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Background: 'The Clinical Ethics Advisory Group' (CEAG) is the clinical ethics support body for Newcastle upon Tyne Hospitals National Health Service Foundation Trust. A significant change in CEAG's way of working occurred over the past 5 years as a result of Court decisions, increasing public expectations and an increase in CEAG's paediatric case flow.
Purpose: Review historical data: (a) as a useful benchmark to look for the early impact of significant service changes and (b) to seek possible reference ('sentinel') cases for use with a posited practical (casuistic) case-based reasoning model.
CMV-Related Hemorrhagic Retinal Vasculitis in a Multiple Myeloma Patient on Daratumumab Therapy: A Case Report.
Ocul Immunol Inflamm
November 2024
Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.
Purpose: To report a case of cytomegalovirus (CMV)-related hemorrhagic retinal vasculitis in a patient with multiple myeloma (MM) on daratumumab, a trial cereblon E3 ligase modulatory drug (CELMoD), dexamethasone, and acyclovir, and discuss clinical implications for CMV prophylaxis.
Methods: Case report, narrative review of CMV reactivation risk in MM patients on daratumumab and antiviral agent efficacy for CMV prophylaxis.
Results: A 63-year-old female presented with 3 days of progressive unilateral vision loss in the right eye to the level of counting fingers.
Case report: successful treatment of primary intradural extramedullary extraskeletal Ewing sarcoma in adult patient with intralesional surgery, chemotherapy, and proton beam therapy of the cerebrospinal axis.
Ther Adv Med Oncol
November 2024
Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Skłodowska-Curie National Research Institute of Oncology, Roentgena 5, Warsaw 02-781, Poland.
Ewing sarcoma is a rare malignant neoplasm that primarily affects bone in children. Extraskeletal location is less common, while intradural extramedullary Ewing sarcoma (IEES) in adults is a casuistic phenomenon. Due to its rarity, a standardized treatment strategy for IEES has not been established.
View Article and Find Full Text PDFArticle Synopsis
- - Three cases of similar breast lesions are discussed, which present significant diagnostic challenges even with advanced laboratory techniques.
- - The lesions include low-grade spindle cell metaplastic carcinoma, desmoid fibromatosis, and phyllodes tumor, highlighting the need for careful diagnostic algorithms and understanding of molecular characteristics.
- - Effective treatment requires close collaboration among specialists for accurate diagnosis and tailoring of individualized therapy based on the specific lesion type and its unique characteristics.
End-of-life care for the devout Jewish patient.
J Eval Clin Pract
February 2025
Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Rationale: The Joint Commission emphasizes the importance of cultural competence and effective communication in quality medical care, particularly during end-of-life (EOL), when decisions are influenced by diverse cultural and religious backgrounds. For Orthodox Jewish patients, the philosophical framework used for EOL decision-making may conflict with that used in traditional Western medical ethics. In this paper, we explore the complexities of EOL decision-making for devout Jewish patients and highlight how approaches may differ from a Western ethical framework.
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