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https://www.readbyqxmd.com/read/28351067/do-medical-students-narrative-representations-of-the-good-doctor-change-over-time-comparing-humanism-essays-from-a-national-contest-in-1999-and-2013
#1
Pooja C Rutberg, Brandy King, Elizabeth Gaufberg, Pamela Brett-MacLean, Perry Dinardo, Richard M Frankel
PURPOSE: To explore medical students' conceptions of "the good doctor" at two points in time separated by 14 years. METHOD: The authors conducted qualitative analysis of narrative-based essays. Following a constant comparative method, an emergent relational coding scheme was developed which the authors used to characterize 110 essays submitted to the Arnold P. Gold Foundation Humanism in Medicine Essay Contest in 1999 (n = 50) and 2013 (n = 60) in response to the prompt, "Who is the good doctor?" RESULTS: The authors identified five relational themes as guiding the day-to-day work and lives of physicians: doctor-patient, doctor-self, doctor-learner, doctor-colleague, and doctor-system/society/profession...
April 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28351063/from-communication-skills-to-skillful-communication-a-longitudinal-integrated-curriculum-for-critical-care-medicine-fellows
#2
Amanda L Roze des Ordons, Christopher J Doig, Philippe Couillard, Jason Lord
PROBLEM: Communication with patients and families in critical care medicine (CCM) can be complex and challenging. A longitudinal curricular model integrating multiple techniques within classroom and clinical milieus may facilitate skillful communication across diverse settings. APPROACH: In 2014-2015, the authors developed and implemented a curriculum for CCM fellows at the Cumming School of Medicine, University of Calgary, to promote the longitudinal development of skillful communication...
April 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28351046/retinal-vein-occlusions
#3
Jost B Jonas, Jordi Monés, Agnès Glacet-Bernard, Gabriel Coscas
Retinal vein occlusions (RVOs) have been defined as retinal vascular disorders characterized by dilatation of retinal veins with retinal and subretinal hemorrhages, macular edema, and a varying degree of retinal ischemia. Retinal angiography, either as fluorescein and indocyanine green (ICG) angiography or in the form of optical coherence tomography (OCT)-based angiography, is essential for the diagnosis and assessment of the prognosis of RVOs. It allows the differentiation of diverse types of RVOs, such as perfused or nonperfused, as well as the detection of different modalities in the natural history of RVOs...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28351044/diagnosis-and-detection
#4
Giovanni Staurenghi, Marco Pellegrini, Alessandro Invernizzi, Chiara Preziosa
The aim of the chapter is to provide a practical but exhaustive guide in detecting macular edema and to describe its features according to the retinal condition that causes it. The most useful imaging techniques (biomicroscopy, retinography, optical coherence tomography, and fluorescein/indocyanine-green angiography will be analyzed in order to identify the best diagnostic algorithm in each pathology. There is a table at the end of the chapter which summarizes the important points of the chapter.
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28351030/a-comparison-of-different-training-methods-in-the-successful-learning-of-endobronchial-ultrasound-guided-transbronchial-needle-aspiration
#5
Wen Chao Zhang, Wei Chen, Jian Ping Zhou, Andrew D Lerner, Lei Ni, Ji Min Shen, Tian Li Yan, Min Zhou, Guo Chao Shi, Yi Xiang
BACKGROUND: Standardized training of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS- TBNA) is available only in highly developed countries. OBJECTIVE: To compare the skill differences in the performance of EBUS-TBNA by pulmonologists trained under different learning methods. METHODS: We performed a retrospective study of 145 EBUS-TBNA cases. We set up 3 comparative training groups: a standardized training group, a teaching group, and a self-study group...
