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Results 451 - 500 of 602
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van Mook Walther N K A - - 2004
Spirochaetes are well known causative agents of diarrhoea in veterinary medicine. In human medicine the relationship between presence of spirochaetes in the colon on the one hand, and its clinical significance on the other, is far less clear. In the majority of cases the colonization of the colon with these ...
Jackson Michael - - 2004
Optical spectroscopy and imaging have been used in medicine since medicine was first practised. However, the more sophisticated instrumental methods now under development have made little impact on clinical medicine. In this paper a brief overview of the development of optical diagnostics is presented, highlighted by some successful pre-clinical applications. ...
Marini John J - - 2004
OBJECTIVE: To synthesize the emerging body of experimental, observational, and clinical trial data into a practical guideline for safe and effective ventilatory management of acute respiratory distress syndrome. DATA SOURCES: Relevant, peer-reviewed, scientific literature and personal observations from clinical practice. STUDY SELECTION: Relevant experimental studies and high-impact observational and clinical ...
Barker Gail P - - 2004
This paper compares the expenses of a telemedicine program to those of a traditional clinical practice using data from two fiscal years (FY) 1998/1999 and 2000/2001. As part of that evaluation, we compared expenses of the University of Arizona's clinical practice group, the University Physicians Incorporated (UPI), to those of ...
Tracy Cynthia M. - - 2003
Atrial fibrillation is the most common cardiac arrhythmia and presents a unique management challenge for the physician. Given the variability of clinical presentation as well as the variability of clinical sequelae, no single approach meets all patients' needs. This challenging arrhythmia has recently been reviewed in the American College of ...
Kogan Jennifer R - - 2003
PURPOSE: To determine the feasibility, reliability and validity of the mCEX when used to evaluate medical students' clinical skills in a medicine core clerkship. METHOD: In 2002, students were required to complete nine mCEX during their medicine clerkship. Mean mCEX scores were correlated with exam scores and course grades. RESULTS: ...
Watts Martin - - 2003
The objective of the study was to assess the use of a computer toxicology database/clinical decision aid by clinical practitioners. The study investigated the sources that Emergency Department (ED) personnel use to obtain toxicology information and performed a quality audit of the current database. A questionnaire survey of ED staff ...
Plaice Caroline - - 2003
Knowledge management, like clinical governance, is a practical science. Clinical governance, with its emphasis on creating an environment where clinical quality is monitored and acted upon, is one of the foundation stones of the new National Health Service (NHS). Both knowledge management and clinical governance need to share the same ...
Spyropoulos Alex C - - 2003
New paradigms for the diagnosis, prophylaxis, acute treatment, and ongoing management of patients with venous thromboembolic disease (VTE), a better understanding of the genotypic and phenotypic mechanisms of thrombophilic states, and the possibility of a greatly expanded armamentarium of antithrombotic therapies are necessitating a more formalized and systematic approach to ...
Ledger William L - - 2003
Hospital-based infertility management will alter radically over the next few years. The forthcoming National Institute for Clinical Excellence guidelines should improve financial support for couples having National Health Service (NHS) assisted conception treatment, and increasing NHS interest in clinical governance may well lead to policy on issues such as number ...
Pascuzzi Robert M - - 2003
Based on the history and physical examination, it is often possible to arrive at a relatively specific diagnosis of peripheral neuropathy. The clinical history and examination are often sufficient to create a more focused and appropriate laboratory evaluation, counseling for the patient as to long-term prognosis, and options for clinical ...
Turner-Stokes Lynne - - 2003
Clinical governance has been introduced in the UK as a mechanism to improve the quality of health services, and the professional performance of clinicians. Specialist societies have a pivotal role to play in developing systems to support its implementation in clinical practice. Rehabilitation medicine is a specialty characterised by closely ...
Chan Moon Fai - - 2003
PRIMARY OBJECTIVE: To explore the current level of computerization in clinical practice in the Hong Kong Special Administrative Region through a population-based, Chinese medicine practitioner (CMP). METHODS AND PROCEDURES: A self-completed, one-page two-sided, questionnaire were sent to the sample via mail, and a second mailing was sent to those who ...
Bartram Clive - - 2003
The evaluation of EP is complicated by the lack of any gold standard and a shifting clinical emphasis as management regimens go in and out of favor. As with all functional bowel disease, there is a residue of patients who are difficult to manage, and in whom a clinician will ...
Stoopler Eric T - - 2003
Patients presenting with oral mucosal disease can be challenging to diagnose and manage. There are several disorders that can present with similar clinical signs and symptoms, and knowledge of each disease will guide the clinician toward proper management. This article highlights recurrent aphthous stomatitis, a common ulcerative condition encountered in ...
Papaluca Amati Marisa - - 2003
The evaluation of quality, safety, and efficacy of medicinal products by the European Medicines Evaluation Agency (EMEA) via the centralized procedure is the only available regulatory procedure for obtaining marketing authorization for gene therapy (GT) medicinal products in the European Union. The responsibility for the authorization of clinical trials remains ...
