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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It is currently recognized that in addition to the major impact of human papillomavirus (HPV) infection in females, HPV causes considerable disease in men at the genitals, anal canal, and oropharynx. Specifically, genital HPV infections may progress to genital warts and penile carcinoma. Although studies concerning the natural history of HPV infections and associated neoplasias have mainly focused on women, during the last 2 decades considerable attention has been given in further understanding these infections in men. The HIM (HPV infection in men) Study, the only prospective multicenter study of male HPV natural history,...
Source: Acta Cytologica - Category: Cytology Source Type: research
Sexual intercourse is regarded as the primary route of human papillomavirus (HPV) transmission. Reported rates of the genotype-specific genital concordance of HPV infection among heterosexual partners vary. Most studies have evaluated only male/female genital transmission, but lately, the oral region has gained interest because of a rising trend of HPV-associated oropharyngeal cancer. Risk factors for type-specific concordance have been reported as an increasing number of younger couples, persistent HPV infection, higher frequency of sexual intercourse, rising number of spouse ’s lifetime sexual partners, and sexual ...
Source: Acta Cytologica - Category: Cytology Source Type: research
Publication date: 21 February 2019Source: Cell, Volume 176, Issue 5Author(s): Shashi Gujar, John Bell, Jean-Simon DialloOncolytic viruses (OVs) preferentially infect and kill cancer cells without harming normal cells. OVs can revert cancer-associated immune suppression and initiate clinically meaningful antitumor immune responses. OVs and their resultant immunological events can act at both primary and metastatic sites. Thus, OVs can be exploited for cancer gene therapies and immunotherapies alone or in combination with other interventions, including immune checkpoint blockade.
Source: Cell - Category: Cytology Source Type: research
Publication date: 21 February 2019Source: Cell, Volume 176, Issue 5Author(s): Mary T. Joy, Einor Ben Assayag, Dalia Shabashov-Stone, Sigal Liraz-Zaltsman, Jose Mazzitelli, Marcela Arenas, Nora Abduljawad, Efrat Kliper, Amos D. Korczyn, Nikita S. Thareja, Efrat L. Kesner, Miou Zhou, Shan Huang, Tawnie K. Silva, Noomi Katz, Natan M. Bornstein, Alcino J. Silva, Esther Shohami, S. Thomas CarmichaelSummaryWe tested a newly described molecular memory system, CCR5 signaling, for its role in recovery after stroke and traumatic brain injury (TBI). CCR5 is uniquely expressed in cortical neurons after stroke. Post-stroke neuronal kno...
Source: Cell - Category: Cytology Source Type: research
Publication date: 21 February 2019Source: Cell, Volume 176, Issue 5Author(s): Ting Fu, Sally Coulter, Eiji Yoshihara, Tae Gyu Oh, Sungsoon Fang, Fritz Cayabyab, Qiyun Zhu, Tong Zhang, Mathias Leblanc, Sihao Liu, Mingxiao He, Wanda Waizenegger, Emanuel Gasser, Bernd Schnabl, Annette R. Atkins, Ruth T. Yu, Rob Knight, Christopher Liddle, Michael Downes, Ronald M. EvansSummaryIncreased levels of intestinal bile acids (BAs) are a risk factor for colorectal cancer (CRC). Here, we show that the convergence of dietary factors (high-fat diet) and dysregulated WNT signaling (APC mutation) alters BA profiles to drive malignant trans...
Source: Cell - Category: Cytology Source Type: research
Journal Name: Clinical Chemistry and Laboratory Medicine (CCLM) Issue: Ahead of print
Source: Clinical Chemistry and Laboratory Medicine - Category: Laboratory Medicine Source Type: research
CANCER symptoms vary depending on which part of the body is affected by a tumour. You could be at risk of deadly tumour signs if you notice this feeling in your teeth. It could be a warning sign of deadly mouth cancer. Should you see a doctor?
Source: Daily Express - Health - Category: Consumer Health News Source Type: news
CONCLUSION:: To conclude, the outcomes of radiocephalic arteriovenous fistulas created by nephrologists are at par with historic outcomes. PMID: 30784345 [PubMed - as supplied by publisher]
Source: The Journal of Vascular Access - Category: Surgery Tags: J Vasc Access Source Type: research
Daisy Wyatt, 14, of Blackwood, Wales, finished treatment for rare bone cancer in 2016 after diagnosis at 12 years old. But the family were soon told it had spread to her lungs and was incurable.
Source: the Mail online | Health - Category: Consumer Health News Source Type: news
Since the beginning of the year, more than 160 people have contracted the virus, which was spread through a religious group and a Valentine ’ s Day gift fair.
Source: NYT Health - Category: Consumer Health News Authors: Tags: Measles Vaccination and Immunization Japan Source Type: news
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