This commentary examines relationships between bioethics, research, and advances in technology. It explores the role of bioethicists in promulgating 'blue skies' thinking which might well be crucial in challenging the 'received wisdom' on how the regulation of technologies should proceed.

This case note analyses a recent judgment by the European Court of Human Rights involving two married couples who failed in their rights-based challenge to provisions of Austria's Artificial Procreation Act prohibiting heterologous techniques for in vitro fertilisation (i.e. techniques using donor ova and sperm).

PURPOSE : We aimed to compare the intra- and interoperator variability of lobar volumetry and emphysema scores obtained by semi-automated and manual segmentation techniques in lung emphysema patients. MATERIALS AND METHODS : In two sessions held three months apart, two operators performed lobar volumetry of unenhanced chest computed tomography examinations ...

Non-healing wounds represent a challenging problem for physicians and patients alike. Although treatment strategies are aimed at specific causes, there are basic management principles that apply to all wounds. The purpose of this article is to review these core management principles as they apply to lower extremity wounds. Key points ...

Lower extremity peripheral artery disease (PAD) affects 8 million men and women in the United States and will be increasingly common as the U.S. population lives longer with chronic disease. People with PAD have poorer walking endurance, slower walking velocity, and poorer balance, compared with individuals without PAD. People with ...

During the last decade, the rapid evolution of transcatheter aortic valve replacement (TAVR) has revolutionized the treatment of severe aortic stenosis. Since the PARTNER A and B trials, this technique has become the treatment of reference for inoperable patients, and an attractive alternative to surgical aortic valve replacement in those ...

Acute stroke affects about 800,000 patients annually in the US and is the leading cause of disability. It is a complex condition with multiple causes and requires comprehensive but rapid evaluation by stroke specialists working in institutions with well-organized stroke systems of care. Acute stroke treatment is focused on early ...

Adoption of the transradial approach for coronary procedures is rapidly growing in the US. A decrease in vascular complications and improved patient comfort are the primary benefits of this technique compared to femoral artery access. However, as this is still an invasive procedure, it is important for operators who utilize ...

Hybrid coronary revascularization combines the benefits of both percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) in the treatment of multivessel coronary artery disease (CAD) by combining the benefits of the LIMA-to-LAD graft and drug eluting stent (DES) to non-LAD regions. Through this approach, a patient receives the ...

The relationship between low concentrations of high density lipoprotein cholesterol (HDL-C) and heightened risk for cardiovascular (CV) disease has been known for decades. Despite the consistent inverse relationship among epidemiological studies, the linkage between a residual low HDL-C among patients treated with statins and excess cardiovascular risk is less clearly ...

Thermodynamic and structural characteristics of the Escherichia coli DnaT protein trimerization reaction have been quantitatively examined using fluorescence anisotropy and analytical ultracentrifugation methods. Binding of magnesium to the DnaT monomers regulates the intrinsic affinity of the DnaT trimerization reaction. Comparison between the DnaT trimer and the isolated N-terminal core domain ...

The oligomerization reaction of the Escherichia coli DnaT protein has been quantitatively examined using fluorescence anisotropy and analytical ultracentrifugation methods. In solution, DnaT exists as a monomer-trimer equilibrium system. At the estimated concentration in the E. coli cell, DnaT forms a mixture of the monomer and trimer states with a ...

African swine fever (ASF) is a notifiable viral pig disease with high mortality and serious socio-economic consequences. Since ASF emerged in Georgia in 2007 the disease has spread to several neighbouring countries and cases have been detected in areas bordering the European Union (EU). It is uncertain how fast the ...

: The Department of Veterans Affairs (VA) Quality Enhancement Research Initiative (QUERI) has demonstrated how implementation science can enhance the quality of health care. During this time an increasing number of implementation research projects have developed or utilized health information technology (HIT) innovations to leverage the VA's electronic health record ...

Alpers-Huttenlocher syndrome is an uncommon mitochondrial disease most often associated with mutations in the mitochondrial DNA replicase, polymerase-γ. Alterations in enzyme activity result in reduced levels or deletions in mitochondrial DNA. Phenotypic manifestations occur when the functional content of mitochondrial DNA reaches a critical nadir. The tempo of disease progression ...

The management strategy remains controversial for patients presenting with type A acute aortic dissection with cerebrovascular accident or coma. The present study aimed to help guide surgeons treating these high-risk patients. Of 1873 patients with type A acute aortic dissection enrolled in the International Registry for Acute Dissection, 87 (4.7%) ...

Rationale: It is estimated that some hundreds of Canadian patients with multiple sclerosis (MS) have journeyed abroad to avail themselves of 'liberation therapy' (venoplasty) following the initial report by Zamboni et al in 2009. That study also led to public pressure upon Departments of Health in Canadian Provinces to fund ...

Several dental implant studies have reported that radiographic evaluation of bone quality can aid in reducing implant failure. Bone quality is assessed in terms of its quantity, density, trabecular characteristics and cells. Current imaging modalities vary widely in their efficiency in assessing trabecular structures, especially in a clinical setting. Most ...

