Xiang, Jinle; Zhu, Wenxue; Li, Zhixi; Ling, Shengbao
2012-06-01
The protective effects of juice and fermented vinegar from Hovenia dulcis peduncles on chronically ethanol-induced biochemical changes in male mice were investigated. Administration of ethanol (50%, v/v, 10 mL kg⁻¹) to mice for 6 weeks induced liver damage with a significant increase (P < 0.01) of the liver index, aspartate transaminase (AST), alanine transaminase (ALT), gamma glutamyl transferase (γ-GT) in the serum and the hepatic lipid peroxidation (LPO) level. In contrast, administration of juice or fermented vinegar from Hovenia dulcis peduncles (10 mL kg⁻¹ bw) along with alcohol significantly (P < 0.05) decreased the activities of the enzymes (AST, ALT and γ-GT), liver index, concentrations of triglyceride (TG) and total cholesterol (TCH) in the serum and the hepatic TG and LPO levels. Mice treated with juice or fermented vinegar from Hovenia dulcis peduncles showed better profiles of the antioxidant systems with relatively higher glutathione (GSH) content, total superoxide dismutase (T-SOD), catalase (CAT) and glutathione peroxidase (GSH-Px) activities. All these results were accompanied by histological observations in liver. The results demonstrate that both of the juice and fermented vinegar from Hovenia dulcis peduncles have beneficial effects in reducing the adverse effect of alcohol.
Lim, Sue Ji; Kim, Myungsuk; Randy, Ahmad; Nho, Chu Won
2015-04-01
Hovenia dulcis Thunb. (Rhamnaceae) is a hardy tree native to Europe, the Middle East, and North Africa, and it is also grown in parts of Asia and has been used in traditional medicine to treat liver toxicity, stomach disorders, and inflammation. This study investigated the anti-allergy potential of an extract of the branches of H. dulcis (HDB) using the antigen-stimulated mast cell-like cell line rat basophilic leukemia (RBL)-2H3 and a passive cutaneous anaphylaxis (PCA) mouse model. Degranulation assay, reverse transcription PCR, enzyme-lined immunosorbent assays, western blot analyses, and PCA were performed to measure allergic responses and proinflammatory mediators in antigen-stimulated rat basophilic leukemia (RBL)-2H3 mast cells and the PCA mouse model. In antigen-stimulated RBL-2H3 cells, HDB inhibited the secretion of β-hexosaminidase (indicating the inhibition of degranulation) and histamine release; decreased expression and production of the inflammatory mediators, cyclooxygenase-2 and prostaglandin E2, and cytokines interleukin-4 and tumor necrosis factor-α; and suppressed activation of nuclear factor κB, a transcription factor involved in the response to cytokines. HDB attenuated phosphorylation of the mast cell downstream effectors Lyn, Syk, phospholipase Cγ, protein kinase Cμ, extracellular signal-regulated kinase and p38. In IgE-sensitized mice, HDB inhibited mast cell-dependent PCA. Furthermore, HDB contained pinosylvin and possessed significant anti-allergic activities. These results suggest that HDB would be of value in the prevention and treatment of allergic diseases.
Anatomy, Ultrastructure and Chemical Composition of Food Bodies of Hovenia dulcis (Rhamnaceae)
Buono, Rafael Andrade; de Oliveira, Alaíde Braga; Paiva, Elder Antonio Sousa
2008-01-01
Background and Aims Food bodies (FBs) are structures that promote mutualism between plants and ants, which help protect them against herbivores. The present study aims to describe the anatomical organization, ultrastructure and chemical composition of the FBs in Hovenia dulcis, which represent the first structures of this type described in Rhamnaceae. Methods Leaves in various stages of development were collected and fixed for examination under light, transmission and scanning electron microscopy. Samples of FBs were subjected to chemical analysis using thin-layer chromatography and nuclear magnetic resonance of 1H and 13C. Key Results The FBs vary from globose to conical and are restricted to the abaxial leaf surface, having a mixed origin, including epidermis and parenchyma. The FB epidermis is uniseriate, slightly pilose and has a thin cuticle. The epidermal cells are vacuolated and pigments or food reserves are absent. The parenchyma cells of immature FBs have dense cytoplasm showing mitochondria, endoplasmic reticulum and plastids. Mature FB cells store oils, which are free in the cytosol and occupy a large portion of the cell lumen. In these cells the plastids accumulate starch. Conclusions The lipids present in FBs are glycerin esters characteristic of plant energy reserves. Ants were observed collecting these FBs, which allows us to infer that these structures mediate plant–ant interactions and can help protect the young plants against herbivores, as these structures are prevalent at this developmental stage. PMID:18413656
Choi, Ra-Yeong; Woo, Moon-Jae; Ham, Ju Ri; Lee, Mi-Kyung
2017-06-01
The anti-steatotic and anti-inflammatory effects of fruit water extract (FW) and seed ethanol extract (SE) of Hovenia dulcis Thunb. in chronic alcohol-fed rats were investigated. Rats were fed a liquid diet containing 36% calories from alcohol and orally administered FW or SE (300 and 500mg/kg/day). Both FW and SE reduced hepatic lipid contents and droplets, serum lipid concentration and inflammatory markers (hs-CRP, TNF-α and IL-6) levels compared with the alcohol control group. Alcohol led to significant decreases in the hepatic fatty acid oxidative gene (Ppargc1a, Cpt1a and Acsl1) levels, while it significantly increased the Myd88 and Tnfa gene levels. However, FW or SE supplementation significantly up-regulated gene expression of Ppargc1a, Ppara, Cpt1a and Acsl1, and down-regulated gene expression of Myd88, Tnfa and Crp compared with the alcohol control group. FW or SE supplementation also significantly decreased hepatic activities of fatty acid synthase and phosphatidate phosphohydrolase in chronic alcohol-fed rats. Plasma alcohol and acetaldehyde levels, hepatic enzyme activity and protein expression of CYP2E1 were lowered by FW or SE supplementation. These results indicate that both FW and SE play an important role in improvement of alcoholic hepatic steatosis and inflammation via regulation of lipid and inflammation metabolism. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
Peduncles elicit large-mammal endozoochory in a dry-fruited plant
Zhou, Youbing; Newman, Chris; Xie, Zongqiang; Macdonald, David W.
2013-01-01
Background and Aims Plants have evolved a variety of seed dispersal mechanisms to overcome lack of mobility. Many species embed seeds in fleshy pulp to elicit endozoochory, i.e. disseminating seed through the animal gut. In contrast to well-studied fleshy fruited plants, dry-fruited plants may exploit this dispersal mutualism by producing fleshy appendages as a nutritional reward to entice animals to swallow their diaspores, but this has been little studied. In this study, it is hypothesized that these accessory fruits represent co-adaptations facilitating the syndrome of mammalian endozoochorous dispersal. Methods Field observations (focal tree watches, faecal surveys and fruiting phenology) with experimental manipulations (examination of seed germination and feeding trials) were conducted over 2 years in a native population of the raisin tree, Hovenia dulcis, which produces enlarged, twisted brown peduncles with external black seeds, in central China. Key Results Birds were not observed to swallow seeds or carry infructescences away during 190 h of focal tree watches. However, H. dulcis seeds were detected in 247 faecal samples, representative of two herbivore and four carnivore mammalian species. Feeding trials revealed that peduncles attracted mammals to consume the entire infructescence, thereby facilitating effective seed dispersal. The germination rate of egested seeds proved higher than that of unconsumed seeds. It was also noted that this mutualism was most vulnerable in degraded forest. Conclusions Hovenia dulcis peduncle sets are confirmed to adapt primarily to mammalian endozoochory, a mutualistic association similar in function to fleshy pulp or foliage. This demonstrates that plant organ systems can be adapted to unique mutualisms that utilize animal dispersal agents. Such an ecological role has until now been attributed only to bird epizoochory. Future studies should consider more widely the putative role of peduncle sets and mammalian endozoochory as a dispersal mechanism, particularly for those plants that possess relatively large accessory fruits. PMID:23644364
Zhou, Youbing; Newman, Chris; Chen, Jin; Xie, Zongqiang; Macdonald, David W
2013-09-01
Ongoing global climate change is predicted to increase the frequency and magnitude of extreme weather events, impacting population dynamics and community structure. There is, however, a critical lack of case studies considering how climatic perturbations affect biotic interactions. Here, we document how an obligate seed dispersal mutualism was disrupted by a temporally anomalous and meteorologically extreme interlude of unseasonably frigid weather, with accompanying snowstorms, in subtropical China, during January-February 2008. Based on the analysis of 5892 fecal samples (representing six mammalian seed dispersers), this event caused a substantial disruption to the relative seed dispersal function for the raisin tree Hovenia dulcis from prestorm 6.29 (2006) and 11.47 (2007), down to 0.35 during the storm (2008). Crucially, this was due to impacts on mammalian seed dispersers and not due to a paucity of fruit, where 4.63 fruit per branch were available in January 2008, vs. 3.73 in 2006 and 3.58 in 2007. An induced dietary shift occurred among omnivorous carnivores during this event, from the consumption fruit to small mammals and birds, reducing their role in seed dispersal substantially. Induced range shift extinguished the functionality of herbivorous mammals completely, however, seed dispersal function was compensated in part by three omnivorous carnivores during poststorm years, and thus while the mutualism remained intact it was enacted by a narrower assemblage of species, rendering the system more vulnerable to extrinsic perturbations. The storm's extended effects also had anthropogenic corollaries - migrating ungulates becoming exposed to heightened levels of illegal hunting - causing long-term modification to the seed dispersal community and mutualism dynamics. Furthermore, degraded forests proved especially vulnerable to the storm's effects. Considering increasing climate variability and anthropogenic disturbance, the impacts of such massive, aberrant events warrant conservation concern, while affording unique insights into the stability of mutualisms and the processes that structure biodiversity and mediate ecosystem dynamics. © 2013 John Wiley & Sons Ltd.
[Application of lower body negative pressure (LBNP) in aerospace medicine].
Wu, Ping; Xie, Bao-sheng; Huang, Wei-fen
2002-06-01
Effects of LBNP is similar to that produced by gravitational force, especially as a stress factor on the cardiovascular system as has been concerned in the area of aerospace medicine. This paper described experimental equipment, methods and physiological effects of LBNP, especially its application in the area of aerospace medicine. Several aspects for future research were put forward.
A doctor of the highest caliber treats an illness before it happens.
Zhan, Mei
2009-01-01
"A doctor of the highest caliber treats an illness before it happens," a seemingly antiquated doctrine in traditional Chinese medicine, is enjoying surging popularity among practitioners in urban China and the United States today. In this essay, I examine how the meanings and contours of traditional Chinese medicine have shifted in recent decades as it is molded into a "preventive medicine" through translocal encounters. From the 1960s and the early 1970s, the emphasis China's socialist health care placed on preventive health among the rural poor shaped the practice of Chinese herbal medicine and especially acupuncture. This version of preventive medicine was also exported to the Third World, which China strove to champion. Since the end of the Cold War and especially during the 1990s, as China strives to "get on track with the world" (specifically, affluent nation-states, especially in North America and the European Union), traditional Chinese medicine has been rapidly commodified and reinvented as a new kind of preventive medicine tailored for cosmopolitan, middle-class lifestyles. The emergence of this radically new preventive medicine resuscitates certain stories of antiquity and continuity, emphasizing that traditional Chinese medicine has always been "preventive" while obliterating recent memories of the proletariat world and its preventive medicine.
Westaway, K; Frank, O; Husband, A; McClure, A; Shute, R; Edwards, S; Curtis, J; Rowett, D
2015-08-01
Hot days are increasingly common and are often associated with increased morbidity and mortality, especially in the elderly. Most heat-related illness and heat-related deaths are preventable. Medicines may accentuate the risk of dehydration and heat-related illness, especially in elderly people taking multiple medicines, through the following mechanisms: diuresis and electrolyte imbalance, sedation and cognitive impairment, changed thermoregulation, reduced thirst recognition, reduced sweat production, and hypotension and reduced cardiac output. Commonly used medicines that may significantly increase the risk include diuretics, especially when combined with an angiotensin converting enzyme (ACE) inhibitor or an angiotensin II receptor blocker (ARB), anticholinergics and psychotropics. Initiation of individualized preventive measures prior to the start of the hot weather season, which includes a review of the patient and their medicines to identify thermoregulatory issues, may reduce the risk of heat-related illness or death. © 2015 John Wiley & Sons Ltd.
Harmful Interactions: Mixing Alcohol with Medicines
... Interactions Print version Harmful Interactions Mixing Alcohol With Medicines You’ve probably seen this warning on medicines ... falls and serious injuries, especially among older people. Medicines may have many ingredients Some medications—including many ...
The prices people pay for medicines in Zimbabwe.
Gavaza, P; Simoyi, T; Makunike, B; Maponga, C C
2009-01-01
To collect, analyse and compare prices of medicines in different sectors and parts of the country and to compare them with the medicine prices in other countries. A prospective cross sectional study. Pharmacy outlets in Zimbabwe comprising 27 retail pharmacies, 23 dispensing doctors, eight public hospital pharmacies and seven municipal clinics. Median price ratios, 25th percentiles and 75th percentiles. Innovator brands in the private sector were priced 10 times the International References Prices (IRP) and more than three times the price of generic medicines. Dispensing doctors were charging the highest prices for medicines and the public sector had the least prices. The national procurement agency, NatPharm, procured medicines at prices slightly below the Management Sciences for Health (MSH) prices. Prices of medicines in the public sector were higher than average prices for medicines from seven other African countries. Medicine prices in Zimbabwe are high, a scenario that may compromise affordability and accessibility to medicines especially by the poor. Urgent steps are needed to reduce the level and effect of the high prices on the population, especially the poor.
[ilin Pills for oligoasthenospermia: Advances in clinical studies].
Zhang, Kai-Shu; Fu, Long-Long; Shang, Xue-Jun; Gu, Yi-Qun
2017-10-01
Industrialization and environmental pollution are bringing more problems to human reproduction and increasing the prevalence of male infertility. Western medicine has shown its limitations in the management of male infertility, especially that of oligoasthenospermia. Traditional Chinese medicine (TCM), however, has long and rich experiences in the treatment of oligoasthenospermia, with a large variety of medicinal prescriptions based on the TCM theories, among which Qilin Pills shows a particularly significant therapeutic effect on oligoasthenospermia, especially when combined with Western medicine. At present, published studies on Qilin Pills are mainly in the stage of clinical observation, while basic researches and studies on its relevant mechanisms are rarely seen.
[Mass spectrometry in medicine and biotechnology].
Polunina, T A; Kireev, M N; Khramchenkova, T A; Spitsyn, A N; Grigor'eva, G V
2013-01-01
History of development and improvement of tandem mass spectrometry, possibilities of its application at the contemporary stage in various fields of medicine and biotechnology including production of novel medicinal preparations, identification of biologically active substances, pathogenic microorganisms and causative agents of especially dangerous infections is given.
... the world, especially in countries with warm, humid climates. Some outbreaks have been traced to contaminated vegetables ( ... MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department ...
Ocular Safety of Topical Naltrexone
2013-04-01
prescription medicines , vitamins and herbal supplements. Especially tell your doctor if you take any opioid-containing medicines for pain, cough, or...squamous cell carcinoma. International Journal of Molecular Medicine 2000;5:191-6. 13. Zagon IS, McLaughlin PJ. Naloxone prolongs the survival time of mice...human pancreatic adenocarcinoma. International Journal of Molecular Medicine 2000;5:77-84. 18 35. Zagon IS, Verderame MF, Zimmer WE, McLaughlin PJ
[Integrative medicine development in China: enlightenment from Kampo medicine].
Gao, Peng-fei
2011-10-01
Japanese Kampo medicine has made huge progress in the 300-year development, especially in Kampo education, research and development of Kampo medicinal drugs, and industrialization and internationalization of Kampo medicine in recent 30 years. Based on the study of Japanese Kampo medicine, this article discussed some characteristics of Kampo medicine. For example, the emphasis of Kampo medicine research is the effectiveness and scientificalness; classical prescriptions are the main application in Kampo medicine while it also values correspondence between prescription and syndrome as well as abdomen examination; Kampo medicine emphasized the continuity of education after graduation; international development is accelerating in the research of Kampo medicinal drugs. Such a development strategy of Kampo medicine may benefit the development of integrative medicine in China.
Adipose tissue derived mesenchymal stem cells for musculoskeletal repair in veterinary medicine
Arnhold, Stefan; Wenisch, Sabine
2015-01-01
Adipose tissue derived stem cells (ASCs) are mesenchymal stem cells which can be obtained from different adipose tissue sources within the body. It is an abundant cell pool, which is easy accessible and the cells can be obtained in large numbers, cultivated and expanded in vitro and prepared for tissue engineering approaches, especially for skeletal tissue repair. In the recent years this cell population has attracted a great amount of attention among researchers in human as well as in veterinary medicine. In the meantime ASCs have been well characterized and their use in regenerative medicine is very well established. This review focuses on the characterization of ASCs for their use for tissue engineering approaches especially in veterinary medicine and also highlights a selection of clinical trials on the basis of ASCs as the relevant cell source. PMID:25973326
Adipose tissue derived mesenchymal stem cells for musculoskeletal repair in veterinary medicine.
Arnhold, Stefan; Wenisch, Sabine
2015-01-01
Adipose tissue derived stem cells (ASCs) are mesenchymal stem cells which can be obtained from different adipose tissue sources within the body. It is an abundant cell pool, which is easy accessible and the cells can be obtained in large numbers, cultivated and expanded in vitro and prepared for tissue engineering approaches, especially for skeletal tissue repair. In the recent years this cell population has attracted a great amount of attention among researchers in human as well as in veterinary medicine. In the meantime ASCs have been well characterized and their use in regenerative medicine is very well established. This review focuses on the characterization of ASCs for their use for tissue engineering approaches especially in veterinary medicine and also highlights a selection of clinical trials on the basis of ASCs as the relevant cell source.
Stem cells: intellectual property issues in regenerative medicine.
Zachariades, Nicholas A
2013-12-01
The topic of stem cells for use in regenerative medicine, especially embryonic stem cells, inspires much debate, discussion, and outrage as it slices through the very core moral values of society. These social and moral issues have, in turn, resulted in government policies that have influenced the study of stem cells in regenerative medicine.
A Qualitative Study of the "Doctor as Teacher" Principle in Naturopathic Medicine
ERIC Educational Resources Information Center
Adams, Matthew R.
2017-01-01
There is a field of complementary and alternative medicine known as naturopathic medicine. There are five naturopathic schools in the United States of America and two in Canada. Information regarding the practices and experiences of naturopathic physicians, especially relating to the principle of "doctor as teacher" is non-existent. The…
Riessen, R; Janssens, U; Buerke, M; Kluge, S
2016-05-01
In this paper the German Society for Medical Intensive Care Medicine and Emergency Medicine (DGIIN) provides statements regarding the importance and advancement of Medical Intensive Care Medicine within the structures of Internal Medicine in Germany. Of pivotal importance are the training of medical intensivists, the cooperation with intensivists from other disciplines and the collaboration with emergency departments. In order to fulfil the various and challenging tasks in patient care, training, research and medical education competently and on an international level, more intensivists in leading positions especially in academic institutions are essential.
... t bother most people (such as venom from bee stings and certain foods, medicines, and pollens) can ... Common allergens include: Animal dander Bee stings or stings from other insects Foods, especially nuts, fish, and shellfish Insect bites Medicines Plants Pollens
Alcohol use disorders and current pharmacological therapies: the role of GABAA receptors
Liang, Jing; Olsen, Richard W
2014-01-01
Alcohol use disorders (AUD) are defined as alcohol abuse and alcohol dependence, which create large problems both for society and for the drinkers themselves. To date, no therapeutic can effectively solve these problems. Understanding the underlying mechanisms leading to AUD is critically important for developing effective and safe pharmacological therapies. Benzodiazepines (BZs) are used to reduce the symptoms of alcohol withdrawal syndrome. However, frequent use of BZs causes cross-tolerance, dependence, and cross-addiction to alcohol. The FDA-approved naltrexone and acamprosate have shown mixed results in clinical trials. Naltrexone is effective to treat alcohol dependence (decreased length and frequency of drinking bouts), but its severe side effects, including withdrawal symptoms, are difficult to overcome. Acamprosate showed efficacy for treating alcohol dependence in European trials, but two large US trials have failed to confirm the efficacy. Another FDA-approved medication, disulfiram, does not diminish craving, and it causes a peripheral neuropathy. Kudzu is the only natural medication mentioned by the National Institute on Alcohol Abuse and Alcoholism, but its mechanisms of action are not yet established. It has been recently shown that dihydromyricetin, a flavonoid purified from Hovenia, has unique effects on GABAA receptors and blocks ethanol intoxication and withdrawal in alcoholic animal models. In this article, we review the role of GABAA receptors in the treatment of AUD and currently available and potentially novel pharmacological agents. PMID:25066321
Methodological challenges to human medical study.
Zhong, Yixin; Liu, Baoyan; Qu, Hua; Xie, Qi
2014-09-01
With the transformation of modern medicinal pattern, medical studies are confronted with methodological challenges. By analyzing two methodologies existing in the study of physical matter system and information system, the article points out that traditional Chinese medicine (TCM), especially the treatment based on syndrome differentiation, embodies information conception of methodological positions, while western medicine represents matter conception of methodological positions. It proposes a new way of thinking about combination of TCM and western medicine by combinating two kinds of methodological methods.
Complementary and alternative medicine use in Iranian patients with diabetes mellitus.
Hashempur, Mohammad Hashem; Heydari, Mojtaba; Mosavat, Seyed Hamdollah; Heydari, Seyyed Taghi; Shams, Mesbah
2015-09-01
There is increasing interest in complementary and alternative medicine generally, and especially by those affected by chronic diseases, such as diabetes mellitus. We aimed to determine the prevalence and pattern of complementary and alternative medicine use among patients suffering from diabetes mellitus in Shiraz, southern Iran. Another objective was to explore associated factors for use of complementary and alternative medicine among patients with diabetes mellitus. A 19-item semi-structured questionnaire (open- and close-ended) was administered to 239 patients with diabetes mellitus in this cross-sectional study. It was carried out in two outpatient diabetes clinics affiliated with the Shiraz University of Medical Sciences, Shiraz, Iran. One hundred and eighty patients (75.3%) used at least one type of complementary and alternative medicine in the last year prior to the interview. Patients with diabetes mellitus who were living in a large family (≥5 members), not taking insulin, and believed that complementary and alternative medicine have synergistic effects with conventional medicine, were independently and significantly (P values: 0.02, 0.04, and 0.01, respectively) more likely to use complementary and alternative medicine. Most of the users (97.7%) reported use of herbal preparations, and 89.4% of users did not change their medication, neither in medication schedule nor its dosage. The use of complementary and alternative medicine, especially herbal remedies, is popular among diabetes patients in Shiraz, Iran. This use is associated with patients' family size, type of conventional medications and their view about concomitant use of complementary and conventional medicine.
Larson, E B
2001-05-15
During the past quarter century, general internal medicine has emerged as a vital discipline. In the realm of patient care, it is the integrating discipline par excellence. Ironically, as general internists face the challenge of integrating advances of dizzying speed and complexity, and as their clinical practice becomes increasingly effective, it has become much more difficult for them to earn a living. General internists find themselves at the crossroads of prosperity and despair. Although general medicine research leads the research agenda in many departments of medicine, it is particularly vulnerable. The necessary multidisciplinary "programmatic" infrastructure is expensive, and results often take many years to obtain, particularly in the study of chronic disease. The educational environment in many institutions is particularly difficult for general medicine, both because the current emphasis on technical skills obscures patients' and learners' real needs and because complex patients on general medicine services are now so ill and their turnover so rapid. General internal medicine and geriatrics are synergistic, especially in today's marketplace. A focus on geriatric medicine could help general medicine continue to flourish. General internists are ideally suited to the integrated care of elderly patients with multiple problems, research opportunities are enormous in the geriatric population, and the teaching of geriatrics requires a high level of generalist skills. Problems that plague current generalist practice have unique significance to older patients. Organizations that represent general internists would do well to join forces with many other advocacy groups, especially those representing the interests of elderly patients and geriatric medicine.
1993-04-01
student dropout rate and a lacking scientific tradition. This paper would be beneficial to someone interested in educa- tion, especially the...Competition is keen, especially in engineering, and medicine. The test is very difficult. It tests students knowledge of biology, chemistry, physics...States’ Industrial and National War Colleges and prepares "civilians and military to perform executive and advisory functions, especially in those
An Education Strategy to Respond to Medicine Inequality in Africa.
Byrn, Stephen R; Ekeocha, Zita; Clase, Kari L
2017-07-01
People living in Africa face a heavy and wide-ranging burden of disease that takes an incalculable toll on social and economic development as well as shortening life expectancy (life expectancy in Tanzania is about 60 vs. about 80 in the United States and Europe. Further, the pharmaceutical market in developing countries is immature and may not support quality medicines. In many cases, a tender system is used, and medicines are bought by the government at the lowest price. In addition to access to medicines, a number of pharmaceutical sciences problems are apparent. The availability of infrastructure and especially standard instruments such as HPLC and X-ray diffraction is minimal. Additionally, there is an important need to increase access to advanced education for men and women in Africa, especially access to state-of-the-art scientific education. Utilizing the mandate of Nelson Mandela, Purdue's conceptual approach has been to utilize education to combat these problems. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.
A pilot study of herbal medicine use in a Midwest Latino population
Kiefer, David; Bradbury, E. Jane; Tellez-Girón, Patricia
2014-01-01
Background Herbal medicine use is common in the United States, especially in immigrant populations. This plant use is incompletely understood, with significant gaps in the literature for people living in the Midwest, about the plant species used, and about how home herbal medicine use interacts with allopathic medicine. Methods This pilot project used a qualitative research approach (interviews and focus groups, convenience sampling) to explore this topic for Latin America immigrants living in Madison, Wisconsin. Results Eight interviews and focus groups consisting of 42 people yielded 199 minutes of audio recordings and the mention of 57 medicinal plants. These plants were obtained from gardens, relatives and friends (abroad and local), mail order, and ten local retail establishments. Retail sites sold fresh plants, dried plants, spices, foods, and packaged products, ranging from 20 to over 150 plant products per site. A preponderance of plants, especially in Latino-focused stores, was food that also served a medicinal purpose. Participants mentioned 35 distinct health and disease categories for which herbal medicines were used, and sometimes, but not always, discussed plant use with their health care provider. When compared with likely Latin binomial taxonomic names, clinically-relevant confusions with the use of common plant names were also identified. Conclusions Overall, the findings presented illustrate the complexities surrounding herbal medicine use, and create a case for future work to involve other demographics, and focus on botanical identification, the quantification of disclosure rates, and the development of educational interventions for physicians and patients. PMID:24908901
ERIC Educational Resources Information Center
Milligan, J. E.; And Others
1983-01-01
Pregnant women, especially those working in veterinary medicine, face occupational health/disease risks from mutagens, teratogens, and carcinogens. These hazards can be placed into three categories: physical, chemical, and biological. Each of these hazards is discussed with examples. (Author/JN)
Ushie, Boniface Ayanbekongshie; Ugal, David Betelwhobel; Ingwu, Justin Agorye
2016-01-01
Lower availability of medicines in Nigerian public health facilities-the most affordable option for the masses-undermines global health reforms to improve access to health for all, especially the chronically ill and poor. Thus, a sizeable proportion of healthcare users, irrespective of purchasing power, buy medicines at higher costs from for-profit pharmacies. We examined user evaluation of medicine availability in public facilities and how this influences their choice of where to buy medicines in selected states-Cross River, Enugu and Oyo-in Nigeria. We approached and interviewed 1711 healthcare users using a semi-structured, interviewer-administered questionnaire as they exited for-profit pharmacies after purchasing medicines. This ensured that both clients who had presented at health facilities (private/public) and those who did not were included. Information was collected on why respondents could not buy medicines at the hospitals they attended, their views of medicine availability and whether their choice of where to buy medicines is influenced by non-availability. Respondents' mean age was 37.7±14.4 years; 52% were males, 59% were married, 82% earned ≥NGN18, 000 (US$57.19) per month, and 72% were not insured. Majority (66%) had prescriptions; of this, 70% were from public facilities. Eighteen percent of all respondents indicated that all their medicines were usually available at the public facilities, most (29%), some (44%) and not always available (10%). Reasons for using for-profit pharmacies included: health workers attitudes (43%), referral by providers (43%); inadequate money to purchase all prescribed drugs (42%) and cumbersome processes for obtaining medicines. Lower availability of medicines has serious implications for healthcare behavior, especially because of poverty. It is crucial for government to fulfill its mandate of equitable access to care for all by making medicines available and cheap through reviving and sustaining the drug revolving fund scheme and encouraging the prescription of generic drugs in all public health facilities.
Changing paradigm of cancer therapy: precision medicine by next-generation sequencing
Xue, Yuan; Wilcox, William R.
2016-01-01
Precision medicine aims to identify the right drug, for the right patient, at the right dose, at the right time, which is particularly important in cancer therapy. Problems such as the variability of treatment response and resistance to medication have been long-standing challenges in oncology, especially for development of new medications. Solid tumors, unlike hematologic malignancies or brain tumors, are remarkably diverse in their cellular origins and developmental timing. The ability of next-generation sequencing (NGS) to analyze the comprehensive landscape of genetic alterations brings promises to diseases that have a highly complex and heterogeneous genetic composition such as cancer. Here we provide an overview of how NGS is able to facilitate precision medicine and change the paradigm of cancer therapy, especially for solid tumors, through technical advancements, molecular diagnosis, response monitoring and clinical trials. PMID:27144059
Medicine and psychiatry in Western culture: among Ancient Greek myths and modern prejudices.
Fornaro, Michele; Clementi, Nicoletta; Fornaro, Pantaleo
2009-01-01
While many ancient cultures contributed to our current knowledge about medicine and psychiatry origins, Ancient Greeks were among the best observers of feelings and moods patients could express toward medicine and toward what today referred as "psychopathology". Myths and religious references were used to explain what elsewhere impossible to understand or easily communicated. Most of ancient myths focus on ambiguous feelings patients could have towards drugs, especially psychotropic ones. Interestingly, such prejudices are common yet today. Recalling ancient findings and descriptions made using myths, should represent a valuable knowledge for modern physicians, especially for psychiatrists, and their patients, with the aim of better understanding each other and therefore achieving a better clinical outcome. The paper explores many human aspects and feelings toward doctors and their cures, referring to ancient myths, focusing on the perception of mental illness.
Suicidal Thoughts among Adolescents: An Intercultural Approach.
ERIC Educational Resources Information Center
Choquet, Marie; And Others
1993-01-01
Conducted two epidemiological surveys of suicidal ideation among adolescents in France and Quebec. Results suggest that, in both France and Canada, suicidal ideation was linked to drug use (especially tobacco, illicit drugs, and psychotropic medicine), nonspecific somatic complaints (especially tiredness, sleep difficulties, depression, and…
[Precision and personalized medicine].
Sipka, Sándor
2016-10-01
The author describes the concept of "personalized medicine" and the newly introduced "precision medicine". "Precision medicine" applies the terms of "phenotype", "endotype" and "biomarker" in order to characterize more precisely the various diseases. Using "biomarkers" the homogeneous type of a disease (a "phenotype") can be divided into subgroups called "endotypes" requiring different forms of treatment and financing. The good results of "precision medicine" have become especially apparent in relation with allergic and autoimmune diseases. The application of this new way of thinking is going to be necessary in Hungary, too, in the near future for participants, controllers and financing boards of healthcare. Orv. Hetil., 2016, 157(44), 1739-1741.
Comparison of Leiomyoma of Modern Medicine and Traditional Persian Medicine.
Tansaz, Mojgan; Tajadini, Haleh
2016-04-01
Leiomyoma is the most common benign tumor of the pelvic that is associated with reproductive problems such as infertility, frequent abortions, and undesirable prenatal outcomes. High prevalence of leiomyoma and its relation with important gynecological complications, especially during reproductive ages, on the one hand, and high medical expenses and significant complications of common treatments, on the other, made us search traditional Persian medicine texts for a similar disease. In traditional Persian medicine, a condition has been introduced similar to leiomyoma (Oram-e-rahem). In this article, by collecting materials from traditional medicine texts on leiomyoma, we aim to provide theories for further studies on this topic, as there is an obvious difference between traditional Persian medicine and modern medicine with regard to leiomyoma. When modern medicine has not found a suitable response to treatment, reviewing of traditional Persian medicine for finding better treatment strategies is wise. © The Author(s) 2015.
Drug quality in South Africa: perceptions of key players involved in medicines distribution.
Patel, Aarti; Norris, Pauline; Gauld, Robin; Rades, Thomas
2009-01-01
Substandard medicines contribute to poor public health and affect development, especially in the developing world. However knowledge of how manufacturers, distributors and providers understand the concept of drug quality and what strategies they adopt to ensure drug quality is limited, particularly in the developing world. The purpose of this paper is to explore pharmaceutical manufacturers', distributors' and providers' perceptions of drug quality in South Africa and how they ensure the quality of drugs during the distribution process. The approach taken was qualitative data collection through key informant interviews using a semi-structured interview guide. Transcripts were analysed thematically in Johannesburg, Pretoria and Durban, South Africa. Participants were recruited purposefully from a South African pharmaceutical manufacturer, SA subsidiaries of international manufacturers, national distribution companies, national wholesaler, public and private sector pharmacists, and a dispensing doctor. In total, ten interviews were conducted. Participants described drug quality in terms of the product and the processes involved in manufacturing and handling the product. Participants identified purchasing registered medicines from licensed suppliers, use of standard operating procedures, and audits between manufacturer and distributor and/or provider as key strategies employed to protect medicine quality. Effective communication amongst all stakeholders, especially in terms of providing feedback regarding complaints about medicine quality, appears as a potential area of concern, which would benefit from further research. The paper hightlights that ensuring medicine quality should be a shared responsibility amongst all involved in the distribution process to prevent medicines moving from one distribution system (public) into another (private).
Hierarchy as a barrier to advancement for women in academic medicine.
Conrad, Peter; Carr, Phyllis; Knight, Sharon; Renfrew, Megan R; Dunn, Mary B; Pololi, Linda
2010-04-01
Research on barriers to professional advancement for women in academic medicine has not adequately considered the role of environmental factors and how the structure of organizations affects professional advancement and work experiences. This article examines the impact of the hierarchy, including both the organization's hierarchical structure and professionals' perceptions of this structure, in medical school organization on faculty members' experience and advancement in academic medicine. As part of an inductive qualitative study of faculty in five disparate U.S. medical schools, we interviewed 96 medical faculty at different career stages and in diverse specialties, using in-depth semistructured interviews, about their perceptions about and experiences in academic medicine. Data were coded and analysis was conducted in the grounded theory tradition. Our respondents saw the hierarchy of chairs, based on the indeterminate tenure of department chairs, as a central characteristic of the structure of academic medicine. Many faculty saw this hierarchy as affecting inclusion, reducing transparency in decision making, and impeding advancement. Indeterminate chair terms lessen turnover and may create a bottleneck for advancement. Both men and women faculty perceived this hierarchy, but women saw it as more consequential. The hierarchical structure of academic medicine has a significant impact on faculty work experiences, including advancement, especially for women. We suggest that medical schools consider alternative models of leadership and managerial styles, including fixed terms for chairs with a greater emphasis on inclusion. This is a structural reform that could increase opportunities for advancement especially for women in academic medicine.
Tsai, Ming-Yen; Chen, Shih-Yu; Lin, Chung-Chun
2017-04-01
The Meridian Energy Analysis Device is currently a popular tool in the scientific research of meridian electrophysiology. In this field, it is generally believed that measuring the electrical conductivity of meridians provides information about the balance of bioenergy or Qi-blood in the body. PubMed database based on some original articles from 1956 to 2014 and the authoŕs clinical experience. In this short communication, we provide clinical examples of Meridian Energy Analysis Device application, especially in the field of traditional Chinese medicine, discuss the reliability of the measurements, and put the values obtained into context by considering items of considerable variability and by estimating sample size. The Meridian Energy Analysis Device is making a valuable contribution to the diagnosis of Qi-blood dysfunction. It can be assessed from short-term and long-term meridian bioenergy recordings. It is one of the few methods that allow outpatient traditional Chinese medicine diagnosis, monitoring the progress, therapeutic effect and evaluation of patient prognosis. The holistic approaches underlying the practice of traditional Chinese medicine and new trends in modern medicine toward the use of objective instruments require in-depth knowledge of the mechanisms of meridian energy, and the Meridian Energy Analysis Device can feasibly be used for understanding and interpreting traditional Chinese medicine theory, especially in view of its expansion in Western countries.
[Causal inference in medicine--a historical view in epidemiology].
Tsuda, T; Babazono, A; Mino, Y; Matsuoka, H; Yamamoto, E
1996-07-01
Changes of causal inference concepts in medicine, especially those having to do with chronic diseases, were reviewed. The review is divided into five sections. First, several articles on the increased academic acceptance of observational research are cited. Second, the definitions of confounder and effect modifier concepts are explained. Third, the debate over the so-called "criteria for causal inference" was discussed. Many articles have pointed out various problems related to the lack of logical bases for standard criteria, however, such criteria continue to be misapplied in Japan. Fourth, the Popperian and verificationist concepts of causal inference are summarized. Lastly, a recent controversy on meta-analysis is explained. Causal inference plays an important role in epidemiologic theory and medicine. However, because this concept has not been well-introduced in Japan, there has been much misuse of the concept, especially when used for conventional criteria.
Application of Traditional Chinese Medicine in Treatment of Atrial Fibrillation
Dong, Yan; Yao, Kuiwu; Jiang, Wenrui
2017-01-01
Atrial fibrillation (AF) is the most common cardiac arrhythmia, which is related to many cardiac and cerebral vascular diseases, especially stroke. It can therefore increase cardiovascular mortality and all-cause death. The current treatments of AF remain to be western drugs and radiofrequency ablation which are limited by the tolerance of patients, adverse side effects, and high recurrence rate, especially for the elderly. On the contrary, traditional Chinese medicine (TCM) with long history of use involves various treatment methods, including Chinese herbal medicines (CHMs) or bioactive ingredients, Chinese patent medicines, acupuncture, Qigong, and Tai Chi Chuan. With more and more researches reported, the active roles of TCM in AF management have been discovered. Then it is likely that TCM would be effective preventive means and valuable additional remedy for AF. The potential mechanisms further found by numerous experimental studies showed the distinct characteristics of TCM. Some CHMs or bioactive ingredients are atrial-selective, while others are multichannel and multifunctional. Therefore, in this review we summarized the treatment strategies reported in TCM, with the purpose of providing novel ideas and directions for AF management. PMID:28243308
Sim, Tin Fei; Hattingh, H Laetitia; Sherriff, Jillian; Tee, Lisa B G
2018-05-01
Community pharmacists play a significant role in the provision of non-prescription medicines. There is evidence that women self-medicate and use non-prescription medicines whilst breastfeeding. Studies have demonstrated that breastfeeding women are likely to seek advice from pharmacists, presenting a unique opportunity for pharmacists to provide on-going support of these women especially in relation to the appropriate use of non-prescription medicines. This study aimed to explore community pharmacists' attitudes and perspectives towards the use of non-prescription medicines during breastfeeding. This exploratory study was conducted through semi-structured interviews with 30 community pharmacists in Western Australia, between July and September 2013. Transcribed data were analysed using descriptive and qualitative approaches. NVivo ® Version 10.0 was used to organise qualitative data and quotations to facilitate thematic analysis. Four major themes emerged. Despite the positive attitudes and favourable perceived knowledge level, participants often found themselves in a dilemma when required to make clinical recommendations especially in situations where there was a therapeutic need for treatment but clear guidelines or evidence to suggest safety of the medicines or treatment in lactation was absent. Despite the popularity of complementary medicines, participants felt more confident in providing advice in relation to conventional over complementary medicines. Whilst medication safety is within the field of expertise of pharmacists, the absence of information and safety data was seen as a major challenge and barrier to enable pharmacists to confidently provide evidence-based recommendations. This study has enhanced our understanding of the attitudes and perspectives of community pharmacists towards the use of non-prescription, including complementary medicines, during breastfeeding. Future studies are warranted to confirm the safety of commonly used or requested medicines in breastfeeding. University training and continuing education for pharmacists should include the latest information available regarding the use of both conventional and complementary medicines throughout lactation. Copyright © 2017 Elsevier Inc. All rights reserved.
Natural Antioxidants in Foods and Medicinal Plants: Extraction, Assessment and Resources
Xu, Dong-Ping; Li, Ya; Meng, Xiao; Zhou, Tong; Zhou, Yue; Zheng, Jie; Zhang, Jiao-Jiao; Li, Hua-Bin
2017-01-01
Natural antioxidants are widely distributed in food and medicinal plants. These natural antioxidants, especially polyphenols and carotenoids, exhibit a wide range of biological effects, including anti-inflammatory, anti-aging, anti-atherosclerosis and anticancer. The effective extraction and proper assessment of antioxidants from food and medicinal plants are crucial to explore the potential antioxidant sources and promote the application in functional foods, pharmaceuticals and food additives. The present paper provides comprehensive information on the green extraction technologies of natural antioxidants, assessment of antioxidant activity at chemical and cellular based levels and their main resources from food and medicinal plants. PMID:28067795
Natural Antioxidants in Foods and Medicinal Plants: Extraction, Assessment and Resources.
Xu, Dong-Ping; Li, Ya; Meng, Xiao; Zhou, Tong; Zhou, Yue; Zheng, Jie; Zhang, Jiao-Jiao; Li, Hua-Bin
2017-01-05
Natural antioxidants are widely distributed in food and medicinal plants. These natural antioxidants, especially polyphenols and carotenoids, exhibit a wide range of biological effects, including anti-inflammatory, anti-aging, anti-atherosclerosis and anticancer. The effective extraction and proper assessment of antioxidants from food and medicinal plants are crucial to explore the potential antioxidant sources and promote the application in functional foods, pharmaceuticals and food additives. The present paper provides comprehensive information on the green extraction technologies of natural antioxidants, assessment of antioxidant activity at chemical and cellular based levels and their main resources from food and medicinal plants.
Leung, Gilberto Ka Kit
2010-01-01
An undergraduate education in liberal arts is viewed by many, especially in North America, as a desirable preparation for medical school. In countries where such a pre-medicine curriculum is not available, an introduction of 'humanities in medicine' has recently been emphasized. Few, however, has entertained the idea that Medicine already possesses many elements of a liberal arts education. In this article, the author discussed how Medicine may be treated as a liberal arts curriculum, and how the very awareness of this possibility should be articulated and shared by both medical students and teachers. Medical education in countries without a pre-medical curriculum may be transformed from doctor-training to a new level of an explicit and complete education for the individuals.
Precision Medicine, Cardiovascular Disease and Hunting Elephants.
Joyner, Michael J
2016-01-01
Precision medicine postulates improved prediction, prevention, diagnosis and treatment of disease based on patient specific factors especially DNA sequence (i.e., gene) variants. Ideas related to precision medicine stem from the much anticipated "genetic revolution in medicine" arising seamlessly from the human genome project (HGP). In this essay I deconstruct the concept of precision medicine and raise questions about the validity of the paradigm in general and its application to cardiovascular disease. Thus far precision medicine has underperformed based on the vision promulgated by enthusiasts. While niche successes for precision medicine are likely, the promises of broad based transformation should be viewed with skepticism. Open discussion and debate related to precision medicine are urgently needed to avoid misapplication of resources, hype, iatrogenic interventions, and distraction from established approaches with ongoing utility. Failure to engage in such debate will lead to negative unintended consequences from a revolution that might never come. Copyright © 2016 Elsevier Inc. All rights reserved.
Stem cell research and regenerative medicine in 2014: first year of regenerative medicine in Japan.
Okano, Hideyuki
2014-09-15
It is my great pleasure to announce that we were able to publish the Japan Issue in Stem Cells and Development, especially in this year 2014. This year, 2014, is said to be the First Year of Regenerative Medicine in Japan. This movement is likely to be based on the establishment of a new law system regarding regenerative medicine (an Act for Ensuring the Safety of Regenerative Medicine or the so-called Regenerative Medicine Law) and the partial revision of the Pharmaceutical Affairs Law (PAL). Both laws will come into effect in 2014 in this country. These new law systems are expected to have a great impact on the facilitation of R&D related to regenerative medicine and stem cell biology. In the present Japan Issue, some excellent stem cell research in this country will be introduced to celebrate the First Year of Regenerative Medicine in Japan.
Global medicinal uses of Euphorbia L. (Euphorbiaceae).
Ernst, Madeleine; Grace, Olwen M; Saslis-Lagoudakis, C Haris; Nilsson, Niclas; Simonsen, Henrik Toft; Rønsted, Nina
2015-12-24
The genus Euphorbia (spurges, Euphorbiaceae) is the third largest genus of flowering plants, with almost 2000 species. Its exceptional diversity of growth forms and near-cosmopolitan distribution have attracted human interest since ancient times. For instance in Australia, topical application of latex of Euphorbia peplus L. is used as a home treatment for skin cancer and actinic keratosis. Its use in Australian folk medicine has inspired the release of the drug Picato® (ingenol mebutate), and further fostered interest in natural products and medicinal uses of Euphorbia in recent years. To provide an indicative overview of medicinal uses of the genus Euphorbia driven by the recent interest in biologically active natural products from Euphorbia in drug discovery. We assess documented medicinal knowledge and value of the genus Euphorbia and the taxonomic distribution of this value. We undertook an extensive survey of over 260 multidisciplinary publications on the online repository JSTOR using the search term "Euphorbia medicinal". Medicinal uses were identified for >5% of the species in the genus, including descriptions of treatments for a variety of diseases. The most-cited medicinal uses around the world were treatments for digestive system disorders, skin ailments and, especially in the Southern hemisphere, infections. Consensus ratios indicated that the most-valued medicinal uses of Euphorbia species are in the treatment of digestive and respiratory complaints, inflammation and injuries, especially by members of Euphorbia subg. Chamaesyce. The present study gives a first indicative overview of Euphorbia species used for health and wellbeing around the world. The exceptional diversity of the genus Euphorbia is not only represented by its growth forms but also by its diverse medicinal uses. Our results highlight the importance of research into medicinal uses of Euphorbia species and their importance as a source of natural products. Furthermore the medicinally highly valuable subgenus Chamaesyce was identified as chemically under-investigated, emphasizing the need for further studies investigating the chemical diversity to which the high medicinal value of Euphorbia subg. Chamaesyce can be attributed. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Han, Jinxiang; Huang, Jinzhao
2012-03-01
In this study, based on the resonator model and exciplex model of electromagnetic radiation within the human body, mathematical model of biological order state, also referred to as syndrome in traditional Chinese medicine, was established and expressed as: "Sy = v/ 1n(6I + 1)". This model provides the theoretical foundation for experimental research addressing the order state of living system, especially the quantitative research syndrome in traditional Chinese medicine.
Identifying public health competencies relevant to family medicine.
Harvey, Bart J; Moloughney, Brent W; Iglar, Karl T
2011-10-01
Public health situations faced by family physicians and other primary care practitioners, such as severe acute respiratory syndrome (SARS) and more recently H1N1, have resulted in an increased interest to identify the public health competencies relevant to family medicine. At present there is no agreed-on set of public health competencies delineating the knowledge and skills that family physicians should possess to effectively face diverse public health challenges. Using a multi-staged, iterative process that included a detailed literature review, the authors developed a set of public health competencies relevant to primary care, identifying competencies relevant across four levels, from "post-MD" to "enhanced." Feedback from family medicine and public health educator-practitioners regarding the set of proposed "essential" competencies indicated the need for a more limited, feasible set of "priority" areas to be highlighted during residency training. This focused set of public health competencies has begun to guide relevant components of the University of Toronto's Family Medicine Residency Program curriculum, including academic half-days; clinical experiences, especially identifying "teachable moments" during patient encounters; resident academic projects; and elective public health agency placements. These competencies will also be used to guide the development of a family medicine-public health primer and faculty development sessions to support family medicine faculty facilitating residents to achieve these competencies. Once more fully implemented, an evaluation will be initiated to determine the degree to which these public health competencies are being achieved by family medicine graduates, especially whether they attained the knowledge, skills, and confidence necessary to effectively face diverse public health situations-from common to emergent. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
It's Not Always Good For You: Theatre Is Not Supposed To Be Medicine.
ERIC Educational Resources Information Center
Gregg, Stephen
2002-01-01
Suggests that theatre's capacity to educate is often overstated. Notes theatre created by and for teenagers is especially guilty of proselytizing. Argues the real danger is that the cumulative, subliminal message is that theater is medicine. Suggests that playwrights, directors, and artistic directors leave the education for the classroom and take…
ERIC Educational Resources Information Center
Costa, Celio Juvenal
2000-01-01
Reflects on the current tendency in Brazilian higher education for greater and greater specialization, particularly in human sciences and in medicine. Calls for less specialization and a more historic and general preparation, especially in teacher education. (BT)
Internal Medicine Residents' Preferences regarding Medical Ethics Education.
ERIC Educational Resources Information Center
Jacobson, Jay A.; And Others
1989-01-01
A survey of residents (N=323) in 6 internal medicine programs investigated the topics students wanted included in the medical ethics curriculum and by which of 17 methods they would prefer to be taught. About three-fourths had previous medical ethics instruction, and most wanted more on specific topics, especially legal and end-of-life issues.…
The Progress of Dental Education. Bulletin, 1925, No. 39
ERIC Educational Resources Information Center
Waite, Frederick C.
1925-01-01
Dentistry has evolved from medicine and more especially from the surgical aspect of what is now called medicine. Until the sixteenth century, physic and surgery were separate professions and what we now call dentistry was a part of surgery rather than of physic. For centuries physic was a calling of greater dignity than surgery. Since the major…
Herbal Medicine Research in Taiwan*
Kaphle, Krishna; Wu, Leang-Shin; Yang, Nai-Yen Jack; Lin, Jen-Hsou
2006-01-01
Of all the countries in the world, why did you choose Taiwan to pursue your study? It is a question that I (comments of the first author) have answered a thousand times. My first visit to a laboratory at National Taiwan University opened my eyes to the possibilities of herbal medicine research, especially in the area of veterinary medicine. It became my ambition to link the knowledge of Traditional Chinese Medicine (TCM) and Ayurveda from the Indian subcontinent and their integration with other systems of medicine, including Western medicine (WM), to achieve the concept of Sustainable Medicine, firstly for animals and then for humans. The Ministry of Economic Affairs (MOEA) has implemented a technology development program to quickly establish the key technologies, and this is a moment of opportunity for Taiwan's traditional herbal medicine industry to upgrade and transform itself. This paper, initially intended to be a student's narration, has evolved into a multi-author treatise on the present state and likely future scenario of herbal medicine research in Taiwan. PMID:16550238
Chen, Guilin; Huang, Bill X; Guo, Mingquan
2018-05-21
Medicinal plants have played an important role in maintaining human health for thousands of years. However, the interactions between the active components in medicinal plants and some certain biological targets during a disease are still unclear in most cases. To conduct the high-throughput screening for small active molecules that can interact with biological targets, which is of great theoretical significance and practical value. The ultrafiltration mass spectrometry (UF-LC/MS) is a powerful bio-analytical method by combining affinity ultrafiltration and liquid chromatography-mass spectrometry (LC/MS), which could rapidly screen and identify small active molecules that bind to biological targets of interest at the same time. Compared with other analytical methods, affinity UF-LC/MS has the characteristics of fast, sensitive and high throughput, and is especially suitable for the complicated extracts of medicinal plants. In this review, the basic principle, characteristics and some most recent challenges in UF-LC/MS have been demonstrated. Meanwhile, the progress and applications of affinity UF-LC/MS in the discovery of the active components from natural medicinal plants and the interactions between small molecules and biological target proteins are also briefly summarised. In addition, the future directions for UF-LC/MS are also prospected. Affinity UF-LC/MS is a powerful tool in studies on the interactions between small active molecules and biological protein targets, especially in the high-throughput screening of active components from the natural medicinal plants. Copyright © 2018 John Wiley & Sons, Ltd.
Value-based medicine and vitreoretinal diseases.
Brown, Melissa M; Brown, Gary C; Sharma, Sanjay
2004-06-01
The purpose of the review is to examine the role of value-based medicine and its impact, or potential impact, on vitreoretinal interventions. Value-based medicine integrates evidence-based data from clinical trials with the patient-perceived improvement in quality of life conferred by an intervention. Cost-utility analysis, the healthcare economic instrument used to create a value-based medicine database, is being increasingly used to study the cost-effectiveness of vitreoretinal interventions. Vitreoretinal interventions are generally cost-effective because of the great value they impart to patients. Laser surgical procedures, such as for diabetic retinopathy, threshold retinopathy of prematurity, and exudative macular degeneration appear to be especially cost-effective as a group.
Interventional urology: endourology in small animal veterinary medicine.
Berent, Allyson C
2015-07-01
The use of novel image-guided techniques in veterinary medicine has become more widespread, especially in urologic diseases. With the common incidence of urinary tract obstructions, stones disease, renal disease, and urothelial malignancies, combined with the recognized invasiveness and morbidity associated with traditional surgical techniques, the use of minimally invasive alternatives using interventional radiology and interventional endoscopy techniques has become incredibly appealing to owners and clinicians. This article provides a brief overview of some of the most common procedures done in endourology in veterinary medicine to date, providing as much evidence-based medicine as possible when comparing with traditional surgical alternatives. Copyright © 2015 Elsevier Inc. All rights reserved.
Torkamani, Ali; Andersen, Kristian G; Steinhubl, Steven R; Topol, Eric J
2017-08-24
The foundation for a new era of data-driven medicine has been set by recent technological advances that enable the assessment and management of human health at an unprecedented level of resolution-what we refer to as high-definition medicine. Our ability to assess human health in high definition is enabled, in part, by advances in DNA sequencing, physiological and environmental monitoring, advanced imaging, and behavioral tracking. Our ability to understand and act upon these observations at equally high precision is driven by advances in genome editing, cellular reprogramming, tissue engineering, and information technologies, especially artificial intelligence. In this review, we will examine the core disciplines that enable high-definition medicine and project how these technologies will alter the future of medicine. Copyright © 2017 Elsevier Inc. All rights reserved.
[Possibilities of use of digital imaging in forensic medicine].
Gaval'a, P; Ivicsics, I; Mlynár, J; Novomeský, F
2005-07-01
Based on the daily practice with digital photography and documentation, the authors point out the achievements of the computer technologies implementation to the practice of forensic medicine. The modern methods of imaging, especially the digital photography, offer a wide spectrum of use in forensic medicine--the digital documentation and archivation of autopsy findings, the possibility of immediate consultation of findings with another experts via Internet, and many others. Another possibility is a creation of digital photographic atlas of forensic medicine as a useful aid in pre- and postgradual study. Thus the application of the state-of-the-art computer technologies to the forensic medicine discloses the unknown before possibilities for further development of such a discipline of human medical sciences.
He, Ping; Li, Feng-Jie; Li, Lian-da; Li, Yi-Kui
2017-03-01
Safety issues of traditional Chinese medicine injections has been heated debate. There are two diametrically opposed views: it should be used reasonable and developed healthily or be forbidden to use. Some people have many misunderstandings and prejudices about the safety of traditional Chinese medicine injections. Compared with western medicine,traditional Chinese medicine has its own particularity. Traditional Chinese medicine has complex components. Its research and clinical application is different from western medicine. Adverse reactions of traditional Chinese medicine injections are related to many factors,such as a large number of irrational use,blind use of traditional Chinese medicine injections and western medicine injections,counterfeit and substandard drugs,incorrect methods of intravenous infusion,toxicity of supplementary materials,drug ingredients. Developing traditional Chinese medicine injection is the need for curing sickness to save patients. The purposeful, targeted, organized and planned systematic research of traditional Chinese medicine injections should be strengthened,especially the safety of traditional Chinese medicine. Strengthen supervision and control of rational drug use.Strengthen the examination and approval,supervision and management of all aspects to ensure the safety of patients. Copyright© by the Chinese Pharmaceutical Association.
Seizures and Teens: When Medicines Don't Work--Devices & Diet
ERIC Educational Resources Information Center
Dean, Patricia
2007-01-01
When medicines do not work, the search for seizure control should not stop. Special diets or medical devices may be recommended to help control seizures. While not a cure for epilepsy, they may be able to help, especially for those who are not candidates for surgery or when surgery does not work. This article provides an overview of the devices…
Healthy children's perceptions of medicines: a review.
Hämeen-Anttila, Katri; Bush, Patricia J
2008-06-01
Chronically ill children's perceptions of medicines have been widely studied, but healthy children's less often. However, information on healthy children's beliefs and attitudes about medicine use is needed to be able to target health education messages about medicines appropriately. A literature review was performed to determine schoolchildren's attitudes, beliefs, and knowledge about medicines; autonomy in using medicines; expectations of using medicines; and questions about medicines, so as to guide the development of a medicine education curriculum and to inform health care professionals who communicate with children. This study was a review of literature from 17 countries. The review indicated that children of school age tend to view medicines cautiously. Although age is a factor, children have very limited ideas about how medicines work and issues around medicine efficacy are confusing to them. Even young children recognize that medicines may have harmful effects and, children of all ages and cultures studied want to learn more about medicines. Autonomy in medicine use is surprisingly high and disturbing given that knowledge of medicines is poor. Primary conclusions drawn are (1) children of the same age in different cultures appear similar in their attitudes, beliefs, behaviors, and desires to learn about medicines; (2) children lack information about medicines, especially in view of their levels of autonomy; and (3) health educators and health care professionals should educate children about rational medicine use, at appropriate cognitive development levels, before the children become independent medicine users.
Personalized medicine in cardiovascular diseases.
Lee, Moo-Sik; Flammer, Andreas J; Lerman, Lilach O; Lerman, Amir
2012-09-01
Personalized medicine is a novel medical model with all decisions and practices being tailored to individual patients in whatever ways possible. In the era of genomics, personalized medicine combines the genetic information for additional benefit in preventive and therapeutic strategies. Personalized medicine may allow the physician to provide a better therapy for patients in terms of efficiency, safety and treatment length to reduce the associated costs. There was a remarkable growth in scientific publication on personalized medicine within the past few years in the cardiovascular field. However, so far, only very few cardiologists in the USA are incorporating personalized medicine into clinical treatment. We review the concepts, strengths, limitations and challenges of personalized medicine with a particular focus on cardiovascular diseases (CVDs). There are many challenges from both scientific and policy perspectives to personalized medicine, which can overcome them by comprehensive concept and understanding, clinical application, and evidence based practices. Individualized medicine serves a pivotal role in the evolution of national and global healthcare reform, especially, in the CVDs fields. Ultimately, personalized medicine will affect the entire landscape of health care system in the near future.
Personalized Medicine in Cardiovascular Diseases
Lee, Moo-Sik; Flammer, Andreas J.; Lerman, Lilach O.
2012-01-01
Personalized medicine is a novel medical model with all decisions and practices being tailored to individual patients in whatever ways possible. In the era of genomics, personalized medicine combines the genetic information for additional benefit in preventive and therapeutic strategies. Personalized medicine may allow the physician to provide a better therapy for patients in terms of efficiency, safety and treatment length to reduce the associated costs. There was a remarkable growth in scientific publication on personalized medicine within the past few years in the cardiovascular field. However, so far, only very few cardiologists in the USA are incorporating personalized medicine into clinical treatment. We review the concepts, strengths, limitations and challenges of personalized medicine with a particular focus on cardiovascular diseases (CVDs). There are many challenges from both scientific and policy perspectives to personalized medicine, which can overcome them by comprehensive concept and understanding, clinical application, and evidence based practices. Individualized medicine serves a pivotal role in the evolution of national and global healthcare reform, especially, in the CVDs fields. Ultimately, personalized medicine will affect the entire landscape of health care system in the near future. PMID:23091501
Complementary and alternative medicine in pulmonology.
Mark, John D; Chung, Youngran
2015-06-01
To provide a comprehensive review of complementary and alternative medicine (CAM) therapies for the treatment of pulmonary disorders in children. The use of complementary medicine (CAM) is commonly used by both children and adults with breathing problems, and especially in chronic pulmonary disorders such as asthma and cystic fibrosis. Many clinics and hospitals now offer CAM, even though most of the conventionally trained health practitioners have little knowledge or education regarding CAM therapies. Research in CAM that demonstrates overall benefit is lacking, especially in children. Often parents do not report CAM use to their child's healthcare provider and this could compromise their overall quality of care. Although many research studies evaluating CAM therapies have methodological flaws, data exist to support CAM therapies in treating children with pulmonary disorders. This review examines the latest evidence of CAM use and effectiveness in children with pulmonary disorders. Physicians should be aware of the many CAM therapy options and the research surrounding them in order to provide their patients with the most current and accurate information available.
Medicine and psychiatry in Western culture: Ancient Greek myths and modern prejudices
Fornaro, Michele; Clementi, Nicoletta; Fornaro, Pantaleo
2009-01-01
The origins of Western culture extensively relate to Ancient Greek culture. While many ancient cultures have contributed to our current knowledge about medicine and the origins of psychiatry, the Ancient Greeks were among the best observers of feelings and moods patients expressed towards medicine and toward what today is referred to as 'psychopathology'. Myths and religious references were used to explain what was otherwise impossible to understand or be easily communicated. Most ancient myths focus on ambiguous feelings patients may have had towards drugs, especially psychotropic ones. Interestingly, such prejudices are common even today. Recalling ancient findings and descriptions made using myths could represent a valuable knowledge base for modern physicians, especially for psychiatrists and their patients, with the aim of better understanding each other and therefore achieving a better clinical outcome. This paper explores many human aspects and feelings towards doctors and their cures, referring to ancient myths and focusing on the perception of mental illness. PMID:19811642
[The Paduan School of Medicine: medicine and philosophy in the modern era].
Rebollo, Regina Andrés
2010-06-01
This is a partial contribution to an understanding of the history of the reception and transmission of classical Hippocratic and Galenic texts in Italy's modern period. By examining rotuli and puncti of the School of Medicine of Padua University, which record the subjects and content taught in the period between 1500 and 1600, one can study the official curriculum of this famous school. Perusal of these documents shows the commitment of official medical training to tradition, especially with respect to Hippocrates, Galen, Avicenna and Aristotle.
Milestones in the development of Nordic general practice*
2013-01-01
Abstract The common history and development of Nordic family medicine is important and interesting. This paper looks back on the aspects and factors influencing academic family medicine in the Nordic countries and especially the central position of the Nordic Congresses and the Scandinavian Journal of Primary Health Care. The importance of pioneers and bringing people together is emphasized. More than 30 years of Nordic academic family medicine has indeed had an incredible impact and has initiated development from only a few people to become world leading. PMID:23336114
Penkala-Gawecka, D
2001-01-01
The article discusses society's attitudes towards bio-medicine and complementary medicine in Kazakhstan around the end of the 20th century. It presents the transformation of the health-care system in independent Kazakhstan and its influence on the health situation of the population as well as public opinion on bio-medicine. Presented is a broad spectrum of various fields of complementary medicine which achieved great popularity especially during the 1990s. Among the reasons for that growing popularity appears to be public disenchantment with the collapsing state health-care system which is costly and ineffective. At the same time, an important factor is the durability of traditional beliefs of a magical type which is behind the wide use of nonconventional magic-religious practices -- spells and prayers. Overall public socio-economic malaise and a fear of the future are conducive to a general increase of interest in mystical beliefs and occult practices as well as a paranormal phenomena, and the flourishing of complementary medicine naturally fits into that scheme.
[Research progress on mutation by spaceflight in medicinal plants breeding].
Yan, Shuo; Gao, Wenyuan; Lu, Fuping; Zhao, Runhuai
2010-02-01
Space breeding in medicinal plants is special characteristics in China. Compared with other plants, in spite of a relatively small number, Medicinal plants have more obvious characteristics and advantages. Research on medicinal plants has also been carried into all aspects, such as biological traits, physiology and biochemistry, genomics, as well as differences in chemical composition, and chemical composition analysis is also involved. However, compared with other plants, especially crops and vegetables, biological research is an obvious deficiency, that is mainly reflected in the insufficient genetics and breeding researches, the stability of genetic traits from generation to generation were not followed up and in-depth study in breeding areas was not carried out. If medicinal plants resources from space with the genetic stability good quality were selected, it would address the problem of lack of resources and ease the pressure on wild resources of medicinal plants. It would at the same time play an important role in promoting the development of medicinal botany space breeding and the implementation of modernization of traditional Chinese medicine.
Thorsen, Rikke Stamp; Pouliot, Mariève
2016-01-01
Traditional medicine is commonly assumed to be a crucial health care option for poor households in developing countries. However, little research has been done in Asia to quantify the reliance on traditional medicine and its determinants. This research contributes to filling in this knowledge gap using household survey data collected from 571 households in three rural and peri-urban sites in Nepal in 2012. Questions encompassed household socioeconomic characteristics, illness characteristics, and treatment-seeking behaviour. Treatment choice was investigated through bivariate analyses. Results show that traditional medicine, and especially self-treatment with medicinal plants, prevail as treatment options in both rural and peri-urban populations. Contrarily to what is commonly assumed, high income is an important determinant of use of traditional medicine. Likewise, knowledge of medicinal plants, age, education, gender and illness chronicity were also significant determinants. The importance of self-treatment with medicinal plants should inform the development of health policy tailored to people’s treatment-seeking behaviour. PMID:26130610
Animal-based remedies as complementary medicines in Santa Cruz do Capibaribe, Brazil
Alves, Rômulo RN; Lima, Helenice N; Tavares, Marília C; Souto, Wedson MS; Barboza, Raynner RD; Vasconcellos, Alexandre
2008-01-01
Background The use of animal products in healing is an ancient and widespread cross-cultural practice. In northeastern Brazil, especially in the semi-arid region, animals and plants are widely used in traditional medicine and play significant roles in healing practices. Zootherapies form an integral part of these cultures, and information about animals is passed from generation to generation through oral folklore. Nevertheless, studies on medicinal animals are still scarce in northeastern Brazil, especially when compared to those focusing on medicinal plants. This paper examines the use and commercialization of animals for medicinal purposes in Brazil's semi-arid caatinga region. Methods Data was obtained through field surveys conducted in the public markets in the city of Santa Cruz do Capibaribe, Pernambuco State, Brazil. We interviewed 16 merchants (9 men and 7 women) who provided information regarding folk remedies based on animal products. Results A total of 37 animal species (29 families), distributed among 7 taxonomic categories were found to be used to treat 51 different ailments. The most frequently cited treatments focused on the respiratory system, and were mainly related to problems with asthma. Zootherapeutic products are prescribed as single drugs or are mixed with other ingredients. Mixtures may include several to many more valuable medicinal animals added to other larger doses of more common medicinal animals and plants. The uses of certain medicinal animals are associated with popular local beliefs known as 'simpatias'. We identified 2 medicinal species (Struthio camelus and Nasutitermes macrocephalus) not previously documented for Brazil. The use of animals as remedies in the area surveyed is associated with socio economic and cultural factors. Some of the medicinal animal species encountered in this study are included in lists of endangered species. Conclusion Our results demonstrate that a large variety of animals are used in traditional medicinal practices in Brazil's semi-arid northeastern region. In addition to the need for pharmacological investigations in order to confirm the efficiency of these folk medicines, the present study emphasizes the importance of establishing conservation priorities and sustainable production of the various medicinal animals used. The local fauna, folk culture, and monetary value of these activities are key factors influencing the use and commercialization of animal species for therapeutic purposes. PMID:18647413
What is “colonial” about medieval colonial medicine? Iberian health in global context
McCleery, Iona
2015-01-01
Colonial medicine is a thriving field of study in the history of nineteenth- and twentieth-century medicine. Medicine can be used as a lens to view colonialism in action and as a way to critique colonialism. This article argues that key debates and ideas from that modern field can fruitfully be applied to the Middle Ages, especially for the early empires of Spain and Portugal (mid-fourteenth to mid-sixteenth centuries). The article identifies key modern debates, explores approaches to colonization and colonialism in the Middle Ages and discusses how medieval and modern medicine and healthcare could be compared using colonial and postcolonial discourses. The article ends with three case studies of healthcare encounters in Madeira, Granada and Hispaniola at the end of the fifteenth century. PMID:26550030
Gleason, Ann Whitney
2015-01-01
Gaming as a means of delivering online education continues to gain in popularity. Online games provide an engaging and enjoyable way of learning. Gaming is especially appropriate for case-based teaching, and provides a conducive environment for adult independent learning. With funding from the National Network of Libraries of Medicine, Pacific Northwest Region (NN/LM PNR), the University of Washington (UW) Health Sciences Library, and the UW School of Medicine are collaborating to create an interactive, self-paced online game that teaches players to employ the steps in practicing evidence-based medicine. The game encourages life-long learning and literacy skills and could be used for providing continuing medical education.
