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https://www.readbyqxmd.com/read/29756697/consents-or-waivers-of-responsibility-parents-information-in-nicu
#1
Carlo V Bellieni, Caterina Coradeschi, Maria R Curcio, Elisa Grande, Giuseppe Buonocore
BACKGROUND: Informing the patient is a base of modern medicine; nonetheless, a great discrepancy exists between hospitals on the way this information should be administered. This is particularly important when the patient are babies: the information should be given to their parents who should approve or disapprove the treatment. Aim of this study is to assess the adequacy of the information administered to the parents of babies admitted into the Neonatal Intensive Care Units. METHODS: We analyzed the consent forms of center-north Italy NICUs...
May 14, 2018: Minerva Pediatrica
https://www.readbyqxmd.com/read/29679443/a-20-year-review-the-use-of-exception-from-informed-consent-and-waiver-of-informed-consent-in-emergency-research
#2
Lauren Klein, Johanna Moore, Michelle Biros
BACKGROUND: Due to the acuity and time sensitive needs of their clinical condition, patients presenting with certain emergent pathologies may lack capacity to provide meaningful prospective informed consent to participate in clinical research. For these reasons, these populations have often been excluded from research investigations. To mitigate this, regulations allowing Exception from Informed Consent (EFIC) (21 CFR 50.24) or Waiver of Informed Consent (WIC) (45 CFR 46.101) were developed in 1996...
April 21, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29678969/reducing-the-default-dispense-quantity-for-new-opioid-analgesic-prescriptions-study-protocol-for-a-cluster-randomised-controlled-trial
#3
Marcus A Bachhuber, Denis Nash, William N Southern, Moonseong Heo, Matthew Berger, Mark Schepis, Chinazo O Cunningham
INTRODUCTION: As opioid analgesic consumption has grown, so have opioid use disorder and opioid-related overdoses. Reducing the quantity of opioid analgesics prescribed for acute non-cancer pain can potentially reduce risks to the individual receiving the prescription and to others who might unintentionally or intentionally consume any leftover tablets. Reducing the default dispense quantity for new opioid analgesic prescriptions in the electronic health record (EHR) is a promising intervention to reduce prescribing...
April 20, 2018: BMJ Open
https://www.readbyqxmd.com/read/29674365/protocol-of-a-multicenter-international-randomized-controlled-manikin-study-on-different-protocols-of-cardiopulmonary-resuscitation-for-laypeople-mani-cpr
#4
Enrico Baldi, Enrico Contri, Roman Burkart, Paola Borrelli, Ottavia Eleonora Ferraro, Michela Tonani, Amedeo Cutuli, Daniele Bertaia, Pasquale Iozzo, Caroline Tinguely, Daniel Lopez, Susi Boldarin, Claudio Deiuri, Sandrine Dénéréaz, Yves Dénéréaz, Michael Terrapon, Christian Tami, Cinzia Cereda, Alberto Somaschini, Stefano Cornara, Andrea Cortegiani
INTRODUCTION: Out-of-hospital cardiac arrest is one of the leading causes of death in industrialised countries. Survival depends on prompt identification of cardiac arrest and on the quality and timing of cardiopulmonary resuscitation (CPR) and defibrillation. For laypeople, there has been a growing interest on hands-only CPR, meaning continuous chest compression without interruption to perform ventilations. It has been demonstrated that intentional interruptions in hands-only CPR can increase its quality...
April 19, 2018: BMJ Open
https://www.readbyqxmd.com/read/29660051/resection-of-right-frontal-arteriovenous-malformation-3-dimensional-operative-video
#5
William T Couldwell
The video demonstrates resection of a Grade II Spetzler-Martin unruptured, medium-sized arteriovenous malformation (AVM). A young woman presented with headaches and seizures. The right frontal lesion measured 4.5 cm in largest dimension and had superficial venous drainage. Partial Onyx embolization, primarily of the anterior cerebral feeding arteries, was performed. Bone removal for exposure allowed identification of indentation from the large superficial draining vein. The video demonstrates careful microsurgical dissection on the AVM/brain interface, with selective interruption of feeding arteries circumferentially...
