All posts; Tags Include "Medical Ethics"
- April 4, 2016
- 06:15 PM
- 90 views
Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Cardiac Arrest
by Rogue Medic in Rogue Medic
I wrote about the start of the ALPS (Amiodarone, Lidocaine, Placebo Study) in 2012[1] and the results are now in.
... Read more »
Kudenchuk, P., Brown, S., Daya, M., Rea, T., Nichol, G., Morrison, L., Leroux, B., Vaillancourt, C., Wittwer, L., Callaway, C.... (2016) Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Cardiac Arrest. New England Journal of Medicine. DOI: 10.1056/NEJMoa1514204
- March 8, 2016
- 04:15 PM
- 165 views
What do you do when a patient wakes up during CPR?
by Rogue Medic in Rogue Medic
The return of consciousness without the return of a pulse is still rare, but may be more common with our increased focus on high quality chest compressions. There is still no evidence that interrupting chest compressions, for anything other than defibrillation, improves outcomes.
Is this due to the consistency of the machine? Maybe. Maybe not. We do not have enough evidence to draw that conclusion.
Is this growing population really growing? Maybe. Maybe not. We do not have enough evidence ........ Read more »
Rice, D., Nudell, N., Habrat, D., Smith, J., & Ernest, E. (2016) CPR induced consciousness: It's time for sedation protocols for this growing population. Resuscitation. DOI: 10.1016/j.resuscitation.2016.02.013
Olaussen A, Shepherd M, Nehme Z, Smith K, Bernard S, & Mitra B. (2015) Return of consciousness during ongoing cardiopulmonary resuscitation: A systematic review. Resuscitation, 44-8. PMID: 25447435
Lilja G, Nilsson G, Nielsen N, Friberg H, Hassager C, Koopmans M, Kuiper M, Martini A, Mellinghoff J, Pelosi P.... (2015) Anxiety and depression among out-of-hospital cardiac arrest survivors. Resuscitation, 68-75. PMID: 26433116
- February 3, 2016
- 11:30 AM
- 231 views
The RAD-57 – Still Unsafe?
by Rogue Medic in Rogue Medic
I decided to look for something I wrote that I have been wrong about. I thought about Masimo and their RAD-57. I had been very critical of Dr. Michael O’Reilly (then Executive Vice President of Masimo Corporation) for being an advocate of bad science, but he has been hired away by Apple.[1] He should be less dangerous with a telephone than he was with the RAD-57. At the time, he wrote –... Read more »
Weaver, L., Churchill, S., Deru, K., & Cooney, D. (2012) False Positive Rate of Carbon Monoxide Saturation by Pulse Oximetry of Emergency Department Patients. Respiratory Care. DOI: 10.4187/respcare.01744
Hampson NB, & Holm JR. (2015) Suicidal carbon monoxide poisoning has decreased with controls on automobile emissions. Undersea , 42(2), 159-64. PMID: 26094291
Roderique, J., Josef, C., Feldman, M., & Spiess, B. (2015) A modern literature review of carbon monoxide poisoning theories, therapies, and potential targets for therapy advancement. Toxicology, 45-58. DOI: 10.1016/j.tox.2015.05.004
Touger, M., Birnbaum, A., Wang, J., Chou, K., Pearson, D., & Bijur, P. (2010) Performance of the RAD-57 Pulse Co-Oximeter Compared With Standard Laboratory Carboxyhemoglobin Measurement. Annals of Emergency Medicine, 56(4), 382-388. DOI: 10.1016/j.annemergmed.2010.03.041
O'Reilly, M. (2010) Performance of the Rad-57 Pulse Co-Oximeter Compared With Standard Laboratory Carboxyhemoglobin Measurement. Annals of Emergency Medicine, 56(4), 442-444. DOI: 10.1016/j.annemergmed.2010.08.016
- December 8, 2015
- 01:50 PM
- 290 views
Why is progress so slow in resuscitation research?
by Rogue Medic in Rogue Medic
Why is progress so slow in resuscitation research? A lot of money and time went in to finding out which type of blood-letting ventilation works best – ignoring the absence of valid evidence that ventilation is better than no ventilation. Why not gamble with our patients?
