Academic literature on the topic '“Extreme” clinical practice'
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Journal articles on the topic "“Extreme” clinical practice":
1
Zafrir, Barak, Amir Aker, and Walid Saliba. "Extreme lipoprotein(a) in clinical practice: A cross sectional study." International Journal of Cardiology Cardiovascular Risk and Prevention 16 (March 2023): 200173. http://dx.doi.org/10.1016/j.ijcrp.2023.200173.
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Wortzel, Hal S., Joseph A. Simonetti, Christopher E. Knoepke, Joseph R. Simpson, Leah Brar, Patricia Westmoreland, and Bridget B. Matarazzo. "Extreme Risk Protection Orders: Legislative Intent and Clinician Guidance." Journal of Psychiatric Practice 29, no. 6 (November 2023): 480–88. http://dx.doi.org/10.1097/pra.0000000000000749.
Abstract:
In this second column of a 2-part series exploring extreme risk protections orders, we utilize recent events in Colorado, including legislative efforts to expand the list of eligible petitioners to include clinicians, as an opportunity to explore questions and challenges faced by mental health and medical professionals serving in this capacity. Clinicians are in need of more clear guidance, given an emerging role that comes without clear evidence or practice standards to inform individualized clinical decision-making, and which potentially pits public safety interests against patient care needs, especially those pertaining to therapeutic relationships. In the interim, clinicians will best serve their patients by continuing to practice in a fashion that is analogous to decision-making around other interventions with serious implications for patient autonomy such as involuntary hospitalization. Ongoing collaboration with legislators is needed to arrive at laws that are informed by the limitations inherent in clinical risk assessment and that can be translated into clinical practices that simultaneously support patient needs and community safety.
3
Villarino, L., G. Alcaraz, M. De Miguel, A. Pelavski, A. Lacasta, and M. Roca. "Transfusional practice in the extreme old: peri-operative needs and clinical outcomes." European Journal of Anaesthesiology 31 (June 2014): 263. http://dx.doi.org/10.1097/00003643-201406001-00760.
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Seto, Tiffany, Navendu D. Samant, Nina Shah, Aida Shirazi, A. Dimitrios Colevas, and Jed Abraham Katzel. "Treatment patterns for patients with metastatic or recurrent head and neck cancer in a large integrated health-care system." Journal of Clinical Oncology 39, no. 15_suppl (May 20, 2021): e18015-e18015. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.e18015.
Abstract:
e18015 Background: Since publication of the landmark KEYNOTE-048 Trial, pembrolizumab alone or with platinum-based chemotherapy and 5-fluorouracil (5FU) was established as a standard of care for the frontline treatment of patients with recurrent or metastatic head and neck squamous cell cancer (HNSCC), replacing the EXTREME regimen of Cetuximab with platinum and 5FU. In clinical practice, some clinicians modify the KEYNOTE-048 regimen by substituting a taxane for 5FU (i.e., Paclitaxel + Carboplatin + Pembrolizumab, PCT). Within the Kaiser Permanente Northern California (KPNCAL) network, we identified a cohort of 123 patients who received palliative first-line therapy for metastatic HNSCC to identify practice patterns in a real-world setting within a large health care delivery system. Methods: This is a data-only cohort study of all adult KPNCAL members diagnosed with metastatic HNSCC treated with palliative combination chemotherapy and/or immunotherapy between January 1, 2018 and July 31, 2020. Results: Among a cohort of 123 patients, 28 patients received the EXTREME regimen (platinum + 5FU + cetuximab), 10 received modified EXTREME (platinum + taxane + cetuximab), 14 received platinum + 5FU + pembrolizumab, 9 received platinum + taxane + pembrolizumab and 62 received single agent immunotherapy. From 2018 through mid-2020, there was an apparent shift away from cetuximab based regimens and a concurrent rise in immunotherapy-based regimens. By mid-2020, the majority of patients received an immunotherapy-based regimen (28 patients), while only 5 patients received a cetuximab based regimen (Table). Conclusions: Data from our cohort reported clinical practice patterns within a large multispecialty integrated health-care system in Northern California. Our findings highlight the marked variability in practice patterns within a single health care system for first-line metastatic therapy. While we identified trends away from cetuximab based therapy and toward immunotherapy-based therapy in clinical practice there remained wide practice variations among clinical oncologist treating patients with newly diagnosed metastatic HNSCC. This further emphasizes the need for prospective clinical trials to identify the optimal regimen or to confirm clinical equipoise between regimens among patients with metastatic or recurrent head and neck cancer. [Table: see text]
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Yalamati, P., B. J. Jones, and P. J. Twomey. "Appropriateness of the National Academy of Clinical Biochemistry recommendation of repeating HbA1c analysis for extreme results in clinical practice." Annals of Clinical Biochemistry 46, no. 2 (January 22, 2009): 165–66. http://dx.doi.org/10.1258/acb.2008.008153.
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Wenzel, T., H. Graf von Reventlow, and M. Kletecka-Pulker. "Challenges in the early assessment and protection of refugee survivors of torture and extreme violence." Nervenheilkunde 36, no. 08 (August 2017): 599–607. http://dx.doi.org/10.1055/s-0039-3401519.
Abstract:
ZusammenfassungDie medizinische und psychiatrische Betreuung von Flüchtlingen ist zu einer globalen Herausforderung geworden. Spezielle Behandlung, Unterstützung und Schutz sind aufgrund der Gewalterfahrungen und den daraus resultierenden psychischen Folgen bei vielen Betroffenengruppen erforderlich. Folterüberlebende sind dabei aufgrund der oft schweren psychologischen Traumatisierung als besondere Gruppe zu berücksichtigen. Ihnen steht nach internationalen ethischen und Menschenrechtsstandards besonderer Schutz zu. Hierbei ist es nötig, Betroffene früh wäh-rend des Aufnahmeprozesses zu identifizieren, und diesen besonderen Schutz sowie weitere spezielle Hilfe zu gewähren. Dies erfordert einen interdisziplinären Ansatz unter Berücksichtigung besonderer rechtlicher und menschenrechtlicher Rahmenbedingungen. Bei der Begutachtung sind bezüglich Überlebenden von Folter besondere Aspekte zu berücksichtigen, die im „Istanbul Protokolls“ der Vereinten Nationen festgelegt sind.
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Matei, Valentin. "Ethical implications of placebo using in clinical practice." Romanian Journal of Psychiatry and Psychotherapy 19, no. 1 (March 31, 2017): 1–6. http://dx.doi.org/10.37897/rjpp.2017.1.1.
