"Strategic Medical"

The advent of pathotropic (disease-seeking) targeting technology has ushered cancer gene therapy across the threshold of history, marking the beginning of a new epoch of medical praxis. For the first time, clinical oncologists can reach beyond the finest of catheters, beyond the reach of the most gifted surgeons, to the very fabric of metastatic disease in an effort to halt the progression and turn the tide of otherwise intractable cancers. The enabling molecular biotechnologies embodied in the leading tumor-targeted agent, Rexin-G, and its timely development as a safe and effective anti-cancer drug - from oncogene discovery and target validation, to molecular engineering of the core nanotechnologies, to the first clinical proofs-of principle, confirmatory trials, expanded access programs, and accelerated regulatory approvals - have been extensively documented in the medical literature...

Epidemiological analyses of injury patterns and mechanisms help to identify the expertise military surgeons need in a combat setting and accordingly help to adjust infrastructure and training requirements. Therefore, a MEDLINE search (1949-2009), World Wide Web search (keywords "combat, casualties, war, military, wounded and neurosurgery") and an analysis of deaths among allied war casualties in Afghanistan and Iraq were performed. Up to 10th December 2009 there had been 4,688 allied military deaths in Iraq and 1,538 in Afghanistan...

Osteoarthritis (OA) of the hip joint is a common disorder, especially in aging peoples of Caucasian descent. Hip OA like OA in other joints is heterogeneous and may manifest in early or late adult life. The aetiology of early onset (precocious) bilateral hip OA is poorly understood, but the clinical and radiological characteristics of this form of OA suggest that chondral resorption due to biochemical or metabolic factors is likely to be of pre-eminent importance. The hip arthropathy which occurs in Hereditary Haemochromatosis (HH) and the ostensibly idiopathic precocious bilateral concentric form of hip OA are virtually indistinguishable...

Gender inequalities in health and gender bias in medicine are interrelated challenges facing health care providers and educators. Women and girls are disadvantaged in accessing health care because of their low social status and unequal treatment in medical care. Gender bias has long been inherent in clinical practice, medical research, and education. This can be traced to the medical curriculum that shapes the perceptions, attitudes, and behavior of the future doctor. The author advocates medical curricula change to address gender inequalities in health and gender bias in medicine...

Strategic medication in breeding flocks of domestic fowl (Gallus gallus), using antimicrobial treatment followed by competitive exclusion, was evaluated in 13 trials between February and September 1993. In each trial, the flock had been confirmed as naturally infected with Salmonella enterica serovar Enteritidis and the effect of treatment was determined on salmonella isolation from tissues. Of 11 trials where enrofloxacin was used, a long-term reduction of salmonella was observed in two and a short-term reduction was measured in birds from another five trials...

Mycoplasma hyopneumoniae, the primary pathogen of enzootic pneumonia, occurs worldwide and causes major economic losses to the pig industry. The organism adheres to and damages the ciliated epithelium of the respiratory tract. Affected pigs show chronic coughing, are more susceptible to other respiratory infections and have a reduced performance. Control of the disease can be accomplished in a number of ways. First, management practices and housing conditions in the herd should be optimized. These include all-in/all-out production, limiting factors that may destabilize herd immunity, maintaining optimal stocking densities, prevention of other respiratory diseases, and optimal housing and climatic conditions...

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OBJECTIVE: The purpose of this study was to examine patient attitudes toward weight gain with medications under 4 conditions-medical vs psychiatric and life-threatening vs non-life-threatening. METHOD: In a suburban primary care practice, 241 patients completed surveys that explored the 4 study conditions and the amount of weight, from 0 to 20 or more pounds, willing to be gained on medication. RESULTS: Participants were willing to gain an average of 5...

As part of the project 'Clean pigs', an inventory was made of the different pig farm management systems described in the literature. These systems were evaluated for their potential use in improving animal health, focusing on the pathogens important in the Netherlands. The most promising systems for the control and/or eradication of pig pathogens in the Netherlands can be divided into two groups (with decreasing effect): I. Eradication from an existing positive population. The best systems for this are Embryo Transplantation (ET), Specific-Pathogen Free pigs (SPF), Piglet Snatching and Segregated Weaning (SW)...

Expert evaluation of the correctness of medical care is one of the most complex problems for experts. A total of 303 expert evaluations of this kind were carried out in the Moscow regional Bureau during the recent 11 years. Expert evaluation of surgical care were the most numerous. The percentage of cases when grave defects of medical care were detected is rather high: 58-88%. The authors consider that a universal scheme of expert evaluation concerning infringement of the law by medical workers is to be developed for forensic medical service of the Russian Federation...

Oedema disease (OD) usually occurs after weaning and is due to infection with (ETEEC) enterotoxaemic Escherichia (E.) coli. This study further examines the efficacy of three different in-feed usage programmes of enrofloxacin (ENR/Baytril I.E.R. 2.5%), on the control of post weaning OD in piglets. The recommended in-feed dosage of ENR for this clinical indication, i.e. 50 p.p.m., was used. Five groups with a total of 240 weaned piglets for 28 days period were used in this trial. One group (negative control) was offered feed free of antimicrobials, one group was offered feed as that of the negative control group except that the feed consumption was restricted for the first 12 days post weaning, and three groups were offered feed ad libitum medicated with 50 p...

