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palliative guidelines

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https://www.readbyqxmd.com/read/29230124/oncology-and-palliative-medicine-providing-comprehensive-care-for-patients-with-cancer
#1
REVIEW
Laura Finn, Alva Roche Green, Sonia Malhotra
Background: Despite the evidence for the fundamental need for palliative medicine services in the practice of oncology, integration of these medical specialties remains a clinical challenge. Methods: We reviewed the current literature regarding the practice of palliative medicine in the field of oncology, examining randomized clinical trials of palliative medicine services in advanced cancer, models of palliative medicine delivery, studies of cost effectiveness, and national palliative medicine practice and referral guidelines...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/29229506/the-population-benefit-of-evidence-based-radiotherapy-5-year-local-control-and-overall-survival-benefits
#2
T P Hanna, J Shafiq, G P Delaney, S K Vinod, S R Thompson, M B Barton
BACKGROUND: To describe the population benefit of radiotherapy in a high-income setting if evidence-based guidelines were routinely followed. METHODS: Australian decision tree models were utilized. Radiotherapy alone (RT) benefit was defined as the absolute proportional benefit of radiotherapy compared with no treatment for radical indications, and of radiotherapy over surgery alone for adjuvant indications. Chemoradiotherapy (CRT) benefit was the absolute incremental benefit of concurrent chemoradiotherapy over RT...
December 8, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/29227577/management-of-pain-in-end-stage-renal-disease-patients-short-review
#3
REVIEW
Rupesh Raina, Vinod Krishnappa, Mona Gupta
Pain management in end stage renal disease (ESRD) patients is a complex and challenging task to accomplish, and effective pain and symptom control improves quality of life. Pain is prevalent in more than 50% of hemodialysis patients and up to 75% of these patients are treated ineffectively due to its poor recognition by providers. A good history for PQRST factors and intensity assessment using visual analog scale are the initial steps in the management of pain followed by involvement of palliative care, patient and family counseling, discussion of treatment options, and correction of reversible causes...
December 11, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/29224571/-worried-to-death-the-assessment-and-management-of-anxiety-in-patients-with-advanced-life-limiting-disease-a-national-survey-of-palliative-medicine-physicians
#4
N Atkin, V Vickerstaff, B Candy
BACKGROUND: Anxiety adversely affects quality of life and is common in adults with advanced life-limiting disease. There are no UK-wide guidelines on the assessment and management of anxiety in this specific population and there is little evidence regarding drug treatments. This study aimed to explore how palliative care physicians assess and manage anxiety in their patients, and to identify barriers encountered. METHODS: A cross-sectional survey was undertaken of all physicians working in specialist palliative care in the UK who were members of the Association for Palliative Medicine...
December 11, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/29221846/prevailing-ethical-dilemmas-encountered-by-physicians-in-terminal-cancer-care-changed-after-the-enactment-of-the-natural-death-act-fifteen-years-follow-up-survey
#5
Hsien-Liang Huang, Chien-An Yao, Wen-Yu Hu, Shao-Yi Cheng, Shinn-Jang Huang, Chih-Dao Chen, Wen-Yuan Lin, Yen-Chun Lin, Tai-Yuan Chiu
CONTEXT: Advance directive laws have influences on ethical dilemmas encountered by physicians caring for terminal cancer patients. OBJECTIVES: To identify the prevailing ethical dilemmas among terminal care physicians fifteen years after the Natural Death Act was enacted in Taiwan. METHODS: This study is a cross-sectional survey from April 2014 to February 2015 using the clustering sampling method and a well-structured questionnaire. Targeted participants included physicians at oncology and related wards or palliative care units where terminal cancer care may be provided in Taiwan...
