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2. Applications to augment patient care for Internal Medicine specialists: a position paper from the EFIM working group on telemedicine, innovative technologies & digital health.
- Author
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Pietrantonio F, Florczak M, Kuhn S, Kärberg K, Leung T, Said Criado I, Sikorski S, Ruggeri M, Signorini A, Rosiello F, Drago C, Vinci A, Barreto V, Montano N, Dicker D, and Gomez Huelgas R
- Subjects
- Humans, Europe, Patient Care, Specialization, Digital Health, Telemedicine, Internal Medicine, Delphi Technique
- Abstract
Telemedicine applications present virtually limitless prospects for innovating and enhancing established and new models of patient care in the field of Internal Medicine. Although there is a wide range of innovative technological solutions in Europe, there are overarching elements associated with such technologies when applied to the practices of Internal Medicine specialists. The European Federation of Internal Medicine (EFIM) strongly advocates for active leadership and influence from the Internal Medicine societies and specialist physicians across Europe in the development and application of telemedicine and digital technologies in healthcare. This position paper's conclusions were drawn via Delphi method, which was developed collaboratively from July 2021 to December 2023. The panel, consisting of experts in clinical medicine, public health, health economics and statistics, assessed various aspects related to telemedicine. Participants assigned scores on a Likert scale reflecting perceived value and potential risks. The findings were consolidated in a comprehensive checklist aligning with relevant literature and a SWOT analysis. Specifically, key issues that need to be addressed include promoting the professional development of e-health competencies in the healthcare and medical workforce, using educational campaigns to promote digital literacy among patients and caregivers, designing and implementing telemedicine applications tailored to local conditions and needs and considering the ethical and legal contexts under which these applications are employed. Importantly, there is currently no consensus on care models or standardized protocols among European Internal Medicine specialists regarding the utilization of telemedicine. This position paper aims to outline the opportunities and challenges associated with the application of telemedicine in Internal Medical practice in Europe., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Pietrantonio, Florczak, Kuhn, Kärberg, Leung, Said Criado, Sikorski, Ruggeri, Signorini, Rosiello, Drago, Vinci, Barreto, Montano, Dicker and Gomez Huelgas.)
- Published
- 2024
- Full Text
- View/download PDF
3. Improving Women's Health Across the Life Span-JAMA Internal Medicine Call for Papers.
- Author
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Grady D, Allore HG, Corbie G, Covinsky KE, Durant RW, Ganguli I, Gross CP, Katz MH, Mody L, Wang T, Tripodis Y, and Inouye SK
- Subjects
- Humans, Female, Periodicals as Topic, Women's Health, Internal Medicine
- Published
- 2024
- Full Text
- View/download PDF
4. [Consensus paper of the Austrian Obesity Society on the diagnosis and treatment of people with obesity].
- Author
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Itariu BK
- Subjects
- Humans, Austria, Consensus, Internal Medicine
- Published
- 2023
- Full Text
- View/download PDF
5. Systemic treatment of hepatocellular carcinoma: An EASL position paper.
- Author
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Bruix J, Chan SL, Galle PR, Rimassa L, and Sangro B
- Subjects
- Humans, Internal Medicine organization & administration, Liver Neoplasms therapy, Carcinoma, Hepatocellular therapy, Internal Medicine trends
- Abstract
The last 5 years have witnessed relevant advances in the systemic treatment of hepatocellular carcinoma. New data have emerged since the development of the EASL Clinical Practice Guidelines on the management of hepatocellular carcinoma in 2018. Drugs licensed in some countries now include 4 oral multi-tyrosine kinase inhibitors (sorafenib, lenvatinib, regorafenib and cabozantinib), 1 anti-angiogenic antibody (ramucirumab) and 4 immune checkpoint inhibitors, alone or in combination (atezolizumab in combination with bevacizumab, ipilimumab in combination with nivolumab, nivolumab and pembrolizumab in monotherapy). Prolonged survival in excess of 2 years can be expected in most patients with sensitive tumours and well-preserved liver function that renders them fit for sequential therapies. With different choices available in any given setting, the robustness of the evidence of efficacy and a correct matching of the safety profile of a given agent with patient characteristics and preferences are key in making sound therapeutic decisions. The recommendations in this document amend the previous EASL Clinical Practice Guidelines and aim to help clinicians provide the best possible care for patients today. In view of several ongoing and promising trials, further advances in systemic therapy of hepatocellular carcinoma are foreseen in the near future and these recommendations will have to be updated regularly., Competing Interests: Conflict of interest JB received received consulting fees from AbbVie, Adaptimmune, Arqule, AstraZeneca, Medimmune, Basilea, Bayer, Bio-Alliance, BMS, BTG, Eisai, Gilead, Incyte, Ipsen, Kowa, Lilly, MSD, Nerviano, Novartis, Polaris, Quirem, Roche, Sirtex, Sanofi, Terumo; institutional research grants from Bayer, BTG; educational grants from Bayer, BTG; and speaker fees from Bayer, BTG, Ipsen, Roche, Eisai, Terumo, Sirtex. SC Stephen L. Chan has acted as an advisor to AstraZeneca, Eisai, MSD and Novartis; received research grants from Bayer, Ipsen, MSD and SIRTEX; and received lecture fees from AstraZeneca,Bayer, Eisai, Roche and MSD. PRG received consulting and/or lecturing fees from Bayer, BMS, AstraZeneca, Sirtex, MSD, Eisai, Ipsen, Roche, Adaptimmune, Lilly. LR received consulting fees from Amgen, ArQule, AstraZeneca, Basilea, Bayer, BMS, Celgene, Eisai, Exelixis, Genenta, Hengrui, Incyte, Ipsen, IQVIA, Lilly, MSD, Nerviano Medical Sciences, Roche, Sanofi, Zymeworks; lecture fees from AbbVie, Amgen, Bayer, Eisai, Gilead, Incyte, Ipsen, Lilly, Merck Serono, Roche, Sanofi; travel expenses from Ipsen; and institutional research funding from Agios, ARMO BioSciences, AstraZeneca, BeiGene, Eisai, Exelixis, Fibrogen, Incyte, Ipsen, Lilly, MSD, Nerviano Medical Sciences, Roche, Zymeworks. BS received consulting fees from Adaptimmune, AstraZeneca, Bayer, BMS, BTG, Eisai, Exelixis, Eli-Lilly, IPSEN, Merck, Onxeo, Roche, Sirtex; lecture fees from AstraZeneca, Bayer, BMS, Eisai, Eli-Lilly, Incyte, IPSEN, Roche, Sirtex; institutional research grants from BMS and Sirtex. Please refer to the accompanying ICMJE disclosure forms for further details., (Copyright © 2021 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.)
- Published
- 2021
- Full Text
- View/download PDF
6. Position Paper: SGIM Sex- and Gender-Based Women’s Health Core Competencies
- Author
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Henrich, Janet B, Schwarz, E Bimla, McClintock, Adelaide H, Rusiecki, Jennifer, Casas, Rachel S, and Kwolek, Deborah Gomez
- Subjects
Health Services and Systems ,Health Sciences ,Good Health and Well Being ,Humans ,Female ,United States ,Women's Health ,Education ,Medical ,Graduate ,Certification ,Internal Medicine ,General Practitioners ,sex- and gender-based women’s health core competencies ,Clinical Sciences ,General & Internal Medicine ,Clinical sciences ,Health services and systems ,Public health - Abstract
Women's health care has evolved significantly since it was first acknowledged as an integral part of internal medicine training more than two decades ago. To update and clarify core competencies in sex- and gender-based women's health for general internists, the Society of General Internal Medicine (SGIM) Women and Medicine Commission prepared the following Position Paper, approved by the SGIM council in 2023. Competencies were developed using several sources, including the 2021 Accreditation Council for Graduate Medical Education Program Requirements for Internal Medicine and the 2023 American Board of Internal Medicine Certification Examination Blueprint. These competencies are relevant to the care of patients who identify as women, as well as gender-diverse individuals to whom these principles apply. They align with pivotal advances in women's health and acknowledge the changing context of patients' lives, reaffirming the role of general internal medicine physicians in providing comprehensive care to women.
