A que un no s´imagina fer de metge sense tenir a ma un fonendoscopi?
Jo, desde que un dermatoleg proper em va obrir la llum de la dermatoscòpia, ja no m´imagino fer de metge sense tenir a ma un dermatoscopi.
Per bon ull que tingueu, per aplicats que sigueu i per tant coneixedors dels criteris que apunten a que una lesió pot ser maligna, el que us ofereix la dermatoscòpia és anar una miqueta més enllà d´allà on arriba el vostre ull, amplificant 10 o més vegades el que mirem i amb una llum especial ens permet descobrir llops camuflats en pell de xai o també xais en pell de llop.
Per si encara no ho teniu en els vostres plans, us vull animar a entrar al món de la dermatoscòpia, un bon complement al vostre ull clínic per millorar l´atenció que oferiu als vostres pacients. Estem parlant d´una eina que ens farà més sensibles a la detecció del melanoma! .
Aquesta presentació correspon al que per a mi són les idees claus que varen transmetre els nostres companys del Grup de Treball de Dermatologia de la CAMFIC, al taller de dermatoscòpia que feren al 25 congrés d´Atenció Primària a Tarragona.
Vull agraïr-los la seva feina i generositat.
Espero que aviat també sigueu dels qui no us imagineu un metge sense fonendoscopi ni tampoc sense dermatoscopi!
Dermatoscopia en lesiones pigmentarias
Dra. Rosmary Martin Moreno
Hospital Universitario de Caracas
IV Encuentro Iberoamericano de Dermatología Pediátrica. Caracas 2010
www.dermatologiapediatrica.net
Una visión personal sobre los atributos que definen a un buen médico de familia. Inspirada en el documento sobre las conductas del buen médico de familia elaborado por el grupo de trabajo de ética de la CAMFiC. Aquí tenéis la versión en castellano fruto de vuestras peticiones.
Dermatoscopia en lesiones pigmentarias
Dra. Rosmary Martin Moreno
Hospital Universitario de Caracas
IV Encuentro Iberoamericano de Dermatología Pediátrica. Caracas 2010
www.dermatologiapediatrica.net
Una visión personal sobre los atributos que definen a un buen médico de familia. Inspirada en el documento sobre las conductas del buen médico de familia elaborado por el grupo de trabajo de ética de la CAMFiC. Aquí tenéis la versión en castellano fruto de vuestras peticiones.
Presentació de Noemí Gómez, infermera de Badalona Serveis Assistencials, a la Jornada de celebració del Dia Internacional de les Infermeres, celebrada a Badalona el 14 de maig de 2024.
Presentació de Mª José Sabariego, infermera de Badalona Serveis Assistencials, a la Jornada de celebració del Dia Internacional de les Infermeres, celebrat a Badalona el 14 de maig de 2024.
Presentació de Jaime Bataller, infermer especialista de família i comunitària de Badalona Serveis Assistencials, a la Jornada de celebració del Dia Internacional de les Infermeres, celebrada a Badalona el 14 de maig de 2024.
Presentació de Valentina Suarez i Sara Calmaestra, infermera de salut mental i educadora social de Badalona Serveis Assistencials, a la Jornada de celebració del Dia Internacional de les Infermeres, celebrada a Badalona el 14 de maig de 2024.
Presentació de Teresa Pujadas i Mónica Góme, infermeres referents de l’Equip d’Atenció Residencial de Badalona Serveis Assistencials, a la Jornada de celebració del Dia Internacional de les Infermeres, celebrada a Badalona el 14 de maig de 2024.
Presentació de Mireia Fernández, Infermera Pràctica Avançada IPA-FCC i Membre del Comité de Nafres Complexes de Badalona Serveis Assistencials, a la Jornada de celebració del Dia Internacional de les Infermeres, celebrada a Badalona el 14 de maig de 2024.
Presentació de Maria Iborra, infermera en cures pal·liatives de Badalona Serveis Assistencials, a la Jornada de celebració del Dia Internacional de les Infermeres, celebrat a Badalona el 14 de maig de 2024.