Abstract:
Many authors consider that placebo history is in fact the history of medicine and this is probably true to a large extent. The placebo effect is still extremely used in clinical activity, between 41% and 99% of clinicians worldwide using this intervention. One definition of placebo is: “A medicine or procedure prescribed for the psychological benefit to the patient rather than for any physiological effect”. If we consider both placebo interventions and administration of placebo substances, it is impossible to separate patient-physician interaction (including the environment where the physician performs his/her activities or where the interaction takes place) from placebo effect. There are two extreme poles as regards placebo use in clinical practice: first pole – anything useful for patient's health is good, therefore, as long as we do good to the patient, we can use any placebo variant and, the second one – the patient must know everything about his/her treatment and placebo use is absolutely counter indicated/forbidden without patient's absolute/explicit agreement, but even in this case using placebo effect is rather non-ethic and useless. It is so difficult to separate the very complex interaction between physician-patient from placebo effect as currently defined. Therefore, we can simply renounce, up to the moment when we will have a complete and coherent definition of this effect, to use the concept of “placebo in clinic practice” because for the moment this concept doesn't bring much clarity to the field. It is the authors believe that pushing the principle of patient's autonomy into overdrive risks to pervert the fundamental aspect of medicine - trust and also to push this relationship into a kind of commercial relationship, it is true, one of a somehow special type.
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Dragic, Sasa, Danica Momcicevic, Biljana Zlojutro, Milka Jandric, Tijana Kovacevic, Vlado Djajic, Ognjen Gajic, and Pedja Kovacevic. "Successful Outcomes of Critically Ill Patients with Extreme Metabolic Acidosis Treated with Structured Approach: Case Series." Clinical Medicine Insights: Case Reports 14 (January 2021): 117954762110251. http://dx.doi.org/10.1177/11795476211025138.
Abstract:
Introduction: Hydrogen ion concentration which is expressed as pH value is in human blood maintained in narrow physiological range (7.36-7.44 in arterial blood). This range is crucial for normal functioning of most biochemical reactions. Extreme acidosis with pH < 6.8 is incompatible with life, unless pathophysiologic process is rapidly reversed. Timely, standardized, and structured approach to assessment and management of extreme critical illness is essential to maximize the chances of patient’s survival. Cases: We present a series of 3 critically ill patients admitted to Medical intensive care unit (MICU) diagnosed with extreme metabolic acidosis (pH ⩽ 6.8). Each patient was treated using Checklist for Early Recognition and Treatment of Acute Illness and INjury (CERTAIN) which is a standard decision support tool in our MICU. Causes of extreme metabolic acidosis included hemorrhagic shock, sepsis, and acute renal failure and diabetic ketoacidosis. Rapid assessment, prompt resuscitation (IV fluids, vasopressors, mechanical ventilation, and renal replacement), and application of specific causal treatment led to positive outcomes in all 3 patients. Discussion: Medical physiology textbooks set the lower limit of pH value at which life is possible to 6.8. However, examples from clinical practice show that if adequate resuscitation measures are taken early in the acute phase of the disease, the biochemical cascade of reactions that are considered irreversible (at pH ⩽ 6.8) may be reversed after all. Conclusion: Critical care approach to extreme metabolic acidosis is a prime example of applied clinical physiology where basic science and clinical practice connect. With these case series we show that timely and structured approach to critical illness shifts the boundaries of reversibility for some of the most severe physiologic derangements.
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Gómez-Aparicio, Maria Antonia, Jeannette Valero, Begoña Caballero, Rafael García, Ovidio Hernando-Requejo, Ángel Montero, Alfonso Gómez-Iturriaga, et al. "Extreme Hypofractionation with SBRT in Localized Prostate Cancer." Current Oncology 28, no. 4 (August 3, 2021): 2933–49. http://dx.doi.org/10.3390/curroncol28040257.
Abstract:
Prostate cancer is the most commonly diagnosed cancer among men around the world. Radiotherapy is a standard of care treatment option for men with localized prostate cancer. Over the years, radiation delivery modalities have contributed to increased precision of treatment, employing radiobiological insights to shorten the overall treatment time, improving the control of the disease without increasing toxicities. Stereotactic body radiation therapy (SBRT) represents an extreme form of hypofractionated radiotherapy in which treatment is usually delivered in 1–5 fractions. This review assesses the main efficacy and toxicity data of SBRT in non-metastatic prostate cancer and discusses the potential to implement this scheme in routine clinical practice.
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Williams, David J., Robert J. Thomas, Paul C. Hourd, Amit Chandra, Elizabeth Ratcliffe, Yang Liu, Erin A. Rayment, and J. Richard Archer. "Precision manufacturing for clinical-quality regenerative medicines." Philosophical Transactions of the Royal Society A: Mathematical, Physical and Engineering Sciences 370, no. 1973 (August 28, 2012): 3924–49. http://dx.doi.org/10.1098/rsta.2011.0049.
Abstract:
Innovations in engineering applied to healthcare make a significant difference to people's lives. Market growth is guaranteed by demographics. Regulation and requirements for good manufacturing practice—extreme levels of repeatability and reliability—demand high-precision process and measurement solutions. Emerging technologies using living biological materials add complexity. This paper presents some results of work demonstrating the precision automated manufacture of living materials, particularly the expansion of populations of human stem cells for therapeutic use as regenerative medicines. The paper also describes quality engineering techniques for precision process design and improvement, and identifies the requirements for manufacturing technology and measurement systems evolution for such therapies.
Books on the topic "“Extreme” clinical practice":
1
Lal, Mira, and Johannes Bitzer. Disease severity, pain, and patient perception: themes in clinical practice and research. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198749547.003.0006.
Abstract:
Chapter 6 begins with a discussion of how to assess disease severity. It then moves on to the concepts of physical and emotional pain, which are particularly useful for understanding pelvic floor problems, infertility, pregnancy loss, and chronic pelvic pain. All of these have biological, psychological, and social features associated with their aetiopathogenesis, and presentations. To manage these conditions effectively, it is crucial to understand the patient's perception. First, pelvic/perineal dysfunction is addressed. This includes the loss of urinary and bowel continence, with deleterious effects on biopsychosocial health. The condition is common, and can cause severe morbidity following any delivery mode, including a planned caesarean. This is illustrated by an evaluation of biopsychosocial morbidity, quantified by categorising patient perceptions of severity of incontinence, and related sexual problems. The psychosomatic repercussions of infertility, miscarriage, stillbirth, and chronic pelvic pain are then appraised. Since physical and emotional pain can affect these conditions, timely recognition and biopsychosocial management helps promote positive physical, mental and social health. A special focus is given to endometrial implants outside the uterine cavity (endometriosis). These can cause chronic pelvic pain, infertility, and pregnancy loss, but may be symptomless. Their aetiology remains unclear. Ovulation suppression relieves pain and treatment is tentative, with removal of the affected pelvic organs being an extreme option. Even after this, however, symptoms may persist. A pathway using the tailored psychosomatic approach is advocated to provide patient-centred care where indicated.
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Shephard OAM, Mark, ed. Practical Guide to Global Point-of-Care Testing. CSIRO Publishing, 2016. http://dx.doi.org/10.1071/9781486305193.
Abstract:
Point-of-care testing (POCT) refers to pathology testing performed in a clinical setting at the time of patient consultation, generating a rapid test result that enables informed and timely clinical action to be taken on patient care. It offers patients greater convenience and access to health services and helps to improve clinical outcomes. POCT also provides innovative solutions for the detection and management of chronic, acute and infectious diseases, in settings including family practices, Indigenous medical services, community health facilities, rural and remote areas and in developing countries, where health-care services are often geographically isolated from the nearest pathology laboratory.
