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All posts; Tags Include "Medical Ethics"

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  • June 28, 2015
  • 04:05 AM
  • 1,157 views

Who Will Pay for All the New DBS Implants?

by The Neurocritic in The Neurocritic

Recently, Science and Nature had news features on big BRAIN funding for the development of deep brain stimulation technologies. The ultimate aim of this research is to treat and correct malfunctioning neural circuits in psychiatric and neurological disorders. Both pieces raised ethical issues, focused on device manufacturers and potential military applications, respectively.A different ethical concern, not mentioned in either article, is who will have access to these new devices, and who is goin........ Read more »

  • June 3, 2015
  • 09:15 AM
  • 805 views

Clinical Sequencing Data Sharing Is Essential

by Daniel Koboldt in Massgenomics

The past few decades have seen rapid advances in our knowledge of genetic diseases, which affect an estimated 25 million Americans. These advances can be quantified in things like the growth of dbSNP (now contains about 90 million validated genetic variants) and the number of Mendelian disorders understood at the genetic level (over 5,000). Some of the […]... Read more »

Rehm HL, Berg JS, Brooks LD, Bustamante CD, Evans JP, Landrum MJ, Ledbetter DH, Maglott DR, Martin CL, Nussbaum RL.... (2015) ClinGen - The Clinical Genome Resource. The New England journal of medicine. PMID: 26014595  

  • May 14, 2015
  • 02:15 PM
  • 1,183 views

Mary-Claire King on Inherited Breast/Ovarian Cancer

by Daniel Koboldt in Massgenomics

It is a rare but delightful opportunity to learn about something from an acknowledged world expert. Such was the case last month when I heard Mary-Claire King give the Stanley J. Korsmeyer Memorial lecture, hands-down one of the best talks I’ve ever heard. She was a wonderful public speaker: funny, charming, and straight-shooting. Her topic, of […]... Read more »

Hall JM, Lee MK, Newman B, Morrow JE, Anderson LA, Huey B, & King MC. (1990) Linkage of early-onset familial breast cancer to chromosome 17q21. Science (New York, N.Y.), 250(4988), 1684-9. PMID: 2270482  

King MC. (2014) "The race" to clone BRCA1. Science (New York, N.Y.), 343(6178), 1462-5. PMID: 24675952  

  • March 31, 2015
  • 06:45 AM
  • 1,620 views

African-Americans Receive Heart Transplants at Hospitals With Poor Performance Track Records

by Jalees Rehman in The Next Regeneration

About five million people in the US suffer from heart failure, and approximately half of them die within five years of being diagnosed. Only about 2,500 hundred people a year receive a heart transplant – the treatment of last resort. A new heart can be life-saving, but it is also life-changing. Even under the best conditions, the surgery is complex, and recovery carries a heavy physical and emotional burden.
... Read more »

  • March 11, 2015
  • 09:18 AM
  • 566 views

Conflicts of Interest in Peer Review of Biomedical Research Funding Studied

by Marie Benz in MedicalResearch.com

MedicalResearch.com Interview with: Stephen Gallo, Ph.D. Technical Operations Manager American Institute of Biological Sciences Scientific Peer Advisory and Review Services Reston, VA  20191 Medical Research: What is the background for this study? What are the main findings? Dr. Gallo: Peer … Continue reading →... Read more »

MedicalResearch.com Interview with:, & Stephen Gallo, Ph.D. (2015) Conflicts of Interest in Peer Review of Biomedical Research Funding Studied. MedicalResearch.com. info:/

  • February 23, 2015
  • 10:20 PM
  • 1,240 views

Exercise Medicine is Ancient History

by Rodney Steadman in Gravity's Pull

Exercise was used as medicine at least 2600 years ago.... Read more »

  • February 3, 2015
  • 09:05 AM
  • 1,374 views

Tryin' To Make A Tricorder

by Mark E. Lasbury in The 'Scope

Star Trek technology is coming true; modern medicine has borrowed the idea of the tricorder. There’s currently a $10 million X Prize to produce a working model. The goal is take doctors out of the picture and allow consumers to assess their own health status. To win the money, ten teams have developed hand held devices that can diagnose 16 diseases and monitor half a dozen vital signs in real time. ... Read more »

  • December 13, 2014
  • 12:56 PM
  • 1,262 views

Animal Research Sheds Light on Harmful Mood Disorders in New Mothers

by Wiley Asia Blog in Wiley Asia Blog - Social Science

In the days shortly after giving birth, most mothers experience a period of increased calmness and decreased stress responses, but around 20% of mothers experience anxiety. Some women may become depressed, and around one in a thousand can develop psychosis. The latest evidence indicates that these distressing responses to motherhood are still poorly understood, but that animal research could provide valuable clues to their causes.

