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responsible medicine

James P MacDonald, Pierre A dʼHemecourt, Lyle J Micheli
OBJECTIVE: Young athletes not uncommonly complain of back pain. Many patient-reported outcome measures are used to evaluate back pain, but none have been designed specifically to assess young, athletic patients. The Micheli Functional Scale (MFS) was developed to measure impairment due to back pain in this population. This study examined the reliability, validity, and responsiveness of the MFS used in routine clinical assessments. DESIGN: Retrospective Cohort Study...
November 2016: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Myung Kyu Chung, Patrick J LaRiccia
Presented is the first reported case series of chronic neck and back pain associated with breast scars from breast surgery and successfully treated with an integrative medicine assessment and treatment approach, which included the assessment technique of autonomic response testing and the scar therapy technique of neural therapy. Implications for nursing practice are discussed.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4...
October 25, 2016: Holistic Nursing Practice
Alan Bleakley
Inequalities in society are reflected in patterns of disease and access to health care, where the disadvantaged suffer most. Traditionally, doctors have kept politics out of their work, even though politics often shape medicine. What political responsibilities, then, should doctors have as they facilitate the learning of medical students? The article in this issue by Kumagai, Jackson, and Razack goes straight to the heart of this question. These authors ask whether educators should be wary of "cutting close to the bone" in discussing issues that may restimulate trauma in some medical students...
October 25, 2016: Academic Medicine: Journal of the Association of American Medical Colleges
Arno K Kumagai, Brittani Jackson, Saleem Razack
Learning the societal roles and responsibilities of the physician may involve difficult, contentious conversations about topics such as race, gender, sexual orientation, and class, as well as violence, inequities, sexual assault, and child abuse. If not done well, these discussions may be deeply traumatizing to learners for whom these subjects "cut close to the bone." Equally traumatizing is exposure to injustice and mistreatment, as well as to the sights, sounds, and smells of suffering and pain in the clinical years...
October 25, 2016: Academic Medicine: Journal of the Association of American Medical Colleges
Matthew J Delano, Peter A Ward
Sepsis occurs when an infection exceeds local tissue containment and induces a series of dysregulated physiologic responses that result in organ dysfunction. A subset of patients with sepsis progress to septic shock, defined by profound circulatory, cellular, and metabolic abnormalities, and associated with a greater mortality. Historically, sepsis-induced organ dysfunction and lethality were attributed to the complex interplay between the initial inflammatory and later anti-inflammatory responses. With advances in intensive care medicine and goal-directed interventions, early 30-day sepsis mortality has diminished, only to steadily escalate long after "recovery" from acute events...
November 2016: Immunological Reviews
Liliana Lalaleo, Abbas Khojasteh, Mohammad Fattahi, Mercedes Bonfill, Rosa M Cusido, Javier Palazon
BACKGROUND: Bioactive plant secondary metabolites have complex chemical structures, which are specific to each plant species/family, and accumulate in tiny amounts. The growing market demand for many phytochemicals can lead to the over-harvesting of medicinal plants in their natural habitat, endangering species in the process. OBJECTIVE: An ongoing challenge for our society is therefore to develop a bio-sustainable production of phytochemicals, among other natural resources...
October 24, 2016: Current Medicinal Chemistry
S Katrina Perehudoff, Brigit Toebes, Hans Hogerzeil
A constitutional guarantee of access to essential medicines has been identified as an important indicator of government commitment to the progressive realization of the right to the highest attainable standard of health. The objective of this study was to evaluate provisions on access to essential medicines in national constitutions, to identify comprehensive examples of constitutional text on medicines that can be used as a model for other countries, and to evaluate the evolution of constitutional medicines-related rights since 2008...
June 2016: Health and Human Rights
Carlijn C M Welten, Maarten W J Koeter, Tamar D Wohlfarth, Jitschak G Storosum, Wim van den Brink, Christine C Gispen-de Wied, Hubert G M Leufkens, Damiaan A J P Denys
OBJECTIVE: To investigate whether early nonresponse to antipsychotic treatment of acute mania predicts treatment failure and, if so, to establish the best definition or criterion of an early nonresponse. DATA SOURCES: Short-term efficacy studies assessing antipsychotics that were submitted to the Dutch Medicines Evaluation Board during an 11-year period as part of the marketing authorization application for the indication of acute manic episode of bipolar disorder...
