RESUMO
Workforce adequacy for Mohs micrographic surgery (MMS) is not fully understood. The purpose of this study was to describe the current spectrum of clinical, academic, advocacy and leadership activities through a survey of members of the American College of Mohs Surgery (ACMS). The ACMS membership was electronically sent a 43-question anonymous survey between January and May 2023 and there was a 10.7% response rate representing 184 members across 37 states. Nearly 90% are board certified in micrographic dermatologic surgery and 10.3% indicate that they practice in a rural setting (57.1% suburban and 32.6% urban). The median number of half-day surgeons performed Mohs surgery is 6 and nearly half of Mohs surgeons work in a dermatology-only medical group (48.4%), do no use immunohistochemical stains (60.3%), and do not participate in a multidisciplinary tumor board (58.7%). Many respondents indicate they have capacity in their clinical schedules to accommodate more cases and the reasons are multifactorial.
Assuntos
Neoplasias Cutâneas , Cirurgiões , Humanos , Estados Unidos , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/cirurgia , Liderança , Cirurgia de Mohs , Recursos HumanosRESUMO
Interference is a pivotal issue of a non-dispersive infrared (NDIR) sensor and analyzer. Therefore, the main contribution of this study is to introduce a potential method to compensate for the interference of the NDIR analysis. A potential method to compensate for the interference of a nitric oxide (NO) NDIR analyzer was developed. Double bandpass filters (BPFs) with HITRAN (high-resolution transmission molecular absorption database)-based wavelengths were used to create an ultranarrow bandwidth, where there were least-interfering effects with respect to the coal-fired power plant emission gas compositions. Key emission gases from a coal-fired power plant, comprising carbon monoxide (CO), NO, sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon dioxide (CO2), and water (H2O) (in the form of vapor), were used to investigate the gas interference. The mixtures of those gases were also used to investigate the performance of the double BPFs. We found that CO, CO2, SO2, and H2O significantly affected the detection of NO when a commercial, single narrow BPF was used. In contrast, the double BPFs could remove the interference of CO, NO2, SO2, and CO2 in terms of their concentrations. In the case of H2O, the filter performed well until a level of 50% relative humidity at 25 °C. Moreover, the signal-to-noise ratio of the analyzer was approximately 10 when the double BPFs were applied. In addition, the limit of detection of the analyzer with the double BPFs was approximately 4 ppm, whereas that with the commercial one was 1.3 ppm. Therefore, double BPFs could be used for an NO NDIR analyzer instead of a gas filter correlation to improve the selectivity of the analyzer under the condition of a known gas composition, such as a coal-fired power plant. However, the sensitivity of the analyzer would be decreased.
Assuntos
Transformação Celular Neoplásica/genética , Epidermólise Bolhosa Simples/genética , Perfilação da Expressão Gênica , Marcadores Genéticos/genética , Melanoma/genética , Nevo Pigmentado/genética , Neoplasias Cutâneas/genética , Biópsia , Proliferação de Células , Transformação Celular Neoplásica/patologia , Criança , Pré-Escolar , Dermoscopia , Diagnóstico Diferencial , Epidermólise Bolhosa Simples/patologia , Feminino , Seguimentos , Humanos , Melanoma/patologia , Regressão Neoplásica Espontânea , Nevo Pigmentado/patologia , Neoplasias Cutâneas/patologia , Melanoma Maligno CutâneoRESUMO
BACKGROUND AND AIM: Delayed post-polypectomy hemorrhage is a rare but serious complication. The aim of this study was to identify risk factors for the development of delayed post-polypectomy hemorrhage. METHODS: This was a retrospective case-control study of patients who developed delayed hematochezia after receiving colonoscopic polypectomy. The control patients underwent uneventful polypectomy and were selected at a 4:1 ratio. RESULTS: Of the 7447 lesions examined from the 3253 patients who received colonoscopic polypectomy, 53 lesions (0.7%) of 42 patients (1.3%) developed delayed hemorrhage, and 168 patients were selected as controls. According to multivariate logistic regression analysis, a polyp larger than 10 mm (odds ratio [OR] 2.355, 95% confidence interval [CI] 1.225-4.528, P = 0.010), a pedunculated polyp (OR 3.473, 95% CI 1.576-7.657, P = 0.002), and a polyp located in the right hemi-colon (OR 2.690, 95% CI 1.465-4.940, P = 0.001) were significant risk factors for delayed post-polypectomy hemorrhage. The presence of comorbidities did not increase the risk of delayed hemorrhage. CONCLUSION: Polyp size (large), shape (pedunculated), and location (right hemi-colon) represented substantial risk factors for the development of delayed hemorrhage after colonoscopic polypectomy.
Assuntos
Pólipos do Colo/cirurgia , Colonoscopia , Hemorragia Pós-Operatória/etiologia , Idoso , Estudos de Casos e Controles , Pólipos do Colo/patologia , Feminino , Humanos , Incidência , Modelos Logísticos , Masculino , Prontuários Médicos , Pessoa de Meia-Idade , Razão de Chances , Estudos Retrospectivos , Fatores de Risco , Fatores de TempoRESUMO
Sclerosing mesenteritis is a rare benign disease originated from the mesenteries. It can be related to autoimmune disease, vasculitis, ischemia, infection, trauma and operation, but most of cases are idiopathic. The overall prognosis of sclerosing mesenteritis is usually good with benign, course. However, no consensus of treatment has yet been established. We report a case of spontaneous partial regression of sclerosing mesenteritis presented as a huge mass and diagnosed by finding of contrast enhanced abdominal computed tomography and percutaneous ultrasonography guided needle biopsy.