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Ethical Issues in Rhinologic Surgery: Balancing Benevolent Care and Advancing Surgical Techniques
AbstractPurpose of ReviewTo consider ethical aspects of rhinologic surgery including surgical and medical treatment options, new technologies and techniques, informed consent and patient choice.Recent FindingsThe ethical principles of autonomy, justice, beneficence, non-maleficence and fidelity are fundamental to the practice of medicine as well as to the clinical research that informs new treatment options. Here, they are discussed in the context of treatment of benign rhinologic disease.SummarySurgeons are ethically bound to act in the best interests of the patient, informing and involving them in the clinical decisions ...
Source: Current Otorhinolaryngology Reports - September 22, 2023 Category: ENT & OMF Source Type: research

Exploring reasons behind UK doctors leaving the medical profession: a series of qualitative interviews with former UK doctors
Conclusion New careers were able to address many of the issues that caused participants to leave UK medicine. Consequently, it is important that some of the key issues raised in this study are addressed to retain more doctors in the UK medical workforce.
Source: BMJ Open - September 22, 2023 Category: General Medicine Authors: Pathmanathan, A., Snelling, I. Tags: Open access, Health policy Source Type: research

Effect of robotic-assisted gait training on gait and motor function in spinal cord injury: a protocol of a systematic review with meta-analysis
Introduction Robotic-assisted gait training (RAGT) has been reported to be effective in rehabilitating patients with spinal cord injury (SCI). However, studies on RAGT showed different results due to a varied number of samples. Thus, summarising studies based on robotic-related factors is critical for the accurate estimation of the effects of RAGT on SCI. This work aims to search for strong evidence showing that using RAGT is effective in treating SCI and analyse the deficiencies of current studies. Methods and analysis The following publication databases were electronically searched in December 2022 without restrictions ...
Source: BMJ Open - September 22, 2023 Category: General Medicine Authors: Wang, L., Peng, J.-l., Chen, A.-l. Tags: Open access, Rehabilitation medicine Source Type: research

Dietary supplements to reduce symptom severity and duration in people with SARS-CoV-2: a double-blind randomised controlled trial
Background COVID-19 has caused morbidity, hospitalisation and mortality worldwide. Despite effective vaccines, there is still a need for effective treatments, especially for people in the community. Dietary supplements have long been used to treat respiratory infections, and preliminary evidence indicates some may be effective in people with COVID-19. We sought to evaluate whether a combination of vitamin C, vitamin D3, vitamin K2 and zinc could improve overall health and decrease symptom burden in outpatients diagnosed with COVID-19. Methods Participants were randomised to receive either vitamin C (6 g), vitamin D3 (1000...
Source: BMJ Open - September 22, 2023 Category: General Medicine Authors: Seely, D., Legacy, M., Conte, E., Keates, C., Psihogios, A., Ramsay, T., Fergusson, D. A., Kanji, S., Simmons, J.-G., Wilson, K. Tags: Open access, Complementary medicine, COVID-19 Source Type: research

First implementation of dynamic oxygen-17 (17O) magnetic resonance imaging at 7 Tesla during neuronal stimulation in the human brain
DiscussionThe change of cerebral oxygen metabolism induced by sensorimotor and visual stimulation is not large enough to be reliably detected with the current setup and methodology of dynamic17O MRI at 7  T.
Source: Magnetic Resonance Materials in Physics, Biology and Medicine - September 22, 2023 Category: Materials Science Source Type: research

Regenerative Surgery: Is This an Independent Field of Health Sciences or Only a Semantic Exercise?
AbstractPurpose of ReviewThis manuscript aims at contextualizing the termregenerative surgery, whose recent introduction in the medical jargon has generated some confusion on both its significance and interplay with its synonymousregenerative medicine.Recent FindingsThe manuscript will illustrate the worldwide experience relative to the development ofregenerative surgery–related technologies, as they may be applied and be of interest to transplant medicine. Only few centers have invested in these technologies, the most relevant of which is cell on scaffold seeding technologies whereby cells, ideally isolated from the pat...
Source: Current Transplantation Reports - September 22, 2023 Category: Transplant Surgery Source Type: research

Professional virtue of civility and the responsibilities of medical educators and academic leaders
Incivility among physicians, between physicians and learners, and between physicians and nurses or other healthcare professionals has become commonplace. If allowed to continue unchecked by academic leaders and medical educators, incivility can cause personal psychological injury and seriously damage organisational culture. As such, incivility is a potent threat to professionalism. This paper uniquely draws on the history of professional ethics in medicine to provide a historically based, philosophical account of the professional virtue of civility. We use a two-step method of ethical reasoning, namely ethical analysis inf...
Source: Journal of Medical Ethics - September 22, 2023 Category: Medical Ethics Authors: McCullough, L. B., Coverdale, J., Chervenak, F. A. Tags: Open access Feature article Source Type: research

