14 results on '"Steele KT"'
Search Results
2. Severe cutaneous ulcerations secondary to xylazine (tranq): A case series.
- Author
-
Wei J, Wachuku C, Berk-Krauss J, Steele KT, Rosenbach M, and Messenger E
- Abstract
Competing Interests: None disclosed.
- Published
- 2023
- Full Text
- View/download PDF
3. Two Cases of Insulin-Derived Amyloidosis With Acanthosis Nigricans-Like Changes.
- Author
-
Godse R, Rauck C, Woods R, Steele KT, and Elenitsas R
- Subjects
- Humans, Insulin, Acanthosis Nigricans pathology, Keloid pathology, Amyloidosis chemically induced, Amyloidosis diagnosis, Amyloidosis pathology, Amyloidosis, Familial
- Abstract
Abstract: Insulin-derived amyloidosis (AIns) is a rare iatrogenic subtype of cutaneous amyloidosis occurring at frequent insulin injection sites. Here, we describe 2 cases of AIns accompanied by acanthosis nigricans (AN)-like changes, a rare finding which has been reported fewer than 5 times in the literature. We also report the first case of an AIns nodule being misdiagnosed as a keloid. Both of our patients presented with asymptomatic, hyperkeratotic, pigmented plaques at frequent insulin injection sites, and histopathologic examination showed (1) nodular aggregates of amyloid demonstrating apple-green birefringence with Congo red staining and (2) AN-like features, such as epidermal papillomatosis, hyperkeratosis, and hyperpigmentation. Accurate diagnosis of AIns is crucial, because repeated insulin injection into a nodule can impair glycemic control. However, misdiagnosis is common, as observed with our second patient, whose AIns nodule was misdiagnosed by an outside provider as a keloid, perhaps because of the presence of AN-like features. Our case report adds to the limited but growing body of literature on AIns and significantly increases the number of reported cases of AIns with AN-like features, an even rarer phenomenon., Competing Interests: The authors declare no conflicts of interest. Dr. Rosalie Elenitsas has no conflicts of interest relevant to this manuscript. However, for full disclosure: she has received royalties from Wolters Kluwer as a textbook editor., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2022
- Full Text
- View/download PDF
4. Draining dorsal hand pustules, nodules, and ulcers in a patient with immunosuppression.
- Author
-
Stephens MR, Aderibigbe O, Steele KT, Elder DE, Glaser L, Jacob J, and Rosenbach M
- Published
- 2019
- Full Text
- View/download PDF
5. Painful Pseudoclubbing of a Single Nail Unit.
- Author
-
Gatica-Torres M, Steele KT, Chang B, Zhang PJ, and Rubin AI
- Published
- 2018
- Full Text
- View/download PDF
6. Expediting patient appointments with dermatology rapid access clinics.
- Author
-
Jayakumar KL, Samimi SS, Vittorio CC, Micheletti RG, Steele KT, Ogunleye TA, Richardson V, Chiesa ZC, and Rosenbach M
- Subjects
- Academic Medical Centers, Humans, Outpatient Clinics, Hospital, Patient Satisfaction, Pennsylvania, Retrospective Studies, Ambulatory Care Facilities, Appointments and Schedules, Dermatology, Health Services Accessibility
- Abstract
Background: Lengthy wait times for dermatology appointments in the U.S. limit care access. The University of Pennsylvania's Department of Dermatology has established an urgent care clinic (UCC) and an intermediate care clinic (ICC) to expedite appointments for higher acuity patients., Objective: To describe our rapid access clinics' operations, referral patterns, and distributions of diagnoses., Methods: We performed a retrospective review of dermatology consult order and appointment data for UCC, ICC, and routine care to determine the number of orders, consult appointments, and follow-up appointments; appointment wait times; and frequencies of diagnoses in referring provider and consult appointments. Press Ganey patient satisfaction ratings were also analyzed., Results: The median (interquartile range) wait times for UCC, ICC, and routine care, appointments were 3 (1-8) days, 36 (15-64) days, and 45 (12-97) days, respectively (P<0.001). The proportion of referrals originating from subspecialists varied among UCC (47.6%), ICC (20.2%) and routine care (15.8%), (P<0.001). Distributions of diagnoses differed among UCC, ICC, and routine care. Ratings for most satisfaction metrics were similar across clinic settings., Conclusions: Dermatology rapid access clinics within an academic medical center can reduce wait times for higher acuity patients while maintaining patient satisfaction.
