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641. Neoplasms, Lung (Overview)

, but in older patients or those with significant comorbidities, carboplatin may be substituted. Radiation In the treatment of stage I and stage II NSCLC, radiation therapy alone is considered only when surgical resection is not possible. [ ] Radiation is a reasonable option for lung cancer treatment among those who are not candidates for surgery. [ ] Beta blockers have been found to improve overall survival, disease-free survival, and distant metastasis–free survival, though not locoregional progession–free (...) care is an important part of the treatment of patients with NSCLC. (See .) The American College of Chest Physicians (ACCP) updated its comprehensive set of lung cancer guidelines in 2013. The guideline set includes an executive summary of current recommendations for diagnosis and treatment. [ ] For a summary of guidelines issued by major organizations, see . Go to for complete information on this topic. Previous Next: Pathophysiology Both exposure (environmental or occupational) to particular

2014 eMedicine Emergency Medicine

642. Natural History and Biomarkers of Amyotrophic Lateral Sclerosis and Frontotemporal Dementia Caused by the C9ORF72 Gene Mutation

: Participants will have up to 4 in-person visits and 3 telephone interviews over 3 years. Each in-person visit may take place over several days. They may be either inpatient or outpatient visits. At each visit, participants will undergo a series of brain, language, and behavior tests. These will include: Magnetic resonance imaging (MRI) of the brain. This uses magnets, radio waves, and computers to produce detailed pictures of the brain. Collecting spinal fluid. The clinician will make the participant s (...) back numb and then insert a needle to collect fluid. - Blood samples will be taken. - Participants will be asked to perform several language and movement tests. - Small skin samples will be taken on one visit - Between visits, participants will answer questions about their health over the phone 3 times. Condition or disease Amyotrophic Lateral Sclerosis Frontotemporal Lobar Degeneration Detailed Description: Objective The primary objective of this study is to characterize the natural

2013 Clinical Trials

643. The Genetic Characterization of Dementia

influences on dementia. Eligibility: Individuals who have been diagnosed with dementia. Family members of individuals who have been diagnosed with dementia. Healthy volunteers at least 18 years of age. Design: Participants will be interviewed and answer questions about their medical history. They will also provide general information on the relatives' medical histories. Participants will provide a blood sample for genetic testing. Participants will remain on the study for up to 10 years. They will have (...) to environmental influence may be affected by genetic predisposition. As a second aim in this protocol, we will investigate the association between genetic polymorphisms and dementia. This will be performed by a candidate gene approach, assessing the contribution of genes already associated with familial forms of disease, likely candidates (for example involved in the cholinergic system, cell survival or Beta Amyloid processing) or genes within a genetic region previously linked to disease. Although

2013 Clinical Trials

644. Follow up Study of Diaphragm Pacing for Patients With High Tetraplegia

by (Responsible Party): Craig Hospital Study Details Study Description Go to Brief Summary: This is an observational longitudinal study designed to identify and describe long term outcomes for patients with high tetraplegia who use a Diaphragmatic Pacing System (DPS). As this is not a randomized or experimental study, no specific hypotheses are proposed. The data collected will enable us to answer the following research questions: What are the patterns of long-term DPS use (hours per day using DPS, changes (...) is a relatively rare but devastating condition. Review of National Spinal Cord Injury Database statistics show that only 3.6% of patients with tetraplegia are ventilator dependent at one year post injury.1 A subset of individuals who are ventilatory dependent in the long term and have upper motor neuron paralysis of the diaphragm are candidates for electrophrenic respiration (EPR) which can create inspiratory function through electrical stimulation of the phrenic nerves, resulting in diaphragmatic contraction

2013 Clinical Trials

645. Genes Associated With Bronchopulmonary Dysplasia and Retinopathy of Prematurity

be associated with BPD and ROP. Eligibility: Premature babies born with a weight less than or equal to 1,250 grams. Parents of the premature babies. Design: Parents will answer questions about the mother s health and pregnancy. Delivery and medical information will be collected during the baby s hospitalization for the first month after birth. Parents will provide a saliva sample from the inside of the cheek. A saliva sample will also be collected from the baby within 28 days of birth. If the baby needs (...) tracheal aspiration (removal of fluid from the throat), tracheal fluid samples will also be collected. Parents will have followup interviews about their child s health 6 months, 12 months, and yearly for up to 6 years after birth. This is a genetic study only. Treatment will not be provided as part of this study. Condition or disease Bronchopulmonary Dysplasia Retinopathy of Prematurity Prematurity Pulmonary Disease Detailed Description: Understanding the role of susceptibility genes for risk of BPD

