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https://www.readbyqxmd.com/read/29449241/simplified-guideline-for-prescribing-medical-cannabinoids-in-primary-care
#1
G Michael Allan, Jamil Ramji, Danielle Perry, Joey Ton, Nathan P Beahm, Nicole Crisp, Beverly Dockrill, Ruth E Dubin, Ted Findlay, Jessica Kirkwood, Michael Fleming, Ken Makus, Xiaofu Zhu, Christina Korownyk, Michael R Kolber, James McCormack, Sharon Nickel, Guillermina Noël, Adrienne J Lindblad
OBJECTIVE: To develop a clinical practice guideline for a simplified approach to medical cannabinoid use in primary care; the focus was on primary care application, with a strong emphasis on best available evidence and a promotion of shared, informed decision making. METHODS: The Evidence Review Group performed a detailed systematic review of 4 clinical areas with the best evidence around cannabinoids: pain, nausea and vomiting, spasticity, and adverse events. Nine health professionals (2 generalist family physicians, 2 pain management-focused family physicians, 1 inner-city family physician, 1 neurologist, 1 oncologist, 1 nurse practitioner, and 1 pharmacist) and a patient representative comprised the Prescribing Guideline Committee (PGC), along with 2 nonvoting members (pharmacist project managers)...
February 2018: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29447356/barriers-to-the-availability-and-accessibility-of-controlled-medicines-for-chronic-pain-in-africa
#2
Elmang Nchako, Scottie Bussell, Carlos Nesbeth, Chisom Odoh
Africans endure a high burden of pain and suffering from HIV/AIDS and cancer, yet receive a meager amount of the world's pain medication. This tragedy occurs needlessly, given that inexpensive, effective and easily administered interventions are available. WHO has a 'three-step analgesic ladder' framework for managing cancer pain. This widely adopted clinical practice guideline is an integral part of palliative care programs and has also been applied to non-cancer pain. However, untreated pain is a major public health problem due to the discordance between scientific evidence and public policy...
February 13, 2018: International Health
https://www.readbyqxmd.com/read/29441104/current-status-of-brachytherapy-in-cancer-treatment-short-overview
#3
REVIEW
Janusz Skowronek
Cancer incidence and mortality depend on a number of factors, including age, socio-economic status and geographical location, and its prevalence is growing around the world. Most of cancer treatments include external beam radiotherapy or brachytherapy. Brachytherapy, a type of radiotherapy with energy from radionuclides inserted directly into the tumor, is increasingly used in cancer treatment. For cervical and skin cancers, it has become a standard therapy for more than 100 years as well as an important part of the treatment guidelines for other malignancies, including head and neck, skin, breast, and prostate cancers...
December 2017: Journal of Contemporary Brachytherapy
https://www.readbyqxmd.com/read/29436279/integrated-palliative-care-is-about-professional-networking-rather-than-standardisation-of-care-a-qualitative-study-with-healthcare-professionals-in-19-integrated-palliative-care-initiatives-in-five-european-countries
#4
Marlieke den Herder-van der Eerden, Jeroen van Wijngaarden, Sheila Payne, Nancy Preston, Lisa Linge-Dahl, Lukas Radbruch, Karen Van Beek, Johan Menten, Csilla Busa, Agnes Csikos, Kris Vissers, Jelle van Gurp, Jeroen Hasselaar
BACKGROUND: Integrated palliative care aims at improving coordination of palliative care services around patients' anticipated needs. However, international comparisons of how integrated palliative care is implemented across four key domains of integrated care (content of care, patient flow, information logistics and availability of (human) resources and material) are lacking. AIM: To examine how integrated palliative care takes shape in practice across abovementioned key domains within several integrated palliative care initiatives in Europe...
February 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29435905/neuroendocrine-carcinoma-of-gallbladder-a-step-beyond-palliative-therapy-experience-of-25-cases
#5
Amol Vijay Kanetkar, Shraddha Patkar, Krunal Harischandra Khobragade, Vikas Ostwal, Anant Ramaswamy, Mahesh Goel
PURPOSE: Published literature on gall bladder neuroendocrine tumors (GB NETs) is limited with none reporting the role of multimodal therapy. METHODS: Patients with histologically confirmed GB NETs treated at Tata Memorial Hospital, Mumbai, from January 2010 to June 2017 were analyzed. Staging was done by contrast-enhanced computed tomography (CECT) of abdomen and chest or a positron emission topography (PET) scan. Tumor marker (CA19-9) was measured. WHO-2017 guideline was used to classify GB NETs...
