Assessment of the circumferential margins, extraprostatic extension and Gleason score in radical prostatectomy specimens: Comparison of a partial embedding method with supplemental total inclusion of peripheral tissues.

BACKGROUND: Recent data suggest that up to 21% of positive circumferential margins (PCM) and 47% of extraprostatic extension (EPE) samples may be missed when partial embedding methods are employed. Kim and colleagues (2009) suggested that total inclusion of the periphery (3mm rim) of the prostate prevented the failure to detect PCM and EPE. DESIGN: Radical prostatectomy specimen (n=148) slides were reviewed after adoption of a protocol that included a ∼3 mm rim of peripheral tissues. We evaluated whether the analysis of supplemental slides of prostate periphery changed margin status, presence of EPE, Gleason score and extent of PCM and EPE. RESULTS: Partial sampling resulted in missing 29% of PCM and 20% of EPE without using data from the supplemental slides of prostate periphery. Changes from focal to extensive disease were found in 11/21 (52%) cases of positive circumferential margins and in 5/13 (38%) cases of extraprostatic extension. Changes in the Gleason score were uncommon. CONCLUSIONS: These results indicate the importance of including all the prostate peripheral tissue for microscopic analysis when partial embedding methods are adopted.

[Importance of the Teratogen Information Service in Bahia, Brazil, for prevention of congenital malformations: an initial four-year review]. / A importância do Serviço de Informações sobre Agentes Teratogênicos, Bahia, Brasil, na prevenção de malformações congênitas: análise dos quatro primeiros anos de funcionamento.

Teratogenic agents are defined as physical, chemical, or biological agents or nutrient deficiencies that lead to fetal structural or functional alterations. Information on the effects of exposure to teratogens during pregnancy is of the utmost importance. In order to achieve this goal, in 2001, the Bahia State Teratogen Information Service was created in the Medical Genetics Department at the University Hospital of the Federal University in Bahia. The current paper aimed to describe the first four years of operation in the service. From March 2001 to May 2005, the service was consulted by telephone, fax, and e-mail. During this period, 408 queries were made, for a total of 1,091 different reasons. Most queries were made by pregnant women and health care professionals. Hair products, herbal teas, and misoprostol were the most widely investigated agents. The low number of queries (average 1/day) shows the need for more awareness-raising on the risks posed by the various agents.

A importância do Serviço de Informações sobre Agentes Teratogênicos, Bahia, Brasil, na prevenção de malformações congênitas: análise dos quatro primeiros anos de funcionamento / Importance of the Teratogen Information Service in Bahia, Brazil, for prevention of congenital malformations: an initial four-year review

Agente teratogênico é definido como o agente físico, químico, biológico ou estado de deficiência que, durante a vida embrionária, leva a alteração na estrutura ou função do concepto. Informações sobre a conduta a ser tomada no caso de exposições a teratogênicos durante a gestação são imprescindíveis. Com essa finalidade, em 2001, foi implantado o Serviço de Informações sobre Agentes Teratogênicos da Bahia (SIAT-BA), localizado no Serviço de Genética Médica do Hospital Universitário Professor Edgard Santos da Universidade Federal da Bahia. O objetivo é descrever as características do atendimento do SIAT-BA nos seus primeiros quatro anos de funcionamento. As consultas foram realizadas através do contato via telefone, fax ou e-mail, entre março de 2001 e maio de 2005. Nesse período, o SIAT-BA recebeu 408 consultas, totalizando 1.091 motivos. A maioria das consultas foi realizada por gestantes e profissionais de saúde. Produtos para cabelo, chás e misoprostol foram os agentes mais investigados. O pequeno número de consultas (1/dia) indica a necessidade de maior divulgação do serviço e da conscientização da população sobre os riscos oferecidos pelos diversos agentes.

Teratogenic agents are defined as physical, chemical, or biological agents or nutrient deficiencies that lead to fetal structural or functional alterations. Information on the effects of exposure to teratogens during pregnancy is of the utmost importance. In order to achieve this goal, in 2001, the Bahia State Teratogen Information Service was created in the Medical Genetics Department at the University Hospital of the Federal University in Bahia. The current paper aimed to describe the first four years of operation in the service. From March 2001 to May 2005, the service was consulted by telephone, fax, and e-mail. During this period, 408 queries were made, for a total of 1,091 different reasons. Most queries were made by pregnant women and health care professionals. Hair products, herbal teas, and misoprostol were the most widely investigated agents. The low number of queries (average 1/day) shows the need for more awareness-raising on the risks posed by the various agents.

Versatilidade do retalho musculocutâneo do tensor da fáscia lata / Versatility of the fascia lata tensor musculocutaneous flap

OBJETIVO: Relatar a experiência com a utilização do retalho musculocutâneo do tensor da fáscia lata (TFL em diferentes situações clínicas, evidenciando suas diversas aplicações, analisando e discutindo as indicações, resultados e complicações. MÉTODO: Entre janeiro de 2003 e dezembro de 2005 dezessete retalhos miocutâneos do TFL foram realizados para cobertura cutânea em uma variedade de defeitos em quinze pacientes.Durante o ato operatório a equipe optou pelo posicionamento do paciente em decúbito lateral em oposição ao lado da lesão a ser reparada. RESULTADOS: Houve sucesso com cobertura cutânea adequada em todos os casos. Em quatro destes ocorreu necessidade de enxerto de pele parcial na área doadora. Em dois casos houve isquemia distal do retalho e em um aconteceu pequena deiscência de sutura em zona doadora. CONCLUSÃO: O retalho miocutâneo do tensor da fáscia lata, portanto, possibilita uma excelente cobertura cutânea para tratamento de defeitos em diversos segmentos anatômicos com pouca morbidade em área doadora.

BACKGROUND: The fascia lata tensor (FLT) musculocutaneous flap holds a great versatility. It is used in countless situations. We present our experience with the use of this flap in several circumstances. We also analyze and discuss about indications, results and complications. METHODS: Between January 2003 and December 2005, 15 patients (10 man and 5 women) underwent 17 FLT flaps to treat many skin defects. Patients were between 18 and 65 years-old. Patients' position during surgery was lateral decubitus. Follow up has been obtained from 6 months to 3 years. RESULTS: We succeed with fit skin coverage in all cases. Partial skin graft was necessary in four cases. Distal flap ischemia occurred in two patients. Small dehiscence at the donor site was seen (and treated by simple suture) in one case. CONCLUSION: The FLT musculocutaneous flap is extremely reliable and versatile; it has easy and fast execution and relatively few complications. It can successfully be used in many clinical situations.