Occasionally, in patients with pigmented skin lesions referred for epiluminescence microscopy (ELM) the lesions are deep black naevi that even experienced dermatologists suspect might be malignant ...melanomas. The surface of these lesions is abnormal, often scaly, but their general aspect is regular and not characterized by any gross asymmetry. Inspection by ELM reveals additional features, which, if present in a typical combination, indicate a benign lesion. One simple examination can be enough to exclude malignancy. Histological examination allows the diagnosis of lentiginous junctional naevocytic naevi. Two typical cases are presented.
Epiluminescent microscopy is now used frequently for the differential diagnosis of pigmented skin lesions. In order to improve the distinction between benign and malignant melanocytic tumours it ...seemed advisable to develop a standardized pathway of epiluminescent microscopical analysis and to determine the frequency of structures recognizable with the microscope. A total of 600 melanocytic lesions were examined by epiluminescent microscopy, photographed and classified histologically after excision, revealing 426 naevocellular naevi and 174 melanoma. The experience achieved during the course of the investigation was used as the basis of a procedure for stepwise analysis of keratin layer, pigment structures and blood vessels. The most important findings are described and referred to malignancy. The photographs were analysed for the frequency of occurrence of various pigment structures in different types of lesions. The results differ in several aspects from previous findings.
There are few data available regarding the clinical course of tick-borne encephalitis virus (TBEV) vaccination breakthrough infections. The published studies suggest that vaccination breakthrough ...infections may have a more severe course than native TBEV infection in unvaccinated individuals—potentially due to antibody-dependent enhancement. Here we report a large analysis of vaccination breakthrough infections.
This retrospective analysis was based on a national surveillance dataset spanning the years 2001–2018. Variables reflecting disease severity, such as ‘CNS symptoms’, ‘myelitis’, ‘fatal outcome’ and ‘hospitalization’ were analysed as well as general epidemiological variables. Cases were categorized as ‘unvaccinated’ or ‘ever vaccinated’, the latter category including cases with at least one dose of a TBEV vaccine.
A total of 6073 notified TBEV infection cases were included in our analysis. Sufficient data on vaccination status were available for 95.1% of patients (5777/6073); of these, 5298 presented with a native infection. A total of (334/5777) cases developed an infection despite having been vaccinated at least once. Comparing unvaccinated patients with those with at least one vaccination, we find an odds ratio (OR) 2.73, (95% confidence interval (CI) 0.79–9.50) regarding the variable fatal outcome that did not reach statistical significance. Analysing the clinical variables ‘CNS symptoms’ and ‘myelitis’, there is no difference between these groups (OR 0.86, 95% CI 0.68–1.08; and OR 1.30, 95% CI 0.74–2.27 respectively). Patients who were vaccinated and had an assumed protection at symptom onset (n = 100) had a higher risk for the development of myelitic symptoms (OR 2.21, 95% CI 1.01–4.86) than unvaccinated patients.
Our findings could neither verify that vaccination breakthrough infections might cause a more severe disease than native infections nor prove a clear antibody-dependent enhancement phenomenon. It remains unclear whether the increased myelitis risk in a subgroup of vaccinated patients is a true effect or confounded.
We report on a patient with an abdominal type of benign symmetrical Launois-Bensaude lipomatosis. New aspects of the pathogenesis of abnormal distribution of the fatty tissue are also discussed.
Recycling of automotive batteries for the recovery of secondary lead is extremely important in Brazil, for the country does not possess large reserves of this metal. Lead is one of the most widely ...used metals in the world, but it is highly toxic, posing risks for humans and for the environment if not utilized or treated adequately. Industrial waste containing lead in Brazil are classified by the Brazilian Residue Code (NBR—10004:2004) as hazardous. The lead recycling process employed by the recycling industry in Brazil is the pyrometallurgical process in a rotary furnace. This process consists of four stages: (1) grinding of the battery to separate plastic, electrolyte and lead plates; (2) lead reduction in a rotary furnace; (3) separation of metallic lead from slag; and (4) refining of recycled lead. The purpose of this work is to propose process improvements aimed primarily at increasing production output by reducing the loss of lead in slag and particulates, thereby providing a healthier work environment in line with Brazilian environmental and labor laws.
ObjectivesTo investigate whether cervical screening attendance differs between human papillomavirus (HPV)-vaccinated and unvaccinated women and to investigate potential underlying socioeconomic ...factors.DesignProspective cohort using registry linkage of vaccinations, screening invitations, screening attendance and socioeconomic covariates.SettingSwedish national HPV vaccination and cervical screening programmes.ParticipantsAll Swedish women born between 1988 and 1991 and invited to screening (n=261 434).Outcome measuresAll participants were followed for up to 3 years. Screening attendance was compared between HPV-vaccinated and unvaccinated women. HR and 95% CI were estimated using Cox regression.ResultsVaccination age averaged 18.1 years and the coverage for≥1 dose was 13.5%. In HPV-vaccinated women (n=35 460), screening attendance was higher than in unvaccinated women (n=225 974) (74%vs69%, p<0.001). The crude HR of attendance in HPV-vaccinated women was 1.32 (95% CI 1.30 to 1.34). A positive association remained after adjustment for education, income and migration history (HR=1.10, 95% CI 1.09 to 1.12).ConclusionHPV-vaccinated women were more likely to attend screening than unvaccinated women. Yet, the question needs to be reassessed in routinely vaccinated cohorts, since the vaccinated women included here represent a selected group and may be prone to more health-conscious habits.
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