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1.
J Nepal Health Res Counc ; 19(2): 246-251, 2021 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-34601511

RESUMO

BACKGROUND: Destructive ocular surgeries are performed for many conditions ranging from trauma to tumours, where the eyes cannot be salvaged. The objective of our research was to study the profile of destructive ocular surgery and their indications. METHODS: This retrospective study reviewed all patients who underwent evisceration, enucleation, and exenteration at B.P. Koirala Institute of Health Sciences, a tertiary eye hospital in Eastern Nepal, between January 2008 and December 2019. Medical records on patient demographics, type of surgery performed, and an indication of surgery during the study period were reviewed. RESULTS: One hundred thirty-four patients underwent destructive ocular surgeries. The median age of patients undergoing surgery was 14.5 (3-50) years. Children aged ten years or less accounted for 46.3% of the total patients. Fifty-two percent were male. The left eye was affected in more than half of the cases (56.7%). Enucleation was the most performed destructive ocular surgery (76 cases, 56.7%). Intraocular and ocular adnexal malignancy was the most common overall indication (62 cases, 46.3%). Ocular infection (19 cases, 41.3%) and trauma (15 cases, 32.6%) were the most common indication of evisceration. Retinoblastoma accounted for most cases of enucleation (43 cases, 56.6%). Malignancy was the only indication of exenteration (12 cases, 100%). CONCLUSIONS: Enucleation was the most common destructive ocular surgery. Malignancy accounted for most of the cases of destructive eye surgery, followed by ocular infection. Ocular infection and trauma were the most common indication of evisceration, whereas retinoblastoma and eyelid malignancy were responsible for most of the cases of enucleation and exenteration, respectively.


Assuntos
Neoplasias da Mama , Medicina , Adolescente , Adulto , Criança , Humanos , Masculino , Pessoa de Meia-Idade , Nepal/epidemiologia , Estudos Retrospectivos , Centros de Atenção Terciária , Adulto Jovem
2.
J Nepal Health Res Counc ; 19(2): 439-440, 2021 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-34601549

RESUMO

Medical humanities use the creative and intellectual strengths of the arts for specific purposes in medical education. The author read with great interest the Medical humanities program at the Patan Academy of Health Sciences and has been associated with Medical humanities since 2007. There are several factors favouring the development of Medical humanities in Nepal but the major challenge is there is no specific faculty and/or department involved and the discipline may be relegated to the background in the face of other pressing priorities. In the west humanities faculty had played an important role in popularizing Medical humanities. Clinical teachers can incorporate Medical humanities into their clinical teaching. Large student sizes and lesser number of faculty may be challenges in moving the discipline forward. Keywords: Medical humanities, medical schools, Nepal, undergraduate medical.


Assuntos
Educação Médica , Medicina , Ciências Humanas , Humanos , Nepal , Faculdades de Medicina
3.
Arch Esp Urol ; 74(8): 736-746, 2021 Oct.
Artigo em Espanhol | MEDLINE | ID: mdl-34605413

RESUMO

INTRODUCTION AND OBJECTIVES:  Multiple chemical sensitivity (MCS) is a multi-symptomatic systemic disease whose genitourinary symptoms are poorly known. The aim of this article is to study these symptoms in Spanish publications. MATERIALS AND METHODS: A retrospective study of descriptive type on the genitourinary symptoms of MCS is carried out in the Spanish publications between the years 2000 and 2019. The search in Medline was performed with MeSH terms "multiple chemical sensitivity Spanish" and in Google with free terms "sensibilidad química multiple España". In the publications found, only those referring to genitourinary symptoms were selected, in which year, authors, type of article (clinical case, review, casuistry), genital symptoms, urinary symptoms, specialty, hospital or centre and city were studied. The results of these variables have been analyzed with descriptive statistics. RESULTS: We found 45 Spanish publications on MCS of which 20 (44,4%) mentioned genitourinary symptoms. The 20 articles corresponded to 7 clinical cases, 6 reviews, 2 case series, 2 updates, 1 book chapter, 1 special article and 1 consensus document. We found 12 publications on female genital symptoms (60%), 12 on urinary symptoms (60%) and 4 on male genital symptoms (20%). The specialties with the highest number of publications were Family Medicine and Psychiatry with 3 (15%) and Neumology, Toxicology and Anesthesia and Resuscitation with 2 (10%). There are publications from 13 hospitals and 7 national centers, health agencies or foundations. The publications corresponded to 10 cities, the 2 with the most publications being Madrid with 6 (30%) and Barcelona with 6 (30%). CONCLUSIONS: The genitourinary symptoms of MCS are mentioned in about half of the Spanish publications. There is a clear predominance of these symptoms in women. This "genitourinary syndrome" should be taken into account in urological and gynecological patients with MCS.


