Medical Ethics Research This is an OPML file. It can be used to export all the MedWorm RSS feeds on this topic into your personal RSS reader (usually you have to save this file to your own computer before clicking on an Import OPML command in your own feed reader to upload the file which will then import all the feeds) or it can be used by webmasters to integrate MedWorm feeds with their own website. This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader, such as GoogleReader, or to display this data on your own website or blog. Subscribe to this data using MyMedWorm.Subscribe to this data using GoogleReader.Subscribe to this data using Bloglines.Subscribe to this data using MyYahoo.

This page shows you the most recent publications within this specialty of the MedWorm directory. This is page number 35.

Ethical Dilemmas in Publishing. A Rising Tide of Plagiarism?
Source: Journal of Prosthodontics - August 22, 2012 Category: Dentistry Tags: EDITORIAL Source Type: research

Mandatory evacuation of residents during the Fukushima nuclear disaster: an ethical analysis
Conclusion Careful scrutiny of the case revealed that this public health intervention involved an objective completely unrelated to public health, and that disguising these policies using the reasonable and acceptable purpose of public health made it easier to justify undue restriction of individual liberty.
Source: Journal of Public Health - August 22, 2012 Category: Health Management Authors: Akabayashi, A., Hayashi, Y. Tags: Health Protection Source Type: research

CT and radiographic analysis of sagittal profile changes following thoracoscopic anterior scoliosis surgery
Conclusions: Restoration of sagittal profile is an important goal of scoliosis surgery, but reliable measurement with radiographs suffers from poor endplate clarity. TASF significantly improves thoracic kyphosis and lumbar lordosis while preserving proximal and distal junctional alignment in thoracic AIS patients. Supine CT allows greater endplate clarity for sagittal Cobb measurements and linear relationships were found between supine CT and standing radiographic measurements. In this study, improvements in sagittal kyphosis and lordosis following surgery were in agreement with prior anterior surgery studies, and add to t...
Source: Scoliosis - August 22, 2012 Category: Orthopaedics Authors: Maree IzattClayton AdamEugene VerzinRobert LabromGeoffrey Askin Source Type: research

Publication and Reporting Conduct for Pharmacodynamic Analyses of Tumor Tissue in Early Phase Oncology Trials.
CONCLUSION: Our results suggest ways that investigators, study planners, and reviewers can improve the burden / knowledge value balance in PD studies. PMID: 22912391 [PubMed - as supplied by publisher]
Source: Clinical Cancer Research - August 21, 2012 Category: Cancer & Oncology Authors: Freeman GA, Kimmelman J Tags: Clin Cancer Res Source Type: research

Cardiovascular armamentarium in a patient with bronchopulmonary fistula
Case report A 55-year-old patient with non-small-cell lung cancer suffered from productive cough due to bronchopulmonary fistula (BPF) following pneumectomy (figure 1A,B). First, we used vascular occlusion coils (Tornado Platin Embolization Coils, Cook, Limerick, Ireland, traditionally used for embolisation of selective vessel supply to arteriovenous malformations) placed endobronchially in conjunction with fibrin glue application (figure 1C). However, the occluding material was expectorated only 1 week later, probably due to the size of the fistula (10 mm). Second, an Amplatzer vascular plug IV (St. Jude Medical...
Source: Thorax - August 21, 2012 Category: Respiratory Medicine Authors: Buermann, J., Skowasch, D., Wilhelm, K. E. Tags: Images in Thorax, Journalology, Lung neoplasms, Lung cancer (oncology), Screening (oncology), Lung cancer (respiratory medicine), Cardiothoracic surgery, Radiology (diagnostics), Ethics Chest clinic Source Type: research

Discussing an uncertain future: end-of-life care conversations in chronic obstructive pulmonary disease. A systematic literature review and narrative synthesis
Conclusions Patients' preferences for EOLC conversations vary greatly. Healthcare professionals need to respect the wishes of those not wanting to discuss EOLC and provide multiple opportunities for those who do wish to have these discussions. Recommendations on how to approach the conversation are made.
Source: Thorax - August 21, 2012 Category: Respiratory Medicine Authors: Momen, N., Hadfield, P., Kuhn, I., Smith, E., Barclay, S. Tags: Journalology, End of life decisions (geriatric medicine), End of life decisions (palliative care), Hospice, Ethics Chronic obstructive pulmonary disease Source Type: research

