Medicine and Health Sciences Commons^™

Family Duty Is More Important Than Rights, Charles Weijer

Charles Weijer

No abstract provided.

The Ethical Analysis Of Risk, Charles Weijer

Charles Weijer

No abstract provided.

Benefit-Sharing And Other Protections For Communities In Genetic Research, Charles Weijer

Charles Weijer

No abstract provided.

Merkel Cell Carcinoma Of The Skin, Patricia Tai, Edward Yu, Jon Tonita, James Gilchrist

Edward Yu

Background: Neuroendocrine/Merkel cell carcinoma (MCC) of the skin is an uncommon tumour. Currently, there are only limited data available on the natural history, prognostic factors, and patient management of MCC. Objective: To review our experience and build the largest database from the literature. Methods: Twenty-eight cases from the London Regional Cancer Center were combined with 633 cases obtained from the literature searched in English, French, German, and Chinese for the years 1966 to 1998. The database included age, sex, initial disease status at presentation to the clinic, site of primary, any coexisting disease, any previous irradiation, sizes of primary/nodal/distant metas-tases, …

Clinical Equipoise And Not The Uncertainty Principle Is The Moral Underpinning Of The Randomised Controlled Trial, Charles Weijer, Stanley Shapiro, Kathleen Glass

Charles Weijer

No abstract provided.

The Future Of Research Into Rotavirus Vaccine, Charles Weijer

Charles Weijer

No abstract provided.

Reporting The Study Populations Of Clinical Trials. Clear Transmission Or Static On The Line?, Stanley Shapiro, Charles Weijer, Benjamin Freedman

Charles Weijer

In contrast to attempts that have been made to measure the clarity of reporting of the methods of clinical trials in journal articles, we report here an attempt to measure the accuracy of methods reporting. We focus in this article on eligibility criteria as a test case for the reporting of clinical trial methods. We examined the reporting of eligibility criteria in the protocol, methods paper (if applicable), journal article, and Clinical Alert for articles appearing in print between January 1988 and September 1994 for which a Clinical Alert had been issued. Eligibility criteria were further classified into five categories …

Expensive Medical Technologies And “Indication Extrapolation”: The Case Of Implantable Cardioverter-Defibrillators, Christopher Simpson, George Klein, Barry Hoffmaster

C. Barry Hoffmaster

No abstract provided.

Moral Solutions In Assessing Research Risk, Paul Miller, Charles Weijer

Charles Weijer

No abstract provided.

Protecting Communities In Biomedical Research, Charles Weijer, E. Emanuel

Charles Weijer

Although for the last 50 years, ethicists dealing with human experimentation have focused primarily on the need to protect individual research subjects and vulnerable groups, biomedical research, especially in genetics, now requires the establishment of standards for the protection of communities. We have developed such a strategy, based on five steps. (i) Identification of community characteristics relevant to the biomedical research setting, (ii) delineation of a typology of different types of communities using these characteristics, (iii) determination of the range of possible community protections, (iv) creation of connections between particular protections and one or more community characteristics necessary for its …

Caring And Gender (Book Review), Linda Treiber

Linda A. Treiber

Review of the book "Caring and Gender," by Francesca M. Cancian and Stacey M. Oliker.

The Sum Of My Parts, Charles Weijer

Charles Weijer

No abstract provided.

Chemotherapy In Neuroendocrine/Merkel Cell Carcinoma Of The Skin: Case Series And Review Of 204 Cases, Patricia Tai, Edward Yu, Eric Winquist, Alex Hammond, Larry Stitt, Jan Tonita, Jim Gilchrist

Edward Yu

Purpose: To study the use of chemotherapy for Merkel cell carcinoma (MCC) of the skin. Patients and methods: Twenty-five cases of MCC were treated at the London Regional Cancer Center between 1987 and 1997. Thirteen cases treated with chemotherapy were reviewed with 191 cases from the literature. Results: At presentation, 24 patients had localized skin lesions (stage I) and one had locoregional involvement (stage II). Among the nine cases with recurrent nodal disease, six had chemotherapy as a component of salvage treatment. They were all free of disease at a median of 19 months (range, 12 to 37 months). In …

Radiation Treatment For Cervical Esophagus: Patterns Of Practice Study In Canada, 1996, Patricia Tai, Jake Van Dyk, Edward Yu, Jerry Battista, Matthew Schmid, Larry Stitt, Jon Tonita, Terry Coad

Edward Yu

PURPOSE: To assess the patterns of practice among Canadian radiation oncologists who treat esophageal cancers, using a trans-Canada survey, completed at the end of 1996. METHODS AND MATERIALS: One of 3 case presentations of different stages of cervical esophageal cancer was randomly assigned and sent to participating radiation oncologists by mail. Respondents were asked to fill in questionnaires regarding treatment techniques and to outline target volumes for the boost phase of radiotherapy. Radiation oncologists from 26 of 27 (96%) of all Canadian centers participated. RESULTS: High-energy X-rays (>/= 10 MV) were employed by 68% of the respondents in part …

A Philosophical Disease: Bioethics, Culture, And Identity, Charles Weijer

Charles Weijer

No abstract provided.

