varying ethical values affect the practice of medicine indifferent locales

... appreciation of the patient's perception of the illness, the patient's expectations of the physician and the health care system, and the financial and social implications of the illness to the patient ... defines the art of medicine, which is as necessary to the practice of medicine as is a sound scientific base Clinical Skills History-Taking The written history of an illness should include all the ... appreciation of the 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 of medicine has...

Ngày tải lên: 06/07/2014, 08:20

... precision, they often gain an aura of authority regardless of the fallibility of the 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 of the patient's condition and other test results The development of technically improved imaging studies with greater sensitivity and specificity is one of the most rapidly...

Ngày tải lên: 06/07/2014, 08:20

... 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 practice the 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...

Ngày tải lên: 06/07/2014, 08:20

... understanding of the mechanisms of gender differences in the course and outcome of certain diseases For a more complete discussion of women's health, see Chap Care of the 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 of the physician to use powerful therapeutic ... approach to decision-making in the practice of medicine Evaluation of Outcomes Clinicians generally use objective and readily measurable parameters to judge the outcome of a therapeutic intervention...

Ngày tải lên: 06/07/2014, 08:20

... 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 the practice of medicine The ... 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 the practice of medicine; a wide range of information is available...

Ngày tải lên: 06/07/2014, 08:20

... students of medicine and related professions, and with their patients The practice of medicine 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 the Practice of Medicine The title doctor is derived from the Latin docere, "to teach,"...

Ngày tải lên: 06/07/2014, 08:20

... "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 of the 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...

Ngày tải lên: 06/07/2014, 08:20

... disease, is a complex decision; it depends on the clinical features of the disorder, the desires of the 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...

Ngày tải lên: 07/07/2014, 01:20

... disease, they should be extended to include additional family members The determination of risk for an asymptomatic individual will vary depending on the size of the pedigree, the number of unaffected ... mutations would greatly impact the cost of testing without significantly influencing the effectiveness of mass screening Nevertheless, the individual who carries one of the less common cystic fibrosis–associated ... 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...

Ngày tải lên: 07/07/2014, 01:20

... 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...

Ngày tải lên: 07/07/2014, 01:20

... 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 ... integrated into the practice of medicine In most cases, however, the discovery of disease-associated genes has greatly outpaced studies that assess clinical outcomes and the impact of interventions ... analysis of the 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...

Ngày tải lên: 07/07/2014, 01:20

... 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 of the disposition of test results Informed consent should also include a discussion of the 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...

Ngày tải lên: 07/07/2014, 01:20

... and limitations of the various genetic testing options; Assist the patient, family, and referring physician in the interpretation of the 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 of the 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...

Ngày tải lên: 07/07/2014, 01:20

... presymptomatic diagnosis of the 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...

Ngày tải lên: 07/07/2014, 01:20

... 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 ... heterozygous or homozygous for this allele should therefore avoid the use of oral contraceptives and receive heparin prophylaxis after surgery or trauma The field of pharmacogenomics seeks to identify genes ... hyperthermia, dihydropyrimidine dehydrogenase deficiency, the porphyrias, and glucose-6-phosphase dehydrogenase (G6PD) deficiency As noted above, the identification of genes that increase the...

Ngày tải lên: 07/07/2014, 01:20

... with the right level of challenge Much of the teacher's work in the classroom concerns getting the level of challenge right: this involves the type of tasks set, the speed expected from the student, ... words, e.g 'The girl loved the man', 'The 29 American ate the hamburger', 'The artist painted the boy' In other words the sentence has changed, but the rule has stayed the same We can go further than ... position to affect his or her attitude as will other members of the student's community Another factor affecting the attitude of students is their previous experiences as language learners If they were...

Ngày tải lên: 06/11/2013, 11:15

... similar way [19] When comparing the MLC region of the 2D gels between TA from PV– ⁄ – and PV+ ⁄ + mice, the pattern is virtually identical with the exception of the lack of the PV spot in PV– ⁄ – mice ... levels of MLC3 and PV are much higher in TA than in SOL, the ratio of the two proteins in each of the two muscles seemed to be constant (Fig 2C) A high degree of homology between short segments of ... transcription of mitochondrial genes has been observed as the result of permanent activation of some components of Ca2+ signaling pathways [13,14,24] Based on this, we hypothesized that the prolongation of...

Ngày tải lên: 19/02/2014, 07:20

... interesting encounters they recover the basic values of the human being such as the mystery of love and affection, to find that we only remain in the memory of those who loved us, of those we learned ... of patients and their families, while facilitating the acquirement of skills that allow the professionals to offer ethical responses to the concern and dilemmas proper to this stage of life The ... grief and the bioethical education of health workers Acknowledgements The Editors would like to thank the translation team of the Languages Service of the University of Salamanca for their collaboration...

Ngày tải lên: 19/02/2014, 10:20

... standards of practice are based upon the principles of ethical practice embodied in the NBCC Code of Ethics Therefore, these standards should be used in conjunction with the most recent version of the ... between the responses of the counselor and the client Asynchronous interaction occurs with a gap in time between the responses of the counselor and the client The selection of a specific form of counseling ... in light of delivery systems existing at the moment rather than at the time the standards were adopted In addition to following the NBCC® Code of Ethics pertaining to the practice of professional...

Ngày tải lên: 06/03/2014, 21:20

... History of Medicine, the University of Michigan, the University of Pittsburgh, the Cleveland Clinic, the New York Consortium for the History of Medicine at the New York Academy of Medicine, and the ... about to create In short, the concept of the physician as a professional in the intellectual and moral senses of the term and therefore the concept of the profession of medicine in its intellectual ... began in the second decade of the eighteenth century By then James was the mediciner Professor of Medicine, at Kings College and he gave Rob Roy the hospitality of his home the charm of the Gregorie...

Ngày tải lên: 07/03/2014, 04:20