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https://www.readbyqxmd.com/read/29671736/exclusion-of-medically-necessary-gender-affirming-surgery-for-america-s-armed-services-veterans
#1
William M Kuzon, Emily Sluiter, Katherine M Gast
Gender dysphoria , the term used in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders ( DSM ) to describe distress at the incongruence between one's gender and anatomy, affects approximately 0.6 percent of the population. It is estimated that there are 134,000 Armed Forces veterans in the United States with gender dysphoria. Although gender-affirming surgery is widely accepted as a medically necessary intervention for appropriately selected patients with gender dysphoria, the Veterans Health Administration (VHA) Health Benefits package and VHA Directive 2013-033 specifically prohibit gender-affirming surgery within Veterans Affairs (VA) facilities or using VA funding...
April 1, 2018: AMA Journal of Ethics
https://www.readbyqxmd.com/read/29671728/plastic-surgery-s-contributions-to-surgical-ethics
#2
Chad M Teven, Scott B Grant
We review Kevin Chung and colleagues' 2009 Plastic and Reconstructive Surgery article, "A Systematic Review of Ethical Principles in the Plastic Surgery Literature," which shows that only 110 of the more than 100,000 plastic surgery articles clearly focus on ethical principles. The four fundamental ethical principles (i.e., respect for autonomy, beneficence, nonmaleficence, and justice) were differentially emphasized, with respect for autonomy being most common. Despite the number of ethical issues faced by plastic surgeons, this systematic review found that a relatively small fraction of the plastic surgery literature has focused on ethical principles...
April 1, 2018: AMA Journal of Ethics
https://www.readbyqxmd.com/read/29453580/neurosurgical-management-of-hydrocephalus-by-a-general-surgeon-in-an-extremely-low-resource-setting-initial-experience-in-north-kivu-province-of-eastern-democratic-republic-of-congo
#3
Sarah B Cairo, Justice Agyei, Kavira Nyavandu, David H Rothstein, Luc Malemo Kalisya
PURPOSE: Evaluate the management of hydrocephalus in pediatric patients in the Eastern Democratic Republic of Congo by a general surgeon. METHODS: Retrospective review of a single institution in the province of North Kivu. Patient charts and surgical notes were reviewed from 2003 to 2016. RESULTS: 116 procedures were performed for an average of 8.9 per year. 51.7% of surgeries were on female patients with an average age of 13.6 ± 22.7...
February 16, 2018: Pediatric Surgery International
https://www.readbyqxmd.com/read/29372862/damage-capitation-in-the-modern-liability-climate-a-primer-for-neurosurgeons-and-systematic-review-of-the-literature
#4
Jacob R Lepard, Beverly C Walters, Curtis J Rozzelle
OBJECTIVE Neurosurgery, and particularly spine surgery, is among the most highly litigated medical specialties in the US, rendering the current malpractice climate of primary importance to spine surgeons nationwide. One of the primary methods of tort reform in the civil justice system is malpractice damage capitation (or "caps"); however, its efficacy is widely debated. The purpose of this article is to serve as a review for the practicing neurosurgeon, with particular emphasis on short- and long-term effects of damage caps and on the current debate regarding their utility, based on a systematic review of the literature...
January 26, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29187102/education-and-training-in-pediatric-cardiac-critical-care
#5
REVIEW
Mary E McBride, Dorothy M Beke, James D Fortenberry, Annette Imprescia, Louise Callow, Lindsey Justice, Ronald A Bronicki
Pediatric cardiac critical care is a new and emerging field. There is no standardization to the current education provided, and high-quality patient outcomes require such standardization. For physicians, this includes fellowship training, specific competencies, and a certification process. For advanced practice providers, a standardized curriculum as well as a certification process is needed. There is evidence that supports a finding that critical care nursing experience may have a positive impact on outcomes from pediatric cardiac surgery...
November 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28889818/efficacy-and-safety-of-recombinant-tissue-plasminogen-activator-for-venous-thrombosis-after-paediatric-heart-surgery
#6
Lindsey B Justice, David P Nelson, Joseph Palumbo, Jaclyn Sawyer, Manish N Patel, Jonathan W Byrnes
OBJECTIVE: Reports in the literature of treatment with recombinant tissue plasminogen activator following cardiac surgery are limited. We reviewed our experience to provide a case series of the therapeutic use of tissue plasminogen activator for the treatment of venous thrombosis in children after cardiac surgery. The data describe the morbidity, mortality, and clinical outcomes of tissue plasminogen activator administration for treatment of venous thrombosis in children following cardiac surgery...