Ageing, genes, environment and epigenetics: what twin studies tell us now, and in the future
Compared with younger people, older people are much more variable in their organ function, and these large individual differences contribute to the complexity of geriatric medicine. What determines this variability? Is it due to the accumulation of different life experiences, or because of the variation in the genes we are born with, or an interaction of both? This paper reviews key findings from ageing twin cohorts probing these questions. Twin studies are the perfect natural experiment to dissect out genes and life experiences. We discuss the paradox that ageing is strongly determined by heritable factors (an influence t...
Source: Age and Ageing - August 21, 2012 Category: Geriatrics Authors: Steves, C. J., Spector, T. D., Jackson, S. H. D. Tags: Review Source Type: research

Teaching spiritual care – a grounded theory study among undergraduate nursing educators
Conclusion. Nursing education should prepare students to recognise and act on spiritual cues. Making spiritual assessment and interventions more visible and explicit throughout nursing programmes, in both classroom and clinical settings, will facilitate student maturation as they learn to integrate theoretical thinking into clinical practice. Relevance to clinical practice. Nursing students need role models who demonstrate spiritual care in the fast‐paced hospital environment as well as in other clinical practice settings. To model spirituality as part of nursing care can assist students to overcome their vulnerabi...
Source: Journal of Clinical Nursing - August 21, 2012 Category: Nursing Authors: Pamela H Cone, Tove Giske Tags: ORIGINAL ARTICLE Source Type: research

Assessing the quality of informed consent in a resource-limited setting: A cross-sectional study
Conclusions: Most of the participants signed informed consent forms and a vast majority felt that they received enough information before deciding to participate. On the contrary, several were not aware that they could voluntarily withdraw their participation. Participants in observational studies were more likely than those in clinical trials to perceive that refusal to participate in the parent study would affect their regular medical care.
Source: BMC Medical Ethics - August 21, 2012 Category: Medical Ethics Authors: Ronald KigubaPaul KutyabamiStephen KiwuwaElly KatabiraNelson Sewankambo Source Type: research

Prophylaxis of pseudophakic endophthalmitis
We congratulate Tan et al. for reporting on their experience with antibiotic prophylaxis of pseudophakic endophthalmitis in an Asian population. Given the ethical concerns regarding future randomized trials on this subject, only large retrospective case series can confute or confirm the positive effect of intracameral cephalosporins for pseudophakic endophthalmitis prophylaxis that was established by the European Society of Cataract & Refractive Surgeons (ESCRS) endophthalmitis prophylaxis study. In Tan et al.'s study, of 50 177 eyes having cataract surgery, 20 638 received intracameral cefazolin. The authors found a...
Source: Journal of Cataract and Refractive Surgery - August 20, 2012 Category: Opthalmology Authors: Gianluca Carifi, Bruno Zuberbuhler Tags: Letters Source Type: research

Ethical issues regarding caring for dermatology patients in the U.S. Department of Veterans Affairs Health Care System
Abstract: The U.S. Department of Veterans Affairs (VA) operates the largest integrated health care system within the United States. VA budgets continue to escalate in an environment of heightened financial prudence and accountability. Despite having received many awards in areas from patient satisfaction and safety to product innovations, like any health care system, the VA is not immune to ethical conflict that requires exploration and evaluation. Several VA dermatologists, including section chiefs, were interviewed, and their responses to ethical complexities encountered or anticipated were analyzed in fictional case sce...
Source: Clinics in Dermatology - August 20, 2012 Category: Dermatology Authors: Reuben Reich, Emily Stevens, Robert P. Dellavalle Source Type: research

The ethical controversies of office-based dispensing in academic health centers
Abstract: Office dispensing of cosmecuticals has become a widespread practice in private dermatology offices and even has begun to appear in academic dermatology settings. Proponents of the practice state that in-office dispensing is beneficial for the patient and the physician and can be ethically accomplished with the patient remaining the primary concern of the care provider. This requires the maintenance of professionalism and the sale of efficacious, reasonably priced products that are not misrepresented. Opponents believe that in-office dispensing undermines the physician– patient relationship and may produce an in...
Source: Clinics in Dermatology - August 20, 2012 Category: Dermatology Authors: Diane Whitaker-Worth, Mona Shahriari, Karren Slade, Jane M. Grant-Kels Source Type: research

