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Surgical ethics

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https://www.readbyqxmd.com/read/28818088/assessment-of-the-effect-of-left-atrial-cryoablation-enhanced-by-ganglionated-plexi-ablation-in-the-treatment-of-atrial-fibrillation-in-patients-undergoing-open-heart-surgery
#1
Jiří Bárta, Radim Brát
BACKGROUND: The aim of our study was to investigate, whether enhancement of left atrial cryoablation by ablation of the autonomic nervous system of left atrium leads to influencing the outcomes of surgical treatment of atrial fibrillation in patients with structural heart disease undergoing open-heart surgery. METHODS: The observed patient file consisted of 100 patients, who have undergone a combined open-heart surgery at our department between July 2012 and December 2014...
August 17, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28815690/treatment-of-individuals-who-cannot-receive-blood-products-for-religious-or-other-reasons
#2
REVIEW
Carlton D Scharman, Joseph J Shatzel, Edward Kim, Thomas G DeLoughery
By virtue of their religious principles, Jehovah's Witnesses (JWs) generally object to receiving blood products, raising numerous ethical, legal, and medical challenges for providers who care for these patients, especially in the emergent setting. In this review, we discuss several areas relevant to the care of JWs, including the current literature on "bloodless" medical care in the setting of peri- and intra-operative management, acute blood loss, trauma, pregnancy, and malignancy. We have found that medical and administrative efforts in the form of bloodless medicine and surgery programs can be instrumental in helping to reduce risks of morbidity and mortality in these patients...
August 17, 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/28805113/hospitalized-adolescents-perception-of-dignity-a-qualitative-study
#3
Neda Jamalimoghadam, Shahrzad Yektatalab, Marzieh Momennasab, Abbas Ebadi, Najaf Zare
BACKGROUND: Adolescents can be vulnerable to diminished dignity in the hospital because young people have significantly different healthcare needs than children and adults. They like to cooperate with caregivers only when they get respectful and dignified care. Care without considering dignity can adversely influence the adolescents' recovery. However, many studies have been conducted on exploring the concept of the patients' dignity from the adult patients and fewer studies still have explored the dignity of young people...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28801444/radical-cystectomy-bladder-removal-against-intravesical-bcg-immunotherapy-for-high-risk-non-muscle-invasive-bladder-cancer-bravo-a-protocol-for-a-randomised-controlled-feasibility-study
#4
Jamie B Oughton, Heather Poad, Maureen Twiddy, Michelle Collinson, Victoria Hiley, Kathryn Gordon, Mark Johnson, Sunjay Jain, Aidan P Noon, Rohit Chahal, Matt Simms, Mohantha Dooldeniya, Phillip Koenig, Louise Goodwin, Julia M Brown, James W F Catto
INTRODUCTION: High-risk non-muscle invasive bladder cancer (HRNMIBC) is a heterogeneous disease that can be difficult to predict. While around 25% of cancers progress to invasion and metastases, the remaining majority of tumours remain within the bladder. It is uncertain whether patients with HRNMIBC are better treated with intravesical maintenance BCG (mBCG) immunotherapy or primary radical cystectomy (RC). A definitive randomised controlled trial (RCT) is needed to compare these two different treatments but may be difficult to recruit to and has not been attempted to date...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28801396/the-sims-trial-adjustable-anchored-single-incision-mini-slings-versus-standard-tension-free-midurethral-slings-in-the-surgical-management-of-female-stress-urinary-incontinence-a-study-protocol-for-a-pragmatic-multicentre-non-inferiority-randomised-controlled
#5
Mohamed Abdel-Fattah, Graeme MacLennan, Mary Kilonzo, R Phil Assassa, Kirsty McCormick, Tracey Davidson, Alison McDonald, James N'Dow, Judith Wardle, John Norrie
