. 61.1%, respectively; p = 0.02). CONCLUSION: Melanomas can be clinically indistinguishable from SKs despite being evaluated by expert dermatologists. Dermoscopy, even in nonexpert hands, significantly improves their recognition.


Asunto(s)
Dermatología/métodos , Dermoscopía , Queratosis Seborreica/diagnóstico por imagen , Melanoma/diagnóstico por imagen , Neoplasias Cutáneas/diagnóstico por imagen , Adulto , Anciano , Anciano de 80 o más Años , Competencia Clínica , Estudios Transversales , Diagnóstico Diferencial , Reacciones Falso Negativas , Femenino , Humanos , Masculino , Persona de Mediana Edad , Distribución Aleatoria , Sensibilidad y Especificidad , Adulto Joven
7.
Dermatology ; 228(1): 31-3, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24356536

RESUMEN

The rosette structure is a dermoscopic sign visible under polarized light, characterized by 4 white points arranged as a 4-leaf clover. It has been mainly described in facial sun-damaged skin and actinic keratosis, although it has also been found in squamous and basal cell carcinomas, and in 2 cases of hypomelanotic melanomas. We describe 2 different cases of pigmented incipient melanomas with the presence of multiple rosettes and shiny white structures on dermoscopy. In the reflectance confocal microscope they exhibit a disarranged epidermal architecture with atypical and dendritic cells. Histological examination showed focal hyperkeratosis and a normal corneal layer presented alternatively. To our knowledge this is the first description of rosette structures in pigmented melanomas. Based on a proper dermoscopic- confocal-histopathological correlation, we hypothesize that rosettes could correspond to optic phenomena due to changes in the superficial epidermal reaction and in the acrosyringia.


Asunto(s)
Dermoscopía , Melanoma/patología , Neoplasias Cutáneas/patología , Adulto , Anciano de 80 o más Años , Femenino , Humanos , Microscopía Confocal , Pigmentación
9.
Sci Data ; 11(1): 641, 2024 Jun 17.
Artículo en Inglés | MEDLINE | ID: mdl-38886204

RESUMEN

Advancements in dermatological artificial intelligence research require high-quality and comprehensive datasets that mirror real-world clinical scenarios. We introduce a collection of 18,946 dermoscopic images spanning from 2010 to 2016, collated at the Hospital Clínic in Barcelona, Spain. The BCN20000 dataset aims to address the problem of unconstrained classification of dermoscopic images of skin cancer, including lesions in hard-to-diagnose locations such as those found in nails and mucosa, large lesions which do not fit in the aperture of the dermoscopy device, and hypo-pigmented lesions. Our dataset covers eight key diagnostic categories in dermoscopy, providing a diverse range of lesions for artificial intelligence model training. Furthermore, a ninth out-of-distribution (OOD) class is also present on the test set, comprised of lesions which could not be distinctively classified as any of the others. By providing a comprehensive collection of varied images, BCN20000 helps bridge the gap between the training data for machine learning models and the day-to-day practice of medical practitioners. Additionally, we present a set of baseline classifiers based on state-of-the-art neural networks, which can be extended by other researchers for further experimentation.


Asunto(s)
Dermoscopía , Neoplasias Cutáneas , Humanos , Neoplasias Cutáneas/diagnóstico por imagen , España , Redes Neurales de la Computación , Inteligencia Artificial , Aprendizaje Automático
10.
Front Psychol ; 13: 997423, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36405221

RESUMEN

The aim of the study was to analyze the psychometric properties of the Social Justice Scale, composed by Representation, Recognition, and Redistribution dimensions. Likewise, the contribution of social dominance and the belief in a just world in each dimension were analyzed. A total of 471 young adults residing in Madrid participated in the online preliminary study, with an age range of 18-42 years with different genders (74.1% defined themselves as female). The main results indicated adequate psychometric properties for Social Justice Scale through its three dimensions. In addition, we observed that both social dominance and belief in a just world might be psychosocial variables that modulate the levels of social justice. The main findings of the research and need for replication in future studies are discussed.

