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Surgical ethics

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https://www.readbyqxmd.com/read/28643577/an-assessment-of-advance-relatives-approach-for-brain-death-organ-donation
#1
Carine Michaut, Antoine Baumann, Hélène Gregoire, Corinne Laviale, Gérard Audibert, Xavier Ducrocq
BACKGROUND: Advance announcement of forthcoming brain death has developed to enable intensivists and organ procurement organisation coordinators to more appropriately, and separately from each other, explain to relatives brain death and the subsequent post-mortem organ donation opportunity. Research aim: The aim was to assess how potentially involved healthcare professionals perceived ethical issues surrounding the strategy of advance approach. RESEARCH DESIGN: A multi-centre opinion survey using an anonymous self-administered questionnaire was conducted in the six-member hospitals of the publicly funded East of France regional organ and tissue procurement network called 'Prélor'...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28642541/can-uk-undergraduate-dental-programmes-provide-training-in-non-surgical-facial-aesthetics
#2
T W M Walker, F Gately, S Stagnell, A Kerai, C Mills, S Thomas
Aim Recently, more and more dentists have found themselves engaging in the delivery of non-surgical facial aesthetics (NSFA) as part of their regular practice routine. NSFA is a growing field in aesthetic medicine that is practised by a range of clinicians including doctors, dentists and registered prescriber nurses and is an industry estimated to be worth over £3 billion in the UK alone. In the past few years, several public scandals in aesthetic medicine have prompted reactions by several bodies including the Government and Royal Colleges...
June 23, 2017: British Dental Journal
https://www.readbyqxmd.com/read/28642025/total-laparoscopic-resection-surgery-for-a-cervical-carcinoma-that%C3%A2-recurred-in-the-pelvic-sidewall-after-radical-hysterectomy-and%C3%A2-adjuvant-concurrent-chemoradiotherapy
#3
Hiroyuki Kanao, Yoichi Aoki, Kazuyoshi Kato, Maki Matoda, Sanshiro Okamoto, Hidetaka Nomura, Kohei Omatsu, Kuniko Utsugi, Nobuhiro Takeshima
STUDY OBJECTIVE: To show total laparoscopic resection of a cervical carcinoma that recurred at the left pelvic sidewall after radical hysterectomy and concurrent chemoradiotherapy (CCRT). DESIGN: A step-by-step demonstration of the technique in a surgical video, including the strategy for achieving complete surgical resection with negative margins (R0 resection) (Canadian Task Force Classification III). SETTING: For high-risk cervical carcinoma, radical hysterectomy and adjuvant CCRT is the standard treatment, but even this multimodal therapy cannot prevent recurrence...
June 19, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28640984/is-it-right-to-ignore-learning-curve-patients-laparoscopic-colorectal-trials
#4
Alan P Meagher, Shi Yang, Shuyuan Li
BACKGROUND: Increasingly complex, technically demanding surgical procedures utilizing emerging technologies have developed over recent decades and are recognized as having long 'learning curves'. This raises significant new issues. Ethically and scientifically, the outcome of a patient in the learning curve is as important as the outcome of a patient outside the learning curve. The aim of this study is to highlight just one aspect of our approach to learning-curve patients that should change...
June 22, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28639871/an-innovative-streaming-video-system-with-a-point-of-view-head-camera-transmission-of-surgeries-to-smartphones-and-tablets-an-educational-utility
#5
Rafael Oliveira Chaves, Pedro Armando Valente de Oliveira, Luciano Chaves Rocha, Joacy Pedro Franco David, Sanmari Costa Ferreira, Alex de Assis Santos Dos Santos, Rômulo Müller Dos Santos Melo, Edson Yuzur Yasojima, Marcus Vinicius Henriques Brito
PURPOSE: In order to engage medical students and residents from public health centers to utilize the telemedicine features of surgery on their own smartphones and tablets as an educational tool, an innovative streaming system was developed with the purpose of streaming live footage from open surgeries to smartphones and tablets, allowing the visualization of the surgical field from the surgeon's perspective. The current study aims to describe the results of an evaluation on level 1 of Kirkpatrick's Model for Evaluation of the streaming system usage during gynecological surgeries, based on the perception of medical students and gynecology residents...
