1,817 research outputs found
Line-field confocal optical coherence tomography-Practical applications in dermatology and comparison with established imaging methods
Background Non-invasive diagnostic techniques in dermatology gained increasing popularity in the last decade. Reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) are meanwhile established in research and clinical routine. While OCT is mainly indicated for detecting non-melanoma skin cancer, RCM has proven its usefulness additionally in distinguishing melanocytic lesions. Line-field confocal optical coherence tomography (LC-OCT) is an emerging tool combining the principles of both above-mentioned methods. Methods Healthy skin at different body sites and exemplary skin lesions (basal cell carcinoma, malignant melanoma, actinic keratosis) were examined using dermoscopy, RCM, OCT and LC-OCT. Standard features for RCM and OCT and comparable features for LC-OCT were analysed. Results LC-OCT has a lower penetration depth but superior resolution compared to OCT. In comparison with RCM, which provides only horizontal sections, LC-OCT creates both vertical and horizontal images in real time and has nearly the same cellular resolution. Discussion Our preliminary experiences suggest that LC-OCT combines the advantages of RCM and OCT, with optimal resolution and penetration depth to diagnose all types of skin cancer. Larger systematic studies are needed to further characterize the field of use of this device and its sensitivity and specificity compared to histology
Implementation of a dermatoscopy curriculum during residency at Augsburg University Hospital in Germany
Background and objectives
To date, there is no structured program for dermatoscopy training during residency in Germany. Whether and how much dermatoscopy training is acquired is left to the initiative of each resident, although dermatoscopy is one of the core competencies of dermatological training and daily practice. The aim of the study was to establish a structured dermatoscopy curriculum during residency at the University Hospital Augsburg.
Patients and methods
An online platform with dermatoscopy modules was created, accessible regardless of time and place. Practical skills were acquired under the personal guidance of a dermatoscopy expert. Participants were tested on their level of knowledge before and after completing the modules. Test scores on management decisions and correct dermatoscopic diagnosis were analyzed.
Results
Results of 28 participants showed improvements in management decisions from pre- to posttest (74.0% vs. 89.4%) and in dermatoscopic accuracy (65.0% vs. 85.6%). Pre- vs. posttest differences in test score (7.05/10 vs. 8.94/10 points) and correct diagnosis were significant (p < 0.001).
Conclusions
The dermatoscopy curriculum increases the number of correct management decisions and dermatoscopy diagnoses. This will result in more skin cancers being detected, and fewer benign lesions being excised. The curriculum can be offered to other dermatology training centers and medical professionals
Achados RadiolĂłgicos Pulmonares da Fibrose CĂstica
As radiografias de tĂłrax sĂŁo essenciais na avaliação pulmonar em pacientes com fibrose cĂstica e a despeito da superioridade tĂ©cnica da tomografia computadorizada, elas ainda permanecem como a ferramenta diagnĂłstica primária no seguimento destes pacientes. Demonstramos algumas manifestações radiolĂłgicas pulmonares desta entidade diagnĂłstica e destacamos alguns aspectos da literatura
Identity, importance, and their roles in how corporate social responsibility affects workplace attitudes and behavior
This paper contributes to growing research exploring employee attitudinal and behavioral reactions to organizational corporate social responsibility initiatives focused on environmental and social responsibility and sustainability. Drawing on social identity theory, we develop and test a moderated-mediation model where employees’ organizational identification mediates the relationship between their perceptions of organizational CSR initiatives and their work engagement and organizational citizenship behaviors, but this relationship is positive only when employees value the role of organizations in supporting environmental and social causes. In a survey of 250 employees from a variety of German organizations, across a range of industry sectors, our hypotheses were fully supported. Theoretical and practical implications are discussed
Achados Tomográficos Pulmonares em Fibrose CĂstica
Nos Ăşltimos anos, o uso de tomografia computadorizada (TC) em fibrose cĂstica tĂŞm aumentado e vários estudos tĂŞm relatado a superioridade diagnĂłstica da TC sobre a radiografia de tĂłrax na avaliação das diferentes doenças pulmonares. Algumas manifestações tomográficas dessa entidade diagnĂłstica sĂŁo discutidas
