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1261. Patient Modesty: Volume 77

Patient Modesty: Volume 77 Bioethics Discussion Blog: Patient Modesty: Volume 77 What have you been reading, hearing or TV viewing that has provoked some feelings of comfort or concern about what is happening in the world of medicine, medical care, treatment or science? Ethics is all about doing the right thing. Are you aware of any issues in medicine or biologic science which are being done right, could be improved or in fact represent totally unethical behavior? Write about them here.. and I (...) the most weight and they drive many of the treatment actions and protocols. After all, they are responsible for each patient. So one strong avenue to address many of the concerns raised in your numerous volumes is for physicians to recognize and promote each patient as an individual that should receive patient centered care that may include reasonable preferences. How than, if at all, is this concept included in your medical students training? Do the students actively participate in evaluating personal

2016 Bioethics Discussion Blog

1262. Patient Modesty: Volume 74

Patient Modesty: Volume 74 Bioethics Discussion Blog: Patient Modesty: Volume 74 What have you been reading, hearing or TV viewing that has provoked some feelings of comfort or concern about what is happening in the world of medicine, medical care, treatment or science? Ethics is all about doing the right thing. Are you aware of any issues in medicine or biologic science which are being done right, could be improved or in fact represent totally unethical behavior? Write about them here.. and I (...) ” as a reason not to conduct an experiment doesn’t hold much water. Neither does not being in a “position to authorize any survey.” I and every other researcher I know must ask those in authority for permission to conduct research and then get a research proposal approved by an IRB. The only authorities that have turned me and my students down have been in medicine and always for specious reasons, if they give a reason at all. However, when I, students, and a colleague in the medical field have together

2016 Bioethics Discussion Blog

1263. WHO guidelines on drawing blood: best practices in phlebotomy

Antiretroviral Treatment and HIV Care WHO/HQ, Department of HIV/AIDS (WHO/HQ/HTM/HIV) Dr Gerald Dziekan Program Manager WHO Patient Safety Program (PSP) WHO/HQ, Department of Information, Evidence and Research (IER) Dr Selma Khamassi, MD, MSc Injection Safety and Related Infection Control SIGN Secretariat WHO/HQ/HSS/EHT/Diagnostic Imaging and Medical Devices (DIM) Dr Fernando Otaiza, MD, MSc, Infection Prevention and Control in Health Care Biorisk Reduction for Dangerous Pathogens WHO Department of Epidemic (...) Hospital Chief Executive Hong Kong Red Cross Blood Transfusion Service Hong Kong Dr Lawrence Marum Team Leader Medical Transmission Global AIDS Program, HIV Prevention Branch CDC, Atlanta, USA Professor Shaheen Mehtar Head of Academic Unit for Infection Prevention and Control Tygerberg Hospital and Stellenbosch University, Cape Town South Africa Dr Joseph Perz Acting Team Leader, Research and Field Investigations Epidemiology and Surveillance Branch Division of Healthcare Quality Promotion (DHQP) CDC

2010 World Health Organisation Guidelines

1264. Practice Guidelines for the Molecular Diagnosis of Haemophilia A

the highest risk, whilst missense mutations and splicing defects show the lowest risk (Schwaab et al 1995, Oldenburg et al 2002, Goodeve 2003, Coppola et al 2010). However, an important consideration when reporting mutations associated with inhibitor formation is whether or not knowledge of this increased risk may influence treatment strategy when using replacement therapies. The UKHCDO Genetic Testing Network and Genetic Working Party discussed the inclusion of inhibitor risk in genetic analysis reports (...) of records and specimens relating to molecular diagnosis in the UK must conform with the Human Tissue Act 2004 and guidance from the Royal College of Pathologists and Institute of Biomedical Science on the retention and storage of pathological records and specimens, 4 th edition, 2009. 2.0 NOMENCLATURE AND GENE ID Table 1. Gene Name Factor VIII HUGO nomenclature F8 OMIM Number 306700 GeneCards ID F8 Ensembl Gene ID ENSG00000165769 Chromosomal location Xq28 Medline MESH Term Haemophilia A, factor-VIII

2010 United Kingdom Haemophilia Centre Doctors' Organisation

1265. Best practices for injections and related procedures toolkit

for Disease Control and Prevention (CDC) Atlanta, GA, USA Dr Joseph Perz Acting Team Leader, Research and Field Investigations Division of Healthcare Quality Promotion (DHQP) CDC, Atlanta, GA, USA Dr Christie Reed Medical Transmission Global AIDS Program, HIV Prevention Branch CDC, Atlanta, GA, USA Dr Dejana Selenic Medical Transmission Global AIDS Program, HIV Prevention Branch CDC, Atlanta, GA, USA Dr Steven Wiersma Associate Director for Science and Global Activities Division of Viral Hepatitis (...) operating procedure WHO World Health Organization1 Background 1 1 Background Medical treatment is intended to save life and improve health, and all health workers have a responsibility to prevent transmission of health-care associated infections. Adherence to safe injection practices and related infection control is part of that responsibility – it protects patients and health workers. What is a safe injection (1) A safe injection, phlebotomy (drawing blood), lancet procedure or intravenous device

