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PubMed2004

[DRGs in dermatology: results of the DRG evaluation project of the German Society of Dermatology (DDG)].

SUMMARY BACKGROUND: The implementation of a DRG system in Germany--voluntarily since January 1st, 2003, and obligatory after January 1 st, 2004--has led to uncertainty, particularly in the hospitals. There are fears that current well-accepted German diagnostic and therapeutic services may not be properly financed by the new system. In response, the German Dermatologic Society (DDG) in cooperation with the DRG Research Group of the University Hospital Muenster and the German Medical Association carried out a DRG evaluation project in order to investigate the medical and economic homogeneity of the case groups. PATIENTS AND METHODS: 19,403 dermatological cases from 19 hospitals--ten university hospitals and nine non-university hospitals-were collected over a period of four months and then evaluated with regard to their performance, length of stay and cost homogeneity. RESULTS: The data provided the background needed to indicate suspected potential deficiencies for mapping dermatology cases within the German DRG system. Based on the data 10 modifications were formulated and submitted to the InEK by the deadline of March 31st, 2003. CONCLUSIONS: The results of the DRG Evaluation Project show that the G-DRG-Variant Version 1.0 does not offer the necessary possibilities of differentiation to map the broad spectrum of various dermatology services in Germany.

Cost-Benefit Analysis↗
PubMed2006

How Clarence S. Livingood and his Manual of Dermatology influenced dermatologic therapy.

Clarence S. Livingood and his mentors, Pillsbury and Sulzberger, wrote the Manual of Dermatology, a book that was the dermatologic handbook of choice for thousands of medical officers in World War II. By virtue of its wide distribution among a variety of physicians practicing in the medical boom of the 40s, 50s, and 60s, this book (and its formulary) was one of the most influential dermatologic texts of the 20th century. Livingood would repeat the strategies employed in writing this book over and over in his long career advancing dermatology among American medical specialties.

Dermatology↗
PubMed2000

[Implicit personality theories in dermatology. An empirical study on the image that physicians have of patients of diverse dermatologic diagnosis groups].

BACKGROUND AND OBJECTIVE: Studies about the personality of dermatological patients are numerous. The results are inconsistent and peculiarities of the personality are rarely confirmed. Contrary to the usual procedure, this study asks for the impressions physicians have about their patients. PATIENTS/METHODS: To elicit associations dependent on a dermatological diagnosis, 27 physicians filled in a three-dimensional differential asking for their impressions about patients with atopic dermatitis, leg ulcer, malignant melanoma, or psoriasis vulgaris in order to quantify these impressions. RESULTS: The dimension valence (good-bad) did not differ between the groups. The dimensions of excitation (active-passive) and potency (strong-weak) showed the biggest differences between patients with atopic dermatitis and ulcus cruris. The latter get significantly lower values on both dimensions. The correlations between the impression and the duration of employment in dermatology were low. CONCLUSIONS: In our opinion it is necessary to raise the impression of medical personal about their patients because these impressions affect the interaction of the personal with the patient.

Dermatitis, Atopic↗
PubMed1992

Photographic utilization in dermatology clinics in the United States: a survey of university-based dermatology residency programs.

BACKGROUND: Photography has recently been introduced as an adjunct to the clinical management of patients with the dysplastic nevus syndrome (DNS). OBJECTIVE: Our purpose was to evaluate the methods used and the extent of clinical photography in dermatology residency programs in the United States. METHODS: Nonmilitary accredited dermatology residency programs in the United States were surveyed (73% response rate) regarding utilization and technical aspects of clinical photography. RESULTS: Forty-one percent of respondents used photography for the clinical management of 90% or more of patients with DNS. Twenty-four percent of respondents used photography for the clinical management of all patients with DNS. Eighty-one percent of respondents used slides, and 62% utilized total body photographs. The median number of photographs taken for a patient with DNS was 20. CONCLUSION: Dermatologic photography has been widely adopted for the clinical management of patients with DNS. Failure of the health insurance industry to recognize the value of this procedure may result in its underutilization.

Dermatology↗
PubMed2006

Teaching medical students dermatology research skills: six years of experience with the University of Texas Medical Branch dermatology non-degree research honors program, 2001-2006.

Since 2001, the Department of Dermatology at The University of Texas Medical Branch in Galveston has participated in a campus wide non-degree honors research program developed to enhance the research skills of non-dual degree (MD/PhD) medical students. From 2001 through 2006, thirteen students completed the dermatology research program, and earned research honors at graduation. Seven student manuscripts have been published or are in press at peer-review journals and ten of twelve program participants who have applied for dermatology residency positions have been successful at the time of writing.

Animal Experimentation↗
PubMed1989

[Dermatology in Prague and the 1st Congress of the German Dermatology Society 1889].

Around 1900, dermatology as practised in Prague formed a link between Austria and Germany. The Congress of the German Dermatological Society held in 1889 in Prague was the first highlight of this connection. The topics and contents of the papers are characterized. The development of the dermatological clinics in Prague is described and their directors and research emphases are listed.

