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https://www.readbyqxmd.com/read/28644781/teaching-clinical-ethics-at-the-bedside-william-osler-and-the-essential-role-of-the-hospitalist
#1
Matthew William McCarthy, Joseph J Fins
As the field of hospital medicine celebrates its twenty-first anniversary, we believe it is time to expand its mission to play an even greater role in medical education. Given hospitalists' proximity to students and clinical material, members of this growing cohort of physicians are uniquely positioned to teach normative reasoning, professionalism, communication, and medical ethics in real time to trainees on the wards. But, to do so, we must reimagine the role of the hospitalist in graduate and postgraduate medical education...
June 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28643266/adherence-to-osteoporosis-medicines-in-estonia-a-comprehensive-15-year-retrospective-prescriptions-database-study
#2
Ott Laius, Heti Pisarev, Katre Maasalu, Sulev Kõks, Aare Märtson
Some patients do not take medicines as they are supposed to. Our research showed that in Estonia, one fifth of patients did not start treatment with osteoporosis medicines and only 20% used the medicines for at least 3 years as they should. This induces unnecessary costs to the healthcare system. PURPOSE: Medication non-adherence is the number one reason for not obtaining the expected clinical effect of medicines. With osteoporosis treatment, it has been shown that both implementation of treatment and persistence influence the risk of fractures significantly...
December 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/28642541/can-uk-undergraduate-dental-programmes-provide-training-in-non-surgical-facial-aesthetics
#3
T W M Walker, F Gately, S Stagnell, A Kerai, C Mills, S Thomas
Aim Recently, more and more dentists have found themselves engaging in the delivery of non-surgical facial aesthetics (NSFA) as part of their regular practice routine. NSFA is a growing field in aesthetic medicine that is practised by a range of clinicians including doctors, dentists and registered prescriber nurses and is an industry estimated to be worth over £3 billion in the UK alone. In the past few years, several public scandals in aesthetic medicine have prompted reactions by several bodies including the Government and Royal Colleges...
June 23, 2017: British Dental Journal
https://www.readbyqxmd.com/read/28640169/the-use-of-lorazepam-and-electroconvulsive-therapy-in-the-treatment-of-catatonia-treatment-characteristics-and-outcomes-in-60-patients
#4
Ahmet Unal, Abdurrahman Altindag, Bahadir Demir, Ihsan Aksoy
OBJECTIVES: Lorazepam and electroconvulsive therapy (ECT) are effective treatments for catatonia. However, systematic data on these treatments in catatonia are limited. In the present study, we aimed to investigate the clinical and treatment-related characteristics of patients with catatonia who underwent lorazepam and/or ECT. METHODS: Between January 2012 and December 2016, we received 60 patients with catatonia hospitalized in the Gaziantep University Faculty of Medicine Clinic of Psychiatry...
June 20, 2017: Journal of ECT
https://www.readbyqxmd.com/read/28633171/examining-accuracy-of-self-assessment-of-in-training-examination-performance-in-a-context-of-guided-self-assessment
#5
Oksana Babenko, Denise Campbell-Scherer, Shirley Schipper, John Chmelicek, Tanya Barber, Kimberley Duerksen, Shelley Ross
BACKGROUND AND OBJECTIVES: In our family medicine residency program, we have established a culture of guided self-assessment through a systematic approach of direct observation of residents and documentation of formative feedback. We have observed that our residents have become more accurate in self-assessing their clinical performance. The objective of this study was to examine whether this improved accuracy extended to residents' self-assessment of their medical knowledge and clinical reasoning on the In-Training Examination (ITE)...
June 2017: Family Medicine
https://www.readbyqxmd.com/read/28630214/patient-derived-interstitial-fluids-and-predisposition-to-aggressive-sporadic-breast-cancer-through-collagen-remodeling-and-inactivation-of-p53
#6
Timothy Kenny, Hank Schmidt, Kerin Adelson, Yujin Hoshida, Anna P Koh, Nagma Shah, John P Mandeli, Jess Ting, Doris Germain
Despite the fact that interstitial fluid (IF) represents a third of our body fluid, it is the most poorly understood body fluid in medicine. Increased IF pressure is thought to result from the increased deposition of extracellular matrix in the affected tissue preventing its reabsorption. In the cancer field, increased rigidity surrounding a cancerous mass remains the main reason that palpation and radiological examination, such as mammography, are used for cancer detection. While the pressure produced by IF has been considered, the biochemical composition of IF has not been considered in its effect on tumors...
June 19, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/28628255/still-a-reasonable-goal-targeting-cholesterol-in-dialysis-and-advanced-chronic-kidney-disease-patients
#7
EDITORIAL
Gunnar H Heine, Kyrill S Rogacev, Oliver Weingärtner, Gunther Marsche
Chronic kidney disease (CKD) patients have a high burden of cardiovascular disease. In the general population, lipid metabolism disorders, which cause the initiation and progression of atherosclerotic vascular changes, are major targets for preventive and therapeutic strategies in cardiovascular medicine. However, data from large cohort studies and from clinical trials suggest that the treatment guidelines on cardiovascular disease prevention and therapy cannot uncritically be transferred from individuals with intact renal function to CKD patients...
