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Biomedical subjects

L Guenther

Publications and source records attributed to L Guenther.

13 recordsLinked to original sources

Impact of a sun awareness curriculum on medical students' knowledge, attitudes, and behaviour.

BACKGROUND: Physicians teach sun awareness to their patients, but frequently have no formal training in this area. A week-long dermatology curriculum during Sun Awareness Week that included skin cancer and sun awareness education to first-year medical students was introduced in May 1998 at the University of Western Ontario, London, Canada. OBJECTIVE: The purpose of this study was to determine the baseline knowledge, attitudes, and behaviour of the first-year medical students towards sun awareness before and after the new curriculum. METHOD: This study used a pre- and post-test design to determine the impact of the curriculum on the medical students' knowledge, attitudes, and intent to change behaviour. It also reports any influence of demographic variables on these parameters. RESULTS: The students demonstrated a substantial improvement in their knowledge of sun-related topics despite some baseline knowledge. Many students reported unhealthy behaviour prior to the curriculum, but demonstrated an intent to adopt more healthy behaviour after the curriculum. Minor differences in knowledge and behaviour due to demographic characteristics disappeared upon completion of the curriculum. CONCLUSIONS: An undergraduate medical curriculum with skin cancer and sun awareness education can improve the medical students' knowledge, attitudes, and behaviour towards sun awareness.

Adult

Sun and the skin: evaluation of a sun awareness program for elementary school students.

BACKGROUND: Research suggests that childhood exposure to ultraviolet radiation is a significant risk factor for the development of melanoma and nonmelanoma skin cancers. Sun awareness education programs for children can positively influence children's sun protective practices to decrease the risk of skin cancer. OBJECTIVE: The purpose of this study was to evaluate a sun awareness education program, entitled "Sun and the Skin" that had recently been developed and implemented in London, Ontario. METHOD: The study uses a pre- and posttest design to evaluate both knowledge and behaviour of Grade 4 students participating in the program at baseline, immediately after, and 1 month after the program. RESULTS: The students demonstrated a significant increase in their sun-protective practices after participation in the "Sun and the Skin" program. There was a significant improvement in the students' level of knowledge after the program. Improvement in both behaviour and knowledge were maintained weeks after completion of the program. Minor differences in knowledge due to demographic characteristics were detected after the program. CONCLUSIONS: A sun awareness education program for Grade 4 students can improve both their knowledge and behaviour over time. This format should be used in conjunction with changes in school policy in order to make a significant longterm impact.

Child

The role of Apligraf in the treatment of venous leg ulcers.

A cultured, allogeneic, bi-layered human skin equivalent has recently become available to help clinicians manage difficult-to-heal venous ulcers. This skin equivalent has an epidermis and dermis similar to human skin. Its living keratinocytes and fibroblasts are from cultured cell banks derived from human neonatal foreskin. Because the skin equivalent is made up of viable human cells, it cannot be terminally sterilized. Safety concerns, which have been addressed, include the risk of possible transmission of infection, immunogenicity, immunological graft rejection, and tumor formation. However, the maternal blood of the neonatal donor and the master cell banks are screened for infectious agents. Additionally, the human skin equivalent is produced under strict aseptic control, with sterility continuously monitored by the Good Manufacturing Processes. This paper reviews the characteristics of this human skin equivalent and provides practice guidelines.

Algorithms

Skin drugs in pregnancy--which ones to use.

The safety of dermatologic drugs in pregnancy has not been established; however, many are probably safe. Drugs used in pregnancy must be absolutely indicated. Women who are pregnant or contemplating pregnancy should be clearly informed of the risks and benefits of medications they are prescribed.

Contraindications

Melkersson-Rosenthal syndrome and Crohn's disease: one disease or two? Report of a case and discussion of the literature.

In 1985, a 19-year-old woman had clinical features suggesting anorectal Crohn's disease. Two years later, swelling of the vulva associated with perianal swelling developed. The clinical manifestations responded to oral prednisone until 1989, when she returned with a swelling of the upper lip, a polypoid lesion of the oral buccal mucosa, and swelling of the anus and vulva. The lip biopsy demonstrated granulomas. The illness failed to respond to systemic immunosuppressive therapy, wider consultation was made, and the diagnosis of the Melkersson-Rosenthal syndrome was made. Such an appearance of this rare condition is unusual. We describe her case and discuss the literature, raising the possibility that the Melkersson-Rosenthal syndrome and Crohn's disease are the same condition with different initial clinical appearances.

Adult

Metastatic Crohn's disease. Case report and review of the literature.

Metastatic Crohn's disease is an unusual granulomatous inflammation of the skin that is noncontiguous to the gastrointestinal tract. Our review of the English-language literature shows that 23 cases of metastatic Crohn's disease have been published since its description in 1964. The skin lesions can be in the form of erythematous nodules, plaques, or ulcers, and the lower extremities are involved in half of the cases. We describe a 24-year-old woman with metastatic Crohn's disease. Ultrastructural examination revealed changes that were compatible with episodic endothelial cell injuries. Results of both direct and indirect immunofluorescence studies were negative. The possible role of T lymphocytes and macrophages in mediating this vascular damage is considered.

Adult

A controlled comparison of amcinonide cream 0.1 percent and halcinonide cream 0.1 percent in the treatment of eczematous dermatitis.

A 2-week, double-blind clinical trial was conducted to compare the efficacy and cosmetic acceptability of amcinonide cream 0.1 percent and halcinonide cream 0.1 percent in the treatment of 29 patients with eczematous dermatitis. The dermatologic status of each patient was rated by improvement in clinical signs and symptoms, by the investigator's overall evaluation, and by two patient evaluations. Both medications produced statistically significant and equivalent improvement by Week 2. However, amcinonide was significantly favored in the efficacy evaluation of relief from burning pain at Week 2 and in patient acceptability evaluations in regard to the absence of burning, stinging, and itching on application. The role of propylene glycol in the formulation of the halcinonide cream as a contributing cause of irritation is noted.

Adolescent