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Clinical ethics evaluation

R Schwarz, N M Bongers, C Hinterleitner, H Ditt, K Nikolaou, J Fritz, H Bösmüller, M Horger
Purpose: To compare the diagnostic performance of frequency-selective non-linear blending and conventional linear blending contrast-enhanced CT for the diagnosis of acute (AC) and gangrenous (GC) cholecystitis. Materials and methods: Following local ethics committee approval for retrospective data analysis, a database search derived 39 patients (26 men, mean age 67.8 ± 14.6 years) with clinical signs of acute cholecystitis, contrast enhanced CT (CECT) evaluation, cholecystectomy, and pathological examination of the resected specimen...
2018: European Journal of Radiology Open
David J Wright, Richard J Adams, Jeanette Blacklock, Sarah A Corlett, Rebecca Harmston, Margaret McWilliams, Stephen-Andrew Whyte, Gail Fleming
Purpose: To describe the most effective model for managing, educating, and training pharmacist advanced clinical practitioners (ACPs) in the urgent care center (UCC) setting, role evolution and how to measure their effectiveness. Participants and methods: Ethical approval was obtained to perform a qualitative longitudinal cohort study in three sites, with three pharmacists in each trained as ACPs from 2016 to 2017. ACP role, location, management, mentorship, and supervision were locally determined...
2018: Integrated Pharmacy Research and Practice
Saurab Sharma, Mark P Jensen, G Lorimer Moseley, J Haxby Abbott
INTRODUCTION: Low back pain (LBP) is the leading cause of years lived with disability in Nepal and elsewhere. Management of LBP that is evidence-based, easily accessible, cost-effective and culturally appropriate is desirable. The primary aim of this feasibility study is to determine if it is feasible to conduct a full randomised clinical trial evaluating the effectiveness of pain education as an intervention for individuals with LBP in Nepal, relative to guideline-based physiotherapy treatment...
August 10, 2018: BMJ Open
Noreen Fallon, Irene Cassidy, Owen Doody
AIM AND OBJECTIVES: The aim of this study was to explore respiratory clinical nurse specialists' (CNSs') experiences of their role. BACKGROUND: Respiratory illnesses are currently 1 of the top 3 causes of mortality resulting in 1 in 5 deaths and are associated with significant human burden. Respiratory CNSs play a vital role in the management of respiratory disease through supporting improvements in quality of life, reduction of exacerbations, and subsequent hospital admission...
September 2018: Clinical Nurse Specialist CNS
Giancarlo Iannelli, Rocchina Caivano, Antonio Villonio, Vittorio Semeraro, Nicola Maria Lucarelli, Maria Porzia Ganimede, Vito Gisone, Giuseppina Dinardo, Sante Bruno, Luca Macarini, Giuseppe Guglielmi, Aldo Cammarota
OBJECTIVE: To evaluate the effectiveness of a virtual CT-guided navigation system (Sirio-MASMEC Biomed) in performing lung biopsies, with greater attention to lesions smaller than 1 cm, compared to the traditional procedure. METHODS: This study was approved by the Ethics Committee of our Institute. Two hundred patients were prospectively selected. Of these, 100 were subjected to percutaneous procedure with the use of Sirio and 100 to traditional CT-guided percutaneous procedure...
August 10, 2018: Cancer Investigation
Anne Marie Sowerbutts, Simon Lal, Jana Sremanakova, Andrew Clamp, Chris Todd, Gordon C Jayson, Antje Teubner, Anne-Marie Raftery, Eileen J Sutton, Lisa Hardy, Sorrel Burden
BACKGROUND: People with advanced ovarian or gastrointestinal cancer may develop malignant bowel obstruction (MBO). They are able to tolerate limited, if any, oral or enteral (via a tube directly into the gut) nutrition. Parenteral nutrition (PN) is the provision of macronutrients, micronutrients, electrolytes and fluid infused as an intravenous solution and provides a method for these people to receive nutrients. There are clinical and ethical arguments for and against the administration of PN to people receiving palliative care...
August 10, 2018: Cochrane Database of Systematic Reviews
Tiago Lemos Cerqueira, Armando Fartolino Guerrero, Clara Krystal Pérez Fermin, Ricardo Wang, Evelin Elfriede Balbino, Janis L Breeze, Paola Gonzalez Mego, Daniele Argentina Silva, Walid Ezzeldin Omer, Nathalie Monique Vandevelde
BACKGROUND: End-stage renal disease (ESRD) is the last stage of chronic kidney disease, mainly caused by type 2 diabetes mellitus and characterized by an increased mortality risk related to cardiovascular disease. Low-dose aspirin (acetylsalicylic acid or ASA) seems to effectively prevent cardiovascular events in patients with ESRD. However, the number of interventional studies in this population remains limited and the mechanisms of aspirin-related bleeding remain poorly understood. Aspirin's efficacy and safety may be modified by the presence of type 2 diabetes mellitus or platelet hyperreactivity...
