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Right to die

D Finn, A Dorrian, J Sheehy, E M Dempsey, C A Ryan
AIM: To determine the neonatal incidence, indications and outcomes following transfusions with emergency uncrossmatched O-negative blood. METHODS: A 5 year retrospective review in a single tertiary neonatal unit was conducted. The blood transfusion laboratory's database was analysed for all infants who had received an emergency released blood transfusion (ERBT) between January 2010 - December 2014. RESULTS: We calculated a total ERBT rate of 0...
October 26, 2016: Acta Paediatrica
Babette Bais, Wouter A Karst, Bela Kubat, Robert M Verdijk
Retinal hemosiderin deposition is a histologic indicator of sustained hemorrhage but cannot be used to precisely estimate the elapsed time since an episode of trauma. A 5-month-old male infant was admitted to hospital after acute deterioration. Examination revealed encephalopathy, subdural hematomas, and retinal hemorrhages consistent with abusive head trauma (AHT). At the age of 3, he was readmitted to hospital with spontaneous osteopenic fracture of the right femur. The patient deteriorated and died after unsuccessful resuscitation...
October 26, 2016: Journal of Forensic Sciences
Manuela Merli, Concetta Torromeo, Michela Giusto, Gianna Iacovone, Oliviero Riggio, Paolo Emilio Puddu
BACKGROUND & AIMS: Cirrhotic Cardiomyopathy (CC) may interact with the clinical course of liver cirrhosis and can be implicated in the development of several complications in advanced liver disease. The best and easiest parameters which should define a condition of reduced cardiac reserve in cirrhosis are still controversial. The current study was aimed at selecting the cardiac parameters, derived by Doppler echocardiography, predictive of survival during follow-up. METHODS: The study included cirrhotic patients without cardiovascular or pulmonary diseases...
October 26, 2016: Liver International: Official Journal of the International Association for the Study of the Liver
Kerry McBroom
One thousand people die every day in India as a result of TB, a preventable and treatable disease, even though the Constitution of India, government schemes, and international law guarantee available, accessible, acceptable, quality health care. Failure to address the spread of TB and to provide quality treatment to all affected populations constitutes a public health and human rights emergency that demands action and accountability. As part of a broader strategy, health activists in India employ Public Interest Litigation (PIL) to hold the state accountable for rights violations and to demand new legislation, standards for patient care, accountability for under-spending, improvements in services at individual facilities, and access to government entitlements in marginalized communities...
June 2016: Health and Human Rights
I Biasato, M Tursi, S Zanet, E Longato, M T Capucchio
A 7-year-old male castrated domestic short-haired cat suddenly died. Gross examination revealed severe right-sided haemothorax with blood clots, four adult filarial nematodes in the blood clots and the caudal vena cava and haemorrhage dissecting into the tunica media of the right pulmonary artery. Histopathological investigation showed fibrosis of the tunica intima and disorganization/fragmentation of the elastic fibres accompanied by fibrous tissue deposition in the tunica media of both branches of pulmonary artery...
October 22, 2016: Journal of Veterinary Cardiology: the Official Journal of the European Society of Veterinary Cardiology
Zhen Shen, Chen-Yang Zhi, Ruo-Nan Wang, Hai-Cheng Gao
The purpose of this case is to investigate a case of obturator hernia leading to right thigh abscess on 68-year-old woman of China. A 68-year-old Chinese woman was referred to China-Japan Friendship Hospital of Jilin University with abdominal pain, bloating, exhaust, stop defecation in 2011. She had chronic bronchitis, emphysema with a history of 20 years. This patient did not have any bad habits, such as smoking, alcohol consumption, etc. In this surgery, CT was used to diagnose the basic condition of the patient...
October 19, 2016: International Journal of Surgery Case Reports
Arne Ring, Tom Morris, Marcin Wozniak, Nikol Sullo, William Dott, Veerle Verheyden, Tracy Kumar, Nigel Brunskill, Rakesh Vaja, Gavin J Murphy
BACKGROUND: Acute kidney injury (AKI) is a common and severe complication of cardiac surgery. There is no effective prevention or treatment. Sildenafil citrate (Revatio®, Pfizer Inc), a phosphodiesterase type 5 inhibitor, prevents post cardiac surgery AKI in pre-clinical studies, however its use is contraindicated in patients with symptomatic cardiovascular disease. METHODS: To assess the safety and pharmacokinetics of intravenous sildenafil in cardiac surgery patients we conducted an open label, dose escalation study with 6 patients per dose level...
October 25, 2016: British Journal of Clinical Pharmacology
S Ram Kumar, Grace Kung, Nathan Noh, Novel Castillo, Brian Fagan, Winfield J Wells, Vaughn A Starnes
BACKGROUND: We have previously shown that neonates in profound cardiogenic shock caused by a severe Ebstein anomaly can be successfully salvaged with fenestrated right ventricular exclusion and systemic to pulmonary shunt (modified Starnes procedure). The long-term outcome of single-ventricle management in these patients is not known. METHODS: We retrospectively reviewed the records of patients who underwent neonatal Starnes procedure between 1989 and 2015. Patient demographics, clinical variables, and outcome data were collected...
