Larger moles the ones to watch when screening for skin cancer
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.