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Wisdom in medicine

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https://www.readbyqxmd.com/read/28332881/an-individualized-approach-to-the-evaluation-and-management-of-primary-aldosteronism
#1
Anand Vaidya, Carl D Malchoff, Richard J Auchus
OBJECTIVE: With the increased emphasis on personalized and individualized medicine, the American Association of Clinical Endocrinologists Adrenal Scientific Committee has developed a series of articles to update members on personalized medicine as it applies to adrenal diseases. METHODS: Synthesis of literature review, guidelines from professional societies, and personal experience. RESULTS: Since Conn described primary aldosteronism (PA) over 60 years ago, debate has raged about the prevalence of PA in the hypertensive population, the wisdom of broadly screening for PA, and prudent approach to the evaluation and management of these patients...
March 23, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28218938/voices-from-family-medicine-on-becoming-a-family-physician
#2
William B Ventres
In this essay-part memoir, part reflection, and part oral history-I review my early professional development, a several years' long progression after residency training, during which I grew from functioning as a technically competent primary care doctor to being a capable and compassionate family physician. As part of that development, and with my colleague John Frey, MD, I interviewed several of the founders of the modern family medicine movement. Here I review some of their answers to the fundamental question of my early practice years: What does it mean to be a family physician? I cite some of their words of wisdom, those of particular import for me, and discuss how these words both helped me become a family physician and ring true even today as we approach the 50th anniversary of the founding of family medicine...
February 2017: Family Medicine
https://www.readbyqxmd.com/read/28130475/breast-cancer-screening-in-the-precision-medicine-era-risk-based-screening-in-a-population-based-trial
#3
REVIEW
Yiwey Shieh, Martin Eklund, Lisa Madlensky, Sarah D Sawyer, Carlie K Thompson, Allison Stover Fiscalini, Elad Ziv, Laura J Van't Veer, Laura J Esserman, Jeffrey A Tice
Ongoing controversy over the optimal approach to breast cancer screening has led to discordant professional society recommendations, particularly in women age 40 to 49 years. One potential solution is risk-based screening, where decisions around the starting age, stopping age, frequency, and modality of screening are based on individual risk to maximize the early detection of aggressive cancers and minimize the harms of screening through optimal resource utilization. We present a novel approach to risk-based screening that integrates clinical risk factors, breast density, a polygenic risk score representing the cumulative effects of genetic variants, and sequencing for moderate- and high-penetrance germline mutations...
January 2017: Journal of the National Cancer Institute
https://www.readbyqxmd.com/read/28118680/surgical-wisdom-and-genghis-khan-s-pax-mongolica
#4
Jakob Köstenbauer
BACKGROUND: The unrivalled conquests of Genghis Khan (CE c.1162-1227) led to the establishment of the Greater Mongolian Empire. By 1279, the Mongol dynasty controlled a vast Empire which, for the first time in history, unified Europe and China via the famous Silk Road. The ensuing century of peace and stability is referred to by historians as the Pax Mongolica, which facilitated Europe's renaissance and remarkably contributed to the rise of modern medicine and surgery. METHODS: Secondary sources from published literature, primary sources from manuscripts and illustrations courtesy of universities, museum libraries and archives...
March 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28053888/a-glimpse-of-ayurveda-the-forgotten-history-and-principles-of-indian-traditional-medicine
#5
REVIEW
Yogini S Jaiswal, Leonard L Williams
Ayurveda is considered as one of the oldest of the traditional systems of medicine (TSMs) accepted worldwide. The ancient wisdom in this traditional system of medicine is still not exhaustively explored. The junction of the rich knowledge from different traditional systems of medicine can lead to new avenues in herbal drug discovery process. The lack of the understanding of the differences and similarities between the theoretical doctrines of these systems is the major hurdle towards their convergence apart from the other impediments in the discovery of plant based medicines...
