Epigenetics

2018 ◽  
Vol 11 (12) ◽  
pp. 689-692
Author(s):  
Sarah C Hillman ◽  
Jeremy Dale
Keyword(s):  
General Practice ◽  
Clinical Practice ◽  
Medical Training ◽  
Personalised Medicine ◽  
Postgraduate Education ◽  
Everyday Practice ◽  
Everyday Clinical Practice

Genetics is explored as both part of our undergraduate medical training and then postgraduate education in general practice. Epigenetics is a rapidly progressing field that will increasingly become part of our everyday practice as we enter an era of personalised medicine. But what is epigenetics and how does it differ from genetics? Why is it important to GPs? Epigenetics is a relatively new concept, but one with wide reaching and important implications for everyday clinical practice. Here we aim to describe the concepts behind epigenetics, discuss the inheritability of the epigenome, and its importance and applicability to patients in general practice.

Reflection and mental health nursing. Part two: reflection in everyday practice

2019 ◽  
Vol 8 (3) ◽  
pp. 122-123
Author(s):  
John Fowler
Keyword(s):  
Mental Health ◽  
Clinical Practice ◽  
Reflective Learning ◽  
Everyday Practice ◽  
Everyday Clinical Practice ◽  
Mental Health Nursing ◽  
Health Nursing

In the second part of this new series on reflection in mental health nursing, John Fowler examines two different perspectives of reflection that are used in everyday clinical practice. He explores how most nurses are aware of their use of reflection following a nursing action or an incident, but are less aware of their ability to use reflection during action. Further articles in the series will be available online and will examine the application of reflection to everyday clinical practice including making time, reflective techniques and reflective learning.

Genetics-Related Activities in Everyday Practice of Family Physicians in Slovenia

2020 ◽  
pp. 1-7
Author(s):  
Metka Cerovic ◽  
Borut Peterlin ◽  
Zalika Klemenc-Ketis
Keyword(s):  
Clinical Practice ◽  
Medical History ◽  
Patient Management ◽  
Positive Family History ◽  
Genomic Medicine ◽  
Family Physicians ◽  
Everyday Practice ◽  
Genetic Management ◽  
Everyday Clinical Practice ◽  
Family Medical History

<b><i>Introduction:</i></b> Development of genomic technologies has an important impact on patient management in medicine. Nevertheless, translation of new advances of genomic medicine in primary care is challenging and needs to be adapted to the needs of health systems. <b><i>Objective:</i></b> The objective of this study was to analyze the current state of the use and the level of confidence in genetic management activities in everyday clinical practice of family practitioners (FPs) in Slovenia. <b><i>Methods:</i></b> We used a cross-sectional observational study design. The dataset was obtained through a questionnaire containing demographics, questions about the use of genetics in everyday practice, and a scale for measuring the responders’ confidence in their ability to carry out basic genetic activities during patient treatment. The questionnaire was sent by regular mail to every FP in Slovenia (<i>N</i> = 950). <b><i>Results:</i></b> The questionnaire was completed by a total of 271 physicians (response rate 28.5%), with an average physicians’ age of 45.5 ± 10.6 years. In their everyday clinical practice, the majority of Slovenian FPs report to encounter genetic conditions more than once a month (241, 91.2%). Family medical history is the most commonly used among all activities related to genetic management of patients. Only 5.9% of Slovenian FPs are confident in their ability to carry out basic activities related to genetic patient management. Most of them believe they are only competent enough to obtain family medical history and identify a positive family history. The FPs who reported a lower degree of confidence are those with the lowest level of education in the field of medical genetics and older physicians (age &#x3e;50 years). <b><i>Conclusions:</i></b> Slovenian family physicians commonly encounter patients with genetic conditions but are not confident in their ability to carry out basic medical genetic tasks. Therefore, additional education is necessary.

“Bridging Gaps – Improving Outcomes”: Problem domains in schizophrenia research, treatment and policy

2016 ◽  
Vol 13 (03) ◽  
pp. 118-120
Author(s):  
W. Wölwer ◽  
W. Gaebel ◽  
V. Toeller
Keyword(s):  
Clinical Practice ◽  
Mental Healthcare ◽  
Knowledge Gaps ◽  
Everyday Clinical Practice ◽  
Treatment Gaps ◽  
Different Types

Summary Background: The provision of mental healthcare for patients with schizophrenia is still characterized both by knowledge gaps and by treatment gaps in everyday clinical practice. Aim: This article discusses the different types of treatment gaps in schizophrenia and describes actions taken to overcome these gaps especially in Europe.

