Oxford Textbook of Clinical Nephrology

With expert input from additional section editors William G. Bennett, Jeremy R. Chapman, Adrian Covic, Marc E. De Broe, Vivekanand Jha, Neil Sheerin, Robert Unwin, and Adrian Woolf, the Oxford Textbook of Clinical Nephrology is a three-volume international textbook of nephrology with an unrivalled clinical approach backed up by science. It has been completely rewritten in 365 chapters for its fourth edition to bring it right up to date, make it easier to obtain rapid answers to questions, and to suit delivery in electronic formats as well as in print. This edition offers increased focus on the medical aspects of transplantation, HIV-associated renal disease, and infection and renal disease, alongside entirely new sections on genetic topics and clinical and physiological aspects of fluid/electrolyte and tubular disorders. The emphasis throughout is on marrying advances in scientific research with clinical management. The target audience is primarily the nephrologist in clinical practice and training as well as other healthcare professionals with an interest in renal disease.

Author(s):  
Des Spence

Contrary to traditional thinking and teaching, it is not illness that dictates the health-seeking behaviour of a population but the healthcare system itself, and—most importantly—our actions as healthcare professionals. A scourge affecting clinical practice in the developed world today is the medicalization of all interactions, accompanied by overinvestigation, overdiagnosis, and overtreatment. The medical profession retains its traditional duty, wherever possible, to diagnose disease and treat or cure illness appropriately, also to comfort the sick, irrespective of the ability to cure. At the same time, a long-held principle of medicine at all levels is to do no harm, while at the same time supporting the maintenance of health and protecting those who are well. This chapter explains how maintaining the balance between these apparent conflicting precepts is a scarce skill that needs to be taught by example during the education and training of the modern doctor.


Dementia ◽  
2016 ◽  
Vol 17 (5) ◽  
pp. 573-584 ◽  
Author(s):  
Ellen StClair Tullo ◽  
Tony Johnstone Young ◽  
Richard Philip Lee

Adopting principles of person-centred communication has been highlighted as one strategy to improve care of people living with dementia (PLWD) in health and social care settings. However, person-centred communication is interpreted and applied variably in different settings, and healthcare professionals’ views about communicating with PLWD are under-explored. This study aimed to investigate medical students’ views about the principles and applicability of a model of person centred communication – the Dementia Model of Effective Communication (DeMEC) – to clinical practice. Quantitative and qualitative data was collected using questionnaires ( n = 531), focus groups ( n = 21) and interviews ( n = 10). Students generally endorsed the person-centred approach to communication, but two aspects were highlighted as complex and divisive – the acceptability or otherwise of lying, and of communicating with family in advance of the PLWD. We discuss the nature of these communicative dilemmas, implications for the education and training of medical students, and future directions for research.


2011 ◽  
Vol 7 (3) ◽  
pp. 225
Author(s):  
Gianfranco Sinagra ◽  
Michele Moretti ◽  
Giancarlo Vitrella ◽  
Marco Merlo ◽  
Rossana Bussani ◽  
...  

In recent years, outstanding progress has been made in the diagnosis and treatment of cardiomyopathies. Genetics is emerging as a primary point in the diagnosis and management of these diseases. However, molecular genetic analyses are not yet included in routine clinical practice, mainly because of their elevated costs and execution time. A patient-based and patient-oriented clinical approach, coupled with new imaging techniques such as cardiac magnetic resonance, can be of great help in selecting patients for molecular genetic analysis and is crucial for a better characterisation of these diseases. This article will specifically address clinical, magnetic resonance and genetic aspects of the diagnosis and management of cardiomyopathies.


Liver Cancer ◽  
2021 ◽  
pp. 1-43
Author(s):  
Masatoshi Kudo ◽  
Yusuke Kawamura ◽  
Kiyoshi Hasegawa ◽  
Ryosuke Tateishi ◽  
Kazuya Kariyama ◽  
...  

