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questioning medicine

Julie Dare, Celia Wilkinson, Michael Garlepp, Johnny Lo, Steve Allsop
OBJECTIVES: This qualitative study explored the barriers and enablers influencing Western Australian (WA) community pharmacists' knowledge, confidence, willingness and practice in engaging older clients (>60 years) in alcohol-related health discussions. METHODS: Two focus groups were conducted with a total of 14 community pharmacists who had previously completed a formative quantitative survey (n = 63), and indicated willingness to participate in a follow-up focus group...
October 20, 2016: International Journal of Pharmacy Practice
Marian L Neuhouser, Ashley Wilder Smith, Stephanie M George, James T Gibson, Kathy B Baumgartner, Richard Baumgartner, Catherine Duggan, Leslie Bernstein, Anne McTiernan, Rachel Ballard
PURPOSE: Use of complementary and alternative medicine (CAM) is common among breast cancer patients, but less is known about whether CAM influences breast cancer survival. METHODS: Health Eating, Activity, and Lifestyle (HEAL) Study participants (n = 707) were diagnosed with stage I-IIIA breast cancer. Participants completed a 30-month post-diagnosis interview including questions on CAM use (natural products such as dietary and botanical supplements, alternative health practices, and alternative medical systems), weight, physical activity, and comorbidities...
October 21, 2016: Breast Cancer Research and Treatment
Scott D Cook-Sather, Peter C Adamson, Jin Li, Hakon Hakonarson
No abstract text is available yet for this article.
October 20, 2016: Anesthesiology
Gregory A Schmidt, Timothy D Girard, John P Kress, Peter E Morris, Daniel R Ouellette, Waleed Alhazzani, Suzanne M Burns, Scott K Epstein, Andres Esteban, Eddy Fan, Miquel Ferrer, Gilles L Fraser, Michelle Gong, Catherine Hough, Sangeeta Mehta, Rahul Nanchal, Sheena Patel, Amy J Pawlik, Curtis N Sessler, Thomas Strøm, William Schweickert, Kevin C Wilson, Jonathon D Truwit
BACKGROUND: This clinical practice guideline addresses six questions related to liberation from mechanical ventilation in critically ill adults. It is the result of a collaborative effort between the American Thoracic Society (ATS) and American College of Chest Physicians (CHEST). METHODS: A multi-disciplinary panel posed six clinical questions in a Population, Intervention, Comparator and Outcomes (PICO) format. A comprehensive literature search and evidence synthesis was performed for each question, which included appraising the certainty in the evidence (i...
October 20, 2016: American Journal of Respiratory and Critical Care Medicine
J Wu, A Platero Luengo, M A Gil, K Suzuki, C Cuello, M Morales Valencia, I Parrilla, C A Martinez, A Nohalez, J Roca, E A Martinez, J C Izpisua Belmonte
More than eighteen years have passed since the first derivation of human embryonic stem cells (ESCs), but their clinical use is still met with several challenges, such as ethical concerns regarding the need of human embryos, tissue rejection after transplantation and tumour formation. The generation of human induced pluripotent stem cells (iPSCs) enables the access to patient-derived pluripotent stem cells (PSCs) and opens the door for personalized medicine as tissues/organs can potentially be generated from the same genetic background as the patient recipients, thus avoiding immune rejections or complication of immunosuppression strategies...
October 2016: Reproduction in Domestic Animals, Zuchthygiene
Afsin Emre Kayipmaz, Orcun Ciftci, Cemil Kavalci, Emir Karacaglar, Haldun Muderrisoglu
BACKGROUND: This study aimed to explore the ST segment elevation myocardial infarction (STEMI) management practices of emergency medicine specialists working in various healthcare institutions of seven different geographical regions of Turkey, and to examine the characteristics of STEMI presentation and patient admissions in these regions. METHODS: We included 225 emergency medicine specialists working in all geographical regions of Turkey. We e-mailed them a 20-item questionnaire comprising questions related to their STEMI management practices and characteristics of STEMI presentation and patient admissions...
2016: PloS One
Y-C Huang, J Xiao, W Y Leung, W W Lu, Y Hu, K D Luk
Previous human study suggested that fresh-frozen intervertebral disc allograft transplantation can relieve neurological symptoms and restore segmental kinematics. Before wide clinical application, research into the pathophysiology of the postoperative disc allograft is needed. One important question that remains to be answered in disc allografting is the healing process of the host-graft interface and the subsequent change of the endplates. With the goat model for lumbar disc allografting, histology, micro-computed tomography analysis, scanning electron microscopy and energy-dispersive X-ray spectroscopy mapping were applied to evaluate the healing of the host-graft interfaces, the remodelling of subchondral bone, and the changes of the bony and cartilaginous endplates after transplantation...