Presentació de Noelia Leal i Silvia Ortigosa, infermeres de Badalona Serveis Assistencials, a la Jornada de celebració del Dia Internacional de les Infermeres, celebrada a Badalona el 14 de maig de 2024.
Presentació de Vicky Sanchez, infermera del servei d'endoscòpies de Badalona Serveis Assistencials, a la Jornada de celebració del Dia Internacional de les Infermeres, celebrada a Badalona el 14 de maig de 2024.
2024 State of Marketing Report – by HubspotMarius Sescu
https://www.hubspot.com/state-of-marketing
· Scaling relationships and proving ROI
· Social media is the place for search, sales, and service
· Authentic influencer partnerships fuel brand growth
· The strongest connections happen via call, click, chat, and camera.
· Time saved with AI leads to more creative work
· Seeking: A single source of truth
· TLDR; Get on social, try AI, and align your systems.
· More human marketing, powered by robots
ChatGPT is a revolutionary addition to the world since its introduction in 2022. A big shift in the sector of information gathering and processing happened because of this chatbot. What is the story of ChatGPT? How is the bot responding to prompts and generating contents? Swipe through these slides prepared by Expeed Software, a web development company regarding the development and technical intricacies of ChatGPT!
Product Design Trends in 2024 | Teenage EngineeringsPixeldarts
The realm of product design is a constantly changing environment where technology and style intersect. Every year introduces fresh challenges and exciting trends that mold the future of this captivating art form. In this piece, we delve into the significant trends set to influence the look and functionality of product design in the year 2024.
How Race, Age and Gender Shape Attitudes Towards Mental HealthThinkNow
Mental health has been in the news quite a bit lately. Dozens of U.S. states are currently suing Meta for contributing to the youth mental health crisis by inserting addictive features into their products, while the U.S. Surgeon General is touring the nation to bring awareness to the growing epidemic of loneliness and isolation. The country has endured periods of low national morale, such as in the 1970s when high inflation and the energy crisis worsened public sentiment following the Vietnam War. The current mood, however, feels different. Gallup recently reported that national mental health is at an all-time low, with few bright spots to lift spirits.
To better understand how Americans are feeling and their attitudes towards mental health in general, ThinkNow conducted a nationally representative quantitative survey of 1,500 respondents and found some interesting differences among ethnic, age and gender groups.
Technology
For example, 52% agree that technology and social media have a negative impact on mental health, but when broken out by race, 61% of Whites felt technology had a negative effect, and only 48% of Hispanics thought it did.
While technology has helped us keep in touch with friends and family in faraway places, it appears to have degraded our ability to connect in person. Staying connected online is a double-edged sword since the same news feed that brings us pictures of the grandkids and fluffy kittens also feeds us news about the wars in Israel and Ukraine, the dysfunction in Washington, the latest mass shooting and the climate crisis.
Hispanics may have a built-in defense against the isolation technology breeds, owing to their large, multigenerational households, strong social support systems, and tendency to use social media to stay connected with relatives abroad.
Age and Gender
When asked how individuals rate their mental health, men rate it higher than women by 11 percentage points, and Baby Boomers rank it highest at 83%, saying it’s good or excellent vs. 57% of Gen Z saying the same.
Gen Z spends the most amount of time on social media, so the notion that social media negatively affects mental health appears to be correlated. Unfortunately, Gen Z is also the generation that’s least comfortable discussing mental health concerns with healthcare professionals. Only 40% of them state they’re comfortable discussing their issues with a professional compared to 60% of Millennials and 65% of Boomers.
Race Affects Attitudes
As seen in previous research conducted by ThinkNow, Asian Americans lag other groups when it comes to awareness of mental health issues. Twenty-four percent of Asian Americans believe that having a mental health issue is a sign of weakness compared to the 16% average for all groups. Asians are also considerably less likely to be aware of mental health services in their communities (42% vs. 55%) and most likely to seek out information on social media (51% vs. 35%).
AI Trends in Creative Operations 2024 by Artwork Flow.pdfmarketingartwork
This article is all about what AI trends will emerge in the field of creative operations in 2024. All the marketers and brand builders should be aware of these trends for their further use and save themselves some time!
