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This is with reference to a patient suffering from low hemoglobin (as low as 4-5) for over a decade. With blood transfusion or medication (including some injections etc.), the hemoglobin rises slowly to 7-8-9 but then again has a tendency to fall back. What could be the reason?
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In case of anemia, a logic route must be started:
1. What are the age and sex of the patient?
2. Is this anemia regenerative (increased reticulocytes count) or hypo-regenerative (decreased reticulocytes count)?
3. What are the morphological features of anemia? Normo-, macro (megalo)-, microcytic? Normo-, hypochromic?
4. What are the biochemical parameters associated with? (haptoglobin, LDH, bilirubin)
5. Iron balance? B12 and folate?
6. It is possible to postulate (or exclude) a chronic disorder? (Tumor, inflammation, infection; autoimmune diseases)
7. Are the other cellular lines involved? (cytopenia; dysplasia)
Based on the above results, a bone marrow aspiration could be performed, to check (in primis) for an erythroblastopenic situation (Diamond-Blackfan anemia if case of paediatric patient; tymoma; idiopathic pure red cells aplasia and other in case of adult patient).
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The question is with reference to a patient suffering from differential body temperature, her right side (particularly the hand) occasionally being substantially colder than the left.
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I agree with Ishag it normally is vascular in nature. That being said having carpel tunnel syndrome one of the symptoms is a decrease in temperature compared to the other hand.
If it is severe it could be Subclavian steal syndrome (SSS), also called subclavian steal phenomenon or subclavian steal steno-occlusive disease, is a constellation of signs and symptoms that arise from retrograde (reversed) blood flow in the vertebral artery or the internal thoracic artery, due to a proximal stenosis (narrowing) and/or occlusion of the subclavian artery. The arm may be supplied by blood flowing in a retrograde direction down the vertebral artery at the expense of the vertebrobasilar circulation. This is called the subclavian steal. It is more severe than typical vertebrobasilar insufficiency.
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Is the Homoeopathic remedy a placebo or has any medicinal effect?
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For excellent informations and references on research in 顺心彩票opathy, go to: https://www.hri-research.org
See their FAQs also.
A perfect read to treat ignorance : Bornh?ft, G. et P. Matthiessen (eds) (2011). Homeopathy in Healthcare. Effectiveness, Appropriateness, Safety, Costs, Berlin, Springer-Verlag, 234 p.
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All living beings are movable water reservoirs in which the same energy pulses. In these reservoirs, energy creates chloroplasts, proteins, cells with all organs, tissues and organs, and maintains what we call life. When water does not have the ability to store the energy of, life forms we would know there would not be.
Water is the greatest secret of our time!
The established scientific world today acknowledged that water, without which there is no life, is very little known and that it is rather unexplored in many aspects. Because of this it is considered that she hides many "secrets". It turned out that some of the water theories, which arose about 2,000 years ago, are worth more than those set by the modern scientific elite.
Water is unpredictable in its behavior, and the way in which its molecules are restructured and today are a great "mystery".
In academic discussions, such phenomena are said to be "the wonder of nature" or "the secret of nature." It is obvious that the matter for which science has no explanation for now or at least the so-called "expert public" is not familiar with it. The term often used in this context is a "supernormal phenomenon".
But what can be above nature?
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Thanks Sir Cyril for honest comment. Perhaps it would be helpful to recommend this topic to your colleagues that you think might be included in the discussion?
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Why or why not?
Some philosophers maintain that science is morally neutral, while other philosophers maintain that science produces morality.
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Yes. Most moral questions are oversimplified strategic questions. Doing X is amoral because doing X has side effects and long term effects which, if taking into account, would make doing X stupid from point of view of your own interests. For people unable to think all the time about such side effects and long term consequences it makes sense to simplify the question by a moral which names the type of behavior which has such harmful consequences amoral. But this does not change the point that what defines this moral are pragmatic, strategic questions: What is the best way to behave given my own interests? And for answering this question, science is certainly helpful. Because it helps to find out what are these consequences.
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This question warrants a response from the general medical and academic community since this is a new genre of medicine that is building exponentially in impact on health care services nationwide.
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Health Information System Journals – 2016 Rankings
A study was performed in 2016, when AIS-SIG-Health members were asked to recommend journals to add to the AIS Basket of Top eHealth Journals. 61 members responded to the survey. Survey Responses were ordered based on percentage of people who voted to add each journal to the basket. Please see attached PDF file of results. That should begin to answer your question.
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What is the best online database for anatomy in order to interpret articles and visualize details in a good models?
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Here are a couple of good resources I use regularly. Check out Anatomy Atlases for Anatomical Variants - You'll find all the weird anomalies here :) The University of Michigan is also a GREAT resource for all things anatomy, including radiological images, etc. The Radiology Educational Website is another place to check out. This one links to other web pages, some of which are fabulous. Others not so much. But if you are looking for something specific, it is a good place to start. The links are below :) Good Luck!
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Dear Colleagues,
Do you know of any applications that help adjust references in a manuscript to a journal's stylesheet? I am familiar with Mendeley but I was wondering whether there is program that does not require prior uploading cited papers (just as Mendeley does).
Thanks a lot!
Monika
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Dear Monika,
I recommend EndNote, and I am sure a large number of people are using it. You may be able get the application from your Uni library for free. You can initially gather your references from various sources (e.g., PubMed), and then you can set the sytle of the Journal you choose. There is a long list of journals already available there, if not, you can download them on line.
Best wishes,
Refik
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Hello,
I was looking at a couple of histological slides from a book. I was wondering if anyone knew how to determine whether a slide is from the pituitary gland just from looking at the features of the image and nothing else.
Thank you,
Timon S
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These are transmission electron micrographs - not the kind of histology appropriate for tissue identification.
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Dear all,
I am involved in a small project to investigate the way scientists communicate their work and are engaged in social media. We have created a small survey, which you can find following the link below.
The survey is anonymous, and we calculated that you would need maximum 5 minutes to complete it. I know you are all very busy, but I would be extremely grateful if you could find few minutes to complete the questionnaire.
Thank you very much for your time and your help!
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I would love to get updated with the results of the survey... How can we stay in touch?
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Antibiotics are given to safe guard against secondary bacterial infections due to reduced immunity during viral infections.
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Dear Anthony,
Microbes are already ruling the world, in practically every niche. We have more microbes living in our body than our own signature cells. All multicellular beings are like preserved food of microbes and shall finally be consigned to microbes.
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Dear Researchers,
Water is the most important element and has lot of medicinal properties, then why isn't it recognised as effective medicine?
Best regards
Devansh Mehta
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Everything depends on dosage - poison or cure
More than 1L water intake will cause a death due to effect at the cellular level
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The practice of medicine is no longer an independent arena. The art of medicine is exclusively exposed through its inherent interdisciplinary nature. Research scientists continue to elegantly discover what exists within various diseases; they inform the biomedical community of what already exists. Engineers utilize this information to create that which is yet to exist ; they develop novel tools that can be implemented into clinical practice. And the physician of the future holds the honorable responsibility of bridging the gap between these once distant worlds. A physician of the future connects the dots, and pushes the limits of what we can offer patients. A physician of the future constantly searchers for the answers through an interdisciplinary approach involving bioengineers and scientists.
Bioinformatics and open access medical data has ushered in an era of medical practice infused with information unseen hitherto. And now, the responsibility to formulate solutions to unresolved clinical problems rests within the collaborative efforts of the biomedical community.
My intense passion for propelling the progress of medical therapies has lead me on a fruitful journey throughout the world. It is clear to me that because we live in such a technologically advanced era, we simultaneously hold the noble responsibility of acting altruistically to translate technology into better cures for cancer, more effective therapies for neuropsychiatric diseases, and improved diagnostic techniques. From neurosurgery and family medicine, to lung disease and kidney failure, all sectors of medicine will need to embrace the future face of medicine.
It is clear, though:
The future of medicine has arrived. And how we respond is merely a personal choice.
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Role of Engineers in medical science is very big because every surgical equipment or anything related to medical science, it can also be medicines, everything has a contribution of Engineers. Chemical Engineers play a greater role in the field of medical science because medicines or any different experiment is only done by them.
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We're doing a study on the wound healing activity of Moringa oleifera using Sprague Dawley rats, and we are having trouble finding the exact formulas/programs to use in doing the statistical analysis for our research, most especially for the computation for the sample size appropriate for the study. (We're planning to use ANOVA + post hoc for the data that we'll be collecting)
Our study is planning to have 5 groups based on the wound regimen that we plan to apply: Negative control, Positive control (over-the-counter wound ointment), Leaves extract, Stem extract, and a leaf and stem extract combination
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How to Calculate Sample Size for Animal Studies
Please let me know if these references/sites are helpful to you:
1. How to calculate sample size in animal studies? Web ·?
How to calculate sample size in animal studies? ... To clarify this issue of sample size in animal studies, ... To calculate the sample size by power analysis a ...
