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https://www.readbyqxmd.com/read/29774540/conservative-thickness-layers-in-mohs-micrographic-surgery
#1
Stanislav N Tolkachjov, Jonathan A Cappel, Elizabeth A Bryant, Christopher B Harmon
BACKGROUND: Mohs micrographic surgery (MMS) is used to treat cutaneous malignancies in locations to maximize tissue sparing. The authors' aim is to demonstrate the utility of conservative thickness layers (CTL) in MMS and review patient and tumor characteristics and the potential anatomic locations where this technique may be most useful. METHODS: We performed a retrospective chart review of patients with tumors treated with CTL in MMS of 339 tumors, recording patient demographics, tumor characteristics, MMS stages for clearance, repairs, complications, and follow-up...
May 17, 2018: International Journal of Dermatology
https://www.readbyqxmd.com/read/29771877/cholera-epidemic-lusaka-zambia-october-2017-may-2018
#2
Nyambe Sinyange, Joan M Brunkard, Nathan Kapata, Mazyanga Lucy Mazaba, Kunda G Musonda, Raymond Hamoonga, Muzala Kapina, Fred Kapaya, Lwito Mutale, Ernest Kateule, Francis Nanzaluka, James Zulu, Chileshe Lukwesa Musyani, Alison V Winstead, William W Davis, Hammad S N'cho, Nelia L Mulambya, Patrick Sakubita, Orbie Chewe, Sulani Nyimbili, Ezinne V C Onwuekwe, Nedghie Adrien, Anna J Blackstock, Travis W Brown, Gordana Derado, Nancy Garrett, Sunkyung Kim, Sydney Hubbard, Amy M Kahler, Warren Malambo, Eric Mintz, Jennifer Murphy, Rupa Narra, Gouthami G Rao, Margaret A Riggs, Nicole Weber, Ellen Yard, Khozya D Zyambo, Nathan Bakyaita, Namani Monze, Kennedy Malama, Jabbin Mulwanda, Victor M Mukonka
On October 6, 2017, an outbreak of cholera was declared in Zambia after laboratory confirmation of Vibrio cholerae O1, biotype El Tor, serotype Ogawa, from stool specimens from two patients with acute watery diarrhea. The two patients had gone to a clinic in Lusaka, the capital city, on October 4. Cholera cases increased rapidly, from several hundred cases in early December 2017 to approximately 2,000 by early January 2018 (Figure). In collaboration with partners, the Zambia Ministry of Health (MoH) launched a multifaceted public health response that included increased chlorination of the Lusaka municipal water supply, provision of emergency water supplies, water quality monitoring and testing, enhanced surveillance, epidemiologic investigations, a cholera vaccination campaign, aggressive case management and health care worker training, and laboratory testing of clinical samples...
May 18, 2018: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/29770463/a-first-for-dermatopathology-and-pathology-in-general-appropriate-use-criteria-in-dermatopathology-from-the-american-society-of-dermatopathology
#3
Adam I Rubin, Michael Hitchcock
In this issue of the Journal of Cutaneous Pathology(1), the ASDP Appropriate Use Criteria (AUC) Task Force releases a landmark series of recommendations on AUC from the American Society of Dermatopathology. This is the first set of AUC in dermatopathology and, indeed, in pathology overall. These recommendations were developed as part of the work of the ASDP AUC Task Force, created in 2015. This publication provides strong, evidence-based recommendations that will improve the delivery and utilization of care for our patients, just as AUC for Mohs surgery have elevated the discourse on that procedure for the benefit of patients and society as a whole(2)...
May 17, 2018: Journal of Cutaneous Pathology
https://www.readbyqxmd.com/read/29770284/solitary-palmar-keratoacanthoma-case-report
#4
Raghavendra L Girijala, Young Kwak, David Wright, Leonard H Goldberg
Keratoacanthoma (KA) is a squamous neoplasm exhibiting a triphasic growth pattern involving rapid growth, stabilization, and eventual spontaneous resolution. Historically, keratoacanthomas were thought to originate on hair-bearing skin or sun-exposed surfaces. However, recent reports demonstrate that they can occur on the mucous membranes, subungual regions, and palms and soles. We report a 74-year-old man who developed a KA on the left palmar surface after minor trauma, for which he underwent Mohs' micrographic surgery...
March 15, 2018: Curēus
https://www.readbyqxmd.com/read/29765274/review-of-eyelid-reconstruction-techniques-after-mohs-surgery
#5
REVIEW
Sagar Yatin Patel, Kamel Itani
Mohs micrographic surgery achieves high cure rates while preserving healthy tissue making it the optimal treatment for skin cancer. The goals of eyelid reconstruction after Mohs surgery include restoring eyelid structure and function while attaining acceptable aesthetic results. Given the variety of eyelid defects encountered after Mohs surgery, a thorough understanding of the complex eyelid anatomy as well as an in-depth knowledge of the numerous reconstructive techniques available are required to accomplish these reconstructive goals...
