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Medically assisted death

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https://www.readbyqxmd.com/read/28644057/the-implementation-of-medical-monitoring-programs-following-potentially-hazardous-exposures-a-medico-legal-perspective
#1
David Vearrier, Michael I Greenberg
CONTEXT: Clinical toxicologists may be called upon to determine the appropriateness of medical monitoring following documented or purported exposures to toxicants in the occupational, environmental, and medical settings. METHODS: We searched the MEDLINE database using the Ovid(®) search engine for the following terms cross-referenced to the MeSH database: ("occupational exposures" OR "environmental exposures") AND ("physiologic monitoring" OR "population surveillance")...
June 23, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28633314/qualitative-identification-of-fentanyl-analogs-and-other-opioids-in-postmortem-cases-by-uhplc-ion-trap-msn
#2
Elisa N Shoff, M Elizabeth Zaney, Joseph H Kahl, George W Hime, Diane M Boland
Since 2013, the Miami-Dade County Medical Examiner Department has experienced an increase in the number of opioid-related deaths. The majority of cases coincided with the introduction of fentanyl into the local heroin supply. From 2014 to 2015, Miami-Dade County experienced a near 600% increase in fentanyl-related deaths, followed by an additional 200% increase in 2016. In 2015, two novel fentanyl analogs were identified in medical examiner cases: beta-hydroxythiofentanyl and acetyl fentanyl. In 2016, four additional fentanyl analogs emerged: para-fluoroisobutyryl fentanyl, butyryl fentanyl, furanyl fentanyl and carfentanil, as well as the synthetic opioid U-47700...
June 13, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/28604832/insects-and-associated-arthropods-analyzed-during-medicolegal-death-investigations-in-harris-county-texas-usa-january-2013-april-2016
#3
Michelle R Sanford
The application of insect and arthropod information to medicolegal death investigations is one of the more exacting applications of entomology. Historically limited to homicide investigations, the integration of full time forensic entomology services to the medical examiner's office in Harris County has opened up the opportunity to apply entomology to a wide variety of manner of death classifications and types of scenes to make observations on a number of different geographical and species-level trends in Harris County, Texas, USA...
2017: PloS One
https://www.readbyqxmd.com/read/28599052/tccc-updates-two-decades-of-saving-lives-on-the-battlefield-tactical-combat-casualty-care-turns-20
#4
Frank K Butler
BACKGROUND: Twenty years ago, the original Tactical Combat Casualty Care (TCCC) article was published in this journal. Since TCCC is essentially a set of bestpractice prehospital trauma care guidelines customized for use on the battlefield, the presence of a journal with a specific focus on military medicine was a profound benefit to the initial presentation of TCCC to the US Military. METHODS: In the two ensuing decades, which included the longest continuous period of armed conflict in our nation's history, TCCC steadily evolved as the prehospital trauma care evidence base was augmented and as feedback from user medics, corpsmen, and pararescuemen was obtained...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28598715/responding-to-a-suicide-death-the-role-of-first-responders
#5
Kenneth Norton
Effective response by first responders in the immediate aftermath of a suicide death can play a critical role in reducing risk and promoting healing for family, friends and the larger community by helping people who are newly bereaved to cope with the immediate crisis, created by the death. They also can lay the foundation for the difficult journey of mourning and healing that must follow. Stressing the importance of a comprehensive and coordinated community response to suicide, this article addresses the principles and practices that are called for in the Guidelines by highlighting four distinct first responder communities: law enforcement and emergency medical services; medical examiners; funeral professionals; and clergy and faith leaders...
June 9, 2017: Death Studies
https://www.readbyqxmd.com/read/28594767/the-case-for-a-national-maternal-mortality-review-committee
#6
Steven L Clark, Michael A Belfort
The United States has the highest maternal mortality ratio of any high-resource country; the 2014 ratio of 22 per 100,000 live births is in fact four to five times higher than that of the best-performing nations, and recent data suggest that this ratio may be increasing. The causes of this disparity are unknown and may be related to social, economic, cultural, or medical issues or a combination of factors. Repeated counts of categories of maternal death are of little assistance in determining the actual cause of death or in identifying preventive measures...