- Published
- 2018
7. Eyebrow and Eyelash Loss.
- Author
-
Lipoff JB, Steele KT, and Jariwala N
- Subjects
- Adult, Costa Rica, Emigrants and Immigrants, Eyebrows, Eyelashes, Humans, Male, Alopecia etiology, Leprosy, Lepromatous complications, Leprosy, Lepromatous diagnosis
- Published
- 2017
- Full Text
- View/download PDF
8. Ocular surface squamous neoplasia among HIV-infected patients in Botswana.
- Author
-
Steele KT, Steenhoff AP, Bisson GP, and Nkomazana O
- Subjects
- Adult, Aged, Botswana epidemiology, Carcinoma, Squamous Cell etiology, Eye Neoplasms etiology, Female, Follow-Up Studies, HIV Infections epidemiology, Humans, Incidence, Male, Middle Aged, Prognosis, Retrospective Studies, Young Adult, Carcinoma, Squamous Cell epidemiology, Eye Neoplasms epidemiology, HIV Infections complications
- Abstract
Background: Ocular surface squamous neoplasia (OSSN) is a group of ocular tumours that has been rising in incidence among HIV-infected individuals in sub-Saharan Africa. Surgical excision is the mainstay of treatment for OSSN in this region., Methods: This retrospective cohort study examined the clinical characteristics and treatment modalities used for 468 patients with OSSN from a large tertiary referral center in Gaborone, Botswana, over a 10-year period from 1998 to 2008., Results: The estimated annual incidence of OSSN in Botswana reached a peak of 7.0 cases per 100 000 persons per year in 2004. The mean age of the patients in the study was 38 years (interquartile range 30 - 44), and 53.9% were women. Of the patients, 48.5% were known to be HIV-infected, 1.5% were HIV-uninfected, and 50.0% had unknown HIV status. Among HIV-infected patients with CD4 counts, the median CD4 count was 192 cells/µL. As initial OSSN treatment, 20.7% of patients received simple surgical excision, 70.9% received surgical excision with adjunctive beta radiation, 0.9% received evisceration, 1.3% received enucleation, and 6.2% underwent surgical removal of unknown type. The overall rate of known recurrence was 7.1%; however, among those with at least 6 months of follow-up, the recurrence rate was 24.2%. Rates of known recurrence after simple surgical excision and surgical excision with adjunctive beta-radiation were 10.3% and 5.4%, respectively., Conclusion: This study confirms the high incidence of OSSN among young individuals in Botswana. Further investigation is warranted to determine the most effective treatment modalities to prevent recurrence of OSSN among patients in sub-Saharan Africa.
- Published
- 2015
- Full Text
- View/download PDF
9. Robotic teledermatopathology from an African dermatology clinic.
- Author
-
Micheletti RG, Steele KT, and Kovarik CL
- Subjects
- Botswana, Connective Tissue Diseases diagnosis, Dermatitis diagnosis, Humans, Lichenoid Eruptions diagnosis, Retrospective Studies, Skin Diseases, Infectious diagnosis, Skin Neoplasms diagnosis, Dermatology methods, Remote Consultation, Robotics, Skin Diseases diagnosis, Telepathology methods
