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Surgical ethics

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https://www.readbyqxmd.com/read/28446925/ethical-legal-and-clinical-aspects-of-live-surgery-in-urology-contemporary-issues-and-a-glimpse-of-the-future
#1
REVIEW
Alin Adrian Cumpanas, Ovidiu Catalin Ferician, Silviu Constantin Latcu, Catalin Pricop, Razvan Tiberiu Bardan
Beside dry and wet lab training, simulators, video tapes, fellowships and clinical visits, live surgery has gained popularity during the last years, being an attraction point at large scientific meetings and at postgraduate courses as well. This type of surgical training raises both ethical and legal issues. Thus, there are professional societies that have banned such meetings, mainly due to safety reasons for the patient. The current article aims to identify and to discuss ethical and legal issues related to the topic, advantages, disadvantages and weak points of this emerging challenge for modern medicine, trying to analyze the issues from all relevant points of view: those of the patient, the surgeon and the session attendant...
2017: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
https://www.readbyqxmd.com/read/28446164/core-information-sets-for-informed-consent-to-surgical-interventions-baseline-information-of-importance-to-patients-and-clinicians
#2
Barry G Main, Angus G K McNair, Richard Huxtable, Jenny L Donovan, Steven J Thomas, Paul Kinnersley, Jane M Blazeby
BACKGROUND: Consent remains a crucial, yet challenging, cornerstone of clinical practice. The ethical, legal and professional understandings of this construct have evolved away from a doctor-centred act to a patient-centred process that encompasses the patient's values, beliefs and goals. This alignment of consent with the philosophy of shared decision-making was affirmed in a recent high-profile Supreme Court ruling in England. The communication of information is central to this model of health care delivery but it can be difficult for doctors to gauge the information needs of the individual patient...
April 26, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28445263/acupuncture-for-enhancing-early-recovery-of-bowel-function-in-cancer-protocol-for-a-systematic-review
#3
Yi-Hua Liu, Yang Ye, Jia-Bin Zheng, Xue-Qian Wang, Ying Zhang, Hong-Sheng Lin
BACKGROUND: Cancer patients undergoing surgical procedure often suffer from bowel dysfunction and postoperative ileus (POI). Cancer management for early recovery of bowel function is still a challenging topic. Acupuncture has been commonly used in a variety of gastrointestinal diseases. The aim of this study is to evaluate the effects of acupuncture therapy to reduce the duration of POI and enhance bowel function in cancer patients. METHODS: We will systematically screen all randomized controlled trials (RCTs) published through electronically and hand searching...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28437155/eyelid-reconstruction-using-the-hughes-tarsoconjunctival-advancement-flap-long-term-outcomes-in-122-consecutive-cases-over-a-13-year-period
#4
James McKelvie, Reid Ferguson, Stephen G J Ng
This article evaluates the complications and long term functional and cosmetic outcomes of tarsoconjunctival advancement flaps for repairing a range of lower eyelid defects in a large cohort of consecutive cases. A retrospective series of 122 consecutive cases of eyelid reconstruction using tarsoconjunctival-advancement flaps was conducted at Waikato Hospital, or Hamilton Eye Clinic, New Zealand. All cases of lid reconstruction using tarsoconjunctival-advancement flaps between January 1, 2001 until April 3, 2014 were included for analysis...
April 24, 2017: Orbit
https://www.readbyqxmd.com/read/28434104/mullerian-dysgenesis-a-critical-review-of-the-literature
#5
REVIEW
Souzana Choussein, Dimitrios Nasioudis, Dimitrios Schizas, Konstantinos P Economopoulos
PURPOSE: To present an update of the genetic, clinical, diagnostic, and therapeutic aspects of Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome. METHODS: Studies were considered eligible if they have evaluated patients with MRKH syndrome. Eligible articles were identified by a search of MEDLINE bibliographical database from 1950 to August 2016. A purely descriptive approach was adopted concerning all outcomes examined by the individual studies. RESULTS: MRKH syndrome is defined as congenital aplasia of the upper vagina and impairment of uterine development in normal 46XX females...