An accidental case of aconite poisoning due to Kampo herbal medicine ingestion.
Ono, Takiyoshi; Hayashida, Makiko; Uekusa, Kyoko; Lai, Cui Fan; Hayakawa, Hideyuki; Nihira, Makoto; Ohno, Youkichi
2009-05-01
An accidental case of aconite intoxication occurred after a patient took a therapeutic dose of Kampo herbal medicine containing Aconiti tuber, Uzu but had used the wrong decoction procedure. The poisoning was likely caused by an increased level of Aconitum alkaloids in the decoction; the patient developed aconite intoxication due to incomplete decoction. Aconitum alkaloid levels in the leftover solution which the patient had drunk and in the decoction extracted from 3g Uzu were determined. It was found that decoction makes the medicine safer to drink. Older individuals, especially those with dementia, have a higher risk of aconite poisoning because they sometimes do not boil the medicine appropriately.
Botanical medicine and cancer: a review of the safety and efficacy.
Boon, Heather; Wong, Jacqueline
2004-12-01
It is currently estimated that > 50% of all patients diagnosed with cancer explore complementary and alternative medicine - especially herbal medicine. We conducted a comprehensive review to assess the safety and efficacy of herbal medicines commonly used by patients in an attempt to: prevent cancer; treat cancer; and treat adverse effects associated with conventional cancer treatments. Current evidence suggests that Asian ginseng, garlic, green tea, tomatoes and soy intake as part of the diet may be useful in preventing various cancers; additional research is needed in order to determine the efficacy of essiac, evening primrose oil, mistletoe, reishi, shiitake and turmeric as cancer treatments; and ginger may be effective in treating chemotherapy-induced nausea and vomiting.
Tippens, Kim; Marsman, Kevin; Zwickey, Heather
2009-04-01
Alternative medicine researchers and policy makers have classified prayer as a mind-body intervention, and thus, a modality of complementary and alternative medicine (CAM). As such, numerous epidemiological surveys of CAM utilization-which have included prayer-depict increasing CAM use, particularly in specific racial and ethnic groups. This paper discusses the implications of conflating prayer and CAM, especially regarding the definitions of both concepts and the resulting statistics of CAM utilization.
Yokoi, Masayuki; Tashiro, Takao
2014-01-01
We studied how the separation of dispensing and prescribing of medicines between pharmacies and clinics (the “separation system”) can reduce internal medicine costs. To do so, we obtained publicly available data by searching electronic databases and official web pages of the Japanese government and non-profit public service corporations on the Internet. For Japanese medical institutions, participation in the separation system is optional. Consequently, the expansion rate of the separation system for each of the administrative districts is highly variable. The data were subjected to multiple regression analysis; daily internal medicines were the objective variable and expansion rate of the separation system was the explanatory variable. A multiple regression analysis revealed that the expansion rate of the separation system and the rate of replacing brand name medicine with generic medicine showed a significant negative partial correlation with daily internal medicine costs. Thus, the separation system was as effective in reducing medicine costs as the use of generic medicines. Because of its medical economic efficiency, the separation system should be expanded, especially in Asian countries in which the system is underdeveloped. PMID:24999122
Yokoi, Masayuki; Tashiro, Takao
2014-04-07
We studied how the separation of dispensing and prescribing of medicines between pharmacies and clinics (the "separation system") can reduce internal medicine costs. To do so, we obtained publicly available data by searching electronic databases and official web pages of the Japanese government and non-profit public service corporations on the Internet. For Japanese medical institutions, participation in the separation system is optional. Consequently, the expansion rate of the separation system for each of the administrative districts is highly variable. The data were subjected to multiple regression analysis; daily internal medicines were the objective variable and expansion rate of the separation system was the explanatory variable. A multiple regression analysis revealed that the expansion rate of the separation system and the rate of replacing brand name medicine with generic medicine showed a significant negative partial correlation with daily internal medicine costs. Thus, the separation system was as effective in reducing medicine costs as the use of generic medicines. Because of its medical economic efficiency, the separation system should be expanded, especially in Asian countries in which the system is underdeveloped.
[Research strategies in standard decoction of medicinal slices].
Chen, Shi-Lin; Liu, An; Li, Qi; Toru, Sugita; Zhu, Guang-Wei; Sun, Yi; Dai, Yun-Tao; Zhang, Jun; Zhang, Tie-Jun; Takehisa, Tomoda; Liu, Chang-Xiao
2016-04-01
This paper discusses the research situation of the standard decoction of medicinal slices at home and abroad. Combined with the experimental data, the author proposes that the standard decoction of medicinal slices is made of single herb using standard process which should be guided by the theory of traditional Chinese medicine, based on clinical practice and referred to modern extraction method with a standard process. And the author also proposes the principles of establishing the specification of process parameters and quality standards and established the basis of drug efficacy material and biological reference. As a standard material and standard system, the standard decoction of medicinal slices can provide standards for clinical medication, standardize the use of the new type of medicinal slices especially for dispensing granules, which were widely used in clinical. It can ensure the accuracy of drugs and consistency of dose, and to solve current supervision difficulties. Moreover the study of standard decoction of medicinal slices will provide the research on dispensing granules, traditional Chinese medicine prescription standard decoction and couplet medicines standard decoction a useful reference. Copyright© by the Chinese Pharmaceutical Association.
Photoacoustic Spectroscopy Analysis of Traditional Chinese Medicine
NASA Astrophysics Data System (ADS)
Chen, Lu; Zhao, Bin-xing; Xiao, Hong-tao; Tong, Rong-sheng; Gao, Chun-ming
2013-09-01
Chinese medicine is a historic cultural legacy of China. It has made a significant contribution to medicine and healthcare for generations. The development of Chinese herbal medicine analysis is emphasized by the Chinese pharmaceutical industry. This study has carried out the experimental analysis of ten kinds of Chinese herbal powder including Fritillaria powder, etc., based on the photoacoustic spectroscopy (PAS) method. First, a photoacoustic spectroscopy system was designed and constructed, especially a highly sensitive solid photoacoustic cell was established. Second, the experimental setup was verified through the characteristic emission spectrum of the light source, obtained by using carbon as a sample in the photoacoustic cell. Finally, as the photoacoustic spectroscopy analysis of Fritillaria, etc., was completed, the specificity of the Chinese herb medicine analysis was verified. This study shows that the PAS can provide a valid, highly sensitive analytical method for the specificity of Chinese herb medicine without preparing and damaging samples.
Speak Up: Anesthesia and Sedation
... anesthesiologist assistant. • Ask the anesthesia professional about the benefits and risks of anesthesia. • Follow instructions for eating, drinking and taking medicines, especially instructions for when not ...
Petersen, Albert; Held, Nadja
2017-01-01
Background Substandard and falsified medical products present a serious threat to public health, especially in low- and middle-income countries. Their identification using pharmacopeial analysis is expensive and requires sophisticated equipment and highly trained personnel. Simple, low-cost technologies are required in addition to full pharmacopeial analysis in order to accomplish widespread routine surveillance for poor-quality medicines in low- and middle-income countries. Methods Ten faith-based drug supply organizations in seven countries of Africa and Asia were each equipped with a Minilab of the Global Pharma Health Fund (GPHF, Frankfurt, Germany), suitable for the analysis of about 85 different essential medicines by thin-layer chromatography. Each organization was asked to collect approximately 100 medicine samples from private local medicine outlets, especially from the informal sector. The medicine samples were tested locally according to the Minilab protocols. Medicines which failed Minilab testing were subjected to confirmatory analysis in a WHO-prequalified medicine quality control laboratory in Kenya. Results Out of 869 medicine samples, 21 were confirmed to be substandard or falsified medical products. Twelve did not contain the stated active pharmaceutical ingredient (API), six contained insufficient amounts of the API, and three showed insufficient dissolution of the API. The highest proportion of substandard and falsified medicines was found in Cameroon (7.1%), followed by the Democratic Republic of Congo (2.7%) and Nigeria (1.1%). Antimalarial medicines were most frequently found to be substandard or falsified (9.5% of all antimalarials). Thin-layer chromatography according to the Minilab protocols was found to be specific and reproducible in the identification of medicines which did not contain the stated API. Since only samples which failed Minilab testing were subjected to confirmatory testing using pharmacopeial methods, this study did not assess the sensitivity of the Minilab methodology in the detection of substandard medicines, and may underestimate the prevalence of poor-quality medicines. Conclusions Surveillance for poor-quality medicines can be carried out by local organizations in low- and middle-income countries using a simple, low-cost technology. Such surveillance can identify an important subgroup of the circulating substandard and falsified medical products and can help to prevent them from causing harm in patients. A collaboration of the national drug regulatory authorities with faith-based organizations and other NGOs may therefore represent a promising strategy towards the Sustainable Development Goal of “ensuring access to quality medicines”. PMID:28877208
Medicinal plants in Brazil: Pharmacological studies, drug discovery, challenges and perspectives.
Dutra, Rafael C; Campos, Maria M; Santos, Adair R S; Calixto, João B
2016-10-01
This review article focuses on pre-clinical and clinical studies with some selected Brazilian medicinal plants in different areas of interest, conducted by research groups in Brazil and abroad. It also highlights the Brazilian market of herbal products and the efforts of Brazilian scientists to develop new phytomedicines. This review is divided into three sections. The section I describes the Brazilian large biodiversity and some attempts of Brazilian scientists to assess the pharmacological profile of most plant extracts or isolated active principles. Of note, Brazilian scientists have made a great effort to study the Brazilian biodiversity, especially among the higher plants. In fact, more than 10,000 papers were published on plants in international scientific journals between 2011 and 2013. This first part also discussed the main efforts to develop new medicines from plants, highlighting the Brazilian phytomedicines market. Despite the large Brazilian biodiversity, notably with the higher plants, which comprise over 45,000 species (20-22% of the total worldwide), and the substantial number of scientific publications on medicinal plants, only one phytomedicine is found in the top 20 market products. Indeed, this market is still only worth about 261 million American dollars. This represents less than 5% of the global Brazilian medicine market. The section II of this review focus on the use of Brazilian plant extract and/or active principles for some selected diseases, namely: central nervous systems disorders, pain, immune response and inflammation, respiratory diseases, gastrointestinal tract and metabolic diseases. Finally, section III discusses in more details some selected Brazilian medicinal plants including: Cordia verbenacea, Euphorbia tirucalli, Mandevilla velutina, Phyllanthus spp., Euterpe oleracea, Vitis labrusca, Hypericum caprifoliatum and Hypericum polyanthemum, Maytenus ilicifolia, Protium kleinii and Protium heptaphylium and Trichilia catigua. Most of these publications are preliminary and only report the effects of crude extracts, both in vitro and in vivo studies. Only very few studies have been dedicated to investigate the mechanisms of action of isolated compounds. Likewise, studies on safety (toxicology), pharmacokinetic, and especially on well-conducted clinical trials are rare. In conclusion, in spite of the abundant Brazilian biodiversity and the thousands of academic publications on plants in international peer-reviewed scientific journals, few patents and medicines have been derived from such studies. Undoubtedly, great efforts must be made to improve the development of plant-derived medicine market in Brazil, especially by involving the partnership between academia and pharmaceutical companies. Copyright © 2016 Elsevier Ltd. All rights reserved.
David, Sean P; Johnson, Samuel G; Berger, Adam C; Feero, W Gregory; Terry, Sharon F; Green, Larry A; Phillips, Robert L; Ginsburg, Geoffrey S
2015-01-01
Genomic research has generated much new knowledge into mechanisms of human disease, with the potential to catalyze novel drug discovery and development, prenatal and neonatal screening, clinical pharmacogenomics, more sensitive risk prediction, and enhanced diagnostics. Genomic medicine, however, has been limited by critical evidence gaps, especially those related to clinical utility and applicability to diverse populations. Genomic medicine may have the greatest impact on health care if it is integrated into primary care, where most health care is received and where evidence supports the value of personalized medicine grounded in continuous healing relationships. Redesigned primary care is the most relevant setting for clinically useful genomic medicine research. Taking insights gained from the activities of the Institute of Medicine (IOM) Roundtable on Translating Genomic-Based Research for Health, we apply lessons learned from the patient-centered medical home national experience to implement genomic medicine in a patient-centered, learning health care system. © 2015 Annals of Family Medicine, Inc.
Current situation and perspectives of clinical study in integrative medicine in china.
Wang, Jie; Xiong, Xingjiang
2012-01-01
Integrative medicine is not only an innovative China model in clinical practice, but also the bridge for TCM toward the world. In the past thirty years, great achievements have been made in integrative medicine researches, especially in clinical practice. The clinical achievements mainly include the following three: innovating methodology of disease-syndrome combination, excavating the classical theory in traditional Chinese medicine (TCM), preventing and curing refractory diseases. The development ideas and strategies of integrative medicine for future mainly include (a) standing on frontier field of international medicine and improving the capability of preventing and curing refractory diseases; (b) moving prevention and control strategy forward and improving the curative effect of common and frequent disease; (c) excavating the classical theory of TCM and broadening the treatment system of modern medicine; (d) improving the innovation level of new high effective drugs on the basis of classical prescriptions and herbs in TCM; (e) rerecognizing the theory of formula corresponding to syndrome in TCM and enhancing the level of clinical research evidence based on evidence-based medicine. Integrative medicine will do obtain greater achievements in creating new medicine and pharmacology and make more tremendous contributions for the great rejuvenation of the Chinese nation and human health care.
The Middle Ages Contributions to Cardiovascular Medicine
Ranhel, André Silva; Mesquita, Evandro Tinoco
2016-01-01
The historical period called the Middle Ages, a long interval between the 5th and the 15th centuries, is still commonly known as the Dark Ages, especially in the area of health sciences. In the last decades, this "classic" view of the Middle Ages has been gradually modified with advances in historiographical studies and the history of science. During that period in Western Europe, knowledge about the human body suffered a regression in terms of anatomy and physiology, with the predominance of religious conceptions mainly about diseases and their treatments. Knowledge on the cardiovascular system and heart diseases has been classically described as a repetition of the concepts developed by Galen from the dissection of animals and his keen sense of observation. However, the Middle East, especially Persia, was the birth place of a lot of intellectuals who preserved the ancient knowledge of the Greeks while building new knowledge and practices, especially from the 8th to the 13th century. The invasion of the Arabs in North of Africa and the Iberian Peninsula and the eclosion of the Crusades resulted in a greater contact between the East and the West, which in turn brought on the arrival of the Arab medical knowledge, among others, to 12th century Europe. Such fact contributed to an extremely important change in the scientific medical knowledge in the West, leading to the incorporation of different concepts and practices in the field of cardiovascular Medicine. The new way of teaching and practicing Medicine of the great Arab doctors, together with the teaching hospitals and foundations in the Koran, transformed the Medicine practiced in Europe definitely. The objective of this paper is to describe the knowledge drawn up from the Middle Ages about the cardiovascular system, its understanding and therapeutic approach to cardiologists and cardiovascular surgeons. PMID:27556317
Marsman, Kevin; Zwickey, Heather
2009-01-01
Abstract Background Alternative medicine researchers and policy makers have classified prayer as a mind–body intervention, and thus, a modality of complementary and alternative medicine (CAM). As such, numerous epidemiological surveys of CAM utilization—which have included prayer—depict increasing CAM use, particularly in specific racial and ethnic groups. Objectives This paper discusses the implications of conflating prayer and CAM, especially regarding the definitions of both concepts and the resulting statistics of CAM utilization. PMID:19388867
Crew Resource Management Use in U.S. Air Force Flight and Family Medicine Clinics
2013-06-30
However, it is much less studied in medicine, especially outpatient care. Because of their dual role as physicians and aircrew, flight surgeons might...rank, gender , and major command (MAJCOM) affiliation to see if any of these covariates might explain any variation in individual domain scores...variables. Covariates included group (flight surgeon versus family physician), rank, gender , and MAJCOM. Significant covariate effects were further
Bates, C J; Walmsley, C M; Prentice, A; Finch, S
1999-03-01
To describe the extent of use of medicines by older people living in Britain, and to explore relationships with vitamin status indices. The National Diet and Nutrition Survey of people aged 65 years and over collected data from a British sample during 1994-95. The present study has made novel use of it, to relate medicine use with biochemical indices of vitamin status. Eighty postcode areas, selected randomly from mainland Britain. 1506 people, 65 years and over gave information about use of medication, and a 4-day weighed food record. Three-quarters gave blood for status indices. 78% of those living in the community and 93% of those in institutions were using medication. Certain vitamin status indices: plasma retinol, erythrocyte folate and riboflavin, paradoxically suggested better status in users than in non-users of antihypertensive, gastrointestinal, central nervous system, corticosteroid or diabetic drugs. There was evidence of a link with renal insufficiency, especially for plasma retinol, but neither this nor increased nutrient intake, acute phase effects or haemoconcentration could explain the paradoxical associations. Caution is needed in interpreting certain vitamin status indices, especially in older people who are extensively using medicines. New vitamin indices are needed, to avoid confounding interferences.
Clinical Holistic Medicine: Chronic Pain in Internal Organs
Ventegodt, Søren; Merrick, Joav
2005-01-01
Holistic medicine seems to be efficient in the treatment of chronic pain in internal organs, especially when the pain has no known cause. It is quite surprising that while chronic pain can be one of the toughest challenges in the biomedical clinic, it is often one of the simplest things to alleviate in the holistic clinic. These pains are regarded as being caused by repressed emotions and are explained as psychosomatic reactions. Using holistic medicine, the patients can often be cured of their suffering when they assume responsibility for the repressed feelings. The holistic process theory of healing states that the return to the natural (pain free) state of being is possible whenever the person obtains the resources needed for existential healing. This shift is explained by the related quality of life and life mission theories. The resources needed are “holding” or genuine care in the dimensions of awareness, respect, care, acknowledgment, and acceptance with support and processing in the dimensions of feeling, understanding, and letting go of negative attitudes and beliefs. The preconditions for the holistic healing to take place are “love” and trust. Obtaining the full trust of the patient, therefore, seems to be the biggest challenge of holistic medicine, especially when dealing with a patient in pain. PMID:15798880
... who take certain arthritis or pain medicines, including aspirin, that can cause ulcers. It protects the stomach ... and nonprescription medications you are taking, especially antacids, aspirin, arthritis medications, and vitamins.tell your doctor if ...
Münstedt, K; Maisch, M; Tinneberg, H R; Hübner, J
2014-12-01
Whereas we have some information on complementary medicine in the field of oncology, little is known about complementary medicine in the field of obstetrics and gynaecology especially outside of hospitals. All office-based obstetricians and gynaecologists in the state of Hesse, Germany, were contacted and asked to fill in an assessment form regarding cooperation in the field of complementary and alternative medicine (CAM), as well as the perceived efficacy of various CAM methods for a number of pathological conditions in the field of obstetrics and gynaecology. It was found that more than half of Hessian office-based obstetricians and gynaecologists had existing cooperation regarding CAM, especially with colleagues, but also midwives, pharmacists, physiotherapists, and health practitioners. The probability of cooperation was significantly inversely associated with age. It was found that the probability for advising CAM differed between various health problems. The following CAM methods were considered reasonable for the treatment of different conditions: phytotherapy for climacteric complaints and premenstrual syndrome; homoeopathy for puerperal problems; acupuncture and traditional Chinese medicine for complaints during pregnancy; and dietary supplements for the side effects of cancer therapy. The analysis shows that there is much cooperation in the field of CAM. Comparison between physicians' perceived efficacy of CAM methods and objective findings shows that there is a need for the provision of valid information in the field.
Innovative Approaches to Increase Access to Medicines in Developing Countries
Stevens, Hilde; Huys, Isabelle
2017-01-01
Access to essential medicines is problematic for one third of all persons worldwide. The price of many medicines (i.e., drugs, vaccines, and diagnostics) is unaffordable to the majority of the population in need, especially in least-developed countries, but also increasingly in middle-income countries. Several innovative approaches, based on partnerships, intellectual property, and pricing, are used to stimulate innovation, promote healthcare delivery, and reduce global health disparities. No single approach suffices, and therefore stakeholders need to further engage in partnerships promoting knowledge and technology transfer in assuring essential medicines to be manufactured, authorized, and distributed in low- and middle-income countries (LMICs) in an effort of making them available at affordable and acceptable conditions. PMID:29270407
[Applications of near-infrared spectroscopy to analysis of traditional Chinese herbal medicine].
Li, Yan-Zhou; Min, Shun-Geng; Liu, Xia
2008-07-01
Analysis of traditional Chinese herbal medicine is of great importance to its quality control Conventional analysis methods can not meet the requirement of rapid and on-line analysis because of complex process more experiences or needed. In recent years, near-infrared spectroscopy technique has been used for rapid determination of active components, on-line quality control, identification of counterfeit and discrimination of geographical origins of herbal medicines and so on, due to its advantages of simple pretreatment, high efficiency, convenience to use solid diffuse reflection spectroscopy and fiber. In the present paper, the principles and methods of near-infrared spectroscopy technique are introduced concisely. Especially, the applications of this technique in quantitative analysis and qualitative analysis of traditional Chinese herbal medicine are reviewed.
Hericium erinaceus: an edible mushroom with medicinal values.
Khan, Md Asaduzzaman; Tania, Mousumi; Liu, Rui; Rahman, Mohammad Mijanur
2013-05-24
Mushrooms are considered as nutritionally functional foods and source of physiologically beneficial medicines. Hericium erinaceus, also known as Lion's Mane Mushroom or Hedgehog Mushroom, is an edible fungus, which has a long history of usage in traditional Chinese medicine. This mushroom is rich in some physiologically important components, especially β-glucan polysaccharides, which are responsible for anti-cancer, immuno-modulating, hypolipidemic, antioxidant and neuro-protective activities of this mushroom. H. erinaceus has also been reported to have anti-microbial, anti-hypertensive, anti-diabetic, wound healing properties among other therapeutic potentials. This review article has overviewed the recent advances in the research and study on H. erinaceus and discussed the potential health beneficial activities of this mushroom, with the recognition of bioactive compounds responsible for these medicinal properties.
Medicinally important aromatic plants with radioprotective activity
Samarth, Ravindra M; Samarth, Meenakshi; Matsumoto, Yoshihisa
2017-01-01
Aromatic plants are often used as natural medicines because of their remedial and inherent pharmacological properties. Looking into natural resources, particularly products of plant origin, has become an exciting area of research in drug discovery and development. Aromatic plants are mainly exploited for essential oil extraction for applications in industries, for example, in cosmetics, flavoring and fragrance, spices, pesticides, repellents and herbal beverages. Although several medicinal plants have been studied to treat various conventional ailments only a handful studies are available on aromatic plants, especially for radioprotection. Many plant extracts have been reported to contain antioxidants that scavenge free radicals produced due to radiation exposure, thus imparting radioprotective efficacy. The present review focuses on a subset of medicinally important aromatic plants with radioprotective activity. PMID:29134131
... of the bowel may be due to: A mechanical cause, which means something is in the way ... lung disease Use of certain medicines, especially narcotics Mechanical causes of intestinal obstruction may include: Adhesions or ...
Levin, Roy J; Both, Stephanie; Georgiadis, Janniko; Kukkonen, Tuuli; Park, Kwangsung; Yang, Claire C
2016-05-01
The article consists of six sections written by separate authors that review female genital anatomy, the physiology of female sexual function, and the pathophysiology of female sexual dysfunction but excluding hormonal aspects. To review the physiology of female sexual function and the pathophysiology of female sexual dysfunction especially since 2010 and to make specific recommendations according to the Oxford Centre for evidence based medicine (2009) "levels of evidence" wherever relevant. Recommendations were made for particular studies to be undertaken especially in controversial aspects in all six sections of the reviewed topics. Despite numerous laboratory assessments of female sexual function, genital assessments alone appear insufficient to characterise fully the complete sexual response. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.
Methoxyflavones from New Lingzhi Medicinal Mushroom, Ganoderma lingzhi (Agaricomycetes).
Shimizu, Kuniyoshi; Amen, Yhiya M; Kaifuchi, Satoru
2016-01-01
Ganoderma lingzhi is one of the most famous medicinal fungi in the world. It has been used in folk medicine, especially in East Asian countries. It is also a white-rot fungus with strong wood degradation ability, especially against lignin. Different classes of bioactive natural products have been reported in Ganoderma, including triterpenes, polysaccharides, sterols, and peptides. The triterpenes and polysaccharides are the primary bioactive compounds of Ganoderma. We report for the first time the presence of 3 methoxyflavones as minor constituents in G. linghzi. The 3 compounds were identified based on different spectroscopic techniques, including 1- and 2-dimensional nuclear magnetic resonance (1H-1H correlation spectroscopy, heteronuclear single quantum coherence, and heteronuclear multiple bond correlation) and mass spectrometry (high-resolution electrospray ionization mass spectrometry). Our report provides an approach to a possible biosynthetic pathway for biosynthetic genes in the mushrooms. Another great possibility is that these compounds may exist or be formed through degradation of the components in the woody substrate, such as lignin, and then subsequently translocate to the fruiting bodies.
Explore and experience: mobile augmented reality for medical training.
Albrecht, Urs-Vito; Noll, Christoph; von Jan, Ute
2013-01-01
In medicine, especially in basic education, it may sometimes be inappropriate to integrate real patients into classes due to ethical issues that must be avoided. Nevertheless, the quality of medical education may suffer without the use of real cases. This is especially true of medical specialties such as legal medicine: survivors of a crime are already subjected to procedures that constitute a severe emotional burden and may cause additional distress even without the added presence of students. Using augmented reality based applications may alleviate this ethical dilemma by giving students the possibility to practice the necessary skills based on virtual but nevertheless almost realistic cases. The app "mARble®" that is presented in this paper follows this approach. The currently available learning module for legal medicine gives users an opportunity to learn about various wound patterns by virtually overlaying them on their own skin and is applicable in different learning settings. Preliminary evaluation results covering learning efficiency and emotional components of the learning process are promising. Content modules for other medical specialtiesare currently under construction.
... including over-the-counter medications and vitamins (and holistic type supplements). Many rhythm disorders, especially tachycardias, respond ... child about this before the doctor visit. Medicine Management What is compliance? Compliance simply means following the ...
[Icelanders' beliefs about medicines. Use of BMQ].
Vilhelmsdottir, Hlif; Johannsson, Magnus
2017-01-01
To study beliefs held by the general public in Iceland about medicines. The Beliefs about Medicines Questionnaire was used to explore Icelanders' beliefs about medicines. A sample of 1500 Icelandic citizens, aged 18-75, obtained from the Social Science Research Insti-tute was given The Beliefs about Medicines Questionnaire. The response rate was 61.6%. Most Icelanders have positive beliefs about their medication as well as general trust. Those who suffer from chronic diseases are more positive towards medicines than others and less inclined to view them as excessively used and harmful. Higher level of education predicts more positive beliefs towards medication - and vice versa. Gender and age do not seem to affect such beliefs. Gaining a better understanding of people´s beliefs about medicines and what determines these beliefs can be of considerable value in the search for ways to improve therapy and adherence, espe-cially for those suffering from chronic diseases. Promoting education for the general public about medicines might result in less mis-understanding among patients and subsequently better grounded -beliefs and more adequate therapeutic adherence. Key words: beliefs, medicines, Icelanders, BMQ, survey. Correspondence: Hlif Vilhelmsdottir, hlif84@gmail.com.
Surrogate end points in women's health research: science, protoscience, and pseudoscience.
Grimes, David A; Schulz, Kenneth F; Raymond, Elizabeth G
2010-04-01
A surrogate end point (e.g., a laboratory test or image) serves as a proxy for a clinical end point of importance (e.g., fracture, thrombosis, or death). Adoption and use of surrogate end points lacking validation, especially in cardiovascular medicine, have caused thousands of patients' deaths, a serious violation of the ethical principle of beneficence. Copyright 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
[Muscle relaxants in the treatment of idiopathic trigeminal neuralgia (author's transl)].
von Albert, H H
1975-08-29
In 195 patients with idiopathic trigeminal neuralgias, atypical facial neuralgia or zoster neuralgia in the face it was shown that, in the initial stages of these diseases, the efficacy of the always satisfactory medicinal treatment with an anticonvulsant (hydantoin or carbamezathine) can be increased by combination with a muscle relaxant (especially chlormezanone). Medicinal therapy is then still frequently possible without side effects and operative treatment (Frazier-Spiller's retrogasserian neurotomy) can be postponed.
Madea, Burkhard; Saukko, Pekka; Musshoff, Frank
2007-01-17
In the last years the research output of forensic medicine has sometimes been regarded as insufficient and as of poor quality, especially when parameters as impact factors and external funding were taken into account. However, forensic medicine has different tasks compared to clinical medicine. The main difference between basic subjects, clinical and forensic medicine is not a lack of scientific efficiency in forensic medicine but is a result of the questions asked, the available methods and specific aims. In contrast to natural-scientific research, forensic science has furthermore important intersections with arts and socio-scientific disciplines. Etiologic and pathogenetic research is of only limited relevance in forensic medicine. Thus, forensic medicine is excluded from these research fields, which are mainly supported by external funding. In forensic medicine research mainly means applied research regarding findings, the probative value and reconstruction as well as examination at different points of intersection between medicine and law. Clinical types of research such as controlled randomised, prospective cross-sectional, cohort or case-control studies can only rarely be applied in forensic medicine due to the area specific research fields (e.g. thantatology, violent death, vitality, traffic medicine, analytical toxicology, hemogenetics and stain analysis). The types of studies which are successfully established in forensic medicine are comparison of methods, sensitivity studies, validation of methods, kinetic examinations etc. Tasks of research in forensic medicine and study types, which may be applied will be addressed.
Introducing High School Students to Careers in Osteopathic Medicine.
Wilson, Nedra F
2017-05-01
An aging population and expansion of health care coverage under the Patient Protection and Affordable Care Act have led to a predicted deficit of primary care physicians by 2025. In response, medical schools must develop new strategies to identify students early in their educational pathways to encourage exploration of careers in science, technology, engineering, and mathematics (STEM) fields, especially medicine. Oklahoma State University Center for Health Sciences developed 2 internship programs, Oklahoma Science Training and Research Students (OKStars) and Native OKStars, to introduce high school students to osteopathic medicine. Native OKStars was designed to encourage Native American students, who are underrepresented in STEM fields, to pursue osteopathic medicine. These programs provided students with a 6-week immersion in biomedical research, along with weekly discussion groups with mentors. Participant questionnaire responses suggested that these programs were effective in introducing them to careers in osteopathic medicine as well as other STEM fields.
Good Deaths, "Stupid Deaths": Humane Medicine and the Call of Invisible Bodies.
Ryan, Maura A
2016-12-01
Jeffrey Bishop's The Anticipatory Corpse exposes a functional metaphysics at the root of contemporary medical practice that gives rise to inhumane medicine, especially at the end of life. His critique of medicine argues for alternative spaces and practices in which the communal significance of the body, its telos, can be restored and the meaning of a "good death" enriched. This essay develops an alternative epistemology of the body, drawing from Christian theological accounts of the communal or Eucharistic body and linking liturgical practices to the cultivation of solidarity. It argues for an epistemology of the body that makes visible the invisible bodies at medicine's margins and illumines the disparate worlds of health care globally. © The Author 2016. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Li, Jing-Jian; Xiong, Chao; Liu, Yue; Liang, Jun-Song; Zhou, Xing-Wen
2016-01-01
Correct identification of medicinal plant ingredients is essential for their safe use and for the regulation of herbal drug supply chain. Loop-mediated isothermal amplification (LAMP) is a recently developed approach to identify herbal medicine species. This novel molecular biology technique enables timely and accurate testing, especially in settings where infrastructures to support polymerase chain reaction facilities are lacking. Studies that used this method have altered our view on the extent and complexity of herbal medicine identification. In this review, we give an introduction into LAMP analysis, covers the basic principles and important aspects in the development of LAMP analysis method. Then we presented a critical review of the application of LAMP-based methods in detecting and identifying raw medicinal plant materials and their processed products. We also provide a practical standard operating procedure (SOP) for the utilization of the LAMP protocol in herbal authentication, and consider the prospects of LAMP technology in the future developments of herbal medicine identification and the challenges associated with its application.
Poor representation of Blacks, Latinos, and Native Americans in medicine.
Rodriguez, José E; Campbell, Kendall M; Adelson, Wendi J
2015-04-01
In this article, the authors discuss how various systems in medicine are limiting representation of blacks, Latinos, and Native Americans. Flat and decreasing percentages of Underrepresented Minorities in Medicine (URMM), especially in the black and Native American populations, is concerning for family medicine since members from URMM groups care for minority and underserved populations in greater numbers. Underrepresentation is not only noted in the medical community but also in our medical schools when it comes to numbers of URMM faculty. The changing definition of "disadvantaged" in medical school admissions has also played a part in limiting URMM representation. In addition, the Medical College Admissions Test (MCAT) excludes black, Latino, and Native American students in greater numbers. The authors support these arguments with evidence from the medical literature. Although unintentional, these systems effectively limit representation of blacks, Latinos, and Native Americans in medicine. Effective changes are suggested and can be implemented to ensure that URMM individuals have equal representation in careers in medicine.
Li, Jing-jian; Xiong, Chao; Liu, Yue; Liang, Jun-song; Zhou, Xing-wen
2016-01-01
Correct identification of medicinal plant ingredients is essential for their safe use and for the regulation of herbal drug supply chain. Loop-mediated isothermal amplification (LAMP) is a recently developed approach to identify herbal medicine species. This novel molecular biology technique enables timely and accurate testing, especially in settings where infrastructures to support polymerase chain reaction facilities are lacking. Studies that used this method have altered our view on the extent and complexity of herbal medicine identification. In this review, we give an introduction into LAMP analysis, covers the basic principles and important aspects in the development of LAMP analysis method. Then we presented a critical review of the application of LAMP-based methods in detecting and identifying raw medicinal plant materials and their processed products. We also provide a practical standard operating procedure (SOP) for the utilization of the LAMP protocol in herbal authentication, and consider the prospects of LAMP technology in the future developments of herbal medicine identification and the challenges associated with its application. PMID:28082999
[German medicine of the age of romanticism (1797-1848) as research problem].
Płonka-Syroka, B
1997-01-01
In the period between 1797 and 1848, German medicine was considerably influenced by philosophy. It absorbed ideas deriving from neo-Platonism and vitalism, as well as the modern philosophy of nature (Naturphilosophie), especially the ideas of Schelling. The article presents the main tendencies in the German medicine of that period: the distinct character of German medical thought as compared to the rest of Europe, the deductive character of medical theories, the grounding of medical thought in non-materialist philosophy and its close ties with the Protestant religion. The author's aim is investigate how German medicine of the period evolved away from European standards set by the model of medicine as an empirical science, based on the inductive method of research. The article presents the state of German medicine of the first half of the nineteenth century against the background of socio-cultural factors and relates German medical theory of the period to the social awareness of that time.
Intracardiac electrophysiology study (EPS)
... rhythm Determine whether you are at risk for future heart events, especially sudden cardiac death See if ... patient with suspected arrhythmia. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: ...
[The criteria for appointing experts in forensic medicine].
Vojtíšek, Tomáš
In the Czech Republic, forensic medicine is an independent medical field, in which physicians with the appropriate attestation perform expert activities, especially in criminal proceedings, after being formally appointed by a regional court. In order to improve the quality of the activities provided by these experts, the Ministry of Justice is endeavouring to tighten up the general conditions for the appointment of new forensic experts. The individual criteria do not, however, take into account the special nature of forensic medicine as a medical field, the very essence of which involves the specialist qualifications which are necessary for the provision of expert opinions, most frequently to the police. In particular, the introduction of a strict requirement for ten-years of work experience after leaving medical school has hindered and stalled the entrance of young physicians with completed post-graduate studies into the area of forensic medicine. An inquiry sent to the regional courts has discovered that the average length of work experience for newly appointed experts in the period from 2004 to 2013 was 8.2 years, that half of them had work experience of seven years or less and that 75 percent of the newly appointed experts did not meet any set requirements for the length of their work experience at the time of their appointment. The new conditions may have a negative impact on attracting qualified graduates to forensic medicine after the completion of their medical studies and in the long term it may endanger the ability of the field of forensic medicine to provide expert opinions in criminal proceedings. In conclusion, it is the authors opinion that the appointment conditions should be set in cooperation with the professional medical associations and that they should take into account the specific characteristics of the individual medical fields, especially if they are to be set directly by means of a legal regulation within the framework of the recodification of the standing of forensic experts in the Czech Republic. forensic medicine - expertises - criminal procedure.
[The joint applications of DNA chips and single nucleotide polymorphisms in forensic science].
Bai, Peng; Tian, Li; Zhou, Xue-ping
2005-05-01
DNA chip technology, being a new high-technology, shows its vigorous life and rapid growth. Single Nucleotide Polymorphisms (SNPs) is the most common diversity in the human genome. It provides suitable genetic markers which play a key role in disease linkage study, pharmacogenomics, forensic medicine, population evolution and immigration study. Their advantage such as being analyzed with DNA chips technology, is predicted to play an important role in the field of forensic medicine, especially in paternity test and individual identification. This report mainly reviews the characteristics of DNA chip and SNPs, and their joint applications in the practice of forensic medicine.
Fernandez, Facundo M.; Hostetler, Dana; Powell, Kristen; Kaur, Harparkash; Green, Michael D.; Mildenhall, Dallas C.; Newton, Paul N.
2012-01-01
Throughout history, poor quality medicines have been a persistent problem, with periodical crises in the supply of antimicrobials, such as fake cinchona bark in the 1600s and fake quinine in the 1800s. Regrettably, this problem seems to have grown in the last decade, especially afflicting unsuspecting patients and those seeking medicines via on-line pharmacies. Here we discuss some of the challenges related to the fight against poor quality drugs, and counterfeits in particular, with an emphasis on the analytical tools available, their relative performance, and the necessary workflows needed for distinguishing between genuine, substandard, degraded and counterfeit medicines. PMID:21107455
Cutshall, Susanne M; Bergstrom, Larry R; Kalish, Daniel J
2016-05-01
Fatigue, stress, and digestive disorders are common among adults, especially women. We conducted a 28-week pilot study to assess the efficacy of a functional medicine approach to improving stress, energy, fatigue, digestive issues, and quality of life in middle-aged women. Findings showed significant improvements in many stress, fatigue, and quality-of-life measures. The treatment program increased mean salivary dehydroepiandrosterone levels and the cortisol-dehydroepiandrosterone ratio. Stool sample analyses suggested that these treatments reduced Helicobacter pylori infections. This study suggests that functional medicine may be an effective approach to managing stress and gastrointestinal symptoms. Copyright © 2016 Elsevier Ltd. All rights reserved.
Hinz-Wessels, Annette; Hulverscheidt, Marion A
2009-01-01
Using the methods of institutional history, this article examines the Department for Tropical Medicine of the Robert Koch-Institute for Infectious Diseases in Berlin. The Heads of Department were deeply involved in the crimes against humanity during National Socialism. The relationship between science and politics is analysed with regard to the so-called self-mobilization of scientists, especially during Word War II. Particularly Gerhard Rose accumulated various posts in science, the military and in state organizations during National Socialism, extending in this way his influence on research in tropical medicine.
Precision medicine: In need of guidance and surveillance.
Lin, Jian-Zhen; Long, Jun-Yu; Wang, An-Qiang; Zheng, Ying; Zhao, Hai-Tao
2017-07-28
Precision medicine, currently a hotspot in mainstream medicine, has been strongly promoted in recent years. With rapid technological development, such as next-generation sequencing, and fierce competition in molecular targeted drug exploitation, precision medicine represents an advance in science and technology; it also fulfills needs in public health care. The clinical translation and application of precision medicine - especially in the prevention and treatment of tumors - is far from satisfactory; however, the aims of precision medicine deserve approval. Thus, this medical approach is currently in its infancy; it has promising prospects, but it needs to overcome numbers of problems and deficiencies. It is expected that in addition to conventional symptoms and signs, precision medicine will define disease in terms of the underlying molecular characteristics and other environmental susceptibility factors. Those expectations should be realized by constructing a novel data network, integrating clinical data from individual patients and personal genomic background with existing research on the molecular makeup of diseases. In addition, multi-omics analysis and multi-discipline collaboration will become crucial elements in precision medicine. Precision medicine deserves strong support, and its development demands directed momentum. We propose three kinds of impetus (research, application and collaboration impetus) for such directed momentum toward promoting precision medicine and accelerating its clinical translation and application.
Precision medicine: In need of guidance and surveillance
Lin, Jian-Zhen; Long, Jun-Yu; Wang, An-Qiang; Zheng, Ying; Zhao, Hai-Tao
2017-01-01
Precision medicine, currently a hotspot in mainstream medicine, has been strongly promoted in recent years. With rapid technological development, such as next-generation sequencing, and fierce competition in molecular targeted drug exploitation, precision medicine represents an advance in science and technology; it also fulfills needs in public health care. The clinical translation and application of precision medicine - especially in the prevention and treatment of tumors - is far from satisfactory; however, the aims of precision medicine deserve approval. Thus, this medical approach is currently in its infancy; it has promising prospects, but it needs to overcome numbers of problems and deficiencies. It is expected that in addition to conventional symptoms and signs, precision medicine will define disease in terms of the underlying molecular characteristics and other environmental susceptibility factors. Those expectations should be realized by constructing a novel data network, integrating clinical data from individual patients and personal genomic background with existing research on the molecular makeup of diseases. In addition, multi-omics analysis and multi-discipline collaboration will become crucial elements in precision medicine. Precision medicine deserves strong support, and its development demands directed momentum. We propose three kinds of impetus (research, application and collaboration impetus) for such directed momentum toward promoting precision medicine and accelerating its clinical translation and application. PMID:28811702
Chinese Herbal Medicine on Cardiovascular Diseases and the Mechanisms of Action.
Liu, Cuiqing; Huang, Yu
2016-01-01
Cardiovascular diseases are the principal cause of death worldwide. The potentially serious adverse effects of therapeutic drugs lead to growing awareness of the role of Chinese herbal medicine in the treatment of cardiovascular diseases. Chinese herbal medicine has been widely used in many countries especially in China from antiquity; however, the mechanisms by which herbal medicine acts in the prevention and treatment of cardiovascular diseases are far from clear. In this review, we briefly describe the characteristics of Chinese herbal medicine by comparing with western medicine. Then we summarize the formulae and herbs/natural products applied in the clinic and animal studies being sorted according to the specific cardiovascular diseases. Most importantly, we elaborate the existing investigations into mechanisms by which herbal compounds act at the cellular levels, including vascular smooth muscle cells, endothelial cells, cardiomyocytes and immune cells. Future research should focus on well-designed clinic trial, in-depth mechanic study, investigations on side effects of herbs and drug interactions. Studies on developing new agents with effectiveness and safety from traditional Chinese medicine is a promising way for prevention and treatment of patients with cardiovascular diseases.
van der Greef, Jan; van Wietmarschen, Herman; Schroën, Jan; Wang, Mei; Hankemeier, Thomas; Xu, Guowang
2010-12-01
Innovative systems approaches to develop medicine and health care are emerging from the integration of Chinese and Western medicine strategies, philosophies and practices. The two medical systems are highly complementary as the reductionist aspects of Western medicine are favourable in acute disease situations and the holistic aspects of Chinese medicine offer more opportunities in chronic conditions and for prevention. In this article we argue that diagnosis plays a key role in building the bridge between Chinese and Western medicine. Recent advances in the study of health, healing, placebo effects and patient-physician interactions will be discussed pointing out the development of a system-based diagnosis. Especially, a system biology-based diagnosis can be used to capture phenotype information, leading towards a scientific basis for a more refined patient characterization, new diagnostic tools and personalized heath strategies. Subtyping of rheumatoid arthritis patients based on Chinese diagnostic principles is discussed as an example. New insights from this process of integrating Western and Chinese medicine will pave the way for a patient-centred health care ecosystem. © Georg Thieme Verlag KG Stuttgart · New York.
Chen, Xiuping; Pei, Lixia; Lu, Jinjian
2013-06-01
Traditional Chinese medicine (TCM), the ancient medicine popular in China and surrounding areas, has been recognized as a typical representative of complementary and alternative medicine. Over long period in clinical practice, especially the progress in basic research, data on the effectiveness and beneficial contribution of TCM herbs to public health and disease control have been accumulated while the quality of the evidence is generally poor. The most common clinical practice of TCM herbs is herb combination called formula which consists of several types of medicinal herbs or minerals, which is quite different from modern medicine. Definitely, tens of hundreds of compounds could be identified in even a small formula. With the regained enthusiasm on natural products based new drug R&D, the proposed multi-target drug discovery strategy, the booming of -omics technologies, and the implementation of ambitious plan of TCM modernization in China, attempts have been made to fill the gap between TCM herbs and modern drugs. However, are we heading to the right direction? Copyright © 2013 Elsevier Ltd. All rights reserved.
Biobanking for Personalized Medicine.
Liu, Angen; Pollard, Kai
2015-01-01
A biobank is an entity that collects, processes, stores, and distributes biospecimens and relevant data for use in basic, translational, and clinical research. Biobanking of high-quality human biospecimens such as tissue, blood and other bodily fluids along with associated patient clinical information provides a fundamental scientific infrastructure for personalized medicine. Identification of biomarkers that are specifically associated with particular medical conditions such as cancer, cardiovascular disease and neurological disorders are useful for early detection, prevention, and treatment of the diseases. The ability to determine individual tumor biomarkers and to use those biomarkers for disease diagnosis, prognosis and prediction of response to therapy is having a very significant impact on personalized medicine and is rapidly changing the way clinical care is conducted. As a critical requirement for personalized medicine is the availability of a large collection of patient samples with well annotated patient clinical and pathological data, biobanks thus play an important role in personalized medicine advancement. The goal of this chapter is to explore the role of biobanks in personalized medicine and discuss specific needs regarding biobank development for translational and clinical research, especially for personalized medicine advancement.
Safety issues and new rapid detection methods in traditional Chinese medicinal materials
Wang, Lili; Kong, Weijun; Yang, Meihua; Han, Jianping; Chen, Shilin
2015-01-01
The safety of traditional Chinese medicine (TCM) is a major strategic issue that involves human health. With the continuous improvement in disease prevention and treatment, the export of TCM and its related products has increased dramatically in China. However, the frequent safety issues of Chinese medicine have become the ‘bottleneck’ impeding the modernization of TCM. It was proved that mycotoxins seriously affect TCM safety; the pesticide residues of TCM are a key problem in TCM international trade; adulterants have also been detected, which is related to market circulation. These three factors have greatly affected TCM safety. In this study, fast, highly effective, economically-feasible and accurate detection methods concerning TCM safety issues were reviewed, especially on the authenticity, mycotoxins and pesticide residues of medicinal materials. PMID:26579423
The interface between veterinary and human antibiotic use.
Shryock, Thomas R; Richwine, Amy
2010-12-01
The identification and early development of novel antimicrobial agents for use in veterinary medicine is subject to many of the same business and technical challenges as those found in antimicrobial agent use for human infectious disease. However, as awareness that some of the antimicrobial classes used in veterinary medicine are the same as used in human medicine, concern by multiple stakeholders has increased that this nonhuman use might be contributing to the problem of antimicrobial resistance to pathogens in humans, particularly with regard to food-borne diseases, such as salmonellosis and campylobacteriosis. Consequently, the interface between veterinary and human antibiotic use and resistance, especially with respect to human microbial food safety, has begun to redirect the industry pipeline of novel antimicrobial agents to be commercialized for use in veterinary medicine.
Precision Medicine in Myelodysplastic Syndromes and Leukemias: Lessons from Sequential Mutations.
Nazha, Aziz; Sekeres, Mikkael A
2017-01-14
Precision medicine can be simply defined as the identification of personalized treatment that matches patient-specific clinical and genomic characteristics. Since the completion of the Human Genome Project in 2003, significant advances have been made in our understanding of the genetic makeup of diseases, especially cancers. The identification of somatic mutations that can drive cancer has led to the development of therapies that specifically target the abnormal proteins derived from these mutations. This has led to a paradigm shift in our treatment methodology. Although some success has been achieved in targeting some genetic abnormalities, several challenges and limitations exist when applying precision-medicine concepts in leukemia and myelodysplastic syndromes. We review the current understanding of genomics in myelodysplastic syndromes (MDS) and leukemias and the limitations of precision-medicine concepts in MDS.
Ouarghidi, Abderrahim; Martin, Gary J; Powell, Bronwen; Esser, Gabrielle; Abbad, Abdelaziz
2013-08-15
A literature review revealed heavy reliance on a few key publications for identification of medicinal plant species from local or vernacular names and a lack of citation of voucher specimens in many publications. There is a need for more reliable and standardized data on the identity of species used for medicine, especially because local names vary from region to region. This is especially true in the case of medicinal roots, for which identification of species is difficult. This paper contributes to existing data on the species sold as medicinal roots (and other underground plant parts such as bulbs, corms, rhizomes and tubers) in Morocco. Data were collected in collaboration with herbalists in Marrakech and collectors in rural regions near Marrakech where species are collected from the wild. The ethno-medicinal uses of these species were also recorded. We identified the vernacular names for 67 medicinal roots (by free listing) used to treat a variety of human diseases. We were able to collect and identify one or more species for 39 of the recorded vernacular names. The ones we were not able to identify were either imported or no longer available in the markets. We collected more than one species for some of the vernacular names for a total of 43 species. We identified six new vernacular names and four species which had not been previously described in the literature. Our botanical identification matched at least one of the names listed in the literature 63% of the time and did not match any species listed in the literature 37% of the time. Of the three most commonly cited pieces of literature we compared to, we found the greatest overlap with the broader, more comprehensive work of Bellakhdar 1997 (as opposed to Benchâabane and Abbad 1997 which worked in a similarly focused geographical area). However there was only 63% agreement between Bellakhdar 1997 and our botanical identifications, and 29% of the time our identification didn't match even the genus of any of the species listed in any of the 3 most commonly cited pieces of literature. More rigorous methodology and reporting are needed for medicinal plant research in Morocco. This will ensure that studies are comparable, help to protect traditional medicine users from negative health effects, and, support efforts to conserve overharvested wild medicinal plants.
The use of Skype in a community hospital inpatient palliative medicine consultation service.
Brecher, David B
2013-01-01
Skype™, an Internet-based communication tool, has enhanced communication under numerous circumstances. As telemedicine continues to be an increasing part of medical practice, there will be more opportunities to use Skype and similar tools. Numerous scenarios in the lay literature have helped to highlight the potential uses. Although most commonly used to enhance physician-to-patient communication, there has been limited reported use of Skype for patient-to-family communication, especially in end of life and palliative care. Our inpatient Palliative Medicine Consultation Service has offered and used this technology to enhance our patients' quality of life. The objective was to provide another tool for our patients to use to communicate with family and/or friends, especially under circumstances in which clinical symptoms, functional status, financial concerns, or geographic limitations preclude in-person face-to face communication.
Bruns, David E; Burtis, Carl A; Gronowski, Ann M; McQueen, Matthew J; Newman, Anthony; Jonsson, Jon J
2015-03-10
Ethical considerations are increasingly important in medicine. We aimed to determine the mode and extent of teaching of ethics in training programs in clinical chemistry and laboratory medicine. We developed an on-line survey of teaching in areas of ethics relevant to laboratory medicine. Reponses were invited from directors of training programs who were recruited via email to leaders of national organizations. The survey was completed by 80 directors from 24 countries who directed 113 programs. The largest numbers of respondents directed postdoctoral training of scientists (42%) or physicians (33%), post-masters degree programs (33%), and PhD programs (29%). Most programs (82%) were 2years or longer in duration. Formal training was offered in research ethics by 39%, medical ethics by 31%, professional ethics by 24% and business ethics by 9%. The number of reported hours of formal training varied widely, e.g., from 0 to >15h/year for research ethics and from 0 to >15h for medical ethics. Ethics training was required and/or tested in 75% of programs that offered training. A majority (54%) of respondents reported plans to add or enhance training in ethics; many indicated a desire for online resources related to ethics, especially resources with self-assessment tools. Formal teaching of ethics is absent from many training programs in clinical chemistry and laboratory medicine, with heterogeneity in the extent and methods of ethics training among the programs that provide the training. A perceived need exists for online training tools, especially tools with self-assessment components. Copyright © 2014 Elsevier B.V. All rights reserved.
[Standardization of cancer biobank in precision medicine era].
Ji, Jiafu
2016-05-25
Tumor specimens have a great role in basic and clinical translational researches on cancer, especially in the era of precision medicine. Thus the standardization of cancer biobank is of high importance. The establishment and maintenance of cancer biobank require comprehensive quality management, so as to provide high quality service for basic and clinical researches. At present, sample-oriented collection and management, and clinical and pathological data annotation are the main focuses of biobank standardization in China.
Chinese Marine Materia Medica Resources: Status and Potential
Fu, Xiu-Mei; Zhang, Meng-Qi; Shao, Chang-Lun; Li, Guo-Qiang; Bai, Hong; Dai, Gui-Lin; Chen, Qian-Wen; Kong, Wei; Fu, Xian-Jun; Wang, Chang-Yun
2016-01-01
Chinese marine materia medica (CMMM) is a vital part of traditional Chinese medicine (TCM). Compared with terrestrial TCM, CMMM, derived from specific marine habitats, possesses peculiar chemical components with unique structures reflecting as potent pharmacological activities, distinct drug properties and functions. Nowadays, CMMM appears to be especially effective in treating such difficult diseases as cancers, diabetes, cardio-cerebrovascular diseases, immunodeficiency diseases and senile dementia, and therefore has become an important medicinal resource for the research and development of new drugs. In recent years, such development has attracted wide attention in the field of medicine. In this study, the CMMM resources in China were systematically investigated and evaluated. It was found that the historic experiences of Chinese people using CMMM have continuously accumulated over a period of more than 3600 years, and that the achievements of the research on modern CMMM are especially outstanding. By June 2015, 725 kinds of CMMMs from Chinese coastal sea areas have been identified and recorded, covering 1552 organisms and minerals. More than 3100 traditional prescriptions containing CMMMs have been imparted and inherited. However, the number of CMMMs is less than the 8188 terrestrial TCMs, from more than 12,100 medicinal terrestrial plants, animals and minerals. In the future, the research and development of CMMM should focus on the channel entries (TCM drug properties), compatibility, effective ingredients, acting mechanisms, drug metabolism and quality standard. This study reveals the high potential of CMMM development. PMID:26950133
Chinese Marine Materia Medica Resources: Status and Potential.
Fu, Xiu-Mei; Zhang, Meng-Qi; Shao, Chang-Lun; Li, Guo-Qiang; Bai, Hong; Dai, Gui-Lin; Chen, Qian-Wen; Kong, Wei; Fu, Xian-Jun; Wang, Chang-Yun
2016-03-03
Chinese marine materia medica (CMMM) is a vital part of traditional Chinese medicine (TCM). Compared with terrestrial TCM, CMMM, derived from specific marine habitats, possesses peculiar chemical components with unique structures reflecting as potent pharmacological activities, distinct drug properties and functions. Nowadays, CMMM appears to be especially effective in treating such difficult diseases as cancers, diabetes, cardio-cerebrovascular diseases, immunodeficiency diseases and senile dementia, and therefore has become an important medicinal resource for the research and development of new drugs. In recent years, such development has attracted wide attention in the field of medicine. In this study, the CMMM resources in China were systematically investigated and evaluated. It was found that the historic experiences of Chinese people using CMMM have continuously accumulated over a period of more than 3600 years, and that the achievements of the research on modern CMMM are especially outstanding. By June 2015, 725 kinds of CMMMs from Chinese coastal sea areas have been identified and recorded, covering 1552 organisms and minerals. More than 3100 traditional prescriptions containing CMMMs have been imparted and inherited. However, the number of CMMMs is less than the 8188 terrestrial TCMs, from more than 12,100 medicinal terrestrial plants, animals and minerals. In the future, the research and development of CMMM should focus on the channel entries (TCM drug properties), compatibility, effective ingredients, acting mechanisms, drug metabolism and quality standard. This study reveals the high potential of CMMM development.
Rationale and Design of the Women and Inclusion in Academic Medicine Study.
Hill, Emorcia V; Wake, Michael; Carapinha, René; Normand, Sharon-Lise; Wolf, Robert E; Norris, Keith; Reede, Joan Y
2016-04-21
Women of color (WOC) (African American, Hispanic, Native American/Alaskan Native, and Asian American) faculty remain disproportionately underrepresented among medical school faculty and especially at senior ranks compared with White female faculty. The barriers or facilitators to the career advancement of WOC are poorly understood. The Women and Inclusion in Academic Medicine (WIAM) study was developed to characterize individual, institutional and sociocultural factors that influence the entry, progression and persistence, and advancement of women faculty in academic medical careers with a focus on WOC. Using a purposive sample of 13 academic medical institutions, we collected qualitative interview data from 21 WOC junior faculty and quantitative data from 3,127 (38.9% of 8,053 eligible women) respondents via an online survey. To gather institutional data, we used an online survey and conducted 23 key administrative informant interviews from the 13 institutions. Grounded theory methodology will be used to analyze qualitative data. Multivariable analysis including hierarchical linear modeling will be used to investigate outcomes, such as the inclusiveness of organizational gender climate and women faculty's intent to stay. We describe the design, methods, rationale and limitations of one of the largest and most comprehensive studies of women faculty in academic medicine with a focus on WOC. This study will enhance our understanding of challenges that face women, and, especially WOC, faculty in academic medicine and will provide solutions at both the individual and institutional levels.
What does «integrative medicine» provide to daily scientific clinical care?
Bataller-Sifre, R; Bataller-Alberola, A
2015-11-01
Integrative medicine is an ambitious and noble-minded attempt to address the shortcomings of the current public health systems in our Western societies, which is restricted by the limited time available, especially in outpatient clinics. Integrative medicine also does not limit the possibilities of useful therapies that have been tested over the centuries (from China, India, etc.) or of certain resources that do not achieve the level of desired scientific credibility but that present certain therapeutic support in specific cases (homeopathy, acupuncture, etc.) but still require a scientific approach. Finally, the resource of botanical products (phytotherapy) constitutes a wide range of possibilities that universities can (and do) make progress on by providing drug brands for these products through the use of the scientific method and evidence-based medical criteria. This approach will help avoid the irrationality of the daily struggle between conventional scientific medicine (which we apply to the immense majority of patients) and the other diagnostic-therapeutic «guidelines» (natural medicine, alternative medicine, complementary medicine, patient-focused medicine and others). Copyright © 2015. Published by Elsevier España, S.L.U.
Nyctanthes arbor-tristis Linn--a critical ethnopharmacological review.
Agrawal, Jyoti; Pal, Anirban
2013-04-19
Nyctanthes arbor-tristis (Oleaceae) is a mythological plant; has high medicinal values in Ayurveda. The popular medicinal use of this plant are anti-helminthic and anti-pyretic besides its use as a laxative, in rheumatism, skin ailments and as a sedative. Vitally, the natives plant it in their home gardens to pass on its medicinal usage to oncoming generations. The present review encompasses an ethnopharmacological evaluation focusing on information on the chemical constituents, pharmacological actions and toxicology in order to reveal the therapeutic potential and gaps requiring research involvement. The present review is based on searches in Scifinder(®), Pubmed (National Library of Medicine) and books published on the subject during the period 1933 to 2012. Nyctanthes arbor-tristis is most important in local and traditional medicines especially in India for treating intermittent fevers, arthritis and obstinate sciatica. Crude extracts and isolated compounds from the plant were shown to be pharmacologically active against inflammation, malaria, viral infection, leishmanisis and as an immunostimulant. The major class of biologically active compounds are the iridoid glucosides incl., Arbortristoside A, B and C from the seeds active as anticancer, anti-leishmania, anti-inflammatory, anti-allergic, immunomodulatory and antiviral. Other molecules; calceolarioside A, 4-hydroxyhexahydrobenzofuran-7one and β-sitosterol from leaves have been reported to be active as anti-leishmanial, anticancer and anti-inflammatory, respectively. The crude extracts have been found to be safe with an LD50 of 16gm/kg, while the LD50 of arbortristoside-A isolated from the seeds was found to be 0.5g/kg. Mostly in-vitro or in some cases in-vivo models provide some evidence especially in the treatment of inflammatory conditions like arthritis, fevers related to malaria and protozoan diseases especially leishmaniasis. The only clinical study found, is for treating malaria, but with crude extract only. Further, more detailed safety data pertaining to the acute and sub-acute toxicity, cardio and immunotoxicity also needs to be generated for crude extracts or pure compounds. Crown Copyright © 2013. Published by Elsevier Ireland Ltd. All rights reserved.
ERIC Educational Resources Information Center
Ingelfinger, Franz J.
1980-01-01
Selected for discussion are certain advances in basic research and technologic innovation which shape the past, present, and future of medical care. Included are infectious diseases, especially hepatitis, immunology, clinical disorders of the immune system and the histocompatability system. (Author/SA)
Stanifer, John W; Kilonzo, Kajiru; Wang, Daphne; Su, Guobin; Mao, Wei; Zhang, Lei; Zhang, La; Nayak-Rao, Shobhana; Miranda, J Jaime
2017-05-01
Traditional medicines are a principal form of health care for many populations, particularly in low- and middle-income countries, and they have gained attention as an important means of health care coverage globally. In the context of kidney diseases, the challenges and opportunities presented by traditional medicine practices are among the most important considerations for developing effective and sustainable public health strategies. However, little is known about the practices of traditional medicines in relation to kidney diseases, especially concerning benefits and harms. Kidney diseases may be caused, treated, prevented, improved, or worsened by traditional medicines depending on the setting, the person, and the types, modes, and frequencies of traditional medicine use. Given the profound knowledge gaps, nephrology practitioners and researchers may be uniquely positioned to facilitate more optimal public health strategies through recognition and careful investigation of traditional medicine practices. Effective implementation of such strategies also will require local partnerships, including engaging practitioners and users of traditional medicines. As such, practitioners and researchers investigating kidney diseases may be uniquely positioned to bridge the cultural, social, historical, and biologic differences between biomedicine and traditional medicine, and they have opportunities to lead efforts in developing public health strategies that are sensitive to these differences. Copyright © 2017 Elsevier Inc. All rights reserved.
Epilepsy and its treatment in the ancient cultures of America.
Elferink, J G
1999-07-01
Epilepsy was a well-recognized disease in pre-Columbian America, as appears from the reports of the Spanish chroniclers of the sixteenth century. Both the Aztecs and the Incas strongly associated epilepsy with magic and religion, which is evident from their ideas about the pathogenesis and treatment of the disease. Apart from treatment of epilepsy by magic means, the Incas and especially the Aztecs used in addition a large number of botanic medicines; the use of these medicines probably had an empiric nature.
Phage Therapy: Beyond Antibacterial Action.
Górski, Andrzej; Jończyk-Matysiak, Ewa; Międzybrodzki, Ryszard; Weber-Dąbrowska, Beata; Łusiak-Szelachowska, Marzanna; Bagińska, Natalia; Borysowski, Jan; Łobocka, Małgorzata B; Węgrzyn, Alicja; Węgrzyn, Grzegorz
2018-01-01
Until recently, phages were considered as mere "bacteria eaters" with potential for use in combating antimicrobial resistance. The real value of phage therapy assessed according to the standards of evidence-based medicine awaits confirmation by clinical trials. However, the progress in research on phage biology has shed more light on the significance of phages. Accumulating data indicate that phages may also interact with eukaryotic cells. How such interactions could be translated into advances in medicine (especially novel means of therapy) is discussed herein.
Global medicinal chemistry and GCPR conference.
Schio, Laurent
2018-06-01
Laurent Schio speaks to Benjamin Walden, Commissioning Editor. Laurent Schio is leading the group of Integrated Drug Discovery of Sanofi, France. He joined Sanofi more than 25 years ago and is an organic chemist by training. He has made most of his career in medicinal chemistry supporting and leading projects, especially in the anti-infective and then in the oncology fields. He has developed a strong expertise in kinases and lately has contributed to the discovery of several clinical candidates for cancer treatment.
Pay attention to the study on active antiliver fibrosis components of Chinese herbal medicine.
Hu, Yi-Yang
2012-08-01
In this review, the researches on Chinese herb components with anti-hepatic fibrosis activity in China in the recent 20 years were generalized. Almost thirty active herb components attracted author's attention, especially, salvianolic acid B and oxymatrine which were investigated comprehensively. Moreover, the author considered that, in view of the complex pathogenesis and the multi-pathway and multi-target superiority of Chinese medicine formula, the effective components formula investigations deserve more attention and probably prompt a potential researching direction.
Values in conflict: neurology before and after the advent of managed care.
McQuillen, M P
1997-01-01
The transformation of American medicine now taking place is fundamentally driven by money. As the pendulum swings from the excesses of fee-for-service medicine (under which system the physician was paid more for doing more), to the equally egregious excesses of managed care (according to which the physician is paid more for doing less), it is the patient--especially the vulnerable patient with a debilitating neurological disease--who stands to lose the most. A survey of the historical roots of this transformation highlights the ethical dilemmas under the course of the pendulum. The ethical principles that should guide both the profession and the business of medicine are explored in search of a common ground on which both physicians and managers can work in concert for the benefit of the patients as well as the society whom both serve. The perils that beset that search must be recognized and avoided if the commons are to be preserved. This is especially true for neurology, where care must be patient, not profit, oriented; must have quality, not cost, as its primary aim; and must not be rationed until there is a floor of universal coverage, with participation by all in allocation decisions.
