dermatologists

皮肤科医生
  • 文章类型: Journal Article
    Patients\' experience accessing dermatologic care is understudied. The purpose of this cross-sectional study was to examine current wait times for new patients to receive dermatological care in NYC. Websites at 58 accredited private and public hospitals in the five boroughs of NYC were reviewed to identify dermatology practices. Office telephone numbers listed on each website were called to collect information pertaining to whether the physician was accepting new patients, type of insurance accepted (public, private, both, or none), and the number of days until a new patient could be seen for an appointment. Data pertaining to the time kept on hold and availability of web-based booking were also collected. Mean waiting time for an appointment was 50 days [standard deviation, SD 66] - nearly 2 months, but the distribution was considerably skewed. The median waiting time was 19.5 days [Interquartile range, IQR 4-60]. The time kept on hold to make the appointment was negligible at about 1 min (63 s, SD = 77) but could take up to ~ 7 min. Two-thirds of dermatologists accepted private, Medicare, and Medicaid insurance (n = 228, 66%); a small number accepted only private insurance (n = 12, 4%) or no insurance at all (n = 16, 5%). The median waiting time for an appointment for the 228 providers that accepted Medicaid was 30.5 days (IQR = 5.0-73.25) while for providers who did not accept Medicaid (n = 116) the median wait time for an appointment was 13.0 days (IQR = 3.0-38.0). Just over half (56%) of the dermatologists allowed for appointments to be booked on their website (n = 193). This research highlights the necessity of incorporating new strategies into routine dermatology appointments in order to increase treatment availability and decrease healthcare inequality.
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  • 文章类型: Journal Article
    背景:深色皮肤个体(DSI)的黄褐斑和炎症后色素沉着的发生率很高。使用带有矿物过滤器的防晒霜对于预防和治疗至关重要。我们的目标是确定皮肤科医生和皮肤科居民在DSI防晒霜处方中的偏好。
    方法:对2022年3月31日在西班牙举行的在线光保护活动的参与者进行的匿名调查。
    结果:66.6%(221/332)的参与者回答了该调查:159名皮肤科医生(71.9%)和62名皮肤科居民(28.1%)。受访者报告建议使用防晒霜的中位数为DSI的80%[四分位距(IQR),50-90].医生报告处方有色防晒霜的中位数百分比为60%(IQR,25-90)的DSI伴痤疮;中位数百分比为90%(IQR,58-99)的DSI与黄褐斑。对具有黑斑病的DSI规定最多的光保护剂是具有抗氧化剂的有机广谱防晒剂:102/220(46.4%)和矿物广谱防晒剂(具有氧化铁):45/220(20.4%)。在有黄褐斑或其他色素性疾病的DSI中,防晒剂最优选的特征如下:防晒系数≥30:217/221(98.2%),UVA保护:214/221(96.8%),伪装颜色:150/220(68.2%)和矿物过滤器,如二氧化钛和氧化锌:151/220(68.6%)或氧化铁:131/220(59.5%)。
    结论:在线调查,潜在的包含偏差。
    结论:受访者报告为大多数DSI开防晒霜,和有色防晒霜,适用于大多数患有色素失调的DSI。然而,DSI最常用的防晒霜是含有抗氧化剂的有机广谱防晒霜.
    BACKGROUND: Dark-skinned individuals (DSI) present high rates of melasma and post-inflammatory hyperpigmentation. The use of sunscreens with mineral filters is essential for prevention and treatment. Our objective was to determine the preferences of dermatologists and dermatology residents in the prescription of sunscreens for DSI.
    METHODS: An anonymous survey of attendees at an online photoprotection event held on March 31, 2022, in Spain.
    RESULTS: The survey was answered by 66.6% (221/332) of the attendees: 159 dermatologists (71.9%) and 62 dermatology residents (28.1%). Respondents reported recommending the use of sunscreen to a median of 80% of DSI [interquartile range (IQR), 50-90]. Physicians reported prescribing tinted sunscreens to a median percentage of 60% (IQR, 25-90) of DSI with acne; and to a median percentage of 90% (IQR, 58-99) of DSI with melasma. The most prescribed photoprotectors to DSI with melasma were organic broad-spectrum sunscreens with antioxidants: 102/220 (46.4%) and mineral broad-spectrum sunscreens (with iron oxides): 45/220 (20.4%). In DSI with melasma or other pigmentary disorders, the most preferred features of sunscreens were as follows: sun protection factor ≥ 30: 217/221 (98.2%), UVA protection: 214/221 (96.8%), color for camouflage: 150/220 (68.2%) and mineral filters such as titanium dioxide and zinc oxide: 151/220 (68.6%) or iron oxides: 131/220 (59.5%).
    CONCLUSIONS: Online survey, potential inclusion bias.
