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Defensive Medicine

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121. Celebrate the joys of working in medicine

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

2017 KevinMD blog

122. 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. (PubMed)

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

2017 Medical Care

123. Another preventable death thanks to alternative medicine

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

2016 Respectful Insolence

124. 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 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

2016 Respectful Insolence

125. Making it up as you go along: So-called “functional medicine” is pure quackery

Making it up as you go along: So-called “functional medicine” is pure quackery Making it up as you go along: So-called "functional medicine" is pure quackery | ScienceBlogs Advertisment Search Search Toggle navigation Main navigation Making it up as you go along: So-called "functional medicine" is pure quackery By on April 17, 2016. I often describe "integrative medicine" as integrating quackery with medicine because that's what this inadvertently appropriately named branch of medicine (...) in essence does. The reason, as I've described time and time again, is to put that quackery on equal footing (or at least apparently equal footing) with science- and evidence-based medicine, a goal that is . Originally known as quackery, the modalities now being "integrated" with medicine then became "complementary and alternative medicine" (CAM), a term that is still often used. But that wasn't enough. The word "complementary" implies a subordinate position, in which the CAM is not the "real" medicine

2016 Respectful Insolence

126. Debates about Conflict of Interest in Medicine: Deconstructing a Divided Discourse.

Debates about Conflict of Interest in Medicine: Deconstructing a Divided Discourse. The pharmaceutical industry plays an increasingly dominant role in healthcare, raising concerns about "conflicts of interest" (COI) on the part of the medical professionals who interact with the industry. However, there is considerable disagreement over the extent to which COI is a problem and how it should be managed. Participants in debates about COI have become entrenched in their views, which is both (...) unproductive and deeply confusing for the majority of medical professionals trying to work in an increasingly commercialized environment. We used a modified meta-narrative review method to analyse debates about COI in the academic and grey literature. We found two Discourse Models: The Critical Discourse Model sees COI in health and biomedicine as a major problem that both can and should be addressed, while the Defensive Discourse Model argues that current efforts to control COIs are at best unnecessary

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2017 Journal Of Bioethical Inquiry

127. Enabling Personalized Medicine Through Exome Sequencing in the U.S. Air Force

Provider-Participant Inclusion Criterion An active or Department of Defense civilian Primary Care, Internal Medicine, or Family Practice Healthcare Provider (Physician, Physician Assistant, or Nurse Practitioner) or resident practicing at Wilford Hall Ambulatory Surgical Center at JBSA Lackland Air Force Base Patient-Participant Exclusion Criteria: Those who do not meet the above inclusion criteria Those with clinically concerning scores on anxiety and distress scales in baseline survey Trainees (basic (...) States, Mississippi Keesler Air Force Base Biloxi, Mississippi, United States, 39530 United States, Texas Baylor College of Medicine Houston, Texas, United States, 77030 Joint Base San Antonio Lackland Air Force Base - 59th Medical Wing San Antonio, Texas, United States, 78236 Sponsors and Collaborators Brigham and Women's Hospital United States Department of Defense More Information Go to Publications: McMorrow D. The $100 genome: implications for the DoD. Technical Report. McLean, Virginia

2017 Clinical Trials

128. Endophytic fungi associated with Monarda citriodora, an aromatic and medicinal plant and their biocontrol potential (PubMed)

Endophytic fungi associated with Monarda citriodora, an aromatic and medicinal plant and their biocontrol potential The Food and Agriculture Organization has estimated that every year considerable losses of the food crops occur due to plant diseases. Although fungicides are extensively used for management of plant diseases, they are expensive and hazardous to the environment and human health. Alternatively, biological control is the safe way to overcome the effects of plant diseases (...) the growth of the Sclerotinia sp. in fumigation assay.Endophytes MC-2 L, MC-14 F, MC-22 F and MC-25 F could effectively be used to control broad range of phytopathogens, while MC-10 L, MC-8 L and MC-9 L could be used to control specific pathogens. Secondly, endophytes showing varying degrees of antagonism in different assays represented the chemo-diversity not only as promising biocontrol agents but also as a resource of defensive and bioactive metabolites.

