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Katsiaryna Laryionava, Katja Mehlis, Elena Bierwirth, Friederike Mumm, Wolfgang Hiddemann, Pia Heußner, Eva C Winkler
BACKGROUND: Many patients with advanced cancer receive chemotherapy close to death and are referred too late to palliative or hospice care, and therefore die under therapy or in intensive care units. Oncologists still have difficulties in involving patients appropriately in decisions about limiting tumor-specific or life-prolonging treatment. OBJECTIVE: The aim of this Ethics Policy for Advanced Care Planning and Limiting Treatment Study is to develop an ethical guideline for end-of-life decisions and to evaluate the impact of this guideline on clinical practice regarding the following target goals: reduction of decisional conflicts, improvement of documentation transparency and traceability, reduction of distress of the caregiver team, and better knowledge and consideration of patients' preferences...
June 15, 2018: JMIR Research Protocols
Jore Hendrikx, Dirk Van Raemdonck, Jacques Pirenne, Steffen Fieuws, Steffen Rex
Transplant procedures are frequently performed outside the regular working hours (after hours). In general surgery, several studies observed worse outcomes for operations performed after hours. The predetermined hypothesis was that patients undergoing transplantation during after hours might suffer from an excess in post-operative mortality and morbidity when compared to patients undergoing transplantations during the regular working hours. A systematic review of the PubMed database identified 11,993 records, of which eleven cohort studies including a total of 287,741 patients investigated the association between the starting time of transplant surgery and postoperative mortality (primary outcome) and/or morbidity (secondary outcome)...
May 8, 2018: Transplantation Reviews
Luke R Johnston, Matthew J Bradley, Carlos J Rodriguez, Michael P McNally, Eric A Elster, James E Duncan
BACKGROUND: During the past decade of conflict, numerous casualties sustained injuries requiring the formation of an ostomy. However, outcomes in those casualties undergoing ostomy reversal have yet to be analyzed. We review the experience and identify risk factors for complications after ostomy reversal in a series of combat casualties at our military treatment facility. STUDY DESIGN: A retrospective review of combat casualties managed with a diverting ostomy who underwent ostomy reversal at our military treatment facility over a 13 year period...
June 12, 2018: Journal of the American College of Surgeons
David A Diamond, Jonathan Swartz, Amy Tishelman, Judith Johnson, Yee-Ming Chan
INTRODUCTION: A central ethical dilemma in management of the patient with a disorder of sex development (DSD) is the potential conflict between respect for the fundamental right of the child for physical and emotional integrity and self-determination, and the right of parents to serve as surrogate decision-makers and act in their child's best interest. METHODS: Over the past 2 years we have encountered three complex DSD cases on the spectrum of mixed gonadal dysgenesis to ovotesticular DSD in which gender assignment and therefore optimal surgical management was uncertain...
June 1, 2018: Journal of Pediatric Urology
Els Leye, Emilomo Ogbe, Maaike Heyerick
BACKGROUND: Hymen reconstruction (HR) involves the restoration of the hymeneal membrane's gross anatomical integrity. Among the medical profession, hymen reconstruction receives particular attention and its necessity is debated because the surgery is not medically indicated, and often reveals conflicting social norms on virginity and marriageability between health professionals and their patients. The focus of this paper is not to address the many open questions that the ethics and politics around HR reveal, but rather aims at contributing to the much-needed empirical evidence...
June 13, 2018: BMC Women's Health
P R Jirge, S M Chougule, A Keni, S Kumar, D Modi
STUDY QUESTION: What is the effect of latent genital tuberculosis (GTB) on ovarian reserve in infertile women? SUMMARY ANSWER: Women with latent GTB have lower ovarian reserves and yield lower numbers of oocytes in IVF. WHAT IS KNOWN ALREADY: Limited evidence suggests that women with GTB may have a low ovarian reserve. Infertile women have a high incidence of latent GTB and treatment improves fertility outcomes. STUDY DESIGN, SIZE, DURATION: This prospective study from February 2013 to January 2016 compared 431 infertile women diagnosed with latent GTB (Group I) to 453 infertile women without latent GTB (Group II)...
June 12, 2018: Human Reproduction
(no author information available yet)
AIM: Previous studies reported conflicting evidence on the effects of obesity on outcomes after gastrointestinal surgery. The aims of this study were to explore the relationship of obesity with major post-operative complications in an international cohort and to present a meta-analysis of all available prospective data. METHODS: This prospective, multi-centre study included adults undergoing both elective and emergency gastrointestinal resection, reversal of stoma, or formation of stoma...