    CONCLUSIONS: Respondents reported to prescribe sunscreens to the majority of DSI, and tinted sunscreens for the majority of DSI with pigmentary disorders. However, the most frequently recommended sunscreens for DSI were organic broad-spectrum sunscreens with antioxidants.
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  • 文章类型: Letter
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  • 文章类型: Journal Article
    背景:患者报告的结果与临床实践相关,显示患者的益处,支持临床医生的决策,并有助于提供高标准的护理。对患者报告的结果进行数字监测仍然很少见。患者获益指数(PBI)衡量患者观点的获益和目标,可能与定期记录和共同决策相关。
    目的:本研究旨在开发PBI的电子版,以检查其在银屑病患者临床实践中的可行性和可接受性。
    方法:我们开发了一个应用程序,在对其可行性和可接受性进行定量调查之前,使用焦点小组和对患者的认知汇报进行有效的PBI。Conduction参加了德国的门诊皮肤科护理室。进行描述性和亚组分析。
    结果:共有139名患者完成了电子PBIs(ePBIs)并参与了调查。ePBI是可以理解的(n=129-137,92.8%-98.6%)和可行的,例如,易于阅读(n=135,97.1%)和简单处理(n=137,98.5%)。可接受性也很高,例如,患者可以想象在实践中使用和讨论ePBI数据(n=91,65.5%)并定期记录(n=88,63.3%).他们认为它可以支持治疗决策(n=118,84.9%)并改善与医生的沟通(n=112,81.3%)。他们可以想象定期填写电子问卷(n=118,84.9%),甚至更喜欢电子版本而不是纸质版本(n=113,81.2%)。年龄较大和受教育程度较低的人表现出更小的可行性,但是后者希望与医生的关系得到改善,并且更愿意投入时间或精力。
    结论:PBI的应用程序和网络版本对于提供全面文档和患者参与实践的患者是可用和可接受的。实施策略应考虑患者的需求,障碍,和促进者,还有医生的态度和医疗保健系统的要求。
    BACKGROUND: Patient-reported outcomes are relevant in clinical practice showing patient benefits, supporting clinicians\' decision-making, and contributing to the delivery of high standards of care. Digital monitoring of patient-reported outcomes is still rare. The Patient Benefit Index (PBI) measures benefits and goals from patients\' views and may be relevant for regular documentation and shared decision-making.
    OBJECTIVE: This study aimed to develop electronic versions of the PBI to examine their feasibility and acceptability in clinical practice for patients with psoriasis.
    METHODS: We developed an app and a web version of the existing, valid PBI using focus groups and cognitive debriefings with patients before conducting a quantitative survey on its feasibility and acceptability. Conduction took part in an outpatient dermatology care unit in Germany. Descriptive and subgroup analyses were conducted.
    RESULTS: A total of 139 patients completed the electronic PBIs (ePBIs) and took part in the survey. The ePBI was understandable (n=129-137, 92.8%-98.6%) and feasible, for example, easy to read (n=135, 97.1%) and simple to handle (n=137, 98.5%). Acceptability was also high, for example, patients can imagine using and discussing the ePBI data in practice (n=91, 65.5%) and documenting it regularly (n=88, 63.3%). They believe it could support treatment decisions (n=118, 84.9%) and improve communication with their physician (n=112, 81.3%). They can imagine filling in electronic questionnaires regularly (n=118, 84.9%), even preferring electronic over paper versions (n=113, 81.2%). Older and less educated people show less feasibility, but the latter expected the relationship with their physician to improve and would be more willing to invest time or effort.
    CONCLUSIONS: The app and web version of the PBI are usable and acceptable for patients offering comprehensive documentation and patient participation in practice. An implementation strategy should consider patients\' needs, barriers, and facilitators but also physicians\' attitudes and requirements from the health care system.
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    文章类型: Journal Article
    根据联邦医学委员会2020年的人口统计数据,女性人数最多的医学专业是皮肤科;在9,078名专家中,占77.9%。男女比例为0.28,即对于每个人来说,有超过3名女性皮肤科医生。通过数据审查,分析妇女在巴西皮肤病学中的参与情况及其在领导职位中的代表性。2022年5月对美国国家医学图书馆PubMed数据库进行了文献综述,并对SBD数据库进行了数据综述。根据巴西皮肤病学会(SBD),大约80%的相关医生是女性。尽管有这种相关性,自1912年成立以来,SBD已经拥有62个董事会,其中53人已知由男性主持,其中4人未知。在已知的董事会中,只有5人(8.62%)由女性担任主席。
    According to the Federal Council of Medicine\'s demographic data from 2020, the medical specialty with the highest number of women is dermatology; with 77.9% within the total of 9,078 specialists. The male/female ratio is 0.28, that is, for each man, there are more than 3 women Dermatologists. Analyze the participation of women in Brazilian dermatology and their representation in leadership positions through data review. A literature review of the National Library of Medicine PubMed database was performed in May 2022 and data review of the SBD database. According to the Brazilian Society of Dermatology (SBD), about 80% of its associated Doctors are women. Despite this correlation, since its foundation in 1912, the SBD has already had 62 directorates, of which 53 were known to be presided over by men and 4 of them are unknown. Among the directorates that are known, only five (8.62%) were chaired by women.
