Master Of Medicine Research Articles

Survival of Dental Implants in Oncology Patients versus Non-Oncology Patients: A 5-Year Retrospective Study.

Patients with a history of cancer are increasingly common in the dental office. Treating cancer patients requires a multidisciplinary team, which should include the dentist, in order to control the complications that occur in the oral cavity and also to recover the patient undergoing treatment in any of its types: surgical, medical, radiotherapeutic, or its possible combinations. Dental implants can be a safe and predictable treatment option for prosthetic rehabilitation. The aim of this paper is to describe in retrospect the success rate of osseointegrated implants in oncology and non-oncology patients placed by the Master of Dentistry in Oncology and Immunocompromised Patients, as well as the Master of Medicine, Surgery and Oral Implantology of the University of Barcelona Dental Hospital, between July 2011 and March 2016. 466 patients were reviewed, with a total of 1405 implants placed, considering the oncological history of the patients and the implant success rate. The total success rate in the concerned period was 96.65%. When comparing cancer patients with healthy ones, the success rate has been 93.02% in the first case, and 97.16% in the latter. According to the literature review, our results encourage implant placement in cancer patients, it is important to recognize that this is an analysis of a complex care pathway with a large number of confounding variables. However, the findings should not be considered as generalizable.

The Discovery of the Hepatitis D Virus: Three Princes of Serendip and the Recognition of Autoantibodies to Liver-Kidney Microsomes.

The Discovery of the Hepatitis D Virus: Three Princes of Serendip and the Recognition of Autoantibodies to Liver-Kidney Microsomes.

Study on metastasis inhibition of Kejinyan decoction on lung cancer by affecting tumor microenvironment

BackgroundKejinyan decoction, as an experienced formula of Zhou Zhongying (the Master of Traditional Chinese Medicine) has been widely used in clinic for lung cancer treatment in China, while the anti-lung cancer mechanism of it is still remained to be elucidated. Herein, our basic study found that the survival of lung cancer xenograft mice was significantly prolonged after intragastrically administered high dose of Kejinyan decoction (3.8 g per kg BW) for 15 days. More importantly, we found that Kejinyan decoction inhibited the metastasis of lung cancer cells in vivo. Thus in this study, we aim to elucidate the anti-metastasis effects of Kejinyan decoction.MethodsRNA-Seq was used to find out the gene regulation of Kejinyan decoction on the mice, flow cytometry assay was used to detect the immunocytes in the spleen, ELISA assay was used to detect the inflammatory factors in the serum and spleen, and immunofluorescence assay was used to detect the level of immune cells and the expression of glycol-metabolism related enzymes in situ. Also, we established a lung cancer orthotopic xenograft tumor model to assess the influence of Kejinyan decoction on the metastatic ability of lung cancer cells in vivo.ResultsGO analysis of gene sequencing of tumor tissue samples showed that Kejinyan decoction regulated immune response. Further flow cytometry analysis of splenic lymphocyte showed that Kejinyan decoction upregulated M1 macrophages and downregulated M2 macrophages, while the total level of macrophages changed little, which was verified by detection of CD68, F4/80, CD206, and CD86 in tumor tissue section. Moreover, detection of inflammatory cytokines showed that Kejinyan decoction downregulated TNF-α, IFN-γ, IL-6, as well as IL-4, IL-13 in tumor microenvironment. Further studies also showed that Kejinyan decoction had little effect on tumor hypoxia, but downregulated glycolysis in tumor tissues. More importantly, we found that Kejinyan decoction inhibited the metastasis of lung cancer cells in vivo.ConclusionOur findings conclude that Kejinyan decoction inhibited lung cancer cell metastasis through affecting macrophage polarization and energy reprogramming.

