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https://www.readbyqxmd.com/read/29149121/ethics-and-genetics-examining-a-crossroads-in-nursing-through-a-case-study%C3%A2
#1
Laura Curr Curr Beamer
BACKGROUND: The field of genetics and genomics is rapidly expanding, particularly in oncology. Genetics and genomics can lead to ethical concerns. Oncology nurses must balance the need for evidence-based oncology care with that of ethical care for patients and their family members. OBJECTIVES: The purpose of this article is to provide an overview of cancer genetics and ethics and their impact on oncology nurses, patients, and families. METHODS: A case study of familial adenomatous polyposis (FAP) is offered to illustrate the impact of a hereditary cancer syndrome on several generations of a family and ethical issues surrounding cancer genetics...
December 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/29147590/paroxysmal-nocturnal-hemoglobinuria-in-pregnancy-a-dilemma-in-treatment-and-thromboprophylaxis
#2
Arpan Patel, Athira Unnikrishnan, Martina Murphy, Robert Egerman, Sarah Wheeler, Ashley Richards, John Wingard
Paroxysmal nocturnal hemoglobinuria (PNH) is a hematologic disorder characterized by an acquired somatic mutation in the phosphatidylinositol glycan class A gene which leads to a higher risk for increased venous and arterial thrombosis. Current treatment for PNH includes eculizumab. Pregnant patients who have PNH have higher risk for thrombosis and hemorrhage with both pregnancy and their underlying PNH. Treatment frequently poses conundrum. The safety and efficacy of eculizumab during pregnancy and breast feeding have not been extensively studied and contraception has been recommended due to potential for teratogenicity...
2017: Case Reports in Hematology
https://www.readbyqxmd.com/read/29147491/augmented-expression-levels-of-lncrnas-eccebpa-and-uca1-in-gastric-cancer-tissues-and-their-clinical-significance
#3
Mojdeh Nasrollahzadeh-Khakiani, Modjtaba Emadi-Baygi, Parvaneh Nikpour
Objectives: As the second cause of cancer death, gastric cancer (GC) is one of the eminent dilemmas all over the world, therefore investigating the molecular mechanisms involved in this cancer is pivotal. Unrestricted proliferation is one of the characteristics of cancerous cells, which is due to deficiency in cell regulatory systems. Long non-coding RNAs (lncRNAs) have emerged as critical regulators of the epigenome. lncRNA extra coding CEBPA (ecCEBPA) is involved in DNA methylation...
October 2017: Iranian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/29146387/dilemmas-in-genetic-counseling-for-low-penetrance-neuro-susceptibility-loci-detected-on-prenatal-chromosomal-microarray-analysis
#4
Dana Brabbing-Goldstein, Adi Reches, Ran Svirsky, Anat Bar-Shira, Yuval Yaron
BACKGROUND: Chromosomal microarray analysis is standard of care in fetuses with malformations, detecting clinically significant copy number variants in 5-7% of cases over conventional karyotyping. However, it also detects variants of uncertain significance in 1.6% - 4.2% of the cases, some of which are low-penetrance neuro-susceptibility loci. The interpretation of these variants in pregnancy is particularly challenging, because the significance is often unclear and the clinical implications may be difficult to predict...
November 13, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29146017/the-need-for-an-epidural-window-of-opportunity-in-pregnant-women-with-a-lumbar-tattoo
#5
REVIEW
Y Zipori, P Jakobi, I Solt, P Abecassis
Pregnant women with lower back tattoos who wish to have an epidural placed during labour pose a dilemma to anesthesiologists. Clear guidelines have not been established. We reviewed the epidural risks in pregnant women with low back tattoos and have suggested precautionary measures to minimise them. Given the limited information available, and in the absence of a clear evidence-based medical contraindication, an epidural technique should not be excluded in those women with a lower back tattoo.
September 21, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29145371/the-digital-subscription-dilemma
#6
David Pogue
No abstract text is available yet for this article.
November 14, 2017: Scientific American
https://www.readbyqxmd.com/read/29143891/in-search-of-the-ideal-promotility-agent-optimal-use-of-currently-available-promotility-agents-for-nutrition-therapy-of-the-critically-ill-patient
#7
REVIEW
Sarah J Diamond, Endashaw Omer, Laszlo Kiraly
PURPOSE OF REVIEW: Enteral nutrition therapy is essential in the management of critically ill patients. Prokinetic agents have been used successfully to aid in the delivery of nutrition and improve feeding tolerance in patients in the intensive care unit (ICU). The aim of this report is to review the existing promotility agents available for use in the critically ill as well as outline the role of potential investigative drugs in order to provide a guide to the management of this difficult and important clinical dilemma...
