Clinical and dermoscopic features of keratinizing skin tumors in BRAFi-treated patients.

e19052 Background: Development of keratinizing skin tumors (KST), including squamous cell carcinomas (SCC), keratoacanthomas (KA) and verrucae (warts), are common in patients receiving BRAF inhibitors (BRAFi), including vemurafenib (V), XL281 (X) and GSK211846 (G). Dermoscopy is a specialized technique for examining skin lesions. While the clinical characteristics of these lesions are well known, the dermoscopic morphology remains to be elucidated. Methods: Patients on V, X or G who developed biopsy-proven KSTs were included in the study. Clinical and dermoscopic images of the KSTs were evaluated to determine the clinical and dermoscopic features. Frequent and reproducible structures were identified. P values were calculated based on Fisher's exact test. Results: 44 lesions (8 SCC/KAs, 36 verrucae) were identified in 21 patients. Clinically, SCC/KAs presented as scaly papules (75%) or plaques (25%) with a central scale/crust (63%), erythematous halo (63%) and/or scaly rim (63%). Verrucae presented as papules (97%) with an erythematous halo (50%). Dermoscopically, keratinizing pearls were exclusive to the SCC/KAs and keratin “petals”, “domes” or horns were seen exclusively in verrucae (Table). In the verrucae, thrombosed vessels were often observed within keratin structures; vs. vessels seen in the SCC/KAs, which were mainly located outside the keratin, around the center or in the base of the tumor. Conclusions: Although KSTs secondary to BRAFi do not result in drug discontinuation, they can affect dosing and quality of life. The dermoscopic features described herein may aid in the differentiation of benign vs. malignant lesions, with keratinizing pearls appearing to be unique to SCC/KAs. Management strategies for BRAFi KSTs may be tailored based on dermoscopic findings, with more conservative treatment for verrucae vs. SCC/KAs, which may decrease morbidity and cost. [Table: see text]

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THIRTY-YEAR TRENDS IN UNIVERSITY STUDENTS’ LIFESTYLE AND QUALITY OF LIFE

Hygiene and Sanitation ◽

10.18821/0016-9900-2019-98-5-534-539 ◽

2019 ◽

Vol 98 (5) ◽

pp. 534-539

Author(s):

Nadezhda Yu. Valkova ◽

E. V. Komarovskaya

Keyword(s):

Quality Of Life ◽

Healthy Lifestyle ◽

Educational Institutions ◽

Medical Institute ◽

Test Results ◽

Exact Test ◽

State Medical Institute ◽

Regular Increase ◽

Bodies Of Water

Material and methods. Questionnaire survey for the estimation of the Quality of life was done in 796 students. 419 students of Arkhangelsk State Medical Institute were tested in 1979-1984, including 205 males and 214 females with an average age of 22.2; 203 students of higher educational institutions of Severodvinsk in 1998-2005 including 85 males and 118 females with average age of 18.7; 173 students of M.V. Lomonosov Northern (Arctic) Federal University (Arkhangelsk and Severodvinsk) including 85 males and 88 females with average age of 19.5. Meaningfulness of differences in studied indices is calculated using Fisher’s exact test. Results. The decline in quality of life and lifestyle indices (dissatisfaction with living conditions, food quality, summer holidays) in 1998-2005 is shown in comparison to 1979-1984 period; in 2014-2015 they significantly increased. Nevertheless, no more than half of the respondents (45%-34%-53%) characterize their diet as adequate and regular. Increase in adherence to healthy lifestyle in modern students is noted: relatively large amount of them regularly takes exercises (10%-13%-39%), toughens up (8%-4%-9%), swim a lot in natural bodies of water (20%-15%-23%), never consume alcohol (12% -13% -35% of males 30%-5%-30% of females). However the proportion of smoking students has increased compared to the first stage of research (57%-70%-65% of males and 6%-75%-53% of females), and the proportion of those toughening themselves up regularly doesn’t exceed 9%. An increase in the number of students with no chronic diseases is shown. More students have complaints about precardialgia while complaints about gastrointestinal dysfunction and headaches became less frequent. Majority of the students are satisfied with their lives. Almost half of the respondents noted good mood as a predominant one.