June 19, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28597159/metabolite-analysis-of-endophytic-fungi-from-cultivars-of-zingiber-officinale-rosc-identifies-myriad-of-bioactive-compounds-including-tyrosol
#8
C Anisha, E K Radhakrishnan
Endophytic fungi associated with rhizomes of four cultivars of Zingiber officinale were identified by molecular and morphological methods and evaluated for their activity against soft rot pathogen Pythium myriotylum and clinical pathogens. The volatile bioactive metabolites produced by these isolates were identified by GC-MS analysis of the fungal crude extracts. Understanding of the metabolites produced by endophytes is also important in the context of raw consumption of ginger as medicine and spice. A total of fifteen isolates were identified from the four varieties studied...
June 2017: 3 Biotech
https://www.readbyqxmd.com/read/28595533/recent-advances-of-computational-modeling-for-predicting-drug-metabolism-a-perspective
#9
Supratik Kar, Jerzy Leszczynski
Absorption, Distribution, Metabolism, Excretion (ADME) properties along with drug induced adverse effects are the major reasons for the late stage failure of drug candidates as well as cause for the expensive withdrawal of many approved drugs from the market. Considering adverse effects of drugs, metabolism factor has great importance in medicinal chemistry and clinical pharmacology because it influences the deactivation, activation, detoxification and toxification of drugs. Computational methods are effective approaches to reduce the number of safety issues by analyzing possible links between chemical structures and metabolism followed by adverse effects, as they serve the integration of information on several levels to enhance the reliability of outcomes...
June 6, 2017: Current Drug Metabolism
https://www.readbyqxmd.com/read/28592225/diagnostic-bone-marrow-sampling-in-cats
#10
Christopher G Byers
Practical relevance: Hematologic disorders are relatively common in cats, as inflammatory, immune-mediated and infectious diseases have the potential to impact erythroid, myeloid and thrombopoietic lines within the bone marrow. Clinical challenges: Clinicians often benefit from information obtained from bone marrow cytology and histopathology in diagnosing hematologic disorders in feline patients. However, these sampling procedures are ones that many veterinarians are intimidated by and thus not comfortably performing in clinical practice...
July 2017: Journal of Feline Medicine and Surgery
https://www.readbyqxmd.com/read/28585183/precision-medicine-for-heart-failure-with-preserved-ejection-fraction-an-overview
#11
Sanjiv J Shah
There are few proven therapies for heart failure with preserved ejection fraction (HFpEF). The lack of therapies, along with increased recognition of the disorder and its underlying pathophysiology, has led to the acknowledgement that HFpEF is heterogeneous and is not likely to respond to a one-size-fits-all approach. Thus, HFpEF is a prime candidate to benefit from a precision medicine approach. For this reason, we have assembled a compendium of papers on the topic of precision medicine in HFpEF in the Journal of Cardiovascular Translational Research...
June 5, 2017: Journal of Cardiovascular Translational Research
https://www.readbyqxmd.com/read/28584869/development-of-the-competency-based-medical-curriculum-for-the-new-augsburg-university-medical-school
#12
Anja Härtl, Pascal Berberat, Martin R Fischer, Helmuth Forst, Stefanie Grützner, Thomas Händl, Felix Joachimski, Renate Linné, Bruno Märkl, Markus Naumann, Reinhard Putz, Werner Schneider, Claus Schöler, Markus Wehler, Reinhard Hoffmann
Aim: With the resolution from April 28, 2014, the Bavarian state government in Germany decided to found a new medical school at Augsburg University, thereby requiring the development of a competency-based medical curriculum. Methods: Two interdisciplinary groups developed a spiral curriculum (following Harden) employing the model of Thumser-Dauth & Öchsner. The curriculum focuses on specifically defined competencies: medical expertise, independent scientific reasoning, argumentation and scholarship, as well as communication skills...
2017: GMS Journal for Medical Education
https://www.readbyqxmd.com/read/28584475/virtopsy-touch-free-autopsy
#13
REVIEW
Raj Kumar Badam, Triekan Sownetha, D B Gandhi Babu, Shefali Waghray, Lavanya Reddy, Komali Garlapati, Sunanda Chavva
The word "autopsy" denotes "to see with own eyes." Autopsy (postmortem) is a process that includes a thorough examination of a corpse noting everything related to anatomization, surface wounds, histological and culture studies. Virtopsy is a term extracted from two words "virtual" and "autopsy." It employs imaging methods that are routinely used in clinical medicine such as computed tomography and magnetic resonance imaging in the field of autopsy, to find the reason for death. Virtopsy is a multi-disciplinary technology that combines forensic medicine and pathology, roentgenology, computer graphics, biomechanics, and physics...
January 2017: Journal of Forensic Dental Sciences
https://www.readbyqxmd.com/read/28575351/-enquire-into-all-the-circumstances-of-the-patient-narrowly-john-rutherford-s-clinical-lectures-in-edinburgh-1749-53
#14
Stephen C Craig
Early eighteenth-century Edinburgh provided a unique learning environment for aspiring practitioners: one in which the unity of medicine and surgery was appreciated and clinical observations and a reasoning practitioner became the well spring of proper patient care. John Rutherford, a surgical apprentice in this environment, student on the wards of London hospitals and under Boerhaave at Leiden, became one of the original medical professors at the University of Edinburgh medical school in 1726. Rutherford taught the popular, theory-based Practice of Medicine for twenty-two years...
