Michael Jackson might have skin cancer, according to "The Sun"
According to the Saturday newspaper "The Sun", Michael Jackson is fighting secretly against skin cancer. According to sources the newspaper, which doctors have diagnosed the disease in recent weeks have said that he cares and is therefore expected to act in the fifties has scheduled concerts. The same King of Pop, 50, said he was "very concerned" when he announced the news, but "is eager to return to the stage." According to "The Sun", the singer recently visited regularly by a dermatologist in Beverly Hills and Cedar-Sinai hospital in Los Angeles. The news has caused concern among the thousands of fans for concerts scheduled in London, which begin July 8.
Campaign to prevent skin cancer
A tent installed in the Plaza de Catalonia reports today about the dangers of sunbathing without protection. Up to seven in the evening, a team of pharmacists and dermatologists from various hospitals in Barcelona analyze skin types and provide information on how to prevent the negative effects of the sun.
Doctors examine the sensitivity of the skin of each patient and recommend the most appropriate sunscreen to prevent health problems. We also checked the presence of freckles or spots to guide users of potential dangers.
The initiative is par for the campaign face the sun, which drives the Spanish Association Against Cancer to promote good practice when sunbathing.
Doctors examine the sensitivity of the skin of each patient and recommend the most appropriate sunscreen to prevent health problems. We also checked the presence of freckles or spots to guide users of potential dangers.
The initiative is par for the campaign face the sun, which drives the Spanish Association Against Cancer to promote good practice when sunbathing.
Rectal cancer and melanoma are linked by gene MIFT
Melanoma and rectal cancer may be associated to a same gene. A multicenter study published in Nature found that the oncogene MIFT could be related to susceptibility to both tumors. Inhibition of the effects of mutation of this gene may have therapeutic implications. The research involved Dr. And Dr. Susana Puig. Celia Badenas, Melanoma research team at the Institute of Biomedical Research August Pi i Sunyer (IDIBAPS) and the Department of Dermatology Hospital Clinic of Barcelona.
The MIFT is important in regulating the transcription of genes related to melanoma, and also responsible for the transcription of hypoxia inducible factor (HIF1A), related to genetic alterations that can lead to kidney cancer. The fact that several of the patients were diagnosed with both diseases when risk factors are so different from each tumor (ultraviolet radiation, number of nevi and melanoma skin to clear, and tobacco, obesity and hypertension for kidney cancer), was researchers to suspect that this match could be a genetic nexus between them, as they recently published in Nature.
Both the epidermis, which develops melanoma, and kidney, tissues are not receiving an adequate supply of oxygen, called hypoxic, which can cause oxidative stress that damages cells and leads to tumor. According to Dr. Puig, "smoking or hypertension may increase the oxidative stress and via HIF1A in the case of kidney cancer, while ultraviolet radiation would do the same to the skin," so that different risk factors trigger the same way to be carcinogenic.
The mutation identified in MITF is an activating mutation that selectively promotes the transcription of some genes. Develop a molecule that specifically block this mutation may have therapeutic implications, especially in patients with melanoma. This is because all melanomas studied expressed the gene MITF, regardless of whether or not mutated. However, in the case of kidney cancer only carriers of the mutation express MITF, so probably only the mutated, they are very rare, could benefit from a potential therapeutic anti-MITF. Carriers of the gene mutated MITF Mi-E318K have a 5 times greater risk of developing these cancers, or both.
The MIFT is important in regulating the transcription of genes related to melanoma, and also responsible for the transcription of hypoxia inducible factor (HIF1A), related to genetic alterations that can lead to kidney cancer. The fact that several of the patients were diagnosed with both diseases when risk factors are so different from each tumor (ultraviolet radiation, number of nevi and melanoma skin to clear, and tobacco, obesity and hypertension for kidney cancer), was researchers to suspect that this match could be a genetic nexus between them, as they recently published in Nature.
Both the epidermis, which develops melanoma, and kidney, tissues are not receiving an adequate supply of oxygen, called hypoxic, which can cause oxidative stress that damages cells and leads to tumor. According to Dr. Puig, "smoking or hypertension may increase the oxidative stress and via HIF1A in the case of kidney cancer, while ultraviolet radiation would do the same to the skin," so that different risk factors trigger the same way to be carcinogenic.
The mutation identified in MITF is an activating mutation that selectively promotes the transcription of some genes. Develop a molecule that specifically block this mutation may have therapeutic implications, especially in patients with melanoma. This is because all melanomas studied expressed the gene MITF, regardless of whether or not mutated. However, in the case of kidney cancer only carriers of the mutation express MITF, so probably only the mutated, they are very rare, could benefit from a potential therapeutic anti-MITF. Carriers of the gene mutated MITF Mi-E318K have a 5 times greater risk of developing these cancers, or both.
Aspirin would prevent colorectal cancer
Patients at high genetic risk may benefit.
Hope for preventative treatment of cancer leads all researchers but also those at high risk. This applies to those with Lynch syndrome, a genetic disorder that increases the risk of cancer, including colorectal, but also other organs such as the endometrium. In this rare syndrome, but which remains the most common cause of hereditary colorectal cancer, patients should undergo colonoscopy including at least every two years from the age of 20 years. The goal is of course the early detection of colorectal cancer known to strike more than one in three of these patients.
The study published Friday in the international journal The Lancet, should give some hope to these patients for whom the average age of discovery of a colorectal cancer is 42 years (sometimes 25 years). This work demonstrates the preventive effect of aspirin. Over 850 people, half taking aspirin and the other half a placebo, it appears that patients who took daily aspirin 600 mg for 2 years had their risk of colorectal cancer reduced by third compared to those taking placebo (inactive product). And without adverse events. The authors found 18 cancers in 427 patients in the aspirin group as against 30 434 for placebo.
A solid foundation
In 2008, these same researchers had not demonstrated the efficacy of aspirin in this study. In extending the monitoring of patients taking aspirin for more than two years, they realized the preventive effect of aspirin. After two years, the difference between the two groups began to appear, but it was still statistically insufficient to draw conclusions.
Cautious optimism of Dr. David Malka, digestive cancer specialist at the Institut Gustave-Roussy (Villejuif): "This is a study that could add a new weapon next to the monitoring of patients for colonoscopy," said he. This time, Professor John Burn (Institute of Medical Genetics, Newcastle University) and colleagues are more categorical: "Our results, put in perspective with other recent research, provide a sound basis for recommending aspirin in preventing systematic in the Lynch syndrome, "they write in The Lancet. No more, they say, to define the correct dose and proper duration of treatment.
Specialists, however, surprised to get this result as the number of polyps detected by colonoscopy was similar for patients taking aspirin or placebo. The theory is, in fact, the polyps are the first step before a possible transformation into cancer. These results obtained in patients at high risk because of their genetic disease, can they be extrapolated to other classes? What is the risk / benefit of treatment in these cases, because of the risk of bleeding associated with aspirin? For now the results obtained with low doses of aspirin used in the prevention of recurrent cardiovascular events, generally less than 100 mg per day have shown no interest in reducing the risk of colorectal cancer -rectal. However, for patients with colorectal cancer treated, studies have shown a preventive effect of aspirin but moderate. It is too early to venture a general recommendation outside the Lynch syndrome.
Hope for preventative treatment of cancer leads all researchers but also those at high risk. This applies to those with Lynch syndrome, a genetic disorder that increases the risk of cancer, including colorectal, but also other organs such as the endometrium. In this rare syndrome, but which remains the most common cause of hereditary colorectal cancer, patients should undergo colonoscopy including at least every two years from the age of 20 years. The goal is of course the early detection of colorectal cancer known to strike more than one in three of these patients.
The study published Friday in the international journal The Lancet, should give some hope to these patients for whom the average age of discovery of a colorectal cancer is 42 years (sometimes 25 years). This work demonstrates the preventive effect of aspirin. Over 850 people, half taking aspirin and the other half a placebo, it appears that patients who took daily aspirin 600 mg for 2 years had their risk of colorectal cancer reduced by third compared to those taking placebo (inactive product). And without adverse events. The authors found 18 cancers in 427 patients in the aspirin group as against 30 434 for placebo.
A solid foundation
In 2008, these same researchers had not demonstrated the efficacy of aspirin in this study. In extending the monitoring of patients taking aspirin for more than two years, they realized the preventive effect of aspirin. After two years, the difference between the two groups began to appear, but it was still statistically insufficient to draw conclusions.
Cautious optimism of Dr. David Malka, digestive cancer specialist at the Institut Gustave-Roussy (Villejuif): "This is a study that could add a new weapon next to the monitoring of patients for colonoscopy," said he. This time, Professor John Burn (Institute of Medical Genetics, Newcastle University) and colleagues are more categorical: "Our results, put in perspective with other recent research, provide a sound basis for recommending aspirin in preventing systematic in the Lynch syndrome, "they write in The Lancet. No more, they say, to define the correct dose and proper duration of treatment.
Specialists, however, surprised to get this result as the number of polyps detected by colonoscopy was similar for patients taking aspirin or placebo. The theory is, in fact, the polyps are the first step before a possible transformation into cancer. These results obtained in patients at high risk because of their genetic disease, can they be extrapolated to other classes? What is the risk / benefit of treatment in these cases, because of the risk of bleeding associated with aspirin? For now the results obtained with low doses of aspirin used in the prevention of recurrent cardiovascular events, generally less than 100 mg per day have shown no interest in reducing the risk of colorectal cancer -rectal. However, for patients with colorectal cancer treated, studies have shown a preventive effect of aspirin but moderate. It is too early to venture a general recommendation outside the Lynch syndrome.
