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Medical problem solving

Michael J Boivin, Horacio Ruiseñor-Escudero, Itziar Familiar-Lopez
There is growing concern that although the more severe forms of HIV-associated neurologic deficits are reduced following highly active anti-retroviral therapy (HAART), mild to moderate cognitive disorders may persist for years after HAART initiation and this may occur despite complete plasma viral suppression. According to the UNAIDS 2014 report, there were 3.2 million children living with HIV around the world at the end of 2013 and 91 % of these resided in sub-Saharan Africa. In the same year, only 24 % of children who needed antiretroviral treatment (ART) received it and 190,000 children died of AIDS-related illnesses...
October 25, 2016: Current HIV/AIDS Reports
Rachel Stork Poeppelman, Cara A Liebert, Daniel Brandt Vegas, Carl A Germann, Anna Volerman
BACKGROUND : Team-based learning (TBL) promotes problem solving and teamwork, and has been applied as an instructional method in undergraduate medical education with purported benefits. Although TBL curricula have been implemented for residents, no published systematic reviews or guidelines exist for the development and use of TBL in graduate medical education (GME). OBJECTIVE : To review TBL curricula in GME, identify gaps in the literature, and synthesize a framework to guide the development of TBL curricula at the GME level...
October 2016: Journal of Graduate Medical Education
Selwin S Audhoe, Karen Nieuwenhuijsen, Jan L Hoving, Judith K Sluiter, Monique H W Frings-Dresen
PURPOSE: To evaluate the barriers to and solutions for return to work (RTW) from the perspective of unemployed workers who were sick-listed due to mental health problems. METHODS: We conducted semi-structured interviews with 25 sick-listed unemployed workers with mental health problems. Qualitative data analysis was performed, using a process of identifying, coding, and categorising the patterns in data. RESULTS: All workers experienced multiple problems in different domains of life related to their disease, personal circumstances (e...
October 19, 2016: Disability and Rehabilitation
Rajeev Kumar, Rajendra G Sonkawade, Anil K Pandey, Madhavi Tripathi, Nishikant A Damle, Praveen Kumar, Chandra S Bal
OBJECTIVE: The aim of this article was to share 10 years of operational experience of medical cyclotron and to provide working knowledge on the same. This experience has helped us gain working knowledge on cyclotron operation with practical points, which may help in improving F yield, minimizing the breakdown time, and help in the prevention of the occurrence of unusual events. MATERIALS AND METHODS: Our facility has a self-shielded radioisotope delivery system eclipse 111 medical cyclotron with an 11 MeV proton beam in use for the past 10 years to produce positron emitters - namely, F, N, and F-2 gas - for PET imaging...
October 13, 2016: Nuclear Medicine Communications
Marko Poglitsch, Ashraf H Ahmed, Michael Resl, Andrea Stoller, Dunja Van Oyen, Cornelia Schwager, Claudia Aigner, Oliver Domenig, Michael Krebs, Manuel Haschke, Michael Stowasser
OBJECTIVE: Primary aldosteronism (PA) is form of hypertension characterized by production of aldosterone by the adrenal that is excessive and relatively autonomous of the renin-angiotensin system. Once detected, unilateral PA can be usually cured by surgical removal of the affected adrenal, while bilateral PA can be specifically treated by medications, which antagonize aldosterone action. Clinical guidelines of Endocrine Societies in Europe and the US recommend screening for PA among most hypertensive patients...
September 2016: Journal of Hypertension
Filipa Alves da Costa, Luísa Silvestre, Catarina Periquito, Clara Carneiro, Pedro Oliveira, Ana Isabel Fernandes, Patrícia Cavaco-Silva
BACKGROUND: Currently, people live longer but often with poor quality of life. The decrease in healthy life-years is partly attributable to the institution of polypharmacy to treat various comorbidities. OBJECTIVES: The objectives of the study were to determine the prevalence and nature of drug-related problems (DRPs) in polypharmacy elderly patients residing in nursing homes and to test the acceptability of a pharmacist's intervention. METHODS: An exposure cohort was constituted in three Portuguese nursing homes, where all polypharmacy (five or more medicines) elderly patients (≥65 years of age) were analysed and then a random stratified sample was extracted to be subject to an intervention...
