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palliative approach

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https://www.readbyqxmd.com/read/29679550/ct-guided-percutaneous-cryoablation-for-palliative-therapy-of-gastric-cancer-liver-metastases
#1
Xu Chang, Yan Wang, Hai-Peng Yu, Wei-Hao Zhang, Xue-Ling Yang, Zhi Guo
OBJECTIVE: Liver metastases occur in approximately 4%-14% of gastric cancer patients and are associated with high mortality. However, no standardized treatment approach is available for these patients. We aimed to assess the clinical outcomes of patients with gastric cancer liver metastases (GCLM) who underwent percutaneous cryoablation. METHODS: We retrospectively enrolled 19 patients with 27 metastatic hepatic tumors who underwent cryoablation for liver metastases after gastrectomy for primary gastric cancer...
April 18, 2018: Cryobiology
https://www.readbyqxmd.com/read/29671282/interventional-cardiology-for-congenital-heart-disease
#2
REVIEW
Damien Kenny
Congenital heart interventions are now replacing surgical palliation and correction in an evolving number of congenital heart defects. Right ventricular outflow tract and ductus arteriosus stenting have demonstrated favorable outcomes compared to surgical systemic to pulmonary artery shunting, and it is likely surgical pulmonary valve replacement will become an uncommon procedure within the next decade, mirroring current practices in the treatment of atrial septal defects. Challenges remain, including the lack of device design focused on smaller infants and the inevitable consequences of somatic growth...
March 29, 2018: Korean Circulation Journal
https://www.readbyqxmd.com/read/29669562/comfort-in-palliative-sedation-compas-a-transdisciplinary-mixed-method-study-protocol-for-linking-objective-assessments-to-subjective-experiences
#3
Stefaan Six, Steven Laureys, Jan Poelaert, Johan Bilsen, Peter Theuns, Reginald Deschepper
BACKGROUND: In case of untreatable suffering at the end of life, palliative sedation may be chosen to assure comfort by reducing the patient's level of consciousness. An important question here is whether such sedated patients are completely free of pain. Because these patients cannot communicate anymore, caregivers have to rely on observation to assess the patient's comfort. Recently however, more sophisticated techniques from the neurosciences have shown that sometimes consciousness and pain are undetectable with these traditional behavioral methods...
April 18, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29669559/exploring-the-meaning-and-practice-of-self-care-among-palliative-care-nurses-and-doctors-a-qualitative-study
#4
Jason Mills, Timothy Wand, Jennifer A Fraser
BACKGROUND: Self-care practice within the palliative care workforce is often discussed, yet seemingly under-researched. While palliative care professionals are required to implement and maintain effective self-care strategies, there appears little evidence to guide them. Moreover, there is an apparent need to clarify the meaning of self-care in palliative care practice. This paper reports qualitative findings within the context of a broader mixed-methods study. The aim of the present study was to explore the meaning and practice of self-care as described by palliative care nurses and doctors...
April 18, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29668791/spirituality-in-palliative-care-experiences-of-an-interdisciplinary-team
#5
Isabel Cristina de Oliveira Arrieira, Maira Buss Thofehrn, Adrize Rutz Porto, Pedro Márlon Martter Moura, Caroline Lemos Martins, Michelle Barboza Jacondino
Objective To understand the experience of spirituality in the daily routine of a palliative care interdisciplinary team. Method A qualitative study was conducted with an oncological palliative care team in southern Brazil. The data was collected through phenomenological interviews in 2014, and interpreted using a hermeneutic phenomenological approach. Results Six professionals participated in the study. Spiritually-related activities, such as prayer and providing comprehensive care, were useful therapeutic resources for offering comfort, survival with dignity and humanization of death, in addition to helping the team and patients understand the end-of-life process and search for meaning in the suffering caused by illness...
