Factors affecting the pursuit of academic careers among dermatology residents.

There is a shortage of academic dermatologists in the United States. This study aimed to examine characteristics of US dermatology residency programs that affect the odds of producing academic dermatologists. Data regarding program size, faculty, grants, alumni residency program attended, lectures, and publications for all accredited US dermatology residency programs were collected; these data were correlated with the ratio of graduating full-time faculty members to estimated total number of graduates for each respective program. Results emphasize that the ratio of faculty to residents and the number of full-time faculty publications may represent key factors by which residency programs can increase their graduation of academic dermatologists.

Factors affecting academic leadership in dermatology.

Although prior studies have examined methods by which to recruit and retain academic dermatologists, few have examined factors that are important for developing academic leaders in dermatology. This study sought to examine characteristics of dermatology residency programs that affect the odds of producing department or division chairs/chiefs and program directors (PDs). Data regarding program size, faculty, grants, alumni residency program attended, lectures, and publications for all accredited US dermatology residency programs were collected. Of the 103 programs examined, 46% had graduated at least 1 chair/chief, and 53% had graduated at least 1 PD. Results emphasize that faculty guidance and research may represent modifiable factors by which a dermatology residency program can increase its graduation of academic leaders.

US dermatology residency program rankings.

Unlike many other adult specialties, US News & World Report does not rank dermatology residency programs annually. We conducted a study to rank individual US dermatology residency programs based on set criteria. For each residency program, data from 2008 related to a number of factors were collected, including annual amount of National Institutes of Health (NIH) and Dermatology Foundation (DF) funding received; number of publications from full-time faculty members; number of faculty lectures given at 5 annual society meetings; and number of full-time faculty members who were on the editorial boards of 6 dermatology journals with the highest impact factors. Most of the data were obtained through extensive Internet searches, and missing data were obtained by contacting individual residency programs. The programs were ranked based on the prior factors according to a weighted ranking algorithm. A list of overall rankings also was created.

Social mixing patterns within a South African township community: implications for respiratory disease transmission and control.

A prospective survey of social mixing patterns relevant to respiratory disease transmission by large droplets (e.g., influenza) or small droplet nuclei (e.g., tuberculosis) was performed in a South African township in 2010. A total of 571 randomly selected participants recorded the numbers, times, and locations of close contacts (physical/nonphysical) and indoor casual contacts met daily. The median number of physical contacts was 12 (interquartile range (IQR), 7-18), the median number of close contacts was 20 (IQR, 13-29), and the total number of indoor contacts was 30 (IQR, 12-54). Physical and close contacts were most frequent and age-associative in youths aged 5-19 years. Numbers of close contacts were 40% higher than in corresponding populations in industrialized countries (P < 0.001). This may put township communities at higher risk for epidemics of acute respiratory illnesses. Simulations of an acute influenza epidemic predominantly involved adolescents and young adults, indicating that control strategies should be directed toward these age groups. Of all contacts, 86.2% occurred indoors with potential exposure to respiratory droplet nuclei, of which 27.2%, 20.1%, 20.0%, and 8.0% were in transport, own household, crèche/school, and work locations, respectively. Indoor contact time was long in households and short during transport. High numbers of indoor contacts and intergenerational mixing in households and transport may contribute to exceptionally high rates of tuberculosis transmission reported in the community.

Cutaneous manifestations of category A bioweapons.

The 2001 anthrax attacks on the United States brought bioterrorism to the forefront of the medical community. Because many bioterrorist agents produce cutaneous disease, dermatologists will likely be first responders during a future attack. Despite this, many dermatologists are not adequately prepared to deal with a bioterrorism attack. It is critical that all first responders be able to recognize symptoms of bioterrorism-related disease and prepared to respond to a bioterrorist attack to minimize threats to public health. This article reviews the diagnosis and treatment of diseases caused by potential biowarfare agents that produce cutaneous manifestations, and also provides information regarding reporting and containment of possible bioterrorism-related diseases.

Force of tuberculosis infection among adolescents in a high HIV and TB prevalence community: a cross-sectional observation study.