11.
Integr Psychol Behav Sci ; 55(1): 18-29, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32207080

RESUMEN

Studies conducted in the last few decades show that young people have a negative evaluation of politics since they relate it to conventional forms of participation. In addition, they engage in unconventional forms of political participation, though they do not think of them as political practices. In this context, a qualitative study was carried out in order to describe the social representations of politics through the narratives provided by adolescents during an interview based on Piaget's clinical method. The results obtained reveal the coexistence of two representations of politics: a conventional and an unconventional one. The representation in which politics is mainly understood as conventional forms of participation appears to be hegemonic, although a polemic unconventional representation was identified. Moreover, in many of the subjects both representations coexist in state of cognitive polyphasia that express a relation of selective prevalence between them, depending on the discursive context they are elicited.


Asunto(s)
Narración , Política , Adolescente , Cognición , Humanos , Investigación Cualitativa , Proyectos de Investigación
12.
Pigment Cell Melanoma Res ; 34(3): 618-628, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33342058

RESUMEN

Nevus count is highly determined by inherited variants and has been associated with the origin of melanoma. De novo melanomas (DNMMs) are more prevalent in patients with a low nevus count and have distinctive dermoscopic features than nevus-associated melanomas. We evaluated the impact of nine single nucleotide polymorphisms (SNPs) of MTAP (rs10811629, rs2218220, rs7023329 and rs751173), PLA2G6 (rs132985 and rs2284063), IRF4 (rs12203592), and PAX3 (rs10180903 and rs7600206) genes associated with nevus count and melanoma susceptibility, and the MC1R variants on dermoscopic features of 371 melanomas from 310 patients. All MTAP variants associated with a low nevus count were associated with regression structures (peppering and mixed regression), blue-whitish veil, shiny white structures, and pigment network. SNPs of PLA2G6 (rs132985), PAX3 (rs7600206), and IRF4 (rs12203592) genes were also associated with either shiny white structures or mixed regression (all corrected p-values ≤ .06). Melanomas from red hair color MC1R variants carriers showed lower total dermoscopy score (p-value = .015) and less blotches than melanomas from non-carriers (p-value = .048). Our results provide evidence that germline variants protective for melanoma risk and/or associated with a low nevus count are associated with certain dermoscopic features, more characteristic of de novo and worse prognosis melanomas.


Asunto(s)
Biomarcadores de Tumor/genética , Dermoscopía/métodos , Color del Cabello , Melanoma/patología , Nevo Pigmentado/patología , Receptor de Melanocortina Tipo 1/genética , Neoplasias Cutáneas/patología , Femenino , Humanos , Masculino , Melanoma/clasificación , Melanoma/genética , Persona de Mediana Edad , Nevo Pigmentado/genética , Polimorfismo de Nucleótido Simple , Neoplasias Cutáneas/genética
13.
Pigment Cell Melanoma Res ; 33(5): 685-694, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32323445

RESUMEN

Congenital melanocytic nevi (CMN) are cutaneous malformations whose prevalence is inversely correlated with projected adult size. CMN are caused by somatic mutations, but epidemiological studies suggest that germline genetic factors may influence CMN development. In CMN patients from the U.K., genetic variants in MC1R, such as p.V92M and loss-of-function variants, have been previously associated with larger CMN. We analyzed the association of MC1R variants with CMN characteristics in two distinct cohorts of medium-to-giant CMN patients from Spain (N = 113) and from France, Norway, Canada, and the United States (N = 53), similar at the clinical and phenotypical level except for the number of nevi per patient. We found that the p.V92M or loss-of-function MC1R variants either alone or in combination did not correlate with CMN size, in contrast to the U.K. CMN patients. An additional case-control analysis with 259 unaffected Spanish individuals showed a higher frequency of MC1R compound heterozygous or homozygous variant genotypes in Spanish CMN patients compared to the control population (15.9% vs. 9.3%; p = .075). Altogether, this study suggests that MC1R variants are not associated with CMN size in these non-UK cohorts. Additional studies are required to define the potential role of MC1R as a risk factor in CMN development.


