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Interest of conflict AND patients

Sunil V Patel, Lisa Zhang, Basheer Elsolh, Daid Yu, A Sami Chadi
AIM: Minimally Invasive Trans anal Total Mesorectal Excision (TaTME) is a new approach in treating rectal cancer. "Spin" can be defined as "reporting strategies to highlight that the experimental treatment is beneficial" despite limitations in study design. The aim of this study was to assess Spin within TaTME publications. METHODS: EMBASE and MEDLINE (2009 - 2017) were searched for publications assessing TaTME in rectal cancer. All publications, published between 2009 - 2017 were eligible for inclusion...
October 20, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Andrew Kotaska
A majority of deep vein thromboses identified in screening studies of hospitalized patients remain clinically insignificant. Guidelines based on these studies markedly overestimate the risk of clinical venous thromboembolism (VTE) and the benefit of heparin prophylaxis. Accordingly, in 2012, the American College of Chest Physicians (ACCP) removed screening studies from the 9th edition of its Antithrombotic and Thrombolytic Therapy guideline (AT9), and downgraded recommendations. Involvement of authors of the 8th edition (AT8) was restricted due to financial and intellectual conflicts of interest...
2018: Thrombosis Journal
Eva Lehtonen, Harshadkumar Patel, Sierra Phillips, Martim Correia Pinto, Sameer Naranje, Ashish Shah
INTRODUCTION/AIM: Recent comparisons of suture versus metal staple skin closure on the rates of wound complications in orthopaedic surgeries have yielded conflicting results. Several studies have since started to approach this question based on anatomic location, comparing suture versus staple closure in total hip and knee arthroplasty and acetabulum fracture surgery. Ankle fractures are one of the most commonly treated fractures by orthopaedic surgeons with unique challenges to skin closure due to the lack of subcutaneous support...
August 22, 2018: Foot
Erin M Wright, Maude Theo Matthai, Chakra Budhathoki
INTRODUCTION: Professionally-related stress among midwives has been demonstrated in a global context to have deleterious effects on their professional, physical, and psychological health. Despite global interest in the subject, there has been no study about professional stress in a cohort of US midwives. METHODS: A convergent parallel mixed-methods design was used. The Job-Related Tension Index (JRTI) survey was administered to a self-selected sample of certified nurse-midwives and certified midwives in clinical practice in the United States via email solicitation of the American College of Nurse-Midwives' membership...
October 15, 2018: Journal of Midwifery & Women's Health
Liqiong Yao, Bei Liu, Li Jiang, Lanxia Zhou, Xiaoju Liu
OBJECTIVES: To investigate the association of cytotoxic T lymphocyte-associated antigen 4 (CTLA4) with immune thrombocytopenia (ITP). METHODS: A case-control association analysis of 277 Chinese Han children was performed. The tagging variants rs11571315 and rs3087243 in the CTLA4 gene were detected using polymerase chain reaction-restriction fragment length polymorphism method. The expression quantitative trait loci (eQTL) analysis and quantitative real-time polymerase chain reaction were performed to determine the relationship of CTLA4 with ITP...
October 14, 2018: Hematology (Amsterdam, Netherlands)
Christina W Cheng, Amy M Cizik, Armagan H C Dagal, Larissa Lewis, John Lynch, Carlo Bellabarba, Richard J Bransford, Haitao Zhou
BACKGROUND: Surgical site infection (SSI) following spine surgery is associated with increased morbidity, reoperation rates, hospital readmissions and cost. The incidence of SSI following posterior cervical spine surgery is higher than anterior cervical spine surgery, with rates from 4.5-18%. It is well documented that higher body mass index (BMI) is associated with increased risk of SSI after spine surgery. There are only a few studies that examine the correlation of BMI and SSI after posterior cervical instrumented fusion (PCIF) using national databases, however, none that compare trauma and non-traumatic patients...
October 10, 2018: Spine Journal: Official Journal of the North American Spine Society
Fergus Cameron, Bryanna Moore, Lynn Gillam
Families of children with diabetes increasingly obtain health information from a variety of sources. Doctor patient relationships have accordingly become more fluid and dynamic with input from other parties. These outside parties include representatives from the diabetes health care industry- industry third parties (ITP's). This review is an exploration of the ethical principles and cognitive processes involved when doctors and patients negotiate around health care practices and the role of ITP's in that dialogue...
