The right to be forgotten and COVID-19: privacy versus public interest / El derecho al olvido y el COVID-19: privacidad frente a interés público / O direito ao esquecimento e COVID-19: privacidade versus interesse público

Abstract: Recent studies highlight the importance of digital surveillance to gather individual health information due to the global pandemic caused by the new COVID-19 disease. This paper analyses its legal and ethical implications at the interface between the individual right to privacy and the collective interests of public health. We framed the discussion in law, deontology and utilitarianism. The lasted theories and human rights, especially privacy, are crucial in our argument. Health-derived dilemmas and efforts to solve them, especially by information technologies, bioethics and law, exist at these perspectives' interface. In particular, we analysed the intersection between autonomy, the right to privacy, and the so-called 'right to be forgotten' in the public health context. In other words, we studied the right to obtain from the controller the erasure of health data - a radical means of control over personal data established in Article 17 of the General Data Protection Regulation (GDPR). Given the lack of specifics regarding collection and re-use of such data under the broad scope of public health purposes, implied consent does not address the issue of proportionality. We highlight legal safeguards' insufficiency, suggesting applying the 'right to be forgotten' according to an ethical interpretation.

Resumen: Estudios recientes destacan la importancia de la vigilancia digital para recoger información sanitaria individual debido a la pandemia mundial causada por la nueva enfermedad COVID-19. Este artículo analiza sus implicaciones legales y éticas en la interfaz entre el derecho individual a la privacidad y los intereses colectivos de la salud pública. Enmarcamos la discusión en el derecho, la deontología y el utilitarismo. Estas últimas teorías y los derechos humanos, especialmente la privacidad, son cruciales en nuestro argumento. Los dilemas relacionados con la salud y los esfuerzos por resolverlos, especialmente a través de la tecnología de la información, la bioética y el derecho, se encuentran en la interfaz de estas perspectivas. En particular, analizamos la intersección entre la autonomía, el derecho a la privacidad y el llamado "derecho al olvido" en el contexto de la salud pública. Es decir, estudiamos el derecho a obtener del responsable del tratamiento la supresión de los datos de salud, un medio radical de control sobre los datos personales establecido en el artículo 17 del Reglamento general de protección de datos (RGPD). Dada la falta de especificidades en cuanto a la recogida y reutilización de dichos datos dentro del amplio ámbito de los objetivos de salud pública, el consentimiento implícito no aborda la cuestión de la proporcionalidad. Destacamos la insuficiencia de las garantías legales, sugiriendo la aplicación del "derecho al olvido" según una interpretación ética.

Resumo: Estudos recentes salientam a importância da vigilância digital para recolher informações individuais de saúde devido à pandemia global causada pela nova doença COVID-19. Este artigo analisa as suas implicações legais e éticas na interface entre o direito individual à privacidade e os interesses coletivos da saúde pública. Enquadramos a discussão no direito, na deontologia e no utilitarismo. As últimas teorias e os direitos humanos, especialmente a privacidade, são cruciais na nossa argumentação. Dilemas derivados da saúde e esforços para os resolver, especialmente através das tecnologias da informação, da bioética e do direito, existem na interface destas perspetivas. Em particular, analisámos a intersecção entre autonomia, direito à privacidade, e o chamado "direito ao esquecimento" no contexto da saúde pública. Por outras palavras, estudámos o direito de obter do responsável pelo tratamento o apagamento dos dados de saúde, um meio radical de controlo dos dados pessoais estabelecido no artigo 17º do Regulamento Geral de Proteção de Dados (RGPD). Dada a falta de especificidades em relação à recolha e reutilização de tais dados no âmbito alargado dos objetivos de saúde pública, o consentimento implícito não aborda a questão da proporcionalidade. Destacamos a insuficiência de salvaguardas jurídicas, sugerindo a aplicação do "direito ao esquecimento" de acordo com uma interpretação ética.