A Practical Guide to Global Point-of-Care Testing shows health professionals how to set up and manage POCT services under a quality-assured, sustainable, clinically and culturally effective framework, as well as understand the wide global scope and clinical applications of POCT.
The book is divided into three major themes: the management of POCT services, a global perspective on the clinical use of POCT, and POCT for specific clinical settings. Chapters within each theme are written by experts and explore wide-ranging topics such as selecting and evaluating devices, POCT for diabetes, coagulation disorders, HIV, malaria and Ebola, and the use of POCT for disaster management and in extreme environments. Figures are included throughout to illustrate the concepts, principles and practice of POCT.
Written for a broad range of practicing health professionals from the fields of medical science, health science, nursing, medicine, paramedic science, Indigenous health, public health, pharmacy, aged care and sports medicine, A Practical Guide to Global Point-of-Care Testing will also benefit university students studying these health-related disciplines.
3
Feinstein, Robert E., and Brian Rothberg. Violence. Oxford University Press, 2014. http://dx.doi.org/10.1093/med/9780199326075.003.0013.
Abstract:
Potentially violent patients need immediate attention and evaluation to determine their risk of imminent violence. A past history of violence is the best predictor of future violent behavior, and individuals who have committed violent acts in the past and have been arrested for assaultive behavior represent the highest risk; people who carry weapons or have access to weapons are of relatively high risk. Individuals with violent impulses who are either intoxicated or are in withdrawal have the most extreme risk for imminent violence. The treatment of acute aggression or agitation involves the judicious use of sedative-anxiolytics or low doses of second-generation antipsychotics. SSRIs have been used to treat aggressive, impulsive, and violent symptoms, particularly in individuals with head injuries, and lithium carbonate can reduce impulsive aggression to extremely low levels in some aggressive patients. Two Tarasoff decisions have become national standards for clinical practice regarding “duty to warn” and “duty to protect” all potential victims of life-threatening danger from a homicidal patient.
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Rivard, Mark J., Luc Beaulieu, and Bruce Thomadsen. Clinical Brachytherapy Physics. Medical Physics Publishing, 2017. http://dx.doi.org/10.54947/9781936366576.
Abstract:
Brachytherapy has been a popular topic for AAPM summer schools, with this marking the third time the subject has been covered (past schools on the topic were held in 1994 and 2005). This book was developed for the AAPM 2017 Summer School in Portland, Oregon, held in conjunction with the American Brachytherapy Association. From Joann Prisciandaro in Medical Physics…"Overall, this text is well written and provides a nice summary of current and developing clinical brachytherapy practice patterns. …from my perspective as a practicing brachytherapy physicist and educator, this text will make an extremely useful reference and will certainly be added to my list of required reading for residents and graduate students." This book is more than a comprehensive overview of the brachytherapy tools and techniques used in a modern clinic. The book also looks at numerous exciting approaches currently under development. Topics include HDR and LDR brachytherapy for the prostate, general planning and model-based dose calculation algorithms, intensity-modulated brachytherapy, electronic brachytherapy sources and techniques, and brachytherapy advances for treating skin, gynecological, and breast cancer. Some of the promising new techniques covered include focal therapy, the use of 3D printing to augment treatment, advances in needle tracking, in vivo dosimetry, and the use of robotics in brachytherapy.
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Gordon, Joanna K., and Mark C. Bellamy. Gastrointestinal physiology in anaesthetic practice. Edited by Jonathan G. Hardman. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0004.
Abstract:
The physiology of the human gut and gastrointestinal tract is complex. Studying it is difficult, and much of what we know relies on extrapolation from animal models. The interactions between normal physiology, deranged physiology, and anaesthetic drugs and procedures are likewise extremely complex, and in some cases paradoxical. A clear understanding of these is likely to be beneficial in achieving best clinical outcomes in anaesthesia for patients undergoing gastrointestinal tract procedures, but also for the critically ill patient undergoing coincidental anaesthetic procedures. Strategies aimed at monitoring the function of the gastrointestinal tract during anaesthesia have in the past been used as research tools, but have potential for use as therapeutic guides. However, further development of these technologies and clinical trials of their application are required, before any firm recommendation in this area can be made.
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Kulkarni, Kunal, James Harrison, Mohamed Baguneid, and Bernard Prendergast, eds. Haematology. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198729426.003.0011.
Abstract:
One of the great British contributions to medicine has been the development of the prospective randomized clinical trial as a method of assessing whether novel treatments demonstrate superiority over established therapy. This replacement of clinician preference, clinical impression, and anecdote by the design and rigorous evaluation of the results of well-designed studies has been enthusiastically embraced by haematologists the world over. The training of haematologists has always involved an understanding of the pathological and scientific processes that underlie blood disorders, engendering a rational clinical approach, and treatments used in the management of haematological disorders are toxic and difficult to use, involving considerable clinical expertise and expense. The widespread use of randomized clinical trials is therefore extremely beneficial to haematologists. The studies summarized within this chapter are examples of how research has influenced day-to-day clinical practice with immense and progressive benefit to patients.
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Cooper, Jill, and Nina Kite. Occupational therapy in palliative care. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199656097.003.0046.
Abstract:
Occupational therapy in palliative care aims to help patients achieve their optimum independence in activities that are important to them. The specific functional difficulties may include extreme fatigue, anxiety and shortness of breath due to advanced disease including metastatic spinal cord compression, fractures, or peripheral neuropathies. Patients may have problems with cognition and perception, body image, life role, and spiritual issues as well as physical disabilities. This chapter describes the broad range of areas in which the occupational therapist works in palliative care together with the interprofessional team. They take a key role in organizing and facilitating safe discharge and care at home, with the aim of achieving best quality of life and avoiding re-admission to hospital wherever possible. The occupational therapist analyses and assesses specific problems and provides a treatment programme or solution to help the patient remain as independent as possible, using clinical reasoning and evidence-based practice.
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Haica, Cristiana. Introducere in psihiatrie. Semiologia psihiatrica pentru psihologi. Editura Universitara, 2021. http://dx.doi.org/10.5682/9786062813437.
