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Death and dying

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https://www.readbyqxmd.com/read/29775791/an-imaging-biomarker-for-assessing-hepatic-function-in-patients-with-primary-sclerosing-cholangitis
#1
Jennifer Schulze, Henrike Lenzen, Jan B Hinrichs, Burckhardt Ringe, Michael P Manns, Frank Wacker, Kristina I Ringe
BACKGROUND & AIMS: We aimed to evaluate the potential of hepatobiliary phase magnetic resonance imaging (MRI) as parameter for assessment of hepatocellular function in patients with primary sclerosing cholangitis (PSC). METHODS: We collected data from 111 patients (83 male, 28 female; median, 44 years old), from March 2012 through March 2016, with a confirmed diagnosis of PSC who underwent MRI evaluation before and after injection (hepatobiliary phase) of a hepatocyte-specific contrast agent (gadoxetate disodium)...
May 15, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29775692/exploring-canadian-physicians-experiences-providing-medical-assistance-in-dying-a-qualitative-study
#2
Narges Khoshnood, Marie-Clare Hopwood, Bhadra Lokuge, Allison Kurahashi, Anastasia Tobin, Sarina Isenberg, Amna Husain
CONTEXT: MAiD allows a practitioner to administer or prescribe medication for the purpose of ending a patient's life. In 2016, Canada was the latest country, following several European countries and American states, to legalize physician-assisted death. Although some studies report on physician attitudes towards MAiD or describe patient characteristics, there are few that explore the professional challenges faced by physicians who provide MAiD. OBJECTIVES: To explore the professional challenges faced by Canadian physicians who provide MAiD...
May 15, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29775674/the-prognostic-value-of-the-frontal-qrs-t-angle-is-comparable-to-cardiovascular-autonomic-neuropathy-regarding-long-term-mortality-in-people-with-diabetes-a-population-based-study
#3
O May, C B Graversen, M Ø Johansen, H Arildsen
Cardiovascular autonomic neuropathy (CAN) is a well known prognostic marker in diabetes. A large angle between the QRS- and the T-wave vector (QRS-T angle) in the electrocardiogram (ECG) has recently been introduced as another marker of poor prognosis. AIM: To assess and compare the long-term predictive power of the frontal plane QRS-T angle with CAN in people with diabetes. METHODS: In 1992-93 people with diabetes in the municipality of Horsens, Denmark, were identified by the prescription method andan age and gender stratified sample of 240 individuals with diabetes were randomly selected...
May 15, 2018: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/29775594/embryogenesis-and-adult-life-in-the-absence-of-intrinsic-apoptosis-effectors-bax-bak-and-bok
#4
Francine F S Ke, Hannah K Vanyai, Angus D Cowan, Alex R D Delbridge, Lachlan Whitehead, Stephanie Grabow, Peter E Czabotar, Anne K Voss, Andreas Strasser
Intrinsic apoptosis, reliant on BAX and BAK, has been postulated to be fundamental for morphogenesis, but its precise contribution to this process has not been fully explored in mammals. Our structural analysis of BOK suggests close resemblance to BAX and BAK structures. Notably, Bok-/- Bax-/- Bak-/- animals exhibited more severe defects and died earlier than Bax-/- Bak-/- mice, implying that BOK has overlapping roles with BAX and BAK during developmental cell death. By analyzing Bok-/- Bax-/- Bak-/- triple-knockout mice whose cells are incapable of undergoing intrinsic apoptosis, we identified tissues that formed well without this process...
May 17, 2018: Cell
https://www.readbyqxmd.com/read/29774592/risk-factors-for-stroke-on-left-ventricular-assist-devices
#5
Muath Bishawi, Jeremy Joseph, Chetan Patel, Jacob Schroder, Mani Daneshmand, Dawn Bowles, Joseph Rogers, Carmelo Milano
BACKGROUND: Patients with end-stage heart failure on left ventricular assist devices (LVADs) are predisposed to a high incidence of stroke. Preoperative factors associated with increased stroke risk are poorly understood. METHODS: We performed a single-center retrospective review of all patients from 2009 to 2014 in whom a rotary flow LVAD was implanted. All patients with symptoms of a cerebrovascular event underwent a non-contrast head computed tomography scan...
