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PubMed1994

Knowledge of malignant melanoma and how it relates to clinical practice among nurse practitioners and dermatology and oncology nurses.

Cutaneous malignant melanoma (CMM) is a growing health problem in the United States. This study evaluated nurses' frequency of skin cancer assessment, ability to recognize CMM, knowledge of risk factors and preventive measures, teaching practices, and barriers to skin cancer assessment. The sample (n = 178) consisted of nurse practitioners (NP), oncology nurses (ON), and dermatology nurses (DN). The participants indicated that skin cancer assessment was within their scope of practice but reported frequencies of performance were low. NP scored lower in overall knowledge, although they had received the highest level of formal skin cancer education (p < 0.05). Recognition of melanoma was moderate, with scores of 54-68% for the three groups. Recognition scores for premalignant and benign lesions were lower. Frequency of skin cancer assessment and teaching were higher for DN (p < 0.05). Total knowledge scores were not predictive of teaching practices. Time limitations and inadequate knowledge were barriers that inversely correlated with frequency of skin cancer assessment. Findings suggest that individual CMM knowledge and experience correlated highly with frequency of assessment and teaching. Programs are needed to educate nurses in skin cancer prevention and detection. The broader implications for future research will be presented.

Adult↗
PubMed1995

Is dermatology slipping into its anec-dotage?

In recent issues, the Archives has run a feature entitled "In the Archives a Century Ago" in which a portion of a very old article is reprinted. These articles seem often to be chosen for comic interest and make good reading, seeing how widely our forefathers missed the mark. It is even better when the author is a familiar name. How could they think such crazy things? Usually a short while after feeling so smug, one of our residents, or perhaps a visiting internist, will give me a strange look after I state some dermatologic concept and ask how we have come to such a conclusion. Sometimes, it can be tough to defend (why do so many people get "insect bite reactions" in the dead of winter?), and I am left wondering how we know what we know.

Dermatology↗
PubMed1994

Gynecologic and dermatologic electrosurgical units: a comparative review.

Electrosurgery is a popular surgical technique in which high-frequency, low-voltage electrical energy produced by an electrosurgical unit is used to excise abnormal tissue with hemostasis. In this study, electrosurgical units were critically evaluated for safety, electrical specifications, design, and performance characteristics. Quantitative electrical specification and histologic thermal artifact measurements and qualitative observations were recorded for 13 electrosurgical units representing 11 manufacturers. The Aspen Sabre 180 and Laerscope e10 were considered exemplary units based on safety criteria alone. Cut-mode thermal artifact was less than 10 microns for the Cooper Leep 6000, Laserscope e10, and Utah Finesse. A maximum fulguration distance of greater than 0.5 mm was demonstrated by the Gyne-Tech Autolepe 2000 and 4000, Laserscope e10, and the Elmed ESU 30. For gynecologic electrosurgery, the Aspen Sabre 180 and Laserscope e10 were rated best, followed closely by the Utah Finesse and Finesse II and the Gyne-Tech Autolepe 4000. Dermatologic electrosurgery may be well accomplished with many of the electrosurgical units, except as noted.

Ambulatory Surgical Procedures↗
PubMed1994

Women in dermatology. Challenges and recommendations.

The total number of women physicians in the United States tripled between 1970 and 1990. Almost 50% of incoming residents in dermatology are women. This article discusses some of the changes, opportunities, and challenges within our profession wrought by these demographic changes. The incorporation of women into all aspects of our specialty is a subject that warrants review, consideration, and creative solutions.

Dermatology↗
PubMed1994

Transcutaneous Po2 and Pco2 measurement in dermatology.

Although transcutaneous Po2 (tcPo2) and Pco2 (tcPco2) measurement was originally developed for the non-invasive Pao2 and Paco2 monitoring, its utilization in dermatology is discussed in this article. Our experimental and clinical studies have revealed that tcPo2 is easily influenced and reduced by various skin changes, such as hyperkeratosis, acanthosis, cellular infiltrate and fibrosis as well as the circulatory disturbance in the skin, and that tcPco2 is kept stable except in ischemic or bullous lesions. Although tcPo2 could be a marker reflecting the severity of some lesions, simultaneous measurement of tcPco2 and cutaneous blood flow would offer more precise information about the circulation and respiration in the skin.

Animals↗
PubMed1994

The dermatologic surgical suite.

In summary the size, layout, surgical lighting, and operative table are the most important variables in providing a comfortable, efficient surgical suite. Each physician will develop their own likes and dislikes when using and experimenting with various instruments and surgical devices. Wherever possible, trial periods should be obtained before committing excessive funds to major purchases. Nothing replaces personal experience in making such selections. A well-equipped, well-designed surgical suite improves the experience for both patients and the dermatologic surgeon.

Dermatology↗
PubMed1993

[The access, utilization and acceptance of dermatology services at a teaching health center from the viewpoint of Hansen's disease patients].

The present Case Study intends to analyse the access, utilization and acceptance of the Dermatology services of a SHC based mainly in the orally reported histories of 27 patients affected by Hansen's disease. The access to SHC--concerning its organization--took place without difficulty, except for the attendance services. However, the utilization level of the services was found to be higher than the established pattern of the care provided whether in actual episodes of the disease or not. The acceptance of the services rendered was consensual and both the technical quality and interpersonal relationship were emphasized.

Adolescent↗
PubMed1994

[Pharmacology of colchicine and its use in dermatology].

This study provides a summary about an old drug, colchicine, which has been used in medicine for two thousand years. It emphasizes the importance of this agent in the treatment of dermatologic diseases, especially in vasculitis. One of the aims of the study to spread the application of colchicine in the therapeutic management.

