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This article discusses a study published in the British Journal of Dermatology that examines the risk of melanoma in patients with a history of keratinocyte carcinoma (KC), with a specific focus on skin of color patients. The study analyzed Medicare claims data from 2009 to 2018 and found that skin of color patients with KC had a higher risk of melanoma compared to patients with seborrhoeic keratosis (SK). The research emphasizes the importance of including skin of color patients in skin cancer studies and calls for further research in this population. Another aspect of the study examined the association between actinic keratosis (AK) and melanoma in Medicare patients aged 65 and older. The study found that a history of AK was associated with an 85% increased risk of melanoma in skin of color patients. However, the absolute risks of melanoma in this group were still low, at less than 1% at 5 years. The study acknowledges limitations, such as the use of claims data and the exclusion of certain patient categories. Overall, the study highlights the increased risk of melanoma in skin of color patients with a history of AK. [Extracted from the article]

Introduction: Hiatal hernia repair is associated with substantial recurrence of both hiatal hernia and symptoms of gastroesophageal reflux (GER). While small randomized controlled trials demonstrate limited differences in outcomes with use of mesh or fundoplication type, uncertainty remains. Methods: A multicenter, retrospective review of patients undergoing surgical treatment of hiatal hernias between 2015 and 2020 was performed. Patients with mesh and with suture-only repair were compared, and partial versus complete fundoplication was compared. Primary outcomes were hernia recurrence and occurrence of postoperative GER symptoms and dysphagia. Multivariable regression was performed to assess the effect of each intervention on clinical outcomes. Results: A total of 453 patients from four sites were followed for a median (IQR) of 17 (13) months. On multivariate analysis, mesh had no impact on hernia recurrence (odds ratio 0.993, 95% CI: 0.53–1.87, p = 0.982), and fundoplication type did not impact recurrence of postoperative GER symptoms (complete: odds ratio 0.607, 95% CI: 0.33–1.12, p = 0.112) or dysphagia (complete: odds ratio 1.17, 95% CI: 0.56–2.43, p = 0.677). Conclusion: During hiatal hernia repair, mesh and fundoplication type do not appear to have substantial impact on GER symptoms, dysphagia, or hernia recurrence. This multicenter study provides real-world evidence to support the findings of small RCTs. [ABSTRACT FROM AUTHOR]