Abstract:
Evaluarea psihologica clinica este un proces etapizat, sistematic, extrem de complex, ce se adreseaza atat functiilor psihice cat si personalitatii umane, ce trebuie sa ia in considerare o multitudine de aspecte care adesea nu sunt evidente, nici aparente. Inainte de a primi tratament medicamentos sau prin interventie psihologica, orice client trebuie sa treaca prin aceasta etapa fundamentala - evaluarea psihologica ce poate face ca terapia sa poata fi eficienta si adecvata. Este extrem de important ca evaluarea psihologica ce preceda interventia psihologica sa fie efectuata in baza unor ipoteze clinice, multimodal si corect, asa cum este prezentata in acest volum. Rezultatele evaluarii clinice trebuie, ulterior evaluarii, formulate intr-un limbaj profesionist, de specialitate, comun psihologiei si psihiatriei. Accesul viitorilor psihologi la acest vocabular de specialitate trebuie sa se faca inca de pe bancile facultatii, cunoasterea semnelor si simptomelor bolilor psihice, a principalelor entitati semiologice psihiatrice fiind extrem de importanta. Scopul urmarit de aceasta carte este acela de a oferi un set rezonabil de informatii de specialitate abordate intr-o maniera didactica, fluida, pornind de la principii de baza si continuand cu metode de lucru, cazuri particulare si analiza diverselor cadre in care acestea pot fi puse in practica. Importanta temei abordate deriva din binomul formare informare. Acest volum este deci important din perspectiva formativa pentru ca pune la dispozitia studentilor, masteranzilor in psihologie, psihologilor cu competente in consiliere, psihoterapie, psihologie clinica, dar si a celor cu alte competente, altor lucratori in domeniul sanatatii mintale, un ghid exhaustiv de semiologie a manifestarilor modurilor normale sau anormale in care fiecare proces si functie psihica poate functiona, imbogatite cu exemple din cazuistica proprie a autoarei sau din literatura de specialitate, ce faciliteaza considerabil intelegerea. Valenta informativa vine din adresarea catre categoria larga a altor persoane care sunt interesate de perspectiva psihologiei asupra bolii psihice.
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Steiner, Hans, Whitney Daniels, Christina Stadler, and Michael Kelly. Disruptive Behavior. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190265458.001.0001.
Abstract:
Disruptive behavior is extremely common in normal and clinical populations. This book addresses its development, the newly grouped diagnoses associated with it (disruptive behavior disorders), and their biopsychosocial causes and treatment. The past decade has seen a great deal of progress in the psychiatric and psychological literature, which has greatly advanced our understanding of these disorders. The book discusses state-of-the-art studies of taxonomy, epidemiology, etiology, and treatment. Each chapter concludes with a thorough discussion of the clinical implications of this new information, exemplified by real case material. A whole chapter is devoted to the forensic implications of this important grouping of disorders. The chapter begins with a discussion of the exemplary cases in the legal literature, providing the clinician and the expert with a concise briefing of the legal underpinnings of these disorders, which in essence seek to bring the world of medicine to the world of crime. The final chapter provides a concise summary of all preceding chapters, summarizing what we have learned and showing the way into the future in terms of basic research, translational research, and clinical practice. Sources and resources are provided for clinicians, researchers, teachers, primary care physicians, criminologists, forensic experts, and interested lay people.
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Stanghellini, Giovanni, Matthew Broome, Andrea Raballo, Anthony Vincent Fernandez, Paolo Fusar-Poli, and René Rosfort, eds. The Oxford Handbook of Phenomenological Psychopathology. Oxford University Press, 2018. http://dx.doi.org/10.1093/oxfordhb/9780198803157.001.0001.
Abstract:
For about one century the catalogue of books in phenomenological psychopathology has been tremendously rich in essays, but remarkably poor in handbooks. Even the cornerstone of our canon, Jaspers’ General Psychopathology, originally written as a textbook, can hardly be given to a student as a basic reading. This makes extremely difficult teaching the fundamentals of our discipline. Students ask for manualized knowledge expecting teachers to explain them what-exactly-must-be-done-in-a-given-circumstance. This Handbook is meant to fill these gaps. It includes a detailed, thorough and reader-friendly description of philosophical and clinical key-concepts and constructs, and of the contributions of leading figures of phenomenological psychopathology. It establishes clear connections between psychopathological knowledge and clinical practice. It liaise phenomenological psychopathology to contemporary debates in nosography, clinical epistemology, research and the neurosciences. It’s stronger benefit is that it brings together evidence-based with person-based knowledge. All learning is based on process of recognition. ‘Recognition’ means identification of someone or something from previous encounters or knowledge. In standard clinical training this process is called ‘diagnosis’ and evidence-based diagnostic skills are deemed fundamental. Students are spot-on when soliciting this kind of knowledge to be regimented and normalized. Yet ‘recognition’ has a second meaning: acknowledging the absolute singularity of what is out there. To recognize someone or something means to be able to tolerate its otherness. This kind of recognition is a practice in which epistemology is in touch with ethics. Whereas recognition qua identification or diagnosis is an act of recollection based on previously acquired knowledge, recognition qua acknowledgement is an ethical act of acceptance of the unique being-so of the other person or state of affairs. The Handbook of Phenomenological Psychopathology engages in bringing together these two kinds of ‘recognition’ and establish a solid as well as flexible framework for the clinic of mental disorders.
Book chapters on the topic "“Extreme” clinical practice":
1
Krausz, Csilla, and Ginevra Farnetani. "Clinical Interpretation of Semen Analysis." In Practical Clinical Andrology, 173–84. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-031-11701-5_13.
Abstract:
AbstractSemen analysis is a fundamental step in the evaluation of the male fertility potential. However, fertility is a “couple-concept” implying the importance of the partner’s fertility status. In fact, a part from extreme conditions (e.g., azoospermia, necrozoospermia, total immotile spermatozoa, etc.) sperm parameters are not fully predictive for natural pregnancy. Semen analysis is divided into macroscopic and microscopic evaluation, and it provides information on the efficiency of spermatogenesis and the integrity of post-testicular structures. Based on the WHO reference values, it is possible to identify alterations of semen parameters, which may derive from many different etiologies. It is essential that the laboratory performs the analysis according to the current WHO guidelines and participate at an external quality control (EQC) program. The clinical interpretation of these alterations is the focus of this chapter.
2
Baljinder, Singh, Watts Ankit, Amit Singh Shekhawat, Singh Ashwin, Pankaj Malhotra, Abdul Waheed, Kaur Harneet, et al. "CXCR4 Theranostics: A Potential Game Changer in Solid Tumors and Hematological Malignancies." In Beyond Becquerel and Biology to Precision Radiomolecular Oncology: Festschrift in Honor of Richard P. Baum, 309–20. Cham: Springer International Publishing, 2024. http://dx.doi.org/10.1007/978-3-031-33533-4_31.
Abstract:
AbstractAn overexpression of CXCR4 receptors is reported in at least 30 different human solid tumors and hematological malignancies. This overexpression is often associated with tumor aggressiveness, increased risk of metastasis, and a higher probability of recurrence, which in turn leads to a poor prognosis. No in vivo method suitable for whole-body CXCR4 disease quantification has been described and this unmet clinical need or the scientific question has been reported recently. 68Ga-Pentixafor which is a CXCR4 targeting high-affinity PET imaging probe and the tracer has been evaluated in multiple myeloma, lymphoproliferative disorders, and in lung carcinoma, and the imaging results are extremely promising. Human dosimetry studies demonstrated excellent pharmacokinetics and low radiation burden to patients. The clinical applications of 68Ga-Pentixafor/177Lu/213Bi-Pentixather as a “theranostics pair” for the diagnosis and treatment of CXCR4-expressing cancers are emerging. CXCR4-based theranostics, which had not been investigated in clinical practice till now (except few preliminary proof-of-concept studies), may be a potential game changer both in the diagnosis and treatment of CXCR4 overexpressing solid tumors and hematological malignancies in which all other available treatment options have eventually failed.
