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https://www.readbyqxmd.com/read/28432090/international-variations-in-clinical-practice-guidelines-for-palliative-sedation-a-systematic-review
#1
REVIEW
Ebun Abarshi, Judith Rietjens, Lenzo Robijn, Augusto Caraceni, Sheila Payne, Luc Deliens, Lieve Van den Block
OBJECTIVES: Palliative sedation is a highly debated medical practice, particularly regarding its proper use in end-of-life care. Worldwide, guidelines are used to standardise care and regulate this practice. In this review, we identify and compare national/regional clinical practice guidelines on palliative sedation against the European Association for Palliative Care (EAPC) palliative sedation Framework and assess the developmental quality of these guidelines using the Appraisal Guideline Research and Evaluation (AGREE II) instrument...
April 20, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28430610/treatment-of-hepatocellular-carcinoma-with-portal-vein-tumor-thrombus-advances-and-challenges
#2
REVIEW
Jin-Fang Jiang, Yong-Cong Lao, Bao-Hong Yuan, Jun Yin, Xin Liu, Long Chen, Jian-Hong Zhong
Portal vein tumor thrombus is a frequent, challenging complication in hepatocellular carcinoma. Hepatocellular carcinoma patients with portal vein tumor thrombus may show worse liver function, less treatment tolerance and worse prognosis than patients without portal vein tumor thrombus, and they may be at higher risk of comorbidity related to portal hypertension. Western and some Asian guidelines stratify hepatocellular carcinoma with portal vein tumor thrombus together with metastatic hepatocellular carcinoma and therefore recommend only palliative treatment with sorafenib or other systemic agents...
February 16, 2017: Oncotarget
https://www.readbyqxmd.com/read/28426492/clinical-practice-guidelines-for-pancreatic-cancer-2016-from-the-japan-pancreas-society-a-synopsis
#3
Koji Yamaguchi, Takuji Okusaka, Kyoko Shimizu, Junji Furuse, Yoshinori Ito, Keiji Hanada, Tooru Shimosegawa, Kazuichi Okazaki
OBJECTIVES: Clinical Practice Guidelines for Pancreatic Cancer based on Evidence-Based Medicine 2006 were first published by the Japan Pancreas Society, and they were revised to Clinical Practice Guidelines for Pancreatic Cancer 2009 in July 2009 and were further revised to Clinical Practice Guidelines for Pancreatic Cancer 2013 in October 2013. These guidelines were established according to evidence-based medicine. In October 2016, the Clinical Practice Guidelines for Pancreatic Cancer were newly revised in Japanese...
May 2017: Pancreas
https://www.readbyqxmd.com/read/28423918/expanding-the-palliative-care-domains-to-meet-the-needs-of-a-community-based-supportive-care-model
#4
Eric W Anderson, Monica S Frazer, Sandra E Schellinger
BACKGROUND: Whole person care is appropriate for seriously ill persons. The current framework of palliative care domains in the National Consensus Project (NCP) Guidelines for Quality Palliative Care offers an opportunity to reassess the domains of care delivered at home, earlier in the course of illness. OBJECTIVE: This qualitative study was used to test the applicability of a proposed, expanded set of domains. The results were used to inform a home-based, upstream model of supportive care for serious illness...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28423917/management-of-opioid-induced-constipation-in-hospice-patients
#5
Leah Sera, Mary Lynn McPherson
BACKGROUND: Constipation is a common symptom in patients with advanced disease taking opioids. Opioid-induced constipation (OIC) is commonly treated with laxatives and stool softeners. Recently, newer agents have come to market which broaden options for patients in whom first-line therapies are not effective. OBJECTIVE: To determine what pharmacologic regimens are currently used in hospice programs to prevent and treat OIC, whether those regimens have changed with the introduction of newer agents and evidence discouraging the use of docusate, and whether hospice programs are standardizing the management of OIC...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28417310/telemedicine-and-palliative-care-an-increasing-role-in-supportive-oncology
#6
REVIEW
Brooke Worster, Kristine Swartz
With the emergence of telemedicine as a routine form of care in various venues, the opportunities to use technology to care for the most vulnerable, most ill cancer patients are extremely appealing. Increasingly, evidence supports early integration of palliative care with standard oncologic care, supported by recent NCCN guidelines to increase and improve access to palliative care. This review looks at the use of telemedicine to expand access to palliative care as well as provide better care for patients and families where travel is difficult, if not impossible...
June 2017: Current Oncology Reports
https://www.readbyqxmd.com/read/28404600/qualitative-interviews-exploring-palliative-care-perspectives-of-latinos-on-dialysis
#7
Lilia Cervantes, Jacqueline Jones, Stuart Linas, Stacy Fischer
BACKGROUND AND OBJECTIVES: Compared with non-Latino whites with advanced illness, Latinos are less likely to have an advance directive or to die with hospice services. To improve palliative care disparities, international ESRD guidelines call for increased research on culturally responsive communication of advance care planning (ACP). The objective of our study was to explore the preferences of Latino patients receiving dialysis regarding symptom management and ACP. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Qualitative study design using semistructured face-to-face interviews of 20 Latinos on hemodialysis between February and July of 2015...
