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Defensive Medicine

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101. Subject: Medical Defense Brochure of the California Medical Association Full Text available with Trip Pro

Subject: Medical Defense Brochure of the California Medical Association 18745647 2008 08 29 2008 11 20 0093-4038 53 1 1940 Jul California and western medicine Cal West Med Subject: Medical Defense Brochure of the California Medical Association. 48 Salmons and Wolcott Co Wolcott P P eng Journal Article United States Cal West Med 0414326 0093-4038 1940 7 1 0 0 1940 7 1 0 1 1940 7 1 0 0 ppublish 18745647 PMC1633921

1940 California and western medicine

102. Medical Decision-Making Capacity

-Making Capacity Medical Decision-Making Capacity Aka: Medical Decision-Making Capacity , Decision-Making Capacity , Decision Making Capacity Evaluation From Related Chapters II. Definitions Patient willingly participates in medical therapy Requires understanding what is involved with the proposed therapy Sufficient understanding and memory to comprehend their own situation Understanding of the consequence of their proposed actions Competence is determined by a judge May indicate whether a person may (...) stand trial Can they distinguish truth from fiction Can they assist their attorney in their own defense Medical Decision-Making Capacity Ability to communicate, understand the information they are given Ability to make logical decisions based on given information Ability to understand their current medical status or condition Ability to understand options for medical care III. Indications: Capacity Assessment Abrupt change in mental status See Refused recommended treatment without adequate reason

2018 FP Notebook

103. Roles of Mas-related G protein-coupled receptor X2 on mast cell-mediated host defense, pseudoallergic drug reactions, and chronic inflammatory diseases. Full Text available with Trip Pro

. In addition to the high-affinity IgE receptor (FcεRI), MCs express numerous G protein-coupled receptors (GPCRs), which are the largest group of membrane receptor proteins and the most common targets of drug therapy. Antimicrobial host defense peptides, neuropeptides, major basic protein, eosinophil peroxidase, and many US Food and Drug Administration-approved peptidergic drugs activate human MCs through a novel GPCR known as Mas-related G protein-coupled receptor X2 (MRGPRX2; formerly known as MrgX2 (...) Roles of Mas-related G protein-coupled receptor X2 on mast cell-mediated host defense, pseudoallergic drug reactions, and chronic inflammatory diseases. Mast cells (MCs), which are granulated tissue-resident cells of hematopoietic lineage, contribute to vascular homeostasis, innate/adaptive immunity, and wound healing. However, MCs are best known for their roles in allergic and inflammatory diseases, such as anaphylaxis, food allergy, rhinitis, itch, urticaria, atopic dermatitis, and asthma

2016 Journal of Allergy and Clinical Immunology

104. 5-aminolevulinic acid photodynamic therapy versus carbon dioxide laser ablation for the treatment of condylomata acuminata

main categories—chemical or physical destruction, immunological therapy, and surgical therapies, including cryotherapy, laser therapy, and excisional procedures. Photodynamic therapy (PDT) with topical 5-aminolevulinic acid (ALA) has emerged as a fourth treatment category. The first line of defense against CA typically involves patient-administered topical treatment; however, the comparative effectiveness of such treatments has not been established, with some evidence suggesting that surgical (...) 5-aminolevulinic acid photodynamic therapy versus carbon dioxide laser ablation for the treatment of condylomata acuminata 5-aminolevulinic acid photodynamic therapy versus carbon dioxide laser ablation for the treatment of condylomata acuminata 5-aminolevulinic acid photodynamic therapy versus carbon dioxide laser ablation for the treatment of condylomata acuminata HAYES, Inc. Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality

2017 Health Technology Assessment (HTA) Database.

105. Does Female Genital Mutilation Have Health Benefits? The Problem with Medicalizing Morality

because it has medical advantages, whereas female circumcision only has “social” advantages (eligibility for marriage, greater acceptance by the community, , and so on). I don’t think that’s the solution, either. First, the idea that “social” benefits are less important than “health” benefits would need some defending: I have already mentioned the pitfalls of capitulating to the domain of medicine having to think through complex moral issues. But let us just assume that all we care about is “health (...) Australasian College of Physicians “the level of protection offered by circumcision and the complication rates of circumcision do not warrant routine infant circumcision in Australia and New Zealand.” In any case, the existence of “some” health benefits (as opposed to net health benefits—and that would still not resolve the moral issues) would make for a very weak defense of the practice even on purely medical grounds. Just think. Removing any healthy tissue from a child’s body will confer “some” health