2013 Clinical Trials

646. Acceptance and Commitment Therapy for the Inpatient Treatment of Psychosis

, and this is often the only chance to provide treatment due to gaps in mental health service utilization (Blow et al., 2011; McCarthy et al., 2007). Thus, there is an urgent need for enhancing the efficacy and effectiveness of VHA inpatient services and tailoring them to better support recovery. Acceptance and Commitment Therapy (ACT), a recovery-oriented, evidence-based adjunct to inpatient treatment for psychosis, is an excellent candidate for investigations within VHA inpatient settings. ACT for psychosis (...) of life. Other Name: ACT Active Comparator: Treatment as Usual (TAU) TAU consists of psychopharmacology, case management, and psychotherapy. Additionally, patients randomized to the TAU condition will meet with ACT facilitators for 15 minutes every other day to provide additional support and answer questions, while ensuring not to discuss or suggest the use of therapeutic techniques related to ACT. Other: Treatment as Usual (TAU) All patients admitted to the acute psychiatry unit are administered anti

2013 Clinical Trials

647. Comparative Efficacy Research of Robot-Assisted Therapy With and Without Constraint-Induced Therapy in Stroke Rehabilitation

Log (MAL) [ Time Frame: Baseline, 2 weeks, and 4 weeks ] The MAL consists of 30 structured questions to interview how the patients rate the frequency (amount of use subscale) and quality (quality of movement subscale) of movements while using their affected arm to accomplish each of the 30 daily activities. The score of each item ranges from 0 to 5, and the higher scores indicate more frequently used or higher quality of movements. The summary score is the mean of the item scores. The clinimetric (...) and perform study tasks (Mini Mental State Examination ≥ 24) welling to provide written informed consent Exclusion Criteria: physician-determined major medical problems or poor physical conditions that would interfere with participation excessive pain in any joint that might limit participation Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided

2013 Clinical Trials

648. The unacceptable cost of silence

The unacceptable cost of silence The unacceptable cost of silence The unacceptable cost of silence | | October 27, 2016 93 Shares Nearly a month before our national presidential election, a video surfaced online capturing a conversation between Presidential candidate Donald Trump and reporter Billy Bush. During this 2005 “private” conversation between the two, Trump lewdly brags to Bush about kissing and groping women without their consent. He is even heard boasting he can “get away (...) . Such derogatory, offensive, or discriminatory comments to or about another person or group are not confined to the OR. The subject of the comments have ranged from patients, nurses, hospital administration, or even other physicians with racist, sexist, or ageist undertones. My years in medical school and early years as a resident, when I was most vulnerable and the least powerful and influential in the medical hierarchy, coincide with the times I was most tolerant of this behavior. So, regrettably, I

2016 KevinMD blog

649. This election is focusing on the wrong health issues

prescription drug prices. With a , this was a missed opportunity for both candidates to discuss the merits of their plans on this key issue. In the days that followed, Mr. Trump spoke at a rally in Altoona, Pennsylvania in which he not only — an action that would have garnered the top headline any other election — but also , to the cheers of his supporters. Mayor Giuliani was interviewed and continued his . During the vice-presidential debate, the Affordable Care Act got mentioned by Governor Pence in his (...) or Republican. This is particularly striking giving that . It was not until the second presidential debate — admittedly one in which the chatter was much more focused on the Trump tape and the challenges it presents for his campaign and party — that a single question was asked on the subject of health care and how the candidates would address the challenges that some are facing of higher costs and, in some cases, less coverage. This provided the first opportunity for the candidates to provide their talking

2016 KevinMD blog

650. Physiotherapist or pseudo Psychologist?

disagree with. Of course exercise and movement interventions should NOT be used in isolation, but movement or exercise therapy is THE foundation treatment we as physiotherapists should use, it’s our primary role, it’s in our bloody job title for christ sake… Physical Therapy. So I questioned this point further on social media, asking for more opinions on when people thought the role of a physiotherapist stops being a physiotherapist. As far as I am concered when a patients tells me (...) with the patients with physical disability and pain limiting their activities. So is it fair to ask physios to help those WITHOUT movement or physical issues as well? The question also begs that if there are no physical issues for a patient, what the hell does a physiotherapist do in a session with a patient? When does a physio stop being a physio and start becoming a psychologist? Now of course many physiotherapists, including myself, are trained in some psychological and other non physical interventions

