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General Medicine Practice

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https://www.readbyqxmd.com/read/28924688/the-barrier-to-informed-choice-in-cancer-screening-statistical-illiteracy-in-physicians-and-patients
#1
Odette Wegwarth, Gerd Gigerenzer
An efficient health care requires both informed doctors and patients. Our current healthcare system falls short on both counts. Most doctors and patients do not understand the available medical evidence. To illustrate the extent of the problem in the setting of cancer screening: In a representative sample of some 5000 women in nine European countries, 92% overestimated the reduction of breast cancer mortality by mammography by a factor of 10-200, or did not know. For a similar sample of about 5000 men with respect to PSA screening, this number was 89%...
2018: Recent Results in Cancer Research
https://www.readbyqxmd.com/read/28923759/extending-the-reach-of-evidence-based-medicine-a-proposed-categorization-of-lower-level-evidence
#2
REVIEW
Frank C Detterbeck, Michael K Gould, Sandra Z Lewis, Sheena Patel
Clinical practice involves making many management decisions for which only limited formal evidence exists. While the methodology of evidence-based medicine has evolved tremendously, there is a need to better characterize lower-level evidence. This should enhance the ability to appropriately weigh the evidence against other considerations, and counter the temptation to think it is more robust than it actually is. A framework to categorize lower-level evidence is proposed, consisting of non-randomized comparisons, extrapolation using indirect evidence, rationale and clinical experience (i...
September 15, 2017: Chest
https://www.readbyqxmd.com/read/28923040/systematic-review-a-review-of-adolescent-behavior-change-interventions-bci-and-their-effectiveness-in-hiv-and-aids-prevention-in-sub-saharan-africa
#3
M Mwale, A S Muula
BACKGROUND: Despite sub-Saharan Africa [SSA] constituting just 12% of the world's population, the region has the highest burden of HIV with 70% of HIV infection in general and 80% of new infections among young people occuring in the region. Diverse intervention programmes have been implemented among young people but with minimal translation to behavior change. A systematic review of Behavior Change Interventions [BCI] targeting adolescents in SSA was therefore conducted with the objective of delineating this intervention vis-a-vis efficacy gap...
September 18, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28922704/direct-acting-antivirals-for-chronic-hepatitis-c
#4
REVIEW
Janus C Jakobsen, Emil Eik Nielsen, Joshua Feinberg, Kiran Kumar Katakam, Kristina Fobian, Goran Hauser, Goran Poropat, Snezana Djurisic, Karl Heinz Weiss, Milica Bjelakovic, Goran Bjelakovic, Sarah Louise Klingenberg, Jian Ping Liu, Dimitrinka Nikolova, Ronald L Koretz, Christian Gluud
BACKGROUND: Millions of people worldwide suffer from hepatitis C, which can lead to severe liver disease, liver cancer, and death. Direct-acting antivirals (DAAs), e.g. sofosbuvir, are relatively new and expensive interventions for chronic hepatitis C, and preliminary results suggest that DAAs may eradicate hepatitis C virus (HCV) from the blood (sustained virological response). Sustained virological response (SVR) is used by investigators and regulatory agencies as a surrogate outcome for morbidity and mortality, based solely on observational evidence...
September 18, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28919180/development-of-a-cyclosporin-a-derivative-with-excellent-anti-hepatitis-c-virus-potency
#5
Jiping Fu, Christopher Becker, Li Cao, Michael Capparelli, Regis Denay, Roger Fujimoto, Yu Gai, Zhaobo Gao, Christian Guenat, Subramanian Karur, Hongyong Kim, Weikuan Li, Xiaolin Li, Wei Li, Thomas Lochmann, Amy Lu, Peichao Lu, Alexandre Luneau, Nicole Meier, Wosenu Mergo, Simon Ng, David Parker, Yunshan Peng, Bernard Riss, Alexey Rivkin, Silvio Roggo, Harald Schroeder, Friedrich Schuerch, Robert L Simmons, Feng Sun, Zachary K Sweeney, Meiliana Tjandra, Michael Wang, Ruidong Wang, Andrew H Weiss, Nicolas Wenger, Quanbing Wu, Xin Xiong, Su Xu, Wenjian Xu, Aregahegn Yifru, Jibin Zhao, Jianguang Zhou, Christian Zürcher, Fabrice Gallou
Synthetic modification of cyclosporin A at P3-P4 positions led to the discovery of NIM258, a next generation cyclophilin inhibitor with excellent anti-hepatitis C virus potency, with decreased transporter inhibition, and pharmacokinetics suitable for coadministration with other drugs. Herein is disclosed the evolution of the synthetic strategy to from the original medicinal chemistry route, designed for late diversification, to a convergent and robust development synthesis. The chiral centers in the P4 fragment were constructed by an asymmetric chelated Claisen rearrangement in the presence of quinidine as the chiral ligand...
