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The Perils of Precision Medicine
By MERCEDITAS VILLANUEVA , MD When The White House announced their Precision Medicine Initiative last year, they referred to precision medicine as “a new era of medicine,” signaling a shift in focus from a “one-size-fits-all-approach” to individualized care based on the specific characteristics that distinguish one patient from another. While there continues to be immense excitement about its game-changing impact in terms of early diagnoses and targeting specific treatment options, the advancements in technology, which underlie this approach, may not always yield the best medical results. In some cases, low cost ap...
Source: The Health Care Blog - December 26, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs

The Ryan White HIV/AIDS Program after the Patient Protection and Affordable Care Act full implementation: a critical review of predictions, evidence, and future directions.
Authors: Ginossar T, Oetzel J, Van Meter L, Gans AA, Gallant JE Abstract The Ryan White HIV/AIDS Program (RWHAP) has been effective in serving people living with HIV (PLWH). Our goal was to examine the impact of the implementation of the Affordable Care Act (ACA) on the program's role in HIV care and its clients. We utilized critical review to synthesize the literature on the anticipated effects of the ACA, and assess the evidence regarding the early effects of the ACA on the program and on PLWH who receive RWHAP services. To date, research on the impact of ACA on RWHAP has been fragmented. Despite the expected ben...
Source: Topics in antiviral medicine - October 23, 2019 Category: Infectious Diseases Tags: Top Antivir Med Source Type: research

HIV Care Providers Emphasize The Importance Of The Ryan White Program For Access To And Quality Of Care ACA Implementation
With the implementation of the Affordable Care Act (ACA) under way, some policy makers have questioned the continued relevance of the Ryan White HIV/AIDS Program as a safety net for people living with HIV/AIDS. We surveyed HIV care providers to understand the role of the Ryan White Program and to identify concerns regarding the ACA implementation. We also addressed whether the program is still relevant after ACA implementation and, if so, what elements should be retained. We found that providers consider the Ryan White Program to be critical in facilitating high-quality care for people living with HIV/AIDS. Most of the pro...
Source: Health Affairs - March 3, 2014 Category: Global & Universal Authors: Sood, N., Juday, T., Vanderpuye-Orgle, J., Rosenblatt, L., Romley, J. A., Peneva, D., Goldman, D. P. Tags: Access To Care, Health Promotion/Disease Prevention, Health Reform, AIDS/HIV, Legal/Regulatory Issues, Pharmaceuticals, Physicians, Public Health, Quality Of Care, Safety-Net Systems, Health Spending, Evidence-Based Medicine, Affordable Care Act, Demograp Source Type: research

Early HIV Treatment Is Essential, But So Is Testing And Linkage To Care
Last week’s announcement of the Strategic Timing of AntiRetroviral Treatment (START) trial results confirms what many experts have long believed — early treatment for HIV reduces illness and death. While START further establishes the vital role of early antiretroviral therapy (ART), many questions remain on how to actually bring the life-saving benefits of treatment to individual patients. In many regards, the very question over when to start treatment is unusual in the field of infectious disease. “No one says we shouldn’t treat TB [tuberculosis] until the size of your cavity is 5 centimeters or your sputum h...
Source: Health Affairs Blog - June 3, 2015 Category: Health Management Authors: Preeti Malani Tags: Drugs and Medical Technology Equity and Disparities Featured Organization and Delivery Public Health Carlos del Rio HIV Medicine Association HIV-AIDS Strategic Timing of AntiRetroviral Treatment Source Type: blogs

JAMA Internal Medicine —Providing Compelling, Credible, Timely, and Essential Evidence
We live in a time of breathtaking advances in biomedicine. During my lifetime, scientific breakthroughs have made previously fatal or debilitating diseases treatable with revolutionary new drugs or molecularly targeted approaches for AIDS, hepatitis, cancer, and many other conditions across the full spectrum of internal medicine. Medical discovery has also helped set the stage for the highly accelerated development of the COVID-19 vaccine —one of the greatest scientific achievements in history. In stark juxtaposition to these advances, we are facing unprecedented challenges and stressors to our health care systems. Misin...
Source: JAMA Internal Medicine - July 3, 2023 Category: Internal Medicine Source Type: research

Cytotoxic and HIV-1 enzyme inhibitory activities of Red Sea marine organisms
Conclusion: The strong cytotoxicity of the soft corals L. arboreum and S. trochliophorum as well as the anti-PR activity of the jelly fish C. andromeda and the red algae G. filamentosa suggests the medicinal potential of crude extracts of these marine organisms.
Source: BMC Complementary and Alternative Medicine - February 25, 2014 Category: Complementary Medicine Authors: Mona EllitheyNamrita LallAhmed HusseinDebra Meyer Source Type: research

HIV Care Continuum for HIV-Infected Emergency Department Patients in an Inner-City Academic Emergency Department
Conclusion To our knowledge, this study is the first to quantify gaps in HIV care for an ED patient population, with the HIV Care Continuum as a framework. Our findings identified distinct phases (ie, testing, provider awareness of HIV diagnosis, and linkage to care) in which the greatest opportunities for intervention exist, if appropriate resources were allocated. This schema could serve as a model for other indolent treatable diseases frequently observed in EDs, where continuity of care is critical.
Source: Annals of Emergency Medicine - March 2, 2015 Category: Emergency Medicine Source Type: research

