Subject(s)
Analgesics, Opioid/administration & dosage , Drug Prescriptions/statistics & numerical data , Medication Adherence/statistics & numerical data , Mohs Surgery/adverse effects , Pain, Postoperative/drug therapy , Aged , Aged, 80 and over , Analgesics, Opioid/adverse effects , Female , Humans , Male , Middle Aged , Opioid-Related Disorders/etiology , Opioid-Related Disorders/prevention & control , Pain, Postoperative/etiology , Practice Patterns, Physicians'/statistics & numerical data , Retrospective Studies , Skin Neoplasms/surgeryABSTRACT
BACKGROUND: It is important to better understand the role that environmental risk factors play on the development of esophageal cancer in Howel-Evans families. Additionally, there is little published about appropriate esophageal cancer screening practices in families genetically confirmed to have this condition. METHODS: Surveys were distributed to 47 addresses of an American family with Howel-Evans syndrome, of which 29 responded and met inclusion criteria. Data was collected about demographics, environmental risk factors, and medical history of participants. RESULTS: We report characteristics of family members with tylosis, rates of esophageal cancer, rates of genetic counseling, and levels of environmental risk factors. Of the survey respondents, 43% reported features of tylosis, 71.4% were male and 28.6% were female and 28.6% reported leukoplakia. Only 21.4% of tylotic family members smoked, 65% drank alcohol, and 28.6% drank well water. More than half (57.1%) of the tylotic individuals had never had an esophagogastroduodenoscopy (EGD) and no one had been diagnosed with esophageal carcinoma. Only 3.4% of respondents had ever received genetic testing for Howel-Evans syndrome, despite genetic confirmation of their relatives. CONCLUSIONS: We encourage dermatologists to discuss smoking-cessation, genetic counseling, and early EGD with affected families.
Subject(s)
Esophageal Neoplasms/diagnosis , Genetic Counseling/statistics & numerical data , Keratoderma, Palmoplantar/genetics , Adult , Alcohol Drinking/adverse effects , Endoscopy, Digestive System , Esophageal Neoplasms/genetics , Esophageal Neoplasms/prevention & control , Female , Humans , Male , Pedigree , Risk Factors , Smoking Cessation , Surveys and Questionnaires , SyndromeABSTRACT
BACKGROUND: Cyanoacrylates, also known as tissue adhesives or skin glues, are commonly used as sealants for lacerations and incisions and have found utility in excisional and cosmetic surgeries in both outpatient and operating room settings. OBJECTIVE: To review the surgical literature on the utilities, advantages, disadvantages, and special uses of cyanoacrylates applicable to dermatology. MATERIALS AND METHODS: PubMed was reviewed for relevant articles related to cyanoacrylates and their use in skin closures. Articles unrelated to cutaneous closures were excluded. RESULTS: Tissue adhesives polymerize to a water resistant, pliable film after application to approximated wound edges and have antibacterial properties. Adhesives slowly slough off as the wound heals, typically after 5 days. Compared with 5-0 nonabsorbable suture, adhesives provide similar tensile strength and similar patient and surgeon satisfaction. Although slightly more expensive than sutures, tissue adhesives obviate the need for wound dressings and suture removal. They do not perform as well as sutures for wounds under higher tension or in the setting of moisture and inadequate hemostasis. CONCLUSION: Cyanoacrylates serve as a safe and effective suture alternative in appropriate dermatologic surgeries and procedures.
