Background/Aim: Non-melanoma skin cancer (NMSC) is the most prevalent type of cancer in adults. Surgery remains the golden-standard treatment for this disease. Mohs micrographic surgery (MMS), a surgical technique, is based on the three-dimensional histopathological examination of the margin and surgical bed, layer by layer, in the excised tissue allowing for the determination of the location of the residual tumor, for its complete excision, with high cure rates and preservation of the unaffected tissue. The aim of this study was to present the epidemiological characteristics of the population that was submitted to MMS, as well as, correlate these characteristics with the characteristics of the tumor itself and the surgical procedure. Patients and Methods: A retrospective cross-sectional study was conducted over a 10-year period with an analysis of patient medical records submitted for MMS at the Department of Dermatology of the ABC School of Medicine. Data were presented and evaluated by nonparametric and parametric analyses, using absolute and relative frequency values for the continuous variable, to which a Chi-square test was applied for the verification of power with a significance level of 5%. For the independent variables, the Student's t-test was used to compare means, with a confidence interval (CI) ranging from 95 to 99%, and Friedman's test was used to verify if there were significant differences in the variables of interest. Results: Female patients accounted for 67% of all enrolled patients (n=335). The mean age was 67 years (SD±12.04; median=68; range=25-93 years). The predominant skin phototype (Fitzpatrick's classification) was phototype II (n=228, 46%). All procedures were performed under local anesthesia. Flap reconstruction was the most predominant surgery type (n=17, 68%). The mean number of MMS's stages was 1.6 (range=1-8). There was a mean of 3.8 fragments of skin tissue (range=1-29) per stage. The mean tumor size was 30 mm (92%). This was associated with female sex (p=0.03), H-zone area (p<0.001), flap reconstruction (p=0.004), tumor removal 7 to 12 months after diagnosis (p<0.001) and non-recurrence tumors (p=0.02). Conclusion: NMSCs were frequently observed in older women with skin phototypes II/III. Reconstruction of the primary defect was feasible under local anesthesia, even in tumors with a marked diameter, decreasing the morbidity of this surgery, providing very satisfactory functional and aesthetic results, reduction costs and ease of access to the surgical procedure. Non-melanoma skin cancer (NMSC) is the most prevalent type of cancer in adults (1, 2). NMSC refers to keratinocytic carcinomas classified as basal cell carcinoma, squamous cell carcinoma and Bowen's disease (3). Surgery remains the gold-standard treatment for this disease. Mohs micrographic surgery (MMS) is replacing the excision and destruction of NMSC in the head, neck, hands, feet and genitalia, due to its advantage in providing high cure rates, preserving normal tissue and optimizing the aesthetic aspects (4). The ...

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Background Mohs micrographic surgery is worldwide used for treating skin cancers. After obtaining tumor-free margins, choosing the most appropriate type of closure can be challenging. Objectives Our aim was to associate type of surgical reconstructions after Mohs micrographic surgery with the characteristics of the tumors as histological subtype, anatomical localization and especially number of surgical stages to achieve complete excision of the tumour. Methods Transversal, retrospective analyses of medical records. Compilation of data such as gender, age, tumor location, histological subtype, number of stages to achieve clear margins and type of repair used. Results A total of 975 of facial and extra-facial cases were analyzed. Linear closure was the most common repair by far (39%) and was associated with the smallest number of Mohs micrographic surgery stages. This type of closure was also more common in most histological subtypes and anatomical locations studied. Using Poisson regression model, nose defects presented 39% higher frequency of other closure types than the frequency of primary repairs, when compared to defects in other anatomic sites ( p < 0.05). Tumors with two or more stages had a 28.6% higher frequency of other closure types than those operated in a single stage ( p < 0.05). Study limitations Retrospective study with limitations in obtaining information from medical records. The choice of closure type can be a personal choice. Conclusions Primary closure should not be forgotten especially in surgical defects with fewer stages and in non-aggressive histological subtypes in main anatomic sites where Mohs micrographic surgery is performed.

The design, prototype implementation, and demonstration of an ethical governor capable of restricting lethal action of an autonomous system in a manner consistent with the Laws of War and Rules of Engagement is presented.

O artigo explora as imbricações entre acumulação capitalista, desterritorialização, racismo e injustiça ambiental em conflitos territoriais urbanos. Por meio de informações históricas e dados demográficos, analisam-se quatro casos no Rio de Janeiro/RJ, entre 2009 e 2016 (período de agudização do caráter neoliberal na governança da cidade): Vila Autódromo, Quilombo do Camorim, Horto Florestal e Santa Marta, que têm em comum a utilização da retórica ambiental estatal como ferramenta para desterritorializações. Destacamos a imputação de atributos ambientais negativos às comunidades (majoritariamente negras) como dimensão importante do racismo ambiental, reduzindo-as à representação da desordem, violando um pressuposto fundamental de sua reprodução cultural (a relação com o ambiente), ao mesmo tempo operando como mecanismo de valorização do solo urbano e controle social.

La Revue des droits de l'homme Revue du Centre de recherches et d'études sur les droits fondamentaux Actualités Droits-Libertés | 2016