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Dana Turner

Remote Work and Benefits of Video Conference

By COVID-19 Resources One Comment
Remote work on phone

Source: ODAC Dermatology Conference’s Parent Company, SanovaWorks

NEW YORK, (Mar. 26, 2020) – Shelley Tanner, SanovaWorks CEO/President

In the wake of COVID 19, I wrote a article about the Top Immediate Needs of a Remote Employee

Regular communication through video conference calls was at the top of my list. I asked the team what their thoughts were and received a great response from Nick.

Nick Gillespie, Assistant Publisher

Use video conference tools, not the phone.

Sometimes staff can feel that it’s an imposition, but the quality of meetings for those participating via video is infinitely better than just via phone

I would say the most important tip is to embrace the video component of remote working.

People quickly become used to the video interface, to the point where it becomes no different from meeting face to face in the office.

Gaging facial expressions and body language is very important for effective communication.

I think if you are a manager in a company, you should make video attendance mandatory for all. 

Some links about the benefits of face to face meetings (even remote ones):

https://timemanagementninja.com/2012/10/5-reasons-why-meeting-face-to-face-is-best/

https://medium.com/@shannonkelly_80469/steve-jobs-on-the-importance-of-face-to-face-meetings-even-in-the-age-of-iphones-a5a4b83621a6

https://sebastiancorp.com/10-reasons-video-conferencing-is-better-than-a-conference-call/

COVID-19 News & Resource Center

By COVID-19 Resources One Comment
COVID-19 Dermatology resources and news

Source: Next Steps in Derm

Each week, Next Steps in Derm will be compiling the top news and updates surrounding COVID-19 to keep you up-to-date and informed.

HIPAA Compliance During COVID-19 Pandemic

Learn what information can be shared about individuals who have contracted COVID-19, those suspected of exposure to the 2019 Novel Coronavirus, and those with whom information can be shared.

For any questions you have related to the response to HIPAA compliance during coronavirus crisis call (800) 231-4096.

JDD CME library offers virtual learning during COVID-19

The JDD CME library is now updated to accommodate a growing demand for online CME resources. We expect this demand to grow in light of the cancellation of some medical meetings due to the global COVID-19 situation. Access the CME library here.

Medicare Telemedicine Health Care Provider Fact Sheet

Source: Centers for Medicare & Medicaid Services
The Centers for Medicare & Medicaid Services (CMS) has broadened access to Medicare telehealth services so that beneficiaries can receive a wider range of services from their doctors without having to travel to a healthcare facility.

 

The American Academy of Dermatology strongly recommends that patients should not stop biologic therapy without consulting their physicians. Read their interim recommendations here.

AAD Coronavirus Resources

Managing your practice through the COVID-19 outbreak

Legislation and regulation

Teledermatology

Managing your business

American Medical Association (AMA) COVID-19
Resource Center for Physicians

AMA Physician’s Guide to COVID-19

  • Prepare your practice
  • Address patient concerns
  • Answer your most pressing questions

COVID-19: Frequently asked questions

  • Patient-physician relationship questions
  • Clinical questions
  • Practice management questions
  • Ethical Questions

Read More….

The Two Most Important Aspects of Communication While Working Remotely

By COVID-19 Resources One Comment
Remote-Work-SanovaWorks

Source: ODAC Dermatology Conference’s Parent Company, SanovaWorks

NEW YORK, (Mar. 23, 2020) Signe Pihlstrand, Vice President, SanovaWorks

In the wake of COVID-19 and the need for social distancing, many companies are having their staff work from home, and a great portion of them don’t have a routine remote policy or have remote processes set up. SanovaWorks has been successfully 100% remote for over six years now, and we gave ourselves many months of preparing, the better part of a year, before launching our remote work culture. These companies unfortunately don’t have that luxury and need to keep their workforce productive and the wheels rolling with an abrupt start to their remote experience. When I think about the most important things a company can do to lay the right foundation for their remote procedures, the plan for how you will communicate regularly is the first thing that comes to mind.

Working remotely requires clear communication and clear expectations.

If your team isn’t used to working remotely, you can’t assume that everyone will be on the same page about how to connect. Setting up defined guidelines for when and how you will communicate is so important.

