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Clinical ethics evaluation

Laxminarayan Karanth, Ankur Barua, Sachchithanantham Kanagasabai, N Sreekumaran Nair
BACKGROUND: Congenital bleeding disorders can cause obstetric haemorrhage during pregnancy, labour and following delivery. Desmopressin acetate (DDAVP) is found to be an effective drug which can reduce the risk of haemorrhage and can also stop bleeding in certain congenital bleeding disorders. Its use in pregnancy has been controversial. Hence beneficial and adverse effects of DDAVP in these groups of pregnant women should be evaluated.This is an update of a Cochrane Review first published in 2013 and updated in 2015...
February 13, 2019: Cochrane Database of Systematic Reviews
Luís Guilherme Casimiro, Sara Pereira, Sofia Pires, Joana Mourão
INTRODUCTION: Informed consent is an active process of the doctor-patient relationship, based on ethical and legal principles. The anesthetic act has inherent risks, which should be subject of specific consent. The aim of this study was to evaluate the degree of implementation of written specific informed consent for anesthesia in the context of elective surgery. MATERIAL AND METHODS: An observational prospective study, at a tertiary university hospital, in 230 patients aged 60 years or older, undergoing elective surgery between May and July 2017...
February 1, 2019: Acta Médica Portuguesa
E Ntemou, P Kadam, D Van Saen, J Wistuba, R T Mitchell, S Schlatt, E Goossens
STUDY QUESTION: Can full spermatogenesis be achieved after xenotransplantation of prepubertal primate testis tissue to the mouse, in testis or subcutaneously? SUMMARY ANSWER: Intratesticular xenotransplantation supported the differentiation of immature germ cells from marmoset (Callithrix jacchus) into spermatids and spermatozoa at 4 and 9 months post-transplantation, while in subcutaneous transplants, spermatogenic arrest was observed at 4 months and none of the transplants survived at 9 months...
February 12, 2019: Human Reproduction
Luohua Jiang, Shuai Chen, Janette Beals, Juned Siddique, Richard F Hamman, Ann Bullock, Spero M Manson
Many community-based translations of evidence-based interventions are designed as one-arm studies due to ethical and other considerations. Evaluating the impacts of such programs is challenging. Here, we examine the effectiveness of the lifestyle intervention implemented by the Special Diabetes Program for Indians Diabetes Prevention (SDPI-DP) demonstration project, a translational lifestyle intervention among American Indian and Alaska Native communities. Data from the landmark Diabetes Prevention Program placebo group was used as a historical control...
February 12, 2019: Prevention Science: the Official Journal of the Society for Prevention Research
Ana Verdelho, Sofia Madureira, Manuel Correia, José Manuel Ferro, Mário Rodrigues, Manuel Gonçalves-Pereira, Mafalda Gonçalves, Ana Catarina Santos, Pedro Vilela, Helena Bárrios, Mariana Borges, Helena Santa-Clara
BACKGROUND: Cognitive impairment and cerebrovascular pathology are both frequent with ageing. Cognitive impairment due to vascular pathology of the brain, termed vascular cognitive impairment (VCI), is one of the most frequent causes of cognitive impairment in elderly subjects. Thus far, VCI has no specific pharmacological treatment. Recent observational studies have suggested a protective effect of physical activity in cognition, but adequate randomised controlled trials (RCT) are lacking...
February 11, 2019: Trials
Florence Skyum, Court Pedersen, Vibeke Andersen, Ming Chen, Andreas Franke, Detlev Petersen, Wolfgang Ries, Christian Backer Mogensen
BACKGROUND: Infectious gastroenteritis is common in the emergency department (ED). Patients infected with either Norovirus or toxigenic Clostridium difficile require special isolation procedures. The aims were to describe the aetiology of infectious gastroenteritis in the ED, evaluate whether current isolation procedures, based on clinical judgement are sufficient, and to identify information that might be used to identify patients requiring isolation. METHODS: Prospective, observational, multicentre study...
February 11, 2019: BMC Infectious Diseases
Yang Liu, Yanying Yin, Qiao-Li Lu, Ying Dan, Mei-Song Xu, Ge Song, Chen Li
BACKGROUND: Previous clinical trials have reported that vinpocetine can be used for the treatment of cognitive dysfunction. However, its efficacy is still inconclusive. In this systematic review study, we aim to assess its efficacy and safety for the treatment of poststroke cognitive dysfunction (PSCD). METHODS: We will search the following electronic databases from the inception to the present to evaluate the efficacy and safety of vinpocetine for patients with PSCD...
