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Medical negligency

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https://www.readbyqxmd.com/read/29241615/provision-of-medical-supply-kits-to-improve-quality-of-antenatal-care-in-mozambique-a-stepped-wedge-cluster-randomised-trial
#1
Ana Pilar Betrán, Eduardo Bergel, Sally Griffin, Armando Melo, My Huong Nguyen, Alicia Carbonell, Santos Mondlane, Mario Merialdi, Marleen Temmerman, A Metin Gülmezoglu
BACKGROUND: High levels of maternal and newborn mortality and morbidity remain a daunting reality in many low-income countries. Several interventions delivered during antenatal care have been shown to improve maternal and newborn outcomes, but stockouts of medical supplies at point of care can prevent implementation of these services. We aimed to evaluate whether a supply chain strategy based on the provision of kits could improve quality of care. METHODS: We did a pragmatic, stepped-wedge, cluster-randomised controlled trial at ten antenatal care clinics in Mozambique...
January 2018: Lancet Global Health
https://www.readbyqxmd.com/read/29240650/oxytocin-use-in-labor-legal-implications
#2
Susan Drummond
Oxytocin is one of the most commonly used medications in obstetrics and has been associated with claims of negligence in cases of adverse outcomes. Errors involving intravenous oxytocin administration for induction or augmentation of labor are most commonly dose related and include failure to avoid or treat tachysystole or failure to asses or treat a fetal heart rate pattern indicative of disruption in oxygenation. Clinicians should be knowledgeable regarding pharmacokinetics of oxytocin and the effect of uterine contractions on fetal oxygenation as well as safe titration of oxytocin to achieve the desired effect while minimizing harm...
December 13, 2017: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/29236272/medical-malpractice-and-transoral-robotic-surgery-evaluation-and-some-preemptive-thoughts
#3
Daniel D Lydiatt, Ryan Sewell
Medical malpractice is costly and disruptive, and it is important to prevent. We conducted a study with the objective to look at medical malpractice in robotic surgery overall, to evaluate reasons for litigation, and to comment on possible strategies to avoid litigation with transoral robotic surgery. We used the Westlaw computerized database to identify all state and federal verdict summaries in medical malpractice cases. We found 17 cases alleging malpractice that involved the use of robotic surgery. In all, the plaintiffs in 6 cases (35%) contended that an open rather than a robotic approach should have been used, 5 (29%) alleged negligent credentialing, 4 (24%) alleged training deficiencies, 2 (12%) alleged manufacturing problems, and 1 (6%) charged that robotic surgery should have been performed instead of open surgery (1 case involved two of these allegations)...
December 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/29234481/in-defense-of-pharmaceutically-enhancing-human-morality
#4
Evangelos D Protopapadakis
Purpose: I will discuss the prospect of pharmaceutically enhancing human morality and decision making in such a way as to eliminate morally unjustifiable choices and promote desirable ones. Background: Our species in the relatively short period since it has emerged has enormously advanced in knowledge, science, and technical progress. When it comes to moral development, the distance it has covered is almost negligible. What if we could medically accelerate our moral development? What if we could once and for all render our species totally immune to certain vices? Methodology: I will examine whether pharmaceutically intervening in human morality would compromise the autonomy of moral agents...
2017: Current Therapeutic Research, Clinical and Experimental
https://www.readbyqxmd.com/read/29209906/the-fourth-annual-brds-on-genome-editing-and-silencing-for-precision-medicines
#5
Amit Kumar Chaudhary, Rajan Sharma Bhattarai, Ram I Mahato
Precision medicine is promising for treating human diseases, as it focuses on tailoring drugs to a patient's genes, environment, and lifestyle. The need for personalized medicines has opened the doors for turning nucleic acids into therapeutics. Although gene therapy has the potential to treat and cure genetic and acquired diseases, it needs to overcome certain obstacles before creating the overall prescription drugs. Recent advancement in the life science has helped to understand the effective manipulation and delivery of genome-engineering tools better...