  1. When – This has the tendency to go both ways: It’s not productive to be bombarded with IMs and emails throughout the day, and radio silence can leave you wondering if anything is getting accomplished. Set up and communicate a clear plan for when you expect to hear from your staff, or colleagues – for instance, a 15-minute touch-base call every morning, emails returned within 24-hours, or maybe a daily end-of-day report from your staff.
  2. How – Pick the ways that your team will communicate and get everyone on the same tools. You don’t want to have to check numerous places for messages. Plus, decide what is communicated by each. Short, occasional messages are best for IMs, while longer messages can be via email – while longer yet should be done in a conversation by video chat.

These ideas may seem obvious, but if not set up to make sure everyone has the same idea about what communication looks like, it can really wreck productivity. If everyone is left to their own devices, you could be fielding phone calls, texts, IMs, video chats, and emails from whatever program someone has on their phone or laptop, at all times of the day, or not at all. Remote working requires its own set of procedures, just like you have at the office.

At SanovaWorks we train everyone on our designated tools and procedures and make it a priority to use video chats whenever possible for the best communication and team member connections!

Statement From Our President and CEO Regarding COVID-19

By COVID-19 Resources One Comment
Sanovaworks Logo

NEW YORK (Mar. 13, 2020) – A Note from Shelley Tanner, SanovaWorks CEO/President

First and foremost, in light of the rapidly evolving global COVID-19 situation, we hope that you and your family are safe and healthy. We send companywide thoughts and prayers to the individuals, families, and other groups who have been impacted by this situation, and hope that things will improve very soon.

While many things are uncertain surrounding this virus, as an organization, SanovaWorks believes in taking action early. We are dedicated to providing the best care and support we can to all our employees and business partners.

We have the extremely good fortune to be functioning already as a virtual company and because of this we hope to be able to provide support and resources to our entire network who might not have the experience we have. Please check our blog for our tips and recommendations for transitioning to and being successful in a remote work environment:https://sanovaworks.com/2020/03/11/top-immediate-needs-of-remote-employees/

In addition to this, in order to protect our teams and others, until further notice, we have issued a complete restriction on all business-related travel. While the CDC has not placed restrictions on domestic travel, they have recently posted travel warnings on their website: https://www.cdc.gov/coronavirus/2019-ncov/travelers/travel-in-the-us.html?mod=article_inline

The CDC also provide general recommendations that we should all be following to prevent the spread of this disease:https://www.cdc.gov/coronavirus/2019-ncov/about/prevention.html

We will be working diligently as teams to connect with many of you so that we can share some very interesting ways to accomplish our results in this new, virtual environment. We have many years of experience transitioning traditional programs to digital programs, and launching successful virtual programs. Because we are already positioned as a remote company that produces virtual programs, we hope that we are able to support your own initiatives and bridge the gap this global situation has caused.

And last but not least, with a shout out to Jim Collins who introduced me to the Stockdale Paradox in his book Good To Great, we all need to look squarely at the facts, but have confidence that together we will prevail, as we balance realism with optimism.

 

Together.

Shelley and the entire SanovaWorks Team

Long Term Use of Novel Therapeutic for Topical Treatment of Primary Axillary Hyperhidrosis in Pediatric Subjects

By Medical Dermatology, ODAC Sessions One Comment

Source: ODAC Dermatology, Aesthetic & Surgical Conference (ODAC) Discovery in Dermatology Poster Session

At the 17th Annual ODAC Dermatology, Aesthetic, and Surgical Conference (ODAC) held January 17-20 in Orlando, FL, Brandon Kirsch, MD, Janet DuBois, MD, Martin N. Zaiac, MD and Deepak Chadha, MS, MBA, RAC presented scientific research of long term data with a novel therapeutic for topical treatment of primary axillary hyperhidrosis in pediatric subjects.

Discovery in Dermatology
The use of retro-metabolically designed drugs in dermatology is novel and has the potential for providing significant therapeutic benefit to pediatric and adult patients.

Sofpironium bromide is an ester analogue of glycopyrrolate that inhibits muscarinic receptors in sweat glands. It was developed according to the principles of retro-metabolic drug design, in which the goal is to create an active compound that is metabolized in vivo to an inactive moiety in a single, predictable reaction. Retro-metabolically designed drugs are rapidly metabolized in the bloodstream, potentially allowing for optimal therapeutic effect at application sites with minimal systemic side effects.