- Published
- 2014
- Full Text
- View/download PDF
10. Diffuse dermal angiomatosis associated with calciphylaxis in a patient with end-stage renal disease.
- Author
-
Steele KT, Sullivan BJ, Wanat KA, Rosenbach M, and Elenitsas R
- Subjects
- Aged, Humans, Male, Angiomatosis etiology, Angiomatosis pathology, Calciphylaxis etiology, Calciphylaxis pathology, Kidney Failure, Chronic complications, Kidney Failure, Chronic pathology, Skin pathology, Skin Diseases etiology, Skin Diseases pathology
- Abstract
Diffuse dermal angiomatosis (DDA) represents a benign, acquired, reactive proliferation of vessels. DDA is clinically characterized by painful livedoid plaques with central ulceration, and the histopathologic hallmark is diffuse endothelial cell hyperplasia in the dermis. DDA has been rarely reported in association with calciphylaxis, a condition characterized by calcification of arterial walls with accompanying thrombosis and cutaneous necrosis. We present a case of a 72-year-old man with end-stage renal disease on peritoneal dialysis who presented with painful lesions on his legs, and was found to have DDA in the setting of calciphylaxis. The possible pathogenesis linking DDA and calciphylaxis is discussed., (© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
- Published
- 2013
- Full Text
- View/download PDF
11. Early mortality and AIDS progression despite high initial antiretroviral therapy adherence and virologic suppression in Botswana.
- Author
-
Steele KT, Steenhoff AP, Newcomb CW, Rantleru T, Nthobatsang R, Lesetedi G, Bellamy SL, Nachega JB, Gross R, and Bisson GP
- Subjects
- Acquired Immunodeficiency Syndrome physiopathology, Acquired Immunodeficiency Syndrome virology, Adult, Aged, Botswana, Disease Progression, Female, Humans, Male, Middle Aged, Prospective Studies, Acquired Immunodeficiency Syndrome drug therapy, Acquired Immunodeficiency Syndrome mortality, Anti-HIV Agents therapeutic use, Patient Compliance, Viral Load
- Abstract
Background: Adverse outcomes occurring early after antiretroviral therapy (ART) initiation are common in sub-Saharan Africa, despite reports of high levels of ART adherence in this setting. We sought to determine the relationship between very early ART adherence and early adverse outcomes in HIV-infected adults in Botswana., Methods: This prospective cohort study of 402 ART-naïve, HIV-infected adults initiating ART at a public HIV clinic in Gaborone, Botswana evaluated the relationship between suboptimal early ART adherence and HIV treatment outcomes in the initial months after ART initiation. Early adherence during the interval between initial ART dispensation and first ART refill was calculated using pill counts. In the primary analysis patients not returning to refill and those with adherence <0.95 were considered to have suboptimal early adherence. The primary outcome was death or loss to follow-up during the first 6 months of ART; a secondary composite outcome included the primary outcome plus incident opportunistic illness (OIs) and virologic failure. We also calculated the percent of early adverse outcomes theoretically attributable to suboptimal early adherence using the population attributable risk percent (PAR%)., Results: Suboptimal early adherence was independently associated with loss to follow-up and death (adjusted OR 2.3, 95% CI 1.1-4.8) and with the secondary composite outcome including incident OIs and virologic failure (adjusted OR 2.6, 95% CI 1.4-4.7). However, of those with early adverse outcomes, less than one-third had suboptimal adherence and approximately two-thirds achieved virologic suppression. The PAR% relating suboptimal early adherence and primary and secondary outcomes were 14.7% and 17.7%, respectively., Conclusions: Suboptimal early adherence was associated with poor outcomes, but most early adverse outcomes occurred in patients with optimal early adherence. Clinical care and research efforts should focus on understanding early adverse outcomes that occur despite optimal adherence.
- Published
- 2011
- Full Text
- View/download PDF
12. In-hospital mortality of HIV-infected cryptococcal meningitis patients with C. gattii and C. neoformans infection in Gaborone, Botswana.