March 29, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28350944/navigation-and-robotics-in-spinal-surgery-where-are-we-now
#6
Samuel C Overley, Samuel K Cho, Ankit I Mehta, Paul M Arnold
Spine surgery has experienced much technological innovation over the past several decades. The field has seen advancements in operative techniques, implants and biologics, and equipment such as computer-assisted navigation and surgical robotics. With the arrival of real-time image guidance and navigation capabilities along with the computing ability to process and reconstruct these data into an interactive three-dimensional spinal "map", so too have the applications of surgical robotic technology. While spinal robotics and navigation represent promising potential for improving modern spinal surgery, it remains paramount to demonstrate its superiority as compared to traditional techniques prior to assimilation of its use amongst surgeons...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28350876/mipe-a-metagenome-based-community-structure-explorer-and-ssu-primer-evaluation-tool
#7
Bin Zou, JieFu Li, Quan Zhou, Zhe-Xue Quan
An understanding of microbial community structure is an important issue in the field of molecular ecology. The traditional molecular method involves amplification of small subunit ribosomal RNA (SSU rRNA) genes by polymerase chain reaction (PCR). However, PCR-based amplicon approaches are affected by primer bias and chimeras. With the development of high-throughput sequencing technology, unbiased SSU rRNA gene sequences can be mined from shotgun sequencing-based metagenomic or metatranscriptomic datasets to obtain a reflection of the microbial community structure in specific types of environment and to evaluate SSU primers...
2017: PloS One
https://www.readbyqxmd.com/read/28350870/bacterial-clonal-diagnostics-as-a-tool-for-evidence-based-empiric-antibiotic-selection
#8
Veronika Tchesnokova, Hovhannes Avagyan, Elena Rechkina, Diana Chan, Mariya Muradova, Helen Ghirmai Haile, Matthew Radey, Scott Weissman, Kim Riddell, Delia Scholes, James R Johnson, Evgeni V Sokurenko
Despite the known clonal distribution of antibiotic resistance in many bacteria, empiric (pre-culture) antibiotic selection still relies heavily on species-level cumulative antibiograms, resulting in overuse of broad-spectrum agents and excessive antibiotic/pathogen mismatch. Urinary tract infections (UTIs), which account for a large share of antibiotic use, are caused predominantly by Escherichia coli, a highly clonal pathogen. In an observational clinical cohort study of urgent care patients with suspected UTI, we assessed the potential for E...
2017: PloS One
https://www.readbyqxmd.com/read/28350785/the-picture-study-diagnostic-accuracy-of-multiparametric-mri-in-men-requiring-a-repeat-prostate-biopsy
#9
Lucy A M Simmons, Abi Kanthabalan, Manit Arya, Tim Briggs, Dean Barratt, Susan C Charman, Alex Freeman, James Gelister, David Hawkes, Yipeng Hu, Charles Jameson, Neil McCartan, Caroline M Moore, Shonit Punwani, Navin Ramachandran, Jan van der Meulen, Mark Emberton, Hashim U Ahmed
BACKGROUND: Transrectal prostate biopsy has limited diagnostic accuracy. Prostate Imaging Compared to Transperineal Ultrasound-guided biopsy for significant prostate cancer Risk Evaluation (PICTURE) was a paired-cohort confirmatory study designed to assess diagnostic accuracy of multiparametric magnetic resonance imaging (mpMRI) in men requiring a repeat biopsy. METHODS: All underwent 3 T mpMRI and transperineal template prostate mapping biopsies (TTPM biopsies)...
March 28, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28350777/understanding-brain-reorganization-in-infants-with-perinatal-stroke-through-neuroexcitability-and-neuroimaging
#10
Chao-Ying Chen, Michael Georgieff, Jed Elison, Mo Chen, James Stinear, Bryon Mueller, Raghavendra Rao, Kyle Rudser, Bernadette Gillick
PURPOSE: The primary aim of this proposed study is to evaluate brain reorganization patterns in infants with perinatal stroke between 3 and 5 months of age using transcranial magnetic stimulation and magnetic resonance imaging, with the addition of the General Movements Assessment. A secondary aim is to demonstrate feasibility and safety of infant-appropriate brain assessment protocols. METHODS: Ten infants with perinatal stroke will be enrolled. In this exploratory study, infants will first receive magnetic resonance imaging scanning during natural sleep to examine their corticospinal tract integrity...