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Comparing Two Views Of Video Demonstration For Access Cavity Preparation: A QuasiRandomized Controlled Trial

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v16i2.1063 ◽

2017 ◽

Vol 16 (2) ◽

Author(s):

Amy Liew Kia Cheen ◽

Hazem Dabbour ◽

Dalia Abdullah

Keyword(s):

Controlled Trial ◽

Dental Students ◽

Fisher Exact Test ◽

Test Results ◽

Cavity Preparation ◽

Exact Test ◽

Baseline Group ◽

And Performance ◽

Video Demonstration

Introduction: Demonstration of the access cavity preparation procedures to dental students is challenging due to the limited operating field and detailed nature of the procedures. It is especially difficult to visualize how instruments are functioning inside the pulp space. The aim of this study was to develop and compare two different views of video demonstration in teaching access cavity preparation. Materials and Methods: Two videos of access cavity preparation were filmed, showing occlusal view of a whole tooth (WT) and sagittal view of a sectioned tooth (ST). Using quasirandomization, third year dental students (n=57) were divided into two groups to watch either one of the videos. The perception and performance of both groups were compared using Mann-Whitney U test and Fisher exact test. Results: At baseline, group WT (n=29) and group ST (n=28) were not significantly different in terms of operative scores (p=0.330). After watching the videos, the basic understanding of the theories were similar between both groups. However, ST responded more positively towards the helpfulness of the video in visualizing the inner anatomy of the tooth and in implementing the procedures (p<0.05). ST also completed the exercise within a shorter time (p<0.001). Nevertheless, the quality of the prepared access cavities was not significantly different between groups. Conclusion(s): Using sagittal view of sectioned tooth in video demonstration of access cavity preparation can improve students learning and performance speed. We highly recommend showing the sagittal view of sectioned tooth in video demonstration of access cavity preparation.

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Inner Prepuce Preserving ‘Bird-Winged Coronal-Collar Skin ReArrangement’ Modification of Tip Urethroplasty

10.47363/jdcrs/2020(1)105 ◽

2020 ◽

pp. 1-4

Author(s):

Prabudh Goel ◽

◽

Jile Dar Rawat ◽

Piyush Kumar ◽

◽

...

Keyword(s):

Ventral Surface ◽

Control Group ◽

Test Results ◽

Penile Shaft ◽

Modified Technique ◽

Exact Test ◽

Tubularized Incised Plate ◽

Fischer Exact Test

Objective: To describe the ‘Bird-Winged Coronal-Collar Skin re-arrangement modification’ of the Tubularized Incised Plate (TIP) urethroplasty to preserve the inner preputial skin on the ventral surface of the penile shaft. Material and Method: Study Group: Prospective review of the results of a single surgeon with Bird-Winged Coronal-Collar skin re-arrangement modification of TIP urethroplasty (n=111; mean age 4.9 years) of distal (n=76) and mid-penile (n-35) hypospadias (mean follow-up 37 months). Control Group: Retrospective review of a single surgeon’s results of distal and mid-penile hypospadias repair with standard TIP urethroplasty (2007-11). Outcome parameters (to compare non-inferiority of the modified technique): Urethro-cutaneous fistula (UCF) at voiding trial and follow-up at 3 months, wound infection, complete dehiscence, local edema, meatal stenosis and quality of urinary stream. Statistical analysis was done with the Fischer Exact Test. Results: With this technique, the authors could provide an inner preputial cover on the ventral/ ventro-lateral aspects of distal penile shaft in all but one patient (complete dehiscence). The results of ‘bird-winged coronal-collar skin re-arrangement’ modification were not-inferior/ comparable to those of standard TIP urethroplasty. Conclusions: The modification is technically feasible and reproducible and the overall results of urethroplasty were not inferior to the standard TIPS procedure.

