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Maree Johnson, Tracy Levett-Jones, R Langdon, Gabrielle Weidemann, Elizabeth Manias, Bronwyn Everett
OBJECTIVES: We sought to evaluate the perceptions of nurses of an e-learning educational program to encourage the use of behavioural strategies-blocking, engaging, mediating, multitasking, and preventing-to reduce the negative effects of interruptions during medication administration. DESIGN: A qualitative design was used to evaluate the impact of this e-learning educational intervention on nurses' behaviour. SETTINGS: Two wards (palliative care and aged care) from two different hospitals within a large local health service within Sydney Australia, were included in the study...
June 30, 2018: Nurse Education Today
Masafumi Tomita, Shuji Saito, Shinichiro Makimoto, Shuntaro Yoshida, Hiroyuki Isayama, Tomonori Yamada, Takeaki Matsuzawa, Toshiyuki Enomoto, Rika Kyo, Toshio Kuwai, Nobuto Hirata, Mamoru Shimada, Tomio Hirakawa, Koichi Koizumi, Yoshihisa Saida
BACKGROUND: Self-expandable metallic stenting (SEMS) for malignant colorectal obstruction (MCO) as a bridge to elective surgery (BTS) is a widely used procedure. The aim of this study was to assess short-term outcomes of SEMS for MCO as BTS. METHODS: This study analyzed pooled data from BTS patients who were enrolled in two multicenter prospective single-arm observational clinical studies that used different stent types. Both studies were conducted by the Japan Colonic Stent Safe Procedure Research Group (JCSSPRG)...
July 13, 2018: Surgical Endoscopy
Sergio Fersino, Stefano Arcangeli, Barbara Alicja Jereczek-Fossa, Rolando D'Angelillo, Filippi Bertoni, Giuseppe Roberto D'Agostino, Luca Triggiani, Renzo Corvò, Stefano Maria Magrini, Filippo Alongi
AIMS: To investigate the role of Radiation Oncology in the management of genito-urinary (GU) cancer excluding prostate and penile cancer. METHODS: The questionnaire was focused on the evaluation of the degree of involvement of radiation oncologists in the work-up of bladder, renal cell carcinoma and testicular cancer (TC). RESULTS: Eighty-eight radiation oncologists completed the survey. The majority (85.4%) of participating radiation oncologists were senior consultants (> 5 years of experience)...
July 13, 2018: La Radiologia Medica
Jimmy Ruiz, Antonius A Miller, Janet A Tooze, Sandrine Crane, William J Petty, Ajeet Gajra, Heidi D Klepin
BACKGROUND: Improved assessment strategies are needed to individualize treatment for adults of all ages receiving palliative chemotherapy for non-small cell lung cancer (NSCLC). Our aim was to evaluate the utility of the Fried Frailty Index (FFI) and a cancer-specific geriatric assessment (GA) to predict chemotherapy toxicity and overall survival (OS). METHODS: We conducted a multi-site pilot study of 50 patients with newly diagnosed advanced NSCLC, age ≥ 18 years...
July 10, 2018: Journal of Geriatric Oncology
Mediget Teshome
The role of operative therapy in stage IV breast cancer continues to evolve with advances in therapy and improvements in survival among this population. Traditionally surgery was performed with palliative intent to alleviate symptoms related to the intact breast primary. Several retrospective studies have challenged this paradigm, demonstrating survival advantage with surgery in de novo metastatic disease. Prospective studies are ongoing and maturing data. A comprehensive approach to local therapy following systemic therapy may be beneficial to achieve improved survival outcome associated with stage IV- no evidence of disease and to decrease local failure in inflammatory breast cancer...
August 2018: Surgical Clinics of North America
Barbara A Jack, Tracy K Mitchell, Mary R O'Brien, Sergio A Silverio, Katherine Knighting
BACKGROUND: Good end-of-life care planning is vital to ensure optimal care is provided for patients and their families. Two key factors are open and honest advance care planning conversations between the patient (where possible), family, and health care professionals, focusing on exploring what their future wishes are; and the development of an advance care plan document. However, in paediatric and neonatal settings, there has been little research to demonstrate how advance care planning conversations take place...