Writing in the British Journal of Pharmacology, Dr David Slatt........ Read more »

Perani, C., & Slattery, D. (2014) Using animal models to study post-partum psychiatric disorders. British Journal of Pharmacology, 171(20), 4539-4555. DOI: 10.1111/bph.12640  

  • October 5, 2014
  • 05:30 AM
  • 1,071 views

Pain needs painkillers – right?

by DJMac in Recovery Review

Overprescribing of opioid painkillers has caused harm to many people including addiction, loss of social functioning and, increasingly though still relatively uncommonly in the UK, to death. Concerns have been raised about deaths associated with tramadol. I’ve written before about the lack of evidence of effectiveness for opiates in chronic pain, but it is hard for [...]
The post Pain needs painkillers – right? appeared first on Recovery Review.
... Read more »

  • October 2, 2014
  • 05:52 AM
  • 1,273 views

JUST PUBLISHED: A Trial to Evaluate the Efficacy of an Integrated Smoking Cessation Intervention among Mental Health Patients

by Mark Rubin in The University of Newcastle's School of Psychology Newsline

Depending on diagnosis and setting, between 33 and 90 per cent of people with mental illness smoke tobacco, both in Australia and worldwide. As a result, tobacco-related diseases are one of the leading causes of mortality among this population subgroup. A paucity of research to date has examined the efficacy of cessation strategies to assist people with mental illness to quit smoking. However, limited findings have suggested that aids that have been found to be effective for the general populati........ Read more »

  • September 10, 2014
  • 07:00 PM
  • 113,481 views

Anecdotes and the Appearance of Improvement

by Rogue Medic in Rogue Medic

We like to give treatments that produce results that we can see and logically attribute to the treatments we gave.

We like to give IV (IntaVenous) furosemide (Lasix – frusemide in Commonwealth countries) for CHF (Congestive Heart Failure).

1. The patient had CHF.
2. I gave IV furosemide.
3. The patient produced urine.... Read more »

  • September 10, 2014
  • 09:00 AM
  • 1,057 views

Return of Results from Next-gen Sequencing

by Daniel Koboldt in Massgenomics

The rapid adoption of next-gen exome and genome sequencing for clinical use (i.e. with patient DNA) raises some difficult questions about the return of results to patients and their families. In contrast to traditional genetic testing, which usually checks for variants in specific genes, high-throughput sequencing has the potential to reveal a number of secondary […]... Read more »

  • August 19, 2014
  • 11:15 PM
  • 1,711 views

Dextrose 10% in the Treatment of Out-of-Hospital Hypoglycemia

by Rogue Medic in Rogue Medic

Is 50% dextrose as good as 10% dextrose for treating symptomatic hypoglycemia?

If the patient is disoriented, but becomes oriented before the full dose of dextrose is given, is it appropriate to continue to treat the patient as if the patient were still disoriented? If your protocols require you to keep giving dextrose, do the same protocols require you to keep giving opioids after the pain is relieved? Is there really any difference?

50% dextrose has problems.... Read more »

Kiefer MV, Gene Hern H, Alter HJ, & Barger JB. (2014) Dextrose 10% in the treatment of out-of-hospital hypoglycemia. Prehospital and disaster medicine, 29(2), 190-4. PMID: 24735872  

  • August 14, 2014
  • 12:35 AM
  • 1,303 views

The Controversy of Admitting 'We Do Not Know What Works'

by Rogue Medic in Rogue Medic

There are several news articles today criticizing a study because the patients might be deprived of a drug that has not been adequately studied in humans. This criticism is coming from journalists – the people who publicized the fraudulent vaccines research by Andrew Wakefield, who was trying to sell his competing vaccine and was being paid to produce negative research by lawyers suing the vaccine companies.[1]

The real controversy is that this untested drug became the standard of care ........ Read more »

Larabee TM, Liu KY, Campbell JA, & Little CM. (2012) Vasopressors in cardiac arrest: a systematic review. Resuscitation, 83(8), 932-9. PMID: 22425731  

Herlitz J, Ekström L, Wennerblom B, Axelsson A, Bång A, & Holmberg S. (1995) Adrenaline in out-of-hospital ventricular fibrillation. Does it make any difference?. Resuscitation, 29(3), 195-201. PMID: 7667549  

Olasveengen, T., Sunde, K., Brunborg, C., Thowsen, J., Steen, P., & Wik, L. (2009) Intravenous Drug Administration During Out-of-Hospital Cardiac Arrest: A Randomized Trial. JAMA: The Journal of the American Medical Association, 302(20), 2222-2229. DOI: 10.1001/jama.2009.1729  

Hagihara A, Hasegawa M, Abe T, Nagata T, Wakata Y, & Miyazaki S. (2012) Prehospital epinephrine use and survival among patients with out-of-hospital cardiac arrest. JAMA : the journal of the American Medical Association, 307(11), 1161-8. PMID: 22436956  

Hayashi Y, Iwami T, Kitamura T, Nishiuchi T, Kajino K, Sakai T, Nishiyama C, Nitta M, Hiraide A, & Kai T. (2012) Impact of early intravenous epinephrine administration on outcomes following out-of-hospital cardiac arrest. Circulation journal : official journal of the Japanese Circulation Society, 76(7), 1639-45. PMID: 22481099  