Zhang, Dequan; Duan, Lizhen; Zhou, Nong
2014-01-01
The Third Month Fair in Dali is a historical festival and fair. The market of traditional medicine (TM) is one of the main parts in the fair, which has important influence on local and peripheral people. In this study, approaches of ethnobotany, pharmacognosy, and participatory rural appraisal were used in market survey. Twenty-six druggists were selected randomly as informants and their TMs were recorded. As a result, 427 TMs were recorded including 362 plant medicines, 33 animal medicines, 13 mineral medicines and 19 unidentified medicines. Xinyi, Shanza and Gancao were the most popular medicines due to their popular usages, whereas Sanqi, Tianma and Renshen were relatively fewer in this investigation probably owing to high price and limited output. The plant medicines were from medicinal plants of 117 families belonged to Angiosperm, Gymnospermae, Pteridophyta, Bryophyta, Lichenes and Fungi. Asteraceae, Apiaceae and Fabaceae provided the maximum numbers of TMs successively. Moreover, these TMs were mainly from the cultivated especially familiar TMs, which reflected significant progress in utilization and conservation of medicinal resource in China. Medicinal market in the Third Month Fair is the most important traditional bazaar in Yunnan province. This study systematically surveyed TMs in the fair for the first time, analyzing and revealing resource compositions and current market situations. These newly gathered data provided precious information for development of medicine cultivation, resource protection and market management as well as further pharmacognostical, pharmacological and clinical researches.
Hericium erinaceus (Yamabushitake): a unique resource for developing functional foods and medicines.
Wang, Mingxing; Gao, Yang; Xu, Duoduo; Konishi, Tetsuya; Gao, Qipin
2014-12-01
Hericium erinaceus (HE) is a fungus inhabiting the mountainous areas of the northeast territories in Asia. HE has been used in traditional folk medicine and medicinal cuisine in China, Korea and Japan. Evidence has been adduced for a variety of physiological effects, including anti-aging, anti-cancer, anti-gastritis, and anti-metabolic disease properties. Hence, HE is an attractive target resource for developing not only medicines, but also functional foods. Basic studies on the physiological functions of HE and on the chemical identification of its active ingredients have progressed in recent decades. In this article, we provide an overview of the biochemical and pharmacological studies on HE, especially of its antitumor and neuroprotective functions, together with a survey of recent developments in the chemical analysis of its polysaccharides, which comprise its major active components.
From Doctors' Stories to Doctors' Stories, and Back Again.
Childress, Marcia Day
2017-03-01
Stories have always been central to medicine, but during the twentieth century bioscience all but eclipsed narrative's presence in medical practice. In Doctors' Stories, published in 1991, Kathryn Montgomery excavated medicine's narrative foundations and functions to reveal new possibilities for how to conceive and characterize medicine. Physicians' engagement with stories has since flourished, especially through the narrative medicine movement, although in the twenty-first century this has been challenged by the health care industry's business-minded and data-driven clinical systems. But doctors' stories-and Montgomery's text-remain crucial, schooling clinicians in reflection, ethical awareness, and resilience. Physicians who write even short, 55-word reflective stories can hold to humanistic and ethical understandings of patient care and of themselves as healers even as they practice in systematized settings and employ evidence-based expertise. © 2017 American Medical Association. All Rights Reserved.
Sketching together the modern histories of science, technology, and medicine.
Pickstone, John V
2011-03-01
This essay explores ways to "write together" the awkwardly jointed histories of "science" and "me dicine"--but it also includes other "arts" (in the old sense) and technologies. It draws especially on the historiography of medicine, but I try to use terms that are applicable across all of science, technology, and medicine (STM). I stress the variety of knowledges and practices in play at any time and the ways in which the ensembles change. I focus on the various relations of "science" and "medicine," as they were understood for a succession of periods--from mainly agricultural societies, through industrial societies, to our biomedical present--trying to sketch a history that encompasses daily practices and understandings as well as major conceptual and technical innovations. The model is meant to facilitate inquiry across topics and across times, including those to come.
Agaricus subrufescens: A review
Wisitrassameewong, Komsit; Karunarathna, Samantha C.; Thongklang, Naritsada; Zhao, Ruilin; Callac, Philippe; Moukha, Serge; Férandon, Cyril; Chukeatirote, Ekachai; Hyde, Kevin D.
2012-01-01
Medicinal mushrooms have currently become a hot issue due to their various therapeutic properties. Of these, Agaricus subrufescens, also known as the “almond mushroom”, has long been valued by many societies (i.e., Brazil, China, France, and USA). Since its discovery in 1893, this mushroom has been cultivated throughout the world, especially in Brazil where several strains of A. subrufescens have been developed and used as health food and alternative medicine. This article presents up-to-date information on this mushroom including its taxonomy and health promoting benefits. Medicinal properties of A. subrufescens are emphasized in several studies which are reviewed here. In addition, safety issues concerning the use of this fungus will be discussed. PMID:23961172
Kogure, Toshiaki; Tatsumi, Takeshi; Oku, Yuko
2010-01-01
Traditional herbal (Kampo) medicines have been used since ancient times to treat patients with mental disorders. In the present report, we describe four patients with dysthymia successfully treated with Kampo medicines: Kamiuntanto (KUT). These four patients fulfilled the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for dysthymic disorder with easy fatigability and sleeplessness, but did not fulfill the criteria for major depressive disorder. Treatment with KUT relieved depressive status, fatigue and sleeplessness in these patients. As a result, their QOL (quality of life) was considerably improved. KUT may be useful as an additional or alternative treatment for dysthymia, especially in the field of primary health care.
Kogure, Toshiaki; Tatsumi, Takeshi; Oku, Yuko
2010-01-01
Traditional herbal (Kampo) medicines have been used since ancient times to treat patients with mental disorders. In the present report, we describe four patients with dysthymia successfully treated with Kampo medicines: Kamiuntanto (KUT). These four patients fulfilled the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for dysthymic disorder with easy fatigability and sleeplessness, but did not fulfill the criteria for major depressive disorder. Treatment with KUT relieved depressive status, fatigue and sleeplessness in these patients. As a result, their QOL (quality of life) was considerably improved. KUT may be useful as an additional or alternative treatment for dysthymia, especially in the field of primary health care. PMID:21614161
Critiquing: A Different Approach to Expert Computer Advice in Medicine
Miller, Perry L.
1984-01-01
The traditional approach to computer-based advice in medicine has been to design systems which simulate a physician's decision process. This paper describes a different approach to computer advice in medicine: a critiquing approach. A critiquing system first asks how the physician is planning to manage his patient and then critiques that plan, discussing the advantages and disadvantages of the proposed approach, compared to other approaches which might be reasonable or preferred. Several critiquing systems are currently in different stages of implementation. The paper describes these systems and discusses the characteristics which make each domain suitable for critiquing. The critiquing approach may prove especially well-suited in domains where decisions involve a great deal of subjective judgement.
Höfer, Juliana; Hoffmann, Falk; Bachmann, Christian
2017-05-01
Despite limited evidence, complementary and alternative medicine treatments are popular in autism spectrum disorder. The aim of this review was to summarize the available evidence on complementary and alternative medicine use frequency in autism spectrum disorder. A systematic search of three electronic databases was performed. All research studies in English or German reporting data on the frequency of complementary and alternative medicine use in individuals with autism spectrum disorder were included. Two independent reviewers searched the literature, extracted information on study design and results, and assessed study quality using an established quality assessment tool. Twenty studies with a total of 9540 participants were included. The prevalence of any complementary and alternative medicine use ranged from 28% to 95% (median: 54%). Special diets or dietary supplements (including vitamins) were the most frequent complementary and alternative medicine treatments, ranking first in 75% of studies. There was some evidence for a higher prevalence of complementary and alternative medicine use in autism spectrum disorder compared to other psychiatric disorders and the general population. Approximately half of children and adolescents with autism spectrum disorder use complementary and alternative medicine. Doctors should be aware of this and should discuss complementary and alternative medicine use with patients and their carers, especially as the evidence is mixed and some complementary and alternative medicine treatments are potentially harmful.
[Virtual reality in neurosurgery].
Tronnier, V M; Staubert, A; Bonsanto, M M; Wirtz, C R; Kunze, S
2000-03-01
Virtual reality enables users to immerse themselves in a virtual three-dimensional world and to interact in this world. The simulation is different from the kind in computer games, in which the viewer is active but acts in a nonrealistic world, or on the TV screen, where we are passively driven in an active world. In virtual reality elements look realistic, they change their characteristics and have almost real-world unpredictability. Virtual reality is not only implemented in gambling dens and the entertainment industry but also in manufacturing processes (cars, furniture etc.), military applications and medicine. Especially the last two areas are strongly correlated, because telemedicine or telesurgery was originated for military reasons to operate on war victims from a secure distance or to perform surgery on astronauts in an orbiting space station. In medicine and especially neurosurgery virtual-reality methods are used for education, surgical planning and simulation on a virtual patient.
Auricular Acupuncture with Laser
Bahr, Frank
2013-01-01
Auricular acupuncture is a method which has been successfully used in various fields of medicine especially in the treatment of pain relief. The introduction of lasers especially low-level lasers into medicine brought besides the already existing stimulation with needles and electricity an additional technique to auricular acupuncture. This literature research looks at the historical background, the development and the anatomical and neurological aspects of auricular acupuncture in general and auricular laser acupuncture in detail. Preliminary scientific findings on auricular acupuncture with laser have been described in detail and discussed critically in this review article. The results of the studies have shown evidence of the effect of auricular laser acupuncture. However, a comparison of these studies was impossible due to their different study designs. The most important technical as well as study parameters were described in detail in order to give more sufficient evidence and to improve the quality of future studies. PMID:23935695
[Quality and objectifiability of training and advanced training in urology].
Müller, S C; Strunk, T; Alken, P
2012-08-01
The attraction to study medicine has not changed, however we are facing a lack of trainees especially in surgical subspecialties like urology. Possible explanations are a 70% proportion of female students and different views on the work-life balance in the future. A high burden of theory and unrealistic multiple choice examinations support those who can learn but there are no objective and reproducible criteria to recognize the competence of a good physician early in the career. This problem continues during residency, especially in surgical subspecialities. The different medical boards in Germany responsible for the training programs have no concepts. Many attempts in other countries to objectively measure surgical skills have so far been ignored. If we do not want to lose our traditionally high competence in medicine we should join those who attempt to improve teaching and to use methods for selecting suitable candidates for surgery as soon and as objectively as possible.
Antioxidant activity and protecting health effects of common medicinal plants.
Škrovánková, Soňa; Mišurcová, Ladislava; Machů, Ludmila
2012-01-01
Medicinal plants are traditionally used in folk medicine as natural healing remedies with therapeutic effects such as prevention of cardiovascular diseases, inflammation disorders, or reducing the risk of cancer. In addition, pharmacological industry utilizes medicinal plants due to the presence of active chemical substances as agents for drug synthesis. They are valuable also for food and cosmetic industry as additives, due to their preservative effects because of the presence of antioxidants and antimicrobial constituents. To commonly used medicinal plants with antioxidant activity known worldwide belong plants from several families, especially Lamiaceae (rosemary, sage, oregano, marjoram, basil, thyme, mints, balm), Apiaceae (cumin, fennel, caraway), and Zingiberaceae (turmeric, ginger). The antioxidant properties of medicinal plants depend on the plant, its variety, environmental conditions, climatic and seasonal variations, geographical regions of growth, degree of ripeness, growing practices, and many other factors such as postharvest treatment and processing. In addition, composition and concentration of present antioxidants, such as phenolic compounds, are related to antioxidant effect. For appropriate determination of antioxidant capacity, the extraction technique, its conditions, solvent used, and particular assay methodology are important. Copyright © 2012 Elsevier Inc. All rights reserved.
Anemone medicinal plants: ethnopharmacology, phytochemistry and biology.
Hao, Da-Cheng; Gu, Xiaojie; Xiao, Peigen
2017-03-01
The Ranunculaceae genus Anemone (order Ranunculales), comprising more than 150 species, mostly herbs, has long been used in folk medicine and worldwide ethnomedicine. Various medicinal compounds have been found in Anemone plants, especially triterpenoid saponins, some of which have shown anti-cancer activities. Some Anemone compounds and extracts display immunomodulatory, anti-inflammatory, antioxidant, and antimicrobial activities. More than 50 species have ethnopharmacological uses, which provide clues for modern drug discovery. Anemone compounds exert anticancer and other bioactivities via multiple pathways. However, a comprehensive review of the Anemone medicinal resources is lacking. We here summarize the ethnomedical knowledge and recent progress on the chemical and pharmacological diversity of Anemone medicinal plants, as well as the emerging molecular mechanisms and functions of these medicinal compounds. The phylogenetic relationships of Anemone species were reconstructed based on nuclear ITS and chloroplast markers. The molecular phylogeny is largely congruent with the morphology-based classification. Commonly used medicinal herbs are distributed in each subgenus and section, and chemical and biological studies of more unexplored taxa are warranted. Gene expression profiling and relevant "omics" platforms could reveal differential effects of phytometabolites. Genomics, transcriptomics, proteomics, and metabolomics should be highlighted in deciphering novel therapeutic mechanisms and utilities of Anemone phytometabolites.
Chinese Herbal Medicine on Cardiovascular Diseases and the Mechanisms of Action
Liu, Cuiqing; Huang, Yu
2016-01-01
Cardiovascular diseases are the principal cause of death worldwide. The potentially serious adverse effects of therapeutic drugs lead to growing awareness of the role of Chinese herbal medicine in the treatment of cardiovascular diseases. Chinese herbal medicine has been widely used in many countries especially in China from antiquity; however, the mechanisms by which herbal medicine acts in the prevention and treatment of cardiovascular diseases are far from clear. In this review, we briefly describe the characteristics of Chinese herbal medicine by comparing with western medicine. Then we summarize the formulae and herbs/natural products applied in the clinic and animal studies being sorted according to the specific cardiovascular diseases. Most importantly, we elaborate the existing investigations into mechanisms by which herbal compounds act at the cellular levels, including vascular smooth muscle cells, endothelial cells, cardiomyocytes and immune cells. Future research should focus on well-designed clinic trial, in-depth mechanic study, investigations on side effects of herbs and drug interactions. Studies on developing new agents with effectiveness and safety from traditional Chinese medicine is a promising way for prevention and treatment of patients with cardiovascular diseases. PMID:27990122
Paniz, Vera Maria Vieira; Cechin, Isabel Carolina Coelho Flores; Fassa, Anaclaudia Gastal; Piccini, Roberto Xavier; Tomasi, Elaine; Thumé, Elaine; Silveira, Denise Silva da; Facchini, Luiz Augusto
2016-01-01
This was a cross-sectional study within Brazil's Project for the Expansion and Consolidation of Family Health, 2005, with the objective of universal and free access to the medication prescribed in the last medical appointment for acute health problems and to estimate the degree to which access may have improved with inclusion of the medicines in prevailing policies and programs. The sample included 4,060 adults living in the area of primary health care units in 41 municipalities in South and Northeast Brazil. Access was greater in the South (83.2%) than in the Northeast (71%), and free access was similar (37%), with a greater share by the Family Health Program (FHP) when compared to the traditional model, especially in the Northeast. Some 60% of prescribed medicines and 50% of those on the National List of Essential Medicines (RENAME) were paid for. No variation was observed in the proportion of medicines present on the prevailing RENAME list and access. However, 40% of the medicines that were paid for can currently be obtained through the Popular Pharmacy Program. The latter program appears to emerge as a new way to guarantee access to medicines prescribed in the health system.
Allaire, A D; Moos, M K; Wells, S R
2000-01-01
To determine the prevalence and types of complementary and alternative medicine therapies used by certified nurse-midwives in North Carolina. Surveys were sent to all 120 licensed certified nurse-midwives in North Carolina requesting information concerning their recommendations for use of complementary and alternative medicine for their pregnant or postpartum patients. Eighty-two responses were received (68.3%). Seventy-seven (93.9%) reported recommending complementary and alternative medicine to their pregnant patients in the past year. Forty-seven (57.3%) reported recommending complementary and alternative medicine to more than 10% of patients. The percentage of nurse-midwives who recommended each type of complementary and alternative medicine was as follows: herbal therapy (73.2%), massage therapy (67.1%), chiropractic (57.3%), acupressure (52.4%), mind-body interventions (48.8%), aromatherapy (32.9%), homeopathy (30.5%), spiritual healing (23.2%), acupuncture (19.5%), and bioelectric or magnetic applications (14.6%). The 60 respondents who reported prescribing herbal therapies gave them for the following indications: nausea and vomiting, labor stimulation, perineal discomfort, lactation disorders, postpartum depression, preterm labor, postpartum hemorrhage, labor analgesia, and malpresentation. Complementary and alternative medicine, especially herbal therapy, is commonly prescribed to pregnant women by nurse-midwives in North Carolina.
Daniel Sennert, The Philosophical Hen, and The Epistolary Quest for a (Nearly-) Universal Medicine.
Klein, Joel A
2015-02-01
This article explores the Wittenberg Professor Daniel Sennert's (1572-1637) pursuit of nearly universal medicines made from noble metals, which he described in his published works and in private correspondence with his brother-in-law, Michael Döring. Of the medicaments that Sennert sought, one called the Philosophical Hen was especially interesting, and involved feeding a hen silver or gold during propitious astrological conjunctions. Sennert's support of this experiment was rooted in his obsession with experience and can be partially explained by looking to an extensive tradition of natural philosophy and natural history. Sennert explained such nearly universal medicines according to the rational principles of academic medicine, arguing that they strengthened the body's innate heat or acted as universal purgatives. From Sennert's candid epistles, we receive a more historicised portrait of the collaborative experimental process by which chymical medicines were conceptualised and tested, and how the consequences of experimental failure and perceived credulity could be increased scepticism.
The Biology of Emergency Medicine: what have 30 years meant for Rosen's original concepts?
Zink, Brian J
2011-03-01
In 1979 Peter Rosen, MD, a leading academic figure in the developing field of emergency medicine (EM), wrote an article, "The Biology of Emergency Medicine," in response to criticism from other specialties and medical leaders that there was no unique biology of EM that would qualify it as a legitimate medical specialty. This essay received much attention at the time and served as rallying cry for emergency physicians (EPs) who were trying to find their places in the house of medicine and especially in medical schools and academic teaching hospitals. Thirty years later, the opposition that prompted many of Rosen's strongly worded impressions and observations on the biology of EM, clinical emergency department (ED) practice, education, and research has largely faded. Many of Rosen's predictions on the eventual success of EM have come true. However, core issues that existed then continue to present challenges for academic EM and clinical emergency practice. © 2011 by the Society for Academic Emergency Medicine.
Potter, David J
2014-01-01
The quality demands of the pharmaceutical industry require prescription medicines to be consistent in their active ingredient content. Achieving this, using raw cannabis as a feedstock, is especially challenging. The plant material is extremely inhomogeneous, and the ratios of active ingredients are affected by a range of factors. These include the genetics of the plant, the growing and storage conditions, the state of maturity at harvest, and the methods used to process and formulate the material. The reasons for this variability are described, with particular emphasis on the botanical considerations. To produce the complex botanical medicine Sativex®, which contains the cannabinoids Δ(9)-tetrahydrocannabinol (THC) and cannabidiol (CBD) and a range of other ingredients, GW Pharmaceuticals had to manage these variables. This medicine, for the treatment of spasticity due to multiple sclerosis, is the first cannabis-based medicine to be approved in the UK. The company's methodology for producing this and other chemotypes is described. Copyright © 2013 John Wiley & Sons, Ltd.
Chen, Guoli; Yang, Zhaohai; Eshleman, James R; Netto, George J; Lin, Ming-Tseh
2016-01-01
Precision medicine, a concept that has recently emerged and has been widely discussed, emphasizes tailoring medical care to individuals largely based on information acquired from molecular diagnostic testing. As a vital aspect of precision cancer medicine, targeted therapy has been proven to be efficacious and less toxic for cancer treatment. Colorectal cancer (CRC) is one of the most common cancers and among the leading causes for cancer related deaths in the United States and worldwide. By far, CRC has been one of the most successful examples in the field of precision cancer medicine, applying molecular tests to guide targeted therapy. In this review, we summarize the current guidelines for anti-EGFR therapy, revisit the roles of pathologists in an era of precision cancer medicine, demonstrate the transition from traditional "one test-one drug" assays to multiplex assays, especially by using next-generation sequencing platforms in the clinical diagnostic laboratories, and discuss the future perspectives of tumor heterogeneity associated with anti-EGFR resistance and immune checkpoint blockage therapy in CRC.
Pharmacokinetic profile of phytoconstituent(s) isolated from medicinal plants—A comprehensive review
Mehta, Piyush; Shah, Rishi; Lohidasan, Sathiyanarayanan; Mahadik, K.R.
2015-01-01
Herbal medicine, the backbone of traditional medicine, has played an important role in human health and welfare for a long period. Traditional therapeutic approaches of regional significance are found in Africa, South and Central America, China, India, Tibet, Indonesia, and the Pacific Islands. The considerable scientific significance and commercial potential of traditional medicines have resulted in increased international attention and global market demands for herbal medicines, especially Chinese herbal medicines. Herbal medicines currently are the primary form of health care for the poor in the developing countries, and also are widely used as a supplement or substitute for conventional drugs in developed countries. These traditional medicines have a pivotal role in the treatment of various ailments and more than 50% of drugs used in Western pharmacopoeia are isolated from herbs or derived from modifications of chemicals found in plants. Herbal medicines usually contain a complex mixture of various bioactive molecules, which make its standardization complicated, and there is little information about all compounds responsible for pharmacological activity. Several research papers have been published that claim pharmacological activity of herbal medicines but few are discussing the role of the exact phytoconstituent. Understanding the pharmacokinetic profile of such phytoconstituents is essential. Although there are research papers that deal with pharmacokinetic properties of phytoconstituents, there are a number of phytoconstituents yet to be explored for their kinetic properties. This article reviews the pharmacokinetic profile of 50 different therapeutically effective traditional medicinal plants from the year 2003 onward. PMID:26587392
Inhibition of Th1 and Th17 Cells by Medicinal Plants and Their Derivatives: A Systematic Review.
Asadi-Samani, Majid; Bagheri, Nader; Rafieian-Kopaei, Mahmoud; Shirzad, Hedayatollah
2017-08-01
Searching for new natural drugs that are capable of targeting Th1 and Th17 may lead to development of more effective treatments for inflammatory and autoimmune diseases. Most of the natural drugs can be derived from plants that are used in traditional medicine and folk medicine. The aim of this systematic review is to identify and introduce plants or plant derivatives that are effective on inflammatory diseases by inhibiting Th1 and Th17 responses. To achieve this purpose, the search terms herb, herbal medicine, herbal drug, medicinal plant, phytochemical, traditional Chinese medicine, Ayurvedic medicine, natural compound, inflammation, inflammatory diseases, Th1, Th17, T helper 1 or T helper 17 were used separately in Title/Keywords/Abstract in Web of Science and PubMed databases. In articles investigating the effect of the medicinal plants and their derivatives in inhibiting Th1 and Th17 cells, the effects of eight extracts of the medicinal plants, 21 plant-based compounds and some of their derivatives, and eight drugs derived from the medicinal plants' compounds in inhibiting Th1 and Th17 cells were reviewed. The results showed that medicinal plants and their derivates are able to suppress Th17 and Th1 T cell functions as well as cytokine secretion and differentiation. The results can be used to produce herbal drugs that suppress Th, especially Th17, responses. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.
Liu, Sixiu; Liang, Shanshan; Liu, Hua; Chen, Lei; Sun, Lingshuang; Wei, Meng; Jiang, Hongli; Wang, Jing
2018-05-22
Recently, the colon has been recognized as an important source of various uremic toxins in patients with end stage renal disease. Medicinal charcoal tablets are an oral adsorbent that are widely used in patients with chronic kidney disease in China to remove creatinine and urea from the colon. A parallel fecal and serum metabolomics study was performed to determine comprehensive metabolic profiles of patients receiving hemodialysis (HD). The effects of medicinal charcoal tablets on the fecal and serum metabolomes of HD patients were also investigated. Ultra-performance liquid chromatography/mass spectrometry was used to investigate the fecal and serum metabolic profiles of 20 healthy controls and 31 HD patients before and after taking medicinal charcoal tablets for 3 months. There were distinct metabolic variations between the HD patients and healthy controls both in the feces and serum according to multivariate data analysis. Metabolic disturbances of alanine, aspartate and glutamate metabolism, arginine and proline metabolism figured prominently in the serum. However, in the feces, alterations of tryptophan metabolism, lysine degradation and beta-alanine metabolism were pronounced, and the levels of several amino acids (leucine, phenylalanine, lysine, histidine, methionine, tyrosine, and tryptophan) were increased dramatically. Nineteen fecal metabolites and 21 serum metabolites were also identified as biomarkers that contributed to the metabolic differences. Additionally, medicinal charcoal treatment generally enabled the serum and fecal metabolomes of the HD patients to draw close to those of the control subjects, especially the serum metabolic profile. Parallel fecal and serum metabolomics uncovered the systematic metabolic variations of HD patients, especially disturbances in amino acid metabolism in the colon. Medicinal charcoal tablets had an impact on the serum and fecal metabolomes of HD patients, but their exact effects still need to be studied further. © 2018 The Author(s). Published by S. Karger AG, Basel.
Force and Presence in the World of Medicine
Bleakley, Alan
2017-01-01
Medicine can not only be read with a poetic imagination, but also configured as a poetic practice, moving beyond the instrumental. The poet Wallace Stevens made a distinction between ‘Force’ and ‘Presence’—the former can be read as combative, the latter as pacific. Modern medicine has been shaped historically by the combative metaphor of a ‘war against disease’, turning medicine into a quasi-militaristic culture fond of hierarchy. This is supplemented by the metaphor of the ‘body as machine’, reducing the complex and unpredictable body to a linear, if complicated, apparatus. The two metaphors align medicine with the modern industrial–military complex that is masculine, heroic, and controlling in character. In an era in which medicine is feminising and expected to be patient-centred, collaborative (inter-professional) and transparent to the public as a democratic gesture, the industrial–military metaphor complex should no longer be shaping medicine—yet its influence is still keenly felt, especially in surgery. This continuing dominance of Force over Presence matters because it is a style running counter to the collaborative, team-based medicine needed for high levels of patient safety. Medicine will authentically democratise only as new, pacific shaping metaphors emerge: those of ‘Presence’, such as ‘hospitality’. Hospitals can once again become places of hospitality.
Gouws, Chrisna; Hamman, Josias H
2018-02-01
The use of traditional herbal medicines has become increasingly popular globally, but in some countries, it is the main or sometimes even the only healthcare service available in the most rural areas. This is especially true for Africa where herbal medicines form a key component of traditional medicinal practices and there is access to a diversity of medicinal plants. Although many benefits have been derived from the use of traditional herbal medicines, many concerns are associated with their use of which herb-drug interactions have been identified to have a rising impact on patient treatment outcome. One type of pharmacokinetic interaction involves the modulation of drug metabolizing enzymes, which may result in enhanced or reduced bioavailability of co-administered drugs. Areas covered: This review highlights the current information available on drug metabolism-associated information with regards to traditional African medicines related to some of the most prevalent diseases burdening the African continent. Expert opinion: It is clear from previous studies that enzyme modulation by traditional African medicines plays a significant role in the pharmacokinetics of some co-administered drugs, but more research is needed to provide detailed information on these interactions, specifically for treatment of prevalent diseases such as tuberculosis and hypertension.
Sport and medicine in ancient Greece.
Appelboom, T; Rouffin, C; Fierens, E
1988-01-01
Sport and medicine in ancient Greece were the result of a widespread tradition of liberty, which was at the heart of one of the most brilliant civilizations in history. Whereas war encouraged the development of surgical knowledge springing out of medical experience on the battlefield, peace promoted the burgeoning of sport as an integral part of Greek upbringing, allowing the channeling of young people's aggressiveness into physical competition. Medicine was magical and mythological, especially in the time of Homer (9th century BC); Aesculapius, the mythical god of healing, was its reference point. With Hippocrates (5th century BC), the body of medical experience was to be codified and built up, and was to undergo a novel evolution based on the theory of the balance of the four humors. The athlete's mentality, faced with trauma in the sports ground, underwent a change; injury was no longer considered a punishment by the gods. At the same time, temple offerings tendered in the hope of victory gave way to the athlete's personal preparation based on a specifically modified lifestyle, diet, and training. The resulting progress in medicine and public health, especially from the 5th century BC onward, was not only to favor athletic performances of high quality but also surgical techniques that were very advanced for their time. Thus it can be seen that the medical knowledge associated with the practice of sport progressed during antiquity because of its obligation to follow the warrior and then the athlete.
Asadi, Leila; Beigi, Marjan; Valiani, Mahbube; Mardani, Fardin
2017-01-01
Medical errors are the main concerns in health systems, which considering their ascending rate in the recent years, especially in the field of midwifery, have caused a medical crisis. Considering the importance of evidence-based health services as a way to improve health systems, the aim of this study was to suggest a guideline for preventing malpractice in midwifery services. In this cross-sectional study that was conducted in 2013, we investigated 206 cases that were referred to the Isfahan Legal Medicine Organization and Medical Council of Forensic Medicine from 2006-2011. Data were collected by a checklist and were analyzed using SPSS-16 software. Descriptive statistical tests (mean, maximum, minimum, standard deviation, frequency, and percentage agreement) were used to describe the data. Then, we used the Delphi technique with the participation from 17 experts in midwifery, gynecology, and legal medicine to provide an evidence-based draft guideline for prevention of midwifery errors. A total of 206 cases were reviewed. In 66 cases (32%) the verdict for malpractice in midwifery services was approved. A practical draft guideline for preventing clinical errors for midwifery in the fields of pregnancy, delivery, and postpartum period was developed. This evidence-based draft guideline can improve the attention of all the healthcare providers, especially midwives and physicians to prevent urgent problems and offer effective health services for mothers and infants.
Asadi, Leila; Beigi, Marjan; Valiani, Mahbube; Mardani, Fardin
2017-01-01
Background: Medical errors are the main concerns in health systems, which considering their ascending rate in the recent years, especially in the field of midwifery, have caused a medical crisis. Considering the importance of evidence-based health services as a way to improve health systems, the aim of this study was to suggest a guideline for preventing malpractice in midwifery services. Materials and Methods: In this cross-sectional study that was conducted in 2013, we investigated 206 cases that were referred to the Isfahan Legal Medicine Organization and Medical Council of Forensic Medicine from 2006–2011. Data were collected by a checklist and were analyzed using SPSS-16 software. Descriptive statistical tests (mean, maximum, minimum, standard deviation, frequency, and percentage agreement) were used to describe the data. Then, we used the Delphi technique with the participation from 17 experts in midwifery, gynecology, and legal medicine to provide an evidence-based draft guideline for prevention of midwifery errors. Results: A total of 206 cases were reviewed. In 66 cases (32%) the verdict for malpractice in midwifery services was approved. A practical draft guideline for preventing clinical errors for midwifery in the fields of pregnancy, delivery, and postpartum period was developed. Conclusions: This evidence-based draft guideline can improve the attention of all the healthcare providers, especially midwives and physicians to prevent urgent problems and offer effective health services for mothers and infants. PMID:28904546
2013-01-01
Background A literature review revealed heavy reliance on a few key publications for identification of medicinal plant species from local or vernacular names and a lack of citation of voucher specimens in many publications. There is a need for more reliable and standardized data on the identity of species used for medicine, especially because local names vary from region to region. This is especially true in the case of medicinal roots, for which identification of species is difficult. This paper contributes to existing data on the species sold as medicinal roots (and other underground plant parts such as bulbs, corms, rhizomes and tubers) in Morocco. Methods Data were collected in collaboration with herbalists in Marrakech and collectors in rural regions near Marrakech where species are collected from the wild. The ethno-medicinal uses of these species were also recorded. Results We identified the vernacular names for 67 medicinal roots (by free listing) used to treat a variety of human diseases. We were able to collect and identify one or more species for 39 of the recorded vernacular names. The ones we were not able to identify were either imported or no longer available in the markets. We collected more than one species for some of the vernacular names for a total of 43 species. We identified six new vernacular names and four species which had not been previously described in the literature. Our botanical identification matched at least one of the names listed in the literature 63% of the time and did not match any species listed in the literature 37% of the time. Of the three most commonly cited pieces of literature we compared to, we found the greatest overlap with the broader, more comprehensive work of Bellakhdar 1997 (as opposed to Benchâabane and Abbad 1997 which worked in a similarly focused geographical area). However there was only 63% agreement between Bellakhdar 1997 and our botanical identifications, and 29% of the time our identification didn’t match even the genus of any of the species listed in any of the 3 most commonly cited pieces of literature. Conclusions More rigorous methodology and reporting are needed for medicinal plant research in Morocco. This will ensure that studies are comparable, help to protect traditional medicine users from negative health effects, and, support efforts to conserve overharvested wild medicinal plants. PMID:23945196
Buschmann, Claas T; Kleber, Christian; Tsokos, Michael; Püschel, Klaus; Hess, Thorsten; Kerner, Thoralf; Stuhr, Markus
2015-06-01
Emergency medical research is subject to special conditions. Emergency patients e.g. are generally considered to be non-capable of giving consent. This results in sparse emergency medical data when compared to clinical observation studies under controlled conditions. After emergency medical treatment, deceased patients are not rarely subject to forensic investigation. The cooperation between emergency and forensic medicine has not only emergency medical training potential in individual cases, but also scientific innovation potential especially with respect to the retrospective evaluation of pre-hospital emergency measures. Such partnerships (like in Berlin at the Charité - Universitätsmedizin Berlin between the Institute of Legal Medicine and the Center for Musculoskeletal Surgery or in Hamburg between the Institute for Legal Medicine at the University Hospital and the Municipal Fire Brigade with the Emergency Medical Service) are yet exceptional in Germany. © Georg Thieme Verlag Stuttgart · New York.
Corroborating evidence-based medicine.
Mebius, Alexander
2014-12-01
Proponents of evidence-based medicine (EBM) have argued convincingly for applying this scientific method to medicine. However, the current methodological framework of the EBM movement has recently been called into question, especially in epidemiology and the philosophy of science. The debate has focused on whether the methodology of randomized controlled trials provides the best evidence available. This paper attempts to shift the focus of the debate by arguing that clinical reasoning involves a patchwork of evidential approaches and that the emphasis on evidence hierarchies of methodology fails to lend credence to the common practice of corroboration in medicine. I argue that the strength of evidence lies in the evidence itself, and not the methodology used to obtain that evidence. Ultimately, when it comes to evaluating the effectiveness of medical interventions, it is the evidence obtained from the methodology rather than the methodology that should establish the strength of the evidence. © 2014 John Wiley & Sons, Ltd.
Hoggatt, Julie
2011-02-01
Companion diagnostics and stratified medicines will be increasingly used over the next ten years. Current market leaders who have created diagnostic divisions with a focus on biomarker identification will benefit, notably Abbott, AstraZeneca, Novartis, and GlaxoSmithKline. Pricing incentives and improvement in efficacy will drive this market. The US FDA is not likely to mandate stratification of medications, but cost containment for clinical trials will be sufficient incentive for companies to pursue this approach. The next area expected to produce stratified medicines is infectious disease, expanding from HIV to hepatitis C and hepatitis B. Celera is likely to be first to market with diagnostics for genetic variations in hepatitis C and hepatitis B. Metabolic disorders, especially diabetes, are also fertile ground for stratified medicine, likely to catch up to oncology and infectious disease over the next decade.
Medical astrology in Spain during the seventeenth century.
Lanuza Navarro, Tayra M C
2006-01-01
It is well known that astrological practice during the Early Modern period was closely related to medicine, and that it provided a tool for diagnosis and treatments. An interesting aspect of this relationship of medicine and astrology is the recognition of the prevailing ideas about medical astrology in the astrological works and astrological-medical treatises. This article discusses the ideas of Galenism and the astrological doctrines that established such a strong relationship between astrology and medicine. There is an overview of the Spanish authors who wrote about the subject, especially those linked with the universities. The paper then goes into detail about the examples of these ideas found in the Spanish printed texts of the seventeenth century. Finally, there is a section on some very interesting and little known treatises on medical astrology which were a reference for the practice of astrological medicine in the period.
Díaz-Reviriego, Isabel; Fernández-Llamazares, Álvaro; Salpeteur, Matthieu; Howard, Patricia L; Reyes-García, Victoria
2016-12-01
Local medical systems are key elements of social-ecological systems as they provide culturally appropriate and locally accessible health care options, especially for populations with scarce access to biomedicine. The adaptive capacity of local medical systems generally rests on two pillars: species diversity and a robust local knowledge system, both threatened by local and global environmental change. We first present a conceptual framework to guide the assessment of knowledge diversity and redundancy in local medicinal knowledge systems through a gender lens. Then, we apply this conceptual framework to our research on the local medicinal plant knowledge of the Tsimane' Amerindians. Our results suggest that Tsimane' medicinal plant knowledge is gendered and that the frequency of reported ailments and the redundancy of knowledge used to treat them are positively associated. We discuss the implications of knowledge diversity and redundancy for local knowledge systems' adaptive capacity, resilience, and health sovereignty.
Personalised Medicine and the Economy of Biotechnological Promise.
Sturdy, Steve
2017-04-01
Rather than seek to distinguish hype from legitimate promise, it may be more helpful to think about personalised medicine as embodying a promissory economy which serves both to mobilize resources for research and - partly at least - to determine the ends to which that research is directed. Personalised medicine is a development of the larger promissory economy of medical biotechnology. As such, it systematically conflates public benefit with the pursuit of commercial and especially pharmaceutical interests. Consequently, research and development in personalised medicine tends to favour the production of expensive new treatments over unprofitable forms of prevention or more effective use of older therapies. A rebalancing of research priorities is needed to favour the pursuit of public benefit, even when it does not deliver private profits. This will in turn require sustained reflection, self-criticism and often self-denial on the part of public research funders and the scientists they support.
Personalised Medicine and the Economy of Biotechnological Promise
Sturdy, Steve
2017-01-01
Rather than seek to distinguish hype from legitimate promise, it may be more helpful to think about personalised medicine as embodying a promissory economy which serves both to mobilize resources for research and — partly at least — to determine the ends to which that research is directed. Personalised medicine is a development of the larger promissory economy of medical biotechnology. As such, it systematically conflates public benefit with the pursuit of commercial and especially pharmaceutical interests. Consequently, research and development in personalised medicine tends to favour the production of expensive new treatments over unprofitable forms of prevention or more effective use of older therapies. A rebalancing of research priorities is needed to favour the pursuit of public benefit, even when it does not deliver private profits. This will in turn require sustained reflection, self-criticism and often self-denial on the part of public research funders and the scientists they support. PMID:28517983
Cogan, E
2015-01-01
This work constitutes a argued analysis of the publication of the article of Hertoghe et al. "Anti aging medicine, a science based, essential medicine " whose full and unreviewed publication was forced in the framework of the Belgian law on the right of reply to an earlier publication entitled " Anti-Aging Medicine: Science or Marketing? ". We confirm the absence of scientific evidence on the effectiveness of hormonal treatments used in this approach by highlighting the different techniques allowing doctors who promote this approach to make believe in their effectiveness. This is clearly to mix in one sentence established truths and unproven facts, use references inappropriately especially by misappropriation of studies on groups of patients with hormone deficiency in order to justify treatment in healthy subjects, to ignore recent references undermining ancient literature, to betray the authors' conclusions. Our critical analysis is also considering compliance with the guidelines for integrity in scientific publications.
A global perspective: training opportunities in Adolescent Medicine for healthcare professionals.
Golub, Sarah A; Arunakul, Jiraporn; Hassan, Areej
2016-08-01
The review briefly describes the current state of adolescent health globally, and highlights current educational and training opportunities in Adolescent Medicine for healthcare providers worldwide. Despite a growing body of literature demonstrating a shift toward recognizing Adolescent Medicine as a subspecialty, there are very few countries that offer nationally recognized Adolescent Medicine training programs. In recent years, several countries have begun to offer educational programming, such as noncredentialed short training programs, conferences, and online courses. Challenges, including cultural barriers, financing, and lack of governmental recognition and support, have hindered progress in the development of accredited training programs globally. It is crucial to support efforts for sustainable training programs, especially within low and middle-income countries where a majority of the world's adolescent population lives. Sharing knowledge of existing curriculums, programs, and systems will increase opportunities globally to build regional capacity, increase access to interdisciplinary services, and to implement health-promoting policies for youth worldwide.
Malpractice risk prevention for primary care physicians.
Blackston, Joseph W; Bouldin, Marshall J; Brown, C Andrew; Duddleston, David N; Hicks, G Swink; Holman, Honey E
2002-10-01
The recent medical malpractice "crisis" has seen skyrocketing liability premiums and increasing fear of liability. Primary care physicians, especially family medicine and internal medicine physicians, have historically experienced low rates of malpractice claims, both in number and amount of payment. This can be attributed to several factors: the esteem held by internal medicine and family medicine physicians in their communities, relatively low numbers of invasive procedures, reluctance of patients to include "their" primary care physician in any potential litigation, and, probably most importantly, the atmosphere of mutual trust and communication between the internist or family physician and the patient. Recent years have seen this trend erased, as insurance industry data suggest primary care physicians presently face significant potential exposure for medical malpractice claims. It is imperative that primary care physicians take steps to insure they are adequately covered in case of a malpractice claim and that they practice aggressive but appropriate risk management to lessen the likelihood of a claim.
Nüchtern, E; Bahemann, A; Egdmann, W; van Essen, J; Gostomzyk, J; Hemmrich, K; Manegold, B; Müller, B; Robra, B P; Röder, M; Schmidt, L; Zobel, A; von Mittelstaedt, G
2015-09-01
In January, 2014, the division "Social Medicine in Practice and Rehabilitation" of the German Society for Social Medicine and Prevention established a working group on the self-image of the physicians active in the field of social medicine (medical expertise and counseling). The result of this work is the contribution presented here after consensus was achieved by specialists of social medicine from different fields and institutions (social security etc.) and in good cooperation with Prof. Dr. Gostomzyk and Prof. Dr. Robra. Based on the importance of an up to date social medicine for claimants and recipients of benefits on the one hand and the social security system on the other, and also on a description of the subjects, objectives and methods the following aspects are presented: · The perspective of social medicine. · Qualification in social medicine, concerning specialist training and continuing medical education. · The fields of duty of experts in social medicine. · The proceedings in social medicine. The working group identified challenges for the specialists in social medicine by a narrowed perception of social medicine by physicians in hospitals and practice, accompanied by an enlarged importance of expertise in social medicine, by the demand for more "patient orientation" and gain of transparency, and concerning the scientific foundation of social medicine. The working group postulates: · The perspective of social medicine should be spread more widely.. · Confidence in experts of social medicine and their independency should be strengthened.. · The not case-related consulting of the staff and executives should be expanded.. · Social medicine in practice needs support by politics and society, and especially by research and teaching.. · Good cooperation and transfer of experiences of the different branches of social security are essential for the impact of social medicine.. © Georg Thieme Verlag KG Stuttgart · New York.
Underuse of medication for circulatory disorders among unmarried women and men in Norway?
Kravdal, Øystein; Grundy, Emily
2014-11-24
It is well established that unmarried people have higher mortality from circulatory diseases and higher all-cause mortality than the married, and these marital status differences seem to be increasing. However, much remains to be known about the underlying mechanisms. Our objective was to examine marital status differences in the purchase of medication for circulatory diseases, and risk factors for them, which may indicate underuse of such medication by some marital status groups. Using data from registers covering the entire Norwegian population, we analysed marital status differences in the purchase of medicine for eight circulatory disorders by people aged 50-79 in 2004-2008. These differences were compared with those in circulatory disease mortality during 2004-2007, considered as indicating probable differences in disease burden. The unmarried had 1.4-2.8 times higher mortality from the four types of circulatory diseases considered. However, the never-married in particular purchased less medicine for these diseases, or precursor risk factors of these diseases, primarily because of a low chance of making a first purchase. The picture was more mixed for the divorced and widowed. Both groups purchased less of some of these medicines than the married, but, especially in the case of the widowed, relatively more of other types of medicine. In contrast to the never-married, divorced and widowed people were as least as likely as the married to make a first purchase, but adherence rates thereafter, indicated by continuing purchases, were lower. The most plausible interpretation of the findings is that compared with married people, especially the never-married more often have circulatory disorders that are undiagnosed or for which they for other reasons underuse medication. Inadequate use of these potentially very efficient medicines in such a large population group is a serious public health challenge which needs further investigation. It is possible that marital status differences in use of medicines for circulatory disorders combined with an increasing importance of these medicines have contributed to the widening marital status gap in mortality observed in several countries. This also requires further investigation.
Ushiroyama, Takahisa
2013-10-22
A serious problem currently plaguing the medical field is the widening gap between academic medicine, which studies the features and causes of illness, and the medical care that patients desire. An example of this gap can be observed in the practice of psychotherapy, which is effective only for certain patients. Kampo medicine that combines the advantages of Western medicine with those of traditional Japanese medicine is currently undergoing a revival in the healthcare sector. The therapeutic policies underlying Kampo medicine are based on the physical constitution and current symptoms of each patient. For this reason, Kampo medicine is referred to as "tailor-made medicine" and has properties similar to "mind and body" or psychosomatic medicine. Some women exhibit multiple undefined stress-related symptoms during the peri-menopausal period. In order to accurately diagnose and provide patient-specific treatment, physicians should not only investigate the various stress factors in patients' lives but should also provide a Sho, or a Kampo diagnosis. The therapeutic approach in Kampo medicine is aimed at harmonizing the mind, body, and spirit; this practice involves the use of narrative and holistic medication that treats the entire being of the patient, resulting in an increased number of specialized treatment plans.There are many Kampo prescriptions tailored to treat women who exhibit various stress-related symptoms. Both Kampo and psychosomatic medicine are based on the principles of narrative-based medicine, and by integrating these two medical systems, an ideal system can be devised to better cope with the various needs of patients. This new medical system established by integrating and harmonizing Western and Eastern medicine can be used for the treatment of women with stress-related symptoms.
Zhang, Bengang; Xiao, Peigen; Qi, Yaodong; Zhang, Zhao; Liu, Haitao; Li, Xiaojin; Wang, Guoping; Terwei, André
2016-01-01
With both a full collection of native vascular plant distributions and a full checklist of source plants of the Chinese Materia Medica (CMM), the Uygur Medicine (UM), and the Kazak Medicine (KM) for the Xinjiang region, we defined medicinal plant: vascular plant ratios (simplified as medicinal plant ratios hereafter) as the value of medicinal plant richness divided by vascular plant richness. We aimed to find whether the ratios are constant or change in different environments, which environmental variables determine medicinal plant ratios, and whether the ratios are more influenced by human or by natural environments. Finally, suggestions for medicinal plant conservation were addressed. We found that (1) medicinal plant ratios were not constant, and they were high in the Tarim Basin which was largely covered by desert, while they were relatively low in mountainous areas, especially in the Tianshan Mountains where the general species richness was high; (2) medicinal plant ratios were not significantly influenced by human activities, indicated by human population density distributions, but they were highly correlated with plant species richness and climate, i.e. ratios decreased with plant species richness and MAP, and were related quadratically with MAT; (3) CMM ratio and UM ratio were more influenced by plant richness than by climate, while KM ratio was more influenced by climate. We concluded that the percentages of plants used as medicines were not influenced by distances from human settlements, but were determined by species richness or climate. We suggest that (1), in general, the medicinal plant ratio could be a complementary indicator for medicinal plant conservation planning and (2), for the region of Xinjiang, not only high diversity areas, but also some extreme environments should be considered as compensation for a better protection of medicinal plants. PMID:27391239
Li, Liping; Zhang, Bengang; Xiao, Peigen; Qi, Yaodong; Zhang, Zhao; Liu, Haitao; Li, Xiaojin; Wang, Guoping; Terwei, André
2016-01-01
With both a full collection of native vascular plant distributions and a full checklist of source plants of the Chinese Materia Medica (CMM), the Uygur Medicine (UM), and the Kazak Medicine (KM) for the Xinjiang region, we defined medicinal plant: vascular plant ratios (simplified as medicinal plant ratios hereafter) as the value of medicinal plant richness divided by vascular plant richness. We aimed to find whether the ratios are constant or change in different environments, which environmental variables determine medicinal plant ratios, and whether the ratios are more influenced by human or by natural environments. Finally, suggestions for medicinal plant conservation were addressed. We found that (1) medicinal plant ratios were not constant, and they were high in the Tarim Basin which was largely covered by desert, while they were relatively low in mountainous areas, especially in the Tianshan Mountains where the general species richness was high; (2) medicinal plant ratios were not significantly influenced by human activities, indicated by human population density distributions, but they were highly correlated with plant species richness and climate, i.e. ratios decreased with plant species richness and MAP, and were related quadratically with MAT; (3) CMM ratio and UM ratio were more influenced by plant richness than by climate, while KM ratio was more influenced by climate. We concluded that the percentages of plants used as medicines were not influenced by distances from human settlements, but were determined by species richness or climate. We suggest that (1), in general, the medicinal plant ratio could be a complementary indicator for medicinal plant conservation planning and (2), for the region of Xinjiang, not only high diversity areas, but also some extreme environments should be considered as compensation for a better protection of medicinal plants.
Urso, Valeria; Signorini, Maria Adele; Tonini, Matteo; Bruschi, Piero
2016-01-11
Mopane woodlands play an important role in the livelihood strategies of local populations; however, they have been scarcely investigated by ethnobiologists and very little is currently known about plants traditionally used by local communities, especially about medicinal plants. Our investigation was aimed to document ethnobotanical knowledge in seven communities living in conditions of extreme poverty in a Mopane area of southern Angola (Namibe province). We focused on plants used as medicines and/or food, in order to highlight the role of wild plants in the livelihood of local communities, and possibly to find out plants with potential pharmacological interest. Ethnobotanical data were recorded through semi-structured interviews, filed in a database and quantitatively analyzed. The following synthetic indexes were used: Cultural Importance index (CI), Informant Consensus Factor (FIC), Fidelity Level (FL). Sixty-six informants (26 males, 40 females) were interviewed. A total of 1247 citations were recorded, concerning 132 ethnospecies (folk taxonomic units not necessarily corresponding to single botanical species); 104 were identified at different taxonomic levels. For medicinal purposes, 116 ethnospecies and 20 different uses (650 citations) were reported; for food purposes, 33 ethnospecies and 8 different uses (597 citations). The main used parts resulted to be fruit (471 citations; 21 ethnospecies), followed by underground organs (288, 82) and leaves (175, 41). According to CI values, Berchemia discolor, Ximenia americana var. americana and Adansonia digitata have the highest cultural value in the investigated communities. All of them are woody plants, as well as most of the identified ethnospecies (trees 34.6%, shrubs 32.7%, perennials 21.2%, annuals 8.7%, others 2.8%). Medicinal plants are especially used to treat disorders of the gastrointestinal tract (52 ethnospecies, 205 citations), obstetric/gynecological troubles (27, 40) and colds and respiratory tract diseases (25, 54). The highest values of FIC were recorded for body care (FIC=1.0), circulatory diseases (FIC=0.91), malaria (FIC=0.81) and digestive disorders (FIC=0.55). The plants showing the highest informants' consensus (FL) were Myrothamnus flabellifolia used to treat colds and respiratory diseases (FL=100%), Terminalia prunioides for digestive diseases (93%) and Euphorbia subsalsa for backache (86%). For five plants cited as medicinal by the informants, no reports were found in the consulted ethnobotanical and ethnopharmacological literature; many uses of several already known medicinal plants were also unrecorded. Food products obtained from wild plants include fresh fruit (20 ethnospecies, 287 citations), alcoholic (11, 107) and non-alcoholic (10, 44) beverages, massa, i.e. a kind of mash, (4, 65), vegetables (10, 40), and others. Results show that people living in Mopane communities of southern Angola hold a valuable knowledge of the uses of plant resources and that some of the plants cited by the informants represent an important component of the local livelihood strategies. We also found some plants worthy of more in-depth investigations on their possible pharmacological activity, including: (i) those used to treat diseases which reached the highest FIC, like malaria and various disorders of the gastrointestinal tract; (ii) plants with a high FL; (iii) plants not previously reported in ethnomedical literature, especially those cited by different informants; (iv) plants with possible nutraceutical or pharma-food properties, i.e. plants with considerable contents in vitamins and/or micronutrients and plants whose food and medicinal uses are closely related. Anthropological and historical studies in ethnopharmacology, quality traditional medicines. Botany, Traditional medicine, Africa, Diarrhea, Malaria. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Herbal Remedies for Functional Dyspepsia and Traditional Iranian Medicine Perspective
Babaeian, Mahmoud; Naseri, Mohsen; Kamalinejad, Mohammad; Ghaffari, Farzaneh; Emadi, Fatemeh; Feizi, Awat; Hosseini Yekta, Nafiseh; Adibi, Peyman
2015-01-01
Context: Functional dyspepsia (FD) is a functional gastro-intestinal disorder with high prevalence. Among various treatment options, treatment by complementary and alternative medicines especially herbal remedies also practiced. Traditional Iranian medicine (TIM), a valuable resource of valid applied studies of ancient Iranian scholars, recommends numerous medicinal plants to treat dyspepsia symptoms. In this study, through investigation of TIM references, we aimed to identify medicinal plants for treatment of digestion insufficiency. Evidence Acquisition: In this qualitative study, dyspepsia symptoms including fullness, early satiety, bloating, nausea, and belching were checked under reliable sources of traditional medicine. Then medicinal plants recommended for the treatment of the symptoms were extracted from the books. Likewise, for investigating the pharmacological properties of medicinal plants used for the relieving of dyspepsia symptoms, electronic databases such as PubMed, Scopus, Google Scholar and some Iranian databases like SID and IranMedex were employed. Results: The study yielded 105 plants from 37 families which could treat various dyspepsia symptoms; fifty-seven plants, mainly from Apiaceae, Lamiaceae, Amaryllidaceae and Zingiberaceae had digestive effects. In this research, based on the information in TIM reference texts, we obtained 58 plants effective for bloating, 40 for nausea, 37 for appetite loss and 7 for belching. In human clinical trials conducted on medicinal plants effective for FD symptoms, 7 single plants were used. Conclusions: Finding the medicinal plants effective on digestion insufficiency based on TIM could suggest a better strategy for the relieving of dyspepsia symptoms. Traditional Iranian medicine prescribes medicinal plants based on each patient’s personal characteristics and practices multiple target therapies. PMID:26734483
Herbal Remedies for Functional Dyspepsia and Traditional Iranian Medicine Perspective.
Babaeian, Mahmoud; Naseri, Mohsen; Kamalinejad, Mohammad; Ghaffari, Farzaneh; Emadi, Fatemeh; Feizi, Awat; Hosseini Yekta, Nafiseh; Adibi, Peyman
2015-11-01
Functional dyspepsia (FD) is a functional gastro-intestinal disorder with high prevalence. Among various treatment options, treatment by complementary and alternative medicines especially herbal remedies also practiced. Traditional Iranian medicine (TIM), a valuable resource of valid applied studies of ancient Iranian scholars, recommends numerous medicinal plants to treat dyspepsia symptoms. In this study, through investigation of TIM references, we aimed to identify medicinal plants for treatment of digestion insufficiency. In this qualitative study, dyspepsia symptoms including fullness, early satiety, bloating, nausea, and belching were checked under reliable sources of traditional medicine. Then medicinal plants recommended for the treatment of the symptoms were extracted from the books. Likewise, for investigating the pharmacological properties of medicinal plants used for the relieving of dyspepsia symptoms, electronic databases such as PubMed, Scopus, Google Scholar and some Iranian databases like SID and IranMedex were employed. The study yielded 105 plants from 37 families which could treat various dyspepsia symptoms; fifty-seven plants, mainly from Apiaceae, Lamiaceae, Amaryllidaceae and Zingiberaceae had digestive effects. In this research, based on the information in TIM reference texts, we obtained 58 plants effective for bloating, 40 for nausea, 37 for appetite loss and 7 for belching. In human clinical trials conducted on medicinal plants effective for FD symptoms, 7 single plants were used. Finding the medicinal plants effective on digestion insufficiency based on TIM could suggest a better strategy for the relieving of dyspepsia symptoms. Traditional Iranian medicine prescribes medicinal plants based on each patient's personal characteristics and practices multiple target therapies.
[Evolutionary medicine: A new look on health and disease].
Bauduer, F
2017-03-01
Evolutionary medicine represents an innovative approach deriving from evolutionary biology. It includes the initial Darwin's view, its actualization in the light of progresses in genetics and also dissident theories (i.e. non gene-based) particularly epigenetics. This approach enables us to reconsider the pathophysiology of numerous diseases, as for instance, infection, and our so-called diseases of civilization especially obesity, type 2 diabetes, allergy or cancer. Evolutionary medicine may also improve our knowledge regarding inter-individual variation in susceptibility to disease or drugs. Furthermore, it points out the impact of our behaviors and environment on the genesis of a series of diseases. Copyright © 2016 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.
[The problems of pharmaceutical support of patients with diabetes mellitus type II].
Khabriev, R U; Malichenko, V S; Malichenko, S B
2016-01-01
The diabetes mellitus acquires a character of sheer spreading global epidemic. Nowadays, in the Russian Federation number of patients with diabetes mellitus reaches 10 million. The accessibility of pharmaceuticals is one of main elements of support of effective treatment of disease. The analysis of federal and regional normative legal acts, territorial programs of state guarantees and data of portal of state purchases demonstrated inefficiency of actual regional system of medicinal support especially in modern economic situation. The necessity of optimization of state costs and also broadening of medicinal coverage of population, including pharmaceuticals for treatment of diabetes mellitus type II, requires development and implementation of step-by-step plan of reforming of regional system of preferential medicinal support.
Recycling Expensive Medication: Why Not?
Pomerantz, Jay M
2004-01-01
New (and proposed) advances in packaging, preserving, labeling, and verifying product integrity of individual tablets and capsules may allow for the recycling of certain expensive medicines. Previously sold, but unused, medication, if brought back to special pharmacies for resale or donation, may provide a low-cost source of patent-protected medicines. Benefits of such a program go beyond simply providing affordable medication to the poor. This article suggests that medicine recycling may be a possibility (especially if manufacturers are mandated to blister-package and bar-code individual tablets and capsules). This early discussion of medication recycling identifies relevant issues, such as: need, rationale, existing programs, available supplies, expiration dates, new technology for ensuring safety and potency, environmental impact, public health benefits, program focus, program structure, and liability. PMID:15266231
Mortensen, Chloe; Bhatnagar, Rahul; Edey, Anthony J
2012-11-01
Pleural disease is now recognized as an important subspecialty of pulmonary medicine, with increasing provision being made for specialist services and procedures. In response, the field of pleural imaging has advanced in recent years, especially with regard to ultrasound. Salient multimodality imaging techniques are discussed.
Essential medicines are more available than other medicines around the globe.
Bazargani, Yaser T; Ewen, Margaret; de Boer, Anthonius; Leufkens, Hubert G M; Mantel-Teeuwisse, Aukje K
2014-01-01
The World Health Organization (WHO) promotes the development of national Essential Medicines Lists (EMLs) in order to improve the availability and use of medicines considered essential within health care systems. However, despite over 3 decades of international efforts, studies show an inconsistent pattern in the availability of essential medicines. We evaluated and compared the availability of essential medicines, and medicines not included in national EMLs, at global and regional levels. Medicine availability in the public and private sector were calculated based on data obtained from national and provincial facility-based surveys undertaken in 23 countries using the WHO/HAI methodology. The medicines were grouped according to their inclusion ('essential') or exclusion (termed 'non-essential') in each country's EML current at the time of the survey. Availability was calculated for originator brands, generics and any product type (originator brands or generics) and compared between the two groups. Results were aggregated by WHO regions, World Bank country income groups, a wealth inequality measure, and therapeutic groups. Across all sectors and any product type, the median availability of essential medicines was suboptimal at 61·5% (IQR 20·6%-86·7%) but significantly higher than non-essential medicines at 27·3% (IQR 3·6%-70·0%). The median availability of essential medicines was 40·0% in the public sector and 78·1% in the private sector; compared to 6·6% and 57·1% for non-essential medicines respectively. A reverse trend between national income level categories and the availability of essential medicines was identified in the public sector. EMLs have influenced the provision of medicines and have resulted in higher availability of essential medicines compared to non-essential medicines particularly in the public sector and in low and lower middle income countries. However, the availability of essential medicines, especially in the public sector does not ensure equitable access.
SBM recommends policy support to reduce smoking disparities for sexual and gender minorities.
Matthews, Phoenix Alicia; Blok, Amanda C; Lee, Joseph G L; Hitsman, Brian; Sanchez-Johnsen, Lisa; Watson, Karriem; Breen, Elizabeth; Ruiz, Raymond; Scout; Simon, Melissa A; Fitzgibbon, Marian; Hein, Laura C; Winn, Robert
2018-01-27
The Society of Behavioral Medicine supports the inclusion of gender and sexual minorities in all local, state, and national tobacco prevention and control activities. These activities include surveillance of tobacco use and cessation activities, targeted outreach and awareness campaigns, increasing access to culturally appropriate tobacco use dependence treatments, and restricting disproportionate marketing to lesbian, gay, bisexual, and transgender communities by the tobacco industry, especially for mentholated tobacco products. © The Society of Behavioral Medicine 2018. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Lossignol, D
2010-01-01
This paper presents the medical practice according to the occidental philosophy (Platon, Spinoza, Kant). Relationships with the concept of "love" (eros, philia, agape) will be described, and the concept of dignity and autonomy as well. The reflection will focus on the end of life aspects. Although medicine cannot avoid morality, ethic, and deontology, it is also part of philosophy and must warrant the respect of human dignity, especially when a physician helps a patient to die.
[Meta-analyses of quarks, baryons and mesons--a "Cochrane Collaboration" in particle physics].
Sauerland, Stefan; Sauerland, Thankmar; Antes, Gerd; Barnett, R Michael
2002-02-01
Within the last 20 years meta-analysis has become an important research technique in medicine for integrating the results of independent studies. Meta-analytical techniques, however, are much older. In particle physics for 50 years now the properties of huge numbers of particles have been assessed in meta-analyses. The Cochrane Collaboration's counterpart in physics is the Particle Data Group. This article compares methodological and organisational aspects of meta-analyses in medicine and physics. Several interesting parallels exist, especially with regard to methodology.
2014-01-01
Background International policy towards access to essential medicines in Africa has focused until recently on international procurement of large volumes of medicines, mainly from Indian manufacturers, and their import and distribution. This emphasis is now being challenged by renewed policy interest in the potential benefits of local pharmaceutical production and supply. However, there is a shortage of evidence on the role of locally produced medicines in African markets, and on potential benefits of local production for access to medicines. This article contributes to filling that gap. Methods This article uses WHO/HAI data from Tanzania for 2006 and 2009 on prices and sources of a set of tracer essential medicines. It employs innovative graphical methods of analysis alongside conventional statistical testing. Results Medicines produced in Tanzania were equally likely to be found in rural and in urban areas. Imported medicines, especially those imported from countries other than Kenya (mainly from India) displayed 'urban bias’: that is, they were significantly more likely to be available in urban than in rural areas. This finding holds across the range of sample medicines studied, and cannot be explained by price differences alone. While different private distribution networks for essential medicines may provide part of the explanation, this cannot explain why the urban bias in availability of imported medicines is also found in the public sector. Conclusions The findings suggest that enhanced local production may improve rural access to medicines. The potential benefits of local production and scope for their improvement are an important field for further research, and indicate a key policy area in which economic development and health care objectives may reinforce each other. PMID:24612518
Mujinja, Phares G M; Mackintosh, Maureen; Justin-Temu, Mary; Wuyts, Marc
2014-03-10
International policy towards access to essential medicines in Africa has focused until recently on international procurement of large volumes of medicines, mainly from Indian manufacturers, and their import and distribution. This emphasis is now being challenged by renewed policy interest in the potential benefits of local pharmaceutical production and supply. However, there is a shortage of evidence on the role of locally produced medicines in African markets, and on potential benefits of local production for access to medicines. This article contributes to filling that gap. This article uses WHO/HAI data from Tanzania for 2006 and 2009 on prices and sources of a set of tracer essential medicines. It employs innovative graphical methods of analysis alongside conventional statistical testing. Medicines produced in Tanzania were equally likely to be found in rural and in urban areas. Imported medicines, especially those imported from countries other than Kenya (mainly from India) displayed 'urban bias': that is, they were significantly more likely to be available in urban than in rural areas. This finding holds across the range of sample medicines studied, and cannot be explained by price differences alone. While different private distribution networks for essential medicines may provide part of the explanation, this cannot explain why the urban bias in availability of imported medicines is also found in the public sector. The findings suggest that enhanced local production may improve rural access to medicines. The potential benefits of local production and scope for their improvement are an important field for further research, and indicate a key policy area in which economic development and health care objectives may reinforce each other.
Ahmed, Mansoor; Hwang, Jung Hye; Choi, Soojeung; Han, Dongwoon
2017-11-14
High prevalence of herbal medicines used in pregnancy and the lack of information on their safety is a public concern. Despite this, no significant research has been done regarding potential adverse effects of using herbal medicines during pregnancy, especially among developing Asian countries. Cross-sectional studies were searched up to year 2016 on PubMed/Medline and EMBASE, the data were extracted and quality of studies was assessed using the quality appraisal tool. The findings are reported in accordance to the PRISMA checklist (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Classification on safety of identified herbal medicines was done based on current scientific literature. This study included eight cross-sectional studies (2729 participants) from seven different Asian countries, of which 1283 (47.01%) women used one or more herbal medicines during pregnancy. Peppermint (22.8%), aniseed (14.7%), olibanum (12.9%), flixweed seed (12.2%) and ginger (11.5%) were the most frequently used herbal medicines. Out of the 33 identified herbal medicines, 13 were classified as safe to use, five as use with caution, eight were potentially harmful to use in pregnancy and information on seven herbal medicines was not available in the current literature. Several herbal medicines identified in this review were classified to be potentially harmful or the information regarding safety in pregnancy was missing. It is recommended that contraindicated herbal medicines should be avoided and other herbals should be taken under supervision of a qualified health care practitioner. The classification regarding safety of herbal medicines in pregnancy can be utilized to create awareness on prevention of adverse effects.