Ethics in cosmetic dermatology
Abstract: The dispensing of nonprescription skin products by dermatologists and the performance of ineffective cosmetic procedures are the most controversial subjects associated with the practice of cosmetic dermatology. These topics have been hotly debated within the profession for several decades, with each side presenting cogent arguments. The debate is also characterized by strong passion and emotions on both sides that are not easily reconciled. Dermatologists and their patients are best served by an objective, organized approach to clearly delineating the various aspects of these issues and providing guidelines for p...
Source: Clinics in Dermatology - August 20, 2012 Category: Dermatology Authors: Leslie Baumann Source Type: research

Ethics of utilizing nurse practitioners and physician's assistants in the dermatology setting
Abstract: Our current supply of dermatologists in training is insufficient to meet the growing demand for dermatology services. In an era of declining reimbursements and the ever increasing clamor for increased access to care, many practices are turning to nurse practitioners and physician assistants as a cost effective means of fulfilling patient demand. Despite the recommendations of the American Academy of Dermatology, there is no explicit consensus among dermatologists on the educational requirements or appropriate utilization of NPs and PAs in dermatology settings. Colleges of nursing and physician assistant programs ...
Source: Clinics in Dermatology - August 20, 2012 Category: Dermatology Authors: Karren Slade, Mark Lazenby, Jane M. Grant-Kels Source Type: research

Ethical issues in geriatric dermatology
Abstract: Physicians should be cognizant of the multitude of unique issues that their geriatric patients present and aware of the overall elder patient's general health status both physically and cognitively, potential drug interactions, and their short-term as well as long-term goals. While respecting patients' autonomy, we must evaluate their ability to make their own decisions regarding their health care. This will require time and patience on our part. We also must overcome our own potential prejudices about what we view as important for the older patient. Finally, we may need to appropriate involve family members or c...
Source: Clinics in Dermatology - August 20, 2012 Category: Dermatology Authors: Demian Fontanella, Jane M. Grant-Kels, Trupal Patel, Robert Norman Source Type: research

Ethical issues in cutaneous melanoma
Abstract: Early diagnosis of cutaneous melanoma (CM) is associated with the finding of superficial tumors resulting in high cure rates with surgery, whereas those with deeply invasive tumors are at higher risk of recurrence and melanoma-specific mortality. Unfortunately, once metastatic to the visceral organs, CM is usually refractory to the presently available treatment modalities, resulting in uniformly poor outcomes in patients. Educating susceptible populations about the risk of developing CM has played an important role in preventive strategies despite the fact that benefits of primary skin screening are controversial...
Source: Clinics in Dermatology - August 20, 2012 Category: Dermatology Authors: Upendra P. Hegde, Jane M. Grant-Kels Source Type: research

Ethical issues in inpatient consultative dermatology
We describe the case of an inpatient suffering from a severe, undiagnosable skin condition that raises key principles of medical ethics. The four principles include autonomy, nonmaleficence, beneficence, and justice. Ethical situations faced by inpatient dermatologists are similar to those experienced by medicine hospitalists, as compared with outpatient dermatologists, given the unique clinical setting in which inpatient dermatology is practiced. Other inpatient services, colleagues, and ethics committees are useful resources for inpatient dermatologists faced with difficult ethical situations.
Source: Clinics in Dermatology - August 20, 2012 Category: Dermatology Authors: Nina K. Hansra, Kanade Shinkai, Lindy P. Fox Source Type: research

Ethical considerations when prescribing biologics in dermatology
Abstract: There are no formal publications describing and discussing the various ethical dilemmas encountered when treating dermatologic disease with biologic therapy. Multiple issues such as safety, efficacy, drug accessibility, and cost need to be considered when prescribing biologics. This contribution uses a case-based approach to evaluate the ethical principles involved with biologic therapy.
Source: Clinics in Dermatology - August 20, 2012 Category: Dermatology Authors: Frank A. Santoro, Marti J. Rothe, Bruce E. Strober Source Type: research

Ethical considerations in dermatologic photography
Abstract: In dermatology, clinical photographs are an essential component of patient care, enabling clinicians to document changes in skin pathology over time. Recent advances in digital technology and the electronic medical record have revolutionized clinical photography; however, these advances bring with them new ethical, legal, and social concerns. Photographs, more than other forms of documentation, have the potential to make patients uncomfortable. The act of photography, especially for those images requiring exposure of the genital area or the entire body, can be an uncomfortable experience for patients, necessitati...
Source: Clinics in Dermatology - August 20, 2012 Category: Dermatology Authors: Nikita Lakdawala, Demian Fontanella, Jane M. Grant-Kels Source Type: research

