A new classification and clinical predictivity for some naevus variants.

Background. The incidence of cutaneous melanoma is rapidly increasing in Europe. Active research is directed toward the identification of naevi as a risk factor. Objective. The aim of our case-control study was to observe different numbers of moles and different mole typology associations in order to evaluate clinical predictivity and to establish a new classification for some naevus variants. Methods. A case-control study was carried out, enrolling 64 cases affected by melanoma and 183 controls, between October 2009 and February 2011. Each patient was interviewed and subjected to clinical examination. The resulting data were analysed using the statistical elaboration program SPSS 16.0. Results. The association of target naevus with other variants increases the degree of risk (target + small brown Odds Ratio 5.25; confidence interval 1.8-15.4); (target + small brown + small black + large brown odds ratio 5.0; confidence interval 1.1-22.4). Therefore, other variants and/or other variant combinations do not significantly increase risk. Conclusion. People presenting two naevus variants in association with other naevus variants seem to run a major risk. The general nonuniformity of the whole naevus panorama should be carefully considered.

"Il corpo ritrovato": dermocosmetological skin care project for the oncologic patient.

Neoplastic disease and its therapeutic options have a huge impact on the patient's quality of life from both the emotional and the working point of view. The project "Il Corpo Ritrovato" aims at creating an interdisciplinary network of physicians to improve the quality of life of the oncologic patient, focusing on such important aspects as dermocosmetological skin care but also on the evaluation of new therapeutic and diagnostic algorithms in order to make further progress in the field of prevention.

Teledermatology: from prevention to diagnosis of nonmelanoma and melanoma skin cancer.

Telemedicine is a rapidly developing application of clinical medicine where medical information is transferred through interactive audiovisual media for the purpose of consulting remote medical procedures or examinations, reducing the time of consultation for patients. Teledermatology as an application of telemedicine was developed in 1995: it turns out to be a gradually more ordinary mean of delivering dermatologic healthcare worldwide and will almost certainly have a greater medical function in the future. In particular, teledermatology can aid in the prevention and diagnosis of nonmelanoma and melanoma skin cancer; telemedicine and teledermatology offer the opportunity to make available consultations with experts also by long distance. Overall, patients seem to accept teledermatology, considering it as an excellent mean to obtain healthcare, particularly in those areas with no expert dermatologists available. Clinicians have also generally reported affirmative experiences with teledermatology in the skin cancer field. Further studies focusing on cost effectiveness, patient outcomes, and patient and clinician satisfaction will facilitate to delineate the potential of teledermatology as a mean of prevention and diagnosis of nonmelanoma and melanoma skin cancer.

Karyological Features of Achyrocline (Asteraceae, Gnaphalieae): stable karyotypes, low DNA content variation and linkage of rRNA genes.

Many Achyrocline (Asteraceae, tribe Gnaphalieae) species are widely used in Argentina, Brazil and Uruguay as popular medicinal and aromatic plants. Achyrocline flaccida, A. satureioides, A. alata, and A. crassiuscula are distributed in Uruguay and popularly known as 'marcelas'. In order to characterize them, we performed chromosome counts, compared the karyotypes, mapped the 5S and 45S rDNA sites by fluorescent in situ hybridization, and estimated their DNA content. All species were diploid with 2n = 28 chromosomes, this being the first report for A. flaccida and A. crassiuscula. All species showed symmetrical karyotypes composed exclusively of biarmed chromosomes. DNA content estimated by flow cytometry revealed 2C values ranging from 5.73 to 6.03 pg, the amounts for A. alata and A. crassiuscula being higher than those for the other species. Cytogenetic mapping of 5S and 45S rDNA sequences in three species, A. flaccida, A. satureioides and A. alata, showed that in these species both sites co-localized in the pericentromeric region of chromosome 10. This site corresponds to the only DAPI(-) and CMA(+) band of their genomes. Southern blot hybridization of 5S and 45S rDNA on BamHI digested genomic DNA confirmed the tight linkage of these rDNA families into a single unit. Cytological data indicate that Achyrocline species are karyologically poorly differentiated, whereas the uncommon distribution of 5S and 45S rDNA suggests a close relationship with other genera of the Anthemidae tribe.

Parental refusal to immunize a 2-month-old infant.

At a 2-month health supervision visit, Monica's pediatrician was surprised by her mother's wish to withhold immunizations. At prior encounters with her parents, including a prenatal visit, the meeting after Monica's birth, and the 2-week health supervision visit, there was no indication that standard immunizations would be refused. Monica's parents informed her pediatrician that the potential side effects from the immunization led them to think that their healthy child should not be immunized. After talking with other parents in the neighborhood, watching a television program on "children who were brain damaged after getting their shots," and looking at several web sites for parents on the Internet, they concluded that it was safer to withhold the immunizations. "Monica is so healthy.....why give her shots that may make her very sick?" Monica was the first child born to these college-educated parents who had been married for 5 years. The pregnancy was full term and notable for two transient episodes of spotting in the first trimester. Both parents looked forward to Monica's birth. There were no perinatal problems, breast feeding was successful with an appropriate weight gain, and the physical examination was normal. The pediatrician explained to the parents that she understood their concerns. "Most of the things we give children for prevention or treatment of disease may be associated with possible side effects. In the case of immunizations, the chance of a serious side effect is much less than the risk that Monica might acquire one of the diseases we can prevent with an immunization. I have seen a few unimmunized infants who were hospitalized with a very serious case of whooping cough, one of the diseases we can prevent by immunizing Monica." The parents thanked the pediatrician for the information and agreed to read several pamphlets about immunizations. The pediatrician observed that her interchange with the parents was cordial but stressful, for both herself and Monica's parents. As the parents left the office, she wondered if there was a more effective way to talk about immunizations with parents who refuse to immunize their children.

Ultrastructural detection of kinetochores by silver impregnation.

We describe a simple silver impregnation method for the ultrastructural detection of kinetochores on meiotic chromosomes of the grasshopper Eyprepocnemis plorans. Testes were fixed with glutaraldehyde and silver-impregnated. After Epon 812 embedding, ultrathin cutting and counterstaining with uranyl acetate, sections were studied by transmission electron microscopy. The meiotic chromosomes showed differentially silver-impregnated 'ball and cup' kinetochores. Some pericentriolar material also showed silver deposits. These observations are discussed in the light of previous results obtained by light microscopy of silver-stained spermatocytes in which both kinetochores and pericentriolar material were also preferentially stained. These results suggest a role for acidic proteins in the composition of these structures.

Liver disease in hemophiliacs: etiological and biochemical data on 159 cases from our geographical area.

A total of 159 hemophiliacs (149 treated) from our geographical area were screened in 1983 for serological evidence of HBV infection and biochemical evidence of liver disease. All were asymptomatic. HBsAg was detected in 16 cases (10%); anti-HBs and anti-HBc in 106 (67%); 19 (12%) subjects were susceptible to HBV. The HBV infection rate evaluated in 70 patients followed-up from 1980 to 1983 was 28% per year. The cumulative risk of HBV infection as well as the rate of seroconversion to HBV increased with increasing age and with increasing frequency of treatment given during the last 12 months. Anti-delta was detected in the serum of 5 (28%) out of 13 HBsAg-positive cases. Follow-up data showed that in 61% of subjects with liver dysfunction, hepatic damage could not be accounted for by HBV infection. AST and/or gamma-globulin increase was detected in 80% of patients. Abnormalities were more pronounced in HBsAg-positive cases and among them in subjects carrying anti-delta. Further follow-up studies are needed to clarify the long-term prognosis of liver disease in hemophiliacs.