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Storylines of family medicine Ⅳ:perspectives on practice—lenses of appreciation

family medicine and Community Health 2024年第S3期12卷 33-42页

作者： William B Ventres Leslie A Stone Radeeb Akhtar Jeffrey M Ring Lucy M Candib Erick Messias Ronald M Epstein Marc Tunzi Amy L Lee Christopher P Morley Carina M Brown David Slawson Jill Konkin David G Campbell Ian Couper Susan Williams Robert Brooks Lucie Walters family and Preventive medicine University of Arkansas for Medical Sciences College of MedicineLittle RockArkansasUSA family medicine and Community Health Icahn School of Medicine at Mount SinaiNew YorkNew YorkUSA Independent Health Psychologist Los AngelesCaliforniaUSA family medicine and Community Health UMass Chan Medical SchoolWorcesterMassachusettsUSA Psychiatry and Behavioral Neurosciences Saint Louis University School of MedicineSaint LouisMissouriUSA family medicine University of Rochester Medical CenterRochesterNew YorkUSA family medicine residency program Natividad Medical CenterSalinasCaliforniaUSA family medicine Tufts University School of MedicineBostonMassachusettsUSA Public Health and Preventive medicine SUNY Upstate Medical UniversitySyracuseNew YorkUSA Cone Health family medicine residency The University of North Carolina School of MedicineGreensboroNorth CarolinaUSA family medicine Atrium HealthCharlotteNorth CarolinaUSA family medicine University of Alberta Faculty of Medicine&DentistryEdmontonAlbertaCanada Cunninghame Arm Medical Centre Australian College of Rural and Remote MedicineLakes EntranceQueenslandAustralia Ukwanda Centre for Rural Health Stellenbosch University Faculty of Medicine and Health SciencesCape TownWestern CapeSouth Africa Adelaide Rural Clinical School The University of AdelaideAdelaideSouth AustraliaAustralia Department of Rural Health Broken Hill UniversityBroken HillNew South WalesAustralia Adelaide Rural Clinical School The University of Adelaide Faculty of Health and Medical SciencesMount GambierSouth AustraliaAustralia

Storylines of family medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine,as interpreted by individual family physicians and medical educators in the USA and elsewhere around the ***‘Ⅳ:perspectives on practice—lenses of appreciation’,authors address the following themes:‘Relational connections in the doctor–patient partnership’,‘Feminism and family medicine’,‘Positive family medicine’,‘Mindful practice’,‘The new,old ethics of family medicine’,‘Public health,prevention and populations’,‘Information mastery in family medicine’and‘Clinical courage.’May readers nurture their curiosity through these essays.

关键词： thematic illustration doctor

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门诊烧伤的预防与治疗

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中国全科医学 2013年第9期16卷 957-960页

作者： Emillia CO Lloyd Blake C Rodgers 周淑新(译) 葛军(译) saint louis university family medicine residency program Belleville Illinois 62220 USA 中国石油天然气集团公司中心河北省廊坊市065000

大多数烧伤可由初级保健医生在门诊实施治疗。加强预防可使烧伤发生率明显下降，特别对儿童而言。与其他创伤管理相似，烧伤管理包括初级和次级评估。处理浅度烧伤可采用药液、蜂蜜、芦荟或抗生素软膏局部用药。部分皮层烧伤局部用抗菌... 详细信息

大多数烧伤可由初级保健医生在门诊实施治疗。加强预防可使烧伤发生率明显下降，特别对儿童而言。与其他创伤管理相似，烧伤管理包括初级和次级评估。处理浅度烧伤可采用药液、蜂蜜、芦荟或抗生素软膏局部用药。部分皮层烧伤局部用抗菌药物或吸收性封闭敷料有助于减少疼痛、促进愈合和防止创面干燥。

关键词：烧伤治疗预防门诊医疗

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Original Research: Treating Sleep Disorders Has Positive Outcomes in Psychiatric Illnesses

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International Journal of Clinical medicine 2015年第11期6卷 845-851页

