JAAD International最新文献

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Paraffin sections may be useful in Mohs micrographic surgery for nonmelanoma skin cancer in select patients 石蜡切片在莫氏显微外科手术治疗非黑色素瘤皮肤癌中可能对特定患者有用

JAAD International

Pub Date : 2024-08-02 DOI: 10.1016/j.jdin.2024.07.005

Ryan T. Ladd MD , Taylor Viggiano MD , Sarah E.B. Smith MD , Skye Buckner-Petty MPH , Yul W. Yang MD, PhD , Shari A. Ochoa MD

引用次数: 0

The Mayo Clinic experience: Once daily dosing of isotretinoin for acne 梅奥诊所的经验：每日一次异维A酸治疗痤疮

JAAD International

Pub Date : 2024-08-02 DOI: 10.1016/j.jdin.2024.07.008

Hasina Maredia MD , Megha Tollefson MD , Aaron Keehr RN , Julio C. Sartori-Valinotti MD

引用次数: 0

The frequency of lichenoid features in mucous membrane pemphigoid: A retrospective review of the histopathology 粘膜丘疹病中苔藓样特征的频率：组织病理学回顾性研究

JAAD International

Pub Date : 2024-08-02 DOI: 10.1016/j.jdin.2024.07.007

Sarah G. McAlpine BS , Paul B. Googe MD , Donna A. Culton MD, PhD

引用次数: 0

The intersection of melanoma survival and social determinants of health in the United States: A systematic review 美国黑色素瘤存活率与健康的社会决定因素之间的交叉关系：系统回顾

JAAD International

Pub Date : 2024-08-02 DOI: 10.1016/j.jdin.2024.07.006

McKenzie E. Maloney BS , Caleb Bacak BS , Kellen Tjioe DDS, MSc, PhD , Loretta S. Davis MD , E. Andrew Balas MD, PhD , Gagan Agrawal MS, PhD , Jorge E. Cortes MD , Marisol Miranda-Galvis DDS, MS, PhD

Background

Despite recent improvements in melanoma survival rates, persistent inequalities pose barriers to care for some patients.

Objective

To assess the influence of social determinants of health (SDoH) on melanoma treatment outcomes.

Methods

A systematic review (Prospective Register of Systematic Reviews CRD42022346854) of manuscripts that examined the association between SDoH and melanoma treatment-related outcomes in the United States was conducted using 5 databases.

Results

The analysis encompassed data from 12 retrospective manuscripts. The SDoH domains most frequently investigated were health care access and quality (n = 6 manuscripts, 50%) and economic stability (n = 7, 58.3%). Other domains included social and community context (n = 5, 41.7%) and education access (n = 3, 25%). These findings revealed significant correlations between poor melanoma survival and low levels of economic stability, limited education, government health insurance, and being uninsured and unmarried.

Limitations

Many SDoH were not analyzed at the patient level. SDoH are vast categories, but manuscripts usually analyze one aspect of a particular category.

Conclusions

These results highlight the need for physicians to recognize the substantial impact of SDoH on melanoma outcomes and to adopt more comprehensive strategies focused on patient-centered care. Integrating social support mechanisms into clinical practice emerges as a key mechanism to promote equitable and effective interventions.

背景尽管黑色素瘤的存活率最近有所提高，但持续存在的不平等现象仍对一些患者的治疗造成了障碍。目的评估健康的社会决定因素（SDoH）对黑色素瘤治疗结果的影响。方法使用 5 个数据库对美国研究 SDoH 与黑色素瘤治疗相关结果之间关系的稿件进行了系统综述（系统综述前瞻性注册表 CRD42022346854）。调查最多的 SDoH 领域是医疗保健的可及性和质量（6 篇，50%）以及经济稳定性（7 篇，58.3%）。其他领域包括社会和社区环境（5 篇，41.7%）和教育机会（3 篇，25%）。这些研究结果表明，黑色素瘤患者的生存率低与经济稳定性低、受教育程度有限、政府医疗保险、无保险和未婚之间存在明显的相关性。结论这些结果突出表明，医生需要认识到 SDoH 对黑色素瘤预后的重大影响，并采取以患者为中心的更全面的护理策略。将社会支持机制纳入临床实践是促进公平有效干预的关键机制。