Asunto(s)
Predisposición Genética a la Enfermedad , Nevo Pigmentado/genética , Receptor de Melanocortina Tipo 1/genética , Neoplasias Cutáneas/genética , Adolescente , Adulto , Estudios de Casos y Controles , Estudios de Cohortes , Femenino , Frecuencia de los Genes/genética , Genotipo , Heterocigoto , Homocigoto , Humanos , Masculino , Nevo Pigmentado/patología , Fenotipo , Neoplasias Cutáneas/patología , España
14.
Dev Psychol ; 55(3): 498-508, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30802102

RESUMEN

This study examined how Argentine adolescents' judgments about the fairness of their society are related to their perceptions of actual and ideal societal wealth distribution, just world beliefs, and trust in political institutions. Six hundred ninety-nine Argentine adolescents from three age groups (12-14 years, 15-16 years, and 17-18 years) in high schools from diverse SES communities were presented with five images depicting more or less egalitarian patterns of national wealth distribution. Participants chose the images that best represented actual and ideal wealth distribution in Argentina, and also rated their level of political trust, general and personal beliefs in a just world (BJW), and views regarding the fairness of Argentine society. Findings revealed that there was a significant gap between adolescents' conception of current wealth distribution and their more egalitarian choices for ideal wealth distribution. In addition, adolescents who judged that the distribution of actual economic resources was more egalitarian had more positive views of the fairness of Argentine society, as well as higher levels of political trust and BJW. Moreover, regression analyses revealed that adolescents' views of the overall fairness of society were independently predicted by both their economic judgments and their noneconomic judgments (political trust and both general and personal BJW), and these effects were not moderated by adolescents' age group or school SES. Notwithstanding the lack of moderated effects (i.e., relations among variables), older adolescents and those from higher SES schools had more negative views of overall fairness of society, the egalitarian nature of existing wealth distribution, political trust, and BJW. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Asunto(s)
Desarrollo del Adolescente , Juicio , Conducta Social , Justicia Social , Percepción Social , Factores Socioeconómicos , Adolescente , Argentina , Niño , Femenino , Humanos , Masculino
15.
Psico USF ; 28(1): 67-77, Jan.-Mar. 2023. tab
Artículo en Inglés | LILACS, INDEXPSI | ID: biblio-1431092

RESUMEN

Different organizations register alarming poverty rates in Argentina. However, there may be differences in who is considered poor according to these measurements and who is considered poor by society, from common sense knowledge. This work analyzes the social representations of people living in poverty in a sample of 605 Argentines, using the free-word association technique. The results suggest that the poor person is first understood as someone who suffers from hunger, a definition that corresponds to indigence according to the official entity that measures poverty and indigence in Argentina. However, while the core of the representation manifests a significant presence of elements of monetary poverty and its effects on nutrition (hunger), the peripheral system shows the deficit in various social rights, such as education, housing, work, and health. Following these results, it is argued that equating poverty with indigence would render the situation of millions of people in Argentina invisible. (AU)


Diferentes organizações registram índices alarmantes de pobreza na Argentina. No entanto, pode haver diferenças entre quem é considerado pobre de acordo com essas medidas e quem é considerado pobre na sociedade, pelo senso comum. Este trabalho analisa as representações sociais de pessoas em situação de pobreza em uma amostra de 605 argentinos/as por meio da técnica de associação de palavras. Os resultados sugerem que a pessoa que vive na pobreza é entendida principalmente como alguém que passa fome, definição que corresponde à indigência segundo o órgão oficial que mede a pobreza e a indigência na Argentina. Não obstante, enquanto no núcleo da representação se identifica a presença de elementos da pobreza monetária e seus efeitos sobre a alimentação (fome), no sistema periférico se identifica elementos relacionados à violação de direitos sociais, como educação, moradia, trabalho e saúde. Conclui-se que igualar a pobreza à indigência tornaria invisível a situação de milhões de pessoas na Argentina. (AU)