In response to The Fatal Flaw in Trial of Continuous or Interrupted Chest Compressions during CPR,[1],[2] Kenny commented that –
there are many things in your blog that are not correct.[1]... Read more »
Nichol, G., Leroux, B., Wang, H., Callaway, C., Sopko, G., Weisfeldt, M., Stiell, I., Morrison, L., Aufderheide, T., Cheskes, S.... (2015) Trial of Continuous or Interrupted Chest Compressions during CPR. New England Journal of Medicine, 2147483647. DOI: 10.1056/NEJMoa1509139
- November 25, 2015
- 10:15 AM
- 437 views
The Fatal Flaw in Trial of Continuous or Interrupted Chest Compressions during CPR
by Rogue Medic in Rogue Medic
This is not a study that has a valid control group to determine if there is any benefit from ventilation. There is no group that does not receive ventilations, so it is like a study of one type of blood-letting vs. another type of blood-letting with the researchers taking for granted that blood-letting does improve outcomes. That is not a problem if blood-letting actually improves outcomes.
Should we take it for granted that blood-letting improves outcomes and that the only hypothesis worth s........ Read more »
Nichol, G., Leroux, B., Wang, H., Callaway, C., Sopko, G., Weisfeldt, M., Stiell, I., Morrison, L., Aufderheide, T., Cheskes, S.... (2015) Trial of Continuous or Interrupted Chest Compressions during CPR. New England Journal of Medicine, 2147483647. DOI: 10.1056/NEJMoa1509139
Alldredge BK,, Gelb AM,, Isaacs SM,, Corry MD,, Allen F,, Ulrich S,, Gottwald MD,, O’Neil N,, Neuhaus JM,, Segal MR,.... (2001) A Comparison of Lorazepam, Diazepam, and Placebo for the Treatment of Out-of-Hospital Status Epilepticus. New England Journal of Medicine, 345(25), 1860-1860. DOI: 10.1056/NEJM200112203452521
- October 20, 2015
- 09:45 PM
- 281 views
How Bad is the Evidence for the New 2015 ACLS Guidelines?
by Rogue Medic in Rogue Medic
The new ACLS guidelines are out. How bad is the evidence?
The short answer – The Advanced Cardiac Life Support guidelines could be worse.
How does the American Heart Association determine that a recommendation is not beneficial?... Read more »
Morrison LJ, Gent LM, Lang E, Nunnally ME, Parker MJ, Callaway CW, Nadkarni VM, Fernandez AR, Billi JE, Egan JR.... (2015) Part 2: Evidence Evaluation and Management of Conflicts of Interest: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation, 132(18 Suppl 2). PMID: 26472990
Lawrence, G. (2002) Tobacco smoke enemas. The Lancet, 359(9315), 1442. DOI: 10.1016/S0140-6736(02)08339-3
- July 29, 2015
- 02:09 PM
- 853 views
The “Invisible Web” Undermines Health Information Privacy
by Jalees Rehman in The Next Regeneration
What do the third parties do with your data? We do not really know because the laws and regulations are rather fuzzy here. We do know that Google, Facebook and Twitter primarily make money by advertising so they could potentially use your info and customize the ads you see. Just because you visited a page on breast cancer does not mean that the "Invisible Web" knows your name and address but they do know that you have some interest in breast cancer. It would make financial sense to sen........ Read more »
Libert, T. (2015) Privacy implications of health information seeking on the web. Communications of the ACM, 58(3), 68-77. DOI: 10.1145/2658983
- June 28, 2015
- 03:05 AM
- 612 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 »
Rossi, P., Machado, A., & Okun, M. (2014) Medicare Coverage of Investigational Devices. JAMA Neurology, 71(5), 535. DOI: 10.1001/jamaneurol.2013.6042
Willis, A., Schootman, M., Kung, N., Wang, X., Perlmutter, J., & Racette, B. (2014) Disparities in deep brain stimulation surgery among insured elders with Parkinson disease. Neurology, 82(2), 163-171. DOI: 10.1212/WNL.0000000000000017
- June 3, 2015
- 08:15 AM
- 375 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
- 01:15 PM