Czechoslovakia↗
PubMed2002

[Prevalence of psychosomatic disorders in dermatologic patients. Experiences in 2 dermatology clinics with a liaison therapy model].

INTRODUCTION: The prevalences and differences of biopsychosocial disorders were investigated in the dermatologic clinics of Erfurt and Giessen, where a liaison-therapy model has been established. Different dermatological diseases were compared by a variety of psychological tests, and patients with the same diagnosis were compared between the two clinics. PATIENTS AND METHODS: We examined 406 patients for psychosomatic problems with diagnostic interviews and psychometric tests. The coping of skin disease questionnaire (CSD) and the Symptom Checklist (SCL-90R) served as diagnostic measures. Between 1995-2000, 71 patients were seen in Erfurt and 335 in Giessen. The distribution of skin diseases and the psychosomatic disorders are shown by ICD-10 diagnoses. RESULTS: The comparison of an East and a West German city showed no significant differences in the whole group or the parallel groups using the CSD and SCL-90R. There was only a tendency to a greater reduction of quality of life in Erfurt. Patients with glossodynia evaluated themselves in all psychometric tests as very "normal". By contrast, patients suffering from alopecia and acne felt very helpless and seemed to have a need of greater psychosocial care. CONCLUSIONS: The biopsychosocial characteristics of the patients treated in the dermato-psychosomatic units in Erfurt and Giessen show no significant differences. Patients with diseases such as alopecia and acne are underestimated in regard to the need for additional psychosocial care. The liaison therapy model is an effective approach to diagnose psychosomatic-dermatological disorders and decide if further psychosomatic treatment is indicated.

Adolescent↗
PubMed1991

Dermatology residency training in 1932 versus dermatology residency training in 1990.

Dermatologic training programs and patient care in 1932 are compared with patient care, research, and residency training programs in 1990. The changes are due to development of newer diagnostic procedures and therapeutic agents, emergence of dermatopharmacology programs, research conducted by and supported by the pharmaceutical industry, and support of cutaneous research by the government. The excellence of teaching and patient care in 1932 was due to the "giants" who created interest in dermatology and by their dedication and ingenuity managed recalcitrant dermatoses without presently available drugs, chemotherapeutic agents, diagnostic techniques, basic information, and advances in cutaneous surgery.

Dermatology↗
PubMed2000

Dermatology practice management enhancement: implications for dermatology in the age of managed care.

Health care delivery in the United States has changed dramatically during the past 10 years. Dermatologists are faced with challenging changes in the way they learn new skills, practice, and provide dermatologic care. Dermatologists can survive and flourish in this environment if they learn proper management and enhancement skills. These skills include proper coding and documentation, regulatory compliance, and new levels of practice effectiveness and efficiency. Dermatologists can offer also the benefit of cosmetic procedures and ethical office-based dispensing to their patients. Greater future unification of this specialty will allow dermatology to flourish and show its need, efficiency, and cost-effectiveness.

Cosmetics↗
PubMed2002

A discrete speech recognition system for dermatology: 8 years of daily experience in a medical dermatology office.

A discrete speech recognition system was customized to recognize approximately 9,000 phrases and terms commonly used in dermatology, and has been used on a daily basis since 1984 to produce as many as 65 consult and follow up letters daily. The systems and procedures necessary for the practical use of this system are described, together with a discussion of the advantages and disadvantages of using this system to automate the transcription of dermatological dictation.

Artificial Intelligence↗
PubMed2000

Interactive medicine: resources in dermatology and dermatologic surgery.

The Internet has proved to be a useful resource in various fields of medicine. Within the field of Dermatology, Internet sites appeal to specialists in dermatology, non-specialist physicians, medical students, and the lay public. In the past 2 years, United States physicians' regular Internet use has increased 300%, according to an ongoing study conducted by the Santa Clara-based Healtheon Corporation. The phenomenon of increased Internet usage is explainable. Patients have access to the Internet and often consult net sources before they see their physician; therefore, it is very important that physicians are likewise "connected" to enhance patient communication. Careful study of approximately 300 Internet sites has yielded a reader-friendly presentation of only the sites that should be most useful to practitioners, medical students, and the lay public. The objective is to promote public health through doctor-patient communication and through the use of valuable interactive medical resources.

Dermatology↗
PubMed2002

[Notoriety of the French dermatology: analysis through dermatological publications].