Distintos organismos registran tasas alarmantes de pobreza en Argentina. Sin embargo, pueden existir diferencias en quién es considerado pobre según estas mediciones y quiénes lo son para la sociedad, desde el sentido común. Este trabajo analiza las representaciones sociales sobre las personas en situación de pobreza en una muestra de 605 argentinos/as, administrando la técnica de asociación de palabras. Los resultados sugieren que la persona en situación de pobreza es entendida primeramente como alguien que sufre hambre, definición que corresponde a indigencia según el organismo oficial que mide la pobreza y la indigencia en Argentina. No obstante, mientras que en el núcleo de la representación social tiene una importante presencia la pobreza monetaria y sus efectos sobre la alimentación (hambre), en el sistema periférico se ubican elementos relativos a la vulneración de derechos sociales, como la educación, la vivienda, el trabajo y la salud. Se concluye que equiparar a la pobreza con la indigencia invisibilizaría la situación de millones de personas en Argentina. (AU)


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Adulto Joven , Pobreza , Representación Social , Clase Social , Estudiantes , Pruebas de Asociación de Palabras , Encuestas y Cuestionarios , Estadística como Asunto , Derechos Socioeconómicos
16.
JAMA Dermatol ; 153(6): 544-551, 2017 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-28355453

RESUMEN

Importance: Melanomas that clinically mimic seborrheic keratosis (SK) can delay diagnosis and adequate treatment. However, little is known about the value of dermoscopy in recognizing these difficult-to-diagnose melanomas. Objective: To describe the dermoscopic features of SK-like melanomas to understand their clinical morphology. Design, Setting, and Participants: This observational retrospective study used 134 clinical and dermoscopic images of histopathologically proven melanomas in 134 patients treated in 9 skin cancer centers in Spain, France, Italy, and Austria. Without knowledge that the definite diagnosis for all the lesions was melanoma, 2 dermoscopy-trained observers evaluated the clinical descriptions and 48 dermoscopic features (including all melanocytic and nonmelanocytic criteria) of all 134 images and classified each dermoscopically as SK or not SK. The total dermoscopy score and the 7-point checklist score were assessed. Images of the lesions and patient data were collected from July 15, 2013, through July 31, 2014. Main Outcomes and Measures: Frequencies of specific morphologic patterns of (clinically and dermoscopically) SK-like melanomas, patient demographics, and interobserver agreement of criteria were evaluated. Results: Of the 134 cases collected from 72 men and 61 women, all of whom were white and who had a mean (SD) age of 55.6 (17.5) years, 110 (82.1%) revealed dermoscopic features suggestive of melanoma, including pigment network (74 [55.2%]), blue-white veil (72 [53.7%]), globules and dots (68 [50.7%]), pseudopods or streaks (47 [35.1%]), and blue-black sign (43 [32.3%]). The remaining 24 cases (17.9%) were considered likely SKs, even by dermoscopy. Overall, lesions showed a scaly and hyperkeratotic surface (45 [33.6%]), yellowish keratin (42 [31.3%]), comedo-like openings (41 [30.5%]), and milia-like cysts (30 [22.4%]). The entire sample achieved a mean (SD) total dermoscopy score of 4.7 (1.6) and a 7-point checklist score of 4.4 (2.3), while dermoscopically SK-like melanomas achieved a total dermoscopy score of only 4.2 (1.3) and a 7-point checklist score of 2.0 (1.9), both in the range of benignity. The most helpful criteria in correctly diagnosing SK-like melanomas were the presence of blue-white veil, pseudopods or streaks, and pigment network. Multivariate analysis found only the blue-black sign to be significantly associated with a correct diagnosis, while hyperkeratosis and fissures and ridges were independent risk markers of dermoscopically SK-like melanomas. Conclusions and Relevance: Seborrheic keratosis-like melanomas can be dermoscopically challenging, but the presence of the blue-black sign, pigment network, pseudopods or streaks, and/or blue-white veil, despite the presence of other SK features, allows the correct diagnosis of most of the difficult melanoma cases.