2016 The Sports Physio blog

651. Video » NIMH Director’s Innovation Speaker Series - Dr. Rosalind Picard, PhD

nothing to do with the study of emotion." Determined, though, that she was on the right course, she did what any bright, intelligent, and motivated person would do. She tried to get her colleagues to work on the subject of emotion. [laughter] But that failed, so, reluctantly, she took it on herself, and in1995 circulated -- and to put it in perspective -- 1995, if I'm correct, is four years post doctorate? Rosalind Picard: Yes. David Armstrong: Four years post doctorate, so we're talking kind (...) the live demo even if it fails. [laughter] And unfortunately, every time there was a long line -- long bit of PowerPoint, there was a decaying exponential in the brightness of the audience, so you are hereby invited -- I was told this is not the norm here, but you are invited if you feel a question midstream, especially when I'm not clear about something grab a -- one of the mics. They just ask that you use the mics so that people can hear you, and pop up -- raise your hand, run to the mic, and feel

2016 NIMH blog

652. Patient Modesty: Volume 74

" to provide a safe and effective outcome of any doctor-patient relationship? And, yes, in that balance some matters of patient modesty might be affected. I speak as the blog moderator and not as a physician as I present this issue of balance for discussion. ..Maurice. Graphic: Balance--from Google Images NOTICE: As of March 14 2016, Volume 74 is now CLOSED to further Comments. Go to to continue posting. posted by Maurice Bernstein, M.D. @ 168 Comments: At , Anonymous said... Thank you Ray for your wisdom (...) , using it more or less broadly than it is usually used, directing it at people who use the concept “needs” when they mean something else (e.g., desire), etc. Before I can respond to your questions, I need to know why you are housing the concept between quotation marks. Human beings (including physicians) have a need for good health. I assume that most U.S. citizens who visit physicians (including physicians) do so because they believe that physicians control the resources that help us satisfy

2016 Bioethics Discussion Blog

653. Patient Modesty: Volume 77

-20 students. secondly, one male said he finally found a Job After 3 years of looking while all the females in his class had jobs the second week. Who looks for a job for 3 straight years? You would think that some re-inventing yourself might be a better option. Another male student was rejoicing after 2 years of graduating he finally got his first interview at a hospital. Just an interview! Ever notice that urology clinics never advertise who their staff are, only the physicians and maybe (...) procedures at (cystoscopies, bladder cancer treatments) has male doctors but 100% female staff. Due to an insurance change I will be changing to a new hospital going forward. I asked already and they have a male RN there. It is a very large practice however so while one male RN is one more than most places have, one male RN is not much in a practice with 9 physicians. I plan to ask for that male RN when I make an appt. and then depending how things go I will have a basis upon which to send a letter

2016 Bioethics Discussion Blog

654. Newly Diagnosed with Hepatitis B? Acute or Chronic? Learning the HBV Basics…

hepatitis B as a result of a mutation that can occur. Fortunately your ALTs are normal – assuming your ALT is 30 IU/mL or less – this is the new upper limit of normal for men. A liver specialist might like to monitor you more carefully to determine if you would be a good candidate for treatment. There is no complete cure at this time, though there are good treatments. Herbal remedies will not provide you with a cure. Talk to your doctor before taking any herbal remedies. Some can cause more harm (...) after six months and you develop hepatitis B surface antibodies (HBsAb), then you have cleared hepatitis B after an “acute” infection. There are some additional that your doctor may order to get a better understanding of your infection, but not everyone has access to these tests. Some tests are rather expensive and they may still need to be repeated over time in order to confirm the diagnosis. Please be patient. The good news is that hepatitis B is not typically an emergency. Here is more good news

2016 hepbblog

655. Mental Status Exam

Patient must be able to understand questions and communicate answers VI. Protocol Interview patient alone, and then again with family Full Mental State Exam evaluates 11 criteria VII. Exam: General Approach (components) ( , ) ( , , , , ) ( , , ) VIII. Exam: General appearance, behavior and attitude See Appearance Clothing and grooming Old or young appearing Healthy or sickly appearing Angry, puzzled, frightened, anxious, contemptuous, apathetic, paranoid Effeminate or masculine Scars or s Grooming (...) mistakes (out of 28 possible) Blessed Orientation Memory Concentration (BOMC) Shortened version of BIMC (6 questions) Positive if >10 mistakes Short Test of Mental Status (STMS) Tests orientation, attention, recall, and copying Also tests calculation, abstraction, clock drawing Positive if score <30 (out of 38 possible points) ( ) Requires payment for clinical use IV. Evaluation: Mental Status in the non-alert patient V. Precautions Language and education heavily impact the mental state evaluation