April 22, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28433757/surgical-volunteerism-or-voluntourism-are-we-doing-more-harm-than-good
#6
EDITORIAL
Faheem Ahmed, Madeline Grade, Carl Malm, Sophia Michelen, Na'eem Ahmed
The significant rise in the number of international health electives undertaken by medical students and doctors in the US, Canada and UK reflects acknowledgement of the inter-connected nature of these challenges to health systems and the drive to help solve them. However, the next generation of international volunteers often operate under a conflicting duality: whilst many of their role models have devoted their lives to global health following a similar volunteering experience, there are pervasive ethical problems associated with short-term global health work that must be identified and addressed to ensure positive outcomes for all parties involved...
April 19, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28430068/caring-for-patients-or-organs-new-therapies-raise-new-dilemmas-in-the-emergency-department
#7
Arjun Prabhu, Lisa S Parker, Michael A DeVita
Two potentially lifesaving protocols, emergency preservation and resuscitation (EPR) and uncontrolled donation after circulatory determination of death (uDCDD), currently implemented in some U.S. emergency departments (EDs), have similar eligibility criteria and initial technical procedures, but critically different goals. Both follow unsuccessful cardiopulmonary resuscitation and induce hypothermia to "buy time": one in trauma patients suffering cardiac arrest, to enable surgical repair, and the other in patients who unexpectedly die in the ED, to enable organ donation...
May 2017: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/28430037/ethical-difficulties-in-the-innovative-surgical-treatment-of-patients-with-recurrent-glioblastoma-multiforme
#8
David J Cote, Naci Balak, Jannick Brennum, Daniel T Holsgrove, Neil Kitchen, Herbert Kolenda, Wouter A Moojen, Karl Schaller, Pierre A Robe, Tiit Mathiesen, Marike L Broekman
No abstract text is available yet for this article.
April 21, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28429143/how-to-treat-lumbar-disc-herniation-in-pregnancy-a-systematic-review-on-current-standards
#9
REVIEW
Alberto Di Martino, Fabrizio Russo, Luca Denaro, Vincenzo Denaro
PURPOSE: In this systematic review, we aim to illustrate the current and safe concepts in the assessment, diagnosis and management of herniated lumbar disc (HLD) during pregnancy. METHODS: A systematic review and reporting on the diagnosis, treatment and clinical results of HLD during pregnancy is performed. RESULTS: The MRI represents the first level and safest diagnostic tool for pregnant women affected by spinal problems allowing for a noninvasive and detailed radiological examination of the spine...
April 20, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28422848/teriparatide-as-a-nonoperative-treatment-for-tibial-and-femoral-fracture-nonunion-a-case-report
#10
Li Xiaofeng, Xu Daxia, Chen Yunzhen
RATIONALE: Fracture nonunion is a great challenge for orthopedic surgeons. Many surgical interventions are associated with significant pain and heavy economic burden. Therefore, our aim was to evaluate the outcomes of a new nonoperative treatment for fracture nonunion. PATIENT CONCERNS: A 44-year-old man suffered closed fractures of the right tibia and left femur. Eleven months after surgery, there was no radiographic healing between fracture fragments. DIAGNOSES: Fracture nonunion of the right tibia and left femur...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28421386/technology-assessment-and-cost-effectiveness-in-orthopedics-how-to-measure-outcomes-and-deliver-value-in-a-constantly-changing-healthcare-environment
#11
REVIEW
Jeremy M Burnham, Fabien Meta, Vincent Lizzio, Eric C Makhni, Kevin J Bozic
PURPOSE OF REVIEW: The purpose of this study is to review the basic concepts of healthcare value, patient outcome measurement, and cost-effectiveness analyses as they relate to the introduction of new surgical techniques and technologies in the field of orthopedic surgery. RECENT FINDINGS: An increased focus on financial stewardship in healthcare has resulted in a plethora of cost-effectiveness and patient outcome research. Recent research has made great progress in identifying orthopedic technologies that provide exceptional value and those that do not meet adequate standards for widespread adoption...
