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https://www.readbyqxmd.com/read/29337086/incidental-pulmonary-nodules-are-common-on-ct-coronary-angiogram-and-have-a-significant-cost-impact
#1
James Robertson, Sandra Nicholls, Philip Bardin, Ronnie Ptasznik, Daniel Steinfort, Alistair Miller
BACKGROUND: Computed tomography (CT) coronary angiogram (CTCA) is commonly used for diagnostic evaluation of low-moderate risk patients due to its excellent performance and cost-effectiveness. However, previous cost analyses have not factored in the burden of management of pulmonary nodules, which are a common occurrence. We sought to describe the frequency and characteristics of lung nodules on CTCA in an Australian tertiary hospital, and to assess cost impacts. METHODS: Consecutive CTCAs performed in the calendar year 2012 were retrospectively identified from the imaging department database...
December 5, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29330838/the-potential-impact-of-multidimesional-geriatric-assessment-in-the-social-security-system
#2
Graziamaria Corbi, Immacolata Ambrosino, Marco Massari, Onofrio De Lucia, Sirio Simplicio, Michele Dragone, Giuseppe Paolisso, Massimo Piccioni, Nicola Ferrara, Carlo Pietro Campobasso
AIM: To evaluate the efficacy of multidimensional geriatric assessment (MGA/CGA) in patients over 65 years old in predicting the release of the accompaniment allowance (AA) indemnity by a Local Medico-Legal Committee (MLC-NHS) and by the National Institute of Social Security Committee (MLC-INPS). METHODS: In a longitudinal observational study, 200 Italian elder citizens requesting AA were first evaluated by MLC-NHS and later by MLC-INPS. Only MLC-INPS performed a MGA/CGA (including SPMSQ, Barthel Index, GDS-SF, and CIRS)...
January 12, 2018: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/29322905/pre-discharge-postoperative-radiographs-after-primary-total-knee-replacement-tradition-or-science
#3
S N Sambandam, V Khanna, G Rohinikumar, V Mounasamy
Consistent evidence exists on the inutility of immediate postoperative radiographs after a total knee replacement (TKR). We hypothesized that eliminating the pre-discharge film would not have any effect on the postoperative patient outcomes. Retrospective analysis of prospectively collected data was performed on 220 knees. Patients undergoing a simple primary TKR operated by 2 surgeons (Surgeon A and B) from January 2013 to July 2015 were divided into 2 groups (Groups 1 and 2 having 112 and 108 knees respectively)...
March 2017: Acta Orthopaedica Belgica
https://www.readbyqxmd.com/read/29319407/malpractice-litigation-in-acute-stroke-care-where-are-we-now
#4
Gilberto Kk Leung, Gerard Porter
Acute stroke care has undergone momentous changes in recent years with the introduction of intravenous thrombolysis, mechanical thrombectomy and integrated stroke services. While these are welcome developments, they also carry unique medico-legal challenges. In 2015, a patient from Greater Manchester was awarded over £1 million in compensation after ambulance paramedics failed to admit her to a specialist unit. This paper explores the medico-legal implications of this first but over looked thrombolysis-related claim in the United Kingdom...
January 1, 2018: Medico-legal Journal
https://www.readbyqxmd.com/read/29310023/some-inconsistencies-in-demirjian-s-method
#5
Giuseppe Quaremba, Claudio Buccelli, Vincenzo Graziano, Alberto Laino, Luigi Laino, Mariano Paternoster, Pierpaolo Petrone
Nowadays, given the massive migration movements toward and across EU countries, age assessment can be highly useful for estimating the real age of asylum seekers or in medico-legal assessments of age-disputed children charged with criminal acts. Demirjian et al.'s dental maturity score is currently a dental scoring system universally adopted for age assessment of unidentified children. Here we explore the biological compatibility of Demirjian's scores with respect to the estimation of certain chronological ages of forensic interest through an algorithm based on the theory of constrained graphs integrated with combinatory analysis...
December 21, 2017: Forensic Science International
https://www.readbyqxmd.com/read/29309773/study-of-measurement-of-the-alcohol-biomarker-phosphatidylethanol-peth-in-dried-blood-spot-dbs-samples-and-application-of-a-volumetric-dbs-device
#6
Olof Beck, Naama Kenan Modén, Sabina Seferaj, Gabriel Lenk, Anders Helander
Phosphatidylethanol (PEth) is a group of phospholipids formed in cell membranes following alcohol consumption. PEth measurement in whole blood samples is established as a specific alcohol biomarker with clinical and medico-legal applications. This study further evaluated the usefulness of dried blood spot (DBS) samples collected on filter paper for PEth measurement. Specimens used were surplus volumes of venous whole blood sent for routine LC-MS/MS quantification of PEth 16:0/18:1, the major PEth homolog. DBS samples were prepared by pipetting blood on Whatman 903 Protein Saver Cards and onto a volumetric DBS device (Capitainer)...