The right to be forgotten versus the right to disclosure of gamete donors' id: ethical and legal considerations / El derecho al olvido frente al derecho a revelar la identificación de los donantes de gametos: consideraciones éticas y jurídicas / O direito ao esquecimento versus o direito à divulgação da identificação de dadores de gâmetas: considerações éticas e legais

Abstract: 15. The anonymity of gamete donors in the context of medically-assisted reproduction techniques (ART) and the right of the offspring to know their genetic or biological parents' identity is a controversial and widely debated topic in the scientific literature. The positions on the issue in each country are different. Sometimes they are in opposition to each other even in countries with strong similarities, such as those in the European Union (EU), in the framework of shared ethical values. Although some countries still enshrine the rule of anonymity, there is an undeniable tendency to guarantee the right to know one's origins by creating relevant exceptions or abolishing donor anonymity status altogether. 16. This article offers ethical and legal considerations of whether the so-called 'right to be forgotten' (RTBF) could be extended to include gamete donors' right to remain anonymous. This perspective goes against the general trend, certainly in Europe, of recognizing that offspring born from donor gametes have a right to access information relating to their genetic progenitors. The novel addition is to question whether the General Data Protection Regulation (GDPR) might provide fertile ground for questioning this approach, and effectively support those jurisdictions where anonymity is still possible.

Resumen: 20. El anonimato de los donantes de gametos en el contexto de las técnicas de reproducción médicamente asistida (RM) y el derecho de la descendencia a conocer su identidad genética o biológica es un tema controvertido y ampliamente debatido en la literatura científica. Las posiciones sobre el tema en cada país son diferentes. A veces se oponen entre sí, incluso en países con fuertes similitudes, como los de la Unión Europea (UE), en el marco de valores éticos compartidos. Aunque algunos países siguen consagrando la norma del anonimato, es innegable la tendencia a garantizar el derecho a conocer el propio origen creando las excepciones pertinentes o suprimiendo por completo el estatus de anonimato del donante. 21. Este artículo ofrece consideraciones éticas y jurídicas sobre si el llamado "derecho al olvido" podría ampliarse para incluir el derecho de los donantes de gametos a permanecer en el anonimato. Esta opinión es contraria a la tendencia general, ciertamente en Europa, de reconocer que los hijos nacidos de gametos donados tienen derecho a acceder a la información relativa a sus padres genéticos. La nueva adición consiste en debatir si el Reglamento general de protección de datos (RGPD) podría proporcionar un terreno fértil para cuestionar este enfoque y apoyar efectivamente a las jurisdicciones en las que el anonimato sigue siendo posible.

Resumo 25. O anonimato dos dadores de gâmetas no contexto das técnicas de reprodução medicamente assistida (RMA) e o direito da descendência a conhecer a sua identidade genética ou biológica é um tema controverso e amplamente debatido na literatura científica. As posições sobre a questão em cada país são diferentes. Por vezes estão em oposição umas às outras, mesmo em países com fortes semelhanças, como os da União Europeia (UE), no quadro de valores éticos partilhados. Embora alguns países ainda consagrem a regra do anonimato, existe uma tendência inegável para garantir o direito de conhecer as suas origens, criando exceções relevantes ou abolindo completamente o estatuto de anonimato dos dadores. 26. Este artigo oferece considerações éticas e legais sobre se o chamado "direito ao esquecimento" poderia ser alargado para incluir o direito dos dadores de gâmetas a permanecerem anónimos. Esta perspetiva vai contra a tendência geral, certamente na Europa, de reconhecer que os descendentes nascidos de gâmetas doadas têm o direito de aceder à informação relacionada com os seus progenitores genéticos. O novo aditamento é debater se o Regulamento Geral de Proteção de Dados (RGPD) poderá fornecer um terreno fértil para questionar esta abordagem, e apoiar efetivamente as jurisdições onde o anonimato ainda é possível.

Evaluación del aprendizaje del tema componentes invariantes del dato científico en la asignatura metodología de la investigación / Assessment of the learning of the topic 'invariant components of scientific data' in research methodology teaching

Resumen Se evaluó el aprendizaje del tema componentes invariantes del dato científico en el examen final de estudiantes que rindieron la asignatura Metodología de la investigación en la carrera de Medicina Veterinaria de la Universidad Nacional de Rosario. Se utilizó un instrumento especialmente diseñado, conformado por un enunciado consistente en un texto que incluye los elementos vinculados con cada uno de los componentes invariantes del dato científico (entidad, propiedad, estado y procedimiento), una consigna de trabajo y una tabla para completar por parte del estudiante como respuesta. De los 57 estudiantes evaluados el 38,6% respondió correctamente. El 26,3% reconoció la entidad y de ellos el 13,3 % también reconoció la propiedad y su valor, pero no el procedimiento y el 86,7% identificó el procedimiento y el estado, pero no la propiedad. En el 35,1% de los casos correspondientes a estudiantes que no identificaron correctamente la entidad, el 35,0 % identificó la propiedad y el 65,0%, sin reconocer ni la entidad ni la propiedad, indicó correctamente el estado y el procedimiento. Estas inconsistencias ponen de manifiesto la atomización del proceso de razonamiento frente al desafío del problema a abordar, a la vez que evidencian un conocimiento frágil.

