Investigating skin age analysis to reduce tanning intentions among adolescents: A pilot study.

As skin cancer rates continue to rise, targeted efforts to reduce excessive exposure to ultraviolet radiation are crucial. Adolescents are a high-risk population for intentional tanning; thus, we sought to determine whether the novel use of skin age analysis with ultraviolet (UV) photography would be an effective tool for reducing intentions to tan in adolescents with a calculated skin age (measured by complexion analysis software) that exceeds their actual age. Surveying 85 students in this study, skin age difference above zero was associated with reduced intentions to tan (P = 0.006) and high-risk sun exposure behaviors were identified. This provides rationale for skin age analysis as a potentially effective intervention in decreasing intentions to tan in this high-risk young population.

Process of Post-operative Telephone Follow-up Implementation for Mohs Micrographic Surgery: A Pilot Study.

Objective: The purpose of this study was to describe and evaluate the process of implementing a routine telephone follow-up (TFU) system for capturing postoperative complications or concerns among Mohs micrographic surgery (MMS) patients. Design: Postoperatively, patients were called twice: 1) within 24 to 48 hours to assess bleeding, swelling, and pain control; and 2) at one week to assess wound care, signs of infection, or other concerns. Setting: The study took place in a single-institution academic dermatology department with five fellowship-trained Mohs surgeons. Participants: Study subjects included patients undergoing MMS during a two-month period. Measurements: Data regarding completed TFU rate, time to complete calls, and patient-reported complication rates were collected and analyzed. Results: Of 349 MMS patients, 263 (75.4%) were successfully contacted during the 24- to 48-hour follow-up window and 232 (66.5%) at the one week interval. Major complication rates were 0.4 percent (n=1) for bleeding and 0.4 percent (n=1) for infection; both were treated by their respective Mohs surgeon. Timed calls averaged approximately three minutes per encounter. Conclusion: TFU is practical and efficient for assessing and mitigating MMS postoperative complications.

Diagnosis of appendicitis by bedside ultrasound in the ED.

BACKGROUND: Computed tomography (CT) has largely become standard of care for diagnosing appendicitis at the expense of increased patient radiation exposure, cost, and time to surgical intervention. To date, there are very limited data on the accuracy of bedside ultrasound (BUS) for the diagnosis of appendicitis in adults. OBJECTIVE: The objective of this study is to evaluate test characteristics of BUS for diagnosis of acute appendicitis in the emergency department. METHODS: Data were prospectively collected on 97 cases of suspected appendicitis, which had BUS performed by trained residents with attending supervision between August 2011 and November 2013. All BUS interpretation and additional diagnostic imaging were left to the discretion of the physician or surgical consultants. A blinded ultrasound fellowship-trained physician reviewed all images after clinical treatment. Bedside ultrasound findings and patient outcomes were reported. RESULTS: A total of 97 adult cases underwent diagnostic ultrasound scans for suspected appendicitis. Of 97 cases, 34 had acute appendicitis by surgery/pathology report. Twenty-four BUS were positive for acute appendicitis and 11 were nondiagnostic. Of 24 positive ultrasounds, 23 had appendicitis on pathology report. There was 1 false-positive result, yielding a sensitivity of 67.65% (95% confidence limits, 49.5%-82.6%) and a specificity of 98.41% (95% confidence limits, 91.4%-99.7%). Of 23 positive BUS, 12 cases went to the Operating Room without an abdominal CT yielding a 12% reduction in CT utilization. If all positive BUS went to the OR without a CT scan, this would yield a 24% reduction in CT utilization. CONCLUSIONS: Bedside ultrasound may be an appropriate initial test to evaluate patients with suspected acute appendicitis in the emergency department.