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April 23, 2014

Ebola Outbreak: Death Toll Rises to Over 140 in Liberia, Guinea

(CNN) – A total of 142 deaths have been reported from the Ebola outbreak in Guinea and Liberia, the World Health Organization said. The virus is still limited to the two nations, the World Health Organization said Tuesday, despite rumors of it spreading to other countries. Nineteen suspected cases reported in Sierra Leone tested negative for the virus, it said.

FDA Discourages Use of Tissue-Shredding Tool

(Nature) – The US Food and Drug Administration (FDA) has suggested that surgeons refrain from using tissue-grinding tools to remove uteruses or uterine growths because they increase the risk of spreading undetected cancer. It has also instructed manufacturers to review the labelling of the devices, known as morcellators, and is considering requiring a ‘black box’ warning, the strongest warning it can mandate.

Fighting Words Are Rarer among British Doctors

(New York Times) – People working in health care there have been discussing military imagery for a decade, said Elena Semino, head of linguistics at the university. “There’s a lot of awareness that battle metaphors can be very harmful to patients,” she told me. “Professionals are conscious of the problems, and they’re advised not to use them.” Instead, British public health leaders and medical practitioners are more apt to talk about the end of life as a “journey” instead of a war, with “pathways” and “steps” instead of fights and weapons.

A New Edition of The New England Journal of Medicine is Available

The New England Journal of Medicine (Volume 370, No. 6, April 17, 2014) is now available online by subscription only.

Articles include:

  • “The Calculus of Cures” by R. Kocher and B. Roberts
  • “Using a Drug-Safety Tool to Prevent Competition” by A. Sarpatwari, J. Avorn, and A.S. Kesselheim
  • “Comparative Effectiveness Questions in Oncology” by S. Mailankody and V. Prasad

April 22, 2014

A New Edition of Medicine, Health Care and Philosophy is Available

Medicine, Health Care and Philosophy (Volume 17, No. 2, May 2014) is now available online by subscription only.

Articles include:

  • “Neither property right nor heroic gift, neither sacrifice nor aporia: the benefit of the theoretical lens of sharing in donation ethics” by Kristin Zeiler
  • “The relevance of the philosophical ‘mind–body problem’ for the status of psychosomatic medicine: a conceptual analysis of the biopsychosocial model” by Lukas Van Oudenhove & Stefaan Cuypers
  • “Written institutional ethics policies on euthanasia: an empirical-based organizational-ethical framework” by Joke Lemiengre, et al.
  • “Diagnosing mental disorders and saving the normal” by Fredrik Svenaeus
  • “Empathy’s blind spot” by Jan Slaby
  • “Empathy as a necessary condition of phronesis: a line of thought for medical ethics” by Fredrik Svenaeu

New Painkiller Rekindles Addiction Concerns

(New York Times) – The abuse of prescription painkillers has reached epidemic proportions in America. Nearly half of the nation’s 38,329 drug overdose deaths in 2010 involved painkillers like hydrocodone and oxycodone, according to the Centers for Disease Control and Prevention. These narcotics now kill more adults than heroin and cocaine combined, sending 420,000 Americans to emergency rooms each year. So many state health officials and advocacy groups were incredulous when the Food and Drug Administration approved just such a drug — against the advice of its own expert advisory committee.

A New Edition of Clinical Trials is Available

Clinical Trials (Volume 11, No. 2, April 2014) is now available online by subscription only.

Articles include:

  • “An evaluation of the effectiveness of recruitment methods: The staying well after depression randomized controlled trial” by Adele Krusche, et al.
  • “Enrollment of racially/ethnically diverse participants in traumatic brain injury trials: Effect of availability of exception from informed consent” by Jose-Miguel Yamal, et al.
  • “Ethical issues in HIV prevention research with people who inject drugs” by Jeremy Sugarman, Scott M Rose, and David Metzger

A Loot at the Lives of American Nurses

(Washington Post) – Photographer and filmmaker Carolyn Jones created “The American Nurse” after publishing a coffee-table book on the subject two years ago, and the film builds on the same mix of powerful images with words of men and women whose lives are devoted to healing.

