Read by QxMD icon Read

palliative guidelines

Janice Gabriel
Subcutaneous administration of medications is a well-recognised route for delivering prescribed therapies, in particular analgesia for patients requiring palliative care. Technological advancements in infusion devices and dressings can result in well-tolerated and effective methods for continuous infusions for this group of individuals. This article discusses how technological developments are resulting in subcutaneous access devices that are easy to insert and can meet the needs of a growing patient population, as well as complying with the latest guidelines on sharps safety...
June 2, 2018: International Journal of Palliative Nursing
Anna Kirstine Winthereik, Mette Asbjoern Neergaard, Anders Bonde Jensen, Peter Vedsted
BACKGROUND: Most patients in end-of-life with life-threatening diseases prefer to be cared for and die at home. Nevertheless, the majority die in hospitals. GPs have a pivotal role in providing end-of-life care at patients' home, and their involvement in the palliative trajectory enhances the patient's possibility to stay at home. The aim of this study was to develop and pilot-test an intervention consisting of continuing medical education (CME) and electronic decision support (EDS) to support end-of-life care in general practice...
June 20, 2018: BMC Family Practice
Dawon Baik, Hwayoung Cho, Ruth M Masterson Creber
BACKGROUND: Shared decision making (SDM) is a key attribute of patient-centered care, which empowers palliative care patients to be able to make optimal medical decisions about end-of-life treatments based on their own values and preferences. AIM: The aim of this systematic literature review is to detail and compare interventions supporting SDM over the last 10 years (January 2008 to December 2017) and to analyze patient/caregiver outcomes at the end of life. METHODS: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines...
January 1, 2018: American Journal of Hospice & Palliative Care
Lisa Burry, Sangeeta Mehta, Marc M Perreault, Jay S Luxenberg, Najma Siddiqi, Brian Hutton, Dean A Fergusson, Chaim Bell, Louise Rose
BACKGROUND: Guidelines suggest limited and cautious use of antipsychotics for treatment of delirium where nonpharmacological interventions have failed and symptoms remain distressing or dangerous, or both. It is unclear how well these recommendations are supported by current evidence. OBJECTIVES: Our primary objective was to assess the efficacy of antipsychotics versus nonantipsychotics or placebo on the duration of delirium in hospitalised adults. Our secondary objectives were to compare the efficacy of: 1) antipsychotics versus nonantipsychotics or placebo on delirium severity and resolution, mortality, hospital length of stay, discharge disposition, health-related quality of life, and adverse effects; and 2) atypical vs...
June 18, 2018: Cochrane Database of Systematic Reviews
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
Hibah Osman, Sudip Shrestha, Sarah Temin, Zipporah V Ali, James F Cleary
No abstract text is available yet for this article.
June 15, 2018: Journal of Oncology Practice
Riley D Stewart, Jeffrey Hawel, Daniel French, Drew Bethune, James Ellsmere
BACKGROUND: Achalasia is a chronic disease affecting the myenteric plexus of the esophagus and lower esophageal sphincter. Treatment is aimed at palliating symptoms to improve quality of life. Treatment options for symptom relapse after esophagomyotomy include botox injection, repeat myotomy, per-oral endoscopic myotomy, or pneumatic balloon dilation (PBD). Data demonstrating the safety and efficacy of PBD for recurrence are scarce. With a lack of published data, guidelines have suggested avoiding PBD for recurrent achalasia because of concern for a high risk of perforation...
June 15, 2018: Surgical Endoscopy
Melissa P Masterson, Allison J Applebaum, Kara Buda, Sally Reisch, Barry Rosenfeld
The study of prognostic understanding is imperative as the trend toward individualized medicine continues. However, without guidelines for discussing prognosis, palliative care clinicians face challenges presenting prognostic information in a way that optimizes patient understanding, psychological adjustment, and decision-making. The present study draws on the experiences of experts in the field of palliative care in order to examine the communication of prognostic information. Fifteen oncology, psycho-oncology, and palliative care professionals with expertise in doctor-patient communication participated in semi-structured interviews that focused on identifying the breadth of factors underlying prognostic understanding, as well as methods to identify and quantify this understanding...
January 1, 2018: American Journal of Hospice & Palliative Care
Jutara Srivali Teal, Dana N Rutledge, Sue Robertson, Eve Cruz
The Supportive Care Nursing Clinical Protocol (SCNCP) was developed to guide holistic nursing care for seriously ill hospitalized patients. The SCNCP uses national guidelines and evidence-based interventions as its foundation. Seriously ill patients may require palliative care, which is synonymous with supportive care. Acute care nurses may not be proficient in providing holistic supportive care for patients with life-limiting illness. At a 670-bed public acute care hospital, palliative care consultation requires a physician order and palliation may arrive late in an illness...
July 2018: Holistic Nursing Practice
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.)
Tamás Kullmann, István Sipőcz, Kofi Agyemang-Prempeh, Orsolya Barna, Tamás Pintér
INTRODUCTION: The paclitaxel-carboplatin doublet is an alternative choice in the first line treatment of metastatic or recurrent cervical cancer according to international guidelines. METHOD: The history of seven patients treated with paclitaxel-platinum in the last three years in the Petz Aladár Hospital is reported. A case report, supporting the efficacy of the combination in emergency and in reintroduced settings is presented as well. RESULTS: The average progression-free survival was 10 months...