Assuntos
Medicina , Sensibilidade Química Múltipla , Feminino , Humanos , Masculino , Estudos Retrospectivos , Espanha
4.
Washington, D.C.; PAHO; 2021-10-14.
Não convencional em Inglês | PAHO-IRIS | ID: phr-54995

RESUMO

The acquisition of antimicrobials without a prescription is a global concern. This practice is thriving in countries that lack adequate legislation or where regulations are not properly enforced. The Pan American Health Organization (PAHO) and its member states in the Region of the Americas approved the Global Action Plan on Antimicrobial Resistance, which recognizes antimicrobial resistance as a threat to global public health that requires a multisectoral response. To tackle antimicrobial resistance, a worldwide change in behavior is needed in terms of how these drugs are used and acquired. National approaches are required to address the indiscriminate use and over-prescription of antimicrobials, and to enforce regulations on prescription and acquisition practices. The objective of this communication handbook is to help communication professionals and health program officials develop strategies to raise awareness and promote the importance of the appropriate use of antimicrobials among different stakeholders; raise public awareness about the importance of obtaining antimicrobials with a prescription in order to achieve multisectoral collaboration to ensure compliance with laws and regulations on this issue; and promote a change in behavior regarding the appropriate use and acquisition of antimicrobials by everyone involved. The target audiences for this handbook are the general population (including adolescents, children, and child caregivers/parents of children), healthcare professionals (including pharmacists and pharmacy staff), and various stakeholders (government officials, professional societies, medical organizations, the private sector, local leaders, and health-influencers, among others).


Assuntos
Resistência a Medicamentos , Resistência Microbiana a Medicamentos , Medicina , Acesso a Medicamentos Essenciais e Tecnologias em Saúde , Gestão de Ciência, Tecnologia e Inovação em Saúde , Sistemas de Saúde , Saúde Pública , Programas Nacionais de Saúde
5.
Orphanet J Rare Dis ; 16(1): 406, 2021 09 30.
Artigo em Inglês | MEDLINE | ID: mdl-34593011

RESUMO

Epidermolysis bullosa (EB) is characterized by skin fragility with blister formation occurring spontaneously or following minor trauma such as gentle pressure or friction. Current physiotherapy practice is based on anecdotal care, clinical expertise and creative problem solving with caregivers and individuals with EB. Evidence based intervention is needed to establish a foundation of knowledge and to guide international practitioners to create and improve standards of care to effectively work with individuals living with EB. This clinical practice guideline (CPG) was created for the purpose of providing evidence based interventions and best clinical practices for the physiotherapy management of individuals with EB. A survey was conducted within the EB community and six outcomes were identified as a priority to address in physiotherapy management, including (1) attaining developmental motor milestones, (2) identifying safe and functional mobility in the natural environment, (3) encouraging ambulation endurance, (4) supporting safe ability to bear weight, (5) improving access to physiotherapy services, and (6) optimizing interaction with the community. A systematic literature review was conducted and articles were critically analyzed by an international panel consisting of thirteen members: healthcare professionals (including physiotherapist, doctors, and occupational therapist), caregivers, and individuals with EB. Recommendations were formulated from evidence and panel consensus. An external panel of twelve were invited to improve the quality and gather feedback on draft manuscript and recommendations. This CPG describes the development of recommendations for physiotherapy management including several best practice interventions. This guideline lays the foundational work for physiotherapist throughout the world to provide high quality services while improving and maintaining functional mobility and independence within the EB community. The CPG outlines limitations in the evidence available and possible future research needed to improve physiotherapy practice.