A report by thenetworkone and Kurio.
The contributing experts and agencies are (in an alphabetical order): Sylwia Rytel, Social Media Supervisor, 180heartbeats + JUNG v MATT (PL), Sharlene Jenner, Vice President - Director of Engagement Strategy, Abelson Taylor (USA), Alex Casanovas, Digital Director, Atrevia (ES), Dora Beilin, Senior Social Strategist, Barrett Hoffher (USA), Min Seo, Campaign Director, Brand New Agency (KR), Deshé M. Gully, Associate Strategist, Day One Agency (USA), Francesca Trevisan, Strategist, Different (IT), Trevor Crossman, CX and Digital Transformation Director; Olivia Hussey, Strategic Planner; Simi Srinarula, Social Media Manager, The Hallway (AUS), James Hebbert, Managing Director, Hylink (CN / UK), Mundy Álvarez, Planning Director; Pedro Rojas, Social Media Manager; Pancho González, CCO, Inbrax (CH), Oana Oprea, Head of Digital Planning, Jam Session Agency (RO), Amy Bottrill, Social Account Director, Launch (UK), Gaby Arriaga, Founder, Leonardo1452 (MX), Shantesh S Row, Creative Director, Liwa (UAE), Rajesh Mehta, Chief Strategy Officer; Dhruv Gaur, Digital Planning Lead; Leonie Mergulhao, Account Supervisor - Social Media & PR, Medulla (IN), Aurelija Plioplytė, Head of Digital & Social, Not Perfect (LI), Daiana Khaidargaliyeva, Account Manager, Osaka Labs (UK / USA), Stefanie Söhnchen, Vice President Digital, PIABO Communications (DE), Elisabeth Winiartati, Managing Consultant, Head of Global Integrated Communications; Lydia Aprina, Account Manager, Integrated Marketing and Communications; Nita Prabowo, Account Manager, Integrated Marketing and Communications; Okhi, Web Developer, PNTR Group (ID), Kei Obusan, Insights Director; Daffi Ranandi, Insights Manager, Radarr (SG), Gautam Reghunath, Co-founder & CEO, Talented (IN), Donagh Humphreys, Head of Social and Digital Innovation, THINKHOUSE (IRE), Sarah Yim, Strategy Director, Zulu Alpha Kilo (CA).
Trends In Paid Search: Navigating The Digital Landscape In 2024Search Engine Journal
The search marketing landscape is evolving rapidly with new technologies, and professionals, like you, rely on innovative paid search strategies to meet changing demands.
It’s important that you’re ready to implement new strategies in 2024.
Check this out and learn the top trends in paid search advertising that are expected to gain traction, so you can drive higher ROI more efficiently in 2024.
You’ll learn:
- The latest trends in AI and automation, and what this means for an evolving paid search ecosystem.
- New developments in privacy and data regulation.
- Emerging ad formats that are expected to make an impact next year.
Watch Sreekant Lanka from iQuanti and Irina Klein from OneMain Financial as they dive into the future of paid search and explore the trends, strategies, and technologies that will shape the search marketing landscape.
If you’re looking to assess your paid search strategy and design an industry-aligned plan for 2024, then this webinar is for you.
5 Public speaking tips from TED - Visualized summarySpeakerHub
From their humble beginnings in 1984, TED has grown into the world’s most powerful amplifier for speakers and thought-leaders to share their ideas. They have over 2,400 filmed talks (not including the 30,000+ TEDx videos) freely available online, and have hosted over 17,500 events around the world.
With over one billion views in a year, it’s no wonder that so many speakers are looking to TED for ideas on how to share their message more effectively.
The article “5 Public-Speaking Tips TED Gives Its Speakers”, by Carmine Gallo for Forbes, gives speakers five practical ways to connect with their audience, and effectively share their ideas on stage.
Whether you are gearing up to get on a TED stage yourself, or just want to master the skills that so many of their speakers possess, these tips and quotes from Chris Anderson, the TED Talks Curator, will encourage you to make the most impactful impression on your audience.