January 2017: Journal of Traditional and Complementary Medicine
https://www.readbyqxmd.com/read/28031068/what-defines-mindfulness-based-programs-the-warp-and-the-weft
#6
R S Crane, J Brewer, C Feldman, J Kabat-Zinn, S Santorelli, J M G Williams, W Kuyken
There has been an explosion of interest in mindfulness-based programs (MBPs) such as Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy. This is demonstrated in increased research, implementation of MBPs in healthcare, educational, criminal justice and workplace settings, and in mainstream interest. For the sustainable development of the field there is a need to articulate a definition of what an MBP is and what it is not. This paper provides a framework to define the essential characteristics of the family of MBPs originating from the parent program MBSR, and the processes which inform adaptations of MBPs for different populations or contexts...
April 2017: Psychological Medicine
https://www.readbyqxmd.com/read/27939421/efficacy-and-safety-of-yahom-as-a-traditional-thai-herbal-therapy-a-systematic-review
#7
Krongkarn Chootip, Nathorn Chaiyakunapruk, Noppamas Soonthornchareonnon, C Norman Scholfield, Anjana Fuangchan
ETHNOPHARMACOLOGICAL RELEVANCE: Yahom is a traditional Thai medicine used to treat syncope and abdominal discomfort. AIM OF THE STUDY: This study aimed to systematically review all available evidence which purports to support these claims. MATERIAL AND METHODS: The systematic review accorded with the Cochrane Collaboration framework and PRISMA reporting. Databases including MEDLINE, Excerpta Medica Database (EMBASE), Cochrane library database, and Google Scholar were searched by keywords, Yahom and Ya-hom...
January 20, 2017: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/27894343/post-marketing-withdrawal-of-anti-obesity-medicinal-products-because-of-adverse-drug-reactions-a-systematic-review
#8
Igho J Onakpoya, Carl J Heneghan, Jeffrey K Aronson
BACKGROUND: We identified anti-obesity medications withdrawn since 1950 because of adverse drug reactions after regulatory approval, and examined the evidence used to support such withdrawals, investigated the mechanisms of the adverse reactions, and explored the trends over time. METHODS: We conducted searches in PubMed, the World Health Organization database of drugs, the websites of drug regulatory authorities, and selected full texts, and we hand searched references in retrieved documents...
November 29, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27740899/teaching-legal-competencies-through-an-individualized-elective-in-medicine-and-law
#9
Marshall B Kapp
Medical education, including education intended to prepare future physicians to care to older individuals, should include development and implementation of competencies relating to a physician's ability to understand and interact with the legal environment and legal actors who will impact the practice of medicine. The wisdom of integrating legal knowledge into the medical curriculum has been documented and literature discusses the content and methods of teaching medical students and residents about law and the legal system...
October 14, 2016: Gerontology & Geriatrics Education
https://www.readbyqxmd.com/read/27729074/folk-knowledge-of-invertebrates-in-central-europe-folk-taxonomy-nomenclature-medicinal-and-other-uses-folklore-and-nature-conservation
#10
Viktor Ulicsni, Ingvar Svanberg, Zsolt Molnár
BACKGROUND: There is scarce information about European folk knowledge of wild invertebrate fauna. We have documented such folk knowledge in three regions, in Romania, Slovakia and Croatia. We provide a list of folk taxa, and discuss folk biological classification and nomenclature, salient features, uses, related proverbs and sayings, and conservation. METHODS: We collected data among Hungarian-speaking people practising small-scale, traditional agriculture. We studied "all" invertebrate species (species groups) potentially occurring in the vicinity of the settlements...
October 11, 2016: Journal of Ethnobiology and Ethnomedicine
https://www.readbyqxmd.com/read/27716590/therapeutic-effects-of-aloe-spp-in-traditional-and-modern-medicine-a-review
#11
REVIEW
Maryam Akaberi, Zahra Sobhani, Behjat Javadi, Amirhossein Sahebkar, Seyed Ahmad Emami
Traditional medicine is a useful guide in medical sciences. In the Islamic Iranian traditional medicine, the medicinal properties of many plants have been mentioned that could be exploited in drug discovery. We aimed to explore the nature and properties of Aloe spp. As described in some major Islamic traditional texts including Ferdows al-Hekmah fi'l-Tibbe (The Paradise of Wisdom in Medicine), Al-Hawi fi'l-Tibb (Comprehensive Book of Medicine), Kamel al-Sanaat al-Tibbyyah (Complete Book of the Medical Art), Al-Qanun fi'l-Tibb (Canon of Medicine), Zakhireh Kharazmshahi (Treasure of Kharazmshah), and Makhzan al-Adwiah (Drug Treasure), and assess the conformity of traditional medicine instructions with the findings of modern pharmacological studies...