3
Kuralić-Ćišić, Lejla, Meliha Bijedić, Irma Dobrinjic, Nermina Kravić, Aida Duraković, and Dajana Stajić. "Online Counseling “The World Without a Label”." In International Perspectives in Values-Based Mental Health Practice, 359–64. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-47852-0_42.
Abstract:
AbstractThe online platform is a platform of the future, both in the world and in Bosnia and Herzegovina. “The World Without a Label” is the first counseling center of this kind in BiH, because it brings together experts from behavioral, psychological, and psychiatric problems in one place. As a special problem of sociopolitical context is victims of sexual violence, war rape crimes. A case study shows a young boy is accompanied by a parent due to behavioral problems manifested by extremely bad social interaction with peers and for spending most of his free time on his computer playing video games. The boy’s mother had previously been treated in a psychiatric clinic’s day hospital, where she shared her own trauma of rape in group psychotherapy and the painful problems she faced in her early 20s, where Republika Srpska Army soldiers systematically raped captured Bosniaks. The father is a former member of the Bosnian army, and he himself had lot of war traumas. Experience in working in the Counseling Centers like this one, as well as with all the scientific and technological achievements, we have enabled the development of procedures for solving mental health problems through online platforms and standardization of those procedures.
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Voits, Toms. "Chapter 17. Role of bilingualism in neurodegenerative disease II." In Studies in Bilingualism, 357–73. Amsterdam: John Benjamins Publishing Company, 2023. http://dx.doi.org/10.1075/sibil.64.17voi.
Abstract:
Over the past decades, bilingualism has emerged as a potential factor having a significant impact on cognition and brain structure. Such research typically examines the effects of bilingualism in healthy children and adults. Conversely, the body of literature examining bilingualism effects in aging populations remains comparatively small. This holds especially true with regards to effects of bilingualism in clinical aging populations. Current evidence suggests that bilingualism might contribute to delaying the expression and/or progression of the symptoms of Alzheimer’s dementia for as much as 5 years. To the extent bilingualism plays an ameliorative role at all, it seems reasonable to expect that it would have similar effects for other neurodegenerative disorders. Nevertheless, relevant studies examining disorders other than Alzheimer’s Disease or Mild Cognitive Impairment are extremely limited. Despite compelling reasons to the contrary, the few relevant studies that do exist are not properly linked, nor appreciated as a meaningful cohort in their own right. Making links across neurodegenerative disorders and bilingualism, to the extent possible, serves both practical health-related and theoretical-oriented needs. This chapter considers whether the currently available evidence is sufficient to allow for claims of bilingualism conveying more general protective effects in clinical aging while identifying gaps in our knowledge and recommending future work to better understand these proposed links.
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Graham, Philip. "13. Legacies." In Susan Isaacs, 287–312. Cambridge, UK: Open Book Publishers, 2023. http://dx.doi.org/10.11647/obp.0297.13.
Abstract:
Her entry in The Oxford Dictionary of National Biography describes Susan Isaacs as ‘the greatest influence on British education in the twentieth century.’ Whether or not this claim is justified, there is no doubt that so-called child-centred education became a much more powerful element in educational practice during the twentieth century and that, as far as infant and primary education were concerned, Susan Isaacs was highly influential in producing this change. The 1967 Plowden Report on primary education was largely built on her views. The reaction to extreme progressive views in the fourth quarter of the twentieth century with increasingly prescriptive curricular changes would not have been to her liking. In contrast, the last quarter of the twentieth century saw a strong confirmation in psychoanalytic circles of the Kleinian theory Susan Isaacs had supported. The Tavistock Clinic, with its emphasis on early infancy and the importance of fantasy and play in personality development became the pre-eminent centre for psychoanalytic research and teaching in the UK. However, the major changes in the field of child development that occurred in the later part of the twentieth century, namely the explosion in the application of the neurosciences and genetics owed little or nothing to Susan Isaacs. Further, it cannot be said that she contributed to the growth of interest in studies evaluating the effectiveness of different forms of therapy.
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Pirelli, Gianni, and Sarah DeMarco. "Guns and the Law." In Firearms and Clinical Practice, 35—C2S25. Oxford University PressNew York, 2023. http://dx.doi.org/10.1093/med-psych/9780190923211.003.0002.
Abstract:
Abstract This chapter provides medical and mental health professionals with essential information related to the intersection of guns and the law. The Second Amendment is reviewed, along with landmark rulings by the Supreme Court of the United States. Federal and state mental health–related prohibitions are addressed as well as those associated with domestic violence, including but certainly not limited to domestic violence–related protective (restraining) orders. “Red flag” laws are then addressed, which are more formally referred to as gun violence restraining orders and extreme risk protection orders, followed by a review of gun rights restoration and relief from disability mechanisms at the federal and state levels. The chapter concludes with an overview of reporting duties of medical and mental health professionals in the overarching risk context as well as particularly relevant gun ownership and safety laws (i.e., magazine capacity, storage, transportation, and right to carry).
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Zaldivar, Roberto. "Bioptics and Adjustable Refractive Surgery for Extreme Ametropia: Current Concepts." In Refractive Surgery with Phakic IOLs: Fundamentals and Clinical Practice, 169. Jaypee Brothers Medical Publishers (P) Ltd., 2013. http://dx.doi.org/10.5005/jp/books/11754_12.
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Rizvi, Tanu, Devanand Bhonsle, Roshni Rahangdale, and Jaspal Bagga. "A Survey on Behavioral Change During the COVID-19 Outbreak in India." In Advances in Medical Technologies and Clinical Practice, 184–203. IGI Global, 2022. http://dx.doi.org/10.4018/978-1-7998-9831-3.ch009.
Abstract:
This study describes the immediate and long-term effects in behavioral and psychological symptoms due to COVID-19. To handle the situation, the Indian government tried in various levels lockdown, scanning of the patients, social distancing, compulsorily wearing the mask, vaccination, quarantine centers, etc., but in the long-term, all these activities affected social and physiological status. In extreme cases, people suffer from depression, which can be characterized by various factors like tiredness, poor sleep, pessimism, guilt, hopelessness, lack of confidence, low mood, gradual reduction in work output, loss of appetite, feeling helpless, loneliness, etc.
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Grocott, Patricia. "Managing Wounds." In Adult Nursing Practice. Oxford University Press, 2012. http://dx.doi.org/10.1093/oso/9780199697410.003.0039.
