Knowledge Of Clinical Medicine Research Articles

Scientific Laboratory “Moscow Polyclinic”: Experience of Project Implementation

Background. In 2021, a new educational project “Scientific Laboratory ‘Moscow Polyclinic’” was launched. Its aim is to develop research competencies among primary health care workers and to boost activities such as journal publication and the organization of specialized scientific and practical conferences. The article briefly describes several characteristics and features of this project for two seasons (2021–2022).
 Materials and methods. The author collected, aggregated, statistically processed, and analyzed the comparative data for two project seasons.
 Results and discussion. The analysis included information on the project design (topic-based tracks, blocks “Transformation” and “Accelerator of Ideas”, sections “Science” and “Service Design”, Scientific Club), the results of sociological surveys and their interpretation, and the brief scientometric characteristics of participants’ publications. Between 2021 and 2022, 9818 specialists took part in the Scientific Laboratory; they were outpatient polyclinic care providers in the Moscow healthcare system. In addition, the number of speakers nearly doubled, and a community of mentors was formed from the active researchers in Moscow healthcare.
 Conclusions. The project speakers included leading foreign and Russian scientists, representatives of scientific journals and peer-reviewed research databases, and Moscow healthcare specialists. They shared with the participants their experience of planning, their methodology for conducting a study; algorithms for selecting a study topic, and the features of research data publication, including possible sources. The project mentors were the chief specialists of the Moscow Healthcare Department, and the heads of medical organizations experienced in carrying out the studies. As a result, the participants successfully published their articles in the peer-reviewed journals from the list of the Higher Attestation Commission (VAK). The project demonstrates that the employees of Moscow polyclinics are not only active professional physicians but also researchers with critical thinking and deep knowledge in clinical medicine.

Rembrandt’s Anatomy Lesson of Dr. Tulp Revisited: Advancements in Teaching Anatomy and Neurobiology in an Integrated Medical Curriculum in the 21st Century.

The recent challenges in anatomy and neurobiology education in medical curricula have imposed a curricular redevelopment in delivery and content, incorporating modules in virtual anatomy and neurobiology, didactic lecture and enhanced cadaveric dissection in a state-of-the-art teaching and learning environment. The combined approach engaged active student participation at each phase of the course, incorporated clinical perspectives, emphasized valuable diagnostic and surgical techniques and procedures, and minimized noxious exposure to formaldehyde by using unembalmed cadavers in a laminar airflow environment. Finally, the objectives of emphasizing the importance of proficiency in anatomy knowledge in clinical medicine were accomplished well within the allocated one semester time frame, in a timely, cost and resource effective manner, and with demonstration of competency to standard during post laboratory examinations.

Post-Mortem Pedagogy: A Brief History of the Practice of Anatomical Dissection.

Anatomical dissection is almost ubiquitous in modern medical education, masking a complex history of its practice. Dissection with the express purpose of understanding human anatomy began more than two millennia ago with Herophilus, but was soon after disavowed in the third century BCE. Historical evidence suggests that this position was based on common beliefs that the body must remain whole after death in order to access the afterlife. Anatomical dissection did not resume for almost 1500 years, and in the interim anatomical knowledge was dominated by (often flawed) reports generated through the comparative dissection of animals. When a growing recognition of the utility of anatomical knowledge in clinical medicine ushered human dissection back into vogue, it recommenced in a limited setting almost exclusively allowing for dissection of the bodies of convicted criminals. Ultimately, the ethical problems that this fostered, as well as the increasing demand from medical education for greater volumes of human dissection, shaped new considerations of the body after death. Presently, body bequeathal programs are a popular way in which individuals offer their bodies to medical education after death, suggesting that the once widespread views of dissection as punishment have largely dissipated.

Experiential knowledge in clinical medicine: use and justification.

Within the evidence-based medicine (EBM) construct, clinical expertise is acknowledged to be both derived from primary experience and necessary for optimal medical practice. Primary experience in medical practice, however, remains undervalued. Clinicians' primary experience tends to be dismissed by EBM as unsystematic or anecdotal, a source of bias rather than knowledge, never serving as the "best" evidence to support a clinical decision. The position that clinical expertise is necessary but that primary experience is untrustworthy in clinical decision-making is epistemically incoherent. Here we argue for the value and utility of knowledge gained from primary experience for the practice of medicine. Primary experience provides knowledge necessary to diagnose, treat, and assess response in individual patients. Hierarchies of evidence, when advanced as guides for clinical decisions, mistake the relationship between propositional and experiential knowledge. We argue that primary experience represents a kind of medical knowledge distinct from the propositional knowledge produced by clinical research, both of which are crucial to determining the best diagnosis and course of action for particular patients.