February 13, 2018: Journal of Gastrointestinal Cancer
https://www.readbyqxmd.com/read/29429920/impact-of-a-clinical-pathway-tool-on-appropriate-palliative-radiation-therapy-for-bone-metastases
#6
Lisa S Rotenstein, Alexander O Kerman, Joseph Killoran, Tracy A Balboni, Monica S Krishnan, Allison Taylor, Neil E Martin
PURPOSE: Clinical pathways increase compliance with treatment guidelines, improve outcomes, and reduce costs. Guidelines recommend single fraction radiation therapy (SFRT) for palliation of uncomplicated bone metastases, but implementation is variable. We examined the effects of a pathway tool on SFRT rates in an academic radiation oncology practice. METHODS AND MATERIALS: Using published literature, clinical guidelines, and expert input, we designed a clinical pathway for bone metastases radiation therapy displayed on a Web-based electronic interface...
December 8, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/29425882/family-meetings-in-in-patient-specialist-palliative-care-a-mechanism-to-convey-empathy
#7
Liz Forbat, Karemah Francois, Lynne O'Callaghan, Julie Kulikowski
CONTEXT: Family meetings are increasingly used in palliative care, yet have little empirical evidence of their impact in in-patient settings. OBJECTIVES: To examine whether relatives report more empathy following a family meeting in a specialist palliative care in-patient ward. METHODS: Pre/post self-complete questionnaires measuring relational empathy and information needs were administered. Qualitative interviews were also conducted. Data were collected over nine months from one inpatient specialist palliative care unit...
February 6, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29423867/uncemented-thompson-s-hemiarthroplasty-safe-palliative-and-cost-effective-surgery-in-the-infirm-patient-a-consecutive-series-of-1445-cases
#8
G Manoharan, B D Chatterton, T S Moores, P J Roberts
BACKGROUND: Guidelines on the management of displaced intracapsular fractures recommend using an Orthopaedic Data Evaluation Panel-rated cemented implant. Prior to the National Institute for Health and Care Excellence guidelines, uncemented implants were commonly used in the UK. METHODS: We retrospectively examined the outcomes of patients with uncemented Thompson's hemiarthroplasties at our unit, between April 2005 and December 2010. Patients who underwent revision surgery before December 2011 were identified...
February 8, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29413727/addressing-spirituality-during-critical-illness-a-review-of-current-literature
#9
REVIEW
Barbara S Gordon, Maggie Keogh, Zachary Davidson, Stephen Griffiths, Vanshdeep Sharma, Deborah Marin, Stephan A Mayer, Neha S Dangayach
OBJECTIVES: The purpose of this review is to provide an overview of research on spirituality and religiosity in the intensive care setting that has been published since the 2004-2005 American College of Critical Care Medicine (ACCM) Clinical Practice Guidelines for the Support of Family in the Patient-Centered Intensive Care Unit with an emphasis on its application beyond palliative and end-of-life care. MATERIALS AND METHODS: ACCM 2004-2005 guidelines emphasized the importance of spiritual and religious support in the form of four specific recommendations: [1] assessment and incorporation of spiritual needs in ICU care plan; [2] spiritual care training for doctors and nurses; [3] physician review of interdisciplinary spiritual need assessments; and [4] honoring the requests of patients to pray with them...
January 31, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29413279/role-of-radiation-therapy-in-patients-with-relapsed-refractory-diffuse-large-b-cell-lymphoma-guidelines-from-the-international-lymphoma-radiation-oncology-group
#10
REVIEW
Andrea K Ng, Joachim Yahalom, Jayant S Goda, Louis S Constine, Chelsea C Pinnix, Chris R Kelsey, Bradford Hoppe, Masahiko Oguchi, Chang-Ok Suh, Andrew Wirth, Shunan Qi, Andrew Davies, Craig H Moskowitz, Siddhartha Laskar, Yexiong Li, Peter M Mauch, Lena Specht, Timothy Illidge
Approximately 30% to 40% of patients with diffuse large B-cell lymphoma (DLBCL) will have either primary refractory disease or relapse after chemotherapy. In transplant-eligible patients, those with disease sensitive to salvage chemotherapy will significantly benefit from high-dose therapy with autologous stem cell transplantation. The rationale for considering radiation therapy (RT) for selected patients with relapsed/refractory DLBCL as a part of the salvage program is based on data regarding the patterns of relapse and retrospective series showing improved local control and clinical outcomes for patients who received peritransplant RT...