July 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28590391/misuse-of-novel-synthetic-opioids-a-deadly-new-trend
#7
Matthew P Prekupec, Peter A Mansky, Michael H Baumann
: Novel synthetic opioids (NSOs) include various analogs of fentanyl and newly emerging non-fentanyl compounds. Together with illicitly manufactured fentanyl (IMF), these drugs have caused a recent spike in overdose deaths, whereas deaths from prescription opioids have stabilized. NSOs are used as stand-alone products, as adulterants in heroin, or as constituents of counterfeit prescription medications. During 2015 alone, there were 9580 deaths from synthetic opioids other than methadone. Most of these fatalities were associated with IMF rather than diverted pharmaceutical fentanyl...
June 5, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28588967/who-multi-country-survey-on-abortion-related-morbidity-and-mortality-in-health-facilities-study-protocol
#8
Caron R Kim, Özge Tunçalp, Bela Ganatra, Ahmet Metin Gülmezoglu
INTRODUCTION: According to the WHO, abortion accounts for about 8% (4.7-13.2) of maternal mortality worldwide. In 2010, the WHO Multi-Country Survey (MCS) on Maternal and Newborn Health collected data on over 300 000 women who were admitted in health facilities to receive pregnancy-related care. Abortion data were partially captured by centring on severe maternal outcomes (ie, near-miss or maternal deaths). Building on the experiences of the prior MCS as well as current WHO reproductive health projects, we are undertaking a multi-country survey to better capture the burden and severity of abortion-related complications and management among women presenting to the health facilities...
November 2016: BMJ Global Health
https://www.readbyqxmd.com/read/28587644/current-and-future-perspectives-on-the-management-of-polypharmacy
#9
Mariam Molokhia, Azeem Majeed
BACKGROUND: Because of ageing populations, the growth in the number of people with multi-morbidity and greater compliance with disease-specific guidelines, polypharmacy is becoming increasingly common. Although the correct drug treatment in patients with complex medical problems can improve clinical outcomes, quality of life and life expectancy, polypharmacy is also associated with an increased risk of adverse drug events, some severe enough to result in hospital admission and even death...
June 6, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28578941/mortality-among-twins-and-singletons-in-sub-saharan-africa-between-1995-and-2014-a-pooled-analysis-of-data-from-90-demographic-and-health-surveys-in-30-countries
#10
Christiaan W S Monden, Jeroen Smits
BACKGROUND: Sub-Saharan Africa has the world's highest under-5 and neonatal mortality rates as well as the highest naturally occurring twin rates. Twin pregnancies carry high risk for children and mothers. Under-5 mortality has declined in sub-Saharan Africa over the last decades. It is unknown whether twins have shared in this reduction. METHODS: We pooled data from 90 Demographic and Health Surveys for 30 sub-Saharan Africa countries on births reported between 1995 and 2014...
May 31, 2017: Lancet Global Health
https://www.readbyqxmd.com/read/28577725/postoperative-liver-volume-was-accurately-predicted-by-a-medical-image-three-dimensional-visualization-system-in-hepatectomy-for-liver-cancer
#11
Wei Cai, Yingfang Fan, Haoyu Hu, Nan Xiang, Chihua Fang, Fucang Jia
BACKGROUND: Liver cancer is the second most common cause of cancer death worldwide. The hepatectomy is the most effective and the only potentially curative treatment for patients with resectable neoplasm. Precisely preoperative assessment of remnant liver volume is essential in preventing postoperative liver failure. The aim of our study is to report our experience of using a medical image three dimensional (3D) visualization system (MI-3DVS), which was developed by our team, in assisting hepatectomy for patients with liver cancer...
