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Internal medicine

Peiling Zhou, Sue C Grady
Doctor-patient conflicts in contemporary China are increasing in numbers and severity. This health geographic study shows how hospitals as a type of therapeutic landscape can shape doctor-patient relationships. First, the comprehensive nature of therapeutic landscapes with an emphasis on power operation within symbolic environments is provided as a framework for this study. Second, the results from participant observation and interviews with patients and doctors previously involved in conflicts are reported from Internal Medicine and Surgery Departments, within four hospitals in Anhui Province, Eastern China...
October 19, 2016: Health & Place
Bertram J Wilm, Christoph Barmet, Simon Gross, Lars Kasper, S Johanna Vannesjo, Max Haeberlin, Benjamin E Dietrich, David O Brunner, Thomas Schmid, Klaas P Pruessmann
PURPOSE: The purpose of this work was to improve the quality of single-shot spiral MRI and demonstrate its application for diffusion-weighted imaging. METHODS: Image formation is based on an expanded encoding model that accounts for dynamic magnetic fields up to third order in space, nonuniform static B0 , and coil sensitivity encoding. The encoding model is determined by B0 mapping, sensitivity mapping, and concurrent field monitoring. Reconstruction is performed by iterative inversion of the expanded signal equations...
October 21, 2016: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
M Arcan Ertürk, Xiaoping Wu, Yiğitcan Eryaman, Pierre-François Van de Moortele, Edward J Auerbach, Russell L Lagore, Lance DelaBarre, J Thomas Vaughan, Kâmil Uğurbil, Gregor Adriany, Gregory J Metzger
PURPOSE: To explore the potential of performing body imaging at 10.5 Tesla (T) compared with 7.0T through evaluating the transmit/receive performance of similarly configured dipole antenna arrays. METHODS: Fractionated dipole antenna elements for 10.5T body imaging were designed and evaluated using numerical simulations. Transmit performance of antenna arrays inside the prostate, kidneys and heart were investigated and compared with those at 7.0T using both phase-only radiofrequency (RF) shimming and multi-spoke pulses...
October 21, 2016: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
Hong Shang, Subramaniam Sukumar, Cornelius von Morze, Robert A Bok, Irene Marco-Rius, Adam Kerr, Galen D Reed, Eugene Milshteyn, Michael A Ohliger, John Kurhanewicz, Peder E Z Larson, John M Pauly, Daniel B Vigneron
PURPOSE: Balanced steady-state free precession (bSSFP) sequences can provide superior signal-to-noise ratio efficiency for hyperpolarized (HP) carbon-13 ((13) C) magnetic resonance imaging by efficiently utilizing the nonrecoverable magnetization, but managing their spectral response is challenging in the context of metabolic imaging. A new spectrally selective bSSFP sequence was developed for fast imaging of multiple HP (13) C metabolites with high spatiotemporal resolution. THEORY AND METHODS: This novel approach for bSSFP spectral selectivity incorporates optimized short-duration spectrally selective radiofrequency pulses within a bSSFP pulse train and a carefully chosen repetition time to avoid banding artifacts...
October 21, 2016: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
Stephen F Cauley, Kawin Setsompop, Berkin Bilgic, Himanshu Bhat, Borjan Gagoski, Lawrence L Wald
PURPOSE: Fast MRI acquisitions often rely on efficient traversal of k-space and hardware limitations, or other physical effects can cause the k-space trajectory to deviate from a theoretical path in a manner dependent on the image prescription and protocol parameters. Additional measurements or generalized calibrations are typically needed to characterize the discrepancies. We propose an autocalibrated technique to determine these discrepancies. METHODS: A joint optimization is used to estimate the trajectory simultaneously with the parallel imaging reconstruction, without the need for additional measurements...
October 21, 2016: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
P Jennings, A Lotito, H Baysson, E Pineau-Blondel, J Berlioz
INTRODUCTION: The purpose of the study was to evaluate physician's satisfaction with the clinical pharmacy activities in a French regional hospital. METHODS: Data were collected by face-to-face interviews carried out by a public health intern with physicians from 14 different departments of medicine and surgery. A specifically designed questionnaire was used for this study. This contained 18 closed-ended questions, 3 open-ended questions and 6 questions relating to the multidisciplinary analysis of prescriptions of elderly patients...
