Utilization of Internet and Social Media by Outpatient Dermatology Patients: A Prospective, Cross-sectional Study.

Background: Online health-related information (HRI) has expanded access to medical knowledge. While there are benefits to the increasing availability of online HRI, there may be limitations to the accuracy, quality of information, and utilization across patient demographics.

Methods: A survey was administered to dermatology outpatients at the Keck School of Medicine of the University of Southern California to examine the utilization of internet and social media for acquiring dermatology-related information (DRI).

A Brief History of Antimicrobial Resistance.

Despite mounting attention in recent years, health threats posed by antimicrobial resistance are not new. Antimicrobial resistance has dogged infectious disease treatment processes since the first modern antimicrobials were discovered.

d-Chiro-Inositol in Clinical Practice: A Perspective from the Experts Group on Inositol in Basic and Clinical Research (EGOI).

Background: d-Chiro-inositol is a natural molecule that, in association with its well-studied isomer myo-inositol, may play a role in treating various metabolic and gynecological disorders.

Objectives: This perspective seeks to explore the mechanisms and functions of d-chiro-inositol, laying the foundations to discuss its use in clinical practice, across dysmetabolism, obesity, and hormonal dysregulation.

Methods: A narrative review of all the relevant papers known to the authors was conducted.

Cultivating Critical Love to Improve Black Maternal Health Outcomes.

Racism is responsible for the maldistribution of power in society and manifests as persistent disparities in maternal health among Black women in the United States. Testimonial injustice is an expression of prejudice that uses identity to undermine individuals' credibility as authoritative "knowers" of their own bodies, selves, and experiences. Among Black women, experiences of testimonial injustice in health care encounters are common and likely contribute to disparities in Black maternal health.

Which History and Social Science Concepts Should Inform Health Professions Education?

Teaching and learning patient advocacy in academic health centers requires critical engagement with social, political, and cultural conceptions of racial difference. This article considers understandings of race and racism typically drawn upon in health care and suggests which historical and social science-based approaches should be used in health professions teaching and learning.

Shedding new light on actinic keratoses and squamous cell carcinoma in situ.

Cutaneous squamous cell carcinoma can arise from various premalignant lesions such as actinic keratosis, Bowen disease, and premalignant genital squamous cell lesions. Identification and treatment can prevent malignant transformation and death. This article describes the causes, epidemiology, and characteristics of suspicious premalignant squamous cell lesions so that clinicians can identify these lesions and refer patients for specialist treatment as appropriate.

How Should Clinicians and Health Care Organizations Promote Equity in Child Abuse and Neglect Suspicion, Evaluation, and Reporting?

Victims of child abuse and neglect come from every racial, ethnic, and socioeconomic background, yet clinical evaluation, reporting to child protective services, and responses to reports inequitably harm Black children and malign families of color. Racial bias and inequity in suspicion, reporting, and substantiation of abuse and neglect and in services offered and delivered, foster care placement, and criminal prosecution are widely documented. In response, clinicians and health care organizations should promote equity by educating clinicians about racial bias, standardizing evaluation using clinical decision support tools, and working with policy makers to support prevention services.

Reflecting on the Journey to Develop New National Long-Term Care Standards.

Samir K. Sinha - Implementation Science Team lead and chair of the Health Standards Organization's National Long-Term Care Services Standard Technical Committee - sheds light on the development of the long-term care national standards. Sinha also discusses what the standards hope to achieve for improved quality of care and quality of life across the sector.

Language and Health (In)Equity in US Latinx Communities.

Language is a social determinant of health, no less so in the case of Latinx persons, who make up the second largest ethnic group in the United States. In US health care, language and linguistic difference are often conceived in discrete, instrumental, and monolithic terms. This article characterizes this conception of language as administrative logic, which is in sharp contrast to language conceived as a richly complex, heterogeneous, communally lived human experience.

PAs' skills in providing vision and ocular care.

Objective: To evaluate characteristics, training, and self-reported skills and abilities in vision and ocular care among PAs not specializing in ophthalmology.

Methods: A survey on PA practice was administered to 5,763 randomly selected US-based PAs, and 537 respondents who completed the survey were invited to complete a separate vision and ocular care survey. Of those respondents, 382 completed the vision and ocular care survey.

COVID-19 biomarkers and their overlap with comorbidities in a disease biomarker data model.