Dynamic optical coherence tomography: a non-invasive imaging tool for the distinction of nevi and melanomas
Along with the rising melanoma incidence in recent decades and bad prognoses resulting from late diagnoses, distinguishing between benign and malignant melanocytic lesions has become essential. Unclear cases may require the aid of non-invasive imaging to reduce unnecessary biopsies. This multicentric, case-control study evaluated the potential of dynamic optical coherence tomography (D-OCT) to identify distinguishing microvascular features in nevi. A total of 167 nevi, including dysplastic ones, on 130 participants of all ages and sexes were examined by D-OCT and dermoscopy with a histological reference. Three blinded analyzers evaluated the lesions. Then, we compared the features to those in 159 melanomas of a prior D-OCT study and determined if a differential diagnosis was possible. We identified specific microvascular features in nevi and a differential diagnosis of melanomas and nevi was achieved with excellent predictive values. We conclude that D-OCT overcomes OCT´s inability to distinguish melanocytic lesions based on its focus on microvascularization. To determine if an addition to the gold standard of a clinical-dermoscopic examination improves the diagnosis of unclear lesions, further studies, including a larger sample of dysplastic nevi and artificial intelligence, should be conducted
Two TRPV1 receptor antagonists are effective in two different experimental models of migraine
Background The capsaicin and heat responsive ion channel TRPV1 is expressed on
trigeminal nociceptive neurons and has been implicated in the pathophysiology
of migraine attacks. Here we investigate the efficacy of two TRPV1 channel
antagonists in blocking trigeminal activation using two in vivo models of
migraine. Methods Male Sprague–Dawley rats were used to study the effects of
the TRPV1 antagonists JNJ-38893777 and JNJ-17203212 on trigeminal activation.
Expression of the immediate early gene c-fos was measured following
intracisternal application of inflammatory soup. In a second model, CGRP
release into the external jugular vein was determined following injection of
capsaicin into the carotid artery. Results Inflammatory up-regulation of c-fos
in the trigeminal brain stem complex was dose-dependently and significantly
reduced by both TRPV1 antagonists. Capsaicin-induced CGRP release was
attenuated by JNJ-38893777 only in higher dosage. JNJ-17203212 was effective
in all doses and fully abolished CGRP release in a time and dose-dependent
manner. Conclusion Our results describe two TRPV1 antagonists that are
effective in two in vivo models of migraine. These results suggest that TRPV1
may play a role in the pathophysiological mechanisms, which are relevant to
migraine
Dynamic optical coherence tomography of chronic venous ulcers
Background
Chronic ulcers, especially venous leg ulcers, are a major burden on the healthcare system. To date there are only few non-invasive established procedures for evaluation of blood perfusion in wounds. Dynamic optical coherence tomography (D-OCT) provides images of the skin's superficial vascularisation.
Objectives
This study aims to investigate if and how the D-OCT measurement of chronic wounds can provide new information about the vascularisation during the healing process.
Methods
We examined 16 venous ulcers over 16 weeks and evaluated the vessel morphology and density using D-OCT at the wound bed, borders, two centimetres adjacent to the wound und at non-ulcerated skin on the contralateral leg.
Results
In D-OCT scans clumps were unique and the most common vessel type in the wound area of venous ulcers, whereas lines and serpiginous vessels were the most common in non-ulcerated skin. At the wound border mottle and cluster patterns occurred more frequently. Healthy skin showed a significant increase of mesh pattern. Vessel density significantly increased at the wound area compared to non-ulcerated skin. During the healing process the wound border showed the most vascular changes while only an increase in curves was observed in the wound centre. Non-healing wounds had fewer dots and blobs at the borders, fewer dots, coils, clumps, lines and serpiginous vessels at the centre and fewer dots in adjacent skin. Temperature analysis showed higher temperatures in non-ulcerated skin, followed by the wound margin and centre. Non-healing wounds showed the lowest temperatures in the wound centre.
Conclusions
These results highlight the non-invasive use of D-OCT for the examination and monitoring of wound healing in chronic venous ulcers. D-OCT imaging of blood vessels may offer the potential to detect disorders of wound healing at an early stage, differentiate ulcers of different genesis and to tailor more individualized, patient-oriented therapy
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