Integrative Medicine in Primary Care

Integrative medicine (IM) is an approach to care that puts the patient at the center and addresses the full range of physical, emotional, mental, social, spiritual and environmental influences that affect a person’s health (Rakel, 2017). Commonly, IM is associated with complementary and alternative medicine therapies (CAM). These are two separate entities. CAM is one of the modalities used in integrative medicine.https://commons.und.edu/pas-grad-posters/1005/thumbnail.jp

Integrative Medicine in Primary Care

Integrative medicine (IM) is an approach to care that puts the patient at the center and addresses the full range of physical, emotional, mental, social, spiritual and environmental influences that affect a person’s health (Rakel, 2017). Commonly, integrative medicine is associated with complementary and alternative medicine therapies (CAM). These are two separate entities. CAM is one of the modalities used in integrative medicine. The review of the literature on IM analyzed studies in primary care settings in all parts of the world. Definitions of IM and CAM are evaluated. Defining what IM is and how to incorporate this approach in an evidence-based manner to primary care is discussed in this project. Patient and provider’s perceptions of their experiences are examined. Study outcomes include positive experiences in IM primary care clinics, reduction in opiate use with CAM and group medical visits (GMV), and resident experiences of incorporating IM into future medical school curriculums. More studies need to be done, this is a somewhat new area for research, but is an important aspect of primary care as more patients are relying on these CAM therapies than ever before. Difficulties in methods for evaluating IM in primary care such as the questionnaires are in need of revisions to account for healthy populations

Improved Leakage Correction for Single-Echo Dynamic Susceptibility Contrast Perfusion MRI Estimates of Relative Cerebral Blood Volume in High-Grade Gliomas by Accounting for Bidirectional Contrast Agent Exchange

Background and purposeContrast agent extravasation through a disrupted blood-brain barrier potentiates inaccurate DSC MR imaging estimation of relative CBV. We explored whether incorporation of an interstitial washout rate in a leakage-correction model for single-echo, gradient-echo DSC MR imaging improves relative CBV estimates in high-grade gliomas.Materials and methodsWe modified the traditional model-based postprocessing leakage-correction algorithm, assuming unidirectional contrast agent extravasation (Boxerman-Weisskoff model) to account for bidirectional contrast agent exchange between intra- and extravascular spaces (bidirectional model). For both models, we compared the goodness of fit with the parent leakage-contaminated relaxation rate curves by using the Akaike Information Criterion and the difference between modeled interstitial relaxation rate curves and dynamic contrast-enhanced MR imaging by using Euclidean distance in 21 patients with glioblastoma multiforme.ResultsThe bidirectional model had improved Akaike Information Criterion versus the bidirectional model in >50% of enhancing tumor voxels in all 21 glioblastoma multiformes (77% ± 9%; P < .0001) and had reduced the Euclidean distance in >50% of enhancing tumor voxels for 17/21 glioblastoma multiformes (62% ± 17%; P = .0041). The bidirectional model and dynamic contrast-enhanced-derived kep demonstrated a strong correlation (r = 0.74 ± 0.13). On average, enhancing tumor relative CBV for the Boxerman-Weisskoff model exceeded that for the bidirectional model by 16.6% ± 14.0%.ConclusionsInclusion of the bidirectional exchange in leakage-correction models for single-echo DSC MR imaging improves the model fit to leakage-contaminated DSC MR imaging data and significantly improves the estimation of relative CBV in high-grade gliomas

Rb-Sr whole rock and U-Pb zircon datings of the granitic-gabbroic rocks from the Skålfjellet Subgroup, southwest Spitsbergen

Recent remapping and new age determinations has shed light on the understanding of Precambrian rocks northwest of Hornsund, southwest Spitsbergen. The Skålfjellet Subgroup has been regarded as the eastern equivalent of the Vimsodden Subgroup, and both of these occur within the Precambrian Eimfjellet Group of southwest Spitsbergen. Although the Eimfjellet Group is considered to be older than the oldest unconformity in the area, the age of the rocks has not been known. The granitic-gabbroic rocks in the Skålfjellet Subgroup have been considered to be the products of granitisation for many years, but recent observations show that they are exotic blocks incorporated into the basic eruptive rocks which are the main constituents of the subgroup. These plutonic rocks have a wide range of compositions, from syenite via granite to gabbroic cumulates, which suggests the existence of a well-differentiated plutonic body at depth. U-Pb zircon and Pb evaporation datings yielded magmatic ages of ca. 1,100 to 1,200 Ma, and a conformable age has been obtained by Rb-Sr whole rock dating. Detrital zircons from the micaceous schists of the Isbjørnhamna Group, which underlies the Skålfjellet Subgroup, show a poorly defined discordia with an upper intercept age of ca. 2,200 Ma and a lower intercept age of ca. 360 Ma. These dating results define the magmatic age of the granitic-gabbroic rocks as late Mesoproterozoic, early Grenvillian. This age is in broad agreement with that of the metavolcanic rock clasts of the Pyttholmen meta-pyroclastic-conglomeratic unit at Vimsodden, which is considered to be the westernmost occurrence of the Skålfjellet Subgroup. A Rb-Sr whole rock age determination of the shaly phyllites from the Deilegga Group was performed in order to place constraints on the age of younger Precambrian event; however, no good isochron was obtained

Demonstration of Non-Gaussian Restricted Diffusion in Tumor Cells Using Diffusion Time-Dependent Diffusion-Weighted Magnetic Resonance Imaging Contrast

Data SetThis zip file contains a .jgw, .jpg, .jpg.aux.xml and .jpg.ovr representing a single georeferenced sheet overlay from the Sanborn Fire Insurance Maps for Salt Lake City, 1950. The downloaded and opened zip file is accessible for viewing in ArcGIS and other GIS software systems. Multiple zip files can be loaded into a GIS software system in order to view a continuous set of sheet overlays