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, as a physician, from a litigious perspective. It reminds me of the common medical practice of defensivemedicine, where one holds back, or adds otherwise irrelevant, even lengthy, steps to the delivery of medical care, simply because of the fear of legal backlash. It is one of the biggest issues dragging down health care today. I cover this ad nauseam in an upcoming article, aptly called, “Playing Hide and Seek-Damages With Our Degree: The Need for Tort Reform in Health care.” Stay tuned for that. Infusing (...) The human touch in medicine: good or bad? The human touch in medicine: good or bad? The human touch in medicine: good or bad? | | April 17, 2018 29 Shares Humans need human touch Patients sometimes need a shoulder to cry on. When I say that, I normally mean it on a completely figurative level. However, at times, it needs to be interpreted differently. There are instances in a medical encounter where an actual shoulder could be of service — a physical crutch that takes off an emotional load
Precision medicine in united airways disease: a "treatable traits" approach. United airways disease (UAD) is the concept that the upper and lower airways, which are anatomically and immunologically related, form a single organ. According to this concept, upper and lower airway diseases are frequently comorbid because they reflect manifestations of a single underlying disease at different sites of the respiratory tract. Allergic asthma-allergic rhinitis is the archetypal UAD, but emerging data (...) , wherein pathophysiological mechanisms and factors contributing to disease are identified and targeted for treatment. Treatable traits in UAD can be analyzed according to a framework comprising airway inflammation (eosinophilic, neutrophilic), impaired airway mucosal defense (impaired mucociliary clearance, antibody deficiency), and exogenous cofactors (allergic sensitizers, tobacco smoke, microbes). Appreciation of treatable traits is necessary in advancing the effort to deliver precise treatments
The â€˜Compleat Physicianâ€™ and Experimentation in Medicines: Everard Maynwaring (c.1629â€“1713) and the Restoration Debate on Medical Practice in London Restoration London saw a wave of publications by physicians advocating that the 'compleat physician' should be one who experimented and produced his own medicines. Only thus, they argued, could the medical hierarchy be restored and medical authority re-established on a defensible basis. This article seeks to explain the context (...) for this unusual approach, and why it failed to attract mainstream physicians by the end of the century, by considering the sixty-year career of one of its leading advocates, Everard Maynwaring (c.1629-1713), a prolific medical author, and what his own failure to enter the medical establishment may show about the problems inherent in this model for the physician. A university-trained gentleman physician who converted to chymical medicine c.1660, Maynwaring published learned and relatively unpolemical texts
Pharmacokinetic Study of Bioactive Flavonoids in the Traditional Japanese Medicine Keigairengyoto Exerting Antibacterial Effects against Staphylococcus aureus Recent studies have demonstrated that flavonoid glucuronides can be deconjugated to the active form aglycone by β-glucuronidase-expressing macrophages. Keigairengyoto (KRT) is a flavonoid-rich traditional Japanese medicine reported to enhance bacterial clearance through immune modulation. Our aims are to examine the pharmacokinetics (...) blood-absorbed flavonoids which enhance macrophage functions in host defense. Flavonoid-rich KRT may be a beneficial treatment for infectious skin inflammation.