Asunto(s)
Dermoscopía/métodos , Queratosis Seborreica/diagnóstico por imagen , Melanoma/diagnóstico por imagen , Neoplasias Cutáneas/diagnóstico por imagen , Adulto , Anciano , Lista de Verificación , Diagnóstico Diferencial , Femenino , Humanos , Queratosis Seborreica/patología , Masculino , Melanoma/patología , Persona de Mediana Edad , Análisis Multivariante , Estudios Retrospectivos , Neoplasias Cutáneas/patología
17.
Integr Psychol Behav Sci ; 47(4): 431-49, 2013 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-24014228

RESUMEN

Research on the belief in a just world (BJW) has been developing since the mid 60s. However, studies have been mainly developed from an individual differences perspective. As a consequence there are no studies that analyze the cognitive processes implied in the appropriation of the BJW during the socialization processes that occur in infancy and onwards. The main purpose of this paper is therefore to analyze this psychological process from childhood to adolescence. The study was carried out with a convenience sample of children and adolescents (N = 216) from Buenos Aires, between 6 and 17 years old, who participated in an interview guided by the piagetian clinical method. Results indicate that during the appropriation process of the BJW participants reconstruct this belief to make it coherent with hypothetical deductive thinking. This is expressed in three different justifications that the individuals give to justify their BJW: immanent justice, social reciprocity and personal merit. Yet, the appropriation process is incomplete. In the majority of the adolescents a magical thinking remains, constituting a state of cognitive polyphasia expressed in oscillating answers. In conclusion, the BJW is not a previous social condition transmitted from one generation to another. Its appropriation goes beyond the mere reproduction of social beliefs and involves a conceptual reconstruction.


Asunto(s)
Desarrollo del Adolescente/fisiología , Actitud , Desarrollo Infantil/fisiología , Justicia Social/psicología , Pensamiento/fisiología , Adolescente , Factores de Edad , Niño , Femenino , Humanos , Masculino
18.
Interdisciplinaria ; 31(1): 57-71, jun. 2014. ilus, tab
Artículo en Español | LILACS | ID: lil-734349

RESUMEN

El objetivo principal del trabajo que se informa fue adaptar y validar la Escala de Creencia Global en un Mundo Justo (Global Belief in a Just World Scale - GBJWS) de Lipkus (1991) en una muestra de estudiantes universitarios de la Ciudad de Buenos Aires (Argentina). Se administró un instrumento de evaluación a 328 estudiantes con edades entre 18 y 40 años (M = 24.1;DT = 3.88), de los cuales el 36.6% eran hombres (n = 120) y el 63.4% mujeres (n = 208). Los resultados obtenidos sugieren adecuadas propiedades psicométricas de la escala GBJWS en la muestra con la que se trabajó. Los análisis realizados confirman la unidimensionalidad de la escala. Asimismo, las puntuaciones en la GBJWS se relacionan positivamente con el autoritarismo del ala de derecha (Right Wing Authoritarianism -RWA), la orientación a la dominancia social (Social Dominance Orientation - SDO)y negativamente con el autoposicionamiento ideológico político. Se considera que el estudio realizado abre una línea de investigación que permite la indagación sistemática de la creencia global en un mundo justo en contextos hispanoparlantes a partir de la construcción de una medida confiable y válida para el contexto argentino. Se recomienda la realización de futuros estudios que utilicen la GBJW en poblaciones diferentes a la estudiada, para así avanzar con respecto a la generalización y representatividad de los resultados presentados en este trabajo.