2010 World Health Organisation Guidelines

1266. Workload for Consultant Anaesthetists in Ireland

hearings or Good Samaritan acts outside the jurisdiction of the Republic of Ireland (Section A, Part 27). At the time of writing, at least 85% of consultants in the Republic of Ireland have signed the 2008 (Connaughton) Consultant Contract. However, it is important to note that many aspects of the contract are the subject of ongoing negotiations between the HSE and the medical representative organisations.5 3. Overview of the consultant contract Definition A contract is a set of statements governing (...) as appropriate.” (Section A, part 12) Maintenance of professional competence and clinical governance The Medical Practitioners Act 2007 places a statutory obligation on all registered medical practitioners to maintain their professional competence and cooperate with any professional competence scheme developed, established or operated by the Medical Council. The Act also places an obligation on the HSE or other employer to facilitate these activities. Professional competence schemes will be delivered

2010 Association of Anaesthetists of GB and Ireland

1267. Promethazine in the treatment of postoperative nausea and vomiting: a systematic review Full Text available with Trip Pro

. Patient-related risk factors in adults are: female gender, history of PONV, duration of surgery > 60 min, nonsmoking status, history of motion sickness, and postoperative use of opioids. Risk factors in children are: duration of surgery 30 minutes, age 3 years, strabismus surgery, and a history of PONV in the patient, parent or sibling. Treatment of PONV includes various classes of medications and none of them is entirely effective. If it is necessary to use combination therapy, then medicines (...) Promethazine in the treatment of postoperative nausea and vomiting: a systematic review Promethazine in the treatment of postoperative nausea and vomiting: a systematic review Signa Vitae Journal of Anesthesia, Intensive Care, Emergency and Pain Medicine Title Author DOI Article Type Special Issue Volume Issue Search Article Menu Export Article More by Authors Links Article Data Views 253 Dowloads 17 Review Open Access Promethazine in the treatment of postoperative nausea and vomiting

2011 Signa Vitae

1268. Communication in Cancer Care

that the quality of communication between older patients and their oncologists contributes to the observed treatment variability—although the traditional medical standard of care might account for physicians who do not recommend BCS,[ ] in addition to a possible geographic preference for recommended treatments.[ ] Nevertheless, a study has shown that discussing treatment options with physicians increased the probability of an older woman receiving definitive primary breast cancer therapy (defined as modified (...) clinical trials that are now enrolling patients. The search can be narrowed by location of the trial, type of treatment, name of the drug, and other criteria. about clinical trials is also available. References Levy MH: Doctor-patient communication: the lifeline to comprehensive cancer care. In: Perry MC, ed.: American Society of Clinical Oncology Educational Book: Thirty-Fourth Annual Meeting, Spring 1998. Alexandria, Va: American Society of Clinical Oncology, 1998, pp 195-202. Parle M, Jones B

2012 PDQ - NCI's Comprehensive Cancer Database

1269. Cancer Genetics Risk Assessment and Counseling

. J Genet Couns 21 (2): 151-61, 2012. Weitzel JN, Blazer KR, MacDonald DJ, et al.: Genetics, genomics, and cancer risk assessment: State of the Art and Future Directions in the Era of Personalized Medicine. CA Cancer J Clin 61 (5): 327-59, 2011 Sep-Oct. Hampel H, Bennett RL, Buchanan A, et al.: A practice guideline from the American College of Medical Genetics and Genomics and the National Society of Genetic Counselors: referral indications for cancer predisposition assessment. Genet Med 17 (1 (...) of the counseling session.[ ] An important objective of genetic counseling is to provide an opportunity for shared decision making when the medical benefits of one course of action are not demonstrated to be superior to another. The relationship between the availability of effective medical treatment for of and the clinical validity of a given test affects the degree to which personal choice or physician recommendation is supported in counseling at-risk individuals.[ ] Uptake of genetic counseling services