May 17, 2018: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29774467/recent-diabetes-related-mortality-trends-in-romania
#6
Sorin Ioacara, Elisabeta Sava, Olivia Georgescu, Anca Sirbu, Simona Fica
AIMS: As there are no published articles on country-level diabetes-related mortality in Romania, we aimed to investigate this aspect for the 1998-2015 period. METHODS: Anonymized demographic and diabetes-related mortality data (underlying or first secondary cause of death) were retrospectively obtained from the National Institute of Statistics/Eurostat microdata. Age-standardized mortality rates (ASMR) and their annual percentage change (APC) were analysed. RESULTS: During 1998-2015, 4,567,899 persons died in Romania, among whom, diabetes was responsible for 168,854 cases...
May 17, 2018: Acta Diabetologica
https://www.readbyqxmd.com/read/29773781/clinicopathological-characteristics-of-traumatic-head-injury-in-juvenile-middle-aged-and-elderly-individuals
#7
Jiawen Wang, Feng Han, Qian Zhao, Bin Xia, Jialin Dai, Qian Wang, Shimei Huang, Cuiyun Le, Zhu Li, Jiangjin Liu, Ming Yang, Changwu Wan, Jie Wang
BACKGROUND Traumatic head injury is a leading cause of death and disability worldwide. How clinicopathological features differ by age remains unclear. This epidemiological study analyzed the clinicopathological features of patients with head injury belonging to 3 age groups. MATERIAL AND METHODS Data of patients with traumatic head injury were obtained from the Department of Cerebral Surgery of the Affiliated Hospital of Guizhou Medical University and the Guizhou Provincial People's Hospital in 2011-2015. Their clinicopathological parameters were assessed...
May 18, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29773431/preoperative-frailty-assessment-predicts-loss-of-independence-after-vascular-surgery
#8
Graham W Donald, Amir A Ghaffarian, Farid Isaac, Larry W Kraiss, Claire L Griffin, Brigitte K Smith, Mark R Sarfati, Julie L Beckstrom, Benjamin S Brooke
OBJECTIVE: Frailty, a clinical syndrome associated with loss of metabolic reserves, is prevalent among patients who present to vascular surgery clinics for evaluation. The Clinical Frailty Scale (CFS) is a rapid assessment method shown to be highly specific for identifying frail patients. In this study, we sought to evaluate whether the preoperative CFS score could be used to predict loss of independence after major vascular procedures. METHODS: We identified all patients living independently at home who were prospectively assessed using the CFS before undergoing an elective major vascular surgery procedure (admitted for >24 hours) at an academic medical center between December 2015 and December 2017...
May 14, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29773072/formal-procedure-to-facilitate-the-decision-to-withhold-or-withdraw-life-sustaining-interventions-in-a-neonatal-intensive-care-unit-a-seven-year-retrospective-study
#9
G Sorin, R Vialet, B Tosello
BACKGROUND: Neonatal deaths are often associated with the complex decision to limit or withdraw life-sustaining interventions (LSIs) rather than therapeutic impasses. Despite the existence of a law, significant disparities in clinical procedures remain. This study aimed to assess deaths occurring in a Neonatal Intensive Care Unit (NICU) and measure the impact of a traceable Limitation or Withdrawal of Active Treatment (LWAT) file on the treatment of these newborns. METHODS: In this monocentric retrospective study, we reviewed all consecutive neonatal deaths occurring during two three-year periods among patients in the NICU at the North Hospital of Marseille: cohort 1 (from 2009 to 2011 without the LWAT file) and cohort 2 (from 2013 to 2015 after introduction of the LWAT file)...
May 17, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29772911/the-incidence-and-impact-of-implantable-cardioverter-defibrillator-shocks-in-the-last-phase-of-life-an-integrated-review
#10
Rik Stoevelaar, Arianne Brinkman-Stoppelenburg, Rohit E Bhagwandien, Rozemarijn L van Bruchem-Visser, Dominic Amj Theuns, Agnes van der Heide, Judith Ac Rietjens
BACKGROUND: Although the implantable cardioverter defibrillator is successful in terminating life threatening arrhythmias, it might give unwanted shocks in the last phase of life if not deactivated in a timely manner. AIMS: This integrated review aimed to provide an overview of studies reporting on implantable cardioverter defibrillator shock incidence and impact in the last phase of life. METHODS AND RESULTS: We systematically searched five electronic databases...
