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681. Safety of Probiotics to Reduce Risk and Prevent or Treat Disease

studies, and interventions are poorly documented. The available evidence in RCTs does not indicate an increased risk; however, rare adverse events are difficult to assess, and despite the substantial number of publications, the current literature is not well equipped to answer questions on the safety of probiotic interventions with confidence. vi Contents Executive Summary ES-1 Introduction 1 Background 1 Project Purpose 3 Scope 4 Analytic Framework 6 Methods 8 Electronic Search for Literature Review (...) 8 Inclusion Screening 9 Data Abstraction and Quality Assessment 11 Analysis 13 Rating the Strength of the Evidence 15 Results 16 Potentially Relevant Studies Not Addressing Safety 18 Included Studies With Nonspecific Safety Statements 18 Included Studies Addressing Specific Harms 20 Discussion 102 Results Summary 102 Scope and Limitations 103 Key Questions 107 Future Research 115 Conclusions 117 References 118 Included Studies 138 Acronyms and Abbreviations 182 Figures Figure 1. Included Studies

2011 EvidenceUpdates

682. Why I Go, uncut

version, which I knew was never going to make it into the Times based on length. But if you are interested in going into some greater depth, feel free to read on. Apologies for the redundant parts; they made very few changes from my original chopped version. But I did want some readers to know about Phil Ireland, and to remind everyone again about Sean Collier. Why I Go In nearly every medical school applicant interview, candidates are asked why they want to pursue medicine as a career. Invariably (...) thing? In trying to answer this question, a part of me wants to speak for all of the doctors and nurses and water sanitation engineers and all the other consultants who have been scrambling to get ourselves over there. So part of “why I go” is “why we go.” I cannot pretend to speak for everyone, but I am confident that it is this fundamental desire to alleviate human suffering that is driving us toward the Hot Zone. Many of the people on the ground or headed there soon are specialists in disaster

2014 Billy Rubin's Blog

683. Patient Modesty: Volume 69

”. It can be very difficult to prove otherwise except in rare instances. For example, Dr. Stanley Chung was brought before the College of Physicians and Surgeons on allegations of frequent and unnecessary rectal and genital exams on patients, some of whom were virgins. Further proof is the fact that no charges have been filed in the case of Dr. Stanley Chung or Dr. Nikita Levy (Johns Hopkins). In Memory and suggestibility in the forensic interview (M. L. Eisen, J. A. Quas and G. S. Goodman) studied (...) modesty issue into sexual assault or sexual battery. If those of us who have become physicians was aware that all of our potential patients had these criminal behaviors in the back of the patient's minds and that each patient was anticipating that some criminal act was about to happen to them, I doubt most of us would have decided upon a different occupation to avoid serious life-changing consequences if accused of such behaviors. Sorry, patients.. no more doctors to examine, make a diagnosis

2014 Bioethics Discussion Blog

684. Why I Go, uncut

version, which I knew was never going to make it into the Times based on length. But if you are interested in going into some greater depth, feel free to read on. Apologies for the redundant parts; they made very few changes from my original chopped version. But I did want some readers to know about Phil Ireland, and to remind everyone again about Sean Collier. Why I Go In nearly every medical school applicant interview, candidates are asked why they want to pursue medicine as a career. Invariably (...) thing? In trying to answer this question, a part of me wants to speak for all of the doctors and nurses and water sanitation engineers and all the other consultants who have been scrambling to get ourselves over there. So part of “why I go” is “why we go.” I cannot pretend to speak for everyone, but I am confident that it is this fundamental desire to alleviate human suffering that is driving us toward the Hot Zone. Many of the people on the ground or headed there soon are specialists in disaster

2014 Billy Rubin's Blog

685. Pharmacologic-based strategies for smoking cessation: clinical and cost-effectiveness analyses

, and population impact sections; and contributed to revisions. Karen Cimon contributed to article selection, study quality assessment, data extraction and tabulation, and analysis of data for the clinical review. Kristen Moulton contributed to article selection, study quality assessment, data extraction, tabulation of data, and preparation of tables for the economic review. Peter Selby contributed to the review and conceptualization of the research questions, identification of articles or topic areas (...) Appendix 3: Data Extraction Form and Quality Assessment for Clinical-Effectiveness Studies 12 Appendix 4: Included studies for questions 1-4, 11, 12 14 Appendix 5: Network diagrams connecting placebo-controlled and head-to-head trials 29 Appendix 6: Characteristics of the included trials 31 Appendix 7: Quality assessment of the included trials 159 Appendix 8: Clinical effects on cessation rates and relapse 165 Appendix 9: Data extraction form for economic studies 219 Appendix 10: Excluded economic