2. How to calculate sample size in animal studies? (PDF ...Web ·?
Full-text (PDF) | Calculation of sample size is one of the important component of design of any research including animal studies. If a researcher select less n...
Dennis
Dennis Mazur
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how much time is it possible to keep alife a man in extracorporeal blood circulation (with the oxygen exchanger)?
what finally kill the patient?
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Extracorporeal Blood Circulation with Oxygen Exhanger and Human Life
Please let me know if these references/sites are helpful to you:
1. Profound Hypothermia for Intracranial Surgery Using a ...
Web ·?
thejns.org/doi/pdf/10.3171/jns.1965.23.2.0184
Profound Hypothermia for Intracranial Surgery Using ... flow was balanced to keep the amount of blood ... for Intracranial Surgery Using a Disposable Bubble ... Published in: Journal of Neurosurgery · 1965 Authors: Russel H Patterson · Bronson S Ray Affiliation: Cornell University · Kettering University
2. The history of extracorporeal oxygenators - Lim - 2006 ...Web ·?
Dr Lim's essay on the History of Extracorporeal ... of blood in an extracorporeal circulation was ... gas exchanger for long-term extracorporeal ...[PDF]The prevention of shock following extracorporeal ... Web ·? https://link.springer.com/content/pdf/10.1007/BF03021372.pdf THE PREVENTION OF SHOCK FOLLOWING
3. EXTRACORPOREAL CIRCULATION ... "How to keep the patient alive" or "How ... heat exchanger is used, the blood is not ...Extracorporeal Blood Oxygenation Devices, Membranes for ...Web ·?
Aug 31, 2016?· ... maintaining the circulation of blood as well as the oxygen and ... of the blood–gas exchanger ... free long-term extracorporeal circulation ...
Dennis
Dennis Mazur
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How can I narrow down factors that influence how disease is correlated to urbanization? What should I consider in measuring urbanization that can be associated with the pattern of cases of a certain disease?
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Stress, hypertension and other related comorbidities, retinal vein occlusion, stroke, etc.
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Today, Many company are providing online pharmacy for different category of medicine vice versa many retailers and wholesalers are opposing online pharmacy. I would like to know that under which circumstances online pharmacy is legal and illegal?
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Above answers are suitable, in India it is legal, it is advises related to health related conditions. Now this is more or less a global practices.
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We’d like to poll a broader view on the features that would be useful to researchers in biomedicine and practitioners outside of the Biomedicine Department and the University Clinique we are already collaborating with. I would greatly appreciate for a valuable feedback. In the end of the project we will share our results with the community in order to facilitate new approaches, methods or data by using our solution in their research and practice.
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Patient education: Customization- have a generic template practitioner can customize (drugs prescribed, notes etc.) Updates- auto-alters, monitoring, pt input, tracking outcomes.
Research: make any software work with other software, interoperability. Prompts to related research- garbage in, garbage out. Need to know what you are looking for, synonyms. Help clinicians form good clinical questions- PICO.
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For my study biomedical sciences, I'm writing an essay about the drug isoprenaline. After reading a lot of papers, it is still unclear for me what the exact molecular mechanism of action of isoprenaline is. Does isoprenaline have an effect on the catalytic activity, the stabilisation/destabilisation of the receptor or a metabolic effect for example?
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Isoprenaline is a pure beta-1 and beta-2 agonist. As others state, the beta-1 effect in the heart which is positively linked to adenyl cyclase increases cAMP hydrolysis from ATP. cAMP will activate PKA with phosphorylates calcium and sodium channels in the open conformation and potassium channels in the closed conformation. This will allow depolarization in nodal cells (calcium) and myocardial cells (sodium, calcium) and limit hyperpolarization in nodal and myocardial cells (potassium). Net effect: increased in chronotropy and inotropy (faster rate, more forceful contraction, respectively). Pharmacology is a beautiful subject.
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Dear Colleagues,
Are you familiar with a very friendly source covering the basics of biostatistics?
Thank you!
Pleasant regards,
Monika
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Dear Monika,
This biostatistical handbook is free:
Dennis
Dennis Mazur
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The importance of active lifestyle in the elderly population is huge, crucial for good health, the length and quality of life. Maximum oxygen consumption and adequate frequency and rhythm of cardiac performance are indicators of good functional ability in the elderly population. They show that active lifestyle people reduce the health risk factors, contribute to the preservation and improvement of health, stimulate active relationships and show responsibility for their own health. Physical activity can replace many drugs, and no medicine can replace physical activity!
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I think that physical activity should be an inevitable and irreplaceable part of everyday routine in maintaining good health, both physically and psychologically, in all age groups. But unfortunately, in Serbia, I believe that this attitude is widespread in urban areas among young people, but not among elderly people, only in those who are engaged in recreational sports. While in rural areas, physical activity is considered optional for young people, and even unnecessary and inappropriate for elderly people, which is highly harmful attitude.?
I think that raising awareness, education, organizing public trainings and similar activities should be at a higher level in rural areas, because there are large differences in understanding that physical activity is necessary, among the elderly population in urban and rural areas.
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One could well argue that the importance of statistics in today's data-driven medicine could use further support like Statistical Medicine to help those who have not as yet developed sufficient statistical interpretative skills in their own research careers. .
Dennis
Dennis Mazur
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Apart from the quality of treatment and care, the qualifications and friendliness of hospital staff, the teamwork, and hygienic standards, do you think that the architecture of the building also plays a role in terms of how fast patients recover?
Of course, architecture is highly subjective, but if we consider clean, functional buildings that many patients find pleasant.
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A bland, uninspiring, poorly functional architectural ambience can work negatively if it conveys a negative placebo effect and creates doubt about the treatments provided there. Similarly, a pleasing, esthetic and functional design can convey a positive placebo effect by enhancing the prestige of the practitioners working in such a well thought-out building. Clinicians rely on the positive placebo effect telegraphed by the accouterments of of their dress, their mannerisms and surroundings to develop a trusting relationship with their patients. It is that trust that improves treatment outcomes.
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How is research conducted to understand, prevent, and treat diseases? four methods?. Discuss the difference between the perspectives of science and modern medicine with respect to disease and conditions
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Diseases are broadly classified as Infectious diseases ( Communicable Diseases ) & Non Communicable diseases ( NCD'S ) . Health care can be divided as preventive care ( Public Health ) , where research is done to prevent diseases . Treatment of diseases can be classified as primary , secondary & tertiary care . The health of a society is measured by Infant Mortality Rate , Maternal Mortality Rate & Life span of adults .
Research has contributed to great advances in Infectious diseases by discovering vaccines for health care & antibiotics for treatment of Infections . The life span of humans has increased from 30 years in the 1950's to about 65 years in developing countries to above 80 years in developed nations . Recently , antibiotic resistance is creating major problems in the management of Infectious diseases . Both preventive aspects , antibiotic misuse & discovery of new molecules to treat infections are the areas of research .
The common cause of morbidity & mortality are NCD's . Diabetes Mellitus , Hypertension , Lipid disorders , Air pollution , Alcohol intake , Obesity & Smoking are the major risk factors for cardiovascular diseases , COPD , Chronic Kidney Disease & chronic liver disease , which are the common causes of mortality in both developing and developed countries . Cancer is becoming a very important cause of mortality . Research in prevention of these diseases by leading a healthy life , primary care to treat DM , HT & lipid disorders early delay events & improve survival . Secondary & tertiary care for these diseases have improved survival .
It is science & modern medicine which has improved the quality of life & improved survival . Each of these diseases need research in preventive care & guidelines for primary , secondary & tertiary care .
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Hello everyone, I will obtain my PhD degree in the early of 2018, and I am looking for a postdoctoral position in biology or medicine. It would be grateful if any of you could supply me a position or give me an recommendation.
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Unfortunately, these days it's a buyers market (and, some argue, a Ponzi pyramid :) ).
Each position attracts a lot of applicants, so it's unlikely someone will just supply you a position.
Though, there are many advices and resources on how to find positions and make the most of them.
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Dear Colleagues,
I need to make a literature search using the EMBASE and MEDLINE databases. Do you know how to access the databases using your university VPN???
I believe my university (UCLA) has access to the databases. However, every time I try to access either of the databases using the VPN, I am directed to a page when I am supposed to subscribe and pay for my access. Any suggestions?
To UCLA folks: I use the Medline VPN which I imagine should have the same access as the UCLA VPN.
Thanks a lot!