August 9, 2018: JMIR Research Protocols
Ergun Alma, Hakan Ercil, Alper Eken, Mehmet Eflatun Deniz, Erbay Tumer, Fatma Yasemin Oksuzler, Zafer Gokhan Gurbuz
OBJECTIVE: To evaluate the feasibility and renoprotective effect of off-clamp partial nephrectomy (PN) by renal scoring systems. METHODS: After approval of the local ethics committee, the radiological and clinical data of patients with renal masses who underwent PN between January 2012 and January 2017 were evaluated in two university hospitals. Total 132 patients who underwent open surgery and off-clamp technique were included. All patients underwent contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI) preoperatively...
August 6, 2018: Asian Journal of Surgery
Rita C Silveira, Eliane Wagner Mendes, Rubia Nascimento Fuentefria, Nadia Cristina Valentini, Renato S Procianoy
BACKGROUND: Preterm infants are high risk for delayed neurodevelopment. The main goal is to develop a program of early intervention for very preterm infants that allows families to apply it continuously at home, and quantify the results of early parental stimulation on improvement of cognition and motor skills. METHODS: Randomized clinical Trial including inborn preterm infants with gestational age less than 32 weeks or birth weight less than 1500 g at 48 h after birth...
August 9, 2018: BMC Pediatrics
Pascal Pujol, Pierre Vande Perre, Laurence Faivre, Damien Sanlaville, Carole Corsini, Bernard Baertschi, Michèle Anahory, Dominique Vaur, Sylviane Olschwang, Nadem Soufir, Noëlle Bastide, Sarah Amar, Michèle Vintraud, Olivier Ingster, Stéphane Richard, Pierre Le Coz, Jean-Philippe Spano, Olivier Caron, Pascal Hammel, Elisabeth Luporsi, Alain Toledano, Xavier Rebillard, Anne Cambon-Thomsen, Olivier Putois, Jean-Marc Rey, Christian Hervé, Caroline Zorn, Karen Baudry, Virginie Galibert, Joseph Gligorov, David Azria, Brigitte Bressac-de Paillerets, Nelly Burnichon, Marc Spielmann, Daniel Zarca, Isabelle Coupier, Olivier Cussenot, Anne-Paule Gimenez-Roqueplo, Sophie Giraud, Anne-Sophie Lapointe, Patricia Niccoli, Isabelle Raingeard, Muriel Le Bidan, Thierry Frebourg, Arash Rafii, David Geneviève
In oncology, the expanding use of multi-gene panels to explore familial cancer predisposition and tumor genome analysis has led to increased secondary findings discoveries (SFs) and has given rise to important medical, ethical, and legal issues. The American College of Medical Genetics and Genomics published a policy statement for managing SFs for a list of genes, including 25 cancer-related genes. Currently, there are few recommendations in Europe. From June 2016 to May 2017, the French Society of Predictive and Personalized Medicine (SFMPP) established a working group of 47 experts to elaborate guidelines for managing information given on the SFs for genes related to cancers...
August 8, 2018: European Journal of Human Genetics: EJHG
Kenji Sugiyama, Takao Nozaki, Tetsuya Asakawa, Tetsuro Sameshima, Schinichiro Koizumi, Hisaya Hiramatsu, Hiroki Namba
Deep brain stimulation (DBS) is used to treat symptoms by modulating the cortico-striato-thalamo-cortical (CSTC) loop in the central nervous system (CNS), and attempts to research loop circuit disorders have been globally initiated among the intractable neurological and psychiatric disorders. DBS treatment has been evaluated for all these newly found CNS loop circuit disorders. In 2011, neurosurgical treatments for psychiatric disorders were renamed from "psychosurgery" to "neurosurgery for psychiatric disorders (NPD)" by the World Society for Stereotactic and Functional Neurosurgery (WSSFN)...
August 9, 2018: Neurologia Medico-chirurgica
Ivy van Dijke, Lance Bosch, Annelien L Bredenoord, Martina Cornel, Sjoerd Repping, Saskia Hendriks
STUDY QUESTION: What are the reasons for or against the future clinical application of germline genome modification (GGM)? SUMMARY ANSWER: A total of 169 reasons were identified, including 90 reasons for and 79 reasons against future clinical application of GGM. WHAT IS KNOWN ALREADY: GGM is still unsafe and insufficiently effective for clinical purposes. However, the progress made using Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR)- CRISPR-associated system (Cas) has led scientists to expect to overcome the technical hurdles in the foreseeable future...
August 6, 2018: Human Reproduction
Ruth Kb Mome, Alison B Wiyeh, Eugene J Kongnyuy, Charles Shey Wiysonge
INTRODUCTION: The HIV pandemic continues to evolve with young women being the most vulnerable group to acquire infection. The presence of sexually transmitted infections (STIs) further enhances HIV susceptibility and also leads to long-term complications such as infertility and cervical cancer. The female condom is a self-initiated method for STI and HIV prevention but there are controversies on its effects. We aim to assess the effectiveness, safety and acceptability of the use of female condoms for prevention of STI and HIV acquisition among women...