作者： Vyas Umesh Mundey Kavita Park Center Inc. Fort Wayne USA Indiana university School of medicine Fort Wayne USA Fort Wayne Medical Education program-family medicine residency Fort Wayne USA university of saint Francis Fort Wayne USA Ivy Tech Community College of Indiana Fort Wayne USA Veteran’s Administration Medical Center (VAMC) Milwaukee USA

Introduction: Sleep and psychiatric disorders are common, and often co-morbid. Sleep disorders may predispose to development or exacerbation of psychiatric disorders. Authors hypothesized that treatment of sleep disorders improve outcomes in psychiatric illnesses. Methods: Charts of patients diagnosed with sleep disorders from October 2007 to December 2007 were reviewed. Outcomes in patients with co-morbid psychiatric disorders were recorded at 6, 12 and 24 months after initiation of sleep disorder treatment. These patients received a baseline psychiatric status score of 0. Change in status at each subsequent time point was scored as: ?2 (marked worsening), ?1 (mild worsening), 0 (no change), +1 (mild improvement) or +2 (marked improvement). We individually compared change in average score at each time point to baseline using the signed rank test. We compared provider documented compliance to sleep therapies between patients with and without psychiatric disorders using Fisher’s exact test. Results: Of 127 charts reviewed, 10 were excluded as patients died within follow-up period. No death was reported as suicide. Of 117 patients, 97.64% were men, 2.36% were women. Age range: 21 - 40: 7.69%, 41 - 60: 42.74%, 61 - 80: 47.87%, >81: 1.70%. 58 patients (45.67%) had coexistent psychiatric diagnoses. There was no difference in provider documented compliance rate to sleep therapies between patients with and without psychiatric disorders at 6, 12 and 24 months, (Fisher’s p value 0.1031, 0.2290 and 0.2248 respectively). Psychiatric status progressively improved compared to baseline (Change in average score by +0.45, +0.56, and +0.79 at 6, 12, and 24 months, respectively, p < 0.0001). Conclusion: Psychiatric disorders did not affect compliance to sleep related treatment. Treatment of co-morbid sleep disorders is associated with improvement in psychiatric disorders. Authors recommend need for prospective study with more subjects.

关键词： Psychiatric Illnesses/Disorders Sleep Illnesses/Disorders

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Original Research: Pupillary Constriction Velocity and Latency to Predict Excessive Daytime Sleepiness

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International Journal of Clinical medicine 2015年第11期6卷 805-812页

作者： Vyas Umesh Woodson B. Tucker Park Center Inc. Fort Wayne USA Indiana university School of medicine Fort Wayne USA Fort Wayne Medical Education program-family medicine residency Fort Wayne USA university of saint Francis Fort Wayne USA Ivy Tech Community College of Indiana Fort Wayne USA Department of Otolaryngology and Human Communication Medical College of Wisconsin Milwaukee USA

Background: Excessive daytime sleepiness (EDS) is common in adults. A need exists for an easier and faster objective clinical measures of EDS. The autonomic nervous system controls pupil size and prior pupillometry studies have demonstrated associations with sleepiness. We used a novel portable device to assess pupillometry and prospectively evaluated a sleep clinic cohort. Methods: Following IRB approval Pupillometry (The ForSiteTM, NeurOptics, Irvine, CA), was performed on 113 sleep clinic patients. Constriction and dilation velocity and latencies, minimum and maximum aperture were obtained along with Epworth Sleepiness Score (ESS), 10 point Visual Analog Scale (VAS), BMI, gender, age and AHI. Three sets of measures were obtained and analyzed with ANOVA, t-test, Linear Regression and Pearson correlation coefficients (SAS, Cary, NC). Results: Both constriction velocity and latency correlated with VAS (n = 88, r = 0.28, p = 0.007 and r = 0.31, p = 0.004). Only constriction velocity correlated with AHI (n = 78, r = -0.27, p = 0.016). Multivariate linear regression which includes VAS and age predicted constriction velocity (r = 0.36, p = 0.002) and latency (r = 0.38, p = 0.001). Using Pearson correlation, AHI and VAS combined were associated with constriction velocity (-0.273 (0.016), and 0.284 (0.007), respectively). Using a maximum constriction velocity threshold value (age adjusted) of 2.8, VAS ≥ 6 was predicted with a sensitivity of 83% and specificity of 84%. Conclusions: Pupillary constriction velocity and latency predict self-reported VAS state of sleepiness. While both are affected by age, only constriction velocity is affected by apnea severity. These data suggest that a portable pupillometer may provide a method to identify individuals with abnormal sleepiness.