- Published
- 2023
7. The role of glucagon-like peptide-1 receptor agonists (GLP1-RAs) in the management of the hypertensive patient with metabolic syndrome: a position paper from the Korean society of hypertension
- Author
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Hae Young Lee, Seung-Hyun Ko, Sungjoon Park, Kyuho Kim, Song-Yi Kim, In-Jeong Cho, Eun Joo Cho, Hyeon Chang Kim, Jae-Hyeong Park, Sung Kee Ryu, Min Kyong Moon, Sang-Hyun Ihm, and the Korean Society of Hypertension
- Subjects
Metabolic syndrome, obesity, hypertension, glucagon ,Like peptide ,1, glucagon ,1 receptor agonist ,Medicine ,Internal medicine ,RC31-1245 - Abstract
Abstract Obesity is the one of the most important components of metabolic syndrome. Because obesity related hypertension accounts for two thirds of essential hypertension, managing obesity and metabolic syndrome is a crucial task in the management of hypertension. However, the current non-pharmacological therapies have limitations for achieving or maintaining ideal body weight. Recently, glucagon-like peptide-1 receptor agonists (GLP1-RAs) have demonstrated excellent weight control effects, accompanied by corresponding reductions in blood pressure. GLP1-RAs have shown cardiovascular and renal protective effects in cardiovascular outcome trials both in primary and secondary prevention. In this document, the Korean Society of Hypertension intends to remark the current clinical results of GLP1-RAs and recommend the government and health-policy makers to define obesity as a disease and to establish forward-looking policies for GLP1-RA treatment for obesity treatment, including active reimbursement policies.
- Published
- 2024
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8. Proposal for the use of angiotensin II in distributive shock after extracorporeal circulation – position paper of the Section of Intensive Care Medicine and the Section of Cardiothoracic Anaesthesiology of the Polish Society of Anaesthesiology and Intensive Therapy
- Author
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Łukasz Krzych, Paweł Nadziakiewicz, and Ewa Kucewicz-Czech
- Subjects
distributive shock ,extracorporeal circulation ,angiotensin ii ,treatment. ,Surgery ,RD1-811 ,Internal medicine ,RC31-1245 - Abstract
Angiotensin II (AT) is a potent vasoconstrictor and hypertensive drug that is registered for the treatment of severe hypotension in vasoplegic shock. Growing experience with the use of AT in cardiac surgery allows the first therapeutic algorithms to be created. This paper is a proposal for the use of AT in distributive shock after extracorporeal circulation.
- Published
- 2024
- Full Text
- View/download PDF
9. Point-of-care ultrasound in internal medicine: A position paper by the ultrasound working group of the European federation of internal medicine.
- Author
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Torres-Macho J, Aro T, Bruckner I, Cogliati C, Gilja OH, Gurghean A, Karlafti E, Krsek M, Monhart Z, Müller-Marbach A, Neves J, Sabio R, Serra C, Smallwood N, Tana C, Uyaroğlu OA, Von Wowern F, and Bosch FH
- Subjects
- Curriculum, Humans, Point-of-Care Testing, Ultrasonography, Internal Medicine education, Point-of-Care Systems
- Abstract
Point-of-care ultrasound (POCUS) is increasingly used to assess medical patients. It has many uses in daily clinical practice, including improved diagnostic timeliness and accuracy, and providing information about a patient's prognosis and follow-up. It has been integrated into numerous specialities, but remains relatively undefined in internal medicine training programs. Ultrasonography is a useful tool in the standard clinical practice of internists in numerous clinical scenarios (Emergency Department, hospital ward, general and specific consultations, and home care). Although POCUS has been recently included in the European curriculum of internal medicine, there are differences between European internists in its use, ranging from not at all to well structured educational programs. The use of POCUS needs to be widespread in internal medicine departments, and to accomplish this we must encourage structured training. This document details the consensus-based recommendations by the European Federation of Internal Medicine (EFIM) Ultrasound working group. We establish POCUS core competencies and clinical settings for internists in a symptom-based approach. We also propose training requirements, providing a framework for training programs at a national level., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2019. Published by Elsevier B.V.)
- Published
- 2020
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10. Advances in the use of dried blood spots on filter paper to monitor kidney disease
- Author
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Carla Nicola and Vandréa de Souza
- Subjects
creatinine ,cystatin c ,dried blood spot testing ,iohexol ,urea ,Internal medicine ,RC31-1245 ,Pediatrics ,RJ1-570 - Abstract
Patients with kidney disease require frequent blood tests to monitor their kidney function, which is particularly difficult for young children and the elderly. For these people, the standard method is to evaluate serum creatinine or cystatin C or drug levels through venous sampling, but more recently, evaluation using dried blood spots has been used. This narrative review reports information from the literature on the use of dried blood spots to quantify the main markers used to detect kidney diseases. The ScienceDirect and PubMed databases were searched using the keywords: "dried blood on filter paper," "markers of renal function," "renal function," "creatinine," "cystatin C," "urea," "iohexol," and "iotalamate." Studies using animal samples were excluded, and only relevant articles in English or Spanish were considered. Creatinine was the most assessed biomarker in studies using dried blood spots to monitor kidney function, showing good performance in samples whose hematocrit levels were within normal reference values. According to the included studies, dried blood spots are a practical monitoring alternative for kidney disease. Validation parameters, such as sample and card type, volume, storage, internal patterns, and the effects of hematocrit are crucial to improving the reliability of these results.
- Published
- 2024
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11. Osler Centenary Papers: When the diagnosis is futile….
- Author
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Luz P
- Subjects
- Humans, Patient Comfort, Truth Disclosure ethics, Internal Medicine ethics, Medical Futility ethics, Medical Futility psychology, Neoplasms diagnosis, Neoplasms psychology, Personhood, Physician-Patient Relations
- Abstract
Competing Interests: Competing interests: None declared.
- Published
- 2019
- Full Text
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12. Position paper of the Italian Society of Internal Medicine (SIMI) on prophylaxis and treatment of venous thromboembolism in patients with cancer.
- Author
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Prisco D, Tufano A, Cenci C, Pignatelli P, Santilli F, Di Minno G, and Perticone F
- Subjects
- Humans, Primary Prevention, Prognosis, Risk Assessment, Risk Factors, Venous Thromboembolism epidemiology, Anticoagulants therapeutic use, Fibrinolytic Agents therapeutic use, Internal Medicine standards, Neoplasms complications, Platelet Aggregation Inhibitors therapeutic use, Venous Thromboembolism etiology, Venous Thromboembolism prevention & control
- Abstract
Cancer patients are at high risk of developing thrombotic events, including venous thromboembolism (VTE) [deep venous thrombosis (DVT) and pulmonary embolism (PE)], and arterial thrombosis. DVT and PE represent the second leading cause of death in cancer patients; moreover, the development of thromboembolic events in cancer patients is linked to a greater need of hospitalization and frequency of side effects during treatment, in particular bleeding, and to an increased risk of recurrence during and following antithrombotic therapy. The thromboembolic risk may be different in different subgroups of cancer population, being highest in patients with metastatic disease, patients with pancreas, stomach, kidney or primary brain cancer, or during therapeutic interventions or surgery. This document focuses on several relevant topics including the epidemiology and pathogenesis of cancer-associated VTE, the current and future strategies of primary prevention and anticoagulant treatment, and the management of bleeding complications. The main literature data are discussed in detail, including, when available, evidence from randomized clinical trials and meta-analyses, international guidelines statements, the results of recently published trials comparing direct oral anticoagulants to low molecular weight heparin, and the design and aims of ongoing trials on prevention/treatment of cancer-associated VTE.
