Larger moles the ones to watch when screen­ing for skin can­cer

The Weekend Australian - Travel - - HEALTH -

WHENcheck­ing skin for signs of can­cer, pay spe­cial at­ten­tion to larger moles. New re­search in the ArchivesofDer­ma­tol­ogy has found that skin le­sions larger than 6mm in di­am­e­ter are more likely to be can­cer­ous than smaller le­sions. Many doc­tors use the 6mm cut-off to de­cide whether a le­sion is likely to be can­cer­ous (melanoma), but some have ar­gued that this may miss smaller melanomas. The study in­volved 1323 pa­tients with a to­tal of 1657 skin le­sions. Each le­sion was mea­sured, and a biopsy taken to look for can­cer cells. Of the le­sions, 804 (48.5 per cent) were larger than 6mm in di­am­e­ter and 138 (8.3 per cent) were di­ag­nosed as melanoma. In­va­sive melanoma, which has spread deeper into the skin, was di­ag­nosed in 1.5 per cent of le­sions smaller than 6mm and in 5.1 per cent of larger le­sions. The find­ings show that the cur­rent guide­lines are ap­pro­pri­ate for skin can­cer screen­ing. Arch Der­ma­tol 2008;144:469-474 (Ab­basi NR, et al) PRE­MA­TURE ba­bies are more likely to sur­vive if fe­male, a sin­gle birth, of a higher birth weight, and if the mother re­ceived steroids to help the baby’s lungs ma­ture says a study in theNew Eng­landJour­nalof Medicine . Th­ese, as well as the week of preg­nancy in which the baby was born, should all be taken into ac­count when de­cid­ing whether to give in­ten­sive care to very pre­ma­ture ba­bies. Re­searchers stud­ied 4446 in­fants born at 22 to 25 weeks of preg­nancy — 83 per cent re­ceived in­ten­sive care. A to­tal of 4192 of the in­fants were fol­lowed up at 18 to 22 months of age. By this time, 73 per cent of the ba­bies had died or suf­fered from a dis­abil­ity. The five fac­tors com­bined— ges­ta­tional age, sex, ex­po­sure to lung-ma­tur­ing steroids, sin­gle birth and birth weight — were bet­ter able to pre­dict sur­vival than ges­ta­tional age alone. N Engl J Med 2008;358:1672-1681 (Tyson JE, et al) PA­TIENTS who need heart surgery to re­open nar­rowed ar­ter­ies could soon be of­fered a dif­fer­ent type of treat­ment, fol­low­ing the pub­li­ca­tion of a new study in the Jour­nalofthe Amer­i­canMed­i­calAs­so­ci­a­tion . When heart ar­ter­ies are clogged, tube-shaped de­vices called ‘‘ stents’’ can be in­serted to hold the ves­sel open. Stents that re­lease drugs to pre­vent the artery from clos­ing over again have been shown to im­prove pa­tient sur­vival com­pared to bare metal stents alone. In this study, re­searchers com­pared two dif­fer­ent types of drug-re­leas­ing stents in 1002 pa­tients with coro­nary artery dis­ease. Pa­tients re­ceived a stent that re­leased ei­ther everolimus or pa­cli­taxel — both drugs pre­vent the artery from clos­ing over, but work in dif­fer­ent ways. Nine months af­ter surgery, those with everolimus-re­leas­ing stents were 44 per cent less likely to have died, suf­fered a heart at­tack, or needed a re­peat pro­ce­dure com­pared to those with the pa­cli­taxel-re­leas­ing stents. JAMA 2008;299:1903-1913 (Stone GW, et al) NASAL surgery could be the an­swer for peo­ple suf­fer­ing from ‘‘ obstructive sleep apnea’’ — a con­di­tion in which block­age of the air­way dur­ing sleep leads to snor­ing and day­time sleepi­ness. A new study in the ArchivesofO­to­laryn­gol­ogy—Headand Neck­Surgery has shown that surgery to re­move air­way ob­struc­tions can im­prove qual­ity of life. The study in­volved 51 pa­tients with sleep apnea (50 men and one wo­man) with an av­er­age age of 39. Be­fore and three months af­ter the surgery, they were sur­veyed about their symp­toms, sleepi­ness, snor­ing and over­all qual­ity of life. Fol­low­ing surgery, symp­toms of nasal ob­struc­tion, snor­ing and sleepi­ness im­proved sig­nif­i­cantly. Pa­tients also re­ported im­prove­ments in all of the qual­ity of life mea­sures, in­clud­ing a 30 per cent im­prove­ment in emo­tional well-be­ing. Arch Oto­laryn­gol Head Neck Surg 2008;134:429-433 (Li HY, et al) Want to know more? Items are ref­er­enced where pos­si­ble. A ref­er­ence such as ‘‘ 2007;35:18-25’’ means the source ar­ti­cle was pub­lished on pages 18-25 in vol­ume num­ber 35 of the pub­li­ca­tion, in 2007. A doi num­ber or web­site ad­dress is used for re­search pub­lished on a jour­nal’s web­site.

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