May 1, 2018: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/29772556/perinatal-brain-injury-mechanisms-and-therapeutic-approaches
#11
Joanne O Davidson, Justin M Dean, Mhoyra Fraser, Guido Wassink, Ted C Andelius, Simerdeep K Dhillon, Laura Bennet, Alistair Jan Gunn
Brain damage resulting from perinatal hypoxia-ischemia evolves slowly over time. While a small number of brain cells may die during a sufficiently profound period of hypoxia-ischemia, many will show initial recovery during a "latent" phase characterized by actively suppressed neural metabolism and activity. Critically, this transient recovery may be followed after ~6 hours by a phase of secondary deterioration, with delayed seizures, failure of mitochondrial function, cytotoxic edema, and bulk cell death over ~72 hours...
June 1, 2018: Frontiers in Bioscience (Landmark Edition)
https://www.readbyqxmd.com/read/29770601/prehospital-identification-of-factors-associated-with-death-during-one-year-follow-up-after-acute-stroke
#12
Per-Olof Hansson, Magnus Andersson Hagiwara, Peter Brink, Johan Herlitz, Birgitta Wireklint Sundström
OBJECTIVES: In acute stroke, the risk of death and neurological sequelae are obvious threats. The aim of the study was to evaluate the association between various clinical factors identified by the emergency medical service (EMS) system before arriving at hospital and the risk of death during the subsequent year among patients with a confirmed stroke. MATERIAL AND METHODS: All patients with a diagnosis of stroke as the primary diagnosis admitted to a hospital in western Sweden (1...
May 16, 2018: Brain and Behavior
https://www.readbyqxmd.com/read/29770360/biomarkers-associated-with-death-after-initiating-treatment-for-tuberculosis-and-hiv-in-patients-with-very-low-cd-4-cells
#13
Fred R Sattler, Daniel Chelliah, Xingye Wu, Alejandro Sanchez, Michelle A Kendall, Evelyn Hogg, David Lagat, Umesh Lalloo, Valdilea Veloso, Diane V Havlir, Alan Landay
Background: The risk of short-term death for treatment naive patients dually infected with Mycobacterium tuberculosis and HIV may be reduced by early anti-retroviral therapy. Of those dying, mechanisms responsible for fatal outcomes are unclear. We hypothesized that greater malnutrition and/or inflammation when initiating treatment are associated with an increased risk for death. Methods: We utilized a retrospective case-cohort design among participants of the ACTG A5221 study who had baseline CD4 < 50 cells/mm3 ...
2018: Pathogens & Immunity
https://www.readbyqxmd.com/read/29770057/aids-in-canada-surveillance-report-2016
#14
L Jonah, A C Bourgeois, M Edmunds, A Awan, O Varsaneux, W Siu
Background: Although there continues to be a global epidemic of people living with human immunodeficiency virus (HIV) there has been a decrease in the number of people dying of acquired immunodeficiency syndrome (AIDS), largely due to successful treatment with antiretroviral therapy. Objective: To provide a descriptive overview of the reported cases of AIDS in Canada by identifying trends by geographic location, sex, age group and mortality. While the descriptive analysis focuses on the year 2016, results are presented for reported cases from the beginning of national AIDS surveillance in 1979...
December 7, 2017: Canada Communicable Disease Report, Relevé des Maladies Transmissibles Au Canada
https://www.readbyqxmd.com/read/29769748/comparative-ecologic-relationships-of-saturated-fat-sucrose-food-groups-and-a-mediterranean-food-pattern-score-to-50-year-coronary-heart-disease-mortality-rates-among-16-cohorts-of-the-seven-countries-study
#15
Daan Kromhout, Alessandro Menotti, Adalberta Alberti-Fidanza, Paolo Emilio Puddu, Peter Hollman, Anthony Kafatos, Hanna Tolonen, Hisashi Adachi, David R Jacobs
BACKGROUND/OBJECTIVES: We studied the ecologic relationships of food groups, macronutrients, eating patterns, and an a priori food pattern score (Mediterranean Adequacy Index: MAI) with long-term CHD mortality rates in the Seven Countries Study. SUBJECTS/METHODS: Sixteen cohorts (12,763 men aged 40-59 years) were enrolled in the 1960s in seven countries (US, Finland, The Netherlands, Italy, Greece, former Yugoslavia: Croatia/Serbia, Japan). Dietary surveys were carried out at baseline and only in a subsample of each cohort...
