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Questões de Inglês
19.971 Questões
Questão 15 99130
FCM PB Medicina 2014/2Text I
Before scrubbing in on a recent Tuesday morning, Dr. Selene Parekh, an orthopedic surgeon at Duke Medical Center, slipped on a pair of sleek, black glasses — Google Glass, the wearable computer with a built-in camera and monitor. He gave the Internet-connected glasses a voice command to start recording and turned to the middle-aged motorcycle crash victim on the operating table.
Dr. Parekh has been using Glass since last year, when Google began selling test versions of its device to thousands of handpicked “explorers”. He now uses it to record and archive all of his surgeries, and soon he will use it to stream live feeds of his operations to hospitals in India as a way to train and educate orthopedic surgeons there.
At many hospitals, a growing number of surgeons are using Google Glass to stream their operations online, float medical images in their field of view, and hold video consultations with colleagues as they operate. The Glass projector is slightly above the user’s right eye, allowing doctors to see medical information without turning away from patients.
One doctor who does not allow the device in his practice, Dr. Matthew S. Katz, said that security and distractions were primary concerns. A doctor wearing Glass could accidentally stream confidential medical information online, and patients might not feel comfortable with their doctors wearing cameras on their faces. “From an ethical standpoint, the bar is higher for use in a medical setting,” said Dr. Katz. “As a doctor, I have to make sure that what I’m doing is safe and secure for my patients — ‘First, do no harm.’ Until I am, I don’t want it in my practice.”
Bakul Patel, the senior policy adviser at the Food and Drug Administration’s Center for Devices, said the agency would regulate only those Glass software programs that function as medical devices, the same approach it takes on health applications on hand-held devices. “The glasses have been on our radar and we’re excited about it,” Mr. Patel said.
Hospitals that are experimenting with Glass say they are doing so very carefully — obtaining patient consent before procedures, using encrypted networks, and complying with the federal regulation that protects patient privacy. Augmedix, a company that has done pilot tests of Glass at medical centers in the San Francisco area, said patients were informed that their doctors would be wearing the device. In a study of 200 cases, only two or three patients asked that their doctors remove it.
Some hospitals see Glass as a relatively low-cost and versatile innovation, much like smartphones and tablets, which more than half of all health care providers use to get access to patient data and other medical information. But hand-held devices are not very useful in the sterile world of surgery. Because Glass is voice-activated and hands-free, it may be particularly well suited for the surgical suite.
Dr. Parekh performs back-to-back surgeries on most days, wearing the Glass headset as he moves from one patient to the next. About six years ago, he founded a charity with the goal of advancing foot and ankle surgery in India. He travels there every year with a team of expert surgeons to hold clinics and training sessions for local orthopedic surgeons. In January, at a conference in Jaipur, Dr. Parekh performed surgery and used Glass to stream the procedure on his personal website. That day, the site drew in so many visitors from India and elsewhere that it crashed. “I’ve been even more excited about Google Glass since then,” he said.
Source: New York Times (Adapted from http://well.blogs.nytimes.com/, June/2014)
Choose the item which best completes the sentence bellow:
“In India, foot and ankle surgery is about 40 years ______ where we are in the U.S.,” doctor said. “So to be able to use Glass to broadcast this and have orthopedic surgeons around the world watch and learn _____ expert surgeons in the U.S. would be tremendous.”
Questão 56 98614
IMEPAC Medicina 2014/1Breast cancer: latest developments
Written by Gabrielle Collett-White, health journalist
To mark Breast Cancer Awareness Month, we look at the latest developments in fighting the disease and find out how you can cut your risk of developing it in the first place.
Nearly 45,000 women are diagnosed with breast cancer in the UK every year.
The number of cases has risen in recent years, but thanks to early detection and improved treatment, survival rates are up.
In fact, breast cancer deaths in the UK have fallen by a fifth in the last ten years.
Developments in screening
National screening programme extended
Research has shown that early detection by screening really works.
The 2008 audit of the NHS Cancer Screening Programme found that women with early stage breast cancer picked up by screening are likely to live as long as someone who has never had the disease.
The number one risk factor for breast cancer is age: 80 per cent of cases are in women over 50.
Digital technology introduced
Screening techniques have improved, too.
