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questioning medicine

N D B Ehelepola, A N Abayagunawardana, T N Sudusinghe
BACKGROUND: Hemolysis can occur in people with G6PD deficiency under oxidative stress. Acalypha indica is a tropical plant used as a medicinal plant as well as a vegetable. There are a few reported cases of Acalypha indica ingestion induced hemolysis in G6PD deficient people. All except one of them are from Sri Lanka. The information available at present (2017) about G6PD deficiency prevalence and variants of the G6PD gene among Sri Lankans is very sparse. There are no past reports on hemolytic crisis in a G6PD deficient person presenting mimicking leptospirosis...
March 14, 2018: BMC Research Notes
David L Chan, Lesley Moody, Eva Segelov, David Metz, Jonathan Strosberg, Nick Pavlakis, Simron Singh
<br>Objectives: There is no consensus regarding optimal follow-up in resected GEP-NETS. We aimed to perform a practice survey to ascertain follow-up patterns by health care practitioners and highlight areas of variation that may benefit from further quantitative research. METHODS: A web-based survey targeted at NET health care providers in Australia, New Zealand, Canada and the United States was developed by a steering committee of medical oncologists and a research methodologist...
March 14, 2018: Neuroendocrinology
Kathrine Vauvert R Hviid, Sara Sofia Malchau, Anja Pinborg, Henriette Svarre Nielsen
BACKGROUND: The incidence of monozygotic twins (MZT) after ART appears to be higher than the incidence after spontaneous conceptions contradicting the aim of ART to avoid multiple pregnancies because of the associated risks. OBJECTIVE AND RATIONALE: The aim was to study the frequency of MZT after IVF and ICSI and how it is influenced by the day of embryo transfer, maternal age, zona pellucida manipulation, controlled ovarian stimulation, stimulation protocol, culture media and embryo quality...
March 12, 2018: Human Reproduction Update
Sonia Maria Gutiérrez Sanfeliciano, John M Schaus
The ability to rapidly assess the preferred conformation of key fragments in a structure "by visual inspection" is a very useful starting point in the process of drug design. With the ability to do so, one could address questions like: "How could we avoid planarity in a molecule?", "Will a molecule change its conformational preference if we make it more or less basic?" or "How does this electronic repulsion affect the conformational preference in the system?" in timely fashion...
2018: PloS One
Vanessa A Thomas, Heather L Crouse, Kristy O Murray, Deborah C Hsu, Elizabeth A Camp, Andrea T Cruz
OBJECTIVE: The aim of this study was to perform a needs assessment of pediatric (PEM) and general emergency medicine (EM) provider knowledge, comfort, and current practice patterns in the evaluation of pediatric tropical infectious diseases. METHODS: An online survey was developed based on educational priorities identified by an expert panel via modified Delphi methodology. The survey included assessment of providers' typical evaluation, diagnosis, and treatment of tropical diseases and was distributed to PEM and EM providers in 2 large professional organizations...
March 12, 2018: Pediatric Emergency Care
Vineet M Arora
With the advent of electronic medical records (EMRs) fueling the rise of big data, the use of predictive analytics, machine learning, and artificial intelligence are touted as transformational tools to improve clinical care. While major investments are being made in using big data to transform health care delivery, little effort has been directed toward exploiting big data to improve graduate medical education (GME). Because our current system relies on faculty observations of competence, it is not unreasonable to ask whether big data in the form of clinical EMRs and other novel data sources can answer questions of importance in GME such as when is a resident ready for independent practice...
March 13, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Marie-Laure Amram, Pierre-Yves Dietrich, Florence Rochon, Mylène Bolmont, Francesco Bianchi-Demicheli
Cancer itself and its treatments can result in physical and/or psychological adverse events which include disorders of sexual health. Both clinicians and patients are reluctant to talk about sexual issues, body image or intimacy between partners. Barriers from the clinician's perspective include feeling inadequately trained, lack of time or privacy. On the patients' side, embarrassment or belief that their sexual health are an untreatable complication of their disease and its treatment are the main barriers...