June 1, 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28637736/transcatheter-closure-mini-invasive-closure-and-open-heart-surgical-repair-for-treatment-of-perimembranous-ventricular-septal-defects-in-children-a-protocol-for-a-network-meta-analysis
#6
Tao You, Kang Yi, Zhao-Hong Ding, Xiao-Dong Hou, Xing-Guang Liu, Xin-Kuan Wang, Long Ge, Jin-Hui Tian
INTRODUCTION: Both transcatheter device closure and surgical repair are effective treatments with excellent midterm outcomes for perimembranous ventricular septal defects (pmVSDs) in children. The mini-invasive periventricular device occlusion technique has become prevalent in research and application, but evidence is limited for the assessment of transcatheter closure, mini-invasive closure and open-heart surgical repair. This study comprehensively compares the efficacy, safety and costs of transcatheter closure, mini-invasive closure and open-heart surgical repair for treatment of pmVSDs in children using Bayesian network meta-analysis...
June 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28631522/evidence-based-management-of-non-tubal-ectopic-pregnancies
#7
Aderemi Olaoluwa Alalade, Fredrick John Ennis Smith, Charlotte Emma Kendall, Funlayo Odejinmi
Recent advances in ultrasonography and the use of other modalities including magnetic resonance imaging scans have led to the early and more accurate diagnosis of non-tubal ectopic pregnancies (NTE). As a result, the management of these pregnancies has evolved. This article addresses the management options currently available for NTE. While surgical management remains the mainstay of treatment for ovarian, abdominal and cornual ectopics, there is growing evidence that some of these can be managed medically...
June 20, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28631150/low-dose-subcutaneous-ketamine-for-postoperative-pain-management-in-rwanda-a-dose-finding-study
#8
Jon Tuchscherer, William P McKay, Theogene Twagirumugabe
PURPOSE: Good pain control is not a normal part of surgical care in sub-Saharan Africa due to lack of resources. The primary objective of this study was to determine an efficacious dose of subcutaneous ketamine for postoperative pain for use in a future randomized controlled trial. METHODS: Following research ethics board and local hospital approval for this research, we obtained informed consent from 31 patients undergoing major surgery for a random walk dose-finding study...
June 19, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28623597/acute-appendicitis-still-a-surgical-disease-results-from-a-propensity-score-based-outcome-analysis-of-conservative-versus-surgical-management-from-a-prospective-database
#9
Niccolò Allievi, Asaf Harbi, Marco Ceresoli, Giulia Montori, Elia Poiasina, Federico Coccolini, Michele Pisano, Luca Ansaloni
OBJECTIVE: The aim of the present study was to compare the outcomes of conservative versus surgical treatment for acute appendicitis. BACKGROUND: Although acute appendicitis is a common disease, great debate exists regarding the appropriate management of patients. Conservative treatment has shown positive results in several RCTs, eliciting questions about indications to surgery, therapeutic appropriateness and ethical conduct. METHODS: Data were prospectively collected; a Propensity Score-based matching method was implemented in order to reduce bias arising from characteristics of the patients; a proportion of patients (69 in total) were excluded to obtain two comparable groups of study (1a)...
June 16, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28619764/medicoeconomic-analysis-of-lobectomy-using-thoracoscopy-versus-thoracotomy-for-lung-cancer-a-study-protocol-for-a-multicentre-randomised-controlled-trial-lungsco01
#10
Pierre-Benoit Pagès, Halim Abou Hanna, Anne-Claire Bertaux, Ludwig Serge Serge Aho, Pierre Magdaleinat, Jean-Marc Baste, Marc Filaire, Richard de Latour, Jalal Assouad, François Tronc, Christophe Jayle, Jérome Mouroux, Pascal-Alexandre Thomas, Pierre-Emmanuel Falcoz, Charles-Henri Marty-Ané, Alain Bernard
INTRODUCTION: In the last decade, video-assisted thoracoscopic surgery (VATS) lobectomy for non-small cell lung cancer (NSCLC) has had a major effect on thoracic surgery. Retrospective series have reported benefits of VATS when compared with open thoracotomy in terms of postoperative pain, postoperative complications and length of hospital stay. However, no large randomised control trial has been conducted to assess the reality of the potential benefits of VATS lobectomy or its medicoeconomic impact...
