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personal medicine

Francisco Martín Rodríguez, Cristina Fernández Pérez, Miguel Castro Villamor, José Luis Martín Conty, Pedro Arnillas Gómez, Verónica Casado Vicente
OBJECTIVES: Our aim was to determine the usefulness of level D personal protective equipment (PPE) in safeguarding health care staff who perform cardiopulmonary resuscitation (CPR). MATERIAL AND METHODS: Quasi-experimental, uncontrolled trial in 96 volunteers chosen randomly and stratified by sex, level of training, and professional category. The subjects were selected from a convenience sample of 164 nurses, physicians, and students of nursing and medicine (40 men [41...
2018: Emergencias: Revista de la Sociedad Española de Medicina de Emergencias
Rieke Schnakenberg, Lukas Radbruch, Christine Kersting, Friederike Frank, Stefan Wilm, Denise Becka, Klaus Weckbecker, Markus Bleckwenn, Johannes M Just, Michael Pentzek, Birgitta Weltermann
BACKGROUND: Although general practitioners (GPs) are among the preferred contact persons for discussing end-of-life issues including advance directives (ADs), there is little data on how GPs manage such consultations. OBJECTIVES: This postal survey asked German GPs about their counselling for end-of-life decisions. METHODS: In 2015, a two-sided questionnaire was mailed to 959 GPs. GPs were asked for details of their consultations on ADs: frequency, duration, template use, and whether they have own ADs...
December 2018: European Journal of General Practice
Latinka Basara, Nataša Jokić Begić, Sanja Popović Grle, Marko Jakopović, Miroslav SamarŽija
Dyspnea or breathlessness is a term primarily used in respiratory medicine. Nevertheless, in the last fifteen years, studies from other fields focus on the affective component of this complex phenomenon due to the frequent observation that psychological states can cause or be caused by dyspnea. Research so far shows that besides the biological component, dyspnea has a strong emotional and psychosocial determinant. This means that apart from its biological factors, dyspnea and its intensity are affected by emotions, personality, anxiety and depression, etc...
March 2018: Psychiatria Danubina
Michael B Wayson, Wesley E Bolch
Internal radiation dose estimates for diagnostic nuclear medicine procedures are typically calculated for a reference individual. Resultantly, there is uncertainty when determining the organ doses to patients who are not at 50th percentile on either height or weight. This study aims to better personalize internal radiation dose estimates for individual patients by modifying the dose estimates calculated for reference individuals based on easily obtainable morphometric characteristics of the patient. Phantoms of different sitting heights and waist circumferences were constructed based on computational reference phantoms for the newborn, 10-year-old, and adult...
March 16, 2018: Physics in Medicine and Biology
George Richard Holt, Kevin Christopher McMains, Randal A Otto
Evaluating and providing global health assistance, humanitarian aid, and medical missions to Middle Eastern countries can be rewarding and challenging. A broad spectrum of financial capabilities supports effective health care delivery and infrastructure. Middle East tension can make obtaining a visa difficult. Personal safety considerations may hinder efforts to develop and carry out clinical and educational programs. Several Middle East countries have sophisticated and modern health care systems. Medical education and specialty training compares with that of Western medicine...
March 12, 2018: Otolaryngologic Clinics of North America
Donald M Hilty, Terry Rabinowitz, Robert M McCarron, David J Katzelnick, Trina Chang, Amy M Bauer, John Fortney
INTRODUCTION: In this era of patient-centered care, telepsychiatry (TP; video or synchronous) provides quality care with outcomes as good as in-person care, facilitates access to care, and leverages a wide range of treatments at a distance. METHOD: This conceptual review article explores TP as applied to newer models of care (e.g., collaborative, stepped, and integrated care). RESULTS: The field of psychosomatic medicine (PSM) has developed clinical care models, educates interdisciplinary team members, and provides leadership to clinical teams...
December 26, 2017: Psychosomatics
Dafina Ilijazi, Mohammad Abufaraj, Melanie R Hassler, Iris E Ertl, David D'Andrea, Shahrokh F Shariat
Bladder cancer (BCa) is the fifth most frequently diagnosed cancer worldwide and is, in fact, the most expensive cancer on a per-patient to treat basis. There is a critical need to implement new tests into clinical practice to improve the quality of clinical care, decrease unnecessary invasive therapies and ultimately save costs. Currently, no molecular or genetic biomarker has been widely integrated into daily clinical practice. However, major milestones have been achieved in our understanding of the molecular alterations in BCa that will provide the basis for integrating molecular and genetic biomarkers into clinical decision making to guide management...
