Epiluminescence microscopy: Criteria of cutaneous melanoma progression

Background: Cutaneous melanoma develops through a series of evolutionary steps (intraepidermal, radial, and vertical growth phases) that are traceable in specific histologic features. Epiluminescence microscopy (ELM) is an in vivo technique that enables the visualization of morphologic structures in pigmented lesions correlated with specific histologic architectural characteristics. Many ELM criteria associated with cutaneous melanoma have been described, but their correlation with tumor progression has not yet been established. Objective: In this preliminary study our purpose was to explore the possibility of recognizing ELM criteria that allow the in vivo detection of the various phases of melanoma progression as well as tumor depth. Methods: Seventy-two cutaneous melanomas (41 'thin' melanomas [TnM], 0.75 mm thickness) were investigated with ELM for the presence of nine standard ELM criteria; their significance was determined by calculating the chi-square test of independence. Results: A significant association is found between the presence of pigment network and TaM and between the presence of gray-blue areas, vascular pattern, and TkM. Moreover, pigment network plus radial streaming is the most significant association of ELM criteria in TnM, whereas gray-blue areas plus vascular pattern is the greatest in TkM. Conclusion: This study shows a good correlation between certain ELM criteria and the histologic architecture of cutaneous melanoma for a preoperative evaluation of the tumor thickness. Further investigation is needed for verifying on a larger number of cases our pilot estimates of sensitivity and specificity of ELM criteria in thin and thick melanomas

Clinical and dermatoscopic criteria for the preoperative evaluation of cutaneous melanoma thickness

Background: Melanoma thickness measured according to the Breslow method is used to determine surgical margin and in patient selection for sentinel node biopsy. Previous studies did not confirm the reliability of melanoma palpability for clinical prediction of tumor thickness. Recently we reported the usefulness of epiluminescence microscopy (dermatoscopy) for in vivo detection of the phases of melanoma progression, as well as tumor depth. Objective: Our purpose was to determine whether the combination of clinical and dermatoscopic criteria could increase the accuracy in preoperative evaluation of melanoma thickness with respect to the clinical elevation and dermatoscopic assessments considered separately. Methods: In a blind retrospective study, 122 cutaneous melanomas were studied to evaluate the presence of several clinical and dermatoscopic criteria and their relation with the histologic thickness. An algorithm of combined criteria was constructed and statistically assessed. Results: Combinations of palpability, diameter of more than 15 mm, pigment network, gray-blue areas, and atypical vascular pattern allowed correct prediction of thickness in 89% of melanomas when categorized in two groups of less than 0.76 mm and more than 0.75 mm thickness, compared with 75% using palpability, and 80% using dermatoscopic criteria. Lower values were obtained in the further subdivision of melanomas into groups of 0.76 to 1.5 mm and more than 1.5 mm thickness. Conclusion: The combination of clinical and dermatoscopic criteria is a more precise guide for the preoperative evaluation of melanoma thickness than either is alone. However, further studies are needed to verify its applicability in establishing the surgical approach to cutaneous melanoma

PERLINDUNGAN KONSUMEN TERHADAP MAKANAN JAJANAN YANG MENGANDUNG FORMALIN DAN BORAKS(SUATU PENELITIAN DI KOTA BANDA ACEH)

ABSTRAKNANDA MAULINA SAFIRA,PERLINDUNGAN KONSUMEN TERHADAP 2014MAKANAN JAJANAN YANG MENGANDUNG FORMALIN DAN BORAKS (Studi Penelitian di Kota Banda Aceh)Fakultas Hukum Universitas Syiah Kuala(iv, 63) pp., tabl., bibl., appdx.( RISMAWATI, S.H., M.Hum. )Dalam Pasal 4 huruf a Undang-Undang Perlindungan Konsumen dijelaskan bahwa konsumen memiliki hak atas keselamatan dalam mengkonsumsi barang. Dalam Pasal 67 Undang-Undang Nomor 18 Tahun 2012 tentang Pangan dijelaskan bahwa ketentuan keamanan pangan diselenggarakan untuk menjaga pangan tetap aman dikonsumsi, sehingga terhindar dari kemungkinan cemaran biologis atau kimia yang dapat membahayakan kesehatan manusia. Dalam Peraturan Menteri Kesehatan Nomor 33 Tahun 2012 tentang Bahan Tambahan Pangan disebutkan bahwa bahan yang dilarang digunakan sebagai bahan tambahan pangan diantaranya adalah formalin dan boraks. Pada kenyataannya, di Kota Banda Aceh terdapat masalah dalam mewujudkan perlindungan konsumen terhadap makanan jajanan yang mengandung formalin dan boraks.Penulisan skripsi ini bertujuan untuk menjelaskan perlindungan konsumen terhadap makanan jajanan yang mengandung formalin dan boraks, faktor penyebab tidak berjalannya perlindungan konsumen terhadap makanan jajanan yang mengandung formalin dan boraks, dan upaya mengatasi hambatan perwujudan perlindungan konsumen terhadap makanan jajanan yang mengandung formalin dan boraks.Data yang diperlukan dalam tulisan ini adalah data sekunder dan data primer. Data sekunder diperoleh melalui penelitian kepustakaan dilakukan dengan cara membaca peraturan perundang-undangan, buku-buku, surat kabar dan bahan-bahan lain yang berkaitan dengan penelitian ini, dan data primer diperoleh dengan cara mewancarai responden dan informan.Hasil penelitian menunjukkan bahwa perlindungan konsumen terhadap makanan jajanan yang mengandung formalin dan boraks di Kota Banda Aceh, belum berjalan sebagaimana yang telah diatur dalam Undang-Undang Nomor 18 Tahun 2012 dan Peraturan Menteri Kesehatan Nomor 33 Tahun 2012. Faktor penyebab tidak berjalannya perlindungan konsumen terhadap makanan jajanan yang mengandung formalin dan boraks yaitu kurangnya sosialisasi peraturan perundang-undangan, kurangnya pengawasan, kurangnya ketegasan dalam penerapan sanksi dan kurangnya laporan dari pihak masyarakat.Upaya mengatasi hambatan perwujudan perlindungan konsumen terhadap makanan jajanan yang mengandung formalin dan boraks yaitu penyuluhan hukum, pengawasan, peringatan dan pembinaan.Disarankan kepada instansi pemerintahan seperti Dinas Kesehatan dan BBPOM untuk menambah jumlah petugas serta mengalokasikan dana dalam melakukan pemeriksaan dan pengujian makanan jajanan sehingga terselenggaranya perlindungan konsumen terhadap makanan jajanan yang mengandung formalin dan boraks.Banda Ace