June 2018: Orvosi Hetilap
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
Jordan Levy, Jesse Zuckerman, Richard Garfinkle, Sergio A Acuna, Jacynthe Touchette, Tsafrir Vanounou, Jean-Sebastien Pelletier
BACKGROUND: A large proportion of patients with colorectal cancer liver metastases (CRCLM) not amenable to curative liver resection will progress on systemic therapy. Intra-arterial therapies (IAT) including conventional transarterial chemoembolization (cTACE), drug eluting beads (DEB-TACE) and yttrium-90 radioembolization (Y-90) are indicated to prolong survival and palliate symptoms. The purpose of this systematic review and meta-analysis is to compare the survival benefit and radiologic response of three intra-arterial therapies in patients with chemorefractory and unresectable CRCLM...
June 7, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Aziz Zaanan, Olivier Bouché, Leonor Benhaim, Bruno Buecher, Nicolas Chapelle, Olivier Dubreuil, Nadim Fares, Victoire Granger, Christine Lefort, Johan Gagniere, Julie Meilleroux, Anne-Sophie Baumann, Veronique Vendrely, Michel Ducreux, Pierre Michel
INTRODUCTION: This document is a summary of the French Intergroup guidelines regarding the management of gastric cancer published in October 2016, available on the website of the French Society of Gastroenterology (SNFGE) (, updated in October 2017. METHODS: This collaborative work was realized under the auspices of several French medical societies involved in management of gastric cancer. Recommendations are graded in three categories (A-C), according to the amount of evidence found in the literature until July 2017...
June 6, 2018: Digestive and Liver Disease
Andrew Neil Davies, Frank Elsner, Marilène Jeanne Filbet, Josep Porta-Sales, Carla Ripamonti, Daniele Santini, Kath Webber
OBJECTIVE: Breakthrough cancer pain (BTcP) is common and has a significant impact on the quality of life of patients with cancer. This review compares current national/international BTcP guidelines in order to identify disparities and priorities for further research. METHODS: Relevant guidelines were identified using searches of PubMed, the National Guideline Clearinghouse, the internet (commercial search engines), and correspondence with key opinion leaders and relevant pharmaceutical companies...
June 6, 2018: BMJ Supportive & Palliative Care
Bryan Boling, Katie Keinath
Acute ischemic stroke is a major cause of mortality and morbidity in the United States and worldwide. Despite the development of specialized stroke centers, mortality and morbidity as a result of acute ischemic strokes can and do happen anywhere. These strokes are emergency situations requiring immediate intervention. This article covers the fundamentals of care involved in treating patients with acute ischemic stroke, including essentials for the initial evaluation, basic neuroimaging, reperfusion therapies, critical care management, and palliative care, as well as current controversies...
2018: AACN Advanced Critical Care
Claudia Ott, Michael Gerken, Daniela Hirsch, Petra Fest, Stefan Fichtner-Feigl, Stefan Munker, Elisabeth Schnoy, Christian Stroszczynski, Martin Vogelhuber, Wolfgang Herr, Matthias Evert, Michael Reng, Hans Jürgen Schlitt, Monika Klinkhammer-Schalke, Andreas Teufel
BACKGROUND: The clinicopathological significance of the mucinous subtype of colorectal cancer (CRC) remains controversial. As of today, none of the current guidelines differentiate treatment with respect to mucinous or nonmucinous cancer. Due to the lack of substantiated data, best treatment remains unclear and the mucinous subtype of CRC is usually treated along the lines of recommendations for adenocarcinoma of the colon. METHODS: We investigated an East-Bavarian cohort of 8,758 patients with CRC...
June 5, 2018: Digestion
Elisabeth P Dellon, Sarah W Helms, Claire E Hailey, Rosemary Shay, Scott D Carney, Howard Joel Schmidt, David E Brown, Mary G Prieur
BACKGROUND: Individuals with cystic fibrosis (CF) face the challenges of managing a chronic, progressive disease. While palliative care is a standard of care in serious illnesses, there are no guidelines for its incorporation into CF care. Patients with CF, caregivers, and CF care providers may lack knowledge about palliative care and perceive barriers to integrated care. OBJECTIVES: To: 1) explore knowledge and perceptions of palliative care among patients with CF, caregivers, and CF care providers; 2) solicit opinions about incorporating palliative care into routine CF care; and 3) solicit recommendations for CF-specific palliative care education for patients and caregivers...
June 3, 2018: Pediatric Pulmonology
M-J Chen, I-C Wu, Y-J Chen, T-E Wang, Y-F Chang, C-L Yang, W-C Huang, W-K Chang, B-S Sheu, M-S Wu, J-T Lin, C-H Chu
A number of clinical guidelines on nutrition therapy in cancer patients have been published by national and international societies; however, most of the reviewed data focused on gastrointestinal cancer or non-cancerous abdominal surgery. To collate the corresponding data for esophageal cancer (EC), a consensus panel was convened to aid specialists from different disciplines, who are involved in the clinical nutrition care of EC patients. The literature was searched using MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, and the ISI Web of Knowledge...
May 31, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Marije Brouwer, Els Maeckelberghe, Willemien DE Weerd, Eduard Verhagen
In 2002, The Netherlands continued its leadership in developing rules and jurisdiction regarding euthanasia and end-of-life decisions by implementing the Euthanasia Act, which allows euthanasia for patients 12 years of age and older. Subsequently, in 2005, the regulation on active ending of life for newborns was issued. However, more and more physicians and parents have stated that the age gap between these two regulations-children between 1 and 12 years old-is undesirable. These children should have the same right to end their suffering as adults and newborn infants...
July 2018: Cambridge Quarterly of Healthcare Ethics: CQ: the International Journal of Healthcare Ethics Committees
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"