Steven Tyler fall
Steven Tyler has fallen in the bathroom of his hotel room in Paraguay. The singer of Aerosmith has even broken teeth. It would have collapsed as he was suffering from food poisoning.
Tyler would have lost consciousness while he was suffering from dehydration caused by food poisoning, said sources at TMZ. It has therefore collapsed in the shower of her room the Bourbon Hotel, located in Asunción.
The rocker was taken to a private hospital. He suffered facial injuries. He even lost teeth during its fall.
The manager of Tyler described the injuries sustained by his client to "minor" to TMZ. He added that the artist had already been discharged from hospital.
Tyler's fall forced the postponement of an Aerosmith concert scheduled for Tuesday in Paraguay. The show will be presented on Wednesday.
Drinking coffee is good against the skin cancer
Regular consumption of coffee reduces the risk of skin cancer, says a U.S. study last Monday.
According to this study by scientists at the American Association for Cancer Research in Boston, drink about three cups of coffee a day would reduce by 20% in women the risk of basalioma, a form of skin cancer.
However, men do seem to enjoy so much. In turn, consume about three cups of coffee a day reduces only 9% of their risk of developing this cancer. Researchers can not yet explain why.
For several years, scientists ask themselves the benefits of caffeine on health.
Various studies have already shown an association between regular coffee consumption and decreased risk of prostate cancer tumor or cervix.
Other studies have shown that caffeine would be useful to address other types of diseases such as Alzheimer's disease, diabetes or liver cancer.
A survey published a year ago, also shows that drinking coffee reduces the risk of depression in women.
According to this study by scientists at the American Association for Cancer Research in Boston, drink about three cups of coffee a day would reduce by 20% in women the risk of basalioma, a form of skin cancer.
However, men do seem to enjoy so much. In turn, consume about three cups of coffee a day reduces only 9% of their risk of developing this cancer. Researchers can not yet explain why.
For several years, scientists ask themselves the benefits of caffeine on health.
Various studies have already shown an association between regular coffee consumption and decreased risk of prostate cancer tumor or cervix.
Other studies have shown that caffeine would be useful to address other types of diseases such as Alzheimer's disease, diabetes or liver cancer.
A survey published a year ago, also shows that drinking coffee reduces the risk of depression in women.
The benefits of coffee on health.
Do you like coffee? Want to know the benefits of caffeine on health? Follow the guide!
Coffee contains many virtues and a recent study, reported by the health aufeminin.com site, it would help in the fight against skin cancer.
If you are a big drinker of coffee, I have good news for you.
Your favorite drink is a concentrated benefit.
According to a study by American scientists coffee reduce the risk of skin cancer in women.
About the man he should receive only 50% of these health benefits.
Other studies have also shown previously that caffeine is beneficial to fight against various diseases such as Alzheimer's, liver cancer or diabetes.
Are you a big coffee drinker? What is your favorite coffee cappuccino, elongated, black or other?
Coffee contains many virtues and a recent study, reported by the health aufeminin.com site, it would help in the fight against skin cancer.
If you are a big drinker of coffee, I have good news for you.
Your favorite drink is a concentrated benefit.
According to a study by American scientists coffee reduce the risk of skin cancer in women.
About the man he should receive only 50% of these health benefits.
Other studies have also shown previously that caffeine is beneficial to fight against various diseases such as Alzheimer's, liver cancer or diabetes.
Are you a big coffee drinker? What is your favorite coffee cappuccino, elongated, black or other?
Madalina Ghenea DiCaprio pictures
Madalina Ghenea combined with DiCaprio to get Hollywood star. Beautiful Romanian long trying to break into the film and its relationship with American actor is the perfect opportunity to get the attention of the world's great directors.
Information week Romanian fashionable world was linked to romance that lives in this period with the renowned Romanian woman Ghenea Madalina Leonardo DiCaprio. Presented for the first time for Romania in the online edition GOSSIP, their relationship is becoming more valves.
Madalina entourage sources believe that this combined with American star to get to Hollywood. These sources say that the beautiful forms which they conquered Italy with more time watching an opportunity to enter the film world at the highest level.
In confirmation of this hypothesis, the dummy would take advantage of DiCaprio's image to make a name on the international scene, is a statement given to Romanian recently even in a week of "boot": "We received several Offers of cinema.'m proposals during the analysis. My dream was always to get a movie star! I want to graduate in psychology and then to make cinema. I'm already preparing seriously, study interpretation, "said Ghenea.
Jill Filipovic Get your freak on girl pictures
Jill Filipovic, a well-known bloggers in the United States has had a pleasant surprise not just the employees that the airline flew from New York to Dublin.
Those who checked luggage Jill found a vibrator in a bag and then left them a note through which an advise on this to find a man. "Get your freak on girl" (Forget the vibrator, you need a man), was the message airline employees.
A company representative in charge of safety said that luggage started an investigation to find out who is responsible for that ticket, and Jill said it would file a complaint against the company.
"They came across an object and left me a note. I was shocked and amused all day I had the head of Missy Elliott song. I complain and I hope to teach staff that walking through the personal belongings of passengers is strictly prohibited, "said Jill Filipovic.
Alzheimer's: These drugs are useless
The High Health Authority (HAS) said on Thursday that the fight against drugs for Alzheimer's disease on the market have an interest in "low".
Has not advocating the continuation of a systematic treatment SIPA
Note drugs against Alzheimer degraded. The Transparency Committee of the High Authority for Health Justice in effect a statement released Thursday that the molecules to combat against the disease have a medical "low". "The relationship between the effectiveness of these drugs and their side effects is considered low by the Transparency Commission" Has that explains the note of "the most modest effects", namely "efficiency versus placebo based primarily on cognition in short-term and whose clinical relevance is questionable. " Worse these drugs have the same "risk of adverse events that may require discontinuation of treatment (digestive disorders, including cardiovascular and neuro-psychiatric)" and "an increased risk of drug interactions because of polypharmacy in older patients usually ".
4 drugs reassessed
In its previous assessment, in 2007, the Transparency Commission had considered the SMR of anti-Alzheimer's as "important," despite "a report efficacy / low", and described the improvement in actual benefit of "minor ". Degradation announced Thursday, however, should have no impact on reimbursement, these drugs are reimbursed at 100%, as part of the ALD (long-term illness) Alzheimer's disease. It could however have an impact on drug prices.
"Four drugs have been revalued: Ebixa (Lundbeck), Aricept (Eisai), Exelon (Novartis Pharma and Reminyl (Janssen Cilag). None of the Transparency Commission who participated in the reassessment or any of the four experts on call for applications to provide a report of scientific expertise are a link of interest with one of these firms. The discussions, which began on July 20, was completed on October 19 "Has continues.
Has not advocating the continuation of a systematic treatment SIPA
Note drugs against Alzheimer degraded. The Transparency Committee of the High Authority for Health Justice in effect a statement released Thursday that the molecules to combat against the disease have a medical "low". "The relationship between the effectiveness of these drugs and their side effects is considered low by the Transparency Commission" Has that explains the note of "the most modest effects", namely "efficiency versus placebo based primarily on cognition in short-term and whose clinical relevance is questionable. " Worse these drugs have the same "risk of adverse events that may require discontinuation of treatment (digestive disorders, including cardiovascular and neuro-psychiatric)" and "an increased risk of drug interactions because of polypharmacy in older patients usually ".
4 drugs reassessed
In its previous assessment, in 2007, the Transparency Commission had considered the SMR of anti-Alzheimer's as "important," despite "a report efficacy / low", and described the improvement in actual benefit of "minor ". Degradation announced Thursday, however, should have no impact on reimbursement, these drugs are reimbursed at 100%, as part of the ALD (long-term illness) Alzheimer's disease. It could however have an impact on drug prices.
"Four drugs have been revalued: Ebixa (Lundbeck), Aricept (Eisai), Exelon (Novartis Pharma and Reminyl (Janssen Cilag). None of the Transparency Commission who participated in the reassessment or any of the four experts on call for applications to provide a report of scientific expertise are a link of interest with one of these firms. The discussions, which began on July 20, was completed on October 19 "Has continues.
Alzheimer: The Health Authority confirms the lack of interest of current medications
The four currently available drugs have been reassessed by the Transparency Commission, which is part of the Health Authority. Front of their very low therapeutic value and their risk of significant side effects, their Actual benefit was lowered and new conditions of use have been decided. Back on the context and the announcements of the HAS that could lead to a significant reduction in the use of these products in France.
At least 800,000 people with Alzheimer's disease
There are about 850 000 people in France of an Alzheimer's disease or related. Of these patients, "550 000 followed medically (assessment end of 2009) 350 000 which benefit from support under the condition long term", said the health authorities at the balance sheet of the plan AD 2008 to 2012.
This disease is the result of a degeneration of neurons that are poorly understood causes: the role of cardiovascular problems? Head injuries? Neurotoxic substances such as solvents or mercury? Role of pesticides, fine particles emitted by diesel engines, aluminum? Others? Early identification of disease is also not yet ready (current research on biological signs, radiological and neuro-psychological).
This misunderstanding is coupled with an inability to prevent or slow down significantly, for the moment, neuronal degradation. Currently available drugs are in fact not effective enough.
4 drugs available but disputed
Donepezil (Aricept ®, Eisai Laboratory), galantamine (Reminyl ®, Janssen Cilag), rivastigmine (Exelon ®, Novartis) and memantine (Ebixa ®, Lundbeck) is available in France for a dozen years.
