Study "Medicine / Pharmacy" Essays 166-220

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Chen, Sl, Cai, Sr, Deng, L, Zhang Chapter

… Chen, SL, Cai, SR, Deng, L, Zhang, XH, Luo, TD, Peng, JJ, Xu, JB, Li, WF, Chen, CQ, Ma, UP, and He, YO ((2014) Efficacy and Complications of Polyethylene Glycols for Treatment of Constipation in Children: A Meta-Analysis. Medicine. Vol. 93. No. 16. Oct 2014.

The work of Chen, Cai Deng, Zhang, Luo, Peng, Xu, Li, Chen, Ma and He entitled "Efficacy and Complications of Polyethylene Glycols For Treatment of Constipation in Children: A Meta-Analysis" published in the Medicine Journal in October 2014, reports that a common problem in children is that of constipation and that constipation is "functional...in 90% to 95% of children" reported to mean that there is not a pathological condition that underlies this compliant. This problem is such that generally presents due to retention of stool that may be linked to training for use of the toilet, dietary changes, some type of illness in children or simply due to children withholding their stool. However, it is reported that there are conditions that may cause constipation although they are not common including such as neurological conditions such as mental retardation, cerebral palsy or even problems with the spinal cord. Also cited as reasons for constipation in children are such as cystic fibrosis, hypothyroidism, and the bowel developing abnormally. Some medications may even result in constipation in children and these may include such as antidepressant, antacides, anticonvulsants and medications given for chemotherapy. Treating functional constipation requires the use of medication administered orally or rectally for the purpose of disimpacting the stool in children. Some of the medications utilized for this purpose include polyethylene glycol also known as 'PEG' stated to be an effective treatment that children tolerate quite well. However, there are other medications that can be used in treating constipation in children and these are listed in…… [read more]


Mind-Body Interventions Essay

… Mind-Body Interventions

Mind -- body interventions comprise a major portion of techniques known as contemporary and alternative medicine (CAM; National Center for Contemporary and Alternative Medicine [NCCAM], 2015). CAM is the term for medical practices and medical products that do not fall under the domain of standard care (Micozzi, 2014). Standard care is typically defined as practices and treatments performed by medical doctors, doctors of osteopathic medicine, nurses, allied health professionals, and other health-care professionals such as physical therapists (Hatfield, 2014; Micozzi, 2014).

Mind -- body interventions include a number of different techniques that can range from relaxation, meditation, hypnosis, biofeedback, yoga, martial arts, and so forth. The research indicates that despite claims that many of these techniques are older, substantiated treatments that are primarily used in underdeveloped countries with great success they actually are quite popular in industrialized countries with higher proportions of middle-class and upper-middle-class people (Harris, Cooper, Relton, & Thomas, 2012). One of the major issues with CAM's is that they are often highly publicized and touted by the individuals that perform them; however, the majority of them do not live up to these claims and expectations when exposed to standard clinical research methods to determine their effectiveness (Hatfield, 2014; Micozzi, 2014). This is not to say that mind -- body interventions do not have a place in medical treatment; however, caution needs to be exercised regarding the claims and potential utility of many of these techniques. The clinical research on the effectiveness of these techniques is quite mixed and it is quite clear that mind -- body interventions and other forms of CAMs are not effective stand-alone treatments for many medical ailments, despite the claims of their proponents. Moreover, many of these techniques appear to have their optimal effectiveness with individuals who suffer from vague or subjective complaints like chronic pain, depression, etc. (Hatfield, 2013; 2014; Micozzi, 2014). Thus, these techniques appear to have their greatest utility as adjunctive treatments that can be used in combination with standard medical techniques.

This is not to say that mind -- body interventions have no utility of all; however, it important to remember that these techniques will not cure serious chronic conditions like cancer, heart disease, etc. But can act as adjunctive treatments can help the person change their lifestyle to a more healthy one that will reduce stress, relieve aspects of pain, and assist in the healing process. In addition, many of these mind-body interventions are misunderstood by both scientists and lay persons. Hypnosis is just one example of this. There is still a debate in the scientific community regarding exactly…… [read more]


Card Andrews, T., Thompson, M., Buckley Chapter

… ¶ … Card

Andrews, T., Thompson, M., Buckley, D.I., Heneghan, C., Deyo, R., Redmond, N., Lucas, P.J., Blair, P.S. & Hay, A. D (2012). Interventions to Influence Consulting and Antibiotic Use for Acute Respiratory Tract Infections in Children: A Systematic Review and Meta-Analysis. PLoS ONE 7(1): e30334. doi:10.1371/journal.pone.0030334

Content summary: Due to the prevalence in Respiratory tract infections (RTIs) in children, this research study sought to investigate how effective interventions meant for parents and caregivers are, in influencing how they use consulting and antibiotics for RTIs in children. In primary care, use of antibiotics generally contributes to increased financial constraints for parents, as well as resistance and side effects to patients. The effectiveness to parents and caregivers was systematically reviewed by the use of a conceptual model that used multilingual knowledge on the topic sourced from four different libraries. The selection used randomized and non-randomized controlled designs and the comparisons excluded treatment controls, which made the output highly reliable. The main outcomes from where data was sought were; the use of antibiotics, parental knowledge on their use and parental knowledge in regard to consultations while the secondary outcomes were the finances spent on interventions and the adverse effects to the health of the users of the RTIs. The authors were thorough in abstracting data and assessing the quality of the findings using a third party to verify disagreements and sometimes sourcing additional information from study authors. Studies of interventions that influenced parental consulting found that they do add to the knowledge parents have on RTIs and it was more effective to provide interventions before a child became ill. Only parents with a college education were able to reduce the inappropriate use of antibiotics especially when the symptoms were specified, although the rate of the antibiotics prescribed did not change in the preceding…… [read more]


Parental Authority Choice on Childhood Vaccinations Research Paper

… Parental Authority Choice on Childhood Vaccinations

Should parents be permitted to opt out of required vaccinations for their children?

Childhood immunization has over the years grown to attract numerous attentions both as a necessary measure and an appalling means to… [read more]


Causes of Syncope Term Paper

… Management plans consider all of the issues a patient is facing, and continue to monitor the patient so that adjustments can be made as and when the patient's condition changes. Proper treatment of the cardiac issues should reduce or eliminate the syncope (Ruwald, 2014).

Syncope that has come about from a B-12 deficiency that has led to anemia is considered relatively easy to treat. Patients will need to increase their B-12 levels, to reduce the chances of syncope. This can be done through diet, but is generally done through supplementation. Tablets are sometimes used in more mild cases, while severe cases can warrant B-12 injections that can restore normal limits more quickly (Manifestations, 2009). With proper B-12 levels, syncope should dissipate.

Follow-Up and Patient Care

For patients who experience syncope based on cardiac or anemia factors, follow-up and proper care is essential. These patients may need emotional support, especially if they are found to have severe cardiac issues. They may also want a second opinion or more testing, and may need to talk to someone about their options. For anemic patients, restoring B-12 levels generally corrects the issue and allows them to return to a normal life, free of episodes of syncope (Manifestations, 2009). If this does not prove to be the case, further follow-up and diagnostic testing may be needed. Patient education is important in these types of cases, so that patients know when they should be concerned, what they should look for, and when they should contact their doctor or other medical professional (Ruwald, et al., 2012).

Follow-up care is more significant for syncope patients who have cardiac issues. These patients must be monitored, but they often need more than just monitoring. They also have to be examined routinely -- and how often will depend on their doctor's opinion and their current diagnosis (Gauer, 2011). Additionally, these patients will often have referrals to specialists such as cardiologists in order to do further testing and make an accurate determination of what steps to take next (Gauer, 2011). Cardiologists are used to treating syncope patients, and will know the next diagnostic and treatment steps for a patient with cardiac syncope issues.

Patient education is vital for heart-related conditions, as it also affects how they take their medications and whether they are knowledgeable of when to contact their doctor if they continue to have syncope or if they experience other problems that they believe could be related to their heart or to the medication they have been given (Freeman, 2011). Side effects of medications are common, and patients with existing heart problems should be especially vigilant in order to reduce the risks they face when it comes to the condition of their heart and blood vessels.

References

Dicpinigaitis, P.V., Lim, L., & Farmakidis, C. (2014). Cough syncope. Respiratory Medicine, 108(2): 244-251.

Freeman, R. (2011). Chapter 20: Syncope. In Longo, Dan L.; Kasper, D.L., Jameson, J.L., Fauci, A.S., Hauser, S.L., & Loscalzo, J. Harrison's principles of internal medicine (Textbook) (18th ed.). New… [read more]


Common Concerns in the Nursing Profession Research Paper

… Patients typically request antibiotics for viral infections without realizing that the drugs will not be effective. The campaign materials also provide tips about how to appropriately treat common infections without antibiotics, which can be quite helpful for people who are not adequately informed.

I have never been prescribed an antibiotic for a condition that should not be treated with antibiotics. However, I have known this to happen to other people -- generally with small children for whom a secondary bacterial infection -- such as an ear infection following a cold -- could be a possibility. I am not confident that cultures were run before the antibiotic was prescribed.

It is a significant concern for future generations that antibiotics are being prescribed for conditions that do not warrant the medication. Antibiotic-resistant microbes are already evident in the environment, and without a concerted effort to preclude these inappropriate prescriptions of antibiotics, there are likely to be global outbreaks of disease for which no treatments are available.

References

Get Smart: Know When Antibiotics Work. Center for Disease Control and Prevention. Retrieved http://www.cdc.gov/getsmart/specific-groups/hcp/index.html

Centers for Disease Control and Prevention. Active Bacterial Core Surveillance Report, Emerging Infections Program Network, Methicillin-Resistant Staphylococcus aureus. (2011). Retreived http://www.cdc.gov/abcs/reports-findings/survreports/mrsa11.pdf

Discussion #3 Glucocorticoids are given via inhalation, PO, and IV for various situations pertaining to asthma. Describe how each of these forms may cause problems in the pediatric patient. How may the drug montelukast be different? What do you tell parents of children with asthma? Are there alternatives to these drugs? Use the internet and your text to discuss the "Step wise" treatment of asthma. Justify your answers and cite your references.

Glucocorticoids do not act immediately and so they must not be relied upon to treat acute asthma exacerbations or as maintenance for pediatric patients who experience severe asthma attacks. Once control over severe persistent asthma occurs, it is preferable to address maintenance with high dosages of inhaled corticosteroids over oral glucocorticoids since corticosteroids are associated with fewer systemic effects.

Montelukast is used to treat the shortness of breath and wheezing caused by asthma and to decrease the number of asthma attacks. It can be administered before exercise to prevent difficult breathing due to bronchospasm. Montelukast does not start to work immediately after administration so it is not useful for sudden or acute breathing attacks. The action of Montelukast is to reduce swelling and inflammation in the airways by blocking the naturally occurring leukotrienes that cause asthma or make it worse.

Some alternative treatments are available, although the effectiveness of these treatments has not been subjected to FDA studies. Diets rich in Omega fatty acids, fruits and vegetables have been shown to be helpful in some people. Also the herb boswellia and the pineapple extract bromelain have been known to help relax smooth muscles and reduce inflammation, respectfully. Some people with asthma have found relief with the Buteyko breathing technique. However, it is important to realize that these alternative treatments are not without some risk, and should be utilized… [read more]


College Career Is Pharmaceutical Chemistry Term Paper

… ¶ … college career is pharmaceutical chemistry. This is a class that really held my attention and I was always eager to attend class and especially I enjoy the lab work we did as students. This paper points to the reasons why I enjoyed the class to such a high degree.

Pharmaceutical Chemistry

The course is not for people who struggle in math; because of course this is an advanced class that requires a familiarity with chemistry and math at a fairly high level. I took it because it fascinates me, the idea of learning about the structure and properties and the analysis that goes into the development of medicinal drugs. We study pharmaceutical agents and metabolites both qualitatively and quantitatively, starting from the most basic agents and how they are used in the process of rational drug design.

I was especially interested in the lectures that were given, because it wasn't the usual professor standing in front of the podium giving us his take on the materials we were to study and understand. In fact there were real world chemists from drug companies that shared in the lectures. Knowing a professional chemist working in the world of pharmaceuticals was standing behind the podium giving us real world information about not only what he does but why what he does and what his colleagues do has huge impacts on society.

There were about ten chemists who lectured, and some were professors from the pharmaceutical industry. Their remarks were never boring and never read directly out of a book or out of notes. To hear their personal experiences, how they got started in the field, how patient they needed to be in their research and what pharmaceuticals they have helped to develop that had a positive impact on some aspect of medicine -- it was fascinating and I was a very good listener and note-taker.