October 25, 2016: Circulation
G Teofilovski-Parapid, R Jankovic, V Kanjuh, R Virmani, N Danchin, N Prates, D V Simic, B Parapid
PURPOSE: Myocardial bridge is a congenital anomaly with a markedly variable reported incidence on autopsy (4.7%-86%), likely related to geographical regions. Our previous retrospective study showed a prevalence of 0.8%, which we doubted to be the true one in the examined sample of the Serbian population. To assess the importance of the phenomenon we conducted a 2-year prospective study at the same institution. METHODS: Ninety-six cadaver hearts from adult individuals of both genders (51 men, 45 women) who died from natural causes underwent special dissection...
October 21, 2016: Annals of Anatomy, Anatomischer Anzeiger: Official Organ of the Anatomische Gesellschaft
Yuriy Pya, Makhabbat Bekbossynova, Saltanat Jetybayeva, Serik Bekbossynov, Saltanat Andossova, Roman Salov, Assel Medressova, Svetlana Novikova, Muradym Murzagaliyev
AIMS: The need for the left ventricular assist devices (LVAD) in patients with end-stage heart failure is well established, but prior to 2011, this was not available to patients in Kazakhstan. We describe the development of the sole LVAD programme in the context of a nascent heart transplantation programme and clinical outcomes for the first three years. METHODS AND RESULTS: From November 2011 to November 2014, 146 patients underwent implantation of 152 VADs (approximately 50 devices implanted per year)...
March 2016: ESC Heart Failure
D Donegan, N Singh Ospina, R Rodriguez-Gutierrez, Z Al-Hilli, G B Thompson, B L Clarke, W F Young
BACKGROUND: In patients with multiple endocrine neoplasia type 1 (MEN-1), pancreaticoduodenal (PD) neuroendocrine tumors (NETs) are associated with early mortality, yet, the best treatment strategy, remains uncertain. AIM: To assess patient important outcomes (mortality and metastasis) of PD NETs and predictors of outcomes in patients with MEN-1. METHODS: Retrospective cohort of patients with MEN-1 who attended the Mayo Clinic, Rochester, MN from 1997-2014...
October 21, 2016: Clinical Endocrinology
Xuehua Piao, Soh Yamazaki, Sachiko Komazawa-Sakon, Sanae Miyake, Osamu Nakabayashi, Takeyuki Kurosawa, Tetsuo Mikami, Minoru Tanaka, Nico Van Rooijen, Masaki Ohmuraya, Akira Oikawa, Yuko Kojima, Soichiro Kakuta, Yasuo Uchiyama, Masato Tanaka, Hiroyasu Nakano
: Tissue-resident macrophages and bone marrow (BM)-derived monocytes play a crucial role in the maintenance of tissue homeostasis; however, their contribution to recovery from acute tissue injury is not fully understood. To address this issue, we generated an acute murine liver injury model using hepatocyte-specific Cflar-deficient (Cflar(Hep-low) ) mice. Cellular FLICE-inhibitory protein (cFLIP) expression was downregulated in Cflar-deficient hepatocytes, which thereby increased susceptibility of hepatocytes to death receptor-induced apoptosis...
October 22, 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Ahmad Masri, Vidyasagar Kalahasti, Lars G Svensson, Eric E Roselli, Douglas Johnston, Donald Hammer, Paul Schoenhagen, Brian P Griffin, Milind Y Desai
BACKGROUND: -In patients with a dilated proximal ascending aorta and trileaflet aortic valve (TAV), we sought to assess a) factors independently associated with increased long-term mortality and b) the incremental prognostic utility of indexing aortic root to patient height. METHODS: -We studied consecutive patients with a dilated aortic root (≥4 cm) that underwent echocardiography and gated contrast-enhanced thoracic aortic computed tomography or magnetic resonance angiography between 2003-2007...
October 21, 2016: Circulation
David Shaw, Denie Georgieva, Bernadette Haase, Dale Gardiner, Penney Lewis, Nichon Jansen, Tineke Wind, Undine Samuel, Maryon McDonald, Rutger Ploeg
Millions of people want to donate their organs after they die for transplantation, and many of them have registered their wish to do so or told their family and friends about their decision. For most of them, however, this wish is unlikely to be fulfilled, as only a small number of deaths (1% in the United Kingdom) occur in circumstances where the opportunity to donate organs is possible. Even for those who do die in the 'right' way and have recorded their wishes or live in a jurisdiction with a 'presumed consent' system, donation often does not go ahead because of another issue: their families refuse to allow donation to proceed...
October 19, 2016: Transplantation
Alessia Pedoto, Dawn P Desiderio, David Amar, Robert J Downey
BACKGROUND: Spray cryotherapy (SCT) of airway lesions is used to effectively palliate respiratory symptoms related to airway obstruction, but significant intraoperative hemodynamic complications have been noted. We reviewed the experience at a single institution using SCT for the treatment of obstructive airway tumors. METHODS: A retrospective review of a single institution experience with intraoperative and postoperative hemodynamic complications associated with SCT was performed...