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Self-Efficacy dan Kualitas Hidup Pasien Diabetes Melitus Tipe 2

Jurnal Penelitian Kesehatan SUARA FORIKES (Journal of Health Research Forikes Voice) ◽

10.33846/sf11208 ◽

2019 ◽

Vol 11 (2) ◽

pp. 146

Author(s):

Nur Wahyuni Munir ◽

Nur Faidah Munir ◽

Syahrul Syahrul

Keyword(s):

Quality Of Life ◽

General Hospital ◽

Self Efficacy ◽

P Value ◽

Test Results ◽

Cross Sectional ◽

Exact Test ◽

Diabetes Melitus

Introduction: Self-efficacy in the self-management of DM patients, consisting of diet, physical activity, glycemic control, medication, and foot care. The purpose of this study was to determine the relationship of self-efficacy with the quality of life of patients with type 2 diabetes mellitus in the Internal Polyclinic Room of the Makassar City Regional General Hospital. Methods: This research used analytic survey with cross sectional design. The study was conducted in the Internal Polyclinic Room of the Makassar City General Hospital in 40 DM patients with accidental sampling technique. The research instruments on the variable self-efficacy used a questionnaire consisting of 15 questions and the variable of quality of life used the WHOQOL-BREF questionnaire consisting of 26 questions. Data analysis used Fisher's Exact Test. Results: A total of 6 respondents had good self-efficacy and 66.7% had a good quality of life. As for the 34 respondents with poor self-efficacy, there were 88.2% who had poor quality of life. The test results showed that there was a significant relationship between self-efficacy and the quality of life of patients with type 2 DM in the internal polyclinic of Makassar City Regional General Hospital (p-value = 0.01). Conclusion: The better the respondent's self-efficacy, the better the quality of life, and vice versa. Nurses can begin the nursing process by assessing the patient's level of self-efficacy, then proceed with providing education related to DM self-management as an intervention that can be integrated into nursing services. Keywords: self-efficacy; quality of life; diabetes mellitus ABSTRAK Pendahuluan: Self-efficacy pada manajemen diri pasien DM, terdiri dari diet, aktifitas fisik, kontrol glikemik, pengobatan, dan perawatan kaki. Tujuan penelitian ini untuk mengetahui hubungan self-efficacy dengan kualitas hidup pasien diabetes melitus tipe 2 di Ruang Poliklinik Interna Rumah Sakit Umum Daerah Kota Makassar. Metode: Jenis penelitian ini adalah survei analitik dengan desain cross sectional. Penelitian dilakukan di Ruang Poliklinik Interna Rumah Sakit Umum Daerah Kota Makassar pada 40 pasien DM dengan teknik accidental sampling. Instrumen pengumpulan data pada variabel self-efficacy menggunakan kuesioner yang terdiri dari 15 pertanyaan dan variabel kualitas hidup menggunakan kuesioner WHOQOL-BREF yang terdiri dari 26 pertanyaan. Analisis data menggunakan Fisher Exact Test. Hasil: Sebanyak 6 responden memiliki self-efficacy yang baik dan 66,7% memiliki kualitas hidup yang baik. Adapun dari 34 responden dengan self-efficacy yang buruk, terdapat 88,2% yang memiliki kualitas hidup kurang. Hasil uji menunjukkan ada hubungan yang signifikan antara self-efficacy dengan kualitas hidup pasien DM tipe 2 di ruangan poliklinik interna Rumah Sakit Umum Daerah Kota Makassar (p-value = 0,01). Kesimpulan: Semakin baik self-efficacy responden, maka kualitas hidupnya juga semakin baik, demikian pula sebaliknya. Perawat dapat memulai proses keperawatan dengan mengkaji tingkat self-efficacy pasien, kemudian dilanjutkan dengan memberikan edukasi terkait manajemen diri DM sebagai sebuah intervensi yang dapat diintegrasikan ke dalam pelayanan keperawatan. Kata kunci: self-efficacy; kualitas hidup; diabetes melitus

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Analysis of Publicly Available German Mobile Apps for Psoriasis Patients using the Mobile Application Rating Scale (MARS). (Preprint)

10.2196/preprints.34017 ◽

2021 ◽

Author(s):

Christian Lull ◽

Jan Alwin von Ahnen ◽

Georg Groß ◽

Victor Olsavszky ◽

Johannes Knitza ◽

...

