Recurrence rate of basal cell carcinoma among different micrographic surgery techniques: systematic review with meta-analysis.

In high-risk basal cell carcinomas (BCCs), micrographic surgery (MS) has high tissue preservation and low recurrence rates. The Mohs technique is the most commonly used technique, with limited use of other MS techniques. No studies have been designed to compare the MS methods. This review aimed to assess BCC recurrence rates of different MS techniques. A systematic review and meta-analysis were conducted to search for related studies in PubMed, LILACS, EMBASE, SCOPUS, WEB OF SCIENCE, CINHAL and COCHRANE until March 2021. Randomized clinical trials (RCTs) and observational studies involving patients with BCC and indications for different MS techniques were included. Study selection and data extraction were performed independently by three peer reviewers, as was the risk of bias assessment using the Joanna Briggs Institute tool. Pooled estimates were assessed using the random-effects model (Logit), and heterogeneity was assessed by the chi-squared test (χ2 ). Stata Software version 17.0 was used for analysis. Eighteen studies were included, two RCTs and sixteen observational studies. The overall recurrence rate was 2% (95% CI, 1.0-3.0%; χ2 = 46.2; P = 0.00; 18 studies, 10 424 BCCs). In studies using the Mohs technique, the recurrence rate was 3.0% (95% CI, 1.0-5.0%; χ2 = 11.0; P = 0.00; 6 studies; 1,582 BCCs), with the Munich technique 3.0% (95% CI, 2.0-5.0%; χ2 = 0.0; no heterogeneity; 3 studies; 404 BCCs), with Tubingen technique 1% (95% CI, 1.0-2.0%; χ2 = 12.1; P = 0.00; 8 studies; 8374 BCCs) and with the Muffin technique 0.0% (95% CI, 0.0-6.0%; 1 study; 64 BCCs). Relapse rates between MS techniques were low and appeared to be similar. However, the design of this review and the absence of primary studies that directly compare the techniques do not allow us to assert the superiority between them.

Anoxia Effects in Asphyxiated Green Sea Turtles (Chelonia mydas) Caught in an Artisanal Fishing Net on the Coast of Brazil.

Among studies of drowning in green sea turtles (Chelonia mydas), none have associated drowning with injuries of organs other than the lung. We describe the gross and microscopical findings in 23 green sea turtles found dead in a fishing net. Deprived of air, these animals experienced hypoxia and anoxia before dying, which caused congestion, hydropic degeneration and necrosis in several organs. There was no evidence of an alternative cause of death. These findings demonstrate a pattern characteristic of death by asphyxia caused by drowning.

Sexual politics and sexual rights in Brazil: an overview.

The objective of this text is to survey the political construction of sexual rights in Brazil working on themes that are especially relevant to the configuration of these rights (reproduction/abortion, STDs/AIDS and sexual diversity), and mapping the main actors, the legal instruments now in place or still being discussed and, lastly, the public policies that have been adopted in the last two decades. We considered the 1988 Brazilian Constitution the landmark from which, in terms of the civil society's perspective at least, demands for new rights are ordained and, at state level, public policies and legal instruments are generated to satisfy these demands.

Determinación prenatal del genotipo RHD por métodos no invasivos / Prediction of fetal RHD from maternal plasma

Introducción. Las técnicas del genotipado de los grupos sanguíneos están particularmente indicadas cuando tenemos que establecer situaciones de poblaciones tras reacciones postransfusionales, tests positivos a la antiglobulina o en casos de enfermedad hemolítica del recién nacido (EHRN). Últimamente ha sido demostrado que la presencia de ADN fetal en plasma materno tiene una tasa de éxito elevada a partir del segundo trimestre de embarazo, pudiendo de esta forma ser solucionadas muchas de las dificultades técnicas existentes. Objetivo. Aplicar las tecnologías de biología molecular, concretamente PCR a tiempo real, efectuando la determinación prenatal del genotipo RHD por métodos no invasivos, utilizando muestras de plasma materno. Material y métodos. Cincuenta y cuatro muestras de plasma correspondientes a 49 embarazadas caucásicas portuguesas Rh(D) negativas con cónyuges Rh(D) positivos. En las muestras de sangre se realizó el fenotipado de los grupos sanguíneos ABO y Rh, la búsqueda de anticuerpos irregulares y el estudio genético por la técnica de PCR en tiempo real. En todos los casos fue posible obtener durante el parto una muestra de sangre del cordón umbilical. Resultados. Los resultados obtenidos a través del genotipado, utilizando plasma materno, fueron concordantes con el fenotipo de sangre del cordón en 46 casos. En 8 casos, a pesar de que en el fenotipado se diagnosticó de fetos RHD-, en el recién nacido se diagnosticaron como R(h)D positivos (en todos los casos las muestras fueron de embarazadas con gestaciones menores de 25 semanas). No hubo casos de resultados falsos-positivos. Discusión. Los resultados indican que el genotipado RHD fetal, utilizando muestras de plasma materno, son fiables a partir de la semana 24 de embarazo. A pesar de ello, son nece sarios más estudios para adoptar este tipo de metodología en la práctica clínica de rutina (AU)