2015 FP Notebook

656. Study of Lymphoma in Asia

about their personal health history. They will answer questions about exposures to chemicals like pesticides. They will also be asked about family medical history and work and residential history. Finally they will answer questions about lifestyle factors like diet and exercise. They will give permission for the researchers to see their medical records. Researchers will also have access to any tumor samples collected as part of treatment. Condition or disease Lymphoma, Non-Hodgkin Multiple Myleoma (...) by the low prevalence and limited range of several important chemical exposures and the high to complete linkage disequilibrium among key candidate genetic loci in Western populations. To optimize the ability to build on and clarify these findings, it is necessary to investigate populations that differ from Caucasians in both exposure patterns and underlying genetic structure. A multidisciplinary case-control study of lymphoma in Asia provides an opportunity to replicate and extend recent and novel

2012 Clinical Trials

657. Addressing Attitudes to Improve Use of Protective Headwear in Older Adults

(14) about the behavior of using protective headwear. The rationale and specific questions were presented to an expert panel and clinicians (behavioralist, 3 geriatricians, long-term care nurse and a nurse health services researcher) to evaluate the content and face validity of each question, and to rank each as high or low importance within each domain. Item reduction and refinement following the expert panels identified 26 candidate questions. Analysis of the PHAQ as an instrumented was also (...) were given the PHAQ, as well as the demographic and functional status questionnaire when they arrived for the focus group. Input into the social marketing content was sought in a structured interview manner, and by using an audience response system with questions projected by power point. At the conclusion of the social marketing, the PHAQ was repeated and sent to participants 2 weeks after the focus group to gage stability of changes in attitudes. Study Design Go to Layout table for study

2012 Clinical Trials

658. "Learning About Biologics"-Rheumatoid Arthritis

Who Are Classified as Having Made an Informed Value Concordant Choice at 2 Weeks [ Time Frame: 2 weeks ] We classified subjects as having made an informed choice to escalate care if they answered at least 75% of the knowledge questions correctly and had low decisional conflict as defined by a score of 25 or lower on the combined subjective knowledge and values clarity subscales. Secondary Outcome Measures : Patient-physician Communication [ Time Frame: 8 weeks ] Patient-physician communication (...) to a printer will have the opportunity to do so in the office. Acceptability to Physicians [ Time Frame: 8 weeks ] Acceptability to physicians will be assessed using four items coded on 5-point Frequency scales (1= None of the time and 5= All of the time) administered by the research assistant once all patient follow-up interviews have been completed: Did the tool make it easier to talk about treatment with your patients? Did the tool increase the amount of time you spent discussing therapy with your

2012 Clinical Trials

659. Safety and Tolerability of Once-daily Oral Aripiprazole in Children and Adolescents With Tourette's Disorder

outside the normal range was flagged for the attention of the study physician who was to indicate whether the value was clinically significant based on the pre-defined criteria for identifying laboratory values of potential clinical relevance. Percentage of participants noted with abnormal laboratory values are reported below. Percentage of Participants With Clinically Significant Abnormal Vital Signs. [ Time Frame: Baseline to Week 52 ] Vital sign measurements included systolic and diastolic blood (...) , with a score of 0 representing absence of symptoms (for item 10, no awareness), and a score of 4 indicating a severe condition (for item 10, awareness/severe distress). In addition, the AIMS included 2 yes/no questions that addressed the subject's dental status (since an edentulous state can cause lingual dyskinesias). The AIMS movement rating score (range 0 to 28) was the sum of the rating scores for facial and oral moments (ie, items 1 to 4), extremity movements (ie, items 5 and 6), and trunk movements

2012 Clinical Trials

660. Vascular Inflammation in Psoriasis Trial (The VIP Trial)

(DLQI) [ Time Frame: Baseline - Week 12 ] Patient reported quality of life outcomes will be assessed using DLQI. The DLQI is calculated by summing the score of 10 questions regarding impact of skin condition on daily life resulting in a maximum of 30 and a minimum of 0. The higher the score, the more quality of life is impaired. Change in Patient-reported Outcomes-MEDFICTS Dietary Assessment) [ Time Frame: Baseline to Week 12 ] Patient reported dietary outcomes will be assessed using MEDFICTS (Meats (...) they are on adalimumab, as compared to NB-UVB phototherapy or placebo. Eligibility Criteria Go to Information from the National Library of Medicine Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Layout table for eligibility information Ages Eligible for Study: 18

2012 Clinical Trials

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