The first 3 are cholinesterase inhibitors: their role is to prevent the breakdown of acetylcholine, which is involved in nervous system function. As for memantine, it is supposed to block certain receptors in the synapses of neurons, which could improve their operation.
Problem: studies have shown that a very modest efficacy, only in some patients, and transitional. Moreover, these drugs have many side effects. Their administration is not effective enough to change the prognosis of the disease, unlike, for example, the combination therapy in HIV, as noted by the President of the Jean-Luc Harousseau HAS.
That's why many doctors, including those of the journal Prescribing, denounce their uselessness for many years almost complete in practice. But despite these warnings, these drugs have been widely prescribed in France: more than 250 million euros per year and repayment of several million boxes sold every year!
It must be said that these drugs were considered by the HAS to have a medical benefit (SMR) important. The explanation? Plan before Alzheimer care was not organized, resulting in estimated value of drug prescriptions (including neurologists) as a structure (it might have been better "structure" support with a harmless placebo and cheap instead of expensive drugs, virtually ineffective and risky ...).
But since the situation has evolved: the role of caregivers is emphasized, the fight against prescription drugs unnecessary and even dangerous as neuroleptics, developed, and so on. (Alzheimer Plan 2008-2012). Hence the decision to re-evaluation in January 2011, said Gilles Bouvenot, Chairman of the Transparency Committee and Professor of therapy.
Reassessment under the sign of independence and transparency
After the case Mediator ®, which showed a probable deleterious influence of Servier laboratory of the French system of medicine (health agencies, doctors, politicians) for 40 years, transparency and the implementation of measures to ensure the independence of decision circuit were a priority.
Without waiting for the reform of the drug, recently passed by Parliament, the Health Authority and the Transparency Commission, therefore evolved their working methods so as not to expose himself to suspicion: the experts to reassess the medical made of four drugs had nothing to dispute of interest with the 4 laboratories. Mr. Harousseau said that everyone could express themselves, "pluralism of expression is a prerequisite for the objectivity of decisions." Besides the discussion of the Commission are available in full on video on the site of HAS since this morning.
Decrease in actual benefit
Between July and October 2011, the Transparency Commission (TC), composed of 26 health professionals in office, has reviewed all existing studies, analyzed the practices in France, Europe and the United States, interviewed experts from different backgrounds and independent (general practitioners, neurologists, geriatricians, doctors working in retirement homes ....) and then listened to the arguments of the four laboratories.
Decisions, voted unanimously after intensive discussions have taken "solely on scientific data," recalled repeatedly Prof. Gilles Bouvenot.
It appears from this work together in an evaluation report is being finalized and as a notice for each product (downloadable at the bottom of this page), that these drugs "have only a very small" regretted Prof. Bouvenot with "best slowdown or stabilization of cognitive decline for a few months, no effect on mood, behavior. In addition their use does not delay entry into the institution." Additional concern: that these drugs have minimal effect in some patients. Now modern science can not predict the responders, or even what percentage of patients may derive little benefit from these drugs.
This reassessment has confirmed against the risk of drug interactions (the elderly are often full of other drugs) and possible side effects: gastrointestinal (nausea, vomiting, diarrhea ..), neuropsychological (difficult to distinguish from dementia) and especially cardiovascular disease (cholinesterase inhibitors: risks of slowing of the heart, syncope, need for installation of a pacemaker ...).
The CT has decided to lower the drug for each medical service rendered important "low" and not "insufficient" because they "can still do something for some patients", said Prof. Bouvenot. Repayment from 65 to 15%, but in practice this might not be too costly for the patient and his family. Indeed, if the doctors still want to prescribe these drugs despite the negative signal that is the demotion, it is likely they will ask a first support 100% for their patient (ALD).
New terms of use and new recommendations for good practice
The CT also noted the rapid depletion of the possible positive effect of these drugs. That is why she recommends, when prescribing, to reassess the patient at 6 months and 1 year.
This reassessment at 1 year should be "systematic, comprehensive, multidisciplinary," stressed Prof. Bouvenot. The attending physician, the neurologist and / or psychiatrist will have to assess the impact of treatment in a collegial manner (which in practice will perhaps not be obvious ...) and stop in the absence of profit objective.
These changes low-SMR, reassessment of the duration and risk / benefit ratio of treatment-and the challenge to the independence of the previous recommendations (Expert bound by conflicts of interest), will lead the HAS to be made public by the end of November new recommendations for the therapeutic management of Alzheimer's disease.
Let us hope that these new recommendations, also transparent and independence displayed, will heavily loaded with non-drug ... in the meantime, hopefully, the next development of truly effective drugs or strategies to block or roll back, this devastating disease that affects more and more families ...
At least 800,000 people with Alzheimer's disease
There are about 850 000 people in France of an Alzheimer's disease or related. Of these patients, "550 000 followed medically (assessment end of 2009) 350 000 which benefit from support under the condition long term", said the health authorities at the balance sheet of the plan AD 2008 to 2012.
This disease is the result of a degeneration of neurons that are poorly understood causes: the role of cardiovascular problems? Head injuries? Neurotoxic substances such as solvents or mercury? Role of pesticides, fine particles emitted by diesel engines, aluminum? Others? Early identification of disease is also not yet ready (current research on biological signs, radiological and neuro-psychological).
This misunderstanding is coupled with an inability to prevent or slow down significantly, for the moment, neuronal degradation. Currently available drugs are in fact not effective enough.
4 drugs available but disputed
Donepezil (Aricept ®, Eisai Laboratory), galantamine (Reminyl ®, Janssen Cilag), rivastigmine (Exelon ®, Novartis) and memantine (Ebixa ®, Lundbeck) is available in France for a dozen years.
The first 3 are cholinesterase inhibitors: their role is to prevent the breakdown of acetylcholine, which is involved in nervous system function. As for memantine, it is supposed to block certain receptors in the synapses of neurons, which could improve their operation.
Problem: studies have shown that a very modest efficacy, only in some patients, and transitional. Moreover, these drugs have many side effects. Their administration is not effective enough to change the prognosis of the disease, unlike, for example, the combination therapy in HIV, as noted by the President of the Jean-Luc Harousseau HAS.
That's why many doctors, including those of the journal Prescribing, denounce their uselessness for many years almost complete in practice. But despite these warnings, these drugs have been widely prescribed in France: more than 250 million euros per year and repayment of several million boxes sold every year!
It must be said that these drugs were considered by the HAS to have a medical benefit (SMR) important. The explanation? Plan before Alzheimer care was not organized, resulting in estimated value of drug prescriptions (including neurologists) as a structure (it might have been better "structure" support with a harmless placebo and cheap instead of expensive drugs, virtually ineffective and risky ...).
But since the situation has evolved: the role of caregivers is emphasized, the fight against prescription drugs unnecessary and even dangerous as neuroleptics, developed, and so on. (Alzheimer Plan 2008-2012). Hence the decision to re-evaluation in January 2011, said Gilles Bouvenot, Chairman of the Transparency Committee and Professor of therapy.
Reassessment under the sign of independence and transparency
After the case Mediator ®, which showed a probable deleterious influence of Servier laboratory of the French system of medicine (health agencies, doctors, politicians) for 40 years, transparency and the implementation of measures to ensure the independence of decision circuit were a priority.
Without waiting for the reform of the drug, recently passed by Parliament, the Health Authority and the Transparency Commission, therefore evolved their working methods so as not to expose himself to suspicion: the experts to reassess the medical made of four drugs had nothing to dispute of interest with the 4 laboratories. Mr. Harousseau said that everyone could express themselves, "pluralism of expression is a prerequisite for the objectivity of decisions." Besides the discussion of the Commission are available in full on video on the site of HAS since this morning.
Decrease in actual benefit
Between July and October 2011, the Transparency Commission (TC), composed of 26 health professionals in office, has reviewed all existing studies, analyzed the practices in France, Europe and the United States, interviewed experts from different backgrounds and independent (general practitioners, neurologists, geriatricians, doctors working in retirement homes ....) and then listened to the arguments of the four laboratories.
Decisions, voted unanimously after intensive discussions have taken "solely on scientific data," recalled repeatedly Prof. Gilles Bouvenot.
It appears from this work together in an evaluation report is being finalized and as a notice for each product (downloadable at the bottom of this page), that these drugs "have only a very small" regretted Prof. Bouvenot with "best slowdown or stabilization of cognitive decline for a few months, no effect on mood, behavior. In addition their use does not delay entry into the institution." Additional concern: that these drugs have minimal effect in some patients. Now modern science can not predict the responders, or even what percentage of patients may derive little benefit from these drugs.
This reassessment has confirmed against the risk of drug interactions (the elderly are often full of other drugs) and possible side effects: gastrointestinal (nausea, vomiting, diarrhea ..), neuropsychological (difficult to distinguish from dementia) and especially cardiovascular disease (cholinesterase inhibitors: risks of slowing of the heart, syncope, need for installation of a pacemaker ...).
The CT has decided to lower the drug for each medical service rendered important "low" and not "insufficient" because they "can still do something for some patients", said Prof. Bouvenot. Repayment from 65 to 15%, but in practice this might not be too costly for the patient and his family. Indeed, if the doctors still want to prescribe these drugs despite the negative signal that is the demotion, it is likely they will ask a first support 100% for their patient (ALD).
New terms of use and new recommendations for good practice
The CT also noted the rapid depletion of the possible positive effect of these drugs. That is why she recommends, when prescribing, to reassess the patient at 6 months and 1 year.
