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Procedures internal medicine

Claire Marant-Micallef, Kevin D Shield, Jérôme Vignat, Enora Cléro, Ausrele Kesminiene, Catherine Hill, Agnès Rogel, Blandine Vacquier, Freddie Bray, Dominique Laurier, Isabelle Soerjomataram
Although medical ionizing radiation (IR) has clear clinical benefits, it is an established carcinogen. This study estimates the number of new cancer cases in France in 2015 attributable to IR exposure from medical procedures. Exposures from external (X-rays, CT scans, interventional radiology) and internal (nuclear medicine) sources were considered. We used 2007 national frequencies of diagnostic examinations by sex and age to estimate the lifetime organ dose exposure adjusted for changes in the use of such procedures over time...
December 8, 2018: International Journal of Cancer. Journal International du Cancer
C Strumann, K Flägel, T Emcke, J Steinhäuser
BACKGROUND: In response to a rising shortage of general practitioners (GPs), physicians in general internal medicine (GIM) have become part of the German primary care physician workforce. Previous studies have shown substantial differences in practice patterns between both specialties. The aim of this study was to analyse and compare the application of procedures by German GPs and GIM physicians based on routine data. METHODS: The Association of Statutory Health Insurance Physicians in the federal state Schleswig-Holstein (Northern Germany) provided invoicing data of the first quarters of 2013 and 2015...
December 3, 2018: BMC Family Practice
Lane Thaut, Wells Weymouth, Branden Hunsaker, Daniel Reschke
BACKGROUND: Central vein catheter (CVC) placement using the modified Seldinger technique is a common procedure in the emergency department, but can be time consuming due to the multiple pieces of equipment included in central line kits and the number of steps in the procedure. Preassembled devices combine a needle, guidewire, dilator, and sheath into one unit and potentially simplify the process and reduce time required for CVC placement using the accelerated Seldinger technique. OBJECTIVE: Our aim was to evaluate whether the use of combination central line devices and the accelerated Seldinger technique will reduce the time required to place a CVC and increase the ease of the procedure...
November 29, 2018: Journal of Emergency Medicine
Jose Maria Chimeno, Natividad Sebastià, Irene Torres-Espallardo, Julia Balaguer, Cristian Candela-Juan, Jose Luis Loaiza, Mar Adria, Blanca Ibanez-Rosello, Adela Cañete, Luis Martí-Bonmatí, Alegría Montoro
Purpose The aims of this study were to estimate the whole-body absorbed-dose with the Dicentric Chromosome Assay (DCA) (biodosimetry) for 131 I-metaiodobenzylguanidine (131 I-mIBG) therapy for high-risk neuroblastoma, and to obtain an initial correlation with the physical dosimetry calculated as described by the Medical Internal Radiation Dosimetry formalism (MIRD). Together both objectives will aidobjectives will aid the optimization of personalized targeted radionuclide therapies. Material and Methods A 12 year-old child with relapsed high-risk neuroblastoma was treated with 131 I-mIBG: a first administration with activity <444 MBq/kg was used as a tracer in order to calculate the activity needed in a second administration to achieve a whole body prescribed dose of approximately 4 Gy...
November 29, 2018: International Journal of Radiation Biology
Ashutosh Sinha, Navin Singh, Bhanu Mani Dixit, Nirmal Kumar Painuly
Introduction: Most preclinical studies using radiopharmaceuticals have been carried out on mice. In nuclear medicine and radioimmunotherapy procedures, I131 and Y90 have been widely used. For better estimation of doses from these procedures, S value plays a vital role. In this study, we have evaluated S values for major source and target combinations of Digimouse voxel phantom. Materials and Methods: We have used the Digimouse voxel phantom which was incorporated in Monte Carlo code FLUKA...
October 2018: Journal of Cancer Research and Therapeutics
Francis Fezeu, Arjun Ramesh, Patrick D Melmer, Shayan Moosa, Paul S Larson, Fraser Henderson
Functional neurosurgery techniques remain integral to the neurosurgical treatment armamentarium but data on global implementation remains scarce. In comparison to high-income countries (HIC), low- and middle-income countries (LMIC) suffer from an increased prevalence of diseases like epilepsy, which may be amenable to functional techniques, and therefore, LMIC may benefit from an increased utilization of these treatment modalities. However, functional techniques tend to be expensive and thus difficult to implement in the LMIC setting...