2012 PDQ - NCI's Comprehensive Cancer Database

1270. Pheochromocytoma and Paraganglioma

chemotherapy regimens have been used in small numbers of patients, but the overall results were disappointing.[ , ] Targeted therapy Novel targeted therapies are emerging as potential treatment strategies for metastatic pheochromocytoma. Disappointing initial results were reported with the mammalian target of rapamycin (mTOR) inhibitor everolimus,[ ] but results from a very small number of patients treated with the tyrosine kinase inhibitor sunitinib have been more promising.[ , ] Radiation therapy 131I (...) that do not take up MIBG. Other therapy Other palliative treatment modalities include external-beam radiation therapy (e.g., for palliation of bone metastases) and embolization, radiofrequency ablation, or cryoablation (e.g., for palliation of bulky hepatic metastases or isolated bony metastases). Current Clinical Trials Use our to find NCI-supported cancer clinical trials that are now enrolling patients. The search can be narrowed by location of the trial, type of treatment, name of the drug

2012 PDQ - NCI's Comprehensive Cancer Database

1271. Genetics of Medullary Thyroid Cancer

or with medical therapy in high-risk surgical patients. consists of surgical removal of the entire thyroid gland, including the posterior capsule, and central lymph node dissection. Parathyroid and pituitary tumors associated with MEN4 are also managed surgically, in accordance with treatment for other familial syndromes such as MEN1. are also treated surgically. Preoperative management aimed at preventing catecholamine-induced complications of the surgery is common. The mainstay of is complete surgical (...) the first line of therapy for MEN1-associated pituitary tumors. In one series of 136 patients, medical therapy was successful in approximately one-half of patients with secreting tumors (49 of 116, 42%), and successful suppression was correlated with smaller tumor size.[ ] Surgery is often necessary for patients who are resistant to this treatment. Radiation therapy is reserved for patients with incomplete surgical resection.[ , ] References Agarwal SK, Ozawa A, Mateo CM, et al.: The MEN1 gene

2012 PDQ - NCI's Comprehensive Cancer Database

1272. Medical transcription

care to ensure that the impositions on MT autonomy are not so onerous as to outweigh its benefits. Medical transcription is still the primary mechanism for a physician to clearly communicate with other healthcare providers who access the patient record, to advise them on the state of the patient's health and past/current treatment, and to assure continuity of care. More recently, following Federal and State Disability Act changes, a written report (IME) became a requirement for documentation (...) notes that were added in the patient's file for interpretation by the primary physician responsible for the treatment. Ultimately, this mess of handwritten notes and typed reports were consolidated into a single patient file and physically stored along with thousands of other patient records in a wall of filing cabinets in the medical records department. Whenever the need arose to review the records of a specific patient, the patient's file would be retrieved from the filing cabinet and delivered

2012 Wikipedia

1273. Medical imaging

in pharmaceutical clinical trials [ ] Medical imaging has become a major tool in clinical trials since it enables rapid diagnosis with visualization and quantitative assessment. A typical goes through multiple phases and can take up to eight years. or outcomes are used to determine whether the therapy is safe and effective. Once a patient reaches the endpoint, he or she is generally excluded from further experimental interaction. Trials that rely solely on are very costly as they have long durations and tend (...) to expand, including studies, , , and assessing the effects of disruption agents on cancer tumors. Nuclear medicine [ ] Main article: Nuclear medicine encompasses both diagnostic imaging and treatment of disease, and may also be referred to as molecular medicine or molecular imaging & therapeutics. Nuclear medicine uses certain properties of isotopes and the energetic particles emitted from radioactive material to diagnose or treat various pathology. Different from the typical concept of anatomic

2012 Wikipedia

1274. Human Trafficking

States annually Affects U.S. residents who are coerced into Forced Labor or Sexual Slavery (87% are <25 years old) Adult women: 46% Minor Girls: 21% Adult Males: 21% Minor Boys: 12% IV. Risk Factors Highest risk Physical, sexual or emotional abuse Runaway, or living in shelter From 10-50% report survival sex to obtain food, shelter, drugs or money Other risk factors Foster care children Juvenile justice system offenders Disabled patients American Indian and Alaskan Native Decreased english (...) proficiency LGBT patients (Lesbian, gay, bisexual, ) Poverty Low education or Delayed presentations for V. Precautions Victims of Human Trafficking are most likely to be seen in health care, especially emergency departments Emergency Departments offer a unique opportunity for identifying and assisting Human Trafficking victims Red Flags Companion (trafficker, may be male or female, and may truly be a close relative) Speaks on behalf of the patient Does not wish to be separated from the patient Acts

2015 FP Notebook

1275. Nifedipine

Maintenance: Nifedipine10 to 20 mg PO every 4 to 8 hours VIII. Adverse Effects Please see s Avoid short acting agents (increased coronary risk) Fetal effects Risk of IX. Monitoring: When used in Preterm Labor Serial s Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Nifedipine." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Cost: Medications nifedipine (on 5 (...) financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See for financial assistance information. Ontology: Nifedipine (C0028066) Definition (CHV) a drug used for hypertension Definition (NCI) A dihydropyridine calcium channel blocking agent. Nifedipine inhibits

