Week 3 - Juan Boza: Busy Is Just a Flavor!

Busy is just a Flavor!

What a week, wouldn't you agree? Between the steep learning curve, the patient interactions, and research, time management was key. For me, week 3 came with a different flavor, a busy one. The reason for this is that before, I was learning about the dynamics of the clinical setting, the details of my project, and adapting to my new routine - just trying not to f*** up! Now, I am no longer in observer mode but in helper mode. I talk to patients, ask questions, and even provide preliminary diagnoses. Like I said, busy flavor!

     Fig 1. The classical case of melanonychia. 
     Brown/black band on the nail extending
     from the nail matrix to the distal end.

Like last week, the learning curve was kind of steep. There are so many nail conditions and so little time! So, for this week's nail condition edition - let's focus on melanonychia. This condition is characterized by a brown/black band from the nail matrix to the distal end of the nail plate (Fig. 1). The differential diagnosis for this condition is essential as it can be confused with hematomas, fungus or bacterial pigments, melanocytic activation, and malignant melanomas. Hence, depending on the band's appearance, the dermatologist may consider performing a biopsy (which I already explained is a traumatic experience). To analyze the appearance of the band, dermatologists use the ABCDEF criteria - A for age, B for band width > 3 mm, C for change over time, D for digits (which finger/s), E for extension (Hutchinson sign), and F for family/personal history. Note that a dermatoscope is needed to perform accurate quantification of these traits. Some important aspects of this criteria are that individuals with bands on multiple fingers are less likely to have melanoma and bands that have been stable for several years (no change).

Research this week was steady. I have been reviewing different artificial intelligence. There are different models of convolutional neural networks that could be implemented. Most likely, I will use preprocessing techniques along with ResNet 150 for the diagnosis. Then, I will concatenate the probabilities with metadata. The main goals of the proposed AI are to distinguish between hematoma and melanonychia and provide confidence on whether the condition is malignant or not. In addition, a comparison with other state-of-the-art AIs will be performed (a ubiquitous aspect of all AI publications). 

Well, I hope your week was as good as mine. See ya' next time!


Comments

Post a Comment

Popular posts from this blog

Week 1

For my first week of immersion I attended the OR's of a few different physicians as my clinical mentor Dr. Jason Spector of plastic surgery and reconstruction was on vacation this week. I was able to see three different hernia repairs, and one double mastectomy and bilateral DIEP flap.  I think my favorite thing I saw was the double mastectomy and bilateral DIEP flap. From what I understand, this is a procedure in which both breasts were removed and fat from the stomach is used to reconstruct the breasts. The novelty of the DIEP flap is that it does not require the removal of muscle which allows patients to recover quicker. Additionally, blood vessels from the fat in the stomach are left in tact and "hooked up" to corresponding vessels in the breast. All in all, the procedure essentially amounted to a breast reconstruction and tummy tuck. It was a 10 hour surgery that required multiple doctors and departments, as this was not just a purely cosmetic procedure- the patient ...
Read more

Week 1 - Samantha Bratcher

Image
Hi, everyone! My name is Samantha Bratcher. My clinical immersion is with Dr. Adam Talenfeld and Dr. Kyungmouk Steve Lee in the Interventional Radiology (IR) department. Although it's not very related to my field at the university (biomechanics/mechanobiology), the clinical experience has still been very interesting. The IR department is super friendly and all the clinicians have been very available to letting me shadow them. It's only been one week, but I've already learned a lot! Every day has been watching something new, from angioplasty to biopsy to embolization. I find it so crazy that they're able to thread a wire through someone's veins to practically any area of the body. It's always a bit crazy to watch. I got a video of a balloon angioplasty using this method. The balloon is inflated inside a person's veins to expand them and increase blood flow. The second video shows the veins and their quality. The rate at which the contrast dye flows through is...
Read more

Week One - Shenghao Tan

I am working with Dr. Mirella Salvatore from the infectious disease division. My research project will revolve around associations of COVID 19 patient clinical characteristics with their hostresponses throughout their hospitalization and recovery.   On the patient care side I have been following Dr. Ole Vielemeyer in ID consultation. A large part of the round is to discuss the choice of antibiotics, itsdosage and duration from lab results and examination reports. Some of the cases this week have been quite complicated and chronic; therefore, joint effort were required to provide adequate treatments. One patient had to battle both Crohn's disease and histoplasmosis, where the immunosuppressant and antibiotics used must be carefully considered to treat the histoplasma and maintain some immune system function, while not severing the GI tract. A part of medical care I learned that I haven't considered much of is the inpatient - outpatient transition: how is the treatments adjusted ...
Read more