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https://www.readbyqxmd.com/read/29769433/medical-imaging-dose-optimization-from-ground-up-expert-opinion-of-an-international-summit
#1
Ehsan Samei, Hannu Jarvinen, Mika Kortesniemi, Georgios Simantirakis, Charles Goh, Anthony Wallace, Eliseo Vano, Adrian Bejan, M M Rehani, J Vassileva
As in any medical intervention, there is either a known or an anticipated benefit to the patient from undergoing a medical imaging procedure. This benefit is generally significant as demonstrated by the manner in which medical imaging has transformed clinical medicine. At the same time, when it comes to imaging that deploys ionizing radiation, there is a potential associated risk from radiation. Radiation risk has been recognized as a key liability in the practice of medical imaging, creating a motivation for radiation dose optimization...
May 17, 2018: Journal of Radiological Protection: Official Journal of the Society for Radiological Protection
https://www.readbyqxmd.com/read/29724165/how-does-a-lifestyle-intervention-during-pregnancy-influence-perceived-barriers-to-leisure-time-physical-activity-the-norwegian-fit-for-delivery-study-a-randomized-controlled-trial
#2
Lene A H Haakstad, Ingvild Vistad, Linda Reme Sagedal, Hilde Lohne-Seiler, Monica K Torstveit
BACKGROUND: To develop effective health promotional and preventive prenatal programs, it is important to understand perceived barriers to leisure-time physical activity during pregnancy, including exercise and sport participation. The aims of the present study was 1) to assess the effect of prenatal lifestyle intervention on the perceived barrier to leisure-time physical activity during pregnancy and the first year after delivery and 2) identify the most important perceived barriers to leisure-time physical activity at multiple time points during and after pregnancy...
May 3, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29719065/-primum-non-nocere-first-do-no-harm-intrapartum-glycaemic-control-and-neonatal-hypoglycaemia
#3
Aditi Modi, Nicholas Levy, George M Hall
We read with interest the excellent paper by Yamamoto et al. [1] and the accompanying insightful editorial by Holt [2] The paper by Yamamato et al. is the first rigorous systematic review assessing the impact of intrapartum glycaemic control on neonatal hypoglycaemia in pregnancies complicated by diabetes. This article is protected by copyright. All rights reserved.
May 2, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/29703860/thinking-clearly-about-the-first-trial-addressing-ethical-challenges-in-cluster-randomised-trials-of-policy-interventions-involving-health-providers
#4
Austin R Horn, Charles Weijer, Spencer Phillips Hey, Jamie Brehaut, Dean A Fergusson, Cory E Goldstein, Jeremy Grimshaw, Monica Taljaard
The ethics of the Flexibility In duty hour Requirements for Surgical Trainees (FIRST) trial have been vehemently debated. Views on the ethics of the FIRST trial range from it being completely unethical to wholly unproblematic. The FIRST trial illustrates the complex ethical challenges posed by cluster randomised trials (CRTs) of policy interventions involving healthcare professionals. In what follows, we have three objectives. First, we critically review the FIRST trial controversy, finding that commentators have failed to sufficiently identify and address many of the relevant ethical issues...
April 27, 2018: Journal of Medical Ethics
https://www.readbyqxmd.com/read/29698934/a-review-of-clinical-radioprotection-and-chemoprotection-for-oral-mucositis
#5
REVIEW
Bryan Oronsky, Sharad Goyal, Michelle M Kim, Pedro Cabrales, Michelle Lybeck, Scott Caroen, Neil Oronsky, Erica Burbano, Corey Carter, Arnold Oronsky
The first tenet of medicine, "primum non nocere" or "first, do no harm", is not always compatible with oncological interventions e.g., chemotherapy, targeted therapy and radiation, since they commonly result in significant toxicities. One of the more frequent and serious treatment-induced toxicities is mucositis and particularly oral mucositis (OM) described as inflammation, atrophy and breakdown of the mucosa or lining of the oral cavity. The sequelae of oral mucositis (OM), which include pain, odynodysphagia, dysgeusia, decreased oral intake and systemic infection, frequently require treatment delays, interruptions and discontinuations that not only negatively impact quality of life but also tumor control and survivorship...