May 2018: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/29765270/simplifying-lip-reconstruction-an-algorithmic-approach
#6
REVIEW
Kyle J Sanniec, Jourdan A Carboy, James F Thornton
The authors provide an overview of lip reconstruction after Mohs surgery based on the senior author's practice. Lip reconstruction offers unique challenges to preserve not only lip function but also aesthetics. Lip reconstruction must take into consideration the three anatomical layers that comprise the lip and defects that involve the mucosa, the muscle, the skin or more than one layer will help determine the modality of repair. The authors offer an algorithm based on defect location, tissue involvement, and severity of defect to simplify an often complex decision-making process...
May 2018: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/29765269/mohs-micrographic-surgery-development-technique-and-applications-in-cutaneous-malignancies
#7
REVIEW
Eillen Luisa A Chen, Divya Srivastava, Rajiv I Nijhawan
Mohs micrographic surgery (MMS) is a specialized technique for treating skin malignancies that offers the highest cure rate by allowing histological evaluation of the entire peripheral and deep margins. MMS also maximally preserves as much uninvolved, normal adjacent tissue as possible, allowing for the best cosmetic and functional outcomes. When used for appropriate indications, this technique is also more cost-effective than other treatment modalities. In this article, the authors will discuss the development of MMS, the steps involved in this procedure, and the indications for this technique...
May 2018: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/29765268/approach-to-the-post-mohs-patient
#8
REVIEW
James F Thornton, Jourdan A Carboy
This article discusses the often unique patient presentations and management challenges of the post Mohs resection surgical patient. This includes social, economic, and health issues. Anesthesia considerations and pre- and postoperative care are also discussed in this article.
May 2018: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/29765267/facial-mohs-reconstruction
#9
James F Thornton
No abstract text is available yet for this article.
May 2018: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/29764108/factors-that-influence-enrolment-and-retention-in-ghana-national-health-insurance-scheme
#10
Agnes Millicent Kotoh, Genevieve Cecilia Aryeetey, Sjaak Van der Geest
BACKGROUND: The government of Ghana introduced the National Health Insurance Scheme (NHIS) in 2004 with the goal of achieving universal coverage within 5 years. Evidence, however, shows that expanding NHIS coverage and especially retaining members have remained a challenge. A multilevel perspective was employed as a conceptual framework and methodological tool to examine why enrolment and retention in the NHIS remains low. METHODS: A household survey was conducted after 20 months educational and promotional activities aimed at improving enrolment and retention rates in 15 communities in the Central and Eastern Regions (ERs) of Ghana...
October 17, 2017: International Journal of Health Policy and Management
https://www.readbyqxmd.com/read/29763492/perianal-extramammary-paget-disease-treated-with-topical-imiquimod-and-oral-cimetidine
#11
Jayla Gray, Arielle Gray, James Swan, Joshua Eberhardt, Kumaran Mudaliar, Rebecca Tung
Extramammary Paget disease (EMPD) is a rare intraepithelial adenocarcinoma. The current mainstay of treatment is wide local excision. We present the case of a 56-year-old woman with perianal EMPD that recurred 4 years after initial treatment with wide local excision with Mohs micrographic surgery tissue processing of marginal tissue. Upon recurrence with anal canal involvement, the patient was treated with a 16-week combination course of topical imiquimod and oral cimetidine. There is growing evidence to support both the use of topical imiquimod for the treatment of EMPD as well as the antioncogenic effects of oral cimetidine...
April 2018: Cutis; Cutaneous Medicine for the Practitioner
https://www.readbyqxmd.com/read/29763491/penile-squamous-cell-carcinoma-with-urethral-extension-treated-with-mohs-micrographic-surgery
#12
Ardeshir E Nadimi, Ali Hendi
Penile squamous cell carcinoma (SCC) with considerable urethral extension is uncommon and difficult to manage. It often is resistant to less invasive and nonsurgical treatments and frequently results in partial or total penectomy, which can lead to cosmetic disfigurement, functional issues, and psychological distress. We report a case of penile SCC in situ with considerable urethral extension with a focus of cells suspicious for moderately well-differentiated and invasive SCC that was treated with Mohs micrographic surgery (MMS)...
April 2018: Cutis; Cutaneous Medicine for the Practitioner
https://www.readbyqxmd.com/read/29747633/a-critique-of-the-uganda-district-league-table-using-a-normative-health-system-performance-assessment-framework
#13
Christine KirungaTashobya, Freddie Ssengooba, Juliet Nabyonga-Orem, Juliet Bataringaya, Jean Macq, Bruno Marchal, Timothy Musila, Bart Criel
BACKGROUND: In 2003 the Uganda Ministry of Health (MoH) introduced the District League Table (DLT) to track district performance. This review of the DLT is intended to add to the evidence base on Health Systems Performance Assessment (HSPA) globally, with emphasis on Low and Middle Income Countries (LMICs), and provide recommendations for adjustments to the current Ugandan reality. METHODS: A normative HSPA framework was used to inform the development of a Key Informant Interview (KII) tool...