Post weaning diarrhoea syndrome (PWDS) in piglets is caused mainly by enterotoxigenic Escherichia (E.) coli (ETEC) strains. Six different in-feed usage programmes of enrofloxacin (ENR/Baytril; I.E.R. 2.5%) were tested for their efficacy on the control of post weaning colibacillosis in piglets, using seven groups with totally 336 weaned piglets for a 28 day period. One group (negative control) was offered feed free of antimicrobials, three groups were offered feed medicated with 50 ppm of ENR starting on weaning day for 5, 7 and 10 days respectively, three groups were offered feed medicated with 50 ppm of ENR starting 7 days post weaning for 5, 7 and 10 days respectively, and were compared with regard to the appearance of clinical signs, mortality, weight gain and feed conversion...

Seventy clinically normal 13-day-old crossbred pigs from 10 litters from a Streptococcus suis-infected herd were randomly assigned by litter and weight to 7 groups of 10 pigs each to determine whether different antibiotic regimens would eliminate the tonsillar carrier state of S. suis. Six antimicrobial regimens were tested: penicillin intramuscularly (IM) once daily (s.i.d.) for 3 consecutive days; penicillin IM s.i.d. for 5 consecutive days; ampicillin IM s.i.d. for 5 consecutive days; ampicillin per os s...

OBJECTIVES: To identify strategies involved in the diagnosis and treatment plans of primary care problems that are uncertain and complex. METHODS: In this exploratory study we observed primary care physicians encountering standardized patients who portrayed typical primary care problems involving uncertainty and complexity. First, we analyzed 10 tapes of nine physicians with a range of clinical experience (first-year residents through faculty physicians) interacting with four standardized patient cases (headache, back pain, hypertension, and abdominal pain)...

OBJECTIVE: To observe and evaluate the performance of primary care internal medicine residents within the outpatient clinic milieu. DESIGN: Longitudinal descriptive study. PATIENTS/PARTICIPANTS: 48 internal medicine resident encounters with two standardized patients at the University of Wisconsin General Internal Medicine Clinics. INTERVENTION: Residents were rated by the standardized patients with a medical skills checklist and an interpersonal skills checklist, and by the staffing physician with a clinical reasoning skills checklist...

A program with the aim to eliminate infections with Mycoplasma hyopneumoniae was applied in 4 herds selling breeding pigs. A "fast" (1 month) variant of the program was applied in one herd selling young gilts (30 kg body weight) and in one herd selling adult breeding stock, and a "slow" (> or = 3.5 months) variant was applied in two corresponding herds. In both variants, the spread of infections was prevented by isolating the breeding stock. These animals were treated with tiamulin before being reintroduced to the original, but emptied and disinfected units...

The academic community has long served the private sector in a consultant capacity in engineering and in the sciences. With respect to occupational medicine, physicians, when working for industry, have generally practiced in a health care setting. Within the past 10 years, however, the business sector has placed more attention on the health implications of its operations as a result of regulations, liability, and rising health care costs. These issues, which go beyond traditional clinical responsibilities, have furthered the need for businesses to receive strategic medical advice to effectively operate and to maintain a competitive edge...

Three field trials were conducted in a large commercial feedlot in Saskatchewan to determine the prevalence of Haemophilus somnus in calves and to evaluate the efficacy of prophylactic mass medication with long-acting oxytetracycline on day 17 (1990, n = 1336), day 11 (1991, n = 4372), or day 8 (1992, n = 5632) postarrival. Hemophilosis accounted for > 40% of the mortality in feedlot calves each year. Haemophilus somnus was cultured from the blood of one febrile calf on day 1 (0.1%, n = 895), but it was not cultured from nasal swabs on day 1 or day 11 (n = 881) or from blood samples on day 11 (n = 883)...

Studies on a Thoroughbred breeding farm in Ohio were done to: (1) compare the effects of daily administration of pyrantel tartrate feed pellets with monthly administration of a pyrantel pamoate paste to yearling horses (21 January-3 September); (2) assess the effects of daily pyrantel tartrate given strategically in spring/summer to foaling mares (1 April-16 August) and given for a prolonged period to barren mares (21 January-3 September); (3) determine if strategic medication of foaling mares with daily pyrantel tartrate protected their foals until weaning...

During the last twenty years pleuropneumonia in pigs, caused by Haemophilus pleuropneumoniae, has spread globally. The increasing importance of the disease within swine production is apparently connected with increasing industrialization and subsequent heavy concentration of a large number of animals in the individual production unit. Haemophilus pleuropneumoniae seems to be specific for pigs. Several more or less pathogenic serotypes of the bacterium are known. Serotype 2 as occurring in Denmark is primary pathogen for pigs which have not previously been in contact with the infection...