2017 Journal of Medical Ethics blog

106. How is it that antivaccine pediatricians keep their medical licenses?

How is it that antivaccine pediatricians keep their medical licenses? How is it that antivaccine pediatricians keep their medical licenses? | ScienceBlogs Advertisment Search Search Toggle navigation Main navigation How is it that antivaccine pediatricians keep their medical licenses? By on August 11, 2017. One of the most important responsibilities pediatricians have to assure the health of the children they take care of is to make sure they are vaccinated. Over the last 100 years, childhood (...) the most famous example of a pediatrician who's betrayed his patients by becoming antivaccine (or at least pandering enthusiastically to the antivaccine movement) is , better known to his fans as "Dr. Bob." Another pediatrician "star" among antivaxers is , who appeared in an antivaccine movie. So did Dr. Rachel Ross, a family practice doctor who used to be on the daytime fluff medical show The Doctors and has now hitched her wagon to the antivaccine propaganda movie . Indeed, after her "enlightenment

2017 Respectful Insolence

107. Machine Learning and Medical Education: Impending Conflicts in Robotic Surgery

Machine Learning and Medical Education: Impending Conflicts in Robotic Surgery Machine Learning and Medical Education: Impending Conflicts in Robotic Surgery | Journal of Medical Ethics blog by Guest Post by Nathan Hodson Research in robotics promises to revolutionize surgery. The system has already brought the first fruits of the revolution into the operating theater through remote controlled laparoscopic (or “keyhole”) surgery. New developments are going further, augmenting the human surgeon (...) for diagnosing diabetic retinopathy. The UC Berkeley Centre for Automation and Learning for Medical Robotics (CAL-MR)is . Given the complexity and delicacy of human soft tissue, these researchers believe that programming a robot to operate on internal organs, the model used by STAR, would be improved by allowing robots to learn for themselves. Preliminary work uses Learning By Observation, which means that the robot “learns” without being programmed. Robots can identify different sensor conditions

2017 Journal of Medical Ethics blog

108. Medical simulation as a moment to reflect

Medical simulation as a moment to reflect Medical simulation as a moment to reflect Medical simulation as a moment to reflect | | July 29, 2018 5 Shares Yesterday, I had an eye-opening experience that made me reflect once again about relationships. During the afternoon, I had to attend a mandatory trauma simulation event. Since I am a surgeon, I am referring to physical traumas like traffic or firearms accidents, and just to be clear — psychological traumas are not included in these groups (...) us better than what we actually are, or to record us as the victim of a certain situation. This could be interpreted as a defense mechanism or even a survival one, but there is no doubt that it can also be deleterious. I wonder what would happen if we constantly had the option to watch the movie of our lives, and on special occasions, we and others could actually judge what had really happened. In front of the screen, it would be very hard to deny the evidence. But I think it would be healthy

2018 KevinMD blog

109. The good, bad, and the ugly of being a medical expert witness

a great deal of freedom and choice when it comes how I spend my time. One of the most controversial is acting as a medical expert witness. In order to have a malpractice suit against a doctor, both plaintiffs and defense attorneys need skilled physicians to render opinions about the standard of care related to the case. Why in the world would someone want to be one of those physicians? The good I have been involved in medical expert witness work since the inception of my career. By nature of my (...) charting errors. It has exponentially improved my documenting abilities in my own practice. It is an opportunity to help elevate the level of the practice of medicine either by defending those who have been unjustly charged or by testifying against those who have breached the standard of care. Medical expert work has been one of my most lucrative extra gigs, and that’s why it’s featured in today’s side hustle profile. The bad Medical expert work has several drawbacks. The first is that you are asked

2018 KevinMD blog

110. Medical residents and academic due process: Know your rights

Medical residents and academic due process: Know your rights Medical residents and academic due process: Know your rights Medical residents and academic due process: Know your rights | | May 20, 2018 24 Shares I recently received a call from a physician resident in the Northeast U.S. who had been notified that she would be terminated from her residency program for a “weak knowledge base.” There would be no contract offered to her for the coming academic year. She reports that her scores (...) to find (and afford) an attorney? Or just quietly go away in order to minimize unpleasant interactions and potential retaliation? Regardless of her actual medical knowledge base, test scores, performance or the faculty’s perception of her, our young doctor does not have any idea what to do about her termination. She doesn’t know who to speak to, what resources are available to her, what her rights are, or what due process is required to be offered her by her institution, ACGME or law. Overwhelmed