Colchicine↗
PubMed1977

Shortage of full-time faculty in dermatology.

A persistent shortage of full-time faculty exists in dermatology. Despite the addition of 124 new full-time faculty since 1971 through 1972, 136 training programs in 1974 through 1975 were actively seeking 88 new full-time faculty and believed they needed 243. With a net gain of 30 new faculty a year, it will take 2.93 years to add 88 new faculty that are being actively sought and 5.16 years to add 155 more that are urgently needed. During this eight years, demand for new faculty will increase, so that figures of need may remain essentially unchanged in 1982 through 1983 and between 1971 through 1972 and 1974 through 1975. Expertise that was most needed was in immunology, electron microscopy, histopathology, microbiology, and biochemistry; many accept faculty in any area or with no special training. Measures should be taken to attract and retain more dermatologists in full-time academic positions.

Dermatology↗
PubMed1993

The national health service and dermatology as a specialty.

The history and development of health care provision prior to and following the introduction of the National Health Service in 1948 is outlined. This article covers all aspects of the training of dermatologists and the development of dermatologic services currently in the United Kingdom.

Consultants↗
PubMed1996

The American Academy of Dermatology's response to managed care and capitation.

Managed care is an important part of the health care delivery system; consequently, dermatologists are seeking information about various managed care plans and are joining them. Managed care can encompass a variety of different systems, including preferred provider organizations, health maintenance organizations, and individual practice associations. They all provide health care services to enrolled members through a defined network of providers who are given the responsibility to provide quality medical care while controlling use and access to specialists. Many members of the American Academy of Dermatology (AAD) respond in surveys that education in various aspects of managed care is an area of great importance to them.

Capitation Fee↗
PubMedDate not supplied

A leprosy survey in a taluk headquarters town and the role of dermatological services and active health education in its success--a preliminary report.

A report of two general surveys done in 1984 and 1987 in Gudiyatham town, is presented. The first survey covered 89.2% and the second survey 82% of the population. The new case detection rate was 3.4 per 1000. The success of the survey was due to the co-operation obtained from the public, most probably because of the intense and sustained health education, combined with leprosy services integrated with a dermatology clinic.

Adolescent↗
PubMed1996

Teaching resources for dermatology on the WWW--quiz system and dynamic lecture scripts using a HTTP-database demon.

The World Wide Web (WWW) is becoming the major way of acquiring information in all scientific disciplines as well as in business. It is very well suitable for fast distribution and exchange of up to date teaching resources. However, to date most teaching applications on the Web do not use its full power by integrating interactive components. We have set up a computer based training (CBT) framework for Dermatology, which consists of dynamic lecture scripts, case reports, an atlas and a quiz system. All these components heavily rely on an underlying image database that permits the creation of dynamic documents. We used a demon process that keeps the database open and can be accessed using HTTP to achieve better performance and avoid the overhead involved by starting CGI-processes. The result of our evaluation was very encouraging.

Computer Communication Networks↗
PubMed1997

Azathioprine in dermatology: a survey of current practice in the U.K.

Azathioprine has an important role in treatment of many inflammatory dermatoses. In view of the current emphasis on evidence-based medicine, we performed a questionnaire-based survey to establish current practice in the use of azathioprine by consultant dermatologists and associate specialists in the U.K. The response rate was 68%. In contrast with the manufacturer's recommendation, our data provide evidence that azathioprine is useful in the treatment of a wide variety of dermatological diseases. However, there is still a need for controlled trials in some conditions. The most common conditions treated were pemphigoid, pemphigus and atopic eczema. In addition, we found that only 13% of dermatologists prescribe azathioprine according to body weight. Most dermatologists felt that azathioprine was well tolerated. No one tested for thiopurine methyltransferase (TPMT) activity, which is thought to be a predictor of severe myelosuppression. The combination of prescribing azathioprine according to body weight and measuring TPMT activity would optimize efficacy and minimize potential severe myelotoxicity.

Azathioprine↗
PubMed1997

Dermatologic drugs, pregnancy, and lactation. A conservative guide.

No database for determination of precise risk of drug use during pregnancy and lactation is available. There are, however, educated opinions concerning the advisability of use of a drug during the childbearing years from manufacturers, the Food and Drug Administration, various teratologists, the American Academy of Pediatrics, and the World Health Organization. Not all medications are absolutely contraindicated during pregnancy and lactation. Some drugs have been extensively used without apparent adverse effects in the mother or infant. When it is necessary to select a medication for use during pregnancy or lactation, the medication should have minimal risk. This article summarizes dermatologic drugs whose known risk is low.

Contraindications↗
PubMed1997

The future of vitamin D in dermatology.

BACKGROUND: Vitamin D3 analogs have been found to be effective in treating psoriasis. OBJECTIVE: We attempted to identify the targets and actions of vitamin D3 in the skin and to explore the availability of synthetic vitamin D3 analogs with selective actions on particular cell types or cell functions. METHODS: A review of the literature focused on the cellular targets of vitamin D3 in the skin and within the immune system. Furthermore, the use of novel vitamin D3 analogs in skin diseases other than psoriasis was reviewed. RESULTS: The vitamin D receptor has been detected in most skin cells, which means that keratinization, hair growth, melanogenesis, fibrogenesis, angiogenesis, and immune-mediated processes are potential targets for vitamin D3. Vitamin D3 analogs have been synthesized with a higher therapeutic index or a higher degree of selectivity than the natural form of vitamin D3. CONCLUSION: Vitamin D3 analogs with wide-ranging clinical applications may become available for dermatology.

Adjuvants, Immunologic↗