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Medical ethics

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https://www.readbyqxmd.com/read/29149335/liberty-in-health-care-a-comparative-study-between-hong-kong-and-mainland-china
#1
Jingxian Wu, Ying Mao
This essay contends that individual liberty, understood as the permissibility of making choices about one's own health care in support of one's own good and the good of one's family utilizing private resources, is central to the moral foundations of a health care system. Such individual freedoms are important not only because they often support more efficient and effective health care services, but because they permit individuals to fulfill important moral duties. A comparative study of the health care systems in Hong Kong and mainland China is utilized to illustrate the conceptual and moral concerns at stake...
November 15, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/29149267/taiwan-biobank-making-cross-database-convergence-possible-in-the-big-data-era
#2
Jui-Chu Lin, Chien-Te Fan, Chia-Cheng Liao, Yao-Sheng Chen
The Taiwan Biobank (TWB) is a biomedical research database of biopsy data from 200,000 participants. Access to this database has been granted to research communities taking part in the development of precision medicines; however, this has raised issues surrounding TWB's access to electronic medical records (EMR). The Personal Data Protection Act of Taiwan restricts access to EMR for purposes not covered by patients' original consent. This commentary explores possible legal solutions to help ensure that the access TWB has to EMR abides with legal obligations, and with governance frameworks associated with ethical, legal and social implications...
November 15, 2017: GigaScience
https://www.readbyqxmd.com/read/29148954/our-life-depends-on-this-drug-competence-inequity-and-voluntary-consent-in-clinical-trials-on-supervised-injectable-opioid-assisted-treatment
#3
Daniel Steel, Kirsten Marchand, Eugenia Oviedo-Joekes
Supervised injectable opioid assisted treament (siOAT) prescribes injectable opioids to individuals for whom other forms of addiction treatment have been ineffective. In this article, we examine arguments that opioid-dependent people should be assumed incompetent to voluntarily consent to clinical research on siOAT unless proven otherwise. We agree that concerns about competence and voluntary consent deserve careful attention in this context. But we oppose framing the issue solely as a matter of the competence of opioid-dependent people and emphasize that it should be considered in the context of inequities in access to siOAT as a medical treatment...
December 2017: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/29146648/economic-evaluation-of-an-e-mental-health-intervention-for-patients-with-retinal-exudative-diseases-who-receive-intraocular-anti-vegf-injections-e-pseye-protocol-for-a-randomised-controlled-trial
#4
Hilde P A van der Aa, Ger H M B van Rens, Frank D Verbraak, Machteld Bosscha, Marc A Koopmanschap, Hannie C Comijs, Pim Cuijpers, Ruth M A van Nispen
INTRODUCTION: Because of the great potential of vascular endothelial growth factor inhibitors (anti-VEGF) for retinal exudative diseases, an increased number of patients receives this treatment. However, during this treatment, patients are subjected to frequent invasive intravitreal injections, and the effects on reversing the process of vision loss are uncertain, which may have negative consequences for patients' mental health. One in three patients experience at least mild symptoms of depression/anxiety...
November 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/29146647/initial-non-operative-management-of-uncomplicated-appendicitis-in-children-a-protocol-for-a-multicentre-randomised-controlled-trial-apac-trial
#5
Max Knaapen, Johanna H van der Lee, Roel Bakx, Sarah-May L The, Ernst W E van Heurn, Hugo A Heij, Ramon R Gorter
INTRODUCTION: Based on epidemiological, immunological and pathology data, the idea that appendicitis is not necessarily a progressive disease is gaining ground. Two types are distinguished: simple and complicated appendicitis. Non-operative treatment (NOT) of children with simple appendicitis has been investigated in several small studies. So far, it is deemed safe. However, its effectiveness and effect on quality of life (QoL) have yet to be established in an adequately powered randomised trial...
