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General internal medicine

Sharon E Card, Heather D Clark, Michelle Elizov, Narmin Kassam
General internal medicine (GIM), like other generalist specialties, has struggled to maintain its identity in the face of mounting sub-specialization over the past few decades. In Canada, the path to licensure for general internists has been through the completion of an extra year of training after three core years of internal medicine. Until very recently, the Royal College of Physicians and Surgeons of Canada (RCPSC) did not recognize GIM as a distinct entity. In response to a societal need to train generalist practitioners who could care for complex patients in an increasingly complex health care setting, the majority of universities across Canada voluntarily developed structured GIM training programs independent of RCPSC recognition...
October 24, 2016: Journal of General Internal Medicine
Gurusankar Saravanabhavan, Kate Werry, Mike Walker, Douglas Haines, Morie Malowany, Cheryl Khoury
Human biomonitoring reference values are statistical estimates that indicate the upper margin of background exposure to a given chemical at a given time. Nationally representative human biomonitoring data on 176 chemicals, including several metals and trace elements, are available in Canada from 2007 to 2013 through the Canadian Health Measures Survey (CHMS). In this work, we used a systematic approach based on the reference interval concept proposed by the International Federation of Clinical Chemistry and Laboratory Medicine and the International Union of Pure and Applied Chemistry to derive reference values (RV95s) for metals and trace elements...
October 17, 2016: International Journal of Hygiene and Environmental Health
Franciszek Hennel, Klaas P Pruessmann
PURPOSE: Fourier encoded MRI signal is complex and, therefore, sensitive to uncontrolled phase variations caused, e.g., by object motion. An alternative encoding is proposed which leads to phaseless (positive real) signals and allows the phase fluctuations to be removed by simple magnitude calculation before the Fourier transform. THEORY AND METHODS: Phaseless encoding uses harmonic modulation of the longitudinal magnetization with different frequencies and phases before excitation...
October 23, 2016: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
Alfred Maroyi
ETHNOPHARMACOLOGICAL RELEVANCE: Crinum macowanii is a deciduous bulbous plant which grows in east, central and southern Africa. Crinum macowanii has been used as herbal medicine by the indigenous people of east and southern Africa has for several centuries. The bulb, leaves and roots of C. macowanii are reported to possess diverse medicinal properties and used to treat or manage various human and animal diseases and ailments throughout its distributional range. Crinum macowanii is used traditionally as a remedy for boils, diarrhoea, fever, inflammation, respiratory system problems, skin rashes, tuberculosis, wounds and urinary tract problems...
October 20, 2016: Journal of Ethnopharmacology
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
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
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
Bayan Sharif-Chan, Dipti Tankala, Christine Leong, Zubin Austin, Marisa Battistella
Objective. To compare peer teaching in a medical and a pharmacy clinical teaching unit and to provide suggestions for future research in pharmacy near-peer teaching. Methods. This exploratory observational study used principles of ethnographic methodology for data collection and analysis. Observations were collected in a large downtown teaching hospital. An average of 4-6 hours per day were spent observing a team of medical trainees from the Faculty (School) of Medicine in the general internal medicine (unit for two weeks, followed by a team of pharmacy trainees in an ambulatory hemodialysis (HD) unit for two weeks...
September 25, 2016: American Journal of Pharmaceutical Education
Hiromi Rakugi
European guidelines (ESH-ESC2013) for the elderly have discussed well about treatment blood pressure (BP) levels and targeting BP levels. In general, elderly patients with systolic BP (SBP) ≥160 mmHg including individuals older than 80 years in good physical and mental conditions are recommended reducing SBP to between 150 and 140 mmHg. Furthermore, fit elderly patients <80 years old are recommended to consider antihypertensive treatment at SBP values ≥140 mmHg with a target SBP <140 mmHg. On the other hand, frail elderly patients are recommended to leave decisions on antihypertensive therapy to the treating physician, and based on monitoring of the clinical effects of treatment...
September 2016: Journal of Hypertension
Andrew D Schreiner, Brad A Keith, Karen E Abernathy, Jingwen Zhang, Walter A Brzezinski
BACKGROUND: Endurance exercise plays a role in cardiovascular risk reduction, but may also be a risk factor for atrial fibrillation. This study was performed to assess the prevalence of atrial fibrillation in a population of long-term, competitive swimmers compared with patients within an internal medicine clinic with known risk factors for atrial fibrillation such as diabetes mellitus and hypertension. METHODS: This cross-sectional study utilized survey data comparing the prevalence of atrial fibrillation in swimmers to a general internal medicine population...
December 2016: Sports Medicine—Open
Kim Tran, Chaim Bell, Nathan Stall, George Tomlinson, Allison McGeer, Andrew Morris, Michael Gardam, Howard B Abrams
BACKGROUND: Isolation precautions have negative effects on patient safety, psychological well-being, and healthcare worker contact. However, it is not known whether isolation precautions affect certain hospital-related outcomes. OBJECTIVE: To examine the effect of isolation precautions on hospital-related outcomes and cost of care. DESIGN: Retrospective, propensity-score matched cohort study of inpatients admitted to general internal medicine (GIM) services at three academic hospitals in Toronto, Ontario, Canada between January 2010 and December 2012...