Pain Relievers Are Valuable, but Even Over-the-Counter Versions Can Be Hazardous

(Washington Post) – Almost 80 percent of adults say that they take some kind of pain medication at least once a week. But determining which pain drug we actually need, and how to use it, has become increasingly fraught. The news on prescription pain pills is even more worrisome. As prescriptions for powerful painkillers such as hydrocodone and oxycodone (Percocet, Vicodin, OxyContin and related generics) have shot up in recent years, there has been an increase in visits to emergency rooms and deaths from the illicit use of those drugs, known as opioids. Three-quarters of prescription drug overdoses (for which the death rate has more than tripled since 1990) are now attributed to painkillers.

Saudi Officials See Spike in MERS Coronavirus Cases

(CNN) – Saudi health officials are stepping up efforts to fight the Middle East respiratory symptom coronavirus, or MERS-CoV, after a recent spike in cases. Saudi Arabia confirmed more than 50 cases of the virus in the past week, at least seven of which were fatal. The Saudi Health Ministry says 13 new cases were reported Monday alone, bringing the total to 257. It is not clear why there was a sudden increase, said Dr. Abdullah Al-Asiri, assistant undersecretary at the Saudi Ministry of Health and a member of the Scientific Committee of Infectious Diseases.

Kids Get Codeine in ER Despite Drawbacks: Some Get No Pain Relief or Face Complication Risk

(Associated Press) – Despite recommended limits on codeine use in children, the potent painkiller is prescribed for children in at least half a million emergency room visits each year, a study suggests. Use of the drug in that setting is hardly rampant – just 3 percent of kids’ ER visits resulted in a codeine prescription in 2010, the 10-year study found. But with more than 25 million ER visits by children each year, the authors say far too many kids are getting the drug when better options are available.

House Calls Are Making a Comebak

(New York Times) – A relic from the medical past — the house call — is returning to favor as part of some hospitals’ palliative care programs, which are sending teams of physicians, nurses, social workers, chaplains and other workers to patients’ homes after they are discharged. The goal is twofold: to provide better treatment and to cut costs.

A New Edition of Journal of the Royal Society of Medicine is Available

Journal of the Royal Society of Medicine (Volume 107, No. 4, April 2014) is now available online by subscription only.

Articles include:

  • “The Immigration Bill: Extending charging regimes and scapegoating the vulnerable will pose risks to public health” by Sarah Steele, et al.
  • “The case for change for British mental healthcare” Emma Stanton
  • “Medicine’s contract with society” Dinesh Bhugra
  • “Trends in hospital admission rates for whooping cough in England across five decades: database studies” Nick Haslam, Uy Hoang, and Michael J Goldacre

A New Edition of Qualitative Health Research is Available

Qualitative Health Research (Volume 24, No. 4, April 2014) is now available online by subscription only.

Articles include:

  • “Homebirth Transfers in the United States: Narratives of Risk, Fear, and Mutual Accommodation” by Melissa Cheyney, Courtney Everson, and Paul Burcher
  • “Physical Intimate Partner Violence in Northern India” by Maya I. Ragavan, Kirti Iyengar, and Rebecca M. Wurtz
  • “’Doing the Impossible’: The Process of Recovery From Chronic Anorexia Nervosa” by Lisa Dawson, Paul Rhodes, and Stephen Touyz
  • “’I Think About Oprah’: Social Class Differences in Sources of Health Information” by Ann V. Bell
  • “Translating Infection Control Guidelines Into Practice: Implementation Process Within a Health Care Institution” by Victoria H. Raveis, et al.

Virtual Doctor Visits Gaining Steam in “Geneticist Deserts”

(Scientific American) – These “geneticist deserts” are prompting a small but growing tide of virtual patient visits. In an age when virtual chats are relatively commonplace, videoconferencing for genetic consultation—telegenetics —is becoming a logical extension of what people already do with their Webcams and smartphones. Telegenetics saves patients time, the cost and burden of transport and, oftentimes, the need to find day care or take time off from work. For doctors, the approach can expand their reach while limiting travel. Moreover, they can bill for their services as if they were seeing patients in their offices with just a slightly different billing code.