September 11, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28511464/a-study-to-assess-the-functional-outcome-of-decompression-and-posterior-lumbar-interbody-fusion-of-low-grade-spondylolisthesis-of-lumbar-vertebra
#7
Deepak Hegde, Sameer Mehra, Santhosh Babu, Arjun Ballal
INTRODUCTION: Spondylolisthesis is defined as the forward displacement of one vertebra over the vertebra below. It is often accompanied by spinal canal stenosis and compression, which is the cause of all the symptoms. AIM: To assess and study the functional outcome after decompression and Posterior Lumbar Interbody Fusion (PLIF) of isthmic spondylolisthesis of lower lumbar vertebra and to study the complications occurring with this technique. MATERIALS AND METHODS: A prospective study was conducted in the Department of Orthopaedics in Justice KS Hegde Charitable Hospital, Mangalore, Karnataka, India from March 2015 to August 2016...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28384945/excision-versus-fixation-of-the-radial-head-a-comparative-study-of-the-functional-outcomes-of-the-two-techniques
#8
Sanath Kumar Shetty, Ashwin Shetty, Bijith Balan, Arjun Ballal, H Ravindranath Rai, Anoop Hegde
INTRODUCTION: The management of displaced and comminuted radial head fractures has been a matter of debate amongst surgeons for many years. Radial head excision formed the mainstay of surgical management of these injuries. Over the years, there have been improvements in the surgical techniques and availability of better implants and instrumentation techniques, hence, open reduction and internal fixation of these fractures is gaining popularity. AIM: To compare the outcome of elbow function between radial head excision and open reduction and internal fixation of the radial head with mini screws of Mason Type II and Type III radial head fractures and to assess the complications that occur in both techniques...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28326200/the-anaesthesiologist-and-palliative-care-in-a-newborn-with-the-adam-sequence
#9
Alberto Vieira Pantoja, Maria Emília Gonçalves Estevez, Bruno Lima Pessoa, Fernando de Paiva Araújo, Bruno Mendonça Barcellos, Ciro Augusto Floriani, Marco Antonio Cardoso de Resende
Reports focusing on biomedical principlism and the role of anaesthesiologists in palliative care are rare. We present the case of a newborn with multiple craniofacial anomalies and a diagnosis of ADAM "sequence," in which surgical removal of placental adhesions to the dura mater and the correction of meningocele was not indicated due to the very short life expectancy. After 48 hours, the odor from the placenta indicted a necrotic process, which prevented the parents from being close to the child and increased his isolation...
2017: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/28198932/eugenics-sterilization-and-historical-memory-in-the-united-states
#10
Alexandra Minna Stern
From the 1920s to the 1950s, California sterilized approximately 20,000 people in state homes and hospitals based on a eugenic law that authorized medical superintendents to perform reproductive surgeries on patients deemed unfit and "suffering from a mental affliction likely to be inherited." Working with a unique resource - a dataset created from 19,000 sterilization recommendations - my team and I have reconstructed patterns and experiences of institutionalization of sterilizations. This article presents several of our important initial findings related to ethnic and gender bias in sterilization policies, and reflects on the relevance of the history for contemporary issues in genomics and social justice...
December 2016: História, Ciências, Saúde—Manguinhos
https://www.readbyqxmd.com/read/28153622/case-report-of-a-primary-pituitary-abscess-and-systematic-literature-review-of-pituitary-abscess-with-a-focus-on-patient-outcomes
#11
REVIEW
Justice O Agyei, Lindsay J Lipinski, Jody Leonardo
BACKGROUND: Pituitary abscess is a rare but potentially life-threatening condition with an incidence of 0.2%-1.1% of operative pituitary lesions. Diagnosis can be challenging, because this disorder shares many similarities with other pituitary lesions in terms of signs and symptoms and radiographic findings. Most pituitary abscesses are categorized as secondary, arising from preexisting pituitary lesions or in conjunction with transsphenoidal surgery, sepsis, meningitis, or sinusitis...
May 2017: World Neurosurgery
https://www.readbyqxmd.com/read/27861870/iatrogenic-burns-of-the-neckline-in-a-patient-with-tetraparesis-during-tracheotomy
#12
Anna Smędra, Ewa Meissner, Maciej Barzdo, Przemysław Grabowski, Michał Kartasiński, Wojciech Krajewski, Jarosław Berent
The paper presents a case of an atypical iatrogenic complication after tracheotomy analyzed on the basis of the case dossier materials submitted to the authors by the court of justice to prepare a forensic medical opinion concerning the correctness of the medical procedure. A 37-year-old woman was brought by the ambulance service to the hospital with acute respiratory failure due to post-tracheostomy tracheal stenosis. Tracheotomy was performed on an emergency basis. The patient suffered severe burns of the chest and neck...
January 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/27763403/ethical-challenges-in-the-care-of-the-inpatient-with-morbid-obesity
#13
Paul L Schneider, Zhaoping Li
OBJECTIVE: To provide a thorough analysis of the range of ethical concerns that may present in relation to the care of the morbidly obese inpatient over the course of several years of care. METHODS: A narrative of the patient's complex medical care is given, with particular attention to the recommendations of three separate ethics committee consultations that were sought by his health care providers. An ethical analysis of the relevant issues is given within the Principles of Biomedical Ethics framework, highlighting the principles of autonomy, beneficence, non-maleficence, and justice...
