scholarly journals Skin lesions suspicious for melanoma: New Zealand excision margin guidelines in practice

2018 ◽  
Vol 10 (3) ◽  
pp. 210 ◽  
Author(s):  
Tess Brian ◽  
Michael B. Jameson
Keyword(s):  
New Zealand ◽  
Standard Deviation ◽  
Cutaneous Melanoma ◽  
Positive Margin ◽  
Skin Lesions ◽  
Excision Biopsy ◽  
Excision Margin ◽  
Biopsy Specimens ◽  
Deep Margin ◽  
Horizontal Margin

ABSTRACT INTRODUCTION New Zealand guidelines for cutaneous melanoma management recommend excision biopsy specimens of suspected lesions have a 2 mm horizontal margin, and a deep margin into upper subcutis. AIM To assess guideline compliance of suspicious lesion biopsies taken in the community and in a hospital. METHODS Patients admitted to Waikato Hospital, Hamilton, for diagnostic or treatment melanoma surgery during the year ending February 2016 were retrospectively identified, and their demographic and biopsy characteristics examined. RESULTS In total, 140 patients had excision biopsies: 61.4% were performed outside the hospital. Biopsy data were available for 126 specimens. Mean horizontal margin was greater (P = 0.001) in hospital biopsies (4.8 mm, standard deviation (s.d.) 3.7 mm) than biopsies performed elsewhere (2.8 mm; s.d. 1.8 mm). Horizontal margins >2.0 mm occurred in 70.6% of specimens; 21.6% of ≤2.0 mm specimens had a tumour-positive margin. Subsequent wide local excision identified residual melanoma in 9.6% of specimens, which was not associated (P = 0.3) with primary horizontal margin ≤2.0 mm. Mean deep margin of hospital biopsies (6.5 mm; s.d. 2.7 mm) was greater (P < 0.001) than in other biopsies (4.1 mm; s.d. 2.7 mm). Horizontal margin >2.0 mm specimens had greater (P < 0.001) mean deep margin (5.9 mm; s.d. 2.7 mm) than specimens with horizontal margin ≤2.0 mm (mean deep margin 3.3 mm; s.d. 2.7 mm). Deep margin ≤2.0 mm (19.0%) was independently associated with the facility where biopsy was performed (P = 0.001) and horizontal margin (P < 0.001). DISCUSSION The New Zealand biopsy deep margin recommendation does not lend itself to meaningful audit. Compliance with the horizontal margin recommendation was low, but of uncertain clinical significance.

scholarly journals Apoptosis as a Mechanism for Keratinocyte Death in Canine Toxic Epidermal Necrolysis

2016 ◽  
Vol 54 (2) ◽  
pp. 249-253 ◽  
Author(s):  
F. Banovic ◽  
S. Dunston ◽  
K. E. Linder ◽  
P. Rakich ◽  
T. Olivry
Keyword(s):  
Cell Death ◽  
Toxic Epidermal Necrolysis ◽  
Caspase 3 ◽  
Skin Lesions ◽  
Terminal Deoxynucleotidyl Transferase ◽  
Epidermal Keratinocytes ◽  
Biopsy Specimens ◽  
Significant Difference ◽  
Keratinocyte Cell ◽  
Life Threatening

In humans and dogs, toxic epidermal necrolysis (TEN) is a life-threatening dermatosis characterized by sudden epidermal death resulting in extensive skin detachment. There is little information on the pathogenesis of keratinocyte cell death in canine TEN. We studied the occurrence of apoptosis in skin lesions of dogs with TEN to determine if apoptosis contributes to the pathogenesis of this disease. Immunostaining with antibodies to activated caspase-3 and the terminal deoxynucleotidyl-transferase (TdT)–mediated deoxyuridine triphosphate (dUTP) nick-end labeling technique revealed positive apoptotic keratinocytes in basal and suprabasal epidermal compartments in 17 biopsy specimens collected from 3 dogs with TEN and 16 from 3 dogs with erythema multiforme (EM). There was no significant difference in the number of positively stained epidermal cells between TEN and EM. These results suggest that apoptosis of epidermal keratinocytes and lymphocytic satellitosis represent one of the early steps in the pathogenesis of canine TEN, as in the human disease counterpart.