April 12, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28402533/caregiver-perspectives-about-using-antipsychotics-and-other-medications-for-symptoms-of-dementia
#8
John William Kerns, Jonathan D Winter, Katherine M Winter, Christine C Kerns, Rebecca S Etz
Background and Objectives: To avoid "chemical restraints," policies and guidelines have been implemented to curb the use of medications for behavioral and psychological symptoms of dementia (BPSD). Antipsychotics have been particularly targeted because of their rare severe side effects. Consequently, caregiver directed non-pharmacologic therapies have increased while medication use for BPSD has diminished. Despite such initiatives, however, antipsychotics continue to be prescribed "off-label" for roughly 20% of nursing home patients...
April 11, 2017: Gerontologist
https://www.readbyqxmd.com/read/28401622/predicting-mortality-in-the-emergency-department-external-validation-and-derivation-of-a-clinical-prediction-tool
#9
Rajat N Moman, Caitlin Loprinzi Brauer, Katherine M Kelsey, Rachel D Havyer, Christine M Lohse, M Fernanda Bellolio
BACKGROUND: he Choosing Wisely campaign has called for better engagement of palliative and hospice care services for patients in the emergency department (ED). PREDICT is a clinical prediction tool that was derived in an Australian ED cohort. It assesses a patient's risk of mortality at one year to select those who would benefit from advanced care planning. Such goals of care discussion can improve patients' ability to communicate what they want out of their healthcare and, in cases of end-of-life, potentially reduce the number of futile interventions...
April 12, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28400548/the-relation-between-cultural-values-euthanasia-and-spiritual-care-in-the-netherlands
#10
Carlo Leget
The aim of this paper is to gain some understanding of euthanasia as a Dutch cultural practice, focusing on value orientations that lie beneath the surface of what is made visible in the many national surveys that have been done in the Netherlands. In order to reach this aim we will take two steps. In the first place we will give a short sketch of euthanasia as it is understood and practiced in the Netherlands. This will be followed by a cultural analysis of the American-Dutch historian James Kennedy who studied the euthanasia debate in the Netherlands from the 1960 until 1985...
March 17, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28399022/palliative-and-end-of-life-care-in-nephrology-moving-from-observations-to-interventions
#11
Nwamaka D Eneanya, Michael K Paasche-Orlow, Angelo Volandes
PURPOSE OF REVIEW: In comparison with patients who have other serious illnesses, patients with advanced kidney disease have a higher rate of intensive care utilization at the end of life and receive palliative care less frequently. Consensus and clinical practice guidelines have therefore recommended the incorporation of palliative care earlier in the disease trajectory. This review summarizes recent literature on this aspect of care and will highlight future directions for patient-centered care within palliative nephrology...
April 8, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28390401/a-process-evaluation-of-systematic-risk-and-needs-assessment-for-caregivers-in-specialised-palliative-care
#12
Kia Toft Thomsen, Mai-Britt Guldin, Mette Kjærgaard Nielsen, Chaitali Laura Ollars, Anders Bonde Jensen
BACKGROUND: Caregiving is strenuous and it may be associated with adverse psychological outcomes. During the palliative care trajectory, there are unique opportunities for providing support and preventing poor bereavement outcome. However, the tasks of palliative care staff in relation to caregivers are often unclear in the daily practice. Assessment is recommended to establish risk and needs and standards for caregiver support are available. Still, the feasibility of applying these standards among caregivers in everyday clinical practice has not been tested so far...
April 8, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28384684/an-international-collaborative-standardizing-a-comprehensive-patient-centered-outcomes-measurement-set-for-colorectal-cancer
#13
Jessica A Zerillo, Maartje G Schouwenburg, Annelotte C M van Bommel, Caleb Stowell, Jacob Lippa, Donna Bauer, Ann M Berger, Gilles Boland, Josep M Borras, Mary K Buss, Robert Cima, Eric Van Cutsem, Eino B van Duyn, Samuel R G Finlayson, Skye Hung-Chun Cheng, Corinna Langelotz, John Lloyd, Andrew C Lynch, Harvey J Mamon, Pamela K McAllister, Bruce D Minsky, Joanne Ngeow, Muhammad R Abu Hassan, Kim Ryan, Veena Shankaran, Melissa P Upton, John Zalcberg, Cornelis J van de Velde, Rob Tollenaar
Importance: Global health systems are shifting toward value-based care in an effort to drive better outcomes in the setting of rising health care costs. This shift requires a common definition of value, starting with the outcomes that matter most to patients. Objective: The International Consortium for Health Outcomes Measurement (ICHOM), a nonprofit initiative, was formed to define standard sets of outcomes by medical condition. In this article, we report the efforts of ICHOM's working group in colorectal cancer...
April 6, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/28376681/what-do-we-know-about-different-models-of-providing-palliative-care-findings-from-a-systematic-review-of-reviews
#14
Louise Brereton, Joseph Clark, Christine Ingleton, Clare Gardiner, Louise Preston, Tony Ryan, Elizabeth Goyder
BACKGROUND: A wide range of organisational models of palliative care exist. However, decision makers need more information about which models are likely to be most effective in different settings and for different patient groups. AIM: To identify the existing range of models of palliative care that have been evaluated, what is already known and what further information is essential if the most effective and cost-effective models are to be identified and replicated more widely...