This reassessment at 1 year should be "systematic, comprehensive, multidisciplinary," stressed Prof. Bouvenot. The attending physician, the neurologist and / or psychiatrist will have to assess the impact of treatment in a collegial manner (which in practice will perhaps not be obvious ...) and stop in the absence of profit objective.
These changes low-SMR, reassessment of the duration and risk / benefit ratio of treatment-and the challenge to the independence of the previous recommendations (Expert bound by conflicts of interest), will lead the HAS to be made public by the end of November new recommendations for the therapeutic management of Alzheimer's disease.
Let us hope that these new recommendations, also transparent and independence displayed, will heavily loaded with non-drug ... in the meantime, hopefully, the next development of truly effective drugs or strategies to block or roll back, this devastating disease that affects more and more families ...
new skin cancer cases
The highest incidence of skin cancer in the world - about 20,000 new cases are reported annually. Skin cancer is the most common cancer in our country and more than 700 South Africans die each year this.
Melanoma is the most common cancer in men between 25 and 29. The high incidence of skin cancer can only be reduced if we are more informed about how to prevent sun damage that can lead to skin cancer.
80% of skin damage takes place before 18 and the damage is until a later age noticeably.
Our sunny climate with long hot summers is one of our biggest advantages. Thousands of people annually to power off to go bay and lazing on the beach to relax. You may be one of them, if you enjoy gardening, golf or any other outdoor activity. In any case, it is imperative that you and your children's skin from the harmful sun protection. 80% of skin damage takes place before 18 and the damage is until a later age noticeably.
There are three main types of cancer:
Basaalselkarsinoom - it is often confused with a sore would not heal and usually appears as a raised, smooth, pêrelagtige button on this part of the head, neck and shoulders to the sun exposed.
Skubselkarsinoom - it is usually on exposed parts of the body and are usually raised, pink, transparent buttons or patches often ulcers or sores in the middle form.
Malignant melanoma - it is often small, brown or black or larger multicolored patches with an irregular outline, sometimes form a crust and bleed.
The ABCD-English guide provides a useful guide to the identification of a malignant melanoma:
A - Asimmetry / Oneweredigheid (one side of the lesion differs from the other)
B - Border / Outline (the outline of the lesion is uneven with notches)
C - Colour / Color (melanoma is often a combination of colors)
D - Diameter / Diameter (cancerous lesion's diameter is usually larger than 6 mm - about the size of a potlooduitveër)
The following people are at higher risk of developing skin cancer:
People with pale skin, especially the kind that forms freckles and easily burn in the sun.
People with light hair and blue or green eyes.
People who have been treated for skin cancer.
People with many moles.
People with a family history of skin cancer
People who do one or more severe sunburn at a young age gained.
Although there are other causes of skin cancer, such as the use of sonbruintoestelle, unusually high exposure to x-rays and contact with chemicals such as arsenic and hydrocarbons, the most common cause is still exposed to the ultraviolet (UV) that we normally get from sunlight .
Prevention:
Sunburn should preferably be avoided but keep in mind that UV exposure happens every day, even when it is cloudy. Take care when you're outside and limit the time in the sun, especially between 10:00 and 15:00 when the sun's rays are the most dangerous. Try as much as possible stay in the shade and be aware that UV rays of grass, cement, glass, sand and water bouncing off.
Apply sunscreen with a sonskermfaktor (SPF) of at least 20 to freely - should sonbeskermingsroom 30 minutes before sun exposure be applied and again after swimming - and every 2 hours of sun exposure.
Early detection greatly increases the chances of successful treatment.
Wear sunglasses that protect your eyes while you are outside and use a liproom a sonbeskermer contains.
Cover yourself and your children with hats and shirts. The hat should be the face, neck and ears covered. The closer woven garments, the better it protects against the sun.
Avoid sonbruintoestelle. According to Professor Werner Sinclair, a dermatologist at the University of the Free State doubled the use of artificial sonbruintoestelle the risk of an individual to develop a melanoma.
Consideration:
Leave any worrying mole or lesion by a velspesialis investigation. If the lesions are difficult identifiable or suspected cancerous, a biopsy will be taken. If the biopsy shows that you have a malignant melanoma, you will further tests like a blood test and an x-ray of the breast should undergo.
Basal cell and skubselkarsinoom usually involves the surgical removal of the lesion, which is adequate treatment should be. Malignant melanoma is more aggressive treatment and a number of treatments may be needed such as surgery, radiation and chemotherapy.
Take the responsibility for skin cancer to yourself, your family and others to avoid. Examine your skin carefully each month and note any changes. Early detection greatly increases the chances of successful treatment.
Melanoma is the most common cancer in men between 25 and 29. The high incidence of skin cancer can only be reduced if we are more informed about how to prevent sun damage that can lead to skin cancer.
80% of skin damage takes place before 18 and the damage is until a later age noticeably.
Our sunny climate with long hot summers is one of our biggest advantages. Thousands of people annually to power off to go bay and lazing on the beach to relax. You may be one of them, if you enjoy gardening, golf or any other outdoor activity. In any case, it is imperative that you and your children's skin from the harmful sun protection. 80% of skin damage takes place before 18 and the damage is until a later age noticeably.
There are three main types of cancer:
Basaalselkarsinoom - it is often confused with a sore would not heal and usually appears as a raised, smooth, pêrelagtige button on this part of the head, neck and shoulders to the sun exposed.
Skubselkarsinoom - it is usually on exposed parts of the body and are usually raised, pink, transparent buttons or patches often ulcers or sores in the middle form.
Malignant melanoma - it is often small, brown or black or larger multicolored patches with an irregular outline, sometimes form a crust and bleed.
The ABCD-English guide provides a useful guide to the identification of a malignant melanoma:
A - Asimmetry / Oneweredigheid (one side of the lesion differs from the other)
B - Border / Outline (the outline of the lesion is uneven with notches)
C - Colour / Color (melanoma is often a combination of colors)
D - Diameter / Diameter (cancerous lesion's diameter is usually larger than 6 mm - about the size of a potlooduitveër)
The following people are at higher risk of developing skin cancer:
People with pale skin, especially the kind that forms freckles and easily burn in the sun.
People with light hair and blue or green eyes.
People who have been treated for skin cancer.
People with many moles.
People with a family history of skin cancer
People who do one or more severe sunburn at a young age gained.
Although there are other causes of skin cancer, such as the use of sonbruintoestelle, unusually high exposure to x-rays and contact with chemicals such as arsenic and hydrocarbons, the most common cause is still exposed to the ultraviolet (UV) that we normally get from sunlight .
Prevention:
Sunburn should preferably be avoided but keep in mind that UV exposure happens every day, even when it is cloudy. Take care when you're outside and limit the time in the sun, especially between 10:00 and 15:00 when the sun's rays are the most dangerous. Try as much as possible stay in the shade and be aware that UV rays of grass, cement, glass, sand and water bouncing off.
Apply sunscreen with a sonskermfaktor (SPF) of at least 20 to freely - should sonbeskermingsroom 30 minutes before sun exposure be applied and again after swimming - and every 2 hours of sun exposure.
Early detection greatly increases the chances of successful treatment.
Wear sunglasses that protect your eyes while you are outside and use a liproom a sonbeskermer contains.
Cover yourself and your children with hats and shirts. The hat should be the face, neck and ears covered. The closer woven garments, the better it protects against the sun.
Avoid sonbruintoestelle. According to Professor Werner Sinclair, a dermatologist at the University of the Free State doubled the use of artificial sonbruintoestelle the risk of an individual to develop a melanoma.
Consideration:
Leave any worrying mole or lesion by a velspesialis investigation. If the lesions are difficult identifiable or suspected cancerous, a biopsy will be taken. If the biopsy shows that you have a malignant melanoma, you will further tests like a blood test and an x-ray of the breast should undergo.
Basal cell and skubselkarsinoom usually involves the surgical removal of the lesion, which is adequate treatment should be. Malignant melanoma is more aggressive treatment and a number of treatments may be needed such as surgery, radiation and chemotherapy.
Take the responsibility for skin cancer to yourself, your family and others to avoid. Examine your skin carefully each month and note any changes. Early detection greatly increases the chances of successful treatment.
Skin cancer is increasing in the Netherlands
The Dutch institution cancer, KWF Cancer, the first time this year a "sonkragalarm" issued. This is when the UV radiation is very high, even seven or eight, that Holland's maximum. The previous summer, eleven such warnings issued, according to some reports sharp increase. In the Netherlands, the cases of skin cancer from 20,800 in 2000 to 36,800 this year rose Trouw reported.
The "sonkragwaarskuwings" is issued so that one more precaution against sonverbranding can take.
Earlier it was also reported that the line south of which people more often develop skin cancer in Belgium, gradually moving northwards, causing their regions must adapt gesondheidsbegrotings.
The "sonkragwaarskuwings" is issued so that one more precaution against sonverbranding can take.
Earlier it was also reported that the line south of which people more often develop skin cancer in Belgium, gradually moving northwards, causing their regions must adapt gesondheidsbegrotings.
Radiotherapy : Use a cream to reduce effects of radiation Jeans
Side effects of radiation are the result of radiation therapy used to treat skin cancer. Patients undergoing radiotherapy have a sunburn like spots on the skin that was exposed to radiation. And while the therapy works well on cancer, it has some drawbacks. Radiotherapy may leave permanent marks on the skin and in extreme cases, the patient has itching, redness, burning, and sometimes blistering of the skin layers affected. Although there are many creams and ointments, they often have no real or lasting relief. Cancer patients undergoing radiotherapy need a healing touch that can soothe their skin affected. Jeans Cream can help your skin as it recovers from the itching and burning that result from radiation damage.