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2017 Pharmaceutical biology

129. Medical School Hotline: John A. Burns School of Medicine University of Hawai‘i at Manoa, Convocation Ceremony Keynote Address, May 14, 2017 (PubMed)

Medical School Hotline: John A. Burns School of Medicine University of Hawai‘i at Manoa, Convocation Ceremony Keynote Address, May 14, 2017 28721314 2019 01 07 2019 01 07 2165-8242 76 7 2017 07 Hawai'i journal of medicine & public health : a journal of Asia Pacific Medicine & Public Health Hawaii J Med Public Health Medical School Hotline: John A. Burns School of Medicine University of Hawai'i at Manoa, Convocation Ceremony Keynote Address, May 14, 2017. 199-200 Bono Raquel C RC Director (...) , Defense Health Agency Medical Corps, United States Navy; Robert T. Wong, MD Endowed Lecturer. eng Journal Article United States Hawaii J Med Public Health 101579076 2165-8242 IM Education, Medical, Undergraduate methods Hawaii Humans Leadership 2017 7 20 6 0 2017 7 20 6 0 2019 1 8 6 0 ppublish 28721314 PMC5511338

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2017 Hawai'i Journal of Medicine & Public Health

130. Fitting tissue chips and microphysiological systems into the grand scheme of medicine, biology, pharmacology, and toxicology (PubMed)

Fitting tissue chips and microphysiological systems into the grand scheme of medicine, biology, pharmacology, and toxicology Microphysiological systems (MPS), which include engineered organoids (EOs), single organ/tissue chips (TCs), and multiple organs interconnected to create miniature in vitro models of human physiological systems, are rapidly becoming effective tools for drug development and the mechanistic understanding of tissue physiology and pathophysiology. The second MPS thematic (...) issue of Experimental Biology and Medicine comprises 15 articles by scientists and engineers from the National Institutes of Health, the IQ Consortium, the Food and Drug Administration, and Environmental Protection Agency, an MPS company, and academia. Topics include the progress, challenges, and future of organs-on-chips, dissemination of TCs into Pharma, children's health protection, liver zonation, liver chips and their coupling to interconnected systems, gastrointestinal MPS, maturation

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2017 Experimental Biology and Medicine

131. In which I am compared to Donald Trump by a pro-quackademic medicine activist

of a history. He has not liked some of the things I've written about CAM in the past. Indeed, he singles out in particular about his defense of alternative medicine. To get a taste of where he's coming from, it's worth citing the article I criticized: The movement from "alternative" to a new language of "complementary" and "integrative" when it arrived in the mid-1990s was partly what would, on the street, be called a "suck-up" gesture. I participated, and still do. We were trying to find a way to play (...) In which I am compared to Donald Trump by a pro-quackademic medicine activist In which I am compared to Donald Trump by a pro-quackademic medicine activist | ScienceBlogs Advertisment Search Search Toggle navigation Main navigation In which I am compared to Donald Trump by a pro-quackademic medicine activist By on October 23, 2016. A little over a month ago, I how proponents of "complementary and alternative medicine" (CAM), now more frequently called "integrative medicine," go to great lengths

2016 Respectful Insolence

132. Better late than never: Orac comments on the hijacking of evidence-based medicine

Better late than never: Orac comments on the hijacking of evidence-based medicine Better late than never: Orac comments on the hijacking of evidence-based medicine | ScienceBlogs Advertisment Search Search Toggle navigation Main navigation Better late than never: Orac comments on the hijacking of evidence-based medicine By on April 3, 2016. It's no secret that I'm a fan of John Ioannidis. (If you don't believe me, just type Ioannidis' name into the blog search box and see how many posts you (...) find.) Over the last couple of decades, Ioannidis has arguably done more to reveal the shortcomings of the medical research enterprise that undergirds our treatments, revealing the weaknesses in the evidence base and how easily clinical trials can mislead, than any other researcher. Indeed, after reading what is Ioannidis' most famous article, " ", back in 2005, I was hooked. I even . This was long before I appreciated the difference between science-based medicine (SBM) and evidence-based medicine

