Sudden cardiac death (SCD) following ventricular tachyarrhythmias constitutes an important clinical cause of mortality; 4% of cases may involve ion channel-mediated cellular excitation in structurally normal hearts. Alterations in such processes could disturb action potential conduction, depolarization/ repolarization gradients, or Ca(2+) homeostasis with potential arrhythmogenic consequences. Although SCD may be ...

Myelodysplastic syndromes (MDS) are a poorly understood group of disorders caused by one or more genetic aberrations in the bone marrow-derived cell line responsible for hematopoiesis. Recent advances in genetic medicine have offered new insights into the epigenesis as well as the prognosis of MDS, but have not resulted in ...

In the coming years, genomics will impact clinical practice in multiple ways. However, one of the most important applications will be in the determination of the best treatments in personalized medicine. This is, in fact, one of the fields in which genetic variants have already been most successful and useful ...

The "Genome Era", a term that has been used to describe the period following the sequencing of the human genome, has heralded significant changes in biomedical research and clinical practice. Personalised medicine aims to use this increased genetic knowledge base to identify predisposition to disease and to tailor treatment to ...

Personalized medicine-tailoring interventions based on individual's genetic information-will likely change routine clinical practice in the future. Yet, how practitioners plan to apply genetic information to inform medical decision making remains unclear. We aimed to investigate physician's perception about the future role of personalized medicine, and to identify the factors that ...

Throughout civilization, animals have played a pivotal role in the advancement of science and medicine. From as early as 400 BC when Hippocrates recognized that diseases had natural causes, the steadfast advances made by biologists, scientists, physicians and scholars were fueled by timely and important facts and information- much of ...

Advances in genomics and human genetics have enabled a more detailed understanding of the impact of genetics in a disease and its treatment. In addition to a patient's clinical signs and symptoms, physicians can now or in near future consider genetic data for their diagnosis and treatment decisions. This new ...

The discovery that phenotypic diversity among differentiated cells results from epigenetic and not genetic differences, and can be reset to restore pluripotency, promises revolutionary advances in medicine. I discuss how this and related seminal discoveries have brought us to an exciting future.

This article is concerned about what may be happening to race and medicine in the "meantime" between today's clinical realities and the promised land of pharmacogenomics where the need for using race in medicine is supposed to fade away. It argues that previous debates over the use of race in ...

After human genome mapping, omics revolution and empowering sequencing technologies developed at the turn of the century, new deals are to switch from population medicine to individual therapies, from curing the disease to preventing it. This review by the pharmacogenetics and predictive medicine working group of the French clinical biology ...

Abstract Osteoporosis is a complex multifactorial bone disorder with a strong genetic basis. It is the most common, severe, progressive skeletal illness that has been increasing, particularly in developed countries. Osteoporosis will no doubt constitute a serious clinical burden in healthcare management in the coming decades. The genetics of osteoporosis ...

2011 marked the fiftieth anniversary of breaking the genetic code in 1961. Marshall Nirenberg, the National Institutes of Health (NIH) scientist who was awarded the Nobel Prize in Physiology or Medicine in 1968 for his role in deciphering the code, wrote in 2004 a personal account of his research. The ...

Knowledge management systems utilize information technology to manage knowledge in organizations with the purpose of creating, supporting, storing and disseminating information. These systems have been around for decades, but have significantly changed over time in complexity and features with the evolution of information technology and the Internet. With the development ...

Medicine has always striven to personalise or stratify approaches towards individual patients, but recently these terms have been applied particularly to denote improved disease sub-classification achieved through new genetic and genomic technologies. Techniques to analyse a person's genetic code have improved in sensitivity exponentially over recent years and at the ...

Discovering the genetic variations that create profiles of risk and drive individual responses to drugs and vaccines has proven more difficult than many initially presupposed. Rhetoric about the prospect of personalized medicine has exceeded the ability to deliver on that vision. There also remain significant ethical and policy obstacles that ...

BACKGROUND: Immunohistochemistry (IHC) plays a central role in the histopathological classification of diseases, including cancer. More recently, the importance of immunohistochemical staining is increasing. IHC usage in diagnostics is invaluable; however, the genetic and therapeutic significance of biomarker immunostaining has become equally relevant. CONTENT: In this article, we would like ...

Acute upper limb ischaemia (AULI) can be managed surgically, via interventional radiology, and conservatively, but no real guidelines exist for when a conservative approach is appropriate. A systematic review of the literature is presented of the surgical, radiological and conservative management of AULI. A search was performed using the electronic ...