See the full article and more summaries like this on SpeakerHub here: https://speakerhub.com/blog/5-presentation-tips-ted-gives-its-speakers
See the original article on Forbes here:
http://www.forbes.com/forbes/welcome/?toURL=http://www.forbes.com/sites/carminegallo/2016/05/06/5-public-speaking-tips-ted-gives-its-speakers/&refURL=&referrer=#5c07a8221d9b
ChatGPT and the Future of Work - Clark Boyd Clark Boyd
Everyone is in agreement that ChatGPT (and other generative AI tools) will shape the future of work. Yet there is little consensus on exactly how, when, and to what extent this technology will change our world.
Businesses that extract maximum value from ChatGPT will use it as a collaborative tool for everything from brainstorming to technical maintenance.
For individuals, now is the time to pinpoint the skills the future professional will need to thrive in the AI age.
Check out this presentation to understand what ChatGPT is, how it will shape the future of work, and how you can prepare to take advantage.
Presentació de Noemí Gómez, infermera de Badalona Serveis Assistencials, a la Jornada de celebració del Dia Internacional de les Infermeres, celebrada a Badalona el 14 de maig de 2024.
Presentació de Mª José Sabariego, infermera de Badalona Serveis Assistencials, a la Jornada de celebració del Dia Internacional de les Infermeres, celebrat a Badalona el 14 de maig de 2024.
Presentació de Jaime Bataller, infermer especialista de família i comunitària de Badalona Serveis Assistencials, a la Jornada de celebració del Dia Internacional de les Infermeres, celebrada a Badalona el 14 de maig de 2024.
Presentació de Valentina Suarez i Sara Calmaestra, infermera de salut mental i educadora social de Badalona Serveis Assistencials, a la Jornada de celebració del Dia Internacional de les Infermeres, celebrada a Badalona el 14 de maig de 2024.
Presentació de Teresa Pujadas i Mónica Góme, infermeres referents de l’Equip d’Atenció Residencial de Badalona Serveis Assistencials, a la Jornada de celebració del Dia Internacional de les Infermeres, celebrada a Badalona el 14 de maig de 2024.
Presentació de Mireia Fernández, Infermera Pràctica Avançada IPA-FCC i Membre del Comité de Nafres Complexes de Badalona Serveis Assistencials, a la Jornada de celebració del Dia Internacional de les Infermeres, celebrada a Badalona el 14 de maig de 2024.
Presentació de Maria Iborra, infermera en cures pal·liatives de Badalona Serveis Assistencials, a la Jornada de celebració del Dia Internacional de les Infermeres, celebrat a Badalona el 14 de maig de 2024.
Presentació de Noelia Leal i Silvia Ortigosa, infermeres de Badalona Serveis Assistencials, a la Jornada de celebració del Dia Internacional de les Infermeres, celebrada a Badalona el 14 de maig de 2024.
Presentació de Vicky Sanchez, infermera del servei d'endoscòpies de Badalona Serveis Assistencials, a la Jornada de celebració del Dia Internacional de les Infermeres, celebrada a Badalona el 14 de maig de 2024.
2024 State of Marketing Report – by HubspotMarius Sescu
https://www.hubspot.com/state-of-marketing
· Scaling relationships and proving ROI
· Social media is the place for search, sales, and service
· Authentic influencer partnerships fuel brand growth
· The strongest connections happen via call, click, chat, and camera.
· Time saved with AI leads to more creative work
· Seeking: A single source of truth
· TLDR; Get on social, try AI, and align your systems.
· More human marketing, powered by robots
ChatGPT is a revolutionary addition to the world since its introduction in 2022. A big shift in the sector of information gathering and processing happened because of this chatbot. What is the story of ChatGPT? How is the bot responding to prompts and generating contents? Swipe through these slides prepared by Expeed Software, a web development company regarding the development and technical intricacies of ChatGPT!
Product Design Trends in 2024 | Teenage EngineeringsPixeldarts
The realm of product design is a constantly changing environment where technology and style intersect. Every year introduces fresh challenges and exciting trends that mold the future of this captivating art form. In this piece, we delve into the significant trends set to influence the look and functionality of product design in the year 2024.