Glover BM, Brown SP, Morrison L, Davis D, Kudenchuk PJ, Van Ottingham L, Vaillancourt C, Cheskes S, Atkins DL, Dorian P.... (2012) Wide variability in drug use in out-of-hospital cardiac arrest: A report from the resuscitation outcomes consortium. Resuscitation. PMID: 22858552  

Stiell IG, Hebert PC, Weitzman BN, Wells GA, Raman S, Stark RM, Higginson LA, Ahuja J, & Dickinson GE. (1992) High-dose epinephrine in adult cardiac arrest. The New England journal of medicine, 327(15), 1045-50. PMID: 1522840  

Callaway, C. (2012) Questioning the Use of Epinephrine to Treat Cardiac Arrest. JAMA: The Journal of the American Medical Association, 307(11), 1198. DOI: 10.1001/jama.2012.313  

  • August 6, 2014
  • 12:00 AM
  • 1,412 views

What is the Best Way to Manage Cardiac Arrest According to the Evidence?

by Rogue Medic in Rogue Medic

There is an excellent review article by Dr. Bentley Bobrow and Dr. Gordon Ewy on the best management of sudden cardiac arrest from the bystander to the ICU (Intensive Care Unit).

They point out something that we tend to resist learning. Cardiac arrest that is not due to respiratory causes does not need respiratory treatment. A person who is unresponsive and gasping is exhibiting signs of cardiac arrest, not signs of respiratory problems.... Read more »

  • August 3, 2014
  • 06:00 PM
  • 1,689 views

Resuscitation characteristics and outcomes in suspected drug overdose-related out-of-hospital cardiac arrest

by Rogue Medic in Rogue Medic

This study is interesting for several reasons.

In a system that claims excellence, the most consistent way to identify the study group is by documentation of a protocol violation - but it is not intended as a study of protocol violations.

This may hint at some benefit from epinephrine (Adrenaline in Commonwealth countries), but that would require some study and we just don't study epinephrine. We only make excuses for not studying epinephrine.

The atropine results suggest that the ........ Read more »

  • August 1, 2014
  • 12:35 AM
  • 1,345 views

Fall With Dementia and No Change from Baseline Mental Status

by Rogue Medic in Rogue Medic

This happens many times every day. A patient falls and may have hit her head, but there is no change from her normal mental status. To complicate matter, she takes an anticoagulant.

There are no clear signs of serious trauma. so should we automatically go to the trauma center?

What can help us decide?... Read more »

  • July 11, 2014
  • 01:15 AM
  • 1,209 views

Remote CPR Skills Testing Online - A Crazy Idea?

by Rogue Medic in Rogue Medic

On the MedicCast, Jamie Davis interviews Roy Shaw of SUMO about a method of remote CPR certification for health care providers.

"The Single Use Manikin Option, or SUMO™, is an AHA-compliant way of getting certified in CPR completely online.[1]"

What different ways of dealing with certification/recertification problems should we use?... Read more »

Sutton RM, Niles D, Meaney PA, Aplenc R, French B, Abella BS, Lengetti EL, Berg RA, Helfaer MA, Nadkarni V. (2011) Low-Dose, High-Frequency CPR Training Improves Skill Retention of In-Hospital Pediatric Providers. PEDIATRICS, 128(1). DOI: 10.1542/peds.2010-2105d  

  • June 30, 2014
  • 12:55 AM
  • 1,325 views

Safety of Intranasal Fentanyl in the Out-of-Hospital Setting - A Prospective Observational Study

by Rogue Medic in Rogue Medic

I have been very critical of plans to have first responders treat people they suspect of having a heroin (or other) opioid overdose with naloxone.

Would first responders be safer with fentanyl?

It is not really the same question, but it does highlight the differences and why I think fentanyl is safer. The patient will be seen by someone more likely to recognize when the treatment is inappropriate. This study looked at IN (IntraNasal) fentanyl given by basic EMTs prior to transport to the E........ Read more »

  • May 25, 2014
  • 07:00 PM
  • 1,362 views

Does Faster Epinephrine Administration Produce Better Outcomes from PEA-Asystole?

by Rogue Medic in Rogue Medic

If we are going to give epinephrine to patients with rhythms that are not shockable (PEA [Pulseless Electrical Activity] or Asystole), it appears that patients receiving epinephrine earlier have better outcomes than patients who receive epinephrine later in the hospital in the less acute care settings.

Does this mean that patients who receive epinephrine have better outcomes than patients who do not receive epinephrine?

We remain willfully ignorant of the answer to that question.
... Read more »

Bigham BL, Koprowicz K, Aufderheide TP, Davis DP, Donn S, Powell J, Suffoletto B, Nafziger S, Stouffer J, Idris A.... (2010) Delayed prehospital implementation of the 2005 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiac care. Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors, 14(3), 355-60. PMID: 20388032  

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