April 19, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28420664/the-uk-cardiac-and-vascular-surgery-interventional-anaemia-response-caviar-study-protocol-for-an-observational-cohort-study-to-determine-the-impact-and-effect-of-preoperative-anaemia-management-in-cardiac-and-vascular-surgical-patients
#12
Marisa Chau, Toby Richards, Caroline Evans, Anna Butcher, Timothy Collier, Andrew Klein
INTRODUCTION: Preoperative anaemia is linked to poor postsurgical outcome, longer hospital stays, greater risk of complications and mortality. Currently in the UK, some sites have developed anaemia clinics or pathways that use intravenous iron to correct iron deficiency anaemia prior to surgery as their standard of care. Although intravenous iron has been observed to be effective in a variety of patient settings, there is insufficient evidence in its use in cardiac and vascular patients...
April 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28413275/comparison-of-trapezius-squeeze-test-and-jaw-thrust-as-clinical-indicators-for-laryngeal-mask-airway-insertion-in-spontaneously-breathing-children
#13
K K Dinesh Kumar, Neerja Bhardwaj, Sandhya Yaddanapudi
BACKGROUND AND AIMS: It is not known whether trapezius squeeze test (TPZ) is a better clinical test than jaw thrust (JT) to assess laryngeal mask airway (LMA) insertion conditions in children under sevoflurane anesthesia. MATERIAL AND METHODS: After the Institutional Ethics Committee approval and written informed parental consent, 124 American Society of Anesthesiologists I and II children of 2-8 years of age undergoing minor surgical procedures were randomized into TPZ and JT groups...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28411342/mesh-fixation-in-endoscopic-inguinal-hernia-repair-evaluation-of-methodology-based-on-a-systematic-review-of-randomised-clinical-trials
#14
Hans Lederhuber, Franziska Stiede, Stephan Axer, Ursula Dahlstrand
BACKGROUND: The issue of mesh fixation in endoscopic inguinal hernia repair is frequently debated and still no conclusive data exist on differences between methods regarding long-term outcome and postoperative complications. The quantity of trials and the simultaneous lack of high-quality evidence raise the question how future trials should be planned. METHODS: PubMed, EMBASE and the Cochrane Library were searched, using the filters "randomised clinical trials" and "humans"...
April 14, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28405409/effects-of-communication-skill-training-cst-based-on-spikes-for-insurance-covered-pharmacy-pharmacists-to-interact-with-simulated-cancer-patients
#15
Manako Hanya, Yoshitake Kanno, Junko Akasaki, Keiko Abe, Kazuhiko Fujisaki, Hiroyuki Kamei
BACKGROUND: With the development of pharmacotherapy and radiotherapy, cancer treatment is being shifted from surgical to outpatient services, consequently increasing insurance-covered pharmacies' frequency of dealing with cancer patients. As the psychology of these patients is complex, it is necessary for pharmacists to educate them in consideration of their cognitive/medical and psychosocial aspects. This study analyzed cancer patient management by pharmacists working in such pharmacies and their communication skills before and after communication skill training based on SPIKES, a six-step protocol for delivering bad news, to confirm the usefulness of such training...
2017: Journal of Pharmaceutical Health Care and Sciences
https://www.readbyqxmd.com/read/28364823/liver-retransplantation-how-much-is-too-much
#16
REVIEW
Jennifer Berumen, Alan Hemming
Hepatic retransplantation has been surgically challenging since the beginning of liver transplant. Outcomes have improved over time, but patient survival with retransplant continues to be significantly worse than that of primary transplant. Many studies have focused on factors to predict outcomes. Models have been developed to help predict risk, but the decision for retransplant must be a multidisciplinary transplant team decision. The question of "when is too much?" can be guided by recipient and donor factors but is an ethical decision that must be made by the liver transplant team...