May 10, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29746431/impact-of-mohs-micrographic-surgery-on-tumor-staging-of-cutaneous-squamous-cell-carcinoma-a-comparison-of-the-7th-and-8th-editions-of-the-american-joint-committee-on-cancer-guidelines
#14
Michael A Montuno, Brandon Brown, Sailesh Konda, Kiran Motaparthi
BACKGROUND: Based on current AJCC-7 guidelines for staging cutaneous squamous cell carcinoma (cSCC), patients with T2 tumor staging represent a prognostically heterogeneous group. The new AJCC-8 guidelines seek to provide improved stratification by inclusion of independent risk factors in the T3 category. These features may be identified in tissue stages during Mohs micrographic surgery (MMS). Thus, low-risk cSCC may be upstaged after MMS, impacting prognosis, additional evaluation, and adjuvant nonsurgical treatment...
May 4, 2018: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/29746011/medication-overuse-headache-detoxification-reduces-headache-disability-the-akershus-study-of-chronic-headache
#15
Espen Saxhaug Kristoffersen, Ragnhild Berling Grande, Kjersti Aaseth, Michael Bjørn Russell, Christofer Lundqvist
BACKGROUND: Medication-overuse headache (MOH) is a chronic headache (≥ 15 days/month) associated with overuse of acute headache medication. The objective was to investigate headache-related disability before and after self-detoxification from MOH in the general population, as well as possible predictors for successful outcome. METHODS: A prospective cohort study. Participants were identified in a cross-sectional epidemiological sample of 30 000 persons aged 30-44 from the general Norwegian population...
May 10, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29742183/facial-basal-cell-carcinoma-in-patients-younger-than-40
#16
Ardeshir Edward Nadimi, Yizhao Zhou, Jaeil Ahn, Ali Hendi
INTRODUCTION: The incidence of basal cell carcinoma in the population younger than 40 years is rising, and a majority of basal cell carcinomas occur on the head and neck. Our objective was to determine whether basal cell carcinomas in the population younger than 40 years occur more frequently at the forehead and its subunits (forehead proper, temple, suprabrow, and glabella). METHODS: We performed a retrospective case review of 4,337 basal cell carcinomas in 3,223 patients treated with Mohs micrographic surgery...
May 1, 2018: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/29742181/a-retrospective-analysis-of-complication-rates-in-mohs-micrographic-surgery-patients-with-clinically-large-tumors-and-tumors-with-aggressive-subclinical-extension
#17
Natasha Cowan, Alina Goldenberg, Pallavi Basu, Robert Eilers, Jennifer Hau, Shang I Brian Jiang
BACKGROUND: Clinically large cutaneous tumors and those with aggressive subclinical extension (ASE) often require wider margins and increased operative time during Mohs micrographic surgery (MMS). Our goal is to improve dermatologic surgeons' counseling information on complication risks for aggressive tumors. OBJECTIVE: To examine the incidence of postoperative complications in MMS patients, with a focus on differences between aggressive and non-aggressive tumors...
May 1, 2018: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/29742179/demographic-and-tumor-characteristics-of-patients-younger-than-50-years-with-nonmelanoma-skin-cancer-referred-for-mohs-micrographic-surgery
#18
Nicola A Quatrano, Euphemia W Mu, David E Orbuch, Adele Haimovic, Roy G Geronemus, Jeremy A Brauer
BACKGROUND: An increase in nonmelanoma skin cancer (NMSC) in younger patients has been reported. Many are treated with Mohs micrographic surgery (MMS). OBJECTIVE: Investigate patient and tumor characteristics in patients less than 50 years undergoing MMS for NMSC at a large, referral-based practice. METHODS & MATERIALS: Retrospective chart review of 1,332 tumors occurring in 1,018 consecutive patients over a five-year period. RESULTS: 81...
May 1, 2018: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/29736115/developing-a-training-course-for-spiritual-counselors-in-health-care-evidence-from-iran
#19
Behzad Damari, Ahmad Hajebi, Jafar Bolhari, Alireza Heidari
Background: Spiritual health can cause mental health promotion and well-being of the people's lives but it is still neglected in practice so that there is no trace of spiritual training in medical education in Iran. This study was conducted to develop a training course for spiritual counselors in the Iranian health-care system. Methods: In this qualitative study, senior managers of the Ministry of Health (MOH) and experts in the related fields were purposively selected as the participants...
April 2018: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/29732876/surface-properties-of-laser-treated-molybdenum-disulfide-nanosheets-for-optoelectronic-applications
#20
Abdullah Alrasheed, Justin M Gorham, Bien Cuong Tran Khac, Fadhel Alsaffar, Frank William DelRio, Koo-Hyun Chung, Moh R Amer
Transition metal dichalcogenide two-dimensional materials have attracted significant attention due to their unique optical, mechanical, and electronic properties. For example, molybdenum disulfide (MoS2) exhibits a tunable band gap that strongly depends on the numbers of layers, which makes it an attractive material for optoelectronic applications. In addition, recent reports have shown that laser thinning can be used to engineer an MoS2 monolayer with specific shapes and dimensions. Here, we study laser-thinned MoS2 in both ambient and vacuum conditions via confocal µ-Raman spectroscopy, imaging X-ray photoelectron spectroscopy (i-XPS), and atomic force microscopy (AFM)...
May 7, 2018: ACS Applied Materials & Interfaces
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