Neonatal Sweet syndrome with associated rectovestibular fistula and review of the literature.

An otherwise healthy 4-week-old term female of Japanese heritage presented with a 1-week history of asymptomatic progressive, generalized skin lesions. The lesion morphology, distribution, and dermatopathology result was consistent with Sweet syndrome. The patient was found to have a congenital type H rectovestibular fistula. This case highlights the rare association of rectovestibular fistula in neonatal Sweet syndrome which has only been described in neonates of Japanese heritage.

A Student Teaching Assistant Program for Diversity, Equity, Inclusion, and Antiracism Curricular Enhancement.

PROBLEM: In the United States, physician bias is exhibited early in medical training and contributes to systemic inequities within the field of medicine. A lack of diversity, equity, inclusion, and antiracism (DEI-AR) content within medical curricula drives critical gaps in knowledge and deficiencies when preparing medical students to serve patients of diverse backgrounds. At the Mayo Clinic Alix School of Medicine (MCASOM), student-led curricular reviews between 2017 to 2018 and 2020 to 2021 revealed opportunities to improve DEI-AR content within preclinical courses. Course directors expressed concern of limited expertise and time to enact effective changes. APPROACH: The MCASOM DEI-AR teaching assistant (TA) program aims to curate a collaborative partnership between course directors and compensated student TAs to facilitate course enhancements responsive to the prior preclinical course review while centering standardized DEI-AR best practices. OUTCOMES: As of January 2024, the program has engaged 14 TAs and partnered with 24 preclinical courses. Postcourse student evaluation responses were collected from 8 courses for 2021 to 2022 (before enhancements) and 2022 to 2023 (after enhancements). Student satisfaction with DEI-AR content is tracked through postcourse evaluations, with preliminary data demonstrating improvement after DEI-AR curricular integration (improvement of mean preenhancement and postenhancement scores of 3.81 to 4.05; t12 = 1.79, P = .21). Qualitative student comments were sorted into general categories of positive, negative, or neutral, showing a 6.25% median increase in positive perception of DEI. NEXT STEPS: Plans for the MCASOM DEI-AR TA program include application of quality improvement strategies to improve program processes and outcomes. Development of a centralized dashboard that integrates course enhancement progress and ongoing feedback from evaluations is anticipated to facilitate this effort. The program additionally aims to develop partnerships with clinical clerkships, which would allow for a more comprehensive enhancement of the overall medical education experience related to DEI-AR.

Scoping review of medical students' perceptions of the field of dermatology.

Background: Although perceived barriers to applying to dermatology have been researched among medical students, there remains a dearth of literature dedicated to understanding perceptions that medical students have of the field of dermatology and dermatologists. Methods: A review of the literature in Embase, Pubmed, Scopus, Web of Science, and ScienceDirect were carried out to identify articles and abstracts between 2016 and 2021 relating to medical student perceptions of the field of dermatology. Peer-reviewed English studies measuring attitudes/level of interest in dermatology or other specialities, understanding of dermatologic topics, procedures, and/or scope of practice were included. Duplicate studies and conference abstracts were excluded. All publications were screened using the PRISMA-Sc guidelines. Findings were summarised and tabulated accordingly. Results: A total of nine articles met inclusion criteria and eight are included in this review since one was not accessible online. Notable findings include non-US medical students perceiving dermatology as monotonous, stigmatized, unfamiliar, and difficult to access with a misunderstanding of the diversity and severity of the conditions dermatologists treat. No data on US medical student perceptions was found. Perceptions were found to be influential in career planning: medical students may reject specialities after exposure to negative comments on the field. Factors attracting students to dermatology include the appeal of being a dermatologist, media portrayal, and dermatologists' influence on patients' lives. Completion of dermatology-related activities improved medical student interest, comfort, and understanding of the field. Early dermatology exposure in US undergraduate premedical students led to heightened interest in the field, more confidence in ability to find dermatology mentors, and increased perception that dermatology serves the needs of underserved communities. Conclusions: This review demonstrates the need to further investigate medical student perceptions of dermatology, particularly in the United States. Perceptions of medical specialities can impact medical student career choices. Understanding which misconceptions may be preventing students from exploring dermatology can inform efforts towards improving diversity, equity, and inclusion: translating to an equitable match and improving patient outcomes. Limitations include exclusion of articles published before 2016, geographic variability in studies, and limited data on evolving student perceptions over time.

Student Faculty Collaborative Clinics Influence on Emergency Department Use.