May 2017: Clinics in Liver Disease
https://www.readbyqxmd.com/read/28363933/feasibility-of-melatonin-for-prevention-of-delirium-in-critically-ill-patients-a-protocol-for-a-multicentre-randomised-placebo-controlled-study
#17
Lisa Burry, Damon Scales, David Williamson, Jennifer Foster, Sangeeta Mehta, Melanie Guenette, Eddy Fan, Michael Detsky, Azar Azad, Francis Bernard, Louise Rose
INTRODUCTION: Delirium is highly prevalent in the intensive care unit (ICU) and is associated with adverse clinical outcomes. At this time, there is no drug that effectively prevents delirium in critically ill patients. Alterations in melatonin secretion and metabolism may contribute to the development of delirium. Administration of exogenous melatonin has been shown to prevent delirium in non-critically ill surgical and medical patients. This trial will demonstrate the feasibility of a planned multicentre, randomised controlled trial to test the hypothesis that melatonin can prevent delirium in critically ill patients compared with placebo...
March 30, 2017: BMJ Open
https://www.readbyqxmd.com/read/28350202/outcomes-of-laparoscopic-cholecystectomy-for-biliary-dyskinesia-in-children
#18
Sarah W Lai, Steven S Rothenberg, Saundra M Kay, Kristin E Shipman, Bethany J Slater
PURPOSE: To determine the outcomes of laparoscopic cholecystectomy as a treatment for biliary dyskinesia in children. METHODS: With ethics approval, a retrospective chart review was performed on children (<21 years) at a single center diagnosed with biliary dyskinesia (defined as gallbladder ejection fraction [EF] <35% and/or pain with cholecystokinin [CCK] on cholescintigraphy, in the absence of gallstones or cholecystitis on ultrasound) and treated with laparoscopic cholecystectomy between March 2010 and February 2016...
March 28, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28344011/the-epidemiology-pathogenesis-transmission-diagnosis-and-management-of-multidrug-resistant-extensively-drug-resistant-and-incurable-tuberculosis
#19
REVIEW
Keertan Dheda, Tawanda Gumbo, Gary Maartens, Kelly E Dooley, Ruth McNerney, Megan Murray, Jennifer Furin, Edward A Nardell, Leslie London, Erica Lessem, Grant Theron, Paul van Helden, Stefan Niemann, Matthias Merker, David Dowdy, Annelies Van Rie, Gilman K H Siu, Jotam G Pasipanodya, Camilla Rodrigues, Taane G Clark, Frik A Sirgel, Aliasgar Esmail, Hsien-Ho Lin, Sachin R Atre, H Simon Schaaf, Kwok Chiu Chang, Christoph Lange, Payam Nahid, Zarir F Udwadia, C Robert Horsburgh, Gavin J Churchyard, Dick Menzies, Anneke C Hesseling, Eric Nuermberger, Helen McIlleron, Kevin P Fennelly, Eric Goemaere, Ernesto Jaramillo, Marcus Low, Carolina Morán Jara, Nesri Padayatchi, Robin M Warren
Global tuberculosis incidence has declined marginally over the past decade, and tuberculosis remains out of control in several parts of the world including Africa and Asia. Although tuberculosis control has been effective in some regions of the world, these gains are threatened by the increasing burden of multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis. XDR tuberculosis has evolved in several tuberculosis-endemic countries to drug-incurable or programmatically incurable tuberculosis (totally drug-resistant tuberculosis)...
March 15, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28343732/ethical-issues-in-non-intervention-trials-for-thyroid-cancer
#20
P Angelos, D M Hartl, J P Shah, I J Nixon, R P Owen, A Rinaldo, J P Rodrigo, A R Shaha, C E Silver, C Suárez, A Ferlito
In recent years, the increasing numbers of small, apparently indolent thyroid cancers diagnosed in the world have encouraged investigators to consider non-intervention as an alternative to surgical management. In the following pages, the prospect of a non-intervention trial for thyroid cancer is considered with attention to the ethical issues that such a trial might raise. Such a non-intervention trial is analyzed relative to 7 ethical considerations: the social or scientific value of the research, the scientific validity of the trial, the necessity of fair selection of participants, a favorable risk-benefit ratio for trial participants, independent review of the trial, informed consent, and allowing the study participants to withdraw from the trial...
March 16, 2017: European Journal of Surgical Oncology
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