The researches on the Belief in a Just World (BJW) started in the 60’ with the experimental studies carried out by Lerner (Lerner, 1965, 1980; Lerner & Clayton, 2011; Lerner & Simmons, 1966). Those studies pointed out that social injustices are frightening for individuals, therefore they need to belief that everyone gets what deserve during his or her life to maintain the control over their environment. If people do not believes that things happen as consequences of their acts, they will feel exposed to undesirable situations that today happen to others, but tomorrow could happen to them. Then, to deny this threat, they blame the victims of injustice, attributing to them the responsibility for their suffering. During the last decades, different studies have shown that individuals from different cultures around the world believe that the world is a just place, and the relations between this belief and socio-political factors (Furnham, 1993, 1998, 2003). In this vein, the system justification theory proposes that the BJW, together with the social dominance orientation (SDO; Jost & Hunyady, 2005; Pratto, Sidanius, Stallworth & Malle, 1994), contributes to support and rationalize the social order denying social injustices by appealing to the merit of the dominant social groups. Moreover, there are evidence that the BJW is positively associated to right wing authoritarianism (RWA- Altemeyer, 1996; Dalbert & Yamauchi, 1994; Moore, 2008) and political ideology self positioning (PI -Schlenker, Chambers & Le, 2012). The aim of this paper is to adapt and validate a Spanish version of the Global Belief in a Just World Scale (GBJWS) by Lipkus (1991) in a sample of university students. Hence, a self-reported questionnaire was administered to 328 university students of the Autonomous City of Buenos Aires (Argentina) aged between 18 and 40 years old (M = 24.1, SD = 3.88), 36.6% were male (n = 120) and 63.4% female (n = 208). Besides, 61.28% of the participants studied Psychology and the remaining 38.72% studied Sociology, both at the University of Buenos Aires. Firstly a descriptive analysis of the items was performed. Secondly, the reliability of the scale was tested studding its internal consistence ( .83). Simultaneously, the construct validity was test by an exploratory factor analysis and a confirmatory factor analysis. Finally, the validity of criteria was studied by analyzing the relations between the GBJW, RWA, SDO, and PI. The results suggest adequate psychometric properties of the GBJWS in this sample of university students and verified the unidimensionality of the scale (X²(df) = 54,01(14); S-B X²(df) = 41,77(14); S-B X² / (df) = 2,98; NNFI = .93; CFI = .96; 2= .96; RMSEA = .08). Furthermore, GBJWS was positively associated with RWA (r = .35; p < .01), SDO (r = .36; p < .01) and negatively with PI (r = -.37; p < .01). It is considered that this paper contributes to the measuring of the GBJW since presents an adaptation and validation of ascale that wasn’t available in Spanish. This study had been done with a university sample because the construction and following adaptations of the original scales were made in such population (Bègue, 2002; Dalbert, Lipkus, Sallay, & Goch, 2001; O`Connor, Morrison, T. & Morrison, M., 1996). The relations between political conservatism are coherent with the support of the status quo, since if the world is thought as a just place, there is no reason to transform it (Furnham, 2003; Jost & Hunyady, 2005). This study had been done with a university sample because the construction and following adaptations of the original scales were made in such population (Bègue, 2002; Dalbert, Lipkus, Sallay & Goch, 2001; O`Connor, Morrison, T. & Morrison, M., 1996). However, it’s necessary to point out that this limitation doesn’t allow the generalization of the results to a general population. Hence, it is recommended for future studies to consider other populations to improve the generalization and representatively of the results presented in this paper.

19.
Artículo en Español | LILACS | ID: lil-662058

RESUMEN

Este trabajo se ocupa de un tema propio de la psicología social: el conocimiento de sentido común. Particularmente, se analizan las distintas creencias que permiten a las personas pensar y sentir que controlan -o no- el medio en que viven centrándose en la creencia en el mundo justo y el fatalismo latinoamericano. Ambas creencias en su origen psicológico se basan en la necesidad de control del medio y en su contenido cumplen la función de legitimar el orden social y mantener el status quo. Se concluye que la complejidad de este tipo de objetos de estudio implica estudios interdisciplinarios que vinculen diferentes niveles de análisis para así poder dar cuenta de cómo se relacionan los mecanismos psicológicos con los procesos históricos-sociales conformando una visión de la realidad para los distintos grupos sociales.


