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Business of medicine

Andrew K Cordova, Robin Feldman
Research universities have made enormous contributions to the field of medicine and the treatment of human disease. Alone or in collaboration with pharmaceutical companies, academic researchers have added to the store of knowledge that has led to numerous life science breakthroughs. A new chapter may be opening for academic researchers, however, that could lead to a darker tale. 'The mouse that trolled: the long and tortuous history of a gene mutation patent that became an expensive impediment to Alzheimer's research, by Bubela et al...
November 2015: Journal of Law and the Biosciences
Mario Plebani
A body of evidence collected in the last few decades demonstrates that the pre- and post-analytical phases of the testing cycle are more error-prone than the analytical phase. However, the paradigm of errors and quality in laboratory medicine has been questioned, analytical mistakes continuing to be a major cause of adverse clinical outcomes and patient harm. Although the brain-to-brain concept is widely recognized in the community of laboratory professionals, there is lack of clarity concerning the inter-relationship between the different phases of the cycle, interdependence between the pre-analytical phase and analytical quality, and the effect of the post-analytical steps on the quality of ultimate laboratory information...
October 12, 2016: Clinical Chemistry and Laboratory Medicine: CCLM
Andrea K Boggild, Jennifer Geduld, Michael Libman, Cedric P Yansouni, Anne E McCarthy, Jan Hajek, Wayne Ghesquiere, Jean Vincelette, Susan Kuhn, David O Freedman, Kevin C Kain
BACKGROUND: Malaria remains the most common specific cause of fever in returned travellers and can be life-threatening. We examined demographic and travel correlates of malaria among Canadian travellers and immigrants to identify groups for targeted pretravel intervention. METHODS: Descriptive data on ill returned Canadian travellers and immigrants presenting to a CanTravNet site between 2004 and 2014 with a diagnosis of malaria were analyzed. Data were collected using the GeoSentinel data platform...
July 2016: CMAJ Open
George Larcos, Mirela Prgomet, Andrew Georgiou, Johanna Westbrook
BACKGROUND: Errors by nuclear medicine technologists during the preparation of radiopharmaceuticals or at other times can cause patient harm and may reflect the impact of interruptions, busy work environments and deficient systems or processes. We aimed to: (a) characterise the rate and nature of interruptions technologists experience and (b) identify strategies that support safety. METHODS: We performed 100 hours of observation of 11 technologists at a major public hospital and measured the proportions of time spent in eight categories of work tasks, location of task, interruption rate and type and multitasking (tasks conducted in parallel)...
October 5, 2016: BMJ Quality & Safety
Jennifer Berglund
The science of the microbiome is arguably one of the hottest topics in medicine, and rightfully so. A deeper understanding of the ecology of the flora in our bodies is providing revolutionary insight beyond the simple form and function of our major parts. This new frontier is dauntingly complex, and most studies focus on details, failing to place these microbial ecosystems within the larger context of evolutionary time and environment.
September 2016: IEEE Pulse
Patricia Nez Henderson, April Roeseler, Gregg Moor, Hershel W Clark, Alfred Yazzie, Priscilla Nez, Chantal Nez, Samantha Sabo, Scott J Leischow
BACKGROUND: Comprehensive smoke-free laws are effective at protecting non-smokers and reducing tobacco use, yet they are not widely adopted by tribal governments. METHODS: A series of smoke-free policy initiatives on the Navajo Nation, beginning in 2008, were reviewed to identify key issues, successes and setbacks. RESULTS: It has been essential that proposed policies acknowledge the Navajo people's spiritual use of nát'oh, a sacred plant used for gift-giving, medicinal purposes and traditional ceremonies, while simultaneously discouraging a secular use of commercial tobacco...
October 2016: Tobacco Control
Jeffrey Siegler, Melissa Kroll, Susan Wojcik, Hawnwan Philip Moy
INTRODUCTION: In the prehospital setting, Emergency Medical Services (EMS) professionals rely on providing positive pressure ventilation with a bag-valve-mask (BVM). Multiple emergency medicine and critical care studies have shown that lung-protective ventilation protocols reduce morbidity and mortality. Our primary objective was to determine if a group of EMS professionals could provide ventilations with a smaller BVM that would be sufficient to ventilate patients. Secondary objectives included 1) if the pediatric bag provided volumes similar to lung-protective ventilation in the hospital setting and 2) compare volumes provided to the patient depending on the type of airway (mask, King tube, and intubation)...