July 13, 2018: BMC Palliative Care
William J Archibald, Philip J Meacham, AnnaLynn M Williams, Andrea M Baran, Adrienne I Victor, Paul M Barr, Deepak M Sahasrahbudhe, Clive S Zent
Melanoma is significantly more common and is associated with a poorer prognosis in patients with an underlying B-cell malignancy. This study reports on the management of patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL) and a subsequent diagnosis of melanoma. In the Wilmot Cancer Institute CLL cohort, which includes 470 patients followed for 2849 person-years, 18 patients (3.8%) developed 22 melanomas. Fourteen melanomas were invasive, a significantly higher rate as compared with the age and sex matched general population (standardized incidence ratio [SIR] 6...
July 6, 2018: Leukemia Research
Christa Schorr, Mark Angelo
No abstract text is available yet for this article.
August 2018: Critical Care Medicine
Kirstine Skov Benthien, Mathilde Adsersen, Morten Aagaard Petersen, Eva Soelberg Vadstrup, Per Sjøgren, Mogens Groenvold
BACKGROUND: The use of chemotherapy in the last 14 days of life should be as low as possible. AIM: To study the factors related to the use of chemotherapy in the last 14 days of life and the factors related to concurrent antineoplastic treatment and specialized palliative care. DESIGN: This was a population-based cohort study. The data were collected from the Danish Register of Causes of Death, the Danish National Patient Register, and the Danish Palliative Care Database...
July 1, 2018: Palliative Medicine
Muhammad Farhan Khaliq, Rayan E Ihle, James Perry
Strongyloides stercoralis is an endemic parasitic infection that can remain asymptomatic for years, but it can cause death in immunosuppressed individuals. Here, we present a case of Strongyloides hyperinfection in a 75-year-old male secondary to sepsis and chronic immunosuppression due to TNF- α inhibitors. Despite aggressive treatment including broad-spectrum antibiotics and antihelminths, his respiratory failure worsened and he died after palliative extubation. S. stercoralis infection remains a diagnostic challenge...
2018: Case Reports in Infectious Diseases
Matthew Farag, Anthony Ta, Siva Shankar, Lih-Ming Wong
We report a case of rapidly growing sarcoma that resulted in mortality only 6 years after radiotherapy for low-grade prostate cancer.At the age of 69 years and a prostate-specific antigen (PSA) that had risen to 9.0 µg/L, transrectal ultrasound-guided biopsy of the prostate found a single core of Gleason 3+3 disease involving 4 mm of a 10 mm core. The patient declined active surveillance and completed 78 Gy of external beam radiotherapy over 39 fractions to a prostate volume of 46 mL.His PSA nadir was 0...
July 11, 2018: BMJ Case Reports
C Le Fèvre, D Antoni, A Thiéry, G Noël
External beam radiation therapy is an efficient treatment, which relieves pain associated with bone metastases, and is prescribed in worldwide. Although bone metastases palliative irradiation recommendations exist, international clinical practices remain variable. The purpose of this article is to show the clinical practices evolution though clinical trials, cost studies and techniques' progression.
July 9, 2018: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
Alessandro Laviano, Luca Di Lazzaro, Angela Koverech
Newly diagnosed cancer patients are frequently found suffering from a metastatic disease, which poses additional challenges to the delivery of effective therapies. Chemotherapy and radiotherapy are associated with side effects which reduce tolerance to treatment and likelihood of tumour response. Identifying preventable factors of reduced response to therapy would translate into better care of cancer patients. Among other factors, malnutrition, as diagnosed by non-volitional weight loss, and cachexia, as revealed by sarcopenia, are universally recognised negative prognostic factors...
July 13, 2018: Proceedings of the Nutrition Society
Brian N Fink, Paul P Rega, Martha E Sexton, Carolina Wishner
IntroductionWhile the art and science of disaster triage continue to evolve, the education of the US health care student in matters pertaining to disaster preparedness and response remains stifled. Unfortunately, these students will be assuming major decision-making responsibilities regarding catastrophes that will be complicated by climate change, nuclear threats, global terrorism, and pandemics. Meanwhile, Sort, Assess, Life-Saving Interventions, Treatment, and/or Transport (SALT) triage is being advocated over the globally popular Simple Triage and Rapid Treatment (START) algorithm for multiple reasons: (1) it's an all-hazard approach; (2) it has four medical interventions; and (3) it has an additional triage color for victims with non-survivable injuries...