- Published
- 2019
- Full Text
- View/download PDF
13. Applications to augment patient care for Internal Medicine specialists: a position paper from the EFIM working group on telemedicine, innovative technologies & digital health
- Author
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F. Pietrantonio, M. Florczak, S. Kuhn, K. Kärberg, T. Leung, I. Said Criado, S. Sikorski, M. Ruggeri, A. Signorini, F. Rosiello, C. Drago, A. Vinci, V. Barreto, N. Montano, D. Dicker, and R. Gomez Huelgas
- Subjects
e-health ,digital medicine ,Internal Medicine ,tele health ,digital health ,Public aspects of medicine ,RA1-1270 - Abstract
Telemedicine applications present virtually limitless prospects for innovating and enhancing established and new models of patient care in the field of Internal Medicine. Although there is a wide range of innovative technological solutions in Europe, there are overarching elements associated with such technologies when applied to the practices of Internal Medicine specialists. The European Federation of Internal Medicine (EFIM) strongly advocates for active leadership and influence from the Internal Medicine societies and specialist physicians across Europe in the development and application of telemedicine and digital technologies in healthcare. This position paper’s conclusions were drawn via Delphi method, which was developed collaboratively from July 2021 to December 2023. The panel, consisting of experts in clinical medicine, public health, health economics and statistics, assessed various aspects related to telemedicine. Participants assigned scores on a Likert scale reflecting perceived value and potential risks. The findings were consolidated in a comprehensive checklist aligning with relevant literature and a SWOT analysis. Specifically, key issues that need to be addressed include promoting the professional development of e-health competencies in the healthcare and medical workforce, using educational campaigns to promote digital literacy among patients and caregivers, designing and implementing telemedicine applications tailored to local conditions and needs and considering the ethical and legal contexts under which these applications are employed. Importantly, there is currently no consensus on care models or standardized protocols among European Internal Medicine specialists regarding the utilization of telemedicine. This position paper aims to outline the opportunities and challenges associated with the application of telemedicine in Internal Medical practice in Europe.
- Published
- 2024
- Full Text
- View/download PDF
14. The Challenges of Teaching Ambulatory Internal Medicine: Faculty Recruitment, Retention, and Development: An AAIM/SGIM Position Paper.
- Author
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Fazio SB, Chheda S, Hingle S, Lo MC, Meade L, Blanchard M, Hoellein A, Brandenburg S, and Denton GD
- Subjects
- Female, Humans, Male, Needs Assessment, Program Development, Program Evaluation, United States, Ambulatory Care methods, Curriculum, Education, Medical, Graduate methods, Education, Medical, Undergraduate methods, Faculty, Medical organization & administration, Internal Medicine education
- Published
- 2017
- Full Text
- View/download PDF
15. Problem-based learning in internal medicine: virtual patients or paper-based problems?
- Author
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Sobocan M, Turk N, Dinevski D, Hojs R, and Pecovnik Balon B
- Subjects
- Educational Measurement, Humans, Prospective Studies, Slovenia, Students, Medical, Education, Medical, Undergraduate methods, Internal Medicine methods, Motivation, Problem-Based Learning methods, Thinking
- Abstract
Background: Teaching using paper problem-based learning (p-PBL) sessions has left some students fatigued with the learning process. Therefore, attempts have been made to replace p-PBL with digitally enhanced, decision-making PBL in the form of virtual patients (VP). Student enthusiasm for substituting p-PBL with VP has not been quantitatively evaluated on the intended educational effects., Aim: To determine the educational effects of substituting p-PBL sessions with VP on undergraduate medical students in their internal medicine course., Methods: We conducted a randomised controlled study on 34 third-year undergraduate medical students in the academic year 2015-2016. Student performance after an intervention substituting p-PBL sessions with VP was analysed. The educational outcomes were measured with knowledge exams and the Diagnostic Thinking Inventory., Results: There was no difference in exam performance between groups (P > 0.833) immediately after the intervention, or in long term. Nor was there a significant difference in improvement of diagnostic thinking between groups (P > 0.935 and P > 0.320)., Conclusions: Our study showed no significant improvement in diagnostic thinking abilities or knowledge exam results with the use of VP. Educators can add VP to sessions to motivate students, but a significant improvement to educational outcome should not be expected., (© 2016 Royal Australasian College of Physicians.)
- Published
- 2017
- Full Text
- View/download PDF
16. Adoption of a Uniform Start Date for Internal Medicine Fellowships and Other Advanced Training: An AAIM White Paper.
- Author
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Barrett JC, Alweis R, Frank M, O'Connor A, McConville JF, Adams ND, Arfons L, Bernard S, Bradley T, Buckley JD, Cohen E, Cornett P, Elkins S, Kopelman R, Luther VP, Petrusky J, McNeill DB, Omar B, Palapiano N, Roth T, Satko S, Fried ED, and Muchmore EA
- Subjects
- Education, Medical, Graduate legislation & jurisprudence, Fellowships and Scholarships legislation & jurisprudence, Humans, Insurance Benefits, Salaries and Fringe Benefits, Time Factors, United States, Education, Medical, Graduate organization & administration, Fellowships and Scholarships organization & administration, Internal Medicine education
- Published
- 2015
- Full Text
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17. The Internal Medicine Subinternship--Now More Important than Ever: A Joint CDIM-APDIM Position Paper.
- Author
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Vu TR, Angus SV, Aronowitz PB, Harrell HE, Levine MA, Carbo A, Whelton S, Ferris A, Appelbaum JS, McNeill DB, Ismail NJ, and Elnicki DM
- Subjects
- Competency-Based Education, Education, Medical, Graduate, Humans, Needs Assessment, Surveys and Questionnaires, United States, Clinical Competence standards, Curriculum, Education, Medical, Undergraduate standards, Internal Medicine education, Internship and Residency
- Abstract
For decades, the internal medicine (IM) subinternship has served as a critical interface between undergraduate and graduate medical education. As such, the vast majority of U.S. medical schools offer this rotation to help students prepare for post-graduate training. Historically an experiential rotation, a formal curriculum with specific learning objectives was eventually developed for this course in 2002. Since then, graduate medical education (GME) has changed significantly with the regulation of duty hours, adoption of competency-based education, and development of training milestones and entrustable professional activities. In response to these and many other changes to residency training and medical practice, in 2010, the Association of Program Directors in Internal Medicine (APDIM) surveyed its members-with input from the Clerkship Directors in Internal Medicine (CDIM) Subinternship Task Force-to determine which core skills program directors expected from new medical school graduates. The results of that survey helped to inform a joint CDIM-APDIM committee's decision to re-evaluate the goals of the IM subinternship in an effort to enhance the transition from medical school to residency. This joint committee defined the minimum expectations of what constitutes an IM subinternship rotation, proposed recommended skills for IM subinterns, and discussed challenges and future directions for this crucial course.
- Published
- 2015
- Full Text
- View/download PDF
18. Introducing the "Internal Medicine Flashcards": call for papers.
- Author
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Dagna L
- Subjects
- Humans, Editorial Policies, Internal Medicine education, Manuscripts, Medical as Topic
- Published
- 2013
- Full Text
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19. [Career development of young scientists in internal medicine. Position paper of the German Society of Internal Medicine].
- Author
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Löhr M
- Subjects
- Humans, Biomedical Research education, Education, Medical, Graduate, Internal Medicine education, Internship and Residency, Translational Research, Biomedical education
- Published
- 2012
- Full Text
- View/download PDF
20. [Career development of young scientists in internal medicine. Position paper of the German Society of Internal Medicine ].
- Subjects
- Career Choice, Curriculum, Faculty, Medical, Germany, Humans, Biomedical Research education, Education, Medical, Graduate, Internal Medicine education, Internship and Residency, Translational Research, Biomedical education
- Published
- 2012
- Full Text
- View/download PDF
21. [Summaries of papers at the 43rd Scientific Inservice Training of the South-Hungary Section of the Hungarian Internists' Society].
- Subjects
- Humans, Internal Medicine
- Published
- 2012
- Full Text
- View/download PDF
22. Journal of General Internal Medicine. From the editor's desk: our paper anniversary.
- Author
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Feldman MD and Kravitz RL
- Subjects
- Anniversaries and Special Events, Humans, Internal Medicine standards, Periodicals as Topic standards, Editorial Policies, Internal Medicine trends, Periodicals as Topic trends
- Published
- 2010
- Full Text
- View/download PDF
23. [Papers from the 9th Congress of the German Interdisciplinary Society for Intensive and Emergency Medicine, 3-6 December, 2008. Hamburg, Germany].