This paper deals with a topic which belongs to social psychology: common sense knowledge. In particular, it analyzes the different beliefs that enable people to think and feel in control -or not- to their environment. This paper makes focus on just world belief and the Latin-American fatalism. Both beliefs are psychological in origin, based on the need for environmental control and their contents serve the function of legitimating social order, supporting the status quo. It is concluded that the complexity of such phenomena involves interdisciplinary studies, which link different levels of analysis in order to explain how psychological mechanisms are related to social historical processes shaping the world views about reality that social groups hold.

20.
Interdisciplinaria ; 27(1): 63-75, jul. 2010.
Artículo en Español | LILACS | ID: lil-633461

RESUMEN

El objetivo de este trabajo es elucidar el proceso por el cual los sujetos transforman las representaciones sociales al apropiarse de ellas, así como también el modo en el que éstas inciden en la formación de conceptos y en las acciones individuales. Por una parte, Duveen (2001) plantea el problema desde la perspectiva de la Psicología Social, recurriendo como instrumento a la Psicología del Desarrollo y piensa la individuación en el interior de las relaciones interpersonales. Por otra parte, Valsiner (2003) aborda esta problemática desde la Psicología Cultural, centrándose en la regulación del flujo de la experiencia intrapersonal, con el objetivo de superar la versión estática de las representaciones sociales que ha primado en la investigación empírica. El análisis de los argumentos esgrimidos por ambos autores permite concluir que el esfuerzo de pensar este proceso desde cualquiera de las disciplinas mencionadas de manera independiente, lleva a dificultades que sugieren la necesidad de una actividad interdisciplinaria.


The aim of this paper is to clarify the process by which individuals transform social representations while appropriating them and the way in which social representations influence on individual actions. Specifically, we will try to answer the following questions: Which are the characteristics of this process? Is it about active or passive internalization? Is it possible to study the concept of individuación (individuation) of social representations from a psychological point of view, regarding the concept itself and its formulation by social psychologies or is it necessary to reformulate it? Does the study of this process involve some kind of interdisciplinary activity? For this purpose, we shall raise the theoretical developments of two contemporary exponents of Psychology. On one hand, Duveen (2001) deals with the problem from the view of Social Psychology, appealing to Developmental Psychology as an instrument and he thinks of individuation amid interpersonal relationships. In this way he remarks that social representations do not act with regard to isolated individuals, but they rather act in pare interaction situations, resulting in the intervention of social and individual restrictions. However he is not able to specify the individuation process of social representations because he cannot adopt the child's point of view, in the way in which developmental psychology does. On the other hand, Valsiner (2003) deals with this problem from the perspective of developmental Cultural Psychology, focusing on the regulation of the flow of intrapersonal experience. His aim is to overcome the static version of social representations that have prevailed in empirical research. From his disciplinary perspective he considers social representations as social semiotic mediation artifacts, that enable individuals to pre-adapt to future events, making the experience of stability possible and integrating future anticipations of future and memories of the past. So, social representation constrains possibilities of action, enabling individual social representation to emerge. The author's main merit is the modification of Social Psychology standard version about the intra-subjective, because he analyzes the process by which an individual uses social representation to organize their experience. However, it is doubtful the use of certain typical concepts of the social representation theory that he uses and reformulates in terms of Developmental Psychology. The analysis of the arguments puts forward by both authors enable us to conclude that the problem of individuation leads to inevitable difficulties for those who deal with any of the mentioned disciplines. Despite researchers move in different problematic spaces, they share a common epistemic frame: the ontological assumption about a dialectic articulation between individual and society or between inter and intra subjective process. Therefore, we advocate for interdisciplinary activity, which is not only a rhetoric resource, but a base in a theoretical and methodological interchange at the moment of delimiting the object of study and to think of the research design. This resource will only be valid if it is focused from the perspective of conceptual discussion and empiric research based on a common epistemic framework. The problem of individuation refers to an object of study constituted by a system of interactions which components should be defined during the investigation itself. Now we face the challenge of studying complex systems. We consider that a dialogue between social and developmental psychologies has started and this should lead to the undertaking of joint investigations, which in time will become the right path for building a plausible explanation for this problem.

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