Medical Student Perception of Plastic Surgery and the Impact of Mainstream Media

BACKGROUND

Plastic surgery as a discipline is poorly understood by many, including primary care physicians, nurses, medical students, and the public. These misconceptions affect the specialty in a number of ways, including referral patterns and recruitment of medical students into residency programs. The reason for these commonly held misconceptions has not yet been addressed in the plastic surgery literature. As such, we assessed medical students' knowledge and perceptions of plastic surgery as a discipline and explored factors influencing these opinions.

METHODS

To assess medical students' knowledge and perceptions of plastic surgery, we conducted an online survey. A total of 231 medical students responded. Interviews were then conducted with 2 focus groups, in which we explored the survey results and reasons behind these misconceptions.

RESULTS

As with previous studies, medical students showed a gap in knowledge with respect to plastic surgery. Although they were generally aware that plastic surgeons perform cosmetic procedures and treat burns, they were largely unaware that plastic surgeons perform hand and craniofacial surgeries. Focus groups revealed that television plays a large role in shaping their ideas of plastic surgery.

CONCLUSION

Medical students have a skewed perception of the discipline of plastic surgery, and this is largely influenced by television. Interventions aimed at educating medical students on the matter are recommended, including a greater presence in the preclerkship medical school curriculum.

Eosinophilic folliculitis: an important differential diagnosis after allogeneic bone-marrow transplant

Eosinophilic folliculitis (EF) is a descriptive histopathological term applied to a heterogeneous group of disorders. In EF, the characteristic histopathological features are eosinophilic spongiosis and pustulosis involving the infundibular region of the hair follicle. EF may be seen in association with bacterial and fungal infection, drug reactions and haematological disorders. However, in those conditions, the histopathological changes are rarely restricted to the infundibula but in most cases include a moderate to dense perifollicular or even diffuse dermal infiltrate of lymphocytes, or eosinophilic or neutrophilic granulocytes. We present two cases of EF after mini-allogeneic bone-marrow transplantation (BMT) in order to highlight this rare and perhaps under-recognized clinical association.

Cercarial dermatitis in the UK

'Swimmer's itch' or cercarial dermatitis (CD) results from an immunological reaction to free-swimming non-human schistosome parasites released from aquatic snails. Affected bathers develop a self-limiting, pruritic, macular or papular eruption shortly after leaving the water. The condition is well-recognized in continental Europe, Asia and America, but has not to date been recorded in the UK.

Development of an enzyme-linked immunosorbent assay for the detection of antibodies against malignant catarrhal fever viruses in cattle serum

Malignant catarrhal fever (MCF) is a sporadic but fatal lymphoproliferative viral disease of cattle, deer and other ruminants. The causative agents are highly-cell-associated herpesviruses of the subfamily gammaherpesvirinae. In this study, an ELISA (WC11-ELISA) was developed to detect antibody to malignant catarrhal fever virus (MCFV) in cattle serum and compared to the commercially produced competitive-inhibition ELISA (CI-ELISA). Crude lysate antigen from alcelaphine herpesvirus-1 strain WC11 was bound to 96-well microplates and used to capture antibodies to MCFV. Dilutions of test sera were added to wells containing bound MCF antigen and control wells containing uninfected cell lysates. A horseradish peroxidase-labelled rabbit-anti-bovine IgG conjugate detected antibodies to MCF, and the results were expressed as absorbance readings at 450 nm. Samples were selected blind from cattle sera which had been sent to the laboratory for diagnostic testing for MCFV antibodies and were tested in both the WC11-ELISA and the CI-ELISA. Good agreement between the WC11-ELISA and CI-ELISA test (k=0.86, n=95) results was found.

Wild carnivore acceptance of baits for delivery of liquid rabies vaccine

A series of experiments are described on the acceptance, by red foxes (Vulpes vulpes) and other species, of two types of vaccine-baits intended to deliver liquid rabies vaccine. The baits consisted of a cube of sponge coated in a mixture of tallow and wax, or a plastic blister-pack embedded in tallow. All baits contained tetracycline as a biological marking agent: examination of thin sections of carnivore canines under an ultraviolet microscope revealed a fluorescent line of tetracycline if an individual had eaten baits. Baits were dropped from fixed-wing aircraft flying about 100 m above ground at approximately 130 km/h. Flight lines followed the edges of woodlots midway between parallel roads. Baits were dropped at one/sec, resulting in one bait/36 m on the ground, or 17 to 25 baits per km2. Crows (Corvus brachyrhynchos) removed many baits, but did not appear to lower the percent of the fox population which took bait. Dropping baits only into corn and woodland to conceal baits, to reduce depredation by crows, reduced acceptance by foxes. Acceptance by foxes ranged between 37 and 68%. Meat added as an attractant did not raise acceptance. Presence, absence, color and perforations of plastic bags did not alter bait acceptance. Dispersal by juvenile foxes probably lowered the estimates of bait acceptance. It took 7 to 17 days for 80% (n = 330) of foxes to eat their first bait. The rapidity with which foxes picked up their first bait appeared more affected by unknown characteristics of years or study areas than by experimental variables. Skunks (Mephitis mephitis) and raccoons (Procyon lotor) also ate these baits, but acceptance was lower. Small mammals contacted baits, but rarely contacted the vaccine, which had the potential for vaccine-induced rabies in some species. Aerial distribution of baits was more cost-effective than ground distribution as practiced in Europe. This system has potential for field control of rabies, although higher acceptance will be desirable.