A New Edition of Journal of Bioethical Inquiry is Available

Journal of Bioethical Inquiry (Volume 11, No. 1, March 2014) is now available online by subscription only.

Articles include:

  • “Investigating Research and Accessing Reproductive Material” by Trudo Lemmens & Bernadette J. Richards
  • “Market Liberalism in Health Care: A Dysfunctional View of Respecting “Consumer” Autonomy” by Michael A. Kekewich
  • “The Incredible Complexity of Being? Degrees of Influence, Coercion, and Control of the “Autonomy” of Severe and Enduring Anorexia Nervosa Patients” by Terry Carney
  • “Treatment Refusal in Anorexia Nervosa: The Hardest of Cases” by Christopher James Ryan & Sascha Callaghan
  • “Making Sense of Child Welfare When Regulating Human Reproductive Technologies” by John McMillan
  • “Understanding Selective Refusal of Eye Donation” by Mitchell Lawlor & Ian Kerridge

April 21, 2014

Team Identifies Source of Most Cases of Invasive Bladder Cancer

(Medical Xpress) – A single type of cell in the lining of the bladder is responsible for most cases of invasive bladder cancer, according to researchers at the Stanford University School of Medicine. Their study, conducted in mice, is the first to pinpoint the normal cell type that can give rise to invasive bladder cancers. It’s also the first to show that most bladder cancers and their associated precancerous lesions arise from just one cell, and explains why many human bladder cancers recur after therapy.

Cancer Stem Cells Linked to Drug Resistance

(Medical Xpress) – Most drugs used to treat lung, breast and pancreatic cancers also promote drug-resistance and ultimately spur tumor growth. Researchers at the University of California, San Diego School of Medicine have discovered a molecule, or biomarker, called CD61 on the surface of drug-resistant tumors that appears responsible for inducing tumor metastasis by enhancing the stem cell-like properties of cancer cells. The findings, published in the April 20, 2014 online issue of Nature Cell Biology, may point to new therapeutic opportunities for reversing drug resistance in a range of cancers, including those in the lung, pancreas and breast.

Who Provides End-of-Life Care in Care Homes?

(Nursing Times) – A study looked at the responsibility for end-of-life care in care homes without nursing staff. It highlighted that formal carers need support to care for frail older people. Most care homes in England do not have nurses on site and instead rely on visits from GPs and district nurses for primary care and referral to specialist services. It is often unclear whether responsibility for the provision of end-of-life care rests with the care home staff or external health professionals. In addition, identifying which care home residents are likely to die imminently and, as such, should be approached about end-of-life care can be difficult.

Building ‘Smart’ Cell-Based Therapies

(Nanowerk News) – A Northwestern synthetic biology team has created a new technology for modifying human cells to create programmable therapeutics that could travel the body and selectively target cancer and other sites of disease. Engineering cell-based, biological devices that monitor and modify human physiology is a promising frontier in clinical synthetic biology. However, no existing technology enabled bioengineers to build such devices that sense a patient’s physiological state and respond in a customized fashion.

April 18, 2014

Cost of Treating Patients May Influence Doctors

(New York Times) – Saying they can no longer ignore the rising prices of health care, some of the most influential medical groups in the nation are recommending that doctors weigh the costs, not just the effectiveness of treatments, as they make decisions about patient care. The shift, little noticed outside the medical establishment but already controversial inside it, suggests that doctors are starting to redefine their roles, from being concerned exclusively about individual patients to exerting influence on how health care dollars are spent.


The Bioethics Poll
Should individuals and/or institutions be allowed to patent human genes?
Yes, with some qualifications

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Which area of research should more money be invested in:
Animal-Human Hybrids
Gene Therapy
Reproductive Technology
Stem Cell Research
"Therapeutic" Cloning
None of the above

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