Role of implantable loop recorder in the clinical diagnosis of syncope: Results of the introduction of an effective diagnostic tool

2015 ◽  
Vol 156 (15) ◽  
pp. 609-613
Author(s):  
Miklós Somlói ◽  
Emil Toldy-Schedel ◽  
Zoltán Nényei ◽  
Róbert Böszörményi ◽  
János Tomcsányi
Keyword(s):  
Clinical Practice ◽  
Diagnostic Yield ◽  
Diagnostic Algorithm ◽  
Definitive Treatment ◽  
Implantable Loop Recorder ◽  
Everyday Clinical Practice ◽  
Loop Recorder ◽  
Early Application ◽  
Electrocardiographic Monitoring ◽  
The Everyday

Introduction: Extension of electrocardiographic monitoring via loop recorder implantation may increase the diagnostic yield of syncope work-up. Aim: In this retrospective observational study, the authors wanted to evaluate the diagnostic performance of implantable loop recorder in the everyday clinical practice. Method: The authors analyzed the electronically stored data of all patients who underwent loop recorder implantation between 2005 and 2014 in their cardiology department because of recurrent syncope of undetermined origin. Results: There were 52 loop recorder implantations within the study period. During the 167 (±136) days of monitoring, 36 (69.2%) diagnostic events occurred. In two-thirds of events, (46.2% of all monitored patients) a specific arrhythmia diagnosis was reached, allowing definitive treatment in these cases. In this selected population, there was no correlation between age, presence of known high-risk predictors, or accompanying trauma, and the mechanism of syncope. Conclusions: The high diagnostic rate of implantable loop recorder in the everyday clinical practice is in accordance with the findings in prospective clinical studies. This observation supports the early application of loop recorder in the diagnostic algorithm of syncope. Orv. Hetil., 2015, 156(15), 609–613.

scholarly journals Kardia Mobile and ISTEL HR applicability in clinical practice: A comparison of Kardia Mobile, ISTEL HR and standard 12-lead electrocardiogram records in 98 consecutive patients of a tertiary cardiovascular care centre

2021 ◽  
Author(s):  
Bartosz Krzowski ◽  
Kamila Skoczylas ◽  
Gabriela Osak ◽  
Natalia Żurawska ◽  
Michał Peller ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Practice ◽  
Cardiovascular Diseases ◽  
Sinus Rhythm ◽  
Sensitivity And Specificity ◽  
Heart Rhythm ◽  
Everyday Practice ◽  
Portable Devices ◽  
Care Centre ◽  
Cardiovascular Care

Abstract Aims Mobile, portable ECG-recorders allow the assessment of heart rhythm in out-of-hospital conditions and may prove useful for monitoring patients with cardiovascular diseases. However, the effectiveness of these portable devices has not been tested in everyday practice. Methods and results A group of 98 consecutive cardiology patients (62 males [63%], mean age 69 ± 12.9 years) were included in an academic care centre. For each patient, a standard 12-lead electrocardiogram (SE), as well as a Kardia Mobile 6L (KM) and Istel (IS) HR-2000 ECG were performed. Two groups of experienced physycians analyzed obtained recordings. After analyzing ECG tracings from SE, KM, and IS, quality was marked as good in 82%, 80%, and 72% of patients, respectively (p &lt; 0.001). There were no significant differences between devices in terms of detecting sinus rhythm (SE [60%, n = 59], KM [58%, n = 56], and IS [61%, n = 60]; SE vs KM p = 0.53; SE vs IS p = 0.76) and atrial fibrillation (SE [22%, n = 22], KM [22%, n = 21], and IS [18%, n = 18]; (SE vs KM p = 0.65; SE vs IS = 0.1). KM had a sensitivity of 88.1% and a specificity of 89.7% for diagnosing sinus rhythm. IS showed 91.5% and 84.6% sensitivity and specificity, respectively. The sensitivity of KM in detecting atrial fibrillation was higher than IS (86.4% vs. 77.3%), but their specificity was comparable (97.4% vs. 98.7%). Conclusion Novel, portable devices are useful in showing sinus rhythm and detecting atrial fibrillation in clinical practice. However, ECG measurements concerning conduction and repolarisation should be clarified with a standard 12-lead electrocardiogram.

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