INTRODUCTION: Single-incision mini-slings (SIMS) represent the third generation of midurethral slings. They have been developed with the aim of offering a true ambulatory procedure for treatment of female stress urinary incontinence (SUI) with reduced morbidity and earlier recovery while maintaining similar efficacy to standard midurethral slings (SMUS). The aim of this study is to determine the clinical and cost-effectiveness of adjustable anchored SIMS compared with tension-free SMUS in the surgical management of female SUI, with 3-year follow-up...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28801390/the-benefits-of-hardware-removal-in-patients-with-pain-or-discomfort-after-fracture-healing-of-the-ankle-a-systematic-review-protocol
#6
Alexandra Thune, Mårten Hagelberg, Hans Nåsell, Olof Sköldenberg
INTRODUCTION: For any orthopaedic surgeon working with trauma; ankle fractures are one of the most common injuries treated. The treatment of ankle fractures can be conservative, using external fixation, but more commonly the fractures are treated with open reduction and internal fixation. Residual pain and discomfort are common in patients after surgical treatment of fractures of the ankle. Sometimes it is difficult to determine whether the pain or discomfort is due to the implants left in situ or the primary injury itself...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28801387/microbubbles-and-ultrasound-accelerated-thrombolysis-must-for-peripheral-arterial-occlusions-protocol-for-a-phase-ii-single-arm-trial
#7
Harm P Ebben, Johanna H Nederhoed, Rutger J Lely, Willem Wisselink, Kakkhee Yeung
INTRODUCTION: Acute peripheral arterial occlusions can be treated with intra-arterial catheter-directed thrombolysis as an alternative to surgical thromboembolectomy. Although less invasive, this treatment is time-consuming and carries a significant risk of haemorrhagic complications. Contrast-enhanced ultrasound using microbubbles could accelerate dissolution of thrombi by thrombolytic medications due to mechanical effects caused by oscillation; this could allow for lower dosages of thrombolytics and faster thrombolysis, thereby reducing the risk of haemorrhagic complications...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28791081/is-the-late-mandibular-fracture-from-third-molar-extraction-a-risk-towards-malpractice-case-report-with-the-analysis-of-ethical-and-legal-aspects
#8
Weuler Dos Santos Silva, Rubens Jorge Silveira, Michelle Gouveia Benicio de Araujo Andrade, Ademir Franco, Rhonan Ferreira Silva
OBJECTIVES: The present study reports a case of late mandibular fracture due to third molar extraction and highlights the inherent clinical, ethical and legal aspects related to this surgical complication. MATERIAL AND METHODS: A female patient underwent surgical procedure for the extraction of the mandibular right third molar. Two days after the surgery the patient reported pain and altered occlusion in the right side of the mandible. After clinical and radiographic re-examination, the diagnosis of late mandibular fracture was established...
April 2017: Journal of Oral & Maxillofacial Research
https://www.readbyqxmd.com/read/28780715/innovation-in-neurosurgery-less-than-ideal-a-systematic-review
#9
REVIEW
I S Muskens, S J H Diederen, J T Senders, A H Zamanipoor Najafabadi, W R van Furth, A M May, T R Smith, A L Bredenoord, M L D Broekman
BACKGROUND: Surgical innovation is different from the introduction of novel pharmaceuticals. To help address this, in 2009 the IDEAL Collaboration (Idea, Development, Exploration, Assessment, Long-term follow-up) introduced the five-stage framework for surgical innovation. To evaluate the framework feasibility for novel neurosurgical procedure introduction, two innovative surgical procedures were examined: the endoscopic endonasal approach for skull base meningiomas (EEMS) and the WovenEndobridge (WEB device) for endovascular treatment of intracranial aneurysms...
August 6, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28770289/diagnostic-value-of-contrast-enhanced-ct-combined-with-18-fdg-pet-in-patients-selected-for-cytoreductive-surgery-and-hyperthermic-intraperitoneal-chemotherapy-hipec
#10
Antonio Sommariva, Laura Evangelista, Giovanna Pintacuda, Anna Rita Cervino, Gaetano Ramondo, Carlo Riccardo Rossi
PURPOSE: Aim of the study is to assess the reliability and correlation with surgical peritoneal cancer index (PCI) of combined PET/CT and ceCT scans (PET/ceCT) performed in a session in patients with peritoneal carcinomatosis candidates for cytoreductive surgery (CS) and hyperthermic intraperitoneal chemotherapy (HIPEC). METHODS: We retrospectively analyzed data collected from 27 patients with different types of peritoneal carcinomatosis candidates to CS + HIPEC who underwent FDG PET/ceCT in a single session...
