I spent eight years as a research biochemist. Throughout that
time I lived with Sam, a large, ginger neutered tom cat. He had
moved in with no fur on his belly and back legs – apparently as
a result of fleas – and a medicine cabinet of powerful and
expensive steroids. I decided that if fleas were causing Sam’s
baldness then I would deal with them rather than spend my
meagre funds on cat steroids. So I bought him a flea collar and
dusted him down with flea powder. Before long his fur had
Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Challenges in implementing individualized medicine illustrated by antimetabolite therapy of childhood acute lymphoblastic leukemia...
Population Screening Mass genetic screening programs require tests of high enough sensitivity and specificity to be cost-effective. An effective screening program should fulfill the following criteria: that the tested disorder is prevalent and serious; that it can be influenced presymptomatically through lifestyle changes, screening, or medications; and that identification of risk does not result in undue discrimination or harm.
We report the results of experiments on economic decisions with two populations,
one of healthy elderly individuals (average age 82) and one of younger students (average
age 20). We examine confidence, decisions under uncertainty, differences between
willingness to pay and willingness to accept and the theory of mind (strategic thinking).
Our findings indicate that the older adults’ decision behavior is similar to that of young
adults, contrary to the notion that economic decision making is impaired with age.
This book provides information on alternative and complementary
therapies that can expand the healing spectrum for
individuals with spinal cord injury (SCI). It discusses healing
perspectives and paradigms that have not been a part of traditional
modern medicine but that, nevertheless, comprised a key component
of healing armamentaria throughout much of mankind’s history.
Molecular analysis is generally more informative if testing is initiated in a symptomatic family member, since the identification of a mutation can direct the testing of other at-risk family members (whether they are symptomatic or not). In the absence of additional familial or environmental risk factors, individuals who test negative for the mutation found in the affected family member can be informed that they are at general population risk for that particular disease. Furthermore, they can be reassured that they are not at risk for passing on the mutation to their children.
Therapeutic Interventions Based on Genetic Risk for Disease Specific treatments are now available for an increasing number of genetic disorders, whether identified through population-based screening or directed testing (Table 64-2). Although the strategies for therapeutic interventions are best developed for childhood hereditary metabolic diseases, these principles are making their way into the diagnosis and management of adult-onset disorders. Hereditary hemochromatosis illustrates many of the issues raised by the availability of genetic screening in the adult population.
Conclusion: Toward a Science of Implementation
Public-health strategies draw largely on quantitative methods—from epidemiology and biostatistics, but also from economics. Clinical practice, including internal medicine, draws on a rapidly expanding knowledge base but remains focused on individual patient care; clinical interventions are rarely population-based. In fact, neither public-health nor clinical approaches alone will prove adequate in addressing the problems of global health.
Internal Medicine Essentials for Clerkship Students is a
collaborative project of the American College of
Physicians (ACP) and the Clerkship Directors in
Internal Medicine (CDIM), the organization of individuals
responsible for teaching internal medicine to
medical students. The purpose of IM Essentials is to
provide medical students with an authoritative educational
resource that can be used to augment learning
during the third year internal medicine clerkship.
It is sometimes said that committees of more than seven are less efficient than individuals,
but the Fifth International Veterinary Behavior Meeting would never have
succeeded if it was down to the efforts of a single individual or even a small committee.
It is testament to the exceptional team work of individuals within many committees
and their skillful management and leadership that we are able to produce this latest
volume. We are indebted to everyone who has helped in whatever way to make
this meeting a success and helped these biennial meetings grow each time.
Preventive measures and therapeutic interventions are not restricted to metabolic disorders. Identification of familial forms of long QT syndrome, associated with ventricular arrhythmias, allows early electrocardiographic testing and the use of prophylactic antiarrhythmic therapy, overdrive pacemakers, or defibrillators (Chap. 226). Individuals with familial hypertrophic cardiomyopathy can be screened by ultrasound, treated with beta blockers or other drugs, and counseled about the importance of avoiding strenuous exercise and dehydration (Chap. 231).
This book was triggered when, as a novice medical student in Oxford, I
first read Dr Paul Tournier’s Doctor’s Casebook in the Light of the Bible. At that
time I was searching for a bridge between the basic sciences and the
Christian faith tradition.
Much later, at a meeting of the International Medicine of the Person
Group in Prague, 1993, I was intrigued by the memories and wholesome
relationships of these continental doctors and their families.
The number of people with diabetes mellitus (DM) has been conservatively estimated to
approximately double by 2030 to a worldwide prevalence of 4.4% at which time 366 million
people will have diabetes (Wild et al., 2004). As the number of people with DM rises, so too
will the burden of diabetic foot disease, particularly since the factors contributing to ulcer
formation such as peripheral neuropathy and vascular disease are already present in 10% of
people at the time of diagnosis (Boulton et al., 2005).
The sequencing of the human genome has generated excitement about
the potential of genomic innovations to improve medical care, preventive and
community health services, and public health. Until fairly recently, genetic
information was used primarily in the diagnosis of relatively rare genetic diseases,
such as cystic fibrosis and Huntington’s Disease, but a transformation
in the use of genetic and genomic information is under way.
Genetic markers of increased risk for such chronic diseases as diabetes
and coronary artery disease have been identified.
This symposium summary has been reviewed in draft form by
individuals chosen for their diverse perspectives and technical expertise,
in accordance with procedures approved by the National Research
Councils Report Review Committee. The purpose of this independent
review is to provide candid and critical comments that will assist the
institution in making its published summary as sound as possible and to
ensure that the report meets institutional standards for objectivity,
evidence, and responsiveness to the study charge.
Constitutively expressed human cytochrome P450 2D6 (CYP2D6; EC
126.96.36.199) is responsible for the metabolism of approximately 25% of drugs
in common clinical use. It is widely accepted that CYP2D6 is localized in
the endoplasmic reticulum of cells; however, we have identified this enzyme
in the mitochondria of human liver samples and found that extensive inter-individual variability exists with respect to the level of the mitochondrial
To establish stable cell lines that produce recombinant multisubunit proteins, it is usually necessary to cotransfect cells with several independent gene constructs. Here, we show that a stepwise fusion of individually transfected cells, results in a fused cell-line that secretes a complete multisubunit protein. Functional expression of recombinant multisubunit proteins may require a deﬁned expression ratio between each protein subunit. The cell-fusion technology described allows a predeﬁned expression level of each subunit.
(BQ) Part 1 book "Sleep medicine - A comprehensive guide to its development, clinical milestones and advances in treatment" presents the following contents: Evolution of sleep medicine by historical periods, sleep medicine from the medieval period to the 19th century, the early evolution of modern sleep medicine,...
The present assessment showed that traditional herbal
medicine has flourished in rural areas where modern
medicine is parsimoniously accessed as a result of the
high cost and long travel time to health center. More-
over inadequate modern medical resources/facilities and
government subsidies also made traditional herbal medi-
cine pertinent in Nepal. It is estimated that there is one
physician for every 20,000 people whereas there is more
than one healer for every 100 people in Nepal [41,42].
In addition, more and more Parties are increasing their controls on the trade in medicines, thus
improving the regulation of legal trade and more effectively combating illegal trade. This manual
has proven to be an excellent tool judging from the fact that many additional copies of it were
requested from the Secretariat.
At CoP12, the Secretariat entered into an agreement to produce a second edition before CoP13,
and I am pleased that this difficult work has been completed by the two original authors with
contributions from various other organizations and individuals.