April 23, 2018: Translational Oncology
https://www.readbyqxmd.com/read/29667726/interventions-for-infantile-haemangiomas-of-the-skin
#6
REVIEW
Monica Novoa, Eulalia Baselga, Sandra Beltran, Lucia Giraldo, Ali Shahbaz, Hector Pardo-Hernandez, Ingrid Arevalo-Rodriguez
BACKGROUND: Infantile haemangiomas (previously known as strawberry birthmarks) are soft, raised swellings of the skin that occur in 3% to 10% of infants. These benign vascular tumours are usually uncomplicated and tend to regress spontaneously. However, when haemangiomas occur in high-risk areas, such as near the eyes, throat, or nose, impairing their function, or when complications develop, intervention may be necessary. This is an update of a Cochrane Review first published in 2011...
April 18, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29590516/organ-transplantation-and-the-uniform-anatomical-gift-act-a-fifty-year-perspective
#7
Blair L Sadler, Alfred M Sadler
Fifty years ago this summer, the Uniform Anatomical Gift Act was adopted by the National Conference of Commissioners on Uniform State Laws and approved by the American Bar Association. The UAGA has provided a sound and stable legal platform on which to base an effective nationwide organ donation system. The cardinal principles of altruism, autonomy, and public trust are still important. At a time when confidence and trust in our government and many private institutions has declined, maintaining trust and confidence in our health care system and its commitment to "first, do no harm" has never been more important...
March 2018: Hastings Center Report
https://www.readbyqxmd.com/read/29589196/debate-the-per-rectal-digital-rectal-examination-exam-in-the-emergency-department-still-best-practice
#8
REVIEW
John Quinn, Tomas Zeleny, Venu Rajaratnam, Dan-Lucian Ghiurluc, Vladimir Bencko
BACKGROUND: Emergency medicine practice in the UK and Ireland offers a junior and middle grade doctor great learning opportunities that force engagement with multiple specialties, life-saving procedures, exposure to a myriad of patient presentations, and opportunities for best practices in medicine. MAIN BODY: The emergency department (ED) can be a hectic and dynamic environment; communication from the ED to specialists is essential to ensure best clinical outcomes for patients...
March 27, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29577583/conscientious-objection-in-reproductive-health-ancient-prerogative-or-harmful-practice
#9
John M Thorp
As the ethics of Medicine arose from philosophical seeds of thought around 500 BC, the Oath of Hippocrates called upon individual physician conscience to place patient well-being first and "do no harm". In the centuries since, this profound statement of ethics has been embraced and molded by Judaism, Islam, Hinduism, and Christianity. It remains pertinent to the vastly different and effective medical practice of the modern world such that many medical schools around the world still incorporate it into the graduation of future physicians...
March 26, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29566176/the-psychological-well-being-and-prenatal-bonding-of-gestational-surrogates
#10
N Lamba, V Jadva, K Kadam, S Golombok
STUDY QUESTION: How does the psychological well-being and prenatal bonding of Indian surrogates differ from a comparison group of mothers? SUMMARY ANSWER: Surrogates had higher levels of depression during pregnancy and post-birth, displayed lower emotional connection with the unborn baby, and greater care towards the healthy growth of the foetus, than the comparison group of mothers. WHAT IS ALREADY KNOWN: Studies in the West have found that surrogates do not suffer long-term psychological harm...
