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John lantos

John D Lantos
The doctors were frustrated. They could see only two options. Neither was very desirable. They could stop the ventilator and let the baby die. Or they could do a tracheostomy and start preparations to discharge him on a ventilator. The parents wanted a third option. They kept hoping that their baby would get better. The doctors were pretty sure that that wasn't going to happen.
November 2016: Hastings Center Report
Angira Patel, Gregory Webster, Kendra Ward, John Lantos
: Aim The aim of the present study was to determine general paediatrician knowledge, practices, and attitudes towards electrocardiogram (ECG) screening in school athletes during pre-participation screening exam (PPSE). METHODS: Paediatricians affiliated with a tertiary children's hospital completed a survey about ECGs for PPSE. RESULTS: In total, 205/498 (41%) responded; 92% of the paediatricians did not include an ECG as part of PPSE; 56% were aware of a case in which a student athlete in their own community had died of sudden unexplained death; 4% had an athlete in their practice die...
October 10, 2016: Cardiology in the Young
Kenneth Alexander, Tomas A Lacy, Angela L Myers, John D Lantos
One of the most divisive issues in pediatrics today concerns the proper response by pediatricians to parents who refuse routine childhood immunizations for their children. Many pediatricians refuse to care for such families. Others continue to provide care and continue to try to convince parents that the benefits of immunizations far outweigh the risks. Two of the most powerful arguments in favor of dismissing such parents are as follows: (1) their refusal suggests such lack of trust in the physicians' recommendations that it undermines the basis for a meaningful physician-patient-parent relationship; and (2) unimmunized children present an unacceptable risk to other children in the physicians' waiting rooms...
September 2, 2016: Pediatrics
John Lantos
Henry K. Beecher was a pioneer of research ethics and a prominent whistleblower with regard to ethically problematic studies. Most of his work focused on research in adults, not children, but he did speculate about the implications of his ethical concerns for research in minors. This paper reviews Beecher's response to Krugman's studies of hepatitis at the Willowbrook State School and the debate that Beecher's article stimulated between Ramsey and McCormick. That debate shaped the terms that were used in current federal regulations for research in children...
2016: Perspectives in Biology and Medicine
Franklin G Miller, John Lantos
No abstract text is available yet for this article.
2016: Perspectives in Biology and Medicine
Donna McKlindon, Jake A Jacobson, Pamela Nathanson, Jennifer K Walter, John D Lantos, Chris Feudtner
Social media, no stranger to health care environments, is increasingly used by patients, families, clinicians, and institutions to interact and engage in new ways. The ethical challenges related to the use of social media in the clinical setting are familiar, yet come with a novel twist, including the possibility of having a conflict "go viral". Health care clinicians and institutions must understand and embrace these technologies, while at the same time promoting policies and practices that ensure the ethically appropriate use of social media and address strategies for preventing and responding to a social media crisis...
September 2016: Pediatrics
Annie Janvier, John Lantos, Judy Aschner, Keith Barrington, Beau Batton, Daniel Batton, Siri Fuglem Berg, Brian Carter, Deborah Campbell, Felicia Cohn, Anne Drapkin Lyerly, Dan Ellsbury, Avroy Fanaroff, Jonathan Fanaroff, Kristy Fanaroff, Sophie Gravel, Marlyse Haward, Stefan Kutzsche, Neil Marlow, Martha Montello, Nathalie Maitre, Joshua T Morris, Odd G Paulsen, Trisha Prentice, Alan R Spitzer
For parents, the experience of having an infant in the NICU is often psychologically traumatic. No parent can be fully prepared for the extreme stress and range of emotions of caring for a critically ill newborn. As health care providers familiar with the NICU, we thought that we understood the impact of the NICU on parents. But we were not prepared to see the children in our own families as NICU patients. Here are some of the lessons our NICU experience has taught us. We offer these lessons in the hope of helping health professionals consider a balanced view of the NICU's impact on families...
September 2016: Pediatrics
John D Lantos
No abstract text is available yet for this article.
July 26, 2016: JAMA: the Journal of the American Medical Association
Lori E Dodd, John D Lantos, José Pinheiro
No abstract text is available yet for this article.
October 2016: Clinical Trials: Journal of the Society for Clinical Trials
Joyce P Samuel, Alyssa Burgart, Susan H Wootton, David Magnus, John D Lantos, Jon E Tyson
The regulatory demarcations between clinical research and quality improvement (QI) are ambiguous and controversial. Some projects that were undertaken as a form of QI were deemed by regulatory agencies to be research and thus to require institutional review board approval. In the era of personalized medicine, some physicians may ask some patients to participate in n-of-1 trials in an effort to personalize and optimize each patient's medical treatment. Should such activities be considered research, QI, or just excellent personalized medicine? Experts in research, research regulation, and bioethics analyze these issues...