September 7, 2017: Bioorganic & Medicinal Chemistry
https://www.readbyqxmd.com/read/28917331/-polypharmacy-and-geriatric-psychiatry
#6
Abdelkrim Hamzaoui, André Joulié, Yahya El Dachri
The ageing of the population is synonymous with multiple pathologies and polypharmacy, which increases risk factors. François-Tosquelles general hospital carried out a study into the administering of medicines within the ageing population in psychiatry and drew up an assessment of professional practices with regard to polypharmacy in geriatric psychiatry.
September 2017: Soins. Gérontologie
https://www.readbyqxmd.com/read/28916928/newborn-screening-in-the-era-of-precision-medicine
#7
Lan Yang, Jiajia Chen, Bairong Shen
As newborn screening success stories gained general confirmation during the past 50 years, scientists quickly discovered diagnostic tests for a host of genetic disorders that could be treated at birth. Outstanding progress in sequencing technologies over the last two decades has made it possible to comprehensively profile newborn screening (NBS) and identify clinically relevant genomic alterations. With the rapid developments in whole-genome sequencing (WGS) and whole-exome sequencing (WES) recently, we can detect newborns at the genomic level and be able to direct the appropriate diagnosis to the different individuals at the appropriate time, which is also encompassed in the concept of precision medicine...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28915887/professional-fulfillment-and-parenting-work-life-balance-in-female-physicians-in-basic-sciences-and-medical-research-a-nationwide-cross-sectional-survey-of-all-80-medical-schools-in-japan
#8
Yuka Yamazaki, Takanori Uka, Eiji Marui
BACKGROUND: In Japan, the field of Basic Sciences encompasses clinical, academic, and translational research, as well as the teaching of medical sciences, with both an MD and PhD typically required. In this study, it was hypothesized that the characteristics of a Basic Sciences career path could offer the professional advancement and personal fulfillment that many female medical doctors would find advantageous. Moreover, encouraging interest in Basic Sciences could help stem shortages that Japan is experiencing in medical fields, as noted in the three principal contributing factors: premature resignation of female clinicians, an imbalance of female physicians engaged in research, and a shortage of medical doctors in the Basic Sciences...
September 15, 2017: Human Resources for Health
https://www.readbyqxmd.com/read/28915876/changes-in-trust-and-the-use-of-korean-medicine-in-south-korea-a-comparison-of-surveys-in-2011-and-2014
#9
Soohyun Kwon, Shinhee Heo, Dongjun Kim, Seunghyun Kang, Jong-Min Woo
BACKGROUND: Korean medicine (KM) has been widely used in Korea. This study aimed to assess the general perceptions of KM, to investigate the patterns of its usage in 2014, and to compare the results with those of an earlier survey from 2011. METHODS: A cross-sectional study was conducted with 1000 Korean people. The questionnaire included items regarding trust in KM, reasons for distrust of KM, and visit frequency to KM clinics. This study used methods consistent with those of a 2011 survey to examine changes in attitudes over 3 years...
September 16, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28910858/overview-of-methods-and-strategies-for-conducting-virtual-small-molecule-screening
#10
Xavier Fradera, Kerim Babaoglu
Virtual screening (VS) in the context of drug discovery is the use of computational methods to discover novel ligands with a desired biological activity from within a larger collection of molecules. These techniques have been in use for many years, there is a wide range of methodologies available, and many successful applications have been reported in the literature. VS is often used as an alternative or a complement to High-throughput screening (HTS) or other methods to identify ligands for target validation or medicinal chemistry projects...