December 5, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29221845/characterizing-the-role-of-u-s-surgeons-in-the-provision-of-palliative-care-a-systematic-review-and-mixed-methods-meta-synthesis
#6
REVIEW
Pasithorn A Suwanabol, Arielle E Kanters, Ari C Reichstein, Lauren M Wancata, Lesly A Dossett, Emily B Rivet, Maria J Silveira, Arden M Morris
CONTEXT: The provision of palliative care varies appropriately by clinical factors such as patient age and severity of disease, but also varies by provider practice and specialty. Surgical patients are persistently less likely to receive palliative care than their medical counterparts for reasons that aren't clear. OBJECTIVES: We sought to characterize surgeon-specific determinants of palliative care in seriously-ill and dying patients. METHODS: We performed a systematic review of the literature focused on surgery and palliative care within PubMed, CINHAL, EMBASE, Scopus, and Ovid Medline databases from January 1, 2000 through December 31, 2016 according to PRISMA guidelines...
December 5, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29220289/osteosarcoma-chondrosarcoma-and-chordoma
#7
Jeremy S Whelan, Lara E Davis
Osteosarcoma (OS), chondrosarcoma, and chordoma are characterized by multiple challenges to the investigator, clinician, and patient. One consequence of their rarity among sarcomas, as well as their biologic and clinical heterogeneity, is that management guidelines are inadequate to inform the range of individual patient-treatment decisions from diagnosis, approaches to surgery, chemotherapy, radiotherapy, treatment of recurrence, palliative care, and quality of survivorship. Of high-grade sarcomas, OSs are among the most curable, with more than two-thirds of patients with localized disease likely to achieve long-term survival...
December 8, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29220099/supportive-palliative-care-should-be-integrated-into-routine-care-for-paediatric-patients-with-life-limiting-kidney-disease
#8
REVIEW
Julia Thumfart, Tobias Reindl, Cornelia Rheinlaender, Dominik Müller
AIM: Paediatric palliative care is no longer restricted to patients with cancer and has been extended to patients with other chronic conditions, such as cystic fibrosis or neuromuscular disorders. This review focused on the current state of palliative care for children and adolescents with chronic kidney disease (CKD). METHOD: We assessed the literature on CKD published up to August 2017. All the papers, except one from 1996, were published this century. This review discusses the role that palliative care plays in the process of decision-making and explores the possibilities of implementing palliative care into the routine therapy of affected patients and providing support for their families...
December 8, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/29199697/anaplastic-lymphoma-kinase-status-in-lung-cancers-an-immunohistochemistry-and-fluorescence-in-situ-hybridization-study-from-a-tertiary-cancer-center-in-india
#9
S S Murthy, S J Rajappa, S D Gundimeda, K M Mallavarapu, S Ayyagari, P Yalavarthi, D Fonseca, P Paliwal, Hgr Nair, V Koppula, Kvvn Raju, S T Rao
BACKGROUND AND OBJECTIVES: Fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) have shown good concordance for the detection of echinoderm microtubule-associated protein-like 4 and anaplastic lymphoma kinase (ALK) rearrangement. Since studies reporting FISH/IHC concordance, clinicopathological features, and clinical outcomes of ALK-positive patients from India are lacking, this study was undertaken. MATERIALS AND METHODS: This is a retrospective, observational study of patients with adenocarcinoma of the lung on whom ALK test was performed between March 2013 and December 2015...
January 2017: Indian Journal of Cancer
https://www.readbyqxmd.com/read/29198408/estimating-the-number-of-fractions-by-tumour-site-for-european-countries-in-2012-and-2025-an-estro-hero-analysis
#10
Josep M Borras, Cai Grau, Julieta Corral, Karen Wong, Michael B Barton, Jacques Ferlay, Freddie Bray, Yolande Lievens
BACKGROUND AND PURPOSE: The optimal number of radiotherapy fractions is a relevant input for planning resource needs. An estimation of the total number of fractions by country and tumour site is assessed for 2012 and 2025. METHODS: European cancer incidence data by tumour site and country for 2012 and 2025 were extracted from the GLOBOCAN database. Incidence and stage data were introduced in the Australian Collaboration for Cancer Outcomes Research and Evaluation (CCORE) model, producing an evidence-based proportion of incident cases with an indication for radiotherapy and fractions by indication...