November 2016: Anesthesia and Analgesia
Josi Amadeu, Cleto Mariosvaldo Piazzetta, Cassius Carvalho Torres-Pereira, José Miguel Amenábar
Melanoma is a malignant neoplasm of melanocytes that can metastasize to every organ of the body, but metastasis to the oral cavity is uncommon. We describe a case of metastatic malignant melanoma to the mandible in a 33-years-old woman. The patient had a 2 cm × 4 cm firm, ulcerated nodule, distal to the second mandibular right molar. Incisional biopsy revealed epithelioid cells and immunohistochemistry was positive for HMB-45, S-100 protein and vimentin. The patient was referred to the local cancer hospital for treatment but died 3 months later...
September 2016: Journal of Oral Biology and Craniofacial Research
Ryo Fujiwara, Mitsuhiro Narita, Susumu Kageyama, Akihiro Kawauchi, Takahisa Nakayama, Natsumi Nishi, Hiroyuki Sugihara, Yusaku Okada
A 67-year-old man presented at our hospital with severe edema on the left side of his neck, chest and brachial regions. He had a history of right radical nephrectomy due to renal cell carcinoma (RCC, clear cell subtype, stage II) 15 years earlier. Thereafter, metastases to the pancreatic tail and right lung, and left lung metastasis were removed at 8 years and 11 years, respectively, after the nephrectomy. Four years earlier, he had also undergone total gastrectomy for gastric carcinoma (poorly differentiated adenocarcinoma, stage IV) and subsequent maintenance chemotherapy for gastric carcinoma...
September 2016: Hinyokika Kiyo. Acta Urologica Japonica
Maxime Cailleret, Steven Jansen, Elisabeth M R Robert, Lucía Desoto, Tuomas Aakala, Joseph A Antos, Barbara Beikircher, Christof Bigler, Harald Bugmann, Marco Caccianiga, Vojtěch Čada, J Julio Camarero, Paolo Cherubini, Hervé Cochard, Marie R Coyea, Katarina Čufar, Adrian J Das, Hendrik Davi, Sylvain Delzon, Michael Dorman, Guillermo Gea-Izquierdo, Sten Gillner, Laurel J Haavik, Henrik Hartmann, Ana-Maria Hereş, Kevin R Hultine, Pavel Janda, Jeffrey M Kane, Vyacheslav I Kharuk, Thomas Kitzberger, Tamir Klein, Koen Kramer, Frederic Lens, Tom Levanic, Juan Carlos Linares Calderon, Francisco Lloret, Raquel Lobo-Do-Vale, Fabio Lombardi, Rosana López Rodríguez, Harri Mäkinen, Stefan Mayr, Ilona Mészáros, Juha M Metsaranta, Francesco Minunno, Walter Oberhuber, Andreas Papadopoulos, Mikko Peltoniemi, Any Mary Petritan, Brigitte Rohner, Gabriel Sangüesa-Barreda, Dimitrios Sarris, Jeremy M Smith, Amanda B Stan, Frank Sterck, Dejan B Stojanović, Maria Laura Suarez, Miroslav Svoboda, Roberto Tognetti, José M Torres-Ruiz, Volodymyr Trotsiuk, Ricardo Villalba, Floor Vodde, Alana R Westwood, Peter H Wyckoff, Nikolay Zafirov, Jordi Martínez-Vilalta
Tree mortality is a key factor influencing forest functions and dynamics, but our understanding of the mechanisms leading to mortality and the associated changes in tree growth rates are still limited. We compiled a new pan-continental tree-ring width database from sites where both dead and living trees were sampled (2,970 dead and 4,224 living trees from 190 sites, including 36 species), and compared early and recent growth rates between trees that died and those that survived a given mortality event. We observed a decrease in radial growth before death in ca...
October 19, 2016: Global Change Biology
Keiji Tasaka, Kousaku Matsubara, Shizuo Takamiya, Shin-Ichi Ishikawa, Aya Iwata, Hiroyuki Nigami
BACKGROUND: Information on long-term follow-up of childhood-onset anorexia nervosa is scarce. This study aimed to show long-term (>10 years) course, outcome and prognostic factors for hospitalized childhood-onset anorexia nervosa-restricting type (ANR). METHODS: Forty-one ANR girls admitted to a single regional center participated. Median age at first admission was 13.3 (range: 8.6-15.6) years. The longitudinal clinical course was retrospectively determined for a median follow-up period of 17...
October 19, 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
Hille Haker
This essay explores the two main objectives of Bishop's book, which he analyzes in the context of the care for the dying: (1) the medical metaphysics underlying medical science and (2) biopolitics as governance of the human body. This essay discusses Bishop's claims in view of newer developments in medicine, especially the turn to the construction of life, and confronts the concept of the patient's sovereignty with an alternative model of vulnerable agency. In order to overcome the impasses of contemporary bioethics, the essay argues that practical reason requires a two-fold ethics: first, it must develop a new hermeneutics of illness and disease, and second, in order to protect the individuals in the process of dying, moral claims concerning death must be based on the concept of human rights...
October 6, 2016: Journal of Medicine and Philosophy
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