April 2017: Pediatric Physical Therapy
https://www.readbyqxmd.com/read/28350764/handgrip-strength-a-population-based-study-of-norms-and-age-trajectories-for-3-to-17-year-olds
#11
Richard W Bohannon, Ying-Chih Wang, Deborah Bubela, Richard C Gershon
PURPOSE: To provide normative values and equations for grip strength obtained from a population-based sample of individuals 3 to 17 years of age. METHODS: This cross-sectional study used grip strength data from 2706 participants (49.2% males, 91% right-hand dominant) in the normative phase of the National Institutes of Health Toolbox project. RESULTS: Analyses showed greater strength in the dominant hand in boys and with each yearly increase in age...
April 2017: Pediatric Physical Therapy
https://www.readbyqxmd.com/read/28350729/real-time-ultrasound-guided-thoracentesis
#12
Rachel Krackov, Denise Rizzolo
Clinicians commonly see patients with pleural effusions requiring thoracentesis. The latest evidence-based guidelines for thoracentesis recommend real-time ultrasound guidance for the safest outcomes from this procedure. This article reviews real-time ultrasound guidance for thoracentesis to help referring clinicians understand the technique and the guidelines for the performance of thoracentesis.
April 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28350540/construction-of-a-biomechanical-head-and-neck-motion-model-as-a-guide-to-evaluation-of-deformable-image-registration
#13
Hendrik Teske, Kathrin Bartelheimer, Jan Meis, Rolf Bendl, Eva Stoiber, Kristina Giske
The use of deformable image registration methods in the context of adaptive radiotherapy leads to uncertainties in the simulation of the administered dose distributions during the treatment course. Evaluation of these methods is a prerequisite to decide if a plan adaptation will improve the individual treatment. Current approaches using manual references limit the validity of evaluation, especially for low contrast regions. In particular for the head and neck region, the highly flexible anatomy and the low soft tissue contrast in control images pose a challenge to image registration and its evaluation...
March 28, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28350463/is-single-molecule-fluorescence-spectroscopy-ready-to-join-the-organic-chemistry-toolkit-a-test-case-involving-click-chemistry
#14
Juan C Scaiano, Anabel E Lanterna
Single Molecule Spectroscopy (SMS) has matured to a point where it can be used as a convenient tool to guide organic synthesis and drug discovery, particularly applicable to catalytic systems where questions related to homogeneous vs. heterogeneous pathways are important. SMS can look at intimate mechanistic details that can inspire major improvements of the catalyst performance, its recovery and reuse. Here we use the click reaction between alkynes and azides as an example where improvements at the bench have been inspired and validated using single-molecule fluorescence spectroscopy...
March 28, 2017: Journal of Organic Chemistry
https://www.readbyqxmd.com/read/28346965/point-of-care-coagulation-tests-monitoring-of-direct-oral-anticoagulants-and-their-reversal-therapy-state-of-the-art
#15
Giacomo E Iapichino, Paolo Bianchi, Marco Ranucci, Ekaterina Baryshnikova
Direct oral anticoagulants (DOACs) exert similar anticoagulant effects to vitamin K antagonists and are increasingly used worldwide. Nevertheless, an evidence-based approach to patients receiving DOACs when any unplanned urgent surgery or bleeding (either spontaneous or traumatic) occurs is still missing. In this review, we investigate the role of point-of-care coagulation tests when other, more specific tests are not available. Indeed, thromboelastography and activated clotting time can detect dabigatran-induced coagulopathy, while their accuracy is limited for apixaban and rivaroxaban, mostly in cases of low drug plasma concentrations...
