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Wisdom in medicine

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https://www.readbyqxmd.com/read/28960730/reasoning-evidence-and-clinical-decision-making-the-great-debate-moves-forward
#1
EDITORIAL
Michael Loughlin, Robyn Bluhm, Stephen Buetow, Kirstin Borgerson, Jonathan Fuller
When the editorial to the first philosophy thematic edition of this journal was published in 2010, critical questioning of underlying assumptions, regarding such crucial issues as clinical decision making, practical reasoning, and the nature of evidence in health care, was still derided by some prominent contributors to the literature on medical practice. Things have changed dramatically. Far from being derided or dismissed as a distraction from practical concerns, the discussion of such fundamental questions, and their implications for matters of practical import, is currently the preoccupation of some of the most influential and insightful contributors to the on-going evidence-based medicine debate...
October 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28944288/the-wisdom-study-breaking-the-deadlock-in-the-breast-cancer-screening-debate
#2
REVIEW
Laura J Esserman
There are few medical issues that have generated as much controversy as screening for breast cancer. In science, controversy often stimulates innovation; however, the intensely divisive debate over mammographic screening has had the opposite effect and has stifled progress. The same two questions-whether it is better to screen annually or bi-annually, and whether women are best served by beginning screening at 40 or some later age-have been debated for 20 years, based on data generated three to four decades ago...
2017: NPJ Breast Cancer
https://www.readbyqxmd.com/read/28853524/-cerebral-palsy-at-the-age-of-modern-obstetrics-ancient-beliefs-versus-solid-facts
#3
Shali Mazaki-Tovi
For many decades the conventional wisdom was that the sole etiology for cerebral palsy is difficult delivery. The adverse outcome associated with cerebral palsy was intuitively related to complications during labor. The blame, unjustifiably and recklessly, was placed on devoted physicians and midwifes. This wrongful accusation, that one may describe as "scientific blood libel" is unprecedented in medicine. In his article, Professor Blickstein scrupulously revises the scientific evidence connecting birth asphyxia and cerebral palsy and refutes the common belief that the only cause for cerebral palsy is complicated delivery...
August 2017: Harefuah
https://www.readbyqxmd.com/read/28762222/-smart-medicine-and-healthcare
#4
Yen-Chiao Angel Lu, Li-Chin Chen
Innovation and rapid technological development in Smart Medicine or Smart Healthcare impact profoundly on many aspects of healthcare. It is believed that Health Information Technology (HIT) has the potential to improve integration between care providers, reduce administrative costs and burdens, reduce medical errors, and improve care quality and patient outcomes. However, issues such as interoperability, compatibility, and integration are critical to effectively integrating hardware and software in order to fully realize the benefits of HIT...
August 2017: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/28758992/demystifying-traditional-herbal-medicine-with-modern-approach
#5
Fu-Shuang Li, Jing-Ke Weng
Plants have long been recognized for their therapeutic properties. For centuries, indigenous cultures around the world have used traditional herbal medicine to treat a myriad of maladies. By contrast, the rise of the modern pharmaceutical industry in the past century has been based on exploiting individual active compounds with precise modes of action. This surge has yielded highly effective drugs that are widely used in the clinic, including many plant natural products and analogues derived from these products, but has fallen short of delivering effective cures for complex human diseases with complicated causes, such as cancer, diabetes, autoimmune disorders and degenerative diseases...
July 31, 2017: Nature Plants
https://www.readbyqxmd.com/read/28736906/dental-pulp-stem-cells-and-the-management-of-neurological-diseases-an-update
#6
REVIEW
Ibrahim Mortada, Rola Mortada, Mohamad Al Bazzal
Medical research in regenerative medicine has brought promising perspectives for the use of stem cells in clinical trials. Stem cells are undifferentiated cells capable of multilineage differentiation and available in numerous sources in the human body. Dental pulp constitutes an attractive source of these cells since collecting mesenchymal stem cells from this site is a noninvasive practice that can be performed after a common surgical extraction of supernumerary or wisdom teeth. Thus, tissue sacrifice is very low and several cytotypes can be obtained owing to these cells' multipotency, in addition to the fact that they can be cryopreserved and stored for long periods...
July 24, 2017: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/28687960/dental-pulp-stem-cells-and-neurogenesis
#7
Ibrahim Mortada, Rola Mortada, Mohamad Al Bazzal
Recent advances in regenerative medicine and cell-based therapy are bringing promising perspectives for the use of stem cells in clinical trials. Stem cells are undifferentiated cells capable of multilineage differentiation and available in numerous sources in the human body. Dental pulp constitutes an attractive source of these cells since collecting mesenchymal stem cells from this site is a noninvasive procedure which can be done following a common surgical extraction of supernumerary or wisdom teeth. Thus tissue sacrifice is very low and several cytotypes can be obtained owing to these cells' multipotency, in addition to the fact that they can be cryopreserved and stored for long periods...
July 8, 2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28618458/dreaming-a-gateway-to-the-unconscious
#8
Steve Paulson, Deirdre Barrett, Kelly Bulkeley, Rubin Naiman
Where do our dreams originate from, and what do they tell us? Is there a universal set of symbols that are common to all dreams, regardless of a person's ethnicity or culture? What does dreaming reveal about the unconscious? Why do some dreams remain etched in our memories, whereas others are almost instantly forgotten? Some scientists have adopted the position that dreams are little more than noise in the brain, without any substantive purpose or function. Yet, such a stance seemingly runs counter to the experience of many people who reflect upon and even analyze their dreams, often in search of clues to their daily lives or insights into their deeper selves...
June 15, 2017: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/28444384/e-science-technologies-in-a-workflow-for-personalized-medicine-using-cancer-screening-as-a-case-study
#9
Ola Spjuth, Andreas Karlsson, Mark Clements, Keith Humphreys, Emma Ivansson, Jim Dowling, Martin Eklund, Alexandra Jauhiainen, Kamila Czene, Henrik Grönberg, Pär Sparén, Fredrik Wiklund, Abbas Cheddad, Þorgerður Pálsdóttir, Mattias Rantalainen, Linda Abrahamsson, Erwin Laure, Jan-Eric Litton, Juni Palmgren
Objective: We provide an e-Science perspective on the workflow from risk factor discovery and classification of disease to evaluation of personalized intervention programs. As case studies, we use personalized prostate and breast cancer screenings. Materials and Methods: We describe an e-Science initiative in Sweden, e-Science for Cancer Prevention and Control (eCPC), which supports biomarker discovery and offers decision support for personalized intervention strategies...
September 1, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28393337/-living-with-tolerable-burden-exploring-the-ethical-self-of-nurses-who-provide-end-of-life-care
#10
Ying-Chun Liu, Yu-Lun Tai, Hsien-Hsien Chiang
BACKGROUND: Providing end-of-life (EOL) care elicits complex emotions in nurses in the context of modern medicine. Nurses must not only watch their patients succumb to disease and death but also witness their suffering. PURPOSE: This qualitative study adopted the perspective of "the other", as proposed by Emmanuel Levinas, to understand the experience of nurses who provide EOL care and the possibilities of nurses build up their ethical selves within the context of modern medicine...
April 2017: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/28332881/an-individualized-approach-to-the-evaluation-and-management-of-primary-aldosteronism
#11
REVIEW
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: We synthesized literature reviews, 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 approaches to evaluate and manage these patients...
June 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28218938/voices-from-family-medicine-on-becoming-a-family-physician
#12
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
#13
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
#14
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
#15
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
#16
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
#17
REVIEW
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
#18
REVIEW
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
#19
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 affect 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
#20
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
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