Abstract Learning evaluation of the topic "invariant components of scientific datum" in a Research methodology course. The learning of the topic invariant components of scientific datum was evaluated in the final exam of students who regularized the subject Methodology of research in the career of Veterinary Medicine of the National University of Rosario. A specially designed instrument was used, consisting of a text that includes the elements linked to each of the invariant components (entity, property, state and procedure), a work slogan and a table to complete by student's responses. Of the 57 students evaluated, 38.6% responded correctly. 26.3% recognized the entity and 13.3% of them also recognized the property and its value, but not the procedure and 86.7% identified the procedure and the state, but not the property. In 35.1% of the students who did not identify correctly the entity, 35.0% identified the property and 65.0%, without recognizing either the entity or the property, correctly indicated the status and the procedure. These inconsistencies show the atomization of the reasoning process in face of the challenge of the problem to be addressed, and at the same time evince the existence of fragile knowledge.

Forgotten double J stent in crossed renal fused ectopia: a rare case report

Ureteral double J (DJ) sent has now become one of the most commonly used tools in endourology. Complications are bound to occur if forgotten to remove, such as encrustations, infection, migration, renal dysfunction, hydronephrosis. Crossed renal fused ectopia is a very rare congenital malformation due to abnormal kidney ascent with fusion during embryogenesis in the first trimester. we report a very rare case of forgotten DJ stent in crossed fused ectopia, in 66 years old diabetic patient post left ureterorenoscopy (URS) done 3 years back. Retrograde intrarenal surgery (RIRS) was done for DJ stent removal right.

Feasibility of minimally invasive management in patients with forgotten double J stent: a single centre experience

Background: aim of the study was to present the experience in managing forgotten/encrusted Double J (DJ) ureteral stents and to review the literature on the subject.Methods: Author retrospectively studied patients presenting to the Outpatient Department from January 2016 to January 2019 with forgotten DJ stent(s) (six or more than six months after the insertion). Data was collected for age, gender, indication for DJ stenting, clinical features at presentation, radiological imaging and surgical procedure performed to extract the DJ stents. The post-operative stay, complications of the procedures and morbidity was also studied.Results: During the study period, a total 32 patients reported to the department with history of forgotten DJ stents. Most common age group involved was 41-60 years. Most common presenting symptoms were lower urinary tract symptoms (LUTS) or dysuria.  Duration of stent in-situ ranged from 6 month to 15 years. Most common sites of encrustations along the forgotten DJ stent were ureter and kidney followed by urinary blabber. Fluoroscopic guided DJ stent removal was done in 8 patients. A combination of Cystolithotripsy, URSL and PCNL was needed to clear the stone and extract the DJ stent in remaining patients.Conclusions: Forgotten/encrusted DJ stent may lead to complications ranging from urinary tract infections to loss of renal function. They can be safely and successfully removed, and the renal function can be preserved. Endo-urological management of forgotten encrusted stents is highly successful and often avoids the need for open surgical techniques.

