Refine
Year of publication
Document Type
- Article (33)
- Conference Proceeding (6)
- Preprint (3)
- Review (2)
- Report (1)
Has Fulltext
- yes (45)
Is part of the Bibliography
- no (45)
Keywords
- Herb induced liver injury (5)
- Herbal hepatotoxicity (3)
- Causality assessment (2)
- Drug hepatotoxicity (2)
- Drug induced liver injury (2)
- Pelargonium sidoides (2)
- Validität (2)
- admission test (2)
- drug induced liver injury (2)
- short essay questions (2)
- Allergic asthma (1)
- CIOMS (1)
- Centers for Disease Control and Prevention (1)
- Council for International Organizations of Medical Sciences (1)
- DILI (1)
- Dark triad (1)
- Dialog-Konsens- Methoden (1)
- Double-blind placebo-controlled trial (1)
- Drugs (1)
- Eignungsprüfung (1)
- Einfachauswahlverfahren (1)
- Eingangstest (1)
- Electron-pion identification (1)
- Exercise challenge (1)
- Exercise challenge at an ambient temperature (1)
- Exercise challenge in a cold chamber (1)
- Exercise-induced asthma (1)
- Exercise-induced bronchoconstriction (1)
- Exhaled nitric oxide (1)
- Fibre/foam sandwich radiator (1)
- Food and Drug Administration (1)
- Forced expiratory volume in 1 s (1)
- Hawaii Department of Health (1)
- Herbal medicine (1)
- Herbalife products (1)
- Herbs (1)
- Honolulu Queen’s Medical Center (1)
- Implicit motives (1)
- Interview (1)
- Ionisation energy loss (1)
- Kava (1)
- LABAs (1)
- Longchain polyunsaturated fatty acids (1)
- MC-Fragen (1)
- Medical study (1)
- Medizinstudium (1)
- Methacholine challenge test (1)
- Multi-motive grid (1)
- Multi-wire proportional drift chamber (1)
- Multiple choice Fragen (1)
- Naturwissenschaften (1)
- Neural network (1)
- Objektivität (1)
- OxyELITE Pro (1)
- Pelargonium sidoides questionable hepatotoxicity (1)
- Pharmacovigilance (1)
- Prüfungen (1)
- Prüfungserfolg (1)
- RUCAM (1)
- Ratewahrscheinlichkeit (1)
- Re-exposure (1)
- Reliabilität (1)
- Ressourcen (1)
- Roussel Uclaf Causality Assessment Method (1)
- Soft skills (1)
- Subjekt (1)
- TR (1)
- Tracking (1)
- Traits of medical students (1)
- Transition radiation detector (1)
- Trigger (1)
- Validity (1)
- Vorkenntnisse (1)
- Xenon-based gas mixture (1)
- Zulassung zum Medizinstudium (1)
- Zulassungskriterien (1)
- admission criteria (1)
- aggression (1)
- alcoholic liver disease (1)
- alcoholic liver injury (1)
- assessment (1)
- asthma (1)
- asthma phenotypes (1)
- autovaccine (1)
- back scan (1)
- biomarkers (1)
- body posture (1)
- breast cancer (1)
- bronchial allergen challenge (1)
- bullying (1)
- central spasticity (1)
- chemoprevention (1)
- colorectal cancer (1)
- communication (1)
- comparative study (1)
- dE/dx (1)
- desensitization (1)
- diagnostic biomarkers (1)
- dialogue consensus methods (1)
- dihydrocannabidiol (1)
- epidemiology (1)
- esophageal cancer (1)
- examination success (1)
- female subjects (1)
- gastric cancer (1)
- guessing likelihood (1)
- harassment (1)
- hepatotoxicity (1)
- herb induced liver injury (1)
- hospitalization (1)
- house dust mite allergy (1)
- immunologic (1)
- inhaled steroids (1)
- interview (1)
- learning strategies (1)
- liver injury (1)
- long essay questions (1)
- long essey questions (1)
- long-acting β2-agonists (1)
- low intellectual abilities (1)
- lung cancer (1)
- medical studies (1)
- medical studies admission (1)
- meta-analysis (1)
- multiple choice question (1)
- multiple choice questions (1)
- natural sciences (1)
- non-sexual (1)
- objecitvity (1)
- offene Fragen (1)
- pathogenesis (1)
- pollen allergy (1)
- pre-school asthma (1)
- preschool asthma (1)
- prior knowledge (1)
- prostatic cancer (1)
- psychological (1)
- qualitative Methode (1)
- qualitative analysis (1)
- readmission rates (1)
- reliability (1)
- safety (1)
- severe uncontrolled asthma (1)
- single best choice question (1)
- single choice questions (1)
- soft skills (1)
- standard value (1)
- stress (1)
- studentisches Lernverhalten (1)
- subjective theories (1)
- subjektive Theorien (1)
