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https://www.readbyqxmd.com/read/29907553/development-and-evaluation-of-an-ethical-guideline-for-decisions-to-limit-life-prolonging-treatment-in-advanced-cancer-protocol-for-a-monocentric-mixed-method-interventional-study
#1
Katsiaryna Laryionava, Katja Mehlis, Elena Bierwirth, Friederike Mumm, Wolfgang Hiddemann, Pia Heußner, Eva C Winkler
BACKGROUND: Many patients with advanced cancer receive chemotherapy close to death and are referred too late to palliative or hospice care, and therefore die under therapy or in intensive care units. Oncologists still have difficulties in involving patients appropriately in decisions about limiting tumor-specific or life-prolonging treatment. OBJECTIVE: The aim of this Ethics Policy for Advanced Care Planning and Limiting Treatment Study is to develop an ethical guideline for end-of-life decisions and to evaluate the impact of this guideline on clinical practice regarding the following target goals: reduction of decisional conflicts, improvement of documentation transparency and traceability, reduction of distress of the caregiver team, and better knowledge and consideration of patients' preferences...
June 15, 2018: JMIR Research Protocols
https://www.readbyqxmd.com/read/29905501/top-ten-tips-palliative-care-clinicians-should-know-about-interventional-symptom-management-options-when-caring-for-patients-with-gastrointestinal-malignancies
#2
Alyson M Johnson, Joshua P Spaete, Paul S Jowell, Arif H Kamal, Deborah A Fisher
Patients diagnosed with advanced stages of gastrointestinal (GI) malignancies are often quite symptomatic, with symptoms primarily related to anatomic sites of obstruction. Endoscopic approaches to the palliation of GI malignancies have begun to overtake surgical approaches as first line in interventional management. We brought together a team of interventional gastroenterologists and palliative care experts to collate practical pearls for the types of endoscopic interventions used for symptom management in patients with GI malignancies...
June 15, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29904292/chronic-peritoneal-indwelling-catheters-for-the-management-of-malignant-and-nonmalignant-ascites
#3
REVIEW
Joseph Caldwell, Hawa Edriss, Kenneth Nugent
Ascites is a debilitating condition affecting patients with end-stage liver disease and advanced abdominal malignancies. Serial paracentesis can reduce symptoms in these patients; indwelling peritoneal catheters provide an alternative approach that allows patients to manage their symptoms at home. A literature search was conducted to identify studies with at least 20 patients published in the last 15 years that reported indwelling catheter placement in patients with chronic ascites. Fourteen studies with 957 patients (687 with malignancy and 270 with cirrhosis) were reviewed...
July 2018: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/29904105/an-interdisciplinary-consensus-on-the-management-of-bone-metastases-from-renal-cell-carcinoma
#4
REVIEW
Viktor Grünwald, Berit Eberhardt, Axel Bex, Anne Flörcken, Thomas Gauler, Thorsten Derlin, Martin Panzica, Hans Roland Dürr, Knut Achim Grötz, Rachel H Giles, Christian von Falck, Anno Graser, Alexander Muacevic, Michael Staehler
Bone is a major site of haematogenous tumour cell spread in renal cell carcinoma (RCC), and most patients with RCC will develop painful and functionally disabling bone metastases at advanced disease stages. The prognosis of these patients is generally poor and the treatment is, therefore, aimed at palliation. However, RCC-associated bone metastases can be curable in select patients. Current data support a multimodal management strategy that includes wide resection of lesions, radiotherapy, systemic therapy, and other local treatment options, which can improve quality of life and survival...
June 14, 2018: Nature Reviews. Urology
https://www.readbyqxmd.com/read/29903540/the-role-of-the-nurse-at-the-end-of-the-life-of-a-critically-ill-patient
#5
M González-Rincón, P Díaz de Herrera-Marchal, M L Martínez-Martín
OBJECTIVE: Analyze the role of the nurse at the end of the life of a critically ill patient. METHOD: Bibliographic review from a search of the health science databases such as PubMed, CINAHL, Cuiden, Scopus, Cochrane, as well as specialized platforms, general and thematic browsers. The limits were language (English or Spanish) and publication date (2005-2015). RESULTS: 180 articles met the inclusion criteria, and 16 of them were selected for analysis...