Vive la difference! the effects of natural and conventional wines on blood alcohol concentrations: A randomized, triple-blind, controlled study

Different alcoholic beverages can have different effects on blood alcohol concentration (BAC) and neurotoxicity, even when equalized for alcohol content by volume. Anecdotal evidence suggested that natural wine is metabolized differently from conventional wines. This triple-blind study compared the BAC of 55 healthy male subjects after consuming the equivalent of 2 units of alcohol of a natural or conventional wine over 3 min in two separate sessions, one week apart. BAC was measured using a professional breathalyzer every 20 min after consumption for 2 h. The BAC curves in response to the two wines diverged significantly at twenty minutes (interval T20) and forty minutes (interval T40), and also at their maximum concentrations (peaks), with the natural wine inducing a lower BAC than the conventional wine [T20 = 0.40 versus 0.46 (p < 0.0002); T40 = 0.49 versus 0.53 (p < 0.0015); peak = 0.52 versus 0.56 (p < 0.0002)]. These differences are likely related to the development of different amino acids and antioxidants in the two wines during their production. This may in turn affect the kinetics of alcohol absorption and metabolism. Other contributing factors could include pesticide residues, differences in dry extract content, and the use of indigenous or selected yeasts. The study shows that with the same quantity and conditions of intake, natural wine has lower pharmacokinetic and metabolic effects than conventional wine, which can be assumed due to the different agronomic and oenological practices with which they are produced. It can therefore be hypothesized that the consumption of natural wine may have a different impact on human health from that of conventional wine

Epiluminescence microscopy for the diagnosis of doubtful melanocytic skin lesions: Comparison of the ABCD rule of dermatoscopy and a new 7-point checklist based on pattern analysis

Objective: To compare the reliability of a new 7-point checklist based on simplified epiluminescence microscopy (ELM) pattern analysis with the ABCD rule of dermatoscopy and standard pattern analysis for the diagnosis of clinically doubtful melanocytic skin lesions. Design: In a blind study, ELM images of 342 histologically proven melanocytic skin lesions were evaluated for the presence of 7 standard criteria that we called the 'ELM 7-point checklist.' For each lesion, 'overall' and 'ABCD scored' diagnoses were recorded. From a training set of 57 melanomas and 139 atypical non-melanomas, odds ratios were calculated to create a simple diagnostic model based on identification of major and minor criteria for the '7-point scored' diagnosis. A test set of 60 melanomas and 86 atypical non-melanomas was used for model validation and was then presented to 2 less experienced ELM observers, who recorded the ABCD and 7-point scored diagnoses. Settings: University medical centers. Patients: A sample of patients with excised melanocytic lesions. Main Outcome Measures: Sensitivity, specificity, and accuracy of the models for diagnosing melanoma. Results: From the total combined sets, the 7-point checklist gave a sensitivity of 95% and a specificity of 75% compared with 85% sensitivity and 66% specificity using the ABCD rule and 91% sensitivity and 90% specificity using standard pattern analysis (overall ELM diagnosis). Compared with the ABCD rule, the 7-point method allowed less experienced observers to obtain higher diagnostic accuracy values. Conclusions: The ELM 7-point checklist provides a simplification of standard pattern analysis because of the low number of features to identify and the scoring diagnostic system. As with the ABCD rule, it can be easily learned and easily applied and has proven to be reliable in diagnosing melanoma