June 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28618130/benefits-of-an-individualized-perioperative-plan-for-children-with-autism-spectrum-disorder
#11
Jo S Swartz, Karen E Amos, Mirna Brindas, Linda G Girling, M Ruth Graham
BACKGROUND: Perioperative care for children with autism spectrum disorder may be challenging. Previous investigators recommend development of an individualized perioperative management plan with caregiver involvement. AIM: The primary goal was to determine the usefulness of an individualized plan based on the decision to provide preoperative sedation stratified by autism spectrum severity level. Secondary goals were to assess the effectiveness of the plan based on subjective assessment of patient behavior at induction of anesthesia and caregiver satisfaction...
June 15, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28612700/knowledge-gaps-in-oral-and-maxillofacial-surgery-a-systematic-mapping
#12
Marie Österberg, Anders Holmlund, Bo Sunzel, Sofia Tranæus, Svante Twetman, Bodil Lund
OBJECTIVES: The aim of this study was to evaluate available knowledge and identify knowledge gaps within the field of oral and maxillofacial surgery, by systematically collecting and evaluating systematic reviews. Twelve specific domains were selected: surgical removal of teeth, antibiotic and corticosteroid prophylaxis, orofacial infections, dental and facial trauma, orthognathic surgery, reconstructive surgery, benign tumors, cysts, premalignant lesions, oral complications of treatment of malignant tumors, hyperbaric oxygen therapy, temporomandibular joint surgery, cost effectiveness of different surgical treatments, and ethics...
January 2017: International Journal of Technology Assessment in Health Care
https://www.readbyqxmd.com/read/28609321/change-in-lung-volume-following-thoracoscopic-anterior-spinal-fusion-surgery-a-3-dimensional-computed-tomography-investigation
#13
Caroline G Yu, Caroline A Grant, Maree T Izatt, Robert D Labrom, Geoffrey N Askin, Clayton J Adam, J Paige Little
STUDY DESIGN: Lung volumes and thoracic anatomy were measured from low-dose computed tomography (CT) scans preoperatively and 2 years following thoracoscopic anterior spinal fusion (TASF) for adolescent idiopathic scoliosis (AIS). OBJECTIVE: The aim of this study was to assess changes in lung volume after TASF surgical correction. SUMMARY OF BACKGROUND DATA: AIS patients are known to have decreased pulmonary function as a consequence of their spinal and ribcage deformity...
June 15, 2017: Spine
https://www.readbyqxmd.com/read/28604517/espghan-guidelines-for-the-evaluation-and-treatment-of-gastrointestinal-and-nutritional-complications-in-children-with-neurological-impairment
#14
Claudio Romano, Myriam van Wynckel, Jessie Hulst, Ilse Broekaert, Jiri Bronsky, Luigi Dall'Oglio, Nataša Fidler 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 comorbidites. Gastrointestinal problems including gastroesophageal reflux disease, constipation and dysphagia are also very frequent in this population and impact quality of life and nutritional status. There is currently a lack of a systematic approach to the care of these patients. With this report, ESPGHAN aims to develop uniform guidelines for the management of the gastroenterological and nutritional problems in neurologically impaired chidren...
June 9, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28600373/evaluation-of-a-physiatrist-directed-prehabilitation-intervention-in-frail-patients-with-colorectal-cancer-a-randomised-pilot-study-protocol
#15
Sherman G Wong, Eugene Maida, David Harvey, Natalie Wagner, Ranil Sonnadara, Nalin Amin
INTRODUCTION: Prehabilitation interventions have shown efficacy in the orthopaedic and cardiothoracic surgical populations, but there has been limited evidence for general surgical patients. We present the protocol for a pilot trial of a novel prehabilitation intervention, consisting of a physiatrist-directed preoperative assessment and treatment programme. METHODS AND ANALYSIS: This is a single-centre pilot randomised controlled trial investigating physiatrist-directed prehabilitation for a 4 to 6-week preoperative period...