How Race, Age and Gender Shape Attitudes Towards Mental HealthThinkNow
Mental health has been in the news quite a bit lately. Dozens of U.S. states are currently suing Meta for contributing to the youth mental health crisis by inserting addictive features into their products, while the U.S. Surgeon General is touring the nation to bring awareness to the growing epidemic of loneliness and isolation. The country has endured periods of low national morale, such as in the 1970s when high inflation and the energy crisis worsened public sentiment following the Vietnam War. The current mood, however, feels different. Gallup recently reported that national mental health is at an all-time low, with few bright spots to lift spirits.
To better understand how Americans are feeling and their attitudes towards mental health in general, ThinkNow conducted a nationally representative quantitative survey of 1,500 respondents and found some interesting differences among ethnic, age and gender groups.
Technology
For example, 52% agree that technology and social media have a negative impact on mental health, but when broken out by race, 61% of Whites felt technology had a negative effect, and only 48% of Hispanics thought it did.
While technology has helped us keep in touch with friends and family in faraway places, it appears to have degraded our ability to connect in person. Staying connected online is a double-edged sword since the same news feed that brings us pictures of the grandkids and fluffy kittens also feeds us news about the wars in Israel and Ukraine, the dysfunction in Washington, the latest mass shooting and the climate crisis.
Hispanics may have a built-in defense against the isolation technology breeds, owing to their large, multigenerational households, strong social support systems, and tendency to use social media to stay connected with relatives abroad.
Age and Gender
When asked how individuals rate their mental health, men rate it higher than women by 11 percentage points, and Baby Boomers rank it highest at 83%, saying it’s good or excellent vs. 57% of Gen Z saying the same.
Gen Z spends the most amount of time on social media, so the notion that social media negatively affects mental health appears to be correlated. Unfortunately, Gen Z is also the generation that’s least comfortable discussing mental health concerns with healthcare professionals. Only 40% of them state they’re comfortable discussing their issues with a professional compared to 60% of Millennials and 65% of Boomers.
Race Affects Attitudes
As seen in previous research conducted by ThinkNow, Asian Americans lag other groups when it comes to awareness of mental health issues. Twenty-four percent of Asian Americans believe that having a mental health issue is a sign of weakness compared to the 16% average for all groups. Asians are also considerably less likely to be aware of mental health services in their communities (42% vs. 55%) and most likely to seek out information on social media (51% vs. 35%).
AI Trends in Creative Operations 2024 by Artwork Flow.pdfmarketingartwork
This article is all about what AI trends will emerge in the field of creative operations in 2024. All the marketers and brand builders should be aware of these trends for their further use and save themselves some time!
A report by thenetworkone and Kurio.
The contributing experts and agencies are (in an alphabetical order): Sylwia Rytel, Social Media Supervisor, 180heartbeats + JUNG v MATT (PL), Sharlene Jenner, Vice President - Director of Engagement Strategy, Abelson Taylor (USA), Alex Casanovas, Digital Director, Atrevia (ES), Dora Beilin, Senior Social Strategist, Barrett Hoffher (USA), Min Seo, Campaign Director, Brand New Agency (KR), Deshé M. Gully, Associate Strategist, Day One Agency (USA), Francesca Trevisan, Strategist, Different (IT), Trevor Crossman, CX and Digital Transformation Director; Olivia Hussey, Strategic Planner; Simi Srinarula, Social Media Manager, The Hallway (AUS), James Hebbert, Managing Director, Hylink (CN / UK), Mundy Álvarez, Planning Director; Pedro Rojas, Social Media Manager; Pancho González, CCO, Inbrax (CH), Oana Oprea, Head of Digital Planning, Jam Session Agency (RO), Amy Bottrill, Social Account Director, Launch (UK), Gaby Arriaga, Founder, Leonardo1452 (MX), Shantesh S Row, Creative Director, Liwa (UAE), Rajesh Mehta, Chief Strategy Officer; Dhruv Gaur, Digital Planning Lead; Leonie Mergulhao, Account Supervisor - Social Media & PR, Medulla (IN), Aurelija Plioplytė, Head of Digital & Social, Not Perfect (LI), Daiana Khaidargaliyeva, Account Manager, Osaka Labs (UK / USA), Stefanie Söhnchen, Vice President Digital, PIABO Communications (DE), Elisabeth Winiartati, Managing Consultant, Head of Global Integrated Communications; Lydia Aprina, Account Manager, Integrated Marketing and Communications; Nita Prabowo, Account Manager, Integrated Marketing and Communications; Okhi, Web Developer, PNTR Group (ID), Kei Obusan, Insights Director; Daffi Ranandi, Insights Manager, Radarr (SG), Gautam Reghunath, Co-founder & CEO, Talented (IN), Donagh Humphreys, Head of Social and Digital Innovation, THINKHOUSE (IRE), Sarah Yim, Strategy Director, Zulu Alpha Kilo (CA).
