Exploring patient–physician trust dynamics in patients with psychocutaneous and general dermatological disease

Purpose: More positive health behaviors, fewer symptoms, higher quality of life, and greater treatment satisfaction have been reported among those with greater physician trust. This study assessed the relationship between physician trust and recurrent stroke/TIA within 1 year of discharge among stroke survivors in Northern Manhattan. Methods: This study used data from the Stroke Warning Information and Faster Treatment (SWIFT) study, a randomized controlled trial conducted from 2005-2012 in a multiethnic cohort of 1,193 mild/moderate ischemic stroke and TIA survivors. The goal was to assess the impact of a stroke preparedness educational intervention on emergency department arrival time after subsequent stroke symptom onset. Physician trust, assessed at baseline, was measured with one item: “What percentage of the time do you trust doctors?”. For the analysis, it was dichotomized with the cutoff at 80%. Recurrent stroke/TIA was assessed at 1 month and 1 year. The association between recurrent stroke/TIA and patient trust was evaluated using multivariate logistic regression adjusted for sociodemographics and comorbidities. Results: In the analytic sample (n=1108), those who answered both exposure and outcome, the prevalence of recurrent stroke/TIA and lack of physician trust was 10.75% and 36.46%, respectively. Consistent with the literature, Hispanics compared to whites had a higher prevalence of lack of physician trust (42.71% vs. 34.11%, p<0.001). Adjusting for race/ethnicity, intervention status, age, sex, education, marital status, smoking, insurance, hypertension, diabetes, body mass index, physical activity, and depression, those who lacked trust had greater odds of recurrent stroke/TIA (OR=1.36, 95% CI:0.86-2.18) than those who had trust. When observing the association among Hispanics and Blacks, those who lacked trust had (OR=1.27, 95% CI: 0.66-2.42) and (OR=1.26, 95% CI: 0.36-4.38) respectively, greater odds of a recurrent episode than those who had trust. Conclusion: Despite insignificant findings, a national study with a greater range of stroke severity and additional measures such as medication compliance may be warranted to provide greater insight on the effects of physician trust on stroke outcomes.

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Health Literacy, Physician Trust, and Diabetes-related Self-care Activities in Hispanics with Limited Resources

Journal of Health Care for the Poor and Underserved ◽

10.1353/hpu.2013.0177 ◽

2013 ◽

Vol 24 (4) ◽

pp. 1756-1768 ◽

Cited By ~ 30

Author(s):

Richard O. White ◽

Chandra Y. Osborn ◽

Tebeb Gebretsadik ◽

Sunil Kripalani ◽

Russell L. Rothman

Keyword(s):

Health Literacy ◽

Self Care ◽

Limited Resources ◽

Physician Trust

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Dermal Dendrocytes: Dynamic Determinants in the Development of Dermatological Disease

Dermal Immune System ◽

10.1201/9780429261893-14 ◽

2019 ◽

pp. 277-290

Author(s):

David P. Fivenson

Keyword(s):

Dermatological Disease

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Use of Artificial Intelligence as a Predictor of the Response to Treatment in Alopecia Areata

Iproceedings ◽

10.2196/35433 ◽

2021 ◽

Vol 6 (1) ◽

pp. e35433

Author(s):

Fernando Alarcón-Soldevilla ◽

Francisco José Hernández-Gómez ◽

Juan Antonio García-Carmona ◽

Celia Campoy Carreño ◽

Ramon Grimalt ◽

...

