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Digit Health ; 5: 2055207619828225, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30792879


Objective: The aim of the study is to evaluate healthcare practitioners' views on and satisfaction with (i) digital image acquisition and storage and (ii) store-and-forward teledermoscopy services for the diagnosis of skin cancer in their clinical practice. Methods: An online survey was conducted among 59 healthcare practitioners (GPs (n=17), dermatologists (n=22), dermatology registrars (n=18), a dermatology research fellow (n=1) and a plastic surgeon (n=1)) to assess usability of digital image acquisition and storage for when the imaging process is conducted by the healthcare practitioners themselves, or by their patients. The study identifies the enablers and barriers of this emerging mode of medical practice. A thematic analysis was used to extract key themes from open-ended responses, which involved identifying themes and patterns within and across participants. Results: Thirty-four healthcare practitioners (58%) had previously used a mobile dermatoscope within their practice. Participants most appreciated its use in their practice for lesion monitoring (59%) and record keeping (39%). Challenges reported were the increased time to support the additional workload (45%), technical issues (33%) and cost of equipment (27%). Practitioners were unsure (36%) or did not advocate teledermoscopy for direct-to-consumer use (41%). Only 23% supported the use of direct-to-consumer teledermoscopy. Conclusion: While most practitioners are receptive to mobile teledermoscopy, there was less support for patient-initiated use, whereby the patient controls the imaging process. As technology improves rapidly it is important to evaluate practitioners' acceptance and satisfaction of evolving telehealth services, moving forward with models of practice where healthcare practitioners and other healthcare providers will feel comfortable engaging in telehealth services.

Biomed Opt Express ; 5(11): 3981-9, 2014 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-25426324


There is considerable interest in the interrogation of biological tissue at terahertz (THz) frequencies, largely due to the contrast in the optical properties of different biological tissues which occur in this electro-magnetic radiation band. Of particular interest are THz biomedical images, which have the potential to highlight different information than those acquired in other frequency bands, thereby providing an augmented picture of biological structures. In this work, we demonstrate the feasibility of an interferometric biological imaging technique using a THz quantum cascade laser (QCL) operating at 2.59 THz to perform coherent imaging of porcine tissue samples. We show the potential of this new THz biomedical imaging technique for in vivo studies, by virtue of its reflection geometry and useful tissue penetration depth enabled by the large THz powers emitted by the quantum cascade laser used in this work. The observed clustering of interferometric tissue signatures opens a pathway towards automatic techniques for the discrimination of healthy tissue types for the study of normal physiology and possible therapeutic approaches.

J Invest Dermatol ; 134(12): 2883-2889, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24991966


The relatively high incidence of Merkel cell carcinoma (MCC) in Queensland provides a valuable opportunity to examine links with other cancers. A retrospective cohort study was performed using data from the Queensland Cancer Registry. Standardized incidence ratios (SIRs) were used to approximate the relative risk of being diagnosed with another primary cancer either following or prior to MCC. Patients with an eligible first primary MCC (n = 787) had more than double the expected number of subsequent primary cancers (SIR = 2.19, 95% confidence interval (CI) = 1.84-2.60; P<0.001). Conversely, people who were initially diagnosed with cancers other than MCC were about two and a half times more likely to have a subsequent primary MCC (n=244) compared with the general population (SIR = 2.69, 95% CI = 2.36-3.05; P<0.001). Significantly increased bi-directional relative risks were found for melanoma, lip cancer, head and neck cancer, lung cancer, myelodysplastic diseases, and cancer with unknown primary site. In addition, risks were elevated for female breast cancer and kidney cancer following a first primary MCC, and for subsequent MCCs following first primary colorectal cancer, prostate cancer, non-Hodgkin lymphoma, or lymphoid leukemia. These results suggest that several shared pathways are likely for MCC and other cancers, including immunosuppression, UV radiation, and genetics.

Carcinoma de Célula de Merkel/epidemiologia , Neoplasias Primárias Múltiplas/epidemiologia , Neoplasias Cutâneas/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Austrália/epidemiologia , Estudos de Coortes , Comorbidade , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Queensland/epidemiologia , Sistema de Registros , Estudos Retrospectivos , Fatores de Risco
J Invest Dermatol ; 134(1): 141-149, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23774529


A germline polymorphism of the microphthalmia transcription factor (MITF) gene encoding a SUMOylation-deficient E318K-mutated protein has recently been described as a medium-penetrance melanoma gene. In a clinical assessment of nevi from 301 volunteers taken from Queensland, we identified six individuals as MITF E318K mutation carriers. The phenotype for 5 of these individuals showed a commonality of fair skin, body freckling that varied over a wide range, and total nevus count between 46 and 430; in addition, all were multiple primary melanoma patients. The predominant dermoscopic signature pattern of nevi was reticular, and the frequency of globular nevi in carriers varied, which does not suggest that the MITF E318K mutation acts to force the continuous growth of nevi. Excised melanocytic lesions were available for four MITF E318K carrier patients and were compared with a matched range of wild-type (WT) melanocytic lesions. The MITF staining pattern showed a predominant nuclear signal in all sections, with no significant difference in the nuclear/cytoplasmic ratio between mutation-positive or -negative samples. A high incidence of amelanotic melanomas was found within the group, with three of the five melanomas from one patient suggesting a genetic interaction between the MITF E318K allele and an MC1R homozygous red hair color (RHC) variant genotype.

Melanoma/genética , Fator de Transcrição Associado à Microftalmia/genética , Nevo/genética , Neoplasias Cutâneas/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Predisposição Genética para Doença/epidemiologia , Predisposição Genética para Doença/genética , Cor de Cabelo/genética , Humanos , Masculino , Melanoma/epidemiologia , Pessoa de Meia-Idade , Nevo/epidemiologia , Fenótipo , Mutação Puntual , Polimorfismo Genético , Neoplasias Cutâneas/epidemiologia , Adulto Jovem