- Subjects
- Germany, Humans, Critical Care, Emergency Medical Services, Interdisciplinary Communication, Internal Medicine
- Published
- 2008
24. HFA of the ESC position paper on the management of LVAD‐supported patients for the non‐LVAD specialist healthcare provider Part 3: at the hospital and discharge
- Author
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Finn Gustafsson, Binyamin Ben Avraham, Ovidiu Chioncel, Tal Hasin, Avishai Grupper, Aviv Shaul, Sanemn Nalbantgil, Yoav Hammer, Wilfried Mullens, Laurens F. Tops, Jeremy Elliston, Steven Tsui, Davor Milicic, Johann Altenberger, Miriam Abuhazira, Stephan Winnik, Jacob Lavee, Massimo Francesco Piepoli, Lorrena Hill, Righab Hamdan, Arjang Ruhparwar, Stefan Anker, Marisa Generosa Crespo‐Leiro, Andrew J.S. Coats, Gerasimos Filippatos, Marco Metra, Giuseppe Rosano, Petar Seferovic, Frank Ruschitzka, Stamatis Adamopoulos, Yaron Barac, Nicolaas De Jonge, Maria Frigerio, Eva Goncalvesova, Israel Gotsman, Osnat Itzhaki Ben Zadok, Piotr Ponikowski, Luciano Potena, Arsen Ristic, Tiny Jaarsma, and Tuvia Ben Gal
- Subjects
End of life ,Internal Medicine ,LVAD ,Surgical departments ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract The growing population of left ventricular assist device (LVAD)‐supported patients increases the probability of an LVAD‐ supported patient hospitalized in the internal or surgical wards with certain expected device related, and patient‐device interaction complication as well as with any other comorbidities requiring hospitalization. In this third part of the trilogy on the management of LVAD‐supported patients for the non‐LVAD specialist healthcare provider, definitions and structured approach to the hospitalized LVAD‐supported patient are presented including blood pressure assessment, medical therapy of the LVAD supported patient, and challenges related to anaesthesia and non‐cardiac surgical interventions. Finally, important aspects to consider when discharging an LVAD patient home and palliative and end‐of‐life approaches are described.
- Published
- 2021
- Full Text
- View/download PDF
25. Position paper of the Italian College of Rheumatologists (CReI) on herpes zoster vaccination
- Author
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D. Marotto, P. Sarzi-Puttini, V. Giorgi, M. Benucci, A. Migliore, P. Amato, and A. Riva
- Subjects
infection ,autoimune rheumatic diseases ,vaccine ,herpes zoster ,Internal medicine ,RC31-1245 - Abstract
Herpes Zoster (HZ) is a blistering, painful and disabling cutaneous rash that can occur in any type of patient at any age. It is caused by reactivation of the Varicella Zoster Virus (VZV). Autoimmune inflammatory rheumatic diseases (AIIRDs) are associated with an increased risk of infections due to use of corticosteroids, comorbidities, the immunosuppressive effect of AIIRDs themselves and of the drugs used to treat them. In light of the clinical and psychological effects of HZ and its complications in affected patients, it is essential to carry out a prevention strategy by implementing vaccination programs in appropriate age and high-risk groups, given also the availability of the new recombinant adjuvanted anti-Herpes Zoster (RZV) vaccine in Italy. The College of Italian Rheumatology think it is useful to share some scientific data on the epidemiological and clinical impact of HZ in patients with AIIRDs and on the current national vaccine availability.
- Published
- 2022
- Full Text
- View/download PDF
26. Redesigning residency education in internal medicine: a position paper from the Association of Program Directors in Internal Medicine.
- Author
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Fitzgibbons JP, Bordley DR, Berkowitz LR, Miller BW, and Henderson MC
- Subjects
- Ambulatory Care, Curriculum, Education, Medical, Graduate economics, Faculty, Medical standards, Financing, Organized, Hospitals, Teaching economics, Hospitals, Teaching standards, Humans, Inpatients, Quality of Health Care, United States, Internal Medicine education, Internship and Residency economics, Internship and Residency standards, Models, Educational
- Abstract
There has been considerable change in the practice of internal medicine in the past quarter century, including the rise of specialization, increasing time pressure, the hospitalist movement, and the rapidly changing responsibilities of internists in inpatient and outpatient settings. Training programs have not adequately responded to these trends, and there is a consensus that the residency education system urgently needs redesign.
- Published
- 2006
- Full Text
- View/download PDF
27. [Political issues in internal medicine in Europe. A position paper].
- Author
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Bauer W, Schumm-Draeger PM, Koebberling J, Gjoerup T, Alegria JJ, Ferreira F, Higgens C, Kramer M, Licata G, Mittelman M, O'Hare J, and Unal S
- Subjects
- Adult, Delivery of Health Care, Integrated trends, Europe, Family Practice trends, Forecasting, Humans, Medicine, Specialization, Delivery of Health Care trends, Internal Medicine trends, Politics, Societies, Medical trends
- Abstract
What will be the future of internal medicine in Europe? Because of rapidly growing concerns regarding the position of internal medicine in many European countries, the European Federation of Internal Medicine (EFIM) has established a working group to analyze the situation. Being well aware of the variation in working practices in the different countries, the members of the group used an "all-European" approach to answer the following questions: Are there problems for internal medicine? If so, what are these problems and why? Why do the health care systems in the European countries need internal medicine? Why do patients need internal medicine? What needs to be done? Internal medicine is the modern, clinical, and scientific medical discipline that is responsible for the care of adult patients with one or more complex, acute, or chronic illnesses. Internal medicine is the cornerstone of an integrated health care delivery service that is needed today. Decision-makers in politics and hospitals, insurers, journalists, and the general public need a better understanding of what internal medicine can offer to the health care system and to the individual patient.
- Published
- 2006
28. Physicians’ responsibility toward environmental degradation and climate change: A position paper of the European Federation of Internal Medicine
- Author
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Luís Campos, J. Vasco Barreto, Stefano Bassetti, Monica Bivol, Amie Burbridge, Pietro Castellino, João Araújo Correia, Mine Durusu-Tanriöver, Carmen Fierbinteanu-Braticevici, Thomas Hanslik, Zbigniew Heleniak, Radovan Hojs, Leonid Lazebnic, Maria Mylona, Matthias Raspe, João Queirós e Melo, Filomena Pietrantonio, Reinold Gans, Runólfur Pálsson, Nicola Montano, Ricardo Gómez-Huelgas, Dror Dicker, Lifelong Learning, Education & Assessment Research Network (LEARN), and Groningen Kidney Center (GKC)
- Subjects
Greenhouse Gases ,Climate Change ,Physicians ,Ecological health footprint ,Internal Medicine ,Humans ,Environment ,EFIM position paper ,Hospitals - Abstract
The current data on climate change and environmental degradation are dramatic. The consequences of these changes are already having a significant impact on people's health. Physicians - as advocates of the patients, but also as citizens - have an ethical obligation to be involved in efforts to stop these changes. The European Federation of Internal Medicine (EFIM) strongly encourages the Internal Medicine societies and internists across Europe to play an active role in matters related to climate change and environmental degradation. At a national level, this includes advocating the adoption of measures that reduce greenhouse gas (GHG) emissions and environmental degradation and contributing to policy decisions related to these issues. At a hospital level and in clinical practice, supporting actions by the health sector to reduce its ecological footprint is vital. At the level of EFIM and its associated internal societies, promoting educational activities and developing a toolkit to prepare internists to better care for citizens who suffer from the consequences of climate change. In addition to advocating and implementing effective actions to reduce the ecological footprint of the health industry, recommending the introduction of these themes in scientific programs of Internal Medicine meetings and congresses and the pre- and postgraduate medical training. At a personal level, internists must be active agents in advocating sustainable practices for the environment, increasing the awareness of the community about the health risks of climate change and environmental degradation, and being role models in the adoption of environmentally friendly behaviour.
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- 2022
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29. A response to the ACP-ASIM position paper on pharmacist scope of practice.
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Zed PJ, Loewen PS, and Jewesson PJ
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- Humans, United States, Internal Medicine, Interprofessional Relations, Pharmaceutical Services trends, Societies, Pharmaceutical
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- 2002
- Full Text
- View/download PDF
30. [Why a white paper on internal medicine?].
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Dupond JL
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- France, Internal Medicine standards
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- 2002
- Full Text
- View/download PDF
31. [Internal medicine position paper; structure of outpatient medical services and the family practice/specialty practice question].