Being able to not only hear about the process of rational drug design, but to use the rational drug design process -- employing computational methods -- in…… [read more]


Diekema, Douglas S. ) Essay

… Diekema, Douglas S. (2012). Improving childhood vaccination rates. New England Journal of Medicine, 266(3), 391-394

The primary concern of Diekema (2012) is the sheer number of parents, who are refusing to vaccinate their children for a wide number of reasons,

The author provides a number of reasons for why parents do not want their children vaccinated. Some base their opinions out of religious reasons; while others think that the vaccines themselves are more harmful than good. Then, there are the parents who just do not want to see their children suffer through the act of the vaccination itself and so avoid it as to not cause their children an undo pain. Yet, the reasoning these parents choose is skewed. Many of these parents were vaccinated themselves. As such, they have very little first hand experience with major diseases like polio or the measles. They have never experienced the painful and debilitating symptoms of such diseases which are now preventable through modern medicine. Unfortunately, this lack of understanding and refusal to vaccinate their children is becoming a major problem. The author presents a number of cases in states all over the country where preventable diseases are rising in greater numbers, most likely attributed to the fact that so many parents are opting out of vaccinating their children.

Diekema (2012) claims that something must be done. He admits that there will be some parents who will simply refuse to vaccinate their children, and thus efforts on educating them should not be wasted on this group. Instead, Diekema (2012) suggests that public health authorities should focus on trying to educate parents who are not so strong in their convictions, but may just be misinformed or confused. The more children who are vaccinated the better for the whole population. Thus, public health initiatives should work on trying to persuade parents who are already on the fence about vaccinations so that more children are protected. Physicians can also play a large role in trying to persuade parents because parents trust their pediatricians who they have worked with since the…… [read more]


Vaccinations and Autism Research Paper

… This is because the initial study, which suggested there was, has been proven to be inaccurate and misleading. Moreover, other data is showing that there is no connection between them. Even though this is taking place, many parents still believe these myths. This is from researchers not being able to conclusively identify the primary causes and symptoms. These shifting theories are creating fear in parents. As a result, they are more cautious and avoid immunizations based upon these worries. This exposes their children to potential outbreaks and is one of the reasons why they are higher in the last several years. (Offit, 2008) (Honey, 2008)

Conclusion

Clearly, the belief that there is connection between autism and vaccinations is incorrect. This is because the authors who introduced this theory admitted to falsifying the evidence in their report. However, due to the fact that there is no known causes, many parents are erring on the side of caution and avoid immunizations. This is problematic, as it exposes their children to outbreaks and possible complications from preventable diseases. Over the course of the time, these concerns have resulted in more cases of the measles, mumps, flu and chicken pox. If these people looked at the actual evidence, they would see that their worries are unfounded.

References

Gross, L. (2009). A Broken Trust: Lessons from the Vaccine -- Autism Wars. PLOS Biology, 7(5), pp. 112 -- 118.

Honey, K. (2008). Attention Focuses on Autism. Journal of Clinical Investigation, 118 (5), pp. 1586 -- 1593.

Hviid, A. (2003). Association Between Thimerosal-Containing Vaccine…… [read more]


Faith Integration Preventing Research Misconduct Research Paper

… According to the NIH, it would not be until 1972, forty years into the experiment, that evidence would emerge of the illicit research. This would lead to the development of the Department of Health, Education and Welfare, which was itself a forerunner to the Department of Human Health Services. (NIH, p. 7)

Though these agencies would not be faith-based in nature, they offered regulatory oversight and emergent ethical codes that align with the concept of faith integration in their moral orientation. In fact, it can be argued that certain Scriptural assertions are realized through the work of these regulatory agencies. Specifically, we consider Romans 12, which commands us to "Be devoted to one another in brotherly love. Honor one another above yourselves." (Romans 12:10)

Being commanded thusly, and applying this concept to the undertaking of research, we can see that faith-integration has the potential to remind us of the reasons for our research. With Tuskegee, the ethical imperatives that should drive research were absent. But incorporating Romans 12:10 denotes that all research must be for the betterment of mankind. As such, research subjects must be treated with the same care and dignity as we would show to our own families. (Timothy 5:1-16)

This matter continues to be of great importance in the field of research. While revelations of the Tuskegee experiments would lead to a great deal of reform in the field, research misconduct may occur for other reasons today. For instance, an article by Crowden (2013) reports on inconsistencies in the outcome of clinical trials involving cancer treatment drug Avastin. The article makes the case that some of the trials exhibiting its positive impact on patients may have been distorted to yield desirable outcomes. This demonstrates the decision to pursue profit through research findings at the expense of human health. According to Crowden, "the Avastin experience has the potential to teach us a lot. Clinical researchers must critically consider the merit and integrity of their research questions before they expose people to new drugs or prevent them from accessing already proven therapeutic regimes -- or both." (Crowden, p. 1)

Here, we can see that there is still a pressing need to inform the field of research with the principles of faith. Where race and disparity resulted in the grossly unethical conditions of the Tuskegee experiments, today it is the pursuit of money that inclines researchers to overlook the good of their human subjects. In either event, evidence speaks to the absence of true faith and its attendant humanistic values.

Works Cited:

Crowden, A. (2013). Clinical Trials Are Useful-Here's How We Can Ensure They Stay So. The Conversation.

Katz, R.V. et al. (2008). Awareness of the Tuskegee Syphilis Study and the U.S. Presidential Apology and Their Influence on Minority Participation in Biomedical Research. American Journal of Public Health, 98(6).

National Institute of…… [read more]


Black Cohosh Efficacy for Reducing Research Paper

… This finding agrees with what I have observed in my practice. As Kupferer and colleagues suggest, more research needs to be done to ensure that these alternative treatment approaches are at least safe, and if found to be effective are available to everyone regardless of income. The perceived efficacy of antidepressants, especially selective serotonin reuptake inhibitors (SSRIs), in reducing symptoms is encouraging because these drugs have been tested for safety and efficacy in clinical trials. By comparison, black cohosh appears to be safe but its efficacy remains unproven.

Conclusions

The use of black cohosh for treating menopausal symptoms predates modern medicine, but contemporary scientists have been weighing in with their own findings. From an evidence-based perspective, black cohosh extracts appear to be safe for ingestion. A number of RCTs have produced findings that suggest black cohosh is effective in reducing symptom severity, but some studies have found no effect. Overall, there are significant methodological problems with most of these studies which could explain the heterogeneity in findings. At present, the efficacy of black cohosh remains unproven scientifically, but there is enough positive evidence to warrant further research.

Based on the findings of Kupferer and colleagues (2009), it seems unlikely that black cohosh will ever emerge as a preferred treatment for menopausal symptoms. The practice implications include concern about patients experimenting on their own and possible interactions with prescription medications. For this reason, patients should be encouraged to discuss with their caregiver any therapies they may be trying on their own.

References

Borrelli, Francesca and Ernst, Edzard. (2008a). Black cohosh (Cimicifuga racemosa) for menopausal symptoms: A systematic review of its efficacy. Pharmacological Research, 58, 8-14.

Borrelli, Francesca and Ernst, Edzard. (2008b). Black cohosh (Cimicifuga racemosa): A systematic review of adverse advents. American Journal of Obstetrics & Gynecology, 199(5), 455-466.

Guttuso, T. Jr. (2012). Effective and clinically meaningful non-hormonal hot flash therapies. Maturitas, 72(1), 6-12.

Kupferer, E.M., Dormire, S.L., and Becker, H. (2009). Complementary and alternative medicine use for vasomotor symptoms among women who have discontinued hormone therapy. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 38(1), 50-59.

Leach, M.J. And Moore, V. (2012). Black cohosh (Cimicifuga spp.) for menopausal symptoms (Review). Cochrane Database of Systematic Reviews, 9, 1-99.

Luoto, Riitta. (2009). Hot flushes and quality of life during menopause. BMC Women's Health, 9:13, doi: 10.1186/1472-6874-9-13.

Notelovitz, Morris. (2006). Clinical opinion: The biologic and…… [read more]


Cervical Cancer Vaccine Term Paper

… Gostin, 2008). In the first place the vaccine does not guarantee 1000% protection against cervical cancer. In the second place it can take place despite papilloma virus vaccine being responsible for nearly 70% of the cervical cancer. Some strains can never be prevented by it. Moreover, it is never effective for sexually active women. These are the recommendations that should accompany the vaccine. There is also need to tell the parents that it is not compulsory.

Even oncologist agreed that they don't have evidence that the vaccine is perfectly safe. As much as the vaccine has not shown evidences that they are fatal, on the other hand there has not been evidence of its safety. One of the oncologists acknowledges that there was need for government assessment and guideline immediately for the use of the vaccine. If there are no definite guideline, private and manufacturers clinical establishment may try to take advantage of the ambiguity hence sell the vaccine. This may pose danger due to the fact that the vaccine is not intended to necessarily make you immune. As a matter of fact all including the people who have taken the vaccine are supposed to be subjected to Pap smear tests so that it rules out the possibility of cervical cancer. I had an encounter with patients who were once misled and stopped screening. In addition, because an issue has not been raised regarding safety of the vaccine, there is need for the government to carry out an assessment and bring out a guide line. One may not be killed by the vaccine since only the virus protein is injected.

Conclusion

When all the fact above are considered keenly much sense and understanding will be realized in the government endeavor to make the cervical cancer vaccine compulsory for young girls. They will realize that this is not the solution or the most effective approach to be taken.

Reference

Cynthia Dailard, (2006) "Achieving Universal Vaccination Against Cervical Cancer in the United States: The Need and the Means," Guttmacher Policy Review.

Gail Javitt, Deena Berkowitz & Lawrence O. Gostin (2008)…… [read more]


Controversy and Disagreement Have Plagued Case Study

… Both this and the condition of the lungs can be related to Mr. Hodor's weight, which is close to obese.

The rationale behind the cardiac exam is to determine its connection with Mr. Hodor's shortness of breath and chronic fatigue. It is expected that connections will be found among these physical factors and Mr. Hodor's weight, as well as blood pressure. These are all highly significant risk factors in terms of Mr. Hodor's cardiac family history.

A third examination will be for hypertension, which appears to be highly probably at a blood pressure of 166/98 mmHg. Along with the high heart rate, this is a significant risk factor for heart disease.

According to Baba et al. (2007), obesity has a highly adverse effect on blood pressure and heart rate, even in young people. It is therefore highly likely that that the root of Mr. Hodor's problem resides in this factor. Once this is addressed, it is likely that his other symptoms will be mitigated and his risk decreased.

When documenting his consultation, I would start by listing Mr. Hodor's chief complaint, which includes shortness of breath and chronic fatigue. After this, I would list the HPI, or History of Present Illness, which includes cardiovascular and respiratory conditions that have worsened over time. The next part of the report will focus on PFSH, or the patient's past, family, and social history. In this, the family history of cardiac conditions is of the greatest importance, since cardiac conditions can be inherited. My assessment component and plan component will include various strategies to help Mr. Hodor lose weight and increase his fitness level.

References

AMA. (2013). Code of Medical Ethics. Retrieved from: http://www.ama-assn.org/ama/

Baba, R., Koketsu, M., Nagashima, M., Inasaka, H., Yoshinaga, M., and Yokota, M. (2007, May). Adolescent obesity adversely affects blood pressure and resting heart rate. Circulation Journal, 71(5). Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/17456998

Dresser, R. (2008, March). Human Dignity and the Practice of Medicine. From: Human Dignity and Bioethics: Essays Commissioned by the President's Council on Bioethics. Retrieved from: http://bioethics.georgetown.edu/pcbe/reports/human_dignity/chapter19.html

Thompson, E.G., and Kloner, R.A. (2011, Apr. 5). Physical exam for High Blood Pressure. Web MD. Retrieved from: http://www.webmd.com/hypertension-high-blood-pressure/physical-exam-for-high-blood-pressure… [read more]


Stem Cell Research Essay

… Furthermore, a Utilitarian approach is based on the prerogative that the final goal of a constructive action justifies any means employed, and the right action is proved right only if it results in the most happiness and common welfare for the whole community. The principle of utility asserts that we ought to always produce the maximal balance of positive value over disvalue, or the least possible disvalue, if only undesirable results can be achieved. In this light, a total clearance for stem cell research is more than relevant. The final purpose of the research is based on solid foundations, and more likely to be true than the notion that an embryo is equal to an adult human being.