October 19, 2016: European Cells & Materials
Mandeep S Tamber, Dimitrios Nikas, Alexandra Beier, Lissa C Baird, David F Bauer, Susan Durham, Paul Klimo, Alexander Y Lin, Catherine Mazzola, Catherine McClung-Smith, Laura Mitchell, Rachana Tyagi, Ann Marie Flannery
BACKGROUND: No evidence-based guidelines exist on the role of cranial-molding orthosis (helmet) therapy for patients with positional plagiocephaly. OBJECTIVE: To address the clinical question: "Does helmet therapy provide effective treatment for positional plagiocephaly?" and to make treatment recommendations based on the available evidence. METHODS: The US National Library of Medicine Medline database and the Cochrane Library were queried by using MeSH headings and key words relevant to the objective of this systematic review...
November 2016: Neurosurgery
Paul Klimo, Patrick Ryan Lingo, Lissa C Baird, David F Bauer, Alexandra Beier, Susan Durham, Alexander Y Lin, Catherine McClung-Smith, Laura Mitchell, Dimitrios Nikas, Mandeep S Tamber, Rachana Tyagi, Catherine Mazzola, Ann Marie Flannery
BACKGROUND: Plagiocephaly, involving positional deformity of the calvarium in infants, is one of the most common reasons for pediatric neurosurgical consultation. OBJECTIVE: To answer the question: "what is the evidence for the effectiveness of repositioning for positional plagiocephaly?" Treatment recommendations are provided based on the available evidence. METHODS: The National Library of Medicine MEDLINE database and the Cochrane Library were queried using MeSH headings and key words relevant to repositioning as a means to treat plagiocephaly and brachycephaly...
November 2016: Neurosurgery
Catherine Mazzola, Lissa C Baird, David F Bauer, Alexandra Beier, Susan Durham, Paul Klimo, Alexander Y Lin, Catherine McClung-Smith, Laura Mitchell, Dimitrios Nikas, Mandeep S Tamber, Rachana Tyagi, Ann Marie Flannery
BACKGROUND: No evidence-based guidelines exist for the imaging of patients with positional plagiocephaly. OBJECTIVE: The objective of this systematic review and evidence-based guideline is to answer the question, Is imaging necessary for infants with positional plagiocephaly to make a diagnosis? METHODS: The National Library of Medicine Medline database and the Cochrane Library were queried with the use of MeSH headings and key words relevant to imaging as a means to diagnose plagiocephaly...
November 2016: Neurosurgery
Giacomo Veronese, Federico Germini, Stella Ingrassia, Ombretta Cutuli, Valeria Donati, Luca Bonacchini, Maura Marcucci, Andrea Fabbri
BACKGROUND: Electrocardiogram (ECG) interpretation is widely performed by emergency physicians. We aimed to determine the accuracy of interpretation of potential ST-segment elevation myocardial infarction (STEMI) ECGs by emergency physicians. METHODS: Thirty-six ECGs resulted in putative STEMI diagnoses were selected. Participants were asked to focus on whether or not the ECG in question met the diagnostic criteria for an acutely blocked coronary artery causing a STEMI...
October 19, 2016: Acute Cardiac Care
Bachir Benarba
BACKGROUND/AIM: This study aimed to document and analyzes the local knowledge of medicinal plants' use by traditional healers in South-west Algeria. METHODS: The ethnobotanical survey was conducted in two Saharian regions of South-west of Algeria: Adrar and Bechar. In total, 22 local traditional healers were interviewed using semi-structured questionnaire and open questions. Use value (UV), fidelity level (FL), and informant consensus factor (FIC) were used to analyze the obtained data...
September 2016: Journal of Intercultural Ethnopharmacology
Joel B Krier, Sarah S Kalia, Robert C Green
The development of massively parallel sequencing (or next-generation sequencing) has facilitated a rapid implementation of genomic sequencing in clinical medicine. Genomic sequencing (GS) is now an essential tool for evaluating rare disorders, identifying therapeutic targets in neoplasms, and screening for prenatal aneuploidy. Emerging applications, such as GS for preconception carrier screening and predisposition screening in healthy individuals, are being explored in research settings and utilized by members of the public eager to incorporate genomic information into their health management...
