Expanding boundaries: The synergy of creative writing and reflective learning in medicine.

This paper explores the role of reflective practice in the medical field and investigates the factors that influence reflective writing. While reflective practice is widely acknowledged as crucial in medical education, there is a need to expand its conceptual boundaries and move beyond mere pedagogical exercises. The paper argues for the inclusion of creative writing, specifically poetry, as a form of reflective practice that allows medical students to effectively process their emotions and develop a more compassionate approach to patient care. By engaging in poetic expression, students can navigate ethical dilemmas, reflect on personal challenges, and cultivate empathy and appreciation for diverse perspectives.

Caduceus vs. Rod of Asclepius: A Serpentine Dilemma in Medical Iconography.

This scholarly inquiry delves into the historical significance of two enduring medical symbols: the Rod of Asclepius and the Caduceus. Tracing their origins back to ancient Greek mythology, we uncover their distinct identities and profound meanings as symbols of healing, unity among medical practitioners, and ethical responsibilities. Beyond aesthetics, these emblems serve as powerful educational tools, fostering universal understanding and connecting modern medicine to its historical heritage. Consequently, embracing their true essence can inspire genuine dedication to the noble mission of caring for others.

Ring of Hope: A Novice's Experience in a Cancer Centre.

The ringing of a bell has become an honored and cherished tradition in the realm of cancer survivorship care. As a medical student, I was initially unaware of this practice, but I have since gained a profound appreciation for its deep significance and emotional potency. Through the act of ringing the bell, patients who have successfully completed their cancer treatment are able to mark the end of a gruelling journey, while also heralding the start of a new and hopeful chapter in their lives.

Dominique-Jean Larrey (1766-1842): The Founder of the Modern Triage System.

Dominique-Jean Larrey was a prominent French surgeon who rose to fame during the age of the Napoleonic Wars. During his service in the French military, he developed dozens of medical innovations. Most important of all were his improvements to the evacuation of the wounded from the battlefield, triage of the wounded, and rapid surgical intervention. His innovations revolutionized military medicine and are still the basis for modern practice today.

Isabella Barbour 'Ella' Pirrie (1857-1929): Pioneering contributions to British nursing.

Miss Isabella "Ella" Barbour Pirrie (1857-1929) made substantial contributions to nursing through her work in Belfast and Edinburgh. Born to a notable medical family, Pirrie's inclination toward nursing was influenced by her father's profession. She trained at the Liverpool Royal Infirmary and was mentored by Florence Nightingale, whose guidance shaped her nursing philosophy and practices. Notably, Pirrie's role in the Belfast Union Workhouse Infirmary was transformative; she championed the implementation of standardized nursing uniforms, enhancing the professional standing and recognition of nurses. Her efforts led to the establishment of a formal nursing training program in Belfast, despite facing significant resistance and challenges. In 1894, Pirrie moved to Edinburgh to become the First Matron at the Lady Grisell Baillie Memorial Hospital. Her tenure there was marked by significant advancements in nursing education, including the establishment of a community and district nursing department. By the end of her service, over 140 nurses had been trained, with many pursuing international missions. Despite her resignation in 1914 due to health issues, Pirrie continued her work as the superintendent of the Deaconess Rest Home in Edinburgh until her death in 1929. Her legacy is commemorated by a statue at Belfast City Hospital and a plaque at Greyfriars' Charteris Sanctuary, reflecting her profound impact on nursing education and the professionalization of the field.

The Critical Need for Disaster Medicine in Modern Medical Education.

Current escalation of natural disasters, pandemics, and humanitarian crises underscores the pressing need for inclusion of disaster medicine in medical education frameworks. Conventional medical training often lacks adequate focus on the complexities and unique challenges inherent in such emergencies. This discourse advocates for the integration of disaster medicine into medical curricula, highlighting the imperative to prepare health-care professionals for an effective response in challenging environments. These competencies encompass understanding mass casualty management, ethical decision-making amidst resource constraints, and adapting health-care practices to varied emergency contexts. Therefore, we posit that equipping medical students with these specialized skills and knowledge is vital for health-care delivery in the face of global health emergencies.

Sir William Macewen (1848-1924): Pioneering the Field of Neurosurgery with Early Breakthroughs in Tumor Resection.

Sir William Macewen, a Scottish surgeon, made significant contributions to neurosurgery, beginning with his successful brain tumor resection in 1879. Born in 1848, Macewen's upbringing in a maritime family fostered a practical approach to learning. Macewen's pivotal brain tumor surgery demonstrated his adherence to antiseptic practices and precise localization techniques. Controversy arose regarding his precedence in neurosurgery, which he addressed through meticulous documentation and public presentations. His diagnostic prowess extended to cases of cerebral abscesses and intracranial conditions, relying on clinical observations rather than imaging technology. His 1893 monograph on brain infections remains influential in neurosurgery. Beyond neurosurgery, Macewen was innovative in asepsis, hernia repair, and bone surgery. His legacy as a clinical educator and advocate for surgical advancements earned him widespread recognition. This historical review aimed to explore and evaluate the published literature regarding Macewen's early brain tumor surgeries, seeking to establish his precedence over later surgeons including Godlee and Bennett.