2016: Narrative Inquiry in Bioethics
https://www.readbyqxmd.com/read/27757182/reallocation-of-shafa-hospital-beds-in-kerman-using-goal-programming-model
#14
Mohammad Hossein Mehrolhasani, Sajad Khosravi, Mahya Tohidi
INTRODUCTION: In order to improve health, hospital sources such as beds and staffing should be properly allocated and used. The aim of this study is reallocation of Shafa hospital beds in Kerman using a goal-programming model. METHODS: This study was an applied cross-sectional study, which used the goal programming model and software WinQSB to optimize bed allocation. By review of the literature and interviews with experts, the constraints in beds allocation were identified, and using the collected data the desired model was designed...
August 2016: Electronic Physician
https://www.readbyqxmd.com/read/27598499/-waiting-lists-management-model-based-on-timeliness-and-justice
#15
Cristian Julio, Patricio Wolff, María Vegoña Yarza
Waiting lists for elective surgery are considered a major health policy concern in most countries of the world. The most common reason to explain this phenomenon is that demand exceeds supply. Traditionally, the management of waiting lists has been focused on timeliness of medical attention. The objective of this paper is to present a waiting lists management model that includes the concepts of timeliness and justice simultaneously. We designed a prioritization method based solely on medical criteria. We developed a computer software to register patients, to prioritize and monitor the waiting lists...
June 2016: Revista Médica de Chile
https://www.readbyqxmd.com/read/27556556/civil-liability-characterization-of-the-demand-for-lawsuits-against-dentists
#16
Alice Aquino Zanin, Lara Maria Herrera, Rodolfo Francisco Haltenhoff Melani
In light of the fact that dentists may be held civilly liable for their practice, it is important to understand the current situation of lawsuits filed against these professionals by studying current legal decisions and the literature. The objective of this study was to analyze the case law of the Court of Justice of São Paulo, Brazil, relative to the profile of patients and professionals, the most commonly involved specialties, the amounts litigated and the court decisions pertaining to civil liability lawsuits against dentists...
August 18, 2016: Brazilian Oral Research
https://www.readbyqxmd.com/read/27437314/a-prospective-study-of-the-functional-outcome-of-anterior-cervical-discectomy-with-fusion-in-single-level-degenerative-cervical-disc-prolapse
#17
Mayur M Kamani, Arjun Ballal, Vikram Shetty, H Ravindranath Rai, Deepak Hegde
INTRODUCTION: Cervical spondylotic myelo-radiculopathy is a form of spinal cord dysfunction syndrome and usually accompanies age related degeneration of the spine. AIM: To determine the functional outcome of anterior cervical discectomy with fusion and plating in single level degenerative cervical disc prolapse. MATERIALS AND METHODS: A total of 20 patients diagnosed with degenerative single level cervical disc prolapse who presented to the Department of Orthopaedic Surgery, Justice KS Hegde Charitable Hospital, Mangalore from the period of November 2012 to May 2014 were enrolled in the study...
May 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27119465/current-options-for-the-treatment-of-pathological-scarring
#18
Julian Poetschke, Gerd G Gauglitz
Scarring is the consequence of surgery, trauma or different skin diseases. Apart from fresh, immature scars,that transform into mature scars over the course of would healing and that do not require further treatment,linear hypertrophic scars, widespread hypertrophic scars, keloids and atrophic scars exist. Symptoms like pruritusand pain, stigmatization as well as functional and aesthetic impairments that are very disturbing for the affected patients can bethe basis for the desire for treatment. Today, a multitude of options for the treatment and prevention of scars exists...
May 2016: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
https://www.readbyqxmd.com/read/27097953/fatal-pulmonary-thromboembolism
#19
A Yakar, F Yakar, N Ziyade, M Yıldız, I Üzün
OBJECTIVE: Venous thromboembolism is a complex, multifactorial disease, involving interactions between acquired or inherited predispositions to thrombosis and various risk factors, such as trauma and surgery. This study investigated the clinical features and most important risk factors of fatal pulmonary thromboembolism (PTE). MATERIALS AND METHODS: Forensic records stored at the Council of Forensic Medicine, Ministry of Justice in Istanbul, Turkey, from January 2010 to December 2014 were screened for deaths of confirmed PTE based on autopsy or computed tomography (CT)...
April 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/26464132/sudden-unexpected-death-as-a-result-of-primary-aortoduodenal-fistula-identified-with-postmortem-computed-tomography
#20
Andrew S Williams, D'Arcy L Little, Jayantha Herath
Aortoenteric fistula (AEF) is an uncommon source of upper gastrointestinal (GI) tract hemorrhage, commonly occurring in persons with previous aortic surgery. Non-surgery related AEFs (primary AEFs) may occur in association with atherosclerotic lesions, infections, malignancies, or, rarely, result from penetrating/eroding foreign bodies. Given its rarity, primary AEF is not commonly considered in the pathologist's preliminary list of differential diagnoses at the commencement of an autopsy; however, the use of postmortem cross-sectional imaging may allow for the identification of primary AEF as a reasonable differential diagnoses prior to conventional autopsy...
December 2015: Forensic Science, Medicine, and Pathology
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