March 15, 2018: Expert Review of Molecular Diagnostics
Eleonore V Grant, Adam H Skolnick, Joshua Chodosh, Michael H Perskin, Nicole M Orr, Caroline Blaum, John A Dodson
More than 13 million persons in the United States aged 65 and older have cardiovascular disease (CVD), and this population is expected to increase exponentially over the next several decades. In the absence of clinical studies that would inform how best to manage this population, there is an urgent need for collaborative, thoughtful approaches to their care. Although cardiologists are traditionally regarded as leaders in the care of older adults with CVD, these individuals have multiple comorbidities, physiological differences, and distinct goals of care than younger patients that require a specialized geriatric lens...
March 15, 2018: Journal of the American Geriatrics Society
Leticia Moreira, Basil Bakir, Priya Chatterji, Zahra Dantes, Maximilian Reichert, Anil K Rustgi
Pancreatic ductal adenocarcinoma is one of the most aggressive forms of cancer, and the third leading cause of cancer-related mortality in the United States. Although important advances have been made in the last decade, the mortality rate of pancreatic ductal adenocarcinoma has not changed appreciably. This review summarizes a rapidly emerging model of pancreatic cancer research, focusing on 3-dimensional organoids as a powerful tool for several applications, but above all, representing a step toward personalized medicine...
March 2018: Cellular and Molecular Gastroenterology and Hepatology
N D B Ehelepola, A N Abayagunawardana, T N Sudusinghe
BACKGROUND: Hemolysis can occur in people with G6PD deficiency under oxidative stress. Acalypha indica is a tropical plant used as a medicinal plant as well as a vegetable. There are a few reported cases of Acalypha indica ingestion induced hemolysis in G6PD deficient people. All except one of them are from Sri Lanka. The information available at present (2017) about G6PD deficiency prevalence and variants of the G6PD gene among Sri Lankans is very sparse. There are no past reports on hemolytic crisis in a G6PD deficient person presenting mimicking leptospirosis...
March 14, 2018: BMC Research Notes
Akhilesh S Pathipati, Christine K Cassel
Although they enter school with enthusiasm for a career in medicine, medical students in the United States subsequently report high levels of burnout and disillusionment. As medical school leaders consider how to address this problem, they can look to business schools as one source of inspiration. In this Commentary, the authors argue-based on their collective experience in both medical and business education-that medical schools can draw three lessons from business schools that can help reinvigorate students...
March 13, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Timothy E Sweeney, Tej D Azad, Michele Donato, Winston A Haynes, Thanneer M Perumal, Ricardo Henao, Jesús F Bermejo-Martin, Raquel Almansa, Eduardo Tamayo, Judith A Howrylak, Augustine Choi, Grant P Parnell, Benjamin Tang, Marshall Nichols, Christopher W Woods, Geoffrey S Ginsburg, Stephen F Kingsmore, Larsson Omberg, Lara M Mangravite, Hector R Wong, Ephraim L Tsalik, Raymond J Langley, Purvesh Khatri
OBJECTIVES: To find and validate generalizable sepsis subtypes using data-driven clustering. DESIGN: We used advanced informatics techniques to pool data from 14 bacterial sepsis transcriptomic datasets from eight different countries (n = 700). SETTING: Retrospective analysis. SUBJECTS: Persons admitted to the hospital with bacterial sepsis. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: A unified clustering analysis across 14 discovery datasets revealed three subtypes, which, based on functional analysis, we termed "Inflammopathic, Adaptive, and Coagulopathic...
March 13, 2018: Critical Care Medicine
Carolina Torres, Paul J Grippo
Pancreatic ductal adenocarcinoma (PDAC) is projected to become the second cause of cancer-related deaths by 2020. Although it has traditionally been approached as one disease, accumulated evidences point to the clinical heterogeneity of this disease which translates into disparity in outcomes between patients. Much emphasis has been put into patient classification introducing a platform for more tailored therapies. In the last ten years, there have been important advances in the understanding of the molecular pathogenesis of PDAC, which has culminated with a comprehensive integrated genomic analysis from RNA expression profiles...