Invasive fungal infections (IFI) are a significant cause of morbidity and mortality in the immunocompromised. The traditional diagnostic methods of culture and histological examination lack sensitivity and often only make a diagnosis late when the fungal burden is high, reducing the chances of cure even with the availability of new ...

ABSTRACT The aim of this systematic review was to evaluate the evidence from randomized controlled trials (RCTs) involving the use of the African Bush Mango, Irvingia gabonensis for body weight reduction in obese and overweight individuals. Electronic and nonelectronic searches were conducted to identify relevant RCTs. The bibliographies of located ...

Background: Bevacizumab, a humanized recombinant anti-vascular endothelial growth factor antibody, was approved in Canada in 2010 for the treatment of high-grade glioma. We report the effectiveness and safety of bevacizumab in the treatment of patients with recurrent high-grade gliomas at a single institution. Methods: Twenty-seven consecutive patients with high-grade glioma ...

Headaches can be benign or life threatening but, with careful attention to the details described in this article, the correct diagnosis and treatment can be arrived at in many cases. Modern imaging techniques have taken the guesswork out of many conditions but a high index of suspicion and attention to ...

The present investigation was designed to evaluate the efficacy of diosmin against ethanol-induced hepatotoxicity in rats by modulating various mechanisms including ethanol metabolizing enzymes, generation of free radicals, imbalance in oxidant-antioxidant status, oxidative damage to membrane lipids, activation of transcription factors and elevation in inflammatory markers involved in ethanol-induced hepatic ...

We evaluated the results of our previous study investigating a precurved fenestrated endograft treatment for thoracic aortic aneurysms and aortic dissection extended to the aortic arch. From February 2010 to December 2011 at 35 Japanese centers, 383 patients (mean age, 75.7 ± 9.4 years) who required stent-graft landing in the aortic arch ...

MODERATOR: Nicholas T. Kouchoukos, MD, St. Louis, Mo. PANELIST: Dianna M. Milewicz, MD, University of Texas Medical School at Houston, Houston, Texas; Alan C. Braverman, MD, Washington University School of Medicine, St. Louis, Mo; Michael Mack, MD, Baylor Health Care System, Plano, Texas; Lars G. Svensson, MD, Cleveland Clinic, Cleveland, ...

Background: Ultrasonic assessment of optic nerve sheath diameter (ONSD) as a non-invasive measure of intracranial pressure (ICP) has been evaluated in the literature as a potential valid technique for rapid ICP estimation in the absence of invasive intracranial monitoring. The technique can be challenging to perform and little literature exists ...

We report the case of an adolescent girl with anti-N-methyl-D-aspartate-receptor (NMDAR) encephalitis who presented with focal seizures and hemichorea, followed by agitation, speech disturbance, mutism, and autonomic dysfunction. The institution of immunotherapy and removal of an ovarian cystadenofibroma led to full resolution of her symptoms with disappearance of serum NMDAR ...

Endografting for treatment of thoracic aortic pathology continues to gain popularity; in some countries, endovascular aortic repair numbers now exceed open surgery cases. The skills and understanding of open surgical teams are not always translated into endovascular interventions, which may be led by a cardiologist or vascular surgeon with little ...

Pediatric neurologists and developmental pediatricians may evaluate patients with primary or associated behavioral and academic concerns. A critical element of the evaluation involves determining that the child's condition is not better explained by underlying inherited metabolic disorders. In this review, psychiatric and behavioral presentations of inherited metabolic disorders are discussed ...

Aims  This study provides a systematic review of existing research that has evaluated unique gambling experiences in Taiwan. Methods  A comprehensive review of electronic databases, including Scopus, PubMed, Chinese Electronic Periodical Services and the Index to Taiwan Periodical Literature System, was conducted to identify evaluations of gambling experiences in Taiwan. ...

Tyrosine kinases have emerged as important tumor targets for the design of potent and selective inhibitors. Eighteen of these tyrosine kinase inhibitors (TKIs) have already been approved for the treatment of diseases that were previously essentially resistant to standard chemotherapy. Major efforts are ongoing that focus on the development of ...

A literature search found no clinical trials or guidelines addressing the management of spontaneous intracranial hypotension (SIH). Based on the available literature and expert opinion, we have developed recommendations for the diagnosis and management of SIH. For typical cases, we recommend brain magnetic resonance (MR) imaging with gadolinium to confirm ...

The prevalence of lower extremity reamputation in diabetic patients has been well-documented. We sought to determine the risk factors for major lower extremity amputation (LEA) after minor foot amputation in diabetic patients. We studied 163 diabetic patients who had undergone an initial minor foot amputation and then had undergone at ...

Acute encephalopathy with biphasic seizures and late reduced diffusion was recently established clinicoradiologically as an encephalopathy syndrome. The outcome of this encephalopathy is characterized by a low mortality rate and high incidence of neurologic sequelae. Although the exact pathogenesis of this encephalopathy is uncertain, excitotoxic injury with delayed neuronal death ...