2010 EvidenceUpdates

686. Ablation procedures for rhythm control in patients with atrial fibrillation: clinical and cost-effectiveness analyses

Adrian Baranchuk, MD, FACC Associate Professor of Medicine and Physiology Queen’s University Kingston, Ontario Craig Mitton, PhD Associate Professor University of British Columbia Vancouver, British Columbia Tanya Horsley, PhD Educational Research Scientist Royal College of Physicians and Surgeons of Canada Ottawa, Ontario Rick Audas, BBA, MBA, MA(Econ), PhD Assistant Professor of Medicine Memorial University St. John’s, Newfoundland CADTH Peer Review Group Reviewers Chris Skedgel, MDE Research (...) ablations occurred in Ontario (910), British Colombia (851), Alberta (119), and Nova Scotia (98). The inpatient and physician costs are estimated to be $19,467,400. Based on trends over the past five years, the projected expenditures on these procedures are estimated to reach $40,888,821 by 2013. Conclusions The evidence in this systematic review indicates that the use of catheter ablation increases the rate of maintenance of sinus rhythm compared with treatment with AADs in patients for whom the use

2010 EvidenceUpdates

687. Adaptation of the American Cancer Society (ACS) Early Detection of Prostate Cancer Patient Decision Aid for Spanish Speaking Men

, a bilingual study staff member will lead the discussion by showing the group slides about prostate cancer screening. A doctor or healthcare professional designee will be available to answer questions about prostate cancer screening. After viewing the slides, you will complete another questionnaire about what you know about prostate cancer. It will also ask what you thought about the information in the slides. Length of Study: Answering the questionnaires and participating in the focus group will take (...) to Primary Outcome Measures : Develop and Evaluate Spanish-Language Slide Set for Group Settings [ Time Frame: At Completion of Focus Group, Questionnaire, and Interview - 1 1/2 hours ] For the evaluation aim of this study a Paired T-Test will be used before and after intervention measures of knowledge. 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

2011 Clinical Trials

688. Kidney Transplant Failure

allosensitization in wait-listed transplant candidates and have established local protocols for collection, storage and shipping. Both class I and class II Anti-HLA antibodies will be appraised using FlowPRA®. Biospecimen Retention: Samples Without DNA Class I and II HLA antibodies 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 (...) for these patients.8 However, in Canada, only 10% of patients with first transplant failure will receive a second transplant.9 Consequently transplant failure is now the fifth leading individual cause of dialysis initiation in Canada.6, 10 Survival after transplant failure is very poor, with 40% mortality in the first 5 years after initiation of dialysis.9, 11, 12 In comparison, the 5 year mortality of de novo incident dialysis patients, including those who are not even transplant candidates, is 50%, 6, 10while

2011 Clinical Trials

689. Hyperbaric Oxygen Therapy (HBO2) for Persistent Post-concussive Symptoms After Mild Traumatic Brain Injury (mTBI)

targeted to improve cognition, memory, and functional status. However, much is unknown about how to measure improvement in post-concussive symptoms after an intervention in the targeted active duty population. In preparation for a pivotal efficacy study, the objectives of this study are to characterize two candidate primary outcome tools in our intended study population, the RPQ and the NSI, in order to better estimate the sample size needed to answer the efficacy question. Agency for Healthcare (...) Research and Quality (AHRQ) conducted a comprehensive review of the literature, interviewed subject matter experts (SME), and conducted focus groups with SMEs to evaluate the evidence for HBO2 for patients with TBI. The AHRQ concluded that "Although they are cited frequently, the case series and time-series studies of HBO2 for TBI patients had serious flaws. There were no high-quality studies of the use of HBO2 to improve function and quality of life in patients with chronic, stable disabilities from

2011 Clinical Trials

690. Jonas Salk

Signature Jonas Edward Salk ( ; October 28, 1914 – June 23, 1995) was an American and . He discovered and developed one of the first successful . Born in New York City, he attended the and , later choosing to do medical research instead of becoming a practicing physician. In 1939, after earning his medical degree, Salk began an internship as a physician scientist at . Two years later he was granted a fellowship at the , where he would study flu viruses with his mentor Until 1955, when the Salk vaccine (...) a vaccine against polio, and, together with the skilled research team he assembled, devoted himself to this work for the next seven years. The field trial set up to test the Salk vaccine was, according to O'Neill, "the most elaborate program of its kind in history, involving 20,000 physicians and public health officers, 64,000 school personnel, and 220,000 volunteers." Over 1,800,000 school children took part in the trial. When news of the vaccine's success was made public on April 12, 1955, Salk