2018 KevinMD blog

111. How I saved my daughter from a medical error

the pediatrics unit. As a hospitalist, I constantly obsess over medical errors. The majority are more subtle than the headlines (wrong-sided surgery). They are things like delays in care, medication errors or communication breakdowns between the health care team. Out of fear of my potential involvement, I consistently double check my work (even after I’ve left work). Thankfully, as an additional line of defense, I have diligent colleagues like nurses, pharmacists and specialists looking out for patients. Yet (...) How I saved my daughter from a medical error How I saved my daughter from a medical error How I saved my daughter from a medical error | | May 9, 2018 7K Shares We had no choice in becoming the “crazy” family that left a hospital against medical advice. Our four-day-old daughter was completely helpless, her condition deteriorating and the staff was ignoring our concerns. I carefully turned off the blue lights, removed her from the isolette, placed her in a car seat and eloped from

2018 KevinMD blog

112. 5 ways to live through medical malpractice lawsuits

5 ways to live through medical malpractice lawsuits 5 ways to live through medical malpractice lawsuits 5 ways to live through medical malpractice lawsuits | | June 8, 2018 98 Shares Nothing troubles physicians more than an unforeseen outcome and a malpractice lawsuit. It cracks open self-doubts and assumptions about medicine and may be life-changing. It commonly fuels burnout, loss of confidence, PTSD and early retirement. And there are links to depression and physician suicide. There’s (...) from the rules we operate by in medicine. That’s why some lawyers specialize exclusively in malpractice defense. For instance, while truthfulness is truthfulness everywhere, high integrity in a deposition looks different from high integrity in patient encounters. With patients, we try to answer questions fully, frequently offering information the patient didn’t know to ask for. Under deposition, it’s honest and appropriate to answer exactly the question you were asked. No more, no less. A defense

2018 KevinMD blog

113. Non-Statin Therapies For LDL-Cholesterol Lowering in the Management of Atherosclerotic Cardiovascular Disease Risk

to continue the statin-ezetimibe combination therapy and continue to monitor adherence to medications and lifestyle, and ongoing LDL-C response to therapy. If patients with clinical ASCVD and comorbidities require >25% additional lowering of LDL-C, a PCSK9 in- hibitor may be preferred as the initial non-statin agent. Clinicians should preferentially prescribe drugs that have been shown in RCTs to provide ASCVD risk-reduction bene?ts that outweigh the potential for adverse effects and drugdrug (...) ., adherence to a heart-healthy diet, regular exercise habits, avoidance of tobacco products, and maintenance of a healthy weight) remains a critical component of ASCVDriskreduction,bothbeforeandinconcertwiththe use of cholesterol-lowering drug therapies. In addition, referral toaregistered dietitian nutritionist (RDN) may be considered to improve understanding of heart-healthy dietary principles and individualize nutrition recom- mendations. Adherence to lifestyle modi?cation should be regularly assessed

2017 American College of Cardiology

114. Management of Opioid Therapy (OT) for Chronic Pain

clinicians or specialists to study and consider the latest information on opioid therapy (OT) and how and whether to incorporate that information or recommendations into their practice. It can be used to provide specific information to guide a patient encounter, such as looking up the dosing of a medication used less frequently or the meaning of the urine drug testing (UDT) result. The section on tapering and its accompanying appendix can be used to assist in the development of a framework for guiding (...) Management of Opioid Therapy (OT) for Chronic Pain VA/DoD CLINICAL PRACTICE GUIDELINE FOR OPIOID THERAPY FOR CHRONIC PAIN Department of Veterans Affairs Department of Defense QUALIFYING STATEMENTS The Department of Veterans Affairs and the Department of Defense guidelines are based upon the best information available at the time of publication. They are designed to provide information and assist decision making. They are not intended to define a standard of care and should not be construed

2017 VA/DoD Clinical Practice Guidelines

115. Effect of Battlefield Acupuncture and Physical Therapy Versus Physical Therapy Alone After Shoulder Surgery

Estimated Study Start Date : May 2018 Estimated Primary Completion Date : January 2019 Estimated Study Completion Date : June 2019 Resource links provided by the National Library of Medicine related topics: Arms and Interventions Go to Arm Intervention/treatment Experimental: BFA with Physical Therapy BFA + post-surgical protocol, intervention = battlefield acupuncture plus post-surgical protocol Device: Battlefield Acupuncture Battlefield Acupuncture uses ASP semi-permanent needles inserted (...) into their ears for pain attenuation in 5 known points. Both groups receive their respective post-surgical rehabilitation protocols Procedure: Post-surgical shoulder protocol Surgery specific post-surgical physical therapy protocol Active Comparator: Physical Therapy alone Intervention = Post-surgical protocol Procedure: Post-surgical shoulder protocol Surgery specific post-surgical physical therapy protocol Outcome Measures Go to Primary Outcome Measures : Change in Pain medication use [ Time Frame: daily

