ABSTRACT
BACKGROUND: The presence or absence of lymph node metastases is a very important prognostic factor for survival and recurrence in patients with cutaneous melanoma. Controversies remain among specialists about whether it is advisable or not to perform a sentinel lymph node biopsy in patients with melanoma, although it is currently supported by most standard guidelines. We performed this study to identify which patients are more prone to having a positive lymph node test result in a population with high melanoma rates in the south of Brazil. MATERIALS AND METHODS: We performed the study with 62 consecutive patients who underwent sentinel lymph node biopsies from 2003 to the early months of 2015 in the city of Blumenau - Santa Catarina, Brazil. RESULTS: Breslow thickness, ulceration, nodular subtype, and Clark level IV were associated with positive sentinel lymph node group status (p 0.05). DISCUSSION: Although there is still a controversy over whether or not this procedure should be performed, most guidelines still support its application. To lower the economical and physical impact, however, it is worthwhile to determine which patients are more prone to acquiring positive lymph node at presentation and, perhaps, in the future, indicate surgery for this particular group, who could benefit most from further treatment options. KEY WORDS: melanoma - sentinel lymph node biopsy - prognosis.
Subject(s)
Melanoma/pathology , Sentinel Lymph Node/pathology , Brazil , Female , Humans , Lymphatic Metastasis , Male , Retrospective Studies , Risk Assessment , Sentinel Lymph Node Biopsy , Skin Neoplasms , Skin Ulcer/pathology , Melanoma, Cutaneous MalignantABSTRACT
La obstrucción de las fosas nasales en el neonato es un cuadro potencialmente fatalpor su respiración nasal obligada. La causa principal es inflamatoria o infecciosa, y con menor frecuencia puede ser de origen congénito, neoplásico, traumático o iatrogénico. La atresia de coanas es la anomalía congénita nasal más común. Una etiología menos frecuente de obstrucción nasal congénita es la estenosis de la apertura piriforme. Debe pensarse en esta última en todo recién nacido con cornaje y dificultad respiratoria de grado variable, asociado a la dificultad de pasar una sonda a través de la región anterior de las fosas nasales. El diagnóstico se confirma por tomografía computarizada del macizo craneofacial. La conducta terapéutica dependerá de la gravedad de los síntomas. Describimos nuestra experiencia con 5 pacientes que presentaban esta afección, tratados quirúrgicamente mediante abordaje sublabial y colocación de tutor nasal
Nasal obstruction in neonates is a potentially fatal condition due to their exclusive nasal breathing. The main cause is inflammatory or infectious rhinitis. Congenital, neoplastic, traumatic or iatrogenic causes are less frequent. Choanal atresia is the most common congenital nasal anomaly. A less common etiology of congenital nasal obstruction is pyriform aperture stenosis. Suspicion might arise in any newborn with varying degrees of stridor and respiratory distress, associated with the difficulty of passing a probe through anterior nares. Diagnosis should be confirmed by a computed tomography of the craniofacial massif. The therapeutic approach will depend on the severity of symptoms. We describe our experience with 5 patients with this condition, treated surgically using a sub-labial approach, and followed by nasal stenting
Subject(s)
Humans , Male , Female , Infant, Newborn , Nasal Obstruction/congenital , Nasal Obstruction/diagnosis , Constriction, Pathologic/congenital , Constriction, Pathologic/diagnosis , Tomography , Nasal Obstruction/chemically induced , Nasal Obstruction/complications , Constriction, Pathologic/complications , Tomography/instrumentationABSTRACT
Nasal obstruction in neonates is a potentially fatal condition due to their exclusive nasal breathing. The main cause is inflammatory or infectious rhinitis. Congenital, neoplastic, traumatic or iatrogenic causes are less frequent. Choanal atresia is the most common congenital nasal anomaly. A less common etiology of congenital nasal obstruction is pyriform aperture stenosis. Suspicion might arise in any newborn with varying degrees of stridor and respiratory distress, associated with the difficulty of passing a probe through anterior nares. Diagnosis should be confirmed by a computed tomography of the craniofacial massif. The therapeutic approach will depend on the severity of symptoms. We describe our experience with 5 patients with this condition, treated surgically using a sub-labial approach, and followed by nasal stenting.
