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Treating Family Members

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1. The ethics of treating family members. (PubMed)

The ethics of treating family members. Many medical professionals receive requests from family and friends asking for medical advice and treatment. But should medics treat their family? Ethically can we treat, or refuse to treat, family members? This is a common ethical challenge that most doctors face during their career and there is limited evidence available. By examining ethical principles, we aim to answer these questions and provide a framework that will guide decision making (...) in this area.There is a paucity of evidence available. Many ethical systems exist and have been discussed since ancient Greece but in recent years, bioethics has become more prominent in medical thinking and debate.We examine ethical systems such as virtue ethics, utilitarianism, deontology and principlism and how they relate to treating family members. We then look at cases in different contexts and describe a system for approaching such cases, allowing doctors to conform to moral standards, and consider

2019 Current Opinion in Anaesthesiology

2. Effectiveness of Satir-Informed Family-Therapy on the Codependency of Drug Dependents' Family Members in Iran: A Randomized Controlled Trial. (PubMed)

Effectiveness of Satir-Informed Family-Therapy on the Codependency of Drug Dependents' Family Members in Iran: A Randomized Controlled Trial. Social workers in substance abuse treatment settings are responsible for involving families in treatment program to improve family functioning. The effectiveness of available interventions in treating codependency of family members of drug users in Iran is not well explored. We evaluated the effectiveness of the Satir communication family therapy (CFT (...) ) in healing codependency of drug dependents' family members in Tehran, Iran.The intervention group participants (n = 27) received a seven-session social work intervention with CFT approach and the control group (n = 26) received treatment as usual. We used the Holyoake Codependency Index to measure participants' codependency at baselines, end of intervention, and 90 days post intervention.Codependents enrolled in the intervention had a significantly lower codependency score than controls at the end

2018 Journal of evidence-informed social work

3. Providing Care to Yourself, Family Members or Those Close to You

if there are complications from surgery, if an adverse event occurs, or if the outcome is less than expected. TREATING OTHERS In relation to family members and persons with whom they have a close relationship, it is inappropriate for surgeons to: • perform any invasive or non-invasive operative procedure • prescribe or administer drugs of dependence • prescribe psychotropic medication • undertake psychotherapy • issue medical certificates SELF TREATMENT The College believes that surgeons should not treat themselves (...) Providing Care to Yourself, Family Members or Those Close to You Approved by: Professional Development and Standards Board Version: 2 Approval date: February 2017 Document owner: Manager, Professional Standards Review date: February 2020 Reference number: FES-PST-034 Providing care to yourself, family members or those close to you INTRODUCTION The Royal Australasian College of Surgeons is committed to ensuring the highest standards of safe and comprehensive surgical care for the community

2017 ASERNIP-S

4. The ethics of treating family members. (PubMed)

The ethics of treating family members. Many medical professionals receive requests from family and friends asking for medical advice and treatment. But should medics treat their family? Ethically can we treat, or refuse to treat, family members? This is a common ethical challenge that most doctors face during their career and there is limited evidence available. By examining ethical principles, we aim to answer these questions and provide a framework that will guide decision making (...) in this area.There is a paucity of evidence available. Many ethical systems exist and have been discussed since ancient Greece but in recent years, bioethics has become more prominent in medical thinking and debate.We examine ethical systems such as virtue ethics, utilitarianism, deontology and principlism and how they relate to treating family members. We then look at cases in different contexts and describe a system for approaching such cases, allowing doctors to conform to moral standards, and consider