BACKGROUND: Understanding of the transmission dynamics of tuberculosis (TB) in high TB and HIV prevalent settings is required in order to develop effective intervention strategies for TB control. However, there are little data assessing incidence of TB infection in adolescents in these settings. METHODS: We performed a tuberculin skin test (TST) and HIV survey among secondary school learners in a high HIV and TB prevalence community. TST responses to purified protein derivative RT23 were read after 3 days. HIV-infection was assessed using Orasure® collection device and ELISA testing. The results of the HIV-uninfected participants were combined with those from previous surveys among primary school learners in the same community, and force of TB infection was calculated by age. RESULTS: The age of 820 secondary school participants ranged from 13 to 22 years. 159 participants had participated in the primary school surveys. At a 10 mm cut-off, prevalence of TB infection among HIV-uninfected and first time participants, was 54% (n = 334/620). HIV prevalence was 5% (n = 40/816). HIV infection was not significantly associated with TST positivity (p = 0.07). In the combined survey dataset, TB prevalence was 45% (n = 645/1451), and was associated with increasing age and male gender. Force of infection increased with age, from 3% to 7.3% in adolescents ≥ 20 years of age. CONCLUSIONS: We show a high force of infection among adolescents, positively associated with increasing age. We postulate this is due to increased social contact with infectious TB cases. Control of the TB epidemic in this setting will require reducing the force of infection.

A randomized, controlled, double-blind study of light emitting diode photomodulation for the prevention of radiation dermatitis in patients with breast cancer.

BACKGROUND AND OBJECTIVES: Radiation dermatitis occurs in a majority of patients with breast cancer who receive radiation therapy (RT), causes significant pain, and may necessitate treatment delay. Light emitting diode (LED) photomodulation has been reported to minimize radiation dermatitis. This study sought to further evaluate the efficacy of LED photomodulation in lessening radiation dermatitis. MATERIALS & METHODS: After surgery, patients with breast cancer received LED photomodulation or sham treatments in conjunction with three-dimensional conformal RT. Reactions were evaluated using standardized photographs graded according to National Cancer Institute criteria. RESULTS: In the LED treatment group (n=18), no patients had grade 0 reactions, six (33.3%) had grade 1 reactions, 12 (66.7%) had grade 2 reactions, and none had a grade 3 reaction. In the sham treatment group (n=15), one (6.6%) patient had a grade 0 reaction, four (26.7%) had grade 1 reactions, 9 (60.0%) had grade 2 reactions, and one (6.7%) had a grade 3 reaction. Two (11.1%) patients in the LED treatment group and one (6.7%) in the control group had to interrupt treatment. Differences between groups were not statistically significant. CONCLUSION: LED photomodulation did not reduce the incidence of radiation-induced skin reactions or interruptions in therapy. .

Trends in types of dermatology books available over the last ten years.

Shifts in interest toward cosmetic and surgical dermatology and away from medical and academic dermatology have been observed in recent years. We hypothesized that this trend would be evident in the types of books available for purchase from a major medical textbook supplier. Books published from 1998-2008 were categorized by type and statistical testing was performed to determine if this trend has been reflected in books published. The percentage of medical dermatology books decreased over time, whereas the percentage of cosmetic and surgical dermatology books increased over time.

Topical PRK 124 (0.125%) lotion for improving the signs and symptoms of rosacea.

BACKGROUND: Current treatments for acne rosacea are often associated with unsatisfactory outcomes and adverse effects. OBJECTIVE: To determine the efficacy and tolerability of a new moisturizing lotion for improving the clinical signs and symptoms of mild-to-moderate acne rosacea. METHODS: In a 12-week, open-label study, a moisturizing lotion containing furfuryl tetrahydropyranyladenine as PRK124 (0.125%, Pyratine-XR, Senetek PLC, Napa, CA) was applied twice daily to subjects with mild-to-moderate rosacea. Improvement in the appearances of erythema and papules were assessed by the treating physician. Skin barrier function was measured by transepidmal water loss after treatment. Tolerability and cosmetic outcome were evaluated by patients. RESULTS: Twenty-one participants completed the study. Overall clinical improvement was observed in 80% of subjects, with most showing mild-to-moderate improvement. Erythema, papule counts, and telangiectasia were reduced. The reduction in TEWL was significant at weeks 4 (p = 0.01), 8 (p < 005), and 12 (p < 0.001). Rosacea symptoms (burning, stinging, dryness) were progressively reduced, with reduction in dryness achieving statistical significance at weeks 4 (p = 0.035), 8 (p = 0.037) and 12 (p = 0.016). Treatments were well tolerated and cosmetic outcomes were acceptable. Treatment-induced irritation was not observed. CONCLUSION: The new moisturizing lotion containing furfuryl tetrahydropyranyladenine as PRK124 shows a continued trend toward improvement of skin barrier function and the appearances of erythema and papules associated with mild-to-moderate rosacea during 12 weeks of treatment.