Evidence - Based Medicine Course Beneficial for Critical Thinking
Significant mean differences in confidence, inquisitiveness, overall score for undergrads
Source: The Doctors Lounge - Psychiatry - May 10, 2017 Category: Psychiatry Tags: Cardiology, Dermatology, Endocrinology, Family Medicine, Geriatrics, Gastroenterology, Gynecology, Infections, AIDS, Internal Medicine, Allergy, Critical Care, Emergency Medicine, Nephrology, Neurology, Oncology, Ophthalmology, Orthopedics, ENT, Pathology Source Type: news

Tropical Travel Trouble 008 Total TB Extravaganza
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog aka Tropical Travel Trouble 008 Peer Reviewer Dr McBride ID physician, Wisconsin TB affects 1/3rd of the population and one patient dies every 20 seconds from TB. Without treatment 50% of pulmonary TB patients will be dead in 5 years. In low to middle income countries both TB and HIV can be ubiquitous, poor compliance can lead to drug resistance and malnourished infants are highly susceptible. TB can be very complex and this post will hopefully give you the backbone to TB m...
Source: Life in the Fast Lane - June 16, 2018 Category: Emergency Medicine Authors: Neil Long Tags: Clinical Cases Tropical Medicine Genexpert meningitis TB TB meningitis Tuberculosis Source Type: blogs

20 Medical Technology Advances: Medicine In The Future – Part I
Mind-reading exoskeletons, digital tattoos, 3D printed drugs, RFID implants for recreational purposes: mindblowing innovations come to medicine and healthcare almost every single day. We shortlisted some of the greatest ideas and developments that could give us a glimpse into the future of medicine, but we found so many that we had trouble fitting them into one article. Here are the first ten spectacular medical innovations to watch for. 1) Mixed reality opens new ways for medical education Augmented, virtual, and mixed reality are all technologies opening new worlds for the human senses. While the difference between...
Source: The Medical Futurist - October 17, 2019 Category: Information Technology Authors: berci.mesko Tags: Future of Medicine 3d printing artificial food brain-computer interface cyborg digital tattoos drug development exoskeleton gamification google glass health insurance Healthcare Innovation List Medical education medical techn Source Type: blogs

Negative Appendectomies - Evaluating Diagnostic Imaging Techniques at General Versus a Pediatric Emergency Department
Acute appendicitis is the most common surgical emergency in children.1,2 Many children with suspected appendicitis initially present to non-pediatric hospitals and are subsequently transferred to pediatric referral centers for further workup and pediatric surgical evaluation.2,3 Radiographic evaluation for appendicitis is becoming standard of care as it aids in identifying acute appendicitis while lessening chances of a negative appendectomy (removal of a normal appendix with no signs of inflammation on pathology).
Source: The Journal of Emergency Medicine - December 23, 2022 Category: Emergency Medicine Authors: Andrew Shieh, Phung K. Pham, Nicole A. Plouffe, Theodore W. Heyming Tags: Selected Topics: Emergency Radiology Source Type: research

It looks like adult cardiologist should avoid doing pediatric echocardiograms !
A cardiologist  is  a physician who has  trained himself  in a special  way  to deal with any problem of heart.Ironically , it exists only on paper.The field has developed so vast  no one can master everything .There is no such  “Pan or global cardiology expert” .In fact it would be shortly become unethical to try to become one ! Pediatric cardiology  has developed into such a big field , doing a echo in newborn or  infant has become a comprehensive job and  requires  special talent .This unique  and excellent study from Narayana Institute , Bangalore published in the  prestigious Annals of pediat...
Source: Dr.S.Venkatesan MD - February 14, 2015 Category: Cardiology Authors: dr s venkatesan Tags: bio ethics Cardiology -Therapeutic dilemma cardiology-ethics adult vs pediatric echo report echocardiography expertise required errors in echo report errors in echocardiography ethical issues in cardiology inadequate echocardiogram incom Source Type: blogs

Beliefs and practices of complementary and alternative medicine (CAM) among HIV/AIDS patients: A qualitative exploration
Conclusions Despite the possible underlying adherence and therapeutic challenges towards taking ARTs; CAM use in contemporary HIV-care may provide a proactive means of engaging PLWHA, and generate self-care practises that promote positive health behaviours, including proper use of ARTs. Therefore, patient-healthcare provider communications are critical.
Source: European Journal of Integrative Medicine - March 21, 2016 Category: Complementary Medicine Source Type: research

Transitioning HIV-Positive Adolescents to Adult Care: Lessons Learned From Twelve Adolescent Medicine Clinics
To maximize positive health outcomes for youth with HIV as they transition from youth to adult care, clinical staff need strategies and protocols to help youth maintain clinic engagement and medication adherence. Accordingly, this paper describe transition processes across twelve clinics within the Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) to provide lessons learned and inform the development of transition protocols to improve health outcomes as youth shift from adolescent to adult HIV care.
Source: Journal of Pediatric Nursing - April 27, 2016 Category: Nursing Authors: Amanda E. Tanner, Morgan M. Philbin, Anna DuVal, Jonathan Ellen, Bill Kapogiannis, J. Dennis Fortenberry, The Adolescent Trials Network for HIV/AIDS Interventions Source Type: research