March 1, 2018: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/29409684/ongoing-strategies-and-updates-on-pain-management-in-gynecologic-oncology-patients
#11
REVIEW
Kari E Hacker, R Kevin Reynolds, Shitanshu Uppal
The opioid crisis in the United States has been declared a public health emergency. Various governmental agencies, cancer care organizations and the Centers for Disease Control and Prevention have issued guidelines in hopes of managing this crisis. Curbing over-prescription of opioids by medical professionals has been a central theme in many of these guidelines. Gynecologic oncologists encounter patients with a variety of pain sources, including acute pain secondary to the underlying malignancy or surgical procedures as well as chronic pain related to the malignancy and the sequelae of treatments rendered...
February 3, 2018: Gynecologic Oncology
https://www.readbyqxmd.com/read/29400987/dose-rounding-of-biologic-and-cytotoxic-anticancer-agents-a-position-statement-of-the-hematology-oncology-pharmacy-association
#12
Rebecca Fahrenbruch, Polly Kintzel, Anne Marie Bott, Steven Gilmore, Ryan Markham
PURPOSE: To present a position statement from the Hematology/Oncology Pharmacy Association (HOPA) that pertains to dose rounding of biologic and cytotoxic anticancer agents. METHODS: The HOPA Standards Committee organized a work group of oncology pharmacist specialists to examine the safety and value of dose rounding of biologic and cytotoxic anticancer agents. Primary literature that describes methods for dose rounding, with clinical or economic data, were analyzed...
February 5, 2018: Journal of Oncology Practice
https://www.readbyqxmd.com/read/29397121/management-of-perceived-devastating-brain-injury-after-hospital-admission-a-consensus-statement-from-stakeholder-professional-organizations
#13
D Harvey, J Butler, J Groves, A Manara, D Menon, E Thomas, M Wilson
Patients with severe grades of life-threatening brain injury are commonly characterized as having devastating brain injury (DBI), which we have defined as: 'any neurological condition that is assessed at the time of hospital admission as an immediate threat to life or incompatible with good functional recovery AND where early limitation or withdrawal of therapy is being considered'. The outcome in patients with DBI is often death or severe disability, and as a consequence rapid withdrawal of life sustaining therapies is commonly contemplated or undertaken...
January 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29395315/patterns-of-palliative-care-referral-in-ovarian-cancer-a-single-institution-5%C3%A2-year-retrospective-analysis
#14
Roni Nitecki, Elisabeth J Diver, Mihir M Kamdar, David M Boruta, Marcela C Del Carmen, Rachel M Clark, Annekathryn Goodman, John O Schorge, Whitfield B Growdon
BACKGROUND: The American Society of Clinical Oncology recommends that patients with advanced cancer receive dedicated palliative care services early in their disease course. This investigation serves to understand how palliative care services are utilized for ovarian cancer patients in a tertiary referral center. METHODS: We conducted a retrospective review of women treated for ovarian cancer at our institution from 2010 through 2015. Clinical variables included presence and timing of palliative care referral...
January 27, 2018: Gynecologic Oncology
https://www.readbyqxmd.com/read/29393189/palliative-and-supportive-care-of-patients-with-intracranial-glioma
#15
Andrea Pace, Veronica Villani
Clinicians dealing with patients affected by malignant brain tumors are frequently involved in providing palliative and supportive care, particularly at the end of life. It requires a multidisciplinary approach by a well-trained specialized neuro-oncology team. Early initiation of palliative care integrated with standard anticancer therapy may be effective for symptom management and results in improvement of the quality of life. However, studies specifically addressing these issues are very limited, thus do not allow the creation of any reliable evidence-based guidelines...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29388714/-i-didn-t-want-to-be-in-charge-and-yet-i-was-bereaved-caregivers-accounts-of-providing-home-care-for-family-members-with-advanced-cancer
#16
Shan Mohammed, Nadia Swami, Ashley Pope, Gary Rodin, Breffni Hannon, Rinat Nissim, Sarah Hales, Camilla Zimmermann
OBJECTIVE: To describe bereaved caregivers' experiences of providing care at home for patients with advanced cancer, while interacting with home care services. METHODS: Caregivers of patients who had completed a 4-month randomized controlled trial of early palliative care versus standard oncology care were recruited 6 months to 5 years after the patient's death. All patients except one (control) had eventually received palliative care. In semi-structured interviews, participants were asked about their experiences of caregiving...