Assuntos
Epidermólise Bolhosa , Medicina , Médicos , Vesícula , Epidermólise Bolhosa/terapia , Humanos , Modalidades de Fisioterapia
6.
Adv Exp Med Biol ; 1336: 179-213, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34628633

RESUMO

Metabolomics is a discipline that offers a comprehensive analysis of metabolites in biological samples. In the last decades, the notable evolution in liquid chromatography and mass spectrometry technologies has driven an exponential progress in LC-MS-based metabolomics. Targeted and untargeted metabolomics strategies are important tools in health and medical science, especially in the study of disease-related biomarkers, drug discovery and development, toxicology, diet, physical exercise, and precision medicine. Clinical and biological problems can now be understood in terms of metabolic phenotyping. This overview highlights the current approaches to LC-MS-based metabolomics analysis and its applications in the clinical research.


Assuntos
Medicina , Metabolômica , Cromatografia Líquida , Espectrometria de Massas , Metaboloma
7.
Rev Med Chil ; 149(4): 602-616, 2021 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-34479349

RESUMO

Among the several programs that allow access to medical specialization in Chile, the National Health Services System Entrance Contest (CONISS) is held annually for newly graduated physicians, which has a high number of applicants. The academic qualifications expressed as National Medical Qualification (CMN) are the main item of the scoring system. We reviewed the total scores and the CMN of the different medical specialization programs that exist in the country, which constitutes novel and relevant information for future medical graduates interested in applying to the program. In addition, the quotas of the different programs are reported, expressed as total, free, and used quotas.


Assuntos
Internato e Residência , Medicina , Médicos , Chile , Humanos , Especialização , Medicina Estatal
8.
BMC Med Educ ; 21(1): 474, 2021 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-34488738

RESUMO

BACKGROUND: In health professions, the curriculum that must be met in order to obtain the academic certificate is based on the development of the so-called competencies. The broad content of the Practicum of the Degree of Physiotherapy has led to the creation of multiple types of evaluation, which makes it difficult for faculty members to reach a consensus on competencies. The aim of this study was to develop and validate content of a rubric for the evaluation of acquired competencies related to physiotherapeutic performance and intervention in traumatology within the Practicum of the Degree of Physiotherapy. METHODS: Following the Delphi methodology, a group of experts from all over the Spanish territory participated in the study. Through on-line questionnaires, several sequential rounds were established, alternated by controlled feedback until obtaining a consensus in the opinion of the experts, which allowed elaborating the final rubric. RESULTS: Initially, 16 experts were contacted, of whom 10 worked and completed the final content of the rubric. For the 3 rounds that were conducted, the initial 142 interventions of the initial proposition, which correspond to specific competencies, were reduced to the final 29 items that compose the specific evaluation rubric presented in this study. CONCLUSIONS: This rubric is an evaluation instrument with valid content for the assessment of specific competencies of Traumatology in the Practicum of the Degree of Physiotherapy.


Assuntos
Medicina , Traumatologia , Competência Clínica , Currículo , Técnica Delfos , Humanos , Modalidades de Fisioterapia
9.
Zhongguo Zhen Jiu ; 41(9): 961-4, 2021 Sep 12.
Artigo em Chinês | MEDLINE | ID: mdl-34491643

RESUMO

Four early lectures of Acupuncture and Moxibustion (1955-1956) in Nanjing University of Chinese Medicine were systematically analyzed and compared. As a result, it is found that it has established a modern acupuncture discipline framework with basic knowledge, basic operation and clinical application as modules. It has not only reflected the modernity exploration of the predecessors, but also presented the evolution and solidification of the modern discipline framework, which provided important reference for understanding and reconstructing the contemporary acupuncture discipline framework.


