Severe methemoglobinemia due to topical dapsone misuse in a teenage girl

Dapsone gel is a topical treatment for facial acne in adolescents and adults, and while systemic dapsone therapy is known to be associated with methemoglobinemia, once-daily topical dapsone has been well tolerated with few side effects in large randomized controlled trials. We describe the first reported case of severe methemoglobinemia in a healthy adolescent using daily topical dapsone. Although the medication was prescribed for facial use only, the patient reported topical use over her back and chest as well. This case illustrates the potential for significant systemic dapsone absorption even with daily topical dosing and demonstrates the need for clear anticipatory guidance to prevent the potential morbidity and mortality associated with methemoglobinemia from improper topical dapsone use.     

Skills Lab aus chirurgischer Sicht

Introduction

For the acquisition of practical skills, the separate learning atmosphere of a skills lab(oratory) is very suitable. Numerous educational objectives of surgical teaching can be pursued using phantoms, manikins or mutual training among students prior to real practical use during clinical traineeships or internships.

Aim and method

This article provides a compact, systematic overview of the skills lab concept, based on published aspects in selected and relatively recent topic-related references from PubMed® including our own approaches, as well as comments and experiences with regard to its further development. In particular, the Magdeburg concept to use the local skills lab MAMBA for surgical teaching within the practical training is demonstrated, which has developed step by step from a basically pure bedside teaching and which includes student tutors in practical teaching in surgery.

Results

By founding the Magdeburg educational and training center options for a practical education, in particular, in surgery were created. The great majority of students accepted the conceptual idea and it has so far been well received. As a first step several well selected topics of practical training during human medical studies were increasingly taught by students who received a didactic course of instruction which also included aspects of the educational objectives. For the future tutorials led by students are planned going beyond the teaching contents of the practical courses and can, thus, lead to a networking with educational objectives of other disciplines. There are not only curricular but also facultative courses in MAMBA which have been steadily optimized since the beginning. This Magdeburg’s concept is planned to be further developed for which there is enough room for development with regard to organizational aspects (personnel and room).     

Ausbildung von Schülern zu Ersthelfern bei der Reanimation

Background

Bystander resuscitation rates in Germany are far lower than they could be. One of the potential reasons may be the fact that training in this field is initiated at a time point too late in the lifelong learning schedule.

Aims

The aim of this article is to give an overview of theory-driven considerations to support the implementation of resuscitation training programs in primary and secondary school learning. In addition, strategies are described which are already applied in this context in Germany.

Material and methods

A discussion on available relevant literature formed the basis for this article.

Results

Sequentially structured programs with an early start during the school career are recommended. They should only include essential evidence-based measures of resuscitation. In Germany at present only few, even if inspiring, initiatives are implemented and structures used are frequently not sustainable. Programs are heterogeneous and quality control is nearly impossible.

Conclusion

A national initiative is highly recommended to implement a nationwide compulsory resuscitation training program during school education. This initiative should be based on the broadest possible consensus of stakeholders.