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引用次数: 0

JAAD International

Pub Date : 2024-07-30 DOI: 10.1016/j.jdin.2024.07.002

Alice Heger MS, Khaled Elsayad PhD, Christian Kandler MD, Jan Siats MD, Michael Oertel MD, Christopher Kittel MD, Hans Theodor Eich PhD

引用次数: 0

Social vulnerabilities in head-neck melanoma care: A retrospective cohort study in the United States 头颈部黑色素瘤护理中的社会脆弱性：美国的一项回顾性队列研究

JAAD International

Pub Date : 2024-07-30 DOI: 10.1016/j.jdin.2024.05.011

Lillian McCampbell BS , David Jun Fei-Zhang BA , Daniel Chelius MD , Ling-Lun Bob Hsia MD , Robert Dellavalle MD, PhD, MSPH , Jill D’Souza MD , David Bentrem MD , Jeffrey Wayne MD , Jeffrey Rastatter MD , Anthony Sheyn MD

Background

Studies addressing social determinants of health (SDH) in head-neck melanomas (HNM) have only assessed socioeconomic factor impact but not a wider scope of SDH.

Objective

Utilizing the Social Vulnerability Index (SVI), to assess the influence of specific SDH and their quantifiable associations with HNM management disparities across the varied community contexts in the United States.

Methods

This retrospective cohort study analyzed adults diagnosed with HNM from 1975 to 2017 from the Surveillance, Epidemiology, and End Results Program database.

Results

A total of 374,138 HNM in adults from 1975 to 2017 were assessed for disparities affiliated with increasing overall vulnerability/SVI scores and SDH themes. For several melanoma subtypes, higher social vulnerability significantly decreased odds (lowest for amelanotic, odds ratio 0.74; 95% confidence interval, 0.63-0.86) for indicated surgery, increased odds of indicated radiation (highest for epithelioid cell, 1.44; 1.08-1.96), and advanced staging on first presentation (highest for acral lentiginous, 1.13; 1.01-1.27). Household composition, followed by socioeconomic status and minority-language status contributed significantly to the overall trend.

Limitations

Limitations include unknown cause of death and SVI score calculation based on county of residency.

Conclusions

This investigation highlights significant detrimental trends in HNM management with overall social vulnerability while showcasing the quantifiable associations of specific SDH themes on HNM-disparities.

背景针对头颈部黑色素瘤（HNM）中健康的社会决定因素（SDH）的研究只评估了社会经济因素的影响，而没有评估范围更广的 SDH。方法这项回顾性队列研究分析了监测、流行病学和最终结果计划数据库中 1975 年至 2017 年期间诊断为 HNM 的成人。结果评估了 1975 年至 2017 年期间共 374 138 例成人 HNM，以了解与总体脆弱性/SVI 分数和 SDH 主题增加相关的差异。对于几种黑色素瘤亚型而言，较高的社会脆弱性会显著降低接受手术的几率（黑色素瘤最低，几率比 0.74；95% 置信区间，0.63-0.86），增加接受放射治疗的几率（上皮样细胞最高，1.44；1.08-1.96），以及首次就诊时的晚期分期（尖状扁平苔藓最高，1.13；1.01-1.27）。家庭组成，其次是社会经济状况和少数民族语言状况对总体趋势的影响很大。结论这项调查突出了与总体社会脆弱性有关的高营养不良症管理的重大不利趋势，同时展示了特定 SDH 主题与高营养不良症差异的量化关联。