Trends In Paid Search: Navigating The Digital Landscape In 2024Search Engine Journal
The search marketing landscape is evolving rapidly with new technologies, and professionals, like you, rely on innovative paid search strategies to meet changing demands.
It’s important that you’re ready to implement new strategies in 2024.
Check this out and learn the top trends in paid search advertising that are expected to gain traction, so you can drive higher ROI more efficiently in 2024.
You’ll learn:
- The latest trends in AI and automation, and what this means for an evolving paid search ecosystem.
- New developments in privacy and data regulation.
- Emerging ad formats that are expected to make an impact next year.
Watch Sreekant Lanka from iQuanti and Irina Klein from OneMain Financial as they dive into the future of paid search and explore the trends, strategies, and technologies that will shape the search marketing landscape.
If you’re looking to assess your paid search strategy and design an industry-aligned plan for 2024, then this webinar is for you.
5 Public speaking tips from TED - Visualized summarySpeakerHub
From their humble beginnings in 1984, TED has grown into the world’s most powerful amplifier for speakers and thought-leaders to share their ideas. They have over 2,400 filmed talks (not including the 30,000+ TEDx videos) freely available online, and have hosted over 17,500 events around the world.
With over one billion views in a year, it’s no wonder that so many speakers are looking to TED for ideas on how to share their message more effectively.
The article “5 Public-Speaking Tips TED Gives Its Speakers”, by Carmine Gallo for Forbes, gives speakers five practical ways to connect with their audience, and effectively share their ideas on stage.
Whether you are gearing up to get on a TED stage yourself, or just want to master the skills that so many of their speakers possess, these tips and quotes from Chris Anderson, the TED Talks Curator, will encourage you to make the most impactful impression on your audience.
See the full article and more summaries like this on SpeakerHub here: https://speakerhub.com/blog/5-presentation-tips-ted-gives-its-speakers
See the original article on Forbes here:
http://www.forbes.com/forbes/welcome/?toURL=http://www.forbes.com/sites/carminegallo/2016/05/06/5-public-speaking-tips-ted-gives-its-speakers/&refURL=&referrer=#5c07a8221d9b
ChatGPT and the Future of Work - Clark Boyd Clark Boyd
Everyone is in agreement that ChatGPT (and other generative AI tools) will shape the future of work. Yet there is little consensus on exactly how, when, and to what extent this technology will change our world.
Businesses that extract maximum value from ChatGPT will use it as a collaborative tool for everything from brainstorming to technical maintenance.
For individuals, now is the time to pinpoint the skills the future professional will need to thrive in the AI age.
Check out this presentation to understand what ChatGPT is, how it will shape the future of work, and how you can prepare to take advantage.
A brief introduction to DataScience with explaining of the concepts, algorithms, machine learning, supervised and unsupervised learning, clustering, statistics, data preprocessing, real-world applications etc.
It's part of a Data Science Corner Campaign where I will be discussing the fundamentals of DataScience, AIML, Statistics etc.