2012 Wikipedia

691. Drug abuse

of certain substances leads to a change in the central nervous system known as a 'tolerance' to the medicine such that more of the substance is needed in order to produce desired effects. With some substances, stopping or reducing use can cause withdrawal symptoms to occur, but this is highly dependent on the specific substance in question. The rate of prescription drug use is fast overtaking illegal drug use in the United States. According to the National Institute of Drug Abuse, 7 million people were (...) taking prescription drugs for nonmedical use in 2010. Among 12th graders, nonmedical prescription drug use is now second only to . In 2011, "Nearly 1 in 12 high school seniors reported nonmedical use of Vicodin; 1 in 20 reported such use of OxyContin." Both of these drugs contain . Avenues of obtaining prescription drugs for misuse are varied: sharing between family and friends, illegally buying medications at school or work, and often " " to find multiple physicians to prescribe the same medication

2012 Wikipedia

692. Emergency medical dispatcher

of its paramedics to their dispatch centre in order to interview callers and prioritize calls. The following year, Dr. Jeff Clawson, a physician employed by the Fire Department as its , developed a series of key questions, pre-arrival instructions, and dispatch priorities to be used in the processing of EMS calls. These ultimately evolved into the (MPDS), APCO (EMD) and PowerPhone's Total Response (CACH) system. Such systems were initially technologically quite primitive; in the mid-1970s the use (...) at the patient's side, but dispatchers could be there in seconds. Physicians began to see a dramatic new potential for the saving of lives by means of simple scripted telephone instructions from the dispatcher, and the concept of Dispatch Life Support was born. Suddenly dispatchers were providing complex information and instructions to callers, and even providing guidance on performing procedures such as (CPR) by telephone. The concept became an area of medical research, and even EMS Medical Directors debated

2012 Wikipedia

693. History of chronic fatigue syndrome

specifically excludes chronic fatigue syndrome. In 1938, Alexander Gilliam described an illness that resembled , interviewing patients and reviewing records of one of several clusters which had occurred in Los Angeles, United States in 1934. The outbreak included all or most of its nurses and doctors. Gilliam called the outbreak "atypical " and described the symptoms as: rapid muscle weakness, vasomotor instability, clonic twitches and cramps, ataxia, severe pain (usually aggravated by exercise), neck (...) and back stiffness, menstrual disturbance and dominant sensory involvement. Novices and convent candidates at a convent were diagnosed with "encephalitis" in 1936. Two towns in had outbreaks of "abortive poliomyelitis" in 1937, and 73 Swiss soldiers were given the same diagnosis in 1939. Outbreaks in were called " " or "simulating poliomyelitis" and were later called "Iceland disease." 800 people in , Australia became ill during 1949-1951 with a disease "resembling poliomyelitis." Two smaller clusters

2012 Wikipedia

694. Health care in Canada

of the of 1984. Contents Current status [ ] The government ensures the quality of care through federal standards. The government does not participate in day-to-day care or collect any information about an individual's health, which remains confidential between a person and their physician. Canada's provincially based Medicare systems are cost-effective because of their administrative simplicity. In each province, each doctor handles the insurance claim against the provincial insurer. There is no need (...) are not permitted by the , but physicians may charge a small fee to the patient for reasons such as missed appointments, doctor's notes and for prescription refills done over the phone. Some physicians charge "annual fees" as part of a comprehensive package of services they offer their patients and their families. Such charges are completely optional and can only be for non-essential health options. Benefits and features [ ] Health cards are issued by provincial health ministries to individuals who enroll

2012 Wikipedia

695. Sanjay Gupta Full Text available with Trip Pro

of his 3-hour documentary, "Weed 3: The Marijuana Revolution", was released in April 2015. Gupta served as a commentator on the TeamCast with former Wolverines kicker for the school's appearance in the , which aired on CNN sibling . Surgeon General candidate [ ] On January 6, 2009, CNN announced that Gupta had been considered for the position of by President . Some doctors said that his communication skills and high-profile would allow him to highlight medical issues and prioritize medical reform (...) in neurological surgery within the , in 2000, followed by a fellowship at the Semmes Murphy Clinic, in Memphis, Tennessee. Career [ ] Medical practice [ ] Gupta is an general neurosurgeon at and has worked on spine, trauma and 3‑D‑ . He has published medical journal articles on screw placement, brain tumors, and spinal cord abnormalities. He is licensed to practice medicine in New York, , and . Gupta (third from left) with (second from left) and two doctors operating on a 12-year-old girl aboard the . During

