Too much informed consent?

Article Abstract:

Informed consent is the ethical and legal requirement that patients be adequately informed of the nature of their condition, the recommended course of treatment or treatments, alternative treatments, and likely outcome and possible side effects of such treatments or of refusing treatment. Although it is very important that patients are fully informed, one has to question at what point informed consent is too much. Patients and their families, particularly when a serious illness is involved, are placed under a great deal of stress. Too much information from too many sources can lead to confusion, fear, and stress, all of which proper informed consent should help alleviate. In a recent experience with a woman who developed breast cancer, informed consent was discussed with the patient and family by a variety of medical personnel a number of times. Information given varied and was overwhelming and confusing. Other families have reported similar experiences. A more precise mechanism for obtaining informed consent is required. The main physician on the case should be the person to give the information and to obtain the consent, and informed consent should only be delegated when more specialized information is required. Care must be taken to use the procedure when required, but to not overdo it and thus overwhelm the patient and family. Informed consent is an important aspect of medical care that should help, not hinder, the patient's care and treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Laws, regulations and rules, Patients, Informed consent (Medical law), Informed consent, Medical ethics, editorial

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Relationship of bacteriologic characteristics to semen indices in men attending an infertility clinic

Article Abstract:

The significance of bacteria found in the sperm of men without reproductive tract symptoms is unclear. Some studies have found that certain types of bacteria can alter the motility and number of sperm, which ultimately affects fertility. The relationship between bacteria in the sperm and characteristics affecting fertility, such as sperm structure, motility, number and the presence of polymorphonuclear leukocytes and other white blood cells was studied among 37 infertile men. Bacteria were isolated in 36 samples; 113 aerobe types (requiring oxygen to live), 74 anaerobes (not requiring oxygen to live) and one yeast. The bacteria found included staphylococci (found in 89 percent of the samples), streptococci (65 percent), diphtheroids (86 percent), peptostreptococcus (62 percent), bacteroides (27 percent), Gardnerella (19 percent), Lactobacillus (16 percent), Actinomyces (16 percent), Enterococcus (11 percent) and Veillonella (11 percent). The presence of polymorphonuclear leukocytes did not correlate well with the isolation of bacteria. The presence of bacteria was not associated with abnormal sperm functioning, sperm number or pus in the sperm. Bacteria in the sperm are probably not a sign of active infection but rather of bacterial colonization, which does not cause sperm damage. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Physiological aspects, Bacteria, Semen, Infertility, Male, Male infertility

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Cavernous lymphangioma of the vulva

Article Abstract:

Lymphangiomas are rare tumors composed of dilated and cystic lymph vessels caused by congenital malformations of the lymphatic system, the system of lymph vessels which function as part of the body's immune system by draining lymph from all over the body and feeding it back into the blood stream. Several kinds of lymphangiomas have been observed. One kind, known as cavernous, appears as a group of blisters composed of dilated vessels, present (although not always visible) from birth. Another type, cystic, is a soft swelling resembling a bunch of grapes, and is usually seen in the neck. Lymphangiomas are sometimes superficial (circumscriptum). A case of cavernous lymphangioma is reported in the vulva, the region of the external female genital organs, of a young woman who had never received radiation therapy or had no history of other disease. The tumor was surgically removed but the disease's prognosis is uncertain and close follow-up is recommended in case of recurrence.

Lymphatic diseases, Lymphangioma

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