Who Needs This Book, and Why a Doctor Had to Write It
h.c. Jalid Sehouli, Noah Block-Harley in The Art of Breaking Bad News Well, 2019
There is hardly any profession in which communication doesn't play a key role. In medicine, communication is crucial and the backbone of every medical intervention. Yet, in the course of most educational and professional training, verbal communication, much less nonverbal communication, is rarely taught in a structured way. If training does include practice conversations, these only take the form of ideal scenarios rather than real-life situations, and conflict is treated only superficially. In the study of medicine, anamnesis represents a crucial step in diagnosis and prognosis. Despite its unquestionable importance, it receives scant attention in medical education and continued training. The chronic lack of time and face-to-face interaction arising from the everyday pressures of the medical profession places additional pressures on both the quality and quantity of anamnesis.
Second cancers after radiotherapy
Michael C. Joiner, Albert J. van der Kogel in Basic Clinical Radiobiology, 2018
The risk of a person developing specific cancers is also influenced by the individual genetic predisposition. The impact of this predisposition varies with the underlying genetic background. Well-known examples of a strong genetic predisposition are mutations of the Rb gene (predisposing for retinoblastoma and osteosarcoma) and of the BRCA1/2 genes (predisposing for early breast and ovarian cancer). In many instances, moreover, the genetic basis of an increase in cancer risk as assessed by anamnesis (‘family history’) is unknown. The fact that the known, and probably most other, predisposing factors are associated with more than one type of cancer, also means that people cured from one of those cancers have a higher than the population average probability to develop other cancers associated with the respective genetic aberration. It must be emphasized that the impact of genetic predisposition on the risk of developing a second cancer after cure from the first cancer is difficult to assess at the present state of knowledge. The most obvious example is the high risk of children treated with radiotherapy for retinoblastoma to develop osteosarcomas in the irradiated volume. Some of the modalities used to effectively treat cancer have a proven carcinogenic potential. A large number of studies have explored the impact of various chemotherapy and radiotherapy schedules, as well as their combination, on the incidence of second cancers. The most detailed and comprehensive analysis of such studies carried out up to 2010 was published by the National Council of Radiation Protection and Measurements (see [36]).
Doctors' understandings of lifestyle
Emily Hansen, Gary Easthope in Lifestyle in Medicine, 2007
Social history taking provides doctors with a medically legitimate framework and a time in consultations when it is appropriate to talk about lifestyle in a biopsychosocial manner, as distinct from the often reductive conceptions of lifestyle found in health promotion and epidemiology. The notion that patients have a social history in addition to a medical history (a history of past medical care including previous diseases, medical procedures, medications, inoculations, screening tests and life events classified as medical such as childbirth or menopause) was an important aspect of doctors’ understandings of lifestyle and of the social.
The relationship between Covid-19 and mucociliary clearance
Published in Acta Oto-Laryngologica, 2021
Mehmet Erkan Kahraman, Fatih Yüksel, Yaşar Özbuğday
In this prospective controlled study, 36 patients (between the ages of 18 and 65 who were hospitalized in the pandemic ward, whose diagnosis of Covid-19 was confirmed by polymerase chain reaction (PCR)) and 36 volunteers (between the ages of 18 and 65 who presented to the otolaryngology outpatient clinic with non-nasal symptoms, and also had a negative PCR test) were included. Anterior rhinoscopic and endoscopic examinations were performed on individuals in both groups using protective equipment (mask, gloves, gowns, face shields, cabin, etc.). Detailed anamnesis and history were taken from the patients. Demographic data, smoking, Covid-19 symptoms and treatment modalities were recorded. Individuals with a history of smell and/or taste disturbance, nasal surgery, acute or chronic sinusitis, use of nasal spray, seasonal allergic rhinitis and nasal polyps were excluded from the study in both groups.
Voice evaluation – contribution of the speech-language pathologist voice specialist – SLP-V: part A. History of the problem and vocal behaviour data, self-assessment and auditory perceptual judgement
Published in Hearing, Balance and Communication, 2021
Mara Behlau, Glaucya Madazio, Thays Vaiano, Claudia Pacheco, Flávia Badaró
The history of the problem and the behavioural data on the use of voice reveal essential aspects of the vocal condition and must be consciously taken. The clinician attitude is to look for a guiding axis that justifies the complaint and the individual’s symptoms. The purpose of a medical anamnesis is to contribute to a medical diagnosis, which is the prerogative of the physician. The history of the vocal problem, taken by the SLP-V, has the primary objective of understanding the value of the vocal behaviour in the aetiology and the maintenance of the voice problem. The functionality of the voice is also a central question. In simple words, understanding what the patient cannot do with the voice is a fundamental aspect of the history of the problem. In addition, identifying whether the patient has lost functionality or has never had it drives the next steps.
Serum uric acid concentration is associated with ascending aortic dilatation in newly diagnosed nondiabetic hypertensive patients
Published in Clinical and Experimental Hypertension, 2020
Wen-Feng Li, Yu-Qing Huang, Ying-Qing Feng
A comprehensive anamnesis was obtained from all patients and all patients underwent a detailed physical examination. Smokers were defined as >10 cigarettes per day at the time of diagnosis. According to the 2010 Chinese guidelines for the management of hypertension, hypertension was defined as systolic blood pressure (SBP) ≥ 140 mm Hg, and/or diastolic blood pressure (DBP) ≥ 90 mm Hg, and/or use of anti-hypertensive medicine within 2 weeks (17). Body mass index (BMI) was calculated as weight (kg)/height (m2). Blood samples were obtained after a 12-h fast; full blood count, creatinine, lipoprotein profile, blood glucose, glycated hemoglobin (HbA1c), and UA levels were determined. Samples were withdrawn from antecubital vein and the serum was immediately separated from the cells by centrifugation at 3,000 r.p.m. for 10 min, stored at −80°C, and then analyzed. All biochemical analyses were performed with a Hitachi 747 Automatic Analyzer. Patients with a total cholesterol level over 200 mg/dl and/or triglyceride level over 150 mg/dl were considered to have hyperlipidemia.
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