Improving cultural competence in medical curricula of Algarve University to reduce health disparities

Abstract The increasing diversity of the Portuguese population and the globalization of health care require advance practice physicians to be culturally competent. Greater appreciation exists for the impact of culture on health care: health seeking behaviors are affected by cultural mores. The field of 'cultural competence' has emerged as one strategy to address these disparities. The Integrated Master of Medicine at the University of Algarve realized that the development of culturally responsive clinical skills is vital to the effectiveness of behavioral health services. To achieve this realization, Cultural Competence Seminars were included as obligatory course in medical curricula, since 2017. Although some cultural competence topics were addressed at different moments of master, in PBL approach and electives. The seminars offered in Year 6 were structured in 3-h interactive lectures per week covering the following topics: gipsy ethnicity, vulnerable groups, Jehovah's Witnesses, Islamic Culture and Ethics in different cultural contexts. These thematic areas were taught by social scientists and interested “experts” or inviting personal testimonys. The learning objectives are related to knowledge-based that focus on information, such as definitions about culture and related concepts; attitudes that seeks to improve provider awareness of the impact of socio-cultural factors on patients' values and behaviors and skills that focus on learning communication regarding the context. The integration of seminars in the medical curricula has been a successful project as it has been well received by students. Reflecting on the conceptualization and implementation of the cultural competence seminars, there are still some challenges to address. That is, cultural competence needs to be further integrated in the curriculum by incorporating in additional clinical communication and clinical skills sessions. Key messages It is a model that can be applied regardless of the meaning a school of medicine attaches to the notion of cultural competence, and can build on existing strengths within the organization.

Chinese medicine master SHENG Xie-sun's creative viewpoint on acupuncture-moxibustion and acupoints of Zhejiang school

The creative viewpoint of SHENG Xie-sun, the master of Zhejiang school of Chinese medicine is introduced regarding the theories of acupuncture-moxibustion and acupoints. It is stated by master SHENG that the five-tissue needling methods are applicable not only for physical disorders, but also for zangfu disorders. Of these methods, the nearby bone needling method presents an instructive significance in treatment of pain disorder. The "reinforcing in the upper and reducing in the lower" needling method supplements the reinforcing and reducing theory of acupuncture. Master SHENG has put forward the theory of flexible selection of acupoint, the phenomenon of acupoint groups and the application of transverse acupoint composition, as well as the measures for intensifying needling induction, promoting qi regulation of acupuncture and improving clinical effect. Besides, the seven Chinese characters are used to summarize acupoint composition, meaning "main point, supplementary point, nearby point, corresponding point, back-shu point, front-mu point and extra point" separately. This creative viewpoint provides a clearer and more feasible mode in treatment with acupuncture-moxibustion and is instructive proactively in clinical practice.

Postgraduate medical specialty training for Botswana: A successful innovative partnership with South Africa

Background. Sub-Saharan Africa has a significant shortage of healthcare providers, and educational collaborations are recommended as one of the crucial steps to increase the medical workforce. Objectives. To describe a successful innovative postgraduate medical specialisation programme involving two neighbouring African countries, Botswana and South Africa (SA). Methods. After lengthy consultative processes, a postgraduate training programme was approved between the University of Botswana and the Colleges of Medicine of SA (CMSA). This programme utilised a 4-year Master of Medicine (MMed) curriculum for consecutive training and examinations in both countries. Extensive collaborations with government and regulatory bodies in both countries were required to facilitate the programme. Results. Despite initial diverse challenges, the two countries continue to support the partnership, with 40 local doctors having graduated as medical specialists since 2014, and additional MMed programmes in development for Botswana. Conclusions. The University of Botswana and CMSA partnership model is a novel and sustainable cross-border collaboration with significant benefits for both health systems and individual trainees. It is possible to have a successful and high-quality specialisation programme without all the resources in place by being innovative and leveraging external partnerships and collaborations. This partnership hopes to encourage other developing countries to explore similar associations.