All in all, it can be stated that the utilitarian position presents the advantage of objectively quantifying the interests of everyone affected by the decision, for the sole purpose of promoting common welfare. Thus, harvesting, fertilizing, genetically screening, implanting and researching human embryos at the risk of damaging or destroying them - is entirely justified from this perspective, and any progressive endeavor is encouraged.

Not only could the following generations be safe from cancer, AIDS, Parkinson's, Alzheimer's, and many other conditions in the face of which medicine is currently powerless, but they could redirect the colossal amount of capital which is now invested in the pharmaceutical industry towards other, more useful endeavors -- such as finding alternative non-polluting sources of energy, or invest in devising technologically advanced vessels by which to explore the universe.

References

Rosenstand, Nina. The Moral of the Story: An Introduction to Ethics. New York: McGraw-Hill Higher…… [read more]


Organizational Leadership Strategies Falls Essay

… Besides, it is important to communicate with the patient about the effectiveness of the medication and assess whether the drug has low benefits or high risks. This helps them determine if they should continue or discontinue the medication (Drenckpohl, Bowers & Cooper, 2007).

When physicians decide to prescribe or de-prescribe a medication, it is necessary to work with the care provider. This reduces the chances of negative effects associated with withdrawal of medications such as psychological and emotional withdrawal. The health professionals must assist patients understand how they can approach a discontinued medication (Drenckpohl, Bowers & Cooper, 2007).

Clinical approaches to Polypharmacy

Before a caregiver prescribes a new medication, it is crucial to obtain a thorough history of patient medication. Both non-prescription and prescription medications must be considered: the patient must carry it to the healthcare provider. After assessing the patient's medical history, then the care provider can proceed and decide whether it is necessary to add more medication and if the benefits would outweigh the risks. In some cases, Nonpharmacologic therapy like exercise or diet modification might be appropriate instead of additional medication. Proper dosing must take into account patient's hepatic and renal function along with the drug's adverse event profile, pharmacodynamics, and pharmacokinetic (Varkey, Sathananthan, Scheifer, Bhagra, Fujiyoshi, Tom & Murad, 2009).

For the elderly, doses must be at a lower rate administered differently than in young patients. This helps in preventing toxicity from occurring. Care providers must evaluate the state of all concomitant diseases and drug-drug reactions to improve patient adherence. Patient adherence can be enhanced through educating both patients and their family members about their medications. Limiting drug prescription, considering generic options, simplifying drug regimens to simple medications and making use of compliance aids are some of the tactics that may help motivate families enhance adherence. Assessing medication regimes and setting reasonable therapeutic goals are very vital in ensuring that polypharmacy does result in unnecessary medical risks (Hines & Yu, 2009).

Conclusion

Polypharmacy has become common across the elderly generation. An array of studies proves that assortments of medications are linked to adverse health outcomes. However, more studies have found that there is an urging need to delineate the impacts linked to unnecessary intake of drugs. Healthcare practitioners ought to be aware of the associated threats and evaluate all medications at every single patient visit. This would help curb the recurrence of Polypharmacy (Drenckpohl, Bowers & Cooper, 2007).

References

Drenckpohl, D., Bowers, L., & Cooper, H. (2007). Use of the six-sigma methodology to reduce incidence of breast milk administration errors in the NICU. Neonatal Network, 26(3), 161-166.

Hines, P.A., & Yu, K.M. (2009). The changing reimbursement landscape: nurses' role in quality and operational excellence. Nursing Economic$, 27 (1), 7-13.

Menaker, R. (2010). Leadership strategies in healthcare. The Journal of Medical Practice Management, 24(6), 339 -- 343.

Miller, D. (Ed.). (2005). Going lean in health care. Institute for Healthcare Improvement Innovation Series. Retrieved from http://www.entnet.org/Practice/upload/GoingLeaninHealthCareWhitePaper.pdf

Varkey, P., Sathananthan, A., Scheifer, A., Bhagra, S., Fujiyoshi, A., Tom, A.,… [read more]


How to Administer Medication Essay

… ¶ … Administer Medication

One of the major responsibilities of nurses is to administer medication, which is a practice that is centered on providing patients with a prescribed substance that is geared towards the diagnosis, prevention, or treatment of a medical condition. The administration of medication also involves definite and total delivery of a prescribed substance to the patient. While there is a single goal of administering medication, there is a wide range of practices that are needed to achieve safe and effective patient outcomes. This practice also consists of a series of practices that are required to plan for and assess the result of administering medication. Generally, the process of administering medication begins with the order for the medicine, which is usually prepared by physicians. This is followed by different routes of administration that are associated with certain advantages and disadvantages. These administration routes also have different implications on the effectiveness of the drug therapy and drug treatment experience by the patient. This paper discusses the different routes of administering medication in light of their advantages and disadvantages as well as implications.

The ability of a drug to reach its intended site of action in the body is usually determined by two major factors i.e. bioavailability of the drug and route of administration ("The Administration of Medicines," 2007). The bioavailability of the drug is the percentage of an administered drug that reaches the general circulation and is accessible for distribution to the anticipated site of action. In contrast, the route of administration is the manner in which a patient is provided with a prescribed substance in order to prevent, diagnose, or treat a medical condition or illness. The most common routes of administration include oral, sublingual, topical, and parenteral administration. These routes determine the degree with which the patient obtains any clinical benefit and the likelihood of any adverse effects from the substances.

Oral administration is the most commonly used route because…… [read more]


Evidence-Based Practice Resource Filtered Unfiltered Article Review

… This does not mean that antibiotics would never be used, but only that they are used appropriately instead of blindly. Instead, evidence-based practice suggests that the healthcare professional should: 1) Review and confirm the diagnosis of AOM; determine if chronic or not. If the symptoms are irregular and not chronic, treat only overt symptoms; 2) Assess the discomfort level of the patient; use Tylenol or Motrin, topical agents, warm compresses, etc. To relieve pain and reduce symptoms; 3) Observe patient for 48-72 hours; educate parent in ways to mitigate symptoms and procedure if condition becomes worse; 4) If chronic or severe, or if AOM is worse after the watchful waiting period, Rx of amoxicillin, 80/90mg/kg per day; 5) Check in 3-4 days for reduction in symptoms, etc.

Part D -- Ethical issues do surround the idea of watchful waiting. In one opinion, watchful waiting is experimenting with a human patient -- waiting to see what develops. The other view holds that watchful waiting is actually more compassionate, because in the long run too many antibiotics are being prescribed and bacterial resistance is increasing. For the medical professional, though, the ethical mandates are: beneficence forming the locus of the Hippocratic Oath - "as to disease, do no harm;" Justice in care - providing the best care equally and fairly; and Autonomy -- the respect to allow each individual to make informed decisions and not push treatments that the client may or may not wish. This also includes saying "no" to the parent who insists on an antibiotic. Instead, explain that viruses do not respond to antibiotics, and overuse could actually put their child in danger (Timko, 2001, 62-5, 121-45).

The ethical nature of research is especially relevant when dealing with disenfranchised populations. Children, for instance, do not yet have the cognitive development to understand the issue of experimentation, and therefore must rely on the parent or guardian for guidance. HIPPA (The National Health Insurance Portability and Accountability Act) is designed to protect the confidentiality of all health information (through case notes, the Internet, to insurance or any agency). In fact, each professional organization must regularly preform a formal risk assessment by documenting how HIPPA rules are followed (Minors Privacy Rights, 2010).

REFERENCES

Diagnosis and Management of Acute Otitis Media. (2004). Pediatrics. 113 (5): 1451-65.

Sources of Evidence-Based Literature. (2006). NYU School of Medicine. Ehrman Medical

Library. Retrieved from: http://library.med.nyu.edu/library/instruction / handouts/pdf/ebmsources.pdf

Minors, Privacy Rights of HIPAA. (2010). University of Miami -- Miller School of Medicine. Retrieved from: http://privacy.med.miami.edu / glossary/xd_minors.htm

Block, S.L. (1997). Causative pathogens, antibiotic resistance and therapeutic considerations in acude otitis media. Pediatric Infections Diseases. 16 (2): 449-56.

Glasziou, P., et.al. (2004). Antibiotics for Acute Otitis Media In Children. Cochrane Database System Review. 1 (1): Retrieved from: http://www.ncbi.nlm.nih.gov / pubmed/14973951

Kelley, P., et al. (2007). Ear, nose and throat. In Hay, et al., eds. Current pediatric diagnosis and treatment, 18th ed. New York: McGraw Hill, pp. 459-92.

McCracken, G. (1998). Treatment of acute otitis media in an era of… [read more]


Doctors and Ethics Research Paper

… In a Melbourne, Australia (in 1959) maternity hospital a father refused to consent to blood transfusions for his infant daughter. The article doesn't say if he objected on religious grounds, just that he refused to authorize the doctor to give the child blood transfusions. The child likely would die without the transfusions, the father was informed because she was "severely jaundiced" (Waller, 621). The child did die and the case went to court and the father was successfully prosecuted for manslaughter; subsequently the Parliament of Victoria passed a law that doctors in Australia can administer blood transfusions to save the lives of children no matter what the parents say (Waller, 621). So problems of this kind have gone from medical ethics to ethical law.

Ethical Issues in a resident clinic

An article in the journal Medical Education points to the need for future doctors to be trained in ethics. This is along the same lines as a previous article in this paper, but in this case a sample of 53 "residents" (future doctors) and 19 preceptors (instructors) were observed by the researchers over a period of two weeks (in 2007). The point of the research was, how often is ethics brought up when future doctors are in training? The author reports that of the 135 medical cases that the "residents" were asked to study and relate to, 81% (109) had ethical strategies included in the presentations (Carrese, et al., 2011).

Some of the ethical issues covered included: a) doctor-patient communication, shared decision making and relationship between patient and doctor; b) how well was the resident learning about "developmental issues" (mental issues in patients), about interactions with the preceptor; and c) were the future doctors informed about (and did they relate well to) the financial issues that are part of a physician's practice; about "doctor frustration" (Carrese, 712).

In conclusion, it is important for doctors to understand what is considered ethical and what is unethical; from the information presented in this paper it is not clear that all doctors are serving their patients ethically. In particular, the idea of concierge medicine seems to be very unethical given that only rich people will be able to afford these exclusive doctors. This paper; points out that healthcare and ethics should go hand-in-hand in every case, and from the references available, it is clear that ethics and healthcare do not always go together. That should change.

Works Cited

Carrese, Joseph A., McDonald, Erin L., Moon, Margaret, Taylor, Holly A., Khaira, Kiran,

Beach, Mary Catherine, and Hughes, Mark T. (2011). Everyday ethics in internal medicine resident clinic: an opportunity to teach. Medical Education, 45(7), 712-721.

Daniels, Katy. (2012). Integration of ethics teaching within GP training. Education for Primary

Care, 23(2), 75-78.

Hotze, Timothy D., Shah, Kavita, Anderson, Emily E., and Wynia, Matthew K. (2011). "Doctor,

Would You Prescribe a Pill to Help Me… " A National Survey of Physicians on Using

Medicine for Human Enhancement. The American Journal of Bioethics, 11(1), 3-13.

Martinsen, Elin.…… [read more]


Herbal Drugs Research Paper

… ¶ … Internet sites that provide herbal drub information (including advice and specifics on the use of herbal medicine). The two Internet sites chosen for this assignment are: a) the University of Chicago Medicine "Herbal Medicine" site; and b) Medline Plus, a service of the United States National Library of Medicine and the National Institutes of Health (NIH).

Purpose of University of Chicago Site (www.uchospitals.edu).

The University of Chicago Medicine site states that it is "…at the forefront of medicine" and the site is clearly intended to provide helpful information but not necessarily a long list of all available herbal remedies. The first impression a user to this website gets is that it is informative and actually provides warning and precautions; it offers specific advice before choosing herbal supplements.

For example, the site warns that the FDA does not scrutinize herbal supplements, and herbal supplements "are not for everyone"; moreover, the site recommends that when attending a doctor's appointment the user of herbal supplements should always let the doctor know what herbal medicines are being taken. Before the site presents some of the more common herbal drugs, it provides a bulleted list of "precautions."

Some of those bullet points include: a) be educated about any herbs before consuming them; b) never take more than the label recommends; c) "Watch for side effects…nausea, dizziness, headache, or upset stomach"; reduce the dosage if these occur; d) be alert for "allergic reactions" (if breathing is difficult call 911); e) do the homework on every company whose herbs you take (do they make outrageous claims? Are there thorough instructions and does the label have a toll-free number and web address?) (www.uchospitals.edu). The U. Of Chicago site also lists 12 herbal supplements, including Green Tea, Garlic, Ginseng, and "Black Cohosh," which is a "shrub-like plant…used for alleviating menopausal conditions…uterine spasms…"

Purpose of Medline Plus Site (www.nim.nih.gov).

