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991.
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Blokx W A M, van Dijk M C R F & Ruiter D J(2010) Histopathology 56 , 121–132 Molecular cytogenetics of cutaneous melanocytic lesions – diagnostic, prognostic and therapeutic aspects This review intends to update current knowledge regarding molecular cytogenetics in melanocytic tumours with a focus on cutaneous melanocytic lesions. Advantages and limitations of diverse, already established methods, such as (fluorescence) in situ hybridization and mutation analysis, to detect these cytogenetic alterations in melanocytic tumours are described. In addition, the potential value of more novel techniques such as multiplex ligation‐dependent probe amplification is pointed out. This review demonstrates that at present cytogenetics has mainly increased our understanding of the pathogenesis of melanocytic tumours, with an important role for activation of the mitogen‐activated protein kinase (MAPK) signalling pathway in the initiation of melanocytic tumours. Mutations in BRAF (in common naevocellular naevi), NRAS (congenital naevi), HRAS (Spitz naevi) and GNAQ (blue naevi) can all cause MAPK activation. All these mutations seem early events in the development of melanocytic tumours, but by themselves are insufficient to cause progression towards melanoma. Additional molecular alterations are implicated in progression towards melanoma, with different genetic alterations in melanomas at different sites and with varying levels of sun exposure. This genetic heterogeneity in distinct types of naevi and melanomas can be used for the development of molecular tests for diagnostic purposes. However, at the moment only few molecular tests have become of diagnostic value and are performed in daily routine practice. This is caused by lack of large prospective studies on the diagnostic value of molecular tests including follow‐up, and by the low prevalence of certain molecular alterations. For the future we foresee an increasing role for cytogenetics in the treatment of melanoma patients with the increasing availability of targeted therapy. Potential targets for metastatic melanoma include genes involved in the MAPK pathway, such as BRAF and RAS. More recently, KIT has emerged as a potential target in melanoma patients. These targeted treatments all need careful evaluation, but might be a promising adjunct for treatment of metastatic melanoma patients, in which other therapies have not brought important survival advantages yet. 相似文献
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Ana Rita Cabral Neide Alonso Ana Brinca Ricardo Vieira Américo Figueiredo 《Anais brasileiros de dermatologia》2013,88(2):272-275
The earlobe is an anatomical structure that has a significant aesthetic role. Its
surgical repair places a challenge due to the difficulty of obtaining a natural
appearing and durable outcome. The authors present two options: the Gavello technique
and the bilobed flap, after the excision of malign neoplasms of the earlobe. The
Gavello technique makes use of a bilobed flap with an anterior base to mold the new
earlobe. D''Hooghe''s bilobed flap with a pre and post-auricular lobe allows the
reconstruction of small earlobes. Both techniques, although old, acquire an important
and current interest in earlobe reconstruction, by reason of the moderate degree of
difficulty, the use of a single time surgical act and under local anesthesia, with a
proper aesthetic result. 相似文献
995.
Patrícia de Carvalho Nagliate Paula Cristina Nogueira Simone de Godoy Isabel Amélia Costa Mendes 《Nurse education in practice》2013,13(4):244-249
BackgroundStandard precautions (SP) play an important role in hospital infection control, as well as in issues related to biosafety and security of patients, professionals and students active in direct or indirect health care delivery.ObjectiveThis research aimed to identify in the literature which instruments nurse researchers have used to evaluate knowledge, attitudes and compliance with SP for infection control.MethodsA literature review was undertaken in the databases Web of Science, Bireme (Medline and Lilacs) and Scopus.Results91.66% of the studies were ranked as evidence level IV; 66.66% of the instruments were structured questionnaires, 58.33% of which had been validated and half of these instruments presented reliability and validity scores for the instrument used. Publications were concentrated in 2009 (41.66%), mostly in English (75%), in nursing journals with impact factor above 1.60 (83.33%).ConclusionsThe instruments nurse researchers most employed were structured questionnaires associated with Likert-type rating scales. 相似文献
996.
