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Surgical ethics

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https://www.readbyqxmd.com/read/28333823/committee-opinion-no-695-sterilization-of-women-ethical-issues-and-considerations
#1
(no author information available yet)
Sterilization is the most common method of contraception among married couples, with nearly twice as many couples choosing female partner sterilization over male sterilization. Although sterilization is among the most straightforward surgical procedures an obstetrician-gynecologist performs, it is enormously complex when considered from a historical, sociological, or ethical perspective. Sterilization practices have embodied a problematic tension, in which some women who desired fertility were sterilized without their knowledge or consent, and other women who wanted sterilization to limit their family size lacked access to it...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28333815/committee-opinion-no-695-summary-sterilization-of-women-ethical-issues-and-considerations
#2
(no author information available yet)
Sterilization is the most common method of contraception among married couples, with nearly twice as many couples choosing female partner sterilization over male sterilization. Although sterilization is among the most straightforward surgical procedures an obstetrician-gynecologist performs, it is enormously complex when considered from a historical, sociological, or ethical perspective. Sterilization practices have embodied a problematic tension, in which some women who desired fertility were sterilized without their knowledge or consent, and other women who wanted sterilization to limit their family size lacked access to it...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28327977/the-ethics-of-choosing-wisely-the-use-of-neuroimaging-for-uncomplicated-headache
#3
David J Cote, Edward R Laws
The use of magnetic resonance imaging (MRI) for evaluation of headache remains excessive among physicians across many specialties according to both the American Headache Society and the American College of Radiology, despite recent attempts at limiting overuse of imaging and procedures. As part of the Choosing Wisely campaign, both of these organizations have explicitly recommended against imaging in patients with uncomplicated or typical migraine headaches. Yet, the practice nevertheless remains prevalent, with estimates ranging from 12...
February 20, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28325535/age-is-just-a-number-wpath-affiliated-surgeons-experiences-and-attitudes-toward-vaginoplasty-in-transgender-females-under-18-years-of-age-in-the-united-states
#4
Christine Milrod, Dan H Karasic
BACKGROUND: A rising number of female-affirmed transgender adolescents are being treated with gonadotropin-releasing hormone analogues and subsequently cross-sex hormones at early or mid-puberty, with vaginoplasty as the presumed final step in their physical transition. But, despite the minimum age of 18 years defining eligibility to undergo this irreversible procedure, anecdotal reports have shown that vaginoplasties are being performed on minors by surgeons in the United States, thereby contravening the World Professional Association for Transgender Health (WPATH) standards of care (SOC)...
March 16, 2017: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/28303723/decellularised-material-as-scaffolds-for-tissue-engineering-studies-in-long-gap-oesophageal-atresia
#5
Esmond Lee, Anna Milan, Luca Urbani, Paolo De Coppi, Mark W Lowdell
Oesophageal atresia refers to an anomaly in foetal development in which the oesophagus terminates in a blind end. Whilst surgical correction is achievable in most patients, when a long gap is present it still represents a major challenge associated with higher morbidity and mortality. In this context, tissue engineering could represent a successful alternative to restore oesophageal function and structure. Naturally derived biomaterials made of decellularised tissues retain native extracellular matrix architecture and composition, providing a suitable bed for the anchorage and growth of relevant cell types...