The Medline Plus site is not as informative in terms of generalized precautions as the University of Chicago site, but it has an enormously impressive list of herbal supplements that are listed alphabetically. Actually the site is designed to do several things. It has links to "Health Topics," "Drugs & Supplements," and "Videos & Cool Tools"; so it is a one-stop site for a number of important aspects of health and medicine.

Under "Drugs & Supplements" there is a category "Herbs and Supplements" and there is an a-Z listing of perhaps 100 herbal supplements. Hit any of the supplements / herbal drugs and a page comes up with specific information about that drug (also, the source for the information is presented). For example, "Asian Ginseng" is native to China and Korea,…… [read more]


Imagery Literature Review Guided Imagery and Pain Literature Review

… ¶ … Imagery Literature Review

Guided Imagery and Pain Management

Ferrell, Betty R., et al. "Pain management for elderly patients with cancer at home." CANCER-PHILADELPHIA- 74 (1994): 2139-2139.

The first study to be examined in this review was conducted by Ferrell and regards pain management techniques in elderly cancer patients who are living in a home environment. Here, the theory is that pain management is a great and noninvasive technique for managing severe levels of pain that cannot be cured through traditional methods. It can be seen as an alternative to overmedication, which can decrease the quality of the patient's live in his or her remaining days. Elderly patients have a particularly hard time recovering from more invasive pain management strategies, and thus this population serves to benefit the most from such pain management techniques. A structured pain evaluation and management program was instituted so that participants could reflect on how it impacts their overall levels of pain. Thus, the dependent variable here was the significance and severity of pain, while the independent variable was the presence of guided imagery. Within the population of 66 elderly oncology patients, there was a plan to conduct three home visits and two follow up sessions, where educational programs depicting strategies of guided imagery aimed to help empower participants to use such strategies autonomously in order to help manage their pain when it was at its worse. The study used repeated measurement analysis and concluded with the concept that the quality of life of patients exposed to guided imagery did improve based on their ability to better manage their pain. Physical pain severity was reduced and psychological stress was also reduced. Thus, the researchers posited that guided imagery is a successful tool for working with elderly oncology patients in lieu of traditional therapies.

Menzies, V., Taylor, a.G., & Bourguignon, C. (2006). Effects of guided imagery on outcomes of pain, functional status, and self-efficacy in persons diagnosed with fibromyalgia. Journal of Alternative & Complementary Medicine, 12(1), 23-30.

This study was conducted in 2006 in order to explore how guided imagery could help establish more successful methods of pain management within populations suffering from fibromyalgia, a type of nerve disorder that often causes chronic pain within those that it inflicts. Menzies et al. used a longitudinal study that focused on a randomized study population group within a controlled clinical trial that tested the control group who were exposed to usual care with an experimental group who introduced to some of the elements of guided imagery as a way to manage and cope with rising pain levels. The study used a theoretical framework that asserted the power of guided imagery as a way t manage chronic pain. In all, 48 people were included in the study; each recruited from their primary physician who helps them set pain management strategies so that they can continue to live their lives, even with the effects of fibromyalgia. In the context of the study, researchers assigned guided imagery techniques randomly to… [read more]


Healthcare Application Meditation Aside Term Paper

… Measuring his patient's pain with visual imaging system known as the Dermatome Pain Map, Kabat-Zinn detected considerable reductions in nerve activity associated with flare-ups of pain in chronic conditions like cancer, arthritis, and lower back pain. Even with the presence of a placebo in his testing to screen for the psychological tendency of patients to affect their own temporary pain relief when administered new treatment, Kabat-Zinn's study of meditation's role as a pain reliever concluded that "the majority of patients experienced considerable improvement in their conditions over the course of the ten-week training program in mindfulness meditation" (Kabat-Zinn, 1982).

Despite several subsequent confirmations how meditation can be integrated within the practice of complementary medicine, the majority of primary care physicians today still refuse to incorporate this mental and spiritual component to healing in their overall treatment regimen (Spiegel, Stroud & Fyfe, 1998). The accelerated spread of pharmaceuticals as the most commonly advised treatment option, even for minor instances of discomfort and irritation, has created a medical environment in which most doctors simply lack the financial incentive to suggest that a patient pursue the personal healing path found through meditation. Nonetheless, when a patient today is confronted by the prospect of chronic pain, increased stress, and psychological uncertainty due to a medical condition, they are far more likely than ever before to meditate as a way of asserting control over their own health outcomes. Research on the willingness of ordinary Americans to pursue complementary medicine, which uses holistic healing to complement Western medicine, has revealed that "the appetite for complementary medicine is stimulated by a need for attention and compassion that many patients are not getting in biotechnical medical care" (Spiegel, Stroud & Fyfe, 1998).

References

Anderson, E., & Anderson, P. (1987). General practitioners and alternative medicine. The Journal of the Royal College of General Practitioners, 37(295), 52. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1710702/

Kabat-Zinn, J. (1982). An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: Theoretical considerations and preliminary results. General hospital psychiatry, 4(1), 33-47. Retrieved from http://brainimaging.waisman.wisc.edu/~perlman/0903-EmoPaper/kabatzinn-mbsr- 1982.pdf

Spiegel, D., Stroud, P., & Fyfe, A. (1998). Complementary medicine. Western Journal of Medicine, 168(4), 241. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1304947/… [read more]


Grossman, J.M., Cross, D.A., Boukus Article Review

… Pharmacists also noted physician errors such as refusing to renew a prescription medication, and then immediately re-filing a new request for the same medication and patient, thereby defeating the purpose of the system. In addition to physician barriers to use, patients also struggle with the electronic systems offering cryptic data on proper use of medications.

This article accurately captures the resistance to employing electronic medical records on a large scale in the United States, which is woefully behind other nations in adopting electronic medical records systems. More research like this is required to point out how physicians can become more amenable to using electronic systems like e-prescriptions. When the barriers to use are identified scientifically, as in this qualitative research, systems designers can create e-prescription software that better serves the end-user populations. Small adaptations to the software and/or hardware can ensure that all physicians are on board with using the systems, which have the potential to reduce medical errors and improve patient outcomes.

However, improving the nature of the systems themselves is not the most important means of increasing the use of electronic medical records. Resistance to use among physicians is a problem that is endemic in the organizational culture. Attitudes toward electronic medical records are poor, and changing those attitudes comes from altering medical school education. Electronic medical records use should become as commonplace as the scalpel. Research such as this is a necessary component of changing the overall attitude and organizational culture.

Reference

Grossman, J.M., Cross, D.A., Boukus, E.R. & Cohen, G. (2011). Transmitting and processing electronic prescriptions: experiences of physician practices and pharmacies. Journal of the American Medical Association. Doi:10.1136/amiajnl-2011-000515… [read more]


Random Drug Testing Medical Professionals Essay

… Random Drug Testing Medical Professionals (Why should we randomly test medical proffessional?)

Randomly testing medical professionals is an ongoing debate in the medical community. Whether or not it should be done depends on the medical facility's budget and the need… [read more]


Management Case Analysis: Pharma Case Study

… The United States government and pharmaceutical industry are key players in the control over Intellectual Property Rights, copyrights, distribution, and pricing of AIDS medications.

The WTO is another significant organization with influence regarding the duration and stipulations of patents and copyrights.

3. International management and business topics

Supply and demand

Non-profit organizations vs. Corporations

Collective action, activism, and government ordinance

4. There is a lot of demand for AIDS medicine therefore the cost of the supply can fluctuate based on the industry's long-term goals and objectives. NPOs and corporations have been at times, at odds and at times, collaborative with respect to combating AIDS. Citizens, NPOs, and governments have all make substantial efforts to resolve the AIDS problem.

5. Pharmaceuticals do not necessarily have a responsibility to make drugs low cost in developing countries. It certainly would make sense and be humane to do so, but they do not have some kind of responsibility. Make the drugs low cost and available gives companies more opportunities for more revenue and revenue for longer. The drugs do not necessary have to be free, but affordable relative to the location and the population in need. Periodic donations are another possible alternative. It is not likely these companies will ever make the drugs entirely free in a place or in the world. Capitalism is far too widespread for that to occur.

References:

Shah, Anup. "Pharmaceutical Companies and AIDS." Global Issues: Social, Political, Economic and Environmental Issues That Affect Us All, Web, Available from: http://www.globalissues.org/article/53/pharmaceutical-corporations-and-aids. 2013 February 18.

UNAIDS. "2002 Report on the Global HIV…… [read more]


Treatments for Rosacea Research Paper

… Rosacea Treatments

Rosacea: Causes, Symptoms, and Treatments

Imagine having a flushed face all the time, at those most inconvenient moments where you do not want to look like Santa Clause himself. This is often the stress sufferers of rosacea must deal with, as they have to face life with a flushed face. There are a number of potential causes related to what is considered adult acne, and with them come a variety of treatments, both topical and more natural in origin.

There are a number of causes of rosacea within adults. Essentially, it is an adult case of acne-like symptoms, with additional signs of irritation in the blood vessels right below the face. Rosacea often occurs in people between 30 and 60 years old, most often females (MacKenzie, 2012). In fact, older adult women are more prone to flare ups of rosacea, which can increase dramatically in cases where woman are going through menopause. It is rarely seen in children, and tends to affect more women than men. Yet, there have been connections linking the presence of rosacea with excessive drinking (Clinical Reference Systems, 2004). When drinking alcohol occurs, there are greater instances of rosacea flare ups fro adult sufferers. Family genes and heritage can also have an influence on people experiencing rosacea (Clinical Reference Systems, 2004). Additionally, stress can prove to be triggers of a rosacea flare up as well (Wong, 2013). Symptoms tend to get worse with increasing stress levels. Another cause presented in recent scientific research could be linked to the presence of mites living inside the pores of the skin. These mites are not necessarily uncommon, but they may have a connection to some individuals having rosacea based on contact with the mite's feces. One particular species of mite, known as Demdox, feds on facial oil, but has been seen to cause rosacea flare ups in individuals. Here, the research suggests that some cases of "rosacea are caused by a reaction to bacteria in the mite's feces" (MacKenzie, 2012). This wide number of causes can work independently or in conjunction to generate flare ups of rosacea, making treatments needing to be flexible to approach multiple causes.

Symptoms tend to be annoying, and can sometimes be quite painful. Essentially, rosacea "is a chronic…… [read more]


Suffer Anymore: Access to Pain Essay

… In fact, according to Brennan et al., "we are at an "inflection point" in which unreasonable failure to treat pain is viewed worldwide as poor medicine, unethical practice, and an abrogation of a fundamental human right" (2007). However, there is a tremendous breakdown between what is seen as an ideal and what occurs in the everyday working environments in many modern medical communities. This is an unacceptable reality because pain management is not unduly burdensome or expensive. Morphine is the first-course medication for severe pain and the fact that is it both inexpensive and widely available removes many of the barriers to offering such relief to patients experiencing pain.

Perhaps one of the reasons that countries are not addressing this problem in a more vigorous manner is that the implications for ignoring pain are not significant, on a diplomatic level. Yes, the implications for ignoring pain management are significant for the individual suffering from un-relieved pain. However, many of these patients are dying and will have no impact on the future of their countries. Moreover, because their family members may not even be aware that pain medications exist that could have alleviated tremendous suffering, the government and medical community may not experience any type of backlash for continued denial. Therefore, the burden will fall to those in the medical community to continue to advocate for patient needs and seek pain relief for their patients. For a nurse practicing in the United States, where the majority of the medical community believes in pain relief, this may not have a tremendous impact on day-to-day working conditions. However, if a nurse works in an international arena, that nurse can expect to encounter resistance when seeking pain medications on behalf of a suffering patient, and must be prepared to strongly advocate on behalf of that patient.

References

Brennan, F., Carr, D., and Cousins, M. (2007). Pain management: A fundamental human right.

Anesthesia & Analgesia, 105(1), 205-221.

Lohman, D. (2009). "Please do not make us suffer any more:" Access to pain treatment as a human right. New York: Human Rights Watch.

