Dealing with unproven treatments involves more than analyzing the available scientific data. The patient-physician relationship--the foundation of medical practice--is challenged and threatened by unproven treatments. To understand the problem, we need to understand ourselves as well as the patient and the disease. Handling the problem effectively can strengthen the patient-physician bond.
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Knowledge and understanding of information after taking decision to participate or not in a randomized trial of surgery vs radiotherapy among patients with locally advanced prostate cancer - an observational study.
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Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden; Department of Care Science, Sophiahemmet University, Stockholm, Sweden.
Background And Purpose: Informed consent from trial participants is mandatory. In a randomized clinical trial, we investigated (1) differences in knowledge and understanding of trial information between patients who participated and those who refrained, (2) differences in perceptions of information, and (3) differences in satisfaction with the information.
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Lunate prosthetic arthroplasty for the treatment of Kienbock's disease: A systematic review.
J Hand Microsurg
March 2025
Pulvertaft Hand Centre, Royal Derby Hospital, United Kingdom.
Purpose: Prosthetic replacement of the fragmented, collapsed and unreconstructable lunate is a treatment option in Kienbock's disease. The objective of this study is to assess the effectiveness, safety and outcomes of prosthetic lunate arthroplasty for the treatment of Kienbock's disease.
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A generalist medical language model for disease diagnosis assistance.
Nat Med
January 2025
State Key Laboratory of Networking and Switching Technology, Beijing University of Posts and Telecommunications, Beijing, China.
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Am J Reprod Immunol
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Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
Recurrent pregnancy loss (RPL) represents a complication of pregnancy occurring in 1%-3% of all couples trying to conceive. About 50%-60% of RPL cases remain idiopathic, therefore therapeutic strategies seem empirical and based on unproven evidence. We investigated the efficacy of corticosteroids in women with RPL.
View Article and Find Full Text PDFNeurosurgery for mental conditions and pain: An historical perspective on the limits of biological determinism.
Surg Neurol Int
December 2024
Department of Psychiatry, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States.
Neurosurgical operations treat involuntary movement disorders (MvDs), spasticity, cranial neuralgias, cancer pain, and other selected disorders, and implantable neurostimulation or drug delivery devices relieve MvDs, epilepsy, cancer pain, and spasticity. In contrast, studies of surgery or device implantations to treat chronic noncancer pain or mental conditions have not shown consistent evidence of efficacy and safety in formal, randomized, controlled trials. The success of particular operations in a finite set of disorders remains at odds with disconfirming results in others.
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