In response to the COVID-19 outbreak, scientists and medical researchers are capturing a wide range of host responses, symptoms and lingering postrecovery problems within the human population. These variable clinical manifestations suggest differences in influential factors, such as innate and adaptive host immunity, existing or underlying health conditions, comorbidities, genetics and other factors-compounding the complexity of COVID-19 pathobiology and potential biomarkers associated with the disease, as they become available. The heterogeneous data pose challenges for efficient extrapolation of information into clinical applications.

How Should Compassion Be Expressed as a Primary Clinical and Ethical Value in Anorexia Nervosa Intervention?

Use of force in the care of patients with severe anorexia nervosa is controversial but can be justified when the disorder becomes life-threatening. This commentary examines the role of force in compassionate care of an adolescent patient hospitalized with extreme anorexia nervosa and suggests strategies for reaching consensus, minimizing harm, and maximizing the chance of a therapeutic outcome when forced intervention is a compassionate thing to do.

A Dermatologist's Guide to Implementation of Gene Expression Profiling in the Management of Melanoma.

With the advent of effective therapeutics, melanoma mortality rates have decreased, yet incidence rates are continuing to rise, making accurate prognostication for risk of recurrence increasingly important. Gene expression profiling (GEP) is a clinically available, objective metric that can be used in conjunction with traditional clinicopathological staging to help physicians stratify risk in melanoma patients. There is a gap in guidance from the American Joint Committee on Cancer (AJCC) and the National Comprehensive Cancer Network (NCCN) regarding how to utilize GEP in melanoma care.

Rosacea and Associated Comorbidities: A Google Search Trends Analysis.

There is recent evidence linking rosacea to systemic disease. We sought to identify correlations in Google searches (Google LLC, Mountain View, California) for rosacea and comorbid conditions to assess whether the public is seeking information regarding these trends. Google search data from January 1, 2004, to February 28, 2018, for rosacea and search terms representing common comorbid conditions were investigated.

What Clinicians and Health Professions Students Should Learn About How Pharmaceutical Marketing Influences Opioid Prescribing and Patient Outcomes.

Marketing drugs and devices to clinicians affects their prescribing behaviors, drives up health care costs, and increases risk of harm to patients. This article canvasses what clinicians and health professions students should know about undue influence of drug and device marketing on their practices. It also considers policy changes that would better protect patients and better situate clinicians to care for patients and communities in ways that are ethical, safe, and effective.

Should "Pain Clearance" Be Routine for Elective Surgery?

For elective surgery, preoperative planning for patients with comorbidities tends to address risk stratification, cardiac clearance, and anticoagulation. This commentary suggests that chronic opioid use should be normalized as a comorbidity requiring "pain clearance" prior to elective surgery. Doing so would likely enhance team communication, optimize patient care, decrease stigma, and facilitate care transitioning and long-term planning.

The Multiple Sclerosis Surveillance Registry: A Novel Interactive Database Within the Veterans Health Administration.

Objective: To demonstrate the infrastructure and utility of an interactive health system database for multiple sclerosis (MS), we present the MS Surveillance Registry (MSSR) within the US Department of Veterans Affairs (VA).

Background: Disease specific databases can be helpful in the management of neurologic conditions but few are fully integrated into the electronic health record and linked to health system data. Creating a consistent information technology (IT) architecture and with ongoing support within disease specific registries has been a challenge.

Use of Noninvasive Ventilation with Volume-assured Pressure Support for Treatment-refractory Myasthenia Gravis.

Stepwise approach to therapy and increasing use of immunosuppressive agents have led to increasingly good prognosis and survival in myasthenia gravis (MG). However, there is a small subset of patients with treatment-refractory disease who experience a higher disease burden and increased rates of myasthenic crises and exacerbations, including respiratory failure. A 54-year-old man with treatment-refractory MG on chronic plasma exchange therapy had rapidly fluctuating weakness, poor sleep quality, and worsening respiratory symptoms in between treatments.

How to Help Patients Considering VCA.

Patients who might benefit from some form of vascularized composite allotransplantation (VCA) can be expected to have prior long-standing relationships with one or more primary care professionals or specialists who are well-positioned to help patients make well-informed decisions about whether and when to pursue VCA. Helping patients decide requires becoming familiar with VCA, its various forms, eligibility criteria, prior and possible outcomes, and potential risks and benefits. This article shares key points for helping patients.