A comment on scaling methane emissions from vegetation and grazing ruminants in New Zealand

2006 ◽  
Vol 33 (7) ◽  
pp. 613 ◽  
Author(s):  
Francis M. Kelliher ◽  
Harry Clark ◽  
Zheng Li ◽  
Paul C. D. Newton ◽  
Anthony J. Parsons ◽  
...  
Keyword(s):  
New Zealand ◽  
Standard Deviation ◽  
Forest Canopy ◽  
Emission Rate ◽  
Oxidative Capacity ◽  
Emission Rates ◽  
Ch4 Emission ◽  
Ch4 Emissions ◽  
Grazed Pasture ◽  
Indigenous Forest

Keppler et al. (2006, Nature 439, 187–191) showed that plants produce methane (CH4) in aerobic environments, leading Lowe (2006, Nature 439, 148–149) to postulate that in countries such as New Zealand, where grazed pastures have replaced forests, the forests could have produced as much CH4 as the ruminants currently grazing these areas. Estimating CH4 emissions from up to 85 million ruminants in New Zealand is challenging and, for completeness, the capacity of forest and pastoral soils to oxidise CH4 should be included. On average, the CH4 emission rate of grazing ruminants is estimated to be 9.6 ± 2.6 g m–2 year–1 (±standard deviation), six times the corresponding estimate for an indigenous forest canopy (1.6 ± 1.1 g m–2 year–1). The forest’s soil is estimated to oxidise 0.9 ± 0.2 g m–2 year–1 more CH4 than representative soils beneath grazed pasture. Taking into account plant and animal sources and the soil’s oxidative capacity, the net CH4 emission rates of forest and grazed ecosystems are 0.6 ± 1.1 and 9.8 ± 2.6 g m–2 year–1, respectively.

scholarly journals The Sensitivity of Wellbeing to Inequalities in Local Wellbeing

2021 ◽  
Author(s):  
◽  
Pascarn Ronald Dickinson
Keyword(s):  
New Zealand ◽  
Standard Deviation ◽  
Local Government ◽  
Subjective Wellbeing ◽  
General Social Survey ◽  
Negative Relationship ◽  
Cross Sectional ◽  
Underlying Causes ◽  
Important Addition ◽  
The Difference

<p>Research points to a robust negative relationship between average levels of subjective wellbeing and the distribution of subjective wellbeing. The fact that our wellbeing falls as wellbeing distributions widen suggests we care about inequalities in the lives of others. Central to this relationship is the role of place and human geography. The literature relating wellbeing to inequality in wellbeing is confined almost exclusively to inter-country comparisons. Virtually no attention has been paid to the relationship between wellbeing and inequality within countries - at the level of regions and below. The aim of this thesis is to test the generality of the inter-country evidence in the sub-national context.  I present four hypotheses which I test on three separate cross-sectional surveys: the New Zealand Quality of Life Survey, The New Zealand General Social Survey and the survey of Māori wellbeing, Te Kupenga. I follow the literature in using the standard deviation of wellbeing as a measure of wellbeing inequality. In each case the negative relationship between individual wellbeing and wellbeing inequality is clearly identifiable. The wellbeing effect of living in a place one standard deviation higher than another is roughly equivalent to the difference between the wellbeing of someone who is fully employed and someone who is unemployed and looking for work. Clearly we are highly sensitive to disparities in the subjective wellbeing of those around us.  I conduct several tests of the psychological drivers that lie behind the wellbeing response to local inequality in wellbeing. The first tests fairness perceptions, and finds sensitivity to wellbeing inequality to be higher among those who do not believe society is intrinsically fair. My test of altruism, while not as convincing empirically, suggests altruistic people may also be less affected by local wellbeing inequality. Both conclusions are consistent with the implied causation running from inequality to wellbeing.  While an important addition to the wellbeing literature, the more important implication of my findings is political. As the New Zealand Local Government Act comes up for renewal, the evidence I have assembled strongly supports providing local government with a clear purpose and the necessary funding to address the underlying causes of local inequalities in wellbeing. On empirical grounds alone, reducing wellbeing inequality is likely to make us all much happier.</p>

scholarly journals Oral and Skin Lesions Among Yemeni Khat Abusers While Chewing and After Quitting：Crosse-Sectional Survey

2021 ◽  
Author(s):  
Rowida A. Albarmaqi ◽  
Yi-Qun Kuang ◽  
Yu-Ye Li ◽  
Noha Saleh Gholais
Keyword(s):  
Standard Deviation ◽  
Dental Health ◽  
Skin Lesions ◽  
Routine Practice ◽  
Cross Sectional ◽  
Khat Chewing ◽  
Skin Symptoms ◽  
Significant Difference ◽  
The Mean ◽  
Symptoms And Signs

