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https://www.readbyqxmd.com/read/28104546/dying-in-intensive-care-units-of-india-commentaries-on-policies-and-position-papers-on-palliative-and-end-of-life-care
#1
REVIEW
Jaydeep Sengupta, Suhita Chopra Chatterjee
PURPOSE: This study critically examines the available policy guidelines on integration of palliative and end-of-life care in Indian intensive care units to appraise their congruence with Indian reality. MATERIALS AND METHODS: Six position statements and guidelines issued by the Indian Society for Critical Care Medicine and the Indian Association of Palliative Care from 2005 till 2015 were examined. The present study reflects upon the recommendations suggested by these texts...
December 24, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/28099352/acute-pancreatitis-in-patients-with-pancreatic-cancer-timing-of-surgery-and-survival-duration
#2
Shaojun Li, Bole Tian
Acute pancreatitis (AP) is a rare manifestation of pancreatic cancer (PC). The relationship between AP and PC remains less distinct.From January 2009 to November 2015, 47consecutive patients with PC who presented with AP were reviewed for this study. Clinical features, clinicopathologic variables, postoperative complications, and follow-up evaluations of patients were documented in detail from our database. In order to identify cutoff threshold time for surgery, receiver operating curve (ROC) was built according to patients with or without postoperative complications...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28092282/neonatal-palliative-care
#3
Elvira Parravicini
PURPOSE OF REVIEW: A significant number of newborns are affected by life-limiting or life-threatening conditions. When prolongation of survival is no longer a goal, or prognosis is uncertain, a plan of care focused on the infant's comfort is essential. The aim of this article is to review the most recent and relevant literature regarding neonatal palliative care (NPC). RECENT FINDINGS: A variety of perinatal and NPC programs are described, but most programs focus exclusively on end-of-life care...
January 13, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28078078/radiotherapy-in-the-management-of-gist-state-of-the-art-and-new-potential-scenarios
#4
L Gatto, M Nannini, M Saponara, V Di Scioscio, G Beltramo, G P Frezza, G Ercolani, A D Pinna, A Astolfi, M Urbini, G Brandi, G Biasco, M A Pantaleo
BACKGROUND: Gastrointestinal stromal tumor (GIST) is the most common mesenchymal neoplasm of the gastrointestinal tract. The main treatment for localized gastrointestinal stromal tumors is surgical resection. Unresectable or advanced GIST are poorly responsive to conventional cytotoxic chemotherapy but the introduction of tyrosine kinase inhibitors (TKIs) marked a revolutionary step in the treatment of these patients, radically improving prognosis and clinical benefit. Historically GIST has been considered radiation-resistant, and the role of radiotherapy in the management of patients with GIST is currently restricted to symptomatic palliation in current treatment guidelines...
2017: Clinical Sarcoma Research
https://www.readbyqxmd.com/read/28074584/the-limits-of-surrogates-moral-authority-and-physician-professionalism-can-the-paradigm-of-palliative-sedation-be-instructive
#5
Jeffrey T Berger
With narrow exception, physicians' treatment of incapacitated patients requires the consent of health surrogates. Although the decision-making authority of surrogates is appropriately broad, their moral authority is not without limits. Discerning these bounds is particularly germane to ethically complex treatments and has important implications for the welfare of patients, for the professional integrity of clinicians, and, in fact, for the welfare of surrogates. Palliative sedation is one such complex treatment; as such, it provides a valuable model for analyzing the scope of surrogates' moral authority...
January 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28074578/managing-conflicts-between-physicians-and-surrogates
#6
Carol Bayley
Two articles in this issue of the Hastings Center Report explore two sides of the same problematic coin. In "The Limits of Surrogates' Moral Authority and Physician Professionalism," Jeffrey Berger discusses the moral problem of a surrogate refusing a treatment, palliative sedation, on behalf of a patient whose suffering is refractory to intensive palliative efforts provided by a multidisciplinary team. In "After the DNR: Surrogates Who Persist in Requesting Cardiopulmonary Resuscitation," Ellen Robinson and her colleagues analyze data from a study of cases in which physicians wished not to perform cardiopulmonary resuscitation on patients whom they thought it would harm...
January 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28068873/patterns-of-treatment-failure-in-anaplastic-thyroid-carcinoma
#7
Sarika N Rao, Mark Zafereo, Ramona Dadu, Naifa Busaidy, Kenneth Hess, Gilbert J Cote, Michelle D Williams, William Nassib William, Vlad C Sandulache, Neil D Gross, Brandon Gunn, Charles Lu, Renata Ferrarotto, Stephen Y Lai, Maria Cabanillas
BACKGROUND: Anaplastic thyroid cancer (ATC) is one of the most lethal forms of cancer with a high mortality rate. Current guidelines support surgery for resectable ATC followed by external beam radiation therapy (EBRT) with or without chemotherapy. Treatment for those who are unresectable is palliative. Our goal was to examine first-line therapies as well as the role of genomic profiling in an effort better understand how to approach ATC. METHODS: This is a retrospective study of ATC patients who were seen at our institution from 1/2013 to 10/2015...