Purdue Pharma LP (2012). Ethics & Pain. Retrieved…… [read more]


Magnetic Therapy: Sound Practice Research Paper

… Though there have been some other claims regarding the effectiveness of magnetic therapies in a variety of other treatments, none of these other studies have reached a threshold of evidence or of stringency in methodology to have become the subject of any widespread scientific examination (Vallbona & Richards, 1999; Livingston, 2012; Ramey, 2012). In addition, none of the findings of any individual study -- including the only widely reviewed study that has found magnetism to have an impact on pain -- have been repeated by other studies despite attempts (Cepeda et al., 2007; Ramey, 2012). The lack of explanation as to how magnetism works and the lack of concrete evidence that it does work both mean that there is little reason to accept this treatment as valid.

Whether or not this theory should be used or recommended is more complex than whether or not it has any proven medical benefit, however. Certainly magnetic therapy should not be used to the exclusion of other therapies, with faith placed in the healing ability of magnets preventing more proven and effective treatments and thus leading to risky health outcomes. In addition, no one should put a great deal of effort or expenditure into receiving these treatments, as this would represent an inappropriate diversion of resources. There is a demonstrated placebo effect for magnets as there is for sugar pills and other forms of false treatment, though, and someone experiencing minor pain or discomfort and who is generally receptive to such ideas might be recommended to try rubbing magnets on the afflicted area just as well as they might be recommended to try a number of harmless yet unproven therapies. A benefit gained from belief is still a benefit gained, and though magnetic therapy should not be supported as medical science it is not entirely unadvisable depending on the ethics of a given situation.

Conclusion

Magnetic therapy, like many fad therapies, has virtually no evidence supporting its efficacy. Though there are some in the medical community that believe magnets can be used to treat pain and a variety of other ailments, there is no repeatable scientific data that supports this opinion. Useful as a placebo for some, magnetic therapy should not be used as a treatment replacement for traditional medicine.

References

Cepeda, S., Carr, D., Sarquis, T., Miranda, N., Garcia, R. & Zarate, C. (2007). Static Magnetic Therapy Does Not Decrease Pain or Opioid Requirements: A Randomized Double-Blind Trial. Anesthesia & Analgesia 104(2): 290-4.

Livingston, J. (2012). Magnetic Therapy: Plausible Attraction? Accessed 12 December 2012. http://www.acemagnetics.com/eduarticles-magsportsbracelets-plausibleatt.html

Ramey, D. (2012). Magnetic and Electromagnetic Therapy. Accessed 12 December 2012. http://www.skeptically.org/quackery/id4.html

Valbona, C. & Richards, T. (1999). Evolution of magnetic therapy…… [read more]


Ethical Analysis of Merck Essay

… Its final result had been that there had been absolutely no distinction in cardiovascular events amongst the 3 groups (Biddle, 2007).

Merck's self-assurance in the security of Vioxx, nevertheless, didn't last. On September 30, 2004, Merck removed Vioxx from the… [read more]


Elder Care Case Study

… Elder Case Studies

Situation-

Mrs. Elli Baker is a 73-year-old female who was transferred to the Emergency Room after collapsing in her backyard.

Just prior to the collapse, she was on the phone with a friend, who reported her to be confused and anxious.

Upon arrival to the ER, Mrs. Baker complained of dyspnea, and had an increase in both respiratory and pulse rates.

Previous medical history includes both diabetes and hypertension.

Medications -- Mrs. Baker uses metformin and hydrochlorothiazide, and recently added a new BP medication, lisinopril.

The ER nurse was able to ask Mrs. Baker a few questions, but after a brief time she became unresponsive and had more difficulty in breathing.

Part a -- Mrs. Baker is clearly in distress. The first step is to alleviate her anxiety, calm her down, so that further assessments can be made. Because of her respiratory difficulties, she should be given Oxygen which should also alleviate some of her tension and presumed pain. Depending on her response rate, it might also be advisable to give her a low-dose sedative, perhaps one of the benzodiazepines (National Institute of Mental Health, 2011). Once Mrs. Baker is able to breath and is less anxious and less likely to hyperventilate, we can reassess her condition and symptoms that caused her collapse. Until the patient is coherent and/or we receive previous medical records, we must proceed based on current information.

Assessment

1. Blood pressure is elevated, and background notes present confusion and anxiety prior to collapse. All immunizations are up-to-date, and no complications reported from recent procedures. Recent medication, lisinopril, Lisinopril presents possible side effects of dizziness, headache and/or difficulty breathing, but these are relatively uncommon (PubMed Health, 2012).

Skin, Hair, Nails

No recent abnormalities with exception of client complaint

Head, Neck, related lymphatics

Unremarkable

Eyes

No abnormalities

Ears, Nose, Mouth and Throat

Unremarkable

Respiratory Function

Difficulty in breathing, airway seems distended

Breasts

Unremarkable

Cardiovascular

Slight pain, unsure whether anxiety issue

Peripheral vascular

High pulse rate, anxious

Abdomen

Unremarkable -- no constipation and positive bowel sounds

Urinary

Unremarkable

Musculoskeletal

Some evidence of osteoarthritis in joints of legs, arms and hands.

Neurologic

Confusion, anxiety

Part B- Medical and Technological Tools

Stethoscope, sphygmomanometer, thermometer, scale -- basic indications of stats -- heart, lungs (clarity), blood pressure, temperature, height and weight

Radiographs to determine if there are osteo-injuries -- findings include osteo issues in hip area, but no breaks, hairline fractures, or joint tears. . There is some discoloration around the upper thigh area, but this bruising seems to be rather localized and not terribly serious in this instance. Patient appears to have sustained a hip pointer based on the swelling, bruising, and tenderness in the area (Brown, 2009).

Syringe, rubber tube, gauze, etc. -- Ordered basic blood tests, CBC for infection, basic toxicity screen, Coagulation tests (PT, PIT, INR), Blood Chemistry (glucose to check diabetes or stoke), Blood Lipid panel (risk factors); may order cardiac enzyme tests and coagulation factors.

Oxygen tank and mask -- designed to increase… [read more]


H1N1 Briefing Case Briefing: This Case Details Term Paper

… H1N1 Briefing

Case Briefing:

This case details the outbreak of the H1N1 flu in Tennessee during 2009, from the initial appearance of the flu strain to the first Tennessee cases in the spring of the year through the virus' dissipation and subsidence in the winter of 2009-1010. Public health entities and their successes and failures in preparing for and then addressing the flu's progress in the face of certain practical difficulties are the focus of the description provided by the authors, with imbalances and inefficiencies in the distribution of vaccines and thus in the availability of the vaccine to the general population and sensitive target groups forming the fundamental problem in this case. Topics involved include healthcare, the complexities of intra-governmental and governmental-private interactions, and organizational communication.

Summary

The H1N1 flu virus was initially identified in Mexico, Texas, and California, in April of 2009, and other states began preparing for an epidemic due to the lack of vaccine for this new and apparently virulent strain. Knowledge about the flu was limited and recommendations from the CDC regarding preparedness and reactions were uncertain and frequently changing in the early days of the virus' spread, leading to some confusion with school closures in Tennessee after the first cases appeared there. The public health officials and network seemed well-prepared for the worst, however, and had time over the summer to hold meetings with other relevant entities and parties and to develop a registration system for healthcare practitioners -- physicians and pharmacists -- that would help to ensure vaccines were delivered in a fair and timely manner in accordance with established priorities once a vaccine had been developed. The flu began to spread in earnest during September, after schools were back in session, yet a vaccine did not become available until October and was at first only available in a form not fit for certain high-risk (and therefore high priority) groups. Misunderstandings and miscommunications regarding the vaccine's availability exacerbated the issue of availability, and though the flu strain proved to be less virulent and less easily spread than initially feared missteps were made in informing practitioners and the public of best practices in confronting the flu. By the time the vaccine was widely available there was lessened demand due to public fears and the subsidence of the epidemic worries.

Background

The H1N1 flu scare was part of a series of viral epidemic scares that created something of a subdued panic during the first decade of the new millennium. SARS, the Avian Flu, the Hanta virus, and others became fairly regular news items that excited public interest and quite rightly led to adjustments in medical preparedness and protocol. The CDC remained a consistent and centralized source both for providing data and recommendations to state health departments as well as tracking cases through reports from medical offices, however the coordination of prevention and treatment efforts at the operational level was very much a matter for individual states and, depending on each state's system, state regions/counties. Tennessee… [read more]


Radiopharmaceutical GA-68 DOTATOC Term Paper

… ¶ … 68Ga]-DOTATOC in Imaging Neuroendocrine Tumors

Non-invasive imaging and monitoring of neuroendocrine tumors has traditionally relied upon conventional scintigraphy and/or dedicated CT (111ln-octreotide scintigraphy). Imaging and monitoring of neuroendocrine tumors through the detection and tracking of tumor-based somatostatin receptors using diagnostic somatostatin analogs is still relatively new, yet current research suggests that it can be far more accurate than traditional methodologies (Hofmann et al., 2001; Buchmann et al., 2007; Gabriel et al., 2007; Poeppel et al., 2011). One study showed that the newer technique achieved a sensitivity of ninety-seven percent, a specificity of ninety-two percent, and an accuracy of ninety-six percent, with only one false positive tumor detection and two false negative results in a data pool of eighty-four patients (Gabriel et al., 2007). Traditional tumor detection methods applied in the same study had significantly higher false negatives and failures to diagnose tumors in many areas of the body, whereas the two false negatives resulting from [68Ga]-DOTATOC somatostatin receptor analysis were both related to tumors in the gastrointestinal tract with liver metasteses (Gabriel et al., 2007). The continued study of various artificial somatostatin analogs as a means of imaging neuroendocrine tumors is called for by these preliminary findings.

More specifically, the study of [68Ga]-DOTATOC as the most effective of these analogs is also warranted by the research ((Hofmann et al., 2001; Buchmann et al., 2007; Gabriel et al., 2007; Poeppel et al., 2011). Much of the current literature finds that [68Ga]-DOTATOC PET applications and other PET applications using other somatostatin analogs are more effective than traditional methods of neuroendocrine tumor detection and monitoring, and the general recommendation of including such testing as a part of best practices can already be made (Hoffmann et al., 2011; Gabriel et al., 2007). Studies comparing the accuracy and efficacy of [68Ga]-DOTATOC in relation to other somatostatin analogs used in similar or otherwise identical PET studies also suggest that [68Ga]-DOTATOC is more effective and accurate than other somatostatin analogs, however these results are not as conclusive and call more fervently for further research in order to establish the true accuracy level of [68Ga]-DOTATOC in relation to other neuroendocrine tumor detection and monitoring methods (Buchmann et al., 2007; Poeppel et al., 2011). Establishing and confirming best practices in this regard will lead to greater efficiency and cost-effectiveness in diagnostic testing and to substantially better patient outcomes through increased accuracy and the earlier detection and treatment of neuroendocrine tumors.

Project Design and Procedures

Potential participants who have recently undergone diagnostic treatment at one of several area hospitals will be contacted by current physician and/or nursing staff to ascertain initial desire to participate, with contact by research…… [read more]


Pancreatic Cancer Etiology Essay

… , 2001).

Other Aspects of Medical Management

Caretakers work on reliving pain through various means. Attention is also given to diets particularly using pancreatic enzyme supplements lipid supplements both of which may provide better quality of life and prolong survival.

Aside from pain, patients also commonly experience depression. This too is treated. A support community is crucial.

Incidence and Mortality Rates of Pancreatic Cancer

Pancreatic cancer is the sixth most common cancer death in the U.S.A. (GUT), and it is generally higher in Western or industrialized countries. Whilst rare before 45, 80% of cases occur between 60 -- 80 years-old. Pancreatic cancer is uncommonly difficult to treat; consequently, statistics of incidence and mortality are usually associated. Whilst men were more generally prone to the cancer, the Surveillance, Epidemiology, and End Results (SEER) has demonstrated that both genders are now equally prone to displaying it.

Exc. 2.

Although I did not find any specific news article within the last seven years that resulted in a medical error, I did find an article printed recently that stated that a large number of heart patients fatally harm themselves from medication errors, even if they have extra help form pharmacists due to the fact that they turn to online, or other sources for help. These include newspapers, magazines, and other websites that, sometimes, end up incorrectly counseling these patients. Most errors were mild, but some were life-threatening.

Apparently, medication errors harm at least 1.5 million people a year in the U.S., according to the Institute of Medicine of the National Academies. People commonly connect medication errors to practitioners, but actually they can come from external sources, too. And, frequently, those most vulnerable are patients who have low-health literacy, are gullible to accepting data from news sites and sources at random, tend to have more trouble understanding and managing their health, and who have cognitive problems.