2018 Current Opinion in Anaesthesiology

5. miRNA-122 Protects Mice and Human Hepatocytes from Acetaminophen Toxicity by Regulating Cytochrome P450 Family 1 Subfamily A Member 2 and Family 2 Subfamily E Member 1 Expression (PubMed)

miRNA-122 Protects Mice and Human Hepatocytes from Acetaminophen Toxicity by Regulating Cytochrome P450 Family 1 Subfamily A Member 2 and Family 2 Subfamily E Member 1 Expression Acetaminophen toxicity is a leading cause of acute liver failure (ALF). We found that miRNA-122 (miR-122) is down-regulated in liver biopsy specimens of patients with ALF and in acetaminophen-treated mice. A marked decrease in the primary miR-122 expression occurs in mice on acetaminophen overdose because (...) of suppression of its key transactivators, hepatocyte nuclear factor (HNF)-4α and HNF6. More importantly, the mortality rates of male and female liver-specific miR-122 knockout (LKO) mice were significantly higher than control mice when injected i.p. with an acetaminophen dose not lethal to the control. LKO livers exhibited higher basal expression of cytochrome P450 family 2 subfamily E member 1 (CYP2E1) and cytochrome P450 family 1 subfamily A member 2 (CYP1A2) that convert acetaminophen to highly reactive

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2017 The American journal of pathology

6. Family members' satisfaction with care and decision‐making in intensive care units and post‐stay follow‐up needs—a cross‐sectional survey study (PubMed)

Family members' satisfaction with care and decision‐making in intensive care units and post‐stay follow‐up needs—a cross‐sectional survey study The aim of this study was to explore family members' satisfaction with care and decision-making during the intensive care units stay and their follow-up needs after the patient's discharge or death.A cross-sectional survey study was conducted.Family members of patients recently treated in an ICU were participating. The questionnaire contented (...) of background variables, the instrument Family Satisfaction in ICU (FS-ICU 24) and questions about follow-up needs. Descriptive and non-parametric statistics and a multiple linear regression were used in the analysis.A total of 123 (47%) relatives returned the questionnaire. Satisfaction with care was higher scored than satisfaction with decision-making. Follow- up needs after the ICU stay was reported by 19 (17%) of the participants. Gender and length of the ICU stay were shown as factors identified

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2017 Nursing open

7. Cell Cycle Arrest and Apoptosis Induction via Modulation of Mitochondrial Integrity by Bcl-2 Family Members and Caspase Dependence in Dracaena cinnabari-Treated H400 Human Oral Squamous Cell Carcinoma (PubMed)

Cell Cycle Arrest and Apoptosis Induction via Modulation of Mitochondrial Integrity by Bcl-2 Family Members and Caspase Dependence in Dracaena cinnabari-Treated H400 Human Oral Squamous Cell Carcinoma Dracaena cinnabari Balf.f. is a red resin endemic to Socotra Island, Yemen. Although there have been several reports on its therapeutic properties, information on its cytotoxicity and anticancer effects is very limited. This study utilized a bioassay-guided fractionation approach to determine (...) externalization of phospholipid phosphatidylserine was observed using DAPI/Annexin V fluorescence double staining mechanism studied through mitochondrial membrane potential assay cytochrome c enzyme-linked immunosorbent and caspases activities revealed depolarization of mitochondrial membrane potential (MMP) and significant activation of caspases 9 and 3/7, concomitant with S phase arrest. Apoptotic proteins array suggested that MMP was regulated by Bcl-2 proteins family as results demonstrated

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2016 BioMed research international

8. Treating Family Members

Treating Family Members Treating Family Members Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Treating Family Members Treating (...) Family Members Aka: Treating Family Members II. Precautions Do not write controlled substance prescriptions (e.g. s, s) for family or friends Home treatment of minor symptoms is reasonable However, major symptoms are best treated with formal evaluations Rendered care may be sub-standard of the care you would deliver to others Clinician may not ask their family member sensitive questions Clinician may stretch their care beyond their level of expertise Family members may have misconceptions

2018 FP Notebook

9. Targeted surgical prevention of epithelial ovarian cancer is cost effective and saves money in BRCA mutation carrying family members of women with epithelial ovarian cancer. A Canadian model. (PubMed)