December 5, 2017: Drug Delivery and Translational Research
https://www.readbyqxmd.com/read/29206598/is-there-unmeasured-indication-bias-in-radiation-related-cancer-risk-estimates-from-studies-of-computed-tomography
#6
Johanna M Meulepas, Michael Hauptmann, Jay H Lubin, Igor Shuryak, David J Brenner
Recently reported studies have associated radiation exposure from computed tomography (CT) scanning with small excess cancer risks. However, since existing medical records were used in these studies, they could not control for reasons for the CT scans and therefore, the results may have been confounded by indication. Here we conducted a study to estimate potential indication bias that could affect hazard ratios for colorectal, lung and female breast cancers by reasons for a CT scan. This involved a retrospective cohort study of electronic records from all patients aged 18-89 years without previous cancer diagnoses, who received at least one CT scan at Columbia University Medical Center in the period of 1994-2014...
December 5, 2017: Radiation Research
https://www.readbyqxmd.com/read/29196112/long-term-outcomes-and-prognostic-factors-in-patients-with-mild-hemoptysis
#7
Joonsung Choi, Jun Hyun Baik, Chi Hong Kim, So Hyang Song, Sung Kyung Kim, Myeongjong Kim, Sungeun Yun
OBJECTIVE: The aim of this retrospective study was to observe the long-term outcomes of conservative treatment and bronchial artery embolization (BAE) in patients with mild hemoptysis and to analyze the risk factors associated with hemoptysis recurrence. METHODS: Patients with mild hemoptysis from January 2005 to January 2016 were enrolled in this study. The patients' medical records, including smoking history, etiologic diseases, bronchoscopic findings, mortality, BAE information, and follow-up data of recurrent hemoptysis, were reviewed and analyzed...
November 27, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29194445/safety-and-efficacy-of-an-oxycodone-vaccine-addressing-some-of-the-unique-considerations-posed-by-opioid-abuse
#8
M D Raleigh, S J Peterson, M Laudenbach, F Baruffaldi, F I Carroll, S D Comer, H A Navarro, T L Langston, S P Runyon, S Winston, M Pravetoni, P R Pentel
Among vaccines aimed at treating substance use disorders, those targeting opioids present several unique medication development challenges. 1) Opioid overdose is a common complication of abuse, so it is desirable for an opioid vaccine to block the toxic as well as the addictive effects of opioids. 2) It is important that an opioid vaccine not interfere with the action of opioid antagonists used to reverse opioid overdose or treat addiction. 3) Some opioids are immunosuppressive and chronic ongoing opioid use could interfere with vaccine immunogenicity...
2017: PloS One
https://www.readbyqxmd.com/read/29190209/national-study-of-burnout-and-career-satisfaction-among-physician-assistants-in-oncology-implications-for-team-based-care
#9
Eric Daniel Tetzlaff, Heather Marie Hylton, Lyudmila DeMora, Karen Ruth, Yu-Ning Wong
PURPOSE: A high rate of burnout has been reported in oncology physicians. Physician assistants (PAs) may also face similar risks of burnout. We sought to measure the personal and professional characteristics associated with burnout and career satisfaction and the potential impact on the oncology PA workforce. PARTICIPANTS AND METHODS: A national survey of PAs in oncology was completed by using the Maslach Burnout Inventory from September 2015 to January 2016. RESULTS: In all, 855 PAs were contacted and 250 submitted complete surveys (response rate, 29...
November 30, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/29185542/pimavanserin-a-novel-therapeutic-option-for-parkinson-disease-psychosis
#10
REVIEW
Trevor Hawkins, Brian D Berman
Purpose of review: In April 2016, the Food and Drug Administration (FDA) approved a first-in-class atypical antipsychotic medication called pimavanserin for the treatment of Parkinson disease psychosis (PDP). We aim to inform readers about its indications, effectiveness, and safety profile. Recent findings: Pimavanserin acts as an inverse agonist at serotonin 5-HT2A receptors and has negligible effects on other receptors, thereby avoiding the D2 receptor antagonism that can potentially worsen motor symptoms...