Natural Medicines Used in the Traditional Tibetan Medical System for the Treatment of Liver Diseases
Li, Qi; Li, Hai-Jiao; Xu, Tong; Du, Huan; Huan Gang, Chen-Lei; Fan, Gang; Zhang, Yi
2018-01-01
Liver disease is one of the most risk factors threatening human health. It is of great significance to find drugs that can treat liver diseases, especially for acute and chronic hepatitis, non-alcoholic fatty liver disease, and liver cancer. The search for drugs with good efficacy from traditional natural medicines has attracted more and more attention. Tibetan medicine, one of the China's traditional medical systems, has been widely used by the Tibetan people for the prevention and treatment of liver diseases for hundreds of years. The present paper summarized the natural Tibetan medicines that have been used in Tibetan traditional system of medicine to treat liver diseases by bibliographic investigation of 22 Tibetan medicine monographs and drug standards. One hundred and ninety three species including 181 plants, 7 animals, and 5 minerals were found to treat liver diseases in traditional Tibetan medicine system. The most frequently used species are Carthamus tinctorius, Brag-zhun, Swertia chirayita, Swertia mussotii, Halenia elliptica, Herpetospermum pedunculosum, and Phyllanthus emblica. Their names, families, medicinal parts, traditional uses, phytochemicals information, and pharmacological activities were described in detail. These natural medicines might be a valuable gift from the old Tibetan medicine to the world, and would be potential drug candidates for the treatment of liver diseases. Further studies are needed to prove their medicinal values in liver diseases treatment, identify bioactive compounds, elucidate the underlying mechanism of action, and clarify their side effects or toxicity with the help of modern phytochemical, pharmacological, metabonomics, and/or clinical trial methods. PMID:29441019
Cranberry juice: effects on health
USDA-ARS?s Scientific Manuscript database
Cranberries have long been used as a part of traditional and folk medicine. Most cranberry juice is consumed as a product containing 27% v/v with sweeteners derived from other fruit juices or other sweeteners. Cranberry juice contains a rich profile of phenolic compounds, especially proanthocyanidin...
Understanding the Perception of Islamic Medicine Among the Malaysian Muslim Community.
Ahmad, Khadher; Ariffin, Mohd Farhan Md; Deraman, Fauzi; Ariffin, Sedek; Abdullah, Mustaffa; Razzak, Monika Munirah Abd; Yusoff, M Y Zulkifli Mohd; Achour, Meguellati
2017-10-26
This study was conducted to identify and describe the patients' perceptions of Islamic medicine based on gender, age, marital, educational level and working status among the Malaysian Muslim population. A nationwide interviewer-administered questionnaire survey was conducted in 2013. An open-ended questionnaire pertaining to Islamic medicine was used to increase the probability of capturing maximum data. This survey implemented a multistage design, stratified by state, proportionate to the size of the state population and was representative of the Malaysian population. Post-survey classification of results was performed accordingly. Complex data analysis was carried out using SPSS 16.0. The discussion was identified and categorised into various sections. The paper concludes that Islamic medicine has a major influence in the Malaysian Muslim community compared to other alternatives. Further, its potential for growth and importance especially for treating spiritual ailments cannot be denied. The respondents indicated that two factors motivate Islamic medicine in Malaysia: (1) the Muslim community opts for alternative healing because of their dissatisfaction with conventional methods; (2) Islamic medicine focuses only on healing spiritual-related problems. The average perception of respondents is that the function of Islamic medicine in healing physical diseases is undervalued and that it is not suitable to replace the functions of modern health institutions.
The use of economic evaluation for guiding the pharmaceutical reimbursement list in Thailand.
Teerawattananon, Yot; Tritasavit, Nattha; Suchonwanich, Netnapis; Kingkaew, Pritaporn
2014-01-01
Medicines expenditure consumes a significant proportion of public health expenditure in Thailand, where Universal Health Coverage has been in place since 2002. The National List of Essential Medicines has been successfully used as a pharmaceutical benefits package for all public health plans. All patients are eligible for all medicines included in the list free of charge by law. Health economic evaluation has been employed as a tool for the development of this list, including price negotiation of medicines before inclusion, especially of high-cost medicines or medicines with high budget implications. This paper illustrates the current process, mechanisms, and impact and informs of seven success factors that have contributed to the successful use of health economic evaluation in Thailand. These include strong political commitment, development of individual and institutional capacity, participation of all relevant stakeholders, establishment of standard methodological and process guidelines, consideration of several elements in the decision-making process, using evidence as a starting point rather than a deciding factor, and strong enforcement. The lessons learned from this study are likely to be applicable to other settings committed to evidence-based decision making. Copyright © 2014. Published by Elsevier GmbH.
Medicinal and therapeutic potential of Sea buckthorn (Hippophae rhamnoides L.).
Suryakumar, Geetha; Gupta, Asheesh
2011-11-18
ETHNOPHARMACOLOGICAL CONTEXT: This review explores the medicinal and therapeutic applications of Sea buckthorn (Hippophae rhamnoides L.) in curtailing different types of acute as well as chronic maladies. The plant is being used in different parts of the world for its nutritional and medicinal properties. Sea buckthorn based preparations have been extensively exploited in folklore treatment of slow digestion, stomach malfunctioning, cardiovascular problems, liver injury, tendon and ligament injuries, skin diseases and ulcers. In the recent years, medicinal and pharmacological activities of Sea buckthorn have been well investigated using various in vitro and in vivo models as well as limited clinical trials. Sea buckthorn has been scientifically analyzed and many of its traditional uses have been established using several biochemical and pharmacological studies. Various pharmacological activities such as cytoprotective, anti-stress, immunomodulatory, hepatoprotective, radioprotective, anti-atherogenic, anti-tumor, anti-microbial and tissue regeneration have been reported. It is clear that Sea buckthorn is an important plant because of its immense medicinal and therapeutic potential. However, several knowledge gaps identified in this paper would give impetus to new academic and R&D activities especially for the development of Sea buckthorn based herbal medicine and nutraceuticals. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Liu, Tao; Wang, Ning
2016-01-01
Functional abdominal pain syndrome (FAPS) is one of the less common functional gastrointestinal disorders. Conventional therapy has unsatisfactory response to it so people turn to Chinese medicine for help. Currently, we reviewed the whole picture of Chinese herbal medicine (CHM) clinical and basic application in the treatment of FAPS, especially the traditional Chinese medicine (TCM) syndrome, the single herb, and Chinese medicine formulae, thus to provide a solid base to further develop evidence-based study for this common gastrointestinal complaint in the future. We developed the search strategy and set the inclusion and exclusion criteria for article search. From the included articles, we totally retrieved 586 records according to our searching criteria, of which 16 were duplicate records and 291 were excluded for reasons of irrelevance. The full text of 279 articles was retrieved for detailed assessment, of which 123 were excluded for various reasons. The number one used single herb is Radix Ginseng. The most common syndrome was liver qi depression. The most frequently used classic formula was Si-Mo-Tang. This reflected the true situation of clinical practice of Chinese medicine practitioners and could be further systematically synthesized as key points of the therapeutic research for FAPS. PMID:27366194
Liu, Tao; Wang, Ning; Zhang, Li; Zhong, Linda
2016-01-01
Functional abdominal pain syndrome (FAPS) is one of the less common functional gastrointestinal disorders. Conventional therapy has unsatisfactory response to it so people turn to Chinese medicine for help. Currently, we reviewed the whole picture of Chinese herbal medicine (CHM) clinical and basic application in the treatment of FAPS, especially the traditional Chinese medicine (TCM) syndrome, the single herb, and Chinese medicine formulae, thus to provide a solid base to further develop evidence-based study for this common gastrointestinal complaint in the future. We developed the search strategy and set the inclusion and exclusion criteria for article search. From the included articles, we totally retrieved 586 records according to our searching criteria, of which 16 were duplicate records and 291 were excluded for reasons of irrelevance. The full text of 279 articles was retrieved for detailed assessment, of which 123 were excluded for various reasons. The number one used single herb is Radix Ginseng. The most common syndrome was liver qi depression. The most frequently used classic formula was Si-Mo-Tang. This reflected the true situation of clinical practice of Chinese medicine practitioners and could be further systematically synthesized as key points of the therapeutic research for FAPS.
Below the radar innovations and emerging property right approaches in Tibetan medicine.
Madhavan, Harilal
2017-11-01
Outside the established legal framework of intellectual property rights, countries have pursued multiple pathways to protect and promote traditional medicine. As Tibetan medicine is a late entrant into commercialization, the proposals to propertize generally fall within the rationale of existing sui-generis paradigms of Intellectual property. In this context, the article enquires the state of innovations in this sector viz-a-viz the property right approaches in place especially in India and China. It argues that beyond the usual complex medical science and technology led-innovations, the pathways of cumulative processes and creative additions through informal experiential learning platforms, where the transfers of knowledge become part of livelihood and social benefits (we call them "below the radar innovations") is ubiquitous in Tibetan medicine. The trends and politics in two recent strategies of protection, that is, Tibetan medicine as economic property (emphasizing patents here among many others) and as a cultural property (intangible cultural heritage) are juxtaposed with these informal innovative attempts. The paper underlines that the productivity-based economic rationale of these protection mechanisms should not obscure sustainability alternatives of "below the radar" (BtR) innovations in Tibetan medicine.
Folk medicinal use of fauna in Mapimi, Durango, México.
Jacobo-Salcedo, Maria del Rosario; Alonso-Castro, Angel Josabad; Zarate-Martinez, Alicia
2011-01-27
To document the use of animal species in traditional medicine from the municipality of Mapimi, Durango, México. Direct interviews were performed in several short visits with inhabitants from the municipality of Mapimi, Durango. The interviews were analyzed with two quantitative tools. The informant consensus factor that estimates the level of agreement between interviewees over which animals to use for each category and the fidelity level which indicates the percentage of informants claiming the use of a certain animal species for the same medicinal purpose. A total of 18 animal species, belonging to 17 families and four taxonomic categories, were reported by interviewees as used for medicinal purposes. Thirteen medicinal species were identified not previously reported. The results of the informant consensus factor showed that the dermatological, diabetes and reproductive categories had the greatest agreement. The most important species according to their fidelity level are: Mephitis macroura and Crotalus atrox. This study demonstrates that many animal species play an important role in healing practices among inhabitants from Mapimi, Durango. Further experiments with medicinal fauna from Mapimi are needed to be carried out to obtain experimental information about their traditional uses, especially with C. atrox. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
Below the radar innovations and emerging property right approaches in Tibetan medicine
2017-01-01
Outside the established legal framework of intellectual property rights, countries have pursued multiple pathways to protect and promote traditional medicine. As Tibetan medicine is a late entrant into commercialization, the proposals to propertize generally fall within the rationale of existing sui‐generis paradigms of Intellectual property. In this context, the article enquires the state of innovations in this sector viz‐a‐viz the property right approaches in place especially in India and China. It argues that beyond the usual complex medical science and technology led—innovations, the pathways of cumulative processes and creative additions through informal experiential learning platforms, where the transfers of knowledge become part of livelihood and social benefits (we call them “below the radar innovations”) is ubiquitous in Tibetan medicine. The trends and politics in two recent strategies of protection, that is, Tibetan medicine as economic property (emphasizing patents here among many others) and as a cultural property (intangible cultural heritage) are juxtaposed with these informal innovative attempts. The paper underlines that the productivity‐based economic rationale of these protection mechanisms should not obscure sustainability alternatives of “below the radar” (BtR) innovations in Tibetan medicine. PMID:29398953
Advanced bioanalytics for precision medicine.
Roda, Aldo; Michelini, Elisa; Caliceti, Cristiana; Guardigli, Massimo; Mirasoli, Mara; Simoni, Patrizia
2018-01-01
Precision medicine is a new paradigm that combines diagnostic, imaging, and analytical tools to produce accurate diagnoses and therapeutic interventions tailored to the individual patient. This approach stands in contrast to the traditional "one size fits all" concept, according to which researchers develop disease treatments and preventions for an "average" patient without considering individual differences. The "one size fits all" concept has led to many ineffective or inappropriate treatments, especially for pathologies such as Alzheimer's disease and cancer. Now, precision medicine is receiving massive funding in many countries, thanks to its social and economic potential in terms of improved disease prevention, diagnosis, and therapy. Bioanalytical chemistry is critical to precision medicine. This is because identifying an appropriate tailored therapy requires researchers to collect and analyze information on each patient's specific molecular biomarkers (e.g., proteins, nucleic acids, and metabolites). In other words, precision diagnostics is not possible without precise bioanalytical chemistry. This Trend article highlights some of the most recent advances, including massive analysis of multilayer omics, and new imaging technique applications suitable for implementing precision medicine. Graphical abstract Precision medicine combines bioanalytical chemistry, molecular diagnostics, and imaging tools for performing accurate diagnoses and selecting optimal therapies for each patient.
The global pipeline of new medicines for the control and elimination of malaria
2012-01-01
Over the past decade, there has been a transformation in the portfolio of medicines to combat malaria. New fixed-dose artemisinin combination therapy is available, with four different types having received approval from Stringent Regulatory Authorities or the World Health Organization (WHO). However, there is still scope for improvement. The Malaria Eradication Research agenda identified several gaps in the current portfolio. Simpler regimens, such as a single-dose cure are needed, compared with the current three-day treatment. In addition, new medicines that prevent transmission and also relapse are needed, but with better safety profiles than current medicines. There is also a big opportunity for new medicines to prevent reinfection and to provide chemoprotection. This study reviews the global portfolio of new medicines in development against malaria, as of the summer of 2012. Cell-based phenotypic screening, and ‘fast followers’ of clinically validated classes, mean that there are now many new classes of molecules starting in clinical development, especially for the blood stages of malaria. There remain significant gaps for medicines blocking transmission, preventing relapse, and long-duration molecules for chemoprotection. The nascent pipeline of new medicines is significantly stronger than five years ago. However, there are still risks ahead in clinical development and sustainable funding of clinical studies is vital if this early promise is going to be delivered. PMID:22958514
Ethnobotanical study on medicinal plants used by Maonan people in China.
Hong, Liya; Guo, Zhiyong; Huang, Kunhui; Wei, Shanjun; Liu, Bo; Meng, Shaowu; Long, Chunlin
2015-04-30
This paper is based on an ethnobotanical investigation that focused on the traditional medicinal plants used by local Maonan people to treat human diseases in Maonan concentration regions. The Maonan people have relied on traditional medicine since ancient times, especially medicinal plants. The aim of this study is to document medicinal plants used by the Maonans and to report the status of medicinal plants and associated traditional knowledge. Ethnobotanical data were collected from June 2012 to September 2014 in Huanjiang Maonan Autonomous County, northern Guangxi, southwest China. In total, 118 knowledgeable informants were interviewed. Following statistically sampling method, eighteen villages from 5 townships were selected to conduct field investigations. Information was collected through the approache of participatory observation, semi-structured interviews, ranking exercises, key informant interviews, focus group discussions, and participatory rural appraisals. A total of 368 medicinal plant species were investigated and documented together with their medicinal uses by the Maonans, most of which were obtained from the wild ecosystems. The plants were used to treat 95 human diseases. Grinding was a widely used method to prepare traditional herbal medicines. There were significant relationships between gender and age, and between gender and informants' knowledge of medicinal plant use. Deforestation for agricultural purposes was identified as the most destructive factor of medicinal plants, followed by drought and over-harvest. The species diversity of medicinal plants used by the Maonans in the study area was very rich. Medicinal plants played a significant role in healing various human disorders in the Maonan communities. However, the conflicts between traditional inheriting system and recent socio-economic changes (and other factors) resulted in the reduction or loss of both medicinal plants and associated indigenous knowledge. Thus, conservation efforts and policies, and innovation of inheriting system are necessary for protecting the medicinal plants and associated indigenous knowledge. Awareness is also needed to be raised among local Maonans focusing on sustainable utilization and management of both medicinal plants and traditional knowledge.
[Directions for future development of preventive medicine in Korea].
Kim, Joon Youn
2006-05-01
It is the actual state of the medical society in our country that many graduates of medical schools want to be clinicians, and accordingly Korea's medical situation is relatively too focused on curative medicine. However, this situation is changing due to several factors including a growing number of doctors, inappropriate regulations for medical fees, changes in social status of doctors themselves, and excessive competition between doctors. Furthermore, we expect more advances in medical field of Korea since Korean government started to attach great importance to sciences and produced policies to support sciences, and as a result, more and more interest and effort in the fields of basic research including preventive medicine is being attached especially by young doctors as compared against the past. However, decline of clinical medicine fields doesn't always mean bright future for the field of preventive medicine. True future is possible and meaningful only when we prepare for it by ourselves. In other words, as the promising future is closed to one who spares no effort, we shouldn't fear to oppose unknown challenges and simultaneously need to support colleagues who bear such a positive mind. It is the most important thing for our preventive medicine doctors to evaluate the past and the present of preventive medicine and to foster a prospective mind to prepare for the future of preventive medicine. I set forth my several views according to directions for the development of preventive medicine which we already discussed and publicized in the academic circle of preventive medicine. Those directions are recommen dation of clinical preventive medicine, promotion of preventive medicine specialty, fostering the next generations, improving the quality of genetic epidemiologic study, participation in control of environmental pollution and food safety, contribution to chronic disease control, and preparation to role in medical services for unified Korea.
Zhang, Bo; Xu, Haidong; Wang, Juntao; Liu, Bin; Sun, Guodong
2017-01-01
Lumbar intervertebral disc herniation (LIDH), as the main contributor to low back pain and sciatica, imposes a heavy burden on both the individual and society. Non-operative treatment or conservative treatment has proven effective in alleviation of the symptoms of LIDH and are considered to be a first-line choice for most cases. Active lifestyle, physical therapy, complementary and alternative medicine therapy or Traditional Chinese medicine (TCM) therapy, and pharmacotherapy are routinely used as effective non-operative treatment for LIDH patients. However, how to choose one or several conservative treatments with higher efficacy, less side effects, minimal injury, and low cost is still a challenge for doctors and LIDH patients. Furthermore, there are some national characteristics for some conservative treatments in different countries, which bring difficulties for the widespread use of these methods. Here we initiated a search on the non-operative treatment especially TCM therapy for LIDH mainly using PubMed, Web of Science, China National Knowledge Internet (CNKI), and Chinese biomedicine database since the 1980s with no restriction of language. According to these related references, we gave a narrative review which emphasizes up-to-date knowledge regarding the effectiveness and safety of various conservative methods with special consideration for TCM therapy including acupuncture, autonomy, Chinese massage, and Chinese herbal medicines, for LIDH treatment. We hope this review will further contribute to an understanding of conservative treatment as an important choice for LIDH patients and provide useful information for the development of more effective conservative methods for LIDH treatment.
Psychosocial support services for family medicine resident physicians.
Addison, Richard B; Riesenberg, Lee Ann; Rosenbaum, Paula
2004-02-01
The stress of residency is well documented. Some residency programs recognize the importance of addressing resident stress and provide psychosocial support services. This study assesses the current state of support services offered to family medicine residents and documents historical trends of support. All US family medicine residency programs were surveyed about program characteristics and the presence or absence of 21 psychosocial support services. The prevalence of current services was compared to that of 10 and 20 years ago. The percentage of family medicine programs offering 17 of 19 support services increased over the previous decades. However, percentages of some key services, especially those that address family life, are still quite low. Increases in services may be due to programs' desire to offer more positive and supportive educational experiences. Offering supportive and reflective opportunities may lessen stress, increase flexibility and balance, create enthusiasm for learning, encourage compassion for patients, and promote future well-being. In times of decreasing interest in family medicine, the presence of effective psychosocial support services may be important for attracting and training the best possible family physicians.
Determination of elements in ayurvedic medicinal plants by AAS
DOE Office of Scientific and Technical Information (OSTI.GOV)
Teerthe, Santoshkumar S.; Kerur, B. R., E-mail: kerurbrk@yahoo.com
India has a rich country for the uses of Ayurvedic medicinal plants for treatment and also the north- Karnataka boasts an unparallel diversity of medicinal plants. The present study attempts to estimate and compare the level of trace and heavy metals in some selected leaves and root samples of Ayurvedic medicinal plants such as Mg, Al, K, Cr, Mn, Fe, Cu, Zn, and Cd. The samples are collected from different places of North-Karnataka regions and sample solutions prepared as the ratio of 1:25:25+950ml=1000ppm.the trace and heavy elemental concentration was estimated using Atomic Absorption Spectrometric (AAS) Method. The average concentrations ofmore » Mg, Mn, Fe and Zn, are ranging from 2ppm to 5250.2ppm and potassium (K) has more concentration as compare to all other. The other elements likes Al, Cr, Cu, and Cd were also estimed and presented in the table. Therefore, these medicinal plants are rich in some essential minerals, especially K, Mg, Mn, Fe and Zn which are essential for human health.« less
The reforms of the Chinese health care system: county level changes: the Jiangxi Study.
Zheng, X; Hillier, S
1995-10-01
A survey of the economic performance of county hospitals in middle income counties in Jiangxi province was undertaken in 1989. The survey considered the impact of health policy changes in the P.R.C., especially cost recovery, decentralization, managerial changes and the promotion of traditional medicine. The financial records of county level hospitals and traditional medicine hospitals for the period 1980-89 were examined, as were patient expenditures. Opinions of those responsible for policy execution were surveyed. The data showed that hospitals from which state subsidy had been removed had become dependent on medicine sales and increasing itemization of treatment to recover costs. The insurance status of patients influenced the length of stay and levels of payment. Uninsured peasants had a shorter stay and were charged more for items of treatment. Traditional Medicine hospitals saw more outpatients than County hospitals, but were more likely to have a deficit. They were also very dependent on medicine sales for income. Most officials questioned felt that the changing system caused problems, but at the same time were eager to invest in equipment as a source of revenue.
Stavelin, Anne; Albe, Xavier; Meijer, Piet; Sarkany, Erika; MacKenzie, Finlay
2017-01-01
The European Organisation for External Quality Assurance Providers in Laboratory Medicine (EQALM) was founded in 1996 and currently has members from 29 European countries and 6 countries from outside Europe. EQALM provides a forum for co-operation and exchange of knowledge on quality-related matters in laboratory medicine, especially with regard to external quality assessment (EQA) programs in Europe. In addition, EQALM represent the EQA providers in laboratory medicine at European level vis-ŕ-vis political, professional, scientific and other bodies, including patients’ organisations. To this end EQALM promotes activities such as organizing meetings with scientific and practical themes for members and other interested parties, issuing scientific publications, developing EQA projects and representing laboratory medicine EQA activities within other organisations and networks. EQALM is active in scientific and educational activity in different fields such as survey frequency, haematology, haemostasis, microbiology, nomenclature, virtual microscopy, traceability, accreditation, and quality assurance of the total testing process. The aim of this paper is to give an overview of the EQALM organisation. PMID:28392724
[Industry-Academia Collaboration in the Clinical Laboratory Field: Chairmen's Introductory Remarks].
Inaba, Tohru; Ikemoto, Toshiyuki
2016-01-01
Industry-academia collaboration has become essential in contemporary medicine. Therefore, many institutes including university corporations have promoted the establishment of an endowed chair and/or performed collaborative research. This symposium was held to overview the present status of industry-academia collaboration in the clinical laboratory field. As a representative of the industry, Mr. Taniguchi (Sysmex) presented the development process of M2BP Glycosylation Isomer, a new marker for liver fibrosis. Mr. Saitoh (Horiba) introduced the achievements of joint collaborative research with Kyoto Prefectural University of Medicine, especially the practical realization of an automated hematology analyzer capable of simultaneously measuring C-reactive protein. Mr. Setoyama (LSI Medience) presented on the characteristic collaboration between academia and commercial laboratories such as Tsukuba Medical Laboratory of Education and Research (TMER). On the other hand, as a representative of academia, Associate Prof. Imai (Kyoto Prefectural University of Medicine) summarized the necessity of clinical laboratories spread regenerative medicine. Finally, Prof. Koshiba (Hyogo College of Medicine) presented on the industry-academia collaboration in routine laboratory work in his institute.
Chen, Guoli; Yang, Zhaohai; Eshleman, James R.; Netto, George J.
2016-01-01
Precision medicine, a concept that has recently emerged and has been widely discussed, emphasizes tailoring medical care to individuals largely based on information acquired from molecular diagnostic testing. As a vital aspect of precision cancer medicine, targeted therapy has been proven to be efficacious and less toxic for cancer treatment. Colorectal cancer (CRC) is one of the most common cancers and among the leading causes for cancer related deaths in the United States and worldwide. By far, CRC has been one of the most successful examples in the field of precision cancer medicine, applying molecular tests to guide targeted therapy. In this review, we summarize the current guidelines for anti-EGFR therapy, revisit the roles of pathologists in an era of precision cancer medicine, demonstrate the transition from traditional “one test-one drug” assays to multiplex assays, especially by using next-generation sequencing platforms in the clinical diagnostic laboratories, and discuss the future perspectives of tumor heterogeneity associated with anti-EGFR resistance and immune checkpoint blockage therapy in CRC. PMID:27699178
Unge, Christian; Ragnarsson, Anders; Ekström, Anna Mia; Indalo, Dorcus; Belita, Alice; Carter, Jane; Ilako, Festus; Södergård, Björn
2011-07-01
The objective of this study was to explore the influence of traditional medicine and religion on discontinuation of antiretroviral therapy (ART) in one of Africa's largest informal urban settlement, Kibera, in Nairobi, Kenya. Semi-structured face-to-face interviews were conducted with 20 patients discontinuing the African Medical and Research Foundation (AMREF) ART program in Kibera due to issues related to traditional medicine and religion. Traditional medicine and religion remain important in many people's lives after ART initiation, but these issues are rarely addressed in a positive way during ART counseling. Many patients found traditional medicine and their religious beliefs to be in conflict with clinic treatment advice. Patients described a decisional process, prior to the actual drop-out from the ART program that involved a trigger event, usually a specific religious event, or a meeting with someone using traditional medicine that influenced them to take the decision to stop ART. Discontinuation of ART could be reduced if ART providers acknowledged and addressed the importance of religious issues and traditional medicine in the lives of patients, especially in similar resource-poor settings. Telling patients not to mix ART and traditional medicine appeared counter-productive in this setting. Introducing an open discussion around religious beliefs and the pros and cons of traditional medicine as part of standard counseling, may prevent drop-out from ART when side effects or opportunistic infections occur.
Ste-Marie, Peter A; Shir, Yoram; Rampakakis, Emmanouil; Sampalis, John S; Karellis, Angela; Cohen, Martin; Starr, Michael; Ware, Mark A; Fitzcharles, Mary-Ann
2016-12-01
Cannabinoids may hold potential for the management of rheumatic pain. Arthritis, often self-reported, is commonly cited as the reason for the use of medicinal herbal cannabis (marijuana). We have examined the prevalence of marijuana use among 1000 consecutive rheumatology patients with a rheumatologist-confirmed diagnosis and compared in an exploratory manner the clinical characteristics of medicinal users and nonusers. Current marijuana use, medicinal or recreational, was reported by 38 patients (3.8%; 95% CI: 2.8-5.2). Ever use of marijuana for medical purposes was reported by 4.3% (95% CI: 3.2-5.7), with 28 (2.8%; 95% CI: 1.9-4.0) reporting current medicinal use. Current medicinal users had a spectrum of rheumatic conditions, with over half diagnosed with osteoarthritis. Medicinal users were younger, more likely unemployed or disabled, and reported poorer global health. Pain report and opioid use was greater for users, but they had similar physician global assessment of disease status compared with nonusers. Medicinal users were more likely previous recreational users, with approximately 40% reporting concurrent recreational use. Therefore, less than 3% of rheumatology patients reported current use of medicinal marijuana. This low rate of use in patients with a rheumatologist-confirmed diagnosis is in stark contrast to the high rates of severe arthritis frequently reported by medicinal marijuana users, especially in Canada. Familiarity with marijuana as a recreational product may explain use for some as disease status was similar for both groups.
Ghana: Background and U.S. Relations
2009-07-08
increased access to credit and markets to diverse types of agricultural infrastructure growth. The key cocoa industry, as well as the cotton, cashew ...rubber, oil palm, soy, fruit, shea nut , timber, and coconut crop sectors, along with bio-fuel and medicinal plants and fisheries, are especially
Microwave-Assisted Synthesis of Bio-Active Heterocycles and Fine Chemicals in Aqueous Media
Human health, especially in the aging population, mostly depends on various medicines, and researchers are combating against emerging diseases by new drug discovery. Heterocyclic compounds hold a special place among pharmaceutically active natural products as well as synthetic co...
Type III Polyketide Synthases: Discovery, Characterization, and Engineering
ERIC Educational Resources Information Center
Pitel, Sheryl Beth Rubin
2009-01-01
The polyketides are a diverse group of natural products with important applications in medicine and industry. Industry, especially the pharmaceutical industry, is under pressure to deliver "greener" chemical syntheses that are less environmentally damaging and incorporate renewable resources. There exists potential to replace current…
Learning about Intermolecular Interactions from the Cambridge Structural Database
ERIC Educational Resources Information Center
Battle, Gary M.; Allen, Frank H.
2012-01-01
A clear understanding and appreciation of noncovalent interactions, especially hydrogen bonding, are vitally important to students of chemistry and the life sciences, including biochemistry, molecular biology, pharmacology, and medicine. The opportunities afforded by the IsoStar knowledge base of intermolecular interactions to enhance the…
Pain Medicines for Pets: Know the Risks
... and must be used cautiously in animals with pre-existing kidney or liver problems. Because most liver-associated toxicities occur during the first three weeks, it’s especially important to closely monitor the results of blood tests during the early stages of long-term NSAID ...
NASA Astrophysics Data System (ADS)
Stauss, Sven; Muneoka, Hitoshi; Terashima, Kazuo
2018-02-01
Plasma science and technology has enabled advances in very diverse fields: micro- and nanotechnology, chemical synthesis, materials fabrication and, more recently, biotechnology and medicine. While many of the currently employed plasma tools and technologies are very advanced, the types of plasmas used in micro- and nanofabrication pose certain limits, for example, in treating heat-sensitive materials in plasma biotechnology and plasma medicine. Moreover, many physical properties of plasmas encountered in nature, and especially outer space, i.e. very-low-temperature plasmas or plasmas that occur in high-density media, are not very well understood. The present review gives a short account of laboratory plasmas generated under ’extreme’ conditions: at cryogenic temperatures and in supercritical fluids. The fundamental characteristics of these cryogenic plasmas and cryoplasmas, and plasmas in supercritical fluids, especially supercritical fluid plasmas, are presented with their main applications. The research on such exotic plasmas is expected to lead to further understanding of plasma physics and, at the same time, enable new applications in various technological fields.
Albuquerque, Ulysses Paulino; Ramos, Marcelo Alves; Melo, Joabe Gomes
2012-03-06
Hypotheses from ethnobotany and chemical ecology can increase our ability to predict the pharmaceutical potential of tropical flora. In order to illustrate how bioprospecting studies can benefit from the incorporation of these hypotheses, especially in tropical dry forests, we discuss evidence from ethnobotanical studies that examine hypotheses about the ecology of plant defense against herbivory. We focus on two hypotheses regarding defense patterns in plants-the plant apparency hypothesis and the resource availability hypothesis-and analyze how these can help us understand the use of medicinal plants by traditional communities. The evidence suggests that medicinal plants in the dry forest are a rich source of drugs in which phenolic compounds, especially tannins, are directly responsible for the therapeutic activity. Phenolic compounds and their potential therapeutic activity are likely good candidates for bioprospecting efforts. We believe that following strategies to link ethnobotanical and chemical ecological approaches will increase the efficiency of bioprospecting studies in tropical forests. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Woodward, Elliott; Lai, Yvonne; Egun, Christyanna; Fitzsimons, Michael G
2018-04-01
The field of medicine is built upon science, technology, engineering, and math (STEM), yet the United States is rapidly falling behind when it comes to educating the next generation in these disciplines, especially under-represented populations. The authors reflect on existing educational literature surrounding efforts to promote interest in STEM among students and under-represented populations. The authors advocate for greater efforts toward the development of youth programing. Cardiac anesthesia is uniquely positioned as a subspecialty to advance the goal of promoting interest in STEM in diverse groups of young students. The authors describe their development and implementation of a community outreach program to enhance interest in medicine through a cardiac dissection experience. Copyright © 2017. Published by Elsevier Inc.
[Bacopa Monnieri - activity and applications in medicine].
Sokołowska, Lilianna; Bylka, Wiesława
2015-01-01
Recently appeared medicinal preparations containing an extract of Bacopa monnieri. B. monnieri has been used in the Ayurvedic system of medicine for centuries, especially to enhance cognitive functions. Active compounds in this plant include numerous saponins type dammarane, mainly bacoside A and B, alkaloids and sterols. The pharmacological research of the extract of Bacopa monnieri support traditional uses of this plant. The results of so far clinical studies of the extract from B. monnieri, indicate to beneficial effect on memory, learning and concentration in adults, children and to improve in anxiety and depression after prolonged administration, although further clinical studies are needed to confirm medical indications. It has been found to be well tolerated. The present review summarizes current knowledge of mechanisms of actions also presents of dietary supplements with B. monnieri.
Hagiwara, Nobuko
2017-01-01
The steadily falling costs of genome sequencing, coupled with the growing number of genetic tests with proven clinical validity, have made the use of genetic testing more common in clinical practice. This development has necessitated nongeneticist physicians, especially primary care physicians, to become more responsible for assessing genetic risks for their patients. Providing undergraduate medical students a solid foundation in genomic medicine, therefore, has become all the more important to ensure the readiness of future physicians in applying genomic medicine to their patient care. In order to further enhance the effectiveness of instructing practical skills in medical genetics, the emphasis of active learning modules in genetics curriculum at medical schools has increased in recent years. This is because of the general acceptance of a better efficacy of active learner-centered pedagogy over passive lecturer-centered pedagogy. However, an objective standard to evaluate students’ skill levels in genomic medicine achieved by active learning is currently missing. Recently, entrustable professional activities (EPAs) in genomic medicine have been proposed as a framework for developing physician competencies in genomic medicine. EPAs in genomic medicine provide a convenient guideline for not only developing genomic medicine curriculum but also assessing students’ competency levels in practicing genomic medicine. In this review, the efficacy of different types of active learning modules reported for medical genetics curricula is discussed using EPAs in genomic medicine as a common evaluation standard for modules’ learning outcomes. The utility of the EPAs in genomic medicine for designing active learning modules in undergraduate medical genetics curricula is also discussed. PMID:29276425
Hagiwara, Nobuko
2017-01-01
The steadily falling costs of genome sequencing, coupled with the growing number of genetic tests with proven clinical validity, have made the use of genetic testing more common in clinical practice. This development has necessitated nongeneticist physicians, especially primary care physicians, to become more responsible for assessing genetic risks for their patients. Providing undergraduate medical students a solid foundation in genomic medicine, therefore, has become all the more important to ensure the readiness of future physicians in applying genomic medicine to their patient care. In order to further enhance the effectiveness of instructing practical skills in medical genetics, the emphasis of active learning modules in genetics curriculum at medical schools has increased in recent years. This is because of the general acceptance of a better efficacy of active learner-centered pedagogy over passive lecturer-centered pedagogy. However, an objective standard to evaluate students' skill levels in genomic medicine achieved by active learning is currently missing. Recently, entrustable professional activities (EPAs) in genomic medicine have been proposed as a framework for developing physician competencies in genomic medicine. EPAs in genomic medicine provide a convenient guideline for not only developing genomic medicine curriculum but also assessing students' competency levels in practicing genomic medicine. In this review, the efficacy of different types of active learning modules reported for medical genetics curricula is discussed using EPAs in genomic medicine as a common evaluation standard for modules' learning outcomes. The utility of the EPAs in genomic medicine for designing active learning modules in undergraduate medical genetics curricula is also discussed.
Medicinal plants: An invaluable, dwindling resource in sub-Saharan Africa.
Moyo, Mack; Aremu, Adeyemi O; Van Staden, Johannes
2015-11-04
The use of plant species for different therapeutic/medicinal purposes is well-entrenched in sub-Saharan Africa. To provide a critical and updated review of the enormous medicinal plant heritage in sub-Saharan Africa with regards to the abundance, importance, conservation status and potential means to help sustain their availability for future generations. A comprehensive literature search involving different online databases, books and theses were conducted in order to obtain, collate and synthesize available information on various fundamental aspects pertaining to African medicinal plants. African biodiversity hotspots are endowed with a high level of endemic species with a significant portion possessing medicinal value. Apart from the extensive ethnobotanical uses of medicinal plants found in Africa, scientific validation of their biological potential such as antimicrobial, antioxidant, anti-inflammatory and anti-diabetic properties have been recognized. Together with the demand arising from their biological efficacies, other anthropogenic factors are exerting conservation strains of the wild population of these medicinal plants. Even though researchers have acknowledged the importance and value of conserving these medicinal plants, several challenges have hampered these efforts on the Continent as a whole. The rich flora occurring in sub-Saharan Africa suggests enormous potential for discovery of new chemical entity with therapeutic value. However, concerted efforts focused on documenting the conservation status of African medicinal plants are pertinent. Application of different biotechnological techniques is needed to sustain these valuable botanical entities, especially to meet increasing pharmaceutical demand. Most importantly, increased public enlightenment and awareness may help eradicate the prejudice against cultivation of medicinal plants. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
The role and effect of complementary and alternative medicine in systemic lupus erythematosus.
Haija, Anan J; Schulz, Steffan W
2011-02-01
The use of complementary and alternative medicine (CAM) is common among patients with systemic lupus erythematosus (SLE), especially those with active disease who often have poorer quality of life and significant unmet needs. It is important for the rheumatologist to be aware of these therapies and to ask the patient with SLE about their active use or future interest in CAM. Future studies on the effectiveness of the aforementioned therapies will be crucial to find better ways for the rheumatologist to integrate their use into the care of the patient with SLE. Published by Elsevier Inc.
Graudenz, K; Raulin, C
2003-07-01
Laser technology has considerably expanded therapeutic modalities in dermatology and aesthetic medicine. In addition, lasers have broadened the spectrum of diagnostic and therapeutic options in many other medical fields. Dermatologists, especially Dr. Leon Goldman, played an important role in the evolution and use of medical lasers. There was a long way from the concept of stimulated emission as the fundamental idea of laser technology by Albert Einstein in 1917 to the practical use of the laser today. We review the development of laser technology from the early days through the latest advances.
Application of virtual reality technology in clinical medicine
Li, Lan; Yu, Fei; Shi, Dongquan; Shi, Jianping; Tian, Zongjun; Yang, Jiquan; Wang, Xingsong; Jiang, Qing
2017-01-01
The present review discusses the application of virtual reality (VR) technology in clinical medicine, especially in surgical training, pain management and therapeutic treatment of mental illness. We introduce the common types of VR simulators and their operational principles in aforementioned fields. The clinical effects are also discussed. In almost every study that dealt with VR simulators, researchers have arrived at the same conclusion that both doctors and patients could benefit from this novel technology. Moreover, advantages and disadvantages of the utilization of VR technology in each field were discussed, and the future research directions were proposed. PMID:28979666
Application of virtual reality technology in clinical medicine.
Li, Lan; Yu, Fei; Shi, Dongquan; Shi, Jianping; Tian, Zongjun; Yang, Jiquan; Wang, Xingsong; Jiang, Qing
2017-01-01
The present review discusses the application of virtual reality (VR) technology in clinical medicine, especially in surgical training, pain management and therapeutic treatment of mental illness. We introduce the common types of VR simulators and their operational principles in aforementioned fields. The clinical effects are also discussed. In almost every study that dealt with VR simulators, researchers have arrived at the same conclusion that both doctors and patients could benefit from this novel technology. Moreover, advantages and disadvantages of the utilization of VR technology in each field were discussed, and the future research directions were proposed.
[Molecular imaging; current status and future prospects in USA].
Kobayashi, Hisataka
2007-02-01
The goal of this review is to introduce the definition, current status, and future prospects of the molecular imaging, which has recently been a hot topic in medicine and the biological science in USA. In vivo imaging methods to visualize the molecular events and functions in organs or animals/humans are overviewed and discussed especially in combinations of imaging modalities (machines) and contrast agents(chemicals) used in the molecular imaging. Next, the close relationship between the molecular imaging and the nanotechnology, an important part of nanomedicine, is stressed from the aspect of united multidisciplinary sciences such as physics, chemistry, biology, and medicine.
Mattsson, Karin; Nilsson, Inger
2002-12-12
The article gives a clinically oriented overview of the efficacy and safety of Ginkgo biloba, St. John's wort, ginseng, Echinacea, saw palmetto and kava based on American experiences. Clinical data support the efficacy for some of these drugs. None of them is free of adverse effects. Generally speaking, trials of herbal medicinal products have been too few, too small and too short. The lack of long-term studies is especially unfortunate since many of the drugs are used for a long time. The difference between American and Swedish legislation on herbal medicine products is described.
Efficiency Analysis of Integrated Public Hospital Networks in Outpatient Internal Medicine.
Ortíz-Barrios, Miguel Angel; Escorcia-Caballero, Juan P; Sánchez-Sánchez, Fabián; De Felice, Fabio; Petrillo, Antonella
2017-09-07
Healthcare systems are evolving towards a complex network of interconnected services due to the increasing costs and the increasing expectations for high service levels. It is evidenced in the literature the importance of implementing management techniques and sophisticated methods to improve the efficiency of healthcare systems, especially in emerging economies. This paper proposes an integrated collaboration model between two public hospitals to reach the reduction of weighted average lead time in outpatient internal medicine department. A strategic framework based on value stream mapping and collaborative practices has been developed in real case study settled in Colombia.
Are essential medicines in Malaysia accessible, affordable and available?
Saleh, Kamaruzaman; Ibrahim, Mohamed I M
2005-12-01
To assess the pharmaceutical sector to know whether people have access to essential medicines. The study was conducted in 20 public health clinics, five public district drug stores and 20 private retail pharmacies selected randomly in five different areas randomly selected (four states and a federal territory). The methodology used was adopted from the World Health Organization study protocol. The degree of attainment of the strategic pharmaceutical objectives of improved access is measured by a list of tested indicators. Access is measured in terms of the availability and affordability of essential medicines, especially to the poor and in the public sector. The first survey in the public health clinics and public district drug stores gathered information about current availability of essential medicines, prevalence of stock-outs and affordability of treatment (except drug stores). The second survey assessed affordability of treatment in public health clinics and private retail pharmacies. Availability, stock-out duration, percent of medicines dispensed, accessibility and affordability of key medicines. The average availability of key medicines in the public health clinics for the country was 95.4%. The average stock-out duration of key medicines was 6.5 days. However, average availability of key medicines in the public district drug stores was 89.2%; with an average stock-out duration of 32.4 days. Medicines prescribed were 100% dispensed to the patients. Average affordability for public health clinics was 1.5 weeks salary and for the private pharmacies, 3.7 weeks salary. The present pharmaceutical situation in the context of essential medicines list implementation reflected that the majority of the population in Malaysia had access to affordable essential medicines. If medicines need to be obtained from the private sector, they are hardly affordable. Although the average availability of essential medicines in Malaysia was high being more than 95.0%, in certain areas in Sabah availability was less than 80.0% and still a problem.
Kennedy, Kieran M; Scriver, Stacey
2016-11-01
Undergraduate medical curricula typically include forensic and legal medicine topics that are of a highly sensitive nature. Examples include suicide, child abuse, domestic and sexual violence. It is likely that some students will have direct or indirect experience of these issues which are prevalent in society. Those students are vulnerable to vicarious harm from partaking in their medical education. Even students with no direct or indirect experience of these issues may be vulnerable to vicarious trauma, particularly students who are especially empathetic to cases presented. Despite these risks, instruction relating to these topics is necessary to ensure the competencies of graduating doctors to respond appropriately to cases they encounter during their professional careers. However, risk can be minimised by a well-designed and thoughtfully delivered educational programme. We provide recommendations for the successful inclusion of sensitive forensic and legal medicine topics in undergraduate medical curricula. Copyright © 2016 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.
The Significance of an Enhanced Concept of the Organism for Medicine
2016-01-01
Recent developments in evolutionary biology, comparative embryology, and systems biology suggest the necessity of a conceptual shift in the way we think about organisms. It is becoming increasingly evident that molecular and genetic processes are subject to extremely refined regulation and control by the cell and the organism, so that it becomes hard to define single molecular functions or certain genes as primary causes of specific processes. Rather, the molecular level is integrated into highly regulated networks within the respective systems. This has consequences for medical research in general, especially for the basic concept of personalized medicine or precision medicine. Here an integrative systems concept is proposed that describes the organism as a multilevel, highly flexible, adaptable, and, in this sense, autonomous basis for a human individual. The hypothesis is developed that these properties of the organism, gained from scientific observation, will gradually make it necessary to rethink the conceptual framework of physiology and pathophysiology in medicine. PMID:27446221
[Perspectives of psychoanalytic psychosomatics].
Küchenhoff, J
2001-01-01
The paper discusses a variety of perspectives of psychoanalytic psychosomatics in the past, the present and the future. An epigenetic model of scientific development is introduced and developmental strains in psychosomatic medicine are evaluated according to the claims of the bio-psycho-social model. In historical terms, the psychological dimension of psychoanalytic psychosomatics has been the first strain to be elaborated; it is being extended still. The biological, somatic and bodily dimension of psychosomatic medicine was the next to be explored; during the last decade, this strain has found increasing interest, especially neurobiological research. Though the social dimension has not been neglected, it will be the main task for psychoanalytic psychosomatics to consider in the future. Likewise, a mandatory future challenge will be a more intensive discussion of the epistemological basis of psychosomatic medicine and psychoanalytic psychosomatics. The historical development of psychosomatic medicine is highlighted by examples drawn mainly from the history of Heidelberg Psychosomatic University Clinic that has its 50th anniversary in 2000.
A Survey of Chinese Medicinal Herbal Treatment for Chemotherapy-Induced Oral Mucositis
Meyer-Hamme, Gesa; Beckmann, Kathrin; Radtke, Janine; Efferth, Thomas; Greten, Henry Johannes; Rostock, Matthias; Schröder, Sven
2013-01-01
Oral mucositis is one of the common side effects of chemotherapy treatment with potentially severe implications. Despite several treatment approaches by conventional and complementary western medicine, the therapeutic outcome is often not satisfactory. Traditional Chinese Medicine (TCM) offers empirical herbal formulas for the treatment of oral ulceration which are used in adaptation to chemotherapy-induced mucositis. While standard concepts for TCM treatment do not exist and acceptance by conventional oncologists is still low, we conducted a review to examine the evidence of Chinese herbal treatment in oral mucositis. Eighteen relevant studies on 4 single herbs, 2 combinations of 2 herbs, and 11 multiherbal prescriptions involving 3 or more compounds were included. Corresponding molecular mechanisms were investigated. The knowledge about detailed herbal mechanisms, especially in multi-herbal prescriptions is still limited. The quality of clinical trials needs further improvement. Meta-analysis on the existent database is not possible but molecular findings on Chinese medicinal herbs indicate that further research is still promising for the treatment of chemotherapy-induced oral mucositis. PMID:24285975
From evidence based medicine to mechanism based medicine. Reviewing the role of pharmacogenetics.
Wilffert, Bob; Swen, Jesse; Mulder, Hans; Touw, Daan; Maitland-Van der Zee, Anke-Hilse; Deneer, Vera
2013-06-01
The translation of evidence based medicine to a specific patient presents a considerable challenge. We present by means of the examples nortriptyline, tramadol, clopidogrel, coumarins, abacavir and antipsychotics the discrepancy between available pharmacogenetic information and its implementation in daily clinical practice. Literature review. A mechanism based approach may be helpful to personalize medicine for the individual patient to which pharmacogenetics may contribute significantly. The lack of consistency in what we accept in bioequivalence and in pharmacogenetics of drug metabolising enzymes is discussed and illustrated with the example of nortriptyline. The impact of pharmacogenetics on examples like tramadol, clopidogrel, coumarins and abacavir is described. Also the present status of the polymorphisms of 5-HT2A and C receptors in antipsychotic-induced weight gain is presented as a pharmacodynamic example with until now a greater distance to clinical implementation. The contribution of pharmacogenetics to tailor-made pharmacotherapy, which especially might be of value for patients deviating from the average, has not yet reached the position it seems to deserve.
Bajpai, Vivek K; Park, Yong-Ha; Na, MinKyun; Kang, Sun Chul
2015-03-26
Nowadays plant derived natural compounds have gained huge amount of research attention especially in food and medicine industries due to their multitude of biological and therapeutic properties as alternative medicines. In this study, a diterpenoid compound taxoquinone, isolated from Metasequoia glyptostroboides was evaluated for its α-glucosidase and tyrosinase inhibitory efficacy in terms of its potent anti-diabetic and depigmentation potential, respectively. As a result, taxoquinone at the concentration range of 100-3,000 μg/mL and 200-1,000 μg/mL showed potent efficacy on inhibiting α-glucosidase and tyrosinase enzymes by 9.24-51.32% and 11.14-52.32%, respectively. The findings of this study clearly evident potent therapeutic efficacy of an abietane diterpenoid taxoquinone isolated from M. glyptostroboides with a possibility for using it as a novel candidate in food and medicine industry as a natural alternative medicine to prevent diabetes mellitus type-2 related disorders and as a depigmentation agent.
Woman, M.D.: issues, perceptions and choices.
Johns, C. J.
1996-01-01
I would end with some summarizing points and questions. 1. A majority of women identify gender-related issues influencing their career choices and pathways. 2. Women are diverse in their choices and priorities, with varying balances of personal and professional life. 3. Eighty-three percent of the women responding to the survey have married, and 82% of those married have children. They thus are likely to have two sets of seriously competing responsibilities. 4. It is possible to identify especially promising women during residency or fellowship. Exploring their priorities and values with good mentors will be important to avoid short-changing academic medicine of competent women. 5. Men and women need to be SUPERCHOOSERS in making the choices right for that individual, rather than superwomen or supermen. 6. We can question whether the development and potential of women (and some men) in academic medicine could be enhanced by: a. Consideration of guidance or support for child care resources? b. Flexibility in the system (tenure clock, etc.)? c. Identification of limited full-time clinical or research opportunities for faculty with young children or unusual family demands? d. Facilitation of bridging after a period of part-time activity or re-entry after limited participation? e. Consideration of part-time work at home and flexible on-site work hours for periods of special family demands? Finally, a supportive work environment is important for both men and women in medicine and is an essential priority in academic medicine. Medicine is a wonderful field. Academic medicine on my terms, to include family, has been very rewarding. Sometimes there also have been disappointments, in that I have fallen short of some of my aspirations. However, I must accept the responsibility for my choices. I owe a great debt to many of the men and women of the American Clinical and Climatological Association and of Johns Hopkins who are both friends and colleagues and especially to my husband, Dick Johns. After 42 years of marriage, I am still learning about the balance of personal and professional life. May we all be Superchoosers! PMID:8725556
Woman, M.D.: issues, perceptions and choices.
Johns, C J
1996-01-01
I would end with some summarizing points and questions. 1. A majority of women identify gender-related issues influencing their career choices and pathways. 2. Women are diverse in their choices and priorities, with varying balances of personal and professional life. 3. Eighty-three percent of the women responding to the survey have married, and 82% of those married have children. They thus are likely to have two sets of seriously competing responsibilities. 4. It is possible to identify especially promising women during residency or fellowship. Exploring their priorities and values with good mentors will be important to avoid short-changing academic medicine of competent women. 5. Men and women need to be SUPERCHOOSERS in making the choices right for that individual, rather than superwomen or supermen. 6. We can question whether the development and potential of women (and some men) in academic medicine could be enhanced by: a. Consideration of guidance or support for child care resources? b. Flexibility in the system (tenure clock, etc.)? c. Identification of limited full-time clinical or research opportunities for faculty with young children or unusual family demands? d. Facilitation of bridging after a period of part-time activity or re-entry after limited participation? e. Consideration of part-time work at home and flexible on-site work hours for periods of special family demands? Finally, a supportive work environment is important for both men and women in medicine and is an essential priority in academic medicine. Medicine is a wonderful field. Academic medicine on my terms, to include family, has been very rewarding. Sometimes there also have been disappointments, in that I have fallen short of some of my aspirations. However, I must accept the responsibility for my choices. I owe a great debt to many of the men and women of the American Clinical and Climatological Association and of Johns Hopkins who are both friends and colleagues and especially to my husband, Dick Johns. After 42 years of marriage, I am still learning about the balance of personal and professional life. May we all be Superchoosers!
Vlieger, Arine M; Blink, Marjolein; Tromp, Ellen; Benninga, Marc A
2008-08-01
Many pediatric patients use complementary and alternative medicine, especially when facing a chronic illness for which treatment options are limited. So far, research on the use of complementary and alternative medicine in patients with functional gastrointestinal disease has been scarce. This study was designed to assess complementary and alternative medicine use in children with different gastrointestinal diseases, including functional disorders, to determine which factors predicted complementary and alternative medicine use and to assess the willingness of parents to participate in future studies on complementary and alternative medicine efficacy and safety. The prevalence of complementary and alternative medicine use was assessed by using a questionnaire for 749 children visiting pediatric gastroenterology clinics of 9 hospitals in the Netherlands. The questionnaire consisted of 35 questions on the child's gastrointestinal disease, medication use, health status, past and future complementary and alternative medicine use, reasons for its use, and the necessity of complementary and alternative medicine research. In this study population, the frequency of complementary and alternative medicine use was 37.6%. A total of 60.3% of this group had used complementary and alternative medicine specifically for their gastrointestinal disease. This specific complementary and alternative medicine use was higher in patients with functional disorders than organic disorders (25.3% vs 17.2%). Adverse effects of allopathic medication, school absenteeism, age
Traditional uses of medicinal plants in gastrointestinal disorders in Nepal.
Rokaya, Maan B; Uprety, Yadav; Poudel, Ram C; Timsina, Binu; Münzbergová, Zuzana; Asselin, Hugo; Tiwari, Achyut; Shrestha, Shyam S; Sigdel, Shalik R
2014-12-02
Gastrointestinal disorders cause morbidity and can lead to mortality, especially in the developing world where sanitation is deficient. A large part of the human population relies on medicinal plants for treating various diseases, including gastrointestinal disorders. The present review summarizes the traditional uses of medicinal plants of Nepal used to treat gastrointestinal disorders, and evaluates their bio-efficacy based on a review of the available phytochemical and pharmacological literature. We searched different electronic databases and libraries for the literature on medicinal plants used in Nepal to treat gastrointestinal disorders. For each species, we also searched the literature for information on conservation status, as well as for phytochemical and pharmacological studies in support of the ethnobotanical information. We used principal component analysis to explore the relation among disorders and plant families, plant life forms, plant parts and preparation modes. We also performed permutation tests to determine if botanical families were used more often than expected considering their availability in the Nepali flora. We documented a total of 947 species belonging to 158 families and 586 genera used to treat gastrointestinal disorders in Nepal. Diarrhea was the disorder treated by the highest number of species (348), followed by stomachache (340) and dysentery (307). Among the reported species, five were endemic to Nepal, whereas 16 orchid species were protected under CITES Appendices II and III. The randomization test showed that species belonging to 14 families were used less often than expected, whereas plants belonging to 25 families were used more often than expected. The PCA scatter plot showed distinct groups of gastrointestinal disorders treated with similar plant life forms, plant parts, and/or preparation modes. We found 763 phytochemical studies on 324 species and 654 pharmacological studies on 269 species. We showed the diversity and importance of medicinal plants used to treat gastrointestinal disorders in the traditional health care system of Nepal. As such disorders are still causing several deaths each year, it is of the utmost importance to conduct phytochemical and pharmacological studies on the most promising species. It is also crucial to increase access to traditional medicine, especially in rural areas. Threatened species need special attention for traditional herbal medicine to be exploited sustainably. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Consumers' views on generic medicines: a review of the literature.
Hassali, Mohamed A A; Shafie, Asrul A; Jamshed, Shazia; Ibrahim, Mohamed I M; Awaisu, Ahmed
2009-04-01
To review the literature on consumers' knowledge, attitudes and opinions of the use of generic medicines. A narrative review of studies conducted from 1970 to 2008 on consumers perceptions and views towards generic medicines was performed. An extensive literature search was undertaken using indexing services available at the authors' institution library. The following keywords were used for the search: brand, generic, multisource, medications, medicines, drugs, pharmaceuticals and consumers, customers, and patients. Electronic databases searched were Medline, Inside Web, ISI Web of Knowledge, Science Direct, Springer Link, JSTOR, Proquest, Ebsco Host and Google Scholar. These electronic databases were searched for full text papers published in English from 1970 to October 2008. Twenty studies were identified. Eleven were from the USA, four were from Europe, two were from Canada and one each was from Australia, Brazil and Malaysia. In general, consumers showed mixed reactions towards the use of generic medicines. This was evident from the divergence of views observed by country development level, consumers' socioeconomic characteristics, drug product characteristics, pharmaceutical reimbursement system, policy environment, contact with health care professionals, past experience with medications, and knowledge of the seriousness of a medical condition. Patient confidence and knowledge pertaining to generic medicines use have increased over the past four decades, especially in developed countries. Mass educational efforts, financial incentives, and greater communication among patients and health care professionals were seen as major drivers to the uptake of generic medicines among consumers.
[Confused Germanic blasphemy. Jacob Moleschott and materialistic medicine].
de Liguori, Girolamo
2005-01-01
Starting from the reading of a recent biography of the Dutch materialistic physiologist Jacopo Moleschott (1822-1893), this article proposes a brief survey of the impact, especially in Italy, of the materialistic paradigm, not only in the field of medicine and of the natural sciences, but also in that of philosophy and of literature. From the rejection and ferocious criticisms of the Jesuits, such as Padre Previti, to the harsh ironies of Tommaseo--who, in reference to the academic lessons of Moleschott, spoke of "confused Germanic blasphemy"--, the survey proceeds to a recognition of the role and influence of Moleschott's perspective in the field of medicine, in that of science, and especially in the philosophical and epistemological debate on the relation between the experimental sciences and philosophy. The survey then proceeds to touch on the classical controversy over the Chemische Briefe of Liebig (1844), the dispute with Bufalini on the new way of thinking about the relation between physiology and pathology, and the influence exerted by the Dutch physiologist on Salvatore Tommasi. The article in the end broadens to include a rapid analysis of Moleschott's contribution to the field of literature, as well as to the more complicated debate on the natural sciences and materialism, which still today presents, beyond the outdated models of positivistic scientism, well-grounded themes of interest, if not of validity.
Search and Evaluation of Learning Materials for Ophthalmology, 1973-1975.
ERIC Educational Resources Information Center
Prince, Arlene Leinbach; And Others
A study of instructional materials, especially media, available for ophthalmology teaching was initiated at the University of Washington School of Medicine in March 1973. Some 115 catalog and distribution sources were contracted, from which more than 200 potential titles were identified. Fifty three materials were reviewed and evaluated. Six…
Health Care Communication: A Problematic Site for Applied Linguistics Research.
ERIC Educational Resources Information Center
Candlin, Christopher N.; Candlin, Sally
2003-01-01
Addresses how applied linguists and those concerned with discourse analysis in particular have recently approached the study of health care communication, especially in intercultural contexts, and relates these approaches to studies undertaken by researchers in other academic disciplines, such as the sociology of medicine and by health care…
Hospital Bioethics: A Beginning Knowledge Base for the Neonatal Social Worker.
ERIC Educational Resources Information Center
Silverman, Ed
1992-01-01
Notes that life-saving advances in medicine have created difficult ethical and legal dilemmas for health care professionals. Presents beginning knowledge base for bioethical practice, especially in hospital neonatal units. Outlines key elements of bioethical decision making and examines potential social work role from clinical and organizational…
Clinical Reasoning Skills of Speech and Language Therapy Students
ERIC Educational Resources Information Center
Hoben, Kirsty; Varley, Rosemary; Cox, Richard
2007-01-01
Background: Difficulties experienced by novices in clinical reasoning have been well documented in many professions, especially medicine (Boshuizen and Schmidt 1992, 2000; Elstein, Shulman and Sprafka 1978; Patel and Groen 1986; Rikers, Loyens and Schmidt 2004). These studies have shown that novice clinicians have difficulties with both knowledge…
The Core Course in Medical Microbiology at Baylor College of Medicine
ERIC Educational Resources Information Center
Knight, Vernon; And Others
1978-01-01
Principal features of Baylor's course are annually-revised lecture handouts, medically-oriented laboratory sessions with a manual written especially for the course, and clinical demonstrations of infectious disease. Improvement in student performance seems to be related to the course format, increased teaching proficiency, and allocations of hours…
Crop development related to temperature and photoperiod
USDA-ARS?s Scientific Manuscript database
Plant development, or the progression of plants through their life cycle, has been of great interest in human history because of the need to know and predict when the harvested part of the plant was at the optimum stage. This knowledge was especially important (even vital) in medicinal plants, where...
Precision medicine has been made possible by the translation of ‘omics to the clinic, and human microbiome studies must likewise transition to applications in public health. This will require especially robust measurements and assimilation of data from multiple population-scale c...
Shafiq, Yasir; Shaikh, Babar Tasneem; Kumar, Ramesh
2011-01-01
Child health outcomes in the poor communities are largely affected by the non-availability of essential medicines at government health facilities and non-affordability of prescribed medicines at private retail pharmacies. This phenomenon largely defines health seeking behaviours and health service utilisation patterns of the families of the children. Using observational visits, we examined the shelf-availability of medicines for children less than 5 years of age at a rural health centre and conducted focus group discussions with the mothers to explore the effects of non-availability and non-affordability of medicines. We also validated all information by interviewing the health care providers of the area. We found that erratic and insufficient supply of essential medicines at the government health facility and a limited purchasing power to buy medicines from a retail pharmacy, led to considerable 'financial burden' on the poor people, non-compliance with the treatment, health care seeking from informal health providers and healer shopping. This trend has a serious repercussion on the health seeking behaviours and of course the health outcomes, especially among children. On the users' side, health education and health promotion campaign must be instituted to explain the adverse effects on child health ensure appropriate health care seeking behaviours. For the supply side, the health care authorities must ensure the availability of essential medicines for the children at the government facilities. Local community representatives must be involved in the matters related to medicines stock management at the facility.
Tian, Jing-Zhuo; Liang, Ai-Hua; Liu, Jing; Zhang, Bo-Li
2017-12-01
Aristolochic acids (AAs) widely exist in such plants as Aristolochia and Asarum. The renal toxicity of AAs as well as its carcinogenicity to urinary system have been widely known. In 2003 and 2004, China prohibited the use of Aristolochiae Radix, Aristolochiae Manshuriensis Caulis and Aristolochiae Fangchi Radix, and required administering other AAs-containing medicines in accordance with the regulations for prescription drugs. In this paper, we retrieved literatures on the content determination of AAs in recent 10 years in China. It suggested that the AAs content is lower in Asarum herb, especially in its roots and rhizomes, and most of which do not show detectable amount of AA-I. Some of traditional Chinese medicines show fairly small amount of detectable AA-I. The AAs content in Aristolochia herb (including Fructus Aristolochiae, kaempfer dutchmanspipe root) is relatively high; however, there are fewer literatures for studying the content determination of AAs in Chinese patent medicines. There were many factors affecting AAs content, including the parts used, origins, processing methods, extraction process. It suggested that we should pay attention to the toxicity of Chinese medicines containing AAs and use these decoction pieces and traditional Chinese medicines cautiously. In addition, basic studies for the origins, processing methods and extraction process of Chinese patent medicines containing AAs, as well as supervision and detection of AAs content in traditional Chinese medicinal materials, decoction pieces and Chinese patent medicines shall be strengthened for reducing medication risk and guaranteeing clinical medication safety. Copyright© by the Chinese Pharmaceutical Association.
Gureje, Oye; Nortje, Gareth; Makanjuola, Victor; Oladeji, Bibilola D; Seedat, Soraya; Jenkins, Rachel
2015-02-01
Traditional and complementary systems of medicine include a broad range of practices, which are commonly embedded in cultural milieus and reflect community beliefs, experiences, religion, and spirituality. Two major components of this system are discernible: complementary alternative medicine and traditional medicine, with different clientele and correlates of patronage. Evidence from around the world suggests that a traditional or complementary system of medicine is commonly used by a large number of people with mental illness. Practitioners of traditional medicine in low-income and middle-income countries fill a major gap in mental health service delivery. Although some overlap exists in the diagnostic approaches of traditional and complementary systems of medicine and conventional biomedicine, some major differences exist, largely in the understanding of the nature and cause of mental disorders. Treatments used by providers of traditional and complementary systems of medicine, especially traditional and faith healers in low-income and middle-income countries, might sometimes fail to meet widespread understandings of human rights and humane care. Nevertheless, collaborative engagement between traditional and complementary systems of medicine and conventional biomedicine might be possible in the care of people with mental illness. The best model to bring about that collaboration will need to be established by the needs of the extant mental health system in a country. Research is needed to provide an empirical basis for the feasibility of such collaboration, to clearly delineate its boundaries, and to test its effectiveness in bringing about improved patient outcomes. Copyright © 2015 Elsevier Ltd. All rights reserved.
The Stability of Medicinal Plant microRNAs in the Herb Preparation Process.
Xie, Wenyan; Melzig, Matthias F
2018-04-16
Herbal medicine is now globally accepted as a valid alternative system of pharmaceutical therapies. Various studies around the world have been initiated to develop scientific evidence-based herbal therapies. Recently, the therapeutic potential of medicinal plant derived miRNAs has attracted great attraction. MicroRNAs have been indicated as new bioactive ingredients in medicinal plants. However, the stability of miRNAs during the herbal preparation process and their bioavailability in humans remain unclear. Viscum album L. (European mistletoe) has been widely used in folk medicine for the treatment of cancer and cardiovascular diseases. Our previous study has indicated the therapeutic potential of mistletoe miRNAs by using bioinformatics tools. To evaluate the stability of these miRNAs, various mistletoe extracts that mimic the clinical medicinal use as well as traditional folk medicinal use were prepared. The mistletoe miRNAs including miR166a-3p, miR159a, miR831-5p, val-miR218 and val-miR11 were quantified by stem-loop qRT-PCR. As a result, miRNAs were detectable in the majority of the extracts, indicating that consumption of medicinal plant preparations might introduce miRNAs into mammals. The factors that might cause miRNA degradation include ultrasonic treatment, extreme heat, especially RNase treatment, while to be associated with plant molecules (e.g., proteins, exosomes) might be an efficient way to protect miRNAs against degradation. Our study confirmed the stability of plant derived miRNAs during herb preparations, suggesting the possibility of functionally intact medicinal plant miRNAs in mammals.
Xu, Bing-Qing; Zhang, Yu-Qing
2017-01-01
Background: G. divaricata (L.) DC belongs to genus the Gynura Cass which is a kind of perennial herb that has good health protection efficacy and is especially used widely in medicine and functional food. It is one of the most famous traditional Chinese medicinal herbs and is usually used to cure bronchitis, pulmonary tuberculosis, kink cough, rheumatism, diabetes, and so on. It has a long history for the treatment of diabetes mellitus in the folk medicine. This review is aimed at gathering all information relating to G. divaricata and obtaining new insights for further studies on G. divaricata Materials and Methods: PubMed, Springer Link, Web of Science, Science Direct and Research Gate were used for the literature search. The key search terms included G. divaricata isolation and identification, flavonoids and their combinations without language restriction. The period for the search is from year 1979 to 2016. Results: The main chemical components were listed, and the folk application, the extraction and separation methods of main chemical components, pharmacological effects of G. divaricata were discussed, which further demonstrated the plant’s value as health food and medicine. Conclusion: The present review is of great significance to the development of new medicinal resources and health food of G. divaricata PMID:28480422
Update on value-based medicine.