Miller Mark D - - 2003
OBJECTIVE/METHODS: The authors examined recurrence rates of major depression in elderly subjects with different foci of interpersonal psychotherapy (IPT), who were treated for up to 3 years with either monthly maintenance IPT and pill placebo or with monthly clinical management and pill placebo. RESULTS: Among subjects with an IPT focus ...
Brandt C A - - 2003
Clinical Study Data Management Systems (CSDMSs) are a class of software that support centralized management of data generated during the conduct of clinical studies. Commercial CSDMSs include Oracle Clinical, ClinTrial and MetaTrial. Such systems, which are typically deployed at an institutional or organizational level, must accommodate diverse types of data ...
Hickstein H - - 2002
The role of antibodies in the occurrence of recurrent spontaneous miscarriage is well known. However there are many controversial issues in the management of habitual abortion. This paper describes the effect of Protein A immunoadsorption on serum levels of these antibodies and its impact on a case of a successfully ...
Chichetti Steven - - 2002
While considerable advances have been made in the understanding of the tissue-destructive mechanisms involved in etiology of periodontitis, the adoption and application of this knowledge has not been generally incorporated into the daily management of patients with chronic periodontitis. A number of adjunctive pharmacotherapeutic agents have been investigated in clinical ...
Weitzenhoffer Andre - - 2002
It has been said that traditional clinical hypnotists, essentially those practicing before 1900, made excessive use of symptom removal to the detriment of their patients. However, statements of this kind have never been documented. This article is based on a search of the relevant literature that examines the hypnotic methods ...
- - 2002
To identify primary health care professionals' views about patients presenting with breast problems, and their approaches to clinical management. Qualitative study using practice-based semi-structured group discussions with primary health care professionals. All practices were involved in a study evaluating the effect of the national breast symptom management guidelines on clinical ...
Hart Curtis W - - 2002
This article outlines the method utilized by physicians and major figures in the founding of Clinical Pastoral Education, Helen Flanders Dunbar, in her work of 1943, Psychosomatic Diagnosis, and relates it to the currently evolving approach in bioethics known as clinical pragmatism. It assesses Dewey's influence on both Dunbar in ...
Tschopp Mathias - - 2002
Handheld computers are commonly used in clinical practice and often considered invaluable by physicians. Though full of promise, the technology is still costly and literature assessing its real use in clinical practice remains scarce. In an effort to better understand how Personal Digital Assistants (PDA) can be utilized as clinical ...
Parker Malcolm - - 2002
The relationship between evidence-based medicine (EBM) and clinical judgement is the subject of conceptual and practical dispute. For example, EBM and clinical guidelines are seen to increasingly dominate medical decision-making at the expense of other, human elements, and to threaten the art of medicine. Clinical wisdom always remains open to ...
Finer N N The Luton and Dunstable Hospital NHS Trust, Luton, Beds, UK. - - 2001
The role of sibutramine as an effective adjunct to diet and exercise in weight management programmes has been proven in clinical trials. Although the reality of managing obesity in clinical practice is very different from that of a controlled clinical trial, there is good evidence that sibutramine is an easy-to-use ...
Phoojaroenchanachai M - - 2001
To determine how well elderly-essential-hypertensives (EHT) were managed at the general medicine (GM) clinics at Siriraj Hospital when compared to those at the hypertension (HT) clinic. Adequacy of BP management (ADBP) was considered when DBP < 85 mmHg in diabetic patients with HT or < 90 mmHg in non-diabetic EHT. ...
- - 2001
The U.S. Food and Drug Administration recently approved the marketing of the Nellcor N-400 Fetal Oxygen Saturation Monitoring System, a fetal pulse oximeter. The American College of Obstetricians and Gynecologists Committee on Obstetric Practice cannot endorse the adoption of this device in clinical practice at this time because of concerns ...
Mowle S - - 2001
'Benchmarking' clinical practice and integrating such data with national guidelines offers a way of establishing standards for use in clinical governance. We report on a feasibility project for benchmarking clinical practice in one topic area (otitis media) using simulated clinical scenarios. Consistency and variations in clinical management were identified for ...
Dale A W - - 2001
Assessment of clinical management of Chlamydia trachomatis genital tract infection was made, with particular regard to the UK National Guideline. Questionnaires for self-completion, mailed to lead clinicians in 31 Genitourinary Medicine (GUM) clinics in the North Thames Region between May and June 1999, focused on policies and practice. Audit of ...
Paget T - - 2001
There has been a recent increasing interest in reflective practice in nursing. There is a wealth of literature about its apparent advantages and benefits, but very little empirical research into clinical outcomes consequent to reflective practice. This study attempts an initial exploration into this area. A retrospective, three-phase, multi-method study ...
Bull R - - 2001
Primary tasks for clinical directors are to disseminate information to colleagues, provide feedback to senior professional managers, and to play key roles in strategic planning and resource allocation in health services. These tasks are seen to reduce barriers between clinicians and management. The application of clinical directorates across healthcare organisations ...
Kennedy Sidney H - - 2001
There is a recognized gap between knowledge derived from 'efficacy' data - based on usually brief randomized controlled trials and findings in natural practice 'effectiveness' studies. In considering the limitations of current antidepressants in clinical practice, we have selected three clinically important issues to examine in a natural practice data ...