Keyword(s):

Mobile Application ◽

Rating Scale ◽

Mobile Apps ◽

Management Strategies ◽

Skin Lesions ◽

Main Function ◽

Health Apps ◽

Erythematous Plaques ◽

Google Play

BACKGROUND Psoriasis is a chronic inflammatory skin disease. The visibility of the erythematous plaques on the skin as well as the pain and itch caused by the skin lesions frequently leads to psychological distress in patients. Smartphone apps are widespread, easily accessible and could effectively complement current management strategies of psoriasis patients. OBJECTIVE To systematically identify and objectively assess the quality of currently publicly available German apps for psoriasis patients and compile brief, ready-to-use app descriptions. METHODS We conducted a systematic search and assessment of German apps for psoriasis patients available in the Google Play and Apple App Store. The identified apps were randomly assigned to and independently rated using the Mobile Application Rating Scale (MARS) by three reviewers. Apps were ranked accordingly to their mean MARS rating and the highest ranked app was evaluated independently by two psoriasis patients using the User Version of the Mobile Application Rating Scale (uMARS). App information, including origin, main function and technical aspects and was congregated. RESULTS In total, we were able to identify 95 different apps for psoriasis, of which 15 were available in both app stores, 5 were not specifically intended for psoriasis patients and 1 was designed for clinical trials only. Consequently, the remaining nine apps were included in the final evaluation. Mean MARS score varied between 3.51 and 4.18. The app with the highest mean MARS score was “Psoriasis Helferin” (4.18/5) . When rated by patients, the app was rated lower in all MARS subcategories, resulting in a mean uMARS score of 3.48. CONCLUSIONS App quality was heterogenous and only a minority of identified apps was available in both app stores. The discrepant patient results highlight the importance of involving patients when developing and evaluating health apps. CLINICALTRIAL Deutsches Register klinische Studien (DRKS): DRKS00020963

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An Audit of UK Hospital Doctors’ Knowledge and Experience of Myalgic Encephalomyelitis

Medicina ◽

10.3390/medicina57090885 ◽

2021 ◽

Vol 57 (9) ◽

pp. 885

Author(s):

Keng Ngee Hng ◽

Keith Geraghty ◽

Derek F. H. Pheby

Keyword(s):

Medical Education ◽

Clinical Manifestations ◽

Clinical Expertise ◽

Test Results ◽

Further Training ◽

Exact Test ◽

Training Event ◽

Hospital Doctors ◽

The Impact

Background and Objectives: There is some evidence that knowledge and understanding of ME among doctors is limited. Consequently, an audit study was carried out on a group of hospital doctors attending a training event to establish how much they knew about ME and their attitudes towards it. Materials and Methods: Participants at the training event were asked to complete a questionnaire, enquiring about prior knowledge and experience of ME and their approaches to diagnosis and treatment. A total of 44 completed questionnaires were returned. Responses were tabulated, proportions selecting available options determined, 95% confidence limits calculated, and the significance of associations determined by Fisher’s exact test. Results: Few respondents had any formal teaching on ME, though most had some experience of it. Few knew how to diagnose it and most lacked confidence in managing it. None of the respondents who had had teaching or prior experience of ME considered it a purely physical illness. Overall, 91% of participants believed ME was at least in part psychological. Most participants responded correctly to a series of propositions about the general epidemiology and chronicity of ME. There was little knowledge of definitions of ME, diagnosis, or of clinical manifestations. Understanding about appropriate management was very deficient. Similarly, there was little appreciation of the impact of the disease on daily living or quality of life. Where some doctors expressed confidence diagnosing or managing ME, this was misplaced as they were incorrect on the nature of ME, its diagnostic criteria and its treatment. Conclusion: This audit demonstrates that most doctors lack training and clinical expertise in ME. Nevertheless, participants recognised a need for further training and indicated a wish to participate in this. It is strongly recommended that factually correct and up-to-date medical education on ME be made a priority at undergraduate and postgraduate levels. It is also recommended that this audit be repeated following a period of medical education.

