{"title":"Neuroethics: history and relevance","authors":"Shashivadhanan Sundaravadhanan","doi":"10.5455/im.53537","DOIUrl":"https://doi.org/10.5455/im.53537","url":null,"abstract":"The brain holds a special status as the core of our selfhood and autonomy. Manipulating the function of the brain is fundamentally different from manipulating the function of other organs like the heart or the kidney and raises several distinct ethical issues. Progress in neuroscience is rapidly increasing about neural correlates of the mind. New ethical issues are arising as neuroscience gives us unprecedented ways to understand the human mind and to predict, influence and even control it. Neuroethics encompasses two broad areas. One is fundamental neuroethics also called the neurosciences of ethics and the other is applied neuroethics, which is called the ethics of neurosciences. Analysis of the current body of literature reveals that brain research is presently focusing on neuroimaging, neuropharmacology, neurogenetics and neurotechnology. All these novel technologies are dual-use, making them very prone to abuse. Neuroethics is the term coined to tackle problems resulting from brain research, whether fundamental or applied. The progress in neurosciences continues in such a breakneck speed that it calls for an urgent requirement to embrace this field which is very essential to channelize brain research. Duty of neuroethics is not only to protect the society from neurosciences abuse but also guard the neuroscientists from society's criticism. World over there has been a technological explosion making it difficult for the physician to keep pace with evolving trends in neurosciences. This paper attempts to trace the birth and evolution of neuroethics. An attempt has been made to classify the areas which it encompasses, define its current status and predict its future relevance.","PeriodicalId":93574,"journal":{"name":"International medicine (Antioch, Turkey)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70794063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Erratum to The impact of a redesigned clinical course curriculum on the development of clinical reasoning skills among medical students: a quantitative study [Int Med 2019; 1(4): 185-192]","authors":"Rhys E. Taylor, S. Htun","doi":"10.5455/im.302644484","DOIUrl":"https://doi.org/10.5455/im.302644484","url":null,"abstract":"","PeriodicalId":93574,"journal":{"name":"International medicine (Antioch, Turkey)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70792946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Intracranial hypotension in a boy with Marfan syndrome: a case report","authors":"M. Direk","doi":"10.5455/IM.32962","DOIUrl":"https://doi.org/10.5455/IM.32962","url":null,"abstract":"Intracranial hypotension is a rare condition in children and adolescents and the management is not standardized. We report here a child with intracranial hypotension due to Marfan syndrome. A 12-year-old boy presented persistent bilateral frontal headache over two weeks. The patient had no headache when he was in a supine position and it was more severe when he was in an upright position. His physical examination revealed a characteristic marfanoid habitus with tall stature, pectus carinatum, lens dislocation, and joint hyperextensibility. Lumbar puncture was performed and cerebrospinal fluid (CSF) opening pressure was measured below 60 mmH2O. The imaging of the patient showed bilateral subdural hemorrhage, cerebellar tonsillar herniation into the foramen magnum, dural venous distention, pachymeningeal enhancement, dural ectasia, and thoracic CSF leak on the left side. According to these findings, Marfan syndrome and intracranial hypotension syndrome were diagnosed.","PeriodicalId":93574,"journal":{"name":"International medicine (Antioch, Turkey)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70793086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Tutak, Erkan Çakmak, M. Şahin, B. Turk, M. Şahin, Cafer Yetkin
{"title":"A Case report of Mucormycosis and Myocardial Infarction","authors":"A. Tutak, Erkan Çakmak, M. Şahin, B. Turk, M. Şahin, Cafer Yetkin","doi":"10.5455/IM.33790","DOIUrl":"https://doi.org/10.5455/IM.33790","url":null,"abstract":"Mucormycosis is an aggressive and angioinvasive fungal infection which often spreads from the paranasal sinuses to the orbital or cranial area. Our case was a 52-year-old male patient with a history of diabetes mellitus (DM) and coronary artery disease (CAD). The patient, referred to the emergency department due to confusion and drowsiness, was admitted to the intensive care unit (ICU) with a diagnosis of diabetic ketoacidosis (DKA). During the physical examination in the ICU, samples were taken from the roof of the mouth with a preliminary diagnosis of mucormycosis. Amphotericin B was initiated to the patient. Inferior myocardial infarction (MI) developed in the follow-up and the patient died at the 20th hour of ICU admission. When the records of the patient were examined, it was determined that he was referred to the outpatient clinic for the examination three times in the last 15 days. In this paper, our aim is to review patients with mucormycosis and MI and to emphasize the importance of physical examination.","PeriodicalId":93574,"journal":{"name":"International medicine (Antioch, Turkey)","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70793165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