Statističke metode u farmakoterapiji

Introduction: Pharmacotherapy dealing with drug research is extremely complex process because in addition to basic knowledge in pharmacology, it includes both knowledge in clinical medicine and medical statistics. Methods: Statistical methods applied in medical research have been studied on examples of individual statistical methods applied in particular clinical trials. Topic: the following problems have been discussed: study design, study plan, criteria for selecting patients, the required and sufficient minimum number of patients in the clinical trial, the selection of the most commonly used descriptive and analytical statistical procedures, but also a critical review of analytical statistical procedures that have great potential in checking the conformity of everyday clinical practice with evidence-based medicine. Conclusions: Knowledge of statistical methods is a valuable companion and tool of clinicians, since it enables them to carry out appropriate research with the best possible conclusions based on medical evidence.

A study on the feasibility of increasing the teaching content of nursing education in the stage of rural doctor education

Objective To explore the insertion of the teaching contents of nursing in rural doctors' higher education, so as to increase their understanding of medical knowledge and improve their medical skills. Method 90 rural doctors of Grade 2014 were chosen as the research object, and according to their willingness to participate, they were divided into control group and observation group. The students in the control group were mainly taught by the relevant knowledge of clinical medicine, while nursing teaching content was inserted in the teaching of observation group. In the teaching process, firstly, the teaching contents of nursing were reorganized, and then the teaching content of clinical medicine was taken as the main line, according to the development of teaching content, flexibly inserting nursing teaching part. The results of the final examination of the internal medicine of the two groups were compared and the specific learning experience of rural doctors was investigated. SPSS 20.0 was used to analyze the data, the count data was expressed as percentage, and chi square test was performed. Results The number of students in the con-trol group and the observation group whose subjective score was more than 40 was 17.65% and 48.72% respectively. The number of students scoring <30 points accounted for 23.53% and 5.13% of the total number of students, and there was a statistically significant difference between the two groups (P<0.05) . The ob-servation group had a better learning experience, and had little influence on the learning of clinical medical knowledge. Conclusion In the stage of education for rural doctors, inserting the teaching contents of nursing can improve the teaching effect. Key words: Rural doctor; Nursing teaching; Teaching reform

Single best answer question-writing tips for clinicians

Assessment is essential for progression in medical careers. Thus, an important aspect of developing as a clinical teacher is the ability to produce high-quality assessments for junior colleagues. The single...

Methods and methodology of pathology

The lecture gives the state-of-the-art of the methodology of human pathology that is an area of the scientific and practice activity of specialists to produce and systematize objective knowledge of pathology and to use the knowledge in clinical medicine. It considers the objects and subjects of an investigation, materials and methods of a pathologist, and the results of his/her work.

Continuing Medical Education Exam: January 2016

Instructions: The GIE: Gastroinintestinal Endoscopy CME Activity can now be completed entirely online. To complete do the following: 1. Read the CME articles in this issue carefully and complete the activity: Sanaka MR, Rai T, Navaneethan U, et al. Adenoma detection rate in high-risk patients differs from that in average-risk patients. Gastrointest Endosc 2016;83:172-8. Bahin FF, Jayanna M, Hourigan LF, et al. Long-term outcomes of a primary complete endoscopic resection strategy for short-segment Barrett’s esophagus with high-grade dysplasia and/or early esophageal adenocarcinoma. Gastrointest Endosc 2016;83:68-77. Othman MO, Guerrero R, Elhanafi S, et al. A prospective study of the risk of bacteremia in directed cholangioscopic examination of the common bile duct. Gastrointest Endosc 2016;83:151-7. Jensen DM, Ohning GV, Kovacs TOG, et al. Doppler endoscopic probe as a guide to risk stratification and definitive hemostasis of peptic ulcer bleeding. Gastrointest Endosc 2016;83:129-36. 2. Log in online to complete a single examination with multiple choice questions followed by a brief post-test evaluation. Visit the Journal’s Web site at www.asge.org (members) or www.giejournal.org (nonmembers). 3. Persons scoring greater than or equal to 75% pass the examination and can print a CME certificate. Persons scoring less than 75% cannot print a CME certificate; however, they can retake the exam. Exams can be saved to be accessed at a later date. You may create a free personal account to save and return to your work in progress, as well as save and track your completed activities so that you may print a certificate at any time. The complete articles, detailed instructions for completion, as well as past Journal CME activities can also be found at this site. Target Audience This activity is designed for physicians who are involved with providing patient care and who wish to advance their current knowledge of clinical medicine. Learning Objectives Upon completion of this educational activity, participants will be able to: 1. Examine the adenoma detection rate in high-risk versus average-risk patients. 2. Determine the long-term safety and efficacy of complete endoscopic resection of short-segment Barrett’s esophagus. 3. Analyze the appropriateness of prophylactic antibiotics during single-operator cholangioscopy. 4. Define the utility of endoscopic Doppler probe assessment in the evaluation and management of hemorrhage due to peptic ulcer disease.