March 27, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28346920/microbial-composition-of-the-initial-colonization-of-newborns
#16
Samuli Rautava
Early-life interaction with indigenous intestinal microbes is a prerequisite for healthy immune and metabolic maturation. Human infants acquire their gut microbiota predominantly from the mother. A considerable inoculum of microbes is received by the neonate during vaginal delivery. Recent observations suggest that human gut colonization may be initiated prenatally by microbes in amniotic fluid, but the significance of this phenomenon remains unknown. After birth, neonatal gut colonization is guided by human milk factors, which selectively promote the growth of specific microbes, as well as by live microbes present in human milk...
2017: Nestlé Nutrition Institute Workshop Series
https://www.readbyqxmd.com/read/28346851/aquatic-therapy-for-people-with-lymphedema-a-systematic-review-and-meta-analysis
#17
Wai Yeung, Adam I Semciw
BACKGROUND: Aquatic therapy has several proposed benefits for people with lymphedema. A systematic review of the evidence for aquatic therapy in lymphedema management has not been conducted. METHOD AND RESULTS: Systematic review and meta-analysis were conducted. Five electronic databases were searched to identify randomized controlled trials (RCTs) of people with lymphedema, which compared aquatic therapy with other lymphedema interventions. Qualitative analysis was undertaken where quantitative analysis was not possible...
March 27, 2017: Lymphatic Research and Biology
https://www.readbyqxmd.com/read/28346808/patient-reported-outcomes-1-year-after-immediate-breast-reconstruction-results-of-the-mastectomy-reconstruction-outcomes-consortium-study
#18
Andrea L Pusic, Evan Matros, Neil Fine, Edward Buchel, Gayle M Gordillo, Jennifer B Hamill, Hyungjin M Kim, Ji Qi, Claudia Albornoz, Anne F Klassen, Edwin G Wilkins
Purpose The goals of immediate postmastectomy breast reconstruction are to minimize deformity and optimize quality of life as perceived by patients. We prospectively evaluated patient-reported outcomes (PROs) in women undergoing immediate implant-based or autologous reconstruction. Methods Women undergoing immediate postmastectomy reconstruction for invasive cancer and/or carcinoma in situ were enrolled at 11 sites. Women underwent implant-based or autologous tissue reconstruction. Patients completed the BREAST-Q, a condition-specific PRO measure for breast surgery patients, and Patient-Reported Outcomes Measurement Information System-29, a generic PRO measure, before and 1 year after surgery...
March 27, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28346651/breast-cancer-metastases-to-the-head-and-neck-case-series-and-literature-review
#19
Jeremiah C Tracy, Nicholas R Mildenhall, Richard O Wein, Miriam A O'Leary
Breast cancer is the most common cancer in women and is the second most common cause of cancer-related death. Despite the relatively high prevalence of this disease, breast cancer manifestations in the head and neck are relatively rare. Supraclavicular lymphadenopathy and bony metastases to the mandible and maxilla are the most common manifestation of breast cancer in the head and neck. Head and neck metastases are the first presentation of distant disease in approximately one-third of cases. The prognosis of breast cancer with distant metastases to the head and neck is generally poor, and the management of these lesions is controversial...
March 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/28346623/family-medicine-maternity-care-call-to-action-moving-toward-national-standards-for-training-and-competency-assessment
#20
Susanna R Magee, W Suzanne Eidson-Ton, Larry Leeman, Michael Tuggy, Thomas O Kim, Melissa Nothnagle, Joseph Breuner, Mark Loafman
Maternity care is an integral part of family medicine, and the quality and cost-effectiveness of maternity care provided by family physicians is well documented. Considering the population health perspective, increasing the number of family physicians competent to provide maternity care is imperative, as is working to overcome the barriers discouraging maternity care practice. A standard that clearly defines maternity care competency and a systematic set of tools to assess competency levels could help overcome these barriers...
March 2017: Family Medicine
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