U. Chowdhury, Niwin George, L. Sankhyan, Sukhjeet Singh, A. Chauhan, Sreenita Chowdhury
{"title":"Ascending-to-supraceliac abdominal aortic bypass for an adult coarctation of the aorta: a video presentation","authors":"U. Chowdhury, Niwin George, L. Sankhyan, Sukhjeet Singh, A. Chauhan, Sreenita Chowdhury","doi":"10.5455/im.302644392","DOIUrl":"https://doi.org/10.5455/im.302644392","url":null,"abstract":"Among the variety of surgical options available for coarctation of the aorta, the resection and/or graft replacement of the diseased aortic segment and anatomical restoration without residual obstruction is the ideal option [1]. However, such a direct approach may be difficult to perform in late presenters with diminished elasticity and/or calcification of the vessels, extensive collateral formation at different anatomic levels, unusual anatomic features or previous operations [2-7]. Use of supraceliac segment of the abdominal aorta for ascending aorta-to-abdominal aorta bypass has been poorly documented in coarctation of the aorta or interrupted aortic arch presenting in adulthood [8-10]. We report a 42-years-old male patient presenting with isolated interrupted aortic arch undergoing ascending aorta-to-supraceliac abdominal aortic bypass without cardiopulmonary bypass. The postoperative recovery was uneventful. We conclude that ascending aorta-to-abdominal aortic bypass in the supraceliac bare area is a versatile technique in late presenters with coarctation of the aorta and eliminates the complications associated with the anatomical repair.","PeriodicalId":93574,"journal":{"name":"International medicine (Antioch, Turkey)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70793280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Exercise therapy for children with obesity: a systematic literature review","authors":"M. Jung, Alice Rueber, Dagmar Freerk","doi":"10.5455/IM.43763","DOIUrl":"https://doi.org/10.5455/IM.43763","url":null,"abstract":"Background: Obesity in childhood increased in recent years steadily and affects 14 million children in Europe. Since this disease presents a serious health risk and can develop into complications in adulthood, measures must be taken to prevent further damage. Methods: A systematic literature review was carried out in PubMed, MedPilot, CINAHL, Embase, and the Cochrane Library. Randomized controlled trials were included if they were published in the years 2006-2016, were written in German or English and described interventions with children from 0-18. Further studies were included manually. All studies were evaluated by the PEDroscale and the impact of the intervention was compared by the body mass index (BMI) value. Results: Five studies out of the first found 986 were included with a total of 605 children with obesity, thereof 328 in intervention groups and 277 in control groups. Children of the intervention groups undertook on average 100 minutes of exercise per week over three to 24 months periods. A reduction of the BMI value was proven only in four studies and varied from -0.1 kg/m2 up to -0.46 kg/m2 with different interventions. Conclusions: Adequate physical therapy including resistance and endurance training can help improve BMI in children with overweight and obesity.","PeriodicalId":93574,"journal":{"name":"International medicine (Antioch, Turkey)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70793769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Determinants and obstetric outcomes of high prenatal care utilization in a developing country","authors":"J. Awoleke, B. Olofinbiyi","doi":"10.5455/im.50857","DOIUrl":"https://doi.org/10.5455/im.50857","url":null,"abstract":"Background: High prenatal care utilization could put a strain on the resources within the health system, especially in a developing economy. However, the factors responsible have not been explored in the Nigerian context. Methods: Using a prospective design, records of observed visits of antenatal attendees were employed to calculate the Kotelchuck Index, and identify determinants of high prenatal care utilization. Results: Most of the women, 514 (43.5%), had adequate prenatal visits, while 53 (4.5%) had excessive utilization. Excessive prenatal care utilization was predicted by being employed (81.1% versus 18.9%, p=0.024). Also, when compared with adequate users, women who utilized prenatal services excessively were significantly more likely to be aged between 20 years and 39 years (98.1% versus 97.5%, p=0.041), with pre-eclampsia (11.3% versus 2.1%, p<0.0001), and previous cesarean birth (18.9% versus 11.9%, p=0.047). Regarding their deliveries, excessive utilizers were significantly more likely to have cesarean births (30.2% versus 28.2%, p=0.008), and deliver before term (64.2% versus 13%, p<0.0001), compared with adequate utilizers. Mothers with pre-eclampsia (odds ratio: 4.84; 95% CI 1.92–12.23, p=0.001), and delivery before term (odds ratio: 0.09; 95% CI 0.05–0.17, p<0.0001) were found to be independently associated with excessive prenatal care utilization. Conclusions: Availability of emergency obstetric service and improved facilities for neonatal intensive care are advocated to promote safe motherhood.","PeriodicalId":93574,"journal":{"name":"International medicine (Antioch, Turkey)","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70794238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Sanwal, K. Nooruddin, T. Nguyen, Michael Bailey, Aaron Moon, A. Guzman, J. Phillips