A Response to Dubler’s Commentary on “Surmounting Elusive Barriers: The Case for Bioethics Mediation”

Dubler's commentary focuses on knowledge of clinical medicine and "institutional savvy" as pieces of the skill set required of bioethics mediators. Here, I describe why, as a practical matter, such requirements are unlikely to be achieved by a meaningful number of aspirants. Simultaneously, I examine the reasons why Dubler's criteria are inherently risk-laden and would be better addressed as a dialogue among experienced practitioners regarding the merits of alternative stylistic approaches, rather than as universal threshold criteria for the practice of bioethics mediation.

The Business of Emergency Medicine: A Nonclinical Curriculum Proposal for Emergency Medicine Residency Programs

Over the course of their postgraduate medical education, physicians are expected not only to acquire an extensive knowledge of clinical medicine and sound procedural skills, but also to develop competence in their other professional roles as communicator, collaborator, mediator, manager, teacher, and patient advocate. Although the need for physicians to develop stronger service delivery skills is well recognized, residency programs may underemphasize formal training in nonclinical proficiencies. As a result, graduates can begin their professional careers with an incomplete understanding of the operation of health care systems and how to utilize system resources in the manner best suited to their patients' needs. This article proposes the content, educational strategy, and needs assessment for an academic program entitled The Business of Emergency Medicine (BOEM). Developed as an adjunct to the (predominantly) clinical content of traditional emergency medicine (EM) training programs, BOEM is designed to enhance the existing academic curricula with additional learning opportunities by which EM residents can acquire a fundamental understanding of the nonclinical skills of their specialty.

Impact of Genetic Polymorphisms on the Efficacy of HMG-CoA Reductase Inhibitors

Although pharmacologic treatment for cholesterol reduction represents an advance in cardiovascular and atherosclerosis treatment, the benefits of such therapy are still limited because of interindividual variability in the response to these drugs. Disease severity, treatment adherence, physiologic conditions, biologic conditions, and the patient's genetic profile could be cited as important factors in the evaluation of interindividual variability. In regard to the latter consideration, three large groups of genes could be investigated: (i) genes that code for proteins involved in metabolism and/or drug transport, thereby influencing the pharmacokinetics of these compounds; (ii) genes that code for proteins involved in the mechanism of action and/or in the metabolic pathway of drug action, and which therefore influence pharmacodynamics; and (iii) genes that code for proteins involved in direct development of the disease or in intermediate phenotypes. In this review we discuss pharmacogenetic studies of the HMG-CoA reductase inhibitors (statins) and the implications of pharmacogenetic considerations for predicting treatment efficacy and reducing the adverse effects of these drugs. Once new studies have been performed and most of the genetic variability associated with drug action has been revealed, the great challenge will be to apply this knowledge in clinical medicine.

Expectations and essentials for the community practice of pathology

In 3 surveys during the past 10 years, community hospital pathologists were asked what they want, need, or look for when employing a pathologist and, more specifically, what skills and knowledge a newly minted pathologist should have to be successful in the community practice of pathology. The most recent survey, done in spring of 2005, cited surgical pathology diagnosis, frozen section diagnosis, gross dissection, cytology, and fine-needle aspiration as essentials in anatomic pathology. For clinical pathology, knowledge of clinical medicine and test strategies that use the laboratory for clinical problem solving was paramount. New expectations in the latest survey were knowledge of molecular pathology and experience in quality assurance procedures. New pathologists generally meet the expectations of the community hospital workplace; however, there were some deficiencies: they were not proficient in gross pathology or autopsy pathology, they were slow, and many lack the clinical knowledge and experience to be effective consultants. The principal attribute that determines success in the practice of pathology, however, is skill in communication and interpersonal relations, and this remains the major deficiency of the fledgling pathologist.

S18.3: Contributions of artificial neural networks to knowledge in clinical medicine ‐ is there evidence of improvement?