November 29, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/29191721/changes-in-the-use-of-intensive-and-supportive-procedures-for-patients-with-stroke-in-taiwan-in-the-last-month-of-life-between-2000-and-2010
#11
Pei-Yi Wang, Yen-Ni Hung, Robert Smith, Chia-Chin Lin
CONTEXT: Stroke is the second leading cause of death and the primary cause of disability worldwide. It is uncertain what care patients with stroke receive in their end of life care and what trends in care are in recent years. OBJECTIVES: To investigate the changes in the use of intensive and supportive procedures received by Taiwanese stroke patients in their last month of life during 2000-2010. METHODS: Analysis of claims data of 55,930 patients with stroke obtained from the National Health Insurance Research Database were performed to investigate the changes in the use of intensive and supportive procedures for Taiwanese stroke patients in their last month of life during 2000-2010...
November 27, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29191592/adherence-to-surveillance-guidelines-in-resected-nsclc-physician-compliance-and-impact-on-outcomes
#12
Cheryl Ho, Jennifer Siegfried, Karen Remo, Janessa Laskin
BACKGROUND: Resected NSCLC guidelines have varying recommendations on appropriate post-operative surveillance. There is general consensus that patients require follow-up with clinic visits and/or CT scans every 6 months for the first 2 years. This study evaluated compliance with surveillance guidelines and the impact on outcomes. METHODS: The BC Cancer Agency (BCCA) provides cancer control for 4.6 million individuals. Inclusion criteria included referred patients from 2005 to 2010, resected stage Ib/II NSCLC, minimum 2 years follow-up at the BCCA, no prior cancer within 5 years...
October 2017: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
https://www.readbyqxmd.com/read/29191503/management-of-adults-with-congenital-heart-disease-and-pulmonary-arterial-hypertension-in-the-uk-survey-of-current-practice-unmet-needs-and-expert-commentary
#13
Robert Tulloh, Kostas Dimopoulos, Robin Condliffe, Paul Clift
BACKGROUND: Pulmonary arterial hypertension (PAH) is a well-recognised complication of adult congenital heart disease (CHD). However, management is not currently standardised between centres and specific guidelines are lacking. In order to identify and understand the unmet needs related to PAH associated with CHD (PAH-CHD), a survey of physicians was performed. METHODS: An electronic survey was sent to two physician groups: (1) cardiologists registered in a UK cardiology directory; (2) specialist pulmonary hypertension (PH) physicians known to manage patients with adult PAH-CHD...
November 13, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29181069/sorafenib-combined-with-hepatectomy-in-patients-with-intermediate-stage-and-advanced-hepatocellular-carcinoma
#14
Lei Zhuang, Tianfu Wen, Mingqing Xu, Jiayin Yang, Wentao Wang, Hong Wu, Yong Zeng, Lvnan Yan, Yonggang Wei, Bo Li
Introduction: Guidelines based on the Barcelona Clinic Liver Cancer (BCLC) classification system recommend that hepatic resection should be performed only in patients in BCLC stage A. Patients with stage B or stage C should receive palliative or no treatment. However, actual clinical practice varies, and a recent analysis of hepatocellular carcinoma (HCC) surgery outcomes in high volume surgical centers throughout the world concluded that hepatectomy can provide survival benefit for selected patients in all three BCLC stages...
October 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/29179703/is-the-content-of-guidelines-pathways-a-barrier-for-the-integration-of-palliative-care-in-chronic-heart-failure-chf-and-chronic-pulmonary-obstructive-disease-copd-a-comparison-with-the-case-of-cancer-in-europe
#15
Naouma Siouta, Karen Van Beek, Sheila Payne, Lukas Radbruch, Nancy Preston, Jeroen Hasselaar, Carlos Centeno, Johan Menten
BACKGROUND: There is a notable inequity in access to palliative care (PC) services between cancer and Chronic Heart Failure (CHF)/Chronic Obstructive Pulmonary Disease (COPD) patients which also translates into discrepancies in the level of integration of PC. By cross-examining the levels of PC integration in published guidelines/pathways for CHF/COPD and cancer in Europe, this study examines whether these discrepancies may be attributed to the content of the guidelines. DESIGN: A quantitative evaluation was made between integrated PC in published guidelines for cancer and CHF/COPD in Europe...
