BACKGROUND While representing only 3-4% of malignant skin tumors, cutaneous melanoma is the
most aggressive and lethal. Statistical knowledge about the biological behavior of
this tumor is essential for guiding daily outpatient practice and aiding public
health policies. OBJECTIVES To analyze the profile of patients with cutaneous melanoma attending a pathology
department in Teresina (state of Piauí) between 2000 and 2010. METHODS Retrospective study of melanoma patients diagnosed between 2000 and 2010 in the
São Marcos Hospital in the city of Teresina. The pathology laboratory reports were
studied and all the statistical analyses performed using SPSS 19.0. RESULTS A total of 25 in situ, 199 invasive and 89 metastatic melanomas of unknown
primary site were observed. Histological types found were nodular (52.8%),
superficial spreading melanoma (18.6%), acral (10.6%) and lentigo maligna (9.5%).
In 144 (73.4%) cases the Breslow thickness was >1 mm. Metastasis was found in
28.6% of invasive melanomas and nodular melanoma, Clark IV/ V, Breslow > 1 mm,
mitotic index ≥ 6 and ulcerated lesions were more likely to metastasize. CONCLUSION Most melanomas presented Breslow> 1mm. The main factors associated with
metastasis were nodular type, Clark IV / V, Breslow> 1mm, mitotic index ≥ 6
and ulcerated lesions.
Botulinum toxin is already in use to treat abdominal wall giant hernia. The concept is to reduce pressure e create new space in the abdominal compartiment after the surgey. We show a case that a similar aproach was used to treat giant hiatal hernia.
Methods
We used botulinum toxin 4 weeks prior the surgery to increase de abdominal compartment. it was checked in a ct scan.
Results
The surgey was performed with a hiatoplasty, fundoplication and a gastropexy.
Conclusion
The use of botulinum seens to be a new stragy for selected cases.
Video
https://www.dropbox.com/s/td7fr3a6buejqnd/Bianchi%20ET%20botox.wmv?dl=0.
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