Best wishes,
Monika
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Dear Monika,
Universities probably differs from country to country, but I have perfect access to both MEDLINE and EMBASE. When I want to access those ressources, there are 2 ways available through the website of the library of my University.
1) There is a database...of databases on their website. By clicking on one, I am prompted to connect using your university credentials (the ones you usually use to connect yourself to university ressources) and access is usually easy from there.
2) Your library might provide a link that allows you for a quick access once you're on the database website by simply copying it into your browser (it prompts a screen where you have to use your university credential).
3) Finally, your library most likely has a service to help research. They will be your most precious friends (based on my own experience).
On a side note, you can usually access MEDLINE for free anyway using Pubmed (https://www.ncbi.nlm.nih.gov/pubmed/).
Hope this helps and I wish you great success in your research endeavors!
Frédéric
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The majority of the cancer drugs that came on the European market between 2009 and 2013 had no proven effect on either the life expectancy or the quality of life (Davies et al. 2017).
Reference
Davis C, Naci H, Gurpinar E, Poplavska E, Pinto A, Aggarwal A. Availability of evidence of benefits on overall survival and quality of life of cancer drugs approved by European Medicines Agency: retrospective cohort study of drug approvals 2009-13. BMJ 2017;359:j4530. doi:10.1136/bmj.j4530.
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I understand perfectly your question, which is not a question but I suppose you want to call up attention on the conclusions of the manuscript you reference:
" This systematic evaluation of oncology approvals by the EMA in 2009-13 shows that most drugs entered the market without evidence of benefit on survival or quality of life. At a minimum of 3.3 years after market entry, there was still no conclusive evidence that these drugs either extended or improved life for most cancer indications. When there were survival gains over existing treatment options or placebo, they were often marginal. "
I agree with the point: results of newly approved drugs are often very poor and even inferior to what certain publications show.
But the pharma industry is very powerful and they can afford enormous expenses to get approvals.
This is our brave new world, as Huxley wood say.
Best regards
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Is it possible to calculate the Overall score of Cochrane Collaboration Risk of Bias Tool?
Is there any guideline for calculating the OVERALL score of this tool?
Any recommended article or source would be appreciated!
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It is possible, I've used it in my article.
I suggest to read its use through its official website.
Best regards,
Priastana
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I Have written the article in the attached file for publication? in a medical journal. I am afraid that it may not become a subject of professional bias. Kindly read and give me feedback.?
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Enter your answer
Yes, it is workable not only?as future problem?but?as present too.
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A human is an ability to eat, to walk, to memorize, to think, to rightly express your moods. Then he goes to work as electrician, musician, physicicist, physician, etc. All these human? activity is generated by human society, government.
WHERE IS A PURE MAN? Do we think about ourselves (our memory, thinking, why do we live, why do we do such action, etc) frequently? NOT AT ALL! We immersed in highly complicated "whirlpool" оf self-preservation of ourselves, our children, our parents, our relatives, our MONEYS, etc. Our self-preservation is? so complicated that we have no time to think on other subjects. So we are ants, we get commands and we just execute it. That is essence if our life - we do what we do not understand but we are in hurry to make it on time! All it is a comedy.
Besides Shakespeare`s phrase "all the world is a theater" I say all the world is comedy.
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No
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In medicine, I think evidence-based research and - crucial, this - evidence-based practice is quite robust. Insofar as social scientific veracity is concerned, the wide range of variables does create problems. And yet?
I have found some examples of plausible EBR and EBP, most notably in the Olweus AntiSchool Bullying programme, which consistently, it seems, reduces bullying in schools.
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I think that one of the basic issues to your question is the research paradigm (and subsequent epistemology and ontology) you place yourself in. In social science, you have several other stances to which abide to (as Glenn and Dennis have mentioned).
I think?Paradigmatic Controversies, Contradictions, and Emerging Confluences, Revisited, by Y. Lincoln, S. Lynham & E. Guba — The SAGE handbook of qualitative research (2011) has a great synthesis on this issue (page 101's table is great).
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I have long been looking for a substance or medicine that I can work on.
I will be happy with any idea
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You can ask researchers working on soluble CD83. Here is the link for one of their publications. I hope it helps. Good Luck!
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I am curious whether there are any studies that have analysed the question whether there is a relationship between the average number of coffee consumption per person per day and the average number of hours of sleep per person per day. Is there a relationship?
Published studies in all languages would be relevant, as coffee is consumed in many parts of the world.
If you came across something, please feel free to reply.
Thanks so much and best regards,
Rainer
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Please let me know if these references/sites are helpful to you:
1. ?Caffeine Consumption and Sleep Quality in Australian Adults - MDPI
by EJ Watson - ?2016 - ?Cited by 2 - ?Related articles
Aug 4, 2016 - Caffeine consumption remained stable across age groups while the source ... have shown that when caffeine is ingested one to three hours before ... determine the relationship between caffeine consumption and sleep using?...
2. ?Caffeine Consuming Children and Adolescents Show Altered Sleep ..
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Oct 15, 2015 - effects of high caffeine consumption on sleep physiology and ..... between caffeine consumers and controls in the first two hours of ... A close relationship between alpha and SWA is an often-observed phenomenon (i.e.,.
3, ?Coffee, caffeine, and sleep - Sleep Medicine Reviews
by I Clark - ?2017 - ?Cited by 27 - ?Related articles
Jan 30, 2016 - possible causal relationships among coffee- and caffeine-induced changes in sleep quality and health development are .... or after school hours. Whereas ... between caffeine consumption and sleep in adolescents emerge.
4. ?Caffeine Effects on Sleep Taken 0, 3, or 6 hours ... - Semantic Scholar
by C Drake - ?Cited by 80 - ?Related articles
He has been in consulting relationships with Atentiv, Inc (Cambridge, MA), ... or 6 hours prior to bedtime each have significant effects on sleep disturbance ..... related caffeine intake between any of the 4 conditions: 0hr = 126.1 ± 164.9 mg, 3hr?...
Dennis
Dennis Mazur
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What are effective and long-lasting treatments for ADD (attention deficit disorder) / ADHD (attention deficit/hyperactivity disorder), excluding stimulants (like amphetamines, SNRIs, NRIs, or NDRIs)?
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ADHD is a loosely defined behavioral syndrome. It is a common mistake to assume it has single cause implying common treatments will work for all diagnosed with ADHD. Many factors including being the youngest in a school class can result in a child being diagnosed with ADHD. Some children have basically nothing wrong with them others have wide variety of problems.?
In short-term research trials pharmacological interventions invariably appear more effective than non-drug treatments for two reasons. First, drugs alter behaviour much faster than non-drug treatments, and trials most often measure improvements by short-term symptom management (often for no longer than a few weeks). Second, while the behaviour-altering effects of stimulants are almost universal, other forms of treatment are not. Family counselling, for example, will be of little or no benefit if the underlying cause of behavioural problems is exposure to environmental toxins.
In many cases there is nothing to ‘treat’. Many children are naturally inattentive, impulsive and hyperactive. In these cases normal childhood behaviour is pathologised and healthy children are ‘medicated’. Perhaps subconsciously for many busy, stressed adults, being able to control their child’s challenging behaviour is their main concern. If so, stimulant medication wins hands down.
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Who is responsible for this deviation though Hippocrates (Father of Medicine) had strongly recommended the importance of exercise and nutrition in the very distant past itself?
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Vinodh, I think we have deviated from using?exercise as an agent of good health because we are so busy nowadays, and do not have time to do proper exercise. With that said, however, many people DO exercise regularly and as a result are more physically fit than those who do not exercise.?
Outdoor exercise, such as walking, is also good for the mind (which in turn influences the body) and people have also drifted away from this simple indulgement because there are so many other activities competing for their mental attention: video games, television, email and so forth.? They engage the mind and seem to fulfill a need, but in excess they are not good for the mind.?
It is also true that many?important diseases nowadays are not strongly mitigated by exercise.? Many cancers are not strongly associated with exercising;? sexually-transmitted diseases;?hepatitis, influenza and others cannot really be prevented by exercise or cured by it.?? However, the big diseases of history, heart disease and diabetes, can be greatly helped by exercise, although people?tend not to?think in terms of prevention, only cure.? ?
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Many times students critic their clinical marks because I don't have written standard for assessing their quality of activity. I built a special guideline for assessment their activities, but still I seeking for best standard for assessment.
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Clinical teaching to date should be oriented by Person Centered Medicine and the Person Centered Clinical Method. PBL and Evidence based medicine are obsolete and wrong models, because medical science is changed.