Targeted surgical prevention of epithelial ovarian cancer is cost effective and saves money in BRCA mutation carrying family members of women with epithelial ovarian cancer. A Canadian model. Survival but not cure rates have improved for epithelial ovarian cancer (EOC), demonstrating the need for effective prevention. Targeted prevention in BRCA carriers by risk reducing surgery (RRS) prevents 80% of cases but incurs additional up-front costs, compensated for by the potential for long term (...) was $2,904,486 (cost saving of $9,660,381 in treatment costs versus increased cost from cascade testing/RRS of $6,755,895). At a threshold of $100,000 per QALY, prevention was cost effective in all modelled scenarios.Targeted prevention in BRCA mutation carriers not only prevents EOC but is cost-effective compared to treating EOC if it develops.Copyright © 2019 Elsevier Inc. All rights reserved.

2019 Gynecologic Oncology

10. High kinesin family member 11 expression predicts poor prognosis in patients with clear cell renal cell carcinoma. (PubMed)

High kinesin family member 11 expression predicts poor prognosis in patients with clear cell renal cell carcinoma. Kinesin family member 11 (Kif11) is a member of the kinesin family motor proteins, which is associated with spindle formation and tumour genesis. In this study, we investigated the relationship between Kif11 expression and clear cell renal cell carcinoma (CCRCC) development.The relationship between Kif11 expression and CCRCC development was analysed by quantitative real-time (qRT (...) )-PCR analyses, and tissue immunohistochemistry. The prognostic significance of Kif11 expression was explored by univariable and multivariable survival analyses of 143 included patients. Furthermore, SB743921 was used as a specific Kif11 inhibitor to treat 786-O cells with the epithelial to mesenchymal transition (EMT) process analysed by qRT-PCR, and cell survival rates analysed with Annexin V-FITC/PI staining followed by flow cytometric analyses. Disease-free survival curves of Kif11

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2019 Journal of Clinical Pathology

11. Emergency physician care of family members, friends, colleagues and self. (PubMed)

Emergency physician care of family members, friends, colleagues and self. Emergency Physicians are frequently called upon to treat family members, friends, colleagues, subordinates or others with whom they have a personal relationship; or they may elect to treat themselves. This may occur in the Emergency Department (ED), outside of the ED, as an informal, or "curbside" consultation, long distance by telecommunication or even at home at any hour. In surveys, the vast majority of physicians (...) report that they have provided some level of care to family members, friends, colleagues or themselves, sometime during their professional career. Despite being common, this practice raises ethical concerns and concern for the welfare of both the patient and the physician. This article suggests ethical and practical guidance for the emergency physician as to how to approach these situations.Copyright © 2019. Published by Elsevier Inc.

2019 American Journal of Emergency Medicine

12. Activating p53 family member TAp63: A novel therapeutic strategy for targeting p53-altered tumors. (PubMed)

Activating p53 family member TAp63: A novel therapeutic strategy for targeting p53-altered tumors. Over 96% of high-grade ovarian carcinomas and 50% of all cancers are characterized by alterations in the p53 gene. Therapeutic strategies to restore and/or reactivate the p53 pathway have been challenging. By contrast, p63, which shares many of the downstream targets and functions of p53, is rarely mutated in cancer.A novel strategy is presented for circumventing alterations in p53 by inducing (...) decrease in tumor burden at rates similar to those observed in CDDP-treated mice, and 20% of DOPC-miR-130b plus CDDP-treated mice were living tumor free. Systemic injections of scL-miR-130b plus CDDP in a clinically tested, tumor-targeted nanocomplex (scL) improved survival in 60% and complete remissions in 40% of mice that carried HEYA8 xenografts.The miR-130b/TAp63 axis is proposed as a new druggable pathway that has the potential to uncover broad-spectrum therapeutic options for the majority of p53