2018: Revista da Escola de Enfermagem da U S P
https://www.readbyqxmd.com/read/29663123/creation-of-a-restrictive-atrial-communication-in-heart-failure-with-preserved-and-mid-range-ejection-fraction-effective-palliation-of-left-atrial-hypertension-and-pulmonary-congestion
#6
Anna Bauer, Markus Khalil, Monika Lüdemann, Jürgen Bauer, Anoosh Esmaeili, Roberta De-Rosa, Norbert F Voelkel, Hakan Akintuerk, Dietmar Schranz
BACKGROUND: Left atrial decompression is considered in patients with symptomatic heart failure with preserved ejection fraction (HFpEF). We aimed to evaluate the feasibility and efficacy of transcatheter generation of a restrictive atrial septum communication to manage HFpEF from infancy to adulthood with cardiomyopathy and congenital heart defect. METHODS AND RESULTS: From June 2009 to December 2016, 24 patients (50% with an age less than 16 years) with HFpEF were palliated; NYHA-/Ross class IV (n = 10); median systemic ventricular ejection fraction 64 (range 35-78) %...
April 16, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29663037/polyfunctionality-of-cd4-t-lymphocytes-is-increased-after-chemoradiotherapy-of-head-and-neck-squamous-cell-carcinoma
#7
J Doescher, S Jeske, S E Weissinger, C Brunner, S Laban, E Bölke, T K Hoffmann, T L Whiteside, P J Schuler
BACKGROUND: For head and neck squamous cell cancer (HNSCC), standard therapy consists of surgery, radiation, and/or chemotherapy. Antineoplastic immunotherapy could be an option in an adjuvant setting and is already in palliation. A functional immune system is a prerequisite for successful immunotherapy. However, effects of the standard-of-care therapy on the patients' immune system are not fully understood. METHODS: Peripheral blood mononuclear cells (PBMC) were collected from patients with HNSCC (n = 37) and healthy controls (n = 10)...
April 16, 2018: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
https://www.readbyqxmd.com/read/29661335/head-and-neck-cancer-in-the-elderly-frailty-shared-decisions-and-avoidance-of-low-value-care
#8
REVIEW
Leila J Mady, Marci L Nilsen, Jonas T Johnson
Head and neck cancer (HNC) is a disease of older adults. Recurrent and metastatic head and neck squamous cell carcinoma portends a poor prognosis, with median overall survival of less than 12 months. Within this vulnerable population, significant treatment-related toxicities and physical and psychosocial sequelae can be devastating to quality of life at the end of life. Shared decision making and early comprehensive palliative and support services are at the crux of the approach to older adults with HNC. In doing so, low-value care that fails to meet the goals of patients and their caregivers at the end-of-life may be avoided...
May 2018: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/29656713/symptom-management-nutrition-and-hydration-at-end-of-life-a-qualitative-exploration-of-patients-carers-and-health-professionals-experiences-and-further-research-questions
#9
Jessica Baillie, Despina Anagnostou, Stephanie Sivell, Jordan Van Godwin, Anthony Byrne, Annmarie Nelson
BACKGROUND: Symptom management is an essential aspect of palliative and end-of-life care, but evidence suggests that patients' symptoms may not always be relieved, causing significant harm to patients and magnifying their relatives' distress. A growing body of evidence focuses on symptom management at the end-of-life, but research funding for palliative care remains disproportionately low. It is therefore crucial that research funding is targeted at areas of importance to patients and relatives...
April 16, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29656674/psycho-social-approach-of-perinatal-palliative-care
#10
Barthélémy Tosello, Lionel Dany
The diagnosis of some of these antenatal pathologies is difficult to reconcile with post-natal survival. Indeed, the diagnosis and management of pregnancies complicated by lethal fetal abnormalities (LFA) pose a challenge for both the parents and the clinicians. The practices discussed are characterized by the multiple challenges involved (on professional, informational, human, and ethical levels) and question the necessity and validity of a multidisciplinary approach. Revealing professional experiences and practices and the biopsychosocial processes behind them could prove useful in advancing attitudes toward LFA, how it is managed, and the care options available...