Association of Complications in Retained Ureteral Stents

Introduction: One of the most frequent complicationof ureteral stent and difficult case management is stentencrustations resulting in morbidity and financial burdento patient. The primary aim of this study is to evaluatethe complications incidence associated to patients andunderstanding different management techniques and otherfactors includes stent insitu duration, patient literacy level andsocioeconomic level.Material and methods: In this study, there are 48 patientspresented with retained DJ stents to Urology Department,Sri Venkateswara Institute of Medical Sciences (SVIMS),Tirupati, Andhra Pradesh, India between August 2009 andJanuary 2016 were included.Results: The mean age of the patients in the cohort is 42.46years and with highest percentage (37.5%) of the patientsin age group of 40 to 50 years. Most of the patients in thecohort are from poor socio-economic status (66.7%) andilliterate (54.2%). Most of the patients (58.3%) are not awareof stent placement in their body and majority of the patients(83.3%) are unilateral cases. In this study, 31.2% of patientsexperienced multisite encrustations. Stents are placed mostcommonly for ureteric stones following the ureteroscopiclithotripsy and percutaneous nephrolithotomy proceduresin our study. Stone composition revealed predominantlyCalcium oxalate.Conclusion: Retained DJ stents results in morbidity andcomplications like encrustation and stone formation whichcan be treated using combined endo urological procedures.Our study stress the prominence of regular follow up, andexplaining patient about complications, prompt and timelystent removal and change of stent and proper documentation.Maintenance of stent register, is another important measure toavoid potential complications.

A mid-term clinical follow-up of unicompartmental knee arthroplasty with fixed bearing / 中国组织工程研究

BACKGROUND: Most of the domestic and foreign literatures reported the mid-term and long-term effects of the unicompartmental knee arthroplasty of the mobile bearing, but few reported the mid-term and long-term clinical effects of the unicompartmental knee arthroplasty of the fixed bearing. Simultaneously, most of the studies did not analyze the knee function recovery and the lower limb force line change at different time points after the fixed bearing unicompartmental knee arthroplasty, and also ignored the follow-up of the patients’ self-feeling after the unicompartmental knee arthroplasty. OBJECTIVE: To explore the mid-term clinical effect of fixed bearing unicompartmental knee arthroplasty in the treatment of medial compartment osteoarthritis of knee joint and to observe the change of force line of lower limbs. METHODS: From January 2014 to January 2015, a retrospective analysis was made of the data of 66 patients diagnosed as osteoarthritis of the medial compartment of the knee in the Department of Arthritis, Foshan Hospital of Traditional Chinese Medicine. According to the inclusion and exclusion criteria, 66 patients were included, including 18 males and 48 females, aged (62.36±16.33) years. The American Knee Society knee score and the hospital for special surgery knee score were used to assess the knee function before and 1, 3 and 5 years after the operation. Visual analogue scale score was utilized to evaluate the severity of knee. Forgotten joint score was used to assess the subjective feeling of prosthesis after unicompartmental knee arthroplasty. Hip-knee-ankle angle and tibiofemoral angle were measured using X-ray films before treatment and at follow-up to evaluate the force line of weight-bearing lower limbs. RESULTS AND CONCLUSION: (1) The postoperative follow-up time was 5-6 years, averagely 5.5 years. The incision healed in the first stage. There was no early complication such as joint infection or lower extremity deep vein thrombosis, and there was no prosthesis loosening, dislocation or other diseases of the contralateral compartment and patellofemoral joint. (2) The American Knee Society knee score clinical score, American Knee Society knee score function score, hospital for special surgery knee score, knee motion range and visual analogue scale score were lower at 1, 3 and 5 years after operation than those before treatment (P 0.05). (3) Forgotten joint score was higher at 3 and 5 years after treatment than that at 1 year after treatment (P 0.05). (4) Hip-knee-ankle angle and tibiofemoral angle were significantly improved after treatment in all patients compared with those before treatment (P 0.05). (5) The results show that the mid-term clinical effect of unicompartmental knee arthroplasty with fixed bearing is satisfactory, and the degree of self-prosthesis is high. After treatment, the force line of lower limbs was improved, and there was no significant change in the 5-year follow-up.

Comparison of short-term outcomes between unicompartmental knee arthroplasty and posterior Cruciate ligament-retaining total knee Arthroplasty / 中国组织工程研究