Chung Am Choi Min Jung Chang Hye Duck Choi Woo-Young Chung Wan Gyoon Shin 《Regulatory toxicology and pharmacology : RTP》2013
Drug interactions (DIs) constitute a serious problem and are considered to contribute to 6–30% of all adverse events (AEs). The use of existing data, including claims data, is expected to be helpful in detecting unknown DIs by complementing conventional spontaneous reporting systems. In the present study, an ‘Ω shrinkage measure’ was applied to the Korean National Health claims database to test the potential of the claims database as a DI surveillance resource. A well-known DI between non-steroidal anti-inflammatory drugs (NSAIDs) and diuretics was analyzed using the model. International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) codes related to DIs were assigned to the AEs of the DIs: I50, I50.0, I50.1, I50.9, R60, R60.1, R60.9, and J81. An elevated occurrence of AEs versus the expected level was observed using a two-sided 95% lower credibility interval limit above zero, Ω025 = 0.245, which was the screening limit. The result was consistent with the actual DI between the two drugs. The finding indicates that the claims data have the potential to be used as a DI surveillance resource and that the Ω shrinkage measure may be a promising tool for detecting DIs in claims data. 相似文献
997.
Tiphaine Cholley Antoine Thiery-Vuillemin Samuel Limat Marion Hugues Fabien Calcagno Guillaume Mouillet Amélie Anota Virginie Nerich 《Clinical genitourinary cancer》2019,17(1):e227-e234
Background
Targeted therapies have transformed the treatment of metastatic clear-cell renal cell carcinoma (mccRCC). Despite the importance of mccRCC, studies on its economic burden in daily practice are sparse. The purpose of this retrospective study was to evaluate cost of illness for 224 patients with mccRCC included in the cohort published by Thiery-Vuillemin et al (Factors influencing overall survival for patients with metastatic clear-cell renal cell-carcinoma in daily practice. Clin Genitourin Cancer 2018; 16:e297-305), and then to determine the explanatory factors of cost of illness.Patients and Methods
The study was performed from the French Public Healthcare System perspective with lifetime horizon. Only direct medical costs were included. Multiple linear regression was used to search for explanatory factors of cost of illness. The robustness of results was assessed.Results
The mean cost of illness was estimated at €71,185 ± 52,683. Outpatient/inpatient treatment and hospitalization represented 76.0% and 19.7% of this cost, respectively. After adjustment, 5 explanatory factors were identified: time of disease control for the metastatic first-line treatment ≥6 months, number of lines of treatment >2, nephrectomy at metastatic stage, lack of metastases at presentation, and age at metastatic diagnosis younger than 65 years. Individually, they increased cost of illness by 128%, 95%, 53%, 53%, and 23%, respectively.Conclusion
Although it is difficult to transpose our economic evaluation results to those obtained in other countries, it should be noted that our findings were consistent with them and robust. To our knowledge, our study was the first to accurately identify explanatory factors of cost of illness. Identifying them could enable us to predict the budgetary effect on a regional level of managing patients who began their first-line treatment with a targeted therapy. 相似文献998.
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Marcelo Coelho Goiato DDS MD PhD Marcela Filié Haddad DDS MD Aldiéris Alves Pesqueira DDS MD Amália Moreno DDS Daniela Micheline dos Santos DDS MD PhD Lisiane Cristina Bannwart DDS 《Journal of prosthodontics》2011,20(7):566-569
Purpose: The purpose of this study was to evaluate the color stability of MDX4‐4210 maxillofacial elastomer with opacifier addition submitted to chemical disinfection and accelerated aging. Materials and Methods: Ninety specimens were obtained from Silastic MDX4‐4210 silicone. The specimens were divided into three groups (n = 30): Group I: colorless, Group II: barium sulfate opacifier, Group III: titanium dioxide opacifier. Specimens of each group (n = 10) were disinfected with effervescent tablets, neutral soap, or 4% chlorhexidine gluconate. Disinfection was conducted three times a week for 2 months. Afterward, the specimens were submitted to different periods of accelerated aging. Color evaluation was carried out after 60 days (disinfection period) and after 252, 504, and 1008 hours of accelerated aging, using a reflection spectrophotometer. Color alterations were calculated by the CIE L*a*b* system. Data were analyzed by three‐way ANOVA and Tukey test (α= 0.05). Results: Group II exhibited the lowest color change, whereas Group III the highest (p < 0.05), regardless of the chemical disinfection and accelerated aging periods. Conclusion: Opacifier addition, chemical disinfection, and accelerated aging procedures affected the color stability of the maxillofacial silicone. 相似文献