September 2016: Journal of Clinical Psychiatry
Yong Cai, Xiwen Li, Runmiao Wang, Qing Yang, Peng Li, Hao Hu
Currently, the chemical fingerprint comparison and analysis is mainly based on professional equipment and software, it's expensive and inconvenient. This study aims to integrate QR (Quick Response) code with quality data and mobile intelligent technology to develop a convenient query terminal for tracing quality in the whole industrial chain of TCM (traditional Chinese medicine). Three herbal medicines were randomly selected and their chemical two-dimensional barcode (2D) barcodes fingerprints were constructed...
2016: PloS One
Bakhta Aouey, Amira Mahjoubi Samet, Hamadi Fetoui, Monique S J Simmonds, Mohamed Bouaziz
ETHNOPHARMACOLOGICAL RELEVANCE: The leaves of Vitis vinifera is used in traditional medicine for diarrhea, hepatitis and stomachaches. The objective of this study was to investigate the anti-oxidant, anti-inflammatory, analgesic and antipyretic properties of the hydroalcoholic leaf extract of Vitis vinifera (EVV) on experimental models to provide scientific basis for its use. MATERIALS AND METHODS: The EVV was chemically characterized by LC-MS/MS analyses. The in vitro antioxidant activities of the EVV extract were measured using 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging assay and Ferric reducing antioxidant power assay (FRAP)...
October 22, 2016: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Matthew Collin, Venetia Bigley
The maintenance of monocytes, macrophages, and dendritic cells (DCs) involves manifold pathways of ontogeny and homeostasis that have been the subject of intense study in recent years. The concept of a peripheral mononuclear phagocyte system continually renewed by blood-borne monocytes has been modified to include specialized DC pathways of development that do not involve monocytes, and longevity through self-renewal of tissue macrophages. The study of development remains difficult owing to the plasticity of phenotypes and misconceptions about the fundamental structure of hematopoiesis...
October 2016: Microbiology Spectrum
Germán Valero, Paula Cárdenas
The Faculty of Veterinary Medicine and Animal Science of the National Autonomous University of Mexico (UNAM) uses the Moodle learning management system for formative and summative computer assessment. The authors of this article-the teacher primarily responsible for Moodle implementation and a researcher who is a recent Moodle adopter-describe and discuss the students' and teachers' attitudes to summative and formative computer assessment in Moodle. Item analysis of quiz results helped us to identify and fix poorly performing questions, which greatly reduced student complaints and improved objective assessment...
October 25, 2016: Journal of Veterinary Medical Education
Hellen J Amuguni, Melissa Mazan, Robert Kibuuka
Infectious diseases of grave concern to human health are emerging from wildlife and livestock populations in multiple regions of the world. Responding effectively to these emerging pandemics requires engagement of multidisciplinary groups of professionals. Using a One Health approach, One Health Central and Eastern Africa (OHCEA), a network of seven schools of public health and seven veterinary schools, with the support of the United States Agency for International Development (USAID), has engaged in curriculum review with the aim of building the skills of multidisciplinary groups of professionals to improve their capacity to respond to emerging infectious diseases...
October 25, 2016: Journal of Veterinary Medical Education
Jason Ostenson, Akshat C Pujara, Artem Mikheev, Linda Moy, Sungheon G Kim, Amy N Melsaether, Komal Jhaveri, Sylvia Adams, David Faul, Christopher Glielmi, Christian Geppert, Thorsten Feiweier, Kimberly Jackson, Gene Y Cho, Fernando E Boada, Eric E Sigmund
PURPOSE: Diffusion-weighted imaging (DWI) and (18) F-fluorodeoxyglucose-positron emission tomography ((18) F-FDG-PET) independently correlate with malignancy in breast cancer, but the relationship between their structural and metabolic metrics is not completely understood. This study spatially correlates diffusion, perfusion, and glucose avidity in breast cancer with simultaneous PET/MR imaging and compares correlations with clinical prognostics. METHODS: In this Health Insurance Portability and Accountability Act-compliant prospective study, with written informed consent and approval of the institutional review board and using simultaneously acquired FDG-PET and DWI, tissue diffusion (Dt ), and perfusion fraction (fp ) from intravoxel incoherent motion (IVIM) analysis were registered to FDG-PET within 14 locally advanced breast cancers...
