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Enviado por Biblio on 30/1/2015 10:10:50 (19 Lecturas)

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At birth, your data trail began. You were given a name, your height and weight were recorded, and probably a few pictures were taken. A few years later, you were enrolled in day care, you received your first birthday party invitation, and you were recorded in a census. Today, you have a Social Security or national ID number, bank accounts and credit cards, and a smart phone that always knows where you are. Perhaps you post family pictures on Facebook; tweet about politics; and reveal your changing interests, worries, and desires in thousands of Google searches. Sometimes you share data intentionally, with friends, strangers, companies, and governments. But vast amounts of information about you are collected with only perfunctory consent—or none at all. Soon, your entire genome may be sequenced and shared by researchers around the world along with your medical records, flying cameras may hover over your neighborhood, and sophisticated software may recognize your face as you enter a store or an airport.


Enviado por Biblio on 29/1/2015 9:07:45 (21 Lecturas)

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Personalised medicine is about tailoring treatment and care to the individual patient and their specific disease. However, oncology has so far largely resisted the idea of personalising dose levels, despite what is known about wide variations in individual pharmacokinetics, which govern how patients’ bodies absorb, metabolise, distribute and clear therapeutic drugs.

Conventionally, dosage of anti-cancer drugs has been calculated according to the patient’s body surface, which can be estimated by weight and height or more simply by weight alone.

Leading pharmacologists, such as Silvio Garattini of the Mario Negri Institute in Italy, have been arguing for some time that oncologists need to pay more attention to pharmacokinetics (eg EJC 2007, 43:271–282). Poor responses – or indeed unexpectedly severe side-effects – they argue could be the result of a conventional approach to dosing that fails to take this into account.


Enviado por Biblio on 28/1/2015 11:26:17 (20 Lecturas)

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Before starting medical school, James Downar believed that doctors have a moral duty not to let patients die without doing everything to keep them alive. Then he started to experience how lives actually ended.

Many deaths were peaceful. Many were not. He witnessed patients dying of lung cancer who suddenly began coughing up blood, drowning before they could be injected with morphine to relieve their distress.


Enviado por Biblio on 27/1/2015 10:15:32 (26 Lecturas)

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Anders Anell, Ph.D.
N Engl J Med 2015; 372:1-4January 1, 2015DOI: 10.1056/NEJMp1411430

Decision making in Swedish health care is decentralized — 21 elected county councils own and operate almost all hospitals and a majority of primary care facilities, and most physicians are salaried employees of these institutions. There is universal access to high-quality medical services for all citizens at reasonable expenditure levels (see table
Selected Characteristics of the Health Care System and Health Outcomes in Sweden.
and case histories). But the picture is more nuanced than those general facts might imply. Waiting times for consultations and treatment and lack of patient-centeredness are persistent problems, and services are not always distributed equitably, to name a few common concerns.1 The types of organizational reforms undertaken to address such problems depend in part on the ideologies of both the national and local governments — a factor that has been most evident in recent policies related to patient choice and the private provision of care.


Enviado por Biblio on 26/1/2015 10:04:25 (38 Lecturas)

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La ética durante el siglo XX ha alcanzado su máximo desarrollo en la ética aplicada gracias al impulso de la bioética; esta ha sido el referente para el desarrollo de la ética aplicada en otros ámbitos, desde el empresarial al de la administración pública.

Mientras que la bioética ha tenido un importante desarrollo en el ámbito clínico y de investigación, el desarrollo de la ética de las organizaciones sanitarias, salud pública y especialmente evaluación de tecnologías ha sido posterior y menos importante.

La bioética y la evaluación de tecnologías sanitarias fueron contemporáneas en su origen. Su aparición hace 4 décadas trataba de responder a la creciente complejidad del ámbito sanitario, en el que cada día resulta más difícil tomar decisiones tanto en la vertiente técnica como moral.


Enviado por Biblio on 23/1/2015 22:31:09 (40 Lecturas)

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I was delighted to be a part of this ad hoc subcommittee of this American Thoracic Society Ethics and Conflict of Interest Committee that developed An Official Policy Statement: "Managing Conscientious Objections in Intensive Care Medicine." It was just published in the American Journal of Respiratory and Critical Care Medicine 191(2): 219–227.


Enviado por Biblio on 22/1/2015 9:37:35 (57 Lecturas)

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Cómo se prueban los tratamientos: una mejor investigación para una mejor atención en salud es el título del libro publicado por la Organización Panamericana de la Salud en español. Este texto, adaptado para ser leído por pacientes y lectores en general además de por profesionales sanitarios, tiene tres objetivos principales:


Enviado por Biblio on 21/1/2015 9:30:11 (73 Lecturas)

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The My Life, My Death, My Choice campaign has published a new video to provide the facts about the proposed Assisted Suicide (Scotland) Bill currently being considered by the Scottish Parliament.


Enviado por Biblio on 20/1/2015 9:36:47 (80 Lecturas)

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Accidente de moto. Uno de los afectados logra sobrevivir gracias al casco pero, ay, por un golpe en el sitio exacto, tiene un fallo hepático. Sus riñones están destrozados y tiene que vivir conectado a una máquina de diálisis, ya que, aun siendo España el país con mayor tasa de donación del mundo, hay una larga lista de espera. Pero, ¿y si se pudiera imprimir una copia funcional de sus riñones? ¿O del hígado? ¿Y del corazón de un paciente que va por el tercer infarto? Un escenario de ciencia ficción para el que la empresa estadounidense Organinovo ha puesto la primera piedra.


Enviado por Biblio on 19/1/2015 11:33:16 (82 Lecturas)

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As the accountable care organization (ACO) model spreads in the United States, early experiences are being used to improve operations. One aspect of the model receiving substantial attention is the organization's influence on referrals. ACOs are accountable for all their patients' expenditures, whether incurred within or outside their organization, and many patients receive specialty care outside their ACOs.1 Influencing where patients receive care may be a mechanism for assuring quality and controlling cost by reducing duplicative, unnecessary, or high-priced care or by increasing the use of high-quality care — and may therefore be critical to achieving ACOs' cost and quality targets.


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