March 14, 2018: Revue Médicale Suisse
Steven Lin, Cathina Nguyen, Emily Walters, Paul Gordon
BACKGROUND AND OBJECTIVES: Worsening faculty shortages in medical schools and residency programs are threatening the US medical education infrastructure. Little is known about the factors that influence the decision of family medicine residents to choose or not choose academic careers. Our study objective was to answer the following question among family medicine residents: "What is your greatest concern or fear about pursuing a career in academic family medicine?" METHODS: Participants were family medicine residents who attended the Faculty for Tomorrow Workshop at the Society of Teachers of Family Medicine Annual Spring Conference in 2016 and 2017...
March 2018: Family Medicine
Antoine Haddad, Tarek Bou Assi, Olivier Garraud
Unlike their Western counterparts, some of the Eastern/Southern Mediterranean countries lack centralized coordinated blood transfusion services leading to an unequal blood safety level. This was recently highlighted by a recent World Health Organization (WHO) regional committee report in which WHO urges these countries to establish and implement a national blood system with well-coordinated blood transfusion activities and to make attempts to reach 100% voluntary non-remunerated blood donation. The objective is thus to meet the same levels or standards as Western countries in term of self-sufficiency and blood safety...
2018: Frontiers in Medicine
Mehdi Trifa, Dmitry Tumin, Hina Walia, Kathleen L Lemanek, Joseph D Tobias, Tarun Bhalla
Background: The use of complementary and alternative medicine (CAM) therapies has increased in children, especially in those with chronic health conditions. However, this increase may not translate into acceptance of CAM in the perioperative setting. We surveyed caregivers of patients undergoing surgery to determine their knowledge and acceptance of hypnotherapy, acupuncture, and music therapy as alternatives to standard medication in the perioperative period. Materials and methods: An anonymous, 12-question survey was administered to caregivers of children undergoing procedures under general anesthesia...
2018: Journal of Pain Research
Marjorie A Bowman, Anne Victoria Neale, Dean A Seehusen
This issue includes several excellent observational studies prompted by physicians' clinical questions. Many people use lots of menthol cough drops-does the menthol overall lengthen the cough duration? When should we intensify treatment of older individuals with diabetes? Do occipital nerve blocks work for acute migraine headaches? Did you know that the plantar fascia can rupture? What happens to those patients with chest pain but low pretest probability for serious cardiac disease who are admitted to the hospital? Acupuncture can work well-for the patients-but how can we incorporate it into the usual pace of the family medicine office? Is it a win-lose situation when medical assistant roles are expanded? How many practice sites do physicians have and does that make a difference in the number or type of health personnel shortage areas? What would you guess on the presence of humor in the medical office-more or less than half of the visits; introduced by doctors or patients; primary care or specialty doctors?...
March 2018: Journal of the American Board of Family Medicine: JABFM
Rosalyn E Maben-Feaster, R Brent Stansfield, AnneMarie Opipari, Maya M Hammoud
BACKGROUND: One-third of Americans use social media websites as a source of health care information. Twitter, a microblogging site that allows users to place 280-character posts-or tweets-on the Web, is emerging as an important social media platform for health care. However, most guidelines on medical professionalism on social media are based on expert opinion. OBJECTIVE: This study sought to examine if provider Twitter profiles with educational tweets were viewed as more professional than profiles with personal tweets or a mixture of the two, and to determine the impact of provider gender on perceptions of professionalism in an academic obstetrics and gynecology clinic...
March 12, 2018: Journal of Medical Internet Research
Driss Berdaï, Florence Thomas-Delecourt, Karine Szwarcensztein
Early market access of health products is associated with a larger number of requests for information by the health authorities. Compared with these expectations, the growing expansion of health databases represents an opportunity for responding to questions raised by the authorities. The computerised nature of the health system provides numerous sources of data, and first and foremost medical/administrative databases such as the French National Inter-Scheme Health Insurance Information System (SNIIRAM) database...
December 30, 2017: Thérapie
Chloë Campbell, Rhiannon Braund, Caroline Morris
INTRODUCTION Recognition of the need to reduce harm and optimise patient outcomes from the use of medicines is contributing to an evolution of pharmacy practice in primary health care internationally. This evolution is changing community pharmacy and leading to new models of care that enable pharmacist contribution beyond traditional realms. There is little information about the extent of these changes in New Zealand. AIM The aim of this study was to investigate emerging roles of pharmacists in primary health care...