April 11, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29621880/let-archived-paraffin-blocks-be-utilized-for-research-with-waiver-of-informed-consent
#6
Yong-Jin Kim, Jeong Sik Park, Karam Ko, Chang Rok Jeong
Advances in biomedical and genetic research have contributed to more effective public health improvement via bench to bed research and the emergence of personalized medicine. This has certainly showcased the importance of archived human tissues, especially paraffin-embedded blocks in pathology. Currently in Korea, undue legislative regulations of the Bioethics and Safety Act suspend and at times discourage studies from taking place. In this paper, the authors underline the value of paraffin blocks in the era of personalized and translational medicine...
April 5, 2018: Journal of Pathology and Translational Medicine
https://www.readbyqxmd.com/read/29613841/increased-pancreatic-echogenicity-with-us-relationship-to-glycemic-progression-and-incident-diabetes
#7
Chi-Sheng Hung, Ping-Huei Tseng, Chia-Hung Tu, Chien-Chuan Chen, Wei-Chih Liao, Yi-Chia Lee, Han-Mo Chiu, Hung-Ju Lin, Wei-Shiung Yang, Ming-Fong Chen, Ming-Shiang Wu
Purpose To evaluate the association between increased pancreatic echogenicity (IPE) and the risk of glycemic progression and incident diabetes. Materials and Methods This retrospective study was approved by the institutional review board, with waiver of informed consent. Consecutive individuals who had undergone abdominal ultrasonography as part of a health examination at a tertiary hospital between January 2005 and December 2011 were included. IPE was defined as increased echogenicity of the pancreas compared with that of the left lobe of liver...
April 3, 2018: Radiology
https://www.readbyqxmd.com/read/29547909/measuring-use-of-evidence-based-psychotherapy-for-ptsd-in-va-residential-treatment-settings-with-clinician-survey-and-electronic-medical-record-templates
#8
Brian Shiner, Christine Leonard Westgate, Vanessa Simiola, Richard Thompson, Paula P Schnurr, Joan M Cook
Objective: Available studies on implementation of evidence-based psychotherapy (EBP) for patients attending Department of Veterans Affairs (VA) residential post-traumatic stress disorder (PTSD) programs rely on therapist self-report of EBP delivery. Patient-level data on receipt of EBP are needed both to corroborate therapist self-report and to understand patient factors that predict receipt of EBPs for PTSD. Materials and Methods: We identified 159 therapists from 38 VA residential PTSD programs who responded to a survey about EBP implementation during the 2015 fiscal year (FY15)...
March 14, 2018: Military Medicine
https://www.readbyqxmd.com/read/29476214/comparison-of-ultrasound-versus-computed-tomography-for-the-detection-of-kidney-stones-in-the-pediatric-population-a-clinical-effectiveness-study
#9
Nathaniel P Roberson, Jonathan R Dillman, Sara M O'Hara, William R DeFoor, Pramod P Reddy, Richard M Giordano, Andrew T Trout
BACKGROUND: The incidence of pediatric nephrolithiasis in the United States is increasing. There is a paucity of literature comparing the diagnostic performance of computed ultrasound (US) to tomography (CT) in the pediatric population. OBJECTIVE: To determine the diagnostic performance of renal US for nephrolithiasis in children using a clinical effectiveness approach. MATERIALS AND METHODS: Institutional review board approval with a waiver of informed consent was obtained for this retrospective, HIPAA-complaint investigation...
February 23, 2018: Pediatric Radiology
https://www.readbyqxmd.com/read/29373213/does-second-reader-opinion-affect-patient-management-in-pancreatic-ductal-adenocarcinoma
#10
Giuseppe Corrias, Sandra Huicochea Castellanos, Ryan Merkow, Russel Langan, Vinod Balachandran, Monica Ragucci, Gabriella Carollo, Marcello Mancini, Luca Saba, Lorenzo Mannelli
RATIONALE AND OBJECTIVES: To determine the impact of second-opinion assessment on cancer staging and patient management in patients with pancreatic ductal adenocarcinoma. METHODS AND MATERIALS: This retrospective study was approved by our institutional review board with a waiver of informed consent. Second-opinion reports between January 1, 2009 and December 31, 2013, alongside outside reports for 65 consecutive cases of biopsy-proven pancreatic adenocarcinomas, were presented in random order to two experienced abdominal surgeons who independently reviewed them blinded to the origin of the report, images of the examinations, and patient identifier...