Ethical dilemmas in dermatologic surgery
Abstract: Dermatologic surgery presents a unique set of ethical dilemmas not frequently discussed within the medical literature. This contribution presents a few cases commonly encountered by dermatologic surgeons. The case-based discussion follows a principles-based framework for analysis and seeks to identify the central moral conflict and exemplify the development of sound reasoning for subsequent decision making through the consideration of multiple viewpoints and the weighing of potential consequences. Additional cases are provided in concise format to encourage further analysis and discourse on the distinct ethical d...
Source: Clinics in Dermatology - August 20, 2012 Category: Dermatology Authors: William D. Holmes, James D. Whalen Source Type: research

Ethical issues in dermatopathology
Abstract: Some of the most contentious and relevant ethical issues in dermatopathology include client billing, the practice of dermatopathology by physicians without board certification in dermatopathology, and the practice of including recommendations regarding further surgery in dermatopathology reports. Client billing is a system in which clinicians directly compensate laboratories for pathology services and directly bill patients and/or third-party payers. Although proponents argue that this system can reduce health care costs and increase efficiency, others have argued that it creates an environment that fosters uneth...
Source: Clinics in Dermatology - August 20, 2012 Category: Dermatology Authors: Homer O. Wiland, Jane M. Grant-Kels Source Type: research

Ethics in pediatric dermatology
Abstract: The patient-parent-physician relationship is central to studying medical ethics in pediatric dermatology. The rights of children in medical decision making are ambiguous, and parents and physicians will often override the autonomy of a child when a particular treatment is deemed to be in the child's best interest. The use of physical restraint to enforce a treatment should be justified, and a reasonable attempt should be made to ensure the cooperation of the child, if possible. Medical photography is central to the practice of pediatric dermatology in that it allows for serial observation of cutaneous lesions ove...
Source: Clinics in Dermatology - August 20, 2012 Category: Dermatology Authors: John B. Kelly, Hanspaul S. Makkar Source Type: research

Ethics in the dermatology clinic: Part II
Part I of this series on ethics for Clinics in Dermatology dealt with broad ethical issues. We specifically addressed the ethical issues dermatologists deal with when they interact with the American Academy of Dermatology and American Medical Association, hospitals, the US government, pharmaceutical companies, residency training programs and the Accreditation Council for Graduate Medical Education (ACGME), Investigational Review Boards (IRB) and other research organizations, and journal publication editors and editorial boards. In this issue, we have attempted to review some of the specific issues dermatologists face daily...
Source: Clinics in Dermatology - August 20, 2012 Category: Dermatology Authors: Jane M. Grant-Kels Tags: Commentary Source Type: research

A multicenter, randomized, prospective, controlled study comparing sacrospinous fixation and transvaginal mesh in the treatment of posthysterectomy vaginal vault prolapse
Conclusion: Mesh exposure occurrence was balanced against a lower prolapse recurrence rate in the patients undergoing mesh surgery compared with those undergoing SSF.
Source: American Journal of Obstetrics and Gynecology - August 20, 2012 Category: OBGYN Authors: Michael Halaska, Katerina Maxova, Oldrich Sottner, Kamil Svabik, Michal Mlcoch, Dusan Kolarik, Ivana Mala, Ladislav Krofta, Michael J. Halaska Tags: Urogynecology Source Type: research

Re: What We Don't Talk About When We Don't Talk About Sex(1): Results of a National Survey of U.S. Obstetrician/Gynecologists
J. N. Sobecki, F. A. Curlin, K. A. Rasinski and S. T. Lindau Department of Obstetrics and Gynecology, Section of General Internal Medicine, MacLean Center for Clinical Medical Ethics, Section of Geriatrics, Comprehensive Cancer Center, and Center on Demography and Economics of Aging Core on Biomeasures in Population-Based Aging Research, University of Chicago, Chicago, Illinois
Source: The Journal of Urology - August 20, 2012 Category: Urology & Nephrology Authors: Allen D. Seftel Tags: Male and Female Sexual Function and Dysfunction; Andrology Source Type: research