November 28, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/29178865/palliative-care-for-patients-with-parkinson-s-disease-study-protocol-for-a-mixed-methods-study
#16
Herma Lennaerts, Marieke Groot, Maxime Steppe, Jenny T van der Steen, Marieke Van den Brand, Dorian van Amelsvoort, Kris Vissers, Marten Munneke, Bastiaan R Bloem
BACKGROUND: Parkinson's disease (PD) is a chronic, progressive neurological disorder with many intractable consequences for patients and their family caregivers. Little is known about the possibilities that palliative care could offer to patients and their proxies. Guidelines strongly recommend palliative care to improve the quality of life and - if needed - the quality of dying. However, providing palliative care to persons with PD involves specific challenges. For example, a timely initiation of palliative interventions is difficult because due to the gradually progressive nature of PD, there is often no clear marker for the transition from curative towards palliative care...
November 25, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/29172889/communication-disorders-in-palliative-care-investigating-the-views-attitudes-and-beliefs-of-speech-and-language-therapists
#17
Rosy Hawksley, Fiona Ludlow, Heather Buttimer, Steven Bloch
Speech and language therapists (SLTs) provide intervention for communication and swallowing to patients with life-limiting conditions, such as dementia and head and neck cancer. The role of the SLT in palliative care is difficult to define. Much is known about the clinical aspects of this role; however, little is known about the core values, beliefs and expectations of SLTs working in this sector, particularly with regard to their role in supporting patients' communication. Through a series of semi-structured interviews and a follow-up focus group, this report aimed to form a picture of the experiences and views of SLTs about their communication role in palliative care...
November 2, 2017: International Journal of Palliative Nursing
https://www.readbyqxmd.com/read/29166210/improving-spiritual-care-in-hospitals-in-the-netherlands-what-do-health-care-chaplains-involved-in-an-action-research-study-report
#18
Joep van de Geer, Anja Visser, Hetty Zock, Carlo Leget, Jelle Prins, Kris Vissers
Health care chaplains participated in a multicenter trial to explore an implementation strategy for the Dutch multidisciplinary guideline for spiritual care. The intervention was concise spiritual care training for hospital staff of departments where patients in curative and palliative trajectories are treated. Data were collected in semistructured interviews with chaplains who acted as trainers, before and after the intervention. Results based on nine preintervention and eleven post-intervention interviews are presented...
November 22, 2017: Journal of Health Care Chaplaincy
https://www.readbyqxmd.com/read/29162047/treatment-recommendations-within-the-leeway-of-clinical-guidelines-a-qualitative-interview-study-on-oncologists-clinical-deliberation
#19
I Otte, S Salloch, A Reinacher-Schick, J Vollmann
BACKGROUND: Recommending the optimal treatment for an individual patient requires a well-balanced consideration of various medical, social and ethical factors. The interplay of these factors, interpretation of the patient's situation and understanding of the existing clinical guidelines can lead to divergent therapy recommendations, depending on the attending physician. Gaining a better understanding of the individual process of medical decision-making and the differences occurring will support the delivery of optimal individualized care within the clinical setting...
November 21, 2017: BMC Cancer
https://www.readbyqxmd.com/read/29150095/-towards-a-better-use-of-midazolam-in-end-of-life-a-survey-in-a-department-of-medical-oncology
#20
Aurélie Beneton, Alexis Vallard, Christelle Brosse, Géraldine Poenou, Cécile Pacaut, Nicolas Magné, Stéphanie Morisson
INTRODUCTION: At the end of life of cancer patients, sedation is sometimes needed, in order to palliate unbearable symptoms that other treatments fail to relieve. Midazolam is currently recommended for sedation and its prescription is guided by national guidelines. The aim of the present study was to evaluate the practices of midazolam prescription in a department of medical oncology and to compare the results with French national recommendations in order to improve the midazolam use in case of sedation...
November 14, 2017: Bulletin du Cancer
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