November 16, 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/29142773/suprasellar-and-third-ventricular-cavernous-malformation-lessons-learned-in-differential-diagnosis-and-surgical-planning
#8
Kay O Kulason, Julia R Schneider, Ralph Rahme, Fanni Ratzon, Todd A Anderson, Deborah R Shatzkes, Christopher G Filippi, Peter D Costantino, David J Langer, John A Boockvar
Background: While craniopharyngiomas (CPs) are the most common cystic suprasellar lesions in adults, cavernous malformations (CMs) only exceptionally occur in this location and are seldom considered in the differential diagnosis of such lesions. However, unlike CPs, suprasellar CMs are not typically approached via an endoscopic endonasal approach. Case Description: We present a unique clinical case of suprasellar and third ventricular CM mimicking a CP, posing a major decision-making dilemma at the levels of both preoperative diagnosis and surgical planning...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29142770/placental-teratoma-omphalomesenteric-duct-remnant-or-intestinal-organoid-enteroid-differentiation-a-diagnostic-dilemma
#9
Salwa Khedr, Tarek Jazaerly, Stefan Kostadinov
We report an unusual case of fully developed fetal intestinal segment(s) within a nodule on the chorionic plate of the placenta of a 27-year-old female patient at 37 weeks gestation with spontaneous vaginal delivery. Gross examination of the placenta revealed a chorionic plate nodule near the insertion of the umbilical cord, which, upon microscopic evaluation, raised the differential diagnostic possibilities of placental teratoma, vitelline/omphalomesenteric duct anomaly, and intestinal organoid differentiation...
December 2017: Journal of Pediatric Genetics
https://www.readbyqxmd.com/read/29140653/outsource-power-import-safety-challenges-and-opportunities-of-the-u-s-china-food-safety-regulatory-cooperation
#10
Ching-Fu Lin
The United States has a high stake in China’s serious food safety problem, as food products of Chinese origin have dominated the U.S. food market in numerous areas and continue to grow. The conclusion of the U.S.-China Food Safety Agreement (“the Agreement”) has allowed FDA to strengthen regulatory cooperation with its Chinese counterpart in various aspects. The Agreement also paves the way for the implementation of the new regulatory tools incorporated in FSMA, especially in the cross-border context...
2017: Food and Drug Law Journal
https://www.readbyqxmd.com/read/29139332/the-views-of-adults-with-huntington-s-disease-on-assisted-dying-a-qualitative-exploration
#11
Laurence Regan, Nancy J Preston, Fiona J R Eccles, Jane Simpson
BACKGROUND: Assisted dying is frequently debated publicly and research often includes the views of health professionals on this issue. However, the views of people with life-limiting conditions, for whom this issue is likely to have a different resonance, are less well represented. AIM: The purpose of this study was to explore the views of people who live with the inevitability of developing Huntington's disease, a genetically transmitted disease which significantly limits life, on assisted dying...
November 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/29138411/divide-and-conquer-tournament-on-social-networks
#12
Jiasheng Wang, Yichao Zhang, Jihong Guan, Shuigeng Zhou
In social gaming networks, previous studies extensively investigated the influence of a variety of strategies on reciprocal behaviors in the prisoner's dilemma game. The studied frameworks range from the case that an individual uniformly cooperates or defects with all social contacts, to the recently reported divide-and-conquer games, where an individual can choose a particular move to play with each neighbor. In this paper, we investigate a divide-and-conquer tournament among 14 well-known strategies on social gaming networks...
November 14, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29136051/melanotrichoblastoma-a-rare-pigmented-variant-of-trichoblastoma
#13
Erin E Quist, Dominick J DiMaio
Trichoblastomas are rare cutaneous tumors arising from the hair bulb and mesenchyme. Although they are benign, they can pose a diagnostic dilemma for the clinician and pathologist because they clinically and histologically mimic more common lesions such as basal cell carcinomas (BCCs) and trichoepitheliomas. It is important for the clinician and pathologist to be aware of such tumors and their variants. We present a case of a melanotrichoblastoma, an exceedingly rare variant of trichoblastoma, as well as review the current literature on the clinical presentation and histologic differentiation of these unique tumors with their more commonly seen mimics...
October 2017: Cutis; Cutaneous Medicine for the Practitioner
https://www.readbyqxmd.com/read/29135874/meni%C3%A3-re-and-friends-imaging-and-classification-of-hydropic-ear-disease
#14
Robert Gürkov
BACKGROUND: Over 75 years ago, endolymphatic hydrops was discovered as the pathologic correlate of Menière's disease. However, this pathologic finding could be ascertained only in postmortem histologic studies. Due to this diagnostic dilemma and the variable manifestation of the various audiovestibular symptoms, diagnostic classification systems based on clinical findings have been used hitherto. METHODS: A review of the literature of magnetic resonance (MR) imaging of hydropic ear disease...