Restoring medical professionalism
The essence of medical professionalism is placing dedication to the welfare of patients above physicians' personal or proprietary interests. Medicine has become deprofessionalized as a consequence of socioeconomic factors leading to increasing commercialization and perverse financial incentives converting it into a business, the presence of unmanaged conflicts of interest, challenges to medical authority by insurance companies and the consumerism movement, and by gradual changes in the attitudes of physicians. Organized medicine has responded by making explicit its standards of professionalism and its dedication to preserv...
Source: Neurology - August 20, 2012 Category: Neurology Authors: Bernat, J. L. Tags: All Clinical Neurology, All Education, Methods of education, All Ethics in Neurology/Legal issues, Professional conduct and ethics CONTEMPORARY ISSUES IN NEUROLOGIC PRACTICE: HORIZONS Source Type: research

Clinical Application of Pharmacogenomics
The purpose of this review is to discuss the clinical application of pharmacogenomics for select drug therapies (eg, proton pump inhibitors [PPIs], codeine, and carbamazepine) and to highlight limitations and challenges that preclude implementation of pharmacogenomics into clinical practice. Genetic polymorphisms of cytochrome P450 (CYP) enzymes and the presence of the human leukocyte antigen (HLA)-B*1502 allele influence drug disposition and/or response. A portion of PPI pharmacokinetic and pharmacodynamic variability can be explained by CYP2C19 genotype. However, conflicting evidence exists related to Helicobacter pylori...
Source: Journal of Pharmacy Practice - August 20, 2012 Category: Drugs & Pharmacology Authors: Ma, J. D., Lee, K. C., Kuo, G. M. Tags: Pharmacogenomics Source Type: research

Ambiguities in Criminalizing Cartels: A Political Economy
Criminalizing the harms of the powerful has considerable appeal for those who desire a more tractable, ethical and sustainable business sector. Yet, attempts to both establish criminal offences and to enforce them once they are enacted often face perennial challenges. These challenges are a product of the ambiguities—economic, moral and legal—associated with the conduct sought to be criminalized, in this case cartels, and with the character of the criminal law itself. Following Aubert, we argue that exploring these ambiguities reveals critical social and economic shifts in society. Further, these shifts pose si...
Source: British Journal of Criminology - recent issues - August 20, 2012 Category: Forensic Medicine Authors: Haines, F., Beaton-Wells, C. Tags: review-article Source Type: research

Table of Contents
Abstract Budget Problems, Medicaid Expansion Main Topics at SAMHSA Meeting Center Takes Eclectic Approach to Treatment of Pregnant Women Human Rights Watch Questions Ethics of China Drug Study Coaching Youth in Recovery GAO Assesses Treatment and Prevention in 2010 Stradegy Buprenorphine ER Visits up 255 Percent Briefly Noted Resources Coming up
Source: Alcoholism and Drug Abuse Weekly - August 20, 2012 Category: Addiction Source Type: research

Presumed consent and organ donation
This article explores the meaning and moral significance of presumed consent with particular reference to an opt-out policy for postmortem organ donation. It does so under two general categories: circumstances where we believe consent to have been given and those where we have no reason to believe that it has either been given or been refused. In the context of an opt-out policy, the first category would relate to the idea of tacit consent. It is argued both that substituting the term ‘presumed consent’ would be misleading and that it is unlikely that the conditions for tacit consent would be met in practice. R...
Source: Clinical Ethics - August 20, 2012 Category: Medical Ethics Authors: Upton, H. Tags: Papers Source Type: research

Loss of faith in brain death: Catholic controversy over the determination of death by neurological criteria
The diagnosis of death by neurological criteria (colloquially known as ‘brain death’) is accepted in some form in law and medical practice throughout the world, and has been endorsed in principle by the Catholic Church. However, the rationale for this acceptance has been challenged by the accumulation of evidence of integrated vital activity in bodies diagnosed dead by neurological criteria. This paper sets out 10 different Catholic responses to the current crisis of confidence and assesses them in relation to a Catholic understanding of philosophical anthropology. Having considered each of these responses, non...
Source: Clinical Ethics - August 20, 2012 Category: Medical Ethics Authors: Jones, D. A. Tags: Papers Source Type: research