Brown, Melissa M; Brown, Gary C
2013-05-01
To update concepts in Value-Based Medicine, especially in view of the Patient Protection and Affordable Care Act. The Patient Protection and Affordable Care Act assures that some variant of Value-Based Medicine cost-utility analysis will play a key role in the healthcare system. It identifies the highest quality care, thereby maximizing the most efficacious use of healthcare resources and empowering patients and physicians.Standardization is critical for the creation and acceptance of a Value-Based Medicine, cost-utility analysis, information system, since 27 million different input variants can go into a cost-utility analysis. Key among such standards is the use of patient preferences (utilities), as patients best understand the quality of life associated with their health states. The inclusion of societal costs, versus direct medical costs alone, demonstrates that medical interventions are more cost effective and, in many instances, provide a net financial return-on-investment to society referent to the direct medical costs expended. Value-Based Medicine provides a standardized methodology, integrating critical, patient, quality-of-life preferences, and societal costs, to allow the highest quality, most cost-effective care. Central to Value-Based Medicine is the concept that all patients deserve the interventions that provide the greatest patient value (improvement in quality of life and/or length of life).
Jost, Nils; Schüssler-Lenz, Martina; Ziegele, Bettina; Reinhardt, Jens
2015-11-01
The aim of scientific advice is to support pharmaceutical developers in regulatory and scientific questions, thus facilitating the development of safe and efficacious new medicinal products. Recent years have shown that the development of advanced therapy medicinal products (ATMPs) in particular needs a high degree of regulatory support. On one hand, this is related to the complexity and heterogeneity of this group of medicinal products and on the other hand due to the fact that mainly academic research institutions and small- and medium-sized enterprises (SMEs) are developing ATMPs. These often have limited regulatory experience and resources. In 2009 the Paul-Ehrlich-Institut (PEI) initiated the Innovation Office as a contact point for applicants developing ATMPs. The mandate of the Innovation Office is to provide support on regulatory questions and to coordinate national scientific advice meetings concerning ATMPs for every phase in drug development and especially with view to the preparation of clinical trial applications. On the European level, the Scientific Advice Working Party (SAWP) of the Committee for Medicinal Products for Human Use (CHMP) of the European Medicinal Agency (EMA) offers scientific advice. This article describes the concepts of national and EMA scientific advice concerning ATMPs and summarizes the experience of the last six years.
Militares medici in nummis repraesentati: the heritage of military medicine in coins and medals.
Pearn, John
2002-01-01
Coins and commemorative medals constitute one special repository of the history of military medicine. The numismatic record has proven to be the most enduring, albeit one of the most selective, records of the progress of history. Matters of health, and especially of military medicine, have been central to the endeavors and indeed the survival of many cultures and societies. Many such themes in the national and international history of military medicine are preserved in the medallic record. Coins and medallions thus constitute one record of the chronology of this profession, one parallel to that of the more traditional history to be found in oral and written records. This account presents a four-part classification of medical coins and medals of military interest. These examples include (1) medals that portray military surgeons and physicians; (2) medals that commemorate special events of military medicine: (3) coins that portray the themes of the discipline of military medicine and health; and (4) a miscellaneous group that includes such examples as disease "touch pieces" and the militarily worn medals of such bodies as the International Red Cross and the Order of St. John, the latter of which are awarded inter alia for contributions to prehospital care in the field. A representative photo archive of such exemplars is included in this account.
Social Justice as the Moral Core of Family Medicine: A Perspective from the Keystone IV Conference.
Schroeder, Steven A
2016-01-01
A recurring conference theme was the essential place of social justice within family medicine, especially the need to focus on denominator populations, exalt the personal and caring qualities of doctoring, and address social determinants of health. Many expressed solidarity with "community," but it is not always easy to define community in our large and diverse nation. Exhortations for health advocacy were frequently voiced, but putting these into meaningful action agendas is a challenge. There was general agreement that medicine is in flux and that the many expressions of "commodity-centered consumerism" have altered organization and financing. The increasing demands by "consumers", who want low cost, instant availability, and shared decision-making, and yet change doctors when health plans alter coverage also differentially impact high-volume, low-margin specialties such as family medicine. Additional challenges were the electronic health record and calibrating an appropriate work/life balance. Five action steps are recommended: 1) speak out on the important social and moral issues; 2) be the experts on personal care; 3) make common cause with potential allies; 4) help institutions perceive the value of generalism; and 5) help find ways to enrich generalist disciplines to increase the joy of medicine and decrease the threat of burn out. © Copyright 2016 by the American Board of Family Medicine.
Recent developments with boron as a platform for novel drug design.
Leśnikowski, Zbigniew J
2016-06-01
After decades of development, the medicinal chemistry of compounds that contain a single boron atom has matured to the present status of having equal rights with other branches of drug discovery, although it remains a relative newcomer. In contrast, the medicinal chemistry of boron clusters is less advanced, but it is expanding and may soon become a productive area of drug discovery. The author reviews the current developments of medicinal chemistry of boron and its applications in drug design. First generation boron drugs that bear a single boron atom and second generation boron drugs that utilize boron clusters as pharmacophores or modulators of bioactive molecules are discussed. The advantages and gaps in our current understanding of boron medicinal chemistry, with a special focus on boron clusters, are highlighted. Boron is not a panacea for every drug discovery problem, but there is a good chance that it will become a useful addition to the medicinal chemistry tool box. The present status of boron resembles the medicinal chemistry status of fluorine three decades ago; indeed, currently, approximately 20% of pharmaceuticals on the market contain fluorine. The fact that novel boron compounds, especially those based on abiotic polyhedral boron hydrides, are currently unfamiliar could be advantageous because organisms may be less prone to developing resistance against boron cluster-based drugs.
Xu, Bing-Qing; Zhang, Yu-Qing
2017-01-01
G. divaricata (L.) DC belongs to genus the Gynura Cass which is a kind of perennial herb that has good health protection efficacy and is especially used widely in medicine and functional food. It is one of the most famous traditional Chinese medicinal herbs and is usually used to cure bronchitis, pulmonary tuberculosis, kink cough, rheumatism, diabetes, and so on. It has a long history for the treatment of diabetes mellitus in the folk medicine. This review is aimed at gathering all information relating to G. divaricata and obtaining new insights for further studies on G. divaricata . PubMed, Springer Link, Web of Science, Science Direct and Research Gate were used for the literature search. The key search terms included G. divaricata isolation and identification, flavonoids and their combinations without language restriction. The period for the search is from year 1979 to 2016. The main chemical components were listed, and the folk application, the extraction and separation methods of main chemical components, pharmacological effects of G. divaricata were discussed, which further demonstrated the plant's value as health food and medicine. The present review is of great significance to the development of new medicinal resources and health food of G. divaricata .
Jia, Lu-Lu; Lou, Xiang-Ying; Guo, Ying; Leung, Kelvin Sze-Yin; Zeng, Eddy Y
2017-01-01
Food, air, personal care products and indoor dust have been recognized as the main routes of exposure to phthalates in Chinese population, but other sources may have been overlooked, e.g., medicines. To fill the knowledge gap, phthalate esters were measured in 96 over-the-counter medicines made in China, including selected 71 Chinese patented medicines and 25 western medicines. It was found that none of the medicines was free of phthalates. The mean concentrations of individual phthalates ranged from 0.001μg/g (dicyclohexyl phthalate) to 5.85μg/g (diethyl phthalate). Among 9 targeted phthalates, di-n-butyl phthalate was the dominant congener, accounting for >65% of the total phthalates in all medicine samples, followed by di-(2-ethylhexyl) phthalate and diethyl phthalate. Phthalates in medicines appeared to derive from gastroresistant film coatings, plastic packing materials or phthalate contaminated rural herbal plants (especially for Chinese patented medicines). Daily human exposure to phthalates was estimated for local patients for one treatment cycle (e.g., one week) based on suggested consumption dosage and phthalate concentrations. Almost all exposure levels were below the guidelines suggested by the United States Environmental Protection Agency or European Food Safety Authority, indicating low health risk with phthalates from consumption of the medicines. In addition, concentration levels of phthalates in patients would increase upon administration but are expected to decrease to the same values as those in patients before they took medicines in several days. Because the number of medicine samples was limited and the concentrations of phthalates varied in a large range, further investigations are needed to acquire more data for better assessment of human health effects for Chinese population. Capsule: Distribution of phthalate esters in over-the-counter medicines and related exposure for Chinese population are examined. Copyright © 2016 Elsevier Ltd. All rights reserved.
Zhang, Bo-Bo; Hu, Peng-Fei; Huang, Jing; Hu, Yong-Dan; Chen, Lei; Xu, Gan-Rong
2017-12-06
In recent years, Antrodia cinnamomea has attracted great attention around the world as an extremely precious edible and medicinal mushroom. Ubiquinone derivatives, which are characteristic metabolites of A. cinnamomea, have shown great bioactivities. Some of them have been regarded as promising therapeutic agents and approved into clinical trial by the U.S. Food and Drug Administration. Although some excellent reviews have been published covering different aspects of A. cinnamomea, this review brings, for the first time, complete information about the structure, bioactivity, chemical synthesis, biosynthesis, and metabolic regulation of ubiquinone derivatives in A. cinnamomea. It not only advances our knowledge on the bioactive metabolites, especially the ubiquinone derivatives, in A. cinnamomea but also provides valuable information for the investigation on other edible and medicinal mushrooms.
dos Santos, Laura Carvalho
2008-01-01
Early nineteenth century Brazil saw a vibrant movement to study nature, including a number of expeditions aimed at gathering a corpus of knowledge on Brazilian flora. One of the main goals of these expeditions was to map and identify plant species of economic and therapeutic value. The government undertook and sponsored various initiatives, and it was within this context that the Bahian voyager Antônio Moniz de Souza engaged in his activities. He traveled through areas of the Brazilian territory in the first decades of the nineteenth century, observing, cataloging, and collecting products from the three kingdoms, especially plants with medicinal powers. This study of Moniz de Souza pinpoints and analyzes important features in the exploration of nature and knowledge and the use of medicinal plants during this timeframe.
Mushrooms: A Potential Natural Source of Anti-Inflammatory Compounds for Medical Applications
Elsayed, Elsayed A.; El Enshasy, Hesham; Wadaan, Mohammad A. M.; Aziz, Ramlan
2014-01-01
For centuries, macrofungi have been used as food and medicine in different parts of the world. This is mainly attributed to their nutritional value as a potential source of carbohydrates, proteins, amino acids, and minerals. In addition, they also include many bioactive metabolites which make mushrooms and truffles common components in folk medicine, especially in Africa, the Middle East, China, and Japan. The reported medicinal effects of mushrooms include anti-inflammatory effects, with anti-inflammatory compounds of mushrooms comprising a highly diversified group in terms of their chemical structure. They include polysaccharides, terpenoids, phenolic compounds, and many other low molecular weight molecules. The aims of this review are to report the different types of bioactive metabolites and their relevant producers, as well as the different mechanisms of action of mushroom compounds as potent anti-inflammatory agents. PMID:25505823
[OMICS AND BIG DATA, MAJOR ADVANCES TOWARDS PERSONALIZED MEDICINE OF THE FUTURE?].
Scheen, A J
2015-01-01
The increasing interest for personalized medicine evolves together with two major technological advances. First, the new-generation, rapid and less expensive, DNA sequencing method, combined with remarkable progresses in molecular biology leading to the post-genomic era (transcriptomics, proteomics, metabolomics). Second, the refinement of computing tools (IT), which allows the immediate analysis of a huge amount of data (especially, those resulting from the omics approaches) and, thus, creates a new universe for medical research, that of analyzed by computerized modelling. This article for scientific communication and popularization briefly describes the main advances in these two fields of interest. These technological progresses are combined with those occurring in communication, which makes possible the development of artificial intelligence. These major advances will most probably represent the grounds of the future personalized medicine.
Onyiapat, Jane-Lovena; Okafor, Chinyelu; Okoronkwo, Ijeoma; Anarado, Agnes; Chukwukelu, Ekene; Nwaneri, Ada; Okpala, Pat
2017-04-04
The use of CAM by pregnant women is very popular in developed countries. The trend is increasing globally and lack of evidence of safety particularly when used during pregnancy may lead to complications. Pregnancy is a vulnerable period especially during the first trimester. There is scarcity of empirical evidence on CAM use particularly among women in Udi LGA of Enugu State and South East Nigeria. Moreover, studies carried out in Nigeria have been limited to herbal medicine use, which is one aspect of CAM. This study was designed to obtain information on the use of Complementary and Alternative Medicine among pregnant women. The study was a cross sectional descriptive survey of 396 pregnant women systematically drawn from twenty political wards in Udi Local Government Area (LGA) of Enugu State. Interviewer administered questionnaire developed by the researchers was used for data collection. Data were analyzed using descriptive statistics. Majority (82.1%) of the pregnant women in Udi LGA used CAM during pregnancy out of which 53.8% had used CAM in previous pregnancies. CAM used ranges from one single type to sixteen different types with biological products eg, herbal tea, herbal mixture being the most commonly used CAM. Whereas most (89.5%) of the CAM used by pregnant women was consumed orally, approximately half of the pregnant women used CAM together with conventional medicine. The use of CAM by women during pregnancy was high in Udi LGA. Therefore, maternity care providers especially midwives need to elicit CAM commonly used by women during pregnancy and counsel them appropriately for best care and safety. Researchers should focus on establishing the efficacy of CAM products.
Raspe, Matthias; Vogelgesang, Anja; Fendel, Johannes; Weiß, Cornelius; Schulte, Kevin; Rolling, Thierry
2018-04-01
Medical specialty training is the basis for career development of young internists and it is vital for the delivery of high-quality medical care. In 2014 the young internists of two professional bodies in Germany conducted a survey among their young members and described major factors influencing training and working conditions. We present the results of a follow-up survey to describe changes of these factors over time. An additional focus is set on the difficulties of balancing medical career and family. In the end of 2016 we conducted an online-based survey of all members in training of the German Society of Internal Medicine (DGIM) and the Professional Association of German Internists (BDI). The questionnaire used in the 2014 survey was modified and items investigating the balance between career and family were added. A total of 1587 questionnaires were returned and analysed. Mayor findings did not change over time. Psychosocial strain remains very high among medical trainees in internal medicine. A structured training curriculum and meaningful feedback are associated with lower psychosocial strain and higher work satisfaction. Internists - and here especially women - with children experience the daily balance of medical career and family as extremely challenging. These results demonstrate that there is still a serious need for adjusting training and working conditions of young internists in Germany. Especially the role and increasing importance of female physicians has to be recognized by enabling a successful integration of medical career and family. © Georg Thieme Verlag KG Stuttgart · New York.
Stress and medicine use for headache: does sense of coherence modify the association?
Koushede, Vibeke; Holstein, Bjørn E; Andersen, Anette; Hansen, Ebba Holme
2011-10-01
Medicine use as a strategy for coping with daily stressors is an under-studied issue. Studies show that stress is associated with use of over-the-counter medicine, but the underlying mechanisms are not well understood. The aim of this study was to examine whether sense of coherence (SOC) modifies the association between perceived stress and medicine use for headache. National cross-sectional study in Denmark. men and women aged 25-44 years, n = 990. The survey was conducted by web-based questionnaires and telephone interviews. The outcome measure was medicine use for headache. The independent variable was perceived stress. SOC and gender were investigated as moderators. Social class, headache prevalence and severity, and response method were included as co-variates. Our study showed that SOC modified the association between stress and medicine use for headache (only statistically significant among women). The odds for medicine use among women who felt stressed were 2.30 (1.39-3.79) compared to women who did not feel stressed; among men who felt stressed the equivalent odds were 1.46 (0.80-2.66). In analysis stratified by SOC, the odds for medicine use when stressed were 2.09 (0.71-6.21) among women with high SOC, 2.21 (1.10-4.41) among women with medium SOC and 3.69 (1.09-12.47) among women with low SOC. The equivalent odds for men were 1.29 (0.33-5.04), 1.33 (0.59-3.04) and 2.47 (0.57-10.64), respectively. SOC modifies the association between stress and medicine use especially among women. Individuals with fewer coping resources may be more likely to use medicine beyond indication to treat stress.
2013-01-01
Background Ethnobotanical studies on the use of plants amongst migrant populations are of great relevance to public health. Traditional health strategies, which incorporate plants as medicines, foods, or both – can play an important role in individual well-being. However, at the same time, migrant populations’ traditional knowledge of such practices may be under a state of greater threat of decline due to factors such as limited access to the plant materials and physical isolation from the homeland, which serves as the primary living reservoir for this knowledge. Methods In this study, we conducted a medical ethnobotanical survey focusing on a comparison of local medicinal food and health strategies with members of two Asian immigrant populations in metro-Atlanta: Chinese and Taiwanese. Snowball sampling techniques were employed to recruit 83 study participants, 57 of which were included in the final analysis. Semi-structured interview techniques were used to question participants about their beliefs and usage of the yin yang system, usage of Chinese herbs and medicinal foods, preference and usage of Eastern and Western medicines, and gardening for medicinal foods. Results and conclusion Comparison of the two groups demonstrated a remarkable difference in health strategies concerning medicinal plant use, including statistically significant differences in beliefs concerning yin and yang, uses of Eastern versus Western medicine, and gardening for medicinal foods. Domestic health strategies in the form of medicinal foods play an important role in local health practices, especially among the Taiwanese participants. The collective desire for the use of both Eastern and Western medicine by both groups highlights the important role that cultural competency training will play in preparing allopathic health practitioners to serve increasingly diverse patient populations in the US. PMID:23981857
Patterns in medicinal plant knowledge and use in a Maroon village in Suriname.
Van't Klooster, Charlotte; van Andel, Tinde; Reis, Ria
2016-08-02
Traditional medicine plays an important role in the primary health care practices of Maroons living in the interior of Suriname. Large numbers of medicinal plants are employed to maintain general health and cure illnesses. Little is known, however, on how knowledge of herbal medicine varies within the community and whether plant use remains important when modern health care becomes available. To document the diversity in medicinal plant knowledge and use in a remote Saramaccan Maroon community and to assess the importance of medicinal plants vis a vis locally available modern healthcare. We hypothesized that ailments which could be treated by the village health center would be less salient in herbal medicine reports. During three months fieldwork in the Saramaccan village of Pikin Slee, ethnobotanical data were collected by means of participant observations, voucher collections and 27 semi-structured interviews and informal discussions with 20 respondents. To test whether knowledge of medicinal plant species was kept within families, we performed a Detrended Correspondence Analysis. In total, 110 medicinal plant species were recorded, with 302 health use reports and 72 uses, mostly related to general health concerns (42%), diseases of the digestive system (10%), musculoskeletal system and fever (each 7%). Bathing was the most important mode of application. Most health use reports related to cure (58%) and health promotion (39%), while disease prevention played a minor role. Traditional medicine not only treated cultural illnesses, but also health concerns that could be treated with locally available modern medicines. Knowledge of medicinal plant species is not strictly kept within families, but also shared with friends. Certain recipes and applications, however, may be specific family knowledge. Medicinal plants play a very important role in the daily lives of the Pikin Slee villagers. Plant use reflects actual health concerns, but as modern medicines are available for most of these concerns, the use of herbal medicines seems to be a deep rooted cultural preference, especially when concerned with cultural illnesses and health promotion. Locally provided healthcare could be enriched if traditional knowledge, illness concepts, and medicinal plant uses could fit into a larger, community-oriented framework. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Alvarez-Uria, Gerardo; Thomas, Dixon; Zachariah, Seeba; Byram, Rajarajeshwari; Kannan, Shanmugamari
2014-05-01
The World Health Organization (WHO) has been publishing the essential medicines list (EML) since 1977. The EML includes the most efficacious, safe and cost-effective drugs for the most relevant public health conditions worldwide. The WHO performs a cost-effectiveness analysis within each therapeutic group, but very little is known about which therapeutic groups are costliest for hospitals that adopt the WHO EML concept. In this study, we have described the annual consumption of medicines in a district hospital in India, that limited the list of available drugs according to the WHO EML concept. Only 21 drugs constituted 50% of the hospital spending. Anti-infective medicines accounted for 41% of drug spending, especially antiretrovirals which were used to treat HIV infection. Among other therapeutic groups, insulin had the highest impact on the hospital budget. We identified medicines used in perinatal care, which included anti-D immunoglobulin and lung surfactants, that were used rarely, but bore a relatively high cost burden. The results of this study indicate that, in district that adopt the WHO EML, antiretrovirals and antibiotics were the top therapeutic groups for the drug hospital budgets.
Chowaniec, Czesław; Chowaniec, Małgorzata; Wilk, Mateusz
2017-01-01
Creating medico-legal opinion is a sophisticated investigative, analytical, decision-making and creative process. Forensic medicine specialist in cooperation with clinical medicine consultants, on the basis of evidence analysis, which was gathered during procedures and contained in the acts has to create an objective and essential opinion. This opinion is a vital, very important and irreplaceable proof in every case. Judicial body consults with forensic medicine specialist or specialists if there are circumstances for settlement of which there is a need of classified informations - art. 193 of Penalty Code. Forensic medicine specialists face many difficulties which may have effect on quality, positiveness of opinion, compliance with the deadline, increasing expectancy of judicial body or sides. It is very difficult to find clinical specialists which except their clinical knowledge have basic knowledge about law, the role and duties of an court expert. In this article we discuss creating-opinion problems, role and position of court expert in confrontation with expectations of judicial body and the Justice with particular emphasis on medical mistakes and assessment of medical proceedings. We show the complexity of creating of medical opinions, especially these institutional.
Zootherapeutic practices in Aquismón, San Luis Potosí, México.
Alonso-Castro, Angel Josabad; Carranza-Álvarez, Candy; Maldonado-Miranda, Juan José; Del Rosario Jacobo-Salcedo, María; Quezada-Rivera, Diana Alicia; Lorenzo-Márquez, Habacuc; Figueroa-Zúñiga, Luis Alejandro; Fernández-Galicia, Carlos; Ríos-Reyes, Néstor Abel; de León-Rubio, Miguel Ángel; Rodríguez-Gallegos, Valentina; Medellín-Milán, Pedro
2011-10-31
Animal derived products have been a source of medicinal compounds since ancient times. This work documents the use of animal species in traditional medicine in the municipality of Aquismón, San Luis Potosí, México. Direct interviews were performed with inhabitants from Aquismón. The interviews were analyzed with two quantitative tools: (a) the informant consensus (ICF) that estimates the level of agreement about which animals may be used for each category and (b) the relative importance (RI) that determines the extent of potential utilization of each species. A total of 24 animal species used for medicinal purposes, belonging to 22 families and 4 taxonomic categories, were reported by interviewees. Nine medicinal species had not been reported in scientific literature. The results of the IFC showed that diseases of the respiratory systems had the greatest agreement. The most versatile species according to their RI are Crotalus atrox and Mephitis macroura. Further studies with medicinal fauna from Aquismón are required for the experimental validation of their traditional uses, especially with Mephitis macroura and Crotalus atrox. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Tang, Li; Lee, Andy H; Binns, Colin W; Hui, Yer Van; Yau, Kelvin K W
2016-03-01
to investigate usage patterns and factors associated with maternal consumption of Chinese herbal medicines in China. prospective cohort study. Information on the use of Chinese herbal medicines was collected from mothers by personal interview at hospital discharge and followed up by telephone at one, three and six months postpartum. seven hospitals in Jiangyou, Sichuan Province of China. 695 mothers who gave birth to a singleton infant. prevalence, type, frequency and duration of herbal medicine usage. Logistic mixed regression analyses were performed to determine factors affecting the use. a total of 43.5% and 45.0% of mothers consumed Chinese herbal medicines during pregnancy and postpartum, respectively. Angelica sinsensis was the most popular herbal medicine among the participants (pregnancy 28.8%, postpartum 26.8%). Although herbal medicines were taken more regularly by postpartum users, the median usage duration varied from two to three months during pregnancy but 1-1.6 months postpartum. The majority of users (pregnancy 42.9%, postpartum 55.1%) were advised by their mother or mother-in-law to take Chinese herbal medicines. Antenatal alcohol drinking (adjusted odds ratio 2.75, 95% confidence interval 1.01-7.53) was associated with a marginally higher prevalence of herbal consumption during pregnancy, whereas mothers with a lower family income (adjusted odds ratio 1.52, 95% confidence interval 1.12-2.04) were more likely to consume Chinese herbal medicines in the postpartum period. consumption of Chinese herbal medicines appears to be prevalent among Chinese mothers, especially those drinking alcohol whilst pregnant and women from a lower income household. Maternity health professionals need to be aware of the lack of evidence to support the use of Chinese herbal medicines during pregnancy and postpartum, and to provide their clients with scientifically based advice regarding herbal medicine use. Copyright © 2015 Elsevier Ltd. All rights reserved.
Shrestha, Mina; Moles, Rebekah; Ranjit, Eurek; Chaar, Betty
2018-01-01
Accessibility and affordability of evidence-based medicines are issues of global concern. For low-income countries like Nepal, it is crucial to have easy and reliable access to affordable, good-quality, evidence-based medicines, especially in the aftermath of natural or manmade disasters. Availability of affordable and evidence-based high quality medicines depends on the medicine procurement procedure, which makes it an important aspect of healthcare delivery. In this study, we aimed to investigate medicine procurement practices in hospital pharmacies of Nepal within the framework of International Pharmaceutical Federation [FIP] hospital pharmacy guidelines "the Basel Statements". We conducted semi-structured interviews with hospital pharmacists or procurement officers in hospital pharmacies of four major regions in Nepal to explore procurement practices. Data were collected until saturation of themes, analysed using the framework approach, and organised around the statements within the procurement theme of the Basel Statements. Interviews conducted with 53 participants revealed that the procurement guidelines of the Basel Statements were adopted to a certain extent in hospital pharmacies of Nepal. It was found that the majority of hospital pharmacies in Nepal reported using an expensive direct-procurement model for purchasing medicines. Most had no formulary and procured medicines solely based on doctors' prescriptions, which were heavily influenced by pharmaceutical companies' marketing strategies. Whilst most procured only registered medicines, a minority reported purchasing unregistered medicines through unauthorised supply-chains. And although the majority of hospital pharmacies had some contingency plans for managing medicine shortages, a few had none. Procurement guidelines of the Basel Statements were thus found to be partially adopted; however, there is room for improvement in current procurement practices in hospital pharmacies of Nepal. Adoption and regulation of national and international policies is recommended for enhancing medicine accessibility, as well as improving preparedness for health emergencies during natural disasters and health epidemics.
Ranjit, Eurek
2018-01-01
Background Accessibility and affordability of evidence-based medicines are issues of global concern. For low-income countries like Nepal, it is crucial to have easy and reliable access to affordable, good-quality, evidence-based medicines, especially in the aftermath of natural or manmade disasters. Availability of affordable and evidence-based high quality medicines depends on the medicine procurement procedure, which makes it an important aspect of healthcare delivery. In this study, we aimed to investigate medicine procurement practices in hospital pharmacies of Nepal within the framework of International Pharmaceutical Federation [FIP] hospital pharmacy guidelines “the Basel Statements”. Method We conducted semi-structured interviews with hospital pharmacists or procurement officers in hospital pharmacies of four major regions in Nepal to explore procurement practices. Data were collected until saturation of themes, analysed using the framework approach, and organised around the statements within the procurement theme of the Basel Statements. Results Interviews conducted with 53 participants revealed that the procurement guidelines of the Basel Statements were adopted to a certain extent in hospital pharmacies of Nepal. It was found that the majority of hospital pharmacies in Nepal reported using an expensive direct-procurement model for purchasing medicines. Most had no formulary and procured medicines solely based on doctors’ prescriptions, which were heavily influenced by pharmaceutical companies’ marketing strategies. Whilst most procured only registered medicines, a minority reported purchasing unregistered medicines through unauthorised supply-chains. And although the majority of hospital pharmacies had some contingency plans for managing medicine shortages, a few had none. Conclusions Procurement guidelines of the Basel Statements were thus found to be partially adopted; however, there is room for improvement in current procurement practices in hospital pharmacies of Nepal. Adoption and regulation of national and international policies is recommended for enhancing medicine accessibility, as well as improving preparedness for health emergencies during natural disasters and health epidemics. PMID:29401474
Transnational history of medicine after 1950: framing and interrogation from psychiatric journals.
Burnham, John C
2011-01-01
Communication amongst medical specialists helps display the tensions between localism and transnationalisation. Some quantitative sampling of psychiatric journals provides one framework for understanding the history of psychiatry and, to some extent, the history of medicine in general in the twentieth century. After World War II, extreme national isolation of psychiatric communities gave way to substantial transnationalisation, especially in the 1980s, when a remarkable switch to English-language communication became obvious. Various psychiatric communities used the new universal language, not so much as victims of Americanisation, as to gain general professional recognition and to participate in and adapt to modernisation.
Cuminum cyminum and Carum carvi: An update
Johri, R. K.
2011-01-01
Cuminum cyminum and Carum carvi are the sources of cumin and caraway seeds respectively, which have been used since antiquity for the treatment of various indications in traditional healing systems in wide geographical areas. Cumin and caraway seeds are rich sources of essential oils and have been actively researched for their chemical composition and biological activities. In recent times (especially during the last 3 years) considerable progress has been made regarding validation of their acclaimed medicinal attributes by extensive experimental studies. In this attempt many novel bioactivities have been revealed. This review highlights the significance of cumin and caraway as potential source of diverse natural products and their medicinal applications. PMID:22096320
Transnational History of Medicine after 1950: Framing and Interrogation from Psychiatric Journals
BURNHAM, JOHN C.
2011-01-01
Communication amongst medical specialists helps display the tensions between localism and transnationalisation. Some quantitative sampling of psychiatric journals provides one framework for understanding the history of psychiatry and, to some extent, the history of medicine in general in the twentieth century. After World War II, extreme national isolation of psychiatric communities gave way to substantial transnationalisation, especially in the 1980s, when a remarkable switch to English-language communication became obvious. Various psychiatric communities used the new universal language, not so much as victims of Americanisation, as to gain general professional recognition and to participate in and adapt to modernisation. PMID:23752862
The potentiality of medicinal plants as the source of new contraceptive principles in males
Ogbuewu, Ifeanyi Princewill; Unamba-Oparah, Ihemdirim Chukwuma; Odoemenam, Victor Udodirim; Etuk, Idorenyin Friday; Okoli, Ifeanyi Charles
2011-01-01
Rising human population throughout the world especially in developing and underdeveloped countries has detrimental effects on life supporting system on earth. Traditionally, plants have been used to treat different kinds of ailments. The growing importance of phytochemicals in males has been reported. Contraceptive ability of plants has been reported in several animal models. The reversibility of the anti-fertility effects of plants and its active compounds are of potential clinical relevance in the development of male contraceptive. This review attempts to discuss the latest reports on the potentiality of medicinal plants as the source of new contraceptive principles in males. PMID:22540095
BÂRSU, CRISTIAN
2014-01-01
Constantin Stanca (1889–1969) was the first director of the Institute for the Study and Prevention of Cancer from Cluj between 1929 and 1940 and the founder of the Gynecologic Oncology Surgery Department of this Institute. During his important career in gynecology and surgical oncology, which took place in Cluj and in Bucharest, he was also interested in medical sociology and in social medicine. Our paper presents some of Stanca’s objectives in these domains: to increase the health status of women, to prevent gynecological diseases and to improve women’s working conditions, especially in factories. PMID:26528026
[Behaviors in public, private and university environments].
Pérez-Flores, Manuel
2012-09-01
In contemporary democracies, rules of conduct, in public places, are established by law and in private places, by morality. Between both, there is a middle area or interface given by community consensus. In the Community area, rules are consensual among its members. Institutions are an example of such situation. The University, as an institution, without contradicting the law, regulates and requires a behavior that is consistent with its purpose, beyond the private sphere, especially in the Schools of Medicine. We analyze what happens and the underlying purposes that represent the concept of University and Medicine. Special importance is given to ethical, social and cultural analyses.
Social and legal frame conditions for 3D (and) bioprinting in medicine.
Bauer, Heide-Katharina; Heller, Martin; Fink, Matthias; Maresch, Daniela; Gartner, Johannes; Gassner, Ulrich M; Al-Nawas, Bilal
The beginnings of three-dimensional (3D) printing and bioprinting can be traced to as early as 1984. From printing inorganic models for the generation of biologic scaffolds, additive manufacturing (AM) developed to the direct printing of organic materials, including specialized tissues, proteins, and cells. In recent years, these technologies have gained significantly in relevance, and there have been several innovations, especially in the field of regenerative medicine. It is becoming increasingly important to consider the economic and social aspects of AM, particularly in education and information of medical human resources, society, and politics, as well as for the establishment of homogenous, globally adapted legal regulations.
Planting the Seeds of Partnership: Parents as Instructors in Teacher Education
ERIC Educational Resources Information Center
Brown, Colleen; Cianca, Marie; Gladstone-Brown, Wendy; Wischnowski, Michael; Yingling, Jacalyn
2009-01-01
Brenda and Bob have told their family's story many times to professionals as they have navigated through the sometimes precarious waters of education and medicine in search of quality services for their son, Jonathan. Sometimes, along the way, especially when experiencing miscommunication and fragmentation, they've wondered to each other: Is…
Veterinary Medical Needs in Florida.
ERIC Educational Resources Information Center
Florida State Board of Regents, Tallahassee.
There is a wide agreement that (1) Florida needs more practicing veterinarians and veterinary medical services than it now has, especially in the area of large animal and food animal practice, and (2) there is a deficiency of opportunities to study veterinary medicine for those Floridians who would elect this profession. This report takes into…
Crop development related to temperature and photoperiod in temperate cereals
USDA-ARS?s Scientific Manuscript database
Plant development, or the progression of plants through their life cycle, has been of great interest in human history because of the need to know and predict when the harvested part of the plant was at the optimum stage. This knowledge was especially important (even vital) in medicinal plants, where...
Team Deliberate Practice in Medicine and Related Domains: A Consideration of the Issues
ERIC Educational Resources Information Center
Harris, Kevin R.; Eccles, David W.; Shatzer, John H.
2017-01-01
A better understanding of the factors influencing medical team performance and accounting for expert medical team performance should benefit medical practice. Therefore, the aim here is to highlight key issues with using deliberate practice to improve medical team performance, especially given the success of deliberate practice for developing…
Belief in the efficacy of alternative medicine among general practitioners in The Netherlands.
Knipschild, P; Kleijnen, J; ter Riet, G
1990-01-01
A survey among 293 GPs in the Netherlands showed that many believe in the efficacy of common alternative procedures. High scores were especially found for manual therapy, yoga, acupuncture, hot bath therapy and homoeopathy. Other procedures, such as iridology, faith healing and many food supplements, were considered less useful.
Fetal Membranes-Derived Stem Cells Microenvironment.
Favaron, Phelipe Oliveira; Miglino, Maria Angelica
2017-01-01
Recently, the regenerative medicine has been trying to congregate different areas such as tissue engineering and cellular therapy, in order to offer effective treatments to overcome several human and veterinary medical problems. In this regard, fetal membranes have been proposed as a powerful source for obtainment of multipotent stem cells with low immunogenicity, anti-inflammatory properties and nontumorigenicity properties for the treatment of several diseases, including replacing cells lost due to tissue injuries or degenerative diseases. Morpho-physiological data have shown that fetal membranes, especially the yolk sac and amnion play different functions according to the gestational period, which are direct related to the features of the microenvironment that their cells are subject. The characteristics of the microenvironment affect or controls important cellular events involved with proliferation, division and maintenance of the undifferentiated stage or differentiation, especially acting on the extracellular matrix components. Considering the importance of the microenvironment and the diversity of embryonic and fetal membrane-derived stem cells, this chapter will addressed advances in the isolation, phenotyping, characteristics of the microenvironment, and applications of yolk sac and amniotic membrane-derived stem cells for human and veterinary regenerative medicine.
Alsirafy, Samy A; Ibrahim, Noha Y; Abou-Elela, Enas N
2012-01-01
Opioid consumption before and after the establishment of a palliative medicine unit (PMU) in an Egyptian cancer centre was reviewed. A comparison of consumption during the year before the PMU was established to consumption during the third year after the PMU's establishment revealed that morphine consumption increased by 698 percent, fentanyl by 217 percent, and tramadol by 230 percent. Expressed in defined daily dose (DDD) and adjusted for 1,000 new cancer patients, consumption increased by 460 percent, from 4,678 DDD/1,000 new patients to 26,175 DDD/1,000 new patients. Expressed in grams of oral morphine equivalent (g OME), consumption increased by 644 percent, from 233 g OME/1,000 new patients to 1,731 g OME/1,000 new patients. The establishment of the PMU was associated with an increase in opioid consumption, especially morphine, which is an indicator of improvement in cancer pain control. The expression of opioid consumption in OME in addition to DDD may provide further information, especially when weak opioids are included in the analysis.
Payers' Views of the Changes Arising through the Possible Adoption of Adaptive Pathways
Ermisch, Michael; Bucsics, Anna; Vella Bonanno, Patricia; Arickx, Francis; Bybau, Alexander; Bochenek, Tomasz; van de Casteele, Marc; Diogene, Eduardo; Fürst, Jurij; Garuolienė, Kristina; van der Graaff, Martin; Gulbinovič, Jolanta; Haycox, Alan; Jones, Jan; Joppi, Roberta; Laius, Ott; Langner, Irene; Martin, Antony P.; Markovic-Pekovic, Vanda; McCullagh, Laura; Magnusson, Einar; Nilsen, Ellen; Selke, Gisbert; Sermet, Catherine; Simoens, Steven; Sauermann, Robert; Schuurman, Ad; Ramos, Ricardo; Vlahovic-Palcevski, Vera; Zara, Corinne; Godman, Brian
2016-01-01
Payers are a major stakeholder in any considerations and initiatives concerning adaptive licensing of new medicinal products, also referred to as Medicines Adaptive Pathways to patients (MAPPs). Firstly, the scope and necessity of MAPPs need further scrutiny, especially with regard to the definition of unmet need. Conditional approval pathways already exist for new medicines for seriously debilitating or life-threatening diseases and only a limited number of new medicines are innovative. Secondly, MAPPs will result in new medicines on the market with limited evidence about their effectiveness and safety. Additional data are to be collected after approval. Consequently, adaptive pathways may increase the risk of exposing patients to ineffective or unsafe medicines. We have already seen medicines approved conventionally that subsequently proved ineffective or unsafe amongst a wider, more co-morbid population as well as medicines that could have been considered for approval under MAPPs but subsequently proved ineffective or unsafe in Phase III trials and were never licensed. Thirdly, MAPPs also put high demands on payers. Routine collection of patient level data is difficult with high transaction costs. It is not clear who will fund these. Other challenges for payers include shifts in the risk governance framework, implications for evaluation and HTA, increased complexity of setting prices, difficulty with ensuring equity in the allocation of resources, definition of responsibility and liability and implementation of stratified use. Exit strategies also need to be agreed in advance, including price reductions, rebates, or reimbursement withdrawals when price premiums are not justified. These issues and concerns will be discussed in detail including potential ways forward. PMID:27733828
Traditional medicines and globalization: current and future perspectives in ethnopharmacology.
Leonti, Marco; Casu, Laura
2013-01-01
The ethnopharmacological approach toward the understanding and appraisal of traditional and herbal medicines is characterized by the inclusions of the social as well as the natural sciences. Anthropological field-observations describing the local use of nature-derived medicines are the basis for ethnopharmacological enquiries. The multidisciplinary scientific validation of indigenous drugs is of relevance to modern societies at large and helps to sustain local health care practices. Especially with respect to therapies related to aging related, chronic and infectious diseases traditional medicines offer promising alternatives to biomedicine. Bioassays applied in ethnopharmacology represent the molecular characteristics and complexities of the disease or symptoms for which an indigenous drug is used in "traditional" medicine to variable depth and extent. One-dimensional in vitro approaches rarely cope with the complexity of human diseases and ignore the concept of polypharmacological synergies. The recent focus on holistic approaches and systems biology in medicinal plant research represents the trend toward the description and the understanding of complex multi-parameter systems. Ethnopharmacopoeias are non-static cultural constructs shaped by belief and knowledge systems. Intensified globalization and economic liberalism currently accelerates the interchange between local and global pharmacopoeias via international trade, television, the World Wide Web and print media. The increased infiltration of newly generated biomedical knowledge and introduction of "foreign" medicines into local pharmacopoeias leads to syncretic developments and generates a feedback loop. While modern and post-modern cultures and knowledge systems adapt and transform the global impact, they become more relevant for ethnopharmacology. Moreover, what is traditional, alternative or complementary medicine depends on the adopted historic-cultural perspective.
Payers' Views of the Changes Arising through the Possible Adoption of Adaptive Pathways.
Ermisch, Michael; Bucsics, Anna; Vella Bonanno, Patricia; Arickx, Francis; Bybau, Alexander; Bochenek, Tomasz; van de Casteele, Marc; Diogene, Eduardo; Fürst, Jurij; Garuolienė, Kristina; van der Graaff, Martin; Gulbinovič, Jolanta; Haycox, Alan; Jones, Jan; Joppi, Roberta; Laius, Ott; Langner, Irene; Martin, Antony P; Markovic-Pekovic, Vanda; McCullagh, Laura; Magnusson, Einar; Nilsen, Ellen; Selke, Gisbert; Sermet, Catherine; Simoens, Steven; Sauermann, Robert; Schuurman, Ad; Ramos, Ricardo; Vlahovic-Palcevski, Vera; Zara, Corinne; Godman, Brian
2016-01-01
Payers are a major stakeholder in any considerations and initiatives concerning adaptive licensing of new medicinal products, also referred to as Medicines Adaptive Pathways to patients (MAPPs). Firstly, the scope and necessity of MAPPs need further scrutiny, especially with regard to the definition of unmet need. Conditional approval pathways already exist for new medicines for seriously debilitating or life-threatening diseases and only a limited number of new medicines are innovative. Secondly, MAPPs will result in new medicines on the market with limited evidence about their effectiveness and safety. Additional data are to be collected after approval. Consequently, adaptive pathways may increase the risk of exposing patients to ineffective or unsafe medicines. We have already seen medicines approved conventionally that subsequently proved ineffective or unsafe amongst a wider, more co-morbid population as well as medicines that could have been considered for approval under MAPPs but subsequently proved ineffective or unsafe in Phase III trials and were never licensed. Thirdly, MAPPs also put high demands on payers. Routine collection of patient level data is difficult with high transaction costs. It is not clear who will fund these. Other challenges for payers include shifts in the risk governance framework, implications for evaluation and HTA, increased complexity of setting prices, difficulty with ensuring equity in the allocation of resources, definition of responsibility and liability and implementation of stratified use. Exit strategies also need to be agreed in advance, including price reductions, rebates, or reimbursement withdrawals when price premiums are not justified. These issues and concerns will be discussed in detail including potential ways forward.
Wittstock, Marcus; Paeschke, Norbert
2017-11-01
The nature of a falsification of a medicinal product can vary a lot. Therefore the means to detect them and the potential risk to patient safety can also be very different. The whole range of falsification will be described using observed cases from the Federal Institute for Drugs and Medical Devices (BfArM).Based on the relatively low number of detected cases of falsified medicines, the legal supply chain can still be regarded as safe. It has to be assumed that in the illegal supply chain, e. g. illegal internet trade, the majority of the offered medicinal products are not only falsifications due to illegal trade but because they are completely falsified. Therefore there is an especially high risk for the consumer to be harmed by medicinal products that do not fulfil the required specifications.The trend indicates that increased efforts will be necessary to keep the legal supply chain safe and to contain illegal trade with falsifications. The higher federal authorities BfArM, PEI and BVL are involved in this task by coordinating and ensuring the flow of information to the concerned authorities and stakeholders as well as informing the public. Increased efforts are also necessary due to the rising involvement of organised crime in the falsification of medicinal products. A package of measures was enacted with the Falsified Medicines Directive 2011/62/EU to protect the legal supply chain from falsified medicinal products.
de Jonge, Linda; Garne, Ester; Gini, Rosa; Jordan, Susan E; Klungsoyr, Kari; Loane, Maria; Neville, Amanda J; Pierini, Anna; Puccini, Aurora; Thayer, Daniel S; Tucker, David; Vinkel Hansen, Anne; Bakker, Marian K
2015-11-01
Research on associations between medication use during pregnancy and congenital anomalies is significative for assessing the safe use of a medicine in pregnancy. Congenital anomaly (CA) registries do not have optimal information on medicine exposure, in contrast to prescription databases. Linkage of prescription databases to the CA registries is a potentially effective method of obtaining accurate information on medicine use in pregnancies and the risk of congenital anomalies. We linked data from primary care and prescription databases to five European Surveillance of Congenital Anomalies (EUROCAT) CA registries. The linkage was evaluated by looking at linkage rate, characteristics of linked and non-linked cases, first trimester exposure rates for six groups of medicines according to the prescription data and information on medication use registered in the CA databases, and agreement of exposure. Of the 52,619 cases registered in the CA databases, 26,552 could be linked. The linkage rate varied between registries over time and by type of birth. The first trimester exposure rates and the agreements between the databases varied for the different medicine groups. Information on anti-epileptic drugs and insulins and analogue medicine use recorded by CA registries was of good quality. For selective serotonin reuptake inhibitors, anti-asthmatics, antibacterials for systemic use, and gonadotropins and other ovulation stimulants, the recorded information was less complete. Linkage of primary care or prescription databases to CA registries improved the quality of information on maternal use of medicines in pregnancy, especially for medicine groups that are less fully registered in CA registries.
Traditional medicines and globalization: current and future perspectives in ethnopharmacology
Leonti, Marco; Casu, Laura
2013-01-01
The ethnopharmacological approach toward the understanding and appraisal of traditional and herbal medicines is characterized by the inclusions of the social as well as the natural sciences. Anthropological field-observations describing the local use of nature-derived medicines are the basis for ethnopharmacological enquiries. The multidisciplinary scientific validation of indigenous drugs is of relevance to modern societies at large and helps to sustain local health care practices. Especially with respect to therapies related to aging related, chronic and infectious diseases traditional medicines offer promising alternatives to biomedicine. Bioassays applied in ethnopharmacology represent the molecular characteristics and complexities of the disease or symptoms for which an indigenous drug is used in “traditional” medicine to variable depth and extent. One-dimensional in vitro approaches rarely cope with the complexity of human diseases and ignore the concept of polypharmacological synergies. The recent focus on holistic approaches and systems biology in medicinal plant research represents the trend toward the description and the understanding of complex multi-parameter systems. Ethnopharmacopoeias are non-static cultural constructs shaped by belief and knowledge systems. Intensified globalization and economic liberalism currently accelerates the interchange between local and global pharmacopoeias via international trade, television, the World Wide Web and print media. The increased infiltration of newly generated biomedical knowledge and introduction of “foreign” medicines into local pharmacopoeias leads to syncretic developments and generates a feedback loop. While modern and post-modern cultures and knowledge systems adapt and transform the global impact, they become more relevant for ethnopharmacology. Moreover, what is traditional, alternative or complementary medicine depends on the adopted historic-cultural perspective. PMID:23898296
Medical studies and Nazi medicine: Nazi medicine as perceived by Austrian medical students.
Nowak, Stefan; Rásky, Éva; Freidl, Wolfgang
2016-02-01
Austrian medical universities have not covered the topic of Nazi medicine in their curricula to any satisfactory degree to date. In the context of medical-ethical education and on-going medical ethics debates, it seems indispensable to be confronted also with the dark chapters of medical history, and especially Nazi medicine. Students should learn to understand controversial discussions, e.g. about euthanasia, in a historical context. The purpose of this study was to investigate whether students had, during their studies, been confronted with Nazi medical crime and whether they considered such a confrontation as important. The survey also focused on extant knowledge about this topic. From late 2012 to May 2013, 341 late semester students of the medical universities in Vienna, Graz, and Innsbruck were questioned about the coverage of Nazi medicine during their courses, using multiple choice questionnaires. The data were evaluated using a descriptive-statistical approach. The study has shown a low level of knowledge of students about Nazi medicine in the three universities. Only a third of the students had ever heard about "Aktion T4". About 65% of the participants found it important to be comprehensively informed about Nazi medicine during their studies, e.g. with a view to their future career. On average across the three universities, only 43% of the students had been confronted with this topic. The study found a clear wish for more information about Nazi medicine. Universities should, therefore, offer students various opportunities and ways of discussing this issue in the university context.
Khuluza, Felix; Kigera, Stephen; Heide, Lutz
2017-01-01
Substandard and falsified antimalarial and antibiotic medicines represent a serious problem for public health, especially in low- and middle-income countries. However, information on the prevalence of poor-quality medicines is limited. In the present study, samples of six antimalarial and six antibiotic medicines were collected from 31 health facilities and drug outlets in southern Malawi. Random sampling was used in the selection of health facilities. For sample collection, an overt approach was used in licensed facilities, and a mystery shopper approach in nonlicensed outlets. One hundred and fifty-five samples were analyzed by visual and physical examination and by rapid prescreening tests, that is, disintegration testing and thin-layer chromatography using the GPHF-Minilab. Fifty-six of the samples were analyzed according to pharmacopeial monographs in a World Health Organization-prequalified quality control laboratory. Seven out-of-specification medicines were identified. One sample was classified as falsified, lacking the declared active ingredients, and containing other active ingredients instead. Three samples were classified as substandard with extreme deviations from the pharmacopeial standards, and three further samples as substandard with nonextreme deviations. Of the substandard medicines, three failed in dissolution testing, two in the assay for the content of the active pharmaceutical ingredient, and one failed in both dissolution testing and assay. Six of the seven out-of-specification medicines were from private facilities. Only one out-of-specification medicine was found within the samples from public and faith-based health facilities. Although the observed presence of substandard and falsified medicines in Malawi requires action, their low prevalence in public and faith-based health facilities is encouraging. PMID:28219993
An Evidence-Based Review on Medicinal Value of Clays in Traditional Persian Medicine.
Hosseinkhani, Ayda; Montaseri, Hashem; Hosamo, Ammar; Zarshenas, Mohammad Mehdi
2017-01-01
The use of earths and clays for medical purposes dates back to antiquity. In recent years, there has been an increasing interest in researches on traditional remedies in the hope of discovering new drug. Iran is an ancient country with a medical backbone acquired from the experiences of ancient Persian scholars, who had made a great contribution to the development of the medical sciences. Many medical and pharmaceutical books by early Persian scientists still exist and may have the potential of leading researchers to new drug discoveries. Owing to the emergence of new and antimicrobial-resistant infections, present-day medicine has recently begun focusing on medicinal earths and clays especially as mineral antimicrobials. The current study is, therefore, aimed at gathering information regarding medicinal clays in traditional Persian medicine (TPM). Five main Persian materia medica with the key word 'tin' (clay) and current databases such as PubMed, Scopus, ScienceDirect, and Google Scholar were searched by key words 'white, green, red, maroon, violet, black, grey and pink clays' and 'pharmacological effects'. Twenty three clays were found in Persian manuscripts. Although their mineralogical compositions are unknown, different pharmacological properties have been attributed to these mineral medicaments. Clay's properties were widely used in medieval times for the treatment of infections to poisoning. They were also used in compound formulations, possibly for their pharmaceutical formulation modifying effects. Modern scientific proofs have also been found in many of the medicinal clays reported in Persian manuscripts. Although many of the reported clays are still unknown, their characterization may lead to new medicinal developments. Novel analytical methods available today make it possible to elucidate the chemical compositions of these minerals as parameters responsible for their medicinal effects. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.
Indigenous Knowledge of Herbal Medicines among Adolescents in Amassoma, Bayelsa State, Nigeria
Alade, Gideon O.; Okpako, Ese; Ajibesin, Kola’ K.; Omobuwajo, Olanrewaju R.
2016-01-01
Background: The use of herbal medicines in Nigeria is on the increase. Documented Population based data on the use of herbal medicinal products and indigenous knowledge among the younger generations are lacking in Nigeria and Africa at large. Aim: The aim of this study is to investigate the extent of use and general knowledge of herbal medicines among adolescents in the Niger Delta Region of Nigeria. Methods: The study covered a total of Two hundred and twenty-eight adolescents randomly selected in Senior Secondary Schools (SSS 1-3) in Amassoma using a semi structured questionnaire/Interview and informal conversation on the respondents. Findings: Nearly all (97%) the respondents have had contact with herbs. Less than 1% had contact with herbs through formal education (teachers/literatures). Stimulation of interest was majorly through parents (53%). Grandparents were the highest (46%) of custodian of indigenous knowledge. Parents were the next (39.7%). Only 39% of the respondents would prefer the use of herbal medicine to modern medicine. Fever was the main ailment mentioned followed by eye ailment and stomach ache. Vernonia amygdalina was the main plant for the treatment of fever. Conclusion: The study revealed that parents are the major custodians of knowledge being transferred to the younger generation and little or none is learnt from Schools. There is therefore the need to include the study of herbal medicines in School’s curricula especially at SS 2 and SS 3 since they are matured enough to appreciate the importance of Herbal medicine so as to prepare them for the promotion of herbal medicine in future and to preserve our indigenous knowledge. PMID:26234964
Chaves, Luisa A; Campos, Monica R; Bertoldi, Andrea D; Silva, Rondineli M; Bigdeli, Maryam; Ross-Degnan, Dennis; Emmerick, Isabel C M
2017-01-01
The Farmácia Popular Program (FPP) launched a subsidy system in Brazil, but in coexistence with the ongoing regular governmental access to medicines (Unified Health System (SUS) dispensings) mechanisms, causing overlaps in terms of financing and target population. This characteristic is quite different from most countries with medicines cost-sharing schemes. This paper aims to analyse the FPP under a health systems perspective considering the different health system levels. We analysed the findings from the study ‘Impact of consecutive subsidies policies on access to and use of medicines in Brazil – ISAUM-Br’, designed with the objective of describing and evaluating the impact of the government medicines subsidy policies implemented between 2004 and 2011. Patient share of copayment increased with the implementation of the intervention, which decreased the reference price and decreased with SNP (Saúde Não Tem Preço; zero copayment for patients). There was an increased number of FPP dispensations over time, but SUS dispensings remained the most important source for medicines, especially for hypertension and diabetes. FPP allowed the establishment of a well-designed pharmaceutical information system in the country. Despite the improvement on control mechanism, fraud remained a problem. There were important effects on the pharmaceutical market and sales of generic medicines. FPP has proven to be a very important policy for promoting access to medicines for hypertension and diabetes in Brazil. Examining this policy with a health system perspective has allowed us to highlight many of its important consequences, including for the first time a broad and consistent information system on access to medicines in the country. PMID:29527335
Zhang, Aihua; Sun, Hui; Wang, Ping; Han, Ying; Wang, Xijun
2012-01-01
Deconstruction of molecular pathways and advances in enabling technology platforms have opened new horizons for disease management, exploring therapeutic solutions to each individual patient beyond the one-size fits all practice. Application of personalized medicine paradigms aims to achieve the right diagnosis and right treatment for the right patient at the right time at the right cost. With the potential to transform medical practice across global communities, personalized medicine is emerging as the flagship of modern medicine. In recent years, the health care paradigm has shifted from a focus on diseases to a major hot of personalized traditional Chinese medicine (TCM) with holistic approach. TCM focuses on health maintenance, emphasizes on enhancing the body's resistance to diseases and especially showes great advantages in early intervention, personalized and combination therapies, etc. Systems biology, a new science of the 21st century, becomes practically available and resembles TCM in many aspects such as study method and design, and is current key component technologies that serves as the major driving force for translation of the personalized medicine revolution of TCM principles into practice, will advance personalized therapy principles into healthcare management tools for individuals and populations. Such system approach concepts are transforming principles of TCM to modern therapeutic approaches, enable a predictive and preventive medicine and will lead to personalized medicine. To realise the full potential of personalized TCM, we describe the current status of principles and practice of TCM integrated with systems biology platform. Some characteristic examples are presented to highlight the application of this platform to personalized TCM research and development as well as some of the necessary milestones for moving TCM into mainstream health care. Copyright © 2011 Elsevier Ltd. All rights reserved.
A Course on Terror Medicine: Content and Evaluations.
Cole, Leonard A; Natal, Brenda; Fox, Adam; Cooper, Arthur; Kennedy, Cheryl A; Connell, Nancy D; Sugalski, Gregory; Kulkarni, Miriam; Feravolo, Michael; Lamba, Sangeeta
2016-02-01
The development of medical school courses on medical responses for disaster victims has been deemed largely inadequate. To address this gap, a 2-week elective course on Terror Medicine (a field related to Disaster and Emergency Medicine) has been designed for fourth year students at Rutgers New Jersey Medical School in Newark, New Jersey (USA). This elective is part of an overall curricular plan to broaden exposure to topics related to Terror Medicine throughout the undergraduate medical education. A course on Terror Medicine necessarily includes key aspects of Disaster and Emergency Medicine, though the converse is not the case. Courses on Disaster Medicine may not address features distinctively associated with a terror attack. Thus, a terror-related focus not only assures attention to this important subject but to accidental or naturally occurring incidents as well. The course, implemented in 2014, uses a variety of teaching modalities including lectures, videos, and tabletop and hands-on simulation exercises. The subject matter includes biological and chemical terrorism, disaster management, mechanisms of injury, and psychiatry. This report outlines the elective's goals and objectives, describes the course syllabus, and presents outcomes based on student evaluations of the initial iterations of the elective offering. All students rated the course as "excellent" or "very good." Evaluations included enthusiastic comments about the content, methods of instruction, and especially the value of the simulation exercises. Students also reported finding the course novel and engaging. An elective course on Terror Medicine, as described, is shown to be feasible and successful. The student participants found the content relevant to their education and the manner of instruction effective. This course may serve as a model for other medical schools contemplating the expansion or inclusion of Terror Medicine-related topics in their curriculum.
Visiting professorship in hospital medicine: An innovative twist for a growing specialty.
Cumbler, Ethan; Herzke, Carrie; Smalligan, Roger; Glasheen, Jeffrey J; O'Malley, Cheryl; Pierce, J Rush
2016-10-01
As an emerging and rapidly growing specialty, academic hospitalists face unique challenges in career advancement. Key mentoring needs, especially developing reputation and relationships outside of their institution are often challenging. We describe the structure of a novel Visiting Professorship in Hospital Medicine Program. It utilizes reciprocal exchanges of hospitalist faculty at the rank of late assistant to early associate professor. The program is designed explicitly to facilitate spread of innovation between institutions through a presentation by the visiting professor and exposure to an innovation at the host hospital medicine group. It provides a platform to advance the career success of both early- and midcareer hospitalist faculty through 1-on-1 coaching sessions between the visiting professor and early-career faculty at the host institution and commitment by visiting professors to engage in mentoring after the visit. Five academic hospitalist groups participated. Seven visiting professors met with 29 early-career faculty. Experience following faculty exchange visits demonstrates program effectiveness, as perceived by both early-career faculty and the visiting professors, in advancing the goals of mentorship and career advancement. One-year follow-up suggests that 62% of early-career faculty will engage in subsequent interactions with the visiting professor, and half report spread of innovation between academic hospital medicine groups. The Visiting Professorship in Hospital Medicine offers a low-cost framework to promote collaboration between academic hospital medicine groups and facilitate interinstitutional hospitalist mentoring. It is reported to be effective for the goal of professional development for midcareer hospitalists. Journal of Hospital Medicine 2016;11:714-718. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.
Stem cells and regenerative medicine in domestic and companion animals: a multispecies perspective.
Gonçalves, N N; Ambrósio, C E; Piedrahita, J A
2014-10-01
Since their original isolation, the majority of the work on embryonic stem cells (ESC) has been carried out in mice. While the mouse is an outstanding model for basic research, it also has considerable limitations for translational work, especially in the area of regenerative medicine. This is due to a combination of factors that include physiological and size differences when compared to humans. In contrast, domestic animal species, such as swine, and companion animal species, such as dogs, provide unique opportunities to develop regenerative medicine protocols that can then be utilized in humans. Unfortunately, at present, the state of knowledge related to, and availability of, ESC from domestic animals vary among species such as pig, horse, dog and cat, and without exception lags significantly behind the mouse and human. It is clear that much still needs to be discovered. The 'stem cell-like' cell lines being reported are still not satisfactorily used in regenerative medicine, due to reasons such as heterogeneity and chromosomal instability. As a result, investigators have searched for alternate source of cells that can be used for regenerative medicine. This approach has uncovered a range of adult stem cells and adult progenitor cells that have utility in both human and veterinary medicine. Here, we review a range of stem cells, from ESC to induced pluripotent stem cells, and discuss their potential application in the field of regenerative medicine. © 2014 Blackwell Verlag GmbH.
NASA Astrophysics Data System (ADS)
Zhan, Jinliang; Lu, Pei
2006-11-01
Since the quality of traditional Chinese medicine products are affected by raw material, machining and many other factors, it is difficult for traditional Chinese medicine production process especially the extracting process to ensure the steady and homogeneous quality. At the same time, there exist some quality control blind spots due to lacking on-line quality detection means. But if infrared spectrum analysis technology was used in traditional Chinese medicine production process on the basis of off-line analysis to real-time detect the quality of semi-manufactured goods and to be assisted by advanced automatic control technique, the steady and homogeneous quality can be obtained. It can be seen that the on-line detection of extracting process plays an important role in the development of Chinese patent medicines industry. In this paper, the design and implement of a traditional Chinese medicine extracting process monitoring experiment system which is based on PROFIBUS-DP field bus, OPC, and Internet technology is introduced. The system integrates intelligence node which gathering data, superior sub-system which achieving figure configuration and remote supervisory, during the process of traditional Chinese medicine production, monitors the temperature parameter, pressure parameter, quality parameter etc. And it can be controlled by the remote nodes in the VPN (Visual Private Network). Experiment and application do have proved that the system can reach the anticipation effect fully, and with the merits of operational stability, real-time, reliable, convenient and simple manipulation and so on.
Kang, Young Min; Komakech, Richard; Karigar, Chandrakant Shivappa; Saqib, Asma
2017-06-01
Traditional and complementary medicine (T&CM) plays an integral role in providing health care worldwide. It is based on sound fundamental principles and centuries of practices. This study compared traditional Indian medicine (TIM) and traditional Korean medicine (TKM) basing on data obtained from peer reviewed articles, respective government institutional reports and World Health Organization reports. Despite the fact that TIM and TKM have individual qualities that are unique from each other including different histories of origin, they share a lot in common. Apart from Homeopathy in TIM, both systems are hinged on similar principle of body constitutional-based concept and similar disease diagnosis methods of mainly auscultation, palpation, visual inspection, and interrogation. Similarly, the treatment methods of TIM and TKM follow similar patterns involving use of medicinal herbs, moxibustion, acupuncture, cupping, and manual therapy. Both T&CM are majorly practiced in well-established hospitals by T&CM doctors who have undergone an average of 6-7 years of specialized trainings. However, unlike TIM which has less insurance coverage, the popularity of TKM is majorly due to its wide national insurance coverage. These two medical traditions occupy increasingly greater portion of the global market. However, TIM especially Ayurveda has gained more global recognition than TKM although the emergence of Sasang Constitutional Medicine in TKM is beginning to become more popular. This comparative analysis between TIM and TKM may provide vital and insightful contribution towards constitutional-based concept for further development and future studies in T&CM.
DTCA of prescription medicines in the European Union: is there still a need for a ban?
Poser, Mareen
2010-12-01
The pharmaceutical sector is one of the main markets in the European Union. The consumption of medicines is high and steadily increasing. However, the pharmaceutical market is subject to a wider range of restrictions than almost any other sector. The restrictions mainly apply to information provision and advertising practice within the community. One of the main features in pharmaceutical regulation is the ban on direct-to-consumer advertising (DTCA) of prescription medicines. However, an abolition of the ban is controversial in the European Community, especially as the pharmaceutical industry keeps pleading for its ability to use the highly effective marketing strategy of DTCA to promote prescription medicines to the general public. Such advertising is only allowed in two jurisdictions in the world, New Zealand and the United States. In both systems the impact of DTCA on the consumer and the economy has been subject to research. The outcome of these studies is outlined in this article. Since the European Commission has provided a new proposal to amend the current information practice regarding prescription medicines in 2008 (European Commission, Proposal for a Directive of the European Parliament and of the Council Amending, as Regards Information to the General Public on Medicinal Products Subject to Medical Prescription, Directive 2001/83/EC on the Community Code Relating to Medicinal Products for Human Use, COM/2008/0663 final) it is time to examine different options to regulate the provision of information and discuss the need for a ban of DTCA.
Internal Targeting and External Control: Phototriggered Targeting in Nanomedicine.
Arrue, Lily; Ratjen, Lars
2017-12-07
The photochemical control of structure and reactivity bears great potential for chemistry, biology, and life sciences. A key feature of photochemistry is the spatiotemporal control over secondary events. Well-established applications of photochemistry in medicine are photodynamic therapy (PDT) and photopharmacology (PP). However, although both are highly localizable through the application of light, they lack cell- and tissue-specificity. The combination of nanomaterial-based drug delivery and targeting has the potential to overcome limitations for many established therapy concepts. Even more privileged seems the merger of nanomedicine and cell-specific targeting (internal targeting) controlled by light (external control), as it can potentially be applied to many different areas of medicine and pharmaceutical research, including the aforementioned PDT and PP. In this review a survey of the interface of photochemistry, medicine and targeted drug delivery is given, especially focusing on phototriggered targeting in nanomedicine. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.
Ali, Mohammad; Abbasi, Bilal Haider; Ahmad, Nisar; Khan, Haji; Ali, Gul Shad
2017-11-01
The genus Artemisia has been utilized worldwide due to its immense potential for protection against various diseases, especially malaria. Artemisia absinthium, previously renowned for its utilization in the popular beverage absinthe, is gaining resurgence due to its extensive pharmacological activities. Like A. annua, this species exhibits strong biological activities like antimalarial, anticancer and antioxidant. Although artemisinin was found to be the major metabolite for its antimalarial effects, several flavonoids and terpenoids are considered to possess biological activities when used alone and also to synergistically boost the bioavailability of artemisinin. However, due to the limited quantities of these metabolites in wild plants, in vitro cultures were established and strategies have been adopted to enhance medicinally important secondary metabolites in these cultures. This review elaborates on the traditional medicinal uses of Artemisia species and explains current trends to establish cell cultures of A. annua and A. absinthium for enhanced production of medicinally important secondary metabolites.
Actovegin--Cutting-edge sports medicine or "voodoo" remedy?
Lee, Paul; Kwan, Alvin; Nokes, Len
2011-07-01
Actovegin is a deproteinized serum extract of bovine origin, and in recent years it has been used widely in treating sport injuries with many anecdotal reports of success. However, the use of Actovegin in sport medicine has caused a substantial amount of controversy, especially concerning its supposed oxygen-enhancing capacity and an anecdotal belief that its use can increase an athlete's performance. In 2009, a sports physician was arrested with this "performance-enhancing drug," while an editorial in a sports medicine journal strongly questioned the evidence base for using this drug for acute muscle injury. There is also a report that suggested that Actovegin might have induced anaphylactic shock in a cyclist. In this review, we have systematically examined the current evidence on Actovegin. Its mechanism of action, clinical evidence, legal status with sports governing bodies, and its potential role in sport injuries will be discussed.
