Medical intervention

医学干预
  • 文章类型: Journal Article
    背景:补充和替代(CAM)癌症治疗通常很昂贵,并且不在保险范围内。因此,许多人转向众筹来获得这种治疗。
    目的:这项研究的目的是通过专门研究支持蒂华纳CAM癌症治疗的众筹活动,来确定在国外寻求CAM治疗的癌症患者的理由。墨西哥。
    方法:我们刮了GoFundMe.com和GiveSendGo.com众筹平台,以开展参考蒂华纳CAM癌症诊所的活动,始于2022年1月1日至2023年2月28日。作者创建了一个编码框架,以确定在蒂华纳寻求CAM治疗的理由。要补充市场活动元数据,我们编码了受益人的癌症阶段,type,年龄,寻求特定治疗,受益人是否死了,性别,和种族。
    结果:患者在蒂华纳寻求CAM癌症治疗,因为(1)治疗提供了最大的疗效(29.9%);(2)国内提供的治疗不是治愈的(23.2%);(3)诊所治疗整个人,并解决了人的精神层面(20.1%);(4)治疗是无毒的,自然,或侵入性较小(18.2%);(5)诊所提供最新技术(8.5%)。运动筹集了5,275,268.37美元,大多数运动受益者是妇女(69.7%)或白人(71.1%)。
    结论:这些运动传播了关于CAM治疗可能疗效的有问题的错误信息,向蒂华纳的CAM诊所提供资金和代言,让许多活动家缺乏支付CAM治疗所需的资金,同时花费受益人和他们所爱的人的时间,隐私,和尊严。这项研究证实了蒂华纳,墨西哥,是CAM癌症治疗的一个非常受欢迎的目的地。
    BACKGROUND: Complementary and alternative (CAM) cancer treatment is often expensive and not covered by insurance. As a result, many people turn to crowdfunding to access this treatment.
    OBJECTIVE: The aim of this study is to identify the rationales of patients with cancer seeking CAM treatment abroad by looking specifically at crowdfunding campaigns to support CAM cancer treatment in Tijuana, Mexico.
    METHODS: We scraped the GoFundMe.com and GiveSendGo.com crowdfunding platforms for campaigns referencing CAM cancer clinics in Tijuana, initiated between January 1, 2022, and February 28, 2023. The authors created a coding framework to identify rationales for seeking CAM treatment in Tijuana. To supplement campaign metadata, we coded the beneficiary\'s cancer stage, type, age, specific treatment sought, whether the beneficiary died, gender, and race.
    RESULTS: Patients sought CAM cancer treatment in Tijuana because the (1) treatment offers the greatest efficacy (29.9%); (2) treatment offered domestically was not curative (23.2%); (3) the clinic treats the whole person, and addresses the spiritual dimension of the person (20.1%); (4) treatments are nontoxic, natural, or less invasive (18.2%); and (5) clinic offers the newest technology (8.5%). Campaigns raised US $5,275,268.37 and most campaign beneficiaries were women (69.7%) or White individuals (71.1%).
    CONCLUSIONS: These campaigns spread problematic misinformation about the likely efficacy of CAM treatments, funnel money and endorsements to CAM clinics in Tijuana, and leave many campaigners short of the money needed to pay for CAM treatments while costing beneficiaries and their loved one\'s time, privacy, and dignity. This study affirms that Tijuana, Mexico, is a very popular destination for CAM cancer treatment.