- tailored treatment schedule (1)
- tetrahydrocannabinol (1)
- tiotropium (1)
- tolerability (1)
- tolerance (1)
- validity (1)
Institute
- Medizin (42)
- Frankfurt Institute for Advanced Studies (FIAS) (3)
- Informatik (3)
- Physik (3)
- Psychologie (1)
- Sportwissenschaften (1)
Multiple choice (MC)-Klausuren sind im deutschen Medizinstudium trotz weitgehend fehlender Daten zur Validität dieser Prüfungsform zur Regelprüfung geworden. Darüber hinaus ist unklar, in welchem Ausmaß die Studierenden - auch solche mit guten Prüfungsergebnissen - den geprüften Lernstoff tatsächlich beherrschen. Am Fachbereich Medizin der Johann-Wolfgang-Goethe-Universität Frankfurt wurde am Ende des SS 2003 im Fach Mikrobiologie für die Studierenden des 2. klinischen Semesters eine MC-basierte Abschlussprüfung geschrieben. Die Studierenden des 1. klinischen Semesters hatten - bedingt durch Umstellungen des Curriculums - eine identische Ausbildung. Diese wurde durch eine inhaltlich weitgehend identische, im Format aber andere Klausur abgeschlossen, in der sowohl offene Fragen enthalten waren als auch Fragen, bei denen die Studierenden jede Aussage einzeln auf Korrektheit bewerten mussten. Der Vergleich der Ergebnisse für inhaltlich gleiche Fragen zeigt, dass die Studierenden im MC-Format eine hohe Quote richtiger Antworten erzielen, diese jedoch durch ein geändertes Fragenformat stark reduziert wird. So erreichten nur 20 - 30% der Studierenden ein vollständig richtiges Ergebnis, wenn jede Aussage einzeln bewertet werden musste, während die inhaltlich gleiche Frage im MC-Format 80 - 90% richtige Ergebnisse erzielte. In freien Fragen konnten nur 30 - 40% der Studierenden die richtige Antwort aktiv niederschreiben, während 90 -99% der Studierenden die richtige Lösung passiv erkannten. Wir interpretieren diese Ergebnisse dahin, dass der Entscheidungszwang in MC-basierten Fragen einen starken Einfluss auf die Quote richtiger Antworten hat, und die Prüfungsergebnisse damit wesentlich durch das Format beeinflusst werden, das Wissen dagegen nicht beherrscht wird. Die Ergebnisse dieser Studie legen nahe, Sorgfalt bei der Auswahl des Prüfungsverfahrens walten zu lassen und der Steuerung des studentischen Lernverhaltens durch das Prüfungsformat wesentlich mehr Aufmerksamkeit zu widmen als bisher.
Background and aim. In the fall of 2013, the US Centers for Disease Control and Prevention (CDC) published a preliminary report on a cluster of liver disease cases that emerged in Hawaii in the summer 2013. This report claimed a temporal association as sufficient evidence that OxyELITE Pro (OEP), a dietary supplement (DS) mainly for weight loss, was the cause of this mysterious cluster. However, the presented data were inconsistent and required a thorough reanalysis.
Material and methods. To further investigate the cause(s) of this cluster, we critically evaluated redacted raw clinical data of the cluster patients, as the CDC report received tremendous publicity in local and nationwide newspapers and television. This attention put regulators and physicians from the medical center in Honolulu that reported the cluster, under enormous pressure to succeed, risking biased evaluations and hasty conclusions.
Results. We noted pervasive bias in the documentation, conclusions, and public statements, also poor quality of case management. Among the cases we reviewed, many causes unrelated to any DS were evident, including decompensated liver cirrhosis, acute liver failure by acetaminophen overdose, acute cholecystitis with gallstones, resolving acute hepatitis B, acute HSV and VZV hepatitis, hepatitis E suspected after consumption of wild hog meat, and hepatotoxicity by acetaminophen or ibuprofen. Causality assessments based on the updated CIOMS scale confirmed the lack of evidence for any DS including OEP as culprit for the cluster.
Conclusions. Thus, the Hawaii liver disease cluster is now best explained by various liver diseases rather than any DS, including OEP.
