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Medical Virtue

Andreas K Triantafyllidis, Vassilis G Koutkias, Ioanna Chouvarda, Ilia Adami, Angelina Kouroubali, Nicos Maglaveras
Sensor-based health systems can often become difficult to use, extend and sustain. The authors propose a framework for designing sensor-based health monitoring systems aiming to provide extensible and usable monitoring services in the scope of pervasive patient care. The authors' approach relies on a distributed system for monitoring the patient health status anytime-anywhere and detecting potential health complications, for which healthcare professionals and patients are notified accordingly. Portable or wearable sensing devices measure the patient's physiological parameters, a smart mobile device collects and analyses the sensor data, a Medical Center system receives notifications on the detected health condition, and a Health Professional Platform is used by formal caregivers in order to review the patient condition and configure monitoring schemas...
September 2016: Healthcare Technology Letters
C Wyatt Shields Iv, Jeffrey L Wang, Korine A Ohiri, Eric D Essoyan, Benjamin B Yellen, Andrew J Armstrong, Gabriel P López
Liquid biopsies hold enormous promise for the next generation of medical diagnoses. At the forefront of this effort, many are seeking to capture, enumerate and analyze circulating tumor cells (CTCs) as a means to prognosticate and develop individualized treatments for cancer. Capturing these rare cells, however, represents a major engineering challenge due to their low abundance, morphology and heterogeneity. A variety of microfluidic tools have been developed to isolate CTCs from drawn blood samples; however, few of these approaches offer a means to separate and analyze cells in an integrated system...
September 21, 2016: Lab on a Chip
Dehui Luo, Xiang Wan, Jiming Liu, Tiejun Tong
The era of big data is coming, and evidence-based medicine is attracting increasing attention to improve decision making in medical practice via integrating evidence from well designed and conducted clinical research. Meta-analysis is a statistical technique widely used in evidence-based medicine for analytically combining the findings from independent clinical trials to provide an overall estimation of a treatment effectiveness. The sample mean and standard deviation are two commonly used statistics in meta-analysis but some trials use the median, the minimum and maximum values, or sometimes the first and third quartiles to report the results...
September 27, 2016: Statistical Methods in Medical Research
Issa Mirmehdi, Cindy-Marie O'Neal, Davis Moon, Heather MacNew, Christopher Senkowski
PURPOSE: With the implementation of strict 80-hour work week in general surgery training, serious questions have been raised concerning the quality of surgical education and the ability of newly trained general surgeons to independently operate. Programs that were randomized to the interventional arm of the Flexibility In duty-hour Requirements for Surgical Trainees (FIRST) Trial were able to decrease transitions and allow for better continuity by virtue of less constraints on duty-hour rules...
September 16, 2016: Journal of Surgical Education
Virtu Solano-Collado, Adam Rofe, Stefania Spanò
Our immune system is engaged in a continuous battle against invading pathogens, many of which have evolved to survive in intracellular niches of mammalian hosts. A variety of cellular processes are involved in preventing bacterial invasion or in killing bacteria that successfully invade host cells. Recently, the Rab GTPase Rab32 emerged as critical regulator of a host defense pathway that can eliminate bacterial pathogens. Salmonella enterica is an intracellular bacterium and a major cause of infections and deaths in humans...
September 20, 2016: Small GTPases
Hane Htut Maung
Diagnoses in medicine are often taken to serve as explanations of patients' symptoms and signs. This article examines how they do so. I begin by arguing that although some instances of diagnostic explanation can be formulated as covering law arguments, they are explanatory neither in virtue of their argumentative structures nor in virtue of general regularities between diagnoses and clinical presentations. I then consider the theory that medical diagnoses explain symptoms and signs by identifying their actual causes in particular cases...
September 16, 2016: Theoretical Medicine and Bioethics
Kate Tracy, Carol Boushey, Sparkle M Roberts, J Glenn Morris, Lynn M Grattan
The CoASTAL cohort represents the first community cohort assembled to study a HAB related illness. It is comprised of three Native American tribes in the Pacific NW for the purpose of studying the health impacts of chronic, low level domoic acid (DA) exposure through razor clam consumption. This cohort is at risk of domoic acid (DA) toxicity by virtue of their geographic location (access to beaches with a history of elevated DA levels in razor clams) and the cultural and traditional significance of razor clams in their diet...