September 14, 2017: Current Protocols in Chemical Biology
https://www.readbyqxmd.com/read/28910335/medical-leaders-or-masters-a-systematic-review-of-medical-leadership-in-hospital-settings
#11
Mathilde A Berghout, Isabelle N Fabbricotti, Martina Buljac-Samardžić, Carina G J M Hilders
Medical leadership is increasingly considered as crucial for improving the quality of care and the sustainability of healthcare. However, conceptual clarity is lacking in the literature and in practice. Therefore, a systematic review of the scientific literature was conducted to reveal the different conceptualizations of medical leadership in terms of definitions, roles and activities, and personal-and context-specific features. Eight databases were systematically searched for eligible studies, including empirical studies published in peer-reviewed journals that included physicians carrying out a manager or leadership role in a hospital setting...
2017: PloS One
https://www.readbyqxmd.com/read/28906293/frequency-and-variables-associated-with-fasting-orders-in-inpatients-with-ulcerative-colitis-the-audit-of-diet-orders-ulcerative-colitis-adore-uc-study
#12
Zane R Gallinger, Amir Rumman, Kevin Pivovarov, Kyle J Fortinsky, A Hillary Steinhart, Adam V Weizman
INTRODUCTION: Current clinical practice guidelines suggest that patients with ulcerative colitis (UC) hospitalized because of a disease flare should be offered a normal diet, unless such a diet is not tolerated. Studies of hospitalized patients have demonstrated iatrogenic malnutrition from unjustified or inappropriate nil per os (NPO) or clear liquid diet (CLD) orders. In this study, we aim to characterize the burden of this problem in hospitalized patients with UC. METHODS: We conducted a retrospective cohort study of all patients with UC admitted to the gastroenterology service or the general internal medicine service at a tertiary, academic hospital between January 2009 and December 2014, with a length of stay between 2 and 30 days...
October 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28905431/including-health-promotion-and-illness-prevention-in-medical-education-a-progress-report
#13
Richard Hays
CONTEXT: In 1988, the World Federation of Medical Education called for reform in medical education, publishing 12 recommendations. The sixth recommendation of this Edinburgh Declaration was to 'complement instruction about the management of patients with increased emphasis on promotion of health and prevention of disease'. Thirty years on, this paper reports an exploration of what has changed since then. METHODS: Several search strategies were used, including websites of medical standards organisations, and formal searches of PubMed and Google Scholar using key words such as 'medical education standards', 'health promotion', 'illness prevention', 'effectiveness' and 'assessment'...
September 14, 2017: Medical Education
https://www.readbyqxmd.com/read/28905423/who-standards-for-biotherapeutics-including-biosimilars-an-example-of-the-evaluation-of-complex-biological-products
#14
REVIEW
Ivana Knezevic, Elwyn Griffiths
The most advanced regulatory processes for complex biological products have been put in place in many countries to provide appropriate regulatory oversight of biotherapeutic products in general, and similar biotherapeutics in particular. This process is still ongoing and requires regular updates to national regulatory requirements in line with scientific developments and up-to-date standards. For this purpose, strong knowledge of and expertise in evaluating biotherapeutics in general and similar biotherapeutic products, also called biosimilars, in particular is essential...
September 14, 2017: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/28903746/correlation-between-patients-reasons-for-encounters-health-problems-and-population-density-in-japan-a-systematic-review-of-observational-studies-coded-by-the-international-classification-of-health-problems-in-primary-care-ichppc-and-the-international-classification
#15
Makoto Kaneko, Ryuichi Ohta, Naoki Nago, Motoharu Fukushi, Masato Matsushima
BACKGROUND: The Japanese health care system has yet to establish structured training for primary care physicians; therefore, physicians who received an internal medicine based training program continue to play a principal role in the primary care setting. To promote the development of a more efficient primary health care system, the assessment of its current status in regard to the spectrum of patients' reasons for encounters (RFEs) and health problems is an important step. Recognizing the proportions of patients' RFEs and health problems, which are not generally covered by an internist, can provide valuable information to promote the development of a primary care physician-centered system...