Time Management & Productivity - Best PracticesVit Horky
Here's my presentation on by proven best practices how to manage your work time effectively and how to improve your productivity. It includes practical tips and how to use tools such as Slack, Google Apps, Hubspot, Google Calendar, Gmail and others.
The six step guide to practical project managementMindGenius
The six step guide to practical project management
If you think managing projects is too difficult, think again.
We’ve stripped back project management processes to the
basics – to make it quicker and easier, without sacrificing
the vital ingredients for success.
“If you’re looking for some real-world guidance, then The Six Step Guide to Practical Project Management will help.”
Dr Andrew Makar, Tactical Project Management
1. Obrint la carpeta dels
meus apunts
Idees clau del taller de dermatoscòpia del Gdt dermatologia de la
CAMFIC, realitzat al
25 Congrés d´Atenció Primària CAMFIC
Un resum en 25 diapositives.
2. 1/3 de tots els càncers corresponen a
càncer de PELL
Incidència en augment!!
El 80% de MORTALITAT per càncer de
pell és per MELANOMA
Introducció: problemàtica del càncer
cutani
www.maypamintuan.com
3. parlem de que (+) MILIMETRES de
profunditat del melanoma es tradueixen
en (-) ANYS de supervivència
0,8mm: 99% supervivència
>4mm:37-50%
4. prevenció primària: educar en
FOTOPROTECCIÓ
prevenció secundària: Cribratge
Qué poderm fer?: La pilota és al nostre
terrat!
5. Prevenció primària: FOTOPROTECCIÓ!!
la pantalla total.....no existeix!
I per saber-ne més: http://www.dermapixel.com/2015/06/
fotoproteccion-en-la-infancia-que-hay.html
6. Identificar grups de risc
fenotipus: ulls clars, fototipus I i II, cabell ros o pèl roig,
múltiples efélides,>50 nevus típics, molts nevus atípics,
Síndrome de nevus displàsics
antecedents familiars de primer grau de melanoma
7. Amb la sensibilitat que ens sol caracteritzar
als metges de família... resulta que NO SOM
SENSIBLES al càncer de pell ...MOLT per
MILLORAR
És tan freqÜent que l´hem d´anar a buscar
(quan auscultem, quan explorem el genoll...)
l´única mesura que garantitza la
SUPERVIVÈNCIA és el tractament PRECOÇ!
Prevenció secundària:
CRIBRATGE
8. www.flickr.com/photos/jdhancock/
3-Reconeixament de patrons (fotografies...)
1-Mètode clàssic: ABCDE : Detectem 50% ( moneda a l´aire)
2-Procés comparatiu (signe del aneguet lleig)
la dermatoscòpia complementa el
que ha de ser un acurat judici
clínic previ
COM HO FEM?
9. ens permet visualitzar estructures de la pell
més enllà d´allà d´on arriba el nostre ull
( epidermis, unió dermo-epidèrmica i dermis
superficial )
Portem a la butxaca una eina que està més
aprop del que et diu l´anatomo-patòleg
El dermatoscopi ens redueix l´àrea de incertesa
entre benignitat i malignitat
10. Ho veiem en colors, cada un amb
correlació histològica
11. ens permet l´estudi de lesions
pigmentades
Valoració de les lesions tumorals no
melanocítiques: Queratosi seborrèiques.
Carcinoma Basocel.lular...
Mètode de cribratge : objectiu fonamental
a l´Atenció Primària
12. No melanocítiques:(augment de melanina)
Queratosi seborreica
carcinoma basocel.lular
dermatofibroma
lesions vasculars
Melanocítiques: (augment de melanina +proliferació de melanòcits)
Nevus congènits
nevus adquirits
nevus atípics
melanoma
diagnòstic diferencial de les lesions
pigmentades
13. 1ª etapa: és una lesió melanocítica?
criteris de lesió melanocítica: Patró reticle pigmentari
Patró paral.lel
globus
projeccions
pigment blau homogeni
si no
2ª etapa criteris específics d´alguna lesió no melanocítica?no
sí
Queratosi seborreica
Carcinoma basocel.lular
Dermatofibroma
Lesió vascular
anàlisi de patrons
benigne
nevus
sospita maligne
Melanoma
lesions pigmentades: diagnòstic en 2 etapes
14. queratosi seborreica carcinoma basocel.lular
angioma
Font: dermatoweb2.udl.es
Font: dermatoweb2.udl.es
Font- Dra Rosa Senan
dermatofibroma
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criteris de lesió no melanocítica?