Abstract:
This chapter addresses the vital area of wound care, including the impact that wounds can have upon patients and their families, and the nursing management challenges that they present. As a registered nurse caring for patients with wounds, you will be responsible for making a clinical assessment of the patient with a wound, making clinical decisions based on the most appropriate evidence-based, nurse-led interventions, and, crucially, measuring patient outcomes. The latter involves continuous monitoring of how both the patient and his or her wound is responding, or not, to the treatment and care that you give. This chapter presents a generic approach to wound management, and this should help you to deliver high-quality, safe wound care for patients with wounds of differing aetiologies. This includes core components of interventions for acute, chronic, and palliative wound care. Importantly, the chapter has been designed to help you to make the links between assessment, clinical decision-making, nursing interventions, and patient care. Nurses play a key role in the multidisciplinary team in the delivery of wound care, and frequently act as the ‘point of contact’ for the manufacturers and suppliers of wound care products. The approach advocated in this chapter will equip you to make informed assessments and clinical decisions. Wounds are injuries to the body, the skin in particular, causing a breach of the layers of skin (see Chapter 12 Understanding Skin Conditions) and the body boundary. The term ‘wound’ also defines the act of injuring a person’s skin. This may be deliberate, e.g. during a surgical procedure, or deliberate to cause harm, e.g. during warfare, terrorist attacks, or domestic and street violence. Wounding can also occur with accidents (a cut from a kitchen knife), natural disasters (earthquake), and exposure to environmental stresses such as extreme heat (burns, skin cancers), extreme cold (frostbite), excessive pressure, and excessive exposure to water and moisture (trench foot). Wounds also develop because of diseases and conditions such as diabetes, which disrupt the structures of the skin and the normal metabolic processes that maintain skin health (see Chapter 9 Understanding Diabetes Mellitus).
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Eyupoglu, Can. "Epileptic Seizure Detection Using Machine Learning Techniques." In Advances in Medical Technologies and Clinical Practice, 187–200. IGI Global, 2021. http://dx.doi.org/10.4018/978-1-7998-6527-8.ch009.
Abstract:
Epilepsy is a brain disorder that can be defined as a short-time and temporary occurrence of symptoms because of abnormal extreme or synchronous neuronal activity of the brain. Almost one percent of the world's population is struggling with epilepsy illness. The detection of epileptic seizures is mainly realized with reading the electroencephalogram (EEG) recordings by medical doctors due to the unpredictable and complex nature of the disease. This process takes much time and depends on the expert's experience. For this reason, automatic seizure detection using EEG recordings is necessary and of great importance for the comfort of medical doctors and patients. While detecting epileptic seizure automatically, machine learning techniques are used in the field of computer science. This chapter deals with the methods, approaches, models, and techniques which are utilized to detect epileptic seizures.
Conference papers on the topic "“Extreme” clinical practice":
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Car, Zlatan, Nikola Anđelić, Ivan Lorencin, Jelena Musulin, Daniel Štifanić, and Sandi Baressi Šegota. "APPLICATION OF ARTIFICIAL INTELLIGENCE-BASED IMAGE ANALYSIS IN BIOINFORMATICS." In 1st INTERNATIONAL Conference on Chemo and BioInformatics. Institute for Information Technologies, University of Kragujevac,, 2021. http://dx.doi.org/10.46793/iccbi21.047c.
Abstract:
The collection of image data is an extremely common procedure in clinical practice today. Many of the diagnostic approaches generate such data – computed tomography (CT), X-ray radiography, magnetic resonance imaging (MRI), and others. This data collection process allows for the use of computer vision approaches to be applied with the goal of analysis and diagnostics. Artificial Intelligence (AI) based algorithms have repeatedly been shown to be the best performing computer vision algorithms, in many fields including medicine. AI-based – or more precisely machine learning (ML) based, algorithms have capabilities which allow them to learn the patterns contained in the data from the data itself. Among the best performing algorithms are artificial neural networks (ANNs), or more precisely convolutional neural networks (CNNs). Their pitfall is the need for the large amounts of data – but as it has been previously mentioned, the amount of data collected in today’s clinical practice is large and ever increasing. This allows for the development of Smart Diagnostic systems which are meant to serve as support systems to the health professionals. In this paper first, the standard practices and review of the field is given – with the focus on challenges and best practices. Then, multiple examples of the research applying AI-based algorithm analysis are given – including diagnostics of various cancer types (bladder and oral) as well as COVID-19 severity diagnostics and image quality determination.
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SILVA, SERGIO E. LEMOS DA, THALITA VIEIRA VINHAL, GUSTAVO PAULA DE OLIVEIRA, GABRIELA FRATARI FREITAS, LUANNA DE SOUZA FERNANDES, and HEMONIELLE GOMES DE MELO SILVEIRA. "PREVALENCE AND INCIDENCE OF CLINICAL AND SUBCLINICAL BOVINE MASTITIS IN A DAIRY HERD IN THE SOUTHEAST OF GOIÁS, BRAZIL." In II South Florida Congress of Development. brazco, 2022. http://dx.doi.org/10.47172/iisfcdv2022.0023.
Abstract:
Bovine mastitis is a disease of extreme importance to the dairy production chain, since it causes economic losses in production. Mastitis is an inflammatory disease that affects the mammary glands. There are two forms of presentation of the disease, the clinical and subclinical, requiring diagnostic tests to differentiate them. This article aimed to verify the prevalence and incidence of mastitis in a dairy farm located in the southeast of the state of Goiás. To carry out this research, the Somatic Cell Count (SCC) test was used. The results showed 54% mastitis prevalence, a lower value if compared to other studies. The incidence of clinical mastitis was also low, and it was possible to observe periods of more than 30 days without any identification of new cases, due to the care taken on the property, such as the correct management of the herd and milking, hygiene and the use of qualified labor. According to the SCC findings, it can be inferred that the low values of the epidemiological indicators analyzed may be associated with good management and hygiene practices practiced on the property, reducing the prevalence and incidence of mastitis.
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Poigai Arunachalam, Shivaram, Mustafa Sir, Gomathi Marisamy, Annie Sadosty, David Nestler, Thomas Hellmich, and Kalyan S. Pasupathy. "Optimizing Emergency Department Workflow Using Radio Frequency Identification Device (RFID) Data Analytics." In 2017 Design of Medical Devices Conference. American Society of Mechanical Engineers, 2017. http://dx.doi.org/10.1115/dmd2017-3402.