Assuntos
Terapia por Acupuntura , Acupuntura , Medicina , Moxibustão , Instituições Acadêmicas
10.
Adv Exp Med Biol ; 1334: 181-204, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34476750

RESUMO

The anatomical collections at the National Museum of Health and Medicine (NMHM) contain skeletal specimens that highlight the history of military and civilian medicine dating from the American Civil War and the founding of the museum as the Army Medical Museum in 1862. Today, NMHM curates over 6400 gross skeletal specimens consisting primarily of pathological or anomalous single bone elements that display a variety of pathological conditions, including congenital anomalies, neoplasms, healed and unhealed trauma and infectious diseases, and surgical interventions such as amputations and excisions. In an effort to increase accessibility to these pathological specimens, NMHM is collaborating with Virginia Commonwealth University (VCU) and the Laboratory Division of the Federal Bureau of Investigation (FBI) to digitize and disseminate high-quality 3D models via online portals, enabling scholars and educators to manipulate, analyze, and 3D print the models from anywhere in the world. Many institutions with courses in paleopathology and forensic anthropology do not have reference collections or access to museum collections for hands-on teaching. Therefore a digital repository of osteological specimens can provide an unprecedented and unique resource of exemplars for scholars and educators. The sharing of these military medical assets improves historical knowledge and diagnostic capabilities in the fields of medicine and anthropology. This chapter outlines the digitization processes that are being utilized to increase access to these pathological skeletal specimens through multimodal 3D capture.


Assuntos
Medicina , Militares , Osso e Ossos , Humanos , Laboratórios , Museus
11.
South Med J ; 114(9): 593-596, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34480193

RESUMO

OBJECTIVES: Since the onset of the coronavirus disease 2019 (COVID-19) pandemic, many US clinics have shifted some or all of their practice from in-person to virtual visits. In this study, we assessed the use of telehealth among primary care and specialty clinics, by targeting healthcare administrators via multiple channels. METHODS: Using an online survey, we assessed the use of, barriers to, and reimbursement for telehealth. Respondents included clinic administrators (chief executive officers, vice presidents, directors, and senior-level managers). RESULTS: A total of 85 complete responses were recorded, 79% of which represented solo or group practices and 63% reported a daily patient census >50. The proportion of clinics that delivered ≥50% of their consults using telehealth increased from 16% in March to 42% in April, 35% in May, and 30% in June. Clinics identified problems with telehealth reimbursement; although 63% of clinics reported that ≥75% of their telehealth consults were reimbursed, only 51% indicated that ≥75% of their telehealth visits were reimbursed at par with in-person office visits. Sixty-five percent of clinics reported having basic or foundational telehealth services, whereas only 9% of clinics reported advanced telehealth maturity. Value-based care participating clinics were more likely to report advanced telehealth services (27%), compared with non-value-based care clinics (3%). CONCLUSIONS: These findings highlight the adaptability of clinics to quickly transition and adopt telehealth. Uncertainty about reimbursement and policy changes may make the shift temporal, however.


Assuntos
COVID-19/prevenção & controle , Medicina/estatística & dados numéricos , Serviços de Saúde Mental/estatística & dados numéricos , Atenção Primária à Saúde/estatística & dados numéricos , Telemedicina/estatística & dados numéricos , Pesquisas sobre Serviços de Saúde , Humanos , Medicina/métodos , Atenção Primária à Saúde/métodos , SARS-CoV-2 , Telemedicina/métodos , Texas
12.
BMC Med Educ ; 21(1): 487, 2021 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-34507587