Web technology for emergency medicine and secure transmission of electronic patient records.
Halamka, J D
1998-01-01
The American Heritage dictionary defines the word "web" as "something intricately contrived, especially something that ensnares or entangles." The wealth of medical resources on the World Wide Web is now so extensive, yet disorganized and unmonitored, that such a definition seems fitting. In emergency medicine, for example, a field in which accurate and complete information, including patients' records, is urgently needed, more than 5000 Web pages are available today, whereas fewer than 50 were available in December 1994. Most sites are static Web pages using the Internet to publish textbook material, but new technology is extending the scope of the Internet to include online medical education and secure exchange of clinical information. This article lists some of the best Web sites for use in emergency medicine and then describes a project in which the Web is used for transmission and protection of electronic medical records.
(13)C breath tests in personalized medicine: fiction or reality?
Modak, Anil S
2009-11-01
The concept of personalized medicine is gathering momentum as various biomarkers are being discovered and developed to lead to genotype and phenotype diagnostic tests, which will enable physicians to individualize therapy. Noninvasive, rapid (13)C breath tests have the potential to serve as clinically significant diagnostic tools, especially for evaluating the enzyme activity of polymorphic enzymes. This would enable physicians to rapidly identify responders/nonresponders to various drugs primarily metabolized by these enzymes prior to initiation of therapy. With the information on enzyme activity, the physician can prescribe the right drug, at the right dose, at the right time, to the right individual, for the right clinical outcome. However, the promise of the era of personalized medicine, including the novel (13)C breath tests, will have to overcome several regulatory, business and financial hurdles for diagnostic tests to become part of routine mainstream clinical practice over the next decade.
Qu, Fan; Li, Rong; Sun, Wei; Lin, Ge; Zhang, Rong; Yang, Jing; Tian, Li; Xing, Guo-Gang; Jiang, Hui; Gong, Fei; Liang, Xiao-Yan; Meng, Yan; Liu, Jia-Yin; Zhou, Li-Ying; Wang, Shu-Yu; Wu, Yan; He, Yi-Jing; Ye, Jia-Yu; Han, Song-Ping; Han, Ji-Sheng
With the rapid development of assisted reproductive technology, various reproductive disorders have been effectively addressed. Acupuncture-like therapies, including electroacupuncture (EA) and transcutaneous electrical acupoint stimulation (TEAS), become more popular world-wide. Increasing evidence has demonstrated that EA and TEAS are effective in treating gynecological disorders, especially infertility. This present paper describes how to select acupoints for the treatment of infertility from the view of theories of traditional Chinese medicine and how to determine critical parameters of electric pulses of EA/TEAS based on results from animal and clinical studies. It summarizes the principles of clinical application of EA/TEAS in treating various kinds of reproductive disorders, such as polycystic ovary syndrome (PCOS), pain induced by oocyte retrieval, diminished ovarian reserve, embryo transfer, and oligospermia/ asthenospermia. The possible underlying mechanisms mediating the therapeutic effects of EA/TEAS in reproductive medicine are also examined.
Role of Aragvadhadi Sutra in the Management of Fistula -in-Ano.
Kumar, P H; Sahu, M
2000-01-01
Traditional Medicine has its own importance for the treatment of various medical and surgical diseases irrespective of tremendous development of modern medicine. There are number of diseases were after repeated surgery. Fistula-in ano is one such condition which is prone to recurrence even after repeated surgery and can be effectively treated by Ayurvedic medicines. An extensive work has been done on the treatment of Bhagandara by Kshara sutra exploring various aspects of the problem and finding our the solution to them1. the present study is related to similar type of medicated thread known as Aragvadadi Sutra which has been mentioned by sushruta in Bhagandara. It consists of Aragvadha (Cassia fistula), Haridra (Curcuma longa), Agaru (Aquilaria agalocha), Madhu (Honey) and Ghrita (Ghee). This is the first non-caustic thread being tried on different types of Bhagandara. Especially it is a painless thread, non-irritant and very useful in sensitive patients like children, females and elders.
Samuel Johnson: his ills, his pills and his physician friends.
Murray, T Jock
2003-01-01
Samuel Johnson (1709-1784) was one of the greatest men of his age. Although famed for his writings, especially his Dictionary and his folio on Shakespeare, he is remembered for his tavern conversations, his literary clubs and the great biography of his life by Boswell. He always enjoyed having physicians as his friends, and took a great interest in all branches of medicine. He would advise and prescribe for friends who regularly consulted him, and he was not unhappy when mistaken for a physician. Particularly in his last years he had need of physicians for his own care, but held his own distinct views on whether to take their medicines and in what dose--usually much higher than prescribed. His many illnesses and his knowledge and views on medicine make him of continuing interest to physicians and give us insight into medical practice and beliefs in the Age of Enlightenment.
One health-one medicine: unifying human and animal medicine within an evolutionary paradigm.
Currier, Russell W; Steele, James H
2011-08-01
One health is a concept since early civilization, which promoted the view that there was no major distinction between animal and human medicine. Although persisting through the 19th century, this common vision was then all but forgotten in the early 20th century. It is now experiencing a renaissance, coincident with an awakening of the role that evolutionary biology plays in human and animal health, including sexually transmitted infections (STIs). A number of STIs in humans have comparable infections in animals; likewise, both humans and animals have STIs unique to each mammalian camp. These similarities and differences offer opportunities for basic medical and public health studies, including evolutionary insights that can be gleaned from ongoing interdisciplinary investigation--especially with the molecular analytical tools available--in what can become a golden age of mutually helpful discovery. © 2011 New York Academy of Sciences.
The fluidity of biosocial identity and the effects of place, space, and time.
Wiese, Daniel; Rodriguez Escobar, Jeronimo; Hsu, Yohsiang; Kulathinal, Rob J; Hayes-Conroy, Allison
2018-02-01
Public and scientific conceptions of identity are changing alongside advances in biotechnology, with important relevance to health and medicine. In particular, biological identity, once predominantly conceived as static (e.g., related to DNA, dental records, fingerprints) is now being recognized as dynamic or fluid, mirroring contemporary understandings of psychological and social identity. The dynamism of biological identity comes from the individual body's unique relationship with the world surrounding it, and therefore may best be described as biosocial. This paper reviews advances in scientific understandings of identity and presents a model that contrasts prior static approaches to biological identity from more recent dynamically-relational ones. This emerging viewpoint is of broad significance to health and medicine, particularly as medicine recognizes the significance of biography - i.e. the multiple, dense interactions imparted on a body across spatio-temporal dimensions - to phenotypic prediction, especially disease risk. Copyright © 2017 Elsevier Ltd. All rights reserved.
Inhibition of cytochrome P450 by furanocoumarins in grapefruit juice and herbal medicines.
Guo, Lian-qing; Yamazoe, Yasushi
2004-02-01
Furanocoumarins (psoralens) exist in various plants and some of them are used to cure skin diseases. These chemicals draw attentions recently because of their abilities to arouse drug interaction through inhibition of cytochrome P450. Grapefruit juice is a well-known example for food-drug interaction. But in vitro and in vivo studies have shown that the causative components are mainly furanocoumarin derivatives with geranyloxy side chains. In vitro experiments confirmed that furanocoumarins from grapefruit juice are both competitive and mechanism-based inhibitors of CYP3A4. Although the inhibition appeared to be stronger in the dimers than that in the monomers, all contribute comprehensively to the grapefruit juice-drug interaction. Further experiments with other furanocoumarins and related citrus fruits or umbelliferous herbal medicines indicate that drug interaction might also occur with stuffs other than grapefruit juice, especially with traditional medicine.
Vissiennon, Cica; Goos, Karl-Heinz; Arnhold, Jürgen; Nieber, Karen
2017-05-01
Inflammatory bowel disease or irritable bowel syndrome are chronic gastrointestinal disorders which are associated with a lifelong therapeutic need. The disease results in physical, psychological, and social problems with an impact on partnership, sexuality, education, and career. Thus, the number of patients and health care professionals relying on traditional and complementary medicines and especially phytotherapy for the treatment of these chronic conditions is increasing over recent years. One traditional herbal medicinal product consisting of chamomile flower, myrrh, and coffee charcoal has been widely used in clinical practice within this indication area. Long-term experience and an increasing understanding of the pharmacological mechanisms substantiate its application and clinical effectiveness. Mainly the spasmolytic and anti-inflammatory effects provide a rationale for its therapeutic application. In addition, synergistic effects between the herbal components contribute to the overall effect of this medication.
Internationalizing forensic assessments of criminal responsibility.
Meynen, Gerben; Oei, Karel
2011-12-01
One of the important characteristics of current medicine is that it is an international endeavor. The fact that medicine is a global undertaking might even be one of its core strengths. However, the universal nature of medicine can be compromised when local issues become significant factors in medical practice. In this paper we identify criminal law as a relevant factor complicating the process of internationalizing a particular medical practice: the assessment of a defendant within the context of the question of criminal responsibility. Since criminal law--especially the laws relevant to assessments of criminal responsibility--may differ from country to country, or rather from jurisdiction to jurisdiction, forensic psychiatrists face the challenge of finding common ground and a common framework to advance these forensic psychiatric assessments. We describe the current situation and argue for internationalizing the discussion about this assessment, pointing to the example provided by assessments of competence.
Genome Editing Redefines Precision Medicine in the Cardiovascular Field
Lahm, Harald; Dreßen, Martina; Lange, Rüdiger; Wu, Sean M.; Krane, Markus
2018-01-01
Genome editing is a powerful tool to study the function of specific genes and proteins important for development or disease. Recent technologies, especially CRISPR/Cas9 which is characterized by convenient handling and high precision, revolutionized the field of genome editing. Such tools have enormous potential for basic science as well as for regenerative medicine. Nevertheless, there are still several hurdles that have to be overcome, but patient-tailored therapies, termed precision medicine, seem to be within reach. In this review, we focus on the achievements and limitations of genome editing in the cardiovascular field. We explore different areas of cardiac research and highlight the most important developments: (1) the potential of genome editing in human pluripotent stem cells in basic research for disease modelling, drug screening, or reprogramming approaches and (2) the potential and remaining challenges of genome editing for regenerative therapies. Finally, we discuss social and ethical implications of these new technologies. PMID:29731778
King Chulalongkorn: biography and his activities in medicine and public health.
Charulukananan, Somrat; Sueblinvong, Tada
2003-06-01
King Rama V, or Chulalongkorn, was the fifth monarch of the Chakri Dynasty. He was one of the most beloved of the Thai kings due to his many activities including abolishing slavery without bloodshed and especially his skillful diplomacy which succeeded in steering Siam out of the grips of the colonial powers. His activities also included reform of the administration of the kingdom according to the European model and in bringing Siam into the modern era with such exquisite skills that he is still vividly remembered today. His reign also saw many developments in medicine and public health. The King's role in these areas, however, were clouded by his more visible activities in politics and diplomacy. The result is that the Thai public learned rather little about his role in these areas. This article aims at collecting this and to show the King's very important role in modernizing medicine and public health in Siam.
Delivering diabetes care in the Philippines and Vietnam: policy and practice issues.
Beran, David; Higuchi, Michiyo
2013-01-01
The aim of this study is the comparison of 2 studies looking at the barriers to access of diabetes care and medicines in the Philippines and Vietnam. These studies used the Rapid Assessment Protocol for Insulin Access. Diabetes care is provided in specialized facilities and appropriate referral systems are lacking. In Vietnam, no problems were reported with regard to diagnostic tools, whereas this was a concern in the public sector in the Philippines. Both countries had high prices for medicines in comparison to international standards. Availability of medicines was better in Vietnam than in the Philippines, especially with regard to insulin. This affected adherence as did a lack of patient education. As countries aim to provide health care to the majority of their populations through universal coverage, the challenge of diabetes cannot be neglected. Trying to achieve universal coverage in parallel to decentralization, national and local governments need adapted guidance for this.
[Ethics, equity and social determinants of health].
Puyol, Ángel
2012-01-01
The evidence shown by studies on the social determinants of health has changed the relationship between ethics and medicine. The evidence shown by studies on the social determinants of health has changed the relationship between ethics and medicine, and between a normative and a descriptive approach. Studies on the social determinants of health have also modified the traditional concept of equity, necessary health policies and the future of bioethics. More specifically: 1) the boundary between medicine and ethics has become much fuzzier, especially in the field of epidemiology, whose objectives are now inseparable from ethical considerations; 2) the concept of health equity traditionally defined as access to healthcare should be corrected or expanded to incorporate unfair health inequalities that occur before patients reach the healthcare system; and 3) the traditional autonomy bias of bioethics should be replaced by a primary concern for social justice and its relationship with health. Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.
A Dimensionally Reduced Clustering Methodology for Heterogeneous Occupational Medicine Data Mining.
Saâdaoui, Foued; Bertrand, Pierre R; Boudet, Gil; Rouffiac, Karine; Dutheil, Frédéric; Chamoux, Alain
2015-10-01
Clustering is a set of techniques of the statistical learning aimed at finding structures of heterogeneous partitions grouping homogenous data called clusters. There are several fields in which clustering was successfully applied, such as medicine, biology, finance, economics, etc. In this paper, we introduce the notion of clustering in multifactorial data analysis problems. A case study is conducted for an occupational medicine problem with the purpose of analyzing patterns in a population of 813 individuals. To reduce the data set dimensionality, we base our approach on the Principal Component Analysis (PCA), which is the statistical tool most commonly used in factorial analysis. However, the problems in nature, especially in medicine, are often based on heterogeneous-type qualitative-quantitative measurements, whereas PCA only processes quantitative ones. Besides, qualitative data are originally unobservable quantitative responses that are usually binary-coded. Hence, we propose a new set of strategies allowing to simultaneously handle quantitative and qualitative data. The principle of this approach is to perform a projection of the qualitative variables on the subspaces spanned by quantitative ones. Subsequently, an optimal model is allocated to the resulting PCA-regressed subspaces.
A Review of Medicinal Plants for the Treatment of Earache and Tinnitus in Iran.
Mahmoudian-Sani, Mohammad Reza; Hashemzadeh-Chaleshtori, Morteza; Asadi-Samani, Majid; Luther, Tahra
2017-06-01
Despite numerous trials, there has not yet been any definite strategy to reduce replicable long-term tinnitus and earache. Complementary and alternative medical approaches have been used to decrease the symptoms of tinnitus and earache. This study was conducted to report medicinal plants that are used to treat ear disorders, especially earache and tinnitus in different regions of Iran. Directory of Open Access Journals (DOAJ), Google Scholar, PubMed, LISTA (EBSCO), Embase, and Web of Science were searched using relevant search terms to retrieve eligible publications. Twenty-three species from sixteen families were used for the treatment of earache and tinnitus in Iran. Plants from families Asteraceae and Lamiaceae were the most commonly used plants for the treatment of earache. Ginkgo biloba was frequently reported for the treatment of tinnitus. This study shows the important role of medicinal plants in the treatment of earache and tinnitus in some regions of Iran. The medicinal plants reported in this review can be considered in treatments for earache and tinnitus if examined more extensively in clinical trials.
Momordica charantia: a popular health-promoting vegetable with multifunctionality.
Wang, Shuzhen; Li, Zhiliang; Yang, Guliang; Ho, Chi-Tang; Li, Shiming
2017-05-24
Products derived from edible medicinal plants have been used for centuries to prevent, treat, and even cure multiple diseases. Momordica charantia L., widely cultivated around the world, is a typical one bred for vegetables and medicinal usage. All parts of M. charantia possess important medicinal properties, including antidiabetic, anticancer, hypotensive, anti-obesity, antimicrobial, antihyperlipidemic, antioxidant, anti-inflammatory, immuno-modulatory, anthelmintic, neuro-protective, as well as hepato-protective properties both in vitro and in vivo. This review summarizes the active components and medicinal properties of M. charantia, especially the activities and mechanisms of its anti-diabetic and anti-cancer properties. The anti-diabetic properties involve inhibiting intestinal α-glucosidase and glucose transport, protecting islet β-cells, enhancing insulin secretion, increasing hepatic glucose disposal, decreasing gluconeogenesis, and even ameliorating insulin resistance. Moreover, the expressions of PPARs could also be activated and up-regulated. Meanwhile, its anticancer properties are mostly due to apoptosis, cell cycle arrest, and expression of serum factors associated with immunity. In this review, we aim to provide an overview of M. charantia and its benefits for development as a functional food.
Optical Fiber-Based MR-Compatible Sensors for Medical Applications: An Overview
Taffoni, Fabrizio; Formica, Domenico; Saccomandi, Paola; Di Pino, Giovanni; Schena, Emiliano
2013-01-01
During last decades, Magnetic Resonance (MR)—compatible sensors based on different techniques have been developed due to growing demand for application in medicine. There are several technological solutions to design MR-compatible sensors, among them, the one based on optical fibers presents several attractive features. The high elasticity and small size allow designing miniaturized fiber optic sensors (FOS) with metrological characteristics (e.g., accuracy, sensitivity, zero drift, and frequency response) adequate for most common medical applications; the immunity from electromagnetic interference and the absence of electrical connection to the patient make FOS suitable to be used in high electromagnetic field and intrinsically safer than conventional technologies. These two features further heightened the potential role of FOS in medicine making them especially attractive for application in MRI. This paper provides an overview of MR-compatible FOS, focusing on the sensors employed for measuring physical parameters in medicine (i.e., temperature, force, torque, strain, and position). The working principles of the most promising FOS are reviewed in terms of their relevant advantages and disadvantages, together with their applications in medicine. PMID:24145918
Value-based medicine and ophthalmology: an appraisal of cost-utility analyses.
Brown, Gary C; Brown, Melissa M; Sharma, Sanjay; Brown, Heidi; Smithen, Lindsay; Leeser, David B; Beauchamp, George
2004-01-01
To ascertain the extent to which ophthalmologic interventions have been evaluated in value-based medicine format. Retrospective literature review. Papers in the healthcare literature utilizing cost-utility analysis were reviewed by researchers at the Center for Value-Based Medicine, Flourtown, Pennsylvania. A literature review of papers addressing the cost-utility analysis of ophthalmologic procedures in the United States over a 12-year period from 1992 to 2003 was undertaken using the National Library of Medicine and EMBASE databases. The cost-utility of ophthalmologic interventions in inflation-adjusted (real) year 2003 US dollars expended per quality-adjusted life-year (dollars/QALY) was ascertained in all instances. A total of 19 papers were found, including a total of 25 interventions. The median cost-utility of ophthalmologic interventions was 5,219 dollars/QALY, with a range from 746 dollars/QALY to 6.5 million dollars/QALY. The majority of ophthalmologic interventions are especially cost-effective by conventional standards. This is because of the substantial value that ophthalmologic interventions confer to patients with eye diseases for the resources expended.
A comparative legal analysis of social media advertising of drugs in Germany and the United States.
Buechner, Bianca
2013-01-01
Pharmaceutical companies use social media such as Facebook and Twitter more and more to advertise their products. Advertising of medicinal products especially in social media is a critical issue confronting patient protection, competition law and ethical concerns in direct-to-consumer advertising. Advertising in the World Wide Web must take into account national and international regulations, depending on which user from which country will have access to the information posted. Different legal requirements, if any, regulate the advertising of medicinal products. This paper discusses, challenges and compares the requirements and regulations of advertising medicinal products in social media, such as Facebook, in the United States on a federal level and the European Union with Germany as a reference Member State. Social media are very active and fast moving. Therefore, it is challenging and necessary at the same time to set guidelines and regulations for the use of social media in drug advertising. This paper is a first step toward promoting an international, consistent approach when talking about regulating advertising of medicinal products in social media.
MacLean, Adam L; Harrington, Heather A; Stumpf, Michael P H; Byrne, Helen M
2016-01-01
The last decade has seen an explosion in models that describe phenomena in systems medicine. Such models are especially useful for studying signaling pathways, such as the Wnt pathway. In this chapter we use the Wnt pathway to showcase current mathematical and statistical techniques that enable modelers to gain insight into (models of) gene regulation and generate testable predictions. We introduce a range of modeling frameworks, but focus on ordinary differential equation (ODE) models since they remain the most widely used approach in systems biology and medicine and continue to offer great potential. We present methods for the analysis of a single model, comprising applications of standard dynamical systems approaches such as nondimensionalization, steady state, asymptotic and sensitivity analysis, and more recent statistical and algebraic approaches to compare models with data. We present parameter estimation and model comparison techniques, focusing on Bayesian analysis and coplanarity via algebraic geometry. Our intention is that this (non-exhaustive) review may serve as a useful starting point for the analysis of models in systems medicine.
Detection of carbonaceous material in naga bhasma.
Singh, S K; Rai, S B
2012-03-01
Traditional medicines have maintained their popularity in all regions of the developing world and are being adopted increasingly by people worldwide. Indian traditional system of medicine Ayurveda make use of unique metallic-herbal preparations (called Bhasma) which involves different processing steps including repeated steps of calcination of metal in the presence of natural precursor (herbal juices, decoctions, and powders, etc). It has been recently established that Bhasma contains nano/sub-micron size particles and different nutrient elements. However, the role and the end product of the raw materials, especially the herbal parts, used during the synthesis of the drug (Bhasma) is one of the important but unanswered problems in such medicinal preparations. Present work on Naga Bhasma is an attempt to understand the role of natural precursors in detail. Our results on infrared, Raman and X-ray photoelectron spectroscopy along with thermal measurements identify the presence of carbonaceous material (hydrogenated amorphous carbon) in the drug along with other compounds. In addition, this work also suggests the science and mechanism behind such complex preparations which could help in standardization of such medicines.
Chinese medicine education and its challenges in the United States.
Kwon, Yihyun
2014-04-01
Over the past 4 decades Chinese medicine (CM) has come increasingly into the spotlight in the United States as the clinical effectiveness of CM has been not only empirically well-tested over a long period of time but also proven by recent scientific research. It has proven cost effectiveness, safety, and is authorized for natural and holistic approaches. In consideration, CM is one of the underutilized health care professions in the United States with a promising future. However, CM faces many challenges in its education and system, its niche in the health care system as an independent profession, legal and ethical issues. This paper discusses the confronting issues in the United States: present education, standards of CM education with shifting first professional degree level, new delivery systems of CM education. Development of new research models, training of evidence-based practice, and implementation of integrative medicine into CM education also are the key issues in the current CM profession. This paper also discusses opportunities for the CM profession going beyond the current status, especially with a focus on fusion medicine.
Why teach literature and medicine? Answers from three decades.
Jones, Anne Hudson
2013-12-01
In this essay, I look back at some of the earliest attempts by the first generation of literature-and-medicine scholars to answer the question: Why teach literature and medicine? Reviewing the development of the field in its early years, I examine statements by practitioners to see whether their answers have held up over time and to consider how the rationales they articulated have expanded or changed in the following years and why. Greater emphasis on literary criticism, narrative ethics, narrative theory, and reflective writing has influenced current work in the field in ways that could not have been foreseen in the 1970s. The extraordinary growth of interest and work in the field nationally and, especially since 1996, internationally has included practitioners in many additional areas such as disability studies, film studies, therapeutic writing, and trauma studies. Along with the emergence of narrative medicine, this diverse community of scholars and practitioners-affiliated more through their use of narrative methodologies than the teaching of literature-makes the perennial challenge of evaluation and assessment even more complicated.
VALUE-BASED MEDICINE AND OPHTHALMOLOGY: AN APPRAISAL OF COST-UTILITY ANALYSES
Brown, Gary C; Brown, Melissa M; Sharma, Sanjay; Brown, Heidi; Smithen, Lindsay; Leeser, David B; Beauchamp, George
2004-01-01
ABSTRACT Purpose To ascertain the extent to which ophthalmologic interventions have been evaluated in value-based medicine format. Methods Retrospective literature review. Papers in the healthcare literature utilizing cost-utility analysis were reviewed by researchers at the Center for Value-Based Medicine, Flourtown, Pennsylvania. A literature review of papers addressing the cost-utility analysis of ophthalmologic procedures in the United States over a 12-year period from 1992 to 2003 was undertaken using the National Library of Medicine and EMBASE databases. The cost-utility of ophthalmologic interventions in inflation-adjusted (real) year 2003 US dollars expended per quality-adjusted life-year ($/QALY) was ascertained in all instances. Results A total of 19 papers were found, including a total of 25 interventions. The median cost-utility of ophthalmologic interventions was $5,219/QALY, with a range from $746/QALY to $6.5 million/QALY. Conclusions The majority of ophthalmologic interventions are especially cost-effective by conventional standards. This is because of the substantial value that ophthalmologic interventions confer to patients with eye diseases for the resources expended. PMID:15747756
Role of Nutrition in Children Growth in View of Traditional Medicine
Farsani, Gholamreza Mohammadi; Movahhed, Mina
2016-01-01
Background: Growth and development are the basic science in pediatric medicine. Growth disorder in children is one of the important health problems in the world, especially in developing countries. Regardless of the underlying disease, as the main cause of growth disorders, assessment and correction of nutritional status of these children are very important. Given the fundamental importance of this issue and ascending tendency to use complementary medicine in the world, this article discusses the traditional Iranian philosopher’s views on the role of nutrition in child development. Methods: This study reviews textbooks of traditional medicine, particularly in the field of pediatric medicine with a focus on Canon of Medicine of Avicenna. Results: Temperament is the physiological concept of the human body in traditional medicine and has an important role in health, diagnosis, and treatment of disease. Generally, children are born with warm and wet temperament that provides the best condition for growth. However, the personal temperament of each child determines growth, the need for a variety of food groups, and even physical activity. Different appetite and food preferences in children show temperamental variation. Therefore, children need special management regarding special temperament. In Iranian traditional medicine, special lifestyle orders are discussed in detail according to these differentiations and nutritional management is the most important factor considered. Conclusion: In spite of advances in classical medicine in the prevention and treatment of many diseases, there are still a lot of therapeutic challenges in many health problems. Temperamental approach to the human body in traditional medicine provides a different perspective on the medicine. Reflecting on temperamental view in child development may lead to a better understanding of the diagnosis and treatment of diseases. On the other hand, further research studies based on the reform of nutrition with respect to temperament should be considered as a new strategy in the management of developmental disorders. PMID:27840523
Role of Nutrition in Children Growth in View of Traditional Medicine.
Farsani, Gholamreza Mohammadi; Movahhed, Mina
2016-05-01
Growth and development are the basic science in pediatric medicine. Growth disorder in children is one of the important health problems in the world, especially in developing countries. Regardless of the underlying disease, as the main cause of growth disorders, assessment and correction of nutritional status of these children are very important. Given the fundamental importance of this issue and ascending tendency to use complementary medicine in the world, this article discusses the traditional Iranian philosopher's views on the role of nutrition in child development. This study reviews textbooks of traditional medicine, particularly in the field of pediatric medicine with a focus on Canon of Medicine of Avicenna. Temperament is the physiological concept of the human body in traditional medicine and has an important role in health, diagnosis, and treatment of disease. Generally, children are born with warm and wet temperament that provides the best condition for growth. However, the personal temperament of each child determines growth, the need for a variety of food groups, and even physical activity. Different appetite and food preferences in children show temperamental variation. Therefore, children need special management regarding special temperament. In Iranian traditional medicine, special lifestyle orders are discussed in detail according to these differentiations and nutritional management is the most important factor considered. In spite of advances in classical medicine in the prevention and treatment of many diseases, there are still a lot of therapeutic challenges in many health problems. Temperamental approach to the human body in traditional medicine provides a different perspective on the medicine. Reflecting on temperamental view in child development may lead to a better understanding of the diagnosis and treatment of diseases. On the other hand, further research studies based on the reform of nutrition with respect to temperament should be considered as a new strategy in the management of developmental disorders.
Integrative Medicine Selects Best Practice from Public Health and Biomedicine
Ryan, Terence J
2013-01-01
The meaning of terms Integrated and Integrative are described variously by an amalgam of latest scientific advances with ancient healing systems, of complementary medicine and biomedicine, and sexually transmitted infections and HIV/AIDS. It means seamless good quality care between hospital and primary care. They provoke approval mostly from patients and disapproval mostly from advocates of science and evidence-based medicine. The Institute of Applied Dermatology in Kasaragod, Kerala, India has championed a mix of Biomedicine, Yoga and herbals from Ayurvedic medicine, partly based on publications from the Department of Dermatology of the University of Oxford. In Oxford dermatology, acceptance of value of integrative medicine (IM) is demonstrated, especially in wound healing and the skin's blood supply. This has long featured in the university's research program. A variety of approaches to the practice of medicine are illustrated with reference to Osler, Garrod, and Doll. IM is believed to underlie contemporarily best practice. Particular emphasis is given to the control of heat, pain, redness, and swelling, all manifestations of inflammation, and the importance of emotion as a stimulus or inhibitor carried by neural pathways. These may explain some unbelievable Asian practices and one of the many roles of Yoga. The concept of Integrative is expanded to include care of the earth and nutrition, the hazards of climate change, Gardens for Health, do (k) no (w) harm as a key to good practice. PMID:23716803
[Ten years of early complex geriatric rehabilitation therapy in the DRG system].
Kolb, G; Breuninger, K; Gronemeyer, S; van den Heuvel, D; Lübke, N; Lüttje, D; Wittrich, A; Wolff, J
2014-01-01
Geriatric medicine, as a specialized form of treatment for the elderly, is gaining in importance due to demographic changes. Especially important for geriatric medicine is combining acute care with the need to maintain functionality and participation. This includes prevention of dependency on structured care or chronic disability and handicap by means of rehabilitation. Ten years ago, the German DRG system tried to incorporate procedures (e.g., "early rehabilitation in geriatric medicine") in the hospital reimbursement system. OPS 8-550.x, defined by structural quality, days of treatment, and number of therapeutic interventions, triggers 17 different geriatric DRGs, covering most of the fields of medicine. OPS 8-550.x had been revised continuously to give a clear structure to quality aspects of geriatric procedures. However, OPS 8-550.x is based on proven need of in-hospital treatment. In the last 10 years, no such definition has been produced taking aspects of the German hospital system into account as well as aspects of transparency and benefit in everyday work. The German DRG system covers just basic reimbursement aspects of geriatric medicine quite well; however, a practicable and patient-oriented definition of "hospital necessity" is still lacking, but is absolutely essential for proper compensation. A further problem concerning geriatric medicine reimbursement in the DRG system is due to the different structures of providing geriatric in-hospital care throughout Germany.
New developments in anti-malarial target candidate and product profiles.
Burrows, Jeremy N; Duparc, Stephan; Gutteridge, Winston E; Hooft van Huijsduijnen, Rob; Kaszubska, Wiweka; Macintyre, Fiona; Mazzuri, Sébastien; Möhrle, Jörg J; Wells, Timothy N C
2017-01-13
A decade of discovery and development of new anti-malarial medicines has led to a renewed focus on malaria elimination and eradication. Changes in the way new anti-malarial drugs are discovered and developed have led to a dramatic increase in the number and diversity of new molecules presently in pre-clinical and early clinical development. The twin challenges faced can be summarized by multi-drug resistant malaria from the Greater Mekong Sub-region, and the need to provide simplified medicines. This review lists changes in anti-malarial target candidate and target product profiles over the last 4 years. As well as new medicines to treat disease and prevent transmission, there has been increased focus on the longer term goal of finding new medicines for chemoprotection, potentially with long-acting molecules, or parenteral formulations. Other gaps in the malaria armamentarium, such as drugs to treat severe malaria and endectocides (that kill mosquitoes which feed on people who have taken the drug), are defined here. Ultimately the elimination of malaria requires medicines that are safe and well-tolerated to be used in vulnerable populations: in pregnancy, especially the first trimester, and in those suffering from malnutrition or co-infection with other pathogens. These updates reflect the maturing of an understanding of the key challenges in producing the next generation of medicines to control, eliminate and ultimately eradicate malaria.
Ethnopharmacological Approaches for Therapy of Jaundice: Part I
Tewari, Devesh; Mocan, Andrei; Parvanov, Emil D.; Sah, Archana N.; Nabavi, Seyed M.; Huminiecki, Lukasz; Ma, Zheng Feei; Lee, Yeong Yeh; Horbańczuk, Jarosław O.; Atanasov, Atanas G.
2017-01-01
Jaundice is a very common symptom especially in the developing countries. It is associated with several hepatic diseases which are still major causes of death. There are many different approaches to jaundice treatment and the growing number of ethnomedicinal studies shows the plant pharmacology as very promising direction. Many medicinal plants are used for the treatment of jaundice, however a comprehensive review on this subject has not been published. The use of medicinal plants in drug discovery is highly emphasized (based on their traditional and safe uses in different folk medicine systems from ancient times). Many sophisticated analytical techniques are emerging in the pharmaceutical field to validate and discover new biologically active chemical entities derived from plants. Here, we aim to classify and categorize medicinal plants relevant for the treatment of jaundice according to their origin, geographical location, and usage. Our search included various databases like Pubmed, ScienceDirect, Google Scholar. Keywords and phrases used for these searches included: “jaundice,” “hyperbilirubinemia,” “serum glutamate,” “bilirubin,” “Ayurveda.” The first part of the review focuses on the variety of medicinal plant used for the treatment of jaundice (a total of 207 medicinal plants). In the second part, possible mechanisms of action of biologically active secondary metabolites of plants from five families for jaundice treatment are discussed. PMID:28860989
Community medicine teaching and evaluation: scope of betterment.
Gopalakrishnan, S; Kumar, P Ganesh
2015-01-01
There have been rapid and extensive changes in the way assessment is conducted in medical education. Assessment brings about standardization of the manner in which the syllabus is to be implemented and also gives guidelines regarding the teaching pattern, especially when the student is going to rotate through various departments in a medical college. Community Medicine is an important branch of medicine concerned with the health of populations. Existing forms of assessment of community medicine education mainly consists of internal [formative] assessment and final (summative) examination. Advantages of the present system is the similarity of the methods used for internal assessments and final examinations and is relatively easily done since only the knowledge application and recall ability of the student in theory and practical are assessed. Disadvantages in the current evaluation system are neglecting the assessment of psychomotor, affective and communication skills. Evaluation systems can be improved by implementing techniques to assess psychomotor skills, presentation and communication skills, organizational skills and the student's ability to work in a team. Regular feedback from students should be taken periodically for the betterment of Community Medicine education. This article is meant to sensitise the academic experts in medical education to plan better need based methods of assessment in the subject of Community Medicine, in relation to the new MCI 2012 Regulations, in order to make it a better learning experience for the students.
Community Medicine Teaching and Evaluation: Scope of Betterment
Kumar, P. Ganesh
2015-01-01
There have been rapid and extensive changes in the way assessment is conducted in medical education. Assessment brings about standardization of the manner in which the syllabus is to be implemented and also gives guidelines regarding the teaching pattern, especially when the student is going to rotate through various departments in a medical college. Community Medicine is an important branch of medicine concerned with the health of populations. Existing forms of assessment of community medicine education mainly consists of internal [formative] assessment and final (summative) examination. Advantages of the present system is the similarity of the methods used for internal assessments and final examinations and is relatively easily done since only the knowledge application and recall ability of the student in theory and practical are assessed. Disadvantages in the current evaluation system are neglecting the assessment of psychomotor, affective and communication skills. Evaluation systems can be improved by implementing techniques to assess psychomotor skills, presentation and communication skills, organizational skills and the student’s ability to work in a team. Regular feedback from students should be taken periodically for the betterment of Community Medicine education. This article is meant to sensitise the academic experts in medical education to plan better need based methods of assessment in the subject of Community Medicine, in relation to the new MCI 2012 Regulations, in order to make it a better learning experience for the students. PMID:25738009
Teaching science vs. the apprentice model--do we really have the choice?
Marckmann, G
2001-01-01
The debate about the appropriate methodology of medical education has been (and still is) dominated by the opposing poles of teaching science versus teaching practical skills. I will argue that this conflict between scientific education and practical training has its roots in the underlying, more systematic question about the conceptual foundation of medicine: how far or in what respects can medicine be considered to be a science? By analyzing the epistemological status of medicine I will show that the internal aim of medicine ("promoting health through the prevention and treatment of disease") differs from the internal aim of science ("the methodological and systematic acquisition of knowledge"). Therefore, medicine as a whole discipline should not be considered as a science. However, medicine can be conceptually and methodologically scientific in so much as it is based on scientific knowledge. There is evidence from cognitive science research that diagnostic reasoning not only relies on the application of scientific knowledge but also--especially in routine cases--on a process of pattern recognition, a reasoning strategy based on the memory of previously encountered patients. Hence, medical education must contain both: the imparting of scientific knowledge and the rich exposure to concrete cases during practical training. Hence, the question of teaching science vs. the apprentice model will not be "either-or" but rather "both--but in which proportion?"
Theranostics and metabolotheranostics for precision medicine in oncology
NASA Astrophysics Data System (ADS)
Bhujwalla, Zaver M.; Kakkad, Samata; Chen, Zhihang; Jin, Jiefu; Hapuarachchige, Sudath; Artemov, Dmitri; Penet, Marie-France
2018-06-01
Most diseases, especially cancer, would significantly benefit from precision medicine where treatment is shaped for the individual. The concept of theragnostics or theranostics emerged around 2002 to describe the incorporation of diagnostic assays into the selection of therapy for this purpose. Increasingly, theranostics has been used for strategies that combine noninvasive imaging-based diagnostics with therapy. Within the past decade theranostic imaging has transformed into a rapidly expanding field that is located at the interface of diagnosis and therapy. A critical need in cancer treatment is to minimize damage to normal tissue. Molecular imaging can be applied to identify targets specific to cancer with imaging, design agents against these targets to visualize their delivery, and monitor response to treatment, with the overall purpose of minimizing collateral damage. Genomic and proteomic profiling can provide an extensive 'fingerprint' of each tumor. With this cancer fingerprint, theranostic agents can be designed to personalize treatment for precision medicine of cancer, and minimize damage to normal tissue. Here, for the first time, we have introduced the term 'metabolotheranostics' to describe strategies where disease-based alterations in metabolic pathways detected by MRS are specifically targeted with image-guided delivery platforms to achieve disease-specific therapy. The versatility of MRI and MRS in molecular and functional imaging makes these technologies especially important in theranostic MRI and 'metabolotheranostics'. Our purpose here is to provide insights into the capabilities and applications of this exciting new field in cancer treatment with a focus on MRI and MRS.
Hofer, M; Jansen, M; Soboll, S
2006-02-24
As part of the new regulations for licensing doctors there have been numerous attempts at reform by many medical faculties to consider interdisciplinary linkage of the curriculum with emphasis on teaching of small groups of students. This study was undertaken to help answer the question of how much weight should be given to the various subjects and what resources are needed for any reformed curriculum and what key areas of competence need to be given greater importance. 1029 candidates of specialist examinations of the Medical Council of North-Rhine in 2002 and 2003 filled in questionnaires to evaluate retrospectively the actual relevance of individual preclinical and clinical subjects, courses and areas of practical competence to their further medical education and related potentials for improvement in their studies. The participants were from 5 medical faculties in the North-Rhine area of Germany. They were also asked about methods of examination that were effective in aiding their learning behaviour. Those answering the questionnaire considered especially chemistry and physics as well as environmental, occupational and forensic medicine, bio-mathematics, radiotherapy and nuclear medicine among the less relevant subjects. On the other hand, anatomy, physiology, internal medicine, pharmacology and surgery were considered especially relevant. The greatest deficiencies in most of the medical curricula as taught in the North-Rhine medical courses are in the areas of competence in communication and practical clinical skills. Members of this group also pleaded for an increased use of standardized objective structured clinical examinations (OSCE).
Njimoh, Dieudonné Lemuh; Assob, Jules Clement N.; Mokake, Seraphine Ebenye; Nyhalah, Dinga Jerome; Yinda, Claude Kwe; Sandjon, Bertrand
2015-01-01
Microbial infections till date remain a scourge of humanity due to lack of vaccine against some infections, emergence of drug resistant phenotypes, and the resurgence of infections amongst others. Continuous quest for novel therapeutic approaches remains imperative. Here we (i) assessed the effects of extracts/hydrolates of some medicinal plants on pathogenic microorganisms and (ii) evaluated the inhibitory potential of the most active ones in combination with antibiotics. Extract E03 had the highest DZI (25 mm). Extracts E05 and E06 were active against all microorganisms tested. The MICs and MBCs of the methanol extracts ranged from 16.667 × 103 μg/mL to 2 μg/mL and hydrolates from 0.028 to 333333 ppm. Extract E30 had the highest activity especially against S. saprophyticus (MIC of 6 ppm) and E. coli (MIC of 17 ppm). Combination with conventional antibiotics was shown to overcome resistance especially with E30. Analyses of the extracts revealed the presence of alkaloids, flavonoids, triterpenes, steroids, phenols, and saponins. These results justify the use of these plants in traditional medicine and the practice of supplementing decoctions/concoctions with conventional antibiotics. Nauclea pobeguinii (E30), the most active and synergistic of all these extracts, and some hydrolates with antimicrobial activity need further exploration for the development of novel antimicrobials. PMID:26180528
Pelaccia, Thierry; Tardif, Jacques; Triby, Emmanuel; Charlin, Bernard
2017-07-01
Making diagnostic and therapeutic decisions is a critical activity among physicians. It relies on the ability of physicians to use cognitive processes and specific knowledge in the context of a clinical reasoning. This ability is a core competency in physicians, especially in the field of emergency medicine where the rate of diagnostic errors is high. Studies that explore medical decision making in an authentic setting are increasing significantly. They are based on the use of qualitative methods that are applied at two separate times: 1) a video recording of the subject's actual activity in an authentic setting and 2) an interview with the subject, supported by the video recording. Traditionally, activity is recorded from an "external perspective"; i.e., a camera is positioned in the room in which the consultation takes place. This approach has many limits, both technical and with respect to the validity of the data collected. The article aims at 1) describing how decision making is currently being studied, especially from a qualitative standpoint, and the reasons why new methods are needed, and 2) reporting how we used an original, innovative approach to study decision making in the field of emergency medicine and findings from these studies to guide further the use of this method. The method consists in recording the subject's activity from his own point of view, by fixing a microcamera on his temple or the branch of his glasses. An interview is then held on the basis of this recording, so that the subject being interviewed can relive the situation, to facilitate the explanation of his reasoning with respect to his decisions and actions. We describe how this method has been used successfully in investigating medical decision making in emergency medicine. We provide details on how to use it optimally, taking into account the constraints associated with the practice of emergency medicine and the benefits in the study of clinical reasoning. The "own-point-of-view" video technique is a promising method to study clinical decision making in emergency medicine. It is a powerful tool to stimulate recall and help physicians make their reasoning explicit, thanks to a greater psychological immersion. © 2017 by the Society for Academic Emergency Medicine.
Clinical decision-making and secondary findings in systems medicine.
Fischer, T; Brothers, K B; Erdmann, P; Langanke, M
2016-05-21
Systems medicine is the name for an assemblage of scientific strategies and practices that include bioinformatics approaches to human biology (especially systems biology); "big data" statistical analysis; and medical informatics tools. Whereas personalized and precision medicine involve similar analytical methods applied to genomic and medical record data, systems medicine draws on these as well as other sources of data. Given this distinction, the clinical translation of systems medicine poses a number of important ethical and epistemological challenges for researchers working to generate systems medicine knowledge and clinicians working to apply it. This article focuses on three key challenges: First, we will discuss the conflicts in decision-making that can arise when healthcare providers committed to principles of experimental medicine or evidence-based medicine encounter individualized recommendations derived from computer algorithms. We will explore in particular whether controlled experiments, such as comparative effectiveness trials, should mediate the translation of systems medicine, or if instead individualized findings generated through "big data" approaches can be applied directly in clinical decision-making. Second, we will examine the case of the Riyadh Intensive Care Program Mortality Prediction Algorithm, pejoratively referred to as the "death computer," to demonstrate the ethical challenges that can arise when big-data-driven scoring systems are applied in clinical contexts. We argue that the uncritical use of predictive clinical algorithms, including those envisioned for systems medicine, challenge basic understandings of the doctor-patient relationship. Third, we will build on the recent discourse on secondary findings in genomics and imaging to draw attention to the important implications of secondary findings derived from the joint analysis of data from diverse sources, including data recorded by patients in an attempt to realize their "quantified self." This paper examines possible ethical challenges that are likely to be raised as systems medicine to be translated into clinical medicine. These include the epistemological challenges for clinical decision-making, the use of scoring systems optimized by big data techniques and the risk that incidental and secondary findings will significantly increase. While some ethical implications remain still hypothetical we should use the opportunity to prospectively identify challenges to avoid making foreseeable mistakes when systems medicine inevitably arrives in routine care.
Santa-Ana-Tellez, Yared; Mantel-Teeuwisse, Aukje K; Leufkens, Hubert G M; Wirtz, Veronika J
2016-11-01
We evaluated changes in the use of non-steroidal anti-inflammatory drugs (NSAIDs), non-opioid analgesics and cough and cold medicines and its relation with the use of antibiotics after the over-the-counter (OTC) antibiotic sales restrictions in Mexico and Brazil. IMS Health provided retail quarterly data from the private sectors in Mexico and Brazil from the first quarter of 2007 to the first quarter of 2013. Data of each active substance of antibiotics, easily accessible medicines perceived as antibiotics substitutes (cough and cold medicines, analgesics and NSAIDs-the latter two being combined in the analyses), and medicines to control for external factors that can affect the medicines usage trend (antihypertensives) were converted from kilograms to defined daily doses per 1000 inhabitants days (DDD/TID). Interrupted time series were used to estimate changes in level of medicines use at the intervention point and slope after the regulation. The Gregory-Hansen cointegration test was used to explore the relation between the use of antibiotics and perceived substitutes. After the regulation in Mexico NSAIDs-analgesics usage level increased by 1.1 DDD/TID with a slope increase of 0.2 DDD/TID per quarter and the cough and cold medicines usage level increased by 0.4 DDD/TID. In Brazil NSAIDs-analgesics usage level increased by 1.9 DDD/TID, and cough and cold medicines did not change. In the two countries, NSAIDs-analgesics usage changes were related with antibiotic usage changes; in Mexico cough and cold medicines usage changes had a relation with the antibiotics usage changes. These results showed a substitution effect on the use of other medicines, especially NSAIDs and analgesics, after reinforcement of OTC antibiotics sales restrictions. These regulations aimed to improve the antibiotics use and as a consequence reduce antimicrobial resistance; however, this type of policies should be comprehensive and take into account the potential substitution effects on the use of other medicines. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
ERIC Educational Resources Information Center
Strobl, Carolin; Malley, James; Tutz, Gerhard
2009-01-01
Recursive partitioning methods have become popular and widely used tools for nonparametric regression and classification in many scientific fields. Especially random forests, which can deal with large numbers of predictor variables even in the presence of complex interactions, have been applied successfully in genetics, clinical medicine, and…
An Evolutionary Algorithm for Feature Subset Selection in Hard Disk Drive Failure Prediction
ERIC Educational Resources Information Center
Bhasin, Harpreet
2011-01-01
Hard disk drives are used in everyday life to store critical data. Although they are reliable, failure of a hard disk drive can be catastrophic, especially in applications like medicine, banking, air traffic control systems, missile guidance systems, computer numerical controlled machines, and more. The use of Self-Monitoring, Analysis and…
Pediatric formulations: international issues and potential solutions.
Knoppert, David C
2009-01-01
Appropriate dosage forms of medication are often not available for use in newborns, infants, and young children. This is a worldwide phenomenon, but especially in developing countries. The WHO's 'Make medicines child size' campaign emphasizes this shortcoming. Professional organizations, industry, and government from the international arena have the resources to address this and need to work together to create solutions.
ERIC Educational Resources Information Center
Bell, Peter T.; Whaley, W. Lance; Tochterman, Alyssa D.; Mueller, Karl S.; Schultz, Linda D.
2017-01-01
NMR spectroscopy is currently a premier technique for structural elucidation of organic molecules. Quantitative NMR (qNMR) methodology has developed more slowly but is now widely accepted, especially in the areas of natural product and medicinal chemistry. However, many undergraduate students are not routinely exposed to this important concept.…
Kim, Ji Hye; Shin, Yong Cheol; Ko, Seong-Gyu
2014-01-01
Despite the fact that numerous researches were performed on prevention and treatment of inflammation related diseases, the overall incidence has not changed remarkably. This requires new approaches to overcome inflammation mediated diseases, and thus traditional medicine could be an efficacious source for prevention and treatment of these diseases. In this review, we discuss the contribution of traditional medicine, especially Rhus verniciflua Stokes, to modern medicine against diverse inflammation mediated diseases. Traditionally, this remedy has been used in Eastern Asia for the treatment of gastric problems, hepatic disorders, infectious diseases, and blood disorders. Modern science has provided the scientific basis for the use of Rhus verniciflua Stokes against such disorders and diseases. Various chemical constituents have been identified from this plant, including phenolic acid, and flavonoids. Cell-based studies have exhibited the potential of this as antibacterial, antioxidant, neuroprotective, anti-inflammatory, growth inhibitory, and anticancer activities. Enormous animal studies have shown the potential of this against proinflammatory diseases, neurodegenerative diseases, diabetes, liver diseases, and chemical insults. At the molecular level, this medicinal plant has been shown to modulate diverse cell-signaling pathways. In clinical studies, Rhus verniciflua Stokes has shown efficacy against various cancer patients such as colorectal, gastric, hepatic, renal, pancreatic, and pulmonary cancers. Thus, this remedy is now exhibiting activities in the clinic. PMID:25024508
Fu, Haiyan; Fan, Yao; Zhang, Xu; Lan, Hanyue; Yang, Tianming; Shao, Mei; Li, Sihan
2015-01-01
As an effective method, the fingerprint technique, which emphasized the whole compositions of samples, has already been used in various fields, especially in identifying and assessing the quality of herbal medicines. High-performance liquid chromatography (HPLC) and near-infrared (NIR), with their unique characteristics of reliability, versatility, precision, and simple measurement, played an important role among all the fingerprint techniques. In this paper, a supervised pattern recognition method based on PLSDA algorithm by HPLC and NIR has been established to identify the information of Hibiscus mutabilis L. and Berberidis radix, two common kinds of herbal medicines. By comparing component analysis (PCA), linear discriminant analysis (LDA), and particularly partial least squares discriminant analysis (PLSDA) with different fingerprint preprocessing of NIR spectra variables, PLSDA model showed perfect functions on the analysis of samples as well as chromatograms. Most important, this pattern recognition method by HPLC and NIR can be used to identify different collection parts, collection time, and different origins or various species belonging to the same genera of herbal medicines which proved to be a promising approach for the identification of complex information of herbal medicines. PMID:26345990
Mahmood, Sidra; Hussain, Shahzad; Malik, Farnaz
2014-01-01
WHO estimates, around 80% of the especially developing world is indigent on complementary and alternative medicines which are prodigiously derived from herbal material. Parsley (Petroselinum crispum) is an important culinary herb originated from the Mediterranean region. It possesses small and dark seeds with volatile oil content. Petroselinum crispum is now planted throughout the world due to its usage in food industry, perfume manufacturing, soaps, and creams. Its main constituents subsume coumarins, furanocoumarins (bergapten, imperatori), ascorbic acid, carotenoids, flavonoids, apiole, various terpenoic compounds, phenyl propanoids, phathalides, and tocopherol. Due to these constituents, it has been annunciated to possess a number of possible medicinal emblematics including, antimicrobial, antianemic, menorrhagic, anticoagulant, antihyperlipidemic, antihepatotoxic, antihypertensive, diuretic effects, hypoglycaemic, hypouricemic, anti oxidative and estrogenic activities. In Morocco, Parsley is mostly used as an elixir to treat arterial hypertension, diabetes, cardiac and renal diseases. Antioxidant and antibacterial activities of parsley, made it propitious in food systems. Its ELI17 gene has been corroborated as a particularly fast-responding gene. There is a requisite for extensive research to avail the maximal benefits of this significant medicinal plant. The aim of this review paper is to divulge the chemical constituents of parsley that are explicitly related to substantial medicinal facets.
The role of medicinal plants in the treatment of diabetes: a systematic review
Kooti, Wesam; Farokhipour, Maryam; Asadzadeh, Zahra; Ashtary-Larky, Damoon; Asadi-Samani, Majid
2016-01-01
Introduction Diabetes is a serious metabolic disorder and plenty of medical plants are used in traditional medicines to treat diabetes. These plants have no side effects and many existing medicines are derived from the plants. The purpose of this systematic review is to study diabetes and to summarize the available treatments for this disease, focusing especially on herbal medicine. Methods Required papers about diabetes and effective plants were searched from the databases, including Science direct, PubMed, Wiley, Scopus, and Springer. Keywords in this study are ”medicinal plants”, “diabetes”, “symptom”, “herbal”, and “treatment”. Out of the 490 collected articles (published in the period between 1995 and 2015), 450 were excluded due to non-relevance or lack of access to the original article. Results Diabetes is mainly due to oxidative stress and an increase in reactive oxygen species that can have major effects. Many plants contain different natural antioxidants, in particular tannins, flavonoids, C and E vitamins that have the ability to maintain β-cells performance and decrease glucose levels in the blood. Conclusion According to published results, it can be said that medical plants are more affordable and have less side effects compared synthetic drugs, and are more effective in treatment of diabetes mellitus. PMID:26955456
Félix-Silva, Juliana; Silva-Junior, Arnóbio Antônio; Zucolotto, Silvana Maria
2017-01-01
Snakebites are a serious problem in public health due to their high morbimortality. Most of snake venoms produce intense local tissue damage, which could lead to temporary or permanent disability in victims. The available specific treatment is the antivenom serum therapy, whose effectiveness is reduced against these effects. Thus, the search for complementary alternatives for snakebite treatment is relevant. There are several reports of the popular use of medicinal plants against snakebites worldwide. In recent years, many studies have been published giving pharmacological evidence of benefits of several vegetal species against local effects induced by a broad range of snake venoms, including inhibitory potential against hyaluronidase, phospholipase, proteolytic, hemorrhagic, myotoxic, and edematogenic activities. In this context, this review aimed to provide an updated overview of medicinal plants used popularly as antiophidic agents and discuss the main species with pharmacological studies supporting the uses, with emphasis on plants inhibiting local effects of snake envenomation. The present review provides an updated scenario and insights into future research aiming at validation of medicinal plants as antiophidic agents and strengthens the potentiality of ethnopharmacology as a tool for design of potent inhibitors and/or development of herbal medicines against venom toxins, especially local tissue damage. PMID:28904556
Félix-Silva, Juliana; Silva-Junior, Arnóbio Antônio; Zucolotto, Silvana Maria; Fernandes-Pedrosa, Matheus de Freitas
2017-01-01
Snakebites are a serious problem in public health due to their high morbimortality. Most of snake venoms produce intense local tissue damage, which could lead to temporary or permanent disability in victims. The available specific treatment is the antivenom serum therapy, whose effectiveness is reduced against these effects. Thus, the search for complementary alternatives for snakebite treatment is relevant. There are several reports of the popular use of medicinal plants against snakebites worldwide. In recent years, many studies have been published giving pharmacological evidence of benefits of several vegetal species against local effects induced by a broad range of snake venoms, including inhibitory potential against hyaluronidase, phospholipase, proteolytic, hemorrhagic, myotoxic, and edematogenic activities. In this context, this review aimed to provide an updated overview of medicinal plants used popularly as antiophidic agents and discuss the main species with pharmacological studies supporting the uses, with emphasis on plants inhibiting local effects of snake envenomation. The present review provides an updated scenario and insights into future research aiming at validation of medicinal plants as antiophidic agents and strengthens the potentiality of ethnopharmacology as a tool for design of potent inhibitors and/or development of herbal medicines against venom toxins, especially local tissue damage.
Moosa, Shabir; Downing, Raymond; Essuman, Akye; Pentz, Stephen; Reid, Stephen; Mash, Robert
2014-01-17
The World Health Organisation has advocated for comprehensive primary care teams, which include family physicians. However, despite (or because of) severe doctor shortages in Africa, there is insufficient clarity on the role of the family physician in the primary health care team. Instead there is a trend towards task shifting without thought for teamwork, which runs the risk of dangerous oversimplification. It is not clear how African leaders understand the challenges of implementing family medicine, especially in human resource terms. This study, therefore, sought to explore the views of academic and government leaders on critical human resource issues for implementation of family medicine in Africa. In this qualitative study, key academic and government leaders were purposively selected from sixteen African countries. In-depth interviews were conducted using an interview guide. All interviews were audio-recorded, transcribed and thematically analysed. There were 27 interviews conducted with 16 government and 11 academic leaders in nine Sub-Saharan African countries: Botswana, Democratic Republic of Congo, Ghana, Kenya, Malawi, Nigeria, Rwanda, South Africa and Uganda. Respondents spoke about: educating doctors in family medicine suited to Africa, including procedural skills and holistic care, to address the difficulty of recruiting and retaining doctors in rural and underserved areas; planning for primary health care teams, including family physicians; new supervisory models in primary health care; and general human resource management issues. Important milestones in African health care fail to specifically address the human resource issues of integrated primary health care teamwork that includes family physicians. Leaders interviewed in this study, however, proposed organising the district health system with a strong embrace of family medicine in Africa, especially with regard to providing clinical leadership in team-based primary health care. Whilst these leaders focussed positively on entry and workforce issues, in terms of the 2006 World Health Report on human resources for health, they did not substantially address retention of family physicians. Family physicians need to respond to the challenge by respondents to articulate human resource policies appropriate to Africa, including the organisational development of the primary health care team with more sophisticated skills and teamwork.
Behavior of stem cells under outer-space microgravity and ground-based microgravity simulation.
Zhang, Cui; Li, Liang; Chen, Jianling; Wang, Jinfu
2015-06-01
With rapid development of space engineering, research on life sciences in space is being conducted extensively, especially cellular and molecular studies on space medicine. Stem cells, undifferentiated cells that can differentiate into specialized cells, are considered a key resource for regenerative medicine. Research on stem cells under conditions of microgravity during a space flight or a ground-based simulation has generated several excellent findings. To help readers understand the effects of outer space and ground-based simulation conditions on stem cells, we reviewed recent studies on the effects of microgravity (as an obvious environmental factor in space) on morphology, proliferation, migration, and differentiation of stem cells. © 2015 International Federation for Cell Biology.
Tait, Elizabeth M; Laditka, Sarah B; Laditka, James N; Nies, Mary A; Racine, Elizabeth F
2012-01-01
We examined use of complementary and alternative medicine (CAM) for health and well-being by older women and men. Data were from the 2007 National Health Interview Survey, representing 89.5 million Americans ages 50+. Multivariate logistic regression accounted for the survey design. For general health, 52 million people used CAM. The numbers for immune function, physical performance, and energy were 21.6, 15.9, and 10.1 million respectively. In adjusted results, women were much more likely than men to use CAM for all four reasons, especially energy. Older adults, particularly women, could benefit from research on CAM benefits and risks.
Wang, Ningqun; Ji, Shaozhen; Zhang, Hao; Mei, Shanshan; Qiao, Lumin; Jin, Xianglan
2017-12-01
The Cistanche species ("Rou Cong Rong" in Chinese) is an endangered wild species growing in arid or semi-arid areas. The dried fleshy stem of Cistanches has been used as a tonic in China for many years. Modern pharmacological studies have since demonstrated that Herba Cistanches possesses broad medicinal functions, especially for use in anti-senescence, anti-oxidation, neuroprotection, anti-inflammation, hepatoprotection, immunomodulation, anti-neoplastic, anti-osteoporosis and the promotion of bone formation. This review summarizes the up-to-date and comprehensive information on Herba Cistanches covering the aspects of the botany, traditional uses, phytochemistry and pharmacology, to lay ground for fully elucidating the potential mechanisms of Herba Cistanches' anti-aging effect and promote its clinical application as an anti-aging herbal medicine.
Novakovic, Tanja; Martin, Antony P; Parker, Mark; Ferrario, Alessandra; Vukovic, Simo; Łanda, Krzysztof; Duba, Jaroslav; Dankó, Dávid; Kotsopoulos, Nikolaos; Godman, Brian; Ristic, Jelena; Stefanovic, Danka; Tesic, Danka
2017-12-01
The Pharmacoeconomics Section of the Pharmaceutical Association of Serbia organised a one day international conference on the value of innovation in decision-making in health care in Central and Eastern Europe. The focus of the conference was on reimbursement decisions for medicines using health technology assessment and the use of managed entry agreements (MEAs). The objectives of this conference were firstly to discuss the challenges and opportunities with the use of MEAs in Central and Eastern European countries; secondly the role of patient registries especially with outcome based schemes, and finally new approaches to improve accessibility to new medicines including better managing their entry.
"A gentle and humane temper": humility in medicine.
Coulehan, Jack
2011-01-01
Humility is the medical virtue most difficult to understand and practice. This is especially true in contemporary medicine, which has developed a culture more characterized by arrogance and entitlement than by self-effacement and moderation. In such a culture, humility suggests weakness, indecisiveness, or even deception, as in false modesty. Nonetheless, an operational definition of medical humility includes four distinct but closely related personal characteristics that are central to good doctoring: unpretentious openness, honest self-disclosure, avoidance of arrogance, and modulation of self-interest. Humility, like other virtues, is best taught by means of narrative and role modeling. We may rightly be proud of contemporary medical advances, while at the same time experiencing gratitude and humility as healers.
Imhoff, Michael; Cecconi, Maurizio
2015-01-01
Metrology is the science of measurements. Although of critical importance in medicine and especially in critical care, frequent confusion in terms and definitions impact either interphysician communications or understanding of manufacturers’ and engineers’ instructions and limitations when using devices. In this review, we first list the terms defined by the International Bureau of Weights and Measures regarding quantities and units, measurements, devices for measurement, properties of measuring devices, and measurement standards. The traditional tools for assessing the most important measurement quality criteria are also reviewed with clinical examples for diagnosis, alarm, and titration purposes, as well as for assessing the uncertainty of reference methods. PMID:25625255
Telemedicine in Anesthesiology and Reanimatology
Tafro, Lejla; Masic, Izet
2010-01-01
Review SUMMARY In recent years impressive progress is happening in information and telecommunication technologies. The application of computers in medicine allows permanent data storage, data transfer from one place to another, retrieving and data processing, data availability at all times, monitoring of patients over time, etc. This can significantly improve the medical profession. Medicine is one of the most intensive users of all types of information and telecommunication technology. Quickly and reliably store and transfer data (text, images, sounds, etc.) provides significant assistance and improvement in almost all medical procedures. In addition, data in locations far from medical centers can be of invaluable benefit, especially in emergency cases in which the decisive role has anesthesiologists. PMID:24222933
NASA Astrophysics Data System (ADS)
Qaim, S. M.
2004-10-01
Cyclotrons are versatile ion-accelerating machines which find many applications in medicine. In this short review their use in hadron therapy is briefly discussed. Proton therapy is gaining significance because of its capability to treat deep-lying tumours. A strong area of application of cyclotrons involves the production of short-lived neutron deficient radiotracers for use in emission tomography, especially positron emission tomography. This fast and quantitative in vivo diagnostic technique is being increasingly used in neurology, cardiology and oncology. Besides routine patient care, considerable interdisciplinary work on development of new positron emitters is under way. A short account of those efforts is given. The use of cyclotrons in the production of radionuclides for internal radiotherapy is also briefly described.
[Adolpho Lutz: a biographical sketch].
Benchimol, Jaime Larry
2003-01-01
This article portrays the family origins and life story of Adolpho Lutz (1855-1940) up to his transfer to the Instituto Oswaldo Cruz in 1908. His life history is used as a motif for an analysis of the institution of pasteurian and tropical medicine in Brazil. His university and postgraduate study in German-speaking Europe are examined, as are his activities as a clinician and researcher on subjects related to helminthology, parasitology, veterinary medicine and bacteriology in the interior of São Paulo state; his stay at the Molokai leprosarium in Hawaii; and the medical controversies in which he participated as head of the Bacteriological Institute of São Paulo, especially those on cholera, dysenteries, typhoid fever, malaria and yellow fever.
Assessment of hospice health professionals' knowledge, views, and experience with medical marijuana.
Uritsky, Tanya J; McPherson, Mary Lynn; Pradel, Françoise
2011-12-01
The medicinal and recreational use of cannabis has been controversial, especially in the United States. Marijuana for medicinal use is approved in 14 U.S. states and has recently been considered for legalization in several additional states. Given its demonstrated efficacy in symptom management, marijuana has a potential role in palliative care. This study utilized a 16-item questionnaire to assess the knowledge, experience, and views of hospice professionals regarding the use of marijuana in terminally ill patients. The study results revealed that, like the general public, hospice health care providers are generally in favor of legalization of marijuana and, if legalized, would support its use in symptom management for their terminally ill patients.
Spychalla, Megan T; Heathman, Joanne H; Pearson, Katherine A; Herber, Andrew J; Newman, James S
2014-01-01
Hospital medicine is a growing field with an increasing demand for additional healthcare providers, especially in the face of an aging population. Reductions in resident duty hours, coupled with a continued deficit of medical school graduates to appropriately meet the demand, require an additional workforce to counter the shortage. A major dilemma of incorporating nonphysician providers such as nurse practitioners and physician assistants (NPPAs) into a hospital medicine practice is their varying academic backgrounds and inpatient care experiences. Medical institutions seeking to add NPPAs to their hospital medicine practice need a structured orientation program and ongoing NPPA educational support. This article outlines an NPPA orientation and training program within the Division of Hospital Internal Medicine (HIM) at the Mayo Clinic in Rochester, MN. In addition to a practical orientation program that other institutions can model and implement, the division of HIM also developed supplemental learning modalities to maintain ongoing NPPA competencies and fill learning gaps, including a formal NPPA hospital medicine continuing medical education (CME) course, an NPPA simulation-based boot camp, and the first hospital-based NPPA grand rounds offering CME credit. Since the NPPA orientation and training program was implemented, NPPAs within the division of HIM have gained a reputation for possessing a strong clinical skill set coupled with a depth of knowledge in hospital medicine. The NPPA-physician model serves as an alternative care practice, and we believe that with the institution of modalities, including a structured orientation program, didactic support, hands-on learning, and professional growth opportunities, NPPAs are capable of fulfilling the gap created by provider shortages and resident duty hour restrictions. Additionally, the use of NPPAs in hospital medicine allows for patient care continuity that is otherwise missing with resident practice models.