History of Islamic Medical Schools in Turkey’s Territory

In today’s political borders of the Republic of Turkey, there exist very old institutions that train physicians according to Islamic medical science. In this study, 19 health institutions whose locations have been determined and documents finalized were approached in a chronological order and classified according to the historical periods: XIIth and XIIIth centuries (Seljukian period)-10, XIVth century (Ilkhanate dominion)-1, and XVth-XVIIth centuries (Ottoman period)-8 institutions. Some of them have a history of 900 years (Konya Mâristan-ı Atik, 1113; and Mardin Eminüddin Bimaristanı, 1122). In addition, some are in the form of a medical madrasah and an application hospital (Kayseri, 1206; Sivas, 1217). In these institutions, great masters of Islamic medicine (Razi, Fârâbî, Bîrûnî, İbni Sina) and ancient authorities (Hippocrates, Dioscorides, Aretaeus, Galenos) were taught. These institutions had builders, rulers (sultan, melik) or mothers, wives, daughters, and sisters (the presence of female builders in these institutions attracted attention). During the Seljuk period, powerful viziers also built such institutions. These hospitals also provided free services which were considered as “charities” according to the Islamic religion. These institutions were financed by sources (shops, inns, Turkish baths, bridges, mills, vineyards, gardens, fields and annual taxes of many villages) that donated funds through the “foundation” method. Donations were made in the presence of the “kadi” (muslim judges) and many witnesses, with the written document “endowment.” These foundations were not touched by subsequent monarchs. Payment of fees, daily expenses of the physicians, assistant personel and repairing of buildings was done by the board of trustees. Twelve of these institutions are still in use for public interest (polyclinic, museum, health museum, library, university, and education center). When modern medical schools (1827) and hospitals (1842) began to be established as of the XIXth century, these historic buildings were allocated to mental patients, while some were devastated by neglect. However, in the Republic period, they have been restored and used for health and educational purposes.

Analysis of property and efficacy of traditional Chinese medicine in staging revention and treatment of coronavirus disease 2019

Coronavirus disease 2019(COVID-19) triggered a severe and complicated epidemic situation, and it is of great significance to discuss the rules and characteristics of the prescription of COVID-19 in traditional Chinese medicine. This study collected prevention and treatment approaches of traditional Chinese medicine for COVID-19 released from the National Health Committee of China, 7 provinces and municipal health committees, the Chinese Medicine Administration and Handbook of Traditional Chinese Medicine Diagnosis and Treatment of COVID-19 between January 1 and February 18, 2020, and prescriptions prepared by 3 masters of Chinese medicine and 4 well-known Chinese medicine experts. These information were selected according to the inclusion and exclusion criteria, and EpiData 3.0 software was used to establish the "Traditional Chinese Medicine Prescription Library for the Prevention and Treatment of COVID-19" and the "Common Database of Traditional Chinese Medicine for the Prevention and Treatment of COVID-19". A total of 93 effective Chinese medicine prescriptions and a total of 157 kinds of constituent medicines were collected. Data analysis was performed by SPSS 18.0 software. The results showed that: ①most of the medicines are with cold and warm properties, 69 with cold medicines, accounting for 43.95%, 57 with warm medicines, accounting for 36.31%, and less with hot medicines, taking up 1.27%; ②there are many pungent, bitter and sweet medicines, and the distribution of medicinal flavors is different at different disease stage. The pungent medicines are mostly found in the early stage, the bitter drugs are the main flavor in the middle and severe stage, and the sweet medicines are mostly used in the recovery stage; ③the meridian of the drug is more concentrated at the lung, stomach, and heart, and most of drugs are into the lung meridian, accounting for 24.55%; these medicines are mostly into the lungs and stomach in the initial and middle stages, and into the heart and kidney in severe stages; ④oral drugs are mostly non-toxic, among which only 6 kinds are toxic, namely Armeniacae Semen Amarum, Dryopteridis Crassirhizomatis Rhizoma, Paridis Rhizoma, Pinelliae Rhizoma, Aconiti Lateralis Radix Praeparaia; ⑤most of the drugs have five types of functions: treating exterior syndromes, resolving dampness, clearing heat, replenishing deficiency, resolving phlegm, cough, and asthma. In the early stage, both drugs for treating exterior syndromes and heat clearing drugs were equally used, accounting for 18.81% each. In the middle stage, drugs resolving phlegm, cough, and asthma drugs are more often used, accounting for 29.61%. In the severe stage, heat clearing drugs are mostly used, accounting for 33.33%. During the recovery period, tonic deficiency drugs are used the most, accounting for 36.47%. The medical characteristics and efficacy of Chinese medicine in preventing and treating COVID-19 are closely related to the understanding of the etiology of Chinese medicine and the location and pathogenesis of the disease. Staged medication and local conditions need attention during the identification and treatment of COVID-19 clinical syndromes.