关键词： Excessive Daytime Sleepiness Pupillometry Constriction Velocity Constriction Latency

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Second-Line Tisagenlecleucel or Standard Care in Aggressive B-Cell Lymphoma

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四川生理科学杂志 2021年第10期43卷 1805-1805页

作者： Michael R Bishop From the David and Etta Jonas Center for Cellular Therapy University of Chicago Chicago (M.R.B.) Peter MacCallum Cancer Centre and Royal Melbourne Hospital Melbourne VIC (M. Dickinson) Fiona Stanley Hospital Murdoch WA (D.P.) and the Department of Haematology St. Vincent's Hospital Sydney and St. Vincent's Clinical School University of New South Wales Sydney (N.H.) - all in Australia Hospital Universitari Vall d'Hebron and Universitat Autònoma de Barcelona (P. Barba) and the Clinical Hematology Department Institut Català d'Oncologia-Hospitalet de Llobregat (A. Sureda) Barcelona and the Hematology Department Hospital 12 de Octubre Complutense University Instituto de Investigación Hospital 12 de Octubre Centro Nacional de Investigaciones Oncológicas Madrid (J.M.-L.) - all in Spain the Department of Biomedical Sciences Humanitas University and IRCCS Humanitas Research Hospital-Humanitas Cancer Center Milan (A. Santoro) the Department of Hematology Oncology and Cardiovascular Medicine Kyushu University Hospital Fukuoka (K.K.) and Tohoku University Hospital Sendai (H. Harigae) - both in Japan the Third Medical Department Paracelsus Medical University Salzburg Cancer Research Institute-Center for Clinical Cancer and Immunology Trials and Cancer Cluster Salzburg Salzburg (R.G.) and Internal Medicine I Bone Marrow Transplant Unit (W.R.) and the Clinical Division of Hematology and Hemostaseology Department of Medicine I (U.J.) Vienna General Hospital-Medical University of Vienna Vienna - both in Austria Assistance Publique-Hôpitaux de Paris Hemato-Oncology Hôpital Saint-Louis Paris (C.T.) Centre Hospitalier Régional Universitaire de Lille Lille (F.M.) Hospices Civils de Lyon and Université Claude Bernard Lyon 1 Lyon (E.B.) and Centre de Recherche en Cancérologie et Immunologie Nantes-Angers INSERM and Nantes Medical University Nantes (S.L.G.) - all in France the Department of Hematology Oncology and Tumorimmunology Charité-University Hospital Berlin Campus Benjamin Frank

Background:Patient outcomes are poor for aggressive B-cell non-Hodgkin's lymphomas not responding to or progressing within 12 months after first-line *** is an anti-CD19 chimeric antigen receptor T-cell therapy approved for diffuse large B-cell lymphoma after at least two treatment ***:We conducted an international phase 3 trial involving patients with aggressive lymphoma that was refractory to or progressing within 12 months after first-line *** were randomly assigned to receive tisagenlecleucel with optional bridging therapy(tisagenlecleucel group)or salvage chemotherapy and autologous hematopoietic stem-cell transplantation(HSCT)(standard-care group).The primary end point was event-free survival,defined as the time from randomization to stable or progressive disease at or after the week 12 assessment or *** to receive tisagenlecleucel was allowed if a defined event occurred at or after the week 12 *** end points included response and safety.

关键词： lymphoma chemotherapy allowed

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