August 5, 2018: BMJ Open
Jelmer R Prins, Floor Holvast, Janneke van 't Hooft, Arend F Bos, Jan Willem Ganzevoort, Sicco A Scherjon, Sarah A Robertson, Sanne J Gordijn
INTRODUCTION: To establish pregnancy, the maternal immune system must adapt to tolerate the semiallogenic fetus. Less than optimal adaptation of the maternal immune system during (early) pregnancy is implicated in several complications of pregnancy. The development of effective immune modulation interventions as preventive or therapeutic strategies for pregnancy complications holds promise. Several studies sought to evaluate the safety and effectiveness of various approaches. However, a limitation is the high variability in clinical and immune outcomes that are reported...
August 5, 2018: BMJ Open
R Montag, W Dietz, S Nietzsche, T Lang, K Weich, B W Sigusch, P Gaengler
Prospective clinical studies of composite restorations revealed their safety and longevity; however, studies did not elucidate the dynamic mechanisms of deterioration caused by fractures and secondary caries. Therefore, the aims of this 29-y controlled study were 1) to follow up on the clinical behavior of posterior composite restorations annually and 2) to compare clinical outcomes with micromorphologic scanning electron microscopy features. After ethical approval, the single-arm study commenced in 1987 with 194 class I or II primary posterior composite restorations with glass ionomer cement providing pulp protection...
August 1, 2018: Journal of Dental Research
Thiago Rozales Ramis, Carlos Henrique de Lemos Muller, Francesco Pinto Boeno, Bruno Costa Teixeira, Anderson Rech, Marcelo Gava Pompermayer, Niara da Silva Medeiros, Álvaro Reischak de Oliveira, Ronei Silveira Pinto, Jerri Luiz Ribeiro
Ramis, TR, Muller, CHdL, Boeno, FP, Teixeira, BC, Rech, A, Pompermayer, MG, Medeiros, NdS, Oliveira, ÁRd, Pinto, RS, and Ribeiro, JL. Effects of traditional and vascular restricted strength training program with equalized volume on isometric and dynamic strength, muscle thickness, electromyographic activity, and endothelial function adaptations in young adults. J Strength Cond Res XX(X): 000-000, 2018-The purpose of the study was to evaluate and compare the acute and chronic effects of partial vascular occlusion training in young, physically active adults...
July 30, 2018: Journal of Strength and Conditioning Research
Briana Lees, Louise Mewton, Lexine Stapinski, Lindsay M Squeglia, Caroline Rae, Maree Teesson
INTRODUCTION: Binge drinking is the most common pattern of alcohol use among young people in Western countries. Adolescence and young adulthood is a vulnerable developmental period and binge drinking during this time has a higher potential for neurotoxicity and interference with ongoing neural and cognitive development. The purpose of this systematic review will be to assess and integrate evidence of the impact of binge drinking on cognition, brain structure and function in youth aged 10-24 years...
July 30, 2018: BMJ Open
Junpei Komagamine, Kenichi Sugawara, Miho Kaminaga, Shinpei Tatsumi
INTRODUCTION: Given that polypharmacy and potentially inappropriate prescribing are common in elderly orthopaedic patients, pharmacist interventions to improve medication practices among this population are important. However, past studies have reported mixed results regarding the effectiveness of pharmacist-led interventions in inpatient elderly care. Furthermore, few randomised controlled trials have evaluated patient-relevant outcomes as a primary endpoint. Therefore, we will evaluate whether a pharmacist-led intervention could reduce readmission of hospitalised elderly orthopaedic patients with polypharmacy or potentially inappropriate prescribing...
July 30, 2018: BMJ Open
Lesley M McGregor, Robert S Kerrison, Trish Green, Una Macleod, Mark Hughes, Monica Gibbins, Stephen Morris, Colin Rees, Christian von Wagner
INTRODUCTION: Evidence suggests bowel scope screening (BSS) can significantly reduce an individual's risk of developing colorectal cancer (CRC). BSS for 55 year olds was therefore introduced to the English Bowel Cancer Screening Programme (BCSP) in 2013. However, the benefits are only gained from test completion and uptake is low (43%). Primary care involvement has consistently shown benefits to cancer screening uptake and so this study aims to build on this knowledge and evaluate general practitioner (GP) practice led interventions designed to increase BSS attendance...
July 28, 2018: BMJ Open
Cristina Bayón, Teresa Martín-Lorenzo, Beatriz Moral-Saiz, Óscar Ramírez, Álvaro Pérez-Somarriba, Sergio Lerma-Lara, Ignacio Martínez, Eduardo Rocon
BACKGROUND: The use of robotic trainers has increased with the aim of improving gait function in patients with limitations. Nevertheless, there is an absence of studies that deeply describe detailed guidelines of how to correctly implement robot-based treatments for gait rehabilitation. This contribution proposes an accurate robot-based training program for gait rehabilitation of pediatric population with Cerebral Palsy (CP). METHODS: The program is focused on the achievement of some specifications defined by the International Classification of Functioning, Disability and Health framework, Children and Youth version (ICF-CY)...
July 27, 2018: Journal of Neuroengineering and Rehabilitation
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