March 17, 2017: Expert Opinion on Biological Therapy
https://www.readbyqxmd.com/read/28303207/management-strategies-for-neoplastic-and-vascular-brain-lesions-presenting-during-pregnancy-a-series-of-29-patients
#6
Celestino Esteves Pereira, Jose Carlos Lynch
BACKGROUND: The occurrence of a brain tumor or intracranial vascular lesion during pregnancy is a rare event, but when it happens, it jeopardizes the lives of both the mother and infant. It also creates challenges of a neurosurgical, obstetric, and ethical nature. A multidisciplinary approach should be used for their care. METHODS: Between 1986 and 2015, 12 pregnant women diagnosed with brain tumors and 17 women with intracranial vascular lesion underwent treatment at the Neurosurgery Department of the Servidores do Estado Hospital and Rede D'Or/São Luis...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28302162/total-thyroidectomy-may-be-more-reasonable-as-initial-surgery-in-unilateral-multifocal-papillary-thyroid-microcarcinoma-a-single-center-experience
#7
Shuai Xue, Peisong Wang, Jia Liu, Guang Chen
BACKGROUND: The extent of surgery in patients with unilateral multifocal papillary thyroid microcarcinoma (UMPTMC) remains to be controversial. Aimed to improve surgical management of UMPTMC, this study was performed to identify the recurrence of UMPTMC and analyze its predictive factors. METHODS: This study was approved by the Ethical Committee of The First Hospital of the Jilin University, and written informed consent was given by participants for their clinical records to be used in this study...
March 16, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28301309/value-of-dynamic-contrast-enhanced-and-diffusion-weighted-mr-imaging-in-the-detection-of-pathologic-complete-response-in-cervical-cancer-after-neoadjuvant-therapy-a-retrospective-observational-study
#8
Aurélie Jalaguier-Coudray, Rim Villard-Mahjoub, Aurélie Delouche, Béatrice Delarbre, Eric Lambaudie, Gilles Houvenaeghel, Mathieu Minsat, Agnès Tallet, Renaud Sabatier, Isabelle Thomassin-Naggara
Purpose To evaluate the association between dynamic contrast material-enhanced (DCE) and diffusion-weighted (DW) magnetic resonance (MR) imaging with pathologic complete response after preoperative combined chemotherapy and radiation therapy for cervical carcinoma and evaluate the risk of local recurrence. Materials and Methods The institutional ethics committee approved the study and waived the requirement to obtain informed consent. The study comprised 52 patients with locally advanced carcinoma, treated first with combined chemotherapy and radiation therapy, who underwent MR imaging before final surgery between June 2011 and July 2015...
March 14, 2017: Radiology
https://www.readbyqxmd.com/read/28299268/role-of-addition-of-dexamethasone-to-lignocaine-2-with-adrenaline-in-dental-nerve-blocks-for-third-molar-surgery-a-prospective-randomized-control-trial
#9
Saroj Prasad Deo
CONTEXT: Dexamethasone has been frequently used in oral surgical procedure and accepted by oral and maxillofacial surgeon community worldwide. However, this is the first clinical trial that used dexamethasone as adjuvant with lignocaine in dental nerve block (DNB). AIMS: The purpose of this double-blind, randomized control trial (RCT) was to compare the effect of dexamethasone with normal saline (NS) in a lignocaine DNB. SETTINGS AND DESIGN: This prospective, double-blind, RCT was carried out after obtaining approval from the Institutional Ethical Committee...