March 14, 2018: Annals of Medicine
Karin Alejandra Rosemblatt, Leandro Daniel Benmergui
During World War II, the U.S. Indian Service conducted social science experiments regarding governance among Japanese Americans imprisoned at the Poston, Arizona, camp. Researchers used an array of techniques culled from anthropological culture and personality studies, psychiatry, psychology, medicine, and public opinion research to probe how the personality traits of the confined Japanese-Americans and camp leaders affected the social interactions within each group and between them. The research drew on prior studies of Indian personality in the US Southwest, Mexico's Native policies, and indirect colonial rule...
March 14, 2018: Journal of the History of the Behavioral Sciences
Xiang-Tian Yu, Tao Zeng
The diversity and huge omics data take biology and biomedicine research and application into a big data era, just like that popular in human society a decade ago. They are opening a new challenge from horizontal data ensemble (e.g., the similar types of data collected from different labs or companies) to vertical data ensemble (e.g., the different types of data collected for a group of person with match information), which requires the integrative analysis in biology and biomedicine and also asks for emergent development of data integration to address the great changes from previous population-guided to newly individual-guided investigations...
2018: Methods in Molecular Biology
Wei Gan, Xin-Le Liu, Ting Yu, Yuan-Gao Zou, Ting-Ting Li, Shuang Wang, Jin Deng, Lan-Lan Wang, Jian-Ping Cai
Background: A molecular biomarker of physiologic age, as opposed to chronologic age, is needed in clinical medicine. 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxodGsn) and 8-oxo-7, 8-dihydroguanosine (8-oxoGsn) are two promising aging biomarkers. Methods: A total of 1,228 healthy Chinese residents (613 males and 615 females) 2-90 years of age were randomly selected. Spot urine samples were collected, and the concentrations of 8-oxodGsn and 8-oxoGsn were measured using ultra-high-performance liquid chromatography with a triple quadrupole mass spectrometer (UPLC-MS/MS)...
2018: Frontiers in Aging Neuroscience
Mariarosaria Conte, Raffaele De Palma, Lucia Altucci
In recent years, anti-tumor immunotherapy has shown promising results, and immune-oncology is now emerging as the fourth major wave in the treatment of tumors after radiotherapy, chemotherapy and molecular targeted therapy. Understanding the impact of the immune system on neoplastic cells is crucial to improve its effectiveness against cancer. The stratification of patients who might benefit from immunotherapy as well as the personalization of medicine have contributed to the discovery of new immunotherapeutic targets and molecules...
March 10, 2018: International Journal of Biochemistry & Cell Biology
Andreas Jerrentrup, Tobias Mueller, Ulrich Glowalla, Meike Herder, Nadine Henrichs, Andreas Neubauer, Juergen R Schaefer
TV series such as "House MD", "Grey´s Anatomy" or "Emergency Room" are well perceived by medical students. Seminars featuring medical TV series such as "House MD" might serve as door-opener to attract medical students to learn more about rare diseases. The TV series "House MD" is troublesome for the main character Dr. House is an excellent diagnostician but at the same time a rather misanthropic person. Therefore, lecturing medicine with the help of "House MD" requires constant evaluation...
2018: PloS One
John W Wax, Amy W An, Nicole Kosier, Timothy E Quill
Voluntary stopping of eating and drinking (VSED) is a deliberate, self-initiated attempt to hasten death in the setting of suffering refractory to optimal palliative interventions or prolonged dying that a person finds intolerable. Individuals who consider VSED tend to be older, have a serious but not always imminently terminal illness, place a high value on independence, and have significant illness burden. VSED can theoretically be performed independent of clinician assistance and therefore avoids many of the ethical and legal concerns associated with physician-assisted dying or other palliative measures of last resort, However, VSED is an intense process fraught with new sources of somatic and emotional suffering for individuals and their caregivers, so VSED is best supervised by an experienced, well-informed clinician who can provide appropriate pre-intervention assessment, anticipatory guidance, medical treatment of symptoms, and emotional support...
March 2018: Journal of the American Geriatrics Society
Cary Cuncic, Glenn Regehr, Heather Frost, Joanna Bates
INTRODUCTION: The relationship between preceptor and trainee is becoming recognized as a critical component of teaching, in particular in the negotiation of feedback and in the formation of professional identity. This paper elaborates on the nature of the relationships between preceptor and student that evolve in the context of rural longitudinal integrated clerkships (LICs). METHODS: We drew on constructivist grounded theory for the research approach. We interviewed nine LIC family practice preceptors from three sites at one educational institution...
March 12, 2018: Perspectives on Medical Education
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