Abstract Background: Khat chewing is a routine practice in Yemen. Associations between Khat chewing and various adverse oral-dental health conditions have been recorded, however, adverse skin health evidence is still lacking. Objective: To investigate the difference between oral and skin symptoms and signs while chewing Khat and after quitting chewing among Yemeni khat abusers. Method: A descriptive cross-sectional study was conducted on a sample of 300 Yemeni Khat ex-chewer participants in china. Khat chewing status data, a range of oral and skin symptoms and signs, and other pertinent variables were collected using self-administered questionnaires by WeChat. The mean differences between oral and skin symptoms and signs while chewing Khat and after quitting chewing were investigated using the Paired Samples t-test. Result: Of the 300 Yemeni who participated in the study, 255(85%) were men and 45(15%) were women. The oral symptoms and signs mean while chewing was 0.26, 0.022 (standard deviation [SD], whereas that after quitting chewing Khat was 0.10 (mean), 0.269 (standard deviation [SD], t (12.00), P=0.00. The skin symptoms and signs mean while chewing was 0.13, 0.28 (standard deviation [SD], whereas that after quitting chewing Khat was M=0.06, 0.21(standard deviation [SD], t (9.407), P=0.00. Conclusions: There is a statistically significant difference between the mean oral and skin symptoms and signs while chewing and after quitting, whereas long-term Khat chewing negatively affects oral and skin health.

Inherited Deficiency of the Third Component of Complement Associated with Recurrent Pyogenic Infections, Circulating Immune Complexes, and Vasculitis in a Dutch Family

PEDIATRICS ◽  
1983 ◽  
Vol 71 (1) ◽  
pp. 81-87
Author(s):  
John J. Roord ◽  
Mohamed Daha ◽  
Wietse Kuis ◽  
Henri A. Verbrugh ◽  
Jan Verhoef ◽  
...  
Keyword(s):  
Immune Complexes ◽  
Bacterial Infections ◽  
Leukocytoclastic Vasculitis ◽  
Skin Lesions ◽  
The Other ◽  
The Third ◽  
Biopsy Specimens ◽  
Recurrent Pyogenic Infections ◽  
Dutch Family ◽  
Third Component Of Complement

A family is described in which 3/11 children showed a homozygous deficiency of C3, and both parents and six other children had subnormal levels of C3. The three children with selective C3 deficiency suffered repeatedly from bacterial infections, whereas the parents and the other siblings were clinically healthy. During infectious episodes the patients showed a maculopapular skin rash, and at such times immune complexes were present in the serum. Biopsy specimens of the skin lesions showed the picture of leukocytoclastic vasculitis.

‘Quit while you are ahead – and smell the roses!’ A survey of retired Fellows of the Australian and New Zealand College of Anaesthetists

2021 ◽  
pp. 0310057X2110057
Author(s):  
Diana Strange Khursandi ◽  
Victoria Eley
Keyword(s):  
Clinical Practice ◽  
New Zealand ◽  
Standard Deviation ◽  
Response Rate ◽  
Common Factors ◽  
Published Data ◽  
Factors Affecting ◽  
Retirement Decisions ◽  
Zealand College ◽  
The Mean

There are no published data on the age of retirement of anaesthetists in Australia and New Zealand. We surveyed 622 retired Fellows of the Australian and New Zealand College of Anaesthetists to determine their ages of complete retirement from clinical practice, demographics, and whether they had retired at the age they had intended to retire. We also aimed to explore factors affecting the decision to retire, the practice of ‘winding down’, common post-retirement activities, and the arrangement of personal and professional affairs. Responses were received from 371 specialists (response rate 60%). The mean (standard deviation) age of retirement was 65.2 (6.9) years. The mean (standard deviation) retirement ages ranged from 62.0 (7.1) years (those who retired earlier than planned) to 68.0 (4.3) years (those who retired later than they had intended). The mean (standard deviation) age of retirement of the male respondents was 66.0 (6.5) years, and for female respondents was 62.7 (7.7) years. Two hundred and thirty-three respondents (63%) reported winding down their practice prior to retirement, and 360 (97%) had made a will. Poor health and loss of confidence were the two most common factors in the retirement decisions of those who retired earlier than they had planned. Our results may assist current practitioners plan for retirement, and suggest strategies to help health services, departments and private groups accommodate individuals in winding down their practice.