October 12, 2018: Pediatric Diabetes
Feng Zhu, Chuling Li, Jianfeng Gong, Weiming Zhu, Lili Gu, Ning Li
BACKGROUND: Several studies have reported an increased prevalence of Parkinson disease (PD) amongst patients with inflammatory bowel disease (IBD) with conflicting results. We aimed to evaluate the risk of PD in the IBD population by conducting a meta-analysis (MA). METHODS: A systematic review with MA of the existing literature was conducted. The main outcome of interest was the incidence of developing PD in patients previously diagnosed with IBD. RESULTS: Four studies were included in this MA...
September 21, 2018: Digestive and Liver Disease
Jan M Stratil, Monika A Rieger, Susanne Voelter-Mahlknecht
BACKGROUND: In the German rehabilitation system, primary care physicians (PCPs), occupational health physicians (OPs), and rehabilitation physicians (RPs) fulfill different distinct functions and roles. While effective cooperation can improve outcomes of rehabilitation, the cooperation between these groups of stakeholders has been criticized as lacking or insufficient. This article proposes an approach to understand the low levels of cooperation by examining the role of group perception and group identity in intra-professional cooperation as a barrier to cooperation between physicians in different roles...
October 11, 2018: BMC Health Services Research
Georg Griesinger, Christophe Blockeel, Gennady T Sukhikh, Ameet Patki, Bharati Dhorepatil, Dong-Zi Yang, Zi-Jiang Chen, Elke Kahler, Claire Pexman-Fieth, Herman Tournaye
STUDY QUESTION: Is oral dydrogesterone 30 mg daily non-inferior to 8% micronized vaginal progesterone (MVP) gel 90 mg daily for luteal phase support in IVF? SUMMARY ANSWER: Oral dydrogesterone demonstrated non-inferiority to MVP gel for the presence of fetal heartbeats at 12 weeks of gestation (non-inferiority margin 10%). WHAT IS KNOWN ALREADY: The standard of care for luteal phase support in IVF is the use of MVP; however, it is associated with vaginal irritation, discharge and poor patient compliance...
October 10, 2018: Human Reproduction
Aimee Williams, Cathy Richardson, Jill McCready, Benjamin Anderson, Khalid Khalil, Sanna Tahir, Jay Nath, Adnan Sharif
OBJECTIVES: There are conflicting reports in the literature regarding outcomes after kidney transplant for patients of black ethnicity. To investigate further, we compared outcomes for black versus white kidney transplant recipients in a single UK transplant center. MATERIALS AND METHODS: We analyzed 1066 kidney transplant recipients (80 black patients, 986 white patients) within a single-center cohort (2007-2017) in the United Kingdom, with cumulative 4446 patient-year follow-up...
October 5, 2018: Experimental and Clinical Transplantation
Imke Reese, Christiane Schäfer, Jörg Kleine-Tebbe, Birgit Ahrens, Oliver Bachmann, Barbara Ballmer-Weber, Kirsten Beyer, Stephan C Bischoff, Katharina Blümchen, Sabine Dölle, Paul Enck, Axel Enninger, Isidor Huttegger, Sonja Lämmel, Lars Lange, Ute Lepp, Vera Mahler, Hubert Mönnikes, Johann Ockenga, Barbara Otto, Sabine Schnadt, Zsolt Szepfalusi, Regina Treudler, Anja Wassmann-Otto, Torsten Zuberbier, Thomas Werfel, Margitta Worm
Within the last decade, non-celiac gluten/wheat sensitivity (NCGS) has been increasingly discussed not only in the media but also among medical specialties. The existence and the possible triggers of NCGS are controversial. Three international expert meetings which proposed recommendations for NCGS were not independently organized and only partially transparent regarding potential conflicts of interest of the participants. The present position statement reflects the following aspects about NCGS from an allergist's and nutritionist's point of view: (A) Validated diagnostic criteria and/or reliable biomarkers are still required...
2018: Allergo Journal International
Maya Reddy, Fabricio da Silva Costa, Ben Mol
Research in obstetrics is notoriously challenging. Obstetrics deals with mothers and babies, two patients at the same time who are both vulnerable but sometimes have conflicting interests. Fortunately, at least in high resourced settings, the incidence of poor outcomes is low. However, this creates a challenge for researchers, as to show differences studies, require large sample sizes that are often unachievable by a single centre. As a result, collaboration between researchers is essential. This article is protected by copyright...