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2019 Cancer

13. Treat your family like you treat your patients

Treat your family like you treat your patients Treat your family like you treat your patients Treat your family like you treat your patients | | January 24, 2019 45 Shares Many times during difficult patient interactions — when I am not sure about the right thing to do — I let myself be guided by the question: “What would I do if it was my family member?” This internal dialogue usually cuts the clutter and lets me focus on the most important thing: the well-being of my patient. I can step away (...) volunteer obligations I have for the school that week. My husband asks me a simple question which offends me for no reason, and I snap at him feeling somewhat entitled to my rude behavior because I’ve worked hard all day. Then I regret it immediately as I realize that he has been working hard too. I apologize and think how wonderful it would be if I treated my family like I treat my patients. If I treated my family as my patients, I would listen attentively and empathetically when my parents call

2019 KevinMD blog

14. How a concerned family member, friend or member of the public can help someone with gambling problems: a Delphi consensus study (PubMed)

How a concerned family member, friend or member of the public can help someone with gambling problems: a Delphi consensus study Gambling is an enjoyable recreational pursuit for many people. However, for some it can lead to significant harms. The Delphi expert consensus method was used to develop guidelines for how a concerned family member, friend or member of the public can recognise the signs of gambling problems and support a person to change their gambling.A systematic review of websites (...) , books and journal articles was conducted to develop a questionnaire containing items about the knowledge, skills and actions needed for supporting a person with gambling problems. These items were rated over three rounds by two international expert panels comprising people with a lived experience of gambling problems and professionals who treat people with gambling problems or research gambling problems.A total of 66 experts (34 with lived experience and 32 professionals) rated 412 helping

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2016 BMC psychology

15. Prognostic values of the inhibitor of DNA-binding family members in breast cancer (PubMed)

Prognostic values of the inhibitor of DNA-binding family members in breast cancer The inhibitor of DNA‑binding (ID) proteins are dominant‑negative modulators of transcription factors with basic helix‑loop‑helix (bHLH) structures, which control a variety of genes in cell cycle regulation. An increasing volume of evidence has demonstrated that the deregulated expression of IDs in several types of malignancy, including breast carcinoma, has been proven to serve crucial regulatory functions (...) in tumorigenesis and the development of breast cancer (BC). The present study evaluated the prognostic values of the ID family members by investigating a set of publicly accessible databases, including Oncomine, bc‑GenExMiner, Kaplan‑Meier plotter and the Human Protein Atlas. The results demonstrated that mRNA levels of distinct IDs exhibited diverse profiles between BC and normal counterparts. The mRNA expression level of ID2 was significantly higher in breast cancer than normal tissues, while the mRNA

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2018 Oncology reports

16. Late Transitions and Bereaved Family Member Perceptions of Quality of End-of-Life Care. (PubMed)

Late Transitions and Bereaved Family Member Perceptions of Quality of End-of-Life Care. To examine associations between healthcare transitions at the end of life (EOL; late transitions) and bereaved family members' and friends' assessment of EOL quality of care (QOC).National Health and Aging Trends Study (NHATS), a prospective cohort of Medicare enrollees aged 65 and older.United States, all sites of death.Family members and close friends of decedents from NHATS Rounds 2 through 6 (N=1,653 (...) ; weighted 6.0 million Medicare deaths).Multivariable logistic regression with survey weights was used to examine the association between having a late transition and reports of perceived unmet needs for symptom management, spiritual support, concerns with communication, and overall QOC.Seventeen percent of decedents had a late transition. Bereaved respondents for decedents experiencing late transitions were more likely to report that the decedent was treated without respect (21.3% vs 15.6%; adjusted

