Would Our Procedural Competence in Medicine Stand Up to the Same Level of Scrutiny as … a Hockey Goalie?

Editor’s Note: This post is one of two pieces on the topic of procedural competence. Read the other piece here. By: Martin Pusic, MD, PhD, assistant professor, Emergency Medicine, and director, Division of Learning Analytics, New York University School of Medicine Institute for Innovations in Medical Education, New York, New York. When I read Vaisman and Cram’s thoughtful Perspective on academic faculty procedural competence, I agreed with most of what they had to say. Academic faculty are certainly having to adapt to a myriad of dislocations as our health systems adapt to new realities. What doesn’t change is the buck stops with the academic attending, which can be problematic for all the reasons they list. However, there is one facet of their argument with which I take a different perspective and that is the idea that there is a paucity of data on procedural success. Anyone who has done a procedure note in a modern electronic health record (EHR) knows that the data is available and in spades. This will only increase given that the incorporation of digital photos and videos is only a matter of time—why would I write down “we used 1% xylocaine without epinephrine to locally infiltrate the laceration” when my head camera can easily stream this to the EHR? Sure there are issues to be worked out, but soon we’ll be swimming in all the data we could possibly want about our procedural successes or lack thereof. What will we do with all...
Source: Academic Medicine Blog - Category: Universities & Medical Training Authors: Tags: Featured Guest Perspective big data deliberate practice faculty procedural competency Source Type: blogs

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Publication date: Available online 20 January 2020Source: Molecular and Cellular EndocrinologyAuthor(s): Ronald J. van der Sluis, Menno HoekstraAbstractAdrenal-derived glucocorticoids mediate the physiological response to stress. Chronic disturbances in glucocorticoid homeostasis, i.e. in Addison's and Cushing's disease patients, predispose to the development of atherosclerotic cardiovascular disease. Here we review preclinical and clinical findings regarding the relation between changes in plasma glucocorticoid levels and the atherosclerosis extent. It appears that, although the altered glucocorticoid function can in most...
Source: Molecular and Cellular Endocrinology - Category: Endocrinology Source Type: research
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Source: Gynecological Endocrinology - Category: Endocrinology Authors: Source Type: research
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Publication date: Available online 20 January 2020Source: Journal of Pharmaceutical and Biomedical AnalysisAuthor(s): Alexandre Goyon, Peter Yehl, Kelly ZhangABSTRACTMarketed therapies in the pharmaceutical landscape are rapidly evolving and getting more diverse. Small molecule medicines have dominated in the past while antibodies have grown dramatically in recent years. However, the failure of traditional small and large molecules in accessing certain targets has led to increased R&D efforts to develop alternative modalities. Therapeutic oligonucleotides (ONs) can accurately be directed against their ribonucleic acid (RNA...
Source: Journal of Pharmaceutical and Biomedical Analysis - Category: Drugs & Pharmacology Source Type: research
ConclusionsThese results demonstrate that a novel proton-coupled organic cation antiporter plays a predominant role in the blood to brain influx of AC, MA and HA at the BBB, and thus affect the safety of Aconitum species.Graphical abstract
Source: Journal of Ethnopharmacology - Category: Drugs & Pharmacology Source Type: research
This study investigated the cardioprotective effect of vitexin against MIRI and its possible mechanism. Isolated SD rat hearts were subjected to MIRI in a Langendorff perfusion system, and H9c2 cells were subjected to hypoxia/reoxygenation (H/R) in vitro. Ex vivo experiments showed improved left ventricular function and reduced infarct size in the vitexin group. Transmission electron microscopy showed that I/R caused outer mitochondrial membrane rupture, cristae disappearance and vacuolation, while vitexin reduced mitochondrial damage and ultimately reduced cardiomyocyte apoptosis. In vitro, vitexin protected H9c2 cells fr...
Source: Biomedicine and Pharmacotherapy - Category: Drugs & Pharmacology Source Type: research
ConclusionsOur study demonstrates the antitumor effect of IL-24 on endometrial cancer and shows that IL-24 may be a promising therapeutic gene for endometrial cancer gene therapy.Graphical abstract
Source: Biomedicine and Pharmacotherapy - Category: Drugs & Pharmacology Source Type: research
Source: Core Evidence - Category: Drugs & Pharmacology Tags: Core Evidence Source Type: research
Contributors : Diane M Ward ; Alexandra SeguinSeries Type : Expression profiling by high throughput sequencingOrganism : Mus musculusHepatocyte-specific loss of Slc25a37 (Mitoferrin1) in Mitoferrin2-/- mice did not affect animal viability or liver size suggesting that there must be alternative hepatocyte mitochondrial iron importers that function in the absence of Mitoferrins.
Source: GEO: Gene Expression Omnibus - Category: Genetics & Stem Cells Tags: Expression profiling by high throughput sequencing Mus musculus Source Type: research
This study aimed to explore the link between block copolymers’ interfacial properties and nanoscale carrier formation and found out the influence of length ratio on these characters to optimize drug delivery system. A library of diblock copolymers of PEG-PCL and triblock copolymers with additional PEI (PEG-PCL-PEI) were synthesized. Subsequently, a systematic isothermal investigation was performed to explore molecular arrangements of copolymers at air/water interface. Then, structural properties and drug encapsulation in self-assembly were investigated with DLS, SLS and TEM. We found the additional hydrogen bond in t...
Source: Acta Pharmaceutica Sinica B - Category: Cancer & Oncology Source Type: research
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