Assuntos
Implante Mamário/efeitos adversos , Implantes de Mama/efeitos adversos , Celulose/análogos & derivados , Reação a Corpo Estranho/etiologia , Hidrogel de Polietilenoglicol-Dimetacrilato , Adulto , Celulose/efeitos adversos , Celulose/farmacocinética , Feminino , Humanos , Hidrogel de Polietilenoglicol-Dimetacrilato/efeitos adversos , Hidrogel de Polietilenoglicol-Dimetacrilato/farmacocinética , Osmose , Falha de Prótese , Reino UnidoRESUMO
We investigated whether the pigmented-lesion clinic (PLC) run by the Department of Plastic and Reconstructive Surgery at Frenchay Hospital was effective in making and excluding the diagnosis of malignant melanoma, by looking at the pattern of referrals over time, the number of melanomas excised and melanomas in which the diagnosis was delayed or missed. We also investigated whether the PLC was having an effect on the thicknesses of melanomas excised. All 9968 patients attending the PLC between 1 January 1993 and 31 December 1998 were included in the study and 586 malignant melanomas were diagnosed; 24.7% of excisions led to the diagnosis of malignant melanoma. Seven invasive melanomas and two lentigo malignas were missed. There was one histological false negative. The PLC has a sensitivity of 98.5% and specificity of 89.2% for the diagnosis of melanoma; the negative predictive value is 99.9%. The PLC is effective in rapidly making or excluding the diagnosis of malignant melanoma, but has had no effect on the average thickness of melanomas excised over the 6 year study period.
Assuntos
Erros de Diagnóstico , Melanoma/diagnóstico , Neoplasias Cutâneas/diagnóstico , Adulto , Idoso , Biópsia , Reações Falso-Negativas , Feminino , Humanos , Masculino , Melanoma/cirurgia , Pessoa de Meia-Idade , Pacientes Desistentes do Tratamento , Estudos Prospectivos , Encaminhamento e Consulta , Sensibilidade e Especificidade , Neoplasias Cutâneas/cirurgia , Estatísticas não ParamétricasRESUMO
BACKGROUND AND OBJECTIVE: Many laser centres utilise various transparent membranes during treatment sessions with Q-switched lasers to prevent or reduce tissue splatter, thereby reducing the aerosolised biohazard of cellular debris to operator and laser. STUDY DESIGN/MATERIALS AND METHODS: We performed a series of experiments with the Q-Switched Nd:YAG laser, a selection of 11 varieties of membrane and a power meter in order to ascertain which of the membranes was the most effective protector concerning transmission of laser energy. Other mechanical properties such as transparency, strength, ease of application, and flexibility were taken into account. RESULTS: Tegaderm (overall average 94% transmission), Cling Film (93%), Bioclusive (89%), Opsite (91%), and Microwave Cling Film (87%) all consistently performed well in pure transmission terms, whereas other membranes tested such as Acetate (74%), Grades of Melinex (75%, 72%, 75%), 2nd Skin (74%), and Perspex (68%) were unsuitable as protection. CONCLUSION: Cling Film proved to be the best all round membrane. We recommend its use for operator and laser protection against the tissue spatter produced from the Q-Switched Nd:YAG laser.