January 16, 2018: Academic Radiology
https://www.readbyqxmd.com/read/29305077/radiologists-experience-with-patient-interactions-in-the-era-of-open-access-of-patients-to-radiology-reports
#11
Jieming Fang, Johannes Boos, Marcela Pecora Cohen, Jonathan B Kruskal, Ronald Eisenberg, Bettina Siewert, Olga R Brook
PURPOSE: The aim of this study was to evaluate radiologists' experiences with patient interactions in the era of open access of patients to radiology reports. METHODS: This prospective, nonrandom survey of staff and trainee radiologists (n = 128) at a single large academic institution was performed with approval from the institutional review board with a waiver of the requirement to obtain informed consent. A multiple-choice questionnaire with optional free-text comments was constructed with an online secure platform (REDCap) and distributed via departmental e-mail between June 1 and July 31, 2016...
January 2, 2018: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29289669/ambulation-and-survival-following-surgery-in-elderly-patients-with-metastatic-epidural-spinal-cord-compression
#12
Eyal Itshayek, Carlos Candanedo, Shifra Fraifeld, Amir Hasharoni, Leon Kaplan, Josh E Schroeder, José E Cohen
BACKGROUND & CONTEXT: Metastatic epidural spinal cord compression (MESCC) is a disabling consequence of disease progression. Surgery can restore/preserve physical function, improving access to treatments that increase duration of survival; however, advanced patient age may deter oncologists and surgeons from considering surgical management. PURPOSE: Evaluate the duration of ambulation and survival in elderly patients following surgical decompression of MESCC...
December 28, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29279161/accuracy-of-multiparametric-mr-imaging-with-pi-rads-v2-assessment-in-detecting-infiltration-of-the-neurovascular-bundles-prior-to-prostatectomy
#13
Markus Sauer, Julius M Weinrich, Christoph Fraune, Georg Salomon, Pierre Tennstedt, Gerhard Adam, Dirk Beyersdorff
OBJECTIVES: To evaluate the accuracy of assessment of neurovascular bundle (NVB) infiltration using multiparametric magnetic resonance imaging (mpMRI) and PI-RADS V2 prior to prostatectomy. METHODS: The ethics committee approved this retrospective study with waiver of informed consent. N=198 consecutive patients with biopsy proved cancer underwent standardized mpMRI at 3T prior to surgery. NVB infiltration was assessed for each side (a total of 396). Maximum PI-RADS V2 scores were determined for the posterolateral areas adjacent to the NVBs...
January 2018: European Journal of Radiology
https://www.readbyqxmd.com/read/29247353/structured-vs-narrative-reporting-of-pelvic-mri-for-fibroids-clarity-and-impact-on-treatment-planning
#14
Andrea Franconeri, Jieming Fang, Benjamin Carney, Almamoon Justaniah, Laura Miller, Hye-Chun Hur, Louise P King, Roa Alammari, Salomao Faintuch, Koenraad J Mortele, Olga R Brook
OBJECTIVES: To evaluate clarity and usefulness of MRI reporting of uterine fibroids using a structured disease-specific template vs. narrative reporting for planning of fibroid treatment by gynaecologists and interventional radiologists. METHODS: This is a HIPAA-compliant, IRB-approved study with waiver of informed consent. A structured reporting template for fibroid MRIs was developed in collaboration between gynaecologists, interventional and diagnostic radiologists...
December 15, 2017: European Radiology
https://www.readbyqxmd.com/read/29224380/ethics-and-practice-of-trials-within-cohorts-an-emerging-pragmatic-trial-design
#15
Scott Yh Kim, James Flory, Clare Relton
BACKGROUND: With increasing emphasis on pragmatic trials, new randomized clinical trial designs are being proposed to enhance the "real world" nature of the data generated. We describe one such design, appropriate for unmasked pragmatic clinical trials in which the control arm receives usual care, called "Trials within Cohorts" that is increasingly used in various countries because of its efficiency in recruitment, advantages in reducing subject burden, and ability to better mimic real-world consent processes...