Examining the provision of renal denervation therapy in low- and middle-income nations: Current landscape, challenges, future prospects-A mini perspective review.

This paper delves into Renal Denervation Therapy as a promising intervention for resistant hypertension in low- and middle-income countries. With rates of hypertension increasing in LMICs due to lifestyle factors, RDN presents a potentially transformative approach. The methodology involves a comprehensive literature review, focusing on studies in LMICs that unveil proactive developments in standardized guidelines and precision targeting in clinical trials. LMICs actively contribute to research, emphasizing the safety and efficacy of RDN. However, despite these strides, the current landscape reveals challenges, encompassing initial costs, economic disparities, and limitations in healthcare infrastructure. Despite these hurdles, the paper envisions promising future prospects, emphasizing innovative strategies for cost-effective RDN implementation. It advocates for global collaboration and partnerships with international organizations, proposing the expansion of the Global SYMPLICITY Registry to include more LMICs; a testament to a commitment to research advancement. The paper concludes by highlighting comprehensive strategies to overcome challenges, making RDN financially viable in resource-limited settings. It underscores the potential for RDN to enhance global healthcare outcomes, particularly in regions grappling with diverse economic and healthcare challenges.

Evolving perspectives in reverse cardio-oncology: A review of current status, pathophysiological insights, and future directives.

Cardiovascular disease (CVD) and cancer are leading causes of mortality worldwide, traditionally linked through adverse effects of cancer therapies on cardiovascular health. However, reverse cardio-oncology, a burgeoning field, shifts this perspective to examine how cardiovascular diseases influence the onset and progression of cancer. This novel approach has revealed a higher likelihood of cancer development in patients with pre-existing cardiovascular conditions, attributed to shared risk factors such as obesity, a sedentary lifestyle, and smoking. Underlying mechanisms like chronic inflammation and clonal hematopoiesis further illuminate the connections between cardiovascular ailments and cancer. This comprehensive narrative review, spanning a broad spectrum of studies, outlines the syndromic classification of cardio-oncology, the intersection of cardiovascular risk factors and oncogenesis, and the bidirectional dynamics between CVD and cancer. Additionally, the review also discusses the pathophysiological mechanisms underpinning this interconnection, examining the roles of cardiokines, genetic factors, and the effects of cardiovascular therapies and biomarkers in cancer diagnostics. Lastly, it aims to underline future directives, emphasising the need for integrated healthcare strategies, interdisciplinary research, and comprehensive treatment protocols.

Bridging Minds and Machines: The Recent Advances of Brain-Computer Interfaces in Neurological and Neurosurgical Applications.

Brain-computer interfaces (BCIs), a remarkable technological advancement in neurology and neurosurgery, mark a significant leap since the inception of electroencephalography in 1924. These interfaces effectively convert central nervous system signals into commands for external devices, offering revolutionary benefits to patients with severe communication and motor impairments due to a myriad of neurological conditions like stroke, spinal cord injuries, and neurodegenerative disorders. BCIs enable these individuals to communicate and interact with their environment, using their brain signals to operate interfaces for communication and environmental control. This technology is especially crucial for those completely locked in, providing a communication lifeline where other methods fall short. The advantages of BCIs are profound, offering autonomy and an improved quality of life for patients with severe disabilities. They allow for direct interaction with various devices and prostheses, bypassing damaged or nonfunctional neural pathways. However, challenges persist, including the complexity of accurately interpreting brain signals, the need for individual calibration, and ensuring reliable, long-term use. Additionally, ethical considerations arise regarding autonomy, consent, and the potential for dependence on technology. Despite these challenges, BCIs represent a transformative development in neurotechnology, promising enhanced patient outcomes and a deeper understanding of brain-machine interfaces.

Intracerebral haemorrhage in multiple sclerosis: assessing the impact of disease-modifying medications.

Multiple Sclerosis (MS) is a complex autoimmune disorder that significantly impacts the central nervous system, leading to a range of complications. While intracranial haemorrhage (ICH) is a rare but highly morbid complication, more common CNS complications include progressive multifocal leukoencephalopathy (PML) and other CNS infections. This severe form of stroke, known for its high morbidity and mortality rates, presents a critical challenge in the management of MS. The use of disease-modifying drugs (DMDs) in treating MS introduces a nuanced aspect to patient care, with certain medications like Dimethyl Fumarate and Fingolimod showing potential in reducing the risk of ICH, while others such as Alemtuzumab and Mitoxantrone are associated with an increased risk. Understanding the intricate relationship between these DMDs, the pathophysiological mechanisms of ICH, and the individualised aspects of each patient's condition is paramount. Factors such as genetic predispositions, existing comorbidities, and lifestyle choices play a crucial role in tailoring treatment approaches, emphasising the importance of a personalised, vigilant therapeutic strategy. The necessity for ongoing and detailed research cannot be overstated. It is crucial to explore the long-term effects of DMDs on ICH occurrence and prognosis in MS patients, aiming to refine clinical practices and promote patient-centric, informed therapeutic decisions. This approach ensures that the management of MS is not only comprehensive but also adaptable to the evolving understanding of the disease and its treatments.