2016 Respectful Insolence

133. MEDICINE IN THE NATIONAL DEFENSE PROGRAM (PubMed)

MEDICINE IN THE NATIONAL DEFENSE PROGRAM 17857847 2007 09 17 2008 11 20 0003-4932 114 1 1941 Jul Annals of surgery Ann. Surg. MEDICINE IN THE NATIONAL DEFENSE PROGRAM. 1-3 Abell I I eng Journal Article United States Ann Surg 0372354 0003-4932 1941 7 1 0 0 1941 7 1 0 1 1941 7 1 0 0 ppublish 17857847 PMC1385782

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1941 Annals of Surgery

134. Developing an Action Plan for Patient Radiation Safety in Adult Cardiovascular Medicine

Developing an Action Plan for Patient Radiation Safety in Adult Cardiovascular Medicine Developing an Action Plan for Patient Radiation Safety in Adult Cardiovascular Medicine | Circulation: Cardiovascular Imaging Search Hello Guest! Login to your account Email Password Keep me logged in Search March 2019 February 2019 January 2019 This site uses cookies. By continuing to browse this site you are agreeing to our use of cookies. Free Access article Share on Jump to Free Access article Developing (...) an Action Plan for Patient Radiation Safety in Adult Cardiovascular Medicine Proceedings From the Duke University Clinical Research Institute/American College of Cardiology Foundation/American Heart Association Think Tank Held on February 28, 2011 , , MD, MACC, FAHA, Chair , MD, FACC, FAHA , MD, FACC, FAHA , MD, FACC , MD, PhD, FACC, FAHA , and MD, FACC MD, FACC, FAHA *See Appendix for Writing Committee disclosure information. , Pamela S. Douglas , J. Jeffery Carr , Manuel D. Cerqueira , Jennifer E

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2012 American Heart Association

135. Developing an Action Plan For Patient Radiation Safety in Adult Cardiovascular Medicine

Developing an Action Plan For Patient Radiation Safety in Adult Cardiovascular Medicine doi:10.1016/j.jacc.2012.01.005 published online Mar 22, 2012; J. Am. Coll. Cardiol. Allen J. Taylor Cerqueira, Jennifer E. Cummings, Thomas C. Gerber, Debabrata Mukherjee, and Society of Nuclear Medicine, Pamela S. Douglas, J. Jeffrey Carr, Manuel D. Angiography and Interventions, Society of Cardiovascular Computed Tomography, Nuclear Cardiology, Heart Rhythm Society, Society for Cardiovascular American (...) College of Radiology, American Heart Association, American Society of Participating societies include the American College of Cardiology Foundation, Heart Association Think Tank Held on February 28, 2011 Research Institute/American College of Cardiology Foundation/American Cardiovascular Medicine: Proceedings From the Duke University Clinical Developing an Action Plan for Patient Radiation Safety in Adult This information is current as of April 10, 2012 http://content.onlinejacc.org/cgi/content/full

2012 Society for Cardiovascular Angiography and Interventions

136. Granulocyte Macrophage-Colony Stimulating Factor (GM-CSF) Inhalation to Improve Host Defense and Pulmonary Barrier Restoration

Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor) Primary Purpose: Treatment Official Title: GM-CSF Inhalation to Improve Host Defense and Pulmonary Barrier Restoration (GI-HOPE). A Randomized, Double-blind, Parallel Group, Multicenter, Phase II Study Actual Study Start Date : January 2016 Estimated Primary Completion Date : December 31, 2020 Estimated Study Completion Date : December 31, 2020 Resource links provided by the National Library of Medicine resources: Arms (...) Granulocyte Macrophage-Colony Stimulating Factor (GM-CSF) Inhalation to Improve Host Defense and Pulmonary Barrier Restoration Granulocyte Macrophage-Colony Stimulating Factor (GM-CSF) Inhalation to Improve Host Defense and Pulmonary Barrier Restoration - 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