August 2016: Pediatrics
John D Lantos
No abstract text is available yet for this article.
August 2016: American Journal of Bioethics: AJOB
Andrew S Nickels, G Douglas Myers, Liza-Marie Johnson, Avni Joshi, Richard R Sharp, John D Lantos
If untreated, most children with severe combined immunodeficiency disorder (SCID) will die of complications of infection within the first 2 years of life. Early hematopoietic stem cell transplant (HSCT) is the current standard of care for this disease. Although potentially lifesaving, prognosis of HSCT in SCID is variable depending on a number of host and donor factors. Of the survivors, many develop secondary problems such as chronic graft-versus-host disease or even second malignancies. Posttransplant care is complex and requires great effort from parents to adhere to difficult treatment regimens...
July 2016: Pediatrics
William D Mosher, Caroline Moreau, Hannah Lantos
STUDY QUESTION: What factors and subgroups have propelled the recent increase in intrauterine device (IUD) use in the USA? SUMMARY ANSWER: The increase in IUD use, from 1.8 to 9.5% in the USA between 2002 and 2012, was driven primarily by a marked uptake among parous women who intended to have more children. WHAT IS KNOWN ALREADY: Recent data suggest an unprecedented increase in IUD use among women in the USA, yet less is known about how this increase has affected the overall proportion of women, at risk of unintended pregnancy, who are using contraception and which social and economic groups are involved...
August 2016: Human Reproduction
Todd J Kilbaugh, Daniel Groll, Wynne Morrison, Nabina Liebow, John D Lantos
Parents respond to the death of a child in very different ways. Some parents may be violent or angry, some sad and tearful, some quiet and withdrawn, and some frankly delusional. We present a case in which a father's reaction to his daughter's death is a desire to protect his wife from the stressful information. The wife is in the second trimester of a high-risk pregnancy and so is particularly fragile. We asked pediatricians and bioethicists to discuss the ways in which they might respond to the father's understandable but troubling request...
June 2016: Pediatrics
André Kidszun, Jennifer Linebarger, Jennifer K Walter, Norbert W Paul, Anja Fruth, Eva Mildenberger, John D Lantos
Advances in prenatal diagnosis create a unique set of clinical ethics dilemmas. Doctors routinely obtain genetic screening, radiologic images, and biophysical profiling. These allow more accurate diagnosis and prognosis than has ever before been possible. However, they also reveal a wider range of disease manifestations than were apparent when prenatal diagnosis was less sophisticated. Sometimes, the best estimates of prognosis turn out to be wrong. The infant's symptoms may be less severe or more severe than anticipated based on prenatal assessment...
May 2016: Pediatrics
Kruti Acharya, John D Lantos
No abstract text is available yet for this article.
2016: AMA Journal of Ethics
Annie Janvier, John Lantos
No abstract text is available yet for this article.
September 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
Loyal Coshway, Julia Broussard, Kruti Acharya, Karen Fried, Michael E Msall, John D Lantos, Leena Nahata
Teens with autism spectrum disorder often exhibit sexual behaviors in public that are disturbing to parents, teachers, and peers. Some have proposed that such behaviors can be curtailed with hormonal suppression. There is information on the Internet suggesting that such medications work, and some reports in the peer-reviewed medical literature support these claims. Such medications can have serious side effects. In this paper, we present a case in which parents requested such treatment of their teenage son with autism spectrum disorder...
April 2016: Pediatrics
Ryan M Antiel, Thane A Blinman, Rebecca M Rentea, Katherine W Gonzalez, E Marty Knott, David Juang, Tolulope Oyetunji, G W Holcomb, Peter Angelos, John D Lantos
Professionalism requires that doctors acknowledge their errors and figure out how to avoid making similar ones in the future. Over the last few decades, doctors have gotten better at acknowledging mistakes and apologizing to patients when a mistake happens. Such disclosure is especially complicated when one becomes aware of an error made by a colleague. We present a case in which consultant surgeons became aware that a colleague seemed to have made a serious error. Experts in surgery and bioethics comment on appropriate responses to this situation...
March 2016: Pediatrics
Ayman Khmour, John D Lantos
No abstract text is available yet for this article.
March 2016: Acta Paediatrica
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