In the assessment of clinical skills in learning Person Centered Medicine, the method we use is correspondent to the Person Centered Medicine Clinical method? learning of its steps trough a questionnaire fulfilled by three clinical teachers after a simulation session, concerning the learning step and, at the end, of? the full procedure.
The problem is to prepare clinical teachers to teach Person centered Medicine and its epistemological basis which is founded on the paradigm shift of Medical Science , born in 1998, and that will be formalized in Milan on 13-14-15 October 2017 in the Congress:
" Medical science and health paradigm change"
Sign if you agree "la Charte Mondiale de la Santé-the World Health Charter"
Text and info on the Congress website
an on line-live course on Person Centered Clinical Method:
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Does anyone have a well-summarized source for medical teaching methodology?
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Among others, this book is a humorous source of medical speaking. I was especially amused that during a lecture one should not go back and forth before the listeners like a wild animal in cage.
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To prevent duplication of work or on the other hand , provide summation of data or data pool in where similar work is being done in different institutions, ?should we attempt at maintaining a central thesis databank in India ( where I am from ). What can be the difficulties or positives of it.?
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Getting a central repository is possible. The universities where the thesis is registered and being conducted should send the list (title and abstract) to the UGC. The UGC should be maintain this information and display it on their website for everybody's reference. The complete draft of the project can be requested from the authors if need be.
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Please see earlier posts.
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Mr. Gorodetsky. thank you for giving more details. this definitely changes my impression. aggrenox is not for epilepsy, but for stroke prevention. in any case, i now think it is less likely that the problem is localized to the left tempo-parietal lobes. from your description, i think the problem is in the cingulate gyrii or mesial frontal lobes. these areas are hidden and hence even if they are causing non-convulsive seizures, it will be difficult to confirm with EEG. the SPECT and PET are not very good either for these areas. my recommendation is to see a behavioral neurologist and perhaps do functional MRI. the other option is to do MRI with stronger magnetic fields and look at these areas. i cannot suggest any medication at this time, but i do think that you have a localized problem in the brain. thanks, mustafa.
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Are they based mostly on Monte Carlo methods? Are there any based on Las Vegas and Atlantic City algorithms?
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When one thinks about software, it is worth to mention Scipy (many algorithms and methods are covered there including machine learning methods) in Python and Weka for machine learning.
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Status quo and perspectives
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Yes, milk from animals fed industrial food
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I am interested in comparisons among and between different arts in medicine and how they affect well being and quality of life--want to set up a similar study.
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Please let me know if the following references/sites are useful to you:
1. ?Can an art intervention influence quality of life in a hospitalized ...
Many studies have been undertaken to evaluate the effect of art interventions in hospital medicine. Few are large and well controlled. The 'Open Window' study?...
2. ?The Connection Between Art, Healing, and Public Health: A Review ...
Although there is evidence that art-based interventions are effective in ..... survey described the healing benefits of music and art therapy in hospital settings, and?...
Dennis
Dennis Mazur
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Many physicians and physiotherapists advise their patients who have knee osteoarthritis whether in earlier stage or late and chronic stage to stop stair climbing and use lifts if available.
Is this logic suitable for all types of patients with knee osteoarthritis?
Is there any evidence or published article that discuss this issue?
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there is a mechanical association....
however it becomes relevant when there is a predisposing ?factor like altered bio mechanics / .....
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Im against it in 90% of the cases, many questions comes to my mind in their regards, of which, what are the sources of these protiens?, how safe are they?
Many people are replacing food by protuen shakes, and as we know as maximum our diet must be composed 25% of protiens, some are consuming 40% due to these shakes, I wonder the extant of damage there kidneys would suffer from and other organs.
Protien shakes or powders can be a complimentary for the diet of an athelete if taken in proper amounts after body composition analysis, and if theur source is safe and healthy, be it plants.
I need satisfying answers.
Regards
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Protein Supplementation and Athlete Performance - Global Food Forums
by JR Hoffman - ?2016
linked here 2016 recommendations
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which one of this plants is more important in medicine and has more value and is most expensive than other?
colchicum luteum
Periwinkle?
salvia?
saffron?
Calendula officinalis
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Hi
I think Saffron
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What is the mechanism of action of Clomipramine "Anafranil" used for the treatment of nocturnal enuresis?
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Hi,?The mechanism of action can be related to the anticholinergic side effect of the drug, which include urinary retention. Also, all three lower urinary tract controls, i.,e, parasympathetic, sympathetic, and somatic are associated with serotonin and norepinephrine-containing receptors, so increased extracellular levels of serotonin (5GT) and norepinephrine (NE) with clomipramine, which is a 5HT and NE reuptake inhibitor, expect to produce the observed effect. Finally, enuresis is classified as a disorder of arousal, and can occur in both REM and NREM sleep. The drug supresses REM duration, and increases N2, and is also known to lower seisure threshold, suggesting it has an impact on the arousal threshold. Kind regards.?
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The evaluation of treatments in medicine is often made through the Kaplan-Meier Survival Curves. The curves evaluate the probability of survival of patients treated with some medicine in relation of a time series.
My question is if the time variable can be, for instance, be replaced by a dosage variable, e.g., the idea is to evaluate?the probability of survival of?tree alien species applying different tree-girdling depths, evaluating this variable instead of the time series.
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Dear?J?rgen. In this case the intended dosis (cutting depth) is variable from tree to tree. It depends on the cambium depth and it cannot be seen unless the bark is removed. This is why we want to apply this modified analysis, apart from a sensibility-specificity analysis.
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Diabetes is most prevalent all over the world especially type-II diabetes. ?India is called the ?'Diabetic Capital' ?as this metabolic disorder is most prevalent in our country ?Therefore, is there anything like signature medicine ?or advanced ?genetic engineering tool for type-II diabetes to have sigh of relief for the ?patients ?
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The fiirst line of therapy is Metformin
Flax seeds also lowers glucosa and cholestherol
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What are the reasons of knee cracking in young people who do not suffer from any symptoms? In particular, cracking that comes with normal activities.
Is this?normal?for such?type of knee cracking? Should we treat this issue?
Any suggested article that explain this issue would be appreciated!
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Please let me know if this citation (and reference below) is useful to you.
“Why joints pop
Like nearly all the joints in your body, the knee joint is covered by a protective membrane containing synovial fluid. This fluid lubricates the joint, allowing it to move smoothly and easily.
Occasionally, tiny gas bubbles build up in this fluid. When the joint moves, the bubbles are released, causing the nearby ligaments to emit a snap or pop sound. The technical term for this phenomenon is crepitus, which also describes all grinding or crackling sounds and sensations in the body.
When to be concerned about joints popping
Most of the time, this popping and creaking of joints is harmless. However, crepitus is also a symptom of the joint degeneration that leads to osteoarthritis.
?You should worry about joint popping if:
?It's occurring frequently in one location
?It's accompanied by pain
?It's accompanied by joint swelling, tenderness, or stiffness
?You're also having pain as a result of prolonged joint movement, such as when walking
If you're experiencing pain when a joint pops or you have any other of the symptoms listed above, talk with your doctor. If your symptoms and test results indicate it, your doctor may diagnose osteoarthritis and start treatment. Treatments for osteoarthritis can ease pain, improve mobility, and slow disease progression—especially if it's caught early.”
Reference:
Dennis
Dennis Mazur
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In cooperation with my student Jakub Tkac, a student from the Czech Technical University, we ported the old code simulating dynamic recrystallization (implemented in Cellular/Cellang) into a new software version (C++ & Qt). Details can be found in the following links:
Our interest is to find out what you find out good and bad on this software and how it can help you understand modeling of complex systems using cellular automata. Your answers will help to develop future examples more adjusted to yours needs.
Enjoy the source of the code and video provided above.
Jiri Kroc & Jakub Tkac
PS For details and other questions and work see the project
where other question as "New drug development strategy: war of weapons" and information are provided.
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Dear Researcher/Dear Colleague,
This work is a part of wider project that deals with promoting of complex systems, self-organization and emergence. For me and my coworkers it will be great to hear what you find good and not so good on it and enable us to deliver more suitable projects in the future.
Good luck at your research,.
Jiri Kroc
PS Another interesting questions are involved in the project as is:
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Nowdays fast dissolving tablet is common, so to do a new reaserch on this topic what are the aspects needed , on which class of new drug it can be performed.
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Analgesics. In order to get a rapid pharmacological action.you can perform in vitrue dissolution testing as a measure.
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And is there any possible cure? or the disease stays on progressing?