September 13, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28901871/citizenship-and-learning-disabled-people-the-mental-health-charity-mind-s-1970s-campaign-in-historical%C3%A2-context
#16
Jonathan Toms
Current policy and practice directed towards people with learning disabilities originates in the deinstitutionalisation processes, civil rights concerns and integrationist philosophies of the 1970s and 1980s. However, historians know little about the specific contexts within which these were mobilised. Although it is rarely acknowledged in the secondary literature, MIND was prominent in campaigning for rights-based services for learning disabled people during this time. This article sets MIND's campaign within the wider historical context of the organisation's origins as a main institution of the inter-war mental hygiene movement...
October 2017: Medical History
https://www.readbyqxmd.com/read/28901597/the-limits-of-the-treatment-enhancement-distinction-as-a-guide-to-public-policy
#17
Alexandre Erler
Many believe that the treatment-enhancement distinction (TED) marks an important ethical boundary that we should use to shape public policy on biomedical interventions. A common justification for this purported normative force appeals to the idea that, whereas treatments respond to genuine medical needs, (most) enhancements can only satisfy mere preferences or "expensive tastes". This article offers a critique of that justification, while still accepting the TED as a conceptual tool, as well as some of the key ethical axioms endorsed by its proponents...
October 2017: Bioethics
https://www.readbyqxmd.com/read/28900354/knowledge-attitudes-beliefs-and-practices-of-occupational-physicians-towards-seasonal-influenza-vaccination-a-cross-sectional-study-from-north-eastern-italy
#18
REVIEW
M Riccò, S Cattani, F Casagranda, G Gualerzi, C Signorelli
INTRODUCTION: The present study aims to characterize personal attitudes and knowledge of a sample of Italian Occupational Physicians (OPh) towards Seasonal Influenza Vaccine (SIV) in healthcare workers (HCWs). METHODS: In total, 92 OPh (42.4% males, 57.6% females, mean age of 47.3 ± 10.4 years, 50 specialists in Occupational Medicine, 42 specialists in Hygiene and Public Health) were asked about their attitudes towards influenza vaccine, their general knowledge of vaccine practice, their propensity towards vaccines and, eventually, their risk perception about the influenza and influenza vaccine was investigated...
June 2017: Journal of Preventive Medicine and Hygiene
https://www.readbyqxmd.com/read/28899906/does-the-doctrine-of-double-effect-apply-to-the-prescription-of-barbiturates-syme-vs-the-medical-board-of-australia
#19
Xavier Symons
The doctrine of double effect (DDE) is a principle of crucial importance in law and medicine. In medicine, the principle is generally accepted to apply in cases where the treatment necessary to relieve pain and physical suffering runs the risk of hastening the patient's death. More controversially, it has also been used as a justification for withdrawal of treatment from living individuals and physician-assisted suicide. In this paper, I will critique the findings of the controversial Victorian Civil and Administrative Tribunal (VCAT) hearing Syme vs the Medical Board of Australia In that hearing, Dr Rodney Syme, a urologist and euthanasia advocate, was defending his practice of prescribing barbiturates to terminally ill patients...
September 12, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28893861/adrenal-venous-sampling-for-primary-aldosteronism-laboratory-medicine-best-practice
#20
Gregory Kline, Daniel T Holmes
Primary aldosteronism (PA) is the most common form of secondary hypertension and is critical to identify because when caused by an aldosterone-producing adenoma (APA) or another unilateral form, it is potentially curable, and even when caused by bilateral disease, antihypertensives more specific to PA treatment can be employed (ie, aldosterone antagonists). Identification of unilateral forms is not generally accomplished with imaging because APAs may be small and elude detection, and coincidental identification of a non-functioning incidentaloma contralateral to an APA may lead to removal of an incorrect gland...
September 11, 2017: Journal of Clinical Pathology
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