June 13, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Valentina Boursier, Valentina Manna
Selfie-taking and posting is one of the most popular activities among teenagers, an important part of online self-presentation that is related to identity issues and peer relations. The scholarly literature emphasizes different yet conflicting motivations for selfie-behavior, stressing deeper analysis of psychological factors and the influence of gender and age. Expectancies are "explanatory device[s]" that can help us study adolescent behavior. However, no instruments have been devised that specifically explore the expectations teenagers have about selfies and their influence on selfie-frequency...
2018: Frontiers in Psychology
Ken Ho
Diet-induced thermogenesis (DIT) is energy dissipated as heat after a meal, contributing 5-15% to total daily EE. There has been a long interest in the intriguing possibility that a defect in DIT predisposes to obesity. However the evidence is conflicting, DIT is usually quantified by indirect calorimetry which does not measure heat. Using gas exchange, indirect calorimetry measures total post-prandial EE which comprises heat energy produced from brown adipose tissue (BAT) and energy required for processing and storing nutrients...
June 12, 2018: Journal of Endocrinology
Zuhair Alqahtani, Fakhreddin Jamali
PURPOSE: Concomitant use of some non-Aspirin nonsteroidal anti-inflammatory drugs (NANSAIDs) reduces the extent of platelet aggregation of Aspirin (acetylsalicylic acid). This is while many observational studies and clinical trials suggest that Aspirin reduces cardiovascular (CV) risk attributed to the use of NANSAIDs. Thus, the therapeutic outcome of the interaction needs to be assessed. METHODS: We searched various databases up to October 2017 for molecular interaction studies between the drugs and long-term clinical outcomes based on randomized clinical trials and epidemiological observations that reported the effect estimates of CV risks (OR, RR or HR; 95% CI) of the interacting drugs alone or in combinations...
2018: Journal of Pharmacy & Pharmaceutical Sciences: a Publication of the Canadian Society for Pharmaceutical Sciences
Saba Pasha, Brice Ilharreborde, Keith Baldwin
STUDY DESIGN: Systematic review and meta-analysis OBJECTIVE.: To determine the differences in the sagittal spinopelvic parameters between the non-scoliotic controls, pre-operative, and different time points post-operative in Lenke 1 and 5 adolescent idiopathic scoliosis (AIS). SUMMARY OF BACKGROUND DATA: The post-operative changes in the sagittal profile of Lenke 1 and 5 AIS at varying time points after posterior spinal fusion (PSF) has not been rigorously demonstrated; studies performed have had conflicting results...
June 8, 2018: Spine
Andrea Hahn, Matthew L Bendall, Keylie M Gibson, Hollis Chaney, Iman Sami, Geovanny F Perez, Anastassios C Koumbourlis, Timothy A McCaffrey, Robert J Freishtat, Keith A Crandall
Cystic fibrosis (CF) is an autosomal recessive disease associated with recurrent lung infections that can lead to morbidity and mortality. The impact of antibiotics for treatment of acute pulmonary exacerbations on the CF airway microbiome remains unclear with prior studies giving conflicting results and being limited by their use of 16S ribosomal RNA sequencing. Our primary objective was to validate the use of true single molecular sequencing (tSMS) and PathoScope in the analysis of the CF airway microbiome...
2018: Frontiers in Microbiology
Piero Perucca, Gregory Smith, Cesar Santana-Gomez, Anatol Bragin, Richard Staba
Post-traumatic epilepsy is the architype of acquired epilepsies, wherein a brain insult initiates an epileptogenic process culminating in an unprovoked seizure after weeks, months or years. Identifying biomarkers of such process is a prerequisite for developing and implementing targeted therapies aimed at preventing the development of epilepsy. Currently, there are no validated electrophysiological biomarkers of post-traumatic epileptogenesis. Experimental EEG studies using the lateral fluid percussion injury model have identified three candidate biomarkers of post-traumatic epileptogenesis: pathological high-frequency oscillations (HFOs, 80-300 Hz); repetitive HFOs and spikes (rHFOSs); and reduction in sleep spindle duration and dominant frequency at the transition from stage III to rapid eye movement sleep...
June 5, 2018: Neurobiology of Disease
Antonio J Morales-Artacho, Paulino Padial, Amador García-Ramos, Alejandro Pérez-Castilla, Javier Argüelles-Cienfuegos, Blanca De la Fuente, Belén Feriche
Intermittent hypoxic resistance training (IHRT) may help to maximize the adaptations following resistance training, although conflicting evidence is available. The aim of this study was to explore the influence of moderate altitude on the functional, neural and muscle architecture responses of the quadriceps muscles following a power-oriented IHRT intervention. Twenty-four active males completed two 4-week consecutive training blocks comprising general strengthening exercises (weeks 1-4) and power-oriented resistance training (weeks 5-8)...
