Tìm thấy 20+ kết quả cho từ khóa "Clinical Medicine"
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The inexperienced medical student or resident, who has not yet learned the patterns most prevalent in clinical medicine, must work much harder to. achieve the same result and is often at risk of missing the important clinical problem in a sea of compulsively collected but unhelpful data..
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Decision-Making in Clinical Medicine. Clinical Practice Guidelines. According to the 1990 Institute of Medicine definition, clinical practice guidelines are "systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances.". First, guidelines are created using the tools of EBM.
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Decision-Making in Clinical Medicine. Major Influences on Clinical Decision-Making. More than a decade of research on variations in clinician practice patterns has shed much light on forces that shape clinical decisions. as detailed above, provides a partial explanation, but several other key factors play an important role in shaping diagnostic hypotheses and management decisions.
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Applications of Stem Cell Biology in Clinical Medicine. Applications of Stem Cell Biology in Clinical Medicine: Introduction. Endogenous stem cells in tissues such as liver and skin have a remarkable ability to regenerate the organs, whereas heart and brain have a much more limited capability for self-repair. Under rare circumstances, circulating stem cells may contribute to regenerative responses by migrating into a tissue and differentiating into organ-specific cell types.
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Decision-Making in Clinical Medicine. Sources of Evidence: Clinical Trials and Registries. The notion of learning from observation of patients is as old as medicine itself. The major tools used to develop reliable evidence consist of the randomized clinical trial and the large observational registry.
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Gene Therapy in Clinical Medicine. The power and versatility of gene transfer approaches are such that there are few serious disease entities for which gene transfer therapies are not under development. Besides those already discussed, other areas of interest include gene therapies for HIV and for neurodegenerative disorders.
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Decision-Making in Clinical Medicine. Statistical Prediction Models. Bayes' theorem, as presented above, deals with a clinical prediction problem that is unrealistically simple relative to most problems a clinician faces.. Prediction models, based on multivariable statistical models, can handle much more complex problems and substantially enhance predictive accuracy for specific situations.
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Applications of Stem Cell Biology in Clinical Medicine. The use of stem cells in regenerative medicine has been studied for many other organ systems and cell types, including skin, eye, cartilage, bone, kidney, lung, endometrium, vascular endothelium, smooth muscle, striated muscle, and others. In fact, the potential for stem cell regeneration of damaged organs and tissues is virtually limitless.
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The Practice of Genetics in Clinical Medicine. Many disorders exhibit the feature of locus heterogeneity, which refers to the fact that mutations in different genes can cause phenotypically similar disorders. For example, osteogenesis imperfecta (Chap. 86) can each be caused by mutations in distinct genes. The pattern of disease transmission, clinical course, and treatment may differ significantly, depending on the specific gene affected.
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Gene Therapy in Clinical Medicine. Long-Term Expression in Genetic Disease: In Vivo Gene Transfer with Recombinant Adeno-Associated Viral (AAV) Vectors. Recombinant AAV vectors have emerged as attractive gene delivery vehicles for genetic disease. Engineered from a small replication-defective DNA virus, they are devoid of viral coding sequences and trigger very little immune response in experimental animals.
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Gene Therapy in Clinical Medicine. Another local approach uses adenoviral-mediated expression of the tumor suppressor p53, which is mutated in a wide variety of cancers. This strategy has shown complete and partial responses in squamous cell carcinoma of the head and neck, esophageal cancer, and non-small cell lung cancer after direct intratumoral injection of the vector.
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Quantitative tools available to assist in clinical decision-making will also be discussed.. Evidence-based medicine is the term used to describe the integration of the. best available research evidence with clinical judgment and experience in the care of patients. The third goal of this chapter is to provide a brief overview of some of the tools of evidence-based medicine.. Clinical Decision-Making. Clinical Reasoning.
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Evidence-Based Medicine. is traditionally defined as a practice combining medical knowledge (including scientific evidence), intuition, and judgment in the care of patients (Chap. Evidence-based medicine (EBM) updates this construct by placing a much-greater emphasis on the processes by which the clinician gains knowledge of the most up-to-date and relevant clinical research. The key processes of EBM can be summarized in four steps:.
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A critical challenge for physicians and other health care providers is to keep pace with these advances in genetic medicine and to implement testing judiciously.. Clayton EW: Ethical, legal, and social implications of genomic medicine. N Engl J Med PMID: 12904522]. Ensenauer RE: Genetic testing: Practical, ethical, and counseling considerations. Guttmacher AE, Collins FS: Genomic medicine—a primer. N Engl J Med PMID: 12421895].
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pharmacology but also with knowledge of clinical medicine. clinical pharmacology.. Brater D C, Daly W J 2000 Clinical pharmacology in the middle ages: principles that presage the 21st century. Clinical Pharmacology and Therapeutics . Breckenridge A1995 Science, medicine and clinical pharmacology. British Journal of Clinical Pharmacology 40:1-9. Breckenridge A1999 Clinical pharmacology and drug regulation. British Journal of Clinical.
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This is a difficult task, as scientific advances in genetic medicine have outpaced the translation of these discoveries into standards of clinical care.. Common Adult-Onset Genetic Disorders. The risk for many adult-onset disorders reflects the combined effects of genetic factors at multiple loci that may function independently or in combination with other genes or environmental factors.
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Professor of Psychopharmacology, Head of the Department of Clinical Medicine,. Other acknowledgements are made in the appropriate places.. others too numerous to mention who have put their knowledge and practical experience of the use of drugs at our disposal.
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Nonetheless, gene transfer remains one of the most powerful concepts in modern molecular medicine and has the potential to address a host of diseases for which there are currently no cures or, in some cases, no available treatment. Over 5000 subjects have been enrolled in gene transfer studies, and serious adverse events have been rare
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A critical first step before initiating genetic testing is to ensure that the correct clinical diagnosis has been made, whether based on family history, characteristic physical findings, or biochemical testing. Careful clinical assessment can define the phenotype, thereby preventing unnecessary testing and directing testing toward the most probable candidate genes (Fig.
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Fetal neural stem cells derived from miscarriages or abortuses are an alternative, and a clinical trial of fetal neural stem cells in Batten disease is commencing..