INTRODUCTION: The aim of this study was to evaluate the publications of French dermatologists in medical journals. METHODS: All papers published in 1998 and indexed in PubMed were searched under the names of all dermatologists listed in a French registry of hospital dermatologists and analyzed. A sample of 8 departments of dermatology in University hospitals was selected at random and the publications from these departments were compared to those from the departments of rheumatology in the same hospitals. In addition the publications of French, German and Italian dermatologists were compared for the years 1989, 1994 and 1999. RESULTS AND CONCLUSION: In 1998, 452 papers were published by French dermatologists. This was more than for rheumatologists in the selected sample (133 vs 82). The impact factor was rather low (1.8 +/- 3), in part because many papers (43 p. 100) were written in French. In addition original studies and research papers accounted for only 20 p. 100 of all papers. The numbers of papers devoted to clinical research had increased in the last 10 years and compared favorably with German and Italian dermatology. In contrast, the number of research papers had decreased in the last 10 years in strong contrast with the dramatic increase of research papers originating from Germany.

Dermatology↗
PubMed1994

Women in academic dermatology. Results of survey from the professors of dermatology.

BACKGROUND: A survey of the professors of dermatology addressed questions of recruitment and retainment of women in academic dermatology. One hundred thirteen questionnaires were distributed and tabulated anonymously. RESULTS: Most programs selected residents independent of gender. No gender-specific residency problems were identified other than clinical coverage and completion of training related to pregnancy and maternity leave. Less than 50% of departments have faculty development programs in place, though there was considerable support for faculty development programs and modification of tenure track. The number of women faculty was determined for all departmental faculty. Of the total faculty members, 28.1% were women. Of the paid faculty members, 30.7% were women compared with 24.8% of unpaid faculty members. For paid faculty, 10.7% of full professors were women, compared with 34.1% of associate professors and 38.1% of assistant professors. Only two department chairs were identified as women, though five additional women headed divisions. CONCLUSIONS: With regard to residency training, any problems appear to be reflections of anecdotal experience. With regard to faculty, this datum argues for barriers to advancement to positions with administrative responsibility. Strategies for increasing the number of women in senior positions will depend on recognition and encouragement of current women faculty and require a concerted effort to further professional growth and development, to reward academic success, to provide role models and mentors, and to recognize inherent conflicts of professional women.

Dermatology↗
PubMed1994

[Cell and tissue culture models in dermatology. The Frankfurt Center of Dermatology establishes models].

In the course of the Third Frankfurt Talks, for the first time a congress in dermatology was dedicated exclusively to cell and tissue culture models. The complexity of a whole organ, in this case the skin, could be reduced to single aspects without losing the holistic context. Ways of managing this were discussed on an interdisciplinary level by dermatologists, physiologists, pharmacologists and biologists. The results are also expected to be useful to the clinician. Focus points of in vitro investigations for dermatology are wound closure models and the use of in vitro skin for transplantation in the therapy of non-healing ulcers and vitiligo. As an alternative to animal experiments, cultures of human cells are gaining increasing influence in drug testing. The effect of glucocorticosteroids on normal skin fibroblasts, keratinocytes and permanent cell lines is discussed as an example, and in vitro models of diseases such as psoriasis are established. Additionally, basic events such as differentiation and ageing have been modelled in cell cultures of melanocytes and keratinocytes. Mechanical stress, UV radiation and nicotine are discussed as inductors.

Cell Differentiation↗
PubMed1977

Studies on cold insoluble globulin in dermatological patients. II. Its immunochemical quantitation in citrated plasma in a group of unselected dermatological inpatients.

Cold insoluble globulin (CIG) is the main non-clottable protein of heparin precipitable fraction from dermatological patients. CIG is a glycoprotein with a molecular weight of about 440 000. It is found on cell membranes on fibroblasts and is a normal protein of human plasma and serum. Levels of CIG in citrated plasma are sex- and age-dependent, but the origin and its physiological significance is unknown. In plasma of 294 dermatological patients, levels of CIG were elevated in eczema contactum allergicum (males and females 30-49 years), psoriatic arthritis (females 50 years and above) and were depressed in dermatitis herpetiformis (males 30-49 years).

Adult↗
PubMed1994

The first chairs and professors of dermatology, particularly of 'German' dermatology.

A short outline is given of the establishment of the first chairs in dermatology/venerology in Central Europe, starting with the award of the Fothergillian Gold Medal to Robert Willan in 1790 and ending past mid-century with the establishment of the professorial chairs in Munich in 1863 and of Military Dermatology at the Vienna Surgical Academy in 1870.

Awards and Prizes↗
PubMedDate not supplied

Changing paradigms in dermatology: confocal microscopy in clinical and surgical dermatology.

The current practice of pathology and dermatopathology depends upon the evaluation of tissue in some manner extirpated from the patient and then processed and stained. While high resolution of detail can be accomplished by this method, there are certain risks and disadvantages. Recent imaging techniques now allow for a potential of achieving noninvasive high-resolution analysis of lesions in situ in the patient. Of these, Reflectance mode confocal microscopy offers the highest resolution imaging comparable to routine histology. Being entirely non invasive, skin can be observed in its native, dynamic state. This chapter will review the fundamentals of in vivo confocal imaging and the clinical applications in general and surgical dermatology.

Dermatology↗