Changing the culture of American Medicine — Start by removing hubris

This may be the most important post I have ever published. I’m going to tell you about a study that should change the entire way doctors approach patients, and how patients should think of prescribed treatments. These findings should begin a culture change in American medicine. Background: I used to think Medicine would get easier over time. It makes sense, right? You see patterns, you learn how treatments work, and you just get to know stuff. Experience should make it easier to diagnose and treat. That’s not been the case for me. In fact, it’s closer to the opposite. In the exam room, as I look up to the patient from my stool, and before I stand at the white board to explain, I often find myself pausing for a moment to think: Is this really the right course? Does the evidence support doing it this way? Do I know the science, or is it “just the way things are done?” I have the same problem in the hospital—perhaps worse, as there, dogma permeates most of what we do. What keeps popping into my head is the hubris of Medicine. As I grow older, the excessive pride and confidence of the medical establishment becomes more obvious. Why didn’t I see it before? In many cases, medical and surgical treatments that were once thought to be beneficial turn out to be not so. Often, these therapies were backed by expert guidelines and taught to young students as law. Think of that for a moment. We do things to people; we monitor, we medicate, and we e...
Source: Dr John M - Category: Cardiology Authors: Source Type: blogs

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Publication date: Available online 8 August 2018Source: Colloids and Surfaces B: BiointerfacesAuthor(s): R. PranavKumar Shadamarshan, Harini Balaji, Harsha Shrihari Rao, K. Balagangadharan, S. Viji Chandran, N. SelvamuruganAbstractTrans-anethole (TA) is a phenolic phytocompound widely used in the food and health sector because of its diverse biological properties. However, its role in the promotion of bone formation is not known. With the enhanced bioavailability of TA, we aimed to determine its effect on osteogenesis; TA at different concentrations (5, 10, and 20 µM) was loaded onto polycaprolactone (PCL)/polyvinylp...
Source: Colloids and Surfaces B: Biointerfaces - Category: Biochemistry Source Type: research
[News24Wire] A herbicide that is believed to cause cancer is widely in use in South Africa.
Source: AllAfrica News: Health and Medicine - Category: African Health Source Type: news
Abstract Construction of hybrid systems that combine the cancer treatment and diagnosis agents on a single platform, known as theranostic systems, have received great attentions in the field of nanobiomedicine. Here, construction and characterization of a new multifunctional hybrid theranostic system based on RGO, PDA, BSA, DTPA-Mn(II), and MTX constituents, is presented. Accordingly, GO is partially reduced and simultaneously functionalized by dopamine, leading to reduced graphene oxide/polydopamine, RGO-PDA system; and then, the bovine serum albumin protein (BSA) is grafted onto this system. The obtained system,...
Source: Biosensors and Bioelectronics - Category: Biotechnology Authors: Tags: Biosens Bioelectron Source Type: research
PROSTATE cancer risk could be lowered by losing weight or by avoiding pesticides, it ’s been claimed. But you could reveal your chances of developing prostate cancer symptoms by checking your fingers - this is what to look out for.
Source: Daily Express - Health - Category: Consumer Health News Source Type: news
Conclusions: NP practice environment affected the quality of care for 2 chronic conditions. Efforts should be implemented to improve NP practice environment to potentially improve care quality.
Source: Medical Care - Category: Health Management Tags: Original Articles Source Type: research
Conclusions: The heterogeneous effect of state legislation with regard to dense breast tissue on screening mammography follow-up by ultrasound may be explained by specific and unique characteristics of the approaches taken by a variety of states.
Source: Medical Care - Category: Health Management Tags: Original Articles Source Type: research
Publication date: Available online 13 August 2018Source: European Journal of Surgical OncologyAuthor(s): João Gonçalves Filho, Mark E. Zafereo, Faisal I. Ahmad, Iain J. Nixon, Ashok R. Shaha, Vincent Vander Poorten, Alvaro Sanabria, Avi Khafif Hefetz, K. Thomas Robbins, Dipti Kamani, Gregory W. Randolph, Andres Coca-Pelaz, Ricard Simo, Alessandra Rinaldo, Peter Angelos, Alfio Ferlito, Luiz P. KowalskiAbstractThe central compartment is a common site for nodal spread from differentiated thyroid carcinoma, often occurring in patients without clinical or ultrasonographic (US) evidence of neck lymph node metastasi...
Source: European Journal of Surgical Oncology (EJSO) - Category: Surgery Source Type: research
Objectives: Previous retrospective studies demonstrated that circulating tumor cells (CTCs) subtypes correlate with overall survival in patients with pancreatic ductal adenocarcinoma (PDAC). Herein, we report results of a prospective observational study on CTCs dynamics to assess their clinical significance. Methods: The CLUSTER study is a prospective longitudinal study on PDAC CTCs dynamics (NCT02974764). Multiple peripheral blood samples were collected from 200 consecutively enrolled patients with presumed PDAC diagnosis. CTCs were isolated and characterized by immunofluorescence. Results: Two major CTCs subtypes...
Source: Annals of Surgery - Category: Surgery Tags: Papers of the 138Th ASA Annual Meeting Source Type: research
Objective: For patients with gastroparesis, temporary pyloric disruption has been shown to improve symptoms and gastric emptying. Per-oral pyloromyotomy (POP) is an innovative endoscopic procedure to divide the pylorus from within a submucosal tunnel, as a corollary to surgical pyloromyotomy. Here we evaluate subjective and objective outcomes 12-weeks after POP at a high volume center. Methods: The first 100 consecutive patients undergoing POP were included, with procedure dates between January 2016 and October 2017. Patients were evaluated using the Gastroparesis Cardinal Symptom Index (GCSI), and 4-hour solid-phase ...
Source: Annals of Surgery - Category: Surgery Tags: Papers of the 138Th ASA Annual Meeting Source Type: research
Objective: Our objective was to identify the postoperative risk associated with different timing intervals of repair. Background: Timing of carotid intervention in poststroke patients is widely debated with the scales balanced between increased periprocedural risk and recurrent neurologic event. National database reviews show increased risk to patients treated within the first 2 days of a neurologic event compared to those treated after 6 days. Methods: Utilizing Vascular Quality Initiative data, all carotid interventions performed on stroke patients between the years 2012 and 2017 were queried. Patients were then ...
Source: Annals of Surgery - Category: Surgery Tags: Papers of the 138Th ASA Annual Meeting Source Type: research
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