May 17, 2018: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/29769597/long-term-risk-for-end-stage-kidney-disease-and-death-in-a-large-population-based-cohort
#16
Emanuel Zitt, Constanze Pscheidt, Hans Concin, Reinhard Kramar, Raphael S Peter, Jan Beyersmann, Karl Lhotta, Gabriele Nagel
Knowledge of metabolic risk factors for end-stage kidney disease (ESKD) in the general population is limited when considering the competing event death in risk analysis. The aim of our prospective observational study was to investigate how blood pressure and metabolic factors might influence the risks for ESKD and death before ESKD in a large Austrian population-based cohort with long-term follow-up. 177,255 participants (53.8% women; mean age 42.5 years) were recruited between 1988 and 2005 and linked to the Austrian Dialysis and Transplant Registry and the National Mortality Registry...
May 16, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29769257/optimum-hospice-at-home-services-for-end-of-life-care-protocol-of-a-mixed-methods-study-employing-realist-evaluation
#17
Claire Butler, Charlotte Brigden, Heather Gage, Peter Williams, Laura Holdsworth, Kay Greene, Bee Wee, Stephen Barclay, Patricia Wilson
INTRODUCTION: Hospice at home (HAH) services aim to enable patients to be cared for and die in their place of choice, if that is at home, and to achieve a 'good death'. There is a considerable range of HAH services operating in England. The published evidence focuses on evaluations of individual services which vary considerably, and there is a lack of consistency in terms of the outcome measures reported. The evidence, therefore, does not provide generalisable information, so the question 'What are the features of hospice at home service models that work, for whom, and under what circumstances?' remains unanswered...
May 16, 2018: BMJ Open
https://www.readbyqxmd.com/read/29768580/factors-associated-with-loss-to-follow-up-and-death-in-cases-of-drug-resistant-tuberculosis-dr-tb-treated-at-a-reference-center-in-rio-de-janeiro-brazil
#18
Paulo Victor de Sousa Viana, Paulo Redner, Jesus Pais Ramos
Drug-resistant tuberculosis (DR-TB) poses a serious threat to tuberculosis (TB) control in Brazil and worldwide. The current study investigated factors associated with loss to follow-up and death in the course of treatment for DR-TB in a tertiary reference center in the city of Rio de Janeiro, Brazil. This was a retrospective cohort study of cases reported to the Information System on Special Treatments for Tuberculosis (SITETB) from January 1, 2012, to December 31, 2013. A total of 257 patients were reported to the SITETB and initiated treatment for DR-TB...
May 10, 2018: Cadernos de Saúde Pública
https://www.readbyqxmd.com/read/29768547/clinical-outcomes-and-risk-factors-for-death-from-disseminated-histoplasmosis-in-patients-with-aids-who-visited-a-high-complexity-hospital-in-campo-grande-ms-brazil
#19
Barbara Cristina Scarcelli Boigues, Anamaria Mello Miranda Paniago, Gláucia Moreira Espíndola Lima, Maina de Oliveira Nunes, Silvia Naomi de Oliveira Uehara
INTRODUCTION: Disseminated histoplasmosis (DH) is a systemic mycosis caused by Histoplasma capsulatum (H. capsulatum) and is characterized by progressive and fatal evolution in immunocompromised patients. Moreover, it is considered an AIDS-defining disease. METHODS: We performed an observational, analytical, retrospective study to identify the clinical outcomes and risk factors for death from DH in patients with AIDS at an infectious diseases service facility in Brazil between September 2011 and July 2016...
March 2018: Revista da Sociedade Brasileira de Medicina Tropical
https://www.readbyqxmd.com/read/29768405/pathology-and-causes-of-death-in-stranded-humpback-whales-megaptera-novaeangliae-from-brazil
#20
Kátia Regina Groch, Josué Díaz-Delgado, Milton C C Marcondes, Adriana Castaldo Colosio, Elitieri B Santos-Neto, Vítor Luz Carvalho, Gisele Silva Boos, Ana Carolina Oliveira de Meirelles, Hernani Gomes da Cunha Ramos, Juliana Plácido Guimarães, João Carlos Gomes Borges, Jociery Einhardt Vergara-Parente, Judy A St Leger, Antonio Fernández, José Luiz Catão-Dias
This study describes the pathologic findings of 24 humpback whales (Megaptera novaeangliae) found stranded along the Brazilian coast from 2004 to 2016. Eighteen (75%) animals evaluated were found stranded alive. From these, 13 died naturally on shore and five were euthanized. Six died at sea and were washed ashore. Of the 24, 19 (79.2%) were calves, four (16.7%) were juveniles, and one (4.2%) was an adult. The most probable cause of stranding and/or death (CSD) was determined in 23/24 (95.8%) individuals. In calves, CSD included neonatal respiratory distress (13/19; 68...
2018: PloS One
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