In this article, the authors examine how the potential success of head/body transplantation raises questions as to how halakha-Jewish law and jurisprudence-might draw the line between determining whether a person is dead or alive.
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In this article, the authors analyze the Talmudic and halakhic sources upon which the concept of "vital motion" is based so as to evaluate whether the sources support the concept. Through this analysis, the authors present the view that... more
In this article, the authors analyze the Talmudic and halakhic sources upon which the concept of "vital motion" is based so as to evaluate whether the sources support the concept. Through this analysis, the authors present the view that vital and non-vital motion are not distinct halakhic categories. Rather, physical or physiological activity is understood in context as either meaningful or not, depending on whether it is assumed that the person or animal will continue living or not.
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In this article, the authors analyze the Talmudic and halakhic sources upon which the concept of “vital motion” is based so as to evaluate whether the sources support the concept. Through this analysis, the authors present the view that... more
In this article, the authors analyze the Talmudic and halakhic sources upon which the concept of “vital motion” is based so as to evaluate whether the sources support the concept. Through this analysis, the authors present the view that vital and non-vital motion are not distinct halakhic categories. Rather, physical or physiological activity is understood in context as either meaningful or not, depending on whether it is assumed that the person or animal will continue living or not.
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Orthodox Judaism is, in part, a legal code comprising obligations (mitzvoth). Some are positive mitzvoth such as healing the sick, observing the Sabbath, and preserving life. Others are negative mitzvoth such as the prohibition of murder.... more
Orthodox Judaism is, in part, a legal code comprising obligations (mitzvoth). Some are positive mitzvoth such as healing the sick, observing the Sabbath, and preserving life. Others are negative mitzvoth such as the prohibition of murder. The proper course of action in any particular situation is determined by identifying and weighing the mitzvoth that apply to that situation. There is unanimity that the fetus is not considered a completely full human life, and that the life of the mother takes precedence over the life of the fetus. There is also unanimity that abortion is prohibited. However, a difference of opinion exists regarding the exact nature of the prohibition. Some define the prohibition as similar to the prohibition of murder – a severe prohibition. As a result, exceptions to the prohibition are limited to instances when the mother’s life or health is in significant danger. Others define the prohibition of abortion as similar to the prohibition against wounding a person. ...
The topic of this chapter arose from a conversation that one of the authors (IB) had with the editor of this book. In the conversation, the editor expressed the difficulty for physicians to be, at times, critical of some of the choices... more
The topic of this chapter arose from a conversation that one of the authors (IB) had with the editor of this book. In the conversation, the editor expressed the difficulty for physicians to be, at times, critical of some of the choices that they make regarding which medical intervention they either suggested or acquiesced to implement. After discussing the influences of hospital policies, healthcare law, insurance, clinical specialization, and patient autonomy on medical and surgical decision-making, the editor of this book asked, or rather exclaimed: “Is there room for common sense?” In this chapter, we will attempt to answer this question.
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Cervical disc arthroplasty (CDA) has emerged as a popular alternative to anterior cervical discectomy and fusion (ACDF) for the surgical treatment of cervical degenerative disc disease. CDA has been well studied, with efficacy reported to... more
Cervical disc arthroplasty (CDA) has emerged as a popular alternative to anterior cervical discectomy and fusion (ACDF) for the surgical treatment of cervical degenerative disc disease. CDA has been well studied, with efficacy reported to be equivalent to or better than that seen with ACDF, and it is associated with a consistently low incidence of adverse events. The development or progression of myelopathy after CDA is a particularly rare occurrence. In this report, the authors describe the first known case of recurrence of myelopathy at the index level of surgery after CDA implantation due the continuation of the spondylitic process after placement of the artificial disc.