Brain death: justifications and critiques
Controversies about the diagnosis and meaning of brain death have existed as long as the concept itself. Here we review the historical development of brain death, and then evaluate the various attempts to justify the claim that patients who are diagnosed as brain dead can be considered dead for all legal and social purposes, and especially with regard to procuring their vital organs for transplantation. While we agree with most commentators that death should be defined as the loss of integration of the functioning of the organism as a whole, we conclude that patients diagnosed as brain dead have not, in fact, lost this int...
Source: Clinical Ethics - August 20, 2012 Category: Medical Ethics Authors: Truog, R. D., Miller, F. G. Tags: Papers Source Type: research

Organ donation: development and practicalities
The need for organs for donation is far greater than organ availability. In the last decade this has led to restructuring and investment in the organ donation programme with political and public support. The majority of transplanted organs are retrieved from patients dying on an intensive care unit, and the wish to consider organ donation as a normal part of end-of-life care has led to considerable pressure on clinicians to adhere to the large amount of practical and ethical guidance being published to achieve this. There has not been universal acceptance of the guidance by critical care clinicians, and this paper explores...
Source: Clinical Ethics - August 20, 2012 Category: Medical Ethics Authors: Matthews, P. C. Tags: Papers Source Type: research

'I just love these sessions'. Should physician satisfaction matter in clinical ethics consultations?
Clinical ethics committees aim to resolve conflict, facilitate communication and ease moral distress in health care. Dialogue in committee discussions is complex and involves a balance between implicitly and explicitly expressed values of patients, families and professionals. Evaluating effectiveness and concrete outcomes is challenging and most studies focus on broad benefits such as quality of care and reduction of unnecessary or unwanted treatments. In this paper we propose ‘physician satisfaction’ as a valuable outcome. We refer to the clinical ethics approach followed at one large paediatric hospital in Au...
Source: Clinical Ethics - August 20, 2012 Category: Medical Ethics Authors: Delany, C., Hall, G. Tags: Empirical Ethics Source Type: research

Gate-keeping or free choice in crisis resolution and home treatment teams
Crisis resolution and home treatment (CRHT) teams have been introduced into mental health care in the UK because, in general, patients do not want to be admitted to hospital, treatment at home is cheaper and in the only randomized controlled trial conducted so far there was no difference in symptomatic outcome. However, because of compulsory gate-keeping by CRHT teams, some patients no longer have the option of going to hospital if they want to. This aspect of the introduction of CRHT teams has not been discussed so far, but it certainly warrants further examination. Intervention through CRHT teams may in fact increase com...
Source: Clinical Ethics - August 20, 2012 Category: Medical Ethics Authors: Hubbeling, D. Tags: Public Policy & amp; Law Source Type: research

Blood sampling from dying patients: an ethical dilemma
Source: Clinical Ethics - August 20, 2012 Category: Medical Ethics Authors: Magelssen, M., Asten, P., Godal, E., Os, E., Smith, A., Solas, H. R., Hem, M. H. Tags: Case Studies Source Type: research

Brain death and organ transplantation
Source: Clinical Ethics - August 20, 2012 Category: Medical Ethics Authors: Edwards, S. D. Tags: Editorial Source Type: research

Reliability and diagnostic accuracy of qualitative evaluation of diffusion-weighted MRI combined with conventional MRI in differentiating between complete and partial anterior cruciate ligament tears
Conclusions ADC mapping associated with conventional MR sequences is a reproducible method to better differentiate complete and partial ACL tears. Key Points • MRI is widely used for assessing the problematic knee • Additional diffusion-weighted sequences help differentiate between complete and partial ACL tears • DW-MRI for ACL requires a reader-dependent learning curve • Reliable visualisation of complete ACL tears allows more appropriate management of patients Content Type Journal ArticleCategory MusculoskeletalPages 1-10DOI 10.1007/s00330...
Source: European Radiology - August 18, 2012 Category: Radiology Tags: European Radiology Source Type: research

Non-surgical causes of pneumoperitoneum--characteristic 'Rigler's sign' in a chest x-ray due to pneumothorax with a diaphragmatic hernia
Introduction Rigler's sign is a radiological sign of free intraperitoneal air, generally from a perforated viscus. It is the appearance of air on both sides of the bowel wall due to a large quantity of free air in the abdomen. It is important to be aware of the non-surgical causes of this appearance, one of which we describe here. An 87-year-old man whose only medical history was of a long-standing, seemingly asymptomatic, diaphagramatic hernia (figure 1, preoperative film), underwent a total hip replacement with general anaesthesia following an intracapsular hip fracture. Twenty-four hours postoperatively he became hypoxi...
Source: Postgraduate Medical Journal - August 18, 2012 Category: Journals (General) Authors: Dockery, F., George, M., Chinthapalli, S. Tags: Journalology, Oesophagus, Radiology, Mechanical ventilation, Clinical diagnostic tests, Radiology (diagnostics), Ethics Images in medicine Source Type: research

