RESUMO
The randomised controlled trial (RCT) constitutes a quantitative, comparative, controlled study of a particular treatment, and provides invaluable evidence regarding its pharmacotherapeutic efficacy. These studies are generally predicated upon the ethical principle of clinical equipoise. However, this may be insufficient to justify withholding treatment from a control group while assessing drug therapy in a potentially fatal disease. Thus, the criteria for randomisation, informed consent methodology and timing, and consideration of treatment options in such a scenario remain the province of medical ethics. This paper addresses the need for an RCT of ribavirin in the treatment of Crimean Congo haemorrhagic fever, and highlights underlying ethical concerns in light of the current medical, virological and ethical literature.
Assuntos
Antivirais/uso terapêutico , Febre Hemorrágica da Crimeia/tratamento farmacológico , Ensaios Clínicos Controlados Aleatórios como Assunto/ética , Ribavirina/uso terapêutico , Antivirais/administração & dosagem , Ética Médica , Vírus da Febre Hemorrágica da Crimeia-Congo , Febre Hemorrágica da Crimeia/mortalidade , Humanos , Consentimento Livre e Esclarecido/ética , Princípios Morais , Ribavirina/administração & dosagem , Resultado do TratamentoRESUMO
Hemi-facial spasm, facial paralysis, and trigeminal neuralgia are prevailing signs and symptoms with which physicians have been coping for thousands of years. Ibn Sina (known as Avicenna in the West), who was among the leading figures during medieval ages and influenced the upcoming periods in the Eastern and Western hemispheres for long time, focused also on these crucial problems. In his principal medical work, the Canon of Medicine, Avicenna underlined the significance of wry mouth-related disorders and wrote a precise chapter over this topic with the heading "Laqve." However, the term "laqve" is usually accepted only as facial paralysis in most of historical texts. Further detailed analysis of the text reveals that, all the above-mentioned signs and symptoms are considered under the same heading. Therefore, the descriptions articulated by famous physician Avicenna pose great merit from the point of historical view of neurological sciences. The main aim of this article is to reintroduce essential parts of the text by adding comments over specific descriptions, and consequently, to make the text more comprehensible for today's scientists.
Assuntos
Paralisia Facial , Manuscritos Médicos como Assunto , Medicina Arábica/história , Boca/inervação , Médicos , Paralisia Facial/diagnóstico , Paralisia Facial/patologia , Paralisia Facial/terapia , História Medieval , HumanosRESUMO
Gangliogliomas represent only 0.4% of central nervous system neoplasms and 1.3% of brain tumors. They are benign neoplasms with low morbidity and mortality and the patients usually present with seizures, but there has been no adult ganglioglioma with lytic skull lesion. A 49-year-old right handed woman suffering from generalized epileptic seizures was admitted to our hospital. She had also left hemiparesis with 4/5 motor strength. Magnetic resonance imaging and immunohistochemical studies revealed WHO Grade II ganglioglioma. Skull X-ray showed the lytic skull lesions. We have to consider gangliogliomas in the differential diagnosis of lytic skull lesions.
Assuntos
Ganglioglioma , Crânio/patologia , Neoplasias Supratentoriais , Feminino , Ganglioglioma/diagnóstico , Ganglioglioma/patologia , Ganglioglioma/fisiopatologia , Ganglioglioma/cirurgia , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Neoplasias Supratentoriais/diagnóstico , Neoplasias Supratentoriais/patologia , Neoplasias Supratentoriais/fisiopatologia , Neoplasias Supratentoriais/cirurgiaRESUMO
Spinal cord oligodendrogliomas are rare pathologies of the spinal cord, and their location at conus and/or filum terminale is even rarer. There are only 7 spinal cord oligodendrogliomas reported in the literature. Our case is the eighth spinal cord oligodendrogliomas at this location.
Assuntos
Oligodendroglioma/patologia , Neoplasias da Medula Espinal/patologia , Humanos , Laminectomia , Vértebras Lombares , Masculino , Pessoa de Meia-Idade , Oligodendroglioma/cirurgia , Neoplasias da Medula Espinal/cirurgiaRESUMO
The authors report on a 31-year-old male patient harboring multiple intracranial mass lesions which proved histologically to be due to infection with Cladosporium trichoides upon removal of one of the lesions. Aggressive antifungal chemotherapy with fluconazole (400 mg/d for 3 months) in combination with surgery resulted in good clinical and radiologic outcome which prompted us to report this case.