October 18, 2016: Annales Pharmaceutiques Françaises
Ismael Apud, Oriol Romaní
Ayahuasca is a psychoactive beverage from the Amazon, traditionally used by indigenous and mestizo populations in the region. Widespread international use of the beverage began in the 1990s in both secular contexts and religious/spiritual networks. This article offers an analysis of these networks as health care systems in general and for the case of Spain and specifically Catalonia, describing the emergence and characteristics of their groups, and the therapeutic itineraries of some participants. The medical anthropology perspective we take enables us to reflect on the relationship between medicine and religion, and problematize the tensions between medicalization and medical pluralism...
October 18, 2016: International Journal on Drug Policy
Shawneequa L Callier, Rachel Abudu, Maxwell J Mehlman, Mendel E Singer, Duncan Neuhauser, Charlisse Caga-Anan, Georgia L Wiesner
PURPOSE: This review identifies the prominent topics in the literature pertaining to the ethical, legal, and social issues (ELSI) raised by research investigating personalized genomic medicine (PGM). METHODS: The abstracts of 953 articles extracted from scholarly databases and published during a 5-year period (2008-2012) were reviewed. A total of 299 articles met our research criteria and were organized thematically to assess the representation of ELSI issues for stakeholders, health specialties, journals, and empirical studies...
November 2016: Bioethics
Muhammad Abu-Elmagd, Mourad Assidi, Ashraf Dallol, Abdelbaset Buhmeida, Peter Natesan Pushparaj, Gauthaman Kalamegam, Emad Al-Hamzi, Jerry W Shay, Stephen W Scherer, Ashok Agarwal, Bruce Budowle, Mamdooh Gari, Adeel Chaudhary, Adel Abuzenadah, Mohammed Al-Qahtani
The Third International Genomic Medicine Conference (3(rd) IGMC) was organised by the Centre of Excellence in Genomic Medicine Research (CEGMR) at the King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia (KSA). This conference is a continuation of a series of meetings, which began with the first International Genomic Medicine Conference (1(st) IGMC, 2011) followed by the second International Genomic Medicine Conference (2(nd) IGMC, 2013). The 3(rd) IGMC meeting presented as a timely opportunity to bring scientists from across the world to gather, discuss, and exchange recent advances in the field of genomics and genetics in general as well as practical information on using these new technologies in different basic and clinical applications...
October 17, 2016: BMC Genomics
Hagen Frickmann, Wibke Schmeja, Emil Reisinger, Thomas Mittlmeier, Karen Mitzner, Norbert Georg Schwarz, Philipp Warnke, Andreas Podbielski
This study assessed protective effects of a continuous introduction of safe instruments in terms of reduction of needle stick injuries. The retrospective study analyzed correlations between the increasing proportion of safe instruments and a reduction of the incidence of needle stick injuries linked to such instruments in a German university hospital over 5 years. Incidents declined about 17.6% from 80.3 incidents per 1000 employees to 66.2, associated with an increase in the proportions of injuries due to instruments without protective mechanisms such as scalpels or hypodermic needles by 12...
September 29, 2016: European Journal of Microbiology & Immunology
Shruti Gupta, Jehan Alladina, Kevin Heaton, Eli Miloslavsky
BACKGROUND: Subspecialty fellows can serve as a tremendous educational resource to residents; however, there are multiple barriers to an effective resident-fellow teaching interaction in the setting of inpatient consultation. We designed and evaluated a resident-directed intervention to enhance communication and teaching during consultation on the general medicine wards. METHODS: Five medical teams were randomized to receive the intervention over a 3 month period (3 control, 2 intervention teams)...
October 20, 2016: BMC Medical Education
Duk Hwan Kim, Soo Jung Park, Jae Hee Cheon, Tae Il Kim, Won Ho Kim, Sung Pil Hong
OBJECTIVES: The objective of this study was to determine whether a pre-training program influences the entire learning process and overall proficiency of colonoscopy during fellowship. METHODS: From March 2011 to February 2013, a total of 28 first-year gastrointestinal fellows were trained in colonoscopy at a single tertiary center. Before entering their fellowship training, all fellows were board certified in internal medicine, but had no experience performing a full colonoscopy...
2016: PloS One
Gillian W Hooker, Kendall L Umstead, Katie L Lewis, Laura K Koehly, Leslie G Biesecker, Barbara B Biesecker
PURPOSE: As clinical genome sequencing expand its reach, understanding how individuals engage with this process are of critical importance. In this study, we aimed to describe internal engagement and its correlates among a ClinSeq cohort of adults consented to genome sequencing and receipt of results. METHODS: This study was framed using the precaution adoption process model (PAPM), in which knowledge predicts engagement and engagement predicts subsequent behaviors...