2018 Journal of the American Geriatrics Society

17. Brief multifamily Psychoeducation for family members of patients with chronic major depression: a randomized controlled trial. (PubMed)

points, as well as family functioning as evaluated by the patients. Intention-to-treat analyses were conducted.There was no statistically significant effect of BMP on K6 scores at 16- weeks (mean difference 1.17, 95% confidence interval: - 0.63 to 2.98, P = 0.19). Exploratory analyses revealed that BMP reduced depressive symptoms in family members at 8- weeks (difference = - 3.37, 95%CI -6.32 to - 0.43, P = 0.02) and improved family functioning at multiple time points (Role; 8 W, difference = - 0.13 (...) Brief multifamily Psychoeducation for family members of patients with chronic major depression: a randomized controlled trial. Major depressive disorder (MDD) is a common and often chronic problem. Patients with chronic MDD often have negative impacts on the health of their families. Family psychoeducation is recognized as part of the optimal treatment for patients with psychotic disorder, and has been shown to reduce the rate of relapse in individuals with schizophrenia and to reduce

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2018 BMC Psychiatry

18. Genome-Wide Association Study Identifies Cxcl Family Members as Partial Mediators of LPS-induced Periodontitis. (PubMed)

LPS-induced bone loss and, together with expression data, identified Cxcl family members as associated with PD. We observed an increase in Cxcl10 protein, as well as immune cells and pro-inflammatory cytokines in C57BL/6J (high bone loss strain) but not in A/J (low bone loss strain) after LPS injections. Genetic deletion of CXCR3 (Cxcl9 and10 receptor) demonstrated a ∼50% reduction in bone loss and reduced osteoclasts after LPS injections. Furthermore, WT mice treated with AMG-487 (a CXCR3 (...) Genome-Wide Association Study Identifies Cxcl Family Members as Partial Mediators of LPS-induced Periodontitis. Periodontitis (PD) is characterized by bacterial infection and inflammation of tooth-supporting structures and can lead to tooth loss. PD affects ∼47% of the US population over age 30 years and has a heritability of about 50%. Although the host immunoinflammatory response and genetic background play a role, little is known of the underlying genetic factors. We examined natural genetic

2018 Journal of Bone and Mineral Research

19. Insight into the role of PIKK family members and NF-кB in DNAdamage-induced senescence and senescence-associated secretory phenotype of colon cancer cells (PubMed)

Insight into the role of PIKK family members and NF-кB in DNAdamage-induced senescence and senescence-associated secretory phenotype of colon cancer cells Senescence of cancer cells is an important outcome of treatment of many cancer types. Cell senescence is a permanent cell cycle arrest induced by stress conditions, including DNA damage. DNA damage activates DNA damage response (DDR), which involves members of the phosphatidylinositol 3-kinase-related kinase (PIKK) superfamily: protein (...) members in colon cancer cell senescence and connection between DNA-damage-induced senescence and NF-κB-regulated SASP in p53-proficient and p53-deficient colon cancer cells treated with doxorubicin. We showed that doxorubicin induced cell senescence in both p53+/+ and p53-/- HCT116 cells, proving that this process is p53-independent. Senescence was successfully abrogated by a PIKK inhibitor, caffeine, or by simultaneous silencing of three PIKKs by specific siRNAs. By silencing individual members

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2018 Cell death & disease

20. Family with sequence similarity 13, member A modulates adipocyte insulin signaling and preserves systemic metabolic homeostasis (PubMed)

Family with sequence similarity 13, member A modulates adipocyte insulin signaling and preserves systemic metabolic homeostasis Adipose tissue dysfunction is causally implicated in the impaired metabolic homeostasis associated with obesity; however, detailed mechanisms underlying dysregulated adipocyte functions in obesity remain to be elucidated. Here we searched for genes that provide a previously unknown mechanism in adipocyte metabolic functions and identified family with sequence (...) similarity 13, member A (Fam13a) as a factor that modifies insulin signal cascade in adipocytes. Fam13a was highly expressed in adipose tissue, predominantly in mature adipocytes, and its expression was substantially reduced in adipose tissues of obese compared with lean mice. We revealed that Fam13a accentuated insulin signaling by recruiting protein phosphatase 2A with insulin receptor substrate 1 (IRS1), leading to protection of IRS1 from proteasomal degradation. We further demonstrated that genetic

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2018 Proceedings of the National Academy of Sciences of the United States of America

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