November 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/29145282/autosomal-dominant-polycystic-kidney-disease-combined-with-hypertrophic-cardiomyopathy-a-case-report
#6
Yingjing Shen, Chenggang Xu
INTRODUCTION: This report describes the novel sampling of autosomal dominant polycystic kidney disease (ADPKD) combined with hypertrophic cardiomyopathy (HCM). SYMPTOMS AND CLINICAL FINDINGS: A 48-year-old Chinese man presented with anasarca, hypourocrinia, gross hematuria, and weight gain by 10 kg subsequently developed acute kidney injury after struck by acute respiratory distress syndrome, really a threat to his heart. DIAGNOSES: Abdominal ultrasound revealed multiple small cysts in both kidneys, with the right kidney measuring 11...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29145187/diogenes-syndrome
#7
Frédéric Assal
Diogenes syndrome (DS) is not a specific disease but a real neurobehavioral syndrome, characterized by severe domestic squalor, pathological hoarding, lack of insight into the condition, and no need for help. DS can be secondary when associated to psychosis or bipolar disorder, or primary when it occurs as a single entity, usually in the elderly. DS is a clinically complex transnosographic syndrome for which multidimensional approaches need to be considered: medical, psychiatric, neurological, social, scientific, and ethical...
2018: Frontiers of Neurology and Neuroscience
https://www.readbyqxmd.com/read/29143183/micrornas-important-regulators-of-induced-pluripotent-stem-cell-generation-and-differentiation
#8
REVIEW
Zhao-Lin Zeng, Xiao-Long Lin, Li-Lan Tan, Ya-Mi Liu, Kai Qu, Zuo Wang
Induced pluripotent stem (iPS) cells can differentiate into nearly all types of cells. In contrast to embryonic stem cells, iPS cells are not subject to immune rejection because they are derived from a patient's own cells without ethical concerns. These cells can be used in regenerative medical techniques, stem cell therapy, disease modelling and drug discovery investigations. However, this application faces many challenges, such as low efficiency, slow generation time, partially reprogrammed colonies and tumourigenicity...
November 15, 2017: Stem Cell Reviews
https://www.readbyqxmd.com/read/29141641/gender-and-age-disparity-in-the-initiation-of-life-supporting-treatments-a-population-based-cohort-study
#9
Peng-Sheng Ting, Likwang Chen, Wei-Chih Yang, Tien-Shang Huang, Chau-Chung Wu, Yen-Yuan Chen
BACKGROUND: The relationships between age and the life-supporting treatments use, and between gender and the life-supporting treatments use are still controversial. Using extracorporeal membrane oxygenation as an example of life-supporting treatments, the objectives of this study were: (1) to examine the relationship between age and the extracorporeal membrane oxygenation use; (2) to examine the relationship between age and the extracorporeal membrane oxygenation use; and (3) to deliberate the ethical and societal implications of age and gender disparities in the initiation of extracorporeal membrane oxygenation...
November 15, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/29139100/-guidelines-for-non-invasive-and-invasive-home-mechanical-ventilation-for-treatment-of-chronic-respiratory-failure-update-2017
#10
W Windisch, M Dreher, J Geiseler, K Siemon, J Brambring, D Dellweg, B Grolle, S Hirschfeld, T Köhnlein, U Mellies, S Rosseau, B Schönhofer, B Schucher, A Schütz, H Sitter, S Stieglitz, J Storre, M Winterholler, P Young, S Walterspacher
Today, invasive and non-invasive home mechanical ventilation have become a well-established treatment option. Consequently, in 2010 the German Society of Pneumology and Mechanical Ventilation (DGP) has leadingly published the guidelines on "Non-Invasive and Invasive Mechanical Ventilation for Treatment of Chronic Respiratory Failure". However, continuing technical evolutions, new scientific insights, and health care developments require an extensive revision of the guidelines.For this reason, the updated guidelines are now published...
November 2017: Pneumologie
https://www.readbyqxmd.com/read/29138206/monitor-ic-study-a-mixed-methods-prospective-multicentre-controlled-cohort-study-assessing-5-year-outcomes-of-icu-survivors-and-related-healthcare-costs-a-study-protocol
#11
Wytske Geense, Marieke Zegers, Hester Vermeulen, Mark van den Boogaard, Johannes van der Hoeven
INTRODUCTION: Due to advances in critical care medicine, more patients survive their critical illness. However, intensive care unit (ICU) survivors often experience long-term physical, cognitive and mental problems, summarised as post-intensive care syndrome (PICS), impacting their health-related quality of life (HRQoL). In what frequency PICS occurs, and to what extent this influences ICU survivors' HRQoL, is mostly unknown. The aims of this study are therefore to study the: (1) 5-year patient outcomes, (2) predictors for PICS, (3) ratio between HRQoL of ICU survivors and healthcare-related costs, and (4) care and support needs...
