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Hellenic Journal of Nuclear Medicine 2020Current literature records a glaring discrepancy between the rapid developments and progress of medicine and the simultaneous deterioration of the quality and safety of... (Review)
Review
Current literature records a glaring discrepancy between the rapid developments and progress of medicine and the simultaneous deterioration of the quality and safety of the provided health care services. Bibliographic data as far as perceptions of quality and safety in nuclear medicine departments are concerned, are limited and frequently ambiguous. Most nuclear medicine departments provide the same types of services, but not the same quality of service, while patients' perceptions are not always matched by the perceptions of health care providers. The multidimensional nature of quality and safety, deriving from the different criteria and standards by which different groups of the population attempt to interpret and evaluate them, justifies these discrepancies, over most of quality's and safety's dimensions studied. Nuclear medicine's unique characteristic of using radiopharmaceuticals, exposing to ionizing radiation affects dramatically these perceptions, irrespective of whether quality and safety assurance measures already cover radiation protection, instrumentation maintenance, radiopharmaceutical handling, and the management of all the other aspects of patient care. On the other end of the spectrum, patient-centred practice, communication and proper information play as a well decisive role in ensuring patients' satisfaction.
Topics: Humans; Nuclear Medicine; Quality Control; Safety
PubMed: 32361717
DOI: 10.1967/s002449912016 -
Science Translational Medicine Apr 2018Today's most transformative medicines exist because of fundamental discoveries that were made without regard to practical outcome and with their relevance to... (Review)
Review
Today's most transformative medicines exist because of fundamental discoveries that were made without regard to practical outcome and with their relevance to therapeutics only appearing decades later.
Topics: Animals; Humans; Medicine; Science
PubMed: 29695453
DOI: 10.1126/scitranslmed.aaq1787 -
Journal of Controlled Release :... Aug 2022Tumours are the second leading cause of death globally, generating alterations in biological interactions and, as a result, malfunctioning of crucial genetic traits.... (Review)
Review
Tumours are the second leading cause of death globally, generating alterations in biological interactions and, as a result, malfunctioning of crucial genetic traits. Technological advancements have made it possible to identify tumours at the cellular level, making transcriptional gene variations and other genetic variables more easily investigated. Standard chemotherapy is seen as a non-specific treatment that has the potential to destroy healthy cells while also causing systemic toxicity in individuals. As a result, developing new technologies has become a pressing necessity. QDs are semiconductor particles with diameters ranging from 2 to 10 nanometers. QDs have grabbed the interest of many researchers due to their unique characteristics, including compact size, large surface area, surface charges, and precise targeting. QD-based drug carriers are well known among the many nanocarriers. Using QDs as a delivery approach enhances solubility, lengthens retention time, and reduces the harmful effects of loaded medicines. Several varieties of quantum dots used in drug administration are discussed in this article, along with their chemical and physical characteristics and manufacturing methods. Furthermore, it discusses the role of QDs in biological, medicinal, and theranostic applications.
Topics: Drug Carriers; Humans; Neoplasms; Precision Medicine; Quantum Dots
PubMed: 35752250
DOI: 10.1016/j.jconrel.2022.06.033 -
Journal of Thoracic Imaging Sep 2014Professionalism has been described as the "basis of medicine's contract with society." This article reviews the foundational principles of medical professionalism and,... (Review)
Review
Professionalism has been described as the "basis of medicine's contract with society." This article reviews the foundational principles of medical professionalism and, more specifically, defines the nature and scope of radiologists' responsibilities to patients. In the face of ongoing changes in the environment of medical practice, maintenance of professionalism is an adaptive challenge that will require successful practitioners to be open to and actively engaged in continuous learning and self-improvement. Imaging 3.0 is a change process developed by the American College of Radiology to help radiologists redefine and reprioritize their professional activities as the discipline transitions from a volume-based to value-based specialty.
