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1.
Dermatol Online J ; 27(3)2021 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-33865273

RESUMO

OBJECTIVE: We update and expand our 2010 article in this journal, Patient safety in dermatology: A review of the literature [4][DH1]. METHODS: PubMed at the National Center for Biotechnology Information (NCBI), United States National Library of Medicine (NLM) was searched September 2019 for English language articles published between 2009 and 2019 concerning patient safety and medical error in dermatology. Potentially relevant articles and communications were critically evaluated by the authors with selected references from 2020 added to include specific topics: medication errors, diagnostic errors including telemedicine, office-based surgery, wrong-site procedures, infections including COVID-19, falls, laser safety, scope of practice, and electronic health records. SUMMARY: Hospitals and clinics are adopting the methods of high-reliability organizations to identify and change ineffective practice patterns. Although systems issues are emphasized in patient safety, people are critically important to effective teamwork and leadership. Advancements in procedural and cosmetic dermatology, organizational and clinical guidelines, and the revolution in information technology and electronic health records have introduced new sources of potential error. CONCLUSION: Despite the growing number of dermatologic patient safety studies, our review supports a continuing need for further studies and reports to reduce the number of preventable errors and provide optimal care.


Assuntos
Dermatologia/estatística & dados numéricos , Segurança do Paciente , Acidentes por Quedas/prevenção & controle , Acidentes por Quedas/estatística & dados numéricos , /transmissão , Infecção Hospitalar/prevenção & controle , Fármacos Dermatológicos/efeitos adversos , Erros de Diagnóstico/prevenção & controle , Erros de Diagnóstico/estatística & dados numéricos , Documentação , Registros Eletrônicos de Saúde , Incêndios , Humanos , Controle de Infecções , Lasers/efeitos adversos , Erros Médicos/prevenção & controle , Erros Médicos/estatística & dados numéricos , Erros de Medicação/prevenção & controle , Erros de Medicação/estatística & dados numéricos , Equipamento de Proteção Individual , Fatores de Risco
7.
J Drugs Dermatol ; 19(12): 1248, 2020 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-33346507
8.
J Drugs Dermatol ; 19(12): 1250, 2020 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-33346519

RESUMO

Initial studies of teledermatology in pediatric populations indicated that many of the problems experienced in adult virtual visits were even more apparent when treating children. Specifically, it was noted that the difficulty in obtaining medical history and participation of the pediatric patients provided additional challenges in evaluation.1 Direct-to-consumer models have highlighted many of these challenges as well as a general lack of continuity of care previously seen in pediatric teledermatology. Addressing these challenges may be accomplished by further involving parents in the teledermatology workflow.


Assuntos
Dermatologia/organização & administração , Acesso aos Serviços de Saúde/organização & administração , Dermatopatias/diagnóstico , Telemedicina/organização & administração , Triagem/organização & administração , Fatores Etários , Criança , Dermatologia/estatística & dados numéricos , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Fotografação , Encaminhamento e Consulta/organização & administração , Encaminhamento e Consulta/estatística & dados numéricos , Pele/diagnóstico por imagem , Dermatopatias/terapia , Smartphone , Telemedicina/estatística & dados numéricos , Fatores de Tempo , Triagem/estatística & dados numéricos
9.
J Drugs Dermatol ; 19(12): 1236-1237, 2020 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-33346528

RESUMO

Access to health information online has resulted in increased internet use to !nd medical education resources.1,2 The United States (US) population is comprised of 60.1% Whites, 18.5% Hispanics or Latinos, 13.4% Blacks or African Americans, with trends toward increasing diversity. Our objectives were to analyze skin color distributions on the American Academy of Dermatology (AAD) public education website.


Assuntos
Dermatologia/educação , Ilustração Médica , Dermatopatias/diagnóstico , Pigmentação da Pele , Pele/diagnóstico por imagem , Afro-Americanos/estatística & dados numéricos , Cor , Estudos Transversais , Dermatologia/estatística & dados numéricos , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Hispano-Americanos/estatística & dados numéricos , Humanos , Masculino , Dermatopatias/epidemiologia , Estados Unidos
10.
Int J Dermatol ; 59(9): 1043-1056, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32621284