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  • 文章类型: Journal Article
    自2020年以来,黑人生命也是重要的运动和空闲不再是最重要的运动,人们普遍承认,系统性种族主义有助于种族分化的健康结果。卫生专业教育工作者被要求解决医疗保健内部的这种差距,政策,和实践。为了解决医疗保健中的结构性种族主义,出现的一个途径是在研究生住院医师医疗计划中创建医学教育干预措施。本范围审查的目的是审查当前有关反种族主义教育干预的文献,整合了种族主义的系统性或结构性观点,在研究生医学教育中。通过对23篇论文的鉴定和分析,这篇综述确定了医疗干预措施中感兴趣的三个主要组成部分,包括(A)概念化,(b)教学问题,和(C)结果和评估。在每个组成部分中都有重叠的讨论和分析点。概念化解决了研究人员如何以不同的方式概念化种族主义,课程内容的范围教育者选择挑战种族主义,以及社区在课程发展中的作用的缺失。教学问题解决了知识与基于技能的教学,以及一次性研讨会和综合课程之间的紧张关系。结果和评估强调了自我报告的李克特量表是主要的评估类型,教育干预中的自我评价,干预结果和学习目标之间的不一致。这些发现在研究生医学教育计划中深入探索反种族主义医疗干预措施方面是独一无二的,特别是与解决系统性和结构性种族主义的努力有关。研究结果对医学教育领域的现状进行了有意义的回顾,并就更广泛的反种族主义卫生专业课程的未来可能性进行了新的对话。
    Since 2020, brought to the forefront by movements such as Black Lives Matter and Idle No More, it has been widely acknowledged that systemic racism contributes to racially differentiated health outcomes. Health professional educators have been called to address such disparities within healthcare, policy, and practice. To tackle structural racism within healthcare, one avenue that has emerged is the creation of medical education interventions within postgraduate residency medical programming. The objective of this scoping review is to examine the current literature on anti-racist educational interventions, that integrate a systemic or structural view of racism, within postgraduate medical education. Through the identification and analysis of 23 papers, this review identified three major components of interest across medical interventions, including (a) conceptualization, (b) pedagogical issues, and (c) outcomes & evaluation. There were overlapping points of discussion and analysis within each of these components. Conceptualization addressed how researchers conceptualized racism in different ways, the range of curricular content educators chose to challenge racism, and the absence of community\'s role in curricular development. Pedagogical issues addressed knowledge vs. skills-based teaching, and tensions between one-time workshops and integrative curriculum. Outcomes and evaluation highlighted self-reported Likert scales as dominant types of evaluation, self-evaluation in educational interventions, and misalignments between intervention outcomes and learning objectives. The findings are unique in their in-depth exploration of anti-racist medical interventions within postgraduate medical education programming, specifically in relation to efforts to address systemic and structural racism. The findings contribute a meaningful review of the current state of the field of medical education and generate new conversations about future possibilities for a broader anti-racist health professions curriculum.
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  • 文章类型: Journal Article
    本文研究了医学干预对双性体降低癌症风险的主观经验。
    25名具有双性差异的人参加了半结构化访谈,通过主题语篇分析进行分析。
    双性恋者的身体被定位为天生生病,需要修改,与癌症风险合法化的手术和激素干预。这导致了具体的耻辱,对生育和性健康有负面影响。然而,许多参与者抵制生物病态化的论述,并接受双性恋地位。一些医疗干预措施,比如HRT,被认为增加了患癌症的风险。没有知情同意,缺乏有关两性状况和医疗干预后果的信息,被定位为侵犯人权。持续的医疗管理不善加剧了这种情况,包括医疗保健专业人员对双性恋差异缺乏了解,以及医疗保健中双性恋者的客观化或污名化。结果是在健康环境中没有披露双性恋状态,并且对医疗保健专业人员缺乏信任。
    缺乏证据的癌症风险话语证明对双性身体进行医疗干预的合法性需要受到挑战。需要为医疗保健从业人员提供有关与双性人一起工作的文化安全实践的教育和培训。
    UNASSIGNED: This paper examines the subjective experience of medical interventions on intersex bodies to reduce cancer risk.
    UNASSIGNED: Twenty-five individuals with intersex variations took part in semi-structured interviews, analysed through thematic discourse analysis.
    UNASSIGNED: Intersex bodies were positioned as inherently sick and in need of modification, with cancer risk legitimating surgical and hormonal intervention. This resulted in embodied shame, with negative impacts on fertility and sexual wellbeing. However, many participants resisted discourses of bio-pathologisation and embraced intersex status. Some medical interventions, such as HRT, were perceived to have increased the risk of cancer. Absence of informed consent, and lack of information about intersex status and the consequences of medical intervention, was positioned as a human rights violation. This was compounded by ongoing medical mismanagement, including health care professional lack of understanding of intersex variations, and the objectification or stigmatization of intersex people within healthcare. The consequence was non-disclosure of intersex status in health contexts and lack of trust in health care professionals.
    UNASSIGNED: The legitimacy of poorly-evidenced cancer risk discourses to justify medical intervention on intersex bodies needs to be challenged. Healthcare practitioners need to be provided with education and training about cultural safety practices for working with intersex people.