. Results: Fourteen of 27 (52%) residents completed the initial needs assessment while the curriculum was eventually seen by at least 24 of 27 (89%). The ITE was taken by every resident every year. Long-term, 3-year follow-up demonstrated persistent improvement in many drivers of utilization (patient requests, reliance on subspecialists, defensivemedicine, and academic curiosity) and improvement with sustained high performance on the high-value component of the ITE. Conclusion: A multimodal curriculum (...) A multimodal high-value curriculum affects drivers of utilization and performance on the high-value care component of the internal medicine in-training exam Background: Teaching the practice of high-value care (HVC) is an increasingly important function of graduate medical education but best practices and long-term outcomes remain unknown. Objective: Whether a multimodal curriculum designed to address specific drivers of low-value care would affect resident attitudes, skills, and performance
Therapeutic effects of acupuncture with MOK, a polyherbal medicine, on PTU-induced hypothyroidism in rats Acupuncture with MOK, a polyherbal medicine (MOK pharmacopuncture), has been used for the treatment of thyroid syndromes including hypothyroidism and hyperthyroidism in traditional Korean medicine. The present study investigated the effect of MOK pharmacopuncture on hypothyroidism and the mechanism underlying its antioxidation and immune regulation effects. Hypothyroidism was induced (...) the pathological features in the thyroid glands of hypothyroidism rats. The results suggested that the administration of pharmacopuncture may ameliorate the pathological progression of hypothyroidism by multiple actions, including normalization of the hypothyroidism-induced thyroid hormone imbalance, stimulation of the antioxidant defense system, and regulation of the T helper (Th)1/Th2 imbalance. Therefore, MOK extract may be used for the treatment of hypothyroidism in Korean clinics as a useful
Why Current Statistics of Complementary Alternative Medicine Clinical Trials is Invalid It is not sufficiently known that frequentist statistics cannot provide direct information on the probability that the research hypothesis tested is correct. The error resulting from this misunderstanding is compounded when the hypotheses under scrutiny have precarious scientific bases, which, generally, those of complementary alternative medicine (CAM) are. In such cases, it is mandatory to use inferential (...) statistics, considering the prior probability that the hypothesis tested is true, such as the Bayesian statistics. The authors show that, under such circumstances, no real statistical significance can be achieved in CAM clinical trials. In this respect, CAM trials involving human material are also hardly defensible from an ethical viewpoint.
How Prepared Are We for Possible Bioterrorist Attacks: An Approach from Emergency Medicine Perspective Preparedness for bioterrorist attacks and early recognition of specific agents are essential for public health. Emergency departments may play an important role in this field. The large spectrum of bioterrorism involves not only disastrous terrorism with mass casualties, but also microevents using low technology but producing civil unrest, disruption, disease, disabilities, and death. It aims (...) not only to cause mortality and morbidity, but also to lead to social and political disruption. Preparedness appears to be the most potent defense against possible bioterrorist events. In this article, we aim to create awareness against biological agents and underline the importance of emergency departments in this public health problem.
. Personal injury and product liability attorneys have been mining medicine for decades. The considerable expense associated with patient awards and litigation defense is eclipsed by costly changes in medical practices not developed out of sound care principles but deployed attempting to immunize against lawsuits. The crushing cost of health care has been an issue for decades and continues unabated. Most efforts to orchestrate change have been dominated by politicians, economists and special interest (...) Medicine: noble profession or big business? Medicine: noble profession or big business? Medicine: noble profession or big business? | | November 24, 2018 585 Shares In 1976 I graduated from medical school and proudly joined the medical profession. Thirty-seven years later, I retired as an employee of the biggest business in the country. In 2016 the medical industry was responsible for 3.3 trillion dollars of expenditure, comprising 18 percent of the United States GDP. For perspective