Although current practice guidelines provide an evidence-based approach to the management of acute coronary syndromes, application of the evidence by individual physicians has been suboptimal. This gap between comprehensive guidelines and actual practice stimulated Oman Heart Association to issue a simplified series for the management of the common cardiac abnormalities ...

When a construct such as patients' "transition to self-management" of chronic illness is studied by researchers across multiple disciplines, the meaning of key terms can become confused. This results from inherent problems in language where a term can have multiple meanings (polysemy) and different words can mean the same thing ...

This review is based on a presentation given by Dr Newman at the RCPE Genetics Symposium on 20 April 2012.

The purpose of the present report was to define and advocate active surveillance compared with follow-up as needed (prn follow-up), as the preferred management strategy for patients who elect to retain their third molars (M3s). Active surveillance, a nonoperative management strategy for retained M3s, is characterized as a prescribed, regularly ...

Cardiovascular disease (CVD) is a heterogeneous, complex trait that has a major impact on human morbidity and mortality. Common genetic variation may predispose to common forms of CVD in the community, and rare genetic conditions provide unique pathogenetic insights into these diseases. With the advent of the Human Genome Project ...

PURPOSE: The purpose of this study was to estimate the treatment costs directly related to operative and nonoperative management of asymptomatic, disease-free, third molar (M3) teeth. MATERIALS AND METHODS: The data reviewed were limited to claims submitted by oral and maxillofacial surgeons. The data collected included charges for consultations, radiographs, ...

Case management has evolved from a grassroots method to assist patients and facilities to navigate changes in the healthcare system, to a fully fledged profession with core competencies, Standards of Practice, and an evidence-based peer review journal. With the latest healthcare reform, it is clear that case management leads to ...

Pharmacogenomics is emerging as a popular type of study for human genetics in recent years. This is primarily due to the many success stories and high potential for translation to clinical practice. In this review, the strengths and limitations of pharmacogenomics are discussed as well as the primary epidemiologic, clinical ...

This review summarises updated clinical guidelines produced by the Clinical Standards Committee of the Faculty of Dental Surgery, Royal College of Surgeons of England (FDSRCS). This guideline on the management of the palatally ectopic maxillary canine illustrates the information contained in the recently updated online version. The timely recognition of ...

Abstract The past 50 years have seen many changes in laboratory medicine, either as causes or consequences of increases in productivity and expansion of the range of information which can be provided. The drivers and facilitators of change in relation to clinical applications of molecular biology included the need for ...

AIMS: Endotracheal intubation (ETI) and basic ventilation techniques (i.e. mouth-to-mouth/nose, bag-valve-mask ventilation) require skills and training. As an alternative, supraglottic airway devices (SAD) are efficient and technically easy to insert. We therefore evaluated the time to ventilation, success rate, and skill retention for various airway management approaches by medical laypersons ...

How long would it take for forests to recover their original productivity following continuous intensive management if they are left untouched? This issue was explored using the model FORECAST, calibrated and validated for coastal Douglas-fir stands on Vancouver Island (western Canada). Three types of forest management (production of timber, pulp, ...

INTRODUCTION: The Global Initiative for Obstructive Lung Diseases (GOLD) has published a strategy for diagnosis and management of COPD since 2001 and this has formed the basis for numerous national and regional guidelines. OBJECTIVES: We describe the background for the 2011 revision of the GOLD document. METHODS: The GOLD document ...

This paper reviews the role of predominantly nurse-led, multidisciplinary, chronic heart failure management programs as part of the gold-standard management of patients discharged from hospital with this syndrome. It discusses the various options for applying these evidence-based programs and how they apply to the management of those living in rural/remote ...

Learning from mistakes or failures is the purpose of a laboratory's event management system. Laboratories that systematically and effectively learn from failures which occur especially from small mistakes and problems rather than from consequential adverse events, are rare. An effective event management program often requires a cultural sea change that ...

Background: Treatment with antiplatelet drugs (APD) and vitamin K antagonists (VKA) can be a challenge during the management of dermatosurgical interventions. Methods: We performed a cross-sectional study on the perioperative management of APD and VKA in dermatological private practices and clinics in Germany, using anonymized, standardized questionnaires. Results: 233 responses ...

  We analyzed whether decision-making triggers increase accountability of adaptive-management plans. Triggers are prenegotiated commitments in an adaptive-management plan that specify what actions are to be taken and when on the basis of information obtained from monitoring. Triggers improve certainty that particular actions will be taken by agencies in the ...