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  • 文章类型: Journal Article
    发热在宿主防御传染性挑战和指导医疗干预方面都有作用。这些角色仍然没有得到卫生保健提供者和患者及其家人的充分认可和考虑。这篇综述引用了支持这两种角色的报告,并提供了关于临床医生治疗发烧的建议,以及与患者及其家属教育有关的要点。
    Fever has roles both in host defense against infectious challenges and in guidance of medical intervention. These roles remain insufficiently acknowledged and considered by both health care providers and patients and their families. This review cites reports in support of both roles and provides recommendations regarding the clinician\'s approach to fever, as well as points relevant for education of patients and their families.
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  • 文章类型: Journal Article
    我们检查了从土城子遗址出土的一个人的遗骸,据信他来自中国战国时期。遗骸表现为股骨节段性骨折。我们的目的是推断骨折的原因,医疗干预,愈合过程,和骨折愈合后的运动行为,使用几种技术,包括宏观观察,计算机断层扫描(CT),有限元分析。根据长骨的形态,似乎这个人是男性。骨折导致股骨近端内收角度为5.47°,前屈角度为21.34°,而股骨颈前倾角已被10.74°的后倾角所取代。此外,股骨远端形成144.60°的异常前凸角。CT显示成熟的愈伤组织形成和可见的小梁束。有限元分析表明,站立时股骨最大vonMises应力为17.44MPa,行走时最大vonMises应力为96.46MPa。我们建议战国时期的医生对大腿解剖有很好的了解,使他们能够进行骨折复位和固定。合理的医疗干预有利于骨折愈合和负荷恢复。满意的骨折愈合确保个体在康复后能够进行正常的站立和行走活动。
    We examined the remains of an individual who was unearthed from the Tuchengzi site and was believed to be from the Warring States period in China. The remains exhibited segmental femoral fracture. We aimed to deduce the cause of fracture, medical interventions, healing process, and motion behavior after fracture healing using several techniques, including macroscopic observation, computed tomography (CT), and finite element analysis. Based on the morphology of the long bones, it appeared that the individual was male. The fractures resulted in an adduction angle of 5.47° and an anterior flexion angle of 21.34° in the proximal femur, while the femoral neck anteversion angle had been replaced by a retroversion angle of 10.74°. Additionally, the distal femur formed an abnormal anterior convex angle of 144.60°. CT revealed mature callus formation and visible trabecular bundles. The finite element analysis indicated that the maximum von Mises stress in the femur was 17.44 MPa during standing and 96.46 MPa during walking. We suggest that medical practitioners in the Warring States period possessed a good knowledge of thigh anatomy, enabling them to perform fracture reduction and fixation. Reasonable medical intervention facilitated fracture healing and load recovery. Satisfactory fracture healing ensured that the individual could engage in normal standing and walking activities after rehabilitation.
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  • 文章类型: Journal Article
    背景:多囊卵巢综合征(PCOS)是一种异质性疾病,影响4%至21%的卵巢患者。对PCOS的临床治疗的难以接近或不满意导致一些患有这种情况的人在专门的基于网络的论坛上讨论他们的经验。
    目的:本研究通过收集和分析在活跃的PCOS论坛上发布的实验室测试结果,探索将此类基于网络的论坛用于临床研究目的的可行性。特别是在Reddit上托管的PCOSsubreddit。
    方法:我们从PCOSsubreddit收集了大约45,000个帖子。手动读取了5000个帖子的随机子集,和实验室测试结果的存在被标记。这些标记的帖子用于训练机器学习模型,以识别其余帖子中的哪些包含实验室结果。实验室结果是从确定的帖子中手动提取的。将这些自我报告的实验室测试结果与已发表文献中的值进行比较,以评估结果是否与研究人员发表的PCOS队列的值一致。总共选择了10篇论文来代表已发表的PCOS文献,选择标准包括鹿特丹的PCOS诊断标准,过去20年内的出版日期,和至少50名PCOS参与者。
    结果:总体而言,在PCOS网络论坛的实验室检测结果中观察到的总体趋势与临床报告的PCOS一致.一些结果,如促卵泡激素,空腹胰岛素,和抗苗勒管激素,与已发表的PCOS患者的价值一致。这些结果在文献中以及与subreddit相比的高度一致性表明,卵泡刺激素,空腹胰岛素,和抗苗勒管激素在PCOS表型中比其他测试结果更一致。一些结果,比如睾丸激素,性激素结合球蛋白,和稳态模型评估-估计的胰岛素抵抗指数,介于PCOS文献值和正常值之间,由临床测试限值定义。有趣的是,其他结果,包括硫酸脱氢表雄酮,黄体生成素,和空腹血糖,似乎比文献中报道的稍微失调。
    结论:论坛发表的结果与文献中发表的结果之间的差异可能是由于临床研究中的选择过程以及论坛不成比例地描述了PCOS表型的可能性,这些表型不太可能通过医疗干预得到缓解。然而,大多数实验室检测值的一致性程度意味着PCOS网络论坛参与者是研究确定的PCOS队列的代表.PCOSsubreddit的这种验证提供了对subreddit的内容进行更多研究的可能性,以及使用其他医学互联网论坛的内容进行类似研究的想法。
    BACKGROUND: Polycystic ovary syndrome (PCOS) is a heterogeneous condition that affects 4% to 21% of people with ovaries. Inaccessibility or dissatisfaction with clinical treatment for PCOS has led to some individuals with the condition discussing their experiences in specialized web-based forums.