December 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/29133670/multicolor-imaging-in-optic-disc-swelling
#15
Nicey Roy Thomas, Prachi Subhedar Ghosh, Maitreyi Chowdhury, Kumar Saurabh, Rupak Roy
Differentiating optic disc edema (ODE) from pseudo optic disc edema (PODE) continues to pose a diagnostic dilemma. Current report highlights the role of multicolor imaging (MC) in differentiating ODE from PODE. Composite multicolor images of the disc in ODE show greenish hyperreflectance that extends beyond the optic disc margins with irregular blurry margins and obscured disc vasculature whereas PODE shows a greenish hyperreflectance with clear and distinct margins and well delineated disc vasculature. MC imaging adds to the present armamentarium of imaging modalities obviating needless neurological evaluation mandatory in a case of true disc edema...
November 2017: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/29133582/use-of-ketamine-for-acute-suicidal-ideation-in-a-patient-with-chronic-pain-on-prescribed-cannabinoids
#16
Daniel Bigman, Sindhura Kunaparaju, Bradford Bobrin
Ketamine is a standard anaesthetic drug that has been studied as a possible treatment for acute suicidal ideation. Aside to the potential psychotropic effects of ketamine, a Cochrane review reported that available studies suggest a modest effect of ketamine for chronic pain months to years after surgical intervention. We present a patient with acute suicidal ideation who required immediate inpatient psychiatric admission in the setting of concurrent chronic pain on cannabinoids which could not be prescribed within our inpatient hospital setting...
November 12, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29133492/general-practitioner-performed-compression-ultrasonography-for-diagnosis-of-deep-vein-thrombosis-of-the-leg-a-multicenter-prospective-cohort-study
#17
Nicola Mumoli, Josè Vitale, Matteo Giorgi-Pierfranceschi, Silvia Sabatini, Renato Tulino, Marco Cei, Eugenio Bucherini, Carlo Bova, Daniela Mastroiacovo, Alberto Camaiti, Gerardo Palmiero, Luca Puccetti, Francesco Dentali
BACKGROUND: Patients with suspected deep vein thrombosis (DVT) of the lower limb represent a diagnostic dilemma for general practitioners. Compression ultrasonography (US) is universally recognized as the best test of choice. We assessed the diagnostic accuracy of compression US performed by general practitioners given short training in the management of symptomatic proximal DVT. METHODS: From May 2014 to May 2016, we evaluated in a multicenter, prospective cohort study all consecutive outpatients with suspected DVT; bilateral proximal lower limb compression US was performed by general practitioners and by physicians expert in vascular US, each group blinded to the other's findings...
November 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/29132595/remote-ecls-implantation-and-transport-for-retrieval-of-cardiogenic-shock-patients
#18
Sabina P W Guenther, Stefan Buchholz, Frank Born, Stefan Brunner, René Schramm, Dominik J Hoechter, Vera von Dossow, Maximilian Pichlmaier, Christian Hagl, Nawid Khaladj
OBJECTIVE: Extracorporeal life support (ECLS) emerges as a salvage option in therapy refractory cardiogenic shock but is limited to highly specialized tertiary care centers. Critically ill patients are often too unstable for conventional transport. Mobile ECLS programs for remote implantation and subsequent air or ground-based transport for patient retrieval could solve this dilemma and make full-spectrum advanced cardiac care available to patients in remote hospitals in whom shock otherwise might be fatal...
November 2017: Air Medical Journal
https://www.readbyqxmd.com/read/29132340/what-do-japanese-residents-learn-from-treating-dying-patients-the-implications-for-training-in-end-of-life-care
#19
Kazuko Arai, Takuya Saiki, Rintaro Imafuku, Chihiro Kawakami, Kazuhiko Fujisaki, Yasuyuki Suzuki
BACKGROUND: How medical residents' experiences with care for dying patients affect their emotional well-being, their learning outcomes, and the formation of their professional identities is not fully understood. We examine residents' emotional states and learning occurring during the provision of care to dying patients and specifically discuss the impact of providing end-of-life (EOL) care on professional identity formation. METHODS: Semi-structured interviews were conducted with 13 residents who had graduated in the last 3 to 5 years...
November 13, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/29131764/nongynecologic-findings-seen-at-pelvic-us
#20
Akram M Shaaban, Maryam Rezvani, Jeffrey D Olpin, Anne M Kennedy, Ayman H Gaballah, Bryan R Foster, Christine O Menias, Khaled M Elsayes
Ultrasonography (US) is frequently the first imaging modality used to examine women with symptoms involving the pelvis. It is widely available and involves no exposure to ionizing radiation. Images can be acquired with a transabdominal, endovaginal, or translabial approach, and the use of video clips and three-dimensional reconstructions can be helpful. US is excellent for assessment of the uterus, ovaries, and adnexa. Occasionally, nongynecologic pelvic diseases arising from the gastrointestinal, genitourinary, and musculoskeletal systems and the pelvic peritoneal and extraperitoneal spaces may be detected and can be a source of diagnostic dilemma...
November 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
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