April 15, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29652733/circumstances-and-signs-of-approaching-death-in-patients-with-amyotrophic-lateral-sclerosis-undergoing-noninvasive-ventilation-in-home-care-settings
#11
Mitsuko Ushikubo
The purpose of this study was to elucidate the circumstances and symptoms of patients with amyotrophic lateral sclerosis (ALS) using noninvasive positive pressure ventilation (NPPV) in whom death was approaching, to understand how to provide palliative care to dying patients with ALS receiving NPPV management. The participants were 6 home visiting nurses who were head or subhead nurses of a home visiting nursing agency. Data were collected data conducting individual semistructured interviews and then group interviews...
April 12, 2018: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/29650936/-review-of-the-efficacy-of-endoscopic-stenting-for-malignant-colorectal-obstruction-at-tokyo-metropolitan-ohtsuka-hospital
#12
Taiki Masuda, Sakiko Yabe, Eisuke Yamamoto, Kenta Kobayashi, Tetsunori Yoshimura
BACKGROUND: The use of self-expandable metallic stent(SEMS)was first authorized by insurance and became available nationwide in Japan in 2012. Insertion of SEMS for colorectal obstruction due to colorectal cancer is useful as a bridge to surgery(BTS)approach and releases stenosis as palliative care. AIM: To assess the outcomes of SEMS placement for colorectal obstruction. PATIENTS AND METHODS: A total of 14 patients were treated with SEMS between April 2014 and March 2017...
March 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29650688/outcomes-of-elderly-patients-with-advanced-soft-tissue-sarcoma-treated-with-first-line-chemotherapy-a-pooled-analysis-of-12-eortc-soft-tissue-and-bone-sarcoma-group-trials
#13
Eugenie Younger, Saskia Litière, Axel Le Cesne, Olivier Mir, Hans Gelderblom, Antoine Italiano, Sandrine Marreaud, Robin Lewis Jones, Alessandro Gronchi, Winette T A van der Graaf
BACKGROUND: Almost half of patients diagnosed with soft tissue sarcoma (STS) are older than 65 years; however, the outcomes of elderly patients with metastatic disease are not well described. PATIENTS AND METHODS: An elderly cohort of patients aged ≥65 years was extracted from the European Organization for Research and Treatment of Cancer (EORTC) Soft Tissue and Bone Sarcoma Group database of patients treated with first-line chemotherapy for advanced STS within 12 EORTC clinical trials...
April 12, 2018: Oncologist
https://www.readbyqxmd.com/read/29649403/the-arianna-project-an-observational-study-on-a-model-of-early-identification-of-patients-with-palliative-care-needs-through-the-integration-between-primary-care-and-italian-home-palliative-care-units
#14
Gianlorenzo Scaccabarozzi, Emanuele Amodio, Giacomo Pellegrini, Fabrizio Limonta, Pierangelo Lora Aprile, Pietro Giorgio Lovaglio, Carlo Peruselli, Matteo Crippa
OBJECTIVE: The aim of this study was to illustrate the characteristics of patients with palliative care (PC) needs, early identified by general practitioners (GPs), and to analyze their care process in home PC services. BACKGROUND: Early identification and service integration are key components to providing quality palliative care (PC) services ensuring the best possible service for patients and their families. However, in Italy, PC is often provided only in the last phase of life and for oncological patients, with a fragmented service...
March 20, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29644989/the-palliative-care-in-dementia-context-health-professionals-point-of-view-about-advantages-and-resistances
#15
Sabina Zapponi, Maria Chiara Ascari, Erjona Feracaku, Silvia Masin, Paola Paglia, Roberta Petroccione, Ana Pinzaru, Chiara Foà, Giovanna Artioli, Leopoldo Sarli
BACKGROUND AND AIM: The 38/2010 law has expanded the provision of palliative care to patients with chronic-degenerative diseases. The ISTAT data show that 60% of the dying population is suffering from these diseases and could, according to the literature review, benefit particularly from such treatments. This study investigates the point of view of healthcare professionals, working in the context of dementia, regarding the knowledge and application of palliative care in the field of dementia...