- Author
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Knuth P
- Subjects
- Ambulatory Care, Family Practice legislation & jurisprudence, Germany, Humans, Legislation, Medical, Referral and Consultation, Family Practice organization & administration, Internal Medicine legislation & jurisprudence, Internal Medicine organization & administration
- Published
- 2001
- Full Text
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32. Is the Ratio of Retracted Iranian Papers Compatible With Their Research Growth Rate? An International Database Survey
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Mohamad Amin Pourhoseingholi, Farshid Rahimibashar, Masoum Khosh Fetrat, and Amir Vahedian-Azimi
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retracted publication ,scientific misconduct ,academic integrity ,iran ,Medicine ,Internal medicine ,RC31-1245 - Abstract
Background: Retraction of articles occurs as a result of scientific misconducts or honest errors. Objectives: This study aimed to identify the frequency of retracted Iranian publications, compared to those of other countries and adjust them with influential parameters. Methods: All publications that were indexed on the Scopus database from 2008 to 2017 and then retracted, due to scientific misconduct were extracted through the Retraction Watch database and selected as the research community. To calculate the growth of retraction for each proposed country (or region), first, the rate of an absolute number of retracted papers for the years 2013-2017 was divided by the similar number for years 2008-2012, then this rate was adjusted to the retracted rate which is similarly computed for the total retracted statistics of the world. Results: Overall, 545 Iranian retracted publications from 2008 to 2017 were identified, of which 240 and 305 retracted articles were related to the first five years and the second five years of the study, respectively. The results showed that less than 1% (0.82) of all scientific articles published by Iranian researchers were retracted. However, the rate of retracted scientific articles in Iran compared to this rate in the world was significantly higher. Conclusion: Although retracted Iranian publications make up a small percentage of all Iranian publications, the number of retracted publications is increasing. It is important to recognize the reasons for scientific misconducts and to provide researchers with proper education.
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- 2021
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33. Smartphone / smartwatch-based cuffless blood pressure measurement : a position paper from the Korean Society of Hypertension
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Hae Young Lee, Dong-Ju Lee, Jongmo Seo, Sang-Hyun Ihm, Kwang-il Kim, Eun Joo Cho, Hyeon Chang Kim, Jinho Shin, Sungha Park, Il-Suk Sohn, Wook-Jin Chung, Sung Kee Ryu, Ki Chul Sung, Juhan Kim, Dae-Hee Kim, Wook Bum Pyun, and on behalf of the Korean Society of Hypertension
- Subjects
Blood pressure ,Measurement ,Hypertension ,Smartphone ,Plethysmography ,Medicine ,Internal medicine ,RC31-1245 - Abstract
Abstract Smartphone technology has spread rapidly around the globe. According to a report released by the Korea Information Society Development Institute, about 95% of Koreans aged more than 30 years old owned smartphones. Recently, blood pressure (BP) measurement using a photoplethysmography-based smartphone algorithm paired with the smartwatch is continuously evolving. In this document, the Korean Society of Hypertension intends to remark the current results of smartphone / smartwatch-based BP measurement and recommend optimal BP measurement methods using a smartphone device. We aim to increase the likelihood of success in implementing these new technologies into improved hypertension awareness, diagnosis, and control.
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- 2021
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34. Enhancing point-of-care ultrasound (POCUS) utilization in primary care: A thyroid POCUS training course for internal medicine residents.
- Author
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D'Agostino C, Block L, Smith A, Weintraub S, Rose S, Coletti DJ, and Khamis N
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- Humans, Thyroid Diseases diagnostic imaging, Internship and Residency methods, Internal Medicine education, Ultrasonography methods, Curriculum, Point-of-Care Systems, Primary Health Care, Thyroid Gland diagnostic imaging, Clinical Competence statistics & numerical data
- Abstract
Background: POCUS is valuable in primary care, yet outpatient-specific point-of-care ultrasound (POCUS) curriculum integration into internal medicine (IM) residency is limited. We addressed this gap by developing a thyroid POCUS workshop for IM residents., Aim: Develop and implement an educational curriculum to integrate thyroid POCUS into an IM residency program and evaluate the impact on resident knowledge, perceived skills, and attitudes., Setting: The study was conducted in a resident primary care clinic at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Residency Program in Internal Medicine at North Shore University Hospital and Long Island Jewish Medical Center., Participants: All 108 IM residents (PGY1-3) in one program participated in the study during their ambulatory clinic block., Program Description: Residents participated in a 1-hour workshop involving a didactic session and two breakout groups: one for hands-on practice and another for case-based discussions with image review., Program Evaluation: Residents completed pre- and post-session surveys assessing knowledge, perceived skills, and attitudes toward thyroid POCUS. These data showed statistically significant increases in all assessed areas., Discussion: Integrating thyroid POCUS into an IM residency curriculum significantly improved resident knowledge, attitudes, and perceived skills related to these exams. Residents valued this learning experience and expressed intentions to incorporate it into their future practice., (© 2024 Wiley Periodicals LLC.)
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- 2024
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35. Selected papers of 24th Singapore-Malaysia Congress of Medicine.
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- Humans, Internal Medicine
- Published
- 1991
36. [97th meeting of the German Society of Internal Medicine. 6-10 April 1991, Wiesbaden. Abstracts of papers and posters].
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- Humans, Internal Medicine
- Published
- 1991
37. A piece of my mind. Paper patients.
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Kardassakis DG
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- Humans, Certification, Internal Medicine, Specialty Boards
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- 1990
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38. Developing the subspecialty of cardio-nephrology: The time has come. A position paper from the coordinating committee from the Working Group for Cardiorenal Medicine of the Spanish Society of Nephrology
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Patricia de Sequera, Rafael Santamaria, Javier Díez, Alberto Ortiz, and Juan F. Navarro-González
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Nephrology ,medicine.medical_specialty ,Enfermedad cardiovascular ,030232 urology & nephrology ,Psychological intervention ,Specialty ,Disease ,030204 cardiovascular system & hematology ,Subspecialty ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Renal Insufficiency, Chronic ,Enfermedad renal crónica ,business.industry ,medicine.disease ,Diseases of the genitourinary system. Urology ,Cardio-nefrología ,Cardiovascular Diseases ,Family medicine ,Medicina cardiorenal ,Position paper ,Professional association ,RC870-923 ,business ,Kidney disease - Abstract
Patients with the dual burden of chronic kidney disease (CKD) and cardiovascular disease (CVD) experience unacceptably high rates of morbidity and mortality, which also entail unfavorable effects on healthcare systems. Currently, concerted efforts to identify, prevent and treat CVD in CKD patients are lacking at the institutional level, with emphasis still being placed on individual specialty views on this topic. The authors of this position paper endorse the need for a dedicated interdisciplinary team of subspecialists in cardio-nephrology that manages appropriate clinical interventions across the inpatient and outpatient settings. There is a critical need for training programs, guidelines and best clinical practice models, and research funding from nephrology, cardiology and other professional societies, to support the development of the subspecialty of cardio-nephrology. This position paper from the coordinating committee from the Working Group for Cardiorenal Medicine of the Spanish Society of Nephrology (S.E.N.) is intended to be the starting point to develop the subspecialty of cardio-nephrology within the S.E.N.. The implementation of the subspecialty in day-to-day nephrological practice will help to diagnose, treat, and prevent CVD in CKD patients in a precise, clinically effective, and health cost-favorable manner. Resumen: Los pacientes con enfermedad renal crónica (ERC) que presentan enfermedad cardiovascular (ECV) tienen índices de morbilidad y mortalidad inaceptablemente elevados, que impactan desfavorablemente sobre los sistemas de salud. En la actualidad, se requieren actuaciones multidisciplinares para identificar, prevenir y tratar la ECV en los pacientes con ERC, debiendo pues superarse la época de las actuaciones de las especialidades individuales. Los autores de este artículo respaldan la necesidad de un equipo interdisciplinar de subespecialistas en cardionefrología que gestione las intervenciones clínicas adecuadas en el entorno hospitalario y en el ambulatorio. Existe una gran necesidad de programas de formación, de guías y modelos de práctica clínica, y de fondos para la investigación en las sociedades de nefrología, cardiología y otras, para apoyar el desarrollo de la subespecialidad de cardio-nefrología. Este documento de opinión del comité coordinador del Grupo de Trabajo de Medicina Cardiorenal de la Sociedad Española de Nefrología (S.E.N.) pretende ser el inicio del desarrollo de la subespecialidad de Cardionefrología en el marco de la S.E.N. La implementación de la subespecialidad en la práctica nefrológica diaria contribuirá a diagnosticar, tratar y prevenir la ECV en los pacientes con ERC de una manera precisa, clínicamente efectiva y sanitariamente rentable.