Keyword(s):

Artificial Intelligence ◽

Alopecia Areata ◽

Predictive Value ◽

Data Augmentation ◽

Conflicts Of Interest ◽

The United States ◽

Response To Treatment ◽

Disease Evolution ◽

Dermatological Disease

Background Artificial intelligence (AI) has emerged in dermatology with some studies focusing on skin disorders such as skin cancer, atopic dermatitis, psoriasis, and onychomycosis. Alopecia areata (AA) is a dermatological disease whose prevalence is 0.7%-3% in the United States, and is characterized by oval areas of nonscarring hair loss of the scalp or body without evident clinical variables to predict its response to the treatment. Nonetheless, some studies suggest a predictive value of trichoscopic features in the evaluation of treatment responses. Assuming that black dots, broken hairs, exclamation marks, and tapered hairs are markers of negative predictive value of the treatment response, while yellow dots are markers of no response to treatment according to recent studies, the absence of these trichoscopic features could indicate favorable disease evolution without treatment or even predict its response. Nonetheless, no studies have reportedly evaluated the role of AI in AA on the basis of trichoscopic features. Objective This study aimed to develop an AI algorithm to predict, using trichoscopic images, those patients diagnosed with AA with a better disease evolution. Methods In total, 80 trichoscopic images were included and classified in those with or without features of negative prognosis. Using a data augmentation technique, they were multiplied to 179 images to train an AI algorithm, as previously carried out with dermoscopic images of skin tumors with a favorable response. Subsequently, 82 new images of AA were presented to the algorithm, and the algorithm classified these patients as responders and non-responders; this process was reviewed by an expert trichologist observer and presented a concordance higher than 90% with the algorithm identifying structures described previously. Evolution of the cases was followed up to truly determine their response to treatment and, therefore, to assess the predictive value of the algorithm. Results In total, 32 of 40 (80%) images of patients predicted as nonresponders scarcely showed response to the treatment, while 34 of 42 (81%) images of those predicted as responders showed a favorable response to the treatment. Conclusions The development of an AI algorithm or tool could be useful to predict AA evolution and its response to treatment. However, further research is needed, including larger sample images or trained algorithms, by using images previously classified in accordance with the disease evolution and not with trichoscopic features. Conflicts of Interest None declared.

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Oral lichen planus and its recent management: A review

Update Dental College Journal ◽

10.3329/updcj.v10i2.50179 ◽

2020 ◽

Vol 10 (2) ◽

pp. 29-34

Author(s):

Md Ashif Iqbal ◽

Suraiya Yesmin ◽

Fathimath Maaisha ◽

Shaama Ibrahim ◽

Puja Gotame

Keyword(s):

Lichen Planus ◽

Oral Lichen Planus ◽

Cost Effective ◽

Premalignant Lesions ◽

Treatment Modalities ◽

Cochrane Library ◽

Long Run ◽

Dermatological Disease ◽

Keywords Lichen Planus ◽

Oral Lichen

Background: Oral Lichen Planus (OLP) is one of the most common dermatological disease which is present in the oral cavity. It is a chronic autoimmune, mucocutaneous disease that affects oral mucosa as well as the skin, genital mucosa and other sites of the body.Method: In this review study, various databases such as Google Scholar, PubMed Central, Hinari and Cochrane library were searched for articles with keywords lichen planus, oral lichen planus, premalignant lesions, management of Lichen planus. Articles were searched from January 2015 to 5th November 2020.Result: From the 34 articles obtained after reviewing the abstracts, most relevant 32articles were evaluated in this study.Conclusion: The etiology, pathophysiology, clinical presentation, histopathological features, diagnosis and various management for oral lichen planus is discussed. This article also compares the existing and the most recent treatment modalities that are available throughout the world that are discussed in the literatures. However, more intensive studies must be carried out to find the best treatments which are cost-effective in the long run. Update Dent. Coll. j: 2020; 10 (2): 29-34

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The potential of bacteriocin AS-48 in the control of Propionibacterium acnes

10.7287/peerj.preprints.2107 ◽

2016 ◽

Cited By ~ 1

Author(s):

Rubén Cebrián ◽

Sergio Arévalo ◽

Samir Ananou ◽

Salvador Arias-Santiago ◽

Cristina Riazzo ◽

...