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Risk Management Assessments of Anti-tuberculosis Adverse Drug Reaction: A Systematic Review

E3S Web of Conferences ◽

10.1051/e3sconf/202131901042 ◽

2021 ◽

Vol 319 ◽

pp. 01042

Author(s):

Boubacar Traore ◽

Gladys Tsoumbou Bakana ◽

Samira Nani ◽

Samira Hassoune

Keyword(s):

Systematic Review ◽

Risk Management ◽

Adverse Events ◽

Psychological Intervention ◽

Management Strategies ◽

Low Frequency ◽

Treatment Quality ◽

Drug Discontinuation ◽

Risk Minimization

To improve adherence to treatment, quality of life of patients on anti-tuberculosis drugs, and prevent antibiotic resistance, we conducted this systematic review to support risk minimization actions. Methods: Medline, Scopus, and Web of Science were searched with a focus on adverse drug reactions. Two independent reviewers assessed the methodological quality of the included studies using criteria defined by the Newcastle Ottawa Scale. Results: Seven studies were included, and four risk management strategies were identified (psychological intervention, drug dose reduction with or without prescription of adjunctive drugs, drug switching, permanent or temporary drug discontinuation). The strategies adopted were dependent on the nature and severity of the adverse events. All drugs responsible for serious adverse effects were changed or discontinued. Conclusions: The results highlight the relatively low frequency of adverse events leading to permanent discontinuation of 1st-line anti-tuberculosis drugs, but also emphasize the high incidence of adverse events leading to permanent discontinuation of cycloserine.

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Implementasi Voip Server Berbasis IPV6 Dengan Raspberry PI

Manutech : Jurnal Teknologi Manufaktur ◽

10.33504/manutech.v9i01.32 ◽

2019 ◽

Vol 9 (01) ◽

pp. 47-54

Author(s):

Rabbai San Arif ◽

Yuli Fitrisia ◽

Agus Urip Ari Wibowo

Keyword(s):

Internet Protocol ◽

Wireless Transmission ◽

Raspberry Pi ◽

Test Results ◽

Average Delay ◽

Ipv6 Network ◽

Ip Network ◽

Selection Of ◽

Better Than

Voice over Internet Protocol (VoIP) is a telecommunications technology that is able to pass the communication service in Internet Protocol networks so as to allow communicating between users in an IP network. However VoIP technology still has weakness in the Quality of Service (QoS). VOPI weaknesses is affected by the selection of the physical servers used. In this research, VoIP is configured on Linux operating system with Asterisk as VoIP application server and integrated on a Raspberry Pi by using wired and wireless network as the transmission medium. Because of depletion of IPv4 capacity that can be used on the network, it needs to be applied to VoIP system using the IPv6 network protocol with supports devices. The test results by using a wired transmission medium that has obtained are the average delay is 117.851 ms, jitter is 5.796 ms, packet loss is 0.38%, throughput is 962.861 kbps, 8.33% of CPU usage and 59.33% of memory usage. The analysis shows that the wired transmission media is better than the wireless transmission media and wireless-wired.

