PubMed Health⌕ Search

Biomedical subjects

D A Scarborough

Publications and source records attributed to D A Scarborough.

16 recordsLinked to original sources
PubMed2000

The use of conscious sedation for outpatient dermatologic surgical procedures.

BACKGROUND: Dermatologic surgery has undergone increasing levels of sophistication over the past few decades. Commensurate with this demand, an established anesthesia technique called conscious sedation has been employed. OBJECTIVES: Methods for performing office-based conscious sedation are described. Recommendations are made regarding prerequisites for conscious sedation in an office setting, patient selection, complications management, and postoperative discharge requirements. CONCLUSION: The goals of anesthesia are to provide for patient safety and comfort, to increase patient acceptance of the procedure, and to enhance the surgeon's efficiency and satisfaction.

Ambulatory Surgical Procedures↗
PubMed1999

The combined use of propofol and fentanyl for outpatient intravenous conscious sedation.

BACKGROUND: Intravenous conscious sedation is currently being widely utilized for outpatient surgery including dermatologic surgery. Even though this type of anesthesia is typically administered by a trained, licensed anesthetist, it is important for dermatologists who either intend to or are currently utilizing this type of anesthesia to be familiar with some of the methods and agents that are commonly employed. OBJECTIVE: Propofol and fentanyl are two anesthetic agents that are in prevalent use for skin and soft tissue surgery of brief or limited duration. With the goal of familiarizing dermatologic surgeons with this form of anesthesia, a study was conducted to evaluate the safety and effectiveness of the combination of propofol and fentanyl when used for conscious sedation in an outpatient dermatology center. METHODS: Twenty patients, ages 25-65 years, who required conscious sedation were enrolled. Each patient received a standard dosage of fentanyl and propofol, as determined on a kilogram basis. Sedation time, total procedure time, recovery time, and total propofol dose, along with side effects, were determined. RESULTS: The mean onset to sedation was 52.5 seconds, the mean procedure time was 40 minutes 37 seconds, and the mean interval to recovery was 3 minutes 43 seconds, with a mean total dose of propofol of 5.83 mg/kg. Minimal side effects occurred. CONCLUSION: Propofol when used in conjunction with fentanyl appears to be a safe, quick, and effective method of providing conscious sedation.

Adult↗
PubMed1996

Evaluation of the American Academy of Dermatology's National Skin Cancer Early Detection and Screening Program.

BACKGROUND: Increasing incidence and mortality rates from cutaneous melanoma are a major public health concern. As part of a national effort to enhance early detection of melanoma/skin cancer, the American Academy of Dermatology (AAD) has sponsored an annual education and early detection program that couples provision of skin cancer information to the general public with almost 750,000 free skin cancer examinations (1985-1994). OBJECTIVE: To begin to evaluate the impact of this effort, we determined the final pathology diagnosis of persons attending the 1992-1994 programs who had a suspected melanoma at the time of examination. METHODS: We directly contacted all such persons by telephone or mail and received pathology reports from those who had a subsequent biopsy. RESULTS: We contacted 96% of the 4458 persons with such lesions among the 282,555 screenings in the 1992-1994 programs. We obtained a final diagnosis for 72%, and the positive predictive value for melanoma was 17%. Three hundred seventy-one melanomas were found in 364 persons. More than 98% had localized disease. More than 90% of the confirmed melanomas with known histology were in situ or "thin" lesions (< or = 1.50 mm thick). The median thickness of all melanomas was 0.30 mm. The 8.3% of AAD cases with advanced melanoma (metastatic disease, regional disease, or lesions > or = 1.51 mm) is a lower proportion than that reported by the 1990 Surveillance, Epidemiology and End Result Registry. The rate of thickest lesions (> or = 4 mm) and late-stage melanomas among all participants was 2.83 per 100,000 population. Of persons with a confirmed melanoma, 39% indicated (before their examination) that without the free program, they would not have considered having a physician examine their skin. CONCLUSION: The 1992-1994 free AAD programs disseminated broad skin cancer educational messages, enabled thousands to obtain a free expert skin cancer examination, and found mostly thin, localized stage 1 melanomas (usually associated with a high projected 5-year survival rate). Because biases impose possible limitations, future studies with long-term follow-up and formal control groups should determine the impact of early detection programs on melanoma mortality.