June 2017: Surgical Oncology
https://www.readbyqxmd.com/read/28576693/direct-laparoscopic-trocar-insertion-lessons-learned-from-nine-litigated-cases
#12
George A Vilos, Artin Ternamian, Angelos G Vilos, Basim Abu-Rafea, Cici Zhu
STUDY OBJECTIVE: To report circumstances and clinical and medico-legal outcomes of nine litigated cases associated with direct trocar insertion (DTI) injuries to bowel (7 cases) and major vessel (2 cases) during primary laparoscopic access. DESIGN: Case series from 1990 through 2015. PATIENTS: Nine litigated cases. INTERVENTION: Retrospective review of medical and legal records of litigated cases in Canada reviewed by the primary author (GAV)...
May 30, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28548865/a-national-survey-of-canadian-psychiatrists-attitudes-toward-medical-assistance-in-death
#13
Skye Rousseau, Sarah Turner, Harvey Max Chochinov, Murray W Enns, Jitender Sareen
BACKGROUND: Bill C-14 allows for medical assistance in dying (MAID) for patients who have intolerable physical or psychological suffering that occurs in the context of a reasonably foreseeable death. In Canada, psychiatrist support for MAID on the basis of mental illness and beliefs influencing level of support are unknown. The objectives of this research were to 1) determine if psychiatrists are supportive of MAID under certain conditions and on the basis of mental illness and 2) determine what factors are related to psychiatrist support for MAID on the basis of mental illness...
January 1, 2017: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/28532488/mitigating-the-heroin-crisis-in-baltimore-md-usa-a-cost-benefit-analysis-of-a-hypothetical-supervised-injection-facility
#14
Amos Irwin, Ehsan Jozaghi, Brian W Weir, Sean T Allen, Andrew Lindsay, Susan G Sherman
BACKGROUND: In Baltimore, MD, as in many cities throughout the USA, overdose rates are on the rise due to both the increase of prescription opioid abuse and that of fentanyl and other synthetic opioids in the drug market. Supervised injection facilities (SIFs) are a widely implemented public health intervention throughout the world, with 97 existing in 11 countries worldwide. Research has documented the public health, social, and economic benefits of SIFs, yet none exist in the USA. The purpose of this study is to model the health and financial costs and benefits of a hypothetical SIF in Baltimore...
May 12, 2017: Harm Reduction Journal
https://www.readbyqxmd.com/read/28532205/displayed-wounds-encrypted-messages-hyper-realism-and-imagination-in-medical-moulages
#15
Cristiana Bastos
Moulages are three-dimensional colorful replicas of body parts with particular expressions of ailments. Historically, by operating a transition between illness and disease, moulages were a powerful tool in the consolidation of the medical specialty of dermatovenereology. Yet, moulages are not solely an objectification of biological processes suitable for medical teaching; they also activate non-medical cognitions and emotions about life, death, behavior, and morality that are rooted in the history of the art of wax modeling...
May 22, 2017: Medical Anthropology
https://www.readbyqxmd.com/read/28530128/in-vivo-endocrine-secretion-of-prostacyclin-following-expression-of-a-cox-1-pgis-fusion-protein-in-the-salivary-glands-of-rats-via-non-viral-gene-therapy
#16
Zhimin Wang, Raymond L Benza, Lee Zourelias, Angela Sanguino, Ramaz Geguchadze, Kelly J Shields, Changgong Wu, Kristin B Highland, Michael J Passineau
Pulmonary arterial hypertension is a progressive disease that culminates in right heart failure and death. Prostacyclin(PGI2) and its derivatives are effective treatments for PAH when administered as continuous parenteral infusions. This treatment paradigm requires medical sophistication, and patients are at risk for complications from an indewelling catheter; drug interruptions may result in rebound pulmonary hypertension and death. We hypothesized that the salivary gland can be repurposed into an endogenous production site for circulating PGI2 through the expression of a fusion protein embodying cyclooxygenase-1(Cox1) and prostacyclin synthase(PGIS) domains...
