Biomedical subjects

Marc D Brown

Publications and source records attributed to Marc D Brown.

6 recordsLinked to original sources

PubMed2006

Special concern about squamous cell carcinoma of the scalp in organ transplant recipients.

BACKGROUND: Several risk factors are generally accepted to portend more aggressive behavior of cutaneous squamous cell carcinoma. These include tumor size, tumor depth, histologic subtype, location on the lip or ear, tumor arising in scar, recurrent tumor, and tumor demonstrating perineural invasion. Organ transplant recipients can have significant morbidity and mortality from squamous cell carcinoma. OBSERVATIONS: Four organ transplant recipients developed metastatic disease from squamous cell carcinoma of the scalp. CONCLUSIONS: Squamous cell carcinoma of the scalp in organ transplant recipients should be considered a high-risk tumor because of its anatomic location. Margin-controlled tumor extirpation, sentinel lymph node biopsy, and adjuvant radiation therapy should all be considered in the organ transplant recipient population.

Adult↗

PubMed2006

Decreasing the pain of local anesthesia: a prospective, double-blind comparison of buffered, premixed 1% lidocaine with epinephrine versus 1% lidocaine freshly mixed with epinephrine.

BACKGROUND: Local anesthetics are acidic and cause pain on infiltration into the skin. Two methods are commonly used by dermatologists to raise the pH of lidocaine with epinephrine: buffering with sodium bicarbonate or freshly mixing lidocaine with epinephrine on the day of use. OBJECTIVE: Our purpose was to compare the pain induced by infiltration of the skin with 1% lidocaine with epinephrine 1:100,000 buffered with sodium bicarbonate (buffered) versus 1% lidocaine freshly mixed with epinephrine (fresh). METHODS: Sixty volunteers were recruited for this prospective, double-blind study. Each subject received an intradermal injection of the buffered solution and the fresh solution. Immediately after each injection subjects rated the pain of infiltration on a 100-mm visual analog scale. The pain scores for the anesthetic solutions were compared using the paired t test. RESULTS: The pain score for the buffered solution was 18.3 +/- 20.3, and the pain score for the fresh solution was 23.5 +/- 19.1 (P = .0543). Sixty-five percent of subjects felt the fresh solution was more painful than the buffered solution. LIMITATIONS: The results did not reach statistical significance. CONCLUSION: In this small study, buffered lidocaine with epinephrine caused less pain on infiltration into the skin than lidocaine freshly mixed with epinephrine, but the results were not statistically significant.

Anesthetics, Local↗

PubMed2005

Imiquimod for the treatment of skin cancer.

Imiquimod is a topically applied immunomodulator. Although initially approved for genital and perianal warts, dermatologists have prescribed this compound for many neoplastic and nonneoplastic skin conditions. The US Food and Drug Administration recently approved imiquimod for the treatment of actinic keratoses. This article reviews the literature on imiquimod in the treatment of cutaneous malignancies.

Administration, Cutaneous↗

PubMed2005

Metastasizing atypical fibroxanthoma (cutaneous malignant histiocytoma): report of five cases.

BACKGROUND: Atypical fibroxanthoma (AFX) is an unusual malignant fibrohistiocytic tumor of sun-damaged skin. When first described, it was felt to be a reactive tumor of low malignant potential. More recently, it has been shown to be a tumor of intermediate malignant potential. OBJECTIVE: To describe five cases of metastatic AFX. RESULTS: Five patients ranging in age from 65 to 85 years old presented with metastatic AFX. Three of the five cases presented with regional lymph node disease. Also, three of the five cases had other aggressive cutaneous malignancies. LN-2 (CD74) staining was positive in three of five primary tumors and two of five metastatic tumors. CONCLUSION: The metastatic potential of AFX may be underestimated. LN-2 staining may be a useful marker in identifying more aggressive tumor behavior.

Aged↗

PubMed2004

Guidelines for the management of squamous cell carcinoma in organ transplant recipients.

BACKGROUND: Solid-organ transplant recipients have a high incidence of cutaneous squamous cell carcinoma (SCC) and often develop multiple and aggressive tumors. There are few published studies or reviews, which provide guidance to the clinician in the treatment of these patients. OBJECTIVE: The objective was to develop useful clinical guidelines for the treatment of skin cancer in organ transplant recipients (OTRs). METHODS: The members of the Guidelines Committee of the International Transplant-Skin Cancer Collaborative (ITSCC) carried out a computerized search utilizing the databases of the National Library of Medicine for reports in the literature on SCC in OTRs. These reports were collectively examined by the group and combined with experiences from the members' clinical practices in the development of the guidelines. RESULTS: More than 300 articles relating to SCC in OTRs were reviewed. In general, reports concerning the prevention and treatment of SCC in OTRs are of individual cases or small case series. They are retrospective in nature, statistically nonrigorous, and lack the complete epidemiologic data necessary to derive definitive conclusions. Combining these studies and collective clinical experience, however, is at present the best available method for devising guidelines for the treatment of SCC in OTRs. CONCLUSION: Guidelines developed for the treatment of skin cancer in OTRs, supported by the best available data and collective clinical experience, may assist in the management of OTRs with SCC. The development of clinical pathways and complete documentation with rigorous prospective study is necessary to improve and refine future guideline development.

Carcinoma, Squamous Cell↗

PubMed2003

Building the minority faculty development pipeline.

The shortage of faculty in dental education is well documented, but the data also show a shortage of minorities in postgraduate programs, which develop future faculty. In the last ten years, ADEA's effort to address minority issues in dental education has made some progress. In addition, examples of pipelines for minority faculty development that have shown some success include: a partnership between Harlem Hospital and Columbia University School of Dentistry and Oral Surgery in which the school dedicates one position in its postgraduate training programs to an individual participating in the Harlem Hospital General Practice Residency program; a partnership between the National Dental Association Foundation and Colgate-Palmolive Company, which provides scholarships for advanced dental education study; and the Bronx Lebanon Hospital Center Department of Dentistry, which enrolls underrepresented minorities in its General Practice Residency Program, a new Pediatric Dentistry Residency Program, and a unique program providing hands-on experience in HIV/AIDS health care policy and AIDS development management. Critical elements in the relative success of these programs are environment, selection criteria, mentoring, networking, and finance. The true measure of the outcomes is still to be seen.

Black or African American↗