February 2018: Clinical Trials: Journal of the Society for Clinical Trials
https://www.readbyqxmd.com/read/29208620/impact-of-electronic-clinical-decision-support-on-adherence-to-guideline-recommended-treatment-for-hyperlipidaemia-atrial-fibrillation-and-heart-failure-protocol-for-a-cluster-randomised-trial
#16
Maya Elizabeth Kessler, Rickey E Carter, David A Cook, Daryl Jon Kor, Paul M McKie, Laurie J Pencille, Marianne R Scheitel, Rajeev Chaudhry
INTRODUCTION: Clinical practice guidelines facilitate optimal clinical practice. Point of care access, interpretation and application of such guidelines, however, is inconsistent. Informatics-based tools may help clinicians apply guidelines more consistently. We have developed a novel clinical decision support tool that presents guideline-relevant information and actionable items to clinicians at the point of care. We aim to test whether this tool improves the management of hyperlipidaemia, atrial fibrillation and heart failure by primary care clinicians...
December 4, 2017: BMJ Open
https://www.readbyqxmd.com/read/29200837/the-relationship-of-ssri-and-snri-usage-with-interstitial-lung-disease-and-bronchiectasis-in-an-elderly-population-a-case-control-study
#17
Ted Rosenberg, Rory Lattimer, Patrick Montgomery, Christian Wiens, Liran Levy
Background: The association between interstitial lung disease (ILD) and selective serotonin reuptake inhibitors and serotonin norepinephrine reuptake inhibitors (SSRI/SNRI) has been previously described in published case reports. However, its prevalence may be more common than expected. We examined the association between SSRI/SNRI usage and presence of ILD and or bronchiectasis (ILD/B) in an elderly population. Methods: We conducted a retrospective case series and case-control study involving all 296 eligible elderly patients in one primary care geriatric practice in Victoria, BC, Canada...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29167943/penetrating-crohn-disease-does-it-occur-in-the-absence-of-stricturing-disease
#18
Emily S Orscheln, Jonathan R Dillman, Alexander J Towbin, Lee A Denson, Andrew T Trout
PURPOSE: To establish the relationship between penetrating complications and bowel luminal narrowing/stricturing disease in pediatric Crohn disease (CD). MATERIALS AND METHODS: This retrospective study was IRB-approved and HIPAA compliant with waiver of informed consent. CT and MRI examinations describing intra-abdominal penetrating complications in CD patients ≤ 18 years old between January 1, 2009 and March 31, 2016 were reviewed to document: type of complication, affected bowel segment, minimum bowel luminal diameter, maximum upstream diameter, location of penetrating complication relative to luminal narrowing, length of narrowed bowel segment, and the presence of active bowel wall inflammation...
November 22, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28993074/obtaining-waivers-of-parental-consent-a-strategy-endorsed-by-gay-bisexual-and-queer-adolescent-males-for-health-prevention-research
#19
Dalmacio Flores, Ross McKinney, Joyell Arscott, Julie Barroso
BACKGROUND: Requiring parental consent in studies with sexual minority youth (SMY) can sometimes be problematic as participants may have yet to disclose their sexual orientation, may not feel comfortable asking parents' permission, and may promote a self-selection bias. PURPOSE: We discuss rationale for waiving parental consent, strategies to secure waivers from review boards, and present participants' feedback on research without parents' permission. METHODS: We share our institutional review board proposal in which we made a case that excluding SMY from research violates ethical research principles, does not recognize their autonomy, and limits collection of sexuality data...
September 18, 2017: Nursing Outlook
https://www.readbyqxmd.com/read/28981400/clinical-outcomes-of-radiofrequency-ablation-for-early-hypovascular-hcc-a-multicenter-retrospective-study
#20
MULTICENTER STUDY
Dong Ho Lee, Jeong Min Lee, Tae Wook Kang, Hyunchul Rhim, So Yeon Kim, Yong Moon Shin, Jung Wook Seo, Moon Hyung Choi, Kyung Bun Lee
Purpose To retrospectively evaluate the clinical outcomes of radiofrequency ablation (RFA) for early hypovascular hepatocellular carcinomas (HCCs) and to compare them with those of typical hypervascular HCCs. Materials and Methods This retrospective multicenter study received institutional review board approval, with a waiver of the need to obtain informed consent. A total of 56 patients (male-to-female ratio, 40:16; mean age, 61.8 years; age range, 33-87 years) with pathologically proven early HCCs that did not meet the noninvasive diagnosis criteria and who were initially treated with RFA at one of five university-affiliated hospitals between January 2009 and December 2013 comprised the study group...
January 2018: Radiology
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