The Medical clinics of North America
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Med. Clin. North Am. · May 2018
ReviewThe Physical Examination as Ritual: Social Sciences and Embodiment in the Context of the Physical Examination.
The privilege of examining a patient is a skill of value beyond its diagnostic utility. A thorough physical examination is an important ritual that benefits patients and physicians. The concept of embodiment helps one understand how illness and pain further define and shape the lived experiences of individuals in the context of their race, gender, sexuality, and socioeconomic status. Understanding ritual in medicine, including the placebo effects of such rituals, reaffirms the centrality of the physical examination to the process of building strong physician-patient relationships.
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Diagnostic errors are common in clinical practice and lead to adverse patient outcomes. Systematic reviews have shown that inadequate history taking and physical examination lead to a plurality, if not a majority, of diagnostic errors. ⋯ Research into diagnostic error has been hampered by methodologic inconsistency and a paucity of studies in real-world clinical settings. The best evidence indicates that educational interventions to reduce diagnostic error should give physicians feedback about clinical outcomes and enhance their ability to recognize signs and symptoms of specific diseases at the bedside.
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Med. Clin. North Am. · Mar 2018
ReviewThe Intersection of Medicine and Urology: An Emerging Paradigm of Sexual Function, Cardiometabolic Risk, Bone Health, and Men's Health Centers.
Men's mental health and how they think about their health are critical to the future of men's health. Poor health choice patterns are established under age 50, when men are twice as likely to die than women. ⋯ The presentation of a man to a clinician's office with a sexual health complaint presents an opportunity for more complete evaluation. The future of men's health will be well served by integrated men's health centers that focus on the entire man.
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Telemedicine use in urology is an evolving practice. In this article, the authors review the early experience of telemedicine specifically as it relates to urologic practice and discuss the future implications and the utility of telemedicine as it applies to other fields.
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Penile and urethral reconstructive surgical procedures are used to treat a variety of urologic diagnoses. Urethral stricture disease can lead to progressive lower urinary tract symptoms and may require multiple surgical procedures to improve patient's symptoms. Male stress urinary incontinence is associated with intrinsic sphincter deficiency oftentimes associated with radical prostatectomy. Men suffering from urethral stricture disease and stress urinary incontinence should be referred to a urologist because multiple treatment options exist to improve their quality of life.