July 2016: Annals of Maxillofacial Surgery
https://www.readbyqxmd.com/read/28298786/comparison-of-dexmedetomidine-and-magnesium-sulfate-as-adjuvants-with-ropivacaine-for-spinal-anesthesia-in-infraumbilical-surgeries-and-postoperative-analgesia
#10
Reena Makhni, Joginder Pal Attri, Payal Jain, Veena Chatrath
INTRODUCTION: Postoperative pain is a major cause of fear and anxiety in hospitalized patients and so if patients remain pain-free during this period, they can cooperate with the circumstances well, leading to early recovery. Over the last two decades, there has been considerable revival of interest in the use of regional anesthesia techniques for surgery and pain management. As very few studies have been conducted using ropivacaine with dexmedetomidine and magnesium sulfate (MgSO4) as adjuvants, the present study was undertaken with primary aims to compare the hemodynamic stability, onset and duration of sensory and motor block and with secondary aims of the postoperative analgesic effect of dexmedetomidine and MgSO4 along with ropivacaine...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298760/the-effectiveness-of-intravenous-dexmedetomidine-on-perioperative-hemodynamics-analgesic-requirement-and-side-effects-profile-in-patients-undergoing-laparoscopic-surgery-under-general-anesthesia
#11
Vinayak Panchgar, Akshaya N Shetti, H B Sunitha, Vithal K Dhulkhed, A V Nadkarni
BACKGROUND: There is an upward surge in the use of laparoscopic surgeries due to various advantages when compared to open surgeries. Major advantages are, due to small incisions which are cosmetically acceptable and most of them are now daycare procedures. Problem of economic burden and hospital bed occupancy has been overcome with laparoscopic surgeries. All these advantages are not free from disadvantages, as hemodynamic changes such as hypertension; tachycardia and other surgical-related complications are commonly observed intraoperatively...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28296925/worldwide-trends-in-volume-and-quality-of-published-protocols-of-randomized-controlled-trials
#12
Belle V van Rosmalen, Ingo Alldinger, Kasia P Cieslak, Roos Wennink, Mike Clarke, Usama Ahmed Ali, Marc G H Besselink
INTRODUCTION: Publishing protocols of randomized controlled trials (RCT) facilitates a more detailed description of study rational, design, and related ethical and safety issues, which should promote transparency. Little is known about how the practice of publishing protocols developed over time. Therefore, this study describes the worldwide trends in volume and methodological quality of published RCT protocols. METHODS: A systematic search was performed in PubMed and EMBASE, identifying RCT protocols published over a decade from 1 September 2001...
2017: PloS One
https://www.readbyqxmd.com/read/28291213/-intraoperative-fluorescence-diagnosis-using-5-aminolevulinic-acid-in-surgical-treatment-of-children-with-recurrent-neuroepithelial-tumors
#13
A V Kim, V A Khachatryan
AIM: To analyze the efficacy and safety of 5-aminolevulinic acid for intraoperative fluorescence diagnosis (FD) during repeated surgery for recurrent neuroepithelial tumors (NETs) in children. MATERIAL AND METHODS: We performed a retrospective analysis of the results of recurrent NET resection in 13 children aged from 3 to 17 years in the period between December 2013 and May 2015. The source of 5-ALA was a drug "Alasens" that was administered at a dose of 20 mg/kg of body weight 4 h before the beginning of tumor resection...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28280304/factors-associated-with-preoperative-anxiety-levels-of-turkish-surgical-patients-from-a-single-center-in-ankara
#14
Ezgi Erkilic, Elvin Kesimci, Cem Soykut, Cihan Doger, Tülin Gumus, Orhan Kanbak
BACKGROUND: Preoperative anxiety and stress are undoubtedly a difficult experience in patients undergoing elective surgery. These unpleasant sensations depend on several factors. The objective of this study was to evaluate the preoperative anxiety levels in a sample of Turkish population, as well as the underlying causes using the Spielberger State-Trait Anxiety Inventory (STAI anxiety) scale. METHODS: The study was conducted according to the Declaration of Helsinki and was approved by the local ethical committee...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28276121/re-opening-the-window-on-fenestration-as-a-treatment-for-acute-thoracolumbar-intervertebral-disc-herniation-in-dogs
#15
P Freeman, N D Jeffery
Acute thoracolumbar intervertebral disc herniation in dogs is a common cause of "back" pain, pelvic limb paresis or paralysis and incontinence. Treatment of this condition has long been a source of controversy, especially since the introduction of surgical interventions in the 1950s. Unfortunately, formal clinical trials to compare efficacy of conservative and surgical interventions have never been carried out and the current lack of clinical equipoise on this subject now precludes such a trial on ethical grounds...