AromaDb: A Database of Medicinal and Aromatic Plantâ€™s Aroma Molecules With Phytochemistry and Therapeutic Potentials In traditional, herbal medicine, and aromatherapy, use of essential oils and their aroma compounds have been known since long, for the management of various human diseases. The essential oil is a mixture of highly complex, naturally occurring volatile aroma compounds synthesized by medicinal and aromatic plants as secondary metabolites. Essential oils widely used (...) in pharmaceutical, cosmetic, sanitary, food industry and agriculture for their antibacterial, antiviral, antifungal, antiparasitic, insecticidal, anticancer, neuroprotective, psychophysiological, and anti-aging activities. Moreover, volatile aroma compounds comprise a chemically diverse class of low molecular weight organic compounds with significant vapor pressure. However, aroma compounds produced by plants, mainly attract pollinators, seed dispersers and provide defense against pests or pathogens. However
on patients — they’re making money from treating patients. Attention has been given to value-based care to curb this practice, but it requires training physicians to order fewer tests and offer more reassurance. Few insurers want to pay for physicians to talk to patients so there’s no incentive for them to practice value-based medicine. And there are legal penalties for not practicing defensivemedicine. 5. Defensivemedicine protects physicians from litigation. Reassurance and defensivemedicine (...) are polar opposites. Reassurance comes from a deeper knowing or mother’s intuition that discourages the need for emergency treatment for every injury or ailment. Physicians who practice defensivemedicine advise every patient who experiences something out of the ordinary to seek emergency care. Jean was playing it safe while neglecting her maternal instinct in caring for her parents. 6. People fail to trust themselves and others. It’s too easy to doubt others because we’re human and fallible. Trust
Traditional Oriental Medicine for Sensorineural Hearing Loss: Can ethnopharmacology contribute to potential drug discovery? In Traditional Oriental Medicine (TOM), the development of hearing pathologies is related to an inadequate nourishment of the ears by the kidney and other organs involved in regulation of bodily fluids and nutrients. Several herbal species have historically been prescribed for promoting the production of bodily fluids or as antiaging agents to treat deficiencies (...) loss and tinnitus have shown in vitro or in vivo beneficial effects for acquired sensorineural hearing loss produced by noise, aging, ototoxic drugs or diabetes. The inner ear is highly vulnerable to ischemia and oxidative damage, where several TOM agents have revealed a direct effect on the auditory system by normalizing the blood supply to the cochlea and increasing the antioxidant defense in sensory hair cells. These strategies have shown a positive impact on maintaining the inner ear potential
as hard and do not see as many patients as male physicians.” Instead, he said, women doctors prioritize “something else … family, social, whatever.” This perspective was roundly – and rightly – criticized by many women and men both inside and outside of medicine. However, judging by the fact that some people have come to his defense, outdated attitudes persist in some quarters. Earlier this month, the AMA hosted a forum for women in leadership in medicine. There, I heard many ideas, concerns (...) Challenging gender bias in the house of medicine Challenging gender bias in the house of medicine Challenging gender bias in the house of medicine | | September 21, 2018 13 Shares A guest column by the , exclusive to KevinMD.com. Since the 1970s, women have been carving out an increasingly large role in medicine, and the profession is becoming more representative of our society. September is Women in Medicine Month, a great time to acknowledge the changing face of medicine, but also to note
[Treatment of Facial Acne Vulgaris by Chinese Medicine Combined Western Medicine]. Objective To comparatively observe clinical efficacies of Fusidic Acid Cream (FAC) , Longzhu Ointment (LO) , and their combination of minocycline hydrochloride for treating facial acne vulgaris. Methods Totally 186 patients with acne vulgaris were randomly assigned to the FAC group (103 cases) and the LO group (83 cases). Each group was further divided into two subgroups ac- cording to the severity of acne (...) , red area, sclererythrin of united treatment group of the FAC group and the LO group (P <0. 05). Conclusions FAC and LO could effectively control the inflammation of acne. LO had a rapid onset. Combined with minocy- cline hydrochloride, FAC could significantly reduce the secretion of fats, and LO could defense against ultraviolet more significantly.