The article recommends hospital pharmacists to take greater interest in the health and maintenance of their patients following their discharge too, in order to check up on their medication. (Doheny, July 2, 2012 ).

Sources

Doheny, K ( July 2, 2012) Medication Errors Affect Half of Heart Patients WebMD http://www.webmd.com/heart/news/20120702/half-of-heart-patients-make-medication-errors

GUT. Guidelines for the management of patients with pancreatic cancer periampullary and ampullary carcinomas http://gut.bmj.com/content/54/suppl_5/v1.full

Surveillance, Epidemiology and End Results Program. http://seer.cancer.gov/faststats/html/inc_pancreas.html

Neoptolemos JP, Dunn JA, Stocken DD, et al. (2001) Adjuvant chemoradiotherapy and chemotherapy in resectable pancreatic cancer: a randomised controlled trial. Lancet;358:1576-85

NHS Executive. (2011) Guidance on commissioning cancer services. Improving outcomes in upper gastrointestinal cancers. London: Department of Health

Ulrich C. et al. (2001) Consensus guidelines for prevention, screening, and treatment. Pancreatology;1:412-41… [read more]


Electronic Health Records Essay

… Electronic Health Records and E-Prescribing

Electronic Health Records and e-prescribe

Use of EHRs to reduce medication errors

Electronic health records (EHRs) can help reduce medication errors that result in high costs as a result of recalls and fines. EHRs can be used to pass important information regarding the medication being recalled. Through the EHRs, it is possible to contact all patients who were given the recalled medication and advise them accordingly whether to dispose of the medication or to change the dosage. For drugs that have been recalled because of some tablets being oversized such as Hydrocodone Bitartrate and Acetaminophen Tablets U.S. Food and Drug Administration, 2012b ()

, the patients could be advised to make sure they take only the drugs that are of standard size while for drugs that have packaging flaws such as Propofol which was recalled because of glass vial defect U.S. Food and Drug Administration, 2012a ()

, the patients could be advised to return to the nearest health center for exchange. The patients could also be advised on the remedial actions for taking drugs that are recalled such as antidotes. In this way, EHRs would be advantageous in passing information to patients regarding the recalled drugs.

EHRs can also be used to reduce medication errors by preventing patients from being given drugs which have been recalled. The system would automatically notify the physician that the drug has been recalled thus they need to prescribe an alternative drug. At the pharmacy, the pharmacists will also be notified of drug recalls thus keeping them updated on which drugs have been recalled and if the recalls only affect certain lots or batches, the pharmacist will be able to tell if they have any drugs in the recalled lot or batch and these will not be given out to patients.

EHRs will also help to ease the process of drug recalls since the manufacturer will be able to know which pharmacy has the drug or particular lot or batch that has been recalled. This will save the time for collection of these drugs considerably. Patients will also be able to return the recalled medication to their nearest pharmacy which will then return the recalled drugs to the manufacturer thus increasing the efficiency of the recall process.

Safety checks that an EHR's e-prescribing feature can perform

EHRs can help to perform important safety checks for physicians when prescribing drugs. EHRs can alter the physician about any medical errors that may impact patient outcomes.…… [read more]


Health Care Economics Heath Term Paper

… In other words, it could lead to the legalization of drug re-importation and such a situation would further increase the size of the drug re-importation phenomenon. In such a setting, the American pharmaceutical companies would be faced with decreased revenues and competitiveness within the domestic market place, and this would lead to further price increases in the medicines. Furthermore, the safety of the people would be endangered, since the FDA would be unable to supervise drug distribution.

(3)

Another notable challenge within the modern day American health care sector is represented by the prices of the drugs, which continue to increase and make it more difficult for the population to afford medicine. In such a setting, a question has been raised relative to the possibility of capping the prices for drugs in the country. In other words, a question is now being posed relative to the possibility of regulating the prices of the prescription drugs.

Like with any other debate, there are two stands to the issue. For once, there are those argue against drug price control, believing that the political intervention would disrupt the supply-demand equilibrium within the market, and would also reduce the competition within the industry (Morton). From a political standpoint nevertheless, the control of the prescription drug prices is a more appealing solution.

At the political level, the better control of the prices is attractive as it would allow the federal institution to better monitor the activity and revenues of the pharmaceutical companies. Additionally, it would also help to improve the image of the political parties, who would enhance their reputation by making medicine more accessible to the population.

Then, the political parties see the price controls for prescription drugs as a mechanism of controlling the market and economy of the pharmaceutical companies. By implementing new laws and regulations, the government would prevent the leading pharmaceutical companies from gaining monopoly within the market, which is a situation to be avoided. Overall, the political argument for control of prescription drug prices is represented by higher levels of population affordability and access to medicines.

References:

Morton, F.M.S. The problems of price controls. Health and Medicine. http://www.cato.org/pubs/regulation/regv24n1/morton.pdf accessed on October 5, 2012

Health economics II. Overcoming inefficiency through managed care. A look at David Drannove's rationale. University of Canterbury. http://www.econ.canterbury.ac.nz/personal_pages/john_fountain/Teaching/HealthEcon/econ338/workshop/Sam%20on%20Dranove.htm accessed on October 5, 2012

Prescription drug re-importation question and answer sheet. AARP. http://assets.aarp.org/www.aarp.org_/articles/international/ReimportationQA.pdfaccessed on October 5, 2012… [read more]


Patient Exposure to Multiple Diagnostic Essay

… " (Stanford School of Medicine, 2012, .1)

II. Increases in Use of Radiation in Imaging

The June 2012 Physicians Guide to Imaging Radiation Exposure reports that imaging procedures that utilize "ionizing radiation may pose a small increase in a patient's lifetime cancer risk." (p.1) Stated is that imaging procedures using radiation "are essential tools for medical diagnosis and treatment, and no published studies have conclusively linked cancer with radiation at the levels used in imaging. However, consensus statements from the American College of Radiology and other clinical organizations suggest that it is reasonable to act on the assumption that low-level radiation may have a small risk of causing cancer." (Physicians Guide to Imaging Radiation Exposure, 2012, p.1) The individual is exposed to "70 times more radiation" in a CT scan and 160 times more radiation in a CT angiogram when compared to a chest radiograph. (Physicians Guide to Imaging Radiation Exposure, 2012, paraphrased) The use of imaging tests using radiation is reported to have "grown dramatically" as the use of radiation in imaging has "increased twenty-fold between 1980 and 2005 up to 72 million CT scans" being performed each year in the United States. (Physicians Guide to Imaging Radiation Exposure, 2012, paraphrased) It is reported that there are no epidemiological studies that "directly link cancer to radiation at the levels used in imaging procedures." (Physicians Guide to Imaging Radiation Exposure, 2012, p.2) The cancer risk from imaging radiation is reported to be dependent upon the age of the patient at the time of exposure in that the "younger the patient, the higher the risk." (Physicians Guide to Imaging Radiation Exposure. 2012, p.2) There should be extra caution taken when pediatric patients are being imaged and unborn fetuses are reported to be "at even greater risk -- imaging radiation should be avoided if at all possible in pregnancy." (Physicians Guide to Imaging Radiation Exposure, 2012, p.2)

Summary and Conclusion

There is a risk of cancer due to patient radiation exposure during diagnostic testing procedures however; the apparent benefits of the procedures override the concerns of radiation exposure of patients. Individuals should question their physicians about the danger of radiation exposure during multiple imaging diagnostic testing procedures.

Bibliography

A Physicians Guide to Imaging Radiation Exposure (2012) Care Process Model. June 2012. Retrieved from: https://intermountainhealthcare.org/ext/Dcmnt?ncid=521190311

Patient Care: What is Nuclear Medicine (2012) Stanford School of Medicine. Nuclear Medicine and Molecular Imaging. Retrieved from: http://nuclearmedicine.stanford.edu/patient_care/

Kleinerman, RA (2006) Cancer Risks Following Diagnostic…… [read more]


Ebm Evidence-Based Practice Essay

… So in evidence-based medicine there is less value given to authority, tradition, and expert opinion and more value placed on evidence. This is extremely important in assuring accurate and effective diagnostic and intervention techniques as well as in making sure that the profession of healthcare advances by testing existing methods and developing empirically-based new methodologies.

Evidence-based practice is crucial for a number of situations where there are conflicting expert opinions on the diagnosis and treatment of a condition or where mistakes can be critical in the care of a patient. For instance, the treatment protocols surrounding conditions such as cancer have been developed on the basis of RCTs with experimental and existing medications/interventions in order to ascertain the most effective approach to treating some serious conditions (Hoffmann et al., 2010). The increase in the effective treatment of many cancers is due to the reliance on evidence-based medicine.

I agree that evidence-based is crucial for the continuing improvement of healthcare in general even though it requires practitioners to learn new skills, develop critical thinking skills, and be willing to shed with some highly cherished rational beliefs and practices. Moreover, evidence-based practice adds a dimension to the traditional training methods and consultation practices that the healthcare system has relied on. There are several disadvantages such as a lack of research on certain conditions or treatments, the need to understand methodology and statistics, and the need to keep up with the mountains of new information. However, evidence-based practice can only improve healthcare outcomes and improve the healthcare profession, which should be one of our main ongoing goals as professionals.

References

Evidence-Based Medicine Working Group. (1992). Evidence-based medicine: A new approach to teaching the practice of medicine. JAMA, 268 (17), 2420-2425.

Hoffmann, T., Bennett,…… [read more]


Evans, E.G. and Sigurgeirsson Peer Reviewed Journal

… I3 group: 38.3% (41/107); and

4. I4 group: 49.1% (53/108).

The comparison of all four groups indicated that there were significantly higher rates of cure among the two terbinafine groups, as well as measures of all secondary clinical outcomes at week 72; however, the researchers did not identify any differences between the number or type of adverse events recorded in the terbinafine or itraconazole groups.

Conclusion: Based on their findings, Evans and Sigurgeirsson concluded that, "Continuous terbinafine is significantly more effective than intermittent itraconazole in the treatment of patients with toenail onychomycosis" (1999, p. 1031).

Source: Smith, C.G., Herzka, A.S. & Wenz, J.F., Sr. (2004, April). Searching the medical literature. Clinical Orthop Relat Research, 421, pp. 43-49.

Key Points: Finding what you need in the age of information is like trying to drink from a fire hose. The authors describe several popular online research resources and how researchers can use them to their maximum advantage.

Objective: To identify effective search protocols for locating timely and relevant peer-reviewed journal articles and scholarly resources for medical researchers in general and orthopedic surgeons in particular at the time of writing (2004).

Overview: On the one hand, there is more relevant medical information available to researchers today than ever before; on the other hand, though, finding precisely what is needed in an efficient fashion involves a knowledge of what resources are available and how best to use them to find what is wanted. Moreover, finding gold-standard studies that rely on randomized controlled trials and are published in the English language within a certain timeframe (the past 3-5 years is common) can be a challenging enterprise if certain steps are not taken to use the Boolean arguments that are available in MEDLINE and other reliable online research resources such as Excerpta Medica, Science Citation Index. Many healthcare practitioners, especially orthopedic surgeons who lack training in these areas, may not have the requisite search skills needed to access the best of evidence-based practices available online today.

Search Techniques: The authors provide several useful (at the time) tips and guidelines for medical researchers to help them locate relevant studies of interest as well as specific papers using various indexing methods…… [read more]


Practicum Project Plan Term Paper

… ¶ … Opportunities to Reduce Medication Errors

The purpose of the project envisioned herein is to reduce medication errors in the clinical setting with the goal of reducing medication errors by at least 50%. The name of the project, "The… [read more]


Stem Cell Ethics Debating Essay

… However, ES cell research continues wherever this law does not apply, including within the research laboratories of private U.S. companies and overseas. Despite the limited reach of this law, there has yet to be a report of anyone producing, or intending to produce, human embryos on a large scale. The middle ground in this debate appears to be the status quo, which includes the limited availability of established and well-characterized ES cell lines, advances in ES cell research that promotes advances in the field as a whole, and rapid progress in the AS/iPS cell research fields that may eventually render ES cells clinically irrelevant.

Works Cited

Antiniou, Michael. "The Case Against & #8230;" Nature Medicine 7.4 (2001): 397-399. Web. The author argues that the use of embryonic stem cells for research and medicine poses significant ethical and moral issues that cannot be overcome. Of particular concern is the potential for reproductive cloning, a door that the author believes was opened when the UK government approved the use of embryonic stems cells for research and medicine.