Antonia Dean, clinical nurse specialist for Breast Cancer Care says: ‘The screening process now involves taking two views of each breast rather than one to improve detection.
Increasingly hospitals are using digital mammography as well. It's still X-ray technology, but the X-ray images can be viewed digitally, meaning radiographers can zoom in on any part of the breast that's unclear.'
One of the latest developments in screeningis the use of computers to read mammograms so only one radiographer is needed instead of two.
Blood test for breast cancer
A number of research centres around the world are looking into the possibility of developing a reliable blood test for breast cancer.
In the UK trials are underway on a test developed at Nottingham University that could detect breast cancer up to four years earlier than a mammogram.
The test detects subtle changes in proteins in the blood that happen when the immune system begins to fight cancer.
It's hoped that it will lead to cancers being picked up much earlier, making treatment options more effective.
Developments in prevention
Tamoxifen
The hormone therapy drug tamoxifen has been found to reduce the chance of breast cancer returning in certain women.
A review of all tamoxifen prevention trials, where the drug is used on 'high-risk' women who are cancer free, also showed a fall in breast cancer risk of 38 per cent.
But the drug has significant side-effects and more research is needed before it can be considered as a preventative drug.
Gene research
Some women are more at risk of developing breast cancer because they carry a faulty gene.
Two of the most important gene faults are known as BRCA 1 and BRCA 2.
Women who carry one or both of these genes have a 50 to 80 per cent risk of developing breast cancer in their lifetime.
Genetic tests are available for women with a high risk of having these faulty genes, and scientists are looking into other genetic links that may also increase the risk.
But research suggests only 5 to 10 per cent of breast cancer cases have a genetic link – for the vast majority of women the causes aren't clear.
Breast cancer vaccine
While plenty of money has been spent on developing new treatments, research into a preventative vaccine is still in its infancy.
In September 2008 researchers at the Karmanos Cancer Institute in the US announced they had developed a vaccine that targeted excess HER2 protein and eliminated drug-resistant tumours in mice.
Too much HER2 protein causes an aggressive form of breast cancer that affects up to one in five women.
Research is still at a very early stage, but it's hoped that eventually it could lead to a vaccine that can control HER2-positive breast cancer - and even prevent it developing in the first place.
Leading cancer expert Professor Valerie Beral from Oxford University has also called for more investigation into vaccines for breast cancer.
She believes more research should be done on the possibility of developing a vaccine that mimics the hormones in pregnancy and lactation - known factors in reducing a woman's risk of breast cancer.
Developments in treatment
Herceptin
Herceptin is one of the newest treatments available. Research has shown it to help stop some breast cancers returning and it may help keep advanced breast cancer under control.
Herceptin works by disarming the protein HER2 that stimulates the spread of cancer, so it only works on HER2-positive breast cancer.
While it is now available on the NHS, Herceptin is a new drug so studies are still ongoing to determine the most effective way to treat women with this medicine.
Tyverb
Another treatment to look out for is called Tyverb (lapatinib).
This is a similar drug to Herceptin, but given in tablet form rather than by intravenous drip. It's designed for patients with an aggressive form of advanced breast cancer that has not responded to other treatments.
Like Herceptin, its use is limited to those cancers that overproduce the HER2 protein. But the drug has been rejected by NICE who decided that there was not enough clinical evidence to approve it on the NHS.
http://www.netdoctor.co.uk/womenshealth/breastcancernews.htm (edited)
According to the text, in the UK, breast cancer is NOT
Questão 60 98553
IMEPAC Medicina 2014/2Could a commonly prescribed antidepressant slow onset of Alzheimer's?
Thursday 15 May 2014 - 8am PST
New research from the Washington University School of Medicine in St. Louis, MO, and the University of Pennsylvania finds that a commonly prescribed antidepressant may be effective at slowing onset of Alzheimer's disease.
The problems with memory and cognition caused by Alzheimer's are strongly influenced by a build-up of plaques in the brain. The plaques consist of amyloid beta - a protein that is produced as part of normal brain activity. Patients with Alzheimer's disease, however, have elevated levels of amyloid beta, which results in the protein clumping together as plaques.
A previous study by senior author John Cirrito, PhD, assistant professor of neurology at Washington University, suggested that the production of amyloid beta can be reduced by the chemical messenger serotonin.