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Use of SAMe-TT₂R₂ Score to Predict the Quality of Anticoagulation Control in Patients with Atrial Fibrillation Receiving Warfarin in Thailand

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2020.06.10827 ◽

2020 ◽

Vol 103 (6) ◽

pp. 548-552

Keyword(s):

Atrial Fibrillation ◽

Therapeutic Range ◽

Statistical Significance ◽

Discrimination Performance ◽

Poor Quality ◽

Chi Square ◽

Exact Test ◽

Time In Therapeutic Range ◽

Anticoagulation Control

Objective: To predict the quality of anticoagulation control in patients with atrial fibrillation (AF) receiving warfarin in Thailand. Materials and Methods: The present study retrospectively recruited Thai AF patients receiving warfarin for three months or longer between June 2012 and December 2017 in Central Chest Institute of Thailand. The patients were classified into those with SAMe-TT₂R₂ of 2 or less, and 3 or more. The Chi-square test or Fisher’s exact test was used to compare the proportion of the patients with poor time in therapeutic range (TTR) between the two groups of SAMe-TT₂R₂ score. The discrimination performance of SAMe-TT₂R₂ score was demonstrated with c-statistics. Results: Ninety AF patients were enrolled. An average age was 69.89±10.04 years. Most patients were persistent AF. An average CHA₂DS₂-VASc, SAMe-TT₂R₂, and HAS-BLED score were 3.68±1.51, 3.26±0.88, and 1.98±0.85, respectively. The present study showed the increased proportion of AF patients with poor TTR with higher SAMe-TT₂R₂ score. The AF patients with SAMe-TT₂R₂ score of 3 or more had a larger proportion of patients with poor TTR than those with SAMe-TT₂R₂ score of 2 or less with statistical significance when TTR was below 70% (p=0.03) and 65% (p=0.04), respectively. The discrimination performance of SAMe-TT₂R₂ score was demonstrated with c-statistics of 0.60, 0.59, and 0.55 when TTR was below 70%, 65% and 60%, respectively. Conclusion: Thai AF patients receiving warfarin had a larger proportion of patients with poor TTR when the SAMe-TT₂R₂ score was higher. The score of 3 or more could predict poor quality of anticoagulation control in those patients. Keywords: Time in therapeutic range, Poor quality of anticoagulation control, Warfarin, SAMe-TT₂R₂, Labile INR

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Sinonasal effects of external dacryocystorhinostomy

The Journal of Laryngology & Otology ◽

10.1017/s002221512100181x ◽

2021 ◽

pp. 1-4

Author(s):

H Eyigor ◽

E A Cetinkaya ◽

D T Coban ◽

G Ozturk ◽

Ö Erdem

Keyword(s):

Mucociliary Clearance ◽

Nasal Symptom ◽

Ciliary Activity ◽

Test Results ◽

Saccharine Test ◽

Significant Difference ◽

Symptom Scores ◽

Endoscopic Score ◽

External Dacryocystorhinostomy

Abstract Objective External dacryocystorhinostomy is thought to cause mucociliary dysfunction by damaging the mucosa, in turn affecting ciliary activity and mucus quality. This study investigated the effect of external dacryocystorhinostomy on sinonasal function. Methods Patients scheduled for unilateral external dacryocystorhinostomy who underwent endoscopic nasal examination and paranasal sinus computed tomography were included in this study. A saccharine test was performed on the planned surgical side and the mucociliary clearance time was determined. The sinonasal quality of life was measured in all patients, pre-operatively and at six months post-operatively, using the Sino-Nasal Outcome Test-22. The Lund–Kennedy endoscopic score was also determined in all patients, both pre- and post-operatively. Results The study comprised 28 patients (22 females and 6 males). A statistically significant difference was found between the pre- and post-operative saccharine test results (p = 0.006), but not between the pre- and post-operative Sino-Nasal Outcome Test-22 scores (p > 0.05). Conclusion This study is one of only a few to investigate the effect of external dacryocystorhinostomy on sinonasal function. The results showed that external dacryocystorhinostomy impairs mucociliary clearance. The surgical procedure is well tolerated and does not significantly change nasal symptom scores.

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