ABSTRACT
Skin of color centers (SoCCs) in the United States have helped increase the racial/ethnic diversity of and cultivate cultural competence in practicing dermatologists as well as increase skin of color (SoC) research and education to improve patient care. The objective of this cross-sectional survey study was to provide an in-depth analysis of SoCCs and SoC specialty clinics (SoCSCs) in the United States, including their patient care focus, research, and program diversity. As the US population diversifies, it is important to highlight the programmatic, research, and educational work of existing SoCCs so that they can continue to be supported and so efforts are made to encourage the establishment of future centers at academic medical institutions across the United States.
Subject(s)
Skin Pigmentation , Humans , Cross-Sectional Studies , United States , Dermatology , Surveys and Questionnaires , Cultural DiversitySubject(s)
Cellulitis , Racial Groups , United States/epidemiology , Humans , Cross-Sectional Studies , Cellulitis/epidemiology , Hospitalization , HospitalsABSTRACT
To aid in the standardization of evaluating patients with multiple keloids, a Keloid Area and Severity Index (KASI) was developed using patient feedback, previous literature, and clinical expertise. The system was validated using intrarater and interrater reliability assessments. Here, we present a verified, reliable method of assessing keloid area and severity in clinical and research settings.
Subject(s)
Keloid , Humans , Keloid/diagnosis , Keloid/pathology , Reproducibility of ResultsSubject(s)
Academic Medical Centers/trends , Dermatology/education , Internship and Residency/trends , Skin Diseases/ethnology , Skin Pigmentation , Academic Medical Centers/organization & administration , Academic Medical Centers/statistics & numerical data , Cultural Diversity , Dermatologists/education , Dermatology/organization & administration , Dermatology/statistics & numerical data , Dermatology/trends , Ethnicity , Humans , Internship and Residency/organization & administration , Internship and Residency/statistics & numerical data , Skin Diseases/diagnosis , Skin Diseases/therapy , United StatesABSTRACT
BACKGROUND: Malnutrition is a pro-inflammatory state, yet data on nutritional risk factors and development of acute graft-versus-host disease (aGVHD) are extremely limited. PROCEDURE: We conducted a retrospective cohort analysis of pediatric patients up to age 21 years who underwent allogeneic hematopoietic stem cell transplantation (HSCT) at the Children's Hospital of Philadelphia from January 2011 to September 2014 to determine whether malnutrition was associated with development of aGVHD and early mortality. We identified body mass index (BMI) percentile and serum albumin levels as potential markers of malnutrition and defined two composite nutritional risk variables as any of the following: albumin < 2.8 g/dl, weight loss ≥10% from baseline, and low BMI [<25th (NUT25) or <5th percentile (NUT5)]. Nutritional markers and GVHD grade were assessed at baseline, 30, 60, and 90 days post-HSCT, and patients were censored upon development of GVHD. RESULTS: BMI <25th or <5th percentile, NUT25, and NUT5 at the beginning of any 30-day period predicted a three- to fourfold risk of developing of severe (grade III-IV) aGVHD in the subsequent 30 days in models adjusted for age, sex, donor source, and degree of human leukocyte antigen matching. Mortality at day 100 was low, but NUT25 risk at baseline conferred an increased risk of death (7.9% vs. 1%, P = 0.035). CONCLUSIONS: Malnutrition is a targetable risk factor in pediatric HSCT; prospective trials are needed to investigate this relationship further and identify effective nutritional interventions.