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Hi Fathima,
Multiple Sclerosis is a disease of central nervous system,there are no specific test to diagnose it at early stage .usually affects younger age group 18 to 50 years and women more effected than men.presentation are sudden onset unilateral vision loss with painful eyeball movement,or double vision.,or weakness of one half of body or weakness of all ?4 limbs or weakness of both lower limbs anything can occur ,but all are sudden onset. As the disease cause demyelination at optic nerve,brain,brainstem and spinal cord..Diagnosis is based on Mc Donald 2010 criteria with latest added Magnims 2016 for demonstration dissemination in space..Mri brain,spine,orbit with contrast is investigation of choice.Csf oligoclonal bands,VEP test also clue towards chances of MS.Vitamin D will be deficient in MS patients?
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Dear colleagues,
Health professionals face difficult decisions in emergency medicine and trauma and critical care and deal with uncertainty. Sophisticated decision making tools could help reduce uncertainty and doubt and speed up decision making.
Would a decision assisting tool be helpful in EM and Critical Care, that based on "big data"? predicts potential diagnoses, outcomes and events and makes management suggestions to the team ?
What are your thoughts?
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Any of the studies that have developed decision tools in these two arenas of medicine are based on guidelines formulated from large samples of data.? Thus the information from these guidelines are only that--guidelines that are based on a central tendency finding in the data.? In practice, however, the treatment as well as the clinical pathway needs to be tailored to the specifics of that individual patient and that patient may not "fit" within the guidelines of that central tendency.? The art of medicine is based on the individual needs of that patient.
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I know there are a lot of studies about the use of VR in medicine or psychology, what I can't find is something more related to Architecture and Architecture visualization.
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Hi Marco, did you already have a look at this publication (full paper attached)?
Franz G, Von Der Heyde M, Bülthoff HH. An empirical approach to the experience of architectural space in virtual reality-exploring relations between features and affective appraisals of rectangular indoor spaces Automation in Construction. 14: 165-172. DOI: 10.1016/j.autcon.2004.07.009?
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There is some evidence that anti-HIV antibodies can destroy infected cells by binding to HIV envelope on the cell surface and activating NK cells, monocytes, macrophages, etc. via their Fc receptors.?
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High rate of mutation at the env gene segment of the virus might hinder this approach.?
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What is the state of the art in evidence based practice in the field of speech therapy??
In what way is evidence based medicine practiced in aphasia, voice and stuttering therapy or related areas?
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I think there is a lot of literature on the subject. You can find a sample attached.
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?I currently read a claim that the people cured from cancer by chemotherapy are 2%, and another claim that 60% of cancer patients are cured by chemotherapy. Many conflicting results but what is the truth?, although 60% is not bad but why 40% arent responding, the science is really evolving and still cures of cancer are debatable. I know several people who had cancer and was discovered at the early stages, they recieved chemo and all happened to die after several months.
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Cancer is such a complex and misunderstood disease; personalized approach are need for chemotherapy , surgery and every other treatments options available ?.
Cesar. SO. Surgical Oncology. md Anderson Hospital H,Tx.
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I would be thankful if you provide me by methods of gm and types of food, what is the effect of each also. Waiting your professional answers ??
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As far as I know, there are no well documented cases of GM foods causing any diseases other than hysteria in GM opponents.
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This case just brought to our attention (patient's report with pictures attached). Patient urgently seeking consultation by a local dermatologist who is willing to prove/disprove the alleged etiology. Needed for liability and for adequate medical documentation for publishing the case in a scholarly journal.
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Dear Theodor,
Were you able to find a Toronto-based dermatologist to help with the case? The way the system works in Canada is that this patient could see a family doctor, and then get referred to her local dermatologist.
It seems like an interesting cause of chronic dermatitis. A few biopsies may help - and I wonder if the material is polarizable? Also, I wonder if tape stripping could be used to make the?diagnosis (like in fiberglass dermatitis). I would agree with Marko in that the photos really look like self-induced excoriations without a primary dermatosis. However, you must rule out all other causes before jumping directly to that.
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I have a big interest in this field, since the number of PCOS woman is increasing now adays a lot, and a woman with a typical ?PCOS case suffers from obesity, providing them in the proper diet and sports plan can reduce the case but will surely not resolve it completely;
I already know that PCOS is treated by different methods of hormonal therapies which is not working in resolving the problem for many patients, and surgeries might be costly for some, a phobic idea for others and the surgery will never promise that the cysts wont grow again. I already heard from patients taking??natural supplements of Myo-inositol ,D-Chiro-inositol and folic acid; the patients claim they felt a mild improvement maybe the number of cysts stoped increasing but the former ones are still existing.
Im waiting to be provided by a satisfying answer from experts in the field.
Thank you & Best Regards
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Metaformin is the scientific name of medications that control insulin and glocuse blood ?levels, after testing the if there is high blood sugar or insulin resistance in the PCOS female, it is recommended for over weights its true and it works wonders for some, what about the PCOS patients that are underweight? A lot of studies shows that its not recommended in such cases, and a lot of patients I met claim that there professor or specialized dr. Didnt give them metaformin aince they had no problem with insulin or glucose. If you have any idea about more medication types please dont hesitate to write it. Thank you
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Is it true that the use of H2 blocker, proton pump inhibitors and other antacids can lead to the progression of recurring heartburn? The effect of reducing stomach acid can also make gastrin to be over expressed due to the reduction of stomach acid and make the pH of stomach up to neutral. The over growth of H. pylori without control can also lead to the associated risk of colorectal cancer. So, heartburn is not a simple problem and also can be a sign of the serious problem in our GI tract. The probable cancers may occur if heartburn is not treated properly such as esophageal cancer, stomach cancer and colorectal cancer as well. Is it useful for patients to take over-the-counter prescription drug like what I mentioned above.
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Recurrent heartburn could bring to some complication such as Barrett's esophagus
(associated with an increased risk of cancer of the esophagus). The type of cancer that occurs in patients with Barrett's is adenocarcinoma.
However perhaps your question underlines the interaction between PPI and H.Pylori. I enclose the two sentences which I suppose could answer your question
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According to the newest evidence more than 10 % of patients are admitted to the hospital, because of inappropriate prescribing and drug-related problems. More than 20 % of patients are treated within the hospital with at least one inappropriate prescribing medicine and between 2-5 % of all patients suffer from adverse events and more than 50 % of polypharmacy is used without any reason. Inappropriate prescribing is also very expensive, according to the newest data this bill costs over billion in many countries. Especially in western-oriented country clinical pharmacy service has been established next to the patients and other healt care proffesionals, however this trend has not been seen in many Eastern and Central European countries. Why these systems are not establish and in many cases patients are not well protected by serious inappropriate prescribing and medication errors? Why they do not reduce this bill for a more than half with clinical pharmacy service within each hospital (patients and payers should say: Don't Pay Another Bill Until You Pay This)?
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Dear dr. Karamehic,
i agree with you, a basic pharmacology is smth miles away from real clinical pharmacology. Sample example is difference between drug efficacy and drug effectiveness. In my point of view faculty of medicine and pharmacy should cooperate to establish appropriate specialities in real clinical practice (e.g. clinical pharmacy and pharmacology). Without patients' charts, rounding, patient consulting and involving in drug choosing, monitoring etc it is impossible to do clinical pharmacy.
Often we have many opponents of these clinical important science (also I have had in my practice), who think that this service is not important. However, if they respect evidence-based medicine they should support it, because for involving of clinical pharmacy service we have the strongest evidence Ia. If we respect it when conducting guidelines, then we should respect it in this way to accept not refuse this particulary one of the most beneficial service for our patients. Network for Excellence in Health Innovation sad that clnical pharmacy service in daily rounding on the ward is the most effective approach to reduce medical erros (at least 50 %). They cover more than 10 US hospitals. Consequently, if we want really reduce medical errors then we must educate and put clinical pharmacists on the ward in all activities connected with pharmacotherapy.
Regards,
Matej
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According to the newest research within this field app. 10% of patients are admitted to the hospital, because of inappropriate medication treatment in their history. This lead to extreme additional costs and patients' harms. How health system deals with this field in your country? You have clinical pharmacists/pharmacologists to deal with this topic? Have hospitals in your country appropriate risk assessment plans within this topic and plans how to avoid them?
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Dear dr.Stuhec,
Thank you for your response and offer to cooperate in this for me stem the interesting areas! I see that you are very active and that you are well aware in this area and have a very good experience and knowledge in this field!
Very happy to accept, your proposal for cooperation with you and I want it to be mutually beneficial, and to exchange and discuss this issue, which is extremely important with any aspect of society but unfortunately in our country and in the world is not as sufficient developed as it should be!