Inadvertent prescription of gelatin-containing oral medication: its acceptability to patients
This study demonstrated that 43.2% of the study population would prefer not to take animal product-containing medication even if no alternative were available. 51% of men with lower urinary tract symptoms were also found to have inadvertently been prescribed gelatin-containing products against their preferred dietary restriction. Education of healthcare professionals about excipients and getting them to ask about a patient's dietetic preferences may help avoid inadvertent prescription of the excipient gelatin in oral medications. Substitution of gelatin with vegetable-based alternatives and clearer labelling on drug packag...
Source: Postgraduate Medical Journal - August 18, 2012 Category: Journals (General) Authors: Vissamsetti, B., Payne, M., Payne, S. Tags: Press releases, Diet Ethics and law Source Type: research

Ethical and practical considerations in prescribing animal-derived medication
There are many reasons why providing a patient with enough information to allow them to make an informed decision about their treatment is central to good medical care. Some of these have origins in the law: certainly, informing a patient of the risks involved in a procedure or with taking a certain drug is essential in order to avoid charges of negligence should an adverse event causing harm occur. However, the duty of consent goes beyond this. It is no longer acceptable for a doctor to adopt a paternalistic approach in deciding what treatment should be prescribed. This is based on the principle of autonomy: a well-inform...
Source: Postgraduate Medical Journal - August 18, 2012 Category: Journals (General) Authors: Corfield, L., Granne, I. Tags: Diet, Reproductive medicine, Interventional cardiology, Vascular surgery Editorials Source Type: research

Reply
We thank Carifi and Theoulakis for commenting on our article. However, we contend that our research and proposed pupil dynamics assessment can have a clinical impact, especially from medicolegal and ethical perspectives.
Source: American Journal of Ophthalmology - August 17, 2012 Category: Opthalmology Authors: Panagiotis G. Theodossiadis, Vasilis Achtsidis, Sofia Theodoropoulou, Nicholas Tentolouris, Christos Komninos, Kostas N. Fountas Tags: Correspondence Source Type: research

[Correspondence] Absence of humanities in China's medical education system
The crisis of trust between doctors and patients in China has been denounced widely. An online news story on June 5, 2012, described an astonishing scandal at a hospital in Hangzhou, Zhejiang province, in which a female nurse abused an infant and uploaded several photos of the process to her Weibo page (a Chinese social network). The public reacted angrily towards the scandal, and accused the medical staff of having no medical ethics or humanitarianism.
Source: LANCET - August 17, 2012 Category: Journals (General) Authors: Jie Li, Feng Qi, Shanshan Guo, Ping Peng, Ming Zhang Tags: Correspondence Source Type: research

The use of high frequency oscillations to guide neocortical resections in children with medically-intractable epilepsy: How do we ethically apply surgical innovations to patient care?
Conclusion: The use of HFO signatures to guide neocortical resections represents a novel approach for the treatment of epilepsy. It is hoped that the issues discussed herein will contribute to and advance meaningful dialog on the ethical application of this surgical innovation to the treatment of a very vulnerable patient population.
Source: Seizure: European Journal of Epilepsy - August 17, 2012 Category: Neurology Authors: George M. Ibrahim, Aria Fallah, O. Carter Snead, James M. Drake, James T. Rutka, Mark Bernstein Tags: Reviews Source Type: research

Interactions of nanomaterials and biological systems: Implications to personalized nanomedicine.
Abstract The application of nanotechnology to personalized medicine provides an unprecedented opportunity to improve the treatment of many diseases. Nanomaterials offer several advantages as therapeutic and diagnostic tools due to design flexibility, small sizes, large surface-to-volume ratio, and ease of surface modification with multivalent ligands to increase avidity for target molecules. Nanomaterials can be engineered to interact with specific biological components, allowing them to benefit from the insights provided by personalized medicine techniques. To tailor these interactions, a comprehensive knowledge o...
Source: Advanced Drug Delivery Reviews - August 17, 2012 Category: Drugs & Pharmacology Authors: Zhang XQ, Xu X, Bertrand N, Pridgen E, Swami A, Farokhzad OC Tags: Adv Drug Deliv Rev Source Type: research