2012 Wikipedia

696. Bipolar disorder

along with mood. They may feel unstoppable, or as if they have been "chosen" and are on a "special mission", or have other grandiose or delusional ideas. This may lead to violent behavior and, sometimes, hospitalization in an inpatient . The severity of manic symptoms can be measured by rating scales such as the , though questions remain about the reliability of these scales. The onset of a manic or depressive episode is often foreshadowed by . Mood changes, and appetite changes, and an increase (...) , published in 2013, included further and more accurate specifiers compared to its predecessor, the . such as the (KSADS) and the (SCID) are used for diagnostic confirmation of bipolar disorder. Several for the screening and evaluation of bipolar disorder exist, including the , , the and the . The use of evaluation scales cannot substitute a full clinical interview but they serve to systematize the recollection of symptoms. On the other hand, instruments for screening bipolar disorder tend to have lower

2012 Wikipedia

697. Autism

% of children are diagnosed with ASD as of 2017 , a more than doubling from 0.7% in 2000 in the United States. It occurs four-to-five times more often in males than females. The number of people diagnosed has increased dramatically since the 1960s, partly due to changes in diagnostic practice. The question of whether actual rates have increased is unresolved. Contents Characteristics Autism is a highly variable that first appears during or , and generally follows a steady course without . People with autism (...) that is 0.7 for autism and as high as 0.9 for ASD, and siblings of those with autism are about 25 times more likely to be autistic than the general population. However, most of the mutations that increase autism risk have not been identified. Typically, autism cannot be traced to a (single-gene) mutation or to a single , and none of the genetic syndromes associated with ASDs have been shown to selectively cause ASD. Numerous candidate genes have been located, with only small effects attributable to any

2012 Wikipedia

698. Case study Full Text available with Trip Pro

of interviews with the case subject) often accompany the case studies. Similarly, teaching case studies have become increasingly popular in science education. The National Center for Case Studies in Teaching Science has made a growing body of case studies available for classroom use, for university as well as secondary school coursework. Case studies are commonly used in and in job interviews for consulting firms such as , and the , in which candidates are asked to develop the best solution for a case (...) this need, the organization must gather pertient information. Case studies can be used to establish where the problem originates by utilizing several research methods. Research methods should be chosen appropriately to conduct a thourough investigation. The primary methods used include: interviews, surveys, focus groups, observations and in some cases, field trials. The methods chosen rely heavily on the amount of capital the organization is able to spend and the kind of data that is required

2012 Wikipedia

699. Race Against Time: Searching for Hope in AIDS-Ravaged Africa

the criticisms constructive and the writing sincere. His style focuses less on numbers and statistics, and more on connecting decisions by UN officials and western diplomats to consequences on the ground in Africa. His eyewitness accounts are said to be candid and emotional. The book spent seven weeks at #1 on ' s Nonfiction Bestseller List. A second edition was released in June 2006. The Canadian Booksellers Association awarded its Libris Award for non-fiction book of the year to Race Against Time and its (...) . In the second chapter Lewis discusses his history in Africa, beginning in the 1960s as an English teacher in . He contrasts Africa of the 1960s shedding colonial rule, optimistic in future prospects, with Africa of the 2000s struggling with AIDS and increasingly widespread hunger. He acknowledges the trend, noting "there are more doctors in [England] than in Malawi". In the third chapter Lewis examines how the UN, , and the (IMF) failed to fulfill promises of free access to . In the instances where school

2012 Wikipedia

700. Nursing

of settings. In the period, nurse education has undergone a process of diversification towards , and many of the traditional regulations and provider roles are changing. Nurses develop a plan of care, working collaboratively with physicians, therapists, the patient, the patient's family and other team members, that focuses on treating illness to improve quality of life. In the United States and the United Kingdom, advanced practice nurses, such as clinical nurse specialists and nurse practitioners (...) , diagnose health problems and prescribe medications and other therapies, depending on individual state regulations. Nurses may help coordinate the patient care performed by other members of a multidisciplinary health care team such as therapists, medical practitioners and dietitians. Nurses provide care both interdependently, for example, with physicians, and independently as nursing professionals. Contents History [ ] Main articles: and Traditional [ ] Nursing historians face the challenge

2012 Wikipedia

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