December 2016: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/27673509/peer-feedback-learning-and-improvement-answering-the-call-of-the-institute-of-medicine-report-on-diagnostic-error
#12
David B Larson, Lane F Donnelly, Daniel J Podberesky, Arnold C Merrow, Richard E Sharpe, Jonathan B Kruskal
In September 2015, the Institute of Medicine (IOM) published a report titled "Improving Diagnosis in Health Care," in which it was recommended that "health care organizations should adopt policies and practices that promote a nonpunitive culture that values open discussion and feedback on diagnostic performance." It may seem counterintuitive that a report addressing a highly technical skill such as medical diagnosis would be focused on organizational culture. The wisdom becomes clearer, however, when examined in the light of recent advances in the understanding of human error and individual and organizational performance...
April 2017: Radiology
https://www.readbyqxmd.com/read/27547116/suicidal-thoughts-in-the-novel-don-quixote
#13
Saxby Pridmore, Celeste Pridmore
BACKGROUND: During the last century suicide has been medicalised. This restrictive view has been challenged, and the wisdom of experts from beyond medicine is being valued. Fictional literature is a source of information regarding the human experience. OBJECTIVE: To extend our understanding of suicide and suicidal thinking by examining the early-17th Century Spanish novel, "Don Quixote". METHOD: Various translations were examined for accounts of suicide, suicidal thinking, and associated behaviour...
March 2016: Malaysian Journal of Medical Sciences: MJMS
https://www.readbyqxmd.com/read/27540600/highlights-from-the-52nd-annual-meeting-of-the-american-society-of-clinical-oncology-asco-june-3-7-2016-chicago-illinois-usa
#14
A Kibble, A Al-Shamahi, K Kuennemann, F Marqués, L Tremosa, P Cole
The theme of the 52nd Annual American Society of Clinical Oncology (ASCO) meeting, 'Collective Wisdom', was intended to represent the importance of consolidating clinical advances with expertise in areas such as health informatics, pathology and economics in order to improve the role of practice providers in delivering cancer patients every component of quality care. As expected, immunotherapy and precision medicine featured heavily in the 2016 program. Gathering 30,000 oncology professionals in Chicago, educational and science sessions gave the attendees the opportunity to discuss and view ground-breaking research...
July 2016: Drugs of Today
https://www.readbyqxmd.com/read/27532316/the-effectiveness-of-ayurvedic-oil-based-nasal-instillation-nasya-medicines-in-the-treatment-of-facial-paralysis-ardita-a-systematic-review
#15
Manuel Joseph Vivera, Judith Streak Gomersall
BACKGROUND: Ardita (facial paralysis) is a medical condition that disfigures or distorts the facial appearance of the sufferer causing facial asymmetry and malfunction. Ardita patients may benefit from considering alternative treatments such as Ayurveda, including Taila Nasya (nasal instillation of medicated oil). OBJECTIVES: To synthesize the best available evidence on the effectiveness of different Nasya oils in the treatment of Ardita. INCLUSION CRITERIA TYPES OF PARTICIPANTS: Studies conducted on adult sufferers (18-70 years) of Ardita (chronic or acute) in any setting were considered...
April 2016: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/27509070/defining-glioblastoma-resectability-through-the-wisdom-of-the-crowd-a-proof-of-principle-study
#16
Adam M Sonabend, Brad E Zacharia, Michael B Cloney, Aarón Sonabend, Christopher Showers, Victoria Ebiana, Matthew Nazarian, Kristin R Swanson, Anne Baldock, Henry Brem, Jeffrey N Bruce, William Butler, Daniel P Cahill, Bob Carter, Daniel A Orringer, David W Roberts, Oren Sagher, Nader Sanai, Theodore H Schwartz, Daniel L Silbergeld, Michael B Sisti, Reid C Thompson, Allen E Waziri, Guy McKhann
BACKGROUND: Extent of resection (EOR) correlates with glioblastoma outcomes. Resectability and EOR depend on anatomical, clinical, and surgeon factors. Resectability likely influences outcome in and of itself, but an accurate measurement of resectability remains elusive. An understanding of resectability and the factors that influence it may provide a means to control a confounder in clinical trials and provide reference for decision making. OBJECTIVE: To provide proof of concept of the use of the collective wisdom of experienced brain tumor surgeons in assessing glioblastoma resectability...
