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J Drugs Dermatol ; 20(7): 786-789, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34232004


The United States skin of color population is increasing. Consequently, the importance of skin of color education in dermatology residency programs will continue to grow. Previous data has shown a lack of formal education on skin of color across residency programs. In order to address this identified knowledge gap, we created a curriculum focusing exclusively on skin of color for dermatology residents. The purpose of this pilot study was to examine the effect of a week-long curriculum on the perception of dermatology residents’ comfort level treating patients of color and to determine if this type of curriculum could be expanded to other dermatology residents. Results demonstrated a significant increase when residents were asked to rate their overall confidence in managing patients with skin of color on a scale from 1 (minimally confident) to 10 (extremely confident) pre- and post-intervention. Overall, 100% of learners felt that their ability to care for patients of color was improved by this curriculum and that a skin of color curriculum should be an annual component of their dermatology academic curriculum. J Drugs Dermatol. 2021;20(7):786-789. doi:10.36849/JDD.6193.

Dermatologia , Pigmentação da Pele , Currículo , Dermatologia/educação , Humanos , Internato e Residência , Projetos Piloto , Inquéritos e Questionários , Estados Unidos
Sci Adv ; 6(49)2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33277263


Therapeutic compression garments (TCGs) are key tools for the management of a wide range of vascular lower extremity conditions. Proper use of TCGs involves application of a minimum and consistent pressure across the lower extremities for extended periods of time. Slight changes in the characteristics of the fabric and the mechanical properties of the tissues lead to requirements for frequent measurements and corresponding adjustments of the applied pressure. Existing sensors are not sufficiently small, thin, or flexible for practical use in this context, and they also demand cumbersome, hard-wired interfaces for data acquisition. Here, we introduce a flexible, wireless monitoring system for tracking both temperature and pressure at the interface between the skin and the TCGs. Detailed studies of the materials and engineering aspects of these devices, together with clinical pilot trials on a range of patients with different pathologies, establish the technical foundations and measurement capabilities.

Surgery ; 154(6): 1463-9, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24238059


BACKGROUND: The timing of symptom improvement after parathyroidectomy for primary hyperparathyroidism (PHPT) has not been well characterized. METHODS: This prospective study involved administering a questionnaire to patients with PHPT who underwent curative parathyroidectomy over an 11-month period. The questionnaire evaluated the frequency of 18 symptoms of PHPT on a 5-point Likert scale and was administered preoperatively and 1 week, 6 weeks, and 6 months postoperatively. RESULTS: Of 197 eligible patients, 132 (67%) participated in the study. The questionnaires were completed at a rate of 91%, 92%, and 86% at 1 week, 6 weeks, and 6 months postoperatively, respectively. The most commonly reported preoperative symptoms were fatigue (98%), muscle aches (89%), and bone/joint pain (87%). Improvement in symptom severity occurred across all symptoms and was separated into three categories based on the timing of improvement. Fatigue and bone/joint pain demonstrated "Immediate Improvement" (>50% of patients reporting improvement by post-operative week 1), whereas the majority of symptoms showed peak improvement at 6 weeks ("Delayed Improvement"). Symptoms categorized as "Continuous Improvement" were those showing progressive improvement up to 6 months postoperatively (polydipsia, headaches, and nausea/vomiting). CONCLUSION: Symptom improvement was most prominent 6 weeks postparathyroidectomy, although some symptoms showed continued improvement at 6 months.

Hiperparatireoidismo Primário/cirurgia , Paratireoidectomia , Adenoma/fisiopatologia , Adenoma/cirurgia , Estudos de Coortes , Fadiga/fisiopatologia , Feminino , Humanos , Hiperparatireoidismo Primário/fisiopatologia , Masculino , Pessoa de Meia-Idade , Dor/fisiopatologia , Neoplasias Hipofisárias/fisiopatologia , Neoplasias Hipofisárias/cirurgia , Estudos Prospectivos , Inquéritos e Questionários , Fatores de Tempo , Resultado do Tratamento
J Surg Res ; 184(1): 514-8, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23688788


BACKGROUND: Benign multinodular goiter (MNG) is one of the most commonly treated thyroid disorders. Although bilateral resection is the accepted surgical treatment for bilateral MNG, the appropriate surgical resection for unilateral MNG continues to be debated. Bilateral resection generally has lower recurrence rates but higher complication rates than unilateral resection. Therefore, the purpose of this study was to define the recurrence and complication rates of unilateral and bilateral resections to determine the appropriate intervention for patients with unilateral, benign MNG. METHODS: We reviewed a prospectively maintained database of all patients who underwent a thyroidectomy for treatment of benign MNG at a single institution between May 1994 and December 2011. All patients with bilateral MNG were treated with bilateral resection. Surgical treatment for unilateral MNG was determined by surgeon preference, with all but one surgeon opting for unilateral resection to treat unilateral MNG. Data were reported as means ± standard error of the mean. Chi-squared analysis was used to determine statistical significance at a level of P < 0.05. RESULTS: A total of 683 patients underwent thyroidectomy for MNG. Of these patients, 420 (61%) underwent unilateral resection and 263 patients (39%) underwent total thyroidectomy. The mean age was 52 ± 17 y, and 542 patients (79%) were female. The mean follow-up time was 46.1 ± 1.9 mo. The rate of recurrent disease was similar between unilateral (2%, n = 10) and bilateral (1%, n = 3) resections (P = 0.248). Unilateral resection patients had a lower total complication rate than patients with bilateral resections (8% versus 26%, P < 0.001); however, there was no difference in the rate of permanent complications (0.2% versus 1%, P = 0.133). Thyroid hormone replacement was rare in unilateral resection patients but necessary in all patients with bilateral resection (19% versus 100%, P < 0.001). CONCLUSIONS: Patients that had unilateral resections endured less overall morbidities than those who had bilateral resections, and their risk of recurrent disease was similar. They were also significantly less likely to require lifelong hormone replacement therapy postoperatively. Although bilateral resection remains the recommended treatment for bilateral MNG, these data strongly support the use of unilateral thyroidectomy for the treatment of unilateral, benign MNG.

Bócio Nodular/epidemiologia , Bócio Nodular/cirurgia , Neoplasias/epidemiologia , Neoplasias/cirurgia , Complicações Pós-Operatórias/epidemiologia , Tireoidectomia/métodos , Adulto , Idoso , Bases de Dados Factuais/estatística & dados numéricos , Feminino , Seguimentos , Bócio Nodular/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Morbidade , Recidiva Local de Neoplasia/epidemiologia , Neoplasias/tratamento farmacológico , Fatores de Risco , Tireoidectomia/efeitos adversos , Tireoidectomia/estatística & dados numéricos , Tiroxina/uso terapêutico