March 2016: Drugs—Real World Outcomes
G Iakimova, S Dimitrova, T Burté
OBJECTIVES: Computer-delivered Cognitive Behavioral Therapies (C-CBT) are emerging as therapeutic techniques which contribute to overcome the barriers of health care access in adult populations with depression. The C-CBTs provide CBT techniques in a highly structured format comprising a number of educational lessons, homework, multimedia illustrations and supplementary materials via interactive computer interfaces. Programs are often administrated with a minimal or regular support provided by a clinician or a technician via email, telephone, online forums, or during face-to-face consultations...
October 10, 2016: L'Encéphale
M Hirschvogel, M Bassilious, L Jagschies, S M Wildhirt, M W Gee
A model for patient-specific cardiac mechanics simulation is introduced, incorporating a 3-dimensional finite element model of the ventricular part of the heart which is coupled to a reduced-order 0-dimensional closed-loop vascular system, heart valve and atrial chamber model.The ventricles are modeled by a nonlinear orthotropic passive material law. The electrical activation is mimicked by a prescribed parametrized active stress acting along a generic muscle fiber orientation. Our activation function is constructed such that the start of ventricular contraction and relaxation as well as the active stress curve's slope are parameterized...
October 15, 2016: International Journal for Numerical Methods in Biomedical Engineering
Neeraj Nagpal
Physicians and Internists in India have tended to brush under the carpet legal issues affecting their profession. Of concern to all Physicians is the judgment in a recent case where the NCDRC has stated that if MD Medicine Physicians write Physician & Cardiologist on their letterhead it is Quackery. What is MD Medicine degree holder in India qualified and trained to treat ? These are issues which need debate and that can only be initiated once we recognize that there is a problem. Either an MD Medicine is a cardiologist or he is not...
February 2016: Journal of the Association of Physicians of India
Brent I Fox, Bill G Felkey
Some things really never change. For example, medication adherence remains a critical factor that influences the effectiveness of our modern health care system. Is there a magic bullet to solve the problem of nonadherence? We don't think there is. We do believe, however, that tools to monitor adherence continue to improve in their utility.
November 2015: Hospital Pharmacy
A Serrano, J Salinas, S López de Alda, F Parra, M Sánchez, M A Ruiz León, J Moreno
Double J stents are used in Urology in an important number of pathologies. These devices contribute to solve very prevalent pathologies such as upper urinary tract lithiasis. However, there are very frequent symptoms associated with double J catheters that may produce a very important constraint on the quality of life of patients. Although theses symptoms are not severe in most cases, they require medical treatment to be solved in certain patients. Several types of drugs such as analgesics, anti-inflammatories, antibiotics, anticholinergics and alpha-blockers have been used for this pathology, with variable results depending on the authors...
October 2016: Archivos Españoles de Urología
Лариса Ф Матюха, Тетяна А Титова, Тетяна М Бухановська, Богдан О Смаль
INTRODUCTION: diabetes mellitus is among the main challenges in the establishment of an effective health care system. A significant prevalence of disease and, consequently, a large number of complications, caused by it, provokes a constant searching for new measures and means for the struggle. In Ukraine, as in other countries, among methods of such a struggle is to standardize medical care. AIM: explore the state of health care for patients with diabetes in Ukraine...
2016: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Tom M Wilkinson, Tim J Wilkinson
BACKGROUND: Most research into the validity of admissions tools focuses on the isolated correlations of individual tools with later outcomes. Instead, looking at how domains of attributes, rather than tools, predict later success is likely to be more generalizable. We aim to produce a blueprint for an admissions scheme that is broadly relevant across institutions. METHODS: We broke down all measures used for admissions at one medical school into the smallest possible component scores...
October 3, 2016: BMC Medical Education
Ayşen Esen Danacı, Kuzeymen Balıkçı, Orkun Aydın, Cengiz Cengisiz, A Burak Uykur
OBJECTIVE: It has been widely acknowledged that the community and health professionals hold negative attitudes toward patients with impaired mental health. This constitutes a majör obstacle for those patients in coping with their disease, managing their care, and hence regulating their lives. Although studies carried out in Turkey document the presence of stigma, they provide limited information about the ways for solving this problem. Drawing on the litrature, the present study investigated the effect of medical education on stigmatization...