Zhu, Hua-Xu; Duan, Jin-Ao; Guo, Li-Wei; Li, Bo; Lu, Jin; Tang, Yu-Ping; Pan, Lin-Mei
2014-05-01
Resource of traditional Chinese medicine residue is an inevitable choice to form new industries characterized of modem, environmental protection and intensive in the Chinese medicine industry. Based on the analysis of source and the main chemical composition of the herb residue, and for the advantages of membrane science and technology used in the pharmaceutical industry, especially membrane separation technology used in improvement technical reserves of traditional extraction and separation process in the pharmaceutical industry, it is proposed that membrane science and technology is one of the most important choices in technological design of traditional Chinese medicine resource industrialization. Traditional Chinese medicine residue is a very complex material system in composition and character, and scientific and effective "separation" process is the key areas of technology to re-use it. Integrated process can improve the productivity of the target product, enhance the purity of the product in the separation process, and solve many tasks which conventional separation is difficult to achieve. As integrated separation technology has the advantages of simplified process and reduced consumption, which are in line with the trend of the modern pharmaceutical industry, the membrane separation technology can provide a broad platform for integrated process, and membrane separation technology with its integrated technology have broad application prospects in achieving resource and industrialization process of traditional Chinese medicine residue. We discuss the principles, methods and applications practice of effective component resources in herb residue using membrane separation and integrated technology, describe the extraction, separation, concentration and purification application of membrane technology in traditional Chinese medicine residue, and systematically discourse suitability and feasibility of membrane technology in the process of traditional Chinese medicine resource industrialization in this paper.
The Future of General Internal Medicine
Larson, Eric B; Fihn, Stephan D; Kirk, Lynne M; Levin, Wendy; Loge, Ronald V; Reynolds, Eileen; Sandy, Lewis; Schroeder, Steven; Wenger, Neil; Williams, Mark
2004-01-01
The Society of General Internal Medicine asked a task force to redefine the domain of general internal medicine. The task force believes that the chaos and dysfunction that characterize today's medical care, and the challenges facing general internal medicine, should spur innovation. These are our recommendations: while remaining true to its core values and competencies, general internal medicine should stay both broad and deep—ranging from uncomplicated primary care to continuous care of patients with multiple, complex, chronic diseases. Postgraduate and continuing education should develop mastery. Wherever they practice, general internists should be able to lead teams and be responsible for the care their teams give, embrace changes in information systems, and aim to provide most of the care their patients require. Current financing of physician services, especially fee-for-service, must be changed to recognize the value of services performed outside the traditional face-to-face visit and give practitioners incentives to improve quality and efficiency, and provide comprehensive, ongoing care. General internal medicine residency training should be reformed to provide both broad and deep medical knowledge, as well as mastery of informatics, management, and team leadership. General internal medicine residents should have options to tailor their final 1 to 2 years to fit their practice goals, often earning a certificate of added qualification (CAQ) in special generalist fields. Research will expand to include practice and operations management, developing more effective shared decision making and transparent medical records, and promoting the close personal connection that both doctors and patients want. We believe these changes constitute a paradigm shift that can benefit patients and the public and reenergize general internal medicine. PMID:14748863
Flood, David; Mathieu, Irène; Chary, Anita; García, Pablo; Rohloff, Peter
2017-01-13
Access to low-cost essential generic medicines is a critical health policy goal in low-and-middle income countries (LMICs). Guatemala is an LMIC where there is both limited availability and affordability of these medications. However, attitudes of physicians and pharmacy staff regarding low-cost generics, especially generics for non-communicable diseases (NCDs), have not been fully explored in Guatemala. Semi-structured interviews with 30 pharmacy staff and 12 physicians in several highland towns in Guatemala were conducted. Interview questions related to perceptions of low-cost generic medicines, prescription and dispensing practices of generics in the treatment of two NCDs, diabetes and hypertension, and opinions about the roles of pharmacy staff and physicians in selecting medicines for patients. Pharmacy staff were recruited from a random sample of pharmacies and physicians were recruited from a convenience sample. Interview data were analyzed using a thematic approach for qualitative data as well as basic quantitative statistics. Pharmacy staff and physicians expressed doubt as to the safety and efficacy of low-cost generic medicines in Guatemala. The low cost of generic medicines was often perceived as proof of their inferior quality. In the case of diabetes and hypertension, the decision to utilize a generic medicine was based on multiple factors including the patient's financial situation, consumer preference, and, to a large extent, physician recommendations. Interventions to improve generic medication utilization in Guatemala must address the negative perceptions of physicians and pharmacy staff toward low-cost generics. Strengthening state capacity and transparency in the regulation and monitoring of the drug supply is a key goal of access-to-medicines advocacy in Guatemala.
2014-01-01
Background Investigations into knowledge about food and medicinal plants in a certain geographic area or within a specific group are an important element of ethnobotanical research. This knowledge is context specific and dynamic due to changing ecological, social and economic circumstances. Migration processes affect food habits and the knowledge and use of medicinal plants as a result of adaptations that have to be made to new surroundings and changing environments. This study analyses and compares the different dynamics in the transmission of knowledge about food and medicinal plants among Tyrolean migrants in Australia, Brazil and Peru. Methods A social network approach was used to collect data on personal networks of knowledge about food and medicinal plants among Tyroleans who have migrated to Australia, Brazil and Peru and their descendants. A statistical analysis of the personal network maps and a qualitative analysis of the narratives were combined to provide insight into the process of transmitting knowledge about food and medicinal plants. Results 56 personal networks were identified in all (food: 30; medicinal plants: 26) across all the field sites studied here. In both sets of networks, the main source of knowledge is individual people (food: 71%; medicinal plants: 68%). The other sources mentioned are print and audiovisual media, organisations and institutions. Personal networks of food knowledge are larger than personal networks of medicinal plant knowledge in all areas of investigation. Relatives play a major role as transmitters of knowledge in both domains. Conclusions Human sources, especially relatives, play an important role in knowledge transmission in both domains. Reference was made to other sources as well, such as books, television, the internet, schools and restaurants. By taking a personal network approach, this study reveals the mode of transmission of knowledge about food and medicinal plants within a migrational context. PMID:24398225
Haselmair, Ruth; Pirker, Heidemarie; Kuhn, Elisabeth; Vogl, Christian R
2014-01-07
Investigations into knowledge about food and medicinal plants in a certain geographic area or within a specific group are an important element of ethnobotanical research. This knowledge is context specific and dynamic due to changing ecological, social and economic circumstances. Migration processes affect food habits and the knowledge and use of medicinal plants as a result of adaptations that have to be made to new surroundings and changing environments. This study analyses and compares the different dynamics in the transmission of knowledge about food and medicinal plants among Tyrolean migrants in Australia, Brazil and Peru. A social network approach was used to collect data on personal networks of knowledge about food and medicinal plants among Tyroleans who have migrated to Australia, Brazil and Peru and their descendants. A statistical analysis of the personal network maps and a qualitative analysis of the narratives were combined to provide insight into the process of transmitting knowledge about food and medicinal plants. 56 personal networks were identified in all (food: 30; medicinal plants: 26) across all the field sites studied here. In both sets of networks, the main source of knowledge is individual people (food: 71%; medicinal plants: 68%). The other sources mentioned are print and audiovisual media, organisations and institutions. Personal networks of food knowledge are larger than personal networks of medicinal plant knowledge in all areas of investigation. Relatives play a major role as transmitters of knowledge in both domains. Human sources, especially relatives, play an important role in knowledge transmission in both domains. Reference was made to other sources as well, such as books, television, the internet, schools and restaurants. By taking a personal network approach, this study reveals the mode of transmission of knowledge about food and medicinal plants within a migrational context.
The education of traditional Japanese (Kampo) medicine: surveys of training hospitals and residents.
Arai, Makoto; Nakada, Yoshinobu; Izumi, Shun-Ichiro
2017-03-02
Japanese physicians prescribe Kampo medicine, but Kampo education is not standardized. We surveyed training hospitals and residents to identify problems and suggest solutions to promote Kampo education during and after residency. This was a double questionnaire survey of 1011 training hospitals in Japan and 93 Tokai University School of Medicine graduates of 2011. There were 816 effective responses (81%) from the training hospitals. Most instructors (84%) thought physicians should have Kampo clinical skills; 67% thought positively about introducing Kampo education into clinical training; 23% of the hospitals provided Kampo education; 70% of instructors at hospitals without Kampo education indicated the lack of Kampo instructors, 16% lack of time, and 7% no necessity for Kampo education; hospitals permitted Kampo education through voluntary study (42%), lectures sponsored by Kampo manufacturers (35%), and study sessions with other hospitals (32%); independent study sessions (10%); smaller hospitals were less active in Kampo education than larger ones. The survey of residents had 72 effective responses (77%): 91% were interested in Kampo medicine; 96% thought it worth learning; 31% could learn it during residency; 52% were not satisfied with the training, 83% wanted to learn it; 73% thought it should be introduced into the curricula; 93% prescribed Kampo medicine, and residents who learned it prescribed it more; 48% were reluctant to prescribe it after residency; 89% thought Western and Kampo medicine should be integrated. Instructors knew Kampo education was needed, but little of it was taught, especially in small hospitals, because of the lack of Kampo instructors. Residents recognized the need for Kampo medicine and were motivated to learn it. Kampo medicine was mostly prescribed because instructors suggested it. Because of the limited opportunities to learn Kampo medicine, it should be taught during residency. In small hospitals, cooperation with other hospitals could be a solution to teach Kampo medicine.
The Evolution of the Journal Club: From Osler to Twitter.
Topf, Joel M; Sparks, Matthew A; Phelan, Paul J; Shah, Nikhil; Lerma, Edgar V; Graham-Brown, Matthew P M; Madariaga, Hector; Iannuzzella, Francesco; Rheault, Michelle N; Oates, Thomas; Jhaveri, Kenar D; Hiremath, Swapnil
2017-06-01
Journal clubs have typically been held within the walls of academic institutions and in medicine have served the dual purpose of fostering critical appraisal of literature and disseminating new findings. In the last decade and especially the last few years, online and virtual journal clubs have been started and are flourishing, especially those harnessing the advantages of social media tools and customs. This article reviews the history and recent innovations of journal clubs. In addition, the authors describe their experience developing and implementing NephJC, an online nephrology journal club conducted on Twitter. Copyright © 2017 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.
Kozlowska, Weronika; Wagner, Charles; Moore, Erin M; Matkowski, Adam; Komarnytsky, Slavko
2018-01-01
Plants were an essential part of foraging for food and health, and for centuries remained the only medicines available to people from the remote mountain regions. Their correct botanical provenance is an essential basis for understanding the ethnic cultures, as well as for chemical identification of the novel bioactive molecules with therapeutic effects. This work describes the use of herbal medicines in the Beskid mountain ranges located south of Krakow and Lviv, two influential medieval centers of apothecary tradition in the region. Local botanical remedies shared by Boyko, Lemko, and Gorale ethnic groups were a part of the medieval European system of medicine, used according to their Dioscoridean and Galenic qualities. Within the context of ethnic plant medicine and botanical classification, this review identified strong preferences for local use of St John's-wort ( Hypericum perforatum L.), wormwood ( Artemisia absinthium L.), garlic ( Allium sativum L.), gentian ( Gentiana lutea L.), lovage ( Levisticum officinale W.D.J. Koch), and lesser periwinkle ( Vinca minor L.). While Ukrainian ethnic groups favored the use of guilder-rose ( Viburnum opulus L.) and yarrow ( Achillea millefolium L.), Polish inhabitants especially valued angelica ( Angelica archangelica L.) and carline thistle ( Carlina acaulis L.). The region also holds a strong potential for collection, cultivation, and manufacture of medicinal plants and plant-based natural specialty ingredients for the food, health and cosmetic industries, in part due to high degree of biodiversity and ecological preservation. Many of these products, including whole food nutritional supplements, will soon complement conventional medicines in prevention and treatment of diseases, while adding value to agriculture and local economies.
[Social network analysis of traditional Chinese medicine on treatment of constipation].
Du, Li-Dong; Tian, Jin-Hui; Wu, Guo-Tai; Niu, Ting-Hui; Chen, Zhen-He; Ren, Yuan
2017-01-01
The methods of literature metrology and data mining were used to study the research topics and social network analysis of traditional Chinese medicine for constipation. The major Chinese databases were searched to include the research studies of traditional Chinese medicine for constipation. BICOMS analysis software was used to extract and collect the main information and produce co-occurrence Matrix; gCLUTO software was used for cluster analysis. Data analysis was conducted by using SPSS 19.0 software. The results showed that the number of studies on traditional Chinese medicine for constipation was constantly increased, with two literature volume peaks respectively in 2003 and 2006. Related studies have been published in 31 provinces, autonomous regions and municipalities have published, but the studies in developed areas were more than those in developing areas. There was little cooperation between research institutions and the authors, especially the cooperation between different areas. At present, the research field of Chinese medicine for constipation is divided into five research topics. In terms of specific traditional Chinese medicine, angelica sinensis is in the core position. The results showed regional imbalance in the number of studies on Chinese medicine treatment for constipation, as well as little cooperation between researchers and research institutions. The research topics mainly focused on the evaluation of clinical efficacy, but the research on optimizing the prescriptions was still not enough, so the future researchers shall pay more attention to the studies of constipation prescriptions with Angelica sinensis as the core herb. Copyright© by the Chinese Pharmaceutical Association.
Drug utilization and off-label drug use in Spanish pediatric gastroenterology outpatients.
Ruíz-Antorán, Belén; Piñeiro, Roi; Avendaño, Cristina; Román, Enriqueta; Cilleruelo, María Luz; Gutiérrez-Junquera, Carolina; Centeno, Gustavo; Cilleruelo, María José
2013-02-01
The clinical use of medicines outside the conditions authorized in their Summary of Product Characteristics (SPC) (off-label use) is a common practice in pediatrics. The aim of the present study was to describe and quantify the medicines received by children attended in the pediatric gastroenterology department, their off-label use, and compliance with accepted rules for said use. A retrospective observational study was performed on all of the patients who had their first consultation in pediatric gastroenterology between January 1 and October 31, 2010. All of the clinical information and medicines prescribed were analyzed. Off-label use was defined as the use of medicines in indications not included in the officially approved SPC or in ages not included or recommended in the SPC as well as the use of doses, intervals, or administration routes different from those considered in the SPC. A total of 695 patients (52.8% male) were included, 48.2% younger than 2 years. Two-hundred seven patients (29.8%) received 331 prescriptions. The most commonly used medicines were anti-H2 and proton pump inhibitors. Of all the prescriptions, 33.2% were considered off-label, and up to 47.3% of the prescribed patients had at least 1 medicine under off-label conditions. The medical records contained no documentation on information given to the parents regarding off-label use. The study found a high percentage of off-label use of medicines in the Pediatric Gastroenterology outpatient setting, especially in children younger than 2 years. Several initiatives were derived from the present study and implemented in our hospital.
Personalized medicine: is it a pharmacogenetic mirage?
Shah, Rashmi R; Shah, Devron R
2012-01-01
The notion of personalized medicine has developed from the application of the discipline of pharmacogenetics to clinical medicine. Although the clinical relevance of genetically-determined inter-individual differences in pharmacokinetics is poorly understood, and the genotype-phenotype association data on clinical outcomes often inconsistent, officially approved drug labels frequently include pharmacogenetic information concerning the safety and/or efficacy of a number of drugs and refer to the availability of the pharmacogenetic test concerned. Regulatory authorities differ in their approach to these issues. Evidence emerging subsequently has generally revealed the pharmacogenetic information included in the label to be premature. Revised drugs labels, together with a flurry of other collateral activities, have raised public expectations of personalized medicine, promoted as ‘the right drug at the right dose the first time.’ These expectations place the prescribing physician in a dilemma and at risk of litigation, especially when evidence-based information on genotype-related dosing schedules is to all intent and purposes non-existent and guidelines, intended to improve the clinical utility of available pharmacogenetic information or tests, distance themselves from any responsibility. Lack of efficacy or an adverse drug reaction is frequently related to non-genetic factors. Phenoconversion, arising from drug interactions, poses another often neglected challenge to any potential success of personalized medicine by mimicking genetically-determined enzyme deficiency. A more realistic promotion of personalized medicine should acknowledge current limitations and emphasize that pharmacogenetic testing can only improve the likelihood of diminishing a specific toxic effect or increasing the likelihood of a beneficial effect and that application of pharmacogenetics to clinical medicine cannot adequately predict drug response in individual patients. PMID:22591598
Kozlowska, Weronika; Wagner, Charles; Moore, Erin M.; Matkowski, Adam; Komarnytsky, Slavko
2018-01-01
Plants were an essential part of foraging for food and health, and for centuries remained the only medicines available to people from the remote mountain regions. Their correct botanical provenance is an essential basis for understanding the ethnic cultures, as well as for chemical identification of the novel bioactive molecules with therapeutic effects. This work describes the use of herbal medicines in the Beskid mountain ranges located south of Krakow and Lviv, two influential medieval centers of apothecary tradition in the region. Local botanical remedies shared by Boyko, Lemko, and Gorale ethnic groups were a part of the medieval European system of medicine, used according to their Dioscoridean and Galenic qualities. Within the context of ethnic plant medicine and botanical classification, this review identified strong preferences for local use of St John's-wort (Hypericum perforatum L.), wormwood (Artemisia absinthium L.), garlic (Allium sativum L.), gentian (Gentiana lutea L.), lovage (Levisticum officinale W.D.J. Koch), and lesser periwinkle (Vinca minor L.). While Ukrainian ethnic groups favored the use of guilder-rose (Viburnum opulus L.) and yarrow (Achillea millefolium L.), Polish inhabitants especially valued angelica (Angelica archangelica L.) and carline thistle (Carlina acaulis L.). The region also holds a strong potential for collection, cultivation, and manufacture of medicinal plants and plant-based natural specialty ingredients for the food, health and cosmetic industries, in part due to high degree of biodiversity and ecological preservation. Many of these products, including whole food nutritional supplements, will soon complement conventional medicines in prevention and treatment of diseases, while adding value to agriculture and local economies. PMID:29674964
Martini, Mariano; Barberis, Ilaria; Bragazzi, Nicola Luigi; Paluan, Filippo
2018-01-01
The second half of the nineteenth century saw the development of new medical "specialties", which, like the idea of constitutional disease, had a profound influence on medical practice. Against this lively "backdrop", Edoardo Maragliano played a central role in medicine's "renaissance" in Italy. Having graduated in medicine in 1870 at the University of Naples, he worked as an assistant in the University Medical Clinic. After beginning his academic career as professor of pathology at the Faculty of Medicine in Genoa in 1877, he became full professor of internal medicine in 1881. While he studied all fields of internal medicine, his research focused mainly on tuberculosis.His experiments in the medical clinic enabled Maragliano to announce the possibility of immunization against Mycobacterium tuberculosis. Although criticized for using an inactivated vaccine, Maragliano continued to advocate vaccination with any type of vaccine.In the Senate of the Kingdom of Italy, Maragliano actively debated social, economic and sanitary questions, without neglecting his duties as a physician and professor. As an officer during the First World War, he organized military health services and taught medicine at the Military University of Padua.In 1924, Maragliano created the first Italian specialty school in the study of tuberculosis, which provided physicians with specific training in the diagnosis, therapy and prevention of the disease. His scientific zeal and his vision of modern medicine prompted the introduction of new specializations, such as radiology and, especially, pneumology, which led to the creation of one of Europe's most renowned medical schools.
Sher, Hassan; Aldosari, Ali; Ali, Ahmad; de Boer, Hugo J
2015-05-26
Mapping ethnomedicinal plants and associated indigenous knowledge of folk medicines can provide a comprehensive overview of individual herbs employed in health care. Reliance on medicinal plants in remote parts of northern Pakistan is high, especially among women, but no research has investigated specifically which plants are used. This study investigated indigenous knowledge of folk medicines among tribal minorities in selected sites in upper Swat, Buner and Chitral Districts in Khyber Pakhtunkhwa Province. Interviews were conducted with gender-specific focus groups using questionnaires and standardized data sheets, followed by forest walks in each of the visited areas. General medicinal herb use, preparations, storage, marketing and collection habits for each gender group were ascertained from the questionnaires. In total 168 women and 390 men were interviewed and provided information on 127 different shared medicinal species. Species use consensus among the informants ranged from 2.3% to 83.3%, with Cynodon dactylon, Avena sativa, Celtis australis, Datura stramonium, Solanum nigrum, Skimmia laureola, Spiraea nervosa, Ziziphus jujuba, Rumex hastatus, Plantago lanceolata, Lathyrus aphaca and Ficus palmata having the highest reported consensus. The survey also revealed that a number of medicinal species were exploited by the community for both marketing and personal use, and many of these species were reported as being rare, vulnerable or even endangered. The results revealed that women in all the three districts were important custodians of medicinal plant knowledge, but elder women in general and the women from Buner district in particular had a superior understanding of folk medicine. The forest walks revealed that women׳s traditional medicinal knowledge was based on a more limited diversity of plant species. People in tribal communities have an expressed interest in learning efficient techniques for medicinal plant collection, preparation, storage and cultivation advice, and to learn more about the potential of marketing medicinal herbs and ways to reach local market centers. Education and awareness were considered to be essential for improved health care and successful marketing. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Ashigbie, Paul G; Azameti, Devine; Wirtz, Veronika J
2016-01-01
Ghana established its National Health Insurance Scheme (NHIS) in 2003 with the goal of ensuring more equitable financing of health care to improve access to health services. This qualitative study examines the challenges and consequences of medicines management policies and practices under the NHIS as perceived by public and private service providers. This study was conducted in health facilities in the Eastern, Greater Accra and Volta regions of Ghana between July and August 2014. We interviewed 26 Key Informants (KIs) from a purposively selected sample of public and private sector providers (government and mission hospitals, private hospitals and private standalone pharmacies), pharmaceutical suppliers and NHIS district offices. Data was collected using semi-structured interview guides which covered facility accreditation, reimbursement practices, medicines selection, purchasing and pricing of medicines, and utilization of medicines. Codes for data analysis were developed based on the study questions and also in response to themes that emerged from the transcripts and notes. Most KIs agreed that the introduction of the NHIS has increased access to and utilization of medicines by removing cost barriers for patients; however, some pointed out the increased utilization could also be corollary to moral hazard. Common concerns across all facilities were the delays in receiving NHIS reimbursements, and low reimbursement rates for medicines which result in providers asking patients to pay supplementary fees. KIs reported important differences between private and public sectors including weak separation of prescribing and dispensing and limited use of drugs and therapeutic committees in the private sector, the disproportionate effects of unfavorable reimbursement prices for medicines, and inadequate participation of the private sector providers (especially pharmacies and licensed chemical sellers) in the NHIS. Health providers generally perceive the NHIS to have had a largely positive impact on access to medicines. However, concerns remain about equity in access to medicines and the differences in quality of pharmaceutical care delivered by private and public providers. Routine monitoring of medicines use during the implementation of health insurance schemes is important to identify and address the potential consequences of medicines policies and practices under the scheme.
[History of pneumology in antiquity (part 2)].
Demaeyer, Ph
2016-01-01
Nowadays, Hippocrate, "The Father of Medicine", still influences our medicine. He was famous because of the great medical corpus texts preserved in his name. Only recently, our universities have updated the famous Hippocratic Oath to avoid contradictions with our modern ethics. Hippocrate was a great clinician but a poor anatomist. Hippocratical humourism remained accurate until the age of the enlightenment (18th century). Furthermore, it is difficult to distinguish medicine from philosophy in Greek antiquity. So we have to contextualize Greek ancient medicine in this philosophical field. In the 3rd century before Christus (BC), the centre of gravity in medicine shifted to Alexandria. Indeed, a famous academic library was created in 288 BC. At the same time, dissection of human cadavers was authorized until the first century BC. This enabled the evolution of the knowledge in anatomy and physiology. Rome was still polytheistic population until the end of ancient times. Rome integrated Greek gods in his pantheon. Asclepios became Aesculapius. Rome despises physicians in the first ancient age of Rome. The family's father provided medical cares. A lot of Greek physicians settled then in Rome. Again, roman medicine grew in parallel with philosophical trends. These trends were called "sects" but in fact, they were rather medical schools. In this review, we will especially talk about three physicians of this period: Aurelius Cornelius Celsus, Arétée of Cappadocia and Galenus of Pergamon. Thereafter, medical knowledge did not really change significantly until Renaissance period.
A review of effective herbal medicines in controlling menopausal symptoms
Kargozar, Rahele; Azizi, Hoda; Salari, Roshanak
2017-01-01
Background Acute menopausal syndrome especially hot flashes, is one of the most common gynecological problems during menopause. Due to the side effects of hormone therapy, herbal and complementary medicines are always of immense interest to people in the treatment and management of the symptoms and complications of menopause. Objective The aim of this study was to investigate the mechanisms and effects of medicinal plants employed in the treatment of menopausal symptoms. Methods This review article was carried out by examining clinical trial studies between the period of 1994 and 2016. The keywords, which include menopause, climacteric, hot flushes, flashes, herb and phytoestrogens were used to search for herbal medicines used in clinical trials for the treatment of menopausal symptoms using databases such as PubMed, Medline, Scopus, Google scholar, SID and Magiran. Results The results of the study showed that the medicinal plants, which include Sage herb (Salvia officinalis), Lemon balm (Melissa officinalis), Valerina officinalis, Black cohosh (Cimicifuga racemosa), Fenugreek (Trigonella foenum-graecum), Black cumin (Nigella sativa), Vitex (Vitex agnus-castus), Fennel (Foeniculum vulgare), Evening primrose (Oenothera biennis), Ginkgo biloba, Alfalfa (Medicago sativa), Hypericum perforatum, Panax ginseng, Pimpinella anisum, Licorice (Glycyrrhiza glabra), Passiflora incarnata, Red clover (Trifolium pratense), and Glycine soja were effective in the treatment of acute menopausal syndrome with different mechanisms. Conclusion Medicinal plants can play an imperative role in the treatment of acute menopausal syndrome; however, further studies are required to buttress their efficacy in the treatment of acute menopausal syndrome. PMID:29403626
Role of Iranian Traditional Medicine in the Prevention of Respiratory Infectious Diseases.
Soroushzadeh, Sayed Mohammad Ali; Khiveh, Ali; Gerayelimalek, Valiollah
2016-05-01
In order to define appropriate plans for respiratory infectious diseases, in accordance with Iranian traditional medicine, one should cover the topic of "havae vabai". "Havae vabai" is related to the epidemics of respiratory infectious diseases. This study is a review of the role of Iranian traditional medicine in the prevention of respiratory infectious diseases .Resources of traditional medicine with the keyword "havae vabai" were reviewed in Noor digital library. The perspective of traditional medicine for the prevention of disease in "havae vabai" is based on self-recuperation and air modification. Items that are mentioned are; refine the surrounding air, move to a proper space, live in a house with no source of water like fountains and limited flow of air, air-drying, use air freshener, smell fruit sticks, use in-house plants, and place a cloth soaked with vinegar in front of the nose. For self-recuperation, reducing body moisture with proper foods and drugs or with vomiting, diarrhea, phlebotomy, wet-cupping, reduction in food and drink intake, avoiding sexual intercourse, bathing, heavy exercise, inactivity, overeating, hunger, thirst, milk, sweets, fish, fatty foods, fruits especially juicy fruits are recommended. The food that tends to have a sour taste, eating meat cooked with sour taste like vinegar is suggested. The use of the solutions offered in traditional medicine to control air is helpful as it can reduce epidemics, such as influenza; that yearly kills many patients with a heavy financial burden.
Rethinking Regenerative Medicine: A Macrophage-Centered Approach
Brown, Bryan N.; Sicari, Brian M.; Badylak, Stephen F.
2014-01-01
Regenerative medicine, a multi-disciplinary approach that seeks to restore form and function to damaged or diseased tissues and organs, has evolved significantly during the past decade. By adapting and integrating fundamental knowledge from cell biology, polymer science, and engineering, coupled with an increasing understanding of the mechanisms which underlie the pathogenesis of specific diseases, regenerative medicine has the potential for innovative and transformative therapies for heretofore unmet medical needs. However, the translation of novel technologies from the benchtop to animal models and clinical settings is non-trivial and requires an understanding of the mechanisms by which the host will respond to these novel therapeutic approaches. The role of the innate immune system, especially the role of macrophages, in the host response to regenerative medicine based strategies has recently received considerable attention. Macrophage phenotype and function have been suggested as critical and determinant factors in downstream outcomes. The constructive and regulatory, and in fact essential, role of macrophages in positive outcomes represents a significant departure from the classical paradigms of host–biomaterial interactions, which typically consider activation of the host immune system as a detrimental event. It appears desirable that emerging regenerative medicine approaches should not only accommodate but also promote the involvement of the immune system to facilitate positive outcomes. Herein, we describe the current understanding of macrophage phenotype as it pertains to regenerative medicine and suggest that improvement of our understanding of context-dependent macrophage polarization will lead to concurrent improvement in outcomes. PMID:25408693
DOE Office of Scientific and Technical Information (OSTI.GOV)
Chung, Chi-Jung
Cigarette smoking and environmental exposure to heavy metals are important global health issues, especially for urothelial carcinoma (UC). However, the effects of cadmium and lead exposure, as well as the levels of DNA hypomethylation, on UC risk are limited. We evaluated the possible exposure sources of Cd and Pb and the relationship among DNA hypomethylation, urinary Cd and Pb levels, and UC risk. We recruited 209 patients with UC and 417 control patients for a hospital-based case–control study between June 2011 and August 2014. We collected environmental exposure-related information with questionnaires. Blood and urine samples were analyzed to measure themore » Cd and Pb exposure and 5-methyl-2′-deoxycytidine levels as a proxy for DNA methylation. Multivariate logistic regression and 95% confidence intervals were applied to estimate the risk for UC. Study participants with high Cd and Pb exposure in blood or urine had significantly increased risk of UC, especially among the smokers. After adjusting for age and gender, the possible connections of individual cumulative cigarette smoking or herb medicine exposure with the increased levels of Cd and Pb were observed in the controls. Participants with 8.66%–12.39% of DNA hypomethylation had significantly increased risk of UC compared with those with ≥ 12.39% of DNA hypomethylation. Environmental factors including cigarette smoking and herb medicine may contribute to the internal dose of heavy metals levels. Repeat measurements of heavy metals with different study design, detailed dietary information, and types of herb medicine should be recommended for exploring UC carcinogenesis in future studies. - Highlights: • Smoking and herb medicine ingestion is associated with increased urinary Cd and Pb levels. • Urinary levels of Cd and Pb are associated with increased risk of UC. • UC carcinogenesis might have partially resulted from DNA hypomethylation.« less
Motion correction for functional MRI with three-dimensional hybrid radial-Cartesian EPI.
Graedel, Nadine N; McNab, Jennifer A; Chiew, Mark; Miller, Karla L
2017-08-01
Subject motion is a major source of image degradation for functional MRI (fMRI), especially when using multishot sequences like three-dimensional (3D EPI). We present a hybrid radial-Cartesian 3D EPI trajectory enabling motion correction in k-space for functional MRI. The EPI "blades" of the 3D hybrid radial-Cartesian EPI sequence, called TURBINE, are rotated about the phase-encoding axis to fill out a cylinder in 3D k-space. Angular blades are acquired over time using a golden-angle rotation increment, allowing reconstruction at flexible temporal resolution. The self-navigating properties of the sequence are used to determine motion parameters from a high temporal-resolution navigator time series. The motion is corrected in k-space as part of the image reconstruction, and evaluated for experiments with both cued and natural motion. We demonstrate that the motion correction works robustly and that we can achieve substantial artifact reduction as well as improvement in temporal signal-to-noise ratio and fMRI activation in the presence of both severe and subtle motion. We show the potential for hybrid radial-Cartesian 3D EPI to substantially reduce artifacts for application in fMRI, especially for subject groups with significant head motion. The motion correction approach does not prolong the scan, and no extra hardware is required. Magn Reson Med 78:527-540, 2017. © 2016 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. © 2016 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine.
Availability and affordability of antimalarial and antibiotic medicines in Malawi
Khuluza, Felix
2017-01-01
Background Availability and affordability of medicines are key determinants of universal health coverage, yet achieving them presents a major challenge especially in low-income countries. We here present an analysis of availability and prices of antimalarial and antibiotic medicines in public, faith-based and private health facilities in Malawi. Medicines are provided free of charge in the public health care system of Malawi. In contrast, facilities of the Christian Health Association of Malawi (CHAM) usually charge their patients for medicines, as do private for-profit facilities. Methods As part of a study on medicine quality, samples of six antimalarial and six antibiotic medicines were collected in 31 health facilities in four districts of southern Malawi. These included 15 public facilities (i.e. health centres, district hospitals and central hospitals), eight CHAM and eight private facilities. Random selection was used in choosing the included health facilities. The availability of medicines was recorded, including the number of units which could be collected of each medicine, as well as the prices of medicines which were charged in CHAM and private facilities. These data were analyzed using the standard methodology developed by the World Health Organization (WHO) and Health Action International (HAI). Results Availability of the antimalarials artemether/lumefantrine and sulfadoxine/pyrimethamine, which are provided with financial support from international donors, was high in public and CHAM facilities (93% and 100%, respectively). However, availability of antibiotics was much lower (e.g. 40% availability of amoxicillin tablets/capsules in public health centres). Medicine prices were lower than reported from many other countries. The median price ratio (MPR) to a wholesale international procurement price was 2.8 in CHAM facilities and even lower in the private sector (MPR 2.3). Nevertheless, for 10 of the 12 investigated medicines the cost for one course of treatment exceeded the daily wage of a low-paid government worker in Malawi and therefore had to be considered as unaffordable for a major part of the population. Conclusions Continued efforts are required to improve the availability of essential medicines in Malawi. The free provision of medicines in the public health care system remains important in order to achieve universal health coverage, due to the low income in this country. PMID:28419126
Perumal-Pillay, Velisha Ann; Suleman, Fatima
2017-06-19
Inadequate access to affordable essential medicines poses a challenge to achieving Universal Health Coverage. Access to essential medicines for children has been in the spotlight in recent research. However, information from the end users of medicines, i.e. patients is scarce. Obtaining information at a household level is integral to understanding how people access, obtain and use medicines. This study aimed to gather opinions and perceptions from parents/guardians on availability, affordability and quality of medicines and healthcare for children in SA. Eight Focus group discussions were held with 41 individuals in eThekwini, South Africa (SA), from September-November 2016. Participants were parents/guardians of children up to 12 years from different ethnicities, ages, gender, and socio-economic backgrounds. Key informants identified by the principal researcher recruited participants using snowball sampling. Focus group discussions were recorded, transcribed verbatim, coded by the first author, verified by the second author, reconciled for consensus and imported into NVIVO for data analysis. Medicines and healthcare facilities are accessible in urban and peri-urban areas in eThekwini. Medicines may not always be available in public sector facilities due to medicine shortages, compelling parents to purchase medicines from private sector pharmacies. Common medicines were perceived as affordable for most socio-economic groups except the 'Poor' group. Quality of medicines was perceived as 'good' especially if obtained from the private sector but sometimes perceived as 'poor' and viewed with suspicion when received from public sector clinics. Quality of healthcare was perceived as 'good' but requires improvement for both sectors. This is the first study in SA to report on parent/guardian perceptions on availability, affordability and quality of medicines and healthcare for children. It has the potential to be up-scaled to a country-wide investigation to paint a national picture of parents' opinions of healthcare for children. This will allow for patient input into pharmaceutical and healthcare policy governing access to and availability of essential medicines and services within the country. The study recommends that patient input be sought to assess impact of policies on the intended target group in the country to ensure that the policy objectives are achieved.
Schleidgen, Sebastian; Fernau, Sandra; Fleischer, Henrike; Schickhardt, Christoph; Oßa, Ann-Kristin; Winkler, Eva C
2017-11-21
Systems medicine has become a key word in biomedical research. Although it is often referred to as P4-(predictive, preventive, personalized and participatory)-medicine, it still lacks a clear definition and is open to interpretation. This conceptual lack of clarity complicates the scientific and public discourse on chances, risks and limits of Systems Medicine and may lead to unfounded hopes. Against this background, our goal was to develop a sufficiently precise and widely acceptable definition of Systems Medicine. In a first step, PubMed was searched using the keyword "systems medicine". A data extraction tabloid was developed putting forward a means/ends-division. Full-texts of articles containing Systems Medicine in title or abstract were screened for definitions. Definitions were extracted; their semantic elements were assigned as either means or ends. To reduce complexity of the resulting list, summary categories were developed inductively. In a second step, we applied six criteria for adequate definitions (necessity, non-circularity, non-redundancy, consistency, non-vagueness, and coherence) to these categories to derive a so-called précising definition of Systems Medicine. We identified 185 articles containing the term Systems Medicine in title or abstract. 67 contained at least one definition of Systems Medicine. In 98 definitions, we found 114 means and 132 ends. From these we derived the précising definition: Systems Medicine is an approach seeking to improve medical research (i.e. the understanding of complex processes occurring in diseases, pathologies and health states as well as innovative approaches to drug discovery) and health care (i.e. prevention, prediction, diagnosis and treatment) through stratification by means of Systems Biology (i.e. data integration, modeling, experimentation and bioinformatics). Our study also revealed the visionary character of Systems Medicine. Our insights, on the one hand, allow for a realistic identification of actual ethical as well as legal issues arising in the context of Systems Medicine and, in consequence, for a realistic debate of questions concerning its matter and (future) handling. On the other hand, they help avoiding unfounded hopes and unrealistic expectations. This especially holds for goals like improving patient participation which are intensely debated in the context of Systems Medicine, however not implied in the concept.
A need for standardization in visual acuity measurement.
Patel, Hina; Congdon, Nathan; Strauss, Glenn; Lansingh, Charles
2017-01-01
Standardization of terminologies and methods is increasingly important in all fields including ophthalmology, especially currently when research and new technology are rapidly driving improvements in medicine. This review highlights the range of notations used by vision care professionals around the world for vision measurement, and the challenges resulting from this practice. The global community is urged to move toward a uniform standard.
ERIC Educational Resources Information Center
O'Brien, Thomas
2007-01-01
This paper critically examines methadone treatment from the perspective of adult and community education and questions the absence of rehabilitation. It identifies biomedicine and the methodology of evidence based medicine as the discourses that determine our understanding of addiction and treatment. It is especially critical of psychiatry for the…
On the Importance of a Genre-Based Approach in the Teaching of English for Medical Purposes
ERIC Educational Resources Information Center
León Pérez, Isabel K.; Martín-Martín, Pedro
2016-01-01
In experimental disciplinary fields such as medicine, the writing up of a research paper in English may represent a major hurdle, especially for inexperienced writers and users of EAL (English as an Additional Language), mainly due to a lack of familiarity with international discourse conventions. Despite the efforts of many EAP (English for…
Hypoxia-related brain dysfunction in forensic medicine.
Suslo, R; Trnka, J; Siewiera, J; Drobnik, J
2015-01-01
Blood gases levels imbalances belong to important factors triggering central nervous system (CNS) functional disturbances. Hypoxia can be illness-related, like in many COPD patients, or it may be caused by broad range of external or iatrogenic factors - including influence of drugs depressing respiration, failure to keep the patient's prosthesis-supported airways patent, or a mistake in the operation of medical equipment supporting patient's respiration. Hypoxia, especially when it is not accompanied by rapid carbon dioxide retention, can go unnoticed for prolonged times, deepening existing CNS disorders, sometimes rapidly triggering their manifestation, or evoking quite new conditions and symptoms - like anxiety, agitation, aggressive behavior, euphoria, or hallucinations. Those, in turn, often result in situations raising interest in law enforcement institutions which need forensic medicine specialist's assistance and opinion. The possibility of illness or drug-related hypoxia, especially in terminal patients, is used to raise questions about the patients' ability to properly express their will in the way demanded by law - it also must be considered as a factor limiting the patients' responsibility in case they commit crimes. The possibility of hallucinations in hypoxia patients limits their credibility as witnesses or even their ability to report crime or sexual abuse they have been subjected to.
Royal Jelly: An ancient remedy with remarkable antibacterial properties.
Fratini, Filippo; Cilia, Giovanni; Mancini, Simone; Felicioli, Antonio
2016-11-01
Royal Jelly (RJ), a honeybee hypopharyngeal gland secretion of young nurse and an exclusive nourishment for bee queen, has been used since ancient times for care and human health and it is still very important in traditional and folkloristic medicine, especially in Asia within the apitherapy. Recently, RJ and its protein and lipid components have been subjected to several investigations on their antimicrobial activity due to extensive traditional uses and for a future application in medicine. Antimicrobial activities of crude Royal Jelly, Royalisin, 10-hydroxy-2-decenoic acid, Jelleines, Major Royal Jelly Proteins against different bacteria have been reported. All these beehive products showed antimicrobial activities that lead their potential employment in several fields as natural additives. RJ and its derived compounds show a highest activity especially against Gram positive bacteria. The purpose of this Review is to summarize the results of antimicrobial studies of Royal Jelly following the timescale of the researches. From the first scientific applications to the isolation of the single components in order to better understand its application in the past years and propose an employment in future studies as a natural antimicrobial agent. Copyright © 2016 Elsevier GmbH. All rights reserved.
Globalization and health care: global justice and the role of physicians.
Toumi, Rabee
2014-02-01
In today's globalized world, nations cannot be totally isolated from or indifferent to their neighbors, especially in regards to medicine and health. While globalization has brought prosperity to millions, disparities among nations and nationals are growing raising once again the question of justice. Similarly, while medicine has developed dramatically over the past few decades, health disparities at the global level are staggering. Seemingly, what our humanity could achieve in matters of scientific development is not justly distributed to benefit everyone. In this paper, it will be argued that a global theoretical agreement on principles of justice may prove unattainable; however, a grass-roots change is warranted to change the current situation. The UNESCO Declaration on Bioethics and Human Rights will be considered as a starting point to achieve this change through extracting the main values embedded in its principles. These values, namely, respecting human dignity and tending to human vulnerability with a hospitable attitude, should then be revived in medical practice. Medical education will be one possible venue to achieve that, especially through role models. Future physicians will then become the fervent advocates for a global and just distribution of health care.
Methamphetamine-associated psychosis: a new health challenge in Iran
2013-01-01
The rapidly growing popularity of methamphetamine use in Iran has posed a new health challenge to the Iranian health sector. Methamphetamine-associated psychosis (MAP) has been frequently reported in Iran in recent years. Although methamphetamine use and MAP are considerable health problems in Iran but there is still a need to conduct epidemiological studies on the prevalence of MAP and its health-related problems. The present paper emphasizes that health policy makers should consider the immediate needs of drug users, their families and the community to be informed about the detrimental health effects associated with MAP. Although MAP could be managed by prescribing benzodiazepines and psychiatric medications but the most effective regime for stabilizing patients with MAP still needs to be studied in Iran. Constant collaborations among psychiatric services and outpatient psychotherapeutic services should be established to successfully manage MAP in Iran. Iranian clinicians especially emergency medicine specialists should be informed about the differences between the two forms of transient and recurrent MAP in order to implement appropriate pharmacological therapies to manage MAP. It is hoped that special training courses are designed and implemented by health policy makers to inform clinicians, health providers and especially emergency medicine specialists to effectively deal with MAP. PMID:23577655
Zhang, Jingxiao; Li, Yan; Chen, Su-Shing; Zhang, Lilei; Wang, Jinghui; Yang, Yinfeng; Zhang, Shuwei; Pan, Yanqiu; Wang, Yonghua; Yang, Ling
2015-01-01
Inflammation is a hallmark of many diseases like diabetes, cancers, atherosclerosis and arthritis. Thus, lots of concerns have been raised toward developing novel anti-inflammatory agents. Many alternative herbal medicines possess excellent anti-inflammatory properties, yet their precise mechanisms of action are yet to be elucidated. Here, a novel systems pharmacology approach based on a large number of chemical, biological and pharmacological data was developed and exemplified by a probe herb Folium Eriobotryae, a widely used clinical anti-inflammatory botanic drug. The results show that 11 ingredients of this herb with favorable pharmacokinetic properties are predicted as active compounds for anti-inflammatory treatment. In addition, via systematic network analyses, their targets are identified to be 43 inflammation-associated proteins including especially COX2, ALOX5, PPARG, TNF and RELA that are mainly involved in the mitogen-activated protein kinase (MAPK) signaling pathway, the rheumatoid arthritis pathway and NF-κB signaling pathway. All these demonstrate that the integrated systems pharmacology method provides not only an effective tool to illustrate the anti-inflammatory mechanisms of herbs, but also a new systems-based approach for drug discovery from, but not limited to, herbs, especially when combined with further experimental validations. PMID:25636035
Schaefer, Nadine; Moj, Daniel; Lehr, Thorsten; Schmidt, Peter H; Ramsthaler, Frank
2018-03-01
In forensic medicine, expert opinion is often required concerning dose and time of intake of a substance, especially in the context of fatal intoxications. In the present case, a 98-year-old man died 4 days after admission to a hospital due to a femur neck fracture following a domestic fall in his retirement home. As he had obtained high morphine doses in the context of palliative therapy and a confusion of his supplemental magnesium tablets with a diuretic by the care retirement home was suspected by the relatives, a comprehensive postmortem examination was performed. Forensic toxicological GC- and LC-MS analyses revealed, besides propofol, ketamine, and a metamizole metabolite in blood and urine, toxic blood morphine concentrations of approximately 3 mg/l in femoral and 5 mg/l in heart blood as well as 2, 7, and 10 mg/kg morphine in brain, liver, and lung, respectively. A physiologically based pharmacokinetic (PBPK) model was developed and applied to examine whether the morphine concentrations were (i) in agreement with the morphine doses documented in the clinical records or (ii) due to an excessive morphine administration. PBPK model simulations argue against an overdosing of morphine. The immediate cause of death was respiratory and cardiovascular failure due to pneumonia following a fall, femur neck fracture, and immobilization accompanied by a high and probably toxic concentration of morphine, attributable to the administration under palliative care conditions. The presented case indicates that PBPK modeling can be a useful tool in forensic medicine, especially in question of a possible drug overdosing.
Wangensteen, Helle; Klarpås, Line; Alamgir, Mahiuddin; Samuelsen, Anne B. C.; Malterud, Karl E.
2013-01-01
Diarrhoea is a common disease which causes pain and may be deadly, especially in developing countries. In Bangladesh, diarrhoeal diseases affect thousands of people every year, and children are especially vulnerable. Bacterial toxins or viral infections are the most common cause of the disease. The diarrhoea outbreaks are often associated with flood affected areas with contaminated drinking water and an increased risk of spreading the water-borne disease. Not surprisingly, plants found in the near surroundings have been taken into use by the local community as medicine to treat diarrhoeal symptoms. These plants are cheaper and more easily available than conventional medicine. Our question is: What is the level of documentation supporting the use of these plants against diarrhoea and is their consumption safe? Do any of these plants have potential for further exploration? In this review, we have choosen seven plant species that are used in the treatment of diarrhoea; Diospyros peregrina, Heritiera littoralis, Ixora coccinea, Pongamia pinnata, Rhizophora mucronata, Xylocarpus granatum, and Xylocarpus moluccensis. Appearance and geographical distribution, traditional uses, chemical composition, and biological studies related to antidiarrhoeal activity will be presented. This review reveals that there is limited scientific evidence supporting the traditional use of these plants. Most promising are the barks from D. peregrina, X. granatum and X. moluccensis which contain tannins and have shown promising results in antidiarrhoeal mice models. The leaves of P. pinnata also show potential. We suggest these plants should be exploited further as possible traditional herbal remedies against diarrhoea including studies on efficacy, optimal dosage and safety. PMID:23698166
Wangensteen, Helle; Klarpås, Line; Alamgir, Mahiuddin; Samuelsen, Anne B C; Malterud, Karl E
2013-05-22
Diarrhoea is a common disease which causes pain and may be deadly, especially in developing countries. In Bangladesh, diarrhoeal diseases affect thousands of people every year, and children are especially vulnerable. Bacterial toxins or viral infections are the most common cause of the disease. The diarrhoea outbreaks are often associated with flood affected areas with contaminated drinking water and an increased risk of spreading the water-borne disease. Not surprisingly, plants found in the near surroundings have been taken into use by the local community as medicine to treat diarrhoeal symptoms. These plants are cheaper and more easily available than conventional medicine. Our question is: What is the level of documentation supporting the use of these plants against diarrhoea and is their consumption safe? Do any of these plants have potential for further exploration? In this review, we have choosen seven plant species that are used in the treatment of diarrhoea; Diospyros peregrina, Heritiera littoralis, Ixora coccinea, Pongamia pinnata, Rhizophora mucronata, Xylocarpus granatum, and Xylocarpus moluccensis. Appearance and geographical distribution, traditional uses, chemical composition, and biological studies related to antidiarrhoeal activity will be presented. This review reveals that there is limited scientific evidence supporting the traditional use of these plants. Most promising are the barks from D. peregrina, X. granatum and X. moluccensis which contain tannins and have shown promising results in antidiarrhoeal mice models. The leaves of P. pinnata also show potential. We suggest these plants should be exploited further as possible traditional herbal remedies against diarrhoea including studies on efficacy, optimal dosage and safety.
Valantine, Hannah A; Grewal, Daisy; Ku, Manwai Candy; Moseley, Julie; Shih, Mei-Chiung; Stevenson, David; Pizzo, Philip A
2014-06-01
To assess whether the proportion of women faculty, especially at the full professor rank, increased from 2004 to 2010 at Stanford University School of Medicine after a multifaceted intervention. The authors surveyed gender composition and faculty satisfaction five to seven years after initiating a multifaceted intervention to expand recruitment and development of women faculty. The authors assessed pre/post relative change and rates of increase in women faculty at each rank, and faculty satisfaction; and differences in pre/post change and estimated rate of increase between Stanford and comparator cohorts (nationally and at peer institutions). Post intervention, women faculty increased by 74% (234 to 408), with assistant, associate, and full professors increasing by 66% (108 to 179), 87% (74 to 138), and 75% (52 to 91), respectively. Nationally and at peer institutions, women faculty increased by about 30% (30,230 to 39,200 and 4,370 to 5,754, respectively), with lower percentages at each rank compared with Stanford. Estimated difference (95% CI) in annual rate of increase was larger for Stanford versus the national cohort: combined ranks 0.36 (0.17 to 0.56), P = .001; full professor 0.40 (0.18 to 0.62), P = .001; and versus the peer cohort: combined ranks 0.29 (0.07 to 0.51), P = .02; full professor 0.37 (0.14 to 0.60), P = .003. Stanford women faculty satisfaction increased from 48% (2003) to 71% (2008). Increased satisfaction and proportion of women faculty, especially full professors, suggest that the intervention may ameliorate the gender gap in academic medicine.
[Integration of the Principles of Palliative Care In Intensive Care Medicine].
Girbau Campo, M Begoña; Monedero Rodríguez, Pablo; Centeno Cortés, Carlos
2016-01-01
Recent scientific literature has shown a growing interest to integrate palliative medicine principles into the daily workflow in the intensive care unit (ICU). This article reviews this trend with the goal that its application might provide more understanding in the resolution of some current ethical issues. Patients with an advanced disease process and at the end of life who are admitted in the intensive care unit are in such a profound level of suffering and vulnerability that only an holistic and comprehensive approach can provide adequate relief to them. Nevertheless, the reality of the clinical care of these patients in the ICU is far beyond that ideal. Our primary end point is the improvement in the clinical care provided, especially when the patient is dying. It is indeed very complex to make progress in this field, but an effort has to be made. The project is to turn to palliative medicine as a role model for end of life care and as an holistic approach, and introduce palliative medicine principles in the ICU. The goal of this article is to reveal a practical approach to accomplish this, and make it functional in order to improve our patients' clinical and ethical care.
Medicinal and illegal drugs among Danish car drivers.
Behrensdorff, Inge; Steentoft, Anni
2003-11-01
The objective of this study was to get an insight into the prevalence of medicinal and illegal drugs among car drivers in a Danish rural area. The police randomly stopped about 1000 car drivers and asked them to deliver a saliva sample and gave them a questionnaire to fill in at home. Laboratory analyses by specific methods of samples, which a screening found positive, confirmed that 2% were positive for benzodiazepines or illegal drugs (amphetamine, cannabis, cocaine or opiates): 1.3% were positive for illegal drugs and 0.7% for benzodiazepines. Questionnaire statements from some of the drivers confirm that occasionally some of these drive despite a suspicion to be under the influence of an illegal drug (2.8%), an illegal drug including alcohol (4%), a hazardous medicinal drug including alcohol (8.5%), or alcohol alone above the legal limit (24.5%). These results are considered reliable for the survey area and may not reflect national conditions. The overall results indicate that in this study driving under the influence of illegal drugs or alcohol seems to be associated to especially men, aged 22-44 years. Driving under the influence of hazardous medicinal drugs seems to be associated to middle-aged/elderly drivers, both men and women.
[Monitoring medication errors in an internal medicine service].
Smith, Ann-Loren M; Ruiz, Inés A; Jirón, Marcela A
2014-01-01
Patients admitted to internal medicine services receive multiple drugs and thus are at risk of medication errors. To determine the frequency of medication errors (ME) among patients admitted to an internal medicine service of a high complexity hospital. A prospective observational study conducted in 225 patients admitted to an internal medicine service. Each stage of drug utilization system (prescription, transcription, dispensing, preparation and administration) was directly observed by trained pharmacists not related to hospital staff during three months. ME were described and categorized according to the National Coordinating Council for Medication Error Reporting and Prevention. In each stage of medication use, the frequency of ME and their characteristics were determined. A total of 454 drugs were prescribed to the studied patients. In 138 (30,4%) indications, at least one ME occurred, involving 67 (29,8%) patients. Twenty four percent of detected ME occurred during administration, mainly due to wrong time schedules. Anticoagulants were the therapeutic group with the highest occurrence of ME. At least one ME occurred in approximately one third of patients studied, especially during the administration stage. These errors could affect the medication safety and avoid achieving therapeutic goals. Strategies to improve the quality and safe use of medications can be implemented using this information.
Liu, Qiaoxia; Zhou, Binbin; Wang, Xinliang; Ke, Yanxiong; Jin, Yu; Yin, Lihui; Liang, Xinmiao
2012-12-01
A search library about benzylisoquinoline alkaloids was established based on preparation of alkaloid fractions from Rhizoma coptidis, Cortex phellodendri, and Rhizoma corydalis. In this work, two alkaloid fractions from each herbal medicine were first prepared based on selective separation on the "click" binaphthyl column. And then these alkaloid fractions were analyzed on C18 column by liquid chromatography coupled with tandem mass spectrometry. Many structure-related compounds were included in these alkaloids fractions, which led to easy separation and good MS response in further work. Therefore, a search library of 52 benzylisoquinoline alkaloids was established, which included eight aporphine, 19 tetrahydroprotoberberine, two protopine, two benzyltetrahydroisoquinoline, and 21 protoberberine alkaloids. The information of the search library contained compound names, structures, retention times, accurate masses, fragmentation pathways of benzylisoquionline alkaloids, and their sources from three herbal medicines. Using such a library, the alkaloids, especially those trace and unknown components in some herbal medicine could be accurately and quickly identified. In addition, the distribution of benzylisoquinoline alkaloids in the herbal medicines could be also summarized by searching the source samples in the library. © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
A guiding tool in Unani Tibb for maintenance and preservation of health: a review study.
Jabin, Farkhunda
2011-01-01
Unani Tibb is a holistic traditional system of medicine. Ever since 1976, WHO has adopted its policy of promoting traditional medicine, Unani Medicine has enjoyed an upsurge of interest, especially in India, where it has been practiced as one of the Indian systems of medicine. Ali et al (2007) opined that "in Tibb, 'temperament' is a notion of primary importance, though a difficult theory as it indicates the properties of an atom, a molecule, a cell, a tissue, an organ and human body as a whole". Temperament of a person represents its physical constitution and tendencies. It is believed in Tibb that imbalance in temperament predisposes human body to various diseases by producing a biotic imbalance with in body. Causes of initial imbalance in temperament lies in more subtle elements of life like air, water, food, rest, activity, work, evacuation of wastes, sleep etc. To quote Bhika (2006a) "health can be preserved and maintained as long as overall quality of humours is in harmony with overall quality of the temperament of the individual and humoural balance is influenced by lifestyle factors." Hence temperament acts as a guiding force for maintenance and preservation of individuals' health.
Salmikangas, P; Flory, E; Reinhardt, J; Hinz, T; Maciulaitis, R
2010-01-01
The new era of regenerative medicine has led to rapid development of new innovative therapies especially for diseases and tissue/organ defects for which traditional therapies and medicinal products have not provided satisfactory outcome. Although the clinical use and developments of cell-based medicinal products (CBMPs) could be witnessed already for a decade, robust scientific and regulatory provisions for these products have only recently been enacted. The new Regulation for Advanced Therapies (EC) 1394/2007 together with the revised Annex I, Part IV of Directive 2001/83/EC provides the new legal framework for CBMPs. The wide variety of cell-based products and the foreseen limitations (small sample sizes, short shelf life) vs. particular risks (microbiological purity, variability, immunogenicity, tumourigenicity) associated with CBMPs have called for a flexible, case-by-case regulatory approach for these products. Consequently, a risk-based approach has been developed to allow definition of the amount of scientific data needed for a Marketing Authorisation Application (MAA) of each CBMP. The article provides further insight into the initial risk evaluation, as well as to the quality, non-clinical, and clinical requirements of CBMPs. Special somatic cell therapies designed for active immunotherapy are also addressed.
Off-label use of medicines: The need for good practice guidelines.
Dooms, Marc; Killick, James
2017-01-01
'Off-label use' is the term used for the prescription and dispensing of a medicinal product for any indication, patient group, route of administration, dosage or treatment regimen other than that listed in the Summary of Product Characteristics. In this article the authors present a brief overview of current practices of off-label use in Europe and the applicable European law and jurisprudence. They then go on to present a set of guidelines for best practice in off-label use which underlines the need for guidance on prescription to be firmly rooted in the need to ensure patient safety above all other concerns. The article was written from desk research and expert engagement, including a presentation and Q&A in the European Parliament. This article intends to demonstrate that off-label use entails increased risks for patients, especially when it is not underpinned by rigorous clinical studies or the reporting routes for use are not well defined. Europe is seeing a growing trend the promotion of off-label prescription of medicinal products for reasons other than pure medical need, including motives such as cost-containment. This poses a numer of questions for the ethical and legal framework for medicine prescription and dispensing in Europe.
The management of pneumonia in internal medicine.
Bouza, E; Giannella, M; Pinilla, B; Pujol, R; Capdevila, J A; Muñoz, P
2013-01-01
Pneumonia generates a high workload for internal medicine departments. Management of this disease is challenging, because patients are usually elderly and have multiple comorbid conditions. Furthermore, the interpretation and adherence to guidelines are far from clear in this setting. We report the opinion of 43 internists especially interested in infectious diseases that were questioned at the 2011 XXXII National Conference of Spanish Society of Internal Medicine about the main issues involved in the management of pneumonia in the internal medicine departments, namely, classification, admission criteria, microbiological workup, therapeutic management, discharge policy, and prevention of future episodes. Participants were asked to choose between 2 options for each statement by 4 investigators. Consensus could not be reached in many cases. The most controversial issues concerned recognition and management of healthcare-associated pneumonia (HCAP). Most participants were aware of the differences in terms of underlying diseases, etiological distribution, and outcome of HCAP compared with community-acquired pneumonia, but only a minority agreed to manage HCAP as hospital-acquired pneumonia, as suggested by some guidelines. A clinical patient-to-patient approach proved to be the option preferred by internists in the management of HCAP. Copyright © 2012 Elsevier España, S.L. All rights reserved.
Team deliberate practice in medicine and related domains: a consideration of the issues.
Harris, Kevin R; Eccles, David W; Shatzer, John H
2017-03-01
A better understanding of the factors influencing medical team performance and accounting for expert medical team performance should benefit medical practice. Therefore, the aim here is to highlight key issues with using deliberate practice to improve medical team performance, especially given the success of deliberate practice for developing individual expert performance in medicine and other domains. Highlighting these issues will inform the development of training for medical teams. The authors first describe team coordination and its critical role in medical teams. Presented next are the cognitive mechanisms that allow expert performers to accurately interpret the current situation via the creation of an accurate mental "model" of the current situation, known as a situation model. Following this, the authors propose that effective team performance depends at least in part on team members having similar models of the situation, known as a shared situation model. The authors then propose guiding principles for implementing team deliberate practice in medicine and describe how team deliberate practice can be used in an attempt to reduce barriers inherent in medical teams to the development of shared situation models. The paper concludes with considerations of limitations, and future research directions, concerning the implementation of team deliberate practice within medicine.
Pires, Carla; Vigário, Marina; Cavaco, Afonso
2016-06-01
The graphical content of the Medicines Package Inserts (MPIs), such as illustrations and typographic features should be legible and appropriate, as required by international pharmaceutical regulations. To study: (1) the frequency and type of MPIs' key graphic elements, (2) their compliance with regulations and (3) how educated people understand them. Descriptive study: characterisation of the graphical content of 651 MPIs. Usability study: illustrations and tables (purposively selected) were evaluated with questionnaires in three groups of humanities undergraduates (illustrations only, illustrations plus text and text only). Descriptive study: illustrations and tables were respectively identified in 6.3% and 11.8% of the MPIs. The illustrations were mainly related to how to take/use the medicine. Non-recommended graphical representations were found (e.g. italic or underline). Usability test: legibility issues were identified, especially for the group of isolated illustrations. The scarce use of illustrations and tables possibly affected the legibility of the MPIs. Compulsory legibility tests are needed to guarantee the MPIs' proper use, thus contributing to a safe use of medicines. Overall, this study highlighted the need to carefully revise/assess the MPIs' design and probably increase health information experts' awareness on this issue. © 2015 Health Libraries Group.
Volume, value and floristic diversity of Gabon׳s medicinal plant markets.
Towns, Alexandra M; Quiroz, Diana; Guinee, Lieke; de Boer, Hugo; van Andel, Tinde
2014-09-11
African medicinal plant markets offer insight into commercially important species, salient health concerns in the region, and possible conservation priorities. Still, little quantitative data is available on the trade in herbal medicine in Central Africa. The aim of this study was to identify the species, volume, and value of medicinal plant products sold on the major domestic markets in Gabon, Central Africa. We surveyed 21 herbal market stalls across 14 of the major herbal medicine markets in Gabon, collected vouchers of medicinal plants and documented uses, vernacular names, prices, weight, vendor information and weekly sales. From these quantitative data, we extrapolated volumes and values for the entire herbal medicine market. We encountered 263 medicinal plant products corresponding with at least 217 species. Thirteen species were encountered on one-third of the surveyed stalls and 18 species made up almost 50% of the total volume of products available daily, including the fruits of Tetrapleura tetraptera and seeds of Monodora myristica. Although bark comprised the majority of the floristic diversity (22%) and the highest percentage of daily stock (30%), the resin of IUCN red-listed species Aucoumea klaineana represented 20% of the estimated daily volume of the entire herbal market. Plants sold at the market were mainly used for ritual purposes (32%), followed by women׳s health (13%), and childcare (10%). The presence of migrant herbal vendors selling imported species, especially from Benin, was a prominent feature of the Gabonese markets. An estimated volume of 27 t of medicinal plant products worth US$ 1.5 million is sold annually on the main Gabonese markets. Aucoumea klaineana and Garcinia kola are highlighted as frequently sold species with conservation priorities. The herbal market in Gabon is slightly higher in species diversity but lower in volume and value than recently surveyed sub-Saharan African markets. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Hamrosi, Kim K; Raynor, David K; Aslani, Parisa
2014-01-01
Providing written medicine information to consumers enables them to make informed decisions about their medicines, playing an important role in educating and improving health literacy. In Australia, standardized written medicine information called Consumer Medicine Information (CMI) is available for medicines as package inserts, computer prints, or leaflets. Consumers want and read CMI, but may not always ask for it. General practitioners (GPs) and pharmacists are an important source of written medicine information, yet may not always provide CMI in their practice. To examine and compare the awareness, use and provision of CMI by consumers, pharmacists and general practitioners (GPs). Based on previous studies, structured questionnaires were developed and administered to a national sample of consumers (phone survey); community pharmacists and GPs (postal surveys) about utilization of CMI. Descriptive, comparative and logistic regression analyses were conducted. The respondents comprised of 349 pharmacists, 181 GPs and 1000 consumers. Two-thirds of consumers, nearly all (99%) pharmacists and 90% of GPs were aware of CMI. About 88% of consumers reported receiving CMI as a package insert, however most pharmacists (99%) and GPs (56%) reported providing computer-generated CMI. GPs' and pharmacists' main reason for providing CMI was on patient request. Reasons for not providing were predominantly because consumers were already taking the medicine, concerns regarding difficulty understanding the information, or potential non-adherence. Of the 691 consumers reportedly reading CMI, 35% indicated concerns after reading. Factors associated with reading included gender, type of CMI received and frequency of provision. Consumers want and read information about their medicines, especially when received from their GP or pharmacist. Healthcare professionals report usually discussing CMI when providing it to patients, although continued improvements in dissemination rates are desirable. Regular use of CMI remains a challenge, and ongoing strategies to promote CMI use are necessary to improve uptake of CMI in Australia. Copyright © 2014 Elsevier Inc. All rights reserved.
Molecular hydrogen in sports medicine: new therapeutic perspectives.
Ostojic, S M
2015-04-01
In the past 2 decades, molecular hydrogen emerged as a novel therapeutic agent, with antioxidant, anti-inflammatory and anti-apoptotic effects demonstrated in plethora of animal disease models and human studies. Beneficial effects of molecular hydrogen in clinical environment are observed especially in oxidative stress-mediated diseases, such as diabetes mellitus, brain stem infarction, rheumatoid arthritis, or neurodegenerative diseases. A number of more recent studies have reported that molecular hydrogen affects cell signal transduction and acts as an alkalizing agent, with these newly identified mechanisms of action having the potential to widen its application in clinical medicine even further. In particular, hydrogen therapy may be an effective and specific innovative treatment for exercise-induced oxidative stress and sports injury, with potential for the improvement of exercise performance. This review will summarize recent research findings regarding the clinical aspects of molecular hydrogen use, emphasizing its application in the field of sports medicine. © Georg Thieme Verlag KG Stuttgart · New York.
Gevitz, Norman
2013-01-01
This article examines for the first time the theologically based medical ethics of the late sixteenth-century English Calvinist minister William Perkins. Although Perkins did not write a single focused book on the subject of medical ethics, he addressed a variety of moral issues in medicine in his numerous treatises on how laypeople should conduct themselves in their vocations and in all aspects of their daily lives. Perkins wrote on familiar issues such as the qualities of a good physician, the conduct of sick persons, the role of the minister in healing, and obligations in time of pestilence. His most significant contribution was his distinction between “lawful” and “unlawful” medicine, the latter category including both medical astrology and magic. Perkins's works reached a far greater audience in England and especially New England than did the treatises of contemporary secular medical ethics authors and his writings were influential in guiding the moral thinking of many pious medical practitioners and laypersons. PMID:22235029
Gori, L.; Lombardo, G.