Addressing the shortage of pathologists in Africa: Creation of a MMed Programme in Pathology in Zambia.

BackgroundWith approximately one pathologist for one million people compared to ratios of approximately 1 to 25 000 in the United States and United Kingdom, there is a severe shortage of pathologists in much of Africa. The situation is particularly severe in Zambia, where, in 2009, the ratio was 1 to 1.4 million.ObjectiveTo address this, a postgraduate Master of Medicine (MMed) training programme was launched in Lusaka in 2011.MethodsThe process and most significant challenges and lessons learned were documented, as they may be of value to other countries facing similar challenges.ResultsSince 2011, four Zambian pathologists have graduated, doubling the number of indigenous pathologists in the country. Currently 10 students are in training. The most significant problem was issues arising from the split responsibilities of the Ministries of Health and of Education and the most important lesson learned was the crucial need for broad local ownership and commitment.ConclusionSuccessfully addressing the shortage of local pathologists by creating country-specific, postgraduate MMed training programmes, even in situations of restricted resources, is feasible. However, having access to and support from the shared resources, expertise and knowledge of a regional College of Pathologists would be a major advantage.

METHODOLOGICAL PRINCIPLES OF FORMATION OF READINESS OF FUTURE MASTERS OF MEDICINE FOR PEDAGOGICAL ACTIVITIES

Requirements of society to the level of training of future masters of medicine for pedagogical activity, able to improve the educational process on the basis of modern technologies, techniques and means of training in the conditions of dynamic transition from theoretical training to independent professional activity, emphasize attention on the revision of the goals, content of the educational process in institutions of higher education on preparation of masters of medicine for pedagogical activity, especially on methodology of development of experience of pedagogical activity at all stages of education. An important aspect of the process of forming the readiness of future masters of medicine for pedagogical activity in the conditions of institutions of higher medical education – is the choice of a set of methodological approaches and their corresponding principles, that influence on the choice of methods and means of training, the construction of a holistic process of vocational training. Considering the formation of readiness for pedagogical activity as a complex and multidimensional process, a full study of which cannot be carried out from one position, it is necessary to respond to axiological, systemic, competent synergetic, active and cultural approaches.
 Having researched the problem of a high-quality preparation of future masters of medicine for successful independent pedagogical activity, it was summarized that this process will become more effective conditioning that the professional formation of future masters of medicine will occur as a result of their internal movement on the basis of reflection, self-analysis of their own pedagogical activity and the development of internal motivation for self-improvement and gaining pedagogical experience. This, at the same time, necessitates the improvement of the process of theoretical preparation of future masters of medicine, in particular the introduction of technologies of the activity type, aimed at the development of personal and professional qualities of future teachers in institutions of higher medical education.

Tumor-Agnostic Treatment for Cancer: When How is Better than Where.

