Dermoscopic nevus patterns in skin of colour: a prospective, cross-sectional, morphological study in individuals with skin type V and VI.

BACKGROUND: Most of the knowledge on the prevailing dermoscopic patterns of acquired melanocytic nevi (AMV) is based on studies in Caucasians, while little research focuses on the dermoscopic variability in nevi in skin of colour. OBJECTIVE: To analyse the prevalent dermoscopic nevus patterns in subjects with a skin type (ST) V and VI. METHODS: Prospective, cross-sectional, morphological study was conducted in six clinics with enrolment of consecutive individuals with a ST V or VI. Digital dermoscopic images of selected representative AMN were assessed for dermoscopic colours, morphological patterns and pigment distribution. RESULTS: Analysis of 300 nevi from subjects with ST V and VI revealed significant differences in the nevus pattern between these two groups. The majority of nevi in ST V revealed a reticular pattern, whereas persons with ST VI more frequently exhibited a structureless pattern. Black, blue and grey were more frequent in ST VI, whereas the vast majority of nevi in ST V individuals showed dark brown colour. CONCLUSIONS: Our study provides new insights into the nevus pattern in individuals with a dark pigmentary trait, which may aid the diagnosis and management of nevi in this patients group.

Melanocytic nevi with special features: clinical-dermoscopic and reflectance confocal microscopic-findings.

Histopathology is considered the 'gold' standard for the diagnosis and classification of melanocytic nevi, but the widespread use of in vivo diagnostic technologies such as dermoscopy and reflectance confocal microscopy (RCM), has enriched profoundly the knowledge regarding the morphological variability in nevi. This is because most morphological observations made via these in vivo tools are closely correlated with features seen in histopathology. Dermoscopy has allowed for a more detailed classification of nevi. As such, dermoscopy identifies four main morphologic groups (i.e. globular, reticular, starburst and structureless blue nevi), one group of nevi located at special body sites (i.e. face, acral, nail) and one group of nevi with special features. This latter category consists of nevi of the former categories, which are typified by peculiar clinical-histopathological findings. They can be subdivided into 'melanoma simulators' including combined nevi, recurrent nevi and sclerosing nevus with pseudomelanomatous features, 'targetoid' nevi (i.e. halo, cockade, irritated targetoid haemosiderotic and eczematous nevus) and uncommon histopathological variants such as desmoplastic, white dysplastic or ballon cell nevus. While the dermoscopic and RCM patterns of the former categories have been studied in detail, little is currently known about the clinical morphology of the heterogeneous group of 'special' nevi. In this article, we describe the clinical, dermoscopic and RCM features of 'special' nevi and review the current literature on this group of melanocytic proliferations.

A survey of management practices that influence production and welfare of dairy cattle on family farms in southern Brazil.

A survey on dairy production in family dairy farms in the northwest of Santa Catarina, Brazil, was carried out to assess husbandry practices and elements of the living environment that may influence animal welfare and productivity. Three farm systems common in the region were compared: extensive, pasture-based, and semi-intensive. Data were collected through face-to-face interviews with farmers, followed by an inspection of the production environment and of dairy cows on 124 dairy farms. Some welfare and production problems were common to the 3 systems, mainly subclinical mastitis and tick infestations, which affected one-third of cows, deficiencies in the provision of drinking water and shade, and poor hygiene practices during milking. Some problems were specific to farming systems, such as lameness and hock injuries on the semi-intensive farms, and inadequate milking infrastructure and greater frequencies of cows with low body condition scores on extensive and pasture-based farms. A greater proportion of farms in the semi-intensive group had modern, herringbone-type milking parlors, applied the California Mastitis Test, and followed teat disinfection practices, and more pasture-based farms provided shade in the paddocks. The widespread use of pasture and adapted genotypes and individual identification of animals were positive aspects present in all systems. The absence of health and production records in more than half of the farms may prevent farmers from recognizing certain problems. Results of this survey may guide public policies aiming to improve milk productivity and quality with sustainable and low-cost production practices.

[Isosorbide-5-mononitrate in the prevention of digestive hemorrhage in cirrhosis: randomized study]. / 5 mononitrato de isosorbide en la prevención de la hemorragia digestiva en cirrosis: estudio randomizado.

Isosorbide 5-mononitrate (5MI) is a preferential venous dilator that has been shown to decrease portal pressure in acute and long-term haemodynamic studies, and this is not associated with adverse effects on hepatic perfusion. The aim of this trial was to investigate the efficacy and safety of 5MI in the prevention of upper gastrointestinal bleeding in cirrhotic patients. Forty two cirrhotic patients with F2 or F3 esophageal varices showing "red signs" and who had never bled were included and randomly y assigned to receive either 5MI (group I,n23) or placebo (group P,n19). Patients with hepatocarcinomas or complications potentially lethal in the short-term or who were being given drugs such as steroids or interferon were excluded. The end points of the study were bleeding and death. There were no significant differences between the groups in the basal clinical and laboratory data. The mean +/- SD follow-up time was 49 +/- 36 and 43 +/- 25 weeks in the groups I and P, respectively. The percentage of patients free of bleeding 61 weeks after inclusion in the study was 62.4% in the group I and 46.3% in the group P (NS). The percentage of patients surviving 85 weeks after inclusion in the study was 81.2% in the group I and 39.8% in the group P (NS). Treatment did not have to be stopped in any patient of both groups because of side effects. In conclusion, 5MI is a safe drug for the chronic management of portal hypertension, that showed a trend to reduce the risk of bleeding and death in cirrhosis with large esophageal varices.(ABSTRACT TRUNCATED AT 250 WORDS)

5 mononitrato de isosorbide en la prevención de la hemorragia digestiva en cirrosis: estudio randomizado. / [Isosorbide-5-mononitrate in the prevention of digestive hemorrhage in cirrhosis: randomized study]

Isosorbide 5-mononitrate (5MI) is a preferential venous dilator that has been shown to decrease portal pressure in acute and long-term haemodynamic studies, and this is not associated with adverse effects on hepatic perfusion. The aim of this trial was to investigate the efficacy and safety of 5MI in the prevention of upper gastrointestinal bleeding in cirrhotic patients. Forty two cirrhotic patients with F2 or F3 esophageal varices showing [quot ]red signs[quot ] and who had never bled were included and randomly y assigned to receive either 5MI (group I,n23) or placebo (group P,n19). Patients with hepatocarcinomas or complications potentially lethal in the short-term or who were being given drugs such as steroids or interferon were excluded. The end points of the study were bleeding and death. There were no significant differences between the groups in the basal clinical and laboratory data. The mean +/- SD follow-up time was 49 +/- 36 and 43 +/- 25 weeks in the groups I and P, respectively. The percentage of patients free of bleeding 61 weeks after inclusion in the study was 62.4

in the group I and 46.3

in the group P (NS). The percentage of patients surviving 85 weeks after inclusion in the study was 81.2

in the group I and 39.8

in the group P (NS). Treatment did not have to be stopped in any patient of both groups because of side effects. In conclusion, 5MI is a safe drug for the chronic management of portal hypertension, that showed a trend to reduce the risk of bleeding and death in cirrhosis with large esophageal varices.(ABSTRACT TRUNCATED AT 250 WORDS)