April 2017: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/28275425/a-clinical-and-ethical-review-on-late-results-and-benefits-after-evar
#16
REVIEW
Carlo Setacci, Pasqualino Sirignano, Vittorio Fineschi, Paola Frati, Giovanna Ricci, Francesco Speziale
INTRODUCTION: The aim of this review is to assess if late mortality after endovascular repair (EVAR) of abdominal aortic aneurysms (AAA) is a real problem, and whether it could be an issue in the case of medical litigation. MATERIAL AND METHODS: A review of all English language literature was performed on PubMed web-site, looking for all papers reporting EVAR long-term mortality rate. EVAR performances were reviewed also from an ethical and medico-legal point of view, based on current Italian laws...
April 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28270097/factors-influencing-the-level-of-patients-using-the-internet-to-gather-information-before-anaesthesia-a-single-centre-survey-of-815-patients-in-switzerland-the-internet-for-patient-information-before-anaesthesia
#17
T Wieser, M P Steurer, M Steurer, A Dullenkopf
BACKGROUND: Aim of this study was to identify factors associated with patients using the internet to find information about their upcoming surgery in general, and more specifically about anaesthesia. METHODS: With Ethics committee approval, 1000 consecutive patients seen before elective surgery in the anaesthesia preoperative clinic of a Swiss Level 2 hospital were asked to complete a questionnaire. Primary outcome were patients using the internet to gather any medical information related to their upcoming hospital stay, secondary outcome patients using the internet to gather information regarding the upcoming anaesthesia...
March 8, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28264580/-ethical-aspects-of-uterus-transplantation
#18
Roman Chmel, Marta Nováčková, Zlatko Pastor, Jan Matěcha, Miloš Čekal, Jiří Froněk
Uterus transplantation is an experimental treatment method with an ambition to become accepted treatment modality for women with absolute uterine factor infertility. The only legal alternative for these women to get parenthood is adoption which is accepted by most world societies and countries. Surrogate pregnancy is connected with many medical, ethical, legal, religious and social controversies in the great part of the world.Donors (in living donation), recipients, partners and also unborn children must be incorporated into the analysis of ethical risks and benefits of uterus transplantation...
2017: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/28261765/complicated-colorectal-cancer-in-nonagenarian-patients-is-it-better-not-to-perform-anastomosis-in-emergency
#19
Belinda De Simone, Federico Coccolini, Luca Ansaloni, Antonio Tarasconi, Gianluca Baiocchi, Nereo Vettoretto, Peggy Joly, Marianne Ferron, Alessandro Pozzo, Lionel Charre, Salomone Di Saverio, Josephine Andrea Napoli, Ferdinando Agresta, Massimo Sartelli, Fausto Catena
BACKGROUND: Colorectal cancer (CRC) is predominantly a disease of elderly people. Cancer in nonagenarian patients presents an ethical dilemma for surgeons and oncologists, and management of this group of patients in emergency for complicated CRC is debated. Presently described is retrospective study reporting experience of 6 departments of emergency surgery with management of nonagenarian patients sent to emergency surgery for CRC complications. METHODS: Data concerning patients aged over 90 years hospitalized from January 2011 to June 2015 in 6 departments of emergency surgery for complicated CRC were retrospectively analyzed...
January 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28250485/mortality-prediction-in-indian-cardiac-surgery-patients-validation-of-european-system-for-cardiac-operative-risk-evaluation-ii
#20
Prachi Kar, Kanithi Geeta, Ramachandran Gopinath, Padmaja Durga
BACKGROUND AND AIMS: Risk Stratification has an important place in cardiac surgery to identify high-risk cases and optimally allocate resources. Hence various risk scoring systems have been tried to predict mortality. The aim of the present study was to validate the European System for Cardiac Operative Risk Evaluation II (EuroSCORE II) in Indian cardiac surgical patients. METHODS: After obtaining ethics committee clearance, data on EuroSCORE II variables were collected for all patients >18 years undergoing on-pump coronary artery bypass graft (CABG), valve surgery and mixed (CABG + valve) procedures between January 2011 and December 2012...
February 2017: Indian Journal of Anaesthesia
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