October 3, 2016: Prehospital Emergency Care
Trusha C Dhanani, Emily H Mantovani, J Rick Turner
All biologically active agents carry the potential to lead to adverse reactions in certain individuals, including serious cardiac adverse reactions. Since 2005, there has been an international regulatory landscape governing the investigation of a new drug's propensity to lead to the polymorphic ventricular tachycardia Torsades de Pointes (Torsades), a rare but potentially fatal occurrence. When a regulatory agency considers it appropriate, warning information is placed in a medicine's patient information leaflet (label) concerning drug-induced QT interval prolongation, a phenomenon associated with Torsades...
September 28, 2016: International Journal of Pharmacy Practice
Hans-Joerg Fugel, Mark Nuijten, Maarten Postma
RATIONALE: Stratified Medicine (SM) is becoming a natural result of advances in biomedical science and a promising path for the innovation-based biopharmaceutical industry to create new investment opportunities. While the use of biomarkers to improve R&D efficiency and productivity is very much acknowledged by industry, much work remains to be done to understand the drivers and conditions that favour using a stratified approach to create economically viable products and to justify the investment in SM interventions as a stratification option...
December 25, 2016: New Biotechnology
Manisha Gandhi, Anitra Beasley, Emily Vinas, Haleh Sangi-Haghpeykar, Susan M Ramin, Charlie C Kilpatrick
OBJECTIVE: To evaluate the use of mobile technology to facilitate resident learning, assess clinical knowledge, and guide curricular development in a busy clinical environment. METHODS: This was a cross-sectional study conducted in a large (N=48) urban obstetrics and gynecology residency program. Question sets were created in the following areas: office gynecology, general obstetrics, gynecologic surgery and urogynecology, maternal-fetal medicine and ultrasonography, reproductive endocrinology and pediatric gynecology, and gynecologic oncology...
October 2016: Obstetrics and Gynecology
Huong Thanh Vu
This paper by adopting the Software on Market Analysis and Restrictions on Trade assessed the ex-ante impact of tariff elimination under the European-Vietnam free trade agreement (EVFTA) on Vietnam's pharmaceutical imports from the EU based on two scenarios. The results showed that although Vietnam's tariff removal for the EU's medicines would not result in a significant increase in Vietnam's imports from the EU, Vietnam's deeper integration with ASEAN + 3 and TPP (the Trans-Pacific Partnership) nations would affect quite slightly on its imports from the EU...
2016: SpringerPlus
Christopher P Price, Andrew St John, Robert Christenson, Volker Scharnhorst, Michael Oellerich, Patricia Jones, Howard A Morris
Improving quality and patient safety, containing costs and delivering value-for-money are the key drivers of change in the delivery of healthcare and have stimulated a shift from an activity-based service to a service based on patient-outcomes. The delivery of an outcomes-based healthcare agenda requires that the real value of laboratory medicine to all stakeholders be understood, effectively defined and communicated. The value proposition of any product or service is the link between the provider and the needs of the customer describing the utility of the product or service in terms of benefit to the customer...
November 1, 2016: Clinica Chimica Acta; International Journal of Clinical Chemistry
Luís Pinho-Costa, Kenneth Yakubu, Kyle Hoedebecke, Liliana Laranjo, Christofer Patrick Reichel, Maria Del C Colon-Gonzalez, Ana Luísa Neves, Hassna Errami
PURPOSE: Create an index of global reach for healthcare hashtags and tweeters therein, filterable by topic of interest. MATERIALS AND METHODS: For this proof-of-concept study we focused on the field of Primary Care and Family Medicine. Six hashtags were selected based on their importance, from the ones included in the 'Healthcare Hashtag Project'. Hashtag Global Reach (HGR) was calculated using the additive aggregation of five weighted, normalized indicator variables: number of impressions, tweets, tweeters, user locations, and user languages...
September 16, 2016: Journal of Biomedical Informatics
Gillian D Sanders, Peter J Neumann, Anirban Basu, Dan W Brock, David Feeny, Murray Krahn, Karen M Kuntz, David O Meltzer, Douglas K Owens, Lisa A Prosser, Joshua A Salomon, Mark J Sculpher, Thomas A Trikalinos, Louise B Russell, Joanna E Siegel, Theodore G Ganiats
IMPORTANCE: Since publication of the report by the Panel on Cost-Effectiveness in Health and Medicine in 1996, researchers have advanced the methods of cost-effectiveness analysis, and policy makers have experimented with its application. The need to deliver health care efficiently and the importance of using analytic techniques to understand the clinical and economic consequences of strategies to improve health have increased in recent years. OBJECTIVE: To review the state of the field and provide recommendations to improve the quality of cost-effectiveness analyses...