Histomorphological Study of Skin Lesions in Punch Biopsy Specimens with Special References to Neoplastic Lesions

2018 ◽  
Vol 7 (7) ◽  
pp. 841-846
Author(s):  
Mamatha K. ◽  
◽  
S. Susmitha ◽  
Sathyashree K.V. ◽  
Rama Devi P. ◽  
...  
Keyword(s):  
Skin Lesions ◽  
Punch Biopsy ◽  
Biopsy Specimens ◽  
Neoplastic Lesions

scholarly journals Retrospective study of the relative frequency of feline hepatobiliary disease in New Zealand based on 10 years of hepatic biopsy samples

2019 ◽  
Vol 6 (1) ◽  
pp. e000367
Author(s):  
Thomas Fluen ◽  
Michael Hardcastle ◽  
Helen L Smith ◽  
Robyn N A Gear
Keyword(s):  
New Zealand ◽  
Relative Frequency ◽  
Small Animal ◽  
Hepatobiliary Disease ◽  
Hepatocellular Injury ◽  
Biopsy Specimens ◽  
Increased Risk ◽  
Gender And Age ◽  
Hepatobiliary Diseases ◽  
Parenchymal Disease

AimsTo retrospectively determine the relative frequency of feline hepatobiliary diseases from biopsy specimens submitted to a single laboratory across a 10-year period and to establish whether age, sex or breed associations exist.MethodsHistopathological data from 154 liver biopsies of New Zealand cats sampled between 2008 and 2018 were analysed. The samples were allocated to primary, secondary and tertiary disease categories using criteria established by the World Small Animal Veterinary Association. Breed associations were derived using ORs and 95% CIs. Gender and age associations were also evaluated.ResultsThe most frequently diagnosed hepatobiliary diseases were lymphocytic cholangitis (20 per cent), hepatitis (16.9 per cent), reversible hepatocellular injury (16.4 per cent), neutrophilic cholangitis (9.7 per cent), haematopoietic neoplasia (9.7 per cent), hepatocellular neoplasia (5.6 per cent) and cholangiocellular neoplasia (4.1 per cent). Burmese cats were found to be at significantly increased risk of both biliary and parenchymal diseases and Birman cats to be at significantly increased risk of parenchymal disease. Domestic longhair cats were at significantly increased risk of hepatobiliary neoplasia. Birman cats were at significantly increased risk of hepatitis while domestic shorthair cats were at significantly decreased risk of neutrophilic cholangitis, reversible hepatocellular injury and hepatitis.ConclusionsThis study is the first retrospective examination of the relative frequency of hepatobiliary disease in biopsy specimens from New Zealand cats. Some breeds were associated with specific histopathology.

Monitoring of Kindreds With Hereditary Predisposition for Cutaneous Melanoma and Dysplastic Nevus Syndrome: Results of a Swedish Preventive Program

2007 ◽  
Vol 25 (19) ◽  
pp. 2819-2824 ◽  
Author(s):  
Johan Hansson ◽  
Mia Bergenmar ◽  
Per-Åke Hofer ◽  
Göran Lundell ◽  
Eva Månsson-Brahme ◽  
...  
Keyword(s):  
Cutaneous Melanoma ◽  
Skin Lesions ◽  
Preventive Program ◽  
Swedish Population ◽  
Dysplastic Nevus ◽  
Dysplastic Nevus Syndrome ◽  
Increased Risk ◽  
Low Incidence ◽  
Vertical Growth Phase

Purpose To evaluate a program initiated in 1987 by the Swedish Melanoma Study Group aiming to provide preventive surveillance to kindreds with hereditary cutaneous melanoma and dysplastic nevus syndrome. Patients and Methods Overall, 2,080 individuals belonging to 280 melanoma families were followed for 14 years between 1987 and 2001 at 12 participating centers. Data were registered in a central database. Results Among 1,912 skin lesions excised during follow-up, 41 melanomas were removed in 32 individuals. Of these, 15 (37%) were in situ melanomas and 26 (63%) invasive melanomas. The median tumor thickness of invasive melanomas was 0.5 mm. Ulceration was absent in 24 of 26 invasive melanomas (92%) and 12 (46%) lacked vertical growth phase. Compared with melanomas in the general Swedish population, the melanomas identified in these kindreds during follow-up had better prognostic characteristics. All melanomas except one were diagnosed in families with two or more first-degree relatives with melanoma. Diagnosis of melanoma occurred in three of eight kindreds with germline CDKN2A mutations, supporting that families with such mutations are at increased risk for melanoma development. Of the 32 individuals who developed melanoma during follow-up, 21 (66%) had had at least one previously diagnosed melanoma. Conclusion This study shows that a coordinated program aimed at detecting and offering skin surveillance in kindreds with hereditary cutaneous melanoma results in a low incidence of melanomas during the follow-up period and that the tumors that do arise have favorable prognostic characteristics.

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