Gordon Bae, MD

Abstract

Chagas disease, a multisystem infection caused by the protozoan Trypanosoma cruzi, is primarily found in Latin America. In recent years, prevalence has increased in the United States, where reactivation is the most common clinical scenario. Here, we describe cutaneous reactivation of T. cruzi in a patient with limited cutaneous systemic sclerosis on immunosuppression therapy who simultaneously presented with cytomegalovirus reactivation. Histopathology showed parasitized histiocytes in the superficial and deep dermis. Occasional epidermal keratinocytes were also parasitized, and rare organisms were also seen in the walls of blood vessels. Also noted were viral cytopathic changes within the vascular endothelium, and immunostaining confirmed cytomegalovirus. In this report, we describe the difference in cutaneous findings between reactivated and acute Chagas disease, and we also review the histopathologic features that help distinguish T.cruzi from other intracellular organisms.

View details for DOI 10.1097/DAD.0000000000001842

View details for PubMedID 33201010

View details for DOI 10.1016/j.jdcr.2020.05.032

View details for PubMedID 33134460

View details for DOI 10.1097/DER.0000000000000188

View details for PubMedID 27172318

View details for DOI 10.1016/j.amjmed.2019.07.027

View details for PubMedID 31779785

Abstract

Pachydermodactyly is a rare, benign condition characterized by swelling and thickening of the periarticular skin, most commonly at the proximal interphalangeal joints. Diagnosis is routinely made through correlation of clinical, histopathologic, and radiographic findings. Here we report a case of pachydermodactyly in a 25 year-old male, with emphasis on the clinical and histopathologic differential diagnosis and potential diagnostic pitfalls. This article is protected by copyright. All rights reserved.

View details for PubMedID 30221379

Abstract

Over the years, a number of studies have demonstrated an increase in gender and ethnic diversity among US physicians. Despite substantial progress in eliminating gender and racial inequities in the field of medicine, women and ethnic minorities are still underrepresented among medical faculty at academic institutions. This study aims to describe the trends in gender and ethnic diversity among Physical Medicine and Rehabilitation (PM&R) faculty through statistical analysis of data describing gender and ethnicity of full-time academic faculty gathered from the Association of American Medical Colleges Faculty Roster from 1994 to 2014. Proportions representing the percentages of females and ethnic minorities of a given faculty position in medical schools were compared across each of the other faculty ranks. Results showed that the average yearly percent increases in the proportion of female PM&R faculty in associate professor (0.68%) and full professor (0.54%) positions were greater than those in instructor (0.30%) and assistant professor (0.35%) positions. In contrast, the average yearly percent increase in the proportion of non-Caucasian PM&R faculty in full professor positions (0.19%) was less than those in instructor (0.84%), assistant (0.93%), and associate professor (0.89%) positions. Overall, trends among faculty exhibit a steady increase in gender and ethnic diversity, although promotion disparity continues to exist among specific academic positions for some groups. This study provides a current perspective on recent changes in diversity among faculty in PM&R and may prove useful when defining strategies to improve workforce diversity.

View details for DOI 10.1097/PHM.0000000000000716

View details for Web of Science ID 000405783800011

View details for PubMedID 28169861

Abstract

To evaluate whether the lack of diversity in plastic and orthopedic surgery persists into hand surgery through assessment of trainee demographics.Demographic data were obtained from compilations on graduate medical education by the Journal of the American Medical Association. Ethnic diversity was assessed using the proportions of minority trainees. We analyzed the trends in ethnic diversity in hand, orthopedic, and plastic surgery from 1995 to 2012 by evaluating changes in proportions of African American, Hispanic, and Asian trainees. In addition, we compared the proportions of minority trainees in various surgical specialties during 2009 to 2012. Trends in gender diversity were similarly analyzed using the proportions of female trainees.During 1995 to 2012, the proportions of minority and female trainees increased significantly in the fields of orthopedic, plastic, and hand surgery. To assess the current state of diversity in various specialties, we compared minority and female population proportions using pooled 2009 to 2012 data. The percentage of non-Caucasian trainees in hand surgery was significantly higher than that in orthopedic sports medicine and orthopedic surgery and significantly lower than in general surgery. The percentage of female trainees in hand surgery was significantly higher than that in orthopedic sports medicine and orthopedic surgery and significantly lower than in plastic and general surgery.Ethnic and gender diversity in hand surgery increased significantly between 1995 and 2012. Women constitute a fifth of hand surgery trainees. Efforts to increase diversity should be further pursued using proven strategies and innovating new ones.Diversity in the medical field has shown to be a beneficial factor in many aspects including research productivity and patient care. Understanding how the field of hand surgery has changed with regard to the diversity of its trainees may aid in providing more equitable and effective health care.

View details for DOI 10.1016/j.jhsa.2014.10.065

View details for Web of Science ID 000352521000024

View details for PubMedID 25639841

Abstract

Bibliometric analyses of the hand and wrist research have previously shown a significant increase in research productivity in Asia. We examined the key contributors to this change by performing bibliometric analyses regarding hand and wrist research in all Asian countries producing significant research. Original research articles from 1988 to 2007 were collected from seven English language journals based on the impact factor. Trends in research productivity were determined by country using linear regression analysis. Compared to the rest of the world, Asia produced fewer level I and basic studies, but more level IV studies. Significant increase in both research volume and productivity in Asia was observed, with Japan, Korea, and Taiwan having the highest aggregate productivity in hand and wrist research. From 1988 to 2007, the relative research production among Asian countries showed significant change, in contrary to that of Europe, Latin American, and the United States.

View details for DOI 10.1142/S0218810414500221

View details for Web of Science ID 000216855400010

View details for PubMedID 24875505

Abstract

Retrospective cohort comparison.Using acetic acid iontophoresis (AAI) as a treatment modality significantly improved the functionality of hand in patients with recalcitrant scarring.Open trigger finger release patients followed up exclusively at a hand clinic between 2009 and 2011 were analyzed. Group I recovered optimal total active range of motion (TAM) after 14 standard of care (SOC) therapy sessions but Group II (10 digits) could only reach optimal recovery after 7 additional AAI sessions.After SOC therapy, Group I's TAM recovery plateaued at 245 and Group II's at 219 (p < 0.01). After undergoing AAI, the TAM of Group II increased from 219 to 239 (p < 0.01).Clinical studies suggest that AAI can modify collagen structure in scars. AAI could be a novel non-surgical treatment for restoring functionality to areas affected by difficult, recalcitrant scars.AAI significantly improved the TAM of hand surgical patients who could not recover optimally with SOC therapy alone.Level 3.

View details for DOI 10.1016/j.jht.2013.10.008

View details for PubMedID 24373451