Best Wishes
Jasenko Karamehic
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According to the media many fatal medical errors have been happened in many European countries. Although a 'soul' of inappropriate treatment and prescribing is well known in the literature, in a real clinical practice is missing. Many hospitals still do not have their plans how to report medical error, how to resolve the problem and how to report this problem to a patient. Many healthcare professionals still think that they do not make any mistakes and adverse events, which is a point of scarce, because every 10th patient is admitted to the hospital because of medical errors. IN MEDLINE there are almost no study/trial about this topic in this part of Europe. Why medical and pharmacy colleges and governments do not recognize and adopt this important system for patients in to all hospitals? Why they do not introduce clinical pharmacy practice next to the patients' beds, which has been approved by many international studies? I cannot believe that this happen in the 21st century. They should establish this systems and those people should be protected and well paid (in real practice in many institutions they are threatened).
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Great discussion. You are all invited to Join PharmaHuF on LinkedIn where we are collecting a lot of the evidence concerning this subject. Just request to join and I can approve.?
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Appreciate any information, as I am working on process improvement currently in place.
Regards
Rana
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I think that a lot in the world of medicine prescribes drugs in the first contact with the patient and to be avoided at all costs polypharmacy, which does not bring anything good is not the patient but not the company-state (I think it is unnecessary to spend huge funds on lightly prescription drugs), whether is this fear of error doctor -Malpractice or is it the influence of pharmaceutical companies I would certainly not say but I think there both.Only good and continuous education, which should be carried out continuously can improve this aspect, normally with an experience that medical practitioners who prescribe medication gain time !
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There is a wealth of research and information in relation to waste medication in primary care but appears to be limited when related to secondary care (hospitals). I am interested in how health professionals view medication waste and the impact this has upon health services. Additionally I wish to look at the root causes of medication waste within secondary care.
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Dear Karen Stone
Adequate knowledge about the health hazard of hospital waste, proper technique and methods of handling the waste, and practice of safety measures can go a long way toward the safe disposal of hazardous hospital waste and protect the community from various adverse effects of the hazardous waste. With this background, you must consider the levels of healthcare professions in you study and you must prepare appropriate questionnaire for each of them...
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I'm currently tutoring a postgraduate student preparing her dissertation on Metaphor and Metonymy in the language of Medicine. Plus I am researching Metaphor and Metpnymy in Languages for Special Purposes.
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The War against War Metaphors
The age-old practice may harm both science and scientists
[Published 16th February 2007 03:05 PM GMT]
Last month, when the University of Nottingham in the UK opened its new Centre for Healthcare Associated Infections, a facility dedicated to studying and controlling "superbugs," The Guardian newspaper interviewed its director, Richard James, about why such a research center was necessary. He said:
"This is a sophisticated army with astonishing weapons. And each time we develop something new, [bacteria] develop a defense for it."
The use of such war metaphors in science and medicine is not new. As early as 1934, the British Medical Journal wrote about the "War Against Cancer," a phrase we still often hear. But today, militaristic language pops up in almost every scientific domain: conservation biology ("invasive species," "biosecurity"); global warming ("global war on global warming"); and biomedicine ("killer cells," "hitting multiple targets"). The attraction to such language is understandable, as it draws attention, and perhaps even funding (who can forget US President Richard Nixon's declaration to "conquer" cancer in his 1971 state of the union address, since which hundreds of billions of dollars have poured into cancer research?). Still, some scientists worry that the use of war metaphors has negative effects on both science and the scientists who adopt the language.
For instance, scientists who use military terms may risk losing credibility, warned Erik von Elm, an epidemiologist at the University of Berne in Switzerland and co-author of a recent Lancet correspondence on military metaphors. "One of the features of science should be to be objective," but war metaphors are precisely the opposite, he noted. "These terms have an intention, they are sort of modern propaganda." Indeed, when Nottingham's James referred publicly to the coming "post-antibiotic apocalypse," the UK's Chief Nursing Officer accused him of sensationalism and scaremongering.
Scientists who frame problems in a militaristic manner also likely have a drastically limited perception of the problem and how to tackle it, noted Berkeley cognitive linguist George Lakoff. "This is not language, this is the way people think." In microbiology, for instance, scientists often frame viruses and bacteria as the enemy, and may focus on destroying them and be blind to alternatives, said Brigitte Nerlich, professor of science, language and society at the University of Nottingham. With bacteria like methicillin-resistant Staphylococcus aureus (MRSA), however, "You have to look at multiple factors, and not just in terms of attack and defend," she said. Indeed, some argue that our militaristic use of antimicrobial agents has, by introducing new selection pressures, only made pathogens stronger, while a consideration of other factors -- like host behavior and the social and physical environment -- could offer better solutions.
Brendon Larson, assistant professor of environment and resources studies at the University of Waterloo in Canada, argued the same of "invasion biology," where scientists may automatically assume an invading species must be removed. But in some cases, a sustainable relationship makes more sense -- for example, removal of the "invading" Himalayan blackberry from parts of California hurt the native tricolored blackbird, which used the plants as nesting habitats. "We're entrenched in a particular way of seeing this situation, that [invasive species are] enemies, they're bad and we have to get rid of them," Larson told The Scientist. Indeed, according to Larson, the modern use of military terminology may have contributed to US President George W. Bush's decision to merge part of the government agency responsible for invasive species into the Department of Homeland Security.
Still, scientists are not likely to move beyond the adversarial metaphor anytime soon, said Columbia University's Barron Lerner, author of The Breast Cancer Wars: Hope, Fear and the Pursuit of a Cure in Twentieth-Century America. "They're here to stay," Lerner said, admitting that when he was writing about the prevalence of such metaphors, he unknowingly began using them himself. Remembering, as writer Susan Sontag advised, that war metaphors in medicine can be misleading, and remaining aware of metaphors' effect on science, is the best scientists can do, Lerner noted.
Melinda Wenner
P Brickley, "The 21st Century War on Cancer," The Scientist, September 22, 2003.
E von Elm and MK Diener, "The language of war in biomedical journals," The Lancet, January 27, 2007.
R James, "Out of Control?" Exchange Magazine, February, 2007
George Lakoff
LA O'Neill, "A battle cry to decipher immunity," The Scientist, November 8, 2004.
Brigitte Nerlich
I Ganguli, "A new weapon for resistant bacteria," The Scientist, May 2006.
Brendon Larson
BA Palevitz, "The continuing saga of invasive species," The Scientist, April 15, 2002.
BH Lerner, The Breast Cancer Wars: Hope, Fear and the Pursuit of a Cure in Twentieth-Century America, 2001
S Sontag, Illness as metaphor and AIDS and its metaphors, 1989.
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We want to know the epidemiology and physiology of high-altitude hypoxia. Are there any known risks related to the demographic characteristics?
Please answer the question if you know, or please recommend good references for us to read.
Thank you.
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There are risks related to the demographic population. Those impacted most significantly are those arriving acutely to altitude and less so those who reside at altitude of course.?
I can answer a lot more thoroughly but am uncertain if this is an active question. For now, I will just note the changes which occur in the environment before explaining the how and why on the body. Someone else might find this useful
? Atmospheric pressure drops by about tenth for every 1000m of altitude.
? At 10,000 feet arterial O2 sats are usually <60 mm Hg
? At 12,000 feet (3,600 m) 40% fewer oxygen molecules per breath
? At 10,000 feet arterial O2 sats are usually <60 mm Hg
? At 12,000 feet (3,600 m) 40% fewer oxygen molecules per breath
? As one ascends through the atmosphere, every breath ?contains fewer and fewer molecules of oxygen. One must work ?harder to obtain oxygen, by breathing faster and deeper. The %?of oxygen in the atmosphere at sea level is about 21%.
?As altitude increases, this % remains the same but the number of oxygen molecules per breath is reduced. (it may seem obvious but many miss this)
? At 12,000 feet (3,600 m) there are roughly 40% fewer oxygen molecules per breath so the body must adjust to having less oxygen
1.Depth of respiration increases
2. Body produces more oxygen carrying RBC’s
3. Pulmonary capillary pressure increases, blood into parts of the lung which are not normally used when breathing at sea level
4. The body produces more of a particular enzyme 2,3-BPG mutase ?that causes 2,3-Bisphosphoglyceric acid to aid the release of oxygen from hemoglobin to the body tissues.
All this takes time--even speeded up with Diamox
This all causes an?alkalinity and low CO2 which produces a lack of respiratory drive above 3000-4000 meters. This is known as periodic breathing which can be worse into Central apnea
Try spending at least ?nights in a tent at high altitude and you will hear the poor breathing. Higher risk in those with OSA
If active questions still, perhaps you can notify?
Marybeth Lambe MD FAAFP
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Can anyone suggest me how to buy the fresh spores of Cordyceps sinensis and C. militaris fungi?Or please let me know any lab which is working with these fungi?
I am very interested in these species, since they are high value for medicine.
Thank you in advanced.