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引用次数: 0

JAAD International

Pub Date : 2024-07-29 DOI: 10.1016/j.jdin.2024.07.003

Hiroshi Fujimaki MD, PhD , Masayuki Yanagisawa MD, PhD , Toshihiro Yoshitake MD, PhD , Akio Sato MD, PhD

引用次数: 0

Axillary extramammary Paget disease in a patient with a history of Birt-Hogg-Dubé syndrome 一名曾患 Birt-Hogg- Dubé 综合征的患者的腋窝乳腺外帕吉特氏病

JAAD International

Pub Date : 2024-07-25 DOI: 10.1016/j.jdin.2024.06.001

Melissa M. Rames MD , Eucabeth Asamoah MD , Rebecca Danhof MD, MPH , Addison Demer MD

引用次数: 0

Primary cutaneous melanoma of the breast skin: Incidence, characteristics, and management 乳房皮肤的原发性皮肤黑色素瘤：发病率、特征和管理

JAAD International

Pub Date : 2024-07-24 DOI: 10.1016/j.jdin.2024.06.003

Alexander S. Hines MD, Elliott H. Campbell MD, Jacob P. Reinhart MD, Olivia M. Crum MD, Sydney L. Proffer MD, Jerry D. Brewer MD, Lawrence E. Gibson MD, Addison M. Demer MD

引用次数: 0

Why do pressure injuries still occur? A multicenter qualitative study of nurses and caregivers 为什么还会发生压伤？针对护士和护理人员的多中心定性研究

JAAD International

Pub Date : 2024-07-23 DOI: 10.1016/j.jdin.2024.05.006

Wilson Sim MBBS , Tan Hwei Sian Clara Michelle MBBS , Nur Qasrina Binte Iskandar Lim BSc , Veronica Loh MN, BSc , Cheryl Wan Xuan Chua MBBS , Jason Er BSN, MSN , Joyce Er MN, BSc , Phillip Phan PhD , Ellie C.E. Choi MBBS, MRCP

Background

The frequent occurrence of pressure injuries despite their preventability raises important questions about our understanding of the barriers to care. This study explores the lived experience of nurses and caregivers in Singapore to establish a conceptual framework for better understanding of pressure injuries arising in the community.

Methods

A multicenter qualitative study was conducted utilizing semistructured interviews and focused group discussions of nurses and caregivers of patients with pressure injuries. Data were collected with a narrative inquiry approach and analyzed with grounded theory. An iterative cycle of interviewing, coding, discussion, and reflection was conducted until theoretical saturation.

Results

Ten inpatient nurses and 10 caregivers from the community were recruited. Analysis identified cognitive (awareness and caregiver training), emotional (motivation and empowerment), resource (human and infrastructural), and biomedical factors which collectively impacted the effectiveness of prevention. Additionally, constructs of learning and sustainability of caregiving played a crucial role in long term prevention.

Limitation

The derived framework requires further validation with quantitative data and may not be generalizable to other cultural and economic populations.

Conclusion

Multiple constructs have been identified to have a synergistic effect in prevention. Targeted measures should be implemented by healthcare institutions to better equip caregivers in prevention.

背景尽管压伤是可以预防的，但它的频繁发生还是提出了一些重要问题，即我们对护理障碍的理解。本研究探讨了新加坡护士和护理人员的生活经验，以建立一个概念框架，从而更好地理解社区中出现的压伤。方法通过对护士和压伤患者护理人员进行半结构式访谈和集中小组讨论，开展了一项多中心定性研究。数据收集采用叙事调查法，分析采用基础理论。访谈、编码、讨论和反思循环往复，直至理论饱和。分析确定了认知（意识和护理人员培训）、情感（动机和授权）、资源（人力和基础设施）和生物医学因素，这些因素共同影响了预防的有效性。此外，护理工作的学习和可持续性也在长期预防中发挥了至关重要的作用。结论已确定多个因素在预防中具有协同作用。医疗保健机构应采取有针对性的措施，使护理人员更好地开展预防工作。

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引用次数: 0

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