Critères dermoscopiques du mélanome de Dubreuilh (étude de 125 cas)

LYON1-BU Santé (693882101) / SudocSudocFranceF

A Novel Approach to Major Surgery: Tracking Its Pathophysiologic Footprints

Background: To study the ‘metabolic profile' of different surgical procedures and correlate it with pertinent surgical details and postoperative complications. Methods: We conducted a prospective pilot study of 70 patients, ten for each of the seven following groups: (1) laparoscopic cholecystectomy, (2) incisional hernia repair, (3) laparoscopic and (4) open colon surgery, (5) upper gastrointestinal, (6) hepatic, and (7) pancreatic resections. Biochemical assessment included white blood cell count (WBC), C-reactive protein (CRP), glucose, triglycerides (TG), albumin (Alb), and pre-albumin (Pre-Alb), from the day before surgery until 5days thereafter. Biological markers were compared for major versus minor surgery groups, which were defined on a clinical basis. Univariable analysis was used to identify risk factors for postoperative complications and p<0.05 was the significance threshold. Results: Common findings in all surgery groups were the acute inflammatory response (↑: WBC, CRP, ↓: TG, Alb, pre-Alb). Using cut-off values of 240min operative (OR) time and 300ml estimated blood loss (EBL), laparoscopic cholecystectomy, incisional hernia repair, and laparoscopic colectomy could be distinguished from open colectomy, upper gastrointestinal, liver, and pancreas resections. In a biochemical level, increased CRP and reduced postoperative Alb levels were highly discriminative of all types of ‘major surgery.' Significant risk factors for postoperative complications were age, male gender, malignancy, longer OR time, higher blood loss, high CRP, and low Alb levels. Conclusions: Biochemically, CRP and Alb levels can help quantify the magnitude of the surgical trauma, which is correlated with adverse outcomes

Disseminated porokeratosis transiently healed by cancer chemotherapy

International audiencePorokeratosis (PK) is a heterogeneous group of hereditary or acquired cutaneous disorders of epidermal keratinization with various clinical presentations and etiologies. The primary lesion of PK is a superficial annular macule or papule bordered by a peripheral, grooved, keratotic ridge. Common to all PK is the typical histological feature of cornoid lamella, which clinically corresponds to this hyperkeratotic rim. Porokeratosis of Mibelli and disseminated superficial actinic porokeratosis (DSAP) [...