RESUMO

Recommendations were made recently to limit or stop the use of oral and systemic immunotherapies for skin diseases due to potential risks to the patients during the current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) COVID-19 pandemic. Herein, we attempt to identify potentially safe immunotherapies that may be used in the treatment of cutaneous diseases during the current COVID-19 pandemic. We performed a literature review to approximate the risk of SARS-CoV-2 infection, including available data on the roles of relevant cytokines, cell subsets, and their mediators in eliciting an optimal immune response against respiratory viruses in murine gene deletion models and humans with congenital deficiencies were reviewed for viral infections risk and if possible coronaviruses specifically. Furthermore, reported risk of infections of biologic and non-biologic therapeutics for skin diseases from clinical trials and drug data registries were evaluated. Many of the immunotherapies used in dermatology have data to support their safe use during the COVID-19 pandemic including the biologics that target IgE, IL-4/13, TNF-α, IL-17, IL-12, and IL-23. Furthermore, we provide evidence to show that oral immunosuppressive medications such as methotrexate and cyclosporine do not significantly increase the risk to patients. Most biologic and conventional immunotherapies, based on doses and indications in dermatology, do not appear to increase risk of viral susceptibility and are most likely safe for use during the COVID-19 pandemic. The limitation of this study is availability of data on COVID-19.


Assuntos
Infecções por Coronavirus/epidemiologia , Síndrome da Liberação de Citocina/imunologia , Fármacos Dermatológicos/efeitos adversos , Suscetibilidade a Doenças/induzido quimicamente , Pneumonia Viral/epidemiologia , Dermatopatias/tratamento farmacológico , Animais , Betacoronavirus/imunologia , Produtos Biológicos/efeitos adversos , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/imunologia , Síndrome da Liberação de Citocina/virologia , Dermatologia/métodos , Dermatologia/estatística & dados numéricos , Modelos Animais de Doenças , Suscetibilidade a Doenças/imunologia , Medicina Baseada em Evidências/métodos , Medicina Baseada em Evidências/estatística & dados numéricos , Humanos , Fatores Imunológicos/efeitos adversos , Camundongos , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/diagnóstico , Pneumonia Viral/imunologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Medição de Risco , Índice de Gravidade de Doença , Dermatopatias/imunologia
11.
J Am Acad Dermatol ; 83(5): 1538-1539, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32682892
13.
Clin Dermatol ; 38(3): 310-315, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32563342

RESUMO

Dermatology is currently the second least diverse medical specialty, after orthopedic surgery, with only a minority of physicians identifying as underrepresented in medicine (UIM). To diversify our specialty, our understanding and recognition of multifactorial barriers to inclusivity such as financial barriers, lack of mentorship, and the implicit bias against minorities UIM is critical. With collaborative efforts by national dermatology organizations, dermatology residency programs, and medical schools to increase the presence of UIM dermatology physicians in the US health care, this important issue continues to receive the attention it deserves.


Assuntos
Dermatologistas/estatística & dados numéricos , Dermatologia/economia , Dermatologia/estatística & dados numéricos , Mão de Obra em Saúde/estatística & dados numéricos , Internato e Residência/estatística & dados numéricos , Estudantes de Medicina/estatística & dados numéricos , Dermatologia/organização & administração , Humanos , Mentores/estatística & dados numéricos , Grupos Minoritários , Sociedades Médicas , Estados Unidos
15.
J Am Acad Dermatol ; 83(3): 958-959, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32531304
20.
PLoS One ; 15(4): e0232131, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32339203

RESUMO

Rashes, ulcers and skin lesions are well suited for telemedicine. We have developed a smartphone app, the first of its kind in Norway, where a referring physician can write a short medical history and take clinical and dermatoscopic photographs with a smartphone, which is then sent to and evaluated by a dermatologist. In the period from June 1st, 2017, to September 1st, 2019, clinical information and photographs of rash and skin lesions from 171 patients were sent by 40 primary care and nursing home physicians via the smartphone app to four dermatologists for diagnosis and therapeutic advice. A wide range of dermatological conditions were diagnosed, most commonly chronic ulcers (17%), eczema (15%) and pigmented lesions (13%). Assessed later by a dermatologist, referral for regular consultations with a specialist was avoided in 119 patients (70%). Sixteen patients (9%) were recommended a regular consultation with a dermatologist; information for prioritization in the specialist healthcare service was then provided. In 36 patients (21%), further measures by the referring physician were recommended. Our experience indicates that many ordinary consultations on rash, ulcers and skin lesions in the specialist healthcare services can be avoided when using the smartphone app.


Assuntos
Telefone Celular/instrumentação , Dermatologia/organização & administração , Programas de Rastreamento/organização & administração , Aplicativos Móveis/estatística & dados numéricos , Dermatopatias/diagnóstico , Telemedicina/instrumentação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Dermatologia/estatística & dados numéricos , Feminino , Humanos , Lactente , Masculino , Programas de Rastreamento/estatística & dados numéricos , Pessoa de Meia-Idade , Noruega/epidemiologia , Projetos Piloto , Encaminhamento e Consulta , Dermatopatias/epidemiologia , Adulto Jovem
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