Most antidepressants work by stimulating the flow of serotonin in the brain, which prompted Cirrito and first author Dr. Yvette Sheline to investigate antidepressants as a tool to control amyloid beta production.
As part of a 2011 study, they tested a range of antidepressants in mice genetically altered to develop Alzheimer's as they age. The mice in the trial were young and had not yet developed the brain plaques that characterize the disease. The researchers found that the antidepressants successfully reduced amyloid beta production in the mice by an average of 25% after 24 hours.
In their new study - published in the journal Science Translational Medicine - the researchers administered the antidepressant citalopram to older mice who already had plaques in their brain. They then tracked the growth of plaques in the mice for 28 days using a technique called "two-photon imaging."
They found that citalopram halted the growth of the existing plaques, while formation of new plaques was reduced by 78%.
In a second phase of the experiment, 23 human subjects between the ages of 18 and 50 received a single dose of citalopram. The participants were not cognitively impaired or depressed. Over the 24 hours following the administration of the citalopram, samples of spinal fluid were taken from the participants.
The spinal fluid samples showed that amyloid beta production had dropped in the human participants by 37%.
"Antidepressants appear to be significantly reducing amyloid beta production, and that's exciting," says Cirrito.
'There is still much more work to do'
"But while antidepressants generally are well tolerated," he continues, "they have risks and side effects. Until we can more definitively prove that these drugs help slow or stop Alzheimer's in humans, the risks aren't worth it. There is still much more work to do."
The next step for the team is to use mouse models again in an attempt to understand the molecular process that causes serotonin to halt the production of amyloid beta.
Dr. Sheline says the team also plans to study older adults who will be treated for 2 weeks with antidepressants.
"If we see a drop in levels of amyloid beta in their spinal fluid after 2 weeks," she explains, "then we will know that this beneficial reduction in amyloid beta is sustainable."
Last year, a study published in JAMA suggested that poor sleep quality may contribute to an increased build-up of amyloid beta plaques in the brains of older people. Meanwhile, a study published around the same time in the journal Neurology found an association between hardening of the arteries and the build-up of amyloid beta plaques in the brain.
Written by David McNamee http://www.medicalnewstoday.com/articles/276838.php (Accessed May 16, 2014)
The first tests of this new research were made
Questão 59 98552
IMEPAC Medicina 2014/2Could a commonly prescribed antidepressant slow onset of Alzheimer's?
Thursday 15 May 2014 - 8am PST
New research from the Washington University School of Medicine in St. Louis, MO, and the University of Pennsylvania finds that a commonly prescribed antidepressant may be effective at slowing onset of Alzheimer's disease.
The problems with memory and cognition caused by Alzheimer's are strongly influenced by a build-up of plaques in the brain. The plaques consist of amyloid beta - a protein that is produced as part of normal brain activity. Patients with Alzheimer's disease, however, have elevated levels of amyloid beta, which results in the protein clumping together as plaques.
A previous study by senior author John Cirrito, PhD, assistant professor of neurology at Washington University, suggested that the production of amyloid beta can be reduced by the chemical messenger serotonin.
Most antidepressants work by stimulating the flow of serotonin in the brain, which prompted Cirrito and first author Dr. Yvette Sheline to investigate antidepressants as a tool to control amyloid beta production.
As part of a 2011 study, they tested a range of antidepressants in mice genetically altered to develop Alzheimer's as they age. The mice in the trial were young and had not yet developed the brain plaques that characterize the disease. The researchers found that the antidepressants successfully reduced amyloid beta production in the mice by an average of 25% after 24 hours.
"Until we can more definitively prove that these drugs help slow or stop Alzheimer's in humans, the risks aren't worth it," says Cirrito.
In their new study - published in the journal Science Translational Medicine - the researchers administered the antidepressant citalopram to older mice who already had plaques in their brain. They then tracked the growth of plaques in the mice for 28 days using a technique called "two-photon imaging."
They found that citalopram halted the growth of the existing plaques, while formation of new plaques was reduced by 78%.
In a second phase of the experiment, 23 human subjects between the ages of 18 and 50 received a single dose of citalopram. The participants were not cognitively impaired or depressed. Over the 24 hours following the administration of the citalopram, samples of spinal fluid were taken from the participants.