December 2017: Journal of Primary Health Care
Yemisi Takwoingi, Terence J Quinn
Diagnostic Test Accuracy (DTA) describes a field of research that aims to assess how well a test is able to detect or exclude a condition of interest. Although geriatric medicine is not as reliant on investigations as other medical disciplines, almost all patient encounters with older adults will involve some form of diagnostic assessment. Thus, understanding the terminology and methods of DTA is essential for any clinician. In this review we use examples based around the diagnosis of dementia to highlight issues in DTA research...
March 8, 2018: Age and Ageing
Aydan Akyüz Özdemir, Rengin Erdal, Mehmet Haberal
OBJECTIVES: Our aim was to gather information about complementary medicine applications used by chronic renal failure patients and their relation to demographic factors. MATERIALS AND METHODS: Of 1750 chronic renal disease patients who were undergoing hemodialysis, only 450 patients attended in the study. Among 450 patients, 388 gave consent and were interviewed using a previously tested questionnaire. Questions about complementary and alternative medicine use, a list of commonly used methods, and the sources of knowledge about these were asked of all patients...
March 2018: Experimental and Clinical Transplantation
Michael Gold, Anneke Andriessen, Alexandros Bader, Red Alinsod, Elizabeth Shane French, Nathan Guerette, Yegor Kolodchenko, Michael Krychman, Susan Murrmann, Julene Samuels
INTRODUCTION: The use of energy-based devices for the treatment of vaginal laxity, orgasmic dysfunction, and stress incontinence, such as minimally ablative fractional laser and radiofrequency, is gaining momentum. This review aims to answer clinical questions on the application of energy-based devices for feminine genital rejuvenation. METHODS: The target group includes physicians involved in esthetic medicine and feminine genital rejuvenation. A literature review was conducted on technologies in use for feminine rejuvenation to explore their safety, efficacy, tolerability, patient satisfaction, and clinical usability...
March 10, 2018: Journal of Cosmetic Dermatology
Letizia Zullo, Ambra Buschiazzo, Michela Massollo, Mattia Riondato, Alessia Democrito, Cecilia Marini, Fabio Benfenati, Gianmario Sambuceti
This study aimed at developing a method for administration of18 F-Fludeoxyglucose (18 F-FDG) in the common octopus and micro-positron emission tomography (micro-PET) bio-distribution assay for the characterization of glucose metabolism in body organs and regenerating tissues. Methods: Seven animals (two with one regenerating arm) were anesthetized with 3.7% MgCl2 in artificial seawater. Each octopus was injected with 18-30 MBq of isosmotic18 F-FDG by accessing the branchial heart or the anterior vena cava. After an uptake time of ~50 minutes, the animal was sacrificed, placed on a bed of a micro-PET scanner and submitted to 10 min static 3-4 bed acquisitions to visualize the entire body...
March 9, 2018: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
John D Cramer, David H Chi, Barry M Schaitkin, David E Eibling, Jonas T Johnson
OBJECTIVES/HYPOTHESIS: Fellowship is the capstone of academic training and serves as preparation for an academic career. Fellows are expected to educate medical students and residents during and long after fellowship. However, little time is typically spent teaching fellows to become effective educators. We investigate a formal curriculum addressing teaching skills among fellows in otolaryngology-head and neck surgery (OHNS). STUDY DESIGN: E-mail survey. METHODS: We developed and implemented an educational program called Teach the Teacher to build skills as educators for fellows in OHNS...
March 9, 2018: Laryngoscope
Lu Yang, Wenbo Peng, Jon Adams, David William Sibbritt
INTRODUCTION: Emerging evidence has shown that traditional Chinese medicine (TCM) has a positive effect on arthritis. This research provides the first critical, systematic examination of TCM practitioners' perceptions of TCM use for people with arthritis. METHODS: An online survey was distributed to all TCM professionals including acupuncturists and Chinese herbal medicine practitioners registered with the Practitioner Research and Collaborate Initiative (PRACI) practitioner database...
March 8, 2018: Acupuncture in Medicine: Journal of the British Medical Acupuncture Society
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