Jeans Cream is the ointment right to treat the side effects of radiation. It is composed of plant extracts and nutrients is vital for your skin. The cream absorbs into the skin and provides vitamin E and aloe, where they are most needed in areas damaged by radiation. Supplements the cream of the skin with natural vitamins and plant extracts to the skin can recover and cancer patients can continue with radiation treatment necessary. Jeans Cream is widely used by cancer patients in hospitals and is the first doctor recommended it as a way to relieve pain caused by radiotherapy.
A well-nourished skin can handle the side effects of radiation best and ideal way to nourish your skin is made to treat with vitamin E and aloe. Jeans Cream has two of these and must be applied on the affected skin twice a day and to assist in matters such as the appearance of redness and itching or burning. The cream is available online and at the counter of department stores and medical pharmacist. Jeans Cream is doctor approved and recommended by leading hospitals around the United States. JeansCream continues to grow through word of mouth because people who used to side effects of radiation continue to tell others.
Jeans Cream is the result of years of research and experimentation for a product that would provide lasting relief side effects of radiation. Cancer patients have to undergo radiation therapy to get rid of cancerous tissue, but during the processing of their skin may become painful and break down. Jeans Cream is a real help for cancer patients because it can provide a healing touch and thus help them make a success of radiotherapy. The cream is made ready to use and is fragrance free. Gently apply the cream on the affected skin twice a day and especially at bedtime.
Jeans Cream is the ointment right to treat the side effects of radiation. It is composed of plant extracts and nutrients is vital for your skin. The cream absorbs into the skin and provides vitamin E and aloe, where they are most needed in areas damaged by radiation. Supplements the cream of the skin with natural vitamins and plant extracts to the skin can recover and cancer patients can continue with radiation treatment necessary. Jeans Cream is widely used by cancer patients in hospitals and is the first doctor recommended it as a way to relieve pain caused by radiotherapy.
A well-nourished skin can handle the side effects of radiation best and ideal way to nourish your skin is made to treat with vitamin E and aloe. Jeans Cream has two of these and must be applied on the affected skin twice a day and to assist in matters such as the appearance of redness and itching or burning. The cream is available online and at the counter of department stores and medical pharmacist. Jeans Cream is doctor approved and recommended by leading hospitals around the United States. JeansCream continues to grow through word of mouth because people who used to side effects of radiation continue to tell others.
Jeans Cream is the result of years of research and experimentation for a product that would provide lasting relief side effects of radiation. Cancer patients have to undergo radiation therapy to get rid of cancerous tissue, but during the processing of their skin may become painful and break down. Jeans Cream is a real help for cancer patients because it can provide a healing touch and thus help them make a success of radiotherapy. The cream is made ready to use and is fragrance free. Gently apply the cream on the affected skin twice a day and especially at bedtime.
The factors of skin cancer
At present, there is a sharp reduction in ozone due to emission of greenhouse gases in the atmosphere. Which can cause the spread of skin cancer in the world. In fact, melanoma is a type well known.
The worsening air pollution
Currently, the worsening air pollution is characterized by the emission of greenhouse gases into the environment. We can cite mainly nitrous oxide, methane and carbon dioxide. This is due to the development of manufacturing industries and vehicular traffic, especially in urban areas. Indeed, this harmful gas emissions reduced by increasing the ozone layer causing the appearance of various diseases such as respiratory problems, skin cancer, lung cancer, etc..
Ozone as a natural filter
But here we will speak of skin cancer. One of its causes is the lack of the ozone layer which has the property to protect the skin against ultraviolet rays. In other words, it serves as a natural filter. Apart from that there are factors favoring skin cancer such as exposure to certain petroleum products and chemicals, continuous treatment of radiotherapy, severe burns of the skin, etc..
Melanoma, a type of skin cancer
It is estimated that about 74,100 cases of skin cancer other than melanoma are listed in Canada alone. Melanoma is a special case of cancer of the skin or mucous membranes. In general it is in the form of brown spot or button. Like any cancer, melanoma can be treated by chemotherapy. However, it can also be treated by simple surgical removal. Finally, the systematic application of sunscreen is also recommended to prevent the disease.
The worsening air pollution
Currently, the worsening air pollution is characterized by the emission of greenhouse gases into the environment. We can cite mainly nitrous oxide, methane and carbon dioxide. This is due to the development of manufacturing industries and vehicular traffic, especially in urban areas. Indeed, this harmful gas emissions reduced by increasing the ozone layer causing the appearance of various diseases such as respiratory problems, skin cancer, lung cancer, etc..
Ozone as a natural filter
But here we will speak of skin cancer. One of its causes is the lack of the ozone layer which has the property to protect the skin against ultraviolet rays. In other words, it serves as a natural filter. Apart from that there are factors favoring skin cancer such as exposure to certain petroleum products and chemicals, continuous treatment of radiotherapy, severe burns of the skin, etc..
Melanoma, a type of skin cancer
It is estimated that about 74,100 cases of skin cancer other than melanoma are listed in Canada alone. Melanoma is a special case of cancer of the skin or mucous membranes. In general it is in the form of brown spot or button. Like any cancer, melanoma can be treated by chemotherapy. However, it can also be treated by simple surgical removal. Finally, the systematic application of sunscreen is also recommended to prevent the disease.
Skin cancer and kidney cancer: A single genetic defect to 5 times more likely - Inserm and IGR-Nature
This genetic disorder, called Mi-E318K multiplied by 5 the risk of developing melanoma, kidney cancer. This study, conducted by INSERM and Institut Gustave Roussy Cancer (IGR) is therefore to identify a genetic mutation responsible for a common predisposition to melanoma (skin cancer) and renal cell carcinoma (kidney cancer) . The results of this study, published on the website of the journal Nature, highlight the first risk factor common to both types of cancer and could lead to the identification of new therapeutic targets.
The mutation in question is called Mi-E318K, it appears on the gene coding for a protein called MITF (transcription factor associated with microphthalmia) and gives this mutated gene overactivity leading to increased risk of melanoma and kidney cancer individuals carrying this mutation.
A recent study showed the coexistence of melanoma and renal cell carcinoma in some patients. Kidney cancer is often discovered after a diagnosis of melanoma during the staging. To date, no environmental risk factor common to melanoma and kidney cancer had been detected. This suggests the existence of a common genetic predisposition to these cancers.
A group of researchers has suggested that the MITF gene could be involved in this phenomenon as described as oncogene (cancer accelerator) in melanoma and known to be involved in cell activation pathway involved in the development of kidney cancer . The team was able to identify an abnormality in the DNA sequence, the codon 318, the MITF gene. This anomaly was found in 8% of patients with both melanoma and kidney cancer.
"The anomaly, called Mi-E318K, when present in individuals, multiplied by 5 the risk of developing melanoma, kidney cancer."
These results open up many opportunities for development in clinical applications and research: A screening test could be developed in order to find this mutation in patients with either melanoma or kidney cancer. The change would become a biomarker of risk, which, if present, would indicate the need for special surveillance in the kidney and skin. Solar prevention advice could also be given to people with renal cell carcinoma, with fair skin and / or are carriers of many moles. In research, this work sheds new light, to deepen, the signaling pathways involved in oxidative stress (UV and / or hypoxia) and the development of cancer.
The mutation in question is called Mi-E318K, it appears on the gene coding for a protein called MITF (transcription factor associated with microphthalmia) and gives this mutated gene overactivity leading to increased risk of melanoma and kidney cancer individuals carrying this mutation.
A recent study showed the coexistence of melanoma and renal cell carcinoma in some patients. Kidney cancer is often discovered after a diagnosis of melanoma during the staging. To date, no environmental risk factor common to melanoma and kidney cancer had been detected. This suggests the existence of a common genetic predisposition to these cancers.
A group of researchers has suggested that the MITF gene could be involved in this phenomenon as described as oncogene (cancer accelerator) in melanoma and known to be involved in cell activation pathway involved in the development of kidney cancer . The team was able to identify an abnormality in the DNA sequence, the codon 318, the MITF gene. This anomaly was found in 8% of patients with both melanoma and kidney cancer.
"The anomaly, called Mi-E318K, when present in individuals, multiplied by 5 the risk of developing melanoma, kidney cancer."
These results open up many opportunities for development in clinical applications and research: A screening test could be developed in order to find this mutation in patients with either melanoma or kidney cancer. The change would become a biomarker of risk, which, if present, would indicate the need for special surveillance in the kidney and skin. Solar prevention advice could also be given to people with renal cell carcinoma, with fair skin and / or are carriers of many moles. In research, this work sheds new light, to deepen, the signaling pathways involved in oxidative stress (UV and / or hypoxia) and the development of cancer.
Symptoms of skin cancer
The first symptom of skin cancer is in the vast majority of cases, a cutaneous manifestation: a non-healing wound, a new growth or a growth that already exists is changing. This disease can occur in all parts of the body but generally it is those who are most exposed to the sun that are likely to develop cancer of the skin.
Signs of Skin Cancer
Basal cell carcinoma may correspond to
A lump that appears on the ears, neck or face. It is either pink or flesh-colored and can be "beaded" or waxy.
A plaque that appears on the back or chest. It is smooth and pink.
An ulcer that does not disappear.
Squamous cell carcinoma may correspond to
Non-healing ulcer.
A patch of skin white or pink, may be dry or rough.
A nodule that is both firm and warty, white or pink.