April 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28365652/interstage-home-monitoring-after-newborn-first-stage-palliation-for-hypoplastic-left-heart-syndrome-family-education-strategies
#15
Jo Ann Nieves, Karen Uzark, Nancy A Rudd, Jennifer Strawn, Anne Schmelzer, Nancy Dobrolet
Children born with hypoplastic left heart syndrome are at high risk for serious morbidity, growth failure, and mortality during the interstage period, which is the time from discharge home after first-stage hypoplastic left heart syndrome palliation until the second-stage surgical intervention. The single-ventricle circulatory physiology is complex, fragile, and potentially unstable. Multicenter initiatives have been successfully implemented to improve outcomes and optimize growth and survival during the interstage period...
April 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28357161/defining-health-across-the-cancer-continuum
#16
REVIEW
Caleb Dulaney, Audrey S Wallace, Ashlyn S Everett, Laura Dover, Andrew McDonald, Lauren Kropp
Health is not defined by the absence of disease or suffering, but by response to a series of life events that can markedly alter the quality and quantity of life. Patients with cancer experience significant but dynamic physical, psychosocial, and financial challenges. With the increasing number of patients with early stage cancers transitioning to survivorship, there is a critical need to address health promotion and overall well-being. For those with advanced cancer, discussion about prognosis and early integration of palliative care can have a profound impact on the quality of life...
February 15, 2017: Curēus
https://www.readbyqxmd.com/read/28356747/second-line-afatinib-administration-in-an-elderly-patient-with-squamous-cell-carcinoma
#17
Wolfgang Hohenforst-Schmidt, Paul Zarogoulidis, Michael Steinheimer, Naim Benhassen, Chrysanthi Sardeli, Nikos Stalikas, Melpomeni Toitou, Haidong Huang
INTRODUCTION: The majority of cases of lung cancer are still diagnosed at a late stage. At this stage, palliative therapeutic options including nonspecific cytotoxic drugs, targeted therapy, or immunotherapy can be utilized. In 2016, immunotherapy was approved in Europe for squamous cell carcinoma and adenocarcinoma. Moreover, afatinib was also approved as second-line therapy for squamous cell carcinoma. CASE REPORT: This article presents a case of a 76-year-old male with squamous cell carcinoma who received nab-paclitaxel as first-line therapy, and his treatment was switched to the tyrosine kinase inhibitor afatinib (40 mg) after disease progression with left lung atelectasis...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28353038/a-scoring-system-to-guide-the-decision-for-a-new-systemic-treatment-after-at-least-two-lines-of-palliative-chemotherapy-for-metastatic-cancers-a-prospective-study
#18
Brice Chanez, François Bertucci, Marine Gilabert, Anne Madroszyk, Frédérique Rousseau, Delphine Perrot, Patrice Viens, Jean-Luc Raoul
PURPOSE: A four-parameter score has been identified as associated with overall survival (OS) in patients with advanced cancer with an estimated survival inferior to 6 months. Here, we tested its prognostic value for OS in patients who had received more than two lines of systemic therapy. METHODS: We prospectively enrolled patients with advanced cancer who were going to receive a third or more therapeutic line outside classical clinical guidelines. The four parameters (Eastern Cooperative Oncology Group performance status, number of metastatic sites, serum LDH, and serum albumin) were collected at baseline, allowing to calculate the score, which sorted the patients in three groups, A, B, and C (low, intermediate, and high score, respectively)...
March 28, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28345747/survey-of-opioid-tapering-practices-of-pediatric-healthcare-providers-a-national-perspective
#19
Fisher Deborah, Suzanne W Ameringer
OBJECTIVE: The purpose of this study was to describe the current opioid tapering practice. DESIGN: Cross-sectional, online, survey research. PARTICIPANTS: Pediatric healthcare providers from a national sample of practicing nurse practitioners, physician assistants, and physicians who participate in five different pediatric pain and/or palliative care list serves. RESULTS: One hundred four participants responded to the survey...
January 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/28344747/gastric-peritoneal-carcinomatosis-a-retrospective-review
#20
Hwee Leong Tan, Claramae Shulyn Chia, Grace Hwei Ching Tan, Su Pin Choo, David Wai-Meng Tai, Clarinda Wei Ling Chua, Matthew Chau Hsien Ng, Khee Chee Soo, Melissa Ching Ching Teo
AIM: To characterize patients with gastric peritoneal carcinomatosis (PC) and their typical clinical and treatment course with palliative systemic chemotherapy as the current standard of care. METHODS: We performed a retrospective electronic chart review of all patients with gastric adenocarcinoma with PC diagnosed at initial metastatic presentation between January 2010 and December 2014 in a single tertiary referral centre. RESULTS: We studied a total of 271 patients with a median age of 63...
March 15, 2017: World Journal of Gastrointestinal Oncology
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