January 9, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28065197/aligning-guidelines-and-medical-practice-literature-review-on-pediatric-palliative-care-guidelines
#8
Eva De Clercq, Michael Rost, Nadia Pacurari, Bernice S Elger, Tenzin Wangmo
OBJECTIVE: Palliative care for children is becoming an important subspecialty of healthcare. Although concurrent administration of curative and palliative care is recommended, timely referral to pediatric palliative care (PPC) services remains problematic. This literature review aims to identify barriers and recommendations for proper implementation of palliative care for children through the looking glass of PPC guidelines. METHOD: To identify studies on PPC guidelines, five databases were searched systematically between 1960 and 2015: Scopus, PubMed, PsycINFO, the Web of Science, and CINAHL...
January 9, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/28063859/assessing-palliative-care-content-in-dementia-care-guidelines-a-systematic-review
#9
REVIEW
Pamela Durepos, Abigail Wickson-Griffiths, Afeez Abiola Hazzan, Sharon Kaasalainen, Vasilia Vastis, Lisa Battistella, Alexandra Papaioannou
CONTEXT: Families of persons with dementia continue to report unmet needs during end-of-life. Strategies to improve care and quality of life for persons with dementia include development of clinical practice guidelines (CPG) and an integrative palliative approach. OBJECTIVES: We aimed to assess palliative care content in dementia CPGs in order to identify the presence or limitations of recommendations and discussion pertaining to common issues or domains affected by illness as described by the Canadian Hospice Palliative Care 'Square of Care'...
January 4, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28062338/family-caregiver-participation-in-palliative-care-research-challenging-the-myth
#10
Samar Aoun, Susan Slatyer, Kathleen Deas, Cheryl Nekolaichuk
BACKGROUND: Despite international guidelines emphasizing consumer directed care and autonomous decisions in research participation, there is a common myth that research can be an additional and unwanted burden on patients and their family members. AIM: to examine the experiences and impact of research involvement on family caregivers (FC) of terminally ill people, focusing within home-based palliative care. DESIGN: and participants: 316 of 322 participants (98...
January 3, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28058467/-treatment-of-melanoma-during-pregnancy
#11
REVIEW
L A Schneider
Melanoma diagnosed during pregnancy is a rare clinical case presentation which must be mastered. In the absence of guidelines for this clinical challenge, we performed a review of the literature and provide a practical guideline on how to manage such rare clinical cases based on our clinical experience. Expecting mothers require adequate counselling and explanation of all therapeutic options as they take responsibility for more than their own lives. However, they should be guided through the process of diagnostic and therapeutic measures in a potentially life-threatening situation...
January 5, 2017: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
https://www.readbyqxmd.com/read/28057354/neuroendrocrine-tumors-of-the-uterine-cervix-a-therapeutic-challenge-for-gynecologic-oncologists
#12
REVIEW
Gadducci Angiolo, Carinelli Silvestro, Aletti Giovanni
Neuroendocrine tumors (NETs) are aggressive diseases developing from neuroendocrine cells that most frequently involve the gastro-entero-pancreatic tract and the lung, but more rarely are found in almost all body tissues. Limited biological and clinical data are currently available for NETs in uncommon sites, such as female genital tract. NETs represent 0.9% to 1.5% of the tumors of the uterine cervix. They are more likely to have lymph-vascular space invasion and lymph node involvement, and to develop local and distant relapses when compared with the mostly common cervical squamous cell carcinomas or adenocarcinomas...
January 2, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28056512/palliative-care-exposure-in-internal-medicine-residency-education
#13
Asher Edwards, Samuel Nam
As the baby boomer generation ages, the need for palliative care services will be paramount and yet training for palliative care physicians is currently inadequate to meet the current palliative care needs. Nonspecialty-trained physicians will need to supplement the gap between supply and demand. Yet, no uniform guidelines exist for the training of internal medicine residents in palliative care. To our knowledge, no systematic study has been performed to evaluate how internal medicine residencies currently integrate palliative care into their training...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28052721/the-practice-of-terminal-discharge
#14
Lalit Kumar Radha Krishna, Vengadasalam Murugam, Daniel Song Chiek Quah
'Terminal discharges' are carried out in Singapore for patients who wish to die at home. However, if due diligence is not exercised, parallels may be drawn with euthanasia. We present a theoretical discussion beginning with the definition of terminal discharges and the reasons why they are carried out in Singapore. By considering the intention behind terminal discharges and utilising a multidisciplinary team to deliberate on the clinical, social and ethical intricacies with a patient- and context-specific approach, euthanasia is avoided...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28044054/pituitary-metastasis-from-renal-cell-carcinoma-description-of-a-case-report
#15
Chloé Wendel, Marco Campitiello, Francesca Plastino, Nada Eid, Laurent Hennequin, Philippe Quétin, Raffaele Longo
BACKGROUND Pituitary metastasis is uncommon, breast and lung cancers being the most frequent primary tumors. Renal cell carcinoma (RCC) is a rare cause of pituitary metastases, with only a few cases described to date. CASE REPORT We report a case of a 61-year-old man who presented with a progressive deterioration of visual acuity and field associated with a bitemporal hemianopsia. Two years ago, he underwent radical right nephrectomy for a clear cell RCC (ccRCC). The biological tests showed pan-hypopituitarism and diabetes insipidus...
