Purpose: The primary responsibility of institutional review boards is to protect human research subjects and, therefore, ensure that studies are performed in accordance with a standard set of ethical principles. A number of groups have compared the responses of institutional review boards in multicenter clinical trials involving medical therapies. To our knowledge no such studies have been performed to date of trials investigating surgical intervention. We investigated the consistency of the recommendations issued by various institutional review boards in the Minimally Invasive Surgical Therapies study for benign prostatic hyperplasia, a multicenter trial with a uniform consent and study protocol.
Materials And Methods: We obtained the institutional review board response from 6 of the 7 participating institutions after initial submission of the Minimally Invasive Surgical Therapies study protocol and classified the responses. We then redistributed the approved protocols to an institutional review board at another participating institution and analyzed that review of these protocols.
Results: We found that the number and type of responses required for institutional review board approval of an identical study protocol varied significantly among participating institutions. We also found that institutional review board responses were inconsistent in the second review, although all protocols were ultimately approved.
Conclusions: The current system of local institutional review board review in the context of a multicenter surgical trial is inefficient in the review process and may not provide expertise for overseeing surgical trials. Based on these results a central surgical institutional review board may be needed to improve the ethical review process in multicenter trials.
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http://dx.doi.org/10.1016/j.juro.2009.02.032 | DOI Listing |
Foot Ankle Surg
January 2025
Department of Orthopaedics, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, Zhejiang, China. Electronic address:
Background: The optimal treatment of Osteochondral lesion of the talus (OLT) for subchondral bone cysts (SBCs) has not been finalized. The purpose of this systematic review and meta-analysis was to define whether OLT with small SBCs will affect the clinical outcomes of OLTs after arthroscopic microfracture.
Methods: We searched the Embase, Cochrane Library and PubMed databases up to May 13, 2024 for eligible comparative studies.
Neurotherapeutics
January 2025
Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address:
Extracorporeal membrane oxygenation (ECMO) is a technique used to support severe cardiopulmonary failure. Its potential life-saving benefits are tempered by the significant risk for acute brain injury (ABI), from both primary pathophysiologic factors and ECMO-related complications through central nervous system cellular injury, blood-brain barrier dysfunction (BBB), systemic inflammation and neuroinflammation, and coagulopathy. Plasma biomarkers are an emerging tool used to stratify risk for and diagnose ABI, and prognosticate neurofunctional outcomes.
View Article and Find Full Text PDFTrends Endocrinol Metab
January 2025
Department of Hypertension and Endocrinology, Center for Hypertension and Metabolic Diseases, Daping Hospital, Army Medical University, Chongqing Institute of Hypertension, Chongqing, China; Chongqing Institute for Brain and Intelligence, Chongqing, China. Electronic address:
Primary aldosteronism (PA) is a common, salt-sensitive form of endocrine hypertension. Compared with essential hypertension (EH), PA is more susceptible to cardiorenal complications and metabolic risks. However, PA has a low screening rate and a poor response to mineralocorticoid receptor antagonists (MRAs).
View Article and Find Full Text PDFSurg Obes Relat Dis
December 2024
Center for Obesity Research and Education, Temple University, Philadelphia, Pennsylvania.
As accessibility and legalization of cannabis rise throughout the United States (US), programs have sought guidance about whether its use should be considered a contraindication or, if not a contraindication, what recommendations patients should receive regarding appropriate use before and after metabolic and bariatric surgery (MBS). In this review, medical, nutritional, pharmacological, and psychological considerations are presented by a multidisciplinary group of members of the American Society for Metabolic and Bariatric Surgery (ASMBS). Research suggests several risks associated with long-term cannabis use in the general population, but research in the MBS population, specifically, is limited.
View Article and Find Full Text PDFZhonghua Xue Ye Xue Za Zhi
December 2024
State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China Tianjin Institutes of Health Science, Tianjin 301600, China.
Smoldering multiple myeloma (SMM) patients are a heterogeneous group with variable prognosis. A subset of SMM patients have a higher risk of progressing to multiple myeloma (MM) within 2 years. The definition of high-risk patients is not consistent among different risk models, and the combination of various biomarkers and new technologies improves the predictive performance of risk models.
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