October 4, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
James H Lubowitz, Jefferson C Brand, Michael J Rossi
As an editorial policy, medical device and pharmaceutical industry employees are generally permitted to publish original scientific research in Arthroscopy journal but are not permitted to publish systematic reviews. All authors complete the International Committee of Medical Journal Editors Form for Disclosure of Potential Conflicts of Interest, which are thoughtfully considered by our reviewers and editors and readers. In accord with the American Academy of Orthopaedic Surgeons, we believe that "manufacturers of medical devices, biologics, drugs, and other items use(d) in the care of the patient…play an important role in…the development of new technologies...
October 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
F Lotti, G Corona, A Cocci, S Cipriani, E Baldi, S Degl'Innocenti, P N Franco, M Gacci, M Maggi
STUDY QUESTION: When is the investigation and treatment of midline prostatic cysts (MPC) of clinical value in the work-up of males of infertile couples? SUMMARY ANSWER: With a prevalence of 10.2% in infertile men, MPC should be investigated according to a seminal algorithm detecting a MPC volume >0.117 ml, which may impair semen parameters, and could be treated to improve sperm count and achieve natural pregnancy. WHAT IS KNOWN ALREADY: MPC are frequent and are considered a correctable cause of male infertility...
October 4, 2018: Human Reproduction
Johannes Hauswaldt, Valérie Kempter, Wolfgang Himmel, Eva Hummers
BACKGROUND: Routinely recorded data from everyday ambulatory medical care are urgently needed for health services and systems research, but this faces major limitations in Germany. In 2018, European General Data Protection Regulation (GDPR) and new German Federal Data Protection Act (FDPA) become effective. Via simulated real-life scenarios it may be possible to find out if access to and utilization of routine data for research becomes easier or faces additional obstacles. METHODS: General practitioners, information scientists, data trustees and privacy protection experts create concepts, processes and standards for lawful handling of routinely recorded data for secondary research and study their feasibility in 2 scenarios (anonymous and pseudonymous data utilization)...
October 1, 2018: Das Gesundheitswesen
Jing Li
Understanding physicians' decisions when faced with conflicts between their own financial self-interest and patients' economic or health interests is of key importance in health economics and policy. This issue is especially salient in certain medical specialties where less altruistic behavior of physicians can yield significant financial gains. This study examines experimentally measured altruistic preferences of medical students from schools around the U.S., and whether these preferences predict those students' expected medical specialty choice...
September 22, 2018: Journal of Health Economics
Martin Jakobs, Jessica Jesser, Tobias Albrecht, Antje Wick, Andreas Unterberg, Rezvan Ahmadi
INTRODUCTION: Sphenopalatine ganglion stimulation (SPG-S) is an invasive form of neuromodulation by which a neurostimulator is implanted into the pterygopalatine fossa to treat refractory chronic cluster headache. The implant is MRI conditional, up to 3 T, however there is no clinical data on the shape, size, and location of the artifact produced by the implant. MATERIALS AND METHODS: Records of patients with SPG-S were analyzed for postoperative cranial MRI scans...
September 30, 2018: Neuromodulation: Journal of the International Neuromodulation Society
Anne-Mette Hvas, Søs Neergaard-Petersen
Regular exercise may reduce the risk of major cardiovascular thrombotic events. However, previous studies suggest that the risk of myocardial infarction or primary cardiac arrest is transiently increased during exercise. Thus, on the one hand, exercise seems to be able to protect against cardiovascular disease, but on the other hand, it seems to provoke sudden cardiac death. As platelets play a key role in arterial thromboembolic disease, the effect of exercise on platelet function is of special interest. This systematic review summarizes the evidence of the influence of exercise on platelet function in patients with coronary artery disease, angina pectoris, hypertension, or peripheral arterial disease...
September 28, 2018: Seminars in Thrombosis and Hemostasis
Luke Gelinas, Joel S Weissman, Holly Fernandez Lynch, Avni Gupta, Ronen Rozenblum, Emily A Largent, I Glenn Cohen
A key aim of patient-centered outcomes research (PCOR) is to generate data that are important to patients by deliberately and extensively involving them in all aspects of research, from design to dissemination. However, certain elements of PCOR raise challenging and potentially novel ethical and regulatory issues for institutional review boards and oversight bodies. These challenges stem primarily from the engagement of patients in roles other than research subject, such as advisors, study personnel, and co-investigators, which gives rise to questions about appropriate levels of protection, training, and education, as well as identifying and managing conflicts of interest...
October 16, 2018: Annals of Internal Medicine
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