September 2016: Dialogues in Clinical Neuroscience
Renata Castro Martins, Clarice Magalhães Rodrigues Dos Reis, Antonio Thomaz Gonzaga da Matta Machado, João Henrique Lara do Amaral, Marcos Azeredo Furquim Werneck, Mauro Henrique Nogueira Guimarães de Abreu
This cross-sectional study evaluated the relationship between primary and secondary oral health care in Brazil. For this purpose, data from the National Program for Improving Access and Quality of Primary Care were used. Dentists from 12,403 oral health teams (OHTs) answered a structured questionnaire in 2012. The data were analyzed descriptively and by cluster analysis. Of the 12,387 (99.9%) OHTs that answered all the questions, 62.2% reported the existence of Dental Specialties Centers (DSCs) to which they could refer patients...
2016: PloS One
Michael J Murray, Heidi DeBlock, Brian Erstad, Anthony Gray, Judi Jacobi, Che Jordan, William McGee, Claire McManus, Maureen Meade, Sean Nix, Andrew Patterson, M Karen Sands, Richard Pino, Ann Tescher, Richard Arbour, Bram Rochwerg, Catherine Friederich Murray, Sangeeta Mehta
OBJECTIVE: To update the 2002 version of "Clinical practice guidelines for sustained neuromuscular blockade in the adult critically ill patient." DESIGN: A Task Force comprising 17 members of the Society of Critical Medicine with particular expertise in the use of neuromuscular-blocking agents; a Grading of Recommendations Assessment, Development, and Evaluation expert; and a medical writer met via teleconference and three face-to-face meetings and communicated via e-mail to examine the evidence and develop these practice guidelines...
November 2016: Critical Care Medicine
Juliessa M Pavon, Sandro O Pinheiro, Gwendolen T Buhr
OBJECTIVE: We developed a Transitions of Care (TOC) curriculum to teach and measure learner competence in performing TOC tasks for older adults. DESIGN: Internal medicine interns at an academic residency program received the curriculum, which consisted of experiential learning, self-study, and small group discussion. Interns completed retrospective pre/post surveys rating their confidence in performing five TOC tasks, qualitative open-ended survey questions, and a self-reflection essay...
October 18, 2016: Gerontology & Geriatrics Education
Rae Woong Park
Big data indicates the large and ever-increasing volumes of data adhere to the following 4Vs: volume (ever-increasing amount), velocity (quickly generated), variety (many different types), veracity (from trustable sources). The last decade has seen huge advances in the amount of data we routinely generate and collect in pretty much everything we do, as well as our ability to use technology to analyze and understand it. The routine operation of modern health care systems also produces an abundance of electronically stored data on an ongoing basis as a byproduct of clinical practice...
September 2016: Journal of Hypertension
Iwao Kuwajima
Since a concept of Evidence-based Medicine appeared in medical field in 1991, modern medical treatment have been remarkably changed.However, delusive belief of EBM without criticism has brought negative aspect, such as utilization of EBM by companies as a tool of promotion of drug or medical device.Although most of clinical trials were financially supported by drug companies. result of clinical trial does not always ended in favor of test drug or device. When negative results appeared, various way were taken by industry such as usage of SPIN, emphasizing secondary endpoint...
September 2016: Journal of Hypertension
Hui Min Lim, Lee Gan Goh, T Thirumoorthy
Medical reports are required to support court applications to appoint a deputy to make decisions on behalf of a person who has lost mental capacity. The doctor writing such a medical report needs to be able to systematically assess the mental capacity of the person in question, in order to gather the necessary evidence for the Court to make a decision. If the medical report is not adequate, the application will be rejected and the appointment of the deputy delayed. This article sets out the best practices for performing the assessment, and the common errors, issues of concern and best practices in writing the medical report...
October 18, 2016: Singapore Medical Journal
William Peacock
Dear Editor I read with great interest the manuscript titled "A New Panel of Blood Biomarkers for the Diagnosis of Mild Traumatic Brain Injury/Concussion in Adults" by Shan R, et al, published in the January issue of the Journal. (1) I do have some questions. The key to marker discovery studies is a precise and accurate description of how the population was identified, including controls. I have significant concerns about the control population in the manuscript. In the presentation the characteristics of the control group are unclear, described only as "not patients in the ED" and with the same exclusion criteria of the other cohorts...
October 18, 2016: Journal of Neurotrauma
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