- Published
- 2021
39. Examining guidelines and new evidence in oncology nutrition: a position paper on gaps and opportunities in multimodal approaches to improve patient care
- Author
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Carla M. Prado, Michael D. Bastasch, Shila M. Newman, Maureen Gardner, Chelsia Gillis, Anthony D. Sung, Martin Chasen, Suayib Yalcin, Abby C. Sauer, Suzanne Dixon, Refaat Hegazi, and Alessandro Laviano
- Subjects
Oncology ,medicine.medical_specialty ,business.industry ,Nursing research ,Pain medicine ,Prehabilitation ,Disease ,medicine.disease ,Malnutrition ,Quality of life (healthcare) ,Multidisciplinary approach ,Internal medicine ,medicine ,Position paper ,business - Abstract
Malnutrition, muscle loss, and cachexia are prevalent in cancer and remain key challenges in oncology today. These conditions are frequently underrecognized and undertreated and have devastating consequences for patients. Early nutrition screening/assessment and intervention are associated with improved patient outcomes. As a multifaceted disease, cancer requires multimodal care that integrates supportive interventions, specifically nutrition and exercise, to improve nutrient intake, muscle mass, physical functioning, quality of life, and treatment outcomes. An integrated team of healthcare providers that incorporates societies’ recommendations into clinical practice can help achieve the best possible outcomes. A multidisciplinary panel of experts in oncology, nutrition, exercise, and medicine participated in a 2-day virtual roundtable in October 2020 to discuss gaps and opportunities in oncology nutrition, alone and in combination with exercise, relative to current evidence and international societies’ recommendations. The panel recommended five principles to optimize clinical oncology practice: (1) position oncology nutrition at the center of multidisciplinary care; (2) partner with colleagues and administrators to integrate a nutrition care process into the multidisciplinary cancer care approach; (3) screen all patients for malnutrition risk at diagnosis and regularly throughout treatment; (4) combine exercise and nutrition interventions before (e.g., prehabilitation), during, and after treatment as oncology standard of care to optimize nutrition status and muscle mass; and (5) incorporate a patient-centered approach into multidisciplinary care.
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- 2021
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40. ANMCO POSITION PAPER: Role of intra-aortic balloon pump in patients with acute advanced heart failure and cardiogenic shock
- Author
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Roberta Rossini, Cesare Baldi, Massimo Imazio, Manlio Cipriani, Rossella Gilardi, Domenico Gabrielli, Nicola Gasparetto, Carlotta Sorini Dini, Fortunato Scotto di Uccio, Furio Colivicchi, Tullio Usmiani, Daniela Chiappetta, Alberto Somaschini, Marco Ferlini, Paolo Trambaiolo, Loris Roncon, Serafina Valente, Michele Massimo Gulizia, Simona Giubilato, Marco Marini, and Pasquale Caldarola
- Subjects
medicine.medical_specialty ,business.industry ,Advanced heart failure ,Cardiogenic shock ,medicine.medical_treatment ,Articles ,Intra-Aortic Balloon Pumping ,medicine.disease ,Intra-aortic balloon pump ,Mechanical Circulatory Support (MCS) ,Heart failure ,Internal medicine ,medicine ,Cardiology ,Position paper ,AcademicSubjects/MED00200 ,In patient ,Myocardial infarction ,Balloon pump ,Cardiology and Cardiovascular Medicine ,business - Abstract
The treatment of patients with advanced acute heart failure is still challenging. Intra-aortic balloon pump (IABP) has widely been used in the management of patients with cardiogenic shock. However, according to international guidelines, its routinary use in patients with cardiogenic shock is not recommended. This recommendation is derived from the results of the IABP-SHOCK II trial, which demonstrated that IABP does not reduce all-cause mortality in patients with acute myocardial infarction and cardiogenic shock. The present position paper, released by the Italian Association of Hospital Cardiologists, reviews the available data derived from clinical studies. It also provides practical recommendations for the optimal use of IABP in the treatment of cardiogenic shock and advanced acute heart failure.
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- 2021
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- View/download PDF
41. Home blood pressure monitoring: methodology, clinical relevance and practical application: a 2021 position paper by the Working Group on Blood Pressure Monitoring and Cardiovascular Variability of the European Society of Hypertension
- Author
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Paul Muntner, Anastasios Kollias, Paul L. Padfield, Jonathan Mant, George S. Stergiou, Juan Eugenio Ochoa, Richard J McManus, Martino F Pengo, Thomas Mengden, James E. Sharman, Satoshi Hoshide, Geoff Head, G. Mancia, Stefano Omboni, A. de la Sierra, Cristina Giannattasio, Anastasia S. Mihailidou, William B. White, Agustin J. Ramirez, Kazuomi Kario, Paolo Palatini, Angeliki Ntineri, Michael A. Weber, Ji-Guang Wang, Kei Asayama, Eoin O'Brien, Rajiv Agarwal, Y. Imai, R. Asmar, José A. Octavio, Nicolas Postel-Vinay, Martin G. Myers, Grzegorz Bilo, Jirar Topouchian, Efstathios Manios, Camilla Torlasco, Andrew Shennan, Gianfranco Parati, Egle Silva, Paul K. Whelton, Y. Li, Philippe Gosse, Takayoshi Ohkubo, Dario Pellegrini, Teemu J. Niiranen, Michel Burnier, Parati, G, Stergiou, G, Bilo, G, Kollias, A, Pengo, M, Ochoa, J, Agarwal, R, Asayama, K, Asmar, R, Burnier, M, De La Sierra, A, Giannattasio, C, Gosse, P, Head, G, Hoshide, S, Imai, Y, Kario, K, Li, Y, Manios, E, Mant, J, Mcmanus, R, Mengden, T, Mihailidou, A, Muntner, P, Myers, M, Niiranen, T, Ntineri, A, O'Brien, E, Octavio, J, Ohkubo, T, Omboni, S, Padfield, P, Palatini, P, Pellegrini, D, Postel-Vinay, N, Ramirez, A, Sharman, J, Shennan, A, Silva, E, Topouchian, J, Torlasco, C, Wang, J, Weber, M, Whelton, P, White, W, and Mancia, G
- Subjects
cardiovascular risk ,CHRONIC KIDNEY-DISEASE ,2019-20 coronavirus outbreak ,hypertension ,Coronavirus disease 2019 (COVID-19) ,blood pressure measurement ,Physiology ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,MEDLINE ,ORTHOSTATIC HYPOTENSION ,TARGET-ORGAN DAMAGE ,Blood Pressure ,MEDICAL INSTRUMENTATION/EUROPEAN SOCIETY ,cardiovascular disease ,SELF-MEASUREMENT ,Internal Medicine ,medicine ,Humans ,prevention and control ,Blood pressure monitoring ,Hypertension diagnosis ,Societies, Medical ,Science & Technology ,business.industry ,Blood Pressure Determination ,Blood Pressure Monitoring, Ambulatory ,medicine.disease ,WHITE-COAT HYPERTENSION ,home blood pressure monitoring ,PROGNOSTIC VALUE ,Blood pressure ,Peripheral Vascular Disease ,MEASURING DEVICES ,Hypertension ,Cardiovascular System & Cardiology ,Position paper ,Medical emergency ,FOLLOW-UP ,Cardiology and Cardiovascular Medicine ,business ,Life Sciences & Biomedicine ,OUTCOME-DRIVEN THRESHOLDS ,blood pressure monitorign, home, methodology - Abstract
The present paper provides an update of previous recommendations on Home Blood Pressure Monitoring from the European Society of Hypertension (ESH) Working Group on Blood Pressure Monitoring and Cardiovascular Variability sequentially published in years 2000, 2008 and 2010. This update has taken into account new evidence in this field, including a recent statement by the American Heart association, as well as technological developments, which have occurred over the past 20 years. The present document has been developed by the same ESH Working Group with inputs from an international team of experts, and has been endorsed by the ESH. ispartof: JOURNAL OF HYPERTENSION vol:39 issue:9 pages:1742-1767 ispartof: location:Netherlands status: published
- Published
- 2021
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42. Health Information Privacy, Protection, and Use in the Expanding Digital Health Ecosystem: A Position Paper of the American College of Physicians
- Author
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Dejaih Johnson, Lois Snyder Sulmasy, Professionalism Ethics, and Brooke Rockwern
- Subjects
Digital Technology ,business.industry ,Internet privacy ,Privacy protection ,Privacy laws of the United States ,ComputingMilieux_LEGALASPECTSOFCOMPUTING ,General Medicine ,Digital health ,United States ,Health Records, Personal ,Privacy ,Health care ,Internal Medicine ,Electronic Health Records ,Humans ,Position paper ,Medicine ,Health information ,Privacy law ,business ,Computer Security ,Medical ethics - Abstract
Technologic advancements and the evolving digital health landscape have offered innovative solutions to several of our health care system's issues as well as increased the number of digital interactions and type of personal health information that is generated and collected, both within and outside of traditional health care. This American College of Physicians' position paper discusses the state of privacy legislation and regulations, highlights existing gaps in health information privacy protections, and outlines policy principles and recommendations for the development of health information privacy and security protections that are comprehensive, transparent, understandable, adaptable, and enforceable. The principles and recommendations aim to improve on the privacy framework in which physicians have practiced for decades and expand similar privacy guardrails to entities not currently governed by privacy laws and regulations. The expanded privacy framework should protect personal health information from unauthorized, discriminatory, deceptive, or harmful uses and align with the principles of medical ethics, respect individual rights, and support the culture of trust necessary to maintain and improve care delivery.