May 29, 2017: Journal of the History of Medicine and Allied Sciences
https://www.readbyqxmd.com/read/28559034/shared-decisionmaking-in-the-emergency-department-a-guiding-framework-for-clinicians
#15
Marc A Probst, Hemal K Kanzaria, Elizabeth M Schoenfeld, Michael D Menchine, Maggie Breslin, Cheryl Walsh, Edward R Melnick, Erik P Hess
Shared decisionmaking has been proposed as a method to promote active engagement of patients in emergency care decisions. Despite the recent attention shared decisionmaking has received in the emergency medicine community, including being the topic of the 2016 Academic Emergency Medicine Consensus Conference, misconceptions remain in regard to the precise meaning of the term, the process, and the conditions under which it is most likely to be valuable. With the help of a patient representative and an interaction designer, we developed a simple framework to illustrate how shared decisionmaking should be approached in clinical practice...
May 27, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28557945/how-entrustment-is-informed-by-holistic-judgments-across-time-in-a-family-medicine-residency-program-an-ethnographic-nonparticipant-observational-study
#16
Margaretha H Sagasser, Cornelia R M G Fluit, Chris van Weel, Cees P M van der Vleuten, Anneke W M Kramer
PURPOSE: Entrustment has mainly been conceptualized as delegating discrete professional tasks. Because residents provide most of their patient care independently, not all resident performance is visible to supervisors; the entrustment process involves more than granting discrete tasks. This study explored how supervisors made entrustment decisions based on residents' performance in a long-term family medicine training program. METHOD: A qualitative nonparticipant observational study was conducted in 2014-2015 at competency-based family medicine residency programs in the Netherlands...
June 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28557933/transforming-medical-assessment-integrating-uncertainty-into-the-evaluation-of-clinical-reasoning-in-medical-education
#17
Suzette Cooke, Jean-Francois Lemay
In an age where practicing physicians have access to an overwhelming volume of clinical information and are faced with increasingly complex medical decisions, the ability to execute sound clinical reasoning is essential to optimal patient care. The authors propose two concepts that are philosophically paramount to the future assessment of clinical reasoning in medicine: assessment in the context of "uncertainty" (when, despite all of the information that is available, there is still significant doubt as to the best diagnosis, investigation, or treatment), and acknowledging that it is entirely possible (and reasonable) to have more than "one correct answer...
June 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28555108/is-the-comparison-between-exercise-and-pharmacologic-treatment-of-depression-in-the-clinical-practice-guideline-of-the-american-college-of-physicians-evidence-based
#18
Yael Netz
Major depression disorder is most commonly treated with antidepressants. However, due to their side effects clinicians seek non-pharmacologic options, and one of these is exercise. The literature on the benefits of exercise for depression is extensive. Nevertheless, two recent reviews focusing on antidepressants vs. other therapies as a basis for clinical practice guidelines recommended mainly antidepressants, excluding exercise as a viable choice for treatment of depression. The aim of this perspective is to analyze the literature exploring the reasons for this discrepancy...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28553184/initial-experience-in-the-use-of-technetium-99-metastable-hydroxymethylene-diphosphonate-as-an-alternative-ventilation-agent-during-periods-of-interim-shortage
#19
Colin Raymond Young, Kalpna Prasad
Sporadic supply interruptions of select radiopharmaceuticals on the global market require consideration of alternative agents to support continuity of essential nuclear medicine examinations. During an acute shortage of Xenon-133 and technetium-99 metastable (Tc-99m) diethylene-triamine-pentaacetate (DTPA), our institution used aerosolized Tc-99m hydroxymethylene diphosphonate (HDP), a radiopharmaceutical traditionally used in bone scintigraphy, in lieu of traditional ventilation agents, for two cases of suspected pulmonary embolism...
April 2017: World Journal of Nuclear Medicine
https://www.readbyqxmd.com/read/28545802/attitudes-towards-disorders-of-sex-development-nomenclature-among-affected-individuals
#20
Emilie K Johnson, Ilina Rosoklija, Courtney Finlayson, Diane Chen, Elizabeth B Yerkes, Mary Beth Madonna, Jane L Holl, Arlene B Baratz, Georgiann Davis, Earl Y Cheng
INTRODUCTION: Although now commonly used in medicine, the updated "disorders of sex development" (DSD) nomenclature formally introduced in 2006 has never been universally accepted by members of the affected community, particularly advocacy groups. Use of this nomenclature by medical professionals may unintentionally negatively affect access to healthcare and research for individuals with DSD conditions. OBJECTIVE: Among individuals affected by various DSD diagnoses, this study sought to (1) evaluate attitudes towards potentially controversial DSD terminology, (2) determine potential impact of terminology on how affected individuals access healthcare, and (3) explore alternate terms...
May 8, 2017: Journal of Pediatric Urology
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