The diagnosis of drug induced liver injury (DILI) is based primarily on the exclusion of alternative causes. To assess the frequency of alternative causes in initially suspected DILI cases, we searched the Medline database with the following terms: drug hepatotoxicity, drug induced liver injury, and hepatotoxic drugs. For each term, we used the first 100 publications. We reviewed references, selected those reports relevant to our study, and retrieved finally 15 publications related to DILI and alternative causes. A total of 2,906 cases of initially assumed DILI were analyzed in these 15 publications, with diagnoses missed in 14% of the cases due to overt alternative causes. In another 11%, the diagnosis of DILI could not be established because of confounding variables. Alternative diagnoses included hepatitis B, C, and E, CMV, EBV, ischemic hepatitis, autoimmune hepatitis, primary biliary cirrhosis, primary sclerosing cholangitis, hemochromatosis, Wilson’s disease, Gilbert’s syndrome, fatty liver, non alcoholic steatohepatitis, alcoholic liver diseases, cardiac and thyroid causes, rhabdomyolysis, polymyositis, postictal state, tumors, lymphomas, chlamydial and HIV infections. Causality assessment methods applied in these 15 publications were the CIOMS (Council for International Organizations of Medical Sciences) scale alone (n = 5) or combined with the Maria and Victorino (MV) scale (n = 1), the DILIN (Drug-Induced Liver Injury Network) method (n = 4), or the Naranjo scale (n = 1); the qualitative CIOMS method alone (n = 3) or combined with the MV scale (n = 1). In conclusion, alternative diagnoses are common in primarily suspected DILI cases and should be excluded early in future cases, requiring a thorough clinical and causality assessment.
Herbal hepatotoxicity is a rare but highly disputed disease because numerous confounding variables may complicate accurate causality assessment. Case evaluation is even more difficult when the WHO global introspection method (WHO method) is applied as diagnostic algorithm. This method lacks liver specificity, hepatotoxicity validation, and quantitative items, basic qualifications required for a sound evaluation of hepatotoxicity cases. Consequently, there are no data available for reliability, sensitivity, specificity, positive and negative predictive value. Its scope is also limited by the fact that it cannot discriminate between a positive and a negative causality attribution, thereby stimulating case overdiagnosing and overreporting. The WHO method ignores uncertainties regarding daily dose, temporal association, start, duration, and end of herbal use, time to onset of the adverse reaction, and course of liver values after herb discontinuation. Insufficiently considered or ignored are comedications, preexisting liver diseases, alternative explanations upon clinical assessment, and exclusion of infections by hepatitis A-C, cytomegalovirus (CMV), Epstein-Barr virus (EBV), herpes simplex virus (HSV), and varicella zoster virus (VZV). We clearly prefer as alternative the scale of CIOMS (Council for International Organizations of Medical Sciences) which is structured, quantitative, liver specific, and validated for hepatotoxicity. In conclusion, causality of herbal hepatotoxicity is best assessed by the liver specific CIOMS scale validated for hepatotoxicity rather than the obsolete WHO method that is liver unspecific and not validated for hepatotoxicity. CIOMS based assessments will ensure the correct diagnosis and exclude alternative diagnosis that may require other specific therapies.
Background: A good physician should be empathic and altruistic, among other qualities. Therefore, the levels of socially undesirable personality traits (Dark Triad) as well as implicit motives of achievement, affiliation and power (Multi-Motive Grid) among medical students as future physicians were analyzed at two different points in their medical training.
Methods: This study includes 380 medical students in their first year and 217 in their third year in Germany. All participants completed the Dirty Dozen (DD) and Multi-Motive Grid (MMG) questionnaires at the end of two different classes as paper-and-pencil tests. Relevant differences of the Dark Triad traits between the medical students and reference sample and the two different cohorts, as well as their implicit motives, the associations of Dark Triad traits and MMG components and gender differences of the Dark Triad traits were calculated.
Results: There were no significant group differences between year one and year three medical students in narcissism, psychopathy and Machiavellianism (Dark Triad). There were no significant differences between the medical students and reference sample except in psychopathy. Male students scored significantly higher in the Dark Triad traits than female students. In the MMG, first-year students scored significantly higher levels in Fear of Rejection, and lower levels in Hope of Success and Hope of Power than the third-year students. Some associations were found between narcissism and Machiavelliansim with Hope of Success, Hope of Power and Fear of power.
Conclusions: Dark Triad traits already appear to exist before the commencement of medical studies. These traits do not differ significantly between the medical students and reference sample; only a few MMG components seem to differ at different stages of their studies. This lack of differences between the medical students and validation cohort indicates that tests based on (undesirable) personality traits are not suitable criteria for the admission selection of medical students.