July 2016: Harmful Algae
R N Werner, A F Nikkels, B Marinović, M Schäfer, M Czarnecka-Operacz, A M Agius, Z Bata-Csörgő, J Breuer, G Girolomoni, G E Gross, S Langan, R Lapid-Gortzak, T H Lesser, U Pleyer, J Sellner, G M Verjans, P Wutzler, C Dressler, R Erdmann, S Rosumeck, A Nast
BACKGROUND: Herpes zoster (HZ, shingles) is a frequent medical condition which may severely impact the quality of life of affected patients. Different therapeutic approaches to treat acute HZ are available. OBJECTIVE: The aim of this European project was the elaboration of a consensus-based guideline on the management of patients who present with HZ, considering different patient populations and different localisations. This interdisciplinary guideline aims at an improvement of the outcomes of the acute HZ management concerning disease duration, acute pain and quality of life of the affected patients and at a reduction of the incidence of PHN and other complications...
August 31, 2016: Journal of the European Academy of Dermatology and Venereology: JEADV
Ben Kotzee, Agnieszka Ignatowicz, Hywel Thomas
Virtue ethics has long provided fruitful resources for the study of issues in medical ethics. In particular, study of the moral virtues of the good doctor-like kindness, fairness and good judgement-have provided insights into the nature of medical professionalism and the ethical demands on the medical practitioner as a moral person. Today, a substantial literature exists exploring the virtues in medical practice and many commentators advocate an emphasis on the inculcation of the virtues of good medical practice in medical education and throughout the medical career...
August 24, 2016: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
Ravindra Dhar Dubey, Ankit Saneja, Prasoon K Gupta, Prem N Gupta
Gemcitabine (2',2'-difluoro-2'-deoxycytidine; dFdC) is an efficacious anticancer agent acting against a wide range of solid tumors, including pancreatic, non-small cell lung, bladder, breast, ovarian, thyroid and multiple myelomas. However, short plasma half-life due to metabolism by cytidine deaminase necessitates administration of high dose, which limits its medical applicability. Further, due to its hydrophilic nature, it cannot traverse cell membranes by passive diffusion and, therefore, enters via nucleoside transporters that may lead to drug resistance...
October 10, 2016: European Journal of Pharmaceutical Sciences
Alexander Zambrano
Some philosophers and physicians have argued that alcoholic patients, who are responsible for their liver failure by virtue of alcoholism, ought to be given lower priority for a transplant when donated livers are being allocated to patients in need of a liver transplant. The primary argument for this proposal, known as the Responsibility Argument, is based on the more general idea that patients who require scarce medical resources should be given lower priority for those resources when they are responsible for needing them and when they are competing with patients who need the same resources through no fault of their own...
August 12, 2016: Bioethics
S S Hu
The cardiovascular surgery in China has achieved great progress both on scale and technology though development over the past thirty years. However, the technical predominance of cardiovascular surgery in therapies for some diseases has been weakened, along with developments of new drugs and interventional technology. Besides, the change of doctor-patient relationship result from internet medical information service and less attraction of cardiovascular surgery discipline to talents bring certain challenge to the development of cardiovascular surgery...
August 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Angela Huttner, Leonard Leibovici, Ursula Theuretzbacher, Benedikt Huttner, Mical Paul
The informed consent document is intended to provide basic rights to patients but often fails to do so. Patients' autonomy may be diminished by virtue of their illness; evidence shows that even patients who appear to be ideal candidates for understanding and granting informed consent rarely are-particularly those with acute infections. We argue that, for low-risk trials whose purpose is to evaluate non-experimental therapies or other measures toward which the medical community is in a state of equipoise, ethics committees should play a more active role in a more standardized fashion...
August 3, 2016: Clinical Microbiology and Infection
Kyle E Karches, Daniel P Sulmasy
Medical educators and powerful physician organizations agree on the importance of professionalism for the formation of good physicians. However, the many definitions of professionalism found in the literature lack content and differ significantly, undermining attempts to describe and implement professionalism curricula. The work of the contemporary moral philosopher Alasdair MacIntyre on the virtues may help provide some of the content that the concept of professionalism currently lacks. MacIntyre shows the importance of the virtues, particularly justice, courage, and truthfulness, for the success of any "practice," defined as a form of cooperative human activity...