January 5, 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/29303893/failure-of-invasive-airway-placement-and-correlated-severe-complications-dealing-with-inappropriate-training-and-related-medico-legal-issues
#7
Giuseppe A Marraro, Riccardo Zoja, Sara Del Sordo
No abstract text is available yet for this article.
January 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29302514/searching-cause-of-death-through-different-autopsy-methods-a-new-initiative
#8
REVIEW
Abhishek Das, Ranadip Chowdhury
A lawful disposal of human dead body is only possible after establishment of proper and valid cause of death. If the cause is obscure, autopsy is the only mean of search. Inadequacy and unavailability of health care facility often makes this situation more complicated in developing countries where many deaths remain unexplained and proper mortality statistics is missing, especially for infant and children. Tissue sampling by needle autopsy or use of various imaging technique in virtopsy have been tried globally to find out an easier alternative...
April 2017: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/29301113/factors-associated-with-trace-evidence-analyses-and-dna-findings-among-police-reported-cases-of-rape
#9
Camilla Forr, Berit Schei, Lise Eilin Stene, Kari Ormstad, Cecilie Therese Hagemann
OBJECTIVE: The aim of this study was to examine the association between victim, suspect and assault characteristics and (1) forensic analysis of trace evidence, (2) detection of spermatozoa and (3) DNA match in police-reported cases of rape/attempted rape. In addition, we explored whether DNA findings were associated with legal outcome. METHODS: We conducted a retrospective, descriptive study based on police-reported rapes and attempted rapes of women  ≥16 years of age in Sør-Trøndelag Police District throughout 1997-2010...
December 20, 2017: Forensic Science International
https://www.readbyqxmd.com/read/29299947/an-unusual-case-of-suicidal-double-ligature-strangulation
#10
Gian Luca Marella, Enrico De Dominicis, Giovanni Arcudi, Saverio Potenza, Silvestro Mauriello, Filippo Milano, Alessandro Feola, Luigi T Marsella
As suicide by ligature strangulation is rare, the correct medico-legal diagnosis may be difficult to establish if there is no clear supporting circumstantial evidence. We report an unusual case of suicide by strangulation with a double ligature. Investigation of the scene of death and pathological findings at autopsy are reported and discussed. We emphasise the importance of an external examination and an on-the-spot investigation.
January 1, 2018: Medico-legal Journal
https://www.readbyqxmd.com/read/29283002/twenty-three-years-1993-2015-of-homicide-trends-in-the-transkei-region-of-south-africa
#11
Meel Banwari
Background Transkei is regarded as a rural part of South Africa. It was one of the black homelands where rigorous apartheid was practised. The incidence of firearm-related deaths used to be very high, but after the implementation of the Firearm Control Act in 2002, the trend changed. However, the murder rate is still a major public-health problem in this region of South Africa. Objective The aim of this study was to investigate 23 years (1993-2015) of homicide trends in the Transkei region of South Africa. Method A review of records of medico-legal autopsies performed at Mthatha Forensic Pathology Laboratory from 1993 to 2015 was undertaken...
January 1, 2017: Medicine, Science, and the Law
https://www.readbyqxmd.com/read/29258637/mandibular-implant-overdentures-treatment-and-medico-legal-considerations
#12
Charlotte Stilwell
The concept of a two-implant overdenture as the minimum standard of care or first choice treatment for the edentulous mandible was first proposed in 2002 and has since been backed by an overwhelming body of evidence supporting greater patient satisfaction and improved quality of life. This article examines the implant overdenture concept and its various options and discusses best practice from both the patient's and a medico-legal standpoint.
December 1, 2017: Primary Dental Journal
https://www.readbyqxmd.com/read/29229823/sex-determination-of-human-remains-from-peptides-in-tooth-enamel
#13
Nicolas Andre Stewart, Raquel Fernanda Gerlach, Rebecca L Gowland, Kurt J Gron, Janet Montgomery
The assignment of biological sex to archaeological human skeletons is a fundamental requirement for the reconstruction of the human past. It is conventionally and routinely performed on adults using metric analysis and morphological traits arising from postpubertal sexual dimorphism. A maximum accuracy of ∼95% is possible if both the cranium and os coxae are present and intact, but this is seldom achievable for all skeletons. Furthermore, for infants and juveniles, there are no reliable morphological methods for sex determination without resorting to DNA analysis, which requires good DNA survival and is time-consuming...
December 11, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/29228447/ethical-and-medico-legal-remarks-on-uterus-transplantation-may-it-solve-uterine-factor-infertility
#14
S Zaami, E Marinelli, N M di Luca, G Montanari Vergallo
Uterus transplantation was firstly tested with animal trials sixty-five years ago. Despite several successful attempts in human subjects, the different procedures still lay at the experimental stage, in need of further studies and investigations before they can be considered as standard clinical practices. Uterus transplant cannot be regarded as a life-saving procedure, but rather a method to restore woman ability to procreate, when lost, thus improving her quality of life. Uterus transplant is a complex surgical procedure and presents significant health threats...