September 17, 2018: Curēus
Catherine M Stein, Roselle Ponsaran, Erika S Trapl, Aaron J Goldenberg
PURPOSE: While there has been a recent increase in scholarship around developing policies for the return of results from genetic sequencing, it is not clear whether these approaches are appropriate for genetic epidemiology studies. Because genetic epidemiological research increasingly utilizes genome sequencing methods, particularly in large data sets where researchers did not directly ascertain the subjects, it is important to understand researchers' perspectives on the return of results...
November 23, 2018: Genetics in Medicine: Official Journal of the American College of Medical Genetics
Da-Ya Yang, Kun-Song Zhang, Xun Hou, Shao-Ting Feng, Hui-Yan Li, Xin-Xue Liao, Jun Liu, Ming Kuang
OBJECTIVE: To reflectively look at the present methods by which the clinical competence of 5th-year medical students (i.e. interns) in Sun Yat-Sen University (SYSU) are assessed upon finishing internship rotation in internal medicine (IM). METHODS: Current procedures for the competence assessment of end-of-rotation IM interns in the First Affiliated Hospital of SYSU were reviewed, along with a point-by-point appraisal based on the PROFILE approach to structured assessment, and, whenever possible, suggestions for future improvement...
November 21, 2018: Medical Teacher
Daniel Dejene, Tegbar Yigzaw, Samuel Mengistu, Zerihun Wolde, Abiy Hiruy, Damtew Woldemariam, Miftah Awol
Background: A high performing physician workforce is critical to attain nationally set health sector goals. Ethiopia has expanded training of medical doctors. However, little is known about junior doctors' performance. Understanding medical practice is essential to inform medical education and practice, establish licensure examination and guide workforce management decisions. We conducted a practice analysis study to identify gaps in Ethiopian medical education and practice, and to determine composition of subjects in national licensing examination...
2018: Global Health Research and Policy
Olivier Collignon, Franz Koenig, Armin Koch, Robert James Hemmings, Frank Pétavy, Agnès Saint-Raymond, Marisa Papaluca-Amati, Martin Posch
BACKGROUND: In recent years, experience on the application of adaptive designs in confirmatory clinical trials has accumulated. Although planning such trials comes at the cost of additional operational complexity, adaptive designs offer the benefit of flexibility to update trial design and objectives as data accrue. In 2007, the European Medicines Agency (EMA) provided guidance on confirmatory clinical trials with adaptive (or flexible) designs. In order to better understand how adaptive trials are implemented in practice and how they may impact medicine approval within the EMA centralised procedure, we followed on 59 medicines for which an adaptive clinical trial had been submitted to the EMA Scientific Advice (SA) and analysed previously in a dedicated EMA survey of scientific advice letters...
November 20, 2018: Trials
Natalia Buda, Wojciech Kosiak, Elżbieta Radzikowska, Robert Olszewski, Ewa Jassem, Elżbieta Magdalena Grabczak, Andrzej Pomiecko, Jakub Piotrkowski, Maciej Piskunowicz, Malwina Sołtysiak, Szymon Skoczyński, Grzegorz Jaczewski, Jolanta Odrowska, Agnieszka Skoczylas, Marcin Wełnicki, Jakub Wiśniewski, Anna Zamojska
The aim of this study was to establish recommendations for the use of lung ultrasound in internal medicine, based on reliable data and expert opinions. Methods: The bibliography from the databases (Pubmed, Medline, OVID, Embase) has been fully reviewed up to August 2017. Members of the expert group assessed the credibility of the literature data. Then, in three rounds, a discussion was held on individual recommendations (in accordance with the Delphi procedure) followed by secret voting. Thirty-eight recommendations for the use of lung ultrasound in internal medicine were established as well as discussed and subjected to secret voting in three rounds...
2018: Journal of Ultrasonography
César Palacios-González
Background: The first live birth following the use of a new reproductive technique, maternal spindle transfer (MST), which is a mitochondrial replacement technique (MRT), was accomplished by dividing the execution of the MST procedure between two countries, the USA and Mexico. This was done in order to avoid US legal restrictions on this technique. Sources of data: Academic articles, news articles, documents obtained through freedom of information requests, laws, regulations and national reports...
November 16, 2018: British Medical Bulletin
Mario Plebani, Michael Laposata, Giuseppe Lippi
Laboratory medicine plays an increasingly essential role in modern healthcare systems, since it is integral to most care pathways and plays an essential role for optimizing patient flow, harmonizing procedures before and after analysis, improving harmonization and containing unnecessary testing. Nevertheless, recent changes in the nature of laboratory services, promoted by innovation and introduction of more complex tests in emerging diagnostic fields, more advanced diagnostics along with other "internal" and "external" drivers, will promote a paradigmatic transformation of current scenarios...