A Case of Compound Mutations in the MYBPC3 Gene Associated with Biventricular Hypertrophy and Neonatal Death.
We describe a case of compound heterozygosity in the MYBPC3 gene (p.Glu258Lys and IVS25-1G>A) associated with biventricular hypertrophy, atrial enlargement and subsequent neonatal death 33 days postpartum. Other studies have reported compound and/or double heterozygosis in the same or different sarcomeric genes during childhood and adulthood, and neonatal presentations have also been described. Our observations show that the combination of a missense (p.Glu258Lys) and a splice-site mutation (IVS25-1G>A) profoundly affects the clinical course. In families in which parental mutations are known, preimplantation (where e...
Source: Neonatology - August 17, 2012 Category: Perinatology & Neonatology Authors: Marziliano N, Merlini PA, Vignati G, Orsini F, Motta V, Bandiera L, Intrieri M, Veronese S Tags: Neonatology Source Type: research

Common and Conflicting Interests in the Engagements between Conservation Organizations and Corporations.
Abstract The conservation community increasingly views the corporate sector as a positive force for conservation. Collaborations between corporations and nongovernmental conservation organizations (NGOs) seek to mitigate the negative effects of corporate activities and augment positive conservation outcomes. I reviewed the establishment of corporate social responsibility (CSR) policies by corporations; the emerging focus on environmental practices and sustainability; and the history of engagement between corporations and nongovernmental organizations. I considered the ethical and reputation vulnerabilities of t...
Source: Conservation Biology - August 17, 2012 Category: Biology Authors: Robinson JG Tags: Conserv Biol Source Type: research

Total Knee Dislocation: A falsely reassuring radiograph
A 43-year-old man presented to the Emergency Department after an injury to his left knee while playing rugby. He explained in detail how he became wedged between two players resulting in his left knee bending the wrong way until his toes were touching his groin. On the pitch, he returned his lower leg back to a more normal position. On examination, his knee was grossly swollen but not deformed. It was exquisitely tender, particularly in the popliteal fossa. Initially, his dorsalis pedis pulse was easily palpable. An x-ray showed no bony injury and only a small supra-patellar effusion (figure 1). After discussion with the o...
Source: Emergency Medicine Journal - August 17, 2012 Category: Emergency Medicine Authors: Coates, J., Butler, C. Tags: Drugs: infectious diseases, Radiology, Clinical diagnostic tests, Radiology (diagnostics), Ethics, Trauma, Recreation/Sports injury Images in emergency medicine Source Type: research

Bilateral tension pneumothorax
A 24-year-old woman was transferred from an outpatient surgery centre by the paramedic service. During surgery for bilateral augmentation mammoplasty (*) sudden hypoxaemia developed with oxygen saturation decreasing to 58% and drop of blood pressure from 130/95 to 78/61 mm Hg (systolic/diastolic). Due to diminished breath sounds a chest tube was placed on each side and the patient immediately referred to the emergency room. Chest x-ray on admission revealed bilateral tension pneumothorax with both lungs entirely collapsed (figure 1A). The heart silhouette appeared compressed and depression of both diaphragms () w...
Source: Emergency Medicine Journal - August 17, 2012 Category: Emergency Medicine Authors: Wildgruber, M., Rummeny, E. J. Tags: Hypertension, Radiology, Clinical diagnostic tests, Radiology (diagnostics), Ethics, Resuscitation Images in emergency medicine Source Type: research

Pneumorrhachis from a thrown knife
A 27-year-old man was admitted to the emergency department after a sharp object was thrown into his back. There was a 4 cm, vertical cut to the midline of his back at the level of T11. His blood pressure was 128/80 mm Hg with a heart rate of 80 beats per minute. A CT scan was performed, which demonstrates a fracture of T11 and air in the spinal canal tracking up into the cervical spine and down into the lumbar spine (figures 1 and 2). The patient developed hyperaesthesia bilaterally in an L2/3 distribution with decreased sensation in the right-sided L5/S1 distribution. Proprioception in the right foot was de...
Source: Emergency Medicine Journal - August 17, 2012 Category: Emergency Medicine Authors: Grundlingh, J., Grier, G., Ahmad, K. Tags: Hypertension, Radiology, Clinical diagnostic tests, Radiology (diagnostics), Ethics, Trauma Images in emergency medicine Source Type: research