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Medical Ethics
Published in Howard Winet, Ethics for Bioengineering Scientists, 2021
A significant indicator of a physician’s competency is membership on a hospital staff. The privilege comes with a responsibility to adhere to hospital standards for patient care. One of these standards is respect for patient autonomy that is monitored by its Institutional Review Board (IRB) and contracted to the patient via an actual hardcopy document—the human informed consent form (HCF). There are in general two kinds of HCF:The standard permission form to treat the patient for a specific medical condition. If an invasive procedure such as surgery is required this form may be more complicated than the one used for an in-hospital non-invasive treatment.A permission form for an experimental treatment that is part of a study. This form is usually composed by the group of individuals conducting the study. An example of this form is presented in Appendix B.
Assessment of fetal genetic disorders
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Teresa Martino, J. Pratt Rossiter, Karin J. Blakemore
Not only have the indications for referral for prenatal diagnosis have expanded over the last four decades, but also the methods available to prenatally detect genetic disorders have also expanded. In addition to amniocentesis, invasive diagnostic methods currently include CVS, fetal blood sampling, and fetal biopsy for specific indications. Samples obtained by these techniques are used for cytogenetic analysis (karyotype, fluorescence in situ hybridization (FISH), array comparative genomic hybridization), molecular DNA diagnosis, and/or biochemical evaluation, dependent on the specific disorder being investigated. Each invasive procedure has risks and benefits to be considered when offering diagnostic testing.
The Digestive (Gastrointestinal) System and Its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
Angiography can demonstrate acutely bleeding lesions and define vascularity of mass lesions. Because it is an invasive procedure, however, its use is usually reserved for necessary follow-up of endoscopic examinations. Nasogastric (NG) intubation involves passage of a tube through the nose into the stomach and sometimes upper part of the small intestine to obtain contents for analysis.
Recent updates in the development of molecular assays for the rapid identification and susceptibility testing of MRSA
Published in Expert Review of Molecular Diagnostics, 2023
Masako Mizusawa, Karen C Carroll
The Karius test (Karius, Inc., Redwood City, CA, U.S.A.) is a cell-free DNA mNGS assay that does not detect viruses. It has been used in numerous studies to assess a variety of different syndromes. One of the advantages could be the ability to diagnose infections without the need for an invasive procedure (e.g. tissue biopsy or bronchoalveolar lavage). The test performed at Karius has a well-curated database that detects over 1,250 human pathogens [171]. Results are reported in molecules of microbe-specific cell-free DNA per microliter of plasma (MPM). The threshold for a positive result is a statistically significant quantity of cfDNA of an organism compared to negative controls run in parallel [171]. Reported experience with this test has been variable. Edward, et al reviewed the literature for infectious diseases diagnosis in pediatric patients [172]. Stated reasons for ordering the test in four reviewed studies were concern for fungal infection, fever of unknown origin, or investigation of an unexplained lesion on imaging [172]. The majority of patients were immunocompromised and beneficial impact of testing ranged from 7.3% to 14% [172]. None of the patients in the four studies had S. aureus infection detected by mNGS.
Percutaneous endoscopic decompression for calcified thoracic disc herniation using a novel T rigid bendable burr
Published in British Journal of Neurosurgery, 2023
Lei-Ming Zhang, Wen-Ying Lv, Gang Cheng, Deng-Yuan Wang, Jian-Ning Zhang, Xi-Feng Zhang
Our procedure has several advantages. This minimally invasive procedure avoids large scale damages to the muscles and spine, which results in significantly less perioperative pain, shorter hospitalization, and better rehabilitation. This procedure has significantly less intraoperative bleeding, thus reducing the risk of spinal cord injury caused by postoperative hematoma. Postoperative drainage is also not necessary. The patient is awake with local anesthesia and can communicate with the surgeon intraoperatively, which effectively reduces the risk of spinal cord injury. Our procedure can also avoid thoracic complications. Our patients had single-segmental, mild calcifications of the thoracic discs. The efficacy of the modified procedure needs to be verified in future studies in patients with multi-segmental, giant calcifications.
Medical management of non-obstructive azoospermia: A systematic review
Published in Arab Journal of Urology, 2021
Mohammad H. Alkandari, Armand Zini
In conclusion, although surgical extraction of sperm with ART may result in pregnancy, it neither reverses the infertility pathology nor treats the underlying cause of NOA and it may result in deterioration of the testicular condition. Medical therapy is available for men with NOA, particularly those with a hormonal deficiency. These couples may benefit from the medical intervention either through production of sperm in the ejaculate, or indirectly, by improving SRRs at the time of surgical dissection. Succeeding to convert azoospermia to severe oligozoospermia might not be sufficient to induce a natural pregnancy but may allow for successful intrauterine insemination (IUI) or intracytoplasmic sperm injection pregnancy and avoid testicular dissection. Thus, a thorough medical and endocrinological evaluation is essential before proceeding to a more invasive procedure.