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i am working on it now. At our location Central Kalimantan Indonesia we have many of C, militaris infected on lavae and pupa of Setora nitens (Lepidoptera: Limacodidae)
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In sexually transmitted infections, it is important to differentiate a painful ulcer from a painless one. This is because painless ulcers are seen in the chancre of primary syphilis while painful tender ones are seen in Herpes and though rare, in chancroid (H. ducreyi).
I can guess that it must be due to peripheral nerves, but how does this happen?
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Perhaps some pathogens would invade peripheral nerve fibers during the pathogenesis as their skin lesions developed. So we know the existence of neurosyphillis and postherpetic neuralgia.
Some pathogens might numb nerve fibers, others might fire them.
The pathogens also might release some chemical substance into the periphery in the early phase.
Possible mechanisms include cytokines, inflammatory mediators, inhibitory neurotransmitters or anything.
You just asked a great question. It is a fundamental issue.
You could take down some samples of peripheral nerve fibers closely near the skin lesions to do pathology (even electric microscopy). To see what happened?
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We reported 2 cases of Salmonella gallinarum septicemia in human subjects in 2001. Subsequently a case was reported from Iran on Septicemia gallinarum implicated in a case of empyema (1). There appears to be a lot of interest on this topic as implied from 169 reads of our article. Has any one else from the researchgate contributors ever seen any human case of this infection. We think this to be a possibility because the chicken that is raised in poultry farms, prepared for different products and consumed so commonly all over the world,is the commonest bird affected by this species of Salmonella. We will be interested for the valued feedback of our article.
1. Sharifi-Mood B et al. Salmonella gallinarum empyema - First case from Iran. J Med Sci 2006;6(2):180-182.?
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Serovar (not species) Gallinarum/Pullorum is highly adapted to a systemic lifestyle in galliform birds. It is unlikely to infect via the usual faecal-oral route of other serovars into humans and is unlikely to pass through mesenteric lymph nodes. Furthermore it is unlikely to cause gastroenteritis. Nevertheless it could act as an opportunist in people, most likely with immunosuppression or other underlying condition which seems to be the case here. There are older reports of Gallinarum in people, but this is as likely to be misidentification or poor typing of a closely related serovar like Enteritidis or Dublin as actually being the cause. ?There is a report of Pullorum in a Gorilla in Lagos Zoo-again probably a secondary infection. It does cause of course cause Fowl Typhoid which is pretty bad news in poultry production.
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My patient is most likely suffering from this disorder. I want to follow him up after the removal of two large bumps on his both scapulae.
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thanx...
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As in the subject - do you know any comercial systems for computer-based campimetry/perimetry, where light stimuli are displayed on the flat computer screen? I know only common perimeters based on the hemispherical surface stimuli presentation, such as Humphrey Field Analyser or Medmont M700. I'm also familiar?with the software for psychophysics listed at?http://www.hans.strasburger.de/psy_soft.html.
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The latest advance in Visual Field testing ?Viewi system by Cambridge Consultants uses smartphone app to reproduce the hospital-based static perimetry at 顺心彩票 for self-check
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Cardiology, Physiology, Internal Medicine
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Sorry I did not read your question well. Basically, discrepancy in the rate cannot happen as the origin of the pulse in both sides is the same, the heart. But actually we may see in some conditions discrepancy in the rate in the same cases mentioned above, with discrepancy in volume (aortic dissection, coarctation, ... etc.), if they had in addition a cause of variability in the pulse volume (like atrial fibrillation or frequent extrasystoles). In this case the strong beat will be felt in both sides while the weak one will be felt in the normal side only which may create a?discrepancy in the heart rate between the both sides. It similar to the pulse deficit we may found between the apical and radial pulsations in cases of atrial fibrillation and frequent extrasystoles.
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Interleukins can be very unstable and their degradation is related to temperature as well. I'm looking for a protocol who can give a reliable measurement of interleukins in patient with chylothorax or pleural effusion. In detail I would like to understand:
1. How collect the sample? Usually we can not define for how long the fluid remain in the chest cavity or in the chest drain before collection.
2. How prepare the sample, I know have been seen to be collected in heparin container and put in ice and centrifuged and frozen -80. Is there any preparation protocol for how centrifugate and store the sample?
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I'm going out of the box of your queries to suggest an analogous solution. The problem of brain analysis for another labile molecule was solved by developing an? in situ electrochemical probe calibrated to the concentration of analyte in vivo. In their case acsorbate was very close to the electrochemical signal. The 40 y/o technique is not on PubMed but I read in OMNI magazine back then. Terry Christian's group at Tulane developed it. Palo Alto library has the OMNI issue but I'm sure the technique would be well recognized by now. Calibration would need to encompass LT a,b,c,d,e 4 at physiological milieu.
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I want to transfer a cornea from a donor to a receiver.So I would like to know which temperature is the best condition to keep a cornea in the box.Is there any factors that affect the cornea.
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Dear Piraya,
Corneal Preservation and Storage
Hypothermic storage at 2–8 °C is perhaps the most widely applied method world-wide; for example, all eye banks in North America use hypothermic storage owing to its perceived simplicity and its effectiveness. On the other hand, the majority of European eye banks use organ culture at 28–37 °C for storing corneas because of the extended storage time compared with hypothermic storage. Non-viable corneal tissue can be stored by freezing, by freeze drying, in glycerol, or in ethanol.
For more on this topic, please read the review article contained in the following link:
Hoping this will be helpful,
Rafik
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Simulation in medicine
burnout syndrome
Roles and standirization
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Thank you Michael. Med student in the ir Sixth year in México are interns in the hospitals. Some of them develop Burnout syndrome because they are not sure of their roles in critical situations or what id expected from them. Perhaps these situations such as resucitating a patient, if we develop them before their internship, we might help them perform better in medical practíce and know their role in certain situations as a part of a team. Have you published about it? I'll look for it, thank you
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anybody
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We have never done 5 day old pups (P5), but we have successfully embedded P0 and P7. We cardiac perfuse starting at P7 and then PFA fix, but we were unable to perfuse for any younger ages because of size. The below protocol is following 48 hours of fixation in 4% PFA. Unfortunately we take our brains out of the skulls so our protocol may need to be adjusted for your purposes but here's what we do:
P0:
3x30 min 1x PBS
30 min 1:1 PBS/EtOH
2x15 min 70% EtOH
2x30 min 85% EtOH
2x30 min 95% EtOH
30 min 100% EtOH
30 min + overnight FRESH 100% EtOH
(Fresh= bottle opened that day)
30 min Xylene (RT)
45 min Xylene (60 deg)
1 hr 1:1 Xylene/Paraffin
20 min + 1 hr Paraffin
ON Vaccuum Paraffin
P7:
3x1 hr 1x PBS
2x1 hr?1:1 PBS/EtOH
2x1 hr 70% EtOH
2x1 hr 85% EtOH
2x1 hr95% EtOH
2x1 hr 100% EtOH
1 hr + overnight FRESH 100% EtOH
(Fresh= bottle opened that day)
45?min Xylene (RT)
45 min Xylene (60 deg)
1.25 hr 1:1 Xylene/Paraffin
20 min + 2x1 hr Paraffin
ON Vaccuum Paraffin
Just out of curiosity, how do you section such an old pup head? We only keep embryo brains in heads and even then the E17.5 skulls can pose problems.?
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24 year old man with deforming arthropathy and limitation of hip movement. He also has features of aortic stenosis and allergy to food in a way that he develop vomiting from certain foods with irritability, impairment in memory, forgetting, and nervousness.
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Careful assessment of AS severity. Consultation at a center with experience in percutaneous approaches to management of aortic stenosis.
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According to the some evidence there is at least 25 % comorbidity of Alcohol dependence syndrome and MDD, however many more patients are treated with antidepressants (excluding bupropion). What is your opinion about that? In my opion a clear indication should be established to treat these patients with antidepressants (e.g. similar than proton reuptake blockers). If used for these purposes then a short time trial should chosen (e.g.4-6 weeks). For mild symptoms also a Valerian (herb) could be used to prevent frequent antidepressants use in these patients.
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Yes, and for at least two reasons. First, the specific effectiveness of antidepressants over placebo is small and getting smaller. (See recent series of papers in the WPA bulletin, among many other articles on the 'medicalisation of unhappiness'.) DSM-5 notwithstanding, 'understandable misery' does not equate with 'depression'. With active placebos (i.e. drugs without known antidepressant effects that cause symptoms like dry mouth, which make it more likely that patients will think they are taking an effective drug and thus increase placebo effects) the difference between placebo and active wings is even less.
