RESUMO
A 46-year-old African American man presented with a 3- to 4-day history of a new painful lesion on his left lower extremity. Other reported symptoms included a productive cough and chest pain; the patient denied fever and chills. His medical history was significant for a heart transplant 4 months prior to presentation followed by transplant rejection 2 weeks after the transplant. Medications included an antirejection/immunosuppressive regimen consisting of prednisone, tacrolimus, mycophenolate mofetil, and prophylaxis treatment with valganciclovir and trimethoprim-sulfamethoxazole.
Assuntos
Aspergilose/diagnóstico , Transplante de Coração/métodos , Infecções Oportunistas/diagnóstico , Pele/patologia , Aspergilose/patologia , Humanos , Imunossupressores/uso terapêutico , Masculino , Pessoa de Meia-Idade , Necrose/etiologia , Infecções Oportunistas/patologia , Pele/microbiologiaRESUMO
Cosmetic and laser procedures are increasingly popular among patients and are skills in which dermatologists are regarded as well trained. Most dermatology residents intend to incorporate cosmetic procedures into their practice and prefer to learn such procedures during residency through direct patient care. However, there are notable challenges in optimizing how residents are trained in cosmetic and laser dermatology. To address these barriers and elevate the practice of cosmetic dermatology in academic medicine, the Association of Academic Cosmetic Dermatology (AACD) was founded in 2021 as the lead professional society for dermatologists who direct the education of resident trainees in cosmetic and laser dermatology. The AACD, a group of board-certified dermatologists who teach cosmetic and laser dermatology to residents, aims to improve cosmetic dermatology education through collaboration, research, and advocacy.
Assuntos
Dermatologia , Internato e Residência , Humanos , Dermatologia/educação , Currículo , Inquéritos e QuestionáriosRESUMO
Cosmetic dermatology is a key subspecialty of academic dermatology. As such, academic centers are expected to demonstrate excellence in the teaching of cosmetic dermatology skills to trainees, the clinical delivery of cosmetic dermatology services to patients, and the performance of clinical research that advances knowledge and uncovers new therapies in cosmetic dermatology. The Association of Academic Cosmetic Dermatology (AACD), a newly formed medical professional society, includes as its principal aims the support of all of these areas. AACD is comprised of group of board-certified dermatologists who teach cosmetic and laser dermatology at US dermatology residency programs. An expert panel constituted by the AACD recently convened a workshop to review gaps pertaining to academic cosmetic dermatology. This panel considered needs and potential corrective initiatives in three domains: resident education, patient experience, and clinical research. The work of the panel was used to develop a roadmap, which was adopted by consensus, and which will serve to guide the AACD moving forward.
Assuntos
Dermatologia , Internato e Residência , Humanos , Dermatologia/educação , Assistência ao Paciente , Sociedades MédicasRESUMO
Bullous pemphigoid is an acquired subepidermal vesiculobullous disease most commonly seen in the elderly. We report a 16-year-old girl with bullous pemphigoid who achieved disease remission with mycophenolate mofetil as an adjuvant therapy.
Assuntos
Imunossupressores/administração & dosagem , Ácido Micofenólico/análogos & derivados , Penfigoide Bolhoso/tratamento farmacológico , Penfigoide Bolhoso/patologia , Adolescente , Biópsia , Quimioterapia Adjuvante , Feminino , Humanos , Ácido Micofenólico/administração & dosagem , Resultado do TratamentoRESUMO
A patient presented with progressive abdominal distention, discomfort, nausea, vomiting, and constipation. The patient also had congenital macrodactyly of the third, fourth, and fifth digits of the left hand. He [corrected] was diagnosed with macrodactylia fibrolipomatosis with multiple small bowel lipomas and complete small bowel obstruction. Macrodactylia fibrolipomatosis is a rare condition characterized by benign fibrofatty infiltration involving the soft tissues of the distal arm or leg with associated dactylomegaly of the associated digits. This patient had a rare presentation that included extensive small bowel lipomatosis.
Assuntos
Deformidades Congênitas da Mão/complicações , Obstrução Intestinal/etiologia , Intestino Delgado , Lipomatose/complicações , Idoso , Feminino , Humanos , Obstrução Intestinal/diagnóstico por imagem , Lipomatose/diagnóstico por imagem , Masculino , Radiografia , Tomógrafos ComputadorizadosAssuntos
Antineoplásicos/efeitos adversos , Glândulas Écrinas/patologia , Inibidores Enzimáticos/efeitos adversos , Indóis/efeitos adversos , Radiodermite/induzido quimicamente , Sulfonamidas/efeitos adversos , Doenças das Glândulas Sudoríparas/etiologia , Adenocarcinoma/genética , Adenocarcinoma/terapia , Adenocarcinoma de Pulmão , Administração Cutânea , Corticosteroides/administração & dosagem , Corticosteroides/uso terapêutico , Idoso , Antineoplásicos/uso terapêutico , Biópsia , Inibidores Enzimáticos/uso terapêutico , Eritema/tratamento farmacológico , Eritema/etiologia , Humanos , Indóis/uso terapêutico , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/terapia , Masculino , Metaplasia/etiologia , Metaplasia/patologia , Proteínas Proto-Oncogênicas B-raf/antagonistas & inibidores , Proteínas Proto-Oncogênicas B-raf/genética , Prurido/tratamento farmacológico , Prurido/etiologia , Radiodermite/patologia , Radioterapia Adjuvante/efeitos adversos , Sulfonamidas/uso terapêutico , Doenças das Glândulas Sudoríparas/patologia , VemurafenibRESUMO
BACKGROUND: Faced with work-hour restrictions, educators are mandated to improve the efficiency of resident and medical student education. Few studies have assessed learning styles in medicine; none have compared teaching and learning preferences. Validated tools exist to study these deficiencies. Kolb describes 4 learning styles: converging (practical), diverging (imaginative), assimilating (inductive), and accommodating (active). Grasha Teaching Styles are categorized into "clusters": 1 (teacher-centered, knowledge acquisition), 2 (teacher-centered, role modeling), 3 (student-centered, problem-solving), and 4 (student-centered, facilitative). STUDY DESIGN: Kolb's Learning Style Inventory (HayGroup, Philadelphia, Pennsylvania) and Grasha-Riechmann's TSS were administered to surgical faculty (n = 61), residents (n = 96), and medical students (n = 183) at a tertiary academic medical center, after informed consent was obtained (IRB # 06-0612). Statistical analysis was performed using χ(2) and Fisher exact tests. RESULTS: Surgical residents preferred active learning (p = 0.053), whereas faculty preferred reflective learning (p < 0.01). As a result of a comparison of teaching preferences, although both groups preferred student-centered, facilitative teaching, faculty preferred teacher-centered, role-modeling instruction (p = 0.02) more often. Residents had no dominant teaching style more often than surgical faculty (p = 0.01). Medical students preferred converging learning (42%) and cluster 4 teaching (35%). Statistical significance was unchanged when corrected for gender, resident training level, and subspecialization. CONCLUSIONS: Significant differences exist between faculty and residents in both learning and teaching preferences; this finding suggests inefficiency in resident education, as previous research suggests that learning styles parallel teaching styles. Absence of a predominant teaching style in residents suggests these individuals are learning to be teachers. The adaptation of faculty teaching methods to account for variations in resident learning styles may promote a better learning environment and more efficient faculty-resident interaction. Additional, multi-institutional studies using these tools are needed to elucidate these findings fully.