October 25, 2016: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
Bing Yuan
In the field of life sciences, although system biology and "precision medicine" introduce some complex scientifific methods and techniques, it is still based on the "analysis-reconstruction" of reductionist theory as a whole. Adaptability of complex system increase system behaviour uncertainty as well as the difficulties of precise identifification and control. It also put systems biology research into trouble. To grasp the behaviour and characteristics of organism fundamentally, systems biology has to abandon the "analysis-reconstruction" concept...
October 24, 2016: Chinese Journal of Integrative 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
Cristen P Page, Alfred Reid, Catherine L Coe, Martha Carlough, Daryl Rosenbaum, Janalynn Beste, Blake Fagan, Erika Steinbacher, Geoffrey Jones, Warren P Newton
BACKGROUND : Implementation of the educational milestones benefits from mobile technology that facilitates ready assessments in the clinical environment. We developed a point-of-care resident evaluation tool, the Mobile Medical Milestones Application (M3App), and piloted it in 8 North Carolina family medicine residency programs. OBJECTIVE : We sought to examine variations we found in the use of the tool across programs and explored the experiences of program directors, faculty, and residents to better understand the perceived benefits and challenges of implementing the new tool...
October 2016: Journal of Graduate Medical Education
Greg Ogrinc, Emily S Cohen, Robertus van Aalst, Beth Harwood, Ellyn Ercolano, Karyn D Baum, Adam J Pattison, Anne C Jones, Louise Davies, Al West
BACKGROUND : Integrating teaching and hands-on experience in quality improvement (QI) may increase the learning and the impact of resident QI work. OBJECTIVE : We sought to determine the clinical and educational impact of an integrated QI curriculum. METHODS : This clustered, randomized trial with early and late intervention groups used mixed methods evaluation. For almost 2 years, internal medicine residents from Dartmouth-Hitchcock Medical Center on the inpatient teams at the White River Junction VA participated in the QI curriculum...
October 2016: Journal of Graduate Medical Education
Laura Isabell Immohr, Roy Turner, Miriam Pein-Hackelbusch
During development of oral liquid medicines taste assessment is often required to evaluate taste and taste masking. Electronic tongue analysis can provide taste assessment of medicinal products but should only be conducted with medicines that interact with the instrument without damaging the sensor membranes or interfering with their electrical output so that robust data is generated. To explore the impact of a substance deemed unsuitable for electronic tongue analysis the influence of the anionic surfactant sodium lauryl sulfate (SLS), on the performance of the electronic tongue was conducted using electronic tongues equipped with Self-developed PVC based sensors...
October 21, 2016: International Journal of Pharmaceutics
A-Ram Jung, Sang-Hyun Ahn, In-Sik Park, Sun-Young Park, Seung-Il Jeong, Jin-Hong Cheon, Kibong Kim
BACKGROUND: Douchi (fermented Glycine max Merr.) is produced from fermented soybeans, which is widely used in traditional herbal medicine. In this study, we investigated whether Douchi attenuates protein kinase C (PKC) and interleukin (IL)-4 response and cutaneous inflammation in Atopic dermatitis (AD)-like NC/Nga mice. METHODS: To induce AD-like skin lesions, D. farinae antigen was applied to the dorsal skin of 3-week-old NC/Nga mice. After inducing AD, Douchi extract was administered 20 mg/kg daily for 3 weeks to the Douchi-treated mice group...
October 24, 2016: BMC Complementary and Alternative Medicine
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