Introduction
~2.1% of the US population aged <18 years has primary hyperhidrosis (HH); ~65% have axillary HH. Long-term safety/tolerability and efficacy of topical HH treatments have rarely been studied in pediatric patients. Sofpironium bromide is a retro-metabolically designed analog of glycopyrrolate (anticholinergic) in development for topical treatment of primary axillary HH. Absorbed drug is rapidly metabolized, potentially allowing optimal local therapeutic effect with minimal systemic effects..

Procedures
21 of 25 subjects (age 9-16 yrs) with primary axillary HH of ≥6 months duration, completing a previous 1-week safety and pharmacokinetic (PK) study (BBI-4000-CL-105), were enrolled. Objectives were to assess safety/tolerability and PK, and explore efficacy of sofpironium bromide gel, 15% applied to both axillae for 24 weeks.

Results
Mean age (SD) 13.3 (2.29) years. 16 subjects completed this 24-week study. 7 had treatment emergent adverse events (TEAEs); 4 with AEs related to study drug, including expected systemic anticholinergic AEs (blurred vision, dry mouth, dry eyes, mydriasis) and local events (pain, pruritus, rash, erythema). 2 subjects discontinued due to TEAEs, including dry eye, dry mouth, local pruritus, local rash. The majority (52.4%) of subjects did not have any local symptoms/signs, and none observed were severe in nature. PK did not show evidence of drug/major metabolite accumulation, with most subjects having concentrations not quantifiable. The validated patient-reported outcome, Hyperhidrosis Disease Severity Measure-Axillary (HDSM-Ax), showed mean (SD) change from baseline (from previous study) to Week 24 of this study of -1.91 (1.038). A -1.00 change shows clinically meaningful improvement.

Conclusion
In this 24-week study in pediatric subjects sofpironium bromide, 15% was safe/well tolerated. Majority of subjects had no TEAE, and there were no severe or serious AEs. There was no evidence of drug accumulation. There was indication of clinically meaningful improvement in axillary HH.

Top Immediate Needs of Remote Employees

By COVID-19 Resources One Comment
Remote-Work-SanovaWorks

Source: ODAC Dermatology Conference’s Parent Company, SanovaWorks

NEW YORK (Mar. 11, 2020) – A Note from Shelley Tanner, SanovaWorks CEO/President

SanovaWorks transitioned into a 100% virtual company at the end 2012 at the same time press was reporting market leaders like Yahoo and Best Buy stopped all remote work at their companies. To the outside world, it seemed like we were making a crazy decision, heading in the opposite direction from global brand in terms of office culture and environment. We were convinced of the many benefits, so without hesitation we transitioned from two floors of a small office building on Park Avenue South in Manhattan, to a completely remote workforce.

I realize that due to the Coronavirus outbreak many companies are forced to transition some or all of their teams into remote teams without a solid plan, and so I felt compelled to share some of my thoughts on this matter.

The main things remote employees need in the short term are:

  1. Access to information immediately
  2. Regular communication
  3. Clear visibility of priority and goals

For this reason, I am including some of my “must-haves”:

  • Use video conference tools, not the phone. It take more internet bandwidth, but it provides a more engaged experience of meetings. If you don’t know what I’m talking about watch this live enactment of a conference call by phone: https://www.youtube.com/watch?v=DYu_bGbZiiQ
  • Use online project management tools for collaboration and project tracking. We use Wrike.com but there are many other options like Asana or Basecamp.
  • Use online file storage for easy access to documents. We use Egnyte, but there are options like Dropbox and Google also.
  • Ask for feedback. Don’t be afraid to ask what people think. Communicate that this is new and you are figuring it out, but want to support your teams and accomplish results in this new environment. Your teams will give valuable insight into accomplishing results.
  • Commute time turns into connect time: With a remote culture – everything can feel like a meeting. Be prepared for a feeling of meeting fatigue and get out ahead of it making meetings meaningful with clear agendas and timekeeping, etc.

If anyone has specific questions please comment on the Linked In post or direct message me and if I can’t answer, I will ask one of my extremely competent virtual team.