Blood group antigen profile predicted by molecular biology-use of real-time polymerase chain reaction to genotype important KEL, JK,RHD, and RHCE alleles.

The most clinically important blood group systems in transfusion medicine, excluding the ABO system, are the RH, Kell, and Kidd systems. Alloantibodies to antigens of these systems may be produced following blood transfusion or during pregnancy and can result in serious hemolytic transfusion reactions and hemolytic disease of the newborn. We developed rapid and robust techniques for RHD, RHCE, KEL, and JK genotyping with the use of a real-time polymerase chain reaction instrument. Two fluorescence-based methods for the detection of amplification products were used: for KEL1/KEL2, JK1/JK2, and RHE/RHe (exon 5) we used the hybridization probes protocol; for RHC/RHc the analysis was done in sequences of exon 1 for RHC and exon 2 for RHc; and for RHD, analysis was done in sequences of intron 4, exon 7, and exon 4 pseudogene using the SYBR Green I protocol. The genotyping tests were validated with samples from 85 Caucasian Portuguese and 15 Black European blood donors. Complete phenotype-genotype correlations were obtained. The potential use of the presented methods can be predicted in clinical transfusion medicine, allowing appropriate monitoring, early intervention, and improved care. When blood group genotyping techniques are necessary, this methodology is highly competitive for a routine laboratory.

Rapid genotyping of the major alleles at the Duffy (FY) blood group locus using real-time fluorescence polymerase chain reaction.

The Duffy blood group system has clinical importance due to involvement in transfusion reactions and hemolytic disease of the newborn. Recently, the molecular basis of the two alleles, FY*A and FY*B (125G>A), and the mutation situated in the promoter region of the FY gene (-33T>C), have been elucidated. In order to develop an accurate, easy, and rapid genotyping method, we describe a procedure using the LightCycler. Samples from 53 Caucasian Portuguese blood donors and 7 black, healthy, European individuals were phenotyped with commercial antisera. DNA was extracted from blood samples and the relevant sequences were amplified with the same cycling conditions, using real-time polymerase chain reaction. The melting point of the FY*A allele was 63 degrees C and of the FY*B allele, 55 degrees C. The allele without mutation at the promoter region had a melting point at 64 degrees C and the FY*B silent allele at 58 degrees C. The results in Caucasian individuals were similar to those found in European and American populations. When FY genotyping techniques are necessary, the methodology described is preferable to conventional methods as it is reliable, high speed, and uses small volumes, providing a highly competitive technology for use by a routine laboratory.

Leishmania (Viannia) braziliensis is the predominant species infecting patients with American cutaneous leishmaniasis in the State of Minas Gerais, Southeast Brazil.

Skin biopsies from 53 patients with American cutaneous leishmaniasis (ACL) from the State of Minas Gerais, Brazil, were used for a characterization of the Leishmania parasites. A pair of primers flanking the conserved region of the Leishmania minicircle kDNA was used to obtain amplified DNA via the polymerase chain reaction. The amplified products were subsequently hybridized with Leishmania subgenus-specific radiolabeled probes. Parasites from 49 out of 53 samples (92.5%) were characterized as belonging to the subgenus Viannia and four (7.5%) as belonging to the subgenus Leishmania. Clinical, epidemiological and molecular evidence allow us to conclude that Leishmania (V.) braziliensis and Leishmania (L.) amazonensis are the species present in the patients studied and that L. (V.) braziliensis is the predominant species in the State of Minas Gerais, Brazil.