BACKGROUND: Unicompartmental knee arthroplasty and posterior cruciate ligament-retaining total knee arthroplasty are effective for people who were subjected to medial compartment lesions of the knee; however, the short-term effect of middle-aged and elderly people living in mountainous area needs further exploration. OBJECTIVE: To investigate the short-term efficacy of unicompartmental knee arthroplasty and posterior cruciate ligament-retaining total knee arthroplasty in middle-aged and elderly people with medial compartment osteoarthritis of knee joint in Chengde. METHODS: A total of 67 middle-aged and elderly patients with medial compartment osteoarthritis of the knee were selected from January 2017 to February 2019 in the Department of Joint Surgery, Affiliated Hospital of Chengde Medical College. Totally 31 patients in group A were treated with unicompartmental knee arthroplasty and 36 patients in group B were treated with posterior cruciate ligament-retaining total knee arthroplasty. All patients signed the informed consent. This study was approved by the Hospital Ethics Committee. Intraoperative blood loss, postoperative blood transfusion, postoperative hemoglobin decline, hematocrit and C-reactive protein at postoperative 1 and 3 days, and Forgotten Joint Scores at 1, 3, and 6 months and 1 year after surgery were observed and compared between the two groups. RESULTS AND CONCLUSION: (1) The perioperative hemoglobin decline, intraoperative blood loss, and blood transfusion rate were significantly lower, and postoperative hospitalization date was significantly shorter in group A than those in group B (P 0.05). (3) The Forgotten Joint Scores in group A were significantly higher than those in group B at 1, 3, and 6 months and 1 year after operation (P < 0.01). (4) No complications such as lower extremity venous thrombosis, pulmonary embolism and infection occurred in both groups. (5) In summary, unicompartmental knee arthroplasty has the advantages of less intraoperative bleeding, lower transfusion rate, and higher degree of Forgotten Joint Scores for the middle-aged and elderly patients with medial compartment lesions in mountainous areas.

Enfermedades raras y catastróficas en un hospital del norte peruano: Características y factores asociados a la mortalidad / Rare and catastrophic illness in a hospital of northern Peru: Characteristics and factors associated with mortality

Resumen Objetivos: El objetivo fue determinar las características y los factores asociados a la mortalidad en los pacientes atendidos por enfermedades raras (ER) y catastróficas (EC) en un hospital de la seguridad social del norte peruano. Materiales y métodos: Estudio transversal analítico, se utilizaron datos reportados de pacientes atendidos en un hospital del norte del Perú durante el año 2013. Se caracterizó a los pacientes, las enfermedades y se obtuvieron datos estadísticos de asociación. Resultados: De los 2316 pacientes, 2135 (92%) tuvieron EC y 181 (8%) ER. La enfermedad más común fue la insuficiencia renal crónica inespecífica (43%), pero la deficiencia hereditaria del factor VIII fue la que generó mayor gasto total (más de 850 426,35 €) y por cada paciente (2115,49 €). En el análisis multivariado se encontró asociación con la mortalidad al sexo femenino (p<0,001, RPa: 1,76, IC95%:1,67-1,86), la edad (p<0,001, RPa: 1,02, IC95%:1,01-1,03) y la cantidad de días hospitalizados (p<0,001, RPa: 1,08, IC95%:1,07-1,09), ajustando por el tipo de enfermedad. Conclusión: Existen características económicas y factores asociados a la mortalidad en los pacientes atendidos en nuestro medio, por lo que deberían realizarse más investigaciones para conocer mejor sobre este grupo, ya que generalmente se encuentra desatendido.

Abstract Objective: The objective was to determine the characteristics and factors associated with mortality in patients treated for rare diseases (ER) and catastrophic diseases (EC) in a public hospital in northern Peru. Materials and methods: An analytical cross-sectional study. Data are reported of patients treated in a hospital in northern Peru during 2013. Patients and the disease were characterized and statistical data was obtained. Results: Of the 2316 patients, 2135 (92%) had EC and 181 (8%) ER. The most common disease was nonspecific chronic renal failure (43%), but the hereditary factor VIII deficiency generated higher total spending (more than 850 426,35 €) and higher spending per patient (2115,49 €). The multivariate analysis found an association between mortality and gender (female) (p<0,001, RPa: 1,76, 95% CI:1,67 to1,86), age (p<0,001, RPa: 1,02, 95% CI:1,01 to 1,03) and the number of hospitalized days (p<0,001, RPa: 1,08, 95% CI:1,07 to 1,09). Conclusions: There are economic characteristics and factors associated with mortality in patients in our region. Additional research should be conducted to learn more about this group of patients, which are already generally neglected.