Keyword(s):

Antibacterial Activity ◽

Propionibacterium Acnes ◽

Acne Vulgaris ◽

Chemical Compounds ◽

Clinical Isolates ◽

Large Decrease ◽

Large Problem ◽

Specific Pcr ◽

Therapeutic Drugs ◽

Dermatological Disease

Background Global reports show that the antimicrobial-resistance of Propionibacterium acnes isolated from patients with acne vulgaris is becoming a large problem, making it necessary to find new therapeutic drugs. Methods In this study, 23 clinical isolates of P. acnes have been identified by MaldiToff and specific PCR. The susceptibility of theses strains to antibiotics (clindamicin, erytromycin and tetracicline) and to bacteriocin (AS-48) has been established, using the CECT 5684 strain as reference. Moreover, we have investigated the potential of several chemical compounds to bolster the activity of AS-48. Finally, the effectivity of four different formulations containing AS-48 and lysozyme have been evaluated on the surface of swine-ear skin previously inoculated with P. acnes CECT5684 strain. Results. The results presented in this work probe that AS-48 has a significant bactericidal activity against the 23 clinical isolates of P. acnes, including isolates resistant to one or more common antibiotics used in the treatment of acne. Antibacterial synergy of AS-48 with other chemical compounds has been demonstrated, as was the effect of lysozyme and to a lesser extent with palmitic acid. Likewise, the use of a combination therapy into a cream formulation, resulted in large decrease in the number of viable P. acnes counts in an experiemental model. Conclusion. Once more these studios support that compositions comprising bacteriocins displaying antibacterial activity, must be considered an approach for medical and pharmaceutical purposes. These applications are particularly promising in light of emerging antibiotic resistance across bacteria involved in treatment of dermatological disease as acne vulgaris.

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Impact of Perceived Weight Discrimination on Patient Satisfaction and Physician Trust

Fat Studies ◽

10.1080/21604851.2013.731955 ◽

2013 ◽

Vol 2 (1) ◽

pp. 45-55 ◽

Cited By ~ 4

Author(s):

Amanda Marie Balkhi ◽

Mike C. Parent ◽

Mark Mayor

Keyword(s):

Patient Satisfaction ◽

Weight Discrimination ◽

Physician Trust ◽

Perceived Weight

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OP TRENTON 3: An analysis of primary care presentations to a deployed role 1 in support of a United Nation peacekeeping operation

Journal of the Royal Army Medical Corps ◽

10.1136/jramc-2019-001203 ◽

2019 ◽

pp. jramc-2019-001203 ◽

Cited By ~ 3

Author(s):

Christopher Thomas Bonham ◽

S J C Pallett ◽

T J Holland

Keyword(s):

Primary Healthcare ◽

Gastrointestinal Disease ◽

Clinical Care ◽

South Sudan ◽

Operational Environment ◽

Humanitarian Operations ◽

Dermatological Disease ◽

Significant Burden ◽

Sub Saharan ◽

Battle Injuries

ObjectivesHealth data of operational relevance from South Sudan are lacking, outdated and non-representative. This study sets out to record and analyse primary healthcare (PHC) presentations to a deployed UK Level 1 Primary Healthcare Centre (L1 PHC) facility in Bentiu, South Sudan, to inform on disease prevalence for UK Military Personnel in a sub-Saharan Operational environment.MethodsA prospective single-centre cohort study was completed for all PHC presentations to a UK L1 PHC facility while deployed on the United Nations Mission to South Sudan from June 2017 to November 2017.Results861 episodes of clinical care were recorded at Bentiu Camp during the 6-month period. 82% were from disease; 18% non-battle injuries and no battle injuries were seen. As per EPINATO2 categorisation, the top three presentations were acute gastrointestinal disease, dermatological disease and routine clinical care. Differences were noted for June–August and September–November, as a proportion of total cases seen. It was noted that gastrointestinal illnesses were three times more likely in the first half of the operation and bites and sting almost twice as likely.ConclusionsGastrointestinal disease results in a significant burden on humanitarian operations where an extended Relief-in-Place is a key area of risk. The EPINATO2 reporting tool provides insufficient detail for planning purposes and an improved method of data collection is required. Targeting the diagnosis and management of infectious diseases during predeployment training should prepare L1 PHC for the most common cases encountered. Delivery of targeted Force Health Protection training for all personnel with early deployment of L1 PHC forward could improve support to commanders during the highest risk periods.

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