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- 2021
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- View/download PDF
43. North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Position Paper on the Diagnosis and Management of Pediatric Acute Liver Failure
- Author
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Vania Kasper, Mercedes Martinez, Robert H. Squires, Samar H. Ibrahim, James E. Squires, Mohit Kehar, and Estella M. Alonso
- Subjects
medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Gastroenterology ,Liver failure ,MEDLINE ,Liver transplantation ,Hepatology ,Clinical decision support system ,Internal medicine ,Pediatrics, Perinatology and Child Health ,Etiology ,Medicine ,Position paper ,business ,Intensive care medicine ,Pediatric gastroenterology - Abstract
Pediatric acute liver failure (PALF) is a rare, rapidly progressive clinical syndrome with significant morbidity and mortality. The phenotype of PALF manifests as abrupt onset liver dysfunction, which can be brought via disparate etiology. Management is reliant upon intensive clinical care and support, often provided by the collaborative efforts of hepatologists, critical care specialists, and liver transplant surgeons. The construction of an age-based diagnostic approach, the identification of a potential underlying cause, and the prompt implementation of appropriate therapy can be lifesaving; however, the dynamic and rapidly progressive nature of PALF also demands that diagnostic inquiries be paired with monitoring strategies for the recognition and treatment of common complications of PALF. Although liver transplantation can provide a potential life-saving therapeutic option, the ability to confidently determine the certainness that liver transplant is needed for an individual child has been hampered by a lack of adequately tested clinical decision support tools and accurate predictive models. Given the accelerated progress in understanding PALF, we will provide clinical guidance to pediatric gastroenterologists and other pediatric providers caring for children with PALF by presenting the most recent advances in diagnosis, management, pathophysiology, and associated outcomes.
- Published
- 2021
- Full Text
- View/download PDF
44. Peritoneal Dialysis Guidelines 2019 Part 1 (Position paper of Japanese Society of Dialysis Therapy)
- Author
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Noritomo Itami, Kei Nishiyama, Yuichi Ishikawa, Yoshihiko Kanno, Hiroshi Hataya, Masaaki Nakayama, Yasuhiko Ito, Hidetomo Nakamoto, Akihiro C. Yamashita, Atsushi Ueda, Hidemichi Yuasa, Hitoshi Sugiyama, Hideki Kawanishi, Motoshi Hattori, Kenichiro Miura, Riku Hamada, Tadashi Tomo, Hiroyuki Terawaki, Munekazu Ryuzaki, Hideki Yokoi, Yoshie Kanazawa, Kazuhiko Tsuruya, Hyogo Nakakura, Minoru Ito, and Mizuya Fukasawa
- Subjects
medicine.medical_specialty ,Encapsulating Peritoneal Sclerosis ,Dialysis Therapy ,Urology ,medicine.medical_treatment ,Optimal dialysis ,Peritoneal dialysis ,030232 urology & nephrology ,030204 cardiovascular system & hematology ,Peritonitis ,Nutritional management ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Peritoneal function ,Intensive care medicine ,Transplantation ,business.industry ,Icodextrin Solution ,Standard methods ,Diseases of the genitourinary system. Urology ,Clinical Practice ,Systematic review ,Nephrology ,Position paper ,RC870-923 ,EPS ,business - Abstract
Approximately 10 years have passed since the Peritoneal Dialysis Guidelines were formulated in 2009. Much evidence has been reported during the succeeding years, which were not taken into consideration in the previous guidelines, e.g., the next peritoneal dialysis PD trial of encapsulating peritoneal sclerosis (EPS) in Japan, the significance of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), the effects of icodextrin solution, new developments in peritoneal pathology, and a new international recommendation on a proposal for exit-site management. It is essential to incorporate these new developments into the new clinical practice guidelines. Meanwhile, the process of creating such guidelines has changed dramatically worldwide and differs from the process of creating what were “clinical practice guides.” For this revision, we not only conducted systematic reviews using global standard methods but also decided to adopt a two-part structure to create a reference tool, which could be used widely by the society’s members attending a variety of patients. Through a working group consensus, it was decided that Part 1 would present conventional descriptions and Part 2 would pose clinical questions (CQs) in a systematic review format. Thus, Part 1 vastly covers PD that would satisfy the requirements of the members of the Japanese Society for Dialysis Therapy (JSDT). This article is the duplicated publication from the Japanese version of the guidelines and has been reproduced with permission from the JSDT.
- Published
- 2021
45. Alcohol-Related Liver Disease in the Covid-19 Era: Position Paper of the Italian Society on Alcohol (SIA)
- Author
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Pierluigi Allosio, Giovanni Addolorato, Fabio Caputo, Patrizia Balbinot, Davide Mioni, Doda Renzetti, Tiziana Fanucchi, Raffaella Rossin, Gianni Testino, Livia Maccio, Claudia Gandin, S. Arico, Michele Parisi, Maria Francesca Amendola, Aniello Baselice, Vincenzo Palmieri, Vito Campanile, Emanuele Scafato, Valentino Patussi, Mauro Bernardi, Giorgio Zoli, Cristina Meneguzzi, Teo Vignoli, Lisa Lungaro, Giovanni Greco, and Luigi C. Bottaro
- Subjects
medicine.medical_specialty ,Telemedicine ,Physiology ,medicine.medical_treatment ,Telehealth ,Alcohol use disorder ,Alcohol-related liver cirrhosis ,Alcohol-related liver disease ,ALD and SARS-CoV-2 ,Management of AUD ,SARS-CoV-2 infection ,Liver transplantation ,NO ,03 medical and health sciences ,Liver disease ,0302 clinical medicine ,Internal medicine ,Pandemic ,medicine ,Humans ,Intensive care medicine ,Liver Diseases, Alcoholic ,Pandemics ,business.industry ,Gastroenterology ,COVID-19 ,Hepatology ,medicine.disease ,Alcoholism ,030220 oncology & carcinogenesis ,Communicable Disease Control ,Position paper ,Original Article ,030211 gastroenterology & hepatology ,business - Abstract
Background Coronavirus Disease 2019 (COVID-19), firstly reported in China last November 2019, became a global pandemic. It has been shown that periods of isolation may induce a spike in alcohol use disorder (AUD). In addition, alcohol-related liver disease (ALD) is the most common consequence of excessive alcohol consumption worldwide. Moreover, liver impairment has also been reported as a common manifestation of COVID-19. Aims The aim of our position paper was to consider some critical issues regarding the management of ALD in patients with AUD in the era of COVID-19. Methods A panel of experts of the Italian Society of Alcohology (SIA) met via “conference calls” during the lockdown period to draft the SIA’s criteria for the management of ALD in patients with COVID-19 as follows: (a) liver injury in patients with ALD and COVID-19 infection; (b) toxicity to the liver of the drugs currently tested to treat COVID-19 and the pharmacological interaction between medications used to treat AUD and to treat COVID-19; (c) reorganization of the management of compensated and decompensated ALD and liver transplantation in the COVID-19 era. Results and Conclusions The COVID-19 pandemic has rapidly carried us toward a new governance scenario of AUD and ALD which necessarily requires an in-depth review of the management of these diseases with a new safe approach (management of out-patients and in-patients following new rules of safety, telemedicine, telehealth, call meetings with clinicians, nurses, patients, and caregivers) without losing the therapeutic efficacy of multidisciplinary treatment.
