Medicine availability

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  • Malaria is a significant health problem in Africa, particularly in Uganda where malaria accounts for up to 50% of the country’s morbidity and mortality. Recent years have witnessed a surge in both national and international interest in reducing the malaria burden and thus willingness and ability to tackle this disease is currently at an unprecedented level. New funding, tools and leadership have emerged, and an effective class of new medicines, artemisinin combination therapies (ACTs), has been developed to replace failing medicines.

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  • Much has happened since the first edition of this book appeared in 2002. Despite the continuing paucity of robust scientific evidence to support most of its constituent therapies, complementary and alternative medicine (CAM) remains popular with clients who appreciate the holistic approach and have a belief in its effectiveness.

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  • The Twenty-First Century Physician: Expanding Frontiers The Era of Genomics In the spring of 2003, the complete sequencing of the human genome was announced, officially ushering in the genomic era. However, even before this landmark accomplishment, the practice of medicine had been evolving as a result of the insights gained from an understanding of the human genome as well as the genomes of a wide variety of microbes, whose genetic sequences were becoming widely available as a result of the breathtaking advances in sequencing techniques and informatics.

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  • Diabetes Mellitus The success of islet cell and pancreas transplantation provides proof of concept for a cell-based approach for type I diabetes. However, the demand for donor pancreata far exceeds the number available, and maintenance of long-term graft survival remains a problem. The search for a renewable source of stem cells capable of regenerating pancreatic islets has therefore been intensive. Pancreatic βcell turnover occurs in the normal pancreas, although the source of the new βcells is controversial.

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  • Benefit from the most comprehensive Internal Medicine Board review course available—developed by noted author and Kaplan Medical faculty member Dr. Conrad Fischer. This intensive program can also help you prepare for the USMLE Step 2 CK and Step 3 exams. The program includes 54 hours of lectures by our expert faculty and Dr. Fischer's Internal Medicine Lecture Notes.

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  • The Dichotomy of Inpatient and Outpatient Internal Medicine The hospital environment has transformed dramatically over the past few decades. In more recent times, emergency departments and critical care units have evolved to identify and manage critically ill patients, allowing them to survive formerly fatal diseases. There is increasing pressure to reduce the length of stay in the hospital and to manage complex disorders in the outpatient setting.

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  • In many parts of the world, where medicines are not readily available or affordable, the public continue to rely on medicines used traditionally in their cultures. At the same time, affluent consumers in the industrialized world are spending their own money on healthcare approaches that fall outside what has been considered mainstream medicine. A growing body of national and international studies highlight the reality that there is exponential growth of global interest in and use of traditional (i.e. indigenous), complementary and alternative medicine (TCAM).

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  • 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.

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  • The use of non-biomedical therapeutics and the management of cancer are high profile issues in health internationally. They both generate, in their own right, considerable debate amongst academics, practitioners and the wider public. Increasingly, as non-biomedical approaches have become more and more a feature of the range of therapeutic options available to cancer patients, the two have become inextricably linked. This book is concerned with that increasingly evident combination.

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  • Chapter 125. Health Care– Associated Infections (Part 1) Harrison's Internal Medicine Chapter 125. Health Care–Associated Infections Health Care–Associated Infections: Introduction The costs of hospital-acquired (nosocomial) and other health care– associated infections are great. It is estimated that these infections affect 2 million patients, cost $4.5 billion, and contribute to 88,000 deaths in U.S. hospitals annually.

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  • Selection of chemical markers is crucial for the quality control of herbal medicines, including authentication of genuine species, harvesting the best quality raw materials, evaluation of post- harvesting handling, assessment of intermediates and finished products, and detection of harmful or toxic ingredients. Ideal chemical markers should be the therapeutic components of herbal medicines. However, for most herbal medicines, the therapeutic components have not been fully elucidated or easily monitored.

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  • 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.

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  • Chapter 182 provides an overview of the AIDS epidemic in the world today. Here we will limit ourselves to a discussion of AIDS in the developing world. Lessons learned in tackling AIDS in resource-constrained settings are highly relevant to discussions of other chronic diseases, including noncommunicable diseases, for which effective therapies have been developed. We highlight several of these lessons below.

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  • There are a number of tests that can be applied. Thin layer chromatography has proved successful in identifying bear gallbladder, bile, musk, cobra bile and agarwood. The costs, relia- bility and speed of testing vary greatly between different tests, laboratories and countries. Often this is dependent on the nature of the sample. Some techniques are commonly available in most laboratories, yet some are only possible in the few that have perfected the test.

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  • The appropriate time to start contraception depends on the contraceptive method and may also depend on medical and social factors. Traditionally, initiation of hormonal and intrauterine methods of contraception has been delayed until the onset of the next menstrual period in order to avoid inadvertent use during pregnancy. Starting early in the cycle also avoids the need for additional contraception. The manufacturers’ Summaries of Product Characteristics (SPCs) vary in their advice on contraceptive start dates and the need for additional contraception.

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  • Continuous queries are persistent queries that allow users to receive new results when they become available. While continuous query systems can transform a passive web into an active environment, they need to be able to support millions of queries due to the scale of the Internet. No existing systems have achieved this level of scalability. NiagaraCQ addresses this problem by grouping continuous queries based on the observation that many web queries share similar structures.

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  • The increased rates of obesity have become a public health concern because obesity is associated with chronic disease and adverse health outcomes (Institute of Medicine 2005). Furthermore, because obesity is now a characteristic of populations and not only of individuals, researchers, government health organizations, and advocacy groups characterize obesity as an epidemic (Institute of Medicine 2005, 2006a; World Health Organization 2003).

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  • This easy-to-read book is the best all-round introduction to homeopathy available. Dr. Dooley intersperses stories from his twenty years of training and experience as he explains what homeopathy is, how it differs, when to use it, what to expect, how to get results, and what is needed for success in treatment. Highly recommended by homeopathic practitioners.

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  • The Oxford Textbook of Medicine is the foremost international textbook of medicine. Unrivalled in its coverage of the scientific aspects and clinical practice of internal medicine and its subspecialties, it is a fixture in the offices and wards of physicians around the world. Available via www.oxfordmedicine.com, the online edition of the Oxford Textbook of Medicine contains the full-text of the print edition, plus freely available chapter summaries, a searchable collection of full-colour illustrations, photographs, and figures, and links to all material referenced in the text....

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  • Countries should intensify efforts to measure and regularly monitor medicine prices and availability, and adopt policy measures to address the issues identified. A range of policy options are available to address issues of high prices and low availability of medicines. Low public sector availability can be addressed through improved procurement efficiency, and adequate, equitable and sustainable financing. Medicine prices can be reduced by eliminating duties and taxes on medicines and promoting the use of quality-assured generic medicines.

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