July 13, 2018: Prehospital and Disaster Medicine
Katja Krug, René Alexander Ballhausen, Regine Bölter, Peter Engeser, Michel Wensing, Joachim Szecsenyi, Frank Peters-Klimm
BACKGROUND: Family caregivers (FCGs) of patients at the end of life (EoL) cared for at home receive support from professional and non-professional care providers. Healthcare providers in general practice play an important role as they coordinate care and establish contacts between the parties concerned. To identify potential intervention targets, this study deals with the challenges healthcare providers in general practice face in EoL care situations including patients, caregivers and networks...
July 13, 2018: BMC Family Practice
Sofia Nissmark, Agneta Malmgren Fänge
BACKGROUND: Today people can live a long time with a chronic cancer diagnosis, and it affects the entire family. Family members to patients in palliative care often have to leave valued occupations due to lack of time and energy, while new roles are forced upon them, potentially affecting their health. OBJECTIVE: To explore occupational balance, needs and roles among family members to persons in palliative care. METHODS: Six semi-structured interviews were conducted with family members to terminally ill persons enrolled to specialized palliative care...
July 13, 2018: Scandinavian Journal of Occupational Therapy
Xavier Gómez-Batiste, Carles Blay, Marc Antoni Broggi, Cristina Lasmarias, Laura Vila, Jordi Amblàs, Joan Espaulella, Xavier Costa, Marisa Martínez-Muñoz, Bernabé Robles, Salvador Quintana, Joan Bertran, Francesc Torralba, Carmen Benito, Nuria Terribas, Josep Maria Busquets, Carles Constante
Palliative care must be early applied to all types of advanced chronic and life limited prognosis patients, present in all health and social services. Patients' early identification and registry allows introducing palliative care gradually concomitant with other measures. Patients undergo a systematic and integrated care process, meant to improve their life quality, which includes multidimensional assessment of their needs, recognition of their values and preferences for advance care planning purposes, treatments review, family care, and case management...
January 1, 2018: Journal of Palliative Care
C J Lucas, P Galettis, J Schneider
There is increasing interest in the use of cannabinoids for disease and symptom management, but limited information available regarding their pharmacokinetics and pharmacodynamics to guide prescribers. Cannabis medicines contain a wide variety of chemical compounds, including the cannabinoids delta-9-tetrahydrocannabinol (THC), which is psychoactive, and the non-psychoactive cannabidiol (CBD). Cannabis use is associated with both pathological and behavioural toxicity and accordingly, is contraindicated in the context of significant psychiatric, cardiovascular, renal or hepatic illness...
July 12, 2018: British Journal of Clinical Pharmacology
Ambra Mara Giovannetti, Claudia Borreani, Elisabetta Bianchi, Andrea Giordano, Sabina Cilia, Susanna Cipollari, Ilaria Rossi, Claudia Cavallaro, Valentina Torri Clerici, Edoardo Rossetti, Maria Consiglia Stefanelli, Amadio Totis, Angelo Pappalardo, Gina Occhipinti, Paolo Confalonieri, Simone Veronese, Maria Grazia Grasso, Francesco Patti, Paola Zaratin, Mario Alberto Battaglia, Alessandra Solari
BACKGROUND: We performed a qualitative study to investigate the experiences of participants in a multicentre randomized controlled trial on a home-based palliative approach (HPA) for adults with severe multiple sclerosis (MS) and their caregivers. Our aim was to explore the strengths and challenges of the intervention, and circumstances that may have influenced its efficacy. METHODS: Participants to the qualitative study were the patients, their caregivers, patient referring physicians, and the teams who delivered the HPA intervention...
2018: PloS One
Alvin Y Chan, John D Rolston, Brian Lee, Sumeet Vadera, Dario J Englot
OBJECTIVE Corpus callosotomy is a palliative surgery for drug-resistant epilepsy that reduces the severity and frequency of generalized seizures by disconnecting the two cerebral hemispheres. Unlike with resection, seizure outcomes remain poorly understood. The authors systematically reviewed the literature and performed a meta-analysis to investigate rates and predictors of complete seizure freedom and freedom from drop attacks after corpus callosotomy. METHODS PubMed, Web of Science, and Scopus were queried for primary studies examining seizure outcomes after corpus callosotomy published over 30 years...
June 1, 2018: Journal of Neurosurgery
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