March 26, 2018: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/29644005/radiofrequency-assisted-pancreaticoduodenectomy-for-palliative-surgical-resection-of-locally-advanced-pancreatic-adenocarcinoma
#16
Jayant Kumar, Isabella Reccia, Mikael H Sodergren, Tomokazu Kusano, Artur Zanellato, Madhava Pai, Duncan Spalding, Dimitris Zacharoulis, Nagy Habib
Background: Despite careful patient selection and preoperative investigations curative resection rate (R0) in pancreaticoduodenectomy ranges from 15% to 87%. Here we describe a new palliative approach for pancreaticoduodenectomy using a radiofrequency energy device to ablate tumor in situ in patients undergoing R1/R2 resections for locally advanced pancreatic ductal adenocarcinoma where vascular reconstruction was not feasible. Results: There was neither postoperative mortality nor significant morbidity...
March 20, 2018: Oncotarget
https://www.readbyqxmd.com/read/29629318/role-of-surgery-in-pancreatic-neuroendocrine-tumor
#17
REVIEW
Kai Pun Wong, Julian Shun Tsang, Brian Hung-Hin Lang
Pancreatic neuroendocrine tumours (PNETs) are rare. They are generally accepted to be slow-growing and have an indolent course. These tumours can be non-functioning or functioning, consisting of a biochemically heterogeneous group of tumours including insulinomas, gastrinomas, carcinoids and glucagonomas. Although surgery remains the mainstay of treatment, controversy still exists especially for non-functioning tumours <2 cm in size. Whether these should be resected or undergo intensive surveillance remains unclear...
February 2018: Gland Surgery
https://www.readbyqxmd.com/read/29627863/the-codesign-of-an-interdisciplinary-team-based-intervention-regarding-initiating-palliative-care-in-pediatric-oncology
#18
Douglas L Hill, Jennifer K Walter, Jessica A Casas, Concetta DiDomenico, Julia E Szymczak, Chris Feudtner
PURPOSE: Children with advanced cancer are often not referred to palliative or hospice care before they die or are only referred close to the child's death. The goals of the current project were to learn about pediatric oncology team members' perspectives on palliative care, to collaborate with team members to modify and tailor three separate interdisciplinary team-based interventions regarding initiating palliative care, and to assess the feasibility of this collaborative approach. METHODS: We used a modified version of experience-based codesign (EBCD) involving members of the pediatric palliative care team and three interdisciplinary pediatric oncology teams (Bone Marrow Transplant, Neuro-Oncology, and Solid Tumor) to review and tailor materials for three team-based interventions...
April 7, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29627436/ala-pdt-as-palliative-care-in-a-patient-with-secondary-perineum-empd
#19
Shuzhan Shen, Guolong Zhang, Peiru Wang, Yunfeng Zhang, Uma Keyal, Jie Ji, Xiuli Wang
Extramammary Paget's disease (EMPD) is a rare intraepithelial neoplasm arising in apocrine rich area of the skin. It is divided into primary and secondary EMPD based on whether there is an underlying malignancy, either local apocrine cancers or distant neoplasms. Therefore, all patients with EMPD should undergo an extensive and targeted cancer workup, depending on the histological staining pattern and the location. Surgical removal is considered the mainstay of treatment for patients with EMPD. Herein, we present a case of secondary EMPD where photodynamic therapy was effective in terms of improving symptoms and quality of life...
April 5, 2018: Photodiagnosis and Photodynamic Therapy
https://www.readbyqxmd.com/read/29625898/palliative-thoracic-radiation-therapy-for-non-small-cell-lung-cancer-2018-update-of-an-american-society-for-radiation-oncology-astro-evidence-based-guideline
#20
Benjamin Moeller, Ehsan H Balagamwala, Aileen Chen, Kimberly M Creach, Giuseppe Giaccone, Matthew Koshy, Sandra Zaky, George Rodrigues
PURPOSE: To revise the recommendation on the use of concurrent chemotherapy (CC) with palliative thoracic external beam radiation therapy (EBRT) made in the original 2011 American Society for Radiation Oncology guideline on palliative thoracic radiation for lung cancer. METHODS AND MATERIALS: Based on a systematic PubMed search showing new evidence for this key question, the task force felt an update was merited. Guideline recommendations were created using a predefined consensus-building methodology supported by American Society for Radiation Oncology-approved tools for grading evidence quality and recommendation strength...
April 3, 2018: Practical Radiation Oncology
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