Abstract:
Emergency Department (ED) is a complex care delivery environment in a hospital that provides time sensitive urgent and lifesaving care [1]. Emergency medicine is an unscheduled practice and therefore providers experience extreme fluctuations in their workload. ED crowding is a major concern that affects the efficacy of the ED workflow, which often is challenged by long wait times, overuse of observation units, patients either leaving without being seen by a provider and non-availability of inpatient beds to accommodate patients after diagnosis [2]. Evaluating ED workflow is a challenging task due to its chaotic nature, with some success using time-motion studies and novel capacity management tools are nowadays becoming common in ED to address workflow related issues [3]. Several studies reveal that Electronic Medical Record (EMR) adoption has not resulted in significant ED workflow improvements nor reduced the cost of ED operations. Since raw EMR data does not offer operational and clinical decision making insights, advanced EMR data analytics are often sought to derive actionable intelligence from EMR data that can provide insights to improve ED workflow. Improving ED workflow has been an important topic of research because of its great potential to optimize the urgent care needed for the patients and at the same time save time and cost. Radio Frequency Identification Device (RFID) is a wireless automatic identification and data capture technology device that has the potential for improving safety, preventing errors, saving costs, and increasing security and therefore improving overall organizational performance. RFID technology use in healthcare has opened a new space in healthcare informatics research that provides novel data to identify workflow process pitfalls and provide new directions [4]. The potential advantages of RFID adoption in healthcare and especially in ED has been well recognized to save costs and improve care delivery [5]. However, the large upfront infrastructure costs, need for an integrated health information technology (HIT), advanced analytical tools for big data analysis emerging from RFID and skilled data scientists to tackle the data to derive actionable intelligence discourage many hospitals from adoption RFID technology despite its potential advantages. Our recent pilot study on the RFID data analytics demonstrated the feasibility of quantifying and analyzing two novel variables such as ‘patient alone’ time defined as the total time a patient spends alone without interaction with a health care staff in the ED and ‘provider time’ defined as the total time a patient spends interacting with any health care staff [6]. The study motivated a more comprehensive big data analytics of RFID data which can provide better insights into optimizing ED workflow which can improve the quality of care in the ED and also reduce cost. In this work, the authors attempt to describe the RFID adoption in the ED at the Saint Mary’s Hospital at Mayo Clinic, in Rochester, MN, a level one trauma center both for children and adults as a step towards optimizing ED workflow.
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Yu. A., Tikhmeneva, Mironova E.R., and Krikunova A.A. "KIDNEY PATHOLOGIES IN CATS." In OF THE ANNIVERSARY Х INTERNATIONAL SCIENTIFIC AND PRACTICAL CONFERENCE «INNOVATIVE TECHNOLOGIES IN SCIENCE AND EDUCATION» («ITSE 2022» CONFERENCE). DSTU-Print, 2022. http://dx.doi.org/10.23947/itse.2022.228-231.
Abstract:
The anatomical and physiological features of the urinary system of cats make it extremely vulnerable, as a result of which pathological processes often develop in the tissues of organs, in particular the kidneys. Such processes are characterized by an erased clinical picture and a latent chronic course, as a result of which they are not diagnosed in time, which leads to the development of renal failure of varying severity. In this article, we conducted a literature review of the most common pathologies leading to chronic cat disease.
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Nilsson, K., and P. Friberqer. "CHROMOGENIC ENDOTOXIN ASSAYS. - FURTHER METHOD DEVELOPMENT AND PRACTICAL EXPERIENCE." In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1644254.
Abstract:
A kit for the determination of endotoxin by using Lumulus lysate (LAL) and a chromogenic substrate has now been available for three years. Here we will summarize the present status concerning its usefulness in the control of parenteral drugs, in hygienic control and in clinical diagnosis.The wide variation of uses, demands considerable work for method adaptation to the various types of specimen and laboratory. Almost all samples have to be pretreated to become compatible with the reagents in the assay. It has also been found to be important to consider variousdemands depending on the number of samples, how fast the answer is wanted, simplicity and accuracy of the assay that is needed as well as equipment available. In some cases a single screening test is required. Then a tube with 100 pi of LAL reagent can be taken from the freezer. The other extreme is the determination of hundreds of samples in each series. Then microplates and suitable readers can be of great help. Several other procedures used on special occasions allowing e.g. wide assay range or low reagent cost will also be presented.Manual and microplate procedures have been found suitable and can be made safe regarding contamination and losses of endotoxin. Single stage and micro methods have been tested and found to work. Data concerning material and laboratory equipment have been collected and are now available.By using a quantitative procedure forthe determination of the small amounts of endotoxin present in most samples, it has been possible to find optimal reaction conditions and to trace various kindsof errors. Procedures for method controland trouble shooting are also suggested.
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Marquezin, Thiago, and Felipe Lourenço. "iClinic: Software specialized in management of clinics and medical offices." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.544.
Abstract:
Introduction: iClinic is a company that develops software with the purpose of assisting the doctor in the business management of his office or clinic. We believe that healthcare professionals are increasingly intertwined with technology. With that in mind, we offer an efficient and intuitive system, allowing our users to increase their productivity, reduce costs, decrease the no show rate and save time so that they can focus on humanized service. Methodology: A study was structured in order to understand what the doctors’ difficulties were when they became entrepreneurs. In order to contribute to the health area and when realizing that professionals are unassisted in the face of technological advances in their routines, iClinic has developed software capable of managing essential medical care tasks, namely: administrative management, medical records and electronic prescription, agenda service, telemedicine and online appointment scheduling. Results: Through market studies, interviews, routine monitoring of offices and clinics, it was found that the stored information of patients was largely contained in paper charts, notebooks, diaries and spreadsheets. Therefore, the insertion of technology in the administrative routine of offices and clinics was extremely important. With the use of the software, doctors obtained greater control of information, better management of time, financial control, reduction in the show and increase in the number of consultations. Conclusion: The health sector has stood out over the years and iClinic has as a pillar to encourage the evolution of good practices using technology, so the software developed by iClinic contributes immensely to the doctor or professional who runs the clinic and / or office increase the level of organization and efficiency, as the use of technology in administrative activities is indispensable in the globalized world.
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Kojić, Miloš. "A review of the application of the finite element smeared concept to biomedical engineering problems." In 2nd International Conference on Chemo and BioInformatics. Institute for Information Technologies, University of Kragujevac, 2023. http://dx.doi.org/10.46793/iccbi23.006k.
Abstract:
The biomechanical and biochemical processes in the biological systems of living organisms are extremely complex. Advances in understanding these processes are mainly achieved by laboratory and clinical investigations, but in recent decades they are supported by computational modeling. Besides enormous efforts and achievements in this modeling, there still is a need for new methods which can be used in everyday research and medical practice. In this review, first are presented the basic assumptions in the formulation of the smeared concept, termed as Kojic Transport Model (KTM) model - introduced by the author several years ago. Then, it is demonstrated the distinction and advantages of the KTM by referring to selected publications in the literature. Application of the KTM is illustrated on several examples which include drug delivery in tumors, heart electrophysiology, and lung airflow and molecular transport by diffusion.
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Tubaldi, Eleonora, Giovanni Ferrari, Prabakaran Balasubramanian, and Marco Amabili. "Dynamic Behaviour of a Dacron Aortic Graft." In ASME 2019 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 2019. http://dx.doi.org/10.1115/imece2019-11520.
Abstract:
Abstract Woven Dacron grafts are still considered the clinical standard practice in thoracic vascular reconstruction in the case of aortic aneurysm and acute dissection. Despite its characteristics of biocompatibility and durability, very little is known about the dynamic response of Dacron grafts and about their side effects on the heart workload and cardiovascular system. In this study, physiological blood flow conditions are imposed in a Dacron graft via a specifically-developed mock circulatory loop. The effects of different physiological pulsation-per-minute rates are investigated. Since the Dacron prosthesis is extremely stiffer circumferentially and compliant axially with respect to an aortic segment of the same length, bending oscillations are preferred by the graft. This leads to a very significant different dynamic behavior with respect to the replaced human aortic portion altering cardiovascular pressure and blood flow dynamics and eventually causing long-term implant complications.