PURPOSE OF REVIEW: Cardiogenic shock is present in 3.5% of patients presenting with acute decompensated heart failure. Despite advances in therapy, mortality remains high, approaching 70% in some settings. Recent management strategies have incorporated the use of mechanical circulatory support (MCS), which has been associated with better survival in nonrandomized ...

The challenges of integrated, adaptive and ecosystem management are leading government agencies to adopt participatory modes of engagement. Collaborative governance is a form of participation in which stakeholders co-produce goals and strategies and share responsibilities and resources. We assess the potential and challenges of collaborative governance as a mechanism to ...

Chronic obstructive pulmonary disease (COPD) is a global health problem and since 2001 the Global Initiative for Chronic Obstructive Lung Disease (GOLD) has published its strategy document for the diagnosis and management of COPD. This executive summary presents the main contents of the second 5-year revision of the GOLD document ...

The implementation of rangeland biodiversity management strategies relies on the engagement and participation of key stakeholders, including local pastoralists (ranchers). Understanding pastoralists' knowledge of biodiversity, as well as their attitudes towards and perceptions of biodiversity management strategies, is fundamental for the development of efficacious rangeland management. This paper examines perceptions ...

The article presents an account of prominent historical events of present-day ED management and the direction of the field going forward.

Airway problems continue to occur in intensive care setting. Management strategies, staffing, and availability of equipment can all have an influence. We undertook a standardized telephone survey of airway management strategies, staffing, and airway equipment availability in general intensive care units (ICUs) in the UK, before the reporting of the ...

Sudden cardiac arrest (SCA) remains a tragic occurrence on the football field. The limits of preparticipation cardiovascular screening make it compulsory that prearranged emergency medical services be available at all football matches to immediately respond to any collapsed player. Management of SCA involves prompt recognition, immediate cardiopulmonary resuscitation (CPR) and ...

  Structured decision making and value-of-information analyses can be used to identify robust management strategies even when uncertainty about the response of the system to management is high. We used these methods in a case study of management of the non-native invasive species gray sallow willow (Salix cinerea) in alpine ...

Malignant pleural effusions are often symptomatic and diagnosed late in the course of cancer. The optimal management strategy is controversial and includes both invasive and non-invasive strategies. Practitioners have the option of invasive procedures such as intermittent drainage or more permanent catheter drainage to confirm malignancy and to palliate symptoms. ...

Simulation laboratories use realistic clinical scenarios to train physicians in a controlled environment, especially in potentially life-threatening complications that require prompt management. The objective of our study was to develop a comprehensive program using the simulation laboratory to train radiology residents in the management of acute radiologic emergencies. All radiology ...

This article describes and critically appraises clinical trials assessing misoprostol effectiveness in preventing primary postpartum haemorrhage (PPH) in home and community settings in low- and middle-income countries. Of 172 identified studies of misoprostol use in labour only six fulfilled the inclusion criteria. All trials used 600 μg misoprostol in the ...

Foreign body aspiration is a potentially fatal condition. Yet, an accurate diagnosis may not be easy. Management is also challenging and requires a high level of expertise with proper instruments. In this article, we report our experience in the management of peanut aspiration in two young children by means of ...

Perioperative management of antiplatelet agents is a common challenge with the increased number of patients requiring long-term therapy following coronary stenting. Debate currently exists regarding if and when to discontinue antiplatelet therapy prior to elective surgery. The delicate balance between decreasing the risk of bleeding intraoperatively and minimizing the risk ...

Posterior tibial tendon dysfunction is common and a major cause of flat foot (pes planus) and functional impairment in adults. It is frequently undiagnosed and therefore inappropriately managed. This review raises awareness of posterior tibial tendon dysfunction with the intention of improving patient management.

1.Recognize infantile hemangiomas that are associated with a higher risk for complications and associated anomalies.2.Appreciate the typical timing of growth and involution of infantile hemangiomas.3.Become familiar with recently reported treatments for infantile hemangiomas.Infantile hemangiomas are common proliferations of endothelial tissue that affect approximately 4% to 5% of infants.1 Lesions represent ...

The management of complex abdominal problems with the 'open abdomen' (OA) technique has become a routine procedure in surgery. The number of cases treated with an OA has increased dramatically because of the popularisation of damage control for life-threatening conditions, recognition and treatment of intra-abdominal hypertension and abdominal compartment syndrome ...