Harpwood V - - 2001
Explores the relationship between doctors, lawyers and the government in the context of the explosion in clinical negligence litigation, clinical governance and the introduction of the Human Rights Act 1998. Examines these issues from a legal perspective. Concludes that successful risk management, careful monitoring and the implementation of authoritative guidelines ...
Nelson J L - - 2001
Disputes about theory in bioethics almost invariably revolve around different understandings of morality or practical reasoning; I here suggest that the field would do well to become more explicitly contentious about knowledge, and start the task of putting together a clinical epistemology. By way of providing some motivation for such ...
Onion C W - - 2000
Clinical governance--a new NHS concept that seeks, through clinical guidelines and national service frameworks, to encourage and enforce compliance with nationally-devised evidence based clinical policies--has manifold and complex implications. This paper reasons that clinical governance is actually a means to promote excellent practice of a particular kind and that non-compliance ...
Farshi Z - - 2000
AIM: To establish clinical opinion regarding appropriate indications for circumcision and to examine actual clinical practice. METHODS: A questionnaire was sent to all NHS hospital consultants in the Yorkshire region of the UK identified as having a role to play in the management of boys (under 16 years of age) ...
Michell A - - 2000
This article reviews the roots of comparative medicine and argues that during the 20th century it failed to realise its full potential. New opportunities arise from the growing availability of precise, minimally invasive, clinically compatible techniques, which enable us to benefit from the availability of spontaneous analogues of human disease ...
Chumbler N R - - 2000
The degree of clinical decision making and clinical productivity among nurse practitioners (NPs) is of great interest to policy makers and planners involved in providing appropriate outpatient primary care services. The authors performed a statewide mailed survey of all NPs practicing either full-time or part-time in Wisconsin (response rate of ...
Gentles W M - - 2000
A model for a central equipment pool managed by a clinical engineering department has been presented. The advantages to patient care and to the clinical engineering department are many. The distribution of portable technology that has been traditionally managed by the materials management function is a logical match to the ...
Loh P K - - 2000
Clinical indicators are an important component of quality assessment of clinical services. We outline the strategies used in the department of Geriatric Medicine at Royal Perth Hospital (RPH) to report on and improve the results. The clinical indicator for assessment of cognitive function had improved from 19% in September 1998 ...
Schweiger G D - - 2000
Computed tomography fluoroscopy (CTF) was first introduced into clinical practice in Japan in 1993 and in the United States in 1995, yet it has been used predominantly at large academic hospitals. Early literature on CTF is composed primarily of abstracts that detail anecdotal experiences and that have been presented at ...
Svenaeus F - - 2000
In this article I scrutinize the question whether clinical medicine, in order to be considered a hermeneutical enterprise, must be thought of as a reading of different "texts." Three different proposals for a definition of the concept of text in medicine, suggested by other hermeneuticians, are discussed. All three proposals ...
Connelly P J - - 1999
Successful clinical governance can only occur if staff, managers and commissioners are prepared to accept that traditional solutions are not necessarily the most appropriate. Accurate assessment of clinical risk and the development of strong and effective clinical teams with clear leadership, multidisciplinary appraisal and clearly defined implementation plans will help ...
Radvany M G - - 1999
In a time of decreasing resources, managers need a tool to manage their resources effectively, support clinical requirements, and replace aging equipment in order to ensure adequate clinical care. To do this successfully, one must be able to perform technology assessment and capital equipment asset management. The lack of a ...
Franciosa J A - - 1999
Concerns have been raised about the applicability of clinicals trials to the so-called "real world" setting of clinical practice when such trials employ run-in periods. In fact, run-in periods are an essential part of good medical practice, and the limited practical applicability of clinical trial results relates more to their ...
Hackett M - - 1999
Clinical governance places for legal duty for quality on Trust chief executives. The article deals with how chief executives can overcome the cultural and behavioural obstacles to change which impede the journey to developing effective structures for clinical governance. To establish effective structures for clinical governance, chief executives will need ...
Struthers C - - 1998
OBJECTIVES: To review the problem of bone metastases and strategies aimed at the management of bone metastases. DATA SOURCES: Review articles, book chapters, research studies, and clinical practice. CONCLUSIONS: As patients survive for longer periods, effective management of bone metastases becomes critical to maintaining or improving quality of life. Controlling ...
Arnold B L - - 1998
OBJECTIVE: We examined employer importance ratings of 35 employee characteristics in the collegiate, sports medicine clinic, and high school settings and made comparisons among these settings. DESIGN AND SETTING: All prospective employers were sent a survey. Of the 472 surveys mailed, 282 (60%) were returned, with a sample error rate ...
Thompson C - - 1998
A comparison between high vaginal swab (HVS) wet prep examination within the genitourinary medicine (GUM) clinic and that made from an HVS transported in Amies charcoal medium to the laboratory for the diagnosis of Trichomonas vaginalis was made in a prospective study. Clinic wet prep compared with Amies had a ...
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