Melanoma is a mole that has an abnormal appearance. It can thus be presented in the form of:
A mole whose contour is not regular, and changing size or color.
A mole that shows one or bleeding, which shows areas of blue, blue-black or red.
A lesion that appears on a black lining or skin.
Signs of Skin Cancer
Basal cell carcinoma may correspond to
A lump that appears on the ears, neck or face. It is either pink or flesh-colored and can be "beaded" or waxy.
A plaque that appears on the back or chest. It is smooth and pink.
An ulcer that does not disappear.
Squamous cell carcinoma may correspond to
Non-healing ulcer.
A patch of skin white or pink, may be dry or rough.
A nodule that is both firm and warty, white or pink.
Melanoma is a mole that has an abnormal appearance. It can thus be presented in the form of:
A mole whose contour is not regular, and changing size or color.
A mole that shows one or bleeding, which shows areas of blue, blue-black or red.
A lesion that appears on a black lining or skin.
chirurgoe micrographic skin cancer
Your doctor has recommended to remove your chirurgoe micrographic skin cancer. This page will attempt to explain the implications of this procedure and its risks and benefits.
What is the chirurgoie micrographic?
Named after the surgeon who developed the Mohs micrographic surgery (Mohs Frederick) is a specialized surgery that aims to remove some skin cancers. Your surgeon removes the visible portion of the tumor and then removes extra tissue that might contain cancer cells, this process is done layer by layer. The tissue is examined under a microscope while you are still in the center where the intervention takes place. If the tissue contains cancer cells, another layer of tissue is removed and in turn under the microscope. This process is repeated until towed cancer cells have been removed.
The reasons why your doctor has recommended chirurgoe Mohs micrographic are:
Your skin cancer has returned
the tumor that you have been removed, but cancer cells remain
you have cancer is in a region or as little healthy tissue should be removed (eg eye, nose, ears and lips).
the edges of the cancer you are ill-defined
you have cancer is aggressive.
Why should I micrographic surgery?
Other surgical procedures to remove skin tumors are based on the view with the naked eye surgeon to delineate its extent. This can lead to large wounds and scars and tumor recurrence if too little tissue is removed. Micrographic surgery maximizes the chance that your tumor is completely removed (excised) while minimizing the amount of normal tissue to be removed.
What he said during Mohs surgery?
There are different stages:
First, the doctor will inject local anesthetic. This helps to numb the treatment area so that you do ressentier no pain during the procedure. This injection do not fall asleep, and you will be awake. If you are particularly anxious, a mild sedative can be administered in addition. Please discuss with your doctor. Of anesthetic drops can also be used if the tumor is near the eye.
After local anesthesia works, the visible (clinically evident or part) of the tumor is removed along with a small margin of normal tissue. While the sample is sent to the laboratory or the doctor may examine more closely the tissue for cancer cells. This takes between 40 and 60 minutes, so a temporary dressing is applied topically and you rolled over to the waiting room (remember to take things to kill time: books ...).
If cancer cells are present in the tissue examined, you will be reminded in the operating room and more tissue is removed for examination under a microscope. This process will be repeated as many times as the cancer cells are present.
The duration of the effect of local anesthesia is two hours and a supplement of anesthetic can be added. Due to the nature of this technique, it is not possible to determine the duration of the surgery.
What happens after you have removed all the affected tissue?
Once all the tumor cells were removed, there are different options to repair the wound created. These options will be discussed with you in more detail with the doctor doing the procedure.
The wound
can be closed by those who have micrographic surgery immediately after the intervention
can be covered with a bandage and closed by a plastic surgeon
may not be closed to heal itself.
What are the risks?
Your doctor will explain the potential risks to this kind of surgery, but possible complications include:
bleeding in the operated area
pain: The effect of local anesthesia should last until you return home. Analgesics not cheap aspirin (pex paracetamol) should relieve the pain.
damage to a nerve. Although your surgeon will take more care to avoid this, the nerves may occasionally be damaged during surgery, leading to numbness. This effect is usually temporary.
infection of the operated area. It is important to follow the instructions on wound care to minimize the risk.
scar formation. You will have a scar after surgery. Doctors use closing techniques to minimize their size. The size and color of the scar usually fade with time.
What should I do when I got home?
Before leaving the place of surgery, make sure you have obtained all the information of how to take care of the wound at home. You should probably sit for 48 hours after surgery. So if you work, you should take time off during at least two days after surgery.
Next Post opéraoire
A follow-up appointment will be given after surgery. This meeting usually takes place a week later to verify that the skin heals well and to remove any stitches. Usually, an appointment is given three months later. Although éveidemment, each case is unique and does not always follow this diagram.
What is the chirurgoie micrographic?
Named after the surgeon who developed the Mohs micrographic surgery (Mohs Frederick) is a specialized surgery that aims to remove some skin cancers. Your surgeon removes the visible portion of the tumor and then removes extra tissue that might contain cancer cells, this process is done layer by layer. The tissue is examined under a microscope while you are still in the center where the intervention takes place. If the tissue contains cancer cells, another layer of tissue is removed and in turn under the microscope. This process is repeated until towed cancer cells have been removed.
The reasons why your doctor has recommended chirurgoe Mohs micrographic are:
Your skin cancer has returned
the tumor that you have been removed, but cancer cells remain
you have cancer is in a region or as little healthy tissue should be removed (eg eye, nose, ears and lips).
the edges of the cancer you are ill-defined
you have cancer is aggressive.
Why should I micrographic surgery?
Other surgical procedures to remove skin tumors are based on the view with the naked eye surgeon to delineate its extent. This can lead to large wounds and scars and tumor recurrence if too little tissue is removed. Micrographic surgery maximizes the chance that your tumor is completely removed (excised) while minimizing the amount of normal tissue to be removed.
What he said during Mohs surgery?
There are different stages:
First, the doctor will inject local anesthetic. This helps to numb the treatment area so that you do ressentier no pain during the procedure. This injection do not fall asleep, and you will be awake. If you are particularly anxious, a mild sedative can be administered in addition. Please discuss with your doctor. Of anesthetic drops can also be used if the tumor is near the eye.
After local anesthesia works, the visible (clinically evident or part) of the tumor is removed along with a small margin of normal tissue. While the sample is sent to the laboratory or the doctor may examine more closely the tissue for cancer cells. This takes between 40 and 60 minutes, so a temporary dressing is applied topically and you rolled over to the waiting room (remember to take things to kill time: books ...).
If cancer cells are present in the tissue examined, you will be reminded in the operating room and more tissue is removed for examination under a microscope. This process will be repeated as many times as the cancer cells are present.
The duration of the effect of local anesthesia is two hours and a supplement of anesthetic can be added. Due to the nature of this technique, it is not possible to determine the duration of the surgery.
What happens after you have removed all the affected tissue?
Once all the tumor cells were removed, there are different options to repair the wound created. These options will be discussed with you in more detail with the doctor doing the procedure.
The wound
can be closed by those who have micrographic surgery immediately after the intervention
can be covered with a bandage and closed by a plastic surgeon
may not be closed to heal itself.
What are the risks?
Your doctor will explain the potential risks to this kind of surgery, but possible complications include:
bleeding in the operated area
pain: The effect of local anesthesia should last until you return home. Analgesics not cheap aspirin (pex paracetamol) should relieve the pain.
damage to a nerve. Although your surgeon will take more care to avoid this, the nerves may occasionally be damaged during surgery, leading to numbness. This effect is usually temporary.
infection of the operated area. It is important to follow the instructions on wound care to minimize the risk.
scar formation. You will have a scar after surgery. Doctors use closing techniques to minimize their size. The size and color of the scar usually fade with time.
What should I do when I got home?
Before leaving the place of surgery, make sure you have obtained all the information of how to take care of the wound at home. You should probably sit for 48 hours after surgery. So if you work, you should take time off during at least two days after surgery.
Next Post opéraoire
A follow-up appointment will be given after surgery. This meeting usually takes place a week later to verify that the skin heals well and to remove any stitches. Usually, an appointment is given three months later. Although éveidemment, each case is unique and does not always follow this diagram.
Screening for skin cancer 2.0
FotoFinder this the future of early detection of skin cancer at the exhibition Medica 2011. In the center of attention is the rapid exchange of diagnoses between physicians using mobile communication technology.
With Handyscope iPhone and the corresponding application, FotoFinder managed to connect with dermoscopy technology smartphones.
Today, the new online platform Hub allows doctors to upload images from their web space Handyscope private database in the Web through a secure connection to the store and request an assessment of from international experts on skin cancer. The suspicious skin lesions can be immediately sent to specialists to confirm the initial diagnosis with a second opinion.
Skin cancer detection 2.0
This opens new perspectives for teledermatology: patients who do not have access to specialists may also obtain an optimal diagnosis in cases of suspected cancer of the skin. They can enjoy their physician network and rely on an accurate and rapid diagnosis. Early detection of skin cancer greatly increases the chances of recovery.
"The platform Hub and Handyscope pave the way for widespread prevention of skin cancer since the service to obtain a second opinion provides patients around the world the chance to benefit from early detection to diagnosis accurate, "said Andreas Mayer, CEO of FotoFinder Systems.
The platform works with Handyscope Hub, the first mobile dermatoscope connected. The precision lens is connected to the iPhone and allows you to take pictures of the skin lesion with the potential to expand up to 20 times each image. The microscopic images of exceptional quality can see detail of skin lesions in a single glance.
With Handyscope iPhone and the corresponding application, FotoFinder managed to connect with dermoscopy technology smartphones.