Blow, Nathan. "In Search of Common Ground." Nature 451.7180 (2008): 855-858. Web. The author presents several issues facing researchers who work with stem cells and discusses why they are important to advancing this field of research. Of primary concern is developing standard protocols for producing stem cells and creating the necessary protocols and reagents that will allow the therapeutic use of stem cells in humans.

Leeb, C., Jurga, M., McGuckin, C., Forraz, N., Thallinger, C., Moriggl, R. et al. "New Perspectives in Stem Cell Research: Beyond Embryonic Stem Cells." Cell Proliferation 44.1 (2011): 9-14. Web. The focus of this article is the promises and limitations of embryonic, adult, and induced pluripotent stem cells, from the perspective of scientists working in this field. The ethical decisions concerning the use of embryonic stem cells are only mentioned in passing.

Power, Carl and Rasko, E.J. "Promises and Challenges of Stem Cell Research for Regenerative Medicine." Annals of Internal Medicine 155.10 (2011): 706-713. Web. The authors discuss in detail the three main types of stem cell technologies: embryonic, adult, and induced pluripotent. Ethical issues are mentioned occasionally, but not discussed.

Ritz, John M. "Magic from Human Regenerative Technologies -- Stem Cells." Technology and Engineering Teacher May/June (2012): 4-9. Web. The author provides a general overview on cloning technology in laymen's terms. The technologies covered are embryonic…… [read more]


Ga Dota TOC Radio Pharmaceutical Research Proposal

… Nuclear Medicine Communication 28 870-875.

Eberle, A.N. (2005) Melanoma Targerign with DOTA-Melanocyte-Stimulating Hormone Analogue: Structural parameters Affecting Tumor Uptake and Kidney Uptake. Journal of Nuclear Medicine 46, 887-895.

Fani M. Andre, J.P. Maecke, H.R. (2008) 68Ga-PET: a powerful generator-based alternative to cyclotron-based PET radiopharmaceuticals. Contrast Media Molecular ImagingI 3, 67-77.

Florio T, Schettini G (2002). Somatostatin and its receptors. Role in the control of cell proliferation. Minerva Endocrinol. 26:3, 91 -- 102

Forrer, F. Waldherr, C. Maecke, H.R., Mueller-Brand, J. (2006) Targeted radionucleotide therapy with 90Y-DOTATOC in patients with neuroendocrine tumors. Anticancer Research 26, 703-70

Gabriel, M. Andergassen U. Putzer, D. (2007) Innsbruck experience with targeted radionucleotide therapy using different radiolabeled somatostatin analogs. European Journal of Nuclear Medical Molecular Imaging. 34, S220. Froidveaux S. Calame-Christe, M. Tanner, H.

Hofmann, M. Maecke, H. Borner, A. Weckesser, E. Schoffski, P. Oei, M. Schumacher, J. Henze, M. Heppler, A. Meyer, G. (2001) Biokinetics and imaging with the somatostatin receptor PET radioligand 68Ga-DOTATOC: preliminary data European Journal of Nuclear Medicine and Molecular Imaging 28:12 283-295.

Kwekkeboom, D.J., Teunissen, J.J., Bakker, W.H., (2005) Radiolabeled somatostatin analog [177Lu-DOTA,Tyr3]octreotate in patients with endocrine gastropancreatic tumors, Journal of Clinical Oncology, 22, 2754-2762

Meyer, G.J. Macke, H. Schumacher, J. Knapp, W.H. Hofmann, M. (2004) 68Ga-labelled DOTA-derivatised peptide ligands European Journal of Nuclear Medicine and Molecular Imaging 38, 1728-1734

Oberg, K.; Castellano, D. (2011). "Current knowledge on diagnosis and staging of neuroendocrine tumors." Cancer and Metastasis Reviews 30: 3 -- 7

Pettinato, C. Sarnelli, A. DoDonna, M. Civolli, S. Nanni, C. Montini, G. Di Pierro, D. Ferrari, M. Marengo, M. Bergamini, C.(2008) 68 GaDOTA-TOC: Biodistribution and dosimetry in patients affected by neuroendocrine tumors European Journal O. fNuclear Medicine Molecular Imaging 35 72-79.

Putzer, D. Gabriel, M. Henninger, B. Kendler, D. Uprimny, C. Dobrozemsky, G. Decristoforo, C. Bale, R.J. Jashke, W. Virgolini, I.J. (2009) Bone metastases in patients with neuroendocrine tumor: 68 GaDOTA-TOC PET in comparison to CT and…… [read more]


Administration of Vaccine Programs Case Study

… ¶ … administration of vaccine programs throughout the United States is a contentious public policy issue. Illnesses such as the influenza (flu) impose a heavy burden on society and there has been an effort by those in authority in the public health field to advocate for the widespread inoculation of the citizenry in an effort to protect society for the effects of influenza. Unfortunately, the administration of the influenza vaccine program in the United States has been fraught with problems for a number of years which has limited its effectiveness. These problems have been heavily discussed and studied and there are a number of studies detailing the nature of these problems and offering suggestions as to how to address them. Not unexpectedly, the studies and discussions have not resulted in a consensus.

One of the major problems in the influenza fight, one that seemingly reappears every year, is the apparent shortage of available vaccine. Every year public health officials spend countless hours encouraging the public to participate in the vaccine program only to face the likelihood that shortages will not allow everyone who seeks vaccination to be inoculated. One study has addressed this concern by suggesting that litigation concerns are affecting the supply of available vaccine. In an article published in the Journal of the American Medical Association this issue was addressed and studied (Mello, 2005). The authors offer that litigation issues are a definite factor in the shortage of available vaccine and suggest that the laws governing the liability of pharmaceutical companies providing vaccines should be reformed in an effort to minimize said companies exposure and encourage them to produce more vaccine.

In another study from the Vanderbilt School of Medicine, factors other than manufacturing shortages are examined (Jones, 2004). In this study it is suggested that barriers such as misperceptions regarding the risk of vaccination, the fear of side effects, and the effectiveness of vaccination all contribute to the effectiveness of the vaccination program in the United States. It was also argued that the delivery system used by public health authorities and the private sector also contribute to the situation. The study suggests that a more aggressive approach by health care providers might stimulate public interest in the vaccination program.

A third study addressed another concern that often arises in the country's influenza program: who should the program be targeting. The study, done through…… [read more]


Economics / Chapter 14 Essay

… Although Jykka's (2009) study showed the correlation between polypharmacy and mortality, the question of what to do about it still remains. The article written by Anguita (2011) does offer some suggestions as well as recommendations by national organizations. One intervention is for providers (particularly those in primary care) to more vigilantly review a patient's medications. An annual systematic review of a patient's medications can help to ensure that unnecessary, ineffective, and duplicate treatment drugs are eliminated from their regimen. By having a system that closely monitors medications and how they contribute to a patient's medical needs, it helps ensure that patients are receiving appropriate treatments and are not subjected to taking medications that are no longer indicated or have been ineffective. In addition, better communication between hospitals, specialists, primary care providers, and nursing or assisted living homes can facilitate this process and likely lead to improved outcomes for patients. As is often not done, giving patients explanation and reason for the medications that they are prescribed can go a long way in helping patients become more involved and informed about their own healthcare. This is significant for many reasons, but one important reason is the fact that if patients are more aware of their medications and why they are taking them can facilitate in a patient's ability to take a proactive approach to their healthcare. This certainly includes patients being able better address their questions or concerns about the need and/or effect of the medications they are prescribed.

Another key factor in addressing the polypharmacy problem lies within providers' and prescribers' decision making on treatment plans. Resisting the urge or temptation to prescribe at any opportunity that arises. Considering the potential risks and benefits of prescribing medications needs to be carefully considered. Taking a few moments to consider whether a medical concern can be resolved by means other than drug therapy can make a big difference in a patient's morbidity and mortality.

Sergi, De Rui, Sarti, & Manzato (2011) points out another important issue with polypharmacy, which is patient compliance. The more medications and the more often per day that they need to be taken can have a significant on the patient's compliance with taking the medication as prescribed. Sergi (2011) indicates that if the patient is instructed to take three or more pills per day that the compliance proportionally declines. If a patient is not compliant with their medications, it can have deadly consequences if they are cutting out drugs that are high on the priority list of medications needed to treat serious medical conditions.

The optimal outcome of a polypharmacy intervention is to have a better understanding and control of elderly patients' risks for negative outcomes that stem from this. Annual assessment of a patient's medication list is a simple process that can have a significant impact on a patient's morbidity and mortality. If steps are taken to implement such policies and interventions as described above, the results can make for a more productive and longer life for… [read more]


Vasopressin vs. Norepinephrine Infusion in Patients Essay

… Vasopressin vs. Norepinephrine Infusion in Patients with Septic Shock

Understanding septic shock is critical to patient care because of the possible terminal outcomes. Additionally, septic shock is the most common cause of death of patients in intensive care units (ICUs). Russel et.al (2008) examines the relationship between the use of vasopressin and mortality in ICU patients. The research hypothesizes that low-dose vasopressin is more effective at reducing ICU mortality than norepinephrine. The study determined that vasopressin was not more effective than norepinephrine.

The data for this study was collected at the ratio level of measurement. The ratio level of measurement contains all the characteristics of the lower levels of measurement. Additionally, it provides a true zero point. For a true zero point zero actually means none of the drug. Consequently, it would not be possible to improve the level of measurement for the study. The drug was measured in micrograms per minute. The nature of the phenomenon directed the level of measurement of the study. The research question invited the comparison between different doses of drugs.

The criteria established for the study provided the possibility of creating type II errors. Type two errors occur when the researcher fails to reject a true null. This is highly possible because of the interaction of the variant conditions producing an environment where the drug has a small effect but it is not discernable. Since two groups were being compared where the medical conditions were the same and there was no control group, this error is a possibility.

The study used simple random sample of patients. The participants for the study were drawn from 27 different institutions based on their medical…… [read more]


Natural/Holistic Medication Essay

… Upon the introduction of antibiotics, the herb fell out of favor but is slowly gaining back its position in the market as it works well against certain bacterial infections than antibiotics (Aiken-Augusta Holistic Health, Inc., (2011).

Echinacea works by activating chemicals in the body which reduce inflammation hence reduce symptoms of cold. It is also scientifically said to stimulate the body's immune system and contains chemicals that can attack some kind of fungi directly. Echinacea can commercially be found in form of tablets which are administered by giving two tablets three times a day, juice which is freeze dried and extracted, root tincture, liquid (Echinagard) which should be given 20 drops every 2 hours for the first day of symptoms then three times daily and tea which is not as effective. Theses doses are all orally taken and should not be interacted with caffeine or immunosuppressant.

Long-term use of Echinacea can however be unsafe for most people because it may cause side effects like nausea, insomnia, dry mouth, joint and muscle aches or fever. On the other hand Echinacea should also be avoided by people who have allergic reactions towards daisies or those who suffer from diseases such as rheumatoid arthritis or lupus or one who is pregnant or breastfeeding. This is because it may worsen the independent immune tissue damage.

It should however be noted that Echinacea should not be used as a preventive measure for colds and sore throats but should be used a curative measure once the person detects the cold and the sore throat has started.

References

American Holistic medical Association (AHMA) (2012). About Holistic Medicine: What is Holistic Medicine? Retrieved March 28, 2012 from http://www.holisticmedicine.org/content.asp?pl=2&sl=43&contentid=43

Aiken-Augusta Holistic Health, Inc., (2011). Benefits of Echinacea:

it stops a cold when used right. Retrieved March 28, 2012 from http://www.holistic-medicine-md.com/benefits-of-echinacea.html… [read more]


Lung Recruitability in Early Article Review

… , 2012). Surprisingly, no evidence of barotrauma was revealed by CT imaging following MRS and no clinical complications that could be associated with MRS were detected.

These results differ significantly from a previous study by Gattinoni and colleagues (2006), possibly because the methodology and patient population differed. For example, Gattinoni and colleagues used a low PEEP (5 cmH2O) between recruitment phase steps. In addition, the patients may have suffered from more severe ventilation trauma as indicated by a mean ventilation period of 5 days before recruitment into the study. In the present study, patients were recruited into the study within 72 hours of ARDS onset and a PEEP of 10 cmH2O was maintained between the recruitment phase steps. These differences, de Matos and colleagues (2012) suggest, explain why Gattinoni and colleagues found a mean value for potential recruitable lung tissue of only 13 ± 11%.

Notably, the findings of de Matos and colleagues (2012) suggest that baseline CT scans, or the amount of non-aerated tissue, cannot reliably predict an individual patient's response to the MRS maneuver. In other words, the severity of ARDS is not predictive of the efficacy of an MRS intervention as designed by de Matos and colleagues. This explains why no correlation was found between mortality and lung recruitment potential as revealed by MRS maneuvers.