Topics: Clinical Competence; Humans; Radiology
PubMed: 25160596
DOI: 10.1097/RTI.0000000000000100 -
Zhongguo Zhong Yao Za Zhi = Zhongguo... Jan 2017Based on a systematic review of morphology and distribution of plants, alternate names, actions, and properties of herbs recorded in ancient and modern literatures, in... (Review)
Review
Based on a systematic review of morphology and distribution of plants, alternate names, actions, and properties of herbs recorded in ancient and modern literatures, in combination of field investigation, 18 Chinese herbal medicines recorded in ancient bencao literature were regarded to be derived from 7 species in the Ardisia genus. Among them, the variety Ardisia crenata f. hortensis was identified as the source of Zhushagen and Zijinniu. A. hanceana is referenced as Tiesan in the illustrated atlas of Botanical Nomenclature (Zhiwu Mingshi Tukao). The name Pingdimu refers to a different substance in the illustrated atlas of Botanical Nomenclature and the Flower Mirror (Huajing). The medicinals named Yedihong, Aicha, and Duanjiao sanlangare all derived from A. japonica. The origin of the herb Xiaoqing referenced in the Illustrated Classic of the Materia Medica (Bencao Tujing) is A. pusilla. The medicinals Bailiangjin, Jiuguanxue and Zoumatai are derived from A. crispa, A. brevicaulis, and A. gigantifolia, respectively. This investigation clarifies the botanical sources and actions of related Chinese medicinal materials in the genus Ardisia, and provides clues and evidence for utilizing and developing their medicinal plant resources.
Topics: Ardisia; Drugs, Chinese Herbal; Materia Medica; Plants, Medicinal
PubMed: 28948750
DOI: 10.19540/j.cnki.cjcmm.20161222.021 -
BMC Medical Education Apr 2023Healthcare systems often face shortages of certain medical specialists due to lack of interest among medical students. We questioned a common "one solution fits all"...
BACKGROUND
Healthcare systems often face shortages of certain medical specialists due to lack of interest among medical students. We questioned a common "one solution fits all" approach to this problem which involves monetary incentives to lure students to these specialties. Instead, we used the marketing principle the "consumer knows best" to explore ways of elucidating the reasons and proposing solutions for such shortages.
METHODS
A convenience sample of Israeli 6th-year medical students and interns completed questionnaires to determine why they thought three specialties (geriatrics, anesthesiology, emergency medicine) were unpopular and their ideas on increasing their appeal.
RESULTS
119 6th-year students and 84 interns completed questionnaires. Geriatrics was reported having a problematic patient population; not being interesting and challenging; and not considered prestigious by colleagues and the populace. This contrasts with emergency medicine which, although considered prestigious, has difficult working conditions both during and after residency accompanied by much pressure at work. Although, improvements in lifestyle and remuneration were thought by students and interns as possibly making these specialties more attractive, reducing the pressure at work and decreasing on-call obligations were designated by the students/interns as ways to increase emergency medicine's and anesthesiology's appeal. Half the students replied that anesthesiology would be more appealing if work was in shifts (< 16 h), while 60% replied so for emergency medicine and only 18% for geriatrics. 90% of students reported that control over lifestyle would make emergency medicine more attractive while 55% and 48% replied positively for anesthesiology and geriatrics, respectively.
CONCLUSIONS
Using the concept "consumer knows best" provided additional insight into the specialty selection process. Students/interns have specialty-specific opinions as to why some specialties are unpopular. Their ideas about attracting more students to these specialties were also specialty-dependent, i.e. "one solution does not fit all". These observations render problematic a single solution aimed at ameliorating the workforce shortages of multiple specialties. Instead, these results advocate a differential approach wherein the lack of appeal of each unpopular specialty is analyzed individually and the students'/interns' (the "consumers") ideas sought resulting in solutions tailored to address each specialty's lack of attractiveness.
TRIAL REGISTRATION
None.
Topics: Humans; Career Choice; Anesthesiology; Emergency Medicine; Surveys and Questionnaires; Students, Medical; Internship and Residency
PubMed: 37081461
DOI: 10.1186/s12909-023-04241-0 -
Regenerative Medicine 2015Significant investments in regenerative medicine necessitate discussion to align evidentiary requirements and decision-making considerations from regulatory, health... (Review)
Review
Significant investments in regenerative medicine necessitate discussion to align evidentiary requirements and decision-making considerations from regulatory, health system payer and developer perspectives. Only with coordinated efforts will the potential of regenerative medicine be realized. We report on discussions from two workshops sponsored by NICE, University of Alberta, Cell Therapy Catapult and Centre for Commercialization of Regenerative Medicine. We discuss methods to support the assessment of value for regenerative medicine products and services and the synergies that exist between market authorization and reimbursement regulations and practices. We discuss the convergence in novel adaptive licensing practices that may promote the development and adoption of novel therapeutics that meet the needs of healthcare payers.