Today, the new online platform Hub allows doctors to upload images from their web space Handyscope private database in the Web through a secure connection to the store and request an assessment of from international experts on skin cancer. The suspicious skin lesions can be immediately sent to specialists to confirm the initial diagnosis with a second opinion.
Skin cancer detection 2.0
This opens new perspectives for teledermatology: patients who do not have access to specialists may also obtain an optimal diagnosis in cases of suspected cancer of the skin. They can enjoy their physician network and rely on an accurate and rapid diagnosis. Early detection of skin cancer greatly increases the chances of recovery.
"The platform Hub and Handyscope pave the way for widespread prevention of skin cancer since the service to obtain a second opinion provides patients around the world the chance to benefit from early detection to diagnosis accurate, "said Andreas Mayer, CEO of FotoFinder Systems.
The platform works with Handyscope Hub, the first mobile dermatoscope connected. The precision lens is connected to the iPhone and allows you to take pictures of the skin lesion with the potential to expand up to 20 times each image. The microscopic images of exceptional quality can see detail of skin lesions in a single glance.
The skin cancer: the signs that should alert
with Jacques Bazex, dermatologist, member of the National Academy of Medicine
Carcinoma or melanoma, it is skin cancer since the 1960s that continues to grow. A figure: Approximately 90,000 new cases of skin cancer are diagnosed each year in France. In most cases these are carcinomas. It is they who are treated best. But melanoma, much more aggressive, continues to grow. The number is doubling every ten years. How to detect, treat and prevent these cancers? Answers with Jacques Bazex, dermatologist, member of the National Academy of Medicine.
It is obvious: a clear or milky skin is more prone to sunburn than dark skin or black. It also more likely to develop skin cancer after strong sunburn. "When the Irish and the English arrived in Australia to colonize this land, they developed many skin cancers," says Jacques Bazex.
But all is not about color! It seems that along with the pigmentation of the skin coexists genetic factors that predispose to developing melanoma. The sun would play in this case the trigger of something existing.
"There is also a tendency for those with moles are agitated" said our guest. "These are the dysplastic nevi (deform), which are much more sensitive to sun exposure."
Dysplastic nevi - ill-defined edge, varied coloration.
Attention. All skin cancers are not born of moles. In fact, less than a quarter of skin cancers are caused by a nevus. "Any skin lesion, if it is lightly colored, must be the arrival of a suspected melanoma, although this is not a mole," says Jacques Bazex.
Carcinomas and Mélamones: what differences?
Carcinomas account for 90% of cases of skin cancer. There are two forms:
Basal cell carcinomas. These are the most frequent and less severe. Squamous cell carcinomas are a little more difficult but removal is easy. "For carcinomas, always perform a histological examination and ensure that the removal is complete."
As for melanoma, less frequently, it is also much more aggressive. "If taken at the stage completely original, the prognosis is favorable." But he is more reserved when the melanoma has reached a certain development of melanocytes can reel off the rest of the body.
About treatments for melanoma, "at present, nothing is really valid. A drug has been marketed in the United States. It would work on a number of patients as anomalies. In France, interferons have not produced the results we expected, but they opened the way to therapy on immune responses. Work on the immune responses, that's what the school of Nantes. "
Prevention: the role of dermatologists and the role of patient
Remains prevention. As for the dermatologists, there are two schools: those that remove moles on areas of friction in a systematic way, and those who ask their patients to take pictures to observe changes in their moles. "What matters is to be monitored. Taking pictures is good, but we feel that the person concerned. " This should not be limited to visits to the dermatologist once a year. "Be very suspicious of any lesion appeared recently. The melanocyte is degenerate. The melanin granules will grow in a production irregular shape can expand, become nodular, may ulcerate or bleed ... We need to consider any injury, "explains Jacques Bazex. A mole near a nail in the palms, the soles of feet ... in short the whole area of friction must be removed any doubt. "I prefer to remove a lesion or a mole for nothing rather than let it develop a potential cancer. Even after 30 years of experience, we always see some surprises. "
For parents, the message remains the same: protect your children. "Sunburn in childhood determine a part of the development of skin cancer." The weapons remain sunscreen with high protection and whose applications are updated regularly, the T-shirt and glasses.
The indoor tanning ...
For adults, the message is the same, plus a warning Jacques Bazex on tanning booths. "UVA rays you receive in tanning booths do not protect from the sun because UVA does not cause thickening of the skin as UVB. Not only do not protect UVA, but they began considerably your capital for solar as an interesting pigmentation, you will need a lot of UVA. However, they penetrate the skin to the skin cells and can cause injury eventually led to melanoma. However, there are cases where dermatologists are required to use the UVA for some treatments. "But to treat psoriasis, for example, doses of UVA are very low and administered in conjunction with a treatment ensuring the photosensitivity. By adding the amounts of UVA delivered in a treatment for psoriasis, we can not even half of what is delivered in a single tanning session ... Not to mention that we impose the supervision of a professional. "
Protection from the sun, avoid tanning booths, and see a dermatologist once a year: this is a summary of the three councils Jacques Bazex to limit the risk of skin cancer.
Carcinoma or melanoma, it is skin cancer since the 1960s that continues to grow. A figure: Approximately 90,000 new cases of skin cancer are diagnosed each year in France. In most cases these are carcinomas. It is they who are treated best. But melanoma, much more aggressive, continues to grow. The number is doubling every ten years. How to detect, treat and prevent these cancers? Answers with Jacques Bazex, dermatologist, member of the National Academy of Medicine.
It is obvious: a clear or milky skin is more prone to sunburn than dark skin or black. It also more likely to develop skin cancer after strong sunburn. "When the Irish and the English arrived in Australia to colonize this land, they developed many skin cancers," says Jacques Bazex.
But all is not about color! It seems that along with the pigmentation of the skin coexists genetic factors that predispose to developing melanoma. The sun would play in this case the trigger of something existing.
"There is also a tendency for those with moles are agitated" said our guest. "These are the dysplastic nevi (deform), which are much more sensitive to sun exposure."
Dysplastic nevi - ill-defined edge, varied coloration.
Attention. All skin cancers are not born of moles. In fact, less than a quarter of skin cancers are caused by a nevus. "Any skin lesion, if it is lightly colored, must be the arrival of a suspected melanoma, although this is not a mole," says Jacques Bazex.
Carcinomas and Mélamones: what differences?
Carcinomas account for 90% of cases of skin cancer. There are two forms:
Basal cell carcinomas. These are the most frequent and less severe. Squamous cell carcinomas are a little more difficult but removal is easy. "For carcinomas, always perform a histological examination and ensure that the removal is complete."
As for melanoma, less frequently, it is also much more aggressive. "If taken at the stage completely original, the prognosis is favorable." But he is more reserved when the melanoma has reached a certain development of melanocytes can reel off the rest of the body.
About treatments for melanoma, "at present, nothing is really valid. A drug has been marketed in the United States. It would work on a number of patients as anomalies. In France, interferons have not produced the results we expected, but they opened the way to therapy on immune responses. Work on the immune responses, that's what the school of Nantes. "
Prevention: the role of dermatologists and the role of patient
Remains prevention. As for the dermatologists, there are two schools: those that remove moles on areas of friction in a systematic way, and those who ask their patients to take pictures to observe changes in their moles. "What matters is to be monitored. Taking pictures is good, but we feel that the person concerned. " This should not be limited to visits to the dermatologist once a year. "Be very suspicious of any lesion appeared recently. The melanocyte is degenerate. The melanin granules will grow in a production irregular shape can expand, become nodular, may ulcerate or bleed ... We need to consider any injury, "explains Jacques Bazex. A mole near a nail in the palms, the soles of feet ... in short the whole area of friction must be removed any doubt. "I prefer to remove a lesion or a mole for nothing rather than let it develop a potential cancer. Even after 30 years of experience, we always see some surprises. "
For parents, the message remains the same: protect your children. "Sunburn in childhood determine a part of the development of skin cancer." The weapons remain sunscreen with high protection and whose applications are updated regularly, the T-shirt and glasses.
The indoor tanning ...
For adults, the message is the same, plus a warning Jacques Bazex on tanning booths. "UVA rays you receive in tanning booths do not protect from the sun because UVA does not cause thickening of the skin as UVB. Not only do not protect UVA, but they began considerably your capital for solar as an interesting pigmentation, you will need a lot of UVA. However, they penetrate the skin to the skin cells and can cause injury eventually led to melanoma. However, there are cases where dermatologists are required to use the UVA for some treatments. "But to treat psoriasis, for example, doses of UVA are very low and administered in conjunction with a treatment ensuring the photosensitivity. By adding the amounts of UVA delivered in a treatment for psoriasis, we can not even half of what is delivered in a single tanning session ... Not to mention that we impose the supervision of a professional. "
Protection from the sun, avoid tanning booths, and see a dermatologist once a year: this is a summary of the three councils Jacques Bazex to limit the risk of skin cancer.
Sunlight and skin cancer
Sunlight provides us with important physiological effects, it improves the mood and gives a feeling of wellbeing. But the excess of solar radiation without protection can cause harmful effects on the skin, is the most serious skin cancer.
