1 on leadership in clinical medicine

Chapter 003. Decision-Making in Clinical Medicine (Part 1) doc

Ngày tải lên : 06/07/2014, 08:20

... evidence-based medicine Clinical Decision-Making Clinical Reasoning The most important clinical actions are not procedures or prescriptions but the judgments from which all other aspects of clinical medicine ... involves skill in clinical decision-making The first goal of this chapter is to provide an introduction to the study of clinical reasoning Equally bewildering to the student ... statistical concepts that govern the proper interpretation and use of diagnostic tests Quantitative tools available to assist in clinical decision-making will also be discussed Evidence-based medicine...

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Chapter 064. The Practice of Genetics in Clinical Medicine (Part 1) pptx

Ngày tải lên : 07/07/2014, 01:20

... changing the way diseases are classified, enhancing our understanding of pathophysiology, providing practical information concerning drug metabolism and therapeutic responses, and allowing for individualized ... scientific advances in genetic medicine have outpaced the translation of these discoveries into standards of clinical care Common Adult-Onset Genetic Disorders Multifactorial Inheritance The risk ... adult-onset disorders reflects the combined effects of genetic factors at multiple loci that may function independently or in combination with other genes or environmental factors Our understanding...

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Chapter 065. Gene Therapy in Clinical Medicine (Part 1) doc

Ngày tải lên : 07/07/2014, 01:20

... dividing cells in few gene expre transduced transducing inflammatory in both div tissues various tissues responses, and nondiv nonpathogenic cells Main disadvantages Theoretical Might risk of insertional ... limitation Immune responses to vector Genome integration Longterm expression Main Viral Vectors Features Retroviral Lentiviral Adenoviral AAV Hum Foamy Vir advantages gene transfer in gene transfer in ... steps in which the donated DNA enters the target cell and begins expression is referred to as transduction Gene delivery can take place in vivo, in which the vector is directly injected into the...

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Chapter 067. Applications of Stem Cell Biology in Clinical Medicine (Part 1) ppt

Ngày tải lên : 07/07/2014, 01:20

... successful clinical applications These include development of methods for reliably generating large numbers of specific cell types, minimizing the risk of tumor formation or proliferation of inappropriate ... these differentiated cells integrate into organs, survive, and function after transplantation in vivo Early studies of bone marrow–derived stem cells transplanted into heart, liver, and other ... generate, and methods for differentiating them into nonhematopoietic phenotypes are largely lacking The quantity of cells from any single source can also be limiting Organ-specific multipotent stem...

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Mollison’s Blood Transfusion in Clinical Medicine - part 1 pps

Ngày tải lên : 10/08/2014, 16:23

... 19 51 Second edition 19 56 Third edition 19 61 Reprinted 19 63, 19 64 Fourth edition 19 67 Reprinted 19 67 Fifth edition 19 72 Reprinted 19 74 Sixth edition 19 79 Seventh edition 19 83 Eighth edition 19 87 ... Mollison’s Blood Transfusion in Clinical Medicine Mollison’s Blood Transfusion in Clinical Medicine 11 TH EDITION Harvey G Klein MD President of the American Association of Blood Banks; ... Oxypolygelatin Variable 5.5 3.5–7.0 3.0–7.0 7.4 6.4–7.4 6.4–7.4 6.5 7.4 5.5–7.0 5 7.4 pH 14 0 15 4 15 4 15 4 15 4 15 5 13 0 16 0 13 0 16 0 13 0 14 0 14 0 11 97 15 4 14 0 Na+ (meq/l) Adapted from Committee on Fluid...

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Tài liệu An International Perspective on Topics in Sports Medicine and Sports Injury Edited by Kenneth R. Zaslav docx

Ngày tải lên : 20/02/2014, 08:20

... generate, over min, roughly 1. 8 CO2 l.min -1 Under these conditions, 12 An International Perspective on Topics in Sports Medicine and Sports Injury VCO2 would increase by less than 0.06 l.min -1, ie roughly ... training mostly based on strength training The cyclists performed 14 hours of cycling (ie, about 450 km) per week during a nine-month training period During the first month, training sessions ... Reference Intervals as a Clinical Tool to Detect Training Intolerance During Training and Overtraining Rodrigo Hohl1, Lỏzaro Alessandro Soares Nunes1, Rafael Alkmin Reis1, Renộ Brenzikofer1, Rodrigo...