{"title":"A unique case of transitional cell carcinoma of renal pelvis in a patient with Lynch syndrome","authors":"C. Sanwal, K. Nooruddin, T. Nguyen, Michael Bailey, Aaron Moon, A. Guzman, J. Phillips","doi":"10.5455/im.56055","DOIUrl":"https://doi.org/10.5455/im.56055","url":null,"abstract":"Lynch syndrome-associated transitional cell carcinoma of the upper urinary tract is uncommon. Lynch syndrome is a well-known inherited condition with particularly increased risk of colorectal cancers and a lesser extent other types of cancers. We present a rare case of urothelial cancer associated with Lynch syndrome from the time of its diagnosis to its multidisciplinary management to date. This case report outlines the unique characteristics of the case. The patient was positive for a mutation in the MLH1 gene, a known mutation of Lynch syndrome, which has a sparse association to Lynch syndrome-related urothelial carcinoma compared to other genes, e.g., MSH2. The patient's second-degree relative had confirmed Lynch syndrome with the same MLH1 genetic mutation and had colorectal cancer. The first-degree female relative of the patient with urothelial cancer had breast cancer, also not commonly associated with Lynch syndrome. The patient's age at the time of diagnosis of urothelial cancer was 46 years, which is at the lower end of the spectrum of the average age of Lynch syndrome associated with urothelial cancers. This paper also presents a review of the literature regarding upper urinary tract transitional cell carcinoma, its association with Lynch syndrome and various opinions on screening guidelines for urothelial cancer in relatives of a patient diagnosed with Lynch syndrome.","PeriodicalId":93574,"journal":{"name":"International medicine (Antioch, Turkey)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70795275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The efficacy of polyunsaturated fatty acids for atherosclerotic diseases","authors":"H. Bando, M. Bando","doi":"10.5455/IM.302644129","DOIUrl":"https://doi.org/10.5455/IM.302644129","url":null,"abstract":"In the field of anti-aging medicine and health science, various opinions about lipid and health are found. Among lots of clinical and epidemiological research, there has been a significant inverse association between intake of long-chain n-3 polyunsaturated fatty acids (PUFA) and atherosclerosis development [1,2]. These studies included docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), and mortality rate with coronary artery diseases. There was also the Japan EPA Lipid Intervention Study (JELIS), which showed the efficacy of reduction of major coronary events [3]. It showed a 19% reduction in major coronary events by a primary endpoint in the EPA group compared with the control group. Regarding n-3 PUFA, there have been controversies concerning the effect of arteriosclerotic diseases. Formerly, it was rather widely known that the preventive arteriosclerotic effect was present in n-3 PUFA. However, recent papers showed opposite results. This problem is related to not only medical and health matter, but also our meals in our usual lives. In this article, the problem of the effect of n-3 PUFA will be described. The results of the ASCEND (A Study of Cardiovascular Events iN Diabetes) trial were announced and noted in 2018 [4]. The prevention effect of n-3 PUFA on arteriosclerosis was investigated by Randomized Comparison Test (RCT). The result was negative, which was contrary to the clinical effects previously reported. Formerly, there was a study suggested that fish intake could reduce heart diseases [5]. Later, clinical research has been developed concerning the relationship between lipids and arteriosclerotic diseases such as heart diseases. Under these circumstances, there are two reports in 2019 from the supreme medical journal, New England Journal of Medicine. Both results were contradictory, in which one showed a preventive effect in REDUCE-IT [6], and another did not show a preventive effect (VITAL) [7]. Details of these reports will be described in the following. There is a study of the Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial (REDUCE-IT). REDUCE-IT was an RCT study from 473 centers in 11 countries [6,8]. The subjects included patients with established cardiovascular diseases or with diabetes and other risk factors, who had been receiving statin therapy with elevated triglyceride and/or LDL-cholesterol level. In other words, the purpose was the check for the prevention of recurrence of arteriosclerotic events. Subjects (n=8,179) were divided into two groups, which","PeriodicalId":93574,"journal":{"name":"International medicine (Antioch, Turkey)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70792518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}