November 13, 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
Inge Axelsson
It is important to determine the chronological ages of children and adolescent asylum seekers and physicians and researchers working in forensic medicine and paediatrics are involved in this process. However, it appears that forensic doctors in Germany (1) and Sweden, as discussed in this paper, have been ignoring high-quality research in epidemiology, paediatrics and psychology when they assess adolescents, In Sweden, the age of asylum-seeking adolescents is estimated by using radiological assessments of bone and teeth age and the risk of deportation is increased if the estimated age is 18 years or higher...
November 14, 2018: Acta Paediatrica
Norbert Guettler, Edward D Nicol, Joanna d'Arcy, Rienk Rienks, Dennis Bron, Eddie D Davenport, Olivier Manen, Gary Gray, Thomas Syburra
This manuscript focuses on the broad aviation medicine considerations that are required to optimally manage aircrew following non-coronary surgery or percutaneous cardiology interventions (both pilots and non-pilot aviation professionals). Aircrew may have pathology identified earlier than non-aircrew due to occupational cardiovascular screening and while aircrew should be treated using international guidelines, if several interventional approaches exist, surgeons/interventional cardiologists should consider which alternative is most appropriate for the aircrew role being undertaken; liaison with the aircrew medical examiner is strongly recommended prior to intervention to fully understand this...
January 2019: Heart: Official Journal of the British Cardiac Society
Zheng Xie, Jiaqiang Zhang, Gang Yin, Huihao Chen, Haoliang Hu, Haodong Lin, Chunlin Hou
Objective: To evaluate the effectiveness of open reduction and trans-carpometacarpal joint internal fixation with mini locked-plate for treatment of comminuted fracture of base of the fifth metacarpal. Methods: Between July 2015 and December 2017, 8 cases of comminuted fractures of base of the fifth metacarpals were treated with open reduction and trans-carpometacarpal joint internal fixation with mini locked-plate. There were 7 males and 1 female with an age of 19-45 years (mean, 32...
November 1, 2018: Chinese Journal of Reparative and Reconstructive Surgery
Elena Pomari, Francesca Perandin, Giulia La Marca, Zeno Bisoffi
Diagnosis of Schistosoma haematobium relies primarily on microscopical analysis of urine. The method is time consuming and requires some expertise. Genus-specific real-time PCRs have been developed, but we still observed low sensitivity. In the present study, in order to achieve a more sensitive DNA detection of eggs of S. haematobium in urine samples, we wanted to develop a novel protocol of DNA extraction using mechanic disruption of eggs by bead beating as supplementary step. We tested Schistosoma spp. internal transcribed spacer 2 real-time PCR after both methods with and without bead beating...
November 12, 2018: Parasitology Research
Matthew Gorgone, Brian McNichols, Valerie J Lang, William Novak, Alec B O'Connor
Background : Training residents to become competent in common bedside procedures can be challenging. Some hospitals have attending physician-led procedure teams with oversight of all procedures to improve procedural training, but these teams require significant resources to establish and maintain. Objective : We sought to improve resident procedural training by implementing a resident-run procedure team without routine attending involvement. Methods : We created the role of a resident procedure coordinator (RPC)...
October 2018: Journal of Graduate Medical Education
Ralph M Trüeb, Maria Fernanda Reis Gavazzoni Dias
Trichoscopy is the term coined for the use of dermatoscope for the evaluation of hair and scalp. Dermatologists involved in the management of hair and scalp disorders have discovered dermatoscope to be useful in their daily clinical practice, and expert studies suggest that dermoscopy may improve diagnostic capability beyond simple clinical inspection. Therefore, trichoscopy has gained popularity as a tool in the differential diagnosis of hair and scalp disorders. Despite the enthusiasm emerging with its establishment as a valuable dermatologic tool, caution is warranted not to elevate trichoscopy to something like a fetish status...
July 2018: International Journal of Trichology
Yu Guo, Mingmin M Xu, Yuchang Huang, Meiqi Ji, Zeren Wei, Jialei Zhang, Qingchuan Hu, Jian Yan, Yue Chen, Jiaxuan Lyu, Xiaoqian Shao, Ying Wang, Jiamei Guo, Yulong Wei
BACKGROUND: Qigong, as one of the essential elements of Traditional Chinese exercises, has been used to improve physical and psychological health and combat diseases in China for thousands of years. In recent years, the beneficial effects of Qigong on different medical conditions are becoming more accepted by both patients and health care providers. Although it is a common impression that Qigong and related therapies are generally safe procedures, but the current understanding of its adverse events is fragmented...
November 2018: Medicine (Baltimore)
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