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YouTube Google - How to rank any youtube video top 1 on google in 3 days

Ngày tải lên : 28/04/2014, 14:26

... Nothing contained in this document is intended to constitute investment, legal, tax, accounting or other professional advice and you should not rely on the reports, data or other information provided ... discretion NO INVESTMENT ADVICE The information contained in this product has no regard to the specific investment objective, financial situation or particular needs of any specific recipient Idea Incubator, ... Description Tricks First things first, you’ll want to include a link to your main website somewhere in the first line of your description The closer to the front, the easier your link will be to find...

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AN INTERNATIONAL PERSPECTIVE ON TOPICS IN SPORTS MEDICINE AND SPORTS INJURY doc

Ngày tải lên : 27/06/2014, 11:20

... generate, over min, roughly 1. 8 CO2 l.min -1 Under these conditions, 12 An International Perspective on Topics in Sports Medicine and Sports Injury VCO2 would increase by less than 0.06 l.min -1, ie roughly ... training mostly based on strength training The cyclists performed 14 hours of cycling (ie, about 450 km) per week during a nine-month training period During the first month, training sessions ... Reference Intervals as a Clinical Tool to Detect Training Intolerance During Training and Overtraining Rodrigo Hohl1, Lỏzaro Alessandro Soares Nunes1, Rafael Alkmin Reis1, Renộ Brenzikofer1, Rodrigo...

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Chapter 003. Decision-Making in Clinical Medicine (Part 2) pdf

Ngày tải lên : 06/07/2014, 08:20

... focal pulmonary consolidation on the physical examination will increase the clinician's confidence in the diagnosis because it fits the expected pattern of acute bacterial pneumonia Knowing this ... may spend valuable time seeking a pulmonary cause for the symptoms before considering and then confirming the cardiac diagnosis In this situation, the patient's clinical pattern does not fit ... two aspects of expert clinical reasoning: (1) the use of cognitive shortcuts as a way to organize the complex unstructured material that is collected in the clinical evaluation, and (2) the use...

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Chapter 003. Decision-Making in Clinical Medicine (Part 3) ppt

Ngày tải lên : 06/07/2014, 08:20

... make teaching diagnostic reasoning difficult is that expert clinicians not follow a fixed pattern in patient examinations From the outset, they are generating, refining, and discarding diagnostic ... Each question focuses the attention of the examiner to the exclusion of all other inputs until answered, allowing the examiner to move on to the next specific question Negative findings are often ... Based on the presenting complaint, the clinician pulled out a "URI Assessment Form" to improve quality and efficiency of care The physician quickly completed the examination components outlined on...

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Chapter 003. Decision-Making in Clinical Medicine (Part 4) doc

Ngày tải lên : 06/07/2014, 08:20

... physicians teaching at national meetings) and the local level (e.g., local educational programs, "curbside consultations") Opinion leaders not have to be physicians When conducting rounds with clinical ... examination has a very low likelihood of structural intracranial pathology Performance of a head CT or magnetic resonance imaging (MRI) scan in this situation would constitute defensive medicine ... drugs (including dosages and side effects), and are less likely to overreact to foreseeable problems in therapy such as a rise in creatinine levels or symptomatic hypotension Other intriguing research...

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Chapter 003. Decision-Making in Clinical Medicine (Part 5) pptx

Ngày tải lên : 06/07/2014, 08:20

... assist in making clinical decisions in the presence of uncertainty are reviewed Quantitative Methods to Aid Clinical Decision-Making The process of medical decision-making can be divided into two ... patients In summary, expert clinical decision-making can be appreciated as a complex interplay between cognitive devices used to simplify large amounts of complex information interacting with ... parts: (1) defining the available courses of action and estimating the likely outcomes with each, and (2) assessing the desirability of the outcomes The former task involves integrating key information...

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Chapter 003. Decision-Making in Clinical Medicine (Part 6) doc

Ngày tải lên : 06/07/2014, 08:20

... quantitative measure of the information content of a test Values range from 0.5 (no diagnostic information at all, test is equivalent to flipping a coin) to 1. 0 (perfect test) In the testing literature, ... focused on only one possible test parameter (e.g., ST-segment response in a treadmill exercise test) to the exclusion of other potentially relevant data In addition, ROC area comparisons not ... addition, ROC area comparisons not simulate the way test information is actually used in clinical practice Finally, biases in the underlying population used to generate the ROC curves (e.g., related...