April 2017: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/29184110/differential-effects-on-membrane-permeability-and-viability-of-human-keratinocyte-cells-undergoing-very-low-intensity-megasonic-fields
#11
F Domenici, F Brasili, S Giantulli, B Cerroni, A Bedini, C Giliberti, R Palomba, I Silvestri, S Morrone, G Paradossi, M Mattei, F Bordi
Among different therapeutic applications of Ultrasound (US), transient membrane sonoporation (SP) - a temporary, non-lethal porosity, mechanically induced in cell membranes through US exposure - represents a compelling opportunity towards an efficient and safe drug delivery. Nevertheless, progresses in this field have been limited by an insufficient understanding of the potential cytotoxic effects of US related to the failure of the cellular repair and to the possible activation of inflammatory pathway. In this framework we studied the in vitro effects of very low-intensity US on a human keratinocyte cell line, which represents an ideal model system of skin protective barrier cells which are the first to be involved during medical US treatments...
November 28, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29179811/economic-modelling-of-telehealth-substitution-of-face-to-face-specialist-outpatient-consultations-for-queensland-correctional-facilities
#12
Monica Taylor, Liam J Caffery, Paul A Scuffham, Anthony C Smith
Objective The provision of healthcare services to inmates in correctional facilities is costly and resource-intensive. This study aimed to estimate the costs of transporting prisoners from 11 Queensland correctional facilities to the Princess Alexandra Hospital Secure Unit (PAHSU) in Brisbane for non-urgent specialist outpatient consultations and identify the cost consequences that would result from the substitution of face-to-face visits with telehealth consultations.Methods A 12-month retrospective review of patient activity at the PAHSU was conducted to obtain the number of transfers per correctional facility...
November 28, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/29176864/health-assessment-of-french-university-students-and-risk-factors-associated-with-mental-health-disorders
#13
Antoine Tran, Laurie Tran, Nicolas Geghre, David Darmon, Marion Rampal, Diane Brandone, Jean-Michel Gozzo, Hervé Haas, Karine Rebouillat-Savy, Hervé Caci, Paul Avillach
OBJECTIVE: The first year of university is a particularly stressful period and can impact academic performance and students' health. The aim of this study was to evaluate the health and lifestyle of undergraduates and assess risk factors associated with psychiatric symptoms. MATERIALS AND METHODS: Between September 2012 and June 2013, we included all undergraduate students who underwent compulsory a medical visit at the university medical service in Nice (France) during which they were screened for potential diseases during a diagnostic interview...
2017: PloS One
https://www.readbyqxmd.com/read/29176493/the-relative-effects-of-manual-versus-automatic-exposure-control-on-radiation-dose-to-vital-organs-in-total-hip-arthroplasty
#14
Katharine D Harper, Shidong Li, Rachel Jennings, Kamil M Amer, Christopher Haydel, Sayed Ali
INTRODUCTION: Technologic advances have reduced medical radiation exposure while maintaining image quality. The purpose of this study was to determine the effects of the presence of total hip arthroplasty implants, compared with native hips, on radiation exposure of the most radiosensitive organs when manual and automatic exposure control settings are used. METHODS: Detection probes were placed at six locations (stomach, sigmoid colon, right pelvic wall, left pelvic wall, pubic symphysis, and anterior pubic skin) in a cadaver...
November 20, 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29174106/a-rapid-qualitative-assessment-of-oral-cholera-vaccine-anticipated-acceptability-in-a-context-of-resistance-towards-cholera-intervention-in-nampula-mozambique
#15
Rachel Démolis, Carlos Botão, Léonard W Heyerdahl, Bradford D Gessner, Philippe Cavailler, Celestino Sinai, Amílcar Magaço, Jean-Bernard Le Gargasson, Martin Mengel, Elise Guillermet
INTRODUCTION: While planning an immunization campaign in settings where public health interventions are subject to politically motivated resistance, designing context-based social mobilization strategies is critical to ensure community acceptability. In preparation for an Oral Cholera Vaccine campaign implemented in Nampula, Mozambique, in November 2016, we assessed potential barriers and levers for vaccine acceptability. METHODS: Questionnaires, in-depth interviews, and focus group discussions, as well as observations, were conducted before the campaign...