November 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29216493/intimate-partner-violence-against-women-circumstances-of-aggressions-and-oral-maxillofacial-traumas-a-medical-legal-and-forensic-approach
#15
Ítalo de Macedo Bernardino, Luzia Michelle Santos, Alysson Vinicius Porto Ferreira, Tomás Lucio Marques de Almeida Lima, Lorena Marques da Nóbrega, Sérgio d'Avila
INTRODUCTION: Intimate partner violence (IPV) is a serious public health problem that frequently results in oral-maxillofacial traumas, generating high social and economic costs. The aim of this study was to describe the profile of women victims of IPV and determine the pattern of oral-maxillofacial traumas, according to a medical-legal and forensic perspective. An exploratory study of 1361 suspected cases of women victims of IPV was carried out based on database of an Institute of Legal Medicine and Forensic Dentistry of Northeastern Brazil during a period of 4 years...
December 4, 2017: Legal Medicine
https://www.readbyqxmd.com/read/29205147/medico-legal-aspects-on-neuromonitoring-in-thyroid-surgery-informed-consent-on-malpractice-claims
#16
R Demontis, M R Pittau, A Maturo, P Petruzzo, G Calò
AIM: The purpose of this paper is to provide a forensic profile framework of neuromonitoring in thyroid surgery, regarding the information given to the patient and its classification as part of professional liability in the event of recurrent injury. METHOD: Evaluation and reflections on the required behaviour of the surgeon on providing details on the operation before the informed consent is given and to outline the possible legal implications regarding professional liability as a result of recurrent injury...
May 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29200309/survival-and-mortality-following-tbi
#17
Zeev Groswasser, Israela Peled
OBJECTIVES: Evaluation of life expectancy (LE) post traumatic brain injury (TBI) is important for planning services for patients and for dealing with medico-legal aspects. We hypothesized that LE for patients who survived 2 years post injury is equal to that of the general population (GP). METHODS: A cohort of 279 patients was assembled during a 5-year period and was followed for 22-27 years. During follow-up, 32 patients (11.5%) died, creating a huge censored data (88...
December 4, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/29193265/substance-use-disorder-and-compulsory-commitment-to-care-a-care-ethical-decision-making-framework
#18
Marie Nicolini, Joris Vandenberghe, Chris Gastmans
In the era of deinstitutionalisation of psychiatric patients, steady or even increasing rates of compulsory commitment to care (CCC) are an intriguing phenomenon to analyse. From a clinical, legal and ethical perspective, CCC continues to be a controversial practice in psychiatry, and perhaps even more so when applied to patients with severe substance use disorder (SUD). Several reasons make it controversial. The lack of consensus about the benefits of CCC and professional disagreement about what mental illness and autonomy mean in the case of SUD make it difficult to apply ethically sound clinical decision-making in CCC...
November 29, 2017: Scandinavian Journal of Caring Sciences
https://www.readbyqxmd.com/read/29191702/association-of-initial-recorded-rhythm-and-underlying-cardiac-disease-in-sudden-cardiac-arrest
#19
Janna P Kauppila, Antti Hantula, Marja-Leena Kortelainen, Lasse Pakanen, Juha Perkiömäki, Matti Martikainen, Heikki V Huikuri, M Juhani Junttila
BACKGROUND: Asystole (ASY) and pulseless electrical activity (PEA) are increasing and ventricular fibrillation (VF) or ventricular tachycardia (VT) declining as presenting rhythms of sudden cardiac arrest (SCA). Since there is limited information on possible differences in the etiology of underlying structural heart disease, we analyzed the clinical and/or autopsy findings of victims with ASY, PEA or VT/VF. METHODS: All SCA cases with recorded ASY, PEA or VT/VF occurring after onset of witnessed collapse were analyzed by the emergency personnel between the years 2007-2012 within the Oulu University Hospital area...
January 2018: Resuscitation
https://www.readbyqxmd.com/read/29187190/ethical-considerations-in-forensic-genetics-research-on-tissue-samples-collected-post-mortem-in-cape-town-south-africa
#20
Laura J Heathfield, Sairita Maistry, Lorna J Martin, Raj Ramesar, Jantina de Vries
BACKGROUND: The use of tissue collected at a forensic post-mortem for forensic genetics research purposes remains of ethical concern as the process involves obtaining informed consent from grieving family members. Two forensic genetics research studies using tissue collected from a forensic post-mortem were recently initiated at our institution and were the first of their kind to be conducted in Cape Town, South Africa. MAIN BODY: This article discusses some of the ethical challenges that were encountered in these research projects...
November 29, 2017: BMC Medical Ethics
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