Clinical Medicine Studies Research Articles

Umbilical Cord Tissue Mesenchymal Stem Cells: Characterization and Clinical Applications

Umbilical cord tissue (CT) can provide a virtually unlimited source of multipotent mesenchymal stem cells (MSC) that can potentially be used in a variety of regenerative medicine and tissue engineering applications. Cord tissue segments can be frozen and preserved in liquid nitrogen dewars for prolonged periods of time, having been frozen in time at the peak of biological activity. CT stem cells are capable of giving rise to various mesenchymal and non-mesenchymal cell lineages including bone, cartilage, fat and neurons. Thus, CT stem cells are candidates to develop stem cell-based therapies for a wide variety of diseases including cardiovascular, ophthalmic, orthopedic and neurological applications. CT is currently being used in several regenerative medicine clinical studies, examples of which include treatment of graftversus- host disease and non-healing bone fractures. CT represents an additional source of stem cells that have both immediate and future applications for the individual donor.

Replacing Immunoassays With Tryptic Digestion-Peptide Immunoaffinity Enrichment And Lc–MS/MS

For decades, immunoassays have provided the framework for protein biomarker studies in clinical medicine and in therapeutic monitoring for drug development. At the same time, investigators have uncovered many issues that make immunoassays unreliable in many human serum and plasma samples. LC-MS/MS after tryptic digestion of proteins is potentially an attractive solution, but the sensitivity of the method is not sufficient to measure many important low-abundance proteins directly. The use of antipeptide antibodies to immunoenrich peptides of interest can improve the sensitivity of the approach, greatly simplify the matrix enabling shortened chromatographic runs, and facilitate the multiplexed quantification of analytes, which could reduce the costs of quantitative protein measurements in complex specimens. We provide an overview of the method and the steps needed to develop an assay. In addition, we review the efforts to make this method generally more applicable.

Longitudinal Research Databases in Medical Education: Facilitating the Study of Educational Outcomes Over Time and Across Institutions

Many education research questions cannot be answered using participants from one institution or short periods of follow-up. In response to societal demands for accountability and evidence of effectiveness, new models of research must be developed to study the outcomes of educational activities. Following the 2007 Millennium Conference on Medical Education Research, organizers assigned a task force to explore the use of longitudinal databases in education research. This article summarizes the task force's findings. Similar to the Framingham studies in clinical medicine, longitudinal databases assemble prospectively collected information to retrospectively answer questions of interest. Many studies using such databases have been published. The task force identified three general approaches to database-type research. First, institutions can obtain identified information from existing sources, link it with school-specific information and other identified information, deidentify it, and merge it with similar information from other collaborating schools. Second, researchers can obtain from existing sources deidentified information on large samples and explore associations within this dataset. Third, investigators can design and implement databases to prospectively collect trainee information over time and across multiple institutions for the purpose of education research. Although costly, such comprehensive, purpose-built databases would ensure the availability of information needed to answer a variety of medical education research questions. Millennium Conference participants believed that stakeholders should explore the funding and development of such prospective databases. In the meantime, education researchers should use existing sources of individualized learner data to better understand how to develop competent, compassionate clinicians.

Transfusion medicine and proteomics: an alliance for blood quality and safety.

Transfusion medicine and proteomics: an alliance for blood quality and safety.

Non‐haematological uses of cord blood stem cells

Embryonic stem (ES) cell therapies are often promoted as the optimal stem cell source for regenerative medicine applications because of their ability to develop into any tissue in the body. Unfortunately, ES cell applications are currently limited by ethical, political, biological and regulatory hurdles. However, multipotent non-ES cells are available in large numbers in umbilical cord blood (CB). CB stem cells are capable of giving rise to hematopoietic, epithelial, endothelial and neural tissues both in vitro and in vivo. Thus, CB stem cells are amenable to treat a wide variety of diseases including cardiovascular, ophthalmic, orthopaedic, neurological and endocrine diseases. In addition, the recent use of CB in several regenerative medicine clinical studies has demonstrated its pluripotent nature. Here we review the latest developments in the use of CB in regenerative medicine. Examples of these usages include cerebral palsy and type I diabetes. The numbers of individuals affected with each of these diseases are estimated at 10 000 infants diagnosed with cerebral palsy annually and 15 000 youths diagnosed with type 1 diabetes annually. A summary of the initial results from such clinical studies using autologous cord blood stem cells will be presented.