RESUMO

BACKGROUND: Empathy is an important competence in the professional development of medical students. The purpose of our study was to compare the levels and scales of empathy in people studying in different educational strategies. METHODS: The study was conducted between April 2019 and March 2020. Medicine, nursing, midwifery, physiotherapy, psychology, pedagogy and sociology students were the participants of this study. University students preparing for medical professions (n = 1001) and students of programs unrelated to medicine (n = 700) underwent the Empathy Quotient test (EQ-40). We have compared results in both study groups with the use of the distribution of density, analysis of variance and student's t-test. RESULTS: The average results received by students of the university preparing for medical professions were lower (M = 42.6) than those of the non-medical university students (M = 45.3) and the differences between the universities turned out to be statistically important (t = - 5.15, df = 1699, p < 0.001). As many as 14.6% of the students in the 1st EQ class were preparing for various medical professions while 9% studied social sciences. 18.2% of all medical programme students (n = 412) manifested the lowest empathy class. Our research has revealed that the students with Asperger profile (AP) and high-functioning autism (HFA) studied at universities preparing for medical professions (n = 18) more frequently than at non-medical universities (n = 5). CONCLUSIONS: We have noticed a serious indicator of erosion in the levels of empathy in medical students and an increase in the number of people with AP and HFA. Empathy decreases in students after the third year of their studies, regardless of the kind of university. We recommend an introduction of career counselling when specialization is being chosen.


Assuntos
Educação de Graduação em Medicina , Medicina , Estudantes de Medicina , Estudos Transversais , Empatia , Humanos
13.
Artigo em Russo | MEDLINE | ID: mdl-34486873

RESUMO

The article considers issues of actual discussion about "death of history of medicine". For a long time, history of medicine was set out the task to substantiate triumph of one national model and tradition over another one and "to place the past at the service of the future". For example, Richard Horton, the editor-in-chief of The Lancet, believes that historians of medicine in no way respond to such problems of today as commercialization of medicine, drug abuse, paralysis in public health, catastrophic failures in patient care. He assumes this fact being true sign of that the history of medicine "is creeping towards scientific cemetery". Another reason for appearance of "obituaries" of history of medicine is the regular fact that classical courses almost exclusively consisted of narratives about great physicians and progress of medical science and practice. Moreover, the "medical" history of medicine if is not killed then is severely wounded by arrows flying from all sides - accusations in mistakes, indications on blind spots, myths and deliberate distortion of facts. The analysis of above-listed problems the proposals were developed concerning possible ways of revising academic course according modern requirements: training in the field of critical thinking, communication skills, oral speech and written language, academic writing. These tasks can be achieved by involving materials from museums of history of medicine, museums of universities and medical institutions, by collaboration with historical sources, databases of scientific publications and by engaging invited lecturers of various specialties working with historical and medical topics within the framework of other methodologies.


Assuntos
Medicina , História da Medicina , História do Século XX , Humanos , Museus
15.
Lakartidningen ; 1182021 Aug 11.
Artigo em Sueco | MEDLINE | ID: mdl-34498245

RESUMO

Predatory journals exploit researchers' desire for a fast review process and quick publication; this is achieved at the expense of proper scientific review and high publication costs for the authors. During the last decade, international consensus on what characterises predatory journals and publishers has emerged. The proportion of health sciences articles published in predatory journals is around 2 per cent, considerably lower than in other life sciences and social sciences.  In health sciences, China has the highest proportion of articles published in predatory journals. The phenomenon is widespread both in terms of health disciplines and geography; there are examples of Swedish health science being infiltrated. In The European Code of Conduct for Research Integrity, supporting predatory journals is characterised as an unacceptable practice. There are now tools to be used by researchers who want to avoid publishing in predatory journals.