2015 Clinical Trials

137. Why doctors will continue playing defense in the clinic

to be sued for malpractice. This finding was consistent across 6 of 7 different specialties evaluated and was particularly pronounced in obstetrics. Defensive medicine, defined as medical decision making and care provided solely for the purpose of avoiding malpractice litigation, accounts for a significant proportion of health care costs in the U.S. today. Physicians, while striving to provide excellent care for their patients are faced with the harsh realities of our litigious society — many are always (...) so that therapy may be initiated quickly. In many cases, a diagnosis can be confirmed simply by talking to and examining the patient — the medical history and physical exam — which is becoming a lost art. When defensive medicine is practiced, the entire system is perturbed. Why would we order a test when it is unlikely to substantially change what we do. Think “fork in the road.” If a test is ordered, the result should point us one direction or the other. So, just how can we expect to lower

2015 KevinMD blog

138. Psychoticism, Immature Defense Mechanisms and a Fearful Attachment Style are Associated with a Higher Homophobic Attitude. (PubMed)

Psychoticism, Immature Defense Mechanisms and a Fearful Attachment Style are Associated with a Higher Homophobic Attitude. Homophobic behavior and a negative attitude toward homosexuals are prevalent among the population. Despite this, few researches have investigated the psychologic aspects associated with homophobia, as psychopathologic symptoms, the defensive system, and attachment styles.The aim of this study was to investigate the psychologic factors mentioned earlier and their correlation (...) with homophobia.Five hundred fifty-one university students recruited, aged 18-30, were asked to complete several psychometric evaluation.In particular, Homophobia Scale (HS) was used to assess homophobia levels, the Symptoms Check List Revised (SCL-90-R) for the identification of psychopathologic symptoms, the Defence Style Questionnaire (DSQ-40) for the evaluation of defense mechanisms and the Relationship Questionnaire (RQ) for attachment styles.After a regression analysis, we found a significant predictive

2015 Journal Of Sexual Medicine

139. Dr. Robert Wachter: In defense of the ABIM

Dr. Robert Wachter: In defense of the ABIM Dr. Robert Wachter: In defense of the ABIM Dr. Robert Wachter: In defense of the ABIM | | July 8, 2015 25 Shares “What’s up with the ABIM?” “I just got a note about an alternative board. Should I join it?” “Aren’t you glad to be off the Board?” These days, I get these questions from friends and colleagues regularly. When I first joined the board of directors of the (ABIM) in 2004, the organization was a well-respected pillar of American medicine. Today (...) setting high standards, and thus need to be insulated from the politics of government or the advocacy of dues-funded membership organizations. The ABIM was established in 1936, and things were fairly calm for the organization’s first 60 years. When I took the ABIM certifying exam after finishing my internal medicine training in 1986, I was 29 years old. The Board issued me a lifetime certificate, basically deeming me a competent internist until I retired. My expectation — correct at the time

2015 KevinMD blog

140. Food the Forgotten Medicine: More bait and switch from the “College of Medicine”

Food the Forgotten Medicine: More bait and switch from the “College of Medicine” Food the Forgotten Medicine: More bait and switch from the “College of Medicine” – DC's Improbable Science Search this blog Meta Corrected and searchable version of of Lectures on Biostatistics (THES, 1973). Latest Tweets "An anti-EU movement can’t also be anti-US, not without looking as if it hates everyone" by Boris: "less a lovable maverick than a rather unpleasant oddball." by RT : My cartoon - is our safe (...) , that's it Categories Categories Archives Archives » in which I advocate the view put by John Ioannidis that remarkably little is known about the health effects if individual nutrients. That ignorance has given rise to a vast industry selling advice that has little evidence to support it. The 2016 Conference of the so-called "College of Medicine" had the title "Food, the Forgotten Medicine". This post gives some background information about some of the speakers at this event. I’m sorry it appears

2016 DC's Improbable Science blog

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