January 3, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28042136/epidemiology-and-treatment-of-hepatocellular-carcinoma-in-thailand
#16
REVIEW
Soonthorn Chonprasertsuk, Ratha-Korn Vilaichone
Hepatocellular carcinoma (HCC) is the most frequent type of malignant liver tumor in Thailand. The high incidence rate of HCC reflects from chronic HBV infection in this endemic area. Some patients are asymptomatic at presentation whereas many of them presented at advanced stage of HCC with limited treatment options and grave outcome. The Barcelona Clinic Liver Cancer (BCLC) staging system and management allocation for HCC is widely accepted and used in many international guidelines including Thailand. Curative treatment is expected in early stage of HCC while palliative treatment, combination treatment and best supportive care are offered to advanced stage of HCC...
January 1, 2017: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28042066/repurposing-medications-for-hospice-palliative-care-symptom-control-is-no-longer-sufficient-a-manifesto-for-change
#17
David C Currow, Amy P Abernethy, Marie Fallon, Russell K Portenoy
The World Health Organisation (WHO) essential medications list for hospice / palliative care reflects that, with the judicious use of currently available medications, the majority of symptoms can be lessened, and some controlled completely. Even with optimal use of current medications, symptom control is still unacceptable for many people. Currently available medications offer great benefit to a minority of patients, some benefit to an additional group, and no benefit or harms to others. In symptom control, development of new drugs is advancing at a glacial pace, contrasting to the rapid advances seen in many other disciplines...
December 29, 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28039690/the-effect-of-guidelines-in-surgical-decision-making-the-paradigm-of-hepatocellular-carcinoma
#18
Demetrios Moris, Spyridon Vernadakis, Alexandros Papalampros, Athanasios Petrou, Dimitrios Dimitroulis, Eleftherios Spartalis, Evangelos Felekouras, John J Fung
It is not inconceivable to envision surgeons, offering extended liver resection in patients beyond the Barcelona Clinic Liver Cancer (BCLC) staging system criteria with intermediate/advanced hepatocellular carcinoma (HCC), to be found negligent since extensive liver resection is correlated with increased morbidity compared to conservative or palliative treatment. Given that no other classification system than BCLC has been adopted widely for HCC staging and treatment, a revision of the BCLC algorithm and clinical guidelines should be tailored using new molecular and clinical treatment algorithms, as well as including patient's preferences...
November 2016: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/28034065/integration-of-palliative-care-into-standard-oncology-care-american-society-of-clinical-oncology-clinical-practice-guideline-update
#19
Betty R Ferrell, Jennifer S Temel, Sarah Temin, Erin R Alesi, Tracy A Balboni, Ethan M Basch, Janice I Firn, Judith A Paice, Jeffrey M Peppercorn, Tanyanika Phillips, Ellen L Stovall, Camilla Zimmermann, Thomas J Smith
Purpose To provide evidence-based recommendations to oncology clinicians, patients, family and friend caregivers, and palliative care specialists to update the 2012 American Society of Clinical Oncology (ASCO) provisional clinical opinion (PCO) on the integration of palliative care into standard oncology care for all patients diagnosed with cancer. Methods ASCO convened an Expert Panel of members of the ASCO Ad Hoc Palliative Care Expert Panel to develop an update. The 2012 PCO was based on a review of a randomized controlled trial (RCT) by the National Cancer Institute Physicians Data Query and additional trials...
January 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28033624/-plastic-surgery-in-palliative-care-report-on-the-consensus-workshop-of-the-37th-annual-meeting-of-the-german-language-group-for-microsurgery-of-the-peripheral-nerves-and-vessels-dam-2016-in-bochum
#20
A Daigeler, M Lehnhardt, S Bauer, S Goldhammer, P M Vogt
Introduction: At the consensus meeting on "Plastic Surgery in the Palliative Situation" at the 37th Annual Meeting of the DAM 2015 in Bochum, treatment options were discussed with oncologists and palliative care anesthesiologists and recommendations were given. Methods: The literature was reviewed and the results of the expert-meeting options and limits of therapy were illustrated. The role of plastic surgery for palliative care patients was pointed out and recommendations given for successful cooperative treatment...
December 2016: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
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