October 17, 2016: Journal of General Internal Medicine
Bo Gao, Qin Shao, Hani Choudhry, Victoria Marcus, Kung Dong, Jiannis Ragoussis, Zu-Hua Gao
After the publication of the article, the authors noted that the affiliation for Dr Hani Choudhry is wrong. The correct affiliation should be as follows: Bo Gao1, Qin Shao2, Hani Choudhry3, Victoria Marcus2, Kung Dong5, Jiannis Ragoussis4 and Zu-Hua Gao2, 1Department of General Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China; 2Department of Pathology, The Research Institute of McGill University Health Center, Montreal, Québec H4A 3J1, Canada; 3Department of Biochemistry, Faculty of Science, Cancer and Mutagenesis Unit, King Fahd Center for Medical Research, Center of Innovation in Personalized Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; 4McGill University and Genome Quebec Innovation Centre, Montreal, Québec H3B 1S6, Canada; 5Department of Pathology, Beijing Youan Hospital, Capital Medical University, Beijing 100069, P...
October 6, 2016: International Journal of Oncology
Sally J Wadsworth, John C DeFries, Erik G Willcutt, Bruce F Pennington, Richard K Olson
Because of recent concerns about the replication of published results in the behavioral and biomedical sciences (Ioannidis, PLoS Medicine, Vol. 2, 2005, p. e124; Open Science Collaboration, Science, Vol. 349, 2015, p. 943; Pashler & Wagenmakers, Perspectives on Psychological Science, Vol. 7, 2012, pp. 528-530), we have conducted a replication of our recently published analyses of longitudinal reading performance and attention deficit-hyperactivity disorder data from twin pairs selected for reading difficulties (Wadsworth et al...
October 17, 2016: Twin Research and Human Genetics: the Official Journal of the International Society for Twin Studies
Zi-Xiang Kuai, Wan-Yu Liu, Yan-Li Zhang, Yue-Min Zhu
PURPOSE: A generalized intravoxel incoherent motion (IVIM) model, called the GIVIM, was proposed to better account for complex perfusion present in the tissues having various vessels and flow regimes, such as the liver. THEORY AND METHODS: The notions of continuous pseudodiffusion variable as well as perfusion fraction density function were introduced to describe the presence of multiple perfusion components in a voxel. The mean and standard deviation of Gaussian perfusion fraction density function were then used to define two new parameters, the mean pseudodiffusivity ( D¯) and pseudodiffusion dispersion (σ)...
November 2016: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
Bashir Mohamed Elmahi Yousif, Siripen Supakankunti
BACKGROUND: The appropriate use of medicines is essential for the provision of quality health services, patient safety, and the rational use of health resources. In Sudan, general practitioners (GPs) provide 80 % of insured patients' health services. Pharmaceutical service costs have been increasing since 2010. OBJECTIVES: We aimed to use the World Health Organization (WHO) and International Network for the Rational Use of Drugs prescribing indicators to assess prescription quality among GPs in different types of primary healthcare centers (PHCCs) within the National Health Insurance Fund (NHIF) in Gezira State, Sudan...
September 2016: Drugs—Real World Outcomes
Johannes Bircher, Eckhart G Hahn
This paper explores the diagnostic and therapeutic potential of a new concept of health. Investigations into the nature of health have led to a new definition that explains health as a complex adaptive system (CAS) and is based on five components (a-e). Humans like all biological creatures must satisfactorily respond to (a) the demands of life. For this purpose they need (b) a biologically given potential (BGP) and (c) a personally acquired potential (PAP). These properties of individuals are embedded within (d) social and (e) environmental determinants of health...
2016: F1000Research
Sufian S Ahmad, Johannes C Meyer, Anna M Krismer, Suhaib S Ahmad, Dimitrios S Evangelopoulos, Sven Hoppe, Sandro Kohl
PURPOSE: Clinical research in the area of anterior cruciate ligament (ACL) injury has shown substantial growth during the last decade. This was accompanied by the establishment of a wide range of outcome measures used to address the demands of clinical studies. The aim of this study was to evaluate outcome measures reported by highly cited level I trials in ACL research and identify factors influencing citation metrics. METHODS: The database of the Institute for Scientific Information (ISI) was utilized to screen journals under the subject categories "Orthopaedics", "Sports Sciences", "Radiology" and "General medicine" for the 50 most cited level I ACL trials based on predefined inclusion criteria...
October 14, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Grigoriy E Gurvits, Gloria Lan, Amy Tan, Arlene Weissman
BACKGROUND: Increasing prevalence of inflammatory bowel disease (IBD) poses significant challenges to medical community. Preventive medicine, including vaccination against opportunistic infections, is important in decreasing morbidity and mortality in patients with IBD. We conduct first study to evaluate general awareness and adherence to immunisation guidelines by primary care physicians in the USA. METHODS: We administered an electronic questionnaire to the research panel of the American College of Physicians (ACP) assessing current vaccination practices, barriers to vaccination and provider responsibility for administering vaccinations and compared responses with the European Crohn's and Colitis Organization consensus guidelines and expert opinion from the USA...
October 12, 2016: Postgraduate Medical Journal
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