February 23, 2018: Human Reproduction
https://www.readbyqxmd.com/read/29516473/provision-of-respiratory-support-compared-to-no-respiratory-support-before-cord-clamping-for-preterm-infants
#11
REVIEW
Michael P Meyer, Elizabeth Nevill, Maisie M Wong
BACKGROUND: Placental transfusion (by means of delayed cord clamping (DCC), cord milking, or cord stripping) confers benefits for preterm infants. It is not known if providing respiratory support to preterm infants before cord clamping improves outcomes. OBJECTIVES: To assess the efficacy and safety of respiratory support provided during DCC compared with no respiratory support during placental transfusion (in the form of DCC, milking, or stripping) in preterm infants immediately after delivery...
March 8, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29494727/association-of-changes-in-macular-perfusion-with-ranibizumab-treatment-for-diabetic-macular-edema-a-subanalysis-of-the-restore-extension-study
#12
Sonja G Karst, Gabor G Deak, Bianca S Gerendas, Sebastian M Waldstein, Jan Lammer, Christian Simader, Tadhg Guerin, Ursula M Schmidt-Erfurth
Importance: Anti-vascular endothelial growth factor treatment is the first-line therapy in the treatment of center-involving diabetic macular edema. Data on capillary perfusion changes under repeated treatment in a possibly compromised vascular network are limited. Objective: To evaluate the association of repeated ranibizumab injections on macular perfusion in patients with diabetic macular edema. Design, Setting, and Participants: This study analyzed prospectively collected data from the 12-month RESTORE core study and the 24-month open label RESTORE extension study, which assessed the efficacy and safety of ranibizumab in patients with visual impairment due to diabetic macular edema...
April 1, 2018: JAMA Ophthalmology
https://www.readbyqxmd.com/read/29485481/a-lack-of-continuity-in-education-training-and-practice-violates-the-do-no-harm-principle
#13
Robert Englander, Carol Carraccio
The paradigm shift to competency-based medical education (CBME) is under way, but incomplete implementation is blunting the potential impact on learning and patient outcomes. The fundamental principles of CBME call for standardizing outcomes addressing population health needs, then allowing time-variable progression to achieving them. Operationalizing CBME principles requires continuity within and across phases of the education, training, and practice continuum. However, the piecemeal origin of the phases of the "continuum" has resulted in a sequence of undergraduate to graduate medical education to practice that may be continuous temporally but bears none of the integration of a true continuum...
March 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29478884/experimental-infection-by-microparasites-affects-the-oxidative-balance-in-their-avian-reservoir-host-the-blackbird-turdus-merula
#14
Ana Cláudia Norte, David Costantini, Pedro Miguel Araújo, Marcel Eens, Jaime Albino Ramos, Dieter Heylen
By draining resources, microparasites can negatively affect the host fitness, which in turn can result in reduced transmission when virulence leads to reductions in host population size. Therefore, for a microparasite to persist in nature, the level of harm it can do to its host is expected to be limited. We tested this hypothesis for tick-borne Borrelia burgdorferi sensu lato (s.l.) infections in the blackbird Turdus merula, one of the most important avian reservoir hosts in Europe. Experimental and observational data were combined to examine the physiological effects caused by B...
March 2018: Ticks and Tick-borne Diseases
https://www.readbyqxmd.com/read/29460277/plant-responses-to-fertilization-experiments-in-lowland-species-rich-tropical-forests
#15
S Joseph Wright, Benjamin L Turner, Joseph B Yavitt, Kyle E Harms, Michael Kaspari, Edmund V J Tanner, Jelena Bujan, Eric A Griffin, Jordan R Mayor, Sarah C Pasquini, Merlin Sheldrake, Milton N Garcia
We present a meta-analysis of plant responses to fertilization experiments conducted in lowland, species-rich, tropical forests. We also update a key result and present the first species-level analyses of tree growth rates for a 15-yr factorial nitrogen (N), phosphorus (P), and potassium (K) experiment conducted in central Panama. The update concerns community-level tree growth rates, which responded significantly to the addition of N and K together after 10 yr of fertilization but not after 15 yr. Our experimental soils are infertile for the region, and species whose regional distributions are strongly associated with low soil P availability dominate the local tree flora...