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- 2021
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46. Health Care for Our Nation's Veterans: A Policy Paper From the American College of Physicians
- Author
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Ryan, Crowley, Omar, Atiq, David, Hilden, Thomas G, Cooney, and Michael, Tan
- Subjects
Mental Health Services ,Advisory Committees ,Population ,Holistic Health ,Modernization theory ,Health Services Accessibility ,Patient satisfaction ,Nursing ,Health care ,Internal Medicine ,Electronic Health Records ,Humans ,Medicine ,Health Workforce ,education ,Societies, Medical ,health care economics and organizations ,Patient Care Team ,education.field_of_study ,Primary Health Care ,Emergency management ,Delivery of Health Care, Integrated ,business.industry ,Health Policy ,Medical record ,General Medicine ,Telemedicine ,United States ,United States Department of Veterans Affairs ,Education, Medical, Graduate ,Veterans Health Services ,Position paper ,Private Sector ,Health Services Research ,business ,Administration (government) - Abstract
The Veterans Health Administration (VHA) is the United States' largest integrated health care delivery system, serving over 9 million enrollees at nearly 1300 health care facilities. In addition to providing health care to the nation's military veterans, the VHA has a research and development program, trains thousands of medical residents and other health care professionals, and conducts emergency preparedness and response activities. The VHA has been celebrated for delivering high-quality care to veterans, early adoption of electronic medical records, and high patient satisfaction. However, the system faces challenges, including implementation of an expanded community care program, modernization of its electronic medical records system, and providing care to a population with complex needs. The position paper offers policy recommendations on VHA funding, the community care program, medical and health care professions training, and research and development.
- Published
- 2021
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- View/download PDF
47. Financial Profit in Medicine: A Position Paper From the American College of Physicians
- Author
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Ryan, Crowley, Omar, Atiq, David, Hilden, and Michael, Tan
- Subjects
Finance ,Physician-Patient Relations ,Profit (accounting) ,Financial Management ,Financial stability ,business.industry ,General Medicine ,Organizational Policy ,United States ,Fiduciary ,Private equity ,Physicians ,Health care ,Internal Medicine ,Humans ,Position paper ,Medicine ,Economics, Hospital ,business ,Delivery of Health Care ,Health Facilities, Proprietary ,Societies, Medical ,health care economics and organizations ,Quality of Health Care - Abstract
The steady growth of corporate interest and influence in the health care sector over the past few decades has created a more business-oriented health care system in the United States, helping to spur for-profit and private equity investment. Proponents say that this trend makes the health care system more efficient, encourages innovation, and provides financial stability to ensure access and improve care. Critics counter that such moves favor profit over care and erode the patient-physician relationship. American College of Physicians (ACP) underscores that physicians are permitted to earn a reasonable income as long as they are fulfilling their fiduciary responsibility to provide high-quality, appropriate care within the guardrails of medical professionalism and ethics. In this position paper, ACP considers the effect of mergers, integration, private equity investment, nonprofit hospital requirements, and conversions from nonprofit to for-profit status on patients, physicians, and the health care system.
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- 2021
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- View/download PDF
48. Competences of internal medicine specialists for the management of patients with multimorbidity. EFIM multimorbidity working group position paper
- Author
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M Bernabeu-Wittel, O Para, J Voicehovska, R Gómez-Huelgas, J Václavík, E Battegay, M Holecki, B.C. van Munster, Christiane Angermann, Edouard Battegay, Máximo Bernabeu-Wittel, Catherine Bryant, Avishay Elis, Georg Ertl, Ricardo Gómez-Huelgas, Sabrina Grine, Michal Holecki, Annette Kürrle, Olivier Lidove, Ombretta Para, Burcin Saglam, Lelita Santos, Antonino Tuttolomondo, Jan Václavik, Barbara van Munster, Julija Voicehovska, Value, Affordability and Sustainability (VALUE), and Molecular Neuroscience and Ageing Research (MOLAR)
- Subjects
Integrated care ,Multimorbidity ,Competences ,Internal medicine - Abstract
Patients with multimorbidity increasingly impact healthcare systems, both in primary care and in hospitals. This is particularly true in Internal Medicine. This population associates with higher mortality rates, polypharmacy, hospital readmissions, post-discharge syndrome, anxiety, depression, accelerated age-related functional decline, and development of geriatric syndromes, amongst others. Internists and Hospitalists, in one of their roles as Generalists, are increasingly asked to attend to these patients, both in their own Departments as well as in surgical areas. The management of polypathology and multimorbidity, however, is often complex, and requires specific clinical skills and corresponding experience. In addition, patients' needs, health-care environment, and routines have changed, so emerging and re-emerging specific competences and approaches are required to offer the best coordinated, continuous, and comprehensive integrated care to these populations, to achieve optimal health outcomes and satisfaction of patients, their relatives, and staff. This position paper proposes a set of emerging and re-emerging competences for internal medicine specialists, which are needed to optimally address multimorbidity now and in the future.
- Published
- 2023
49. Physicians' responsibility toward environmental degradation and climate change: A position paper of the European Federation of Internal Medicine.
- Author
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Campos, Luís, Barreto, J. Vasco, Bassetti, Stefano, Bivol, Monica, Burbridge, Amie, Castellino, Pietro, Correia, João Araújo, Durusu-Tanriöver, Mine, Fierbinteanu-Braticevici, Carmen, Hanslik, Thomas, Heleniak, Zbigniew, Hojs, Radovan, Lazebnic, Leonid, Mylona, Maria, Raspe, Matthias, Melo, João Queirós e, Pietrantonio, Filomena, Gans, Reinold, Pálsson, Runólfur, and Montano, Nicola
- Subjects
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ENVIRONMENTAL degradation , *INTERNISTS , *CLIMATE change , *INTERNAL medicine , *PHYSICIANS , *CLIMATE change & health - Abstract
• EFIM publishes a position paper about Environment Degradation and Climate Change. • Health industry should reduce its ecological footprint. • Internists should be involved in policy decisions related to climate change. • Internists must be active agents in advocating sustainable practices for the environment. • Internists should be role models in the adoption of environmentally friendly behavior. The current data on climate change and environmental degradation are dramatic. The consequences of these changes are already having a significant impact on people's health. Physicians — as advocates of the patients, but also as citizens — have an ethical obligation to be involved in efforts to stop these changes. The European Federation of Internal Medicine (EFIM) strongly encourages the Internal Medicine societies and internists across Europe to play an active role in matters related to climate change and environmental degradation. At a national level, this includes advocating the adoption of measures that reduce greenhouse gas (GHG) emissions and environmental degradation and contributing to policy decisions related to these issues. At a hospital level and in clinical practice, supporting actions by the health sector to reduce its ecological footprint is vital. At the level of EFIM and its associated internal societies, promoting educational activities and developing a toolkit to prepare internists to better care for citizens who suffer from the consequences of climate change. In addition to advocating and implementing effective actions to reduce the ecological footprint of the health industry, recommending the introduction of these themes in scientific programs of Internal Medicine meetings and congresses and the pre- and postgraduate medical training. At a personal level, internists must be active agents in advocating sustainable practices for the environment, increasing the awareness of the community about the health risks of climate change and environmental degradation, and being role models in the adoption of environmentally friendly behaviour. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
50. International Liver Cancer Association (ILCA) White Paper on Biomarker Development for Hepatocellular Carcinoma
- Author
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Jorge A. Marrero, Morris Sherman, Yujin Hoshida, Ziding Feng, David J. Pinato, Young-Suk Lim, Amit G. Singal, Nabihah Tayob, Jean-Charles Nault, Valérie Paradis, Anna S. Lok, Sudhir Srivastava, Augusto Villanueva, Josep M. Llovet, and Jo Ann Rinaudo
- Subjects
Adult ,Male ,Oncology ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Cirrhosis ,medicine.disease_cause ,Risk Assessment ,Article ,White paper ,Predictive Value of Tests ,Internal medicine ,Biomarkers, Tumor ,medicine ,Overall survival ,Humans ,Progression-free survival ,Early Detection of Cancer ,Societies, Medical ,Retrospective Studies ,Hepatitis B virus ,Hepatology ,business.industry ,Liver Neoplasms ,Gastroenterology ,Middle Aged ,medicine.disease ,Research Design ,Case-Control Studies ,Hepatocellular carcinoma ,Biomarker (medicine) ,Female ,Neoplasm Grading ,Liver cancer ,business - Published
- 2021
- Full Text
- View/download PDF
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