2015 FP Notebook

1276. Intrathecal Morphine

Aka: Intrathecal Morphine , ITM , Spinal Anesthesia in Labor II. Indication Analgesia and Anesthesia for Gives four hours of III. Mechanism Acts at receptors Substantia gelatinosa of dorsal horn Affects afferent visceral pain impulses only Contrast with ITM does not affect second stage somatic pain ITM does not interfere with maternal pushing Does not inhibit efferent muscular paths IV. Labs with platelets Confirm no V. Advantages Single injection into the intrathecal space offers nearly immediate (...) ) Ontology: Spinal Anesthesia (C0002928) Definition (NCI) A procedure in which a pharmaceutical agent is administered into the subarachnoid space, producing a loss of sensation at and below the level of the block. Definition (NCI_NCI-GLOSS) A temporary loss of feeling in the abdomen and/or the lower part of the body. Special drugs called anesthetics are injected into the fluid in the lower part of the spinal column to cause the loss of feeling. The patient stays awake during the procedure. It is a type

2015 FP Notebook

1277. No brain, no pain: it is in the mind, so test results can make it worse

, would be to offer up ‘comfort zones’, or ‘safe zones’, that might be achievable whilst the patient explores their own potential. Considering there may not be any available accepted treatments which guarantee an improvement, I think that it would be advantageous to allow the patient to consider their own options in the most relaxed climate possible (that’s where the best thinking is done ), without any imposed insistence on any requirement for mindset changing, or on any therapies which maybe don’t (...) that make people worse. It is the manner in which the ‘information’ is conveyed to patients that is the problem. A very typical comment on worker’s compensation claim forms re back pain after an investigation: “I didn’t realise my back was so bad!!” Interventional treatment is then commonly implemented with overall results that largely produce ‘placebo’ equivalent rates of benefit for patients in persistent pain but those who aren’t lucky enough to improve, for many emergent reasons, develop

2015 Body in Mind blog

1278. Patient Modesty: Volume 70

Patient Modesty: Volume 70 Bioethics Discussion Blog: Patient Modesty: Volume 70 What have you been reading, hearing or TV viewing that has provoked some feelings of comfort or concern about what is happening in the world of medicine, medical care, treatment or science? Ethics is all about doing the right thing. Are you aware of any issues in medicine or biologic science which are being done right, could be improved or in fact represent totally unethical behavior? Write about them here.. and I (...) brother (which the pastor is paid to be on the board of). Reference: They guard their "brand" and do not want to get involved with anything that lies outside their "core," especially if it can be perceived as "fringe." You can see why there is no organization backing this cause. At , said... As Banterings mentioned, medicine in the US s a huge business - to the tune of 3.8 trillion dollars in medical costs annually as of Feb 2014. That's hardly chump change! We also need to recognize

2015 Bioethics Discussion Blog

1279. Patient Modesty: Volume 71

Patient Modesty: Volume 71 Bioethics Discussion Blog: Patient Modesty: Volume 71 What have you been reading, hearing or TV viewing that has provoked some feelings of comfort or concern about what is happening in the world of medicine, medical care, treatment or science? Ethics is all about doing the right thing. Are you aware of any issues in medicine or biologic science which are being done right, could be improved or in fact represent totally unethical behavior? Write about them here.. and I (...) in medicine. While the validity and scope of the Four Principles of Beauchamp and Childress are often debated, there is no questioning the canonical status of the four principles in the field of Medical Ethics. Briefly, the four principles are: Autonomy – The right for an individual to make his or her own choice. Beneficence – The principle of acting with the best interest of the other in mind. Non-maleficence – The principle that “above all, do no harm,” as stated in the Hippocratic Oath. Justice

2015 Bioethics Discussion Blog

1280. Patient Modesty: Volume 73

Patient Modesty: Volume 73 Bioethics Discussion Blog: Patient Modesty: Volume 73 What have you been reading, hearing or TV viewing that has provoked some feelings of comfort or concern about what is happening in the world of medicine, medical care, treatment or science? Ethics is all about doing the right thing. Are you aware of any issues in medicine or biologic science which are being done right, could be improved or in fact represent totally unethical behavior? Write about them here.. and I (...) published with The New York Times earlier this year. ..."When you go into a hospital, you deserve to know that your sensitive moments are not going to end up on primetime.” ...“People don’t go to the hospital to be on reality television,” Caplan said. “It’s exploitation and it shouldn’t be happening anywhere in a hospital, a nursing home, or any other healthcare setting.” See related: ...Joel Geiderman, co-chair of the emergency medicine department at Cedars-Sinai Medical Center in Los Angeles

2015 Bioethics Discussion Blog

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