May 20, 2017: Human Gene Therapy
https://www.readbyqxmd.com/read/28521781/telling-our-stories-heroin-assisted-treatment-and-snap-activism-in-the-downtown-eastside-of-vancouver
#17
Susan Boyd, Dave Murray, Donald MacPherson
BACKGROUND: This article highlights the experiences of a peer-run group, SALOME/NAOMI Association of Patients (SNAP), that meets weekly in the Downtown Eastside of Vancouver, British Columbia, Canada. SNAP is a unique independent peer- run drug user group that formed in 2011 following Canada's first heroin-assisted treatment trial (HAT), North America Opiate Medication Initiative (NAOMI). SNAP's members are now made up of former research participants who participated in two heroin-assisted trials in Vancouver...
May 18, 2017: Harm Reduction Journal
https://www.readbyqxmd.com/read/28509648/video-assisted-extirpation-of-cranial-mediastinal-masses-in-dogs-18-cases-2009-2014
#18
Melissa A MacIver, J Brad Case, Eric L Monnet, Geraldine B Hunt, Philipp D Mayhew, Michelle L Oblak, Jeffrey J Runge, Ameet Singh, Daniel D Smeak, Michele A Steffey, Sarah E Boston
OBJECTIVE To characterize clinical findings, surgical procedures, complications, and outcomes in dogs undergoing extirpation of masses from the cranial mediastinum via video-assisted thoracic surgery (VATS) and establish preliminary guidelines for case selection when considering VATS for thymectomy in dogs. DESIGN Retrospective case series. ANIMALS 18 client-owned dogs that underwent extirpation of a cranial mediastinal mass by means of VATS at 5 academic referral hospitals from 2009 through 2014. PROCEDURES Medical records were reviewed and data extracted regarding signalment, clinical signs, physical examination findings, diagnostic imaging results, surgical approach and duration, cytologic and histologic examination results, complications, outcome, and cause of death, when applicable...
June 1, 2017: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/28495235/prenatal-detection-of-megacystis-not-always-an-adverse-prognostic-factor-experience-in-25-consecutive-cases-in-a-tertiary-referral-center-with-complete-neonatal-outcome-and-follow-up
#19
Marcella Pellegrino, Daniela Visconti, Vincenzo Davide Catania, Luisa D'Oria, Carlo Manzoni, Maria Giovanna Grella, Alessandro Caruso, Lucia Masini, Giuseppe Noia
INTRODUCTION: Megacystis is a condition of abnormal enlarged fetal bladder for gestational age, which is usually associated with urological malformations that may constitute a life-threatening condition for the baby. OBJECTIVE: The purpose of this study was to assess the prognostic and etiological criteria of fetal megacystis and to describe the neonatal outcome in a large series collected in a single tertiary center. STUDY DESIGN: A retrospective observational study was conducted between 2008 and 2012...
April 14, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28492461/overcoming-barriers-to-initiating-medication-assisted-treatment-for-heroin-use-disorder-in-a-general-medical-hospital-a-case-report-and-narrative-literature-review
#20
Sameer Hassamal, Matthew Goldenberg, Waguih Ishak, Margaret Haglund, Karen Miotto, Itai Danovitch
Deaths due to heroin overdoses are increasing and are the leading cause of death among intravenous heroin users. Although medication-assisted treatment (MAT) improves morbidity and mortality in patients with opioid use disorders, it is underutilized. Most efforts to expand access to MAT have focused on outpatient settings. Although the inpatient medical setting presents a critical opportunity to initiate treatment, general hospitals are often unfamiliar with MAT, creating a number of barriers to its use. In this report, we describe the case of a woman with heroin use disorder who was initiated on buprenorphine maintenance treatment while hospitalized for cardiac disease related to her intravenous heroin use...
May 2017: Journal of Psychiatric Practice
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