Best to all during these challenging times,

Shelley

What’s New in Treatments for Hair Loss with Amy McMichael, MD

By Aesthetic Dermatology, Medical Dermatology, ODAC Sessions, Video Pearls One Comment

During the 2020 ODAC Dermatology, Aesthetic and Surgical Conference, Dr. Amy McMichael, Professor and Chair of Dermatology at the Wake Forest University School of Medicine, sat down with Next Steps in Derm to share important updates regarding treatments on the horizon for the most common forms of hair loss. Dr. McMichael will be presenting at Skin of Color Update 2020 with lectures including Hair & Scalp Disorders in SOC: Diagnostic Approaches and Hot Topics & Controversies in Photoprotection: Making sense of it all.

Read More…..

ODAC and JDD Help Identify Need for Disaster Preparation in Dermatology

By COVID-19 Resources One Comment
JDD ODAC Disaster preparedness Adam Friedman

Source: George Washington University, ODAC and JDD

A new study from the George Washington University found that many dermatologists are unprepared to respond to biological disasters and that the specialty would benefit from formal preparedness training.

WASHINGTON (Jan. 30, 2020) — The dermatology community is inadequately prepared for a biological disaster and would benefit from a formal preparedness training program, according to a study from the George Washington University (GW). The article is published in the Journal of Drugs in Dermatology.

Natural and man-made disasters can cause a range of dermatologic conditions due to environmental exposures, such as secondary infections following a flood, irritation from blistering agents used in chemical warfare, and acute and chronic effects of cutaneous radiation syndrome. A 2003 survey revealed that 88% of dermatologists felt unprepared to respond to a biological attack — this new survey shows that the need for training still exists.

“Recognizing and diagnosing the conditions that can arise following a disaster requires diagnostic acumen, knowledge on reporting, and short- and long-term management strategies,” said Adam Friedman, MD, interim chair of the Department of Dermatology at the GW School of Medicine and Health Sciences and senior author on the study.

This current survey from an interdisciplinary team of dermatology and emergency medicine researchers, led by Emily Murphy, a research fellow in the GW Department of Dermatology, examines whether the field of dermatology has advanced in its bioterrorism preparedness.

The survey, disseminated via the ODAC Dermatology, Aesthetic & Surgical conference listserv, found that only 28.9% of respondents received training in disaster preparedness and response. The respondents to the survey frequently commented that they felt dermatologists should be prepared for bioterrorism-related cutaneous diseases, such as anthrax or smallpox-related diseases, as well as infections resulting from natural disasters.

Similar to the 2003 survey, the authors found that few dermatologists received adequate bioterrorism preparedness training. Even among those who had reported training, many indicated they felt ill prepared to manage patients affected by disasters, especially biological attacks and nuclear or radiological events.

“While few respondents to the survey were trained in disaster preparedness, it is encouraging that 75% reported that it should be included in dermatology training,” Friedman said. “It is a necessary tool to advance the field.”

James Phillips, MD, section chief of disaster and operational medicine in the GW Department of Emergency Medicine, director of the GW Disaster Medicine Fellowship, and co-author on the study, agreed: “My fellows and I found great value in partnering with our dermatology colleagues for this project. It is my firm belief that, while disaster medicine and emergency management primarily fall within the scope of emergency medicine and trauma surgery, education, and training for other specialties is of great value and is virtually unexplored. In an increasingly complex disaster environment, we welcome such research collaborations with other GW specialists.”

###

The article, titled “A Survey of Dermatologists’ Preparedness for Natural and Man-made Disasters,” is published in the Journal of Drugs in Dermatology and can be found at jddonline.com/articles/dermatology/S1545961620P0016X/1.

New and Emerging Therapies for Advanced Non-Melanoma Skin Cancer

By Medical Dermatology, ODAC Sessions 5 Comments
Advanced non-melanoma skin cancer patient image

Source: Next Steps in Dermatology 

At the 17th Annual ODAC Dermatology, Aesthetic, and Surgical Conference (ODAC) held January 17-20 in Orlando, FL, Dr. Desiree Ratner led a discussion on new and emerging therapies for advanced non-melanoma skin cancer discussion.

Treatment Options
The session covered several treatments for patients including patidegib gel 2% and 4% applied once or twice daily in patients with basal cell carcinoma. Patidegib is a topical hedgehog inhibitor made by PellePharm and its mechanism of action is to block Smo signaling, thereby inhibiting the hedgehog pathway that contributes to the development of basal cell carcinomas. This treatment has several advantages in that it does not contribute to hair loss, taste loss, or muscle cramps. It has the potential to treat and mitigate facial basal cell carcinomas in basal cell nevus patients. It is being studied in randomized clinical trials enrolling patients with Gorlin’s syndrome (basal cell nevus syndrome) in the United States and in Europe.