June 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28592716/animal-ethics-and-welfare-education-in-wet-lab-training-can-foster-residents-ethical-values-toward-life
#16
Yuko Iki, Takuya Ito, Katsuyoshi Kudo, Masafumi Noda, Masahiko Kanehira, Teruko Sueta, Ichiro Miyoshi, Yutaka Kagaya, Yoshinori Okada, Michiaki Unno
Live animals are used in surgical skills training in wet lab, which has undeniable effectiveness for the development of future surgeons. However, where such training is provided, animal welfare is a major consideration. Increasingly, institutions that offer wet-lab training are incorporating animal ethics and welfare-related content into their training courses, but the effectiveness of such animal ethics education has yet to be evaluated quantitatively. We investigated whether the animal ethics content of a training course affected trainees by measuring increase in ethical awareness using visual analog scale questionnaires before and after training...
June 7, 2017: Experimental Animals
https://www.readbyqxmd.com/read/28591507/-regarding-surface-ablation-as-an-ethically-superior-option-when-compared-to-lasik-primum-non-nocere
#17
Kepa Balparda
Refractive surgery is an extremely safe surgical intervention, with excellent profiles of clinical improvement and satisfaction. The ethical responsibility of the refractive surgeon is to look for diminishing the patients' exposure to unnecessary risks. Therefore, surface ablation would be a preferable option over LASIK as the former has a better safety profile than the latter, without compromising final visual acuity. Ethically, surface ablation should be considered as the first choice in those patients undergoing Excimer laser refractive surgery...
July 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/28585456/potential-conflicts-in-midwifery-practice-regarding-conscientious-objection-to-abortions-in-scotland
#18
Valerie Fleming, Yvonne Robb
BACKGROUND: This study was developed as a result of a court case involving conflicts between midwives' professional practice and their faith when caring for women undergoing abortions in Scotland. RESEARCH QUESTIONS: What are practising Roman Catholics' perspectives of potential conflicts between midwives' professional practice in Scotland with regard to involvement in abortions and their faith? How relevant is the 'conscience clause' to midwifery practice today? and What are participants' understandings of Canon 1398 in relation to midwifery practice? RESEARCH DESIGN: The theoretical underpinning of this study was Gadamer's hermeneutic out of which the method developed by Fleming et al...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28584431/hospital-acquired-infection-prevalence-and-outcome-in-infants-undergoing-open-heart-surgery-in-the-present-era
#19
Manoj Kumar Sahu, Ch Bharat Siddharth, Velayudham Devagouru, Sachin Talwar, Sarvesh Pal Singh, Shiv Chaudhary, Balram Airan
BACKGROUND: The aim of this study is to evaluate the causal relation between hospital-acquired infection (HAI) and clinical outcomes following cardiac surgery in neonates and infants and to identify the risk factors for the development of HAI in this subset of patients. MATERIALS AND METHODS: After Ethics committee approval, one hundred consecutive infants undergoing open heart surgery (OHS) between June 2015 and June 2016 were included in this prospective observational study...
May 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28578503/journal-impact-factor-and-methodological-quality-of-surgical-randomized-controlled-trials-an-empirical-study
#20
REVIEW
Usama Ahmed Ali, Beata M M Reiber, Joren R Ten Hove, Pieter C van der Sluis, Hein G Gooszen, Marja A Boermeester, Marc G Besselink
PURPOSE: The journal impact factor (IF) is often used as a surrogate marker for methodological quality. The objective of this study is to evaluate the relation between the journal IF and methodological quality of surgical randomized controlled trials (RCTs). METHODS: Surgical RCTs published in PubMed in 1999 and 2009 were identified. According to IF, RCTs were divided into groups of low (<2), median (2-3) and high IF (>3), as well as into top-10 vs all other journals...
June 4, 2017: Langenbeck's Archives of Surgery
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