The Clinical Practice Manual for Hepatocellular Carcinoma was published based on evidence confirmed by the Evidence-based Clinical Practice Guidelines for Hepatocellular Carcinoma along with consensus opinion among a Japan Society of Hepatology (JSH) expert panel on hepatocellular carcinoma (HCC). Since the JSH Clinical Practice Guidelines are based on original articles with extremely high levels of evidence, expert opinions on HCC management in clinical practice or consensus on newly developed treatments are not included. However, the practice manual incorporates the literature based on clinical data, expert opinion, and real-world clinical practice currently conducted in Japan to facilitate its use by clinicians. Alongside each revision of the JSH Guidelines, we issued an update to the manual, with the first edition of the manual published in 2007, the second edition in 2010, the third edition in 2015, and the fourth edition in 2020, which includes the 2017 edition of the JSH Guideline. This article is an excerpt from the fourth edition of the HCC Clinical Practice Manual focusing on pathology, diagnosis, and treatment of HCC. It is designed as a practical manual different from the latest version of the JSH Clinical Practice Guidelines. This practice manual was written by an expert panel from the JSH, with emphasis on the consensus statements and recommendations for the management of HCC proposed by the JSH expert panel. In this article, we included newly developed clinical practices that are relatively common among Japanese experts in this field, although all of their statements are not associated with a high level of evidence, but these practices are likely to be incorporated into guidelines in the future. To write this article, coauthors from different institutions drafted the content and then critically reviewed each other’s work. The revised content was then critically reviewed by the Board of Directors and the Planning and Public Relations Committee of JSH before publication to confirm the consensus statements and recommendations. The consensus statements and recommendations presented in this report represent measures actually being conducted at the highest-level HCC treatment centers in Japan. We hope this article provides insight into the actual situation of HCC practice in Japan, thereby affecting the global practice pattern in the management of HCC.


Author(s):  
Rabia Hussain ◽  
Mohamed Azmi Hassali ◽  
Anees ur Rehman ◽  
Jaya Muneswarao ◽  
Muhammad Atif ◽  
...  

The contribution of all key healthcare professionals is vital to promote an efficient adverse drug reaction (ADR) reporting system. In this context, nurses are important as they are in a better position to observe a patient’s response regarding the drug therapy and to report an ADR. The aim of the study was to explore the perspectives of nurses about ADR reporting system in Lahore, Pakistan. A total of 21 nurses were interviewed. The thematic content analysis of the qualitative interviews yielded six major themes and eight subthemes. Major themes included: (1) Knowledge about the concept of the medication safety & the ADR; (2) Knowledge regarding pharmacovigilance activities; (3) Willingness to report; (4) Practices related to the ADR reporting; (5) Barriers to the ADR reporting; (6) Facilitators to the ADR reporting. The majority of the nurses were aware of medicine safety and ADRs, but in many cases, they were unable to report these ADRs. The study pointed out considerable concerns regarding the knowledge and practices of nurses about pharmacovigilance activities in their workplace, mainly due to increased workload, due to the absence of a reporting system and legal liability. The main challenges turned out to be the lack of knowledge and training, as well as the implementation of guidelines. Based on the findings, it is suggested that outcome of this study can serve as a guide to design policies that support ADR reporting by nurses in Pakistan.


2015 ◽  
Vol 61 (6) ◽  
pp. 859-863 ◽  
Author(s):  
Elie F. Berbari ◽  
Souha S. Kanj ◽  
Todd J. Kowalski ◽  
Rabih O. Darouiche ◽  
Andreas F. Widmer ◽  
...  

Abstract These guidelines are intended for use by infectious disease specialists, orthopedic surgeons, neurosurgeons, radiologists, and other healthcare professionals who care for patients with native vertebral osteomyelitis (NVO). They include evidence and opinion-based recommendations for the diagnosis and management of patients with NVO treated with antimicrobial therapy, with or without surgical intervention.


1978 ◽  
Vol 8 (4) ◽  
pp. 705-710 ◽  
Author(s):  
David Pitcher ◽  
Howard Sergeant

SynopsisPatients admitted to Friern Hospital in 1972 stayed on average for about 5 weeks and spent a total of less than 2 hours individually with senior and junior doctors. Long-stay patients (1 year or more) saw their doctors for an average of less than 1 hour a year. These findings, which in the case of junior doctors were corroborated in 1974, refer only to the time doctors spent with patients alone. The admission, and long-stay discharge rates were greater in the Islington than in the Camden division, and probably reflect differences in clinical practice. It is argued that more psychiatrists are needed – precisely how many will depend on studies of the relative efficiency of different services and training programmes, and on agreement among psychiatrists about minimum professional standards.


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