2018 Clinical Trials

116. Defensive Medicine

: Defensive Medicine II. Definitions Defensive Medicine Deviation from evidence-based medical decisions due to liability threat Example: Ordering advanced imaging (e.g. ) despite reassuring decision rules (e.g. ) Sub-types of Defensive Medicine Assurance behavior Additional services offered that add little medical value Avoidance behavior Replacing care by referring to another medical provider Reducing care by refusing to treat a patient III. Epidemiology Defensive Medicine is practiced by a majority (...) practice is not legally defensible V. References Weinstock et. al. in Majoewsky (2012) EM:Rap 12(8):1-2 Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Defensive Medicine." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Ontology: Defensive Medicine (C0011143) Definition (MSH) The alterations of modes of medical practice, induced by the threat of liability

2018 FP Notebook

117. Preventing, Identifying, and Treating Prescription Drug Misuse Among Active-Duty Service Members Full Text available with Trip Pro

Preventing, Identifying, and Treating Prescription Drug Misuse Among Active-Duty Service Members Prescription drug misuse (PDM) is of critical concern for the military because of its potential impact on military readiness, the health and well-being of military personnel, and associated health care costs. The purpose of this study is to summarize insights gleaned from a series of activities that the RAND Corporation undertook for the Deputy Assistant Secretary of Defense for Readiness to address (...) this important health and military readiness issue. The authors completed a review of U.S. Department of Defense policies and a comprehensive literature review of clinical guidelines and the empirical literature on the prevention and treatment of PDM and conducted individual face-to-face interviews with 66 health and behavioral health care providers at nine medical treatment facilities across three regions within the contiguous United States to identify best practices in the prevention, identification

2017 Rand health quarterly

118. Drugs That May Cause or Exacerbate Heart Failure Full Text available with Trip Pro

Antifungal Medications Several cases of new-onset dilated cardiomyopathy with subsequent HF with amphotericin B and its liposomal formulation have been reported. In each case, HF symptoms and echocardiographic findings normalized on discontinuation of therapy, which occurred within 10 days to 6 months of drug discontinuation. Anticancer Medications Anthracyclines The anthracyclines are a highly used class of cytotoxic agents that target proliferating cells via a diverse mechanism that includes DNA (...) . Hospitalization for HF is the largest segment of those costs. It is likely that the prevention of drug-drug interactions and direct myocardial toxicity would reduce hospital admissions, thus both reducing costs and improving quality of life. Patients with HF often have a high medication burden consisting of multiple medications and complex dosing regimens. On average, HF patients take 6.8 prescription medications per day, resulting in 10.1 doses a day. This estimate does not include over-the-counter (OTC

2016 American Heart Association

119. A computational model for the evaluation of complement system regulation under homeostasis, disease, and drug intervention. Full Text available with Trip Pro

A computational model for the evaluation of complement system regulation under homeostasis, disease, and drug intervention. The complement system is an intricate defense network that rapidly removes invading pathogens. Although many complement regulators are present to protect host cells under homeostasis, the impairment of Factor H (FH) regulatory mechanism has been associated with several autoimmune and inflammatory diseases. To understand the dynamics involved in the pivotal balance between (...) that are influenced by complement dysregulation. We show that FH-mediated disorder induces substantial levels of complement activation compared to homeostasis, by generating reduced levels of C3 and FB, and to a lesser extent C5, and elevated levels of C3a-desArg, Ba, Bb, C5a-desArg, and fC5b-9. These trends are consistent with clinically observed biomarkers associated with complement-mediated diseases. Furthermore, we introduced therapy states by modeling known inhibitors of the complement system, a compstatin

2018 PLoS ONE

120. DISTINCTION BETWEEN MEDICAL DEFENSE AND INDEMNITY DEFENSE FUND Full Text available with Trip Pro

DISTINCTION BETWEEN MEDICAL DEFENSE AND INDEMNITY DEFENSE FUND 18737579 2008 08 29 2008 11 20 0093-402X 16 4 1918 Apr California state journal of medicine Cal State J Med DISTINCTION BETWEEN MEDICAL DEFENSE AND INDEMNITY DEFENSE FUND. 162-3 eng Journal Article United States Cal State J Med 0414327 0093-402X 1918 4 1 0 0 1918 4 1 0 1 1918 4 1 0 0 ppublish 18737579 PMC1593453

1918 California state journal of medicine

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