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Biomedical subjects

R Rhodes

Publications and source records attributed to R Rhodes.

At least 37 records · Page 2Linked to original sources
PubMed1999

The relaxin-like factor is a hormone.

The relaxin-like factor (RLF) circulates in the bloodstream of humans, interacts with a membrane protein with all the characteristics of ligand-receptor binding, and must therefore be considered a hormone by definition. The polyclonal antibody raised against synthetic human RLF showed no crossreactivity to other structurally related hormones, like insulin and relaxin. The sensitivity of this assay (ED50 at 100 pM) allowed the direct measurement of RLF concentrations in serum. The highest levels were detected in the serum of postpuberty males (190 pM), whereas in females and children, the RLF concentration was one order of magnitude lower.

Adolescent↗
PubMed1998

Genetic links, family ties, and social bonds: rights and responsibilities in the face of genetic knowledge.

Currently, some of the most significant moral issues involving genetic links relate to genetic knowledge. In this paper, instead of looking at the frequently addressed issues of responsibilities professionals or institutions have to individuals, I take up the question of what responsibilities individuals have to one another with respect to genetic knowledge. I address the questions of whether individuals have a moral right to pursue their own goals without contributing to society's knowledge of population genetics, without adding to their family's knowledge of its genetic history, and without discovering genetic information about themselves and their offspring. These questions lead to an examination of the presumed right to genetic ignorance and an exploration of a variety of social bonds. Analyzing cases in light of these considerations leads to a surprising conclusion about a widely accepted precept of genetic counseling, to some ethical insights into typical problems, and to some further unanswered questions about personal responsibility in the face of genetic knowledge.

Beneficence↗
PubMed1998

Ethical considerations for residents.

To help residents understand the moral obligations they have undertaken by becoming doctors, the author presents an overview of the ethical landscape of medical practice. She begins by stating that doctors' primary obligation is to use the knowledge of science in working together with others for the good of their patients. This involves (1) relying on the scientific method (and thus eschewing nonscientific alternatives) and supporting or conducting scientific research; (2) embracing the cooperative model (i.e., when appropriate, working cooperatively with other physicians and other health care providers); and (3) working for the good of the patient to preserve life, cure disease, restore or preserve function, educate, and alleviate suffering. In order to fulfill this complex obligation physicians must be professionally competent, they must respect their colleagues and patients, and they must genuinely care about their patients' well-being. The author then discusses the moral complexity of common encounters in medical practice. She explains the ethical conflicts that underlie issues of paternalism, justice, the use of patients for teaching, and end-of-life care. Since new moral problems are introduced with new technology and since medicine is confronting an increasing demand for services in the face of shrinking resources, she maintains that, more than ever, physicians must be aware of the ethical dimensions of their work and be able to organize their understanding of the issues. To meet the complex and demanding commitments of medical practice and to successfully navigate the ethical challenges that they will encounter, physicians must mold themselves not only to be knowledge and skilled professionals but also to be respectful and compassionate human beings.

Adult↗
PubMed1998

Curriculum revision: reaching faculty consensus through the Nominal Group Technique.

A fundamental concept to initiate change in the curriculum revision process is to overcome resistance to change and the boundaries of self-interest. Curriculum change cannot occur without an "unfreezing" of faculty values and interests. The Nominal Group Technique (NGT) was used to facilitate faculty identification of areas needing change in the undergraduate nursing curriculum. The process led to the generation of numerous independent ideas in which all faculty participated. The revised curriculum which resulted from the NGT process has had full and enthusiastic support of the faculty.

Alabama↗
PubMed1995

Results of laparoscopic versus open cholecystectomy in a community hospital.

In a retrospective study, the first 301 patients who had laparoscopic cholecystectomy (LC) in a university-affiliated community hospital were compared with a historical matched control group of patients who had open cholecystectomy. The patients who had LC had a shorter hospital stay, required less postoperative pain medication, resumed normal activities and returned to work sooner, and had a lower minor and total complication rate. The mean operating time was 45 minutes longer for LC. Major complications, common bile duct injuries, and mortality were similar in both patient groups. The learning curve, use of laser, and use of cholangiography were all analyzed. Our results with LC compared favorably with results reported in the medical literature.

Cholecystectomy↗
PubMed1994

A review of ethical issues in transplantation.

Unavoidable and unique characteristics of the transplant surgeon's practice require difficult moral judgments. The two major areas of moral quandary are organ procurement and organ allocation. This paper outlines the key ethical issues in transplantation and draws attention to some of the recent literature that argues more specific issues in greater detail. The subjects discussed include brain death, living organ donation, procurement policies, organ sales, distributive justice, free riders (nondonators), duties and debts, and research.

Disclosure↗
PubMed1993

Acute tumor lysis syndrome complicating fludarabine treatment of prolymphocytic leukemia.

Tumor lysis syndrome rarely occurs during chemotherapy treatment of indolent lymphoid tumors. This report describes for the first time a case of acute tumor lysis syndrome complicating fludarabine treatment of prolymphocytic leukemia. In this particular case the patient had an unexpectedly rapid response to fludarabine 15 days after initiation of the first chemotherapy cycle, which was subsequently complicated by the development of tumor lysis syndrome. Until more data are known concerning fludarabine treatment of prolymphocytic leukemia, cautious monitoring of patients treated with fludarabine should be undertaken, even after completion of the chemotherapy course.

Acute Disease↗
PubMed1993

Debatable donors: when can we count their consent?

Donor consent is the standard requirement for the acceptance of an organ or tissue donation from a living donor. Usually consent to donation is respected as the choice and act of an autonomous agent. There are times, however, when the consent should be paternalistically set aside. The problem for those who must make these decisions is determining when the donor's autonomy should be respected and when paternalistic interference is appropriate. This paper draws on the writings of Kant to develop an autonomy-preserving criterion for determining where to draw the line. It then goes on to display how that criterion could be applied to the case of an adolescent donor who agrees to donate a kidney to his brother.

Adolescent↗
PubMed1992

Mt. St. Anonymous; the adolescent living-related donor.

Seventeen-year-old David is a perfect organ match for his younger brother, Ken, who has kidney failure. David understands that the procedure presents some risk for him and that after surgery he may no longer be able to continue playing football. His idols all have been football players and he now plays on his high school's team. Nevertheless, he wants to donate a kidney to his brother and agrees to being a donor as soon as the option is mentioned. He never displays any ambivalence and says, "I want to donate my kidney because then I'll be a hero to my family." This close family--of two parents and five older siblings--strongly supports the seventeen-year-old's decision, especially after an older brother, who was also a perfect organ match, is found medically (anatomically) unsuitable. The parents and two of the older siblings could still be medically acceptable donors: their organs are likely to be better grafts (one haplotype matches) than a non-related cadaveric kidney would be, but less compatible than the perfect organ match (haploidentical) that could be provided by David, the adolescent brother. Studies have shown that in the short run there is little difference in the survivability of organs from different classes of donors. After several years, however, there is a significant difference with perfectly matched kidneys being much less prone to rejection than the less ideally matched organs.

Adolescent↗