Assuntos
Medicina , Publicações Periódicas como Assunto , Consenso , Humanos , Editoração , Pesquisadores
16.
Stud Health Technol Inform ; 283: 3-11, 2021 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-34545814

RESUMO

Since 2017, the German Society for Medical Informatics, Biometry and Epidemiology e.V. (GMDS) offers the submission of full papers to the annual meetings, optional in Studies in Health Technologies and Informatics (Stud HIT) or in GMS Medical Informatics, Biometrics, and Epidemiology (MIBE). GMDS' aim is to increase the attractiveness of the conference and paper submission process in particular for young scientists and to increase the visibility of the conference. A standardized peer review process was established. Since 2017, a 25-35% of the contributions have been submitted as full papers. A total of 177 papers were published in Stud HTI. With an unofficial journal impact factor of 1.088 (2019) and 0.540 (2020), the papers were cited with a frequency similarly to national medical journals or full paper contributions of International medical informatics conferences.


Assuntos
Informática Médica , Medicina , Tecnologia Biomédica , Ciência de Dados , Fator de Impacto de Revistas
17.
J Pak Med Assoc ; 71(9): 2237-2243, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34580521

RESUMO

This literature review explores the current issues and historical aspects of the problems faced by female medical students and doctors in Pakistan. The literature search comprised PubMed, Education Resources Information Centre and Google Scholar databases to look for resources from education as well as from health sector from 2009 to 2020. Due to lack of local literature on the subject, it was tried to make sense of the career barriers and enablers they face considering the underlying theory and evidence from other countries. Keeping the Pakistani context in view, it explored the interventions adopted in other countries to help reduce the gender-based issues which have resulted in the facilitation of women in health education and healthcare systems. The major gender issues identified were unequal representation of female doctors in leadership positions and in some specialties, work-life imbalances, socio-cultural norms and lack of professional development opportunities.


Assuntos
Medicina , Médicos , Estudantes de Medicina , Feminino , Humanos , Liderança , Paquistão
18.
Zhongguo Zhong Yao Za Zhi ; 46(17): 4575-4580, 2021 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-34581064

RESUMO

This study analyzed the advantages and disadvantages of existing animal models in China and abroad and their goodness of fit based on the clinical characteristics and diagnostic criteria of stable chronic obstructive pulmonary disease(COPD) in traditional Chinese medicine(TCM) and western medicine, followed by the collation and summarization of model evaluation methodologies. The results showed that the existing animal models of stable COPD were mainly modeled via smoke exposure or the combination of multiple methods like smoke exposure plus lipopolysaccharide or protease or bacterial infection. These animal models generally failed to simulate the clinical characteristics of TCM, and their goodness of fit in western medicine was higher than that in TCM. There is a lack of research on the animal models of stable COPD and the disease-syndrome combination models. Although the modeling is guided by the pathogenesis or mechanism of diseased humans, the established models were still not identical with the actual clinical situations. In-depth research is needed to develop quantitative standards for stable COPD models.


Assuntos
Medicamentos de Ervas Chinesas , Medicina , Doença Pulmonar Obstrutiva Crônica , Animais , Modelos Animais de Doenças , Humanos , Medicina Tradicional Chinesa , Modelos Animais , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Síndrome
20.
Ned Tijdschr Geneeskd ; 1652021 09 13.
Artigo em Holandês | MEDLINE | ID: mdl-34523841

RESUMO

Due to the rapid technical development and increasing availability of diagnostic tests, the use of diagnostics by general practitioners and medical specialists is increasing. However, the excessive use of diagnostic tests is also explained by the behavior of the doctors as well as patients. In this Perspective we outline factors that perpetuate excessive use of diagnostic tests, further fuelling overdiagnosis. Solutions to achieve a sustainable culture of more sensible and cost effective diagnostics in both primary and secondary care will have to focus on a combination of factors, in which behavioral interventions for doctors and public information for citizens should play an important role. Worldwide movements such as Too Much Medicine, Choosing Wisely, but also the Dutch 'Doen of Laten' campaign can support this. It will take brave doctors, informed patients, and a supportive work culture.


Assuntos
Clínicos Gerais , Medicina , Atenção , Análise Custo-Benefício , Humanos , Sobremedicalização
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