November 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/29138205/long-term-prognosis-of-young-breast-cancer-patients-%C3%A2-40-years-who-did-not-receive-adjuvant-systemic-treatment-protocol-for-the-paradigm-initiative-cohort-study
#12
Gwen Mhe Dackus, Natalie D Ter Hoeve, Mark Opdam, Willem Vreuls, Zsuzsanna Varga, Esther Koop, Stefan M Willems, Carolien Hm Van Deurzen, Emilie J Groen, Alicia Cordoba, Jos Bart, Antien L Mooyaart, Jan G van den Tweel, Vicky Zolota, Jelle Wesseling, Anna Sapino, Ewa Chmielik, Ales Ryska, Frederic Amant, Annegien Broeks, Ron Kerkhoven, Nikolas Stathonikos, Mitko Veta, Adri Voogd, Katarzyna Jozwiak, Michael Hauptmann, Marlous Hoogstraat, Marjanka K Schmidt, Gabe Sonke, Elsken van der Wall, Sabine Siesling, Paul J van Diest, Sabine C Linn
INTRODUCTION: Currently used tools for breast cancer prognostication and prediction may not adequately reflect a young patient's prognosis or likely treatment benefit because they were not adequately validated in young patients. Since breast cancers diagnosed at a young age are considered prognostically unfavourable, many treatment guidelines recommend adjuvant systemic treatment for all young patients. Patients cured by locoregional treatment alone are, therefore, overtreated. Lack of prognosticators for young breast cancer patients represents an unmet medical need and has led to the initiation of the PAtients with bReAst cancer DIaGnosed preMenopausally (PARADIGM) initiative...
November 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/29138201/effect-of-iron-and-zinc-biofortified-pearl-millet-consumption-on-growth-and-immune-competence-in-children-aged-12-18-months-in-india-study-protocol-for-a-randomised-controlled-trial
#13
Saurabh Mehta, Julia L Finkelstein, Sudha Venkatramanan, Samantha L Huey, Shobha A Udipi, Padmini Ghugre, Caleb Ruth, Richard L Canfield, Anura V Kurpad, Ramesh D Potdar, Jere D Haas
INTRODUCTION: Biofortified crops represent a sustainable agricultural solution for the widespread micronutrient malnutrition in India and other resource-limited settings. This study aims to investigate the effect of the consumption of foods prepared with iron- and zinc-biofortified pearl millet (FeZn-PM) by children on biomarkers of iron and zinc status, growth, and immune function. METHODS AND ANALYSIS: We will conduct a randomised controlled feeding trial in identified slums of Mumbai, India among 200 children aged between 12 and 18 months...
November 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/29138199/electrosclerotherapy-for-capillary-malformations-study-protocol-for-a-randomised-within-patient-controlled-pilot-trial
#14
Sophie E R Horbach, Albert Wolkerstorfer, Daniel Martijn de Bruin, Chantal M A M van der Horst
INTRODUCTION: The current state-of-the-art treatment modality for hypertrophic capillary malformations (CMs), laser therapy, has a considerable rate of non-responders and recurrence. Intralesional bleomycin injections (or 'sclerotherapy') are commonly used to treat venous and lymphatic malformations with an excellent effect, but these intravascular injections are not possible in CMs due to the small diameter of the vessels. Electroporation-an electric field applied to the tissue-could increase the permeability of endothelial cells, which could theoretically facilitate targeted localised bleomycin delivery...