    OBJECTIVE: This study explores the feasibility of using such web-based forums for clinical research purposes by gathering and analyzing laboratory test results posted in an active PCOS forum, specifically the PCOS subreddit hosted on Reddit.
    METHODS: We gathered around 45,000 posts from the PCOS subreddit. A random subset of 5000 posts was manually read, and the presence of laboratory test results was labeled. These labeled posts were used to train a machine learning model to identify which of the remaining posts contained laboratory results. The laboratory results were extracted manually from the identified posts. These self-reported laboratory test results were compared with values in the published literature to assess whether the results were concordant with researcher-published values for PCOS cohorts. A total of 10 papers were chosen to represent published PCOS literature, with selection criteria including the Rotterdam diagnostic criteria for PCOS, a publication date within the last 20 years, and at least 50 participants with PCOS.
    RESULTS: Overall, the general trends observed in the laboratory test results from the PCOS web-based forum were consistent with clinically reported PCOS. A number of results, such as follicle stimulating hormone, fasting insulin, and anti-Mullerian hormone, were concordant with published values for patients with PCOS. The high consistency of these results among the literature and when compared to the subreddit suggests that follicle stimulating hormone, fasting insulin, and anti-Mullerian hormone are more consistent across PCOS phenotypes than other test results. Some results, such as testosterone, sex hormone-binding globulin, and homeostasis model assessment-estimated insulin resistance index, were between those of PCOS literature values and normal values, as defined by clinical testing limits. Interestingly, other results, including dehydroepiandrosterone sulfate, luteinizing hormone, and fasting glucose, appeared to be slightly more dysregulated than those reported in the literature.
    CONCLUSIONS: The differences between the forum-posted results and those published in the literature may be due to the selection process in clinical studies and the possibility that the forum disproportionally describes PCOS phenotypes that are less likely to be alleviated with medical intervention. However, the degree of concordance in most laboratory test values implied that the PCOS web-based forum participants were representative of research-identified PCOS cohorts. This validation of the PCOS subreddit grants the possibility for more research into the contents of the subreddit and the idea of undertaking similar research using the contents of other medical internet forums.
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  • 文章类型: Journal Article
    比较各种侵入性和非侵入性方法治疗恶性青光眼的结果。
    在PubMed和GoogleScholar中查找了与青光眼相关的关键字,以及截至2022年的相关文章被用来整理这篇评论文章。
    在过去的几年中,已经引入了许多手术方法和技术。这篇综述概述了有关恶性青光眼的非手术和手术治疗的最新知识。在这方面,我们首先简要概述了临床表现,病理生理学,和这种疾病的诊断。然后,对目前恶性青光眼治疗的证据进行了综述.最后,我们讨论了对另一只眼进行治疗的必要性以及可能影响手术干预结果的因素.
    液体误导综合症,或者恶性青光眼,是一种严重的疾病,可以由于手术干预而自发发生。恶性青光眼的病理生理是复杂的,关于可能导致这种疾病的潜在机制存在许多理论。恶性青光眼可以使用药物保守治疗,激光治疗,或手术。激光治疗和药物治疗已经足以治疗青光眼,但是效果通常是短暂的,手术治疗被证明是最有效的。已经引入了多种手术方法和技术。尽管如此,没有人在很大一部分患者中作为对照病例进行过研究,以比较有效性,结果,和复发。带虹膜-zonulo囊切除术的平坦部玻璃体切除术似乎仍然效果最好。
    UNASSIGNED: To compare the outcomes of various invasive and noninvasive approaches to the treatment of malignant glaucoma.
