Reconstruction of the nasal subunits after tumor resection

Introduction: A majority of the nods present for reconstruction are secondary to tumor excision. The objective is to analyze the efficacy of the reconstructive technique used to cover the defect after tumor exeresis according to the affected nasal anatomical subunit. Method: Retrospective study of the medical records of 118 patients submitted to resection of the nasal tumors at the Mário Penna Institute in Belo Horizonte/ MG from August 2012 to March 2017. Results: Incidence was higher in women (56%) and whites (54.3%) average age of 71.3 years. A total of 125 tumors were resected, and 122 nose reconstructions were performed. Basal cell carcinoma (90.4%) was the most prevalent nonmelanoma skin tumor, the most frequent solid histological subtype (33.6%). The techniques for reconstruction of defects that affect only one nasal subunit were mostly using the bilobed flap (26.5%). In complex nose reconstructions, the bilobed myocutaneous flap (45.8%) with extension to a glabella region (encompassing the procerus, corrugator and nasal muscles) was the most used, mainly in defects in the lower third of the nose. About 78 patients had cancer follow-up of more than one year, and 82 total sin tumors were evaluated. Seven (8.5%) Tumors retreated even after complete resection, and, among the six patients with compromised margins, only one (1.2%) relapsed. Conclusion: The reconstructive techniques used were effective for treating nasal skin cancer and coverage of defects after resection, with low rates of complication and recurrence

Correlation between hormonal replacement therapy in the menopause and the development of neoplasms.

O climat?rio, per?odo de transi??o entre o ciclo reprodutivo (men?cme) e o n?o reprodutivo (senilidade ou senectude), pode ser caracterizado como um per?odo em que h? diminui??o da produ??o de estrog?nio pela mulher entre a quarta e a sexta d?cadas de vida, o que pode levar a endocrinopatias. A terapia de reposi??o de hormonal (TRH) visa repor os n?veis de estrog?nio e, esse artigo tem como objetivo abordar riscos e benef?cios do uso dessa terap?utica. Sabe-se que a TRH se relaciona ? ocorr?ncia sintomas vasomotores, irritabilidade, ins?nia, altera??es de mem?ria, labilidade emocional, irregularidade menstrual, dispaurenia, eventos cardiovasculares, dem?ncia, incontin?ncia urin?ria e ao surgimento de neoplasias de mama e endom?trio, foco principal desse trabalho. De acordo com WHI 2002 (Women?s Health Initiative study), 15 milh?es de mulheres americanas j? faziam uso de TRH. De acordo com os estudos KEEPS e ELITE, o TRH deve ser iniciado na perimenopausa (50 ? 59anos) ou at? 6-10 anos da menopausa. Adota-se como dose de reposi??o eficaz a menor dose efetiva (individualmente calculada). A reposi??o de Estr?geno e Progest?genos apresentou maior risco de CA de mama em rela??o ? reposi??o de Estr?geno Isolado. Por?m o uso de progest?genos, mostrou- se maiores benef?cios em mulheres com antecedente de endometriose ou CA de endom?trio. A decis?o da TRH deve respeitar a hist?ria fisiol?gica e familiar de cada mulher.Climacteric, a period of transition between the reproductive cycle (menacme) and the non-reproductive cycle (senility or senectude), can be characterized as a period in which there is a decrease in estrogen production by the woman between the fourth and sixth decades of life, which can lead to endocrinopathies. Hormone replacement therapy (HRT) aims to restore estrogen levels, and this article aims to address the risks and benefits of using this therapy. It is known that HRT is related to the occurrence of vasomotor symptoms, irritability, insomnia, memory alterations, emotional lability, menstrual irregularity, dyspaurenia, cardiovascular events, dementia, urinary incontinence and the onset of breast and endometrial neoplasms, the main focus of this work . According to the Women's Health Initiative (WHI) 2002, 15 million American women were already using HRT. According to the KEEPS and ELITE studies, HRT should be started on the perimenopause (50 - 59 years) or up to 6-10 years of menopause. The lowest effective dose (individually calculated) is used as the effective replacement dose. Replacement of estrogen and progestogens presented a higher risk of CA of the breast in relation to the replacement of isolated estrogen. However, the use of progestogens has been shown to be of greater benefit in women with a history of endometriosis or endometrial CA. The HRT decision must respect the physiological and family history of each woman