Biometrical JournalVolume 46, Issue S1 p. 39-39 Oral Sessions Abstracts S18.3: Contributions of artificial neural networks to knowledge in clinical medicine - is there evidence of improvement? Martin Schumacher, Martin Schumacher ms@imbi.uni-freiburg.de Search for more papers by this authorManfred Olschewski, Manfred OlschewskiSearch for more papers by this authorGuido Schwarzer, Guido SchwarzerSearch for more papers by this author Martin Schumacher, Martin Schumacher ms@imbi.uni-freiburg.de Search for more papers by this authorManfred Olschewski, Manfred OlschewskiSearch for more papers by this authorGuido Schwarzer, Guido SchwarzerSearch for more papers by this author First published: 17 March 2004 https://doi.org/10.1002/bimj.200490241AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume46, IssueS1Supplement: Abstracts of the Joint Meeting of the IBS-DR and the DAEMarch 2004Pages 39-39 RelatedInformation

Contribution of Paul Govaerts (1889-1960) to the understanding of oedema and proteinuria. The essential role of physiological knowledge in clinical medicine.

Contribution of Paul Govaerts (1889-1960) to the understanding of oedema and proteinuria. The essential role of physiological knowledge in clinical medicine.

Telomerase and malignant transformation.

Recent progress in our understanding of the role of telomeres and telomerase in cell proliferation, malignant transformation, and genomic stability has opened new possibilities for cancer diagnosis, detection, and treatment. Novel approaches based on this knowledge are being investigated in different laboratories and are likely to have a significant impact on cancer management protocols in the future. This chapter gives an overview of our current knowledge of the function of telomeres and of the mechanisms responsible for their maintenance, followed by comments on potential applications of this knowledge in clinical medicine.

Modernizing the journal club.

Traditionally journal clubs provide a forum to learn presentation skills. We propose a new approach to teaching and learning in journal clubs, focusing on literature acquisition and critical appraisal skills. This approach will enable trainees to use journal clubs for personal professional development as well as for application of new knowledge in clinical medicine to improve patients' outcomes.

Evidentiary challenges to evidence-based medicine.

The evidence-based medicine (EBM) movement has exerted a strong influence on contemporary medicine. It has been used to define the hierarchy of knowledge in clinical medicine by classifying clinical findings according to the perceived relevance and validity of the respective methodologies of studies from which evidence was collected. In the spectrum of theories of knowledge, EBM predominantly relies on findings obtained from population-derived clinical research. This reliance on knowledge obtained from population studies sharply contrasts with a physiologic model of clinical knowledge advocated by basic science researchers and many clinicians. An apparent schism between proponents of physiologic and population models in the approach to the practice of medicine has been created. This dichotomy between practising physicians and EBM physicians in the approach to clinical knowledge should not be irreconcilable. We advocate a consilient approach to the interpretation of evidence and the integration of medical knowledge. This approach relies on 'linking of facts and fact-based theory across various disciplines to create a common groundwork of explanation'.

A look to the future of animal clinical biochemistry: Implications for diagnostics and research

The changing environment in the medical biochemistry arena as a result of new and concerted pressures for cost containment will have and is having its inevitable effect on the field of animal clinical biochemistry. The animal clinical biochemist must be acutely aware of the changes engendered by these pressures and be prepared to respond in a meaningful way. First and foremost, the animal clinical biochemist must be positioned as a scientist with a unique capability to cross disciplinary lines as befits the needs to understand interspecies nuances. As a corollary, there is a need for the animal clinical biochemist to not only keep abreast of new developments but to be a generator of new knowledge in the field. This then implies that research and dissemination of new knowledge is an inherent responsibility of those in the field. In this way, the animal clinical biochemist is positioned as an independent scientist/principal investigator in a broad range of studies involving animals. This further implies that animal clinical biochemists must broaden their knowledge of clinical medicine to be able to converse freely in the “language of medicine”. Numerous new vistas are described and which can be exploited to advance the field and the scope of activities for animal clinical biochemists. Among these are the Point-of-Care systems, new approaches to diabetes management, thyroid disease, autoimmune disease and tumour markers. The list of additional areas is extensive; markers of inflammation, markers of nutritional disease or deficiency, DNA probes in inherited disease, DNA probes of infectious disease. All of these areas are ripe for new ideas and advances in knowledge needing only the imaginative efforts of the animal clinical biochemist.

Case-based reasoning algorithms applied in a medical acquisition tool.

The knowledge of clinical medicine can, efficiently and effectively, be elicited and encoded automatically as cases. The developed knowledge base often contains some redundancy. The cost can be tolerated as it affects neither the performance of the system nor the integrity of the knowledge. The advantages are simplicity in development and reliability in performance.