No nos olvidemos del bazo: el órgano huérfano / Do not forget the spleen: The orphan organ

Si bien cumple una función esencial en procesos como la filtración sanguínea y respuesta inmunitaria, el bazo es el órgano abdominal olvidado o huérfano, ya que ningún especialista (incluyendo a los radiólogos) le presta atención. No obstante, este puede verse afectado por una gran cantidad de patologías benignas y malignas, cuyas características en imágenes es importante conocer para lograr un correcto diagnóstico. En el presente artículo realizamos un ensayo iconográfico sobre las distintas entidades que pueden comprometerlo.

Even when the spleen plays a key role in processes such as blood filtration and immune response, it is the abdominal organ forgotten or orphan. The spleen can be affected by much benign and malignant disease, and is important to know the characteristics images of them to achieve a correct diagnosis. In this iconographic assay we show images of several of these diseases.

Endourological Management of Forgotten Encrusted Ureteral Stents

PURPOSE: To present our experience and discuss the various endourological approaches for treating forgotten encrusted ureteral stents associated with stone formation. MATERIALS AND METHODS: From July 2006 to December 2008, 14 patients (11 men and 3 women) with encrusted ureteral stents were analyzed. The average indwelling time of the stent was 4.9 years (range 1 to 12). Plain-film radiography was used to evaluate encrustation, stone burden, and fragmentation of the stents. Intravenous urogram and a Tc99m diethylene triamine penta acetic-acid renogram was used to assess renal function. RESULTS: In seven patients, the entire stent was encrusted, in three patients the encrustation was confined to the ureteral and lower coil part of the stent, two patients had encrustation of the lower coil, and minimal encrustation was observed in two patients. Percutaneous nephrolithotomy was performed in 5 cases and retrograde ureteroscopy with intra-corporeal lithotripsy in 9 patients. Cystolithotripsy was used to manage the distal coil of the encrusted stent in eight patients. Simple cystoscopic removal of the stents with minimal encrustation was carried-out in two cases. Looposcopy and removal of the stent was performed in one patient with an ileal conduit and retained stent. Only one patient required open surgical removal of the stent. Thirteen out of 14 patients were rendered stone and stent free in one session. All except two stents were removed intact and stone analysis of encrustation and calcification revealed calcium oxalate and calcium phosphate in the majority of the cases. CONCLUSION: Endourological management of forgotten encrusted stents is highly successful and often avoids the need for open surgical techniques.

Ideas for Safer Acupuncture Practice (1) / 全日本鍼灸学会雑誌

We have been collecting various ideas on safer acupuncture practice from participants in our workshop as well as members of the committee. Subjects and presentations of the present workshop were as follows:<br>1. Forgotten needles<br>  1) Ideas of prevention based on a questionnaire survey (Egawa and Ishizaki)<br>  2) Effect of incident reporting system (Yamashita)<br>2. Cleaner method of needle insertion and Oshide (needle-supporting fingers)<br>  1) Merits and demerits of sterilized fingerstall and glove (Miyamoto)<br>  2) History of the clean needle development (Umeda)<br>  3) A novel clean acupuncture needle device (Imai and Ishizaki)<br>Although there was not enough time for discussion, we collected some useful ideas from the participants. A novel clean needle invented by Imai gave a strong impression to the audience. We should continue to discuss a diverse impact when such new devices and concepts become widespread in traditional acupuncture practices. We welcome more ideas and opinions from relevant facilities, clinics and fields in order to further improve safety of acupuncture.

Forgotten Mediastinal Goiter / 대한내분비외과학회지

Forgotten mediastinal goiter is an extremely rare disease. It is most often the consequence of the incomplete removal of a ‘ plunging’ goiter, but it can sometimes be attributed to a concomitant, unrecongnized primary mediastinal goiter which is not connected to the thyroid. A primary mediastinal goiter(autonomous intrathoracic goiter) essentially caused by an abnormal embryonic development of the thyroid gland and a thyroid gland formation located in the thorax or the mediastinum. The differential diagnosis with ordinary recurrence was based on the absence of parenchymatous or vascular connections with the cervical thyroid gland. It is fed by local intrathoracic vessels and observed in the absence of previous thyroidectomy. Nevertheless, for primary mediastinal goiter, sternum-splitting incision will be required in most cases as troublesome mediastinal bleeding may occur which is difficult to control from a cervical collar incision. In this study we report a case of forgotten mediastinal goiter and review the various diagnostic and therapeutic problems posed by the condition. A number of possible solutions that can be implemented for this diasease are identified.