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  • DOI:
    文章类型: Historical Article
    ErwinOppenheim(1893-1975)是德累斯顿的成功皮肤科医生,德国。由于国家社会主义,他于1939年与家人逃离该国,并定居在澳大利亚维多利亚州的墨尔本。那个时代澳大利亚大学和医学委员会关于难民医学的规定阻碍了奥本海姆注册为医生。他被允许治疗皮肤病,但不允许开一些局部制剂以外的药物。尽管有这些限制,奥本海姆很快建立了一个繁忙的私人诊所。他还通过为“自我制药”提供指导,为皮肤病学做出了贡献,“由Oppenheim的儿子和daughter妇于1953年成立的一家大型公司,为澳大利亚和全球市场生产一系列皮肤和其他保健产品。
    Erwin Oppenheim (1893-1975) was a successful dermatologist in Dresden, Germany. He with his family fled the country in 1939 because of National Socialism and settled in Melbourne in the Australian state of Victoria. The regulations of Australian universities and medical boards of that era in relation to refugee medicos hindered Oppenheim\'s registration as a medical practitioner. He was permitted to treat skin conditions, but not allowed to prescribe medications other than some topical preparations. In spite of these restrictions, Oppenheim soon established a busy private practice. He also contributed to dermatology by providing guidance to \"Ego Pharmaceuticals,\" a large company formed by Oppenheim\'s son and daughter-in-law in 1953 that produces a range of skin and other healthcare products for Australian and global markets.
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  • 文章类型: Journal Article
    口服全身和可注射生物治疗在澳大利亚可用于治疗中度至重度银屑病。
    研究澳大利亚的患者和皮肤科医生如何选择口服和注射治疗银屑病。
    在这个离散选择实验(DCE)中,要求患有中度至重度银屑病的成年人和皮肤科医生在2种按给药方式标记的治疗方法(“口服”或“皮下注射”)之间进行选择,每个都有9个治疗属性的随机分配水平。患者对针头恐惧进行了评分。
    对178名患者和43名皮肤科医生进行了调查。症状减轻,安全,和给药方式是发现对治疗选择有显著影响的属性;给药频率是可注射选项的重要属性.当治疗属性保持相等时,对于中度疾病,患者和皮肤科医生更喜欢口服治疗,而不是注射治疗。与针头恐惧程度较低的患者相比,针头恐惧程度较高的患者更倾向于口服治疗。
    参与偏差可能会限制这些发现的普遍性。
    对于中度银屑病,参与者更喜欢口服而不是注射治疗。这些发现证实了需要有效的口服疗法来治疗该疾病。
    UNASSIGNED: Oral systemic and injectable biologic treatments are available in Australia to treat moderate to severe psoriasis.
    UNASSIGNED: To examine how patients and dermatologists in Australia choose between oral and injectable treatments for psoriasis.
    UNASSIGNED: In this discrete choice experiment (DCE), adults with moderate to severe psoriasis and dermatologists were asked to choose between 2 treatments labeled by mode of administration (\'oral\' or \'subcutaneous injection\'), each with randomly assigned levels for 9 treatment attributes. Needle fear was rated by patients.
    UNASSIGNED: Completed surveys from 178 patients and 43 dermatologists were included in the analysis. Symptom reduction, safety, and mode of administration were attributes found to have a significant impact on treatment choice; dosing frequency was a significant attribute for the injectable option. When treatment attributes were held equal, patients and dermatologists preferred oral versus injectable treatments for moderate disease. Patients with higher levels of needle fear were more likely to favor an oral treatment versus patients with lower levels of needle fear.
    UNASSIGNED: Participation bias may limit the generalizability of these findings.
    UNASSIGNED: Participants preferred oral over injectable treatment for moderate psoriasis. These findings corroborate the need for efficacious oral therapies to treat the disease.
