A 2009 meta-analysis of randomized controlled trials found a small difference in survival rates favoring wide excision of primary cutaneous melanomas, but these results were not statistically significant.Mohs surgery has been reported with cure rate as low as 77% and as high as 98.0% for melanoma-in-situ. CCPDMA and the "double scalpel" peripheral margin controlled surgery is equivalent to Mohs surgery in effectiveness on this "intra-epithelial" type of melanoma. Melanomas that spread usually do so to the lymph nodes in the area of the tumor before spreading elsewhere. Attempts to improve survival by removing lymph nodes surgically (lymphadenectomy) were associated with many complications, but no overall survival benefit. Recently, the technique of sentinel lymph node biopsy has been developed to reduce the complications of lymph node surgery while allowing assessment of the involvement of nodes with tumor.Biopsy of sentinel lymph nodes is a widely used procedure when treating cutaneous melanoma.Neither sentinel lymph node biopsy nor other diagnostic tests should be performed to evaluate early, thin melanoma, including melanoma in situ, T1a melanoma or T1b melanoma ≤ 0.5mm. People with these conditions are unlikely to have the cancer spread to their lymph nodes or anywhere else and have a 5-year survival rate of 97%. Because of these considerations, sentinel lymph node biopsy is considered unnecessary health care for them. Furthermore, baseline blood tests and radiographic studies should not be performed only based on identifying this kind of melanoma, as there are more accurate tests for detecting cancer and these tests have high false-positive rates.
However, these procedures are not totally efficient and they vary from country to country.Most mosquitos on aircraft do not carry malaria. The few that do are relatively inefficient invaders. In addition, further natural protection is offered by constraints of the hosting countrys climate.A list of airports at risk has been proposed. International sanitary regulations require the area of airports and the perimeter of 400 m (1,300 ft) around the airport to be made free of Aedes aegypti and Anopheles mosquitos. However, the application of disinsection varies from country to country. Outlook
Airport malaria is not considered a serious public health problem but has a high fatality rate and poses a local threat. The prognosis is poor with fatality rates ranging from 16.9% to 26% with almost all the reports being of the falciparum type. History
There were reports from as early as 1925 that diseases including cholera, plague, smallpox, typhus, yellow fever and malaria could make their way across countries within short periods of time on aircraft. Based on the International Sanitary Convention for Aerial Navigation (1933) (Hague), which came into force in 1935 to protect communities against diseases liable to be imported by aircraft, air-traffic health control administrations, dealt with by the Office International dHygiène Publique, Paris, were able to impose maximally excepted measures for this purpose, but left their actual application to each country concerned. Information regarding disease surveillance was supplied by "The Health Organization of the League of Nations" and updates were published and circulated regularly. Individual governments drew up their own regulations accordingly.