2008-01-01
Agaricus blazei Murrill (ABM) popularly known as ‘Cogumelo do Sol’ in Brazil, or ‘Himematsutake’ in Japan, is a mushroom native to Brazil, and widely cultivated in Japan for its medicinal uses, so it is now considered as one of the most important edible and culinary-medicinal biotechnological species. It was traditionally used to treat many common diseases like atherosclerosis, hepatitis, hyperlipidemia, diabetes, dermatitis and cancer. In vitro and in vivo ABM has shown immunomodulatory and antimutagenic properties, although the biological pathways and chemical substances involved in its pharmacological activities are still not clear. The polysaccharides phytocomplex is thought to be responsible for its immunostimulant and antitumor properties, probably through an opsonizing biochemical pathway. Clinical studies are positive confirmations, but we are still at the beginning, and there are perplexing concerns especially relative to the content of agaritine. Argantine is a well-known carcinogenic and toxic substance in animals, that must be completely and fully evaluated. PMID:18317543
Hakimi, R
2013-03-01
There have been medical consultants in the insurance business since the 19th century. Still the tasks and competences of the medical consultants in private health insurance in Germany are more or less unknown to the public and among doctors. There are only few publications about this topic. All questions submitted to the medical consultant from 1 January 2011 to 31 December 2011 have been examined and classified. Most of the questions to the medical consultant concern the medical necessity of medications, with life style medication playing an especially important role. Alternative medicine, the classification of cure and rehabilitation measures of hospital medical treatments, out-patient operations, new treatments, the length of hospital treatments and out-patient psychotherapy, medical consultation on artificial insemination and cosmetic surgery intervention give more and more reason for a consultation of the medical examiner. The discussion considers the details of individual insurance medicine blocks of consultation in insurance medicine and explains their significance.
Genotoxic alkenylbenzene flavourings, a contribution to risk assessment.
Martins, Célia; Rueff, José; Rodrigues, António S
2018-06-15
Alkenylbenzenes, such as estragole, myristicin and eugenol, are present is several flavourings, functional foods, plant food supplements (PFS) and in complementary and alternative medicines (CAM) including herbal medicines. The increase in consumption in functional foods observed worldwide requires a strict analysis of the scientific validity of their benefits and risk-benefit ratio associated with their intake. Some instances of acute toxicity have been reported associated with the use of herbal medicines and PFS, in particular because quality control is poor, and this poses a risk especially in internet marketed products. In particular, chronic exposure to low levels of these constituents may pose a hazard. However, given the variability in dietary habits, plant properties, plant misidentification or interaction with pharmaceutical drugs or nutrients, the assessment of risk due to the intake of alkenylbenzenes is difficult. We herein review the regulatory status of the most common alkenylbenzenes and their genotoxic activity and potential carcinogenic activity. Copyright © 2018. Published by Elsevier Ltd.
Identifying and training non-technical skills for teams in acute medicine
Flin, R; Maran, N
2004-01-01
The aviation domain provides a better analogy for the "temporary" teams that are found in acute medical specialities than industrial or military teamwork research based on established teams. Crew resource management (CRM) training, which emphasises portable skills (for whatever crew a pilot is rostered to on a given flight), has been recognised to have potential application in medicine, especially for teams in the operating theatre, intensive care unit, and emergency room. Drawing on research from aviation psychology that produced the behavioural marker system NOTECHS for rating European pilots' non-technical skills for teamwork on the flightdeck, this paper outlines the Anaesthetists Non-Technical Skills behavioural rating system for anaesthetists working in operating theatre teams. This taxonomy was used as the design basis for a training course, Crisis Avoidance Resource Management for Anaesthetists used to develop these skills, based in an operating theatre simulator. Further developments of this training programme for teams in emergency medicine are outlined. PMID:15465960
Perspective of the human body in sasang constitutional medicine.
Lee, Junhee; Jung, Yongjae; Yoo, Junghee; Lee, Euiju; Koh, Byunghee
2009-09-01
The Sasang constitutional medicine (SCM), a medical tradition originating from Korea, is distinguished from the traditional Chinese medicine in its philosophical background, theoretical development and especially, the fundamental rationale that analyzes the structure and function of the human body within a quadrifocal scheme. In SCM, the structure of the body is comprehended within the Sasang quadrifocal scheme, and the function of the body is understood within the context of the energy-fluid metabolism and the water-food metabolism controlled by the four main organs (lung, spleen, liver and kidney). Also, the concept of Seong-Jeong is used to explain the structural and functional variations between different constitutional types that arise from the constitutional variations in organ system scheme, which are in turn caused by deviations in the constitutional Seong-Jeong. Therefore, understanding the SCM perspective of the human body is essential in order to fully appreciate the advantages of the constitutional typological system (which focuses on individual idiosyncrasies) found in SCM.
Role of Aragvadhadi Sutra in the Management of Fistula -in-Ano
Kumar, P. Hemantha; Sahu, M.
2000-01-01
Traditional Medicine has its own importance for the treatment of various medical and surgical diseases irrespective of tremendous development of modern medicine. There are number of diseases were after repeated surgery. Fistula-in ano is one such condition which is prone to recurrence even after repeated surgery and can be effectively treated by Ayurvedic medicines. An extensive work has been done on the treatment of Bhagandara by Kshara sutra exploring various aspects of the problem and finding our the solution to them1. the present study is related to similar type of medicated thread known as Aragvadadi Sutra which has been mentioned by sushruta in Bhagandara. It consists of Aragvadha (Cassia fistula), Haridra (Curcuma longa), Agaru (Aquilaria agalocha), Madhu (Honey) and Ghrita (Ghee). This is the first non-caustic thread being tried on different types of Bhagandara. Especially it is a painless thread, non-irritant and very useful in sensitive patients like children, females and elders. PMID:22556930
Gevitz, Norman
2013-04-01
This article examines for the first time the theologically based medical ethics of the late sixteenth-century English Calvinist minister William Perkins. Although Perkins did not write a single focused book on the subject of medical ethics, he addressed a variety of moral issues in medicine in his numerous treatises on how laypeople should conduct themselves in their vocations and in all aspects of their daily lives. Perkins wrote on familiar issues such as the qualities of a good physician, the conduct of sick persons, the role of the minister in healing, and obligations in time of pestilence. His most significant contribution was his distinction between "lawful" and "unlawful" medicine, the latter category including both medical astrology and magic. Perkins's works reached a far greater audience in England and especially New England than did the treatises of contemporary secular medical ethics authors and his writings were influential in guiding the moral thinking of many pious medical practitioners and laypersons.
Draft EU regulation on paediatric medicines: some improvements but still far from perfect.
2006-02-01
(1) In 2004, the European Commission proposed a draft European Regulation on paediatric medicines. This draft was more closely oriented towards defending drug companies' interests than with meeting children's medical needs. (2) Despite pressure from drug companies and their allies, several major improvements were made to the draft at its first reading in the European Parliament, thanks especially to the efforts of the Medicines in Europe Forum. (3) In particular, European deputies pushed for a better definition of children's needs and paediatric research priorities, greater transparency at various important stages of the market authorization procedure, and strengthened pharmacovigilance. (4) Yet the incentives and rewards offered to companies fail to take into account the notion of true therapeutic advantages and R&D expenditure. (5) Unfortunately the Commission refused some important amendments and published a new draft proposal, which was accepted by the Council of Health Ministers at the end of 2005. The new draft will come before the Parliament for a second reading in 2006.
Use of genome editing tools in human stem cell-based disease modeling and precision medicine.
Wei, Yu-da; Li, Shuang; Liu, Gai-gai; Zhang, Yong-xian; Ding, Qiu-rong
2015-10-01
Precision medicine emerges as a new approach that takes into account individual variability. The successful conduct of precision medicine requires the use of precise disease models. Human pluripotent stem cells (hPSCs), as well as adult stem cells, can be differentiated into a variety of human somatic cell types that can be used for research and drug screening. The development of genome editing technology over the past few years, especially the CRISPR/Cas system, has made it feasible to precisely and efficiently edit the genetic background. Therefore, disease modeling by using a combination of human stem cells and genome editing technology has offered a new platform to generate " personalized " disease models, which allow the study of the contribution of individual genetic variabilities to disease progression and the development of precise treatments. In this review, recent advances in the use of genome editing in human stem cells and the generation of stem cell models for rare diseases and cancers are discussed.
Imaging of Muscle Injuries in Sports Medicine: Sports Imaging Series.
Guermazi, Ali; Roemer, Frank W; Robinson, Philip; Tol, Johannes L; Regatte, Ravindar R; Crema, Michel D
2017-03-01
In sports-related muscle injuries, the main goal of the sports medicine physician is to return the athlete to competition-balanced against the need to prevent the injury from worsening or recurring. Prognosis based on the available clinical and imaging information is crucial. Imaging is crucial to confirm and assess the extent of sports-related muscle injuries and may help to guide management, which directly affects the prognosis. This is especially important when the diagnosis or grade of injury is unclear, when recovery is taking longer than expected, and when interventional or surgical management may be necessary. Several imaging techniques are widely available, with ultrasonography and magnetic resonance imaging currently the most frequently applied in sports medicine. This state of the art review will discuss the main imaging modalities for the assessment of sports-related muscle injuries, including advanced imaging techniques, with the focus on the clinical relevance of imaging features of muscle injuries. © RSNA, 2017 Online supplemental material is available for this article.
Herbal medicines for the management of irritable bowel syndrome: A comprehensive review
Rahimi, Roja; Abdollahi, Mohammad
2012-01-01
Irritable bowel syndrome (IBS) is a functional gut disorder with high prevalence. Because of various factors involved in its pathophysiology and disappointing results from conventional IBS medications, the treatment of IBS is challenging and use of complementary and alternative medicines especially herbal therapies is increasing. In this paper, electronic databases including PubMed, Scopus, and Cochrane library were searched to obtain any in vitro, in vivo or human studies evaluating single or compound herbal preparations in the management of IBS. One in vitro, 3 in vivo and 23 human studies were included and systematically reviewed. The majority of studies are about essential oil of Menta piperita as a single preparation and STW 5 as a compound preparation. Some evaluated herbs such as Curcuma xanthorriza and Fumaria officinalis did not demonstrate any benefits in IBS. However, it seems there are many other herbal preparations such as those proposed in traditional medicine of different countries that could be studied and investigated for their efficacy in management of IBS. PMID:22363129
Effects of unique biomedical education programs for engineers: REDEEM and ESTEEM projects.
Matsuki, Noriaki; Takeda, Motohiro; Yamano, Masahiro; Imai, Yohsuke; Ishikawa, Takuji; Yamaguchi, Takami
2009-06-01
Current engineering applications in the medical arena are extremely progressive. However, it is rather difficult for medical doctors and engineers to discuss issues because they do not always understand one another's jargon or ways of thinking. Ideally, medical engineers should become acquainted with medicine, and engineers should be able to understand how medical doctors think. Tohoku University in Japan has managed a number of unique reeducation programs for working engineers. Recurrent Education for the Development of Engineering Enhanced Medicine has been offered as a basic learning course since 2004, and Education through Synergetic Training for Engineering Enhanced Medicine has been offered as an advanced learning course since 2006. These programs, which were developed especially for engineers, consist of interactive, modular, and disease-based lectures (case studies) and substantial laboratory work. As a result of taking these courses, all students obtained better objective outcomes, on tests, and subjective outcomes, through student satisfaction. In this article, we report on our unique biomedical education programs for engineers and their effects on working engineers.
Mahanom, H; Azizah, A; Dzulkifly, M
1999-12-01
The effect of oven drying at 50ᵒC ± 1ᵒC for 9 hour, 70ᵒC ± 1ᵒC for 5 hour and freeze drying on retention of chlorophyll, riboflavin, niacin, ascorbic acid and carotenoids in herbal preparation consisting of 8 medicinal plants was evaluated. The medicinal plants selected were leaves of Apium graveolens (saderi), Averrhoa bilimbi (belimbing buluh), Centella asiatica (pegaga), Mentha arvensis (pudina), Psidium guajava (jambu batu), Sauropus androgynous (cekor manis), Solanum nigrum (terung meranti) and Polygonum minus (kesum ). Results revealed that both type and conditions of the drying treatments affected retention of all phytochemicals analysed. Herbal preparation developed using oven drying was found to have inferior phytochemicals content compared to that obtained by freeze dryer. Nevertheless, the herbal preparation developed using all treatments still retain appreciable amount of phytochemicals studied, especially carotenoids, ascorbic acid, niacin and riboflavin and thus have potential for commercial purposes.
Development of Species-specific Primers for Rapid Detection of Phellinus linteus and P. baumii
Kim, Mun-Ok; Kim, Gi-Young; Nam, Byung-Hyouk; Jin, Cheng-Yun; Lee, Ki-Won; Park, Jae-Min; Lee, Sang-Joon
2005-01-01
Genus Phellinus taxonomically belongs to Aphyllophorales and some species of this genus have been used as a medicinal ingredients and Indian folk medicines. Especially, P. linteus and morphological-related species are well-known medicinal fungi that have various biological activities such as humoral and cell-mediated, anti-mutagenic, and anti-cancer activities. However, little is known about the rapid detection for complex Phellinus species. Therefore, this study was carried out to develop specific primers for the rapid detection of P. linteus and other related species. Designing the species-specific primers was done based on internal transcribed spacer sequence data. Each primer set detected specifically P. linteus (PL2/PL5R) and P. baumii (PB1/PB4R). These primer sets could be useful for the rapid detection of specific-species among unidentified Phellinus species. Moreover, restriction fragment length polymorphism analysis of the ITS region with HaeIII was also useful for clarifying the relationship between each 5 Phellinus species. PMID:24049482
Berger, A; Schüle, S; Flory, E
2011-07-01
Advanced therapy medicinal products (ATMPs) are gene therapy, cell therapy, and tissue engineered products. To gain access to the market within the European Union, ATMPs must be authorized by the European Commission (EC). Especially for small and medium-sized enterprises (SMEs), the European centralized procedure of marketing authorization that is conducted by the European Medicines Agency (EMA) constitutes a major challenge, because SMEs often have little experience with regulatory procedures and many have limited financial possibilities. To tackle these challenges, a certification procedure exclusively for SMEs and their ATMP development was introduced by the EC. Independently from a marketing authorization application, development and/or production processes can be certified. An issued certificate demonstrates that the respective process meets the current regulatory and scientific requirements of the EMA, representing a valuable milestone for putative investors and licensees. This article highlights the background, the detailed procedure, the minimum requirements, as well as the costs of certification, while giving further noteworthy guidance for interested parties.
Perspective of the Human Body in Sasang Constitutional Medicine
Lee, Junhee; Jung, Yongjae; Yoo, Junghee; Lee, Euiju
2009-01-01
The Sasang constitutional medicine (SCM), a medical tradition originating from Korea, is distinguished from the traditional Chinese medicine in its philosophical background, theoretical development and especially, the fundamental rationale that analyzes the structure and function of the human body within a quadrifocal scheme. In SCM, the structure of the body is comprehended within the Sasang quadrifocal scheme, and the function of the body is understood within the context of the energy–fluid metabolism and the water–food metabolism controlled by the four main organs (lung, spleen, liver and kidney). Also, the concept of Seong–Jeong is used to explain the structural and functional variations between different constitutional types that arise from the constitutional variations in organ system scheme, which are in turn caused by deviations in the constitutional Seong–Jeong. Therefore, understanding the SCM perspective of the human body is essential in order to fully appreciate the advantages of the constitutional typological system (which focuses on individual idiosyncrasies) found in SCM. PMID:19745009
The Currency of Consciousness: Neurology, Specialization, and the Global Practices of Medicine.
Casper, Stephen T
2016-01-01
This article explores the formation of a global community of neurologists between 1918 and 1970. Relying chiefly upon documents located in Anglo-American archives, its argument follows a narrative from money to memory, and posits that this global community of neurologists formed not out of a shared science and medicine of the nervous system, but out of shared dispositions in tastes, values, and culture. The localism and heterogeneity of the science and medicine of the nervous system was in fact so pronounced that neurologists - especially when they worked as "global citizens" - were forced to focus upon their superficial commonalities rather than examine local distinctions. This avoidance of a direct effort to define the content of neurology - or at least to confront their differences - exercised a peculiar influence on the specialty. Neurologists and their "official memory" became negotiated, and even imagined constructs. Consequently, these diverse cultures were ultimately subordinated to dominant economic interests.
New approaches within the history and theory of medicine and their relevance for homeopathy.
Schmidt, Josef M
2014-04-01
Conventional sciences have brought forth a wealth of knowledge and benefits, but they have not always been clear and precise about their legitimate scope and methodological limitations. In contrast, new and critical approaches in modern sciences question and reflect their own presuppositions, dependencies, and constraints. Examples are quantum physics, theory and history of science, as well as theory and history of medicine, sociology, and economics. In this way, deprecative dogmatism and animosity amongst sciences ought to be lessened, while the field opens up for each science to redefine its appropriate place in society. This would appear to be a chance for homeopathy, as new approaches, especially within the social and economic sciences, suggest that being a follower of Samuel Hahnemann (1755-1843) may have advantages and privileges that conventional medicine seems to be lacking and whose relevance was overlooked during the rise of economic thinking in the last two centuries. Copyright © 2013 The Faculty of Homeopathy. Published by Elsevier Ltd. All rights reserved.
Sruamsiri, Rosarin; Wagner, Anita K; Ross-Degnan, Dennis; Lu, Christine Y; Dhippayom, Teerapon; Ngorsuraches, Surachat; Chaiyakunapruk, Nathorn
2016-03-17
In 2008, the Thai government introduced the 'high-cost medicines E2 access program' as a part of the National List of Essential Medicines to increase patient access to medicines, improve clinical outcomes and make medicines more affordable. Our objective was to examine whether the 'high-cost medicines E2 access program' achieved its goals. Interrupted time-series design study. 3 tertiary hospitals in different regions of Thailand, January 2006 to December 2012. Patients with target acute and chronic disease diagnoses who newly met E2 program criteria for selected study medicines. High-cost medicines E2 access program. Level and trend changes over time in the proportions of eligible patients who received the indicated E2 medicines and who improved clinically, as well as in costs of treatment. A total of 2024 patients were included in utilisation analyses and 1375 patients with selected acute diseases contributed to analyses of clinical outcome. After 1 year of the E2 program implementation, the percentage of eligible patients receiving the indicated E2 program medicines increased significantly (relative change 12.7% (95% CI 4.4% to 21.0%), especially among those insured by the government's universal coverage scheme (relative change 19.9% (95% CI 9.5% to 30.5%)). The increase in the proportion of clinically improved patients with acute conditions was not significant (relative change 6.2% (95% CI -1.9% to 15.1%)). Quarterly healthcare costs per patient dropped significantly (relative change -13.5% (95% CI -26.9% to -1.7%)). In the study hospitals, the E2 access program seems to have facilitated patient access to specialty medicines, may have contributed to improved health outcomes, and decreased treatment costs. Routine monitoring is needed to assess effects of expanding the programme, including effects on quality of care and financial sustainability. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Ie, Kenya; Tahara, Masao; Murata, Akiko; Komiyama, Manabu; Onishi, Hirotaka
2014-01-01
Despite recent developments in post-graduate family medicine training in Japan, the numbers of junior doctors entering family medicine residencies are still limited. The objective of this qualitative study was to investigate the possible factors associated to the career choice of family medicine, especially in the context of the newly established family medicine programs in Japan. From December 2010 to January 2011, we distributed a semi-structured questionnaire about career choice to 58 physician members of the Japan Primary Care Association, and 41 of them responded. Four researchers used the Modified Grounded Theory Approach (Kinoshita, 2003) for three-stage conceptualization. We extracted a conceptual model of the choice of newly established family medicine as a career in Japan, consisting of six categories and 77 subordinate concepts from 330 variations. The subcategories of personal background affecting the family-medicine career choice were characteristics ("self-reliance," "pioneering spirit"), career direction ("community/rural-orientedness," "multifaceted orientation") and experience (e.g., "discomfort with fragmented care"). We divided the influencing factors that were identified for career choice into supporters (e.g., "role model"), conflict of career choice (e.g., "anxiety about diverse/broad practice"), and the dawn of a new era in family medicine in Japan (e.g., "lack of social recognition," "concern about livelihood," and "too few role models"). Although the dawn of a new era seemed a rather negative influencer, it was unique to our study that the dawn itself could attract those with a "pioneering spirit" and an "attitude of self-training." Unlike previous studies, the positive factors such as lifestyle and the short residency program were not shown to be part of family medicine's attractiveness. In contrast, "concern about livelihood" was specific among our respondents and was related to career choice in the dawn period. "Community-orientedness" and "multifaceted orientation" (which have aspects in common with previous studies' findings) would appear to be universal regardless of cultural and medical system differences. In our study, these universal factors were also found to be part of the attractiveness of family medicine from the practitioners' viewpoints, and these factors may become great influencers for family medicine candidates.
An approach to the concept of tonic: suggested definitions and historical aspects.
Götti, Robert P; Melzer, Jörg; Saller, Reinhard
2014-01-01
In traditional medicine, especially CAM, the concept of (herbal) tonics has a long history in the different medical systems (TEN -- Traditional European Naturopathy; TCM - Traditional Chinese Medicine). Nevertheless, the ideas concerning the function of a tonic differ, e.g., stimulation of body functions, strengthening of organ function, enhancement of adaption, and well-being. Although no exact pharmacodynamic or pharmacokinetic properties of tonics can be given, the following general definition, even in the transcultural comparison between European and Chinese concepts, seems meaningful: A tonic is an agent that has the capability to restore and/or maintain the physiological functioning of an organ system, leading to the subjective feeling of well-being of the patient treated with it. © 2014 S. Karger AG, Freiburg.
Wang, Ningqun; Ji, Shaozhen; Zhang, Hao; Mei, Shanshan; Qiao, Lumin; Jin, Xianglan
2017-01-01
The Cistanche species (“Rou Cong Rong” in Chinese) is an endangered wild species growing in arid or semi-arid areas. The dried fleshy stem of Cistanches has been used as a tonic in China for many years. Modern pharmacological studies have since demonstrated that Herba Cistanches possesses broad medicinal functions, especially for use in anti-senescence, anti-oxidation, neuroprotection, anti-inflammation, hepatoprotection, immunomodulation, anti-neoplastic, anti-osteoporosis and the promotion of bone formation. This review summarizes the up-to-date and comprehensive information on Herba Cistanches covering the aspects of the botany, traditional uses, phytochemistry and pharmacology, to lay ground for fully elucidating the potential mechanisms of Herba Cistanches’ anti-aging effect and promote its clinical application as an anti-aging herbal medicine. PMID:29344414
Biological activity of common mullein, a medicinal plant.
Turker, Arzu Ucar; Camper, N D
2002-10-01
Common Mullein (Verbascum thapsus L., Scrophulariaceae) is a medicinal plant that has been used for the treatment of inflammatory diseases, asthma, spasmodic coughs, diarrhea and other pulmonary problems. The objective of this study was to assess the biological activity of Common Mullein extracts and commercial Mullein products using selected bench top bioassays, including antibacterial, antitumor, and two toxicity assays--brine shrimp and radish seed. Extracts were prepared in water, ethanol and methanol. Antibacterial activity (especially the water extract) was observed with Klebsiella pneumonia, Staphylococcus aureus, Staphylococcus epidermidis and Escherichia coli. Agrobacterium tumefaciens-induced tumors in potato disc tissue were inhibited by all extracts. Toxicity to Brine Shrimp and to radish seed germination and growth was observed at higher concentrations of the extracts.
Severe hypothermia in myxoedema coma: a rewarming by extracorporeal circulation.
Kogan, Alexander; Kassif, Yigal; Shadel, Mordechay; Shwarz, Yaron; Lavee, Jacob; Or, Jacob; Raanani, Ehud
2011-12-01
Myxoedema coma is the most lethal manifestation of hypothyroidism. It represents a true medical emergency, especially in the case of cardiovascular instability. Extracorporeal circulation is usually used for rewarming and for providing cardiac support in patients with severe hypothermia and, in addition, cardiovascular instability. We report the case of an 84-year-old woman who presented to the ED with accidental hypothermia associated with myxoedema that was successfully managed by veno-arterial extracorporeal blood rewarming. This case suggests that veno-arterial extracorporeal rewarming appears to achieve a rapid and consistent rewarming rate and is less invasive and more readily available than cardiopulmonary bypass. © 2011 The Authors. EMA © 2011 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.
Zhao, S; Yang, L; Liu, H; Gao, F
2017-07-01
Stenotrophomona maltophilia has emerged as an important opportunistic pathogen that is highly antibiotic resistant. Analysis of antibiotic susceptibilities, drug-resistant gene profiles and molecular typing of S. maltophilia was undertaken in a university hospital of traditional Chinese medicine in East China. Resistance to sulphamethoxazole (SXT) was found to be an indicator of multi-drug resistance. SXT resistance was mediated by sul and dfrA genes in integrons, especially class 1. Some evidence of clonal dissemination was found, indicating the occurrence of cross-transmission of antibiotic-resistant strains within the hospital. This underscores the need for effective control and prevention measures in hospitals. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.
Mello, Guilherme Arantes; Viana, Ana Luiza d'Ávila
2011-12-01
Health Centers appeared in the United States around 1910. They provided social assistance in conjunction with some type of medical care. Their original separation between preventive and curative medicine was superseded by the concept of whole health in the 1940s, when Health Center discourse became part of medical education. In the 1960s, the notion of community medicine arose out of the war on poverty. These ideas spread through Brazil in the 1920s and were strengthened under the Vargas policy of national construction, but it was the Serviço Especial de Saúde Pública (Special Public Health Service) that was primarily responsible for lending them their practical and conceptual shape in this country.
Legal issues associated with sexual activity between adults and minors in Texas: a review.
Smith, P B; Mumford, D M; Foreman, S
1999-07-01
Recent research on adolescent mothers and the age of their sexual partners has stimulated discussion of whether legal action should be taken against adult men who engage in sexual intercourse with minors. A nonrandom poll that started as casual questions but extended over 6 months to 52 doctors initiated this review. It became apparent that the primary care physicians (pediatrics, family medicine, and internal medicine) had little, if any, understanding of some key legal facts in Texas associated with adolescent sexuality and pregnancy, especially when adult partners are involved. This article provides a legislative overview for practitioners in an attempt to clarify the law, remediate any deficiency of knowledge, and remind physicians of their role in reporting sexual abuse of minors.
[Emergency medicine after a catastrophic disaster: from a view of geriatrics and gerontology].
Okinaga, Shoji; Daito, Hisayoshi; Suzuki, Motoi; Shiihara, Jun; Arai, Hiroyuki
2013-06-01
The megathrust earthquake and the towering tsunami hit the east coast of Japan on March 11th of 2011 after intervals of 1,142 years. About 90 % of nearly 20,000 victims were drowned in devastating waves, while every town and city along the coast turned out to be a ruin. Over 400,000 people were forced to move to the evacuation centers where the evacuees slept on the floor without electricity, running water or heating systems at freezing nights. Emergency medicine, therefore, was more required during the evacuation phase than during the acute phase of the tsunami disaster. Here discussed is the phenomenon that the events happened mostly to the elderly evacuees especially in the swept area by silty polluted seawater.
Personalized Medicine in Pediatrics: The Clinical Potential of Orodispersible Films.
Visser, J Carolina; Woerdenbag, Herman J; Hanff, Lidwien M; Frijlink, Henderik W
2017-02-01
Children frequently receive medicines that are designed for adults. The dose of commercially available products is adapted, mostly based on the child's bodyweight, thereby neglecting differences in pharmacokinetic and pharmacodynamics parameters. If commercial products are unsuitable for administration to children or are unavailable, extemporaneous pharmacy preparations are a good alternative. For this particular population, orodispersible films (ODFs) can be a highly attractive dosage form for the oral administration of drugs. ODFs are relatively easy to prepare in a hospital setting, create dose flexibility, and may suit an individual approach, especially for patients having difficulties in swallowing tablets or being fluid restricted. In this article, various aspects related to pharmacy preparations, clinical application, and preparation of ODFs for pediatric patients are highlighted and discussed.
[Multifocal visual electrophysiology in visual function evaluation].
Peng, Shu-Ya; Chen, Jie-Min; Liu, Rui-Jue; Zhou, Shu; Liu, Dong-Mei; Xia, Wen-Tao
2013-08-01
Multifocal visual electrophysiology, consisting of multifocal electroretinography (mfERG) and multifocal visual evoked potential (mfVEP), can objectively evaluate retina function and retina-cortical conduction pathway status by stimulating many local retinal regions and obtaining each local response simultaneously. Having many advantages such as short testing time and high sensitivity, it has been widely used in clinical ophthalmology, especially in the diagnosis of retinal disease and glaucoma. It is a new objective technique in clinical forensic medicine involving visual function evaluation of ocular trauma in particular. This article summarizes the way of stimulation, the position of electrodes, the way of analysis, the visual function evaluation of mfERG and mfVEP, and discussed the value of multifocal visual electrophysiology in forensic medicine.
The role of economic evaluation in the pricing and reimbursement of medicines.
Drummond, M; Jönsson, B; Rutten, F
1997-06-01
In most countries, governments or health insurers have taken initiatives to influence the price and utilization of medicines. One stated objective of these schemes is to encourage efficiency, or cost-effectiveness. In principle, economic evaluation should to be relevant to decisions about the pricing and reimbursement of health technologies, since it offers a way of estimating the additional value to society of a new intervention (e.g. medicine) relative to current therapy. However, the application of economic evaluation in drug pricing and reimbursement schemes is variable. Therefore, this paper reviews the actual and potential role of economic evaluation in different drug pricing and reimbursement schemes, such as 'free pricing' systems (United Kingdom, United States), two-stage administered systems (France), reference pricing systems (Germany, Netherlands, Sweden) and economic evaluation systems (Australia, Canada). It is concluded that, other than in the case of Australia and Canada, the potential role of economic evaluation could be greatly developed, especially in the case of new medicines, for which there is no close substitute. Comments are also given on the practical problems of using this approach. However, it is noted that economic evaluation alone cannot set a price for a medicine, since a decision has to be made about the proportion of added value going to society and the proportion going to the pharmaceutical company as a reward for innovation.
Evidence, discovery and justification: the case of evidence-based medicine.
Gaeta, Rodolfo; Gentile, Nelida
2016-08-01
The purpose of this paper is to develop some thoughts on philosophical issues surrounding evidence-based medicine (EBM), especially related to its epistemological dimensions. After considering the scope of several philosophical concepts that are relevant to the discussion, and drawing some distinctions among different aspects of EBM, we evaluate the status of EBM and suggest that EBM is mainly a meta-methodology. Then, we outline an evaluation of the thesis that EBM is a 'new paradigm' in the practice of medicine. We argue that EBM does not seem to have arisen in the way Kuhn imagined paradigms to arise but as a conscious, deliberate proposal, more as programme than as a reality. Furthermore, there is something paradoxical about appealing to evidence or to the best evidence as a way of promoting a new paradigm. For the proposal seems to assume that there is something that by its own virtue is the best evidence for a given time. But this idea would have been rejected by Kuhn. If EBM involves a genuine new alternative in the field of medicine and shows a way in which the discipline will endure henceforth, this indicates that it is not what Kuhn once called a 'paradigm' and even, paradoxically, it is good evidence that scientific paradigms do not exist, at least in medicine. © 2015 John Wiley & Sons, Ltd.
Berger, Stephanie; Braehler, Elmar; Ernst, Jochen
2012-07-01
To explore differences between conventional medicine (COM) and complementary and alternative medicine (CAM) regarding the attitude toward and the perceived use of shared decision-making (SDM) from the health professional perspective. Thirty guideline-based interviews with German GPs and nonmedical practitioners were conducted using qualitative analysis for interpretation. The health professional-patient-relationship in CAM differs from that in COM, as SDM is perceived more often. Reasons for this include external context variables (e.g., longer consultation time) and internal provider beliefs (e.g., attitude toward SDM). German health care policy was regarded as one of the most critical factors which affected the relationship between GPs and their patients and their practice of SDM. Differences between COM and CAM regarding the attitude toward and the perceived use of SDM are attributable to diverse concepts of medicine, practice context variables and internal provider factors. Therefore, the perceived feasibility of SDM depends on the complexity of different occupational socialization processes and thus, different value systems between COM and CAM. Implementation barriers such as insufficient communication skills, lacking SDM training or obedient patients should be reduced. Especially in COM, contextual variables such as political restrictions need to be eliminated to successfully implement SDM. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Chegini, Azita; Torab, Seyed Ardeshir; Pourfatollah, Ali Akbar
2017-02-01
Plasma is the liquid part of blood. It is estimated 21.6 million liters of plasma collect from Whole blood annually. From these plasma, 4.2 million liters transfuse, 8.1 million liters fractionate, 9.3 million liters waste. Nowadays, blood products and PDM (plasma derived medicine) consider as essential medicine in modern health care and transfusion medicine. Iranian blood transfusion organization as a non-profit organization was established in 1974 in order to centralize all blood transfusion activities from donor recruitment to distribution of blood components to hospitals. Iran is the only country in EMR region with the rate of 20-29.9 blood donations per 1000 population and reached 100% voluntary non-remunerated blood donation in 2007. RBCs and platelets demand are much more than FFPs so the IBTO was faced the surplus plasma that could cause surplus plasma wastage. Simultaneously, hospitals need more plasma derived medicine especially albumin, IVIG, factor VIII, factor IX. IBTO was faced the challenges such as Fractionators selection, Plasma volume shipment, Contract duration, Product profile, Multiple External audits, Cold chain maintenance, Transporting plasma across international borders, NAT test. To overcome plasma wastage and storage of PDM. IBTO involved toll manufacturing in 2005 and not only prevents plasma wastage but also save MOH (ministry of health) budget. Copyright © 2016. Published by Elsevier Ltd.
Two thousand years of medical advice on breastfeeding: comparison of Chinese and western texts.
Gartner, L M; Stone, C
1994-12-01
This discussion introduces only a few aspects of the historical writings on breastfeeding in the two cultures. Chinese writings seem to be closer in orientation to modern worldwide medical advice, approaching breastfeeding from a more natural and supportive perspective. Ancient and not-so-ancient western medical advice on breastfeeding often implies the inadequacy of the mother to breastfeed her own infant, especially in the early weeks of life. One can only speculate as to what the historical basis for this may be. European medicine emphasizes the testing of milk for its adequacy. Again, the scientific basis for this is not evident. Modern clinical science finds that the milk of virtually all mothers, even those suffering from significant malnutrition, is adequate for the growth and development of the infant. This focus on the "testing" of milk may represent an early example of the reliance on laboratory diagnosis that has so heavily dominated western medicine in recent years. Finally, western medicine seems more managerial with regard to breastfeeding than Chinese medicine, and has perhaps "medicalized" breastfeeding, a compliant often voiced even now in late 20th century America. Nonetheless, both literatures demonstrate that throughout the history of recorded medicine, physicians have been concerned with promoting optimal breastfeeding and have understood the importance of human milk for the survival, growth, and development of the infant.
Okumu, Mitchel Otieno; Ochola, Francis Okumu; Onyango, Allan Odhiambo; Mbaria, James Mucunu; Gakuya, Daniel Waweru; Kanja, Laetitia Wakonyu; Kiama, Stephen Gitahi; Onyango, Mary Atieno
2017-01-01
Complementary and alternative medicine is an integral component of primary healthcare in Kenya. This is because the infrastructural health setup in the country is inadequate in catering for all the medical needs of the population. This particularly holds true in the rural areas where many rural folk rely on products of herbal origin to offset their healthcare needs. More often than not these products are an elaborate cacophony of several different substances of biological origin and thus need personnel adept in their preparation. Sadly, due to loopholes in legislation and regulation, quacks have a field day in the practice. Moreover, the process of planting, harvesting, preparation and storage of herbs and related products dictates that a significant number of people will ultimately be involved in the whole process. This is likely to set the stage for manipulation and compromise of the safety, quality and efficacy of these products. This state of affairs appears unabated especially in the context of the current legal and regulatory framework governing herbal medicine use and practice in Kenya. Not only are these laws inadequate, they are shrouded in ambiguity, open to interpretation and the authorities mandated to implement them often end up performing duplicate roles. The aim of this review is to critique the legal and regulatory provisions governing herbal medicine use and practice in Kenya. In conclusion, laws and regulations meant to control herbal medicine use and practice in Kenya are wanting. Clear and definitive legislation on herbal medicine use and practice coupled with effective implementation by mandated institutions will go a long way in inspiring confidence to all stakeholders of herbal medicine.
Okumu, Mitchel Otieno; Ochola, Francis Okumu; Onyango, Allan Odhiambo; Mbaria, James Mucunu; Gakuya, Daniel Waweru; Kanja, Laetitia Wakonyu; Kiama, Stephen Gitahi; Onyango, Mary Atieno
2017-01-01
Complementary and alternative medicine is an integral component of primary healthcare in Kenya. This is because the infrastructural health setup in the country is inadequate in catering for all the medical needs of the population. This particularly holds true in the rural areas where many rural folk rely on products of herbal origin to offset their healthcare needs. More often than not these products are an elaborate cacophony of several different substances of biological origin and thus need personnel adept in their preparation. Sadly, due to loopholes in legislation and regulation, quacks have a field day in the practice. Moreover, the process of planting, harvesting, preparation and storage of herbs and related products dictates that a significant number of people will ultimately be involved in the whole process. This is likely to set the stage for manipulation and compromise of the safety, quality and efficacy of these products. This state of affairs appears unabated especially in the context of the current legal and regulatory framework governing herbal medicine use and practice in Kenya. Not only are these laws inadequate, they are shrouded in ambiguity, open to interpretation and the authorities mandated to implement them often end up performing duplicate roles. The aim of this review is to critique the legal and regulatory provisions governing herbal medicine use and practice in Kenya. In conclusion, laws and regulations meant to control herbal medicine use and practice in Kenya are wanting. Clear and definitive legislation on herbal medicine use and practice coupled with effective implementation by mandated institutions will go a long way in inspiring confidence to all stakeholders of herbal medicine. PMID:29629018
China's research status in emergency medicine: a 15-year survey of literature.
Wang, Weiwei; Jiang, Ting; Li, Chunyu; Chen, Jun; Cao, Kejiang; Qi, Lian-wen; Li, Ping; Zhu, Wei; Zhu, Baoli; Chen, Yan
2016-03-01
To investigate the research status of emergency medicine in China through literature search of international emergency medicine journals and retrospectively compare the outputs of emergency medicine articles of the 3 major regions of China-Mainland (ML), Taiwan (TW), and Hong Kong (HK). Emergency medicine journals were selected category from Science Citation Index Expand. Articles from the ML, TW, and HK were retrieved from PubMed database. The total number of articles, publication types, research contents, impact factors (IF), and articles published in each journal were conducted for quantity and quality comparisons. A total of 1760 articles from 19 emergency medicine journals were searched, of which 395 were from ML, 1210 from TW, and 155 from HK. Accumulated IF of articles from TW (2451.109) was much higher than that of ML (851.832) and HK (328.579), whereas the average IF of articles from TW (2.02) was the lowest. The number of case reports was the highest, which was, 69 from ML, 637 from TW, and 25 from HK, respectively. Although emergency medicine was involved with multiple organs and multiple systems, the reports of trauma accounted for 25% of the research contents. The total number of articles from both China and the rest of the world increased significantly from 2000 to 2014, especially ML. The total number of articles from TW was still much more than that of ML and HK, whereas the quality of articles from TW was not as good as ML and HK. Case report had the highest share of publication types, whereas the proportions of meta-analysis and observational study were the lowest. As for research contents, the proportion of trauma was still the highest. Copyright © 2015 Elsevier Inc. All rights reserved.
[The "pharmaceutical chain", important asset of health safety in France. Synthesis of the session].
Santini, C
2008-01-01
The National Academy of Pharmacy underlines the importance of health safety guarantees, provided by the "pharmaceutical chain" that bring the medicine until his user (from manufacturers to dispensing pharmacists), chain of which the security of each link is controlled and guaranteed by pharmacists. The first of the safety rules lies in the very fast availability of the medicine for the patients, in every respect of the national territory, due to an efficient system of pharmaceutical distribution and to a tightened network of pharmaceutical dispensaries (that constitutes a network of expertises especially to the service of patients and public health). All along the chain, also exists a same concern to guarantee and to preserve the pharmaceutical quality of the medicines. An essential element of the health safety is the right usage of the medicine, to which contribute: information associated with the marketing of the medicine, the very important role of the dispensing pharmacist as such sanitary adviser and therapeutic education teacher, the intervention of the hospital dispensary in clinical pharmacy, the "Pharmaceutical File" under setting up, pharmacovigilance, traceability of medicines ... Pharmacists, responsible at the level of the different steps of the chain, get appropriate skills, carry out themselves their duties and are responsible in front of the National Board of Pharmacists, and their common professional knowledge reinforces the cohesion and the robustness of the chain. Facing the serious issue of counterfeiting of medicines, the pharmaceutical chain constitutes an important line of defence against the entry of counterfeited drugs into commercial channels. The academy of Pharmacy warns against all evolution that would consist to break, even partially, of the mandatory and continuous pharmaceutical control.
Chaos in Western Medicine: How Issues of Social-Professional Status are Undermining Our Health
Wilson, N. W.
2012-01-01
From the period immediately following the second world war, western (orthodox) medicine – both as a philosophy of medicine and as a professional guild of medical professionals actively practicing medicine – has made progress in leaps and bounds, especially considering the advances in technology and associated enterprises. Over the last thirty years, however, the practice of orthodox medicine has taken a turn for the worst despite progressive philosophies and tenets of basic practice as offered by the professional bodies that regulate how medicine is operated and implemented. Current healthcare environments are in a chaotic state of affairs, most notably due to issues involving affordability of medical professionals. It is argued that the social-professional status of medical doctors allow exorbitant and unreachable demands on governments for increased salaries. The title-based supremacy of doctors within the occupations domain is not supported by what they are offering society at large, and it compromises the ability of medical institutions and governments to provide better and more affordable healthcare. From a sociological point of view, this paper examines the social-religious history of such social class-based occupational power and dominance, and paves the way toward an overhaul of current medical education frameworks that proactively will ensure greater occupational equity in healthcare settings, across all healthcare disciplines tasked with patient care and improvement of healthcare services. In essence, doctoral titles should only be awarded after successful completion of postgraduate doctoral studies, and a new breed of medical professionals must emerge, able to contribute more meaningfully to the advancement of medicine as a profession, as well as toward increased standards of healthcare and improved health services delivery. PMID:23121737
Medicinal Plants with Multiple Effects on Cardiovascular Diseases: A Systematic Review.
Rouhi-Boroujeni, Hojjat; Heidarian, Esfandiar; Rouhi-Boroujeni, Hamid; Deris, Fatemeh; Rafieian-Kopaei, Mahmoud
2017-01-01
Hyperlipidemia, obesity, hypertension, and diabetes are the most important risk factors for cardiovascular diseases. The aim of this systematic review article is to introduce the medicinal plants that exert significant clinical effects on hypertension, hyperlipidemia, obesity, and diabetes. In this review article, the international research databases including MEDLINE, Google scholar, EBSCO, Academic Search, Web of Science, SciVerse, Scopus (SCOPUS), EBSCO, Academic Search, Cochrane, Central Register of Controlled Trials (CENTRAL) and a Chinese database (China Network Knowledge Infrastructure [CNKI]) were searched using the key words hyperlipidemia, hypertension, diabetes, herbal, obesity, and phytomedicine, matched by MESH, from their respective inceptions up to March, 2016. The plants that were effective on one, two, three, or all of four diseases were determined. The doses, side effects, the most important pharmaceutically effective compounds, the used organs, and important points regarding usage were separately recorded. Also known clinically significant interactions were presented. 1023 articles were found to be about medicinal plants and hypertension, 1912 articles about medicinal plants and hyperlipidemia, 810 articles about medicinal plants and obesity, 1174 articles about medicinal plants and diabetes. Of 144 plants included in the analysis, 83 were found to be effective on hyperlipidemia, 100 on hypertension, 66 on obesity, and 72 on diabetes. 43 plants were found to be effective on two diseases, 14 on three diseases, and 34 on all four diseases. Three plants (Tomato, Cranberry and Pomegranate), in food and therapeutic doses, were found to be used to treat cardiovascular diseases especially in pre-eclampsia and hyperlipidemia in pregnancy. Regarding the findings of this study, we can argue that the medicinal plants, other than monotherapy, can be used as poly-therapy, to treat cardiovascular diseases. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.
Radiation Shielding Properties of Some Marbles in Turkey
NASA Astrophysics Data System (ADS)
Günoǧlu, K.; Akkurt, I.
2011-12-01
Especially after development of technology, radiation started to be used in a large fields such as medicine, industry and energy. Using radiation in those fields bring hazordous effect of radition into humancell. Thus radiation protection becomes important in physics. Although there are three ways for radiation protection, shielding of the radiation is the most commonly used method. Natural Stones such as marble is used as construction material especially in critical building and thus its radiation shielding capability should be determined. In this study, gamma ray shielding properties of some different types of marble mined in Turkey, have been measured using a NaI(Tl) scintillator detector. The measured results were also compared with the theoretical calculations XCOM.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Guenoglu, K.; Akkurt, I.
Especially after development of technology, radiation started to be used in a large fields such as medicine, industry and energy. Using radiation in those fields bring hazardous effect of radiation into humancell. Thus radiation protection becomes important in physics. Although there are three ways for radiation protection, shielding of the radiation is the most commonly used method. Natural Stones such as marble is used as construction material especially in critical building and thus its radiation shielding capability should be determined.In this study, gamma ray shielding properties of some different types of marble mined in Turkey, have been measured using amore » NaI(Tl) scintillator detector. The measured results were also compared with the theoretical calculations XCOM.« less
Jeon, Jongwook; Jo, Changrock
2012-12-01
Imwon-Gyeongjeji which was created by Seo Yu-gu in the first half of the 19th century is a encyclopedia of practical use in rural life. It consists of 113 volumes, 16 fields, and 2.52 million total characters. Of these, the field of medicine comes 11th of the contents covering 28 volumes and 1.1 million characters. Its name is Inje-ji. This paper examines the academic background of Seo Yu-gu and his life work briefly, and investigates the characteristics of medical knowledge of late Joseon period contained in the Imwon-Gyeongjeji, Inje-ji Here, we made key comparisons especially with Dongui-Bogam, Joseon's leading medical book. Of the pioneers of medical history studies of Joseon, a Japanese researcher Miki Sakae has made a negative evaluation to Inje-ji. But after concrete investigation we have come to conclude as follows. First, familial ancestors of Seo Yu-gu were engaged in the introduction of foreign-language books, so Seo Yu-gu as an officer of proof-reading and editing of the various books, also had a lot of knowledge on the medical books ever in history. On this background and experience, for over 36 years from 1,806 retirement from official position to his death, he had compiled and edited Imwon-Gyeongjeji. Second, unlike Dongui-Bogam which included improving health skill, Inje-ji focused on curing medicine readily accessible from the major population of that time. Its main features are as follows: i) prescriptions directly linked to the diseases and symptoms, ii) greatly increased medicinal knowledge especially on infectious diseases and trauma, iii) detailed index easy to look up for prescription and iv) his 'own opinions'[an-seol] which can indicate relevant contents within the book and organically combines the whole knowledge in it. Third, "Inje-ji" utilizing medical books in China and Korea even those of Japan, collected more massively almost all the medical knowledge, new illness, herbs of local area, private prescription. Meanwhile Inje-ji modified the errors of the older medical books like Dongui-Bogam or Bencao-Gangmu, expressed its own subjective views about controversial topics. In summary "Inje-ji" can be the last general medical book which collected and edited almost all the medical knowledge of the period in the East Asia with its own editing format. In addition it is recognized that it pursued an evidence-based medicine and the practical medicine relieving the people, rather than medico-philosophical theories in oriental traditional medicine which was criticized by many critical intellectuals afterwards. Given the scrutiny, it seems that evaluation of the "Inje-ji" by Miki Sakae should be revised by thorough investigations. We are just on the starting line of the Inje-ji research in earnest meaning, and expect this research would give more fruitful and deep perspective in the area of Korea history of medicine. The Korean Society for the History of Medicine.
Chamberlain, Geoffrey
2004-11-01
Medicine in ancient Egypt was much more advanced than the rest of the Biblical world, especially in trauma surgery. Care at the time of childbirth was however virtually non-existent. There were no trained obstetricians or midwives but a galaxy of gods were at hand. This article traces what we can piece together about pregnancy of childbirth from the evidence we have in tombs and papyri of Egypt.
Concussion in the National Football League: viewpoint of an elite player.
DeLamielleure, Joe
2014-01-01
Chronic traumatic encephalopathy resulting from head hits and concussions is an unfortunate illness that has affected numerous football players, especially in the National Football League. Many of my fellow players suffer from this problem, and many have died prematurely because of it. I make some suggestions for improving the situation for retired and current players. © 2014 American Society of Law, Medicine & Ethics, Inc.
Analytical Chemistry in Russia.
Zolotov, Yuri
2016-09-06
Research in Russian analytical chemistry (AC) is carried out on a significant scale, and the analytical service solves practical tasks of geological survey, environmental protection, medicine, industry, agriculture, etc. The education system trains highly skilled professionals in AC. The development and especially manufacturing of analytical instruments should be improved; in spite of this, there are several good domestic instruments and other satisfy some requirements. Russian AC has rather good historical roots.
Chambers, R. Andrew
2013-01-01
Addiction is the number one cause of premature illness and death in the U.S., especially among people with mental illness. Yet American medicine lacks sufficient workforce capacity, expertise, training, infrastructure, and research to support treatment for people with co-occurring addictions and mental illness. This essay argues that the addiction psychiatrist is essential in dual diagnosis care. PMID:24223531
V. Carter; A. Brunelle; J. Shaw
2014-01-01
In the late 1860s, Euro-American settlement and related activities, including logging, began affecting the composition and structure of forests of the western United States. These impacts were likely to be most substantial along the corridor of the trans-continental railroad. Construction and maintenance of the railroad created a high dependence for wood, especially...
ERIC Educational Resources Information Center
Machado, Gisele F.; Melo, Guilherme D.; Perri, Silvia H. V.; Fernandes, Fernando V.; Moraes, Olívia C.; Souza, Milena S.; Grano, Fernanda G.; Silva, José E. S.; Nunes, Cáris M.
2017-01-01
Animal experimentation is a controversial topic, especially among the general public and the scientific community. Thirty-eight undergraduate students attending the College of Veterinary Medicine--São Paulo State University in the municipality of Araçatuba, São Paulo, Brazil, were followed up between 2008 and 2011 and were asked to complete an…
Chambers, R Andrew
2013-01-01
Addiction is the number one cause of premature illness and death in the U.S., especially among people with mental illness. Yet American medicine lacks sufficient workforce capacity, expertise, training, infrastructure, and research to support treatment for people with co-occurring addictions and mental illness. This essay argues that the addiction psychiatrist is essential in dual diagnosis care.
Murine typhus in two travelers returning from Bali, Indonesia: an underdiagnosed disease.
Takeshita, Nozomi; Imoto, Kazuya; Ando, Shuji; Yanagisawa, Kunio; Ohji, Goh; Kato, Yasuyuki; Sakata, Akiko; Hosokawa, Naoto; Kishimoto, Toshio
2010-01-01
Two Japanese travelers from Bali were diagnosed with murine typhus in Japan during the same period. Although one had only mild illness, the other experienced liver and kidney dysfunction. Murine typhus may be missed not only in endemic areas around the world, but also in travelers, especially those returning from marine resorts in these areas. © 2010 International Society of Travel Medicine.
Anti-atherosclerotic plants which modulate the phenotype of vascular smooth muscle cells.
Saleh Al-Shehabi, Tuqa; Iratni, Rabah; Eid, Ali H
2016-10-15
Cardiovascular disease (CVD) remains the leading cause of global death, with atherosclerosis being a major contributor to this mortality. Several mechanisms are implicated in the pathogenesis of this disease. A key element in the development and progression of atherosclerotic lesions is the phenotype of vascular smooth muscle cells. Under pathophysiologic conditions such as injury, these cells switch from a contractile to a synthetic phenotype that often possesses high proliferative and migratory capacities. Despite major advances made in the management and treatment of atherosclerosis, mortality associated with this disease remains high. This mandates that other approaches be sought. Herbal medicine, especially for the treatment of CVD, has been gaining more attention in recent years. This is in no small part due to the evidence-based values associated with the consumption of many plants as well as the relatively cheaper prices, easier access and conventional folk medicine "inherited" over generations. Sections: In this review, we provide a brief introduction about the pathogenesis of atherosclerosis then we highlight the role of vascular smooth muscle cells in this disease, especially when a phenotypic switch of these cells arises. We then thoroughly discuss the various plants that show potentially beneficial effects as anti-atherosclerotic, with prime attention given to herbs and plants that inhibit the phenotypic switch of vascular smooth muscle cells. Accumulating evidence provides the justification for the use of botanicals in the treatment or prevention of atherosclerosis. However, further studies, especially clinical ones, are warranted to better define several pharmacological parameters of these herbs, such as toxicity, tolerability, and efficacy. Copyright © 2015 Elsevier Ltd. All rights reserved.
Müller, Stefanie; Janssen, Traute; Wieler, Lothar H
2014-01-01
The proportion of multidrug resistant bacteria causing infections in animals has continuously been increasing. While the relevance of ESBL (extended spectrum beta-lactamase)-producing Enterobacteriaceae spp. and MRSA (methicillin resistant Staphylococcus aureus) is unquestionable, knowledge about multidrug resistant Acinetobacter baumannii in veterinary medicine is scarce. This is a worrisome situation, as A. baumannii are isolated from veterinary clinical specimens with rising frequency. The remarkable ability of A. baumannii to develop multidrug resistance and the high risk of transmission are known in human medicine for years. Despite this, data regarding A. baumannii isolates of animal origin are missing. Due to the changing role of companion animals with closer contact between animal and owner, veterinary intensive care medicine is steadily developing. It can be assumed that the number of "high risk" patients with an enhanced risk for hospital acquired infections will be rising simultaneously. Thus, development and spread of multidrug resistant pathogens is envisioned to rise. It is possible, that A. baumannii will evolve into a veterinary nosocomial pathogen similar to ESBL-producing Enterobacteriaceae and MRSA. The lack of attention paid to A. baumannii in veterinary medicine is even more worrying, as first reports indicate a transmission between humans and animals. Essential questions regarding the role of livestock, especially as a potential source of multidrug resistant isolates, remain unanswered. This review summarizes the current knowledge on A. baumannii in veterinary medicine for the first time. It underlines the utmost significance of further investigations of A. baumannii animal isolates, particularly concerning epidemiology and resistance mechanisms.
Tsabang, Nolé; Kadjob, Stella; Mballa, Rose N; Yedjou, Clement G; Nnanga, Nga; Donfagsiteli, Néhémie T; Tchinda, Alembert T; Agbor, Gabriel A; Ntsama, Claudine; Tchounwou, Paul B
2015-08-01
A majority of Africans rely on traditional medicine as the primary form of health care. Yet most traditional medicine products have a short shelf life, especially for water-based formulations such as macerations, infusions and decoctions. Indeed, many of these water extracts become unfit for human consumption after five to seven days of conservation either because of the degradation or toxicity of active components, and/or the growth of pathogenic organisms. The purpose of this study was to describe and apply a new approach for the development of an improved traditional medicine (ITM) that is cheap, very efficient, not toxic, and easy to produce, and that can be conserved for a longer time without a significant loss of activity. Hence, Laportea ovalifolia was selected from an ethnobotanical prospection in all regions of Cameroon, and was used to prepare an oral hypoglycemic product. This preparation required 9 steps focused on the characterization of the plant species, and the standardization of the ethnopharmacological preparation by a multidisciplinary team of scientists with expertise in botany, ecology, pharmacognosy and pharmacology. Resultantly, four galenic formulations of hypoglycemic medications were produced. A relationship between these four formulations was described as follow: One spoon of oral suspension (10 ml)=one sachet of powder=2 tablets=3 capsules. Hence, our research provides new insight into a drug discovery approach that could alleviate the major problems affecting traditional medicine and enhance its effectiveness in addressing health care in developing and undeveloped countries.
[Foundation and organization of the University of Bologna from the XII century to the Renaissance].
Romero-y Huesca, Andrés; Soto-Miranda, Miguel Angel; Ponce-Landín, Francisco Javier; Moreno-Rojas, Juan Carlos
2006-01-01
The University of Bologna was founded in 1150 and was the first European University to establish this educational trend. The combination of structured teaching and student associations marked the origin of the studium generale. The presence of teaching legists encouraged teachers in others fields to come to Bologna. Ars dictaminis, grammar, logic, philosophy, mathematics and especially medicine were taught there by the middle of the thirteenth century. The university offered advanced instruction in law, medicine, and theology and had a minimum of six to eight professors teaching civil law, canonical law, medicine, logic, natural philosophy and usually rhetoric. Many professors bearing local names were learned scholars and commanding figures in medicine and surgery. Taddeo Alderotti (1210-1295) began to teach medicine in Bologna in about 1260. He soon raised medicine to a prestigious position in the university. The geographical distribution demonstrates the international distribution of the student body: 73% were Italians and 26% non-Italians. The decision of the legislature of Bologna to take control of the university from the students by paying professors was probably the most important decision in the history of Italian universities. Examination of the distribution of professors offers a detailed picture of the faculty. In 1370 the university had 11 professors of civil law, 7 professors of canonical law, 3 professors of medical theory, 2 professors of medical practice (specifically of diagnosis and treatment), and 1 professor of surgery. After growing steadily, the numbers of teachers stabilized at 85 to 110 until the year 1530.
Hwang, Imkyung; Kim, Hoyeon
2013-08-01
In this article, we will examine the theory and practice of encounters between oral history and narrative medicine in view of storytelling. Man is a storytelling animal. Our experience is understood, reconstructed and transmitted as a story and we can find the meaning of life through a story. Oral history is a specific practice and method of research. It refers to the process of recording interviews with people who have something to say, transcribing the record and interpretating the written text to conduct the study of the past. Therefore story is a basic tool of oral history. There has been also growing interest regarding the narrative features of medicine. Especially the illness narrative is one of the most powerful tools in this context. An illness narrative is a patient's story about his illness, including the meaning of the illness in his life. Illness as a specific event of life can only be understood through a story of patient. How can we combine oral history and narrative medicine altogether? We propose two subjects, one is 'healing' and the other is 'the social'. The goal of medicine is healing of suffered people. It is well known that storytelling has a healing effect. Conducting oral history is not only 'recovery history' but also is helping people to have a well organized memory and integrate that into his whole life story. The use of oral history as a means of empowerment should be extended referring the healing effect of medicine. On the other hand, modern medicine has a tendency to reduce the problem of health and illness as an individual one. However story of illness can reveal the dominance of modern biomedicine in the contemporary and have political implications. Oral history deals with memory. Personal memory can only be understood in the context of social and cultural backgrounds. Collective memory is necessary in building community history. Medicine should learn from oral history's social dimensions. In this context, life of KIM Hyeongyul who was activist for second generation Korean Atomic Bomb Victims will be a good example of encounters between oral history and narrative medicine.
AMCP Partnership Forum: Managing Care in the Wave of Precision Medicine.
2018-05-23
Precision medicine, the customization of health care to an individual's genetic profile while accounting for biomarkers and lifestyle, has increasingly been adopted by health care stakeholders to guide the development of treatment options, improve treatment decision making, provide more patient-centered care, and better inform coverage and reimbursement decisions. Despite these benefits, key challenges prevent its broader use and adoption. On December 7-8, 2017, the Academy of Managed Care Pharmacy convened a group of stakeholders to discuss these challenges and provide recommendations to facilitate broader adoption and use of precision medicine across health care settings. These stakeholders represented the pharmaceutical industry, clinicians, patient advocacy, private payers, device manufacturers, health analytics, information technology, academia, and government agencies. Throughout the 2-day forum, participants discussed evidence requirements for precision medicine, including consistent ways to measure the utility and validity of precision medicine tests and therapies, limitations of traditional clinical trial designs, and limitations of value assessment framework methods. They also highlighted the challenges with evidence collection and data silos in precision medicine. Interoperability within and across health systems is hindering clinical advancements. Current medical coding systems also cannot account for the heterogeneity of many diseases, preventing health systems from having a complete understanding of their patient population to inform resource allocation. Challenges faced by payers, such as evidence limitations, to inform coverage and reimbursement decisions in precision medicine, as well as legal and regulatory barriers that inhibit more widespread data sharing, were also identified. While a broad range of perspectives was shared throughout the forum, participants reached consensus across 2 overarching areas. First, there is a greater need for common definitions, thresholds, and standards to guide evidence generation in precision medicine. Second, current information silos are preventing the sharing of valuable data. Collaboration among stakeholders is needed to support better information sharing, awareness, and education of precision medicine for patients. The recommendations brought forward by this diverse group of experts provide a set of solutions to spur widespread use and application of precision medicine. Taken together, successful adoption and use of precision medicine will require input and collaboration from all sectors of health care, especially patients. DISCLOSURES This AMCP Partnership Forum and the development of the proceedings document were supported by Amgen, Foundation Medicine, Genentech, Gilead, MedImpact, National Pharmaceutical Council, Precision for Value, Sanofi, Takeda, and Xcenda.
Doganay-Knapp, Kirsten; Orland, Annika; König, Gabriele M; Knöss, Werner
2018-04-01
Herbal substances and preparations thereof play an important role in healthcare systems worldwide. Due to the variety of these products regarding origin, composition and processing procedures, appropriate methodologies for quality assessment need to be considered. A majority of herbal substances is administered as multicomponent mixtures, especially in the field of Traditional Chinese Medicine and ayurvedic medicine, but also in finished medicinal products. Quality assessment of complex mixtures of herbal substances with conventional methods is challenging. Thus, emphasis of the present work was directed on the development of complementary methods to elucidate the composition of mixtures of herbal substances and finished herbal medicinal products. An indispensable prerequisite for the safe and effective use of herbal medicines is the unequivocal authentication of the medicinal plants used therein. In this context, we investigated the potential of three different PCR-related methods in the characterization and authentication of herbal substances. A multiplex PCR assay and a quantitative PCR (qPCR) assay were established to analyze defined mixtures of the herbal substances Quercus cortex, Juglandis folium, Aristolochiae herba, Matricariae flos and Salviae miltiorrhizae radix et rhizoma and a finished herbal medicinal product. Furthermore, a standard cloning approach using universal primers targeting the ITS region was established in order to allow the investigation of herbal mixtures with unknown content. The cloning approach had some limitations regarding the detection/recovery of the components in defined mixtures of herbal substances, but the complementary use of two sets of universal primer pairs increased the detection of components out of the mixture. While the multiplex PCR did not retrace all components in the defined mixtures of herbal substances, the established qPCR resulted in simultaneous and specific detection of the five target sequences in all defined mixtures. These data indicate that for authentication purposes, complementary PCR-related methods are highly recommendable for the analysis of herbal mixtures in parallel. Copyright © 2018 Elsevier GmbH. All rights reserved.
Interview with David Tauben: University of Washington, Chief of the Division of Pain Medicine.
Tauben, David
2017-07-01
Dr Tauben is Clinical Professor jointly appointed in the Departments of Medicine and Anesthesia & Pain Medicine, and is the Hughes M & Katherine G Blake Endowed Professor, board certified in both Internal Medicine and Pain Medicine. He is also University of Washington (UW) Director of Medical Student and Resident Education in Pain Medicine, and Medical Director of UW TelePain, a tele-video-conferencing program intended to provide innovative pain education and consultative support to a five-state northwest regional primary care providers. He served as a member of the NIH National Pain Strategy task force on pain education and is principal investigator for the UW's prestigious NIH Pain Consortium Center of Excellence for Pain Education, leading curriculum development to extend the pain proficiency qualifications of interprofessional primary care providers. Dr Tauben is a member of the American Pain Society and the International Association for the Study of Pain special interest study groups on Pain Education. He is a founding member of the State of Washington Agency Medical Directors panel of medical experts developing opioid prescription guidelines for the state, and a regular clinical and content expert for regulatory and legislative bodies involved in public policy regarding pain medicine practice and standards. He speaks as a clinical expert in medical management of chronic pain, especially as it applies to primary care practices. Dr Tauben served as an expert for several US Centers for Disease Control clinical outreach programs and policy reviews advising primary care providers on how to prescribe opioids for chronic noncancer pain. He is annually recognized by his peers as recipient of regional awards in care of pain patients, and brings decades of clinical experience of best practice medication management of acute and chronic pain. Dr Tauben received his bachelors degree in philosophy from Yale University, medical degree from Tufts University School of Medicine and completed his residency training at the UW, in Seattle. He is a fellow of the American College of Physicians.
Medicinal plants sold at traditional markets in southern Ecuador.
Tinitana, Fani; Rios, Montserrat; Romero-Benavides, Juan Carlos; de la Cruz Rot, Marcelino; Pardo-de-Santayana, Manuel
2016-07-05
The traditional markets in southern Ecuador and within the Andean region are especially important for plant resource trading among local people, even since before Spanish colonization; therefore, ethnobotanical studies are currently necessary and important. These strategic spaces persist for the traditional medicine cultural value reflected in the higher consumption of medicinal plants, which span all socioeconomic levels of rural and urban people. The purpose of this study includes the following: 1) to create a novel list of medicinal plants sold at 33 traditional markets; 2) to establish medicinal plant use agreement amongst vendors with the Factor of Informant Consensus (FIC); and 3) to determine the most sold medicinal plant species using the Fidelity Level (FL). This study focus on traditional markets ethnobotany utilizes the largest sample of medicinal plants market vendors up to date in Ecuador, interviewing them at 33 traditional markets, located within the Loja province. In order to determine the most sold medicinal plants and their ethnobotanical information, structured questionnaires and personal conversations were conducted with 196 medicinal plant vendors, and voucher specimens were created. Agreement among vendors about the therapeutic use of medicinal plants was measured using the FIC, and the most sold medicinal plant species were assessed with the FL. This research registered 160 medicinal plant species, grouped in 126 genera and 57 families that were sold in 33 traditional markets. The uses of medicinal plants in southern Ecuador are related to a long history of traditional medicine health practices that has persisted until today as well as high plant diversity. The 53 therapeutic uses recorded were grouped into 12 medical categories that were adapted from the World Health Organization. Three medical categories shared the highest value for FIC = 0.92, which showed a high level of agreement of market vendors for 57 medicinal plant species sold to treat ailments related with digestive, dermatological, and sensorial systems. The FL index determined 11 culturally important medicinal plant species based on the reported uses by 40 or more market vendors. Two medicinal plant species had an FL = 100 %, Matricaria recutita and Gaiadendrum punctatum, used to treat digestive and respiratory systems ailments. In the Loja province, people continue to consume medicinal plant species sold at local markets to treat somatic and/or psychosomatic health ailments because sociocultural customs are strongly expressed in ancestral practices of wellbeing. When the largest values of FL (60.5 %-100 %) and FIC (0.81-0.92) indexes are combined, they demonstrated agreement among 196 market vendors in the use of seven medicinal plant species that were most sold for the 12 medical categories. This study stresses how important public policies are for the trade and quality of medicinal plant resources, particularly for local people practicing auto-medication. Reasons for the maintenance of traditional markets in southern Ecuador include lower cost of medicinal plants, confidence in traditional medicine, and/or sociocultural environment. In Ecuador, the sustainable management of wild medicinal plants diversity, particularly the most sold, is crucial for its conservation in nature.