September 13, 2016: JAMA: the Journal of the American Medical Association
Alena Ondrejkovicova, Gabriel Petrovics, Katarína Svitkova, Bibiana Bajtekova, Ondrej Bangha
Acupuncture is one of the branches of Chinese Traditional Medicine dating back almost 5 000 years. The expansion of China's trade and business relations with other Asian countries brought about the spreading of acupuncture in 7th Century. Nowadays, acupuncture is an interdisciplinary clinical field of Medicine dealing with treatment, diagnostics and prevention of mainly functional disorders, algic, allergic and addictive conditions of various etiology, localization and intensity. It draws from the millennia of experience of Oriental Medicine as well as contemporary knowledge of morphology, physiology and neurophysiology...
July 16, 2016: Neuro Endocrinology Letters
Mary Emma Gorham Bigelow, Brian G Jamieson, Chi On Chui, Yufei Mao, Kyeong-Sik Shin, Tony Jun Huang, Po-Hsun Huang, Liqiang Ren, Bishow Adhikari, Jue Chen, Erin Iturriaga
The commercialization of new point of care technologies holds great potential in facilitating and advancing precision medicine in heart, lung, blood, and sleep (HLBS) disorders. The delivery of individually tailored health care to a patient depends on how well that patient's health condition can be interrogated and monitored. Point of care technologies may enable access to rapid and cost-effective interrogation of a patient's health condition in near real time. Currently, physiological data are largely limited to single-time-point collection at the hospital or clinic, whereas critical information on some conditions must be collected in the home, when symptoms occur, or at regular intervals over time...
2016: IEEE Journal of Translational Engineering in Health and Medicine
Robert Robinson
INTRODUCTION: The educational technology of massive open online courses (MOOCs) has been successfully applied in a wide variety of disciplines and are an intense focus of educational research at this time. Educators are now looking to MOOC technology as a means to improve professional medical education, but very little is known about how medical MOOCs compare with traditional content delivery. METHODS: A retrospective analysis of the course evaluations for the Medicine as a Business elective by fourth-year medical students at Southern Illinois University School of Medicine (SIU-SOM) for the 2012-2015 academic years was conducted...
2016: PeerJ
Peter H J Keizers, Andrea Wiegard, Bastiaan J Venhuis
There must be a large market for active pharmaceutical ingredients of illegal source to support the huge and lucrative business of trade in illegal medicines. The active substances found in illegal pharmaceuticals may differ from their legal counterparts concerning purity and associated risks for the health of the user. In this study we show two examples in which the active substance sildenafil, used in erectile dysfunction products, was not of European Pharmacopeia quality. In one case milligram-scale amounts of a 2-mercaptobenzothiazole contamination were found, in another case the mesylate salt rather than the monograph based citrate was used...
November 30, 2016: Journal of Pharmaceutical and Biomedical Analysis
Tilley Pain, Gail Kingston, Janet Askern, Rebecca Smith, Sandra Phillips, Leanne Bell
BACKGROUND: Inpatient care is dependent upon the effective transfer of clinical information across multiple professions. However, documented patient clinical information generated by different professions is not always successfully transferred between them. One obstacle to successful information transfer may be the reader's perception of the information, which is framed in a particular professional context, rather than the information per se. OBJECTIVE: The aim of this research was to investigate how different health professionals perceive allied health documentation and to investigate how clinicians of all experience levels across medicine, nursing and allied health perceive and use allied health notes to inform their decision-making and treatment of patients...
August 29, 2016: HIM Journal
Ashul Govil, Steven C Hao
Development of new medical technology is a crucial part of the advancement of medicine and our ability to better treat patients and their diseases. This process of development is long and arduous and requires a significant investment of human, financial and material capital. However, technology development can be rewarded richly by its impact on patient outcomes and successful sale of the product. One of the major regulatory hurdles to technology development is the Food and Drug Administration (FDA) approval process, which is necessary before a technology can be marketed and sold in the USA...
October 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
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