Immunotherapeutic advances in glioma management: The rise of vaccine-based approaches.

BACKGROUND: Gliomas, particularly glioblastoma multiforme (GBM), are highly aggressive brain tumors that present significant challenges in oncology due to their rapid progression and resistance to conventional therapies. Despite advancements in treatment, the prognosis for patients with GBM remains poor, necessitating the exploration of novel therapeutic approaches. One such emerging strategy is the development of glioma vaccines, which aim to stimulate the immune system to target and destroy tumor cells. AIMS: This review aims to provide a comprehensive evaluation of the current landscape of glioma vaccine development, analyzing the types of vaccines under investigation, the outcomes of clinical trials, and the challenges and opportunities associated with their implementation. The goal is to highlight the potential of glioma vaccines in advancing more effective and personalized treatments for glioma patients. MATERIALS AND METHODS: This narrative review systematically assessed the role of glioma vaccines by including full-text articles published between 2000 and 2024 in English. Databases such as PubMed/MEDLINE, EMBASE, the Cochrane Library, and Scopus were searched using key terms like "glioma," "brain tumor," "glioblastoma," "vaccine," and "immunotherapy." The review incorporated both pre-clinical and clinical studies, including descriptive studies, animal-model studies, cohort studies, and observational studies. Exclusion criteria were applied to omit abstracts, case reports, posters, and non-peer-reviewed studies, ensuring the inclusion of high-quality evidence. RESULTS: Clinical trials investigating various glioma vaccines, including peptide-based, DNA/RNA-based, whole-cell, and dendritic-cell vaccines, have shown promising results. These vaccines demonstrated potential in extending survival rates and managing adverse events in glioma patients. However, significant challenges remain, such as therapeutic resistance due to tumor heterogeneity and immune evasion mechanisms. Moreover, the lack of standardized guidelines for evaluating vaccine responses and issues related to ethical considerations, regulatory hurdles, and vaccine acceptance among patients further complicate the implementation of glioma vaccines. DISCUSSION: Addressing the challenges associated with glioma vaccines involves exploring combination therapies, targeted approaches, and personalized medicine. Combining vaccines with traditional therapies like radiotherapy or chemotherapy may enhance efficacy by boosting the immune system's ability to fight tumor cells. Personalized vaccines tailored to individual patient profiles present an opportunity for improved outcomes. Furthermore, global collaboration and equitable distribution are critical for ensuring access to glioma vaccines, especially in low- and middle-income countries with limited healthcare resources CONCLUSION: Glioma vaccines represent a promising avenue in the fight against gliomas, offering hope for improving patient outcomes in a disease that is notoriously difficult to treat. Despite the challenges, continued research and the development of innovative strategies, including combination therapies and personalized approaches, are essential for overcoming current barriers and transforming the treatment landscape for glioma patients.

Empowering health care consumers & understanding patients' perspectives on AI integration in oncology and surgery: A perspective.

Introduction: Artificial intelligence (AI) is transforming oncology and surgery by improving diagnostics, personalizing treatments, and enhancing surgical precision. Patients appreciate AI for its potential to provide accurate prognoses and tailored therapies. However, AI's implementation raises ethical concerns, data privacy issues, and the need for transparent communication between patients and health care providers. This study aims to understand patients' perspectives on AI integration in oncology and surgery to foster a balanced and patient-centered approach. Methods: The study utilized a comprehensive literature review and analysis of existing research on AI applications in oncology and surgery. The focus was on examining patient perceptions, ethical considerations, and the potential benefits and risks associated with AI integration. Data was collected from peer-reviewed journals, conference proceedings, and expert opinions to provide a broad understanding of the topic. The perspectives of patients was also emphasized to highlight the nuances of their acceptance and concerns regarding AI in their health care. Results: Patients generally perceive AI in oncology and surgery as beneficial, appreciating its potential for more accurate diagnoses, personalized treatment plans, and improved surgical outcomes. They particularly value AI's role in providing timely and precise diagnostics, which can lead to better prognoses and reduced anxiety. However, concerns about data privacy, ethical implications, and the reliability of AI systems were prevalent. Consequently, trust in AI and health care providers was deemed as a crucial factor for patient acceptance. Additionally, the need for transparent communication and ethical safeguards was also highlighted to address these concerns effectively. Conclusion: The integration of AI in oncology and surgeryholds significant promise for enhancing patient care and outcomes. Patients view AI as a valuable tool that can provide accurate prognoses and personalized treatments. However, addressing ethical concerns, ensuring data privacy, and building trust through transparent communication are essential for successful AI integration. Future initiatives should focus on refining AI algorithms, establishing robust ethical guidelines, and enhancing patient education to harmonize technological advancements with patient-centered care principles.