Oncogenic signaling, such as HER2/neu signaling, has been shown to play major role for tumorigenesis in a subset of breast cancer patients. The use of anti-HER2/neu antibody has not only revealed the mechanisms for HER2/neu signaling but also shown a therapeutic advantage of its blockade. Indeed, the use of trastuzumab ...

The most critical element in headache evaluation is the history. The targeted history differentiates primary from secondary headaches and provides a realistic list of conditions associated with secondary headache. Several of these conditions present with specific physical findings, such as papilledema, Horner's syndrome, or a cranial nerve palsy. The targeted ...

The high co-morbidity between alcohol (ethanol) and nicotine abuse suggests that nicotinic acetylcholine receptors (nAChRs), thought to underlie nicotine dependence, may also be involved in alcohol dependence. The β2* nAChR subtype serves as a potential interface for these interactions since they are the principle mediators of nicotine dependence and have ...

MODERATOR: Steven L. Lansman, MD, PhD, Westchester Medical Center, Valhalla, NY. PANELISTS: Wilson Y. Szeto, MD, Hospital of the University of Pennsylvania, Philadelphia, Pa; Giampiero Esposito, MD, Department of Cardiovascular Disease, Cliniche Humanitas, Gavazzeni, Bergamo, Italy; Niels Rahe-Meyer, MD, Clinic for Anesthesiology and Intensive Care Medicine, Franziskus Hospital Bielefeld, Germany; ...

Objective: To compare neurologist and patient perceptions of multiple sclerosis (MS)-related health status. Methods: MS patients (n=99) were recruited from six sites in Canada. Following a consultation with their neurologist, patients estimated their relapse frequency, rated their general health and quality of life (QoL), reviewed descriptions of eight health domains ...

The targeted headache history is paramount in the diagnosis of headache and facial pain. Through placing symptoms in categories, a clear picture of the headache diagnosis will begin to emerge. The physical examination yields no positive findings in most patients with headache. Medication overuse headache is emerging as a common ...

Mild head trauma can cause cerebral infarction in children younger than 18 months of age, yet the pathogenesis, clinical characteristics, and risk factors are not fully understood. Data of 16 cases between August 2008 and September 2011, including clinical manifestations and imaging and laboratory findings were collected and analyzed. All ...

Hypothermic circulatory arrest has been used during aortic arch repairs with acceptable neurologic outcomes. Through the years, we have studied the effects of deep hypothermia on brain metabolism and perfusion both in a pig model and in surgical patients. Hypothermic circulatory arrest has also been used as a method of ...

Background: Management of chronic diseases such as movement disorders can be challenging. Nurse-administered telephone follow-up programs have demonstrated clinical and cost efficacy in a variety of health care models. However, their efficacy in movement disorders has not been sufficiently addressed. This observational study fills a knowledge gap by reporting the ...

To determine the effect of different etiologies on the outcome and mortality after mechanical composite aortic root/ascending replacement. From February 1998 to June 2011, 448 consecutive patients (358 men, age, 52.8 ± 12.3 years) underwent composite mechanical aortic root replacement. Of these 448 patients, 362 (80.8%) were treated for degenerative/atherosclerotic root/ascending aortic ...

The Australian Institute of Health and Welfare (AIHW) is a major national agency established by the Australian government to provide reliable, regular and relevant information and statistics on Australia's health and welfare. The AIHW publishes updated information on survival and prevalence of cancer in Australia on a regular basis. The ...

Background: Electromyography (EMG) for suspected cervical or lumbosacral root compression is often negative, producing expense and physical discomfort that could have been avoided. To improve patient selection for testing, we sought to identify clinical features that would accurately predict presence of radiculopathy on EMG. Methods: Adult patients consecutively evaluated for ...

Although pyridoxine-dependent seizures have been reported for decades, pyridoxamine phosphate oxidase deficiency has only been recently described. Pyridoxamine phosphate oxidase (PNPO) is one of a series of enzymes involved in converting pyridoxine to pyridoxal 5'-phosphate, the biologically active form of pyridoxine. PNPO deficiency is associated with decreased levels of pyridoxal ...

We assessed whether fibrinogen concentrate as targeted first-line hemostatic therapy was more effective than placebo or a standardized transfusion algorithm in controlling coagulopathic bleeding in patients undergoing major aortic surgery. In this single-center, prospective, double-blind study, adults undergoing elective thoracic or thoracoabdominal aortic replacement surgery involving cardiopulmonary bypass were randomized ...

Purpose: To evaluate the prevalence of nonlesional focal epilepsy in an adult epilepsy clinic and its refractoriness to antiepileptic drug therapy. Background: Focal epilepsy is frequently, but not always, associated with structural epileptogenic lesions identifiable on magnetic resonance imaging (MRI). Methods: We analyzed the data from all patients evaluated at ...

There are increasing numbers of mothers as well as fathers who engage in long-term migration to support their children and other family members in their home countries. In this article, the current state of the literature about children and adolescents left at home in these transnational families is surveyed and ...