February 2019: Medicine (Baltimore)
Beverley Lim Høeg, Tine Tjørnhøj-Thomsen, Julie Alling Skaarup, Henriette Langstrup, Vibeke Zoffmann, Lena Saltbaek, Randi Valbjørn Karlsen, Susanne Oksbjerg Dalton, Christoffer Johansen, Pernille Envold Bidstrup
BACKGROUND: Patient and public involvement (PPI) is increasingly becoming a requirement in the effort to improve the relevance and quality of healthcare research. We examined how involving patients with lower education levels affected PPI in the development of the MyHealth randomized clinical trial of breast cancer follow-up from the perspectives of the patients and professionals. MATERIAL AND METHODS: Eight women who had completed breast cancer treatment, four with fewer than 10 years of education, were recruited as members of a patient panel advising researchers in the development of the trial...
February 6, 2019: Acta Oncologica
Nahid Bhadelia, Lauren Sauer, Theodore J Cieslak, Richard T Davey, Susan McLellan, Timothy M Uyeki, Mark G Kortepeter
Emerging and re-emerging infectious diseases pose growing global public health threats. However, research on and development of medical countermeasures (MCMs) for such pathogens is limited by the sporadic and unpredictable nature of outbreaks, lack of financial incentive for pharmaceutical companies to develop interventions for many of the diseases, lack of clinical research capacity in areas where these diseases are endemic, and the ethical dilemmas related to conducting scientific research in humanitarian emergencies...
February 6, 2019: Health Security
Yoshinori Tanaka, Yasuhiro Saihara, Kyoko Izumotani, Hajime Nakamura
In Japan, alkaline electrolyzed water (AEW) apparatus have been approved as a medical device. And for the patients with gastrointestinal symptoms, drinking AEW has been found to be effective in relieving gastrointestinal symptoms. But some users of AEW apparatus do not have abdominal indefinite complaint. Little attention has been given to the benefit for the users which have no abdominal indefinite complaint. The object of this study is to evaluate the effect on health, including gastrointestinal symptoms, when a person without abdominal indefinite complaint, etc ...
October 2018: Medical Gas Research
Masaaki Hirayama, Mikako Ito, Tomomi Minato, Asako Yoritaka, Tyler W LeBaron, Kinji Ohno
Hyposmia is one of the earliest and the most common symptoms in Parkinson's disease (PD). The benefits of hydrogen water on motor deficits have been reported in animal PD models and PD patients, but the effects of hydrogen gas on PD patients have not been studied. We evaluated the effect of inhalation of hydrogen gas on olfactory function, non-motor symptoms, activities of daily living, and urinary 8-hydroxy-2'-deoxyguanine (8-OHdG) levels by a randomized, double-blinded, placebo-controlled, crossover trial with an 8-week washout period in 20 patients with PD...
October 2018: Medical Gas Research
Hamid Ahanchian, Fatemeh Behmanesh, Farahzad Jabbari Azad, Elham Ansari, Maryam Khoshkhui, Reza Farid, Yalda Hassanpur, Samaneh Kouzegaran
Identifying the causes of anaphylaxis which is an acute, potentially fatal systemic reaction is very important in every community. Treatment strategies and pitfalls should also be determined. We sought to determine the most common triggers of anaphylaxis, clinical manifestations and treatment strategies in Mashhad, northeast of Iran. An observational cross-sectional study was conducted to evaluate all patients with a history of anaphylactic reaction who were referred to University Allergy Clinics between 2006 and 2016 in Mashhad Iran...
October 2018: Medical Gas Research
Maimuna Marenah, Jinjie Li, Ashok Kumar, William Murrell
The economic and human cost of knee osteoarthritis is forecast to increase. This will impact not only aging individuals, but also the working age members of emerging economies. The current treatment pathways are often costly, time-consuming, and insufficient to manage the degeneration of the knee over the ever-increasing lifespan of patients around the world. In response to the shortcomings of a focus on symptom management, international and high-impact regulators, researchers, clinicians, and most importantly patients, are increasingly interested in the possible management of knee osteoarthritis with novel therapies in the field of regenerative medicine treatments...
January 2019: Journal of Clinical Orthopaedics and Trauma
Caterina Vicens, Alfonso Leiva, Ferran Bejarano, Ermengol Sempere, Raquel María Rodríguez-Rincón, Francisca Fiol, Marta Mengual, Asunción Ajenjo, Fernando Do Pazo, Catalina Mateu, Silvia Folch, Santiago Alegret, Jose Maria Coll, María Martín-Rabadán, Isabel Socias
INTRODUCTION: Benzodiazepines (BZDs) are mainly used to treat anxiety and sleep disorders, and are often prescribed for long durations, even though prescription guidelines recommend short-term use due to the risk of dependence, cognitive impairment, and falls and fractures. Education of general practitioners (GPs) regarding the prescription of BZDs may reduce the overuse and of these drugs.The aims of this study are to analyse the effectiveness of an intervention targeted to GPs to reduce BZD prescription and evaluate the implementation process...