In the evolving landscape of precision oncology, genomic characterization of tumor has become crucial in order to move toward a molecular-based therapy for the vast majority of cancers. Recently, translational research has offered new perspectives in systemic cancer treatment thanks to the identification of novel oncogenic targets and the development of new targeted therapies, followed by the latest applications of genomic sequencing. Simultaneously, next-generation sequencing (NGS) has expanded its accessibility, being incorporated into clinical studies at the time of the initial screening, disease progression, and often in longitudinal monitoring of molecular changes. Consequently, new potentially targetable molecular alterations have been identified in several different types of tumors, leading to the development of tumor-agnostic treatments. Being highly selective for specific molecular alterations, these drugs are active against different subtypes of oncogene-addicted cancers. Three of these drugs-pembrolizumab [an anti-programmed death 1 (PD-1) monoclonal antibody (MAb)], larotrectinib [a pan-tropomyosin receptor tyrosine kinase (TRK) inhibitor], and entrectinib [a pan-TRK, anaplastic lymphoma kinase (ALK) and ROS-1 inhibitor]-received US FDA approval in 2017, 2018, and 2019, respectively. In this article, we critically review the clinical studies responsible for FDA approval and the most recently updated results. We then discuss the benefits and limitations of these new methodological approaches, paying particular attention to the largest precision medicine master protocol, NCI-MATCH. Among the benefits, there are the increased chances of offering targeted therapies for patients with specific alterations identified in different types of tumors. Among the limitations, we highlight that the same driver mutation may require different therapeutic strategies in different types of cancers. Additionally, the complex study design undeniably requires a dynamic strategy to enroll patients with considerable economic and managerial efforts.

Instrumentos que avaliam o vínculo materno e os riscos de alteração no desenvolvimento infantil

This study was part of the activities developed at the Master of Medicine of the Maternal and Child Health Program of the Federal University of Ceara, Brazil. Objective: To evaluate the bibliographic consistency of the Maternal Attachment Perception Inventory (MAPI) and the Survey of Wellbeing of Young Children (SWYC), indicating reliability and validity information about their measurements. Methods: This is a review study, conducted from February to December of 2017, in the bases of the CAPES journals, the Virtual Health Library (LILACS, MEDLINE and IBECS), Pubmed and Scielo. Results: It was found that these investigative instruments are very necessary in research involving public health, as they are useful for early identification of risks in child health, as well as identify and strengthen family ties of care for children from zero to three years. Conclusion: It was concluded that SWYC is considered a very useful instrument for surveillance of neuropsychomotor, socioemotional and behavioral development, and is also an important indicator of children’s life context. The MAPI proved to be consistent to assess the attachment of mothers of children from six to thirteen years of age, indicating high reliability, however, we indicate the need for further research with this instrument in Brazil, in order to enable its validation. Both instruments proved to be useful in primary care because they are easily accessible, viable, inexpensive and easy to apply, as well as being technically effective and widely used.

Experience in the treatment of chronic gastritis with HE's tube acupuncture technique

HE 's tube acupuncture technique is developed on the base of the theories of zangfu, meridian and collateral by HE Hui-wu, the eminent master of traditional Chinese medicine in 1920s. It is a set of acupuncture technique, in which, the function of the traditional pressing hand is replaced by the needle tube and the seven skills and five manipulations are specially included. In this paper, the experience in the treatment of chronic gastritis with HE 's tube acupuncture technique was introduced. "Regulating the spleen function for the deficiency syndrome" and "taking the liver into the great consideration for the excess syndrome" are the basic principles of treatment. The specific manipulations are predominant, e.g. the conducting-qi manipulation, the sparrow-pecking manipulation, the rotating manipulation, the lifting-thrusting manipulation and the circling manipulation. Moreover, the unique needling techniques are adopted at Zhongwan (CV 12), Weishu (BL 21) and Yanglingquan (GB 34), etc.

FACTORS ASSOCIATED WITH OVERCROWDING IN EMERGENCY ROOM AT DOS DE MAYO NATIONAL HOSPITAL LIMA - PERU

19Feb 2020 FACTORS ASSOCIATED WITH OVERCROWDING IN EMERGENCY ROOM AT DOS DE MAYO NATIONAL HOSPITAL LIMA - PERU Carlos Contreras Camarena , Mori Ramirez H. , Reategui Guzman L. , Leon Gamarra H. , Hidalgo Garcia A. and Silva Valencia J Internal Medicine Master in Public Health Services Management. Principal Professor of San Marcos National University, Lima, Peru. Associate Professor of San Marcos National University, Lima, Peru.

Learning from masters in medicine: George Hoyt Whipple (GHW), a kind of magic.

Learning from masters in medicine: George Hoyt Whipple (GHW), a kind of magic.