2016: Türk Psikiyatri Dergisi, Turkish Journal of Psychiatry
Denise E Doomernik, Harry van Goor, Jan G M Kooloos, Richard P Ten Broek
The Radboud University Medical Center has a problem-based, learner-oriented, horizontally, and vertically integrated medical curriculum. Anatomists and clinicians have noticed students' decreasing anatomical knowledge and the disability to apply knowledge in diagnostic reasoning and problem solving. In a longitudinal cohort, the retention of anatomical knowledge gained during the first year of medical school among second-year medical students was assessed. In May 2011, 346 medical students applied for the second-year gastro-intestinal (GI) tract course...
October 5, 2016: Anatomical Sciences Education
Zolaykha Asghari, Alireza Mardanshahi, Ebrahim Bagherian Farahabadi, Hasan Siamian, Ali Morad Heidari Gorji, Benyamin Mohseni Saravi, Esmaeil Rezazadeh, Seyyed Payam Paymard
INTRODUCTION: Documentation of patients' medical records has been always emphasized because medical records are as a means to be applied by patients, all medical staff, quality evaluations of health care, lawsuits, medical education and, etc. Regarding to this, each of the data elements available in the sheets of medical records has their own values. The rate of completion indicates the importance of the medical recorders for faculty member. So in this article the researcher evaluates the completion of medical records in the teaching hospitals of Mazandaran University of Medical Sciences...
July 24, 2016: Materia Socio-medica
Julia Menichetti, Guendalina Graffigna
The increasing prevalence of chronic conditions among older adults constitutes a major public health problem. Thus, changes in lifestyles are required to prevent secondary conditions and sustain good care practices. While patient engagement received great attention in the last years as key strategy to solve this issue, to date no interventions exist to sustain the engagement of older chronic patients toward their health management. This study describes the design, development, and optimization of PHEinAction, a theoretically-driven intervention program to increase patient engagement in older chronic populations and consequently to foster healthy changes that can help reduce risks of health problems...
2016: Frontiers in Psychology
Li Gao, Qin Li, Raoqi Li, Zebin Deng, Brendan Brady, Ni Xia, Guimin Chen, Yang Zhou, Hengchuan Xia, Keping Chen, Haixia Shi
Recently, graphene oxide (GO) has shown superiority for disease detection arising from its unique physical and chemical properties. However, proteins adsorbed on the surface of GO prevent sensitivity improvement in fluorescence-based detection methods. In this paper, a label-free method based on aptamer modified gold nanoparticles (GNPs) combined with Tween 80 was shown to solve this problem using the detection of thrombin as an example. An aptamer was designed and bound to thrombin by changing its conformation...
October 19, 2016: Analytica Chimica Acta
Sarah Haldane, Kenneth Hinchcliff, Peter Mansell, Chi Baik
Good communication skills are an important entry-level attribute of graduates of professional degrees. The inclusion of communication training within the curriculum can be problematic, particularly in programs with a high content load, such as veterinary science. This study examined the differences between the perceptions of students and qualified veterinarians with regards to the entry-level communication skills required of new graduates in clinical practice. Surveys were distributed to students in each of the four year levels of the veterinary science degree at the University of Melbourne and to recent graduates and experienced veterinarians registered in Victoria, Australia...
September 30, 2016: Journal of Veterinary Medical Education
Qiushi Chen, Turgay Ayer, Jagpreet Chhatwal
BACKGROUND: Sequential decision problems are frequently encountered in medical decision making, which are commonly solved using Markov decision processes (MDPs). Modeling guidelines recommend conducting sensitivity analyses in decision-analytic models to assess the robustness of the model results against the uncertainty in model parameters. However, standard methods of conducting sensitivity analyses cannot be directly applied to sequential decision problems because this would require evaluating all possible decision sequences, typically in the order of trillions, which is not practically feasible...
September 28, 2016: Medical Decision Making: An International Journal of the Society for Medical Decision Making
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