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By: John E. Bennett, MD, MACP, Adjunct Professor of Medicine, Uniformed Services University of the Health Sciences, F. Edward Hebert School of Medicine; Director, Infectious Diseases Training Program, NIH Office of Clinical Research Training and Medical Education, Bethesda, Maryland

The increasing use of ionizing radiation in medicine worldwide (4 billion diagnostic procedures in 2008) is an indication of its benefits purchase propranolol cheap cardiovascular system worksheet pdf. Conversely buy propranolol 40mg on line cardiovascular rrr, with the wide range of diagnostic techniques using ionizing radiation propranolol 40mg free shipping cardiovascular disease epidemiology australia, we must never lose sight of the associated risks order 5 mg accutane otc. Clear framework conditions on the admissibility of such screening must be drawn up buy cheap super p-force 160 mg on-line. Whichever diagnostic method or treatment is chosen order generic finasteride on-line, it should always be performed with the lowest possible radiation dose for both the patient and the medical personnel. Apart from the obvious benefit of improving human health, it is very important to ensure the patient’s safety, and increasingly, that of the medical personnel as well. This requires, firstly, the setting of standards and limits; and secondly, a good quality assurance regime (testing of equipment and procedures). Modern high-tech diagnosis and treatment methods demand specialist knowledge and expertise at the highest level from physicians and medical personnel. A solid education and training in radiation medicine, therefore, offers the basis for effective radiation protection. In order to achieve this on a global scale, we must support developing countries, particularly via the transfer of expertise and training support. The points I have touched on will be intensively discussed by you during the course of this conference. This is an important and honourable task: let us define uniform global standards for the justification and optimized use of ionizing radiation and radioactive substances, both to the benefit of the patient, and for the protection of medical personnel. Being here today for me also means that there is life and work — important life and work — outside the scope of the lessons learned from last year’s accident at Fukushima. Indeed, safety of nuclear power plants and contaminations following a nuclear accident have been, and still are, at the forefront of the concerns of governments and the public worldwide, but it is as well tremendously important to continue progressing in a field of safety which rarely makes the first page of newspapers: radiation protection in medicine. Let me begin by stating that the use of ionizing radiation in medicine has brought humankind tremendous benefits since it was first used more than a hundred years ago. Over the years, the development of new technologies, new procedures and new uses has quickened its pace. This has resulted in medical radiation exposures becoming a very significant component of the total radiation exposure of humans. It is currently estimated that every single day, 10 million people receive diagnostic, therapeutic or interventional medical radiation procedures. While the majority of these procedures are performed safely and appropriately, there are situations throughout the world where radiation safety is either lacking or deficient.

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Improve communication and education stra- althcare system and increase the patient’s role tegies to increase patient health literacy purchase propranolol 80 mg line arteries of the head and neck. Develop common principles and legal frame- lic and private sector organisations deliver information works that enable sharing of patient-level in ways that make it difcult to understand and act on purchase 40 mg propranolol overnight delivery capillaries kidney, data for research in a way that is ethical and or that are even incomplete and inaccurate order propranolol 80mg online arteries in the heart. This stratifcation will the skill and competence of health professionals buy 1 mg finasteride otc, patient greatly reduce the number of patients within any such advocacy organisations buy aurogra cheap online, media and government and subgroups order levitra professional visa. In view of this, international co-operation will private sector agencies to provide health information in become increasingly important in order to recruit suf- a manner appropriate to their audiences are as equally cient numbers of patients for the generation of statisti- important as an individual’s skills. Data everyone with access to accurate and actionable health protection regulation, invented mainly to protect consu- information; 2) delivering person-centred, lay-friendly mers against the misuse of personal data, for example on health information resources and services involving pa- the internet, needs to be reviewed critically in the context 14 of its detrimental impact on medical research, in order not Examples of on-going activities to stife data collection for research purposes, registries or cross-border sharing of research data. Europe involve a strong voice from patient advocacy groups to adequately balance the interests of the individual patients In May 2011 the Health Directorate of the European and society as a whole. Commission‘s Directorate General for Research and In- novation organised the conference ‘European Perspec- tives in Personalised Medicine’, which aimed to take Key Enablers for Challenge 1 stock of recent achievements in health-related research Europe: e. Ministries of health, fnance, re- ritise future actions needed at the European level. The work- cieties, foundations, patient organisations, healthcare shops (http://ec. Recently members king Groups develop positions on key topics and of these societies have published an opinion paper make proposals and recommendations to the Forum. Patient recruit- In Canada, the Canadian Institutes for Health Research ment – consents and ethics; 4. Increasing the impact of research jects in various diseases areas were funded through and development investment. Develop- comprehensive cataloguing of high quality biobank speci- ment of prospective surveillance and monitoring systems mens and biomarkers, and their use in all large-scale studies for personal health data will also contribute to the accu- on patient and population cohorts (‘top-down approach’) mulation of data on individuals across their life course. Thus it is not only omics or imaging technologies misinformation on diseases, their symptoms and potential that will generate vast amounts of data. Aspects include: (1) how health records data from diferent types of registries and to store and provide access to huge amounts of human emerging fows of unstructured data coming from, for ex- health-related sensitive data under a secure and common ample, connected objects or social media. Even though of huge datasets taking into account the fact that storage the launch of translational projects as a main driver for pro- may be either centralised or decentralised; (3) how to in- ducts and services development is key, market successes terrogate such data; and (4) how to link such data to ex- 18 perimental data. Furthermore it needs to be determined • Create a framework for data usage and connect it to who fnances such activities and who will reap the bene- a digital environment to facilitate and improve medi- fts. New solutions, such as cloud computing and secure cal data sharing while ensuring transparency and data user authentication, have been developed to cope with protection. Yet most of these still have to • Support an appropriate infrastructure to collect and demonstrate their applicability, especially in the health store the huge amount of information generated. Some public–priva- • Involve big data organisations in research, motivate te partnership projects of the Innovative Medicines Initiati- and stimulate them to invest in research.