February 1, 2018: Psycho-oncology
https://www.readbyqxmd.com/read/29379831/translating-a-us-early-palliative-care-model-for-turkey-and-singapore
#17
REVIEW
Imatullah Akyar, James N Dionne-Odom, Grace Meijuan Yang, Marie A Bakitas
The field of palliative care is growing in acceptance and sophistication globally. No longer considered just for patients at end-of-life, palliative care is now being incorporated early in the disease trajectory. Despite professional guidelines supporting early palliative care, there are few models that have been created that can be translated into practice cross-culturally. In the United States, the Educate, Nurture, Advise, Before, Life Ends (ENABLE) early palliative care telehealth model has demonstrated effectiveness in improving quality of life, mood, symptom relief, and survival for patients with cancer and is now being tested in patients with heart failure...
January 2018: Asia-Pacific Journal of Oncology Nursing
https://www.readbyqxmd.com/read/29375887/a-questionnaire-survey-of-pharmacists-regarding-the-clinical-practice-guidelines-for-the-appropriate-use-of-granulocyte-colony-stimulating-factors
#18
Tetsuya Sasaki, Yasuhisa Kato, Atsushi Sato, Noriko Usui, Eishi Baba, Toshimi Takano, Nobuyuki Susumu, Kazunori Ohnishi, Hitomi Nishimoto, Katsuyuki Kiura
Background: Clinical practice guidelines should be user-friendly and confirming their penetration rate and compliance are critical. Methods: We conducted a nationwide web-based questionnaire survey among pharmacists regarding the 2013 guidelines for the appropriate use of granulocyte-colony stimulating factors (G-CSFs) (version 2, published by the Japan Society of Clinical Oncology [JSCO]) between August 24 and September 6, 2015. Results: A total of 301 pharmacists responded; 96...
2018: Journal of Pharmaceutical Health Care and Sciences
https://www.readbyqxmd.com/read/29368644/differences-in-do-not-resuscitate-orders-hospice-care-utilization-and-late-referral-to-hospice-care-between-cancer-and-non-cancer-decedents-in-a-tertiary-hospital-in-taiwan-between-2010-and-2015-a-hospital-based-observational-study
#19
Tzu-Chien Shih, Hsiao-Ting Chang, Ming-Hwai Lin, Chun-Ku Chen, Tzeng-Ji Chen, Shinn-Jang Hwang
BACKGROUND: In 2009, the Taiwanese national health insurance system substantially expanded hospice coverage for terminal cancer patients to include patients with end-stage brain, dementia, heart, lung, liver, and kidney diseases. This study aimed to evaluate differences in do-not-resuscitate (DNR) status and hospice care utilization between terminal cancer patients and advanced non-cancer patients after the policy change. METHODS: Data were obtained from the Death and Hospice Palliative Care Database of Taipei Veterans General Hospital in Taiwan...
January 24, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29367874/locoregional-therapies-in-cholangiocarcinoma
#20
Peter L Labib, Brian R Davidson, Ricky A Sharma, Stephen P Pereira
Cholangiocarcinoma is a rare and aggressive malignancy of the biliary tract. Complete surgical resection can be curative, but the majority of patients are diagnosed with advanced disease and usually die within a year of diagnosis. Most deaths are attributable to local disease progression rather than distant metastases, supporting the use of locoregional therapies. There is evidence that locoregional therapies can provide local tumor control resulting in increased survival while avoiding some of the side effects of systemic treatments, increasing potential treatment options for patients who may be unsuitable for systemic palliative treatments...
October 2017: Hepatic Oncology
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