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There is limited information of the effect of the COVID-19 pandemic on the general population's perceptions towards teledermatology. This study aims to assess the pandemic's impact on people's willingness to use teledermatology as well as to investigate influencing factors. We recruited 544 participants through Amazon Mechanical Turk (MTurk) and surveyed them using REDCap. Participants' willingness to use teledermatology before, during, and after the COVID-19 pandemic was measured via a 5-point Likert scale. The survey also included questions regarding factors influencing participants' attitudes towards teledermatology and their sociodemographic characteristics. Of the 185 participants who reported unwillingness to use teledermatology prior to the COVID-19 pandemic, 79.2% and 66.5% became either neutral or willing to use teledermatology during and after the pandemic, respectively. Less than half of prior satisfactory telemedicine users reported willingness to use teledermatology before the pandemic; willingness to use teledermatology increased to 80.1% and 63.8% during and after the COVID-19 pandemic, respectively. The top reason for lack of interest in teledermatology was concern for security and privacy (24.4%). Although a useful tool, teledermatology has been met with reluctance by the public. However, the unique circumstances of the COVID-19 pandemic have improved the public's perceptions and readiness to use teledermatology.

While women living with HIV (WLWH) are twice as likely to report severe or undertreated chronic pain compared to men, little is known about pain among WLWH. Our goal was to characterize the correlates of pain as well as its impact on quality-of-life outcomes among women enrolled in the Sexual Health and HIV/AIDS Women's Longitudinal Needs Assessment (SHAWNA), an open longitudinal study of WLWH accessing care in Metro Vancouver, Canada. We conducted logistic regression analyses to identify associations between self-reported major or persistent pain with sociostructural and psychosocial correlates and with quality-of-life outcomes. Data are presented as adjusted odds ratios (aORs) with 95% confidence intervals. Among 335 participants, 77.3% reported pain at ≥ 1 study visit, with 46.3% experiencing any undiagnosed pain and 53.1% managing pain with criminalized drugs. In multivariable analysis, age (aOR 1.04[1.03–1.06] per year increase), food and housing insecurity (aOR 1.54[1.08–2.19]), depression diagnosis (aOR 1.34[1.03–1.75]), suicidality (aOR 1.71[1.21–2.42]), and non-daily, non-injection opioid use (aOR 1.53[1.07–2.17]) were associated with higher odds of pain. Daily non-injection opioid use (aOR 0.46[0.22–0.96]) and health services access (aOR 0.63[0.44–0.91]) were associated with lower odds of pain. In separate multivariable confounder models, pain was associated with reduced odds of good self-rated health (aOR 0.64[0.48–0.84] and increased odds of health interference with social activities (aOR 2.21[1.63–2.99]) and general function (aOR 3.24[2.54–4.13]). In conclusion, most WLWH in our study reported major or persistent pain. Pain was commonly undiagnosed and associated with lower quality of life. We identified structural and psychosocial factors associated with pain in WLWH, emphasizing the need for low-barrier, trauma-informed, and harm reduction-based interventions. [ABSTRACT FROM AUTHOR]

Local ablation of oligometastases has been shown to improve patient survival (1). Oligometastases are more frequent in viral-related head and neck squamous cell carcinomas (HNSCC) compared to non-viral HNSCC, with lung as the most common site (2). We reviewed patients with HPV-positive (+) HNSCCs who developed lung metastases, and report outcomes for all patients, focusing on those receiving definitive intent local ablation. We reviewed all HPV(+) HNSCCs patients who developed distant metastases (DM) to lung ± other organs after definitive radiotherapy or chemoradiotherapy at our institution from January 2003 to December 2021. DM in lung were further classified as oligometastases (≤5 lesions) vs polymetastases. Among those patients classified as oligometastases, we pragmatically sub-staged according to the American Joint Commission on Cancer 8th edition for primary non-small cell lung cancer (NSCLC) (3) (oligometastasis mimicking the behavior of NSCLC) to assess differences in outcome after local ablative therapy. Oligometastases in lung were confirmed by p16(+) staining to rule out lung primary when possible. Definitive intent local ablation (LA) was defined as either surgical resection or definitive-intent [EQD2 ≥40 Gy; alpha/beta=10 Gy] (chemo)radiation. Overall survival (OS) and progression free survival (PFS) after lung metastases were estimated by Kaplan Meier curves, with log rank test for outcome comparison. Of 1908 consecutive patients treated during the study period, 170 (9%) developed DM to lung and other sites. Lung was the only DM site in 79 patients (4%), of whom, 20 (1%) had oligometastases and underwent LA: 15 underwent surgery (1 lobectomy, 2 segmentectomies, 12 wedge resections), 1 surgery + radiation, 3 radiation alone and 1 chemoradiation. Median follow-up was 2.0 years (range 0-13.5). For OM patients receiving LA, OS at 3 and 5 years after detection of metastasis was 69% and 57%; PFS was 40% at 3 years and 34% at 5 years. When patients who developed isolated lung metastases were staged as per the TNM 8th edition for lung cancer, most patients were N0 (n=16) and early stage. Some patients with N+ disease (n=4) or very advanced T category disease (T4, n=1) were treated with definitive intent as well. OS of oligometastatic lung DM treated with local ablative treatment according to lung cancer N stage showed 75% at 3 years and 75% at 5 years for N+ disease, and 67% at 3 years and 50% at 5 years for N0 disease (p = 0.587). PFS of oligometastatic lung DM treated with ablative treatment according to lung cancer N stage was not statistically different with 25% at 3 years and 25% at 5 years for N+ disease, and 44% at 3 years and 36% at 5 years for N0 disease (p = 0.678). For comparison, across all 170 patients with DM to lung and other sites, OS at 3 and 5 years after detection was 22% and 16%. For the 150 patients who did not receive LA, these rates were 15% and 10% respectively. For the 79 with lung-only DM who did not receive LA, these rates were 21% and 16% respectively. These were statistically different compared to OS at 3 and 5 years for OM patients receiving LA (p < 0.001). [Display omitted] Patients with oligometastatic HPV(+) HNSCC to lung treated with local ablation with definitive intent have significantly longer OS compared to those with polymetastatic disease who had palliative treatment or best supportive care treatment. Isolated lung lesions, large lung lesions, and lung lesions with nodal involvement treated with definitive intent all showed substantially longer OS compared with patients who did not receive ablative therapy. Isolated pulmonary DM in patients with HPV(+) HNSCC should be considered for local ablation with definitive intent. [ABSTRACT FROM AUTHOR]