... appreciation ofthe patient's perception ofthe illness, the patient's expectations ofthe physician and the health care system, and the financial and social implications ofthe illness to the patient ... defines the art of medicine, which is as necessary to thepracticeofmedicine as is a sound scientific base Clinical Skills History-Taking The written history of an illness should include all the ... appreciation ofthe role of stem cells in normal tissue function and in the development of cancer, degenerative disease, and other disorders The knowledge gleaned from the science ofmedicine has...
... precision, they often gain an aura of authority regardless ofthe fallibility ofthe tests themselves, the instruments used in the tests, and the individuals performing or interpreting them Physicians ... relieve the physician from the responsibility of carefully observing, examining, and studying the patient It is also essential to appreciate the limitations of diagnostic tests By virtue of their ... significance in the context ofthe patient's condition and other test results The development of technically improved imaging studies with greater sensitivity and specificity is one ofthe most rapidly...
... charges of malpractice and society from the excessive costs associated with the overuse of medical resources There are, however, caveats associated with clinical practice guidelines since they tend ... for the uniqueness of each individual and his or her illness The physician's challenge is to integrate into clinical practicethe useful recommendations offered by experts without accepting them ... and to help the physician decide how best to manage that individual's condition The battery of diagnostic tests complements the history and the physical examination The accuracy of a given test...
... understanding ofthe mechanisms of gender differences in the course and outcome of certain diseases For a more complete discussion of women's health, see Chap Care ofthe Elderly The relative proportion of ... 5% of hospitalized patients, and the incidence increases with use of a large number of drugs No matter what the clinical situation, it is the responsibility ofthe physician to use powerful therapeutic ... approach to decision-making in thepracticeofmedicine Evaluation of Outcomes Clinicians generally use objective and readily measurable parameters to judge the outcome of a therapeutic intervention...
... by the interplay of genetic and environmental factors Indeed, we have just begun to scratch the surface of possibilities that the era of genomics will provide to thepracticeofmedicineThe ... travel may be offset by the quality of care at these distant locations As much as any other factor influencing global aspects of medicine, the Internet has transformed the transfer of medical information ... complete discussion of global issues, see Chap Medicine on the Internet On the whole, the Internet has had a very positive effect on thepracticeof medicine; a wide range of information is available...
... students ofmedicine and related professions, and with their patients Thepracticeofmedicine is dependent on the sum total of medical knowledge, which in turn is based on an unending chain of scientific ... ages, to track to their sources the causes of disease, to correlate the vast stores of knowledge, that they may be quickly available for the prevention and cure of disease—these are our ambitions ... learning is an integral part of being a physician and must be given the highest priority Research, Teaching, and thePracticeofMedicineThe title doctor is derived from the Latin docere, "to teach,"...
... "hand-offs" from the outpatient to the inpatient environment, from the critical care unit to a general medicine floor, and from the hospital to the outpatient environment Clearly, one ofthe important ... American Board of Internal Medicine, working together with the American College of Physicians– American Society of Internal Medicine and the European Federation of Internal Medicine, has published ... aspects of diagnosis and treatment; (4) the need for numerous physicians to be involved in the care of most patients who are seriously ill; and (5) an increased number of malpractice suits, some of...
... disease, is a complex decision; it depends on the clinical features ofthe disorder, the desires ofthe patient and family, and whether the results of genetic testing will alter medical decision-making ... limitations of genetic testing in the management of a number of diverse diseases This is a difficult task, as scientific advances in genetic medicine have outpaced the translation of these discoveries ... influence the severity of infirmity, effect of treatment, and progression of disease The primary care clinician is now faced with the role of recognizing and counseling patients at risk for a number of...
... mutations would greatly impact the cost of testing without significantly influencing the effectiveness of mass screening Nevertheless, the individual who carries one ofthe less common cystic fibrosis–associated ... disease, they should be extended to include additional family members The determination of risk for an asymptomatic individual will vary depending on the size ofthe pedigree, the number of unaffected ... the relative risk ranges from two- to fivefold, underscoring the importance of family history for these prevalent disorders Pending further advances in genetic testing, the key to assessing the...
... history of breast and ovarian cancer on the paternal side of her family The early age of onset, as well as the co-occurrence of breast and ovarian cancer in this family, suggests the possibility of ... alteration in the proband and other family members, if they so desire In the example shown, if the proband's father has the BRCA1 mutation, there is a 50:50 probability that the mutation was transmitted ... carrying the disease-associated alleles will manifest a clinical disorder Furthermore, genes associated with some of these disorders often exhibit variable expression of disease For example, the breast...