June 11, 2018: Enfermería Intensiva
https://www.readbyqxmd.com/read/29899281/integrative-approaches-in-pediatric-palliative-care
#6
Kate Shafto, Suzanne Gouda, Kris Catrine, Melanie L Brown
Pediatric palliative care is a field which focuses on caring for and treating the symptoms and distress typically associated with life-limiting illness. Integrative medicine is supported by evidence and aims to heal the whole person, including all aspects of one’s lifestyle. Therapies offered by integrative medicine often empower patients and families, allowing for a sense of control. This review addresses the merging of integrative medicine philosophy and modalities with the care given to children with life-limiting illness...
June 13, 2018: Children
https://www.readbyqxmd.com/read/29898674/early-and-late-signs-that-precede-dying-among-older-persons-in-nursing-homes-the-multidisciplinary-team-s-perspective
#7
Helene Åvik Persson, Anna Sandgren, Carl-Johan Fürst, Gerd Ahlström, Lina Behm
BACKGROUND: Nursing home residents in Sweden are old, frail and usually have multiple morbidities which often make dying a prolonged suffering. It has been found that older persons at nursing homes receive far less palliative care than younger persons, partly because it is difficult to identify when the final stage of life begins. The identification may help the staff to enable the older person and their families to participate in planning the care in accordance with their own preferences and values...
June 4, 2018: BMC Geriatrics
https://www.readbyqxmd.com/read/29893776/quality-of-primary-palliative-care-for-older-people-with-mild-and-severe-dementia-an-international-mortality-follow-back-study-using-quality-indicators
#8
Rose Miranda, Yolanda W H Penders, Tinne Smets, Luc Deliens, Guido Miccinesi, Tomás Vega Alonso, Sarah Moreels, Lieve Van den Block
Background: measuring the quality of primary palliative care for older people with dementia in different countries is important to identify areas where improvements can be made. Objective: using quality indicators (QIs), we systematically investigated the overall quality of primary palliative care for older people with dementia in three different countries. Design/setting: a mortality follow-back survey through nation- and region-wide representative Sentinel Networks of General Practitioners (GPs) in Belgium, Italy and Spain...
June 8, 2018: Age and Ageing
https://www.readbyqxmd.com/read/29889256/hybrid-therapy-for-metastatic-epidural-spinal-cord-compression-technique-for-separation-surgery-and-spine-radiosurgery
#9
Ori Barzilai, Ilya Laufer, Adam Robin, Ran Xu, Yoshiya Yamada, Mark H Bilsky
BACKGROUND: Despite major advances in radiation and systemic treatments, surgery remains a critical step in the multidisciplinary treatment of metastatic spinal cord tumors. OBJECTIVE: To describe the indications, rationale, and technique of "hybrid therapy" (separation surgery and concomitant spine stereotactic radiosurgery [SRS]) along with practical nuances. METHODS: Separation surgery describes a posterolateral approach for circumferential epidural decompression and stabilization...
June 8, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29888803/the-effectiveness-of-exercise-based-rehabilitation-to-patients-with-myeloproliferative-neoplasms-an-explorative-study
#10
Kasper Mønsted Pedersen, Graziella Zangger, Nana Brochmann, Birk Mygind Grønfeldt, Ann-Dorthe Zwisler, Hans Carl Hasselbalch, Lars Hermann Tang
The aim of the study was to determine the impact of an interdisciplinary exercise-based rehabilitation intervention on fatigue and quality of life (QOL) in patients with Philadelphia-negative myeloproliferative neoplasms (MPNs). At the Danish Knowledge Centre for Rehabilitation and Palliative Care, a 5-day interdisciplinary exercise-based rehabilitation intervention was carried out on 48 patients with MPN. It was followed by 12 weeks of self-exercising prior to follow-up. Initially and at follow-up, participants filled out validated questionnaires; Brief Fatigue Inventory, Multidimensional Fatigue Inventory, European Organization for Research and Treatment of Cancer Quality-of-Life questionnaire, Myeloproliferative Neoplasm Symptom Assessment Form and Hospital Anxiety and Depression Scale...