Second - as has already been pointed out - patients whose lives have been sufficiently messed up to seek treatment are very probably feeling understandably unhappy, especially if they have been trying and failing to abstain or drink moderately. Antidepressants will not cause them to regard their excessive drinking and other undesirable behaviour as somehow positive and desirable and neither will it have that effect on their families and employers. However, when they have been dry for 2-3 months, much of that unhappiness often improves or diminishes to 'ordinary' human levels. (We all live in an imperfect world.) Families and employers may also feel happier and more hopeful. Conversely, real underlying illnesses - eg real, as opposed to diagnostically fashionable and 'spectrumised', bipolar disorder - is much easier to diagnose with confidence in an abstinent patient when the dust has settled somewhat. So prescribing antidepressants on admission is not only a waste of not very effective medication and a source of needless side effects but can actually obscure the aetiology, assessment and diagnosis of underlying conditions and lead to inappropriate long-term prescribing.
Thirdly, most trials of antidepressants in alcoholism (and heroin abuse) don't seem to have notably positive outcomes compared with appropriate placebos or energetic non-pharmacological alternatives. I would put in a good word for supervised disulfiram as part of the long-term management programme if patients find it impossible to abstain or drink moderately for long enough to benefit from the change but I've probably offended enough people and therapeutic orthodoxies as it is.
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Ventilator-associated pneumonia (VAP) is a type of lung infection that occurs in people who are on breathing machines in hospitals. It affects critically ill persons that are in an intensive care unit (ICU). VAP is a major source of increased illness and death. Persons with VAP have increased lengths of ICU hospitalization and have up to a 20-30% death rate.Prevention of VAP involves limiting exposure to resistant bacteria, discontinuing mechanical ventilation as soon as possible, and a variety of strategies to limit infection while intubated. How can prevent Ventilator-associated pneumonia in ICU wards?
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Dear Nader! With my pleasure. Please read carefully all papers in the attachment. Vladimir
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What software to use, previous works done in the same area?
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According to the data there is app. 5-10 % of hospital admissions because of inappropriate prescribing (IP). For example at admissions to the psychiatric hospitals about 20 % drugs are not prescribed (missed). Within the hospitals about 5-10 % drugs are prescribed in an IP way. Due to the many research in last decade, which have been done in many western countries, there are still many EU hospitals without appropriate systems, which would be protect patients from being treated with IP. In many hospitals there are still no teams of health care professionals (clinicians, clinical pharmacists, nurses, nurses with prescribing rights) which would discussed about IP every day at clinical rounds. In my opinion, this step should be done on behalf of the patients and the appropriate systems should be established by governments. However, there is important to establish e-prescribing but to include a well-teached clinical pharmacist to this system is the best option. What do you think?
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In addition to the high associated costs of program implementation, I believe that providers are afraid of repercussions from negative patient satisfaction.
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I am working on a thesis about how different hand tool designs affect the pressure distribution over the palm of the hands. However, it is somewhat difficult to get references about how excessive pressures may impair the use of a product and what are its implications on hands, in a physiological level (like schemias, calluses, etc.). I found only very sparse mentions of pressure in some texts, like Cacha and Tichauer and Gage. One reference that may be helpful is the one listed below, but I can't get my hands on it:
Mechanical considerations of skin in work. AMERICAN JOURNAL OF INDUSTRIAL MEDICINE. Volume 8, Issue 4-5, 1985, Pages: 463–472, Thomas J. Armstrong
Article first published online : 11 JAN 2007, DOI: 10.1002/ajim.4700080428
Does someone have it or know any reference that may help me in this way?
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Paul W. Brand, FRCS,?and the bioengineers with whom he worked at the US Public Hearth 顺心彩票, Carville, LA (USA)?did considerable research?regarding soft tissue response to stress.???The tree editions of his book, Clinical Mechanics of the Hand, contain synopses of this research.? Although these books are out of print, they continue to be highly regarded and prized?in the hand/upper extremity surgery and rehabilitation fields.? You may be able to locate one or all of these books through your medical library; or the Internet.? Below are a few of Brand's journal publications that may pertain:
Brand, P. W. (2006). Pressure sore--the problem. J Tissue Viability, 16(2), 9-11.
MacMoran, J. W., & Brand, P. W. (1987). Bone loss in limbs with decreased or absent sensation: ten year follow-up of the hands in leprosy. Skeletal Radiol, 16(6), 452-459.
Brand, P. W. (1979). Management of the insensitive limb. Phys Ther, 59(1), 8-12.
Brand, P. W., & Ebner, J. D. (1969). Pressure sensitive devices for denervated hands and feet. A preliminary communication. J Bone Joint Surg Am, 51(1), 109-116.
Brand, P. W., & Ebner, J. D. (1969). A pain substitute pressure assessment in the insensitive limb. Am J Occup Ther, 23(6), 479-486.
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After reading the editorial published in Nepal Journal of Epidemiology by Dr.?Shrikant I Bangdiwala,?Professor,?Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC, USA. I?had a mind to think more about significance, p value and Confidence Interval.
Interested scientists are requested to write a letter to the editor for Dr. Shrikant's Editorial which can come up with a new change in the research.?
On 7 March 2016, the American Statistical Association (ASA) released a statement to improve the interpretation of statistical significance and p-values and their role in scientific research. In their concluding remarks, they state “Good statistical practice, as an essential component of good scientific practice, emphasizes principles of good study design and conduct, a variety of numerical and graphical summaries of data, understanding of the phenomenon under study, interpretation of results in context, complete reporting and proper logical and quantitative understanding of what data summaries mean. No single index should substitute for scientific reasoning”. The ASA statement also states: “Informally, a p-value is the probability under a specified statistical model that a statistical summary of the data (for example, the sample mean difference between two compared groups) would be equal to or more extreme than its observed value” .? The p-value is thus a single index, so where does it and ‘statistical significance’ stand within ‘good statistical practice’?
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I think the statement on p-values issued by the ASA could be fairly summarised by
Use with caution.
There are many well-documented problems with the p-value, and many acceptable uses as long as one keeps in mind the limits of the experiment.?Below is a post that explains this well--- and notes that it is simplistic and probably wrong to believe that Fisher would necessarily today be "pro p-value".
As with so many questions, the answer is neither yes nor no, but somewhere in the grey. Note also that replacing p-values with confidence intervals may be better, but may not be sufficient. It depends on your question.
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Specifically I am interested in effects of that flavonoid on heart, liver and skin associated conditions. Thanks in advance.
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Dr?Yaroslav,
Although hundred of papers were released about quercetin that described quercetin ?as a typical antioxidant flavonoid ?but these studies? still ?surround querceitn mainly in one circle '' a possible protective agents from heart disease''. some trials used quercertin in controlling liver cancer cataract and so on.?
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good day for you all , i am mostafa mahran a demonstrator of anatomy in college of medicine , cairo , egypt , i am new to research gate and dont know where to star or what to do , if someone can help me i will be more than thankful for that help , thank you all , god bless u
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Welcome Mostafa,
At the first glance I would say please read your questions and answers carefully before sending. why? to avoid spelling mistakes and misunderstanding of your questions. To increase your score in research gate try to answer as many as questions in your field.
Good Luck
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Necsito saber sobre los propiedades de los mejores materiales para impresiones dentales enfocados al adulto mayor como son todos los tipos de protesis
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Yo recomiendo tomar impresiones con silicon o con hule cuando se trata de protesis fija ya que habra una minima distorsion, ademas de que la impresion no sufre modificaciones por un buen tiempo, al contrario que las impresiones con alginato las cuales son de valor en casos de protesis removible,parcial o total. Hay Dentistas ?de generacion anterior que les gusta tomar una impresion final con pasta sinquenolica aplicada a la cucharilla individual para protesis total.
Cada material tiene el lado positivo y el lado no tan positivo, lo importante es saber como manejar cada uno de acuerdo a las instrucciones del fabricante.
Yo me acuerdo que en la Facultad tomaba impresiones hasta con modelina(ya ni se conoce) ya sea de alta o baja.
pero esto es otra clase de platica
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Load bearing activities increase the calcium absorption as it prescribed in all osteoporosis cases. Is there any reliable test to measure the absorption after load bearing exercise? Any supportive articles are appreciated.
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Both increased net Ca absorption and increased net bone mineral formation will cause the Ca isotope composition of blood and urine (d44Ca) to shift in a positive direction. This is the natural Ca isotope composition, not anything involving tracers. See, for example:
Channon M, Gordon GW, Morgan JLL, Skulan, JL, Smith, SM, Anbar AD. Using natural, stable calcium isotopes of human blood to detect and monitor changes in bone mineral balance. Bone 2015; 77: 69-74; DOI: 10.1016/j.bone.2015.04.023.
I think this article is available here.