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Cabero, Flávia Vidal, Ruffo Freitas-Junior, Rosângela da Silveira Corrêa, Danielle Cristina Netto Rodrigues, Leonardo Ribeiro Soares, and Paola Ferreira de Freitas. "CLINICAL IMAGE QUALITY EVALUATION OF MAMMOGRAPHY FOR BREAST CANCER SCREENING." In Abstracts from the Brazilian Breast Cancer Symposium - BBCS 2021. Mastology, 2021. http://dx.doi.org/10.29289/259453942021v31s2053.
Abstract:
Objectives: To evaluate mammographic image quality in a real clinical practice scenario for breast cancer screening. Materials and Methods: Observational prospective study where images from digital mammograms from Diagnostic Service (DS) in the state of Goiás in 2019 were analyzed. A specific protocol was created based on evaluation criteria of the Brazilian College of Radiology, European Guidelines, and American College of Radiology. For each variable, score 1 was attributed to conformity and zero for nonconformity. Logistic regression model was utilized using the following independent variables: location (city vs. country), Public health system – Sistema Unico de Saude (SUS) (public vs. private), number of monthly examinations (≤300 vs. >300), device manufacturing year (≤2011 vs. >2011), and breast density (≤75% vs. >75% of the parenchyma). Results: Of the 163 fully functioning mammograms, 151 (92.6%) were eligible, providing 1,024 images. We evaluated 12,032 items, of which 4,096 were craniocaudal projections, 4,608 mediolateral oblique projections, and 3,328 equipment related. On the clinical image analysis as to the positioning of the patient, the higher conformity for symmetry parameters, in both projections (>90%), was observed. The conformity rate among the other parameters varied from 18.6% to 100%. In the multivariable analysis, it was observed that only the variables monthly examinations (OR 3.44; 95%CI 1.67–7.09; p=0.0008) and mammogram device manufacturing year (OR 2.46; 95%CI 1.02–5.95; p=0.04) were related to a higher conformity rate. After the percentage consolidation conformity rate per DS, as to the final clinical mammography quality, no DS presented desirable conformity (>90%), 20 DS obtained acceptable conformity (between 70% and 89%), and 10 DS presented conformity below 70%. Conclusion: Conformity rate of mammographic examination is extremely low and varies according to the multiple parameters analyzed. Mammographies performed at centers with less productivity (≤300/monthly) and with newer devices (>2,011) presented higher chances of conformity at the clinical imaging evaluation.
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Porumb, Andra-Teodora, Adina Săcara-Oniţa, and Cristian Porumb. "THE DENTAL MEDICINE SECTOR IN THE AGE OF THE COVID-19 PANDEMIC – RECOVERY BETWEEN RISKS AND CHALLENGES." In Sixth International Scientific-Business Conference LIMEN Leadership, Innovation, Management and Economics: Integrated Politics of Research. Association of Economists and Managers of the Balkans, Belgrade, Serbia, 2020. http://dx.doi.org/10.31410/limen.2020.101.
Abstract:
In this paper we will show how the COVID-19 pandemic has affected one of the sectors that have undergone a booming development in recent years, namely the sector of dental medicine. This is an industry that includes numerous and diversified activities: treatments and surgical interventions in dental practices and clinics, dental aesthetics interventions in luxury clinics, the organization of specialization courses, conferences and congresses, the development of extremely innovative procedures and materials. Dental tourism has also had a spectacular trend, especially in Eastern European countries. Within a very short period of time, this highly profitable field, but which presents a huge risk of transmitting potential viruses, has recorded significant financial losses. In March 2020, in some European countries a lockdown was imposed by governmental decree or ordinance, all private practices having ceased their activity, whereas in other countries a significant number of clinics closed on their own initiative, and those remaining open recorded a staggering decrease in the number of patients. Courses, conferences, and congresses have been cancelled one after another throughout Europe. As a result of the cancellation of many flights, the activity in the branch of dental tourism has ceased almost entirely. For two months, an extremely small number of medical units, especially hospitals, were reorganized to provide care in dental emergencies, according to a very strict protocol to limit the risk of contamination. In view of resuming their activity as of May, professionals in the sector had to meet several severe protection conditions, regulated by institutional documents by the National Orders/Colleges of Dentists. In October, in the face of the second wave of the pandemic, the governments of European countries took less restrictive measures in an attempt to avoid a new lockdown and the decrease in the supply of goods and services to the population to such a great extent, so this time, governments have not closed private practices, despite the fact that in some countries the beginning of November has brought about a new isolation – albeit a partial one – and a renewed closedown of some businesses. We will analyze, in the context of the ongoing pandemic, the situation of this sector in several European countries. Given that the demand for dental services has only decreased very little, professionals in the sector have tried in various ways to continue their work so as not to sacrifice the dental health of the population. The risk/benefit ratio is very hard to manage in this field, so precautions, prevention, and protection measures in dental practices remain of the utmost importance. If the branch of organization of courses, conferences, congresses can compensate to a certain extent the sharp decline in revenues during the lockdown period by moving the activity on online platforms, the branch of dental tourism is still suffering massively, and the possibilities of recovery are greatly reduced. Dentists remain the most exposed to risks. They are facing medical and financial concerns and have to make final treatment decisions amidst an uncertain and dangerous situation
Reports on the topic "“Extreme” clinical practice":
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Pereira, João, André Moreira, Joana Azevedo, David Ferreira, Elisabete Ribeiro, Pedro Varanda, and Luís Rodrigues. Application of Tenodesis for an Extremely Rare Hand Extensor Injury in an Athlete: A Case Report. Science Repository, April 2024. http://dx.doi.org/10.31487/j.ijscr.2024.01.03.
Abstract:
Spontaneous tendon ruptures of the wrist are a rare pathology, usually secondary to rheumatoid arthritis or distal radius fractures and most commonly evolving the extensor pollicis longus. Sport-related etiology is a growing tendency of this pathology. As far as the authors know, this is one of the first sport-related extensor carpi radialis brevis (ECRB) isolated spontaneous rupture described in the literature. We describe a case of a 41 year-old female amateur kickboxer who developed acute dorsal radial pain in the right wrist during practice. After attempting conservative treatment for 4 months with rest and NSAIDs she recurred at our clinic. Local pain at dorsal wrist extension was observed. MRI demonstrated an isolated ECRB rupture with associated fibrous tissue proximal to the extensor retinaculum. Surgical management was proposed and consisted of fibrous tissue debridement and ECRB-ECRL tenodesis. At 3 months of follow-up the patient reported return-to-play with impaired wrist motion and mild pain at maximum wrist extension. At 12 months of follow-up the patient was completely recovered and asymptomatic. Isolated tendon ruptures are a rare pathology, causing extreme pain and disability in the sport setting. Surgical management of this ECRB tendon rupture by tenodesis allowed for appropriate pain control and functional results and early return-to-play.