Student-faculty collaborative clinics, like the Crimson Care Collaborative (CCC), provide primary care access to underserved communities. Affiliated with a community health center, CCC-Chelsea serves a largely immigrant and refugee population. This study aimed to analyze patients' reported ED use before and after they presented to CCC-Chelsea and whether types of insurance affect ED use. We prospectively surveyed 229 patients presenting to CCC-Chelsea between 2013 and 2019. Patients who presented for two or more visits at least one year apart were included in the study. A two-sided Wilcoxon signed rank test was used to compare reported ED use before and after presenting to CCC-Chelsea, and a Kruskal-Wallis test analyzed the association between ED use and insurance status. Most patients (77.7%) presenting to CCC-Chelsea identified as Hispanic, 70.9% were male, 50.6% of patients reported an income of less than $15,000 yearly, and 30.4% had an income between $15,000-$30,000. Most patients (51.9%) did not specify the type of insurance used, followed by public insurance (36.7%), with the remaining having private or no insurance. Results from our survey showed that patients who returned to CCC-Chelsea reported a decrease in the average number of yearly ED visits after attending CCC-Chelsea (pre-CCC 1.544, post-CCC 0.696, p < 0.001 at the 95% CI). There was no difference in reported average number of ED visits yearly and insurance type (p = 0.579). Patients' reported ED utilization after accessing care at CCC-Chelsea decreased. Increased access to student-faculty collaborative clinics could reduce ED use in underserved populations.

Differentiation of hydrochlorothiazide-induced dermatitis from stasis dermatitis.

A woman in her 60s with a history of hypertension and stasis dermatitis presented to a primary care clinic with a bilateral, erythematous rash on the legs, stomach, and chest. Photosensitive rash and dermatitis may be caused by many conditions. Hydrochlorothiazide-induced dermatitis is a rare side effect of thiazide diuretics. Early identification of sulfa-sensitivity and photoallergic or phototoxic reaction is essential to accurate diagnosis and treatment of photosensitive dermatitis. Soliciting a targeted history is essential to delineating drug-induced dermatitis from stasis dermatitis. A thorough skin examination can elucidate the focal or extensive nature of the rash and is essential to making an accurate diagnosis. Immediate cessation of hydrochlorothiazide and switching drugs classes for hypertension management typically leads to resolution of symptoms.

The Impact of Student-Faculty Collaborative Clinics on Patients' Health Seeking Behaviors in Underserved Communities.

The Crimson Care Collaborative (CCC) is a network of seven student-faculty clinics in the Greater Boston area that provides primary care services to underserved patient populations and social services to address social determinants of health. Promoting healthy behaviors and health-seeking habits are among the most important focuses in the field of public health and medicine. The main objective of this study is to understand the influence that the student-faculty collaborative clinic in Chelsea has on where patients seek out medical information and if that influence changes with time. To study this phenomenon, a retrospective analysis was conducted for six years of data (2013-2019). The CCC Chelsea patient survey database included 349 surveys for 229 patients. McNemar's test for paired patient survey data showed no significant difference between health information seeking preferences before and after a CCC visit ([2.783], p = 0.093). Chi-square comparing these three visit types is associated with a significant p-value of 0.025 ([Formula: see text] = 7.374). Patients who are at their second visit at CCC are more likely to report favoring reliable sources of medical information, and patients at their third visit are increasingly more likely to report first consulting reliable sources of medical information, including doctors and other healthcare providers. Fisher's test showed no significant difference between health information seeking preferences for patients who last saw a health professional less than 6 months prior to survey administration and greater than 6 months prior to survey administration at a significance level of 0.05 (p = 0.06). Our results suggest that clinic attendance may have an impact on patients' use of reputable sources of medical information in CCC Chelsea, and the positive impact that clinic attendance has on health information seeking habits may be long-standing.

Surgical Scrubbing and Attire in the Operating Room and ICU: A Multicultural Guide.

In response to the challenges faced as diverse students when first encountering the intricacies of scrubbing into the operating room (OR), we have prepared a rudimentary surgical skills guide to supplement the knowledge of students and educators alike. In keeping with the need to adapt standard protocols to accommodate religious and cultural practices, this guide focuses on hijab, natural hair, dastar, protective styles, and beard protocol in the OR. It addresses some of the personal protective equipment needs of Muslims, Orthodox Jews, Sikhs, and groups maintaining beards as a part of cultural or religious practices. We intend this guide to serve as a foundation on which the medical field can update its educational practices in line with the increased diversity of the medical professions, while also continuing to ensure the safety of OR and ICU patients. This guide also highlights COVID-19-specific changes in personal protective equipment and seeks to open up a conversation about the necessity of currently held surgical practices.