    UNASSIGNED: Glaucoma-related keywords were looked up in PubMed and Google Scholar, and related articles up to 2022 were used to put together this review article.
    UNASSIGNED: Numerous surgical methods and techniques have been introduced in the past few years. This review outlined current knowledge regarding the nonsurgical and surgical management of malignant glaucoma. In this regard, we first briefly outlined the clinical presentation, pathophysiology, and diagnosis of this disorder. Then, the current evidence on the management of malignant glaucoma was reviewed. Finally, we discuss the need for treatment of the other eye and the factors that might affect the outcome of surgical intervention.
    UNASSIGNED: Fluid misdirection syndrome, or malignant glaucoma, is a severe disorder that can occur spontaneously due to surgical intervention. The pathophysiology of malignant glaucoma is complicated, and numerous theories exist about the underlying mechanisms that may contribute to the disease. Malignant glaucoma can be treated conservatively using medications, laser therapy, or surgery. Laser treatments and medical treatments have been adequate for the treatment of glaucoma, but the effects have generally been short-lived, and surgical treatment has proved to be the most effective. There have been a variety of surgical methods and techniques introduced. Still, none have been studied in a large proportion of patients as a control case to compare effectiveness, outcomes, and recurrence. Pars plana vitrectomy with irido-zonulo-capsulectomy still seems to have the best results.
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  • 文章类型: Systematic Review
    这项研究旨在探讨影响卫生保健专业人员对放射事件的干预的因素,并确定它们引起的行动。根据确定的关键字,对Cochrane进行了搜查,Scopus,WebofScience,和PubMed直到2022年3月。审查了18篇符合纳入标准的同行评审文章。本系统评价使用PICOS和PRISMA(系统评价和荟萃分析的首选报告项目)指南进行。在这项研究中包含的18项研究中,8个是横断面研究,7是描述性研究,2是介入研究,1是系统审查。作为定性分析的结果,确定了影响卫生保健专业人员在放射事件中干预的7个因素:事件的稀有性;卫生保健专业人员对放射事件的不足;感官反应;困境和道德关注;沟通,工作量;以及其他因素。影响卫生保健专业人员介入放射事件的最重要因素是放射事件教育不足,影响其他因素的形成。这些和其他因素导致的行动,如延迟治疗,死亡,以及卫生服务的中断。需要进一步研究影响卫生保健专业人员干预的因素。
    This research aims to explore the factors affecting the intervention of health-care professionals regarding a radiological event and to determine what actions they cause. In line with the keywords determined, a search was conducted on Cochrane, Scopus, Web of Science, and PubMed until March 2022. Eighteen peer-reviewed articles that met the inclusion criteria were reviewed. This systematic review was conducted using the PICOS and PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses)guidelines. Of the 18 studies included in the study, 8 were cross-sectional studies, 7 were descriptive studies, 2 were interventional studies, and 1 was a systematic review. As a result of the qualitative analysis, 7 factors affecting the intervention of health-care professionals in a radiological event were identified as follows: rarity of the event; inadequacy of health-care professionals against the radiological event; sensory responses; dilemma and ethical concern; communication, workload; and other factors. The most important factor affecting the intervention of health-care professionals in a radiological event is inadequate education about a radiological event, which influences the formation of other factors. These and other factors cause actions such as delayed treatment, death, and disruption of health services. Further studies are needed on the factors affecting the intervention of health-care professionals.