May 2018: Ecology
https://www.readbyqxmd.com/read/29415013/population-impact-of-lung-cancer-screening-in-the-united-states-projections-from-a-microsimulation-model
#16
Steven D Criss, Deirdre F Sheehan, Lauren Palazzo, Chung Yin Kong
BACKGROUND: Previous simulation studies estimating the impacts of lung cancer screening have ignored the changes in smoking prevalence over time in the United States. Our primary rationale was to perform, to our knowledge, the first simulation study that estimates the health outcomes of lung cancer screening with explicit modeling of smoking trends for the whole US population. METHODS/FINDINGS: Utilizing a well-validated microsimulation model, we estimated the benefits and harms of an annual low-dose computed tomography screening scenario with a realistic screening adherence rate versus a no-screening scenario for the US population from 2016-2030...
February 2018: PLoS Medicine
https://www.readbyqxmd.com/read/29408150/first-do-no-harm-the-impact-of-financial-incentives-on-dental-x-rays
#17
Martin Chalkley, Stefan Listl
This article assesses the impact of dentist remuneration on the incidence of potentially harmful dental X-rays. We use unique panel data which provide details of 1.3 million treatment claims by Scottish NHS dentists made between 1998 and 2007. Controlling for unobserved heterogeneity of both patients and dentists we estimate a series of fixed-effects models that are informed by a theoretical model of X-ray delivery and identify the effects on dental X-raying of dentists moving from a fixed salary to fee-for-service and patients moving from co-payment to exemption...
March 2018: Journal of Health Economics
https://www.readbyqxmd.com/read/29368188/the-nocebo-effect-challenges-the-non-medical-infliximab-switch-in-practice
#18
N W Boone, L Liu, M J Romberg-Camps, L Duijsens, C Houwen, P H M van der Kuy, R Janknegt, R Peeters, R B M Landewé, B Winkens, A A van Bodegraven
BACKGROUND: In clinical practice, non-medical switching of biological medication may provoke nocebo effects due to unexplained deterioration of therapeutic benefits. Indication extrapolation, idiosyncratic reactions, and interchangeability remain challenged in clinical practice after biosimilar approval by the European Medicines Agency. The principle of "first do no harm" may be challenged in a patient when switching from originator to biosimilar biological. AIM: To describe the 1-year results of a pragmatic study on infliximab biosimilar implementation in immune-mediated inflammatory disease patients on the basis of shared decision-making under effectiveness and safety monitoring...
January 24, 2018: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29360032/clinicians-need-for-an-ecological-approach-to-violence-reduction
#19
Bandy X Lee, John L Young
We now know that harmful social policies, such as those that deny health care to some people, can generate structural violence and be far more harmful than any type of direct violence. A health professional who engages in public health promotion must thus consider the adverse effects of structural violence generated by bad policies. On this view, the dictum, "first, do no harm," can be interpreted as a mandate to protect patients from injustice. Health care professionals' responsibilities extend to motivating policies that prevent avoidable deaths and disabilities...
January 1, 2018: AMA Journal of Ethics
https://www.readbyqxmd.com/read/29342846/mental-health-and-drivers-of-need-in-emergent-and-non-emergent-emergency-department-ed-use-do-living-location-and-non-emergent-care-sources-matter
#20
Moira C McManus, Robert J Cramer, Maureen Boshier, Muge Akpinar-Elci, Bonnie Van Lunen
Emergency department (ED) utilization has increased due to factors such as admissions for mental health conditions, including suicide and self-harm. We investigate direct and moderating influences on non-emergent ED utilization through the Behavioral Model of Health Services Use. Through logistic regression, we examined correlates of ED use via 2014 New York State Department of Health Statewide Planning and Research Cooperative System outpatient data. Consistent with the primary hypothesis, mental health admissions were associated with emergent use across models, with only a slight decrease in effect size in rural living locations...
January 13, 2018: International Journal of Environmental Research and Public Health
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