Topics: Animals; Costs and Cost Analysis; Humans; Regenerative Medicine
PubMed: 26565607
DOI: 10.2217/rme.15.51 -
Journal of the American College of... Sep 2016Patients, hospitals, insurers, and the public rely on competent physicians. The definition and documentation of competency in cardiovascular training and practice... (Review)
Review
Patients, hospitals, insurers, and the public rely on competent physicians. The definition and documentation of competency in cardiovascular training and practice continues to evolve. New tools, such as the American College of Cardiology's in-training examination, restructured Core Cardiovascular Training Statement, curricular and lifelong learning competencies, and the Accreditation Council for Graduate Medical Education Milestones help define competent trainees and practitioners, and level the playing field. The American Board of Internal Medicine's Maintenance of Certification program is undergoing critical review, and a common vision of its future form and role are not yet clear. This paper explores present-day cardiovascular competency components, assessment tools, and strategies, and identifies challenges for the future.
Topics: Cardiology; Clinical Competence; Professional Practice
PubMed: 27634126
DOI: 10.1016/j.jacc.2016.05.097 -
Pulmonary Pharmacology & Therapeutics Dec 2022COVID-19 medicines, such as molnupiravir are beginning to emerge for public health and clinical practice. On the other hand, drugs display marked variability in their... (Review)
Review
COVID-19 medicines, such as molnupiravir are beginning to emerge for public health and clinical practice. On the other hand, drugs display marked variability in their efficacy and safety. Hence, COVID-19 medicines, as with all drugs, will be subject to the age-old maxim "one size prescription does not fit all". In this context, pharmacogenomics is the study of genome-by-drug interactions and offers insights on mechanisms of patient-to-patient and between-population variations in drug efficacy and safety. Pharmacogenomics information is crucial to tailoring the patients' prescriptions to achieve COVID-19 preventive and therapeutic interventions that take into account the host biology, patients' genome, and variable environmental exposures that collectively influence drug efficacy and safety. This expert review critically evaluates and summarizes the pharmacogenomics and personalized medicine aspects of the emerging COVID-19 drugs, and other selected drug interventions deployed to date. Here, we aim to sort out the hope, hype, and reality and suggest that there are veritable prospects to advance COVID-19 medicines for public health benefits, provided that pharmacogenomics is considered and implemented adequately. Pharmacogenomics is an integral part of rational and evidence-based medical practice. Scientists, health care professionals, pharmacists, pharmacovigilance practitioners, and importantly, patients stand to benefit by expanding the current pandemic response toolbox by the science of pharmacogenomics, and its applications in COVID-19 medicines and clinical trials.
Topics: Humans; Pharmacogenetics; Precision Medicine; Pandemics; COVID-19 Drug Treatment
PubMed: 36265833
DOI: 10.1016/j.pupt.2022.102172 -
Plastic and Reconstructive Surgery Oct 2021Evidence-based medicine, as described by Dr. Sackett, is defined as the "conscientious, explicit, and judicious use of current best evidence, combined with individual...
Evidence-based medicine, as described by Dr. Sackett, is defined as the "conscientious, explicit, and judicious use of current best evidence, combined with individual clinical expertise and patient preferences and values, in making decisions about the care of individual patients." In the late 2000s, seminal articles in Clinics in Plastic Surgery and Plastic and Reconstructive Surgery introduced evidence-based medicine's role in plastic surgery and redefined varying levels of evidence. The American Society of Plastic Surgeons sponsored the Colorado Springs Evidence-Based Medicine Summit that set forth a consensus statement and action plan regarding the increased incorporation of evidence-based medicine into the field; this key meeting ushered a new era among plastic surgeons worldwide. Over the past decade, Plastic and Reconstructive Surgery has incorporated evidence-based medicine into the Journal through an increase in articles with level I and II evidence, new sections of the Journal, and the introduction of validated tools to help authors perform prospective and randomized studies that ultimately led to best practices used today. Plastic surgery is a specialty built on problem-solving and innovation, values starkly in-line with evidence-based medicine. Evidence-based medicine is becoming more ingrained in our everyday practice and plastic surgery culture; however, we must work actively to ensure that we continue this trend. In the next decade, we will possibly see that level I and II evidence articles start to inhabit many of our journal issues.
Topics: Evidence-Based Medicine; History, 19th Century; History, 20th Century; History, 21st Century; Humans; Publishing; Quality Improvement; Societies, Medical; Surgery, Plastic; United States
PubMed: 34495896
DOI: 10.1097/PRS.0000000000008368