The spinal fluid samples showed that amyloid beta production had dropped in the human participants by 37%.
"Antidepressants appear to be significantly reducing amyloid beta production, and that's exciting," says Cirrito.
'There is still much more work to do'
"But while antidepressants generally are well tolerated," he continues, "they have risks and side effects. Until we can more definitively prove that these drugs help slow or stop Alzheimer's in humans, the risks aren't worth it. There is still much more work to do."
The next step for the team is to use mouse models again in an attempt to understand the molecular process that causes serotonin to halt the production of amyloid beta.
Dr. Sheline says the team also plans to study older adults who will be treated for 2 weeks with antidepressants.
"If we see a drop in levels of amyloid beta in their spinal fluid after 2 weeks," she explains, "then we will know that this beneficial reduction in amyloid beta is sustainable."
Last year, a study published in JAMA suggested that poor sleep quality may contribute to an increased build-up of amyloid beta plaques in the brains of older people. Meanwhile, a study published around the same time in the journal Neurology found an association between hardening of the arteries and the build-up of amyloid beta plaques in the brain.
Written by David McNamee http://www.medicalnewstoday.com/articles/276838.php (Accessed May 16, 2014)
The effect of most antidepressants is to
Questão 63 98059
FACERES Medicina 2014/1Newly Detected Objects Draw Searchers for Malaysian Plane
By MICHELLE INNIS and CHRIS BUCKLEYMARCH 20, 2014
The New York Times
SYDNEY, Australia — Satellite cameras spotted objects floating in the southern Indian Ocean that might be parts of the Malaysia Airlines jet that vanished on March 8, the Australian prime minister, Tony Abbott, said on Thursday.
Mr. Abbott and an Australian rescue organizer both counseled caution about the sighting, found in images recorded on Tuesday. The first Royal Australian Air Force plane to fly over the estimated location of the objects returned to base Thursday without spotting anything that fit the description – a reminder of how the hunt for the missing Boeing 777 jetliner could remain long, difficult and possibly fruitless.
The Australian Maritime Safety Authority said in a message on Twitter that the search aircraft, a P-3 Orion, was “unable to locate debris — cloud and rain limited visibility — further aircraft to continue search.” Later, a United States Navy P-8A Poseidon also returned from searching the target area to an air base near Perth, the capital of Western Australia, and “had nothing of significance to report,” according to a message from the United States Seventh Fleet, which is overseeing the American military contribution to the search. Cmdr. William J. Marks, the spokesman for the fleet, said in an email that the Poseidon had found “no indication of debris.”
http://www.nytimes.com/2014/03/20/world/asia/missing-malaysia-flight.html?_r=0
The stretch “had nothing of significance to report” corresponds to:
Questão 62 98058
FACERES Medicina 2014/1Newly Detected Objects Draw Searchers for Malaysian Plane
By MICHELLE INNIS and CHRIS BUCKLEYMARCH 20, 2014
The New York Times
SYDNEY, Australia — Satellite cameras spotted objects floating in the southern Indian Ocean that might be parts of the Malaysia Airlines jet that vanished on March 8, the Australian prime minister, Tony Abbott, said on Thursday.
Mr. Abbott and an Australian rescue organizer both counseled caution about the sighting, found in images recorded on Tuesday. The first Royal Australian Air Force plane to fly over the estimated location of the objects returned to base Thursday without spotting anything that fit the description – a reminder of how the hunt for the missing Boeing 777 jetliner could remain long, difficult and possibly fruitless.
The Australian Maritime Safety Authority said in a message on Twitter that the search aircraft, a P-3 Orion, was “unable to locate debris — cloud and rain limited visibility — further aircraft to continue search.” Later, a United States Navy P-8A Poseidon also returned from searching the target area to an air base near Perth, the capital of Western Australia, and “had nothing of significance to report,” according to a message from the United States Seventh Fleet, which is overseeing the American military contribution to the search. Cmdr. William J. Marks, the spokesman for the fleet, said in an email that the Poseidon had found “no indication of debris.”
http://www.nytimes.com/2014/03/20/world/asia/missing-malaysia-flight.html?_r=0
P-3 Orion was “unable to locate debris” means:
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