Incentivising civility in clinical environments
Agent-based or system-based interventions? Several months ago, an Israeli resident in emergency medicine engaged in a hunger strike to protest 26-hour shifts. His protest was part of a country-wide struggle of medical residents from all disciplines against such long shifts, arguing that they are a thing of the past, and that they harm patient care. While there is actually no evidence that long shifts harm patient outcomes, they very likely reduce civility among staff members and towards patients.1 Two kinds of strategies are possible to address this likely source of incivility: expect and train residents to be kinder and m...
Source: Journal of Medical Ethics - September 22, 2023 Category: Medical Ethics Authors: Browne, T. K., Lederman, Z. Tags: Commentary Source Type: research

There is no 'I in team, but there are two in civil
McCullough et al’s article about the professional virtue of civility makes a persuasive case that civility should be a core value in medical education, and that civility facilitates the development of organisational cultures committed to excellence in clinical and scientific reasoning.1 In particular, the negative implications of incivility on the well-being of individuals, on team-working dynamics and on patient safety, creates a strong argument that incivility from healthcare professionals is entirely unacceptable. However, in terms of professional attitudes, civility is the bare minimum that modern clinicians requ...
Source: Journal of Medical Ethics - September 22, 2023 Category: Medical Ethics Authors: Donaldson, T. Tags: Commentary Source Type: research

The Cardiovascular Burden of Rheumatoid Arthritis – Implications for Treatment
Mortality in rheumatoid arthritis is increased, about twice vs. controls, and cardiovascular diseases are a major cause. The pathogenesis is primarily accelerated atherosclerosis of the coronary, cervical, and cerebral arteries which is premature, pervasive, and progressive but often occult, under-recognized and under-treated. It is mostly driven by the chronic, systemic autoimmune inflammation but increased prevalence of traditional risk factors and adverse effects of treatments are also very important.
Source: The American Journal of Medicine - September 22, 2023 Category: General Medicine Authors: Ami Schattner Tags: Review Source Type: research

Unravelling a mysterious skin lesion in a patient with Ulcerative Colitis
A 53-year-old male with a history of long-standing ulcerative colitis presented to the emergency department with pain and swelling in his left lower extremity. He was diagnosed 12 years prior to the presentation with ulcerative colitis. He was initially managed with mesalamine for 5 years after which he lost response. For the following 6 years, he was placed on multiple immunosuppressive medications including adalimumab, infliximab, and mirikizumab. He remained symptomatic despite these medications.
Source: The American Journal of Medicine - September 22, 2023 Category: General Medicine Authors: Khaled Al-Smadi, Ammar Qureshi, Hasan Sqour, Ruijun Jeanna Su, Zeid Kayali Tags: Diagnostic Dilemma Source Type: research

Luca Giovanella. Integrated Diagnostics and Theranostics of Thyroid Diseases
Source: European Journal of Nuclear Medicine and Molecular Imaging - September 22, 2023 Category: Nuclear Medicine Source Type: research

The prognostic significance of a negative PSMA-PET scan prior to salvage radiotherapy following radical prostatectomy
ConclusionFavorable bRFS after SRT in patients with BR and negative PSMA-PET following RP was achieved. These data support the usage of early SRT for patients with negative PSMA-PET findings.
Source: European Journal of Nuclear Medicine and Molecular Imaging - September 22, 2023 Category: Nuclear Medicine Source Type: research

Distinct subtypes of spatial brain metabolism patterns in Alzheimer ’s disease identified by deep learning-based FDG PET clusters
ConclusionWe identified distinct subtypes of AD with different clinicopathologic features. The deep learning-based approach to distinguish AD subtypes on FDG PET could have implications for predicting individual outcomes and provide a clue to understanding the heterogeneous pathophysiology of AD.
Source: European Journal of Nuclear Medicine and Molecular Imaging - September 22, 2023 Category: Nuclear Medicine Source Type: research

Patterns of PET-positive residual tissue at interim restaging and risk of treatment failure in advanced-stage Hodgkin ’s lymphoma: an analysis of the randomized phase III HD18 trial by the German Hodgkin Study Group
ConclusionPET-2-positive residuals of AS-HL are mostly located in the mediastinum, and a majority of patients have few affected regions. The risk of progression was twofold higher in patients with more than two positive regions in PET-2.
Source: European Journal of Nuclear Medicine and Molecular Imaging - September 22, 2023 Category: Nuclear Medicine Source Type: research