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  • 文章类型: Journal Article
    未经证实:肌内注射肾上腺素是过敏反应的主要干预措施。
    UNASSIGNED:分析三级儿科中心因过敏反应而入院的儿童的干预数据,并将其与过敏反应在线注册网络的数据进行比较。
    UNASSIGNED:使用经过验证的结构化在线问卷来收集有关过敏性反应的一线和二线干预措施的数据。该研究是与欧洲过敏反应登记处合作进行的。
    未经评估:研究组包括114名儿童(76名男孩,66.87%)年龄5个月-17岁,以中度至重度过敏反应为主(环和梅默氏III级,和穆勒量表中的四级)。在103名(90.4%)儿童中,医疗干预的第一线是由医务人员提供的。在一线干预中,给予39名(34.8%)儿童肾上腺素。五名(4.4%)儿童接受了第二剂肾上腺素,并被送入重症监护病房。在二线干预中,12名(15.6%)儿童服用了肾上腺素。在三分之一中,它至少是对相同触发因素的第二个反应。接受肾上腺素治疗的儿童年龄较大(9.3±4.8岁),与未治疗的患者相比(7.3±4.6年,p=0.034)。在过敏反应发作后,儿童立即获得了35.1%的肾上腺素自动注射器处方,应急培训7.9%,和咨询避免过敏触发的30.7%。III级R&M反应增加了AAI处方的3倍几率(95%CI:1.08-8.15)。
    UNASSIGNED:有必要继续对儿童过敏反应的正确管理进行教育。
    UNASSIGNED: Intramuscular adrenaline administration is the primary intervention in anaphylaxis.
    UNASSIGNED: To analyse the data on intervention in children admitted due to anaphylaxis to the tertiary paediatric centre and compare them to the data from the Network for Online-Registration of Anaphylaxis.
    UNASSIGNED: A validated structured on-line questionnaire was used to collect data concerning the first and second-line intervention in anaphylaxis. The study was conducted in cooperation with the European Anaphylaxis Registry.
    UNASSIGNED: The study group comprised 114 children (76 boys, 66.87%) aged 5 months-17 years with the predominance of moderate-to-severe anaphylaxis (grade III in Ring and Messmer\'s, and grade IV in Mueller\'s scale). In 103 (90.4%) children the first line of medical intervention was provided by medical staff. In the first-line intervention 39 (34.8%) children were given adrenaline. Five (4.4%) children were given the second dose of adrenaline and were admitted to the intensive care unit. In the second-line intervention adrenaline was given to 12 (15.6%) children. In one third it was at least the second reaction to the same trigger. Children treated with adrenaline were older (9.3 ±4.8 years), in comparison to those not treated (7.3 ±4.6 years, p = 0.034). Directly after the episode of anaphylaxis the children got the prescription for the adrenaline autoinjector in 35.1%, emergency training in 7.9%, and counselling on the avoidance of the anaphylaxis trigger in 30.7%. Grade III R&M reaction increased 3-fold the odds of AAI prescription (95% CI: 1.08-8.15).
    UNASSIGNED: There is a strong need to continue education on proper management of anaphylaxis in children.
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  • 文章类型: English Abstract
    The purpose of the study is to draw the attention of the legal and medical community to the problem of insufficient awareness of the patient about the upcoming medical intervention; to identify the scope of interaction between the court and the expert in relation to disputes related to improper information. Despite the fact that the conclusion about improper informing of the patient implies a legal assessment of the circumstances, special medical knowledge is needed to identify some defects of voluntary informed consent. The expert, in particular, can answer the questions of the court about what risks are characteristic of a certain type of medical intervention (perforations, bleeding, etc.) and how high their probability was in relation to a particular patient (taking into account his state of health, anatomical features); whether there were alternative treatment options. Based on the explanations received, the court will be able to assess whether the patient\'s attention was focused on the relevant circumstances, whether his consent was conscious, and the complications that occurred were foreseeable.
    UNASSIGNED: Обратить внимание юридического и медицинского сообщества на проблему недостаточной информированности пациента о предстоящем медицинском вмешательстве; обозначить сферу взаимодействия суда и эксперта применительно к спорам, связанным с ненадлежащим информированием. Несмотря на то что вывод о ненадлежащем информировании пациента предполагает юридическую оценку обстоятельств, для выявления некоторых дефектов добровольного информированного согласия необходимы специальные медицинские познания. Эксперт, в частности, может ответить на вопросы суда о том, какие риски характерны для определенного типа медицинского вмешательства (перфорации, кровотечения и пр.) и насколько высокой была их вероятность применительно к конкретному пациенту (с учетом его состояния здоровья, анатомических особенностей); существовали ли альтернативные варианты лечения. На основании полученных разъяснений суд сможет оценить, было ли акцентировано внимание пациента на соответствующих обстоятельствах, являлось ли его согласие осознанным, а наступившие осложнения — предвидимыми.
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