Defensivemedicine â€” A comment 22654130 2012 07 26 2018 12 01 0008-5286 52 12 2011 Dec The Canadian veterinary journal = La revue veterinaire canadienne Can. Vet. J. Defensivemedicine--a comment. 1276 Fleming Bryce I BI eng Letter Comment Canada Can Vet J 0004653 0008-5286 IM Can Vet J. 2011 Oct;52(10):1048-50 22467960 Animals Humans Legislation, Veterinary Licensure ethics Veterinary Medicine ethics methods 2012 6 2 6 0 2012 6 2 6 0 2012 7 27 6 0 ppublish 22654130 PMC3215457
International Multicenter Study of the Immunogenicity of Medicinal Product GamEvac-Combi International Multicenter Study of the Immunogenicity of Medicinal Product GamEvac-Combi - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies (...) before adding more. International Multicenter Study of the Immunogenicity of Medicinal Product GamEvac-Combi The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT03072030 Recruitment Status : Active, not recruiting First Posted : March 7, 2017 Last Update Posted : March 15, 2019 Sponsor: Gamaleya Research
Celebrate the joys of working in medicine Celebrate the joys of working in medicine Celebrate the joys of working in medicine | | December 6, 2017 411 Shares I keep a spare set of scrubs in my car. It’s an act of preparedness, informed by experience. A couple of months ago, I came out of an ED room after performing a particularly unsavory procedure and noticed that my left knee was wet. Disgusted, I shared my misfortune with my coworkers, and all of them had the same sympathetic response (...) ; they mirrored my grimace and cautiously offered hope: “Maybe it’s just urine.” Urine! What a comforting thought. Urine is (usually) sterile, so I gratefully embraced that optimistic yet plausible narrative and finished my shift. I called my mom on my way home from work and told her about my day. “Why didn’t you change clothes?!” she squawked. “Oh, well, I didn’t have any spare scrubs, and I think maybe it was just urine,” I responded defensively. “That’s gross,” she replied. I suppose it is. That night
Can Economic Model Transparency Improve Provider Interpretation of Cost-effectiveness Analysis? Evaluating Tradeoffs Presented by the Second Panel on Cost-effectiveness in Health and Medicine. The Second Panel on Cost-Effectiveness in Health and Medicine convened on December 7, 2016 at the National Academy of Medicine to disseminate their recommendations for conduct, methodological practices, and reporting of cost-effectiveness analyses (CEAs). Following its summary, panel proceedings included (...) that cost-effectiveness models are made publicly available. However, there remains the questions of whether making economic modelers' work open-access through journals is fair under the defense that these models remain one's own intellectual property, or whether journals can properly manage the peer-review process specifically for cost-effectiveness analyses. In this article, we elaborate on these issues and provide some suggested solutions that may increase the dissemination and application of cost
because neither of them practices or is trained in integrative medicine, the attorneys argue. The irony is rich. Wollner's defense was an "integrative" doctor who said his treatment was appropriate and to criticize the state's two expert witnesses for not being trained in integrative medicine. That's what we're talking about in the community far more often than the integrative doctors in ivory tower academia would like to acknowledge. Patients like Stephanie Sofransky pay the price. Tags Categories (...) Another preventable death thanks to alternative medicine Another preventable death thanks to alternative medicine | ScienceBlogs Advertisment Search Search Toggle navigation Main navigation Another preventable death thanks to alternative medicine By on October 11, 2016. What is it about Florida and quacks? It’s as though it’s the Wild West there when it comes to regulating the practice of medicine. There, quacks can get away with almost anything, or so it would seem. After all, Brian Clement
Defending Dr. Bob Sears: On the affinity between “integrative medicine” and antivaccine views Defending Dr. Bob Sears: On the affinity between "integrative medicine" and antivaccine views | ScienceBlogs Advertisment Search Search Toggle navigation Main navigation Defending Dr. Bob Sears: On the affinity between "integrative medicine" and antivaccine views By on September 27, 2016. It’s been nearly three weeks since we learned that the Medical Board of California had initiated disciplinary (...) of California. It comes from Jennifer Margulis, PhD, who claims that of . If you don’t believe me, just check out her website, which is chock full of posts “standing with Sears” and promoting Andrew Wakefield’s antivaccine conspiracy propaganda piece . So, not surprisingly, her defense of Dr. Bob invokes the views of some rather dubious physicians. First, she begins by quoting the charges against Dr. Bob, where the board points out that the “standard of care requires that a physician evaluating a patient