Summary

Mechanical ventilation of patients suffering from ARDS has historically been associated with a high mortality rate. Although several studies have investigated lung recruitment strategies, none had achieved significant improvement in lung recruitment without causing additional tissue damage. A recent study by de Matos and colleagues (2012) utilizing MRS may have ended this history of marginal success, by showing that potential recruitable lung ranged between 25% and 53% (median 45%). Early and aggressive intervention using MRS therefore appears to represent a method of lung recruitment that successfully limits the damage caused by mechanical ventilation in ARDS patients.

References

de Matos, Gustavo F.J., Stanzani, Fabiana, Passos, Rogerio H., Fontana, Mauricio F., Albaladejo, Renata, Caserta, Raquel E. et al. (2012). How large is the lung recruitability in early ARDS: A prospective case series of patients monitored by CT. Critical Care, 16, 1-14.

Gattinoni, Luciano, Caironi, Pietro, Cressoni, Massimo, Chiumello, Davide, Ranieri, V. Marco, Quintel, Michael et al. (2006). Lung recruitment in patients with the acute respiratory distress syndrome. New England Journal…… [read more]


Motivation Why Asthma Patients Research Paper

… ¶ … motivation why asthma patients do or do not adhere to medication directions as prescribed by a physician, and to what extent the adherence is maintained. This aim is clearly and succinctly communicated through the title of the study.

The abstract succeeds in effectively outlining the purpose, methodology and results. The abstract is organized into sections describing separately background, methods, results, and conclusions, which is an effective means of presenting key information regarding the study in a clear and organized manner.

Strengths - in regards to strengths, this study included exploration of behavior and personality as variables affecting the experience of asthma patients. Before this study, only observable characteristics, such as triggers, inflammation, physiology, and response to medication were investigated in asthma research while behavior was essentially ignored (Axelsson et al., 2011). The study by Axelsson et al. (2011) demonstrated that the behavior of medication adherence has the potential to change the expression of asthma and can significantly impact the severity with which the disease is experienced. The role of personality in medication adherence among patients with asthma was investigated by the same author previously, but the focus was not behavioral measures (Axelsson, 2009).

Weaknesses/limitations -- With regard to weaknesses, in the study by Axelsson et al. (2011) the participants are quite homogenous, in that they are all the same age and have all experienced asthma for the majority of their lives. This is a weakness because it renders the results of the study less applicable and generalizable to the population that does not have these characteristics. Therefore, this weakness results in decreased reliability for the study. However, the authors do note that this limitation to the study could be considered a strength, as the findings are based on individuals who have had several years of experience living with asthma (Axelsson et al., 2011). Another potential weakness of the study is that the sample size was small, consisting of only eighteen participants.

Participants and Setting - the participants in the study are described as young adults with asthma that were born between 1985 and 1987. All of the participants had also been regularly prescribed medication for asthma and had completed a questionnaire on medication adherence. The authors thoroughly and accurately provided description of the participants through a table that outlined overall characteristics of the sample. No specific information was given as to the setting in which the interviews took place.

Sample - the sample was homogenous, consisting of individuals that were 22 years old asthma patients that had a long history of adhering to prescription medications. The homogeneity of the sample may have limited its adequacy in providing rich, varied data for the study. The sampling method used was application of a purposive procedure, which resulted in a sample consisting of participants with varied adherence scores. This sampling method was appropriate for the study.

Documentation rigor -- the methodological description offered in the report by Axelsson et al. (2011) was thorough, lending to the potential for easy replication of… [read more]


VA Quality Management Flow Chart Essay

… VA Quality Management Flow Chart

The most common process completed in the VA outpatient mental health clinics and the process that causes the greatest concern for quality of care is diagnosis, medication administration and follow-up. According a study conducted by Alexander Young, when even just two VA clinics were compared, the quality results were overwhelming different. In one clinic, fewer patients were seen, ensuring that the full diagnosis and treatment flow chart could be followed. In the other clinic, a much higher amount of patients were seen, resulting in less clinical followup and greater incidences of poor-quality medication management attributed to patient factors. In a second study conducted by Lewis Kazis, mental health patients in the private sector were compared to those in the VA sector and overwhelmingly, the same quality management issues was observed. VA patients did not receive proper followup and their condition did not improve.

The critical evaluation points for collecting data regarding this quality of care issue happen first at the diagnosis level in ensuring that the proper diagnosis is given and then next after the administration of the medication. According to the studies, these two points resulted in the highest occurrence of poor care. In both studies, patients were either…… [read more]


Sepsis Bundle Research Proposal

… Emergency Room Sepsis Bundle Practicum

The objectives of this practicum are three-fold as follows:

To assess a tertiary healthcare facility's emergency room nursing staff's current level of knowledge concerning the diagnosis of sepsis;

To assess a tertiary healthcare facility's emergency… [read more]


Acupuncture and Migraines Can Be so Severe Research Paper

… Acupuncture & Migraines

Migraines can be so severe they become debilitating. They interrupt the daily living activities of people and in some cases can actually cause the individual to become violently ill. What is the most beneficial method for a… [read more]


Spirit Catches You and You Fall Down Term Paper

… ¶ … Spirit Catches You and You Fall Down, teach us about how to face a complicated, troubling, and heart-rending set of circumstances and yet resist rushing to judgment, determining causes, finding fault, and solving problems before fully understanding how… [read more]


Health and Culture Alejandro Flores Term Paper

… They had already done much to improve Alejandro's condition including move to a new home. It is perfectly reasonable to assume that the doctors at the clinic did not know how to treat Alejandro, and it made sense to revert to the traditional Puerto Rican remedies.

3. Which of the normative cultural values described in the Lecture might apply to Alejandro's case? Please explain.

Normative cultural values have a strong bearing on views towards health, wellness, and illness as well as the authority of doctors. The normative cultural values that are described in the lecture that apply to the Alejandro case include the following. First, the Flores family does not have anything against the American medical system. Their primary concern is the health of their child. Many American patients might view doctors as being authority figures, but for the Flores family, a doctor is just a person who is an expert in pharmaceutical company-driven medicine. An espiritista has no more clout than a doctor: an esperitista is simply someone who has spent a lifetime training in the healing arts. The Flores family does not make a normative judgment against the espiritista simply because she comes from a different worldview and way of thinking than the doctors at the clinic. The normative cultural values of the clinic are more closed-minded. The clinic doctors do not value the input of espiritistas, and cannot imagine that herbal remedies might be used as adjuncts or complementary medicine. The Flores family has an open mind towards all types of interventions.

References

"The Case of Alejandro Flores." (n.d.). Retrieved online: http://support.mchtraining.net/national_ccce/case3/case.html

Phillips, M.J. (n.d.). Normative cultural values. Lecture. Online: http://support.mchtraining.net/national_ccce/case3/lecture.html#… [read more]


Medical Terminology Physiotherapy Essay

… It was found that these patients improved greatly. The arterial blood gasses showed a higher concentration of oxygen, lung function tests showed improvement and dyspnoea had considerably decreased. This improved the overall quality of their life. (Tang, Taylor, and Blackstock 1-13)

Other organs of the body, such as the heart, also respond well to physiotherapy, which increases its strength and contractile ability. Physiotherapy helps improve blood circulation and hence many disorders related to it. Geriatrics is another branch of medicine that is dependant on physiotherapy to a great extent. Age related diseases, such as dementia, can cause incontinence which can be improved through physical therapy. It can also help pregnant women through pregnancy, labor and post partum recovery. Researches also show benefit of physiotherapy amongst diabetics and patients suffering from other metabolic disorders. (Noton)

In today's medicine, physiotherapy has evolved to be an integral part of it. A physiotherapist is now seen working in hospital wards, intensive care units and outpatient departments. The importance of physical therapy has greatly increased in modern medicine, allowing it to increase and spread in its research. As this field continues to evolve, a great part of the future medicine might depend on this occupation.

REFERENCES:

Cooney, Jenifer, Rebecca Jane, and Vereena Matschke. "Benefits of Exercise in Rheumatoid Arthritis." Journal of Aging Research. (2011): n. page. Web. 21 Nov. 2011. .

Noton, Adriana. "The Role Of A Physiotherapist In Modern Medicine." Health & Fitness. N.p., 23 September 2011. Web. 21 Nov 2011. .

Prasad, Ammani, Esta Tennenbaum, and Christine Mikelsons. "Physiotherapy in Cystic Fibrosis." Journal of the Royal Society of Medicine. 93.35 (2000): 27-33. Web. 21 Nov. 2011. .

Tang, Clarice, Nicholas Taylor, and Felicity Blackstock. "Chest physiotherapy for patients admitted to hospital with an acute exacerbation of chronic obstructive pulmonary disease (COPD): a systematic review." Physiotherapy. 96.1 (2010): 1-13. Web. 21 Nov. 2011. .… [read more]


Pharmaceutical Companies Intellectual Property and the Global AIDS Epidemic Research Paper

… Pharmaceutical Companies, Intellectual Property and the Global AIDS Epidemic

Over the last several years, there has been a focus in the world community on providing many developing nations with low cost prescriptions drugs to effectively fight the AIDS virus. This… [read more]


Sociology - HPV Vaccine Essay

… The vaccine is not as much about sex as it is about protecting women and young girls from a disease that can be deadly and that is becoming more treatable and preventable. It is true that not all cervical cancers… [read more]


Thoracic Manipulation on Patients Article Critique

… " (Sharples, 2010) The HVLA manipulation is reported to involve a quick thrust over a short distance through what is termed a pathologic barrier. The movement is within a joint's normal ROM and does not exceed the anatomic barrier or ROM." (Sharples, 2010) When the patient is properly positioned HVLA makes a requirement of very little force and is specifically targeted to spinal segments." (Sharples, 2010) Treatment goals include "restoration of joint play or a desirable gap between articulating surfaces." (Sharples, 2010) This technique is stated to be effective in restoration of joint motion with little risk of worsening of symptoms. Sharples reports that the "biomechanical influence of manipulation is to improve the plasticity and elasticity of shortened and thickened soft tissue." (Sharples, 2010) In addition, fluid dynamic such as blood, lymph and synovial fluid" and is a model that focuses on "diminishing muscle tone and modulating pain." (Sharples, 2010)

References

Barrett, AJ and Breen, AC (2000) Adverse Effects of Spinal Manipulation. Journal of the Royal Society of Medicine 2000;93;258-9.

Cagnie, B et al. (2004) How Common are Side Effects of Spinal Manipulation and Can These Side Effects be Predicted? Manual Therapy 2004;9:151-6.

Cleland, JA, et al. (2004) Immediate effects of thoracic manipulation in patients with neck pain: a randomized clinical trial. 24 Jul 2004. Manual Therapy. Retrieved from: http://academic.regis.edu/clinicaleducation/pdf%27s/Cleland_tx%20manip%20for%20neck%20pain.pdf

Flynn, T. et al. (2007) The immediate effect of thoracic spin manipulation on cervical range of motion and pain in patients with primary complaint of neck pain -- a technical note. Orthopedic Division Review: 2007;32-6.

Gibbons, P. And Tehan, P. (2000) Manipulation of the Spine, Thorax and Pelvis. Edinburgh: Churchill Livingstone, 2000, p. 68-9.

Gonzales-Iglesias, J. et al. (2009a) Thoracic spine manipulation in the management of patients with neck pain: a randomized clinical trial. The Journal of Orthopedic and Sports Physical Therapy. 2009a:39-20-7.

Greenman, PE (1996) Principles of Manual Medicine. 2nd ed. Philadelphia: Lippincott, Williams and Wilkins. P.24-31.

Gross, AR, Kay, T. Hondras, M. (2007) Manual Therapy for Mechanical Neck Disorders: A Systematic Review. Manual Therapy 2002;7:131-59.

Hurwitz, EL et al. (2004) Adverse Reactions to Chiropractic Treatment and Their Effects on Satisfaction and Clinical Outcomes among Patients enrolled in the UCLA Neck Pain Study. Journal of Manipulative and Physiological Therapeutics, 2004; 27; 16-25.

Lebouef-Yde, C. et al. (1997) Side Effects of Chiropractic Treatment: A Prospective Study. Journal of Manipulative and Physiological Therapeutics. 1997;20-511-5.

Parkin-Smith, GF and Penter, CS (1998) Clinical Trial Investigating the Effect of two Manipulative Approaches in the…… [read more]

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