January 30, 2019: BMJ Open
Yue-Rong Zhao, Hong-Mei Song, Lei Ni
BACKGROUND: Previous clinical trials have reported that cyclophosphamide can be used for the treatment of acute lymphoblastic leukemia (ALL). However, its efficacy is still unclear. In this systematic review study, we aim to evaluate its efficacy and safety for ALL. METHODS: The following 9 databases will be searched from their inception to the present: Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Allied and Complementary Medicine Database (AMED), and four Chinese databases...
February 2019: Medicine (Baltimore)
Hengheng Dai, Haisong Li, Jisheng Wang, Binghao Bao, Yubing Yan, Bin Wang, Song Sun
BACKGROUND: As one of the common male sexual dysfunction diseases, the treatment effect of premature ejaculation is often difficult to guarantee. In China, there are many randomized clinical trials that confirm that acupuncture has a good therapeutic effect on premature ejaculation. The aim of this study was to compare the efficacy and safety of acupuncture for premature ejaculation from intravaginal ejaculation latency (IELT), premature ejaculation diagnostic tool (PEDT), Arab premature ejaculation index (AIPE), and premature ejaculation index (IPE)...
February 2019: Medicine (Baltimore)
John Strang, Michael Kelleher, Soraya Mayet, Ed Day, Jennifer Hellier, Sarah Byford, Caroline Murphy, Blair McLennan, James Shearer, Elizabeth Ryan, John Marsden
BACKGROUND: People recovering from heroin addiction need better treatments than are currently offered. The chronic relapsing nature of drug dependence means that helping a patient to achieve abstinence is often difficult. Naltrexone blocks the effects of ingested heroin; however, evidence is conflicting regarding the best delivery method. OBJECTIVES: The primary purpose of the trial was to evaluate the clinical effectiveness and cost-effectiveness of extended-release naltrexone versus standard oral naltrexone versus relapse prevention therapy without medication for opioid use disorder (OUD)...
January 2019: Health Technology Assessment: HTA
Sabrina Cerqueira-Santos, Kérilin S S Rocha, Thays C Boaventura, Elisdete M S Jesus, Carina C Silvestre, Bárbara M C Sodré- Alves, Divaldo P de Lyra
WHAT IS KNOWN AND OBJECTIVE: Qualified dispensing is fundamental for the promotion of the rational use of medicines. Documentation is an indicator of quality and one of the essential steps in the care process. However, in Brazil, there are no models of clinical documentation applicable to dispensing practices. Thus, the objective of this study was to develop and validate an instrument to document the dispensing process of prescribed medicines. METHODS: A methodological development study was carried out from February 2017 to October 2017 in two stages, which were (i) the development of the instrument and (ii) content validation of the proposed instrument...
January 30, 2019: Journal of Clinical Pharmacy and Therapeutics
Anna-Lydia Peschmann, Meinrad Beer, Bettina Ammann, Jens Dreyhaupt, Katharina Kneer, Ambros J Beer, Christian Beltinger, Daniel Steinbach, Holger Cario, Henning Neubauer
BACKGROUND: Quantitative diffusion-weighted imaging (DWI) probes into tissue microstructure in solid tumours. In this retrospective ethically approved study, we investigated DWI as a potential non-invasive predictor of tumour dignity and prognosis in paediatric patients with neuroblastic tumours. METHODS: Nineteen consecutive patients with neuroblastoma (NB, n = 15), ganglioneuroblastoma (GNB, n = 1) and ganglioneuroma (GN, n = 3) underwent 3-T magnetic resonance imaging at first diagnosis and after 3-month follow-up, following a protocol including DWI (b = 50 and 800 s/mm2 ) in addition to standard sequences...
January 30, 2019: European radiology experimental
Johnny M Downs, Tamsin Ford, Robert Stewart, Sophie Epstein, Hitesh Shetty, Ryan Little, Amelia Jewell, Matthew Broadbent, Jessica Deighton, Tarek Mostafa, Ruth Gilbert, Matthew Hotopf, Richard Hayes
OBJECTIVES: Creation of linked mental health, social and education records for research to support evidence-based practice for regional mental health services. SETTING: The Clinical Record Interactive Search (CRIS) system was used to extract personal identifiers who accessed psychiatric services between September 2007 and August 2013. PARTICIPANTS: A clinical cohort of 35 509 children and young people (aged 4-17 years). DESIGN: Multiple government and ethical committees approved the link of clinical mental health service data to Department for Education (DfE) data on education and social care services...
January 29, 2019: BMJ Open
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