RESUMO
BACKGROUND: Basal cell carcinoma (BCC) is usually diagnosed by clinical and dermatoscopy examination, but diagnostic accuracy may be suboptimal. Reflectance confocal microscopy (RCM) imaging increases skin cancer diagnostic accuracy. OBJECTIVE: To evaluate additional benefit in diagnostic accuracy of handheld RCM in a prospective controlled clinical setting. METHODS: A prospective, multicenter study in 3 skin cancer reference centers in Italy enrolling consecutive lesions with clinical-dermatoscopic suspicion of BCC (ClinicalTrials.gov: NCT04789421). RESULTS: A total of 1005 lesions were included, of which 474 histopathologically confirmed versus 531 diagnosed by clinical-dermatoscopic-RCM correlation, confirmed with 2 years of follow-up. Specifically, 740 were confirmed BCCs. Sensitivity and specificity for dermatoscopy alone was 93.2% (95% CI, 91.2-94.9) and 51.7% (95% CI, 45.5-57.9); positive predictive value was 84.4 (95% CI, 81.7-86.8) and negative predictive value 73.3 (95% CI, 66.3-79.5). Adjunctive RCM reported higher rates: 97.8 (95% CI, 96.5-98.8) sensitivity and 86.8 (95% CI, 82.1-90.6) specificity, with positive predictive value of 95.4 (95% CI, 93.6-96.8) and negative predictive value 93.5 (95% CI, 89.7-96.2). LIMITATIONS: Study conducted in a single country. CONCLUSIONS: Adjunctive handheld RCM assessment of lesions clinically suspicious for BCC permits higher diagnostic accuracy with minimal false negative lesions.
Assuntos
Carcinoma Basocelular , Neoplasias Cutâneas , Humanos , Dermoscopia/métodos , Estudos Prospectivos , Carcinoma Basocelular/diagnóstico por imagem , Carcinoma Basocelular/patologia , Neoplasias Cutâneas/diagnóstico por imagem , Neoplasias Cutâneas/patologia , Sensibilidade e Especificidade , Microscopia Confocal/métodosRESUMO
Biomass can be used as an energy source to thermochemical conversion processes to biocrude production. However, the supply and dependence on only one biomass for biocrude production can be an obstacle due to its seasonality, availability, and logistics costs. In this way, biomass waste and agroindustrial residues can be mixture and used as feedstock to the hydrothermal co-liquefaction (co-HTL) process as an alternative to obtaining biocrude. In this sense, the present paper analyzed the biocrude yield influence of the co-HTL from a quaternary unprecedented blend of different biomasses, such as sugarcane bagasse, brewer's spent grain (BSG), sludge from a paper recycling mill (PRM), and microalgae (Chlorella vulgaris). In this way, a simplex lattice design was employed and co-HTL experiments were carried out in a 2000 mL high-pressure stirred autoclave reactor under 275 °C for 60 min, considering 15% of feedstock/water ratio. Significant effects in each feedstock and their blends were analyzed aiming to increase biocrude and biochar yield. It was found that the addition of microalgae is only significant when considered more than 50% into the blend with BSG and PRM sludge to increase biocrude yield.
Assuntos
Carvão Vegetal , Chlorella vulgaris , Microalgas , Saccharum , Esgotos , Celulose , Temperatura , Microalgas/química , Biomassa , Água/química , Biocombustíveis/análiseRESUMO
Paciente femenino de 55 años, quien presentaba lesión papulo-nodular localizada en tórax posterior, de aproximadamente 0,8 centímetros de diámetro, de meses de evolución; la lesión era muy oscura y de consistencia dura, recordando clínicamente a un melanoma maligno (Foto 1). Al examen con dermatoscopio, la lesión se caracterizaba por áreas ovoides azuladas. Además, en la periferia se observaron estructuras marrón-azuladas con digitaciones periféricas compatibles con estructuras en hojas de arce. Se observó ulceración central, no se observaron estructuras vasculares.(Foto 2)