November 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/29134342/an-introduction-and-overview-of-machine-learning-in-neurosurgical-care
#15
REVIEW
Joeky T Senders, Mark M Zaki, Aditya V Karhade, Bliss Chang, William B Gormley, Marike L Broekman, Timothy R Smith, Omar Arnaout
BACKGROUND: Machine learning (ML) is a branch of artificial intelligence that allows computers to learn from large complex datasets without being explicitly programmed. Although ML is already widely manifest in our daily lives in various forms, the considerable potential of ML has yet to find its way into mainstream medical research and day-to-day clinical care. The complex diagnostic and therapeutic modalities used in neurosurgery provide a vast amount of data that is ideally suited for ML models...
November 13, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29133515/-rather-one-more-chemo-than-one-less%C3%A2-oncologists-and-oncology-nurses-reasons-for-aggressive-treatment-of-young-adults-with-advanced-cancer
#16
Katsiaryna Laryionava, Pia Heußner, Wolfgang Hiddemann, Eva C Winkler
BACKGROUND: Empirical research demonstrates that there is a tendency to administer tumor-directed therapy to patients with advanced cancer close to death, especially if they are young. The aim of this qualitative study was to understand oncologists' treatment decisions and oncology nurses' perception of these decisions in young adult patients and to investigate the extent to which young age was a factor in cancer treatment decisions. MATERIALS AND METHODS: We conducted 29 face-to-face interviews with oncologists and oncology nurses at the Department of Hematology and Oncology at the University Hospital in Munich, Germany...
November 13, 2017: Oncologist
https://www.readbyqxmd.com/read/29133500/hatpins
#17
Irene Koplinka-Loehr
Hatpins is a first-person narrative that delves into a physician's experience of a patient death during the early years of residency. The essay reflects on the conflicted physician-patient relationships that can develop even over the short tenure of residency. While residency seeks to create medically prepared and compassionate physicians, this piece speaks to the importance of the often subtle learning that comes from ethical, social, and cultural aspects of both the lives and deaths of our patients.
November 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/29133325/minimally-invasive-surgery-versus-open-surgery-in-the-treatment-of-lumbar-spondylolisthesis-study-protocol-of-a-multicentre-randomised-controlled-trial-misos-trial
#18
Mark P Arts, Jasper Fc Wolfs, Jos Ma Kuijlen, Godard Cw de Ruiter
INTRODUCTION: Patients with symptomatic spondylolisthesis are frequently treated with nerve root decompression, in addition to pedicle screw fixation and interbody fusion. Minimally invasive approaches are gaining attention in recent years, although there is no clear evidence supporting the proclamation of minimally invasive spine surgery (MISS) being better than open surgery. We present the design of the MISOS (Minimal Invasive Surgery versus Open Surgery) trial on the effectiveness of MISS versus open surgery in patients with degenerative or spondylolytic spondylolisthesis...
November 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/29132631/success-or-failure-of-hospital-information-systems-of-public-hospitals-affiliated-with-zahedan-university-of-medical-sciences-a-cross-sectional-study-in-the-southeast-of-iran
#19
Jahanpour Alipour, Afsaneh Karimi, Saeid Ebrahimi, Fatemeh Ansari, Yousef Mehdipour
INTRODUCTION: After implementation, evaluation of hospital information systems (HISs) is critical to ensure the fulfillment of the system goals. This study aimed to assess the success or failure of HISs in public hospitals affiliated with Zahedan University of Medical Sciences. MATERIALS AND METHODS: A cross-sectional descriptive and analytic study was performed in 2016. The study population comprised IT and HIS authorities and hospital information system users...
December 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29132275/evidence-of-biased-advertising-in-the-case-of-social-egg-freezing
#20
Christopher Barbey
Oocyte cryopreservation, or 'egg freezing,' is the practice of preserving unfertilised oocytes for later fertilisation. This practice allows women to extend their reproductive years. In 2014, Facebook and Apple announced that they would subsidise their female employees' elective - or 'social' - use of egg freezing so that these women can more easily reconcile the demands of career and family life. This announcement engendered controversy and moral debate. Given that social egg freezing (SEF) is becoming more popular, ethical and empirical analyses are warranted...
November 2017: New Bioethics: a Multidisciplinary Journal of Biotechnology and the Body
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