... integrated into thepracticeofmedicine In most cases, however, the discovery of disease-associated genes has greatly outpaced studies that assess clinical outcomes and the impact of interventions ... genes The pattern of disease transmission, clinical course, and treatment may differ significantly, depending on the specific gene affected In these cases, the choice of which genes to test is often ... analysis ofthe gene of interest In addition, PCR enables genetic testing on minimal amounts of DNA extracted from a wide range of tissue sources including leukocytes, fibroblasts, epithelial...
... of their personal likelihood of disease in preparing pretest educational strategies Often, patients harbor unwarranted fear or denial of their likelihood of genetic risk Genetic testing has the ... that is comprehensible to the patient, who should be made aware ofthe disposition of test results Informed consent should also include a discussion ofthe mechanics of testing Most molecular ... mutation often express considerable anxiety and despair as they address the issue of risk to their children When a condition does not manifest until adulthood, clinicians will be faced with the question...
... and limitations ofthe various genetic testing options; Assist the patient, family, and referring physician in the interpretation ofthe test results; and Refer the patient and other at-risk family ... ultimate expression of disease; Address medical management issues; Assist in determining the role of genetic testing for the individual and family; Ensure that the patient is aware ofthe indications, ... both for themselves and for others in their family; Assess and enhance the patient's ability to cope with the genetic information offered; Discuss how nongenetic factors may relate to the ultimate...
... presymptomatic diagnosis ofthe disorder However, up to onethird of individuals who are homozygous for the HFE mutation not have evidence of iron overload Consequently, in the absence of a positive family ... contrast to the issue of population screening, it is important to test and counsel other family members when the diagnosis of hemochromatosis has been made in a proband Testing allows the physician ... also permits presymptomatic detection of iron overload and the institution of treatment (phlebotomy) before the development of organ damage Table 64-2 Examples of Genetic Testing and Possible Interventions...
... heterozygous or homozygous for this allele should therefore avoid the use oforal contraceptives and receive heparin prophylaxis after surgery or trauma The field of pharmacogenomics seeks to identify genes ... clinical course Although genetic diagnosis of these and other disorders is only beginning to be used in the clinical setting, predictive testing holds the promise of allowing earlier and more targeted ... hyperthermia, dihydropyrimidine dehydrogenase deficiency, the porphyrias, and glucose-6-phosphase dehydrogenase (G6PD) deficiency As noted above, the identification of genes that increase the...
... the aim ofthe lesson clear? Are the stages ofthe lesson clears? Does the teacher a variety of activities? Does the teacher encourage real use of language? Does the T use a warmer to begin the ... ORIGINAL STUCTURE: How often you | go | to the zoo? Introduce pictures ofthe park, the sports center, the mountain, the river, the kitchen and the school Check if the students know the vocabulary Set ... If the teacher has noticed any common mistakes, bring them to the attention ofthe students • FURTHER PRACTICE If the teacher has enough time and the students have mastered the structure, the...
... UNIVERSITY, HANOI COLLEGE OF FOREIGN LANGUAGES POST GRADUATE STUDIES DEPARTMENT TRẦN QUỐC VIỆT A STUDY ON THE TECHNIQUES FOR THE IMPROVEMENT TO THE TEACHING OFORAL SKILLS IN LIGHT OF COMMUNICATIVE ENGLISH ... THỦ THUẬT NÂNG CAO VIỆC DẠY KỸ NĂNG NGHE NÓI TIẾNG ANH THEO ĐƯỜNG HƯỚNG GIAO TIẾP CHO GIÁO VIÊN TRUNG HỌC CƠ SỞ TẠI TỈNH QUẢNG NGÃI) M.A.THESIS HA NOI-2007 ...
... National University-Hanoi for their valuable lectures And their knowledge, their thoughtfulness as well as their sympathy I will always appreciate For the accomplishment of this study, I wish to show ... like to acknowledge my debt to Assoc Prof Dr Lê Hùng Tiến and the staff members of Postgraduate Department, College of Foreign Languages, VNU-Hanoi for their enthusiastic support I am sincerely ... Teachers' workload 11 • Professional support 11 • Teachers' responses to the new Tieng Anh 6-9 textbook series .11 • Teachers' perception of their own teaching 11 2.6.2.5...
... than the ENGLISH textbook series They like the clear layout, the variety of exercise types and the logical sequencing ofthe TIENG ANH textbook series However, they want to reduce the number of ... use ofthe advantages offered and to minimize the shortcomings revealed Also in the first chapter are the definition and principles ofthe communicative approach Last in the first chapter are the ... formed the basis of pattern -practice drills, the distinguished feature of Audio-lingual classroom practice Often these drills were on audio cassette tapes and it was because of this method that the...