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Comprehensive assessment of quality of care includes patient-reported outcomes, safety of care delivered, and patient satisfaction. The impact of the patient-reported ODI (baseline and 12-month) scores on satisfaction with outcomes... more
Comprehensive assessment of quality of care includes patient-reported outcomes, safety of care delivered, and patient satisfaction. The impact of the patient-reported ODI (baseline and 12-month) scores on satisfaction with outcomes following spine surgery is not well documented. To determine the impact of patient disability [Oswestry disability index (ODI) scores] at baseline and 12-months on satisfaction with outcomes following surgery. Analysis of prospectively collected longitudinal web-based multicenter data. Patients undergoing elective surgery for degenerative lumbar disease were entered into a prospective multicenter registry. Primary outcome measures: Oswestry disability index (ODI), North American Spine Society satisfaction (NASS) questionnaire. Baseline and 12-month ODI scores were recorded. Satisfaction at 12-month after surgery was measured using NASS questionnaire. Multivariable proportional odds logistic regression analysis was conducted to determine the impact of base...
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The aim of this study was to evaluate the usefulness of early Transcranial Doppler (TCD) in guiding initial resuscitation of traumatic and non-traumatic comatose patients before diagnostic imaging and invasive neurologic monitoring. This... more
The aim of this study was to evaluate the usefulness of early Transcranial Doppler (TCD) in guiding initial resuscitation of traumatic and non-traumatic comatose patients before diagnostic imaging and invasive neurologic monitoring. This was a prospective, interventional study and included patients in coma, before performing diagnostic imaging. A TCD was performed as soon as possible upon admission. Diastolic velocity (DV) <20 cm/s and Pulsatility Index (PI) >1.4 at both middle cerebral arteries were considered abnormal and specific therapy was started with fluid expansion with 2 L 0.9% saline solution, followed by norepinephrine infusion to increase MAP above 110 mmHg. An increment in DV >20 cm/s was considered as a good response. Twenty-eight patients were included, 9 had normal TCD and 19 (68%) had abnormal TCD values. Mean values pre- and post-treatment were: MAP 84 ± 16/121 ± 9 mmHg; PI 2.26 ± 0.52/1.28 ± 0.47; DV 13 ± 7/33 ± 18 cm/s (P<0.0001 for all values); 13 pa...
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The Spine Journal, Volume 6, Issue 5, Pages 16S, September 2006, Authors:Richard D. Guyer, MD; Robert J. Banco, MD; Fabien D. Bitan, MD; Scott L. Blumenthal, MD; Andrew Cappucino, MD; Fred H. Geisler, MD, PhD; Stephen Hochschuler, MD;... more
The Spine Journal, Volume 6, Issue 5, Pages 16S, September 2006, Authors:Richard D. Guyer, MD; Robert J. Banco, MD; Fabien D. Bitan, MD; Scott L. Blumenthal, MD; Andrew Cappucino, MD; Fred H. Geisler, MD, PhD; Stephen Hochschuler, MD; Richard T. Holt, MD; Louis G. Jenis ...
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METHODS: Records from patients enrolled in the investigational device exemption study of the CHARITÉ Artificial Disc were analyzed at four high-enrollment sites. Patients enrolled in one of the three arms of the study: nonrandomized,... more
METHODS: Records from patients enrolled in the investigational device exemption study of the CHARITÉ Artificial Disc were analyzed at four high-enrollment sites. Patients enrolled in one of the three arms of the study: nonrandomized, randomized, and continued access. ...
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Abstract: An antibody that inhibits over 95% of the cytosolic NADP+-dependent 7-hydroxybutyrate (GHB) dehydrogenase activity of either rat brain or kidney was found to inhibit only approximately 50% of the conversion of [1–14C]GHB to... more
Abstract: An antibody that inhibits over 95% of the cytosolic NADP+-dependent 7-hydroxybutyrate (GHB) dehydrogenase activity of either rat brain or kidney was found to inhibit only approximately 50% of the conversion of [1–14C]GHB to 14CO2 by rat kidney homogenate. A similar result was obtained with sodium valproate, a potent inhibitor of GHB dehydrogenase. The mitochondrial fraction from rat brain and kidney was found to catalyze the conversion of [1–14C]GHB to 14CO2. The dialyzed mitochondrial fraction also catalyzed the oxidation of GHB to succinic semialdehyde (SSA) in a reaction that did not require added NAD+ or NADPT and which was not inhibited by sodium valproate. The enzyme from the mitochondrial fraction which converts GHB to SSA appears to be distinct from the NADP+-depen-dent cytosolic oxidoreductase which catalyzes this reaction.