Musings on genome medicine: genome wide association studies

We are grateful to the editors of Genome Medicine who have rather incautiously invited us to write a monthly commentary on the exciting events that have occurred in this burgeoning field. We have decided to write the column together because one of us (DGN) is a clinical investigator and the other (SHO) is a basic geneticist and developmental biologist. Together we believe we can do justice to the field and eschew cant. We begin with a discussion of the controversial role of genome wide association studies in clinical medicine.

Integration of a seminar on the anatomical basis of otorhinolaryngology (ENT) into the clinical course improves the confidence and performance of students in the clinical discipline

A sound knowledge of the scientific basis of medicine is a prerequisite for successful learning and understanding of clinical issues. Teachers of clinical medicine, however, often complain that their students' knowledge on the scientific basis of medicine is too low. In the clinical curricula of most medical schools in Germany, students rely on self-directed learning efforts to optimize their knowledge of basic issues for the study of clinical medicine. Using anatomy and otorhinolaryngology (ENT) as an example, we have compared the effects of a structured seminar for recall of anatomical knowledge and its elaboration under clinical perspective with self-directed learning efforts of the same contents. Effects on clinical performance and students confidence were compared in a randomized trial. We found that the clinical performance of students was significantly higher (6.9%) in the seminar group compared with the control group. Furthermore, the students' self-estimation of clinical competence was increased in the seminar group and they were more content with their clinical course in ENT. Based on the design of the study we believe that the improvement of clinical performance was a longterm effect due to deeper understanding of the clinical problems among participants of the seminar. Irrespective of their experimental study group, most students asked for more integration of seminars on the scientific basis of medicine into the clinical curriculum. With the significant increase in clinical performance shown in this study and the limited effort needed for implementation, these seminars could be an efficient way to improve the quality of teaching in clinical medicine.

A Critical Review of Recent Randomized Controlled Clinical Trials in the Treatment of Asymptomatic Bacteriuria of Pregnancy

The randomized clinical trial represents the gold standard of intervention studies in clinical medicine. This is partly due to the validity of results obtained when confounders, both known and unknown, are assigned equally to treatment groups without the practitioners’ bias of treatment selection. Few clinical trials exist to assess the effectiveness of various treatment regimes for asymptomatic bacteriuria of pregnancy. This study reviews critically the randomized controlled clinical trials for the treatment of asymptomatic bacteriuria of pregnancy. Articles for the review were obtained through a literature search employing MEDLINE over a ten-year period. Nine randomized trials resulted from the search that were in the English language or had English translation available. These included five randomized trials without control groups done in a single centre, and one trial with a control group assessing prophylaxis against recurrent asymptomatic bacteriuria.Review of these studies finds that single dose therapy when compared to longer dosing regimes shows a trend to a higher cure rate but that all of the studies were under-powered. This lack of power results in a significant beta error. No difference between short and long term therapy could, therefore, be shown statistically. When a control group is introduced into the randomized trial, a high rate of spontaneous resolution is seen. Short term therapy resulted in a lower cure rate when compared to no treatment in this setting and only three day or greater treatments showed cure rates above spontaneous remission rates. The only study addressing prophylaxis was severely under-powered and suffered technical complications leading to the inability to draw any conclusions. Adequately powered studies to show effectiveness of single dose therapy and prophylaxis of asymptomatic bacteriuria of pregnancy are needed.

Role of Epidemiology in Occupational Dermatology

The role of epidemiology in occupational dermatology is multifaceted, but the goal is to gain useful information from looking at defined populations. Useful information means that the results of observation or study of that population are sufficiently unbiased to be true (valid) for the study population as well as for individuals with similar circumstances (e.g., risk factors or exposures) who were not part of the study (generalizability). The future of epidemiology in occupational skin diseases includes analyzing ongoing studies, developing new studies, and setting up programs for surveillance and screening. There will also be continuing interaction among industry, government, attorneys, and clinicians. Much useful data can be obtained using computers and establishing databases; but the data will be most useful if some of the epidemiologic concepts described are followed. Dermatologists should be encouraged to learn more about epidemiology and to use its methods to enhance both their practice and the quality of studies they may contribute to the medical literature.