June 11, 2018: European Journal of Cancer Care
https://www.readbyqxmd.com/read/29887891/malignant-bowel-obstruction-in-advanced-gynecologic-cancers-an-updated-review-from-a-multidisciplinary-perspective
#11
REVIEW
Yeh Chen Lee, Nazlin Jivraj, Catherine O'Brien, Tanya Chawla, Eran Shlomovitz, Sarah Buchanan, Jenny Lau, Jennifer Croke, Johane P Allard, Preeti Dhar, Stephane Laframboise, Sarah E Ferguson, Neesha Dhani, Marcus Butler, Pamela Ng, Terri Stuart-McEwan, Pamela Savage, Lisa Tinker, Amit M Oza, Stephanie Lheureux
Malignant bowel obstruction (MBO) is a major complication in women with advanced gynecologic cancers which imposes a significant burden on patients, caregivers, and healthcare systems. Symptoms of MBO are challenging to palliate and result in progressive decompensation of already vulnerable patients with limited therapeutic options and a short prognosis. However, there is a paucity of guidelines or innovative approaches to improve the care of women who develop MBO. MBO is a complex clinical situation that requires a multidisciplinary approach to ensure the appropriate treatment modality and interprofessional care to optimally manage these patients...
2018: Obstetrics and Gynecology International
https://www.readbyqxmd.com/read/29886838/new-perspectives-regarding-anaplastic-thyroid-carcinoma-approach-improvement
#12
Ana Sofia Figueiredo, Patricia Andrea-Ferreira
BACKGROUND AND OBJECTIVE: Anaplastic thyroid carcinoma is rare, but represents the deadliest type of thyroid cancer that is characterised by a rapid course. Diagnosis is usually made at a late stage, when more than half of the patients have distant metastasis. Our main purpose is to review the current information on anaplastic thyroid aetiology and risk factors that might contribute to an earlier diagnosis as well as to give new perspectives regarding the most recent treatment options and future directions...
June 10, 2018: Endocrine, Metabolic & Immune Disorders Drug Targets
https://www.readbyqxmd.com/read/29886041/outcomes-after-acute-symptomatic-seizures-in-children-admitted-to-a-neonatal-neurocritical-care-service
#13
Hannah C Glass, Adam L Numis, Dawn Gano, Varun Bali, Elizabeth E Rogers
BACKGROUND: Neonatal seizures due to acute brain injury are associated with high rates of death, disability, and epilepsy. Our objective was to examine incidence of and risk factors for epilepsy among survivors of acute symptomatic neonatal seizures who were cared for by a neonatal neurocritical care service. METHODS: Neonates with acute symptomatic seizures who were admitted to UCSF Benioff Children's Hospital Neuro-Intensive Care Nursery from July 2008 to June 2014 were considered for inclusion...
April 20, 2018: Pediatric Neurology
https://www.readbyqxmd.com/read/29882187/electroanatomic-mapping-guided-catheter-ablation-of-supraventricular-tachycardia-in-children-with-ebstein-s-anomaly
#14
Yakup Ergul, Serhat Koca, Celal Akdeniz, Volkan Tuzcu
In Ebstein's anomaly (EA), tachycardia substrates are complex, and accessory pathway (AP) ablations are often challenging. This study demonstrates the utility of the EnSite Velocity system (St. Jude Medical, St Paul, MN) in the catheter ablation of supraventricular tachycardia in children with EA. Twenty patients [Female/Male = 8/12, median age 11.5 years (2.6-18)] with EA who underwent catheter ablation guided by the EnSite Velocity system between December 2011 and December 2016 were retrospectively evaluated...