Functional Infrared Imaging Of The Breast, J. Keyserlingk, P. Ahlgren, E. Yu, N. Belliveau, M. Yassa

Edward Yu

In order to re-assess the potential contribution of infrared (IR) imaging as a first-line component of a multi-imaging strategy using currently available technology, we first review the history of its introduction and clinical application, including the results of the Breast Cancer Detection Demonstration Projects (BCDDP). We then discuss experiments with a new high-resolution, computerized IR station and software program acquired by the Ville Marie Breast Center to assess IR imaging's ability to complement clinical examination and mammography in the early detection of breast cancer. Our goal is to show that high-resolution IR imaging provides additional safe, practical, and objective information …

Bioethics: An Anthology, Charles Weijer

Charles Weijer

No abstract provided.

An Historical Take On The Physician's Charter, Nuala Kenny, Charles Weijer

Charles Weijer

No abstract provided.

Correspondence, Gustavo D. Aguirre

Gustavo D. Aguirre, VMD, PhD

No abstract provided.

Clinical Equipoise And Rct Design, Charles Weijer

Charles Weijer

This presentation addresses these questions:
• “Upon what ethical grounds may the physician offer RCT enrollment to a patient?”
• Which is the preferred moral basis of the RCT?

Molecular Cloning, Characterization And Expression Of A Novel Retinal Clusterin-Like Protein Cdna, Qi Zhang, Kunal Ray, Gregory M. Acland, Jill M. Czarnecki, Gustavo D. Aguirre

Gustavo D. Aguirre, VMD, PhD

The Ethical Analysis Of Risks And Potential Benefits In Human Subjects Research: History, Theory, And Implications For U.S. Regulation, Charles Weijer

Charles Weijer

This paper addresses three questions central to the ethical analysis of risks and potential benefits in human subjects research:

1. How was the ethical analysis of risk understood by the members of the U.S. National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research (National Commission)?
2. What conceptual framework should guide the ethical analysis of risk?
3. What changes to U.S. regulations would the implementation of such a framework require?

Issues For Rural Practice, J Western, T Makkai, Julie Mcmillan, K Dwan

Julie McMillan

No abstract provided.

A Sustainable Programme To Prevent Falls And Near-Falls In Community-Dwelling Older People: Results Of A Randomised Trial, Margaret Steinberg, Colleen Cartwright, Nancy Peel, Gail Williams

Professor Colleen M Cartwright

STUDY OBJECTIVE---In the causative mechanism of falls among older community dwellers, slips and trips have been found to be significant precursors. The purpose of the two year trial was to assess the effectiveness of multi-component interventions targeting major risk factors for falls in reducing the incidence of slips, trips and falls among the well, older community. DESIGN---Four groups with approximately equal numbers of participants were randomly allocated to interventions. The prevention strategies included education and awareness raising of falls risk factors, exercise sessions to improve strength and balance, home safety advice to modify environmental hazards, and medical assessment to optimise …

Peg [Percutaneous Endoscopic Gastrostomy] Feeding, Dementia And The Need For Policies And Guidelines: Opinion, Colleen Cartwright, Margaret Steinberg

Professor Colleen M Cartwright

The author discusses the need for well structured policies and guidelines for the decision to commence or withhold percutaneous endoscopic gastrostomy feeding.

An Occupational Study Of Physical Playing-Related Injuries In College Music Students, Christine Guptill, Christine Zaza, Stanley Paul

Christine A Guptill

Several studies have been conducted on the playing-related physical injuries of college music students. In this study, a client-centered, occupation-based survey was administered to music majors at a large midwestern university. The primary objectives of the study were to examine which health professionals were consulted by this population, and to determine student satisfaction with any treatment they might have received. Secondary objectives included evaluating students' perceptions of the need for professionals with specialized knowledge of music and musicians, and examining the lifetime prevalence of playing-related injuries in this population. The survey response rate was 92.3% (108/117). Ninety-three respondents (87.7%) of …

Viral Shedding And Biodistribution Of G207, A Multimutated, Conditionally Replicating Herpes Simplex Virus Type 1, After Intracerebral Inoculation In Aotus, T. Todo, F. Feigenbaum, S. Rabkin, F. Lakeman, J. Newsome, P. Johnson, E. Mitchell, Daniel Belliveau, J. Ostrove, R. Martuza

Daniel J. Belliveau

G207 is a multimutated, conditionally replicating herpes simplex virus type 1 (HSV-1) that is currently in clinical trial for patients with malignant glioma. G207 exhibits an efficient oncolytic activity in tumor cells, yet minimal toxicity in normal tissue when injected into the brains of HSV-susceptible mice or nonhuman primates. In this study, we evaluated the shedding and biodistribution of clinical-grade G207 after intracerebral inoculation (3 × 107 pfu) in four New World owl monkeys (Aotus nancymae). Using PCR analyses and viral cultures, neither infectious virus nor viral DNA was detected from tear, saliva, or vaginal secretion samples at any time …

End-Of-Life Decision-Making: Practical And Ethical Issues For Health Professionals, Colleen Cartwright

Professor Colleen M Cartwright

Life-extending changes in medical technology and an ageing population pose practical and ethical problems relating to end-of-life decision making. Health professionals need to understand the fears and concerns of their patients, their preferred place to die and to respect patient autonomy. Such wishes may be expressed verbally by a competent patient or through an advance directive (living will) or proxy by an incompetent patient. There is an urgent need for increased and improved training of health professionals in pain management and palliative care, and for the development of practical, ethical policies and guidelines with respect to withdrawing/withholding life-sustaining treatment. In …

Respiratory Protection, David Wallace, Tori Burns, Dale Stephenson, Dean Lillquist

Dale J. Stephenson

No abstract provided.