Adult↗
PubMed1990

Fat transfer for aging skin: technique for rhytids.

Dermatologic surgeons are familiar with many surgical and nonsurgical techniques for the reduction of facial rhytids. Injectable collagen, silicone, and fibril are commonly employed as injectable filler materials. Properly done, fat transfer is another valuable tool for use in facial restoration. Fat transfer is an excellent technique for intervention in the aging process, and is easily managed as an office procedure. We will review the near-century-old history of fat grafting and outline the structural dynamics in the process of facial aging. Our experience from the last 50 fat transfer procedures performed will be reviewed with specific attention to patient selection, extraction and injection technique, complications, and overall results.

Adipose Tissue↗
PubMed1988

Syringe-assisted liposuction: a cosmetic surgeon's office technique.

Liposuction surgery is the fastest growing cosmetic surgical procedure in the United States. Our goal is to present a clinical review of our last 50 patients. We will present a technique of liposuction void of suction machine that is easily managed as an office surgical technique. The technique is modified from that of Dr. Fournier. We will outline the technique, including patient preoperative evaluation, monitoring, fluid management, postprocedure complications, photographic results, and, most importantly, patient selection.

Adipose Tissue↗
PubMed1983

DNA repair in skin of lupus erythematosus following in vivo exposure to ultraviolet radiation.

The in vivo repair of pyrimidine dimers induced in the DNA of skin of 9 patients diagnosed as systemic or discoid lupus erythematosus (LE) was measured. A small area of the buttock was exposed to radiation emitted from a Burdick UV-800 sunlamp. The number of pyrimidine dimers was measured by incubating the epidermal skin DNA with UV-specific endonuclease and sedimenting the DNA through alkaline sucrose gradients. The initial number of dimers induced following sunlamp exposure was 7.6 +/- 1.8 per 10(8) daltons DNA. The level of photorepair was measured by illuminating an area of the skin with greater than 450-nm radiation immediately following sunlamp exposure. We found that 56.5 +/- 9.5% of the dimers are photorepaired with 5 min of illumination. Excision repair was measured in an area of the skin covered for 2 and 24 h postirradiation. Approximately 44 and 81% of the dimers induced immediately following sunlamp exposure were removed at these respective times. These observations in LE are similar to those observed in the skin of normal individuals.

Adult↗
PubMed1983

An investigation of 2'-deoxycoformycin in the treatment of cutaneous T-cell lymphoma.

We have investigated the use of 2'-deoxycoformycin (DCF), a potent inhibitor of adenosine deaminase (ADA), in the treatment of 4 patients with advanced mycosis fungoides (MF). Since DCF has demonstrated an adverse effect in vitro and in vivo on the survival of leukemia T-cell lines, it appeared reasonable to examine its effect in patients with advanced cutaneous T-cell lymphoma. A total of 8 courses of DCF were given to the 4 patients. Since this study was part of an ongoing phase I investigation, each patient received a fixed dose (varying from 4 mg/sq m to 10 mg/sq m daily for 3 consecutive days) on a 28-day schedule. One patient had reversible renal insufficiency. Three patients had reversible myelosuppression. Two patients had a complete remission of disease for 7+ and 9+ mo. respectively. Two additional patients had partial remissions for 4 and 9 mo, respectively. We concluded that effective antitumor activity in advanced MF can be achieved with DCF at doses that may not be associated with prohibitive toxicity. We would encourage further investigation of this agent in patients with advanced cutaneous T-cell lymphoma.

Adenosine Deaminase↗