August 4, 2016: Neurosurgery
https://www.readbyqxmd.com/read/27392498/strategy-of-integrated-evaluation-on-treatment-of-traditional-chinese-medicine-as-interaction-of-system-to-system-and-establishment-of-novel-fuzzy-target-contribution-recognition-with-herb-pairs-a-case-study-on-astragali-radix-fructus-corni
#17
Yu Duan, Ke Pei, Hao Cai, Sicong Tu, Xinwei Cheng, Zhengwei Zhang, Kailei Fan, Fengxian Qiao, Kunming Qin, Baochang Cai
To date, in the struggle against diseases and the development of TCM, what we lack is wisdom rather than knowledge. Studies on pharmacology of traditional Chinese medicine are facing critical challenges on how to select the proper parameters or targets to represent the pharmacological evaluation system. With seven steps of optimized modules established by ourselves, we can re-evaluate TCM in a panorama view with a proper pharmacological evaluation system. In this article, with the treatment of TCM as 'interaction of system to system', a novel and generally applicable approach called fuzzy target contribution recognition was established and agents from Astragali Radix-Fructus Corni in resisting diabetic nephropathy were successfully discovered for the first time...
October 15, 2016: Molecular and Cellular Endocrinology
https://www.readbyqxmd.com/read/27373145/precision-imaging-more-descriptive-predictive-and-integrative-imaging
#18
EDITORIAL
Alejandro F Frangi, Zeike A Taylor, Ali Gooya
Medical image analysis has grown into a matured field challenged by progress made across all medical imaging technologies and more recent breakthroughs in biological imaging. The cross-fertilisation between medical image analysis, biomedical imaging physics and technology, and domain knowledge from medicine and biology has spurred a truly interdisciplinary effort that stretched outside the original boundaries of the disciplines that gave birth to this field and created stimulating and enriching synergies. Consideration on how the field has evolved and the experience of the work carried out over the last 15 years in our centre, has led us to envision a future emphasis of medical imaging in Precision Imaging...
October 2016: Medical Image Analysis
https://www.readbyqxmd.com/read/27179600/beyond-cannabis-plants-and-the-endocannabinoid-system
#19
REVIEW
Ethan B Russo
Plants have been the predominant source of medicines throughout the vast majority of human history, and remain so today outside of industrialized societies. One of the most versatile in terms of its phytochemistry is cannabis, whose investigation has led directly to the discovery of a unique and widespread homeostatic physiological regulator, the endocannabinoid system. While it had been the conventional wisdom until recently that only cannabis harbored active agents affecting the endocannabinoid system, in recent decades the search has widened and identified numerous additional plants whose components stimulate, antagonize, or modulate different aspects of this system...
July 2016: Trends in Pharmacological Sciences
https://www.readbyqxmd.com/read/27102663/pitfalls-and-pearls-of-wisdom-in-18f-fdg-pet-imaging-of-tumors
#20
REVIEW
Tracey Britton, Nicholas Robinson
(18)F-FDG PET imaging of tumors has pitfalls and pearls of wisdom that begin at the point of scheduling and continue through the patient interview, the resting phase, the scan itself, and the image review. Interviewing the patient at the time of scheduling, followed by placing a reminder phone call shortly before the appointment, can save a nuclear medicine department the financial loss of wasted doses and missed appointment slots in the schedule. The pitfalls and pearls of wisdom in tumor imaging are ever changing, and the technologist is in a constant state of inquiry about the patient's disease process and ability to comply...
June 2016: Journal of Nuclear Medicine Technology
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