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  • 文章类型: Journal Article
    背景:尽管在COVID-19大流行期间,远程皮肤科在全球范围内普及,持久的障碍,比如糟糕的回忆和照片质量,阻碍其在实践中的有效使用。需要了解荷兰皮肤科医生的经验和在荷兰医疗保健系统中使用远程皮肤病学系统的满意度。整体评估可以提供有价值的见解,以了解障碍如何相互关联,这对于实践中的皮肤学创新是必要的。
    目标:在复杂适应系统观点的指导下,这项研究旨在了解荷兰皮肤科医生的经验和对培训的满意度,支持沟通,互动,以及在COVID-19大流行期间使用荷兰数字医院的远程皮肤病学平台,发现见解,以改善未来的远程皮肤病学服务。
    方法:2021年12月向荷兰皮肤科医生发送了一份基于网络的问卷,他们(1)拥有活跃的远程皮肤病学平台帐户,(2)在2019年10月1日至2021年9月30日期间回复了皮肤远程咨询。该问卷包括经过验证的存储和转发远程医疗服务用户满意度问卷(SAF-TSUQ)问卷,和新的问题;远程皮肤科医生的人口统计学,在COVID-19大流行期间使用皮肤学,全科医生(GP)的远程皮肤病学表现,以及皮肤科医生在远程皮肤病学过程中的作用。开放式问题是通过以社会技术模型为指导的扎根理论方法进行分析的,并辅之以复杂的自适应系统观点。与3位皮肤科医生进行了小组讨论,以提供对问卷答复的更多见解。
    结果:我们从249位受邀皮肤科医生中的25位(10%)获得了响应。总的来说,皮肤科医生在远程皮肤科有积极的经验。有趣的是,远程皮肤科的使用频率仍不受COVID-19大流行的影响。然而,远程皮肤科会诊的临床内容(照片和查询信息)质量不足和不完整影响了远程皮肤科工作流程的效率。皮肤科医生表示需要改进,以避免耗时的过程或物理转诊。小组讨论丰富并确认了答复,建议解决方案,如全科医生的强制性字段,以进行完整的回忆。
    结论:荷兰皮肤科医生认为远程皮肤科是提供皮肤科护理的宝贵工具。然而,有关提供的临床内容的质量和完整性的改进对于荷兰医疗保健中复杂的远程皮肤病学系统的有效性和效率是必要的。这可以提高皮肤科医生的满意度和远程皮肤科服务的质量。管理权衡,例如时间投资与图像质量,对于远程皮肤病学的实施至关重要,应从复杂性角度进行评估,以了解权衡并防止意外后果。
    BACKGROUND: Despite the global upscale of teledermatology during the COVID-19 pandemic, persistent barriers, such as the poor anamnesis and photo quality, hinder its effective use in practice. Understanding Dutch dermatologists\' experiences and satisfaction with using the teledermatology system in the Dutch health care system is needed. A holistic evaluation may provide valuable insight to understand how barriers interrelate which is deemed necessary for the innovation of teledermatology in practice.
    OBJECTIVE: Guided by a complex adaptive system perspective, this study aims to understand Dutch dermatologists\' experience and satisfaction with their training, support communication, interaction, and usage of a teledermatology platform of a Dutch digital hospital during the COVID-19 pandemic, uncovering insights to improve teledermatology services for the future.
    METHODS: A web-based questionnaire was sent in December 2021 to Dutch dermatologists who (1) had an active teledermatology platform account, and (2) responded to a teledermatology consultation between October 1, 2019, and September 30, 2021. The questionnaire consisted of the validated Store-and-Forward Telemedicine Service User-satisfaction Questionnaire (SAF-TSUQ) questionnaire, and new questions regarding; demographics of teledermatologists, the use of teledermatology during the COVID-19 pandemic, the performance of teledermatology by general practitioners (GP), and the role of dermatologists in the teledermatology process. The open-ended questions were analyzed by a grounded theory approach guided by a sociotechnical model and complemented by a complex adaptive system perspective. A panel discussion with 3 dermatologists was performed to provide additional insight into the responses to the questionnaire.
    RESULTS: We obtained responses from 25 out of the 249 (10%) invited dermatologists. Overall, dermatologists had a positive experience with teledermatology. Interestingly, teledermatology use frequency remained unaffected by the COVID-19 pandemic. However, the insufficient quality and incompleteness of the clinical content (photos and anamneses information) of the teledermatology consultation impacted the efficiency of the teledermatology workflow. Dermatologists expressed the need for improvement to avoid time-consuming processes or physical referrals. The panel discussion enriched and confirmed the responses, suggesting solutions like mandatory fields for the GPs for a complete anamnesis.
    CONCLUSIONS: Dutch Dermatologists view teledermatology as a valuable tool to provide access to dermatology care. However, improvements regarding the quality and completeness of the provided clinical content are necessary for the effectiveness and efficiency of the complex teledermatology system in Dutch health care. This could increase both the dermatologists\' satisfaction and the quality of teledermatology services. Managing trade-offs, such as time investments versus image quality, is crucial for teledermatology implementation and should be assessed from a complexity perspective to understand trade-offs and prevent unintended consequences.
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  • 文章类型: News
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