June 7, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29877219/endoscopic-and-surgical-treatment-of-benign-tracheal-stenosis-a-multidisciplinary-team-approach
#15
Cengiz Özdemir, Celalettin I Kocatürk, Sinem Nedime Sökücü, Bugra Celal Sezen, Ali Cevat Kutluk, Salih Bilen, Levent Dalar
PURPOSE: Surgical resection and reconstruction are considered the most appropriate approaches to treat post-intubation tracheal stenosis (PITS). Bronchoscopic methods can be utilized as palliative therapy in patients who are ineligible for surgical treatment or who develop post-surgical re-stenosis. We investigated treatment outcomes in patients with benign tracheal stenosis. METHODS: A retrospective review was performed in patients who were diagnosed with PITS...
June 7, 2018: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29871500/systematic-review-for-the-quality-of-end-of-life-care-for-patients-with-dementia-in-the-hospital-setting
#16
Felicity Moon, Fiona McDermott, David Kissane
BACKGROUND: Patients with dementia may receive suboptimal end-of-life care in hospital settings reflecting broader debate around the palliative status of dementia syndromes. OBJECTIVES: To synthesize literature describing the quality of end-of-life care for patients with dementia dying in hospital. METHODS: An integrative review assessed the quality of 26 articles concerning medical, nursing, and psychosocial care of patients with dementia dying in hospital settings...
January 1, 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29870302/voluntarily-stopping-eating-and-drinking-a-practical-approach-for-long-term-care-facilities
#17
David A Gruenewald
Some residents of long-term care (LTC) facilities with lethal or serious chronic illnesses may express a wish to hasten their death by voluntarily stopping eating and drinking (VSED). LTC facility clinicians, administrators, and staff must balance resident safety, moral objections to hastened death, and other concerns with resident rights to autonomy, self-determination, and bodily integrity. Initially, requests for hastened death, including VSED must be treated as opportunities to uncover underlying concerns...
June 5, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29869590/encountering-existential-loneliness-among-older-people-perspectives-of-health-care-professionals
#18
Malin Sundström, Anna-Karin Edberg, Margareta Rämgård, Kerstin Blomqvist
PURPOSE: Existential loneliness is part of being human that is little understood in health care, but, to provide good care to their older patients, professionals need to be able to meet their existential concerns. The aim of this study was to explore health care professionals' experiences of their encounters with older people they perceive to experience existential loneliness. METHOD: We conducted 11 focus groups with 61 health professionals working in home care, nursing home care, palliative care, primary care, hospital care, or pre-hospital care...
December 2018: International Journal of Qualitative Studies on Health and Well-being
https://www.readbyqxmd.com/read/29869483/pet-imaging-in-adaptive-radiotherapy-of-prostate-tumors
#19
Bettina Beuthien-Baumann, Stefan A Koerber
The integration of data from positron-emission-tomography, combined with computed tomography as PET/CT or combined with magnet resonance imaging as PET/MRI, into radiation treatment planning of prostate cancer is gaining higher impact with the development of more sensitive and specific radioligands. The classic PET-tracer for prostate cancer imaging are [11C]choline and [11C]acetate, which are currently outperformed by ligands binding to the prostate-specific- membrane-antigen (PSMA). [68Ga]PSMA-11, which is the most frequently applied tracer, has shown to detect lymph node metastases, local recurrences, distant metastases and intraprostatic foci with high sensitivity, even at relatively low PSA levels...
June 4, 2018: Quarterly Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/29865024/are-we-using-placebo-effects-in-specialized-palliative-care
#20
Jarl Sigaard, Birthe Dinesen
Background Placebo effects are positive treatment effects that occur because of the psycho-social context around the therapy. Such effects are well documented in pain treatment, as well as in the treatment of other common symptoms. Specialized Palliative Care focuses on the relief of pain and other symptoms in terminally ill cancer patients. Aims The aim of this study was to explore whether and/or how a Specialized Palliative Care Team might contribute to the creation of placebo effects. Methods The study was conducted as a qualitative study using a phenomenological/hermeneutic approach...
December 29, 2017: Scandinavian Journal of Pain
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