August 2, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28761375/continuous-transversus-abdominis-plane-block-vs-intermittent-bolus-for-analgesia-after-abdominal-surgery-a-randomized-trial
#11
Vasanth Rao Kadam, Roelof M Van Wijk, John L Moran, Shantan Ganesh, A Kumar, Rajesh Sethi, Patricia Williams
BACKGROUND: Continuous and intermittent bolus techniques of transversus abdominis plane (TAP) blocks have been used for analgesia after abdominal surgery. Although both are effective, there are no studies comparing them. The aim of this study is to compare analgesia and cost-effectiveness between these groups. METHODS: After obtaining ethical approval, 20 American Society of Anesthesiologists ASA grade I to III patients undergoing elective abdominal surgery were recruited with 10 patients allocated to each arm...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28760799/rationale-and-study-design-for-an-individualised-perioperative-open-lung-ventilatory-strategy-with-a-high-versus-conventional-inspiratory-oxygen-fraction-iprove-o2-and-its-effects-on-surgical-site-infection-study-protocol-for-a-randomised-controlled-trial
#12
Carlos Ferrando, Marina Soro, Carmen Unzueta, Jaume Canet, Gerardo Tusman, Fernando Suarez-Sipmann, Julian Librero, Salvador Peiró, Natividad Pozo, Carlos Delgado, Maite Ibáñez, César Aldecoa, Ignacio Garutti, David Pestaña, Aurelio Rodríguez, Santiago García Del Valle, Oscar Diaz-Cambronero, Jaume Balust, Francisco Javier Redondo, Manuel De La Matta, Lucía Gallego, Manuel Granell, Pascual Martínez, Ana Pérez, Sonsoles Leal, Kike Alday, Pablo García, Pablo Monedero, Rafael Gonzalez, Guido Mazzinari, Gerardo Aguilar, Jesús Villar, Francisco Javier Belda
INTRODUCTION: Surgical site infection (SSI) is a serious postoperative complication that increases morbidity and healthcare costs. SSIs tend to increase as the partial pressure of tissue oxygen decreases: previous trials have focused on trying to reduce them by comparing high versus conventional inspiratory oxygen fractions (FIO2) in the perioperative period but did not use a protocolised ventilatory strategy. The open-lung ventilatory approach restores functional lung volume and improves gas exchange, and therefore it may increase the partial pressure of tissue oxygen for a given FIO2...
July 31, 2017: BMJ Open
https://www.readbyqxmd.com/read/28756397/penile-transplantation-as-an-appropriate-response-to-botched-traditional-circumcisions-in-south-africa-an-argument-against
#13
Keymanthri Moodley, Stuart Rennie
Traditional male circumcision is a deeply entrenched cultural practice in South Africa. In recent times, there have been increasing numbers of botched circumcisions by untrained and unscrupulous practitioners, leading to genital mutilation and often, the need for penile amputation. Hailed as a world's first, a team of surgeons conducted the first successful penile transplant in Cape Town, South Africa in 2015. Despite the euphoria of this surgical victory, concerns about the use of this costly intervention in a context of severe resource constraints have been raised...
July 29, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28754612/differentiation-potential-of-human-cd133-positive-hematopoietic-stem-cells-into-motor-neuron-like-cells-in-vitro
#14
Sepideh Alavi Moghaddam, Behnam Yousefi, Davood Sanooghi, Faezeh Faghihi, Nasim Hayati Roodbari, Nikoo Bana, Mohammad Taghi Joghataei, Paria Pooyan, Babak Arjmand
Spinal cord injuries and motor neuron-related disorders impact on life of many patients around the world. Since pharmacotherapy and surgical approaches were not efficient to regenerate these types of defects; stem cell therapy as a good strategy to restore the lost cells has become the focus of interest among the scientists. Umbilical cord blood CD133(+) hematopoietic stem cells (UCB- CD133(+) HSCs) with self- renewal property and neural lineage differentiation capacity are ethically approved cell candidate for use in regenerative medicine...
July 25, 2017: Journal of Chemical Neuroanatomy
https://www.readbyqxmd.com/read/28754173/a-randomized-double-blind-placebo-controlled-trial-on-the-role-of-preemptive-analgesia-with-acetaminophen-paracetamol-in-reducing-headache-following-electroconvulsive-therapy-ect
#15
Amila Isuru, Asiri Rodrigo, Chamara Wijesinghe, Dileepa Ediriweera, Shan Premadasa, Carmel Wijesekara, Lalith Kuruppuarachchi
BACKGROUND: Electroconvulsive therapy (ECT) is a safe and efficient treatment for several severe psychiatric disorders, but its use is limited by side effects. Post-ECT headache is one of the commonest side effects. Preemptive analgesia is effective in post-surgical pain management. The most commonly used analgesic is acetaminophen (paracetamol). However, acetaminophen as a preemptive analgesic for post-ECT headache has not been studied adequately. This study was conducted to compare the incidence and severity of post-ECT headache in patients who were administered acetaminophen pre-ECT with a placebo group...