15. patró reticular pigmentat
patró globular o en empedrat
patró homogeni blau
patró en ¨esclat d´estels¨
patró paral.lel al solc o la cresta
patró multicomponent
les lesions malignes solen
tenir >de 2 patrons
paral.lel al solc
a la cresta
patrons de lesions melanocítiques:
16. Asimetria, múltiples colors
patrons: multicomponent, en ¨esclat d´estels¨,
inespecífic
reticle pigmentat atípic
projeccions atípiques
punts-glòbuls atípics
vasos irregulars i polimòrfics
estructures de regressió
vel blau-blanc
Quistes tipus mílium
hipertricosi
canvis de pigmentació perifol.licular
Patró global: Reticular, globular, reticulo-globular,
pigmentació marró difusa,
multicomponent amb homegeneïcitat d´estructures
lesió melanocítica, 2ª etapa: com diferenciar
entre melanoma i nevus melanocític
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17. 2ª etapa valorar les irregularitats en els patrons
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patró reticular
patró globular
patró homogeni
patró en esclat d´¨estels¨
reticle irregular, xarxes diferents amb
final abrupte en perifèria, asimètric
reticle regular, fi, es difumina en perifèria,
simètric
glòbuls irregulars i
de diferents mides,
asimètric
glòbuls regulars, homogenis,
lesió harmònica
Recent aparició estable en el temps
melanoma nevus de Reed, de Spitz: DERIVAR
18. www.actasdermo.org
línies paral.leles als solc ( més fines)
nevus acral
línies paral.leles a la cresta
melanoma
patró paral.lel
2ª etapa valorar les irregularitats en els patrons
19. Criteris negatius ( NO hi son al
melanoma: únic color, simetria de patró
Criteris positius: almenys 1 ha d´estar
present: Vel blau-blanc
Múl-ples
punts marrons
Projeccions
radials
Pseudòpodes
Despigmentació
pseudo-cicatricial
Punts/glòbuls negres
perifèrics
Múl-ples colors Re#cle pigmentat
prominent
Múl$ples punts blau-
gris (en “pebre”)
2ª etapa: Mètode 11 punts de Menzies
ens ajuda a diferenciar també el melanoma del nevus melanocític
20. l´objectiu és identificar totes les lesions
potencialment malignes amb un alt
nivell de SENSIBILITAT
avalua només la presència de 3 criteris
dermatoscòpics
1 ASIMETRIA
2 RETICLE ATÍPIC
3 ESTRUCTURES BLANC-BLAVOSES
Tècnica de criba molt senzilla:
Regla dels 3 punts
21. ASIMETRIA d´estructura i colors ( no
de silueta)
hi ha color BLANC-BLAU? (blanc
indica regressió, blau lesió profunda)
hi ha RETICLE ATÍPIC? (xarxa irregular
línies gruixudes)
per cada un que sigui present suma un punt
> 2 punts sospita de malignitat: DERIVAR
Regla dels 3 punts
23. àsimètrica: 1 punt
color blanc-blau: 1 punt
no hi ha reticle: 0 punts
2 punts: DERIVAR
Aquesta regla, no discrimina si una lesió és
melanocítica ( melanoma) o no ( carcinoma )
regla dels 3 punts
24. Un gran augment en la sensibilitat diagnòstica de pocs
( dermatòlegs )té menys impacte global que un petit
augment de la sensibilitat diagnòstica de molts ( metges
de família)
25. tot sortint del taller vaig sentir a més d´un que deia:
¨necessito un dermatoscopi JA!¨
bona feina! Gdt dermatologia CAMFIC
gràcies de nou!
26. per casos clínics haureu d´anar a un taller!
jo a canvi us ofereixo una mica de ...
dermatoscòpia i natura