October 20, 2016: Genetics in Medicine: Official Journal of the American College of Medical Genetics
Kanchi Muralidhar, Deepak Tempe, Yatin Mehta, Poonam Malhotra Kapoor, Chirojit Mukherjee, Thomas Koshy, Prabhat Tewari, Naman Shastri, Satyajeet Misra, Kumar Belani
During current medical care, perioperative transesophageal echocardiography (TEE) has become a vital component of patient management, especially in cardiac operating rooms and in critical care medicine. Information derived from echocardiography has an important bearing on the patient's outcome. The Indian Association of Cardiovascular and Thoracic Anaesthesiologists (IACTA) has promoted the use of TEE during routine clinical care of patients undergoing cardiac surgery. An important mission of IACTA is to oversee training and certify anesthesiologists in the perioperative and intensive care use of TEE...
October 2016: Annals of Cardiac Anaesthesia
Sarah J Beesley, Eliotte L Hirshberg, Michael J Lanspa
In a recently published issue of Critical Care Medicine, Kar and colleagues investigated glucose management of critically ill patients with type 2 diabetes. In this commentary, we discuss the challenges of investigating glucose control in the critically ill, why so many internally valid studies in this field lead to conflicting results, and the obstacles preventing investigators from reaching a conclusive answer.
September 2016: Annals of Translational Medicine
Manuel Wohde, Silvia Berkner, Thomas Junker, Sabine Konradi, Lisa Schwarz, Rolf-Alexander Düring
The spread of veterinary medicinal products (VMPs) and biocides via manure onto agriculturally used areas represents a very important emission into the environment for these product groups. Within this literature study, publicly available transformation studies with liquid manure are summarized. Transformation studies were evaluated regarding the transformation fate of tested substances, the origin and characteristics of used manure, the experimental setup, and the measured parameters. As main topics within the 42 evaluated transformation studies, the high dependency of transformation on temperature, redox potential, dry matter content, and other parameters is reported...
2016: Environmental Sciences Europe
Outi Laatikainen, Sami Sneck, Risto Bloigu, Minna Lahtinen, Timo Lauri, Miia Turpeinen
Adverse drug events (ADEs) are more likely to affect geriatric patients due to physiological changes occurring with aging. Even though this is an internationally recognized problem, similar research data in Finland is still lacking. The aim of this study was to determine the number of geriatric medication-related hospitalizations in the Finnish patient population and to discover the potential means of recognizing patients particularly at risk of ADEs. The study was conducted retrospectively from the 2014 emergency department patient records in Oulu University Hospital...
2016: Frontiers in Pharmacology
James Gilligan, Bandy X Lee, Shikha Garg, Morkeh Blay-Tofey, Audrey Luo
Many national and international institutions advocate approaching violence as a problem in public health and preventive medicine, in a manner similar to the way we address other disabling and life-threatening pathologies such as cancer, diabetes, and heart disease. Prevention by a health model requires an ecological perspective. Previous work has found evidence that economic factors, including unemployment and relative poverty, as well as political culture and values, may affect violent death rates, including homicide and suicide...
September 2016: Journal of Public Health Policy
Robert Battat, Marc Jhonson, Lorne Wiseblatt, Cruff Renard, Laura Habib, Manouchka Normil, Brian Remillard, Timothy F Brewer, Galit Sacajiu
BACKGROUND: Recent calls for reform in healthcare training emphasize using competency-based curricula and information technology-empowered learning. Continuing Medical Education programs are essential in maintaining physician accreditation. Haitian physicians have expressed a lack access to these activities. The Haiti Medical Education Project works in alliance with Haitian medical leadership, faculty and students to support the Country's medical education system. We present the creation, delivery and evaluation of a competency-based continuing medical education curriculum for physicians in rural Haiti...
October 19, 2016: BMC Medical Education
Mario Plebani
The last 50years have seen substantial changes in the landscape of laboratory medicine: its role in modern medicine is in evolution and the quality of laboratory services is changing. The need to control and improve quality in clinical laboratories has grown hand in hand with the growth in technological developments leading to an impressive reduction of analytical errors over time. An essential cause of this impressive improvement has been the introduction and monitoring of quality indicators (QIs) such as the analytical performance specifications (in particular bias and imprecision) based on well-established goals...
October 16, 2016: Clinical Biochemistry
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