Evoked Potentials in Clinical Medicine

Recent technological advances have facilitated the conduct of evoked potential studies, and permitted their wider use in a clinical context. Evoked potential studies are performed to determine the presence, extent and site of disease of the peripheral and central sensory pathways. This may be helpful for diagnostic purposes, and for characterizing more completely the changes occurring in various diseases. Certain evoked potential components have also been used in the evaluation of cognitive function. The major uses and limitations of evoked potential studies in clinical medicine are reviewed, but technical details are not provided in the interest of simplicity.

Antidepressant-Induced Sexual Dysfunction in Men

University of Michigan School of Medicine Clinical Studies Unit For Affective Disorders, Department of Psychiatry, Neuroscience Laboratory, Mental Health Research Institute, University of Michigan, Ann Arbor, Michigan

Regional lung function studies in clinical medicine.

Regional lung function studies in clinical medicine.

The Study of Clinical Medicine.

The Study of Clinical Medicine.

Book Review Studies in Clinical Medicine . By C. O. Hawthorne, M.D., Fellow of the Royal Faculty of Physicians and Surgeons of Glasgow; Lecturer on Medicine, Medical Graduates' College and Polyclinic, London, etc., etc. London: John Bale, Sons and Danielson, Limited. 1912.

Book Review Studies in Clinical Medicine . By C. O. Hawthorne, M.D., Fellow of the Royal Faculty of Physicians and Surgeons of Glasgow; Lecturer on Medicine, Medical Graduates' College and Polyclinic, London, etc., etc. London: John Bale, Sons and Danielson, Limited. 1912.

Studies in Clinical Medicine.

This is a collection of nearly forty essays and papers on subjects relating to internal medicine, many of the articles being revisions of reprints of papers that have already appeared in medical journals. Fourteen of the chapters are concerned with clinical lectures. The articles for the most part are carefully written and the subjects gone into with great thoroughness. Such are the several articles dealing with rheumatism, rheumatoid arthritis and the retinal and other ocular symptoms of disease. The clinical lectures are instructive in that some one feature of a case is emphasized and its importance and its relation to other aspects of the disease clearly set forth. We might cite as an illustration the way in which the author approaches the subject of pernicious anemia from the point of view of edema. The style is clear and the essays make entertaining and instructive reading.

Presidential Address on the Study of Clinical Medicine: Delivered at the First Meeting of the Clinical Society of London for the Session 1900-01

Presidential Address on the Study of Clinical Medicine: Delivered at the First Meeting of the Clinical Society of London for the Session 1900-01

William Sharpey M.D., F.R.S.

DR. SHARPEY, whose death we regret to announce took place on Sunday, was born April 1, 1802. He entered on the study of medicine at the University of Edinburgh in 1818. In the autumn of 1822 he came to London, where he spent three months in dissecting, and then proceeded to Paris, and occupied the following winter in the study of clinical medicine and surgery in the hospitals. In 1823 he graduated in Edinburgh, and subsequently was for a short time engaged in the practice of his profession in his native town, Arbroath. Soon afterwards he appears to have changed the plan of his life, and for the purpose of educating himself for the scientific career which he had resolved to adopt, he proceeded to the Continent. After spending several months, which were devoted to general culture, at Rome, Naples, and Florence, he resumed the study of anatomy at Pavia, under Panizza. The following years were spent partly in Edinburgh, partly in Paris, Vienna, Heidelberg, and, Berlin. At Berlin he became the pupil and friend of Rudolphi, and by laborious anatomical studies laid the foundation of his future success and eminence. In 1831 he began to lecture in Edinburgh on anatomy, having his friend Prof. Allen Thomson as his associate; and in 1836 was invited by the Council of the University of London, now University College, to accept the Chair of Anatomy and Physiology, which he occupied until 1874.

ART. XXIV.???An Introduction to the Study of Clinical Medicine; being a Guide to the Investigation of Disease. For the Use of Students

ART. XXIV.???An Introduction to the Study of Clinical Medicine; being a Guide to the Investigation of Disease. For the Use of Students