Hedgehog pathway inhibitor resistance is unusual but may occur as “rebound” tumor growth after drug cessation or secondarily after long-term smoothened inhibitor therapy. Resistance to hedgehog pathway inhibitors is classified into primary and secondary resistance. Primary resistance has been postulated to bypass mechanisms of genes downstream of smoothened, such as the G497 W mutation. Secondary resistance in patients who showed an initial response has actually been thought to be due to de novo mutations located on regions in smoothened to which hedgehog pathway inhibitors bind or selective clonal expansion of minority clones in the pre-treated tumor. Further studies are definitely needed to elucidate what drives resistance to hedgehog pathway inhibitors and how basal cell carcinoma resistance may be overcome by other novel, emerging therapies.

Patient Cases
Dr. Ratner presented a number of interesting patient cases with advanced basal cell carcinomas sometimes so large that patients lose mobility and function of a body part or organ. In most cases, locally advanced BCCs respond well to oral hedgehog inhibitors, which can be used for long-term control or neoadjuvantly prior to surgery. In the case of one patient, an aggressive orbital BCC caused contraction of the tissues around his eye, such that he was not able to open it. Despite treatment with an oral hedgehog inhibitor, his tumor continued to grow, resulting in destruction of his orbit and locoregional metastasis.

Samples of his tumor and normal skin were sent to Stanford University, which performed whole exome sequencing. In the studies of these samples, it became evident that the tumor should have responded to vismodegib but had developed resistance due to another as yet unknown mechanism. Therapies designed to override resistance such as second-generation smoothened inhibitors are under development.

Read more. 

Deciding When to Perform Mohs: ODAC Q&A

By ODAC Sessions, Surgical Dermatology No Comments
Patel at ODAC Mohs

Source: The Dermatologist

The following is an excerpt from The Dermatologist as coverage from ODAC Dermatology, Aesthetic & Surgical 2020 where Sailesh Konda, MD, and Vishal Patel, MD, reviewed the guidelines and discussed considerations for when and when not to perform MMS.

Mohs micrographic surgery (MMS) is considered the gold standard of treatment for many skin cancers. However, this option is not always appropriate for every situation and every patient. Several factors should be considered when determining which option to use, including tumor size, patient age, and aesthetic outcomes, for treating skin cancer.

The Dermatologist: What are the guidelines for determining what tumors should and should not be treated with MMS?

Dr Konda: The appropriate use criteria (AUC) for MMS was developed in 2012 by an ad hoc task force.2 In general, MMS may be considered as a treatment option for tumors on the head, neck, hands, feet, pretibial surface, ankles, and genitalia; aggressive tumors of any location; tumors greater than 2 cm on trunk or extremities; recurrent tumors, and tumors arising in patients with a history of immunosuppression, radiation, or genetic syndromes.

An AUC score is assigned to tumors based on their characteristics. Tumors with scores of 7 to 9 are appropriate, 4 to 6 are uncertain (in extenuating circumstances, MMS may be considered), and 1 to 3 are inappropriate.

However, practitioners should remember that these are only guidelines! Even if a tumor meets criteria for MMS, the physician and patient should still discuss all available treatment options—both surgical and nonsurgical— and take into consideration associated cure rates; long-term clinical and aesthetic outcome; the patient’s age and comorbidities; and risks, benefits, and adverse effects before deciding on a treatment.

The Dermatologist: What tumors often deemed appropriate for MMS might not actually require MMS, and why?

Dr Konda: Superficial basal cell carcinoma and squamous cell carcinoma in situ are tumors that have been deemed appropriate for MMS. However, these tumors may also be treated with topical therapy (imiquimod and 5-fluorouracil), local destruction, fusiform or disc excision, photodynamic therapy, and lasers (CO2 +/- diode for follicular extension). These treatment modalities may provide cure rates lower than but approaching those of MMS, and may be preferred by physicians and patients in certain circumstances. When discussing treatment options, patients should be made aware of any therapies that may be used off-label or are not FDA-approved.

Additionally, lentigo maligna (melanoma in situ) and lentigo maligna melanoma may be treated with either MMS (frozen sections), staged excision with central debulk and complete margin assessment (permanent sections), or wide local excision (permanent sections).

Read more….