- Author
-
Steele KT, Thakur R, Nthobatsang R, Steenhoff AP, and Bisson GP
- Subjects
- AIDS-Related Opportunistic Infections microbiology, Adult, Botswana epidemiology, Female, Hospital Mortality, Humans, Male, Meningitis, Cryptococcal microbiology, Middle Aged, Prevalence, Treatment Outcome, AIDS-Related Opportunistic Infections epidemiology, AIDS-Related Opportunistic Infections mortality, Cryptococcus gattii isolation & purification, Cryptococcus neoformans isolation & purification, Meningitis, Cryptococcal epidemiology, Meningitis, Cryptococcal mortality
- Abstract
The clinical presentations and outcomes of cryptococcal meningitis (CM) may be associated with the cryptococcal species causing the infections. To evaluate clinical differences between CM caused by C. neoformans and Cryptococcus gattii, we examined outcomes in HIV-infected adults with CM admitted to Princess Marina Hospital in Gaborone, Botswana. Among HIV-infected adults with CM, we found that 29 of 96 (30%) patients were infected with C. gattii, but species type was not associated with in-hospital mortality [mortality for C. gattii: 5 of 29 (17%) vs C. neoformans: 13 of 67 (19%); OR = 0.87 (95% CI 0.28 to 2.70)]. The proportion of C. gattii infection among this HIV-infected cohort in Botswana is the highest reported to date, but we found no difference between C. gattii and C. neoformans in clinical presentation or in-hospital mortality.
- Published
- 2010
- Full Text
- View/download PDF
13. Implicit depression and hopelessness in remitted depressed individuals.
- Author
-
Meites TM, Deveney CM, Steele KT, Holmes AJ, and Pizzagalli DA
- Subjects
- Adolescent, Adult, Female, Humans, Male, Middle Aged, Neuropsychological Tests, Personality Inventory, Predictive Value of Tests, Psychometrics, Surveys and Questionnaires, Affect physiology, Cognition Disorders psychology, Depressive Disorder psychology, Mental Recall physiology
- Abstract
Cognitive theories of depression posit that automatically activated cognitive schemas, including negative thoughts about the self and the future, predispose individuals to develop depressive disorders. However, prior research has largely examined these constructs using explicit tests in currently depressed individuals. Using the Implicit Association Test (IAT), the present study examined automatic associations between the self and mood state ("depression IAT") and between the future and mood state ("hopelessness IAT") before and after a negative mood induction in 19 remitted depressed individuals and 23 healthy controls. In the depression IAT, remitted depressed participants exhibited an overall lower tendency to associate themselves with happiness relative to the healthy controls before the mood induction. Control, but not remitted depressed, participants' automatic associations between the self and happiness diminished following the mood induction. Contrary to our hypotheses, no significant findings emerged when considering the hopelessness IAT. Consistent with prior studies, no significant correlations emerged between implicit and explicit biases, suggesting that these measures probe different processes. Results extend prior IAT research by documenting the presence of a reduced tendency to associate the self with happiness in a sample at increased risk for depression.
- Published
- 2008
- Full Text
- View/download PDF
14. Enhanced negative feedback responses in remitted depression.
- Author
-
Santesso DL, Steele KT, Bogdan R, Holmes AJ, Deveney CM, Meites TM, and Pizzagalli DA
- Subjects
- Adult, Analysis of Variance, Brain Mapping, Contingent Negative Variation physiology, Depression pathology, Electroencephalography, Female, Gyrus Cinguli physiopathology, Humans, Male, Neuropsychological Tests, Photic Stimulation, Probability Learning, Reaction Time, Time Factors, Conflict, Psychological, Depression physiopathology, Feedback physiology
- Abstract
Major depressive disorder (MDD) is characterized by hypersensitivity to negative feedback that might involve frontocingulate dysfunction. MDD patients exhibit enhanced electrophysiological responses to negative internal (errors) and external (feedback) cues. Whether this dysfunction extends to remitted depressed (RD) individuals with a history of MDD is currently unknown. To address this issue, we examined the feedback-related negativity in RD and control participants using a probabilistic punishment learning task. Despite equivalent behavioral performance, RD participants showed larger feedback-related negativities to negative feedback relative to controls; group differences remained after accounting for residual anxiety and depressive symptoms. The present findings suggest that abnormal responses to negative feedback extend to samples at increased risk for depressive episodes in the absence of current symptoms.
- Published
- 2008
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.