The concept of professional competence of masters in medicine in China

The concept of professional competence of masters in medicine in China

Masters in team sports medicine from the University of Barcelona

Masters in team sports medicine from the University of Barcelona

Pre-professional reflective practice: Strategies, perspectives and experiences

IntroductionReflective practice (RP) is a crucial component of health professions' practice. For students, RP is a way to increase their professional competence and improve patient care. To facilitate RP in students and meet their learning needs, educators need an understanding of their students' knowledge and experiences of RP. The aims of this research were to explore senior student osteopaths’ experiences of RP and develop recommendations for improving student engagement with RP. MethodThis research used a descriptive survey method. All students enrolled in the Master of Osteopathic Medicine at Southern Cross University during 2016 were invited to complete an anonymous online survey. ResultsStudents perceived RP as an important catalyst for personal and professional development. They reported using reflection to reconsider clinical decisions, identify gaps in their knowledge and skills, and enhance patient-centred care. Students felt there was a need for RP to be introduced earlier in the course (Year 1) and that greater focus be given to RP during workplace learning including allocation of time for reflective discussion with clinical educators. The data revealed that students who had completed a previous postgraduate qualification were more likely to use reflection frequently, especially after patient consultations. ConclusionThis research supports the important role that RP can play in developing professional competence in student osteopaths and identifies curricula approaches that have the potential to improve student engagement.

Sustaining a Collegewide Teaching Academy as a Community: 10 Years of Experience With the Master Teacher Program at the University of Tennessee College of Veterinary Medicine.

On the basis of strategic initiatives and an evolving focus on educational program enhancement, faculty and staff members designed a structured program to provide leadership and resources for improving instruction and disseminating educational scholarship in a veterinary college. The University of Tennessee College of Veterinary Medicine Master Teacher Program was conceptualized in the teaching academy model as a forum for professional development and dialogue. A small leadership team worked with other faculty to develop the program proposal, including its mission, vision, values, and initial goals. Programming includes monthly meetings to discuss a range of policy, theoretical, and practical topics, as well as periodic workshops focused on current strategic initiatives or hot topics. Ten years later, the program continues to successfully connect educators and have an impact on the college and profession. Attendance has grown steadily; feedback has been positive. Participants rate the program's overall value highly, particularly its impact on their teaching, the opportunity to stay current in educational topics, and the opportunity to learn from colleagues. Discussions within the program have provided valuable input for college policy and practices. Keys to sustained success have included a historical culture emphasizing the teaching mission, alignment with college goals, consistency in leadership and programming, periodic revisions and rebranding, and attention to new faculty and staff needs. This article describes the development, growth, and perceived impact of the program and emphasizes lessons learned and actions taken to sustain its success without additional personnel and at minimal cost.

Study on famous prescription of prestigious traditional Chinese medicine master Lu Zhizheng based on QbD concept: optimization of extraction process and granule forming process of Meiyan Shuqi Prescription

Based on the concept of quality by design( QbD),the design space of Meiyan Shuqi Prescription extraction process was established,and its granules forming process was optimized. The content of total flavonoids was the critical quality attribute( CQA).The amount of water,extraction time and frequency were used as the critical process parameters( CPPs). Box-Behnken experimental design was used to optimize the extraction process. The design space of Meiyan Shuqi Prescription extraction process was established and verified. The results of variance analysis showed that the P value of the quadratic regression model was less than 0. 01,which indicated that the model had a statistical significance,and the relationship between each factor and response value could be functionalized by the established model. Through further optimization of design space,the optimal extraction process of Meiyan Shuqi prescription was13-fold volume of water,extraction for 3 times and each extraction time of 1. 4 hours. Furthermore,the forming process optimized by single factor was as follows: the excipient was dextrin; the ratio of extract powder to excipient was 1 ∶1; the wetting agent was 70% ethanol; and the amount of wetting agent was 0. 3 m L·g-1. The Meiyan Shuqi Prescription extraction process and the forming process based on QbD concept provide reference for the study of other traditional Chinese medicine prescriptions.