1,721,161 research outputs found
Legal accountability in Clinical Ethics Consultation
No full textThe aim of this paper is to outline the framework for a critical reflection about legal accountability associated with Clinical Ethics Consultation (CEC). First of all, we will explain why we believe that, at the present time, in Italy, CEC provided by an individual Ethics Consultant shoud be considered the best format to guarantee a quality service to patients and healthcare professionals. We will then analyse whether and when an Ethics Consultant can be held liable for violation of a civil or criminal law. Finally, starting from the analysis of the jurisprudential evolution and the healthcare legislation reforms, we will propose a discipline applicable to the Ethics Consultant's activity in case of damage to a patient. According to this perspective, we will illustrate why the formal and juridical acknowledgement of the Ethics Consultant's activity can define the contents of his actual role in the care process while helping to spread the CEC culture as a dialogic process meant to effectively improve health care through the identification, analysis and resolution of ethical dilemmas in clinical practice
Targeting NGF system to fight neuropathic pain behavioral and immunohistochemical evidence in mice
Full text linkBackground and Aims: it has been demonstrated that the anti-NGF αD11 and the anti-TrkA MNAC13 counteract neuropathic pain in mice. The aim of this study was to evaluate the duration of the action of the two antibodies and the structural and morphological alterations induced in central and peripheral nervous system.
Methods: Chronic Constriction Injury (CCI) of the sciatic nerve was performed in C57BL/6J mice. Mice were administered with αD11 or MNAC13 (70 or 100 μg/mouse/day) from day 3 until day 10 post-CCI. Analgesic effects were tested through Dynamic Plantar Aesthesiometer from day 3 to day 90. Spinal cords and sciatic nerves were collected at D3, D11, D24 and D90 for immunohistochemistry.
Results: αD11 and MNAC13 induce significant dose- and time-dependent analgesic effects: the antiallodynic effect was still present at D90 following the highest doses of both antibodies. Immunohistochemical analysis show significant differences in inflammatory and myelination markers between treated and control animals, treated animals showing reduced glial and mast cells activation and a better nerve regeneration.
Conclusions: Data obtained prove that: i) the analgesic effect of the antibodies αD11 and MNAC13 are extremely long-lasting, being observable more than two months after the end of the treatment and ii) the antiNGF and antiTrkA antibodies reduce inflammation and facilitate the regenerative processes. Therefore, our results strongly support the importance of considering the NGF system in the development of novel therapies to modulate and control neuropathy
How to continue COVID-19 vaccine clinical trials? The ethics of vaccine research in a time of pandemic
No full textBetween December 2020 and March 2021, the US Food and Drug Administration and the European Medicines Agency issued Emergency Use Authorizations and Conditional Marketing Authorizations for the distribution of the first COVID-19 vaccines. Although these vaccines were thoroughly assessed before their approval, regulators required companies to continue ongoing placebo-controlled clinical trials in order to gather further reliable scientific information on their safety and efficacy, as well as to start new studies to evaluate additional candidates. The aim of this paper is to present and discuss the ethical issues raised by the tension between the need to continue these types of clinical trials and the obligations related to the protection of the rights and well-being of research participants. Specifically, we question whether—how, and to what extent—fundamental principles governing research involving human beings can be applied to the current pandemic situation. We argue that continuing ongoing placebo-controlled clinical trials can be considered ethically justifiable only if all participants are adequately informed of any developments that may affect their willingness to remain enrolled, including the current situation of resource scarcity and the prioritization criteria established for vaccination. However, we also argue that currently approved vaccines, which are considered safe and effective enough to be administered to millions of people as part of the vaccination campaign, necessarily represent the “best proven intervention” currently available and, therefore, should be used as comparators in future studies instead of placebo
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Symmetric sensorineural progressive hearing loss from chronic idiopathic pachymeningitis.
No full textWe present the case of a 68 year-old man with a diffused hypertrophic pachymeningitis (HP) involving both internal auditory canals. The clinical symptoms were headache, decreased vision in one eye, progressive bilateral and symmetrical sensory-neural hearing loss (PSNHL) responsive to steroid treatment. Although hearing loss is a frequent manifestation of HP, only few studies reported an adequate audiological assessment and follow-up. Mechanisms related to the auditory involvement are discussed on the basis of audiological data. Gadolinium enhanced MRI is the most adequate technique for HP detection and for the differential diagnosis. A delay in the diagnosis of HP seems to be quite common and the consequences may be severe, especially in cases of optic nerve involvement. For these reasons, a cerebral MRI should probably be included in the assessment of PSNHL, especially when neurological signs coexist or are reported in the medical history
Purinergic signalling in inflammation of the central nervous system
No full textInflammation is the most fundamental body reaction to noxious stimuli. No vascularized tissue, organ or apparatus is free from this response. Several mediators of inflammation, originating from outside (exogenous) or inside (endogenous) the body, are known. Among the endogenous factors, extracellular nucleotides and nucleosides are attracting interest for their ubiquity and striking ability to modulate diverse immune responses. Until recently, it was doubted that the central nervous system (CNS), reportedly an 'immunoprivileged organ', could be the site of immune reactions. Nowadays, it is acknowledged that inflammation and immunity have a key role in a vast range of CNS diseases. Likewise, it is clear that purinergic signalling profoundly affects neuroinflammation. Here, we provide a brief update of the state of the art in this expanding field
Diffusion weighted MR Imaging in the detection of Cholesteatoma and correlation with surgical findings
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Giant cell granuloma of the temporal bone: A case report
No full textPROBLEM: Giant cell granuloma (GCG) is a rare nonneoplastic bone lesion that occurs mostly in the jawbones; few cases arise in the remainder of the skull, including the temporal bone. Previously, giant cell lesions of the temporal bone were regarded as giant cell tumours (GCT). The importance of distinguishing GCG from GCT lies in the presumed difference in prognosis; GCTs have higher rates of recurrence, metastasis, and malignant transformation. METHODOLOGY: We describe the case of a 12-year-old child with temporal bone GCG extending to the middle cranial fossa. The patient underwent a subtotal petrosectomy via retroauricular approach, associated with resection of the zygomatic process. RESULTS: No evidence of recurrence was found 36 months later. CONCLUSION: The diagnosis of GCG was based on clinical history, histology, imaging, and response to treatment. The patient was treated with the standard surgical approach, and has a good outcome at three years follow-up
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