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Chapter 003. Decision-Making in Clinical Medicine (Part 7) docx

Ngày tải lên : 06/07/2014, 08:20

... meaning that a negative result is almost 10 times more likely if the patient is disease-free than if he has disease Applications to Diagnostic Testing in CAD Consider two tests commonly used in ... Even if these can be integrated into a summary result, multiple levels of useful information may be present (e.g., strongly positive, positive, indeterminate, negative, strongly negative) While ... of sensitivity to use in a particular decision will often vary, depending on the distribution of disease stages present in the tested population A hospitalized population typically has a higher...

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Chapter 003. Decision-Making in Clinical Medicine (Part 8) docx

Ngày tải lên : 06/07/2014, 08:20

... of HIV infection and the prevalence and incidence of HIV infection in the population targeted This model, which required over 75 separate data points, provides novel insights into a clinical ... outcome, simulating the whole decision process, or providing algorithmic guidance Computer-based predictions using Bayesian or statistical regression models inform a clinical decision but not actually ... general steps are involved First, the decision problem must be clearly defined Second, the elements of the decision must be made explicit This involves specifying the alternatives being considered,...

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Chapter 003. Decision-Making in Clinical Medicine (Part 10) pps

Ngày tải lên : 06/07/2014, 08:20

... routinely treated with medicine alone) would be extremely misleading since the quality of "medical therapy" has made huge improvements in the interval Randomized controlled clinical trials include ... potentially harmful intervention, such as smoking or overeating to develop obesity The major difference between a well-done clinical trial and a well-done prospective observational study of a particular ... protection from treatment selection bias in the latter The underlying concept in the use of observational data to compare diagnostic or therapeutic strategies is that there is enough uncertainty in...

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Chapter 003. Decision-Making in Clinical Medicine (Part 11) docx

Ngày tải lên : 06/07/2014, 08:20

... Translating clinical research into clinical practice: Impact of using prediction rules to make decisions Ann Intern Med 14 4:2 01, 2006 [PMID: 16 4 619 65] Sanders GD et al: Cost-effectiveness of screening ... randomized controlled trials JAMA 287:2973, 2002 [PMID: 12 05 212 7] Del Mar C et al: Clinical Thinking: Evidence, Communication and Decision Making Malden, Mass., Blackwell, 2006 Grimes DA et al: Refining ... final step in guideline construction is peer review, followed by a final revision in response to the critiques provided Guidelines are closely tied to the process of quality improvement in medicine...

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Chapter 003. Decision-Making in Clinical Medicine (Part 9) doc

Ngày tải lên : 06/07/2014, 08:20

... access for concise overviews of UK required; and common clinical developing interventions countries MEDL INE for National Library http://www.nlm.nih.gov of Free via Internet Medicine database ... of data in abstract form However, it is often difficult, using MEDLINE, to locate reports that are on point in a sea of irrelevant or unhelpful information and being reasonably certain that important ... data since 19 91 available on Web http://www.acpjc.org Subscrip tion required site, updated yearly Clinica l Evidence Monthly http://www.clinicaleviden Subscrip updated directory ce.com tion of...

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Chapter 064. The Practice of Genetics in Clinical Medicine (Part 2) pptx

Ngày tải lên : 07/07/2014, 01:20

... the key to assessing the inherited risk for common adult-onset diseases rests in the collection and interpretation of a detailed personal and family medical history in conjunction with a directed ... Some adult-onset disease-causing mutations are more prevalent in certain ethnic groups For instance, >2% of the Ashkenazi population carry one of three specific mutations in the BRCA1 or BRCA2 ... causation A personal or family history of deep-vein thrombosis, in the absence of known environmental or medical risk factors, suggests a hereditary thrombotic disorder (Chap 11 1) The physical examination...

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Chapter 064. The Practice of Genetics in Clinical Medicine (Part 3) potx

Ngày tải lên : 07/07/2014, 01:20

... before initiating genetic testing is to ensure that the correct clinical diagnosis has been made, whether based on family history, characteristic physical findings, or biochemical testing Careful clinical ... strong family history (e.g., breast cancer, hemochromatosis), testing often includes known candidate genes, or traditional linkage analyses within pedigrees can identify disease-causing genes Once ... onset, as well as the co-occurrence of breast and ovarian cancer in this family, suggests the possibility of an inherited mutation in BRCA1 or BRCA2 It is unclear though—without genetic testing—whether...

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