2018: Frontiers in Physiology
Rebecka Lundgren, Sarah Burgess, Heather Chantelois, Susan Oregede, Brad Kerner, Anna E Kågesten
The years between 10-19 represent a critical stage of human development during which boys and girls learn and embody socially constructed gender norms, with long-term implications for their sexual and reproductive health. This ethnographic cohort study sought to understand how gendered norms and practices develop during the transition from child to young adult in post-conflict northern Uganda. A total of 60 girls and boys aged 10-19 were selected using purposive sampling for in-depth interviews over a three-year period; 47 individuals completed all four interviews...
June 8, 2018: Culture, Health & Sexuality
Ben de Jong, Anne Sophie Schuppers, Arriette Kruisdijk-Gerritsen, Maurits Erwin Leo Arbouw, Hubertus Laurentius Antonius van den Oever, Arthur R H van Zanten
BACKGROUND: Studies evaluating nicotine replacement therapy (NRT) to prevent nicotine withdrawal symptoms in ICU patients have yielded conflicting results. We performed a randomised controlled double-blind pilot study to assess the safety and efficacy of NRT in critically ill patients. Mechanically ventilated patients admitted to two medical-surgical intensive care units and smoking more than 10 cigarettes per day before ICU admission were enrolled in this study. Participants were randomised to transdermal NRT (14 or 21 mg per day) or placebo until ICU discharge or day 30...
June 7, 2018: Annals of Intensive Care
Erica Koegler, Caitlin E Kennedy
The association between poor mental health and factors related to HIV acquisition and disease progression (also referred to as HIV-related factors) may be stronger among conflict-affected populations given elevated rates of mental health disorders. We conducted a scoping review of the literature to identify evidence-based associations between mental health (depression, anxiety, and post-traumatic stress disorder [PTSD]) and factors related to HIV acquisition and progression in conflict-affected populations...
2018: Conflict and Health
Annop Phupradit, Somratai Vadcharavivad, Atiporn Ingsathit, Surasak Kantachuvesiri, Nutthada Areepium, Supasil Sra-Ium, Titinun Auamnoy, Chonlaphat Sukasem, Vasant Sumethkul, Chagriya Kitiyakara
BACKGROUND: Tacrolimus, a critical dose drug, is widely used in transplantation. Knowing the contribution of genetic factors, which significantly influence tacrolimus variability, is beneficial in the personalization of its starting dose. The significant impact of CYP3A5*3 polymorphisms on tacrolimus exposure has been reported. Conflicting results of the additional influence of POR*28 polymorphisms on tacrolimus pharmacokinetic inter-individual variability have been observed among different populations...
June 6, 2018: Therapeutic Drug Monitoring
Hamada S Ahmad, Sherief E Farrag, Amr E Okasha, Aisha O Kadry, Tamer B Ata, Amir A Monir, Ibrahim Shady
BACKGROUND: Hyaluronic acid (HA) and platelet-rich plasma (PRP) are two treatment options used for knee osteoarthritis (KOA) but studies comparing the efficacy of the two yield conflicting results. In addition, the association of clinical outcomes of PRP intra-articular injections with changes in the ultrasonography structural appearance of the knee has not been investigated. AIM: To compare the efficacy of PRP and HA intra-articular injections as mono-therapeutic options for primary KOA, and to determine whether the clinical outcomes are associated with changes in the ultrasonography structural appearance...
May 2018: International Journal of Rheumatic Diseases
Haley Moulton, Tor D Tosteson, Wenyan Zhao, Loretta Pearson, Kristina Mycek, Emily Scherer, James N Weinstein, Adam Pearson, William Abdu, Susan Schwarz, Michael Kelly, Kevin McGuire, Alden Milam, Jon D Lurie
STUDY DESIGN: Prospective evaluation of an informational web-based calculator for communicating estimates of personalized treatment outcomes. OBJECTIVE: To evaluate the usability, effectiveness in communicating benefits and risks, and impact on decision quality of a calculator tool for patients with intervertebral disc herniations, spinal stenosis, and degenerative spondylolisthesis who are deciding between surgical and non-surgical treatments. SUMMARY OF BACKGROUND DATA: The decision to have back surgery is preference-sensitive and warrants shared decision-making...
June 5, 2018: Spine
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