RESUMO
INTRODUCTION: The advent of immunotherapy has impacted both the management and, to a lesser extent, the outcomes for patients with head and neck mucosal melanoma. As a consequence, one might expect that the role of the surgeon would be limited to the diagnostic work-up and that systemic therapies would be the mainstay of treatment. METHODS AND RESULTS: Here, we present the surgical aspects of the recently published United Kingdom Head and Neck Mucosal Melanoma Guideline to highlight the continued role of surgeons in the management of this disease. We highlight key areas where surgeons remain the lead clinician and reinforce the multidisciplinary requirement for exemplary patient care. CONCLUSIONS: Despite the advent of immunotherapy, surgeons continue to have a key role to play in this disease. When indicated, it is essential that appropriate surgery is offered by a suitably experienced team.
Assuntos
Neoplasias de Cabeça e Pescoço , Melanoma , Cirurgiões , Terapia Combinada , Neoplasias de Cabeça e Pescoço/cirurgia , Humanos , Imunoterapia , Melanoma/terapiaRESUMO
Bullying in schools is now widely acknowledged and the detrimental effect on children who are bullied is well recognised. A literature review aimed at exploring the links between bullying and depression in primary school children uncovered evidence of depression in the children who bully. Further analysis of the literature identified conflicting research findings. This article summarises the causes and implications of aggression and bullying behaviour, including future outcomes for children who bully. Further research is necessary as the evidence suggesting that bullies are depressed contradicts indications that they are confident and have a high self-esteem.