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As people have to deal with false or unreliable information and resources buy propranolol 80mg low price blood vessels breaking on face, curating these with medical professionals and expert patients is the key propranolol 40 mg with mastercard coronary artery revascularization. Customized Mobile Apps The number of medical mobile applications has been rising for years purchase propranolol canada cardiovascular system of fish, therefore patients and doctors find it harder and harder to choose the right app for their health management or work buy generic accutane from india. Customized mobile apps such as the pApp that lets doctors create mobile apps for their patients could be the next step cheap viagra soft 50mg amex. The functions the app should have such as logging blood pressure or medications can be chosen from a menu order viagra extra dosage mastercard; and the patient can download the app right away. Digestible Sensors It is possible to swallow digital devices and tiny sensors for gathering and storing data, transmitting body temperature, heart and respiration rate to an external device. In diseases related to our gastrointestinal system, it could give instant diagnosis by combining the results of lab markers and colonoscopy only by swallowing the device that includes a video camera as well. Digital Literacy in Medical Education The only way to prepare healthcare professionals for the digital technologies coming to medicine is to include digital literacy and the main trends of the future of medicine in the official medical curriculum. Medical students can access the materials in a gamification based e-learning platform, and answer questions about the topics covered in the lectures on a Facebook page for bonus points. A new course, Disruptive Technologies in Medicine, aims at introducing students to the technologies from genomics to telemedicine they will use by the time they start practicing medicine. Expensive laboratory equipment is not so much needed for performing biological experiments; elements of the experiments can be ordered on demand and the data or information required are much more accessible than before. The iGem events made it absolutely clear that the number of opportunities in using biotech for different purposes is almost infinite. The new generation of scientists represented by Jack Andraka leverages the power of already available resources and materials in order to come up with real innovations. Embedded Sensors As an addition to digestable and wearable sensors, tooth- embedded sensors can recognize jaw movements, coughing, speaking and even smoking. Evidence-based Mobile Health The number of medical mobile applications has been rising for years, although persuading users to keep on using the apps is a real challenge. The question is not whether such applications could be used in the process of practicing medicine or delivering healthcare, but which ones and to what extent can be useful, therefore evidence based background is needed for implementing mobile apps in the clinical settings. Full Physiological Simulation What if it is possible to examine the human body with all its physiological functions without experimenting with people? One of the most potential applications being developed in this area is the Virtual Physiological Human, a framework enabling collaborative investigation of the human body. Medical students would be able to study the human body in details like never before understanding the core concepts of how our body works and the pathology of diseases. Another example, HumMod consists of 5000 variables describing cardiovascular and metabolic physiology, among others. Gamification Based Wellness Gamification seems to be the key in persuading people to live a healthy lifestyle or stick to the therapy they have been prescribed to as 63% of American adults agree that making everyday activities more like a game would make them more fun and rewarding.