- 600 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
- 05:45 AM
- 824 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 »
Kilic, A., Higgins, R., Whitson, B., & Kilic, A. (2015) Racial Disparities in Outcomes of Adult Heart Transplantation. Circulation, 131(10), 882-889. DOI: 10.1161/CIRCULATIONAHA.114.011676
- March 11, 2015
- 08:18 AM
- 321 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
- 09:20 PM
- 682 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 »
Tipton, C. (2014) The history of "Exercise Is Medicine" in ancient civilizations. AJP: Advances in Physiology Education, 38(2), 109-117. DOI: 10.1152/advan.00136.2013
- February 3, 2015
- 08:05 AM
- 914 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 »
Fridman GY, Tang H, Feller-Kopman D, & Hong Y. (2015) MouthLab: A Tricorder Concept Optimized for Rapid Medical Assessment. Annals of biomedical engineering. PMID: 25605586
Chandler, D. (2014) A Doctor in the Palm of Your Hand: How the Qualcomm Tricorder X-Prize could help to revolutionize medical diagnosis. IEEE Pulse, 5(2), 50-54. DOI: 10.1109/MPUL.2013.2296803
Gulec SA, Daghighian F, & Essner R. (2006) PET-Probe: Evaluation of Technical Performance and Clinical Utility of a Handheld High-Energy Gamma Probe in Oncologic Surgery. Annals of surgical oncology. PMID: 16865592
- December 13, 2014
- 11:56 AM
- 754 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
- 04:30 AM
- 687 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 »
Franklin, G. (2014) Opioids for chronic noncancer pain: A position paper of the American Academy of Neurology. Neurology, 83(14), 1277-1284. DOI: 10.1212/WNL.0000000000000839
- October 2, 2014
- 04:52 AM
- 764 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 »
Metse, A., Bowman, J., Wye, P., Stockings, E., Adams, M., Clancy, R., Terry, M., Wolfenden, L., Freund, M., Allan, J.... (2014) Evaluating the efficacy of an integrated smoking cessation intervention for mental health patients: Study protocol for a randomised controlled trial. Trials, 15(266), 1-7. DOI: 10.1186/1745-6215-15-266
- September 10, 2014
- 06:00 PM
- 82,732 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 »
Figueras J, & Weil MH. (1978) Blood volume prior to and following treatment of acute cardiogenic pulmonary edema. Circulation, 57(2), 349-55. PMID: 618625
Francis GS, Siegel RM, Goldsmith SR, Olivari MT, Levine TB, & Cohn JN. (1985) Acute vasoconstrictor response to intravenous furosemide in patients with chronic congestive heart failure. Activation of the neurohumoral axis. Annals of internal medicine, 103(1), 1-6. PMID: 2860833
Hoffman JR, & Reynolds S. (1987) Comparison of nitroglycerin, morphine and furosemide in treatment of presumed pre-hospital pulmonary edema. Chest, 92(4), 586-93. PMID: 3115687
- September 10, 2014
- 08:00 AM
- 677 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 »
Tabor HK, Auer PL, Jamal SM, Chong JX, Yu JH, Gordon AS, Graubert TA, O'Donnell CJ, Rich SS, Nickerson DA.... (2014) Pathogenic variants for mendelian and complex traits in exomes of 6,517 European and african americans: implications for the return of incidental results. American journal of human genetics, 95(2), 183-93. PMID: 25087612
- August 19, 2014
- 10:15 PM
- 1,066 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
Levy SB, & Rosh AJ. (2006) Images in emergency medicine. Dextrose extravasation causing skin necrosis. Annals of emergency medicine, 48(3). PMID: 16934641
topics
join us!
Do you write about peer-reviewed research in your blog? Use ResearchBlogging.org to make it easy for your readers — and others from around the world — to find your serious posts about academic research.
If you don't have a blog, you can still use our site to learn about fascinating developments in cutting-edge research from around the world.
Research Blogging is powered by SMG Technology.
To learn more, visit seedmediagroup.com.