November 23, 2017: Vaccine
https://www.readbyqxmd.com/read/29161410/autonomy-affinity-and-the-assessment-of-damages-acb-v-thomson-medical-pte-ltd-2017-sgca-20-and-shaw-v-kovak-2017-ewca-civ-1028
#16
Craig Purshouse
In ACB v Thomson Medical Pte Ltd [2017] SGCA 20 and Shaw v Kovak [2017] EWCA Civ 1028, the idea that 'lost autonomy' should be recognised as a new form of actionable damage in the tort of negligence was rejected in Singapore and England, respectively. This, it will be argued, was the correct outcome. Protecting an interest in autonomy via the tort of negligence would undermine the coherence of that tort. In ACB, however, a new, different, form of damage was recognised: loss of 'genetic affinity'. This commentary will discuss some problems that protecting an interest in 'genetic affinity' raises before critiquing the approach to assessing damages in ACB...
November 17, 2017: Medical Law Review
https://www.readbyqxmd.com/read/29155035/utility-of-anesthetic-block-for-endometrial-ablation-pain-a-randomized-controlled-trial
#17
Jordan S Klebanoff, Nima R Patel, Nancy L Sloan
BACKGROUND: Second-generation endometrial ablation has been demonstrated safe for abnormal uterine bleeding treatment in premenopausal women, who have completed childbearing, in short-stay surgical centers and in physicians' offices. However, no standard regarding anesthesia exists and practice varies depending on physician or patient preference and hospital policy and setting. OBJECTIVE: To evaluate whether local anesthetic, in combination with general anesthesia, affects postoperative pain and associated narcotic use following endometrial ablation...
November 15, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29152753/the-hospital-otolaryngologist-the-louisiana-state-university-experience
#18
Phillip G Allen, Laura T Hetzler, Daniel W Nuss, Rohan R Walvekar, Gretchen Penton, Elona Sharbaugh
OBJECTIVES/HYPOTHESIS: To describe the implementation and impact of a hospital otolaryngologist in an academic medical center setting. Our hypothesis was that the hospital otolaryngologist would increase productivity of the Louisiana State University (LSU) faculty otolaryngologists and provide more timely access to inpatient otolaryngology services. STUDY DESIGN: Retrospective clinical and administrative database review. METHODS: A comparative database review was performed with data from the year predating the initiation of the hospitalist program (2013) to the first full year after initiation of the program (2014)...
November 20, 2017: Laryngoscope
https://www.readbyqxmd.com/read/29142830/parathyroid-hormone-and-serum-calcium-levels-measurements-as-predictors-of-postoperative-hypocalcemia-in-total-thyroidectomy
#19
Mohammed Algarni, Rajab Alzahrani, Gianlorenzo Dionigi, Al-Hakami Hadi, Haia AlSubayea
Background: The rules of quantitative measures such as parathyroid hormone (PTH) levels in the first hours following total thyroidectomy have since been validated repeatedly. Such measures play an integral rule in identifying patients at significant risk for hypocalcaemia and have allowed for earlier supplementation of these patients with calcium with or without vitamin D. Methods: A retrospective analysis was conducted of 40 consecutive patients with well differentiated thyroid cancer (WDTC) who underwent total thyroidectomy without central neck dissection (CND) as an initial surgery and no comorbidity at King Abdulaziz Medical City (National Guard hospital), between July 2011 and July 2012...
October 2017: Gland Surgery
https://www.readbyqxmd.com/read/29142787/sleep-apnea-symptoms-and-cardiovascular-disease-risks-among-haitian-medical-students
#20
Diana M Rosenthal, Donaldson F Conserve, Dodley Severe, Michaele A Gedeon, Ferdinand Zizi, Georges Casimir, Samy I McFarlane, Girardin Jean Louis
Sleep apnea is a prevalent sleep disorder that disproportionately affects blacks and has been previously studied among Caribbean-born blacks in Brooklyn, New York, but there has been negligible research in the Caribbean, specifically Haiti, and developing countries on this pressing health issue. A total of 373 medical students (mean age=20.6 years ± 2.3 years) from a medical school in Haiti participated in this study. Participants were administered a questionnaire assessing their sleep health and cardiovascular outcomes...
April 2017: Journal of Sleep Disorders & Therapy
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