July 28, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28750664/harvesting-multipotent-progenitor-cells-from-a-small-sample-of-tonsillar-biopsy-for-clinical-applications
#16
Raju Khatri, Michal Arad, Timothy Ortlip, Benjamin A Portney, W Alex Meltzer, Silviu Diaconu, Lorna E Silipino, Ying Wang, David M Kaetzel, Rodney J Taylor, Michal Zalzman
BACKGROUND: Human adult stem cells hold the potential for the cure of numerous conditions and degenerative diseases. They possess major advantages over pluripotent stem cells as they can be derived from donors at any age, and therefore pose no ethical concerns or risk of teratoma tumor formation in vivo. Furthermore, they have a natural ability to differentiate and secrete factors that promote tissue healing without genetic manipulation. However, at present, clinical applications of adult stem cells are limited by a shortage of a reliable, standardized, and easily accessible tissue source which does not rely on specimens discarded from unrelated surgical procedures...
July 27, 2017: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28748892/clinical-profile-of-geriatric-acute-kidney-injury-in-a-tertiary-care-center-from-south-india
#17
Eshwarappa Mahesh, Praveen Nallamuthu, Mahesh Kumar, Parampalli Rakesh Madhyastha, Gurudev Konanna
The incidence of acute kidney injury (AKI) is high in the elderly, who comprise an ever-growing segment of the population. Elderly patients pose a different set of diagnostic and therapeutic challenge owing to their associated comorbidities. AKI in the elderly is associated with an increased risk of mortality, morbidity, prolonged length of stay, and progression to chronic kidney disease. Data regarding the clinical profile of AKI in the elderly from the South Indian population are limited. Hence, we present this analysis of the etiological and prognostic factors associated with AKI in elderly population from South India...
July 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28746936/defining-standards-in-experimental-microsurgical-training-recommendations-of-the-european-society-for-surgical-research-essr-and-the-international-society-for-experimental-microsurgery-isem
#18
René H Tolba, Zoltán Czigány, Suzanne Osorio Lujan, Mihai Oltean, Michael Axelsson, Yelena Akelina, Antonio Di Cataldo, Iren Miko, Istvan Furka, Uta Dahmen, Eiji Kobayashi, Mihai Ionac, Norbert Nemeth
BACKGROUND: Expectations towards surgeons in modern surgical practice are extremely high with minimal complication rates and maximal patient safety as paramount objectives. Both of these aims are highly dependent on individual technical skills that require sustained, focused, and efficient training outside the clinical environment. At the same time, there is an increasing moral and ethical pressure to reduce the use of animals in research and training, which has fundamentally changed the practice of microsurgical training and research...
July 26, 2017: European Surgical Research. Europäische Chirurgische Forschung. Recherches Chirurgicales Européennes
https://www.readbyqxmd.com/read/28737572/european-society-for-paediatric-gastroenterology-hepatology-and-nutrition-guidelines-for-the-evaluation-and-treatment-of-gastrointestinal-and-nutritional-complications-in-children-with-neurological-impairment
#19
Claudio Romano, Myriam van Wynckel, Jessie Hulst, Ilse Broekaert, Jiri Bronsky, Luigi Dall'Oglio, Nataša F Mis, Iva Hojsak, Rok Orel, Alexandra Papadopoulou, Michela Schaeppi, Nikhil Thapar, Michael Wilschanski, Peter Sullivan, Frédéric Gottrand
OBJECTIVES: Feeding difficulties are frequent in children with neurological impairments and can be associated with undernutrition, growth failure, micronutrients deficiencies, osteopenia, and nutritional comorbidities. Gastrointestinal problems including gastroesophageal reflux disease, constipation, and dysphagia are also frequent in this population and affect quality of life and nutritional status. There is currently a lack of a systematic approach to the care of these patients. With this report, European Society of Gastroenterology, Hepatology and Nutrition aims to develop uniform guidelines for the management of the gastroenterological and nutritional problems in children with neurological impairment...
August 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28733301/a-3d-navigation-template-for-guiding-a-unilateral-lumbar-pedicle-screw-with-contralateral-translaminar-facet-screw-fixation-a-study-protocol-for-multicentre-randomised-controlled-trials
#20
Zhen-Xuan Shao, Wei He, Shao-Qi He, Sheng-Lei Lin, Zhe-Yu Huang, Hong-Chao Tang, Wen-Fei Ni, Xiang-Yang Wang, Ai-Min Wu
INTRODUCTION: The incidence of lumbar disc degeneration disease has increased in recent years. Lumbar interbody fusion using two unilateral pedicle screws and a translaminar facet screw fixation has advantages of minimal invasiveness and lower costs compared with the traditional methods. Moreover, a method guided by a three-dimensional (3D) navigation template may help us improve the surgical accuracy and the success rate. This is the first randomised study using a 3D navigation template to guide a unilateral lumbar pedicle screw with contralateral translaminar facet screw fixation...
July 21, 2017: BMJ Open
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