To prevent this cancer is important to know the risk factors and prevention
Risk Factors
1. The harmful effect is cumulative throughout life. The more a child starts the exposure increases the risk
2. Having clear skin, which are almost never tans
3. Severe sunburn and repetitive
4. Exhibitions are intense but intermittent exposures in homes and continuing outdoor workers
Ten photoprotection
1. No young children exposed to the sun, if possible up to 3 years
2. Use clothing, hat and parasol.
3. Good hydration, drink water and eat fruits
4. Avoid exposure during midday astronomical (11 to 15 hours)
5. Avoid excessive exposure
6. Whenever possible, know the UV index. If more than 6, children should not sunbathe
7. Using filters with sun protection factor (SPF) of 20 or higher, even on days nuvolats
8. Correct application of sunscreen. Apply in a generous and uniform on clean dry skin. About 20-30 minutes before exposure. Reapply every 2 hours maximum
9. Always use waterproof
10. Do not use sunscreen in the sun for longer
To prevent this cancer is important to know the risk factors and prevention
Risk Factors
1. The harmful effect is cumulative throughout life. The more a child starts the exposure increases the risk
2. Having clear skin, which are almost never tans
3. Severe sunburn and repetitive
4. Exhibitions are intense but intermittent exposures in homes and continuing outdoor workers
Ten photoprotection
1. No young children exposed to the sun, if possible up to 3 years
2. Use clothing, hat and parasol.
3. Good hydration, drink water and eat fruits
4. Avoid exposure during midday astronomical (11 to 15 hours)
5. Avoid excessive exposure
6. Whenever possible, know the UV index. If more than 6, children should not sunbathe
7. Using filters with sun protection factor (SPF) of 20 or higher, even on days nuvolats
8. Correct application of sunscreen. Apply in a generous and uniform on clean dry skin. About 20-30 minutes before exposure. Reapply every 2 hours maximum
9. Always use waterproof
10. Do not use sunscreen in the sun for longer
The prevention of skin cancer installed in schools
With the arrival of summer, increase the warning message to protect themselves from sunlight and prevent possible skin diseases. In this sense, there are ten schools in the city during this next year, part of a pilot program called Solar Campaign 2011. This pioneering project, promoted by the Spanish Association Against Cancer (AECC) and the Public Health Agency of Barcelona (ASPB), put on sunscreen vending machines in schools so that children can protect themselves themselves against the sun.
Among the ten schools that carried out the experience, are the Primary Master and Antaviana Morera, both of New Districts, particularly in the neighborhoods and the City of Roquetas meridian respectively. The remaining schools are located throughout the city. It also collaborate the CEIP The Orchards, John Rock and Provençals Guipúzcoa, in the district of Sant Martí school Orlandai of Sarria, the Provincial Primary School in the Eixample or Ciutadella Park in Old Town.
The project not only provides for the installation of these dispensers sunscreen, but also planned to place an information stand at schools, where young people informed about the need for sun protection. At this stop, the young can make a few simple tests to know what the level of protection your skin needs.
A GROWING EVIL
It has been shown that the incidence of malignant melanoma in Catalonia has increased in the two decades after dar. Has also increased the level of mortality, which rose from 26 cases to over a hundred in this period.
Experts point out that the use of sunscreens, such as creams, are essential for children to prevent the onset of skin cancer after reaching adulthood. It also recommended the use of opaque clothing and avoiding exposure to sunlight from 10 am to 16 pm, the time of maximum solar radiation.
Among the ten schools that carried out the experience, are the Primary Master and Antaviana Morera, both of New Districts, particularly in the neighborhoods and the City of Roquetas meridian respectively. The remaining schools are located throughout the city. It also collaborate the CEIP The Orchards, John Rock and Provençals Guipúzcoa, in the district of Sant Martí school Orlandai of Sarria, the Provincial Primary School in the Eixample or Ciutadella Park in Old Town.
The project not only provides for the installation of these dispensers sunscreen, but also planned to place an information stand at schools, where young people informed about the need for sun protection. At this stop, the young can make a few simple tests to know what the level of protection your skin needs.
A GROWING EVIL
It has been shown that the incidence of malignant melanoma in Catalonia has increased in the two decades after dar. Has also increased the level of mortality, which rose from 26 cases to over a hundred in this period.
Experts point out that the use of sunscreens, such as creams, are essential for children to prevent the onset of skin cancer after reaching adulthood. It also recommended the use of opaque clothing and avoiding exposure to sunlight from 10 am to 16 pm, the time of maximum solar radiation.
Skin cancer is growing
There is a continued increase in the annual incidence of melanoma in Catalonia of 2.53% in men and 5.29% in women, according to a report of the ICO
The campaign aims to raise awareness of the Council on the effects of an incorrect exposure to the sun, to the increased incidence of skin cancer. Photo: Press Service DDB.
To prepare for the current summer campaign of the Province of Barcelona beaches Care Take care of yourself and you, the Department of Public Health and Consumer Affairs commissioned a study at the Catalan Institute of Oncology (ICO), which indicates that "in Recent years have seen a continued increase in the annual incidence of melanoma in the order of 2.53% in men and 5.29% in women. "
The study, "the importance of this type of cancer is its high invasive capacity, ie, to generate metastasis (spread to distant organs of a malignant primary tumor) which reduces the chances of cure. If diagnosed and treated in the early stages, the cure rates of melanoma are high. "
"In Catalonia, approximately 776 diagnosed cases of melanoma each year, with a higher proportion in women than in men (542 women and 234 men), representing 2.9% of all cancer cases in women and 1, 5% in men. The mortality rate for melanoma represents about 2.15% of cancer mortality in men and 0.95% in women. "
"In recent years there has been a continued increase in the annual incidence of around 2.53% in men and 5.29% in women, as well as mortality in both men and women ( 0.83% and 1.45% respectively). This increase in the incidence, according to experts, would result in greater exposure to solar radicacions and artificial changes in the habits of exposure. It is considered that approximately 65% to 90% of melanomas are caused by exposure to intense ultraviolet radiation.
Melanoma is associated with episodes of sunburn. The risk of melanoma is greater when there is a pattern of intermittent but intense sun exposure to episodes of sunburn, as is typical of the holiday. The consequences of this pattern of exposure are particularly important in children and adolescents and at-skinned people have a higher risk of burns. "
The result of these considerations, the Department decided to reinforce his campaign with advice on exposure to sunlight which includes the classic range, which it distributed 40,000 units this year to councils of the 25 coastal municipalities of the province as part of that campaign summer and beaches this year and the beaches Care Take care you.
The campaign aims to raise awareness of the Council on the effects of an incorrect exposure to the sun, to the increased incidence of skin cancer. Photo: Press Service DDB.
To prepare for the current summer campaign of the Province of Barcelona beaches Care Take care of yourself and you, the Department of Public Health and Consumer Affairs commissioned a study at the Catalan Institute of Oncology (ICO), which indicates that "in Recent years have seen a continued increase in the annual incidence of melanoma in the order of 2.53% in men and 5.29% in women. "
The study, "the importance of this type of cancer is its high invasive capacity, ie, to generate metastasis (spread to distant organs of a malignant primary tumor) which reduces the chances of cure. If diagnosed and treated in the early stages, the cure rates of melanoma are high. "
"In Catalonia, approximately 776 diagnosed cases of melanoma each year, with a higher proportion in women than in men (542 women and 234 men), representing 2.9% of all cancer cases in women and 1, 5% in men. The mortality rate for melanoma represents about 2.15% of cancer mortality in men and 0.95% in women. "
"In recent years there has been a continued increase in the annual incidence of around 2.53% in men and 5.29% in women, as well as mortality in both men and women ( 0.83% and 1.45% respectively). This increase in the incidence, according to experts, would result in greater exposure to solar radicacions and artificial changes in the habits of exposure. It is considered that approximately 65% to 90% of melanomas are caused by exposure to intense ultraviolet radiation.
Melanoma is associated with episodes of sunburn. The risk of melanoma is greater when there is a pattern of intermittent but intense sun exposure to episodes of sunburn, as is typical of the holiday. The consequences of this pattern of exposure are particularly important in children and adolescents and at-skinned people have a higher risk of burns. "
The result of these considerations, the Department decided to reinforce his campaign with advice on exposure to sunlight which includes the classic range, which it distributed 40,000 units this year to councils of the 25 coastal municipalities of the province as part of that campaign summer and beaches this year and the beaches Care Take care you.
Michael Jackson might have skin cancer, according to "The Sun"
According to the Saturday newspaper "The Sun", Michael Jackson is fighting secretly against skin cancer. According to sources the newspaper, which doctors have diagnosed the disease in recent weeks have said that he cares and is therefore expected to act in the fifties has scheduled concerts. The same King of Pop, 50, said he was "very concerned" when he announced the news, but "is eager to return to the stage." According to "The Sun", the singer recently visited regularly by a dermatologist in Beverly Hills and Cedar-Sinai hospital in Los Angeles. The news has caused concern among the thousands of fans for concerts scheduled in London, which begin July 8.
Campaign to prevent skin cancer
A tent installed in the Plaza de Catalonia reports today about the dangers of sunbathing without protection. Up to seven in the evening, a team of pharmacists and dermatologists from various hospitals in Barcelona analyze skin types and provide information on how to prevent the negative effects of the sun.
Doctors examine the sensitivity of the skin of each patient and recommend the most appropriate sunscreen to prevent health problems. We also checked the presence of freckles or spots to guide users of potential dangers.
The initiative is par for the campaign face the sun, which drives the Spanish Association Against Cancer to promote good practice when sunbathing.
Doctors examine the sensitivity of the skin of each patient and recommend the most appropriate sunscreen to prevent health problems. We also checked the presence of freckles or spots to guide users of potential dangers.
The initiative is par for the campaign face the sun, which drives the Spanish Association Against Cancer to promote good practice when sunbathing.
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