July 2016: Family Medicine
G Michael Leffel, Ross A Oakes Mueller, Sandra A Ham, Farr A Curlin, John D Yoon
THEORY: In the Project on the Good Physician, the authors endeavor to advance medical character education by proposing and testing a moral intuitionist model of virtuous caring that may be applicable to physician training. This model proposes that the moral intuition to care/harm motivates students to extend care to those in need. HYPOTHESES: Hypothesis 1: Medical students will report stronger preferences for the intuition to Care/harm over other moral intuitions in clinical decision making...
July 28, 2016: Teaching and Learning in Medicine
Vlado Kambovski
Talking about Acad. Momir Polenakovic, on the occasion of his 75th anniversary and 50 years of work, it is my pleasure to say that he is one of the rare medical workers, researchers, visionaries and educators, especially in the field of nephrology. With his work he became famous in Macedonia and in the world and raised the Macedonian nephrology to a European level. He is characterized with the highest virtues of the scientist: knowledge, diligence, searching for truth and empathy. Acad. Polenakovic is an example to all younger counterparts for his exceptionally correct and friendly relations with all his associates, and, he also supports his younger colleagues in their work and development...
2015: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
Sharon L Manne, Shannon Myers-Virtue, David Kissane, Melissa Ozga, Deborah A Kashy, Stephen Rubin, Carolyn J Heckman, Norman Rosenblum
OBJECTIVE: Fear of cancer recurrence is an important clinical phenomenon and is associated with decrements in life domains. The study goals were to characterize patterns of global fear of recurrence (FOR) and four domains of fear (health, role, womanhood, and death worry) over time in women who were diagnosed with gynecological cancer and to identify demographic, medical, and psychological predictors of FOR. METHOD: One hundred eighteen women participating in the Usual Care arm of a randomized trial completed the Concerns about Recurrence scale as well as measures of depressive symptoms, cancer-specific distress, coping, coping efficacy, and social network responses at four time points...
July 16, 2016: Psycho-oncology
L E Gorelova, A E Loktev
Sanitation measures of the final period of World War II included the sanitary surveillance of water and power forces, observation of their placement and content of the territory occupied by them, monitor the implementation of military rules of personal hygiene and health education. The content of anti-epidemic measures was control of vectors of infectious and parasitic diseases, the protection of troops against the penetration of these diseases from the outside, the sanitary-epidemiological investigation and vaccination of staff, early detection and isolation of infectious patients, their timely hospitalization, disinfection of the source of infection, identify the sources of infection and epidemiological surveillance behind the hearth...
April 2016: Voenno-medit︠s︡inskiĭ Zhurnal
Suryakanta Swain, Sitty Manohar Babu, Sarwar Beg, Jayshree Jena
Nanoparticles (NPs) achieve preferential accumulation in the tumor site by virtue of their passive and ligand-based targeting mechanisms. The unique properties of nanoparticle such as large surface-to-volume ratio, small size, the ability to encapsulate various drugs, and tunable surface chemistry, give those many advantages over their bulk counterparts. Polymer-based nanomedicine, an arena that entails the use of polymeric NPs, polymer micelles, dendrimers, polymersomes, polyplexes, polymer-lipid hybrid systems, and polymer-drug/protein conjugates for improvement in efficacy of cancer therapeutics, has been widely explored...
July 13, 2016: Current Drug Delivery
J D Blom, F R E Smink, E V Kwidama, V M Vladár Rivero
BACKGROUND: A frequent complaint in psychiatry is that the psychiatrist-patient relationship and the quality of care are hampered by bureaucratic processes. AIM: To provide an analysis of various types of bureaucracy in psychiatry that can serve as a starting-point for the improvement of care and the performance of qualitative studies. METHOD: We conducted an exploratory study using PubMed, Google, and various Dutch medical journals. RESULTS: Contemporary psychiatry is characterised by a bureaucratic organization structure...
2016: Tijdschrift Voor Psychiatrie
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