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https://www.readbyqxmd.com/read/29668027/heart-transplant-in-children-what-a-primary-care-provider-needs-to-know
#1
Swati Sehgal, Emily Shea, Lauren Kelm, Deepak Kamat
Heart transplantation is offered to children with heart failure that is not amenable to medical or surgical therapy. Indications for heart transplant include unrepairable congenital heart disease, failed palliation of congenital heart disease, and cardiomyopathies. There has been tremendous progress in this field since the first heart transplant was performed in 1967. Each year, approximately 500 pediatric heart transplants take place worldwide. Pediatric heart transplant survivors are living longer with their initial transplant...
April 1, 2018: Pediatric Annals
https://www.readbyqxmd.com/read/29667475/how-family-caregivers-help-older-relatives-navigate-statutory-services-at-the-end-of-life-a-descriptive-qualitative-study
#2
Lisa Ann Williams, Tess Moeke-Maxwell, Janine Wiles, Stella Black, Gabriella Trussardi, Ngaire Kerse, Merryn Gott
BACKGROUND: A key challenge in meeting the palliative care needs of people in advanced age is the multiple healthcare and social service agencies typically involved in their care. The 'patient navigator' model, originally developed in cancer care, is the professional solution most often recommended to address this challenge. However, little attention has been paid, or is known, about the role that family carers play in enabling their dying relatives to negotiate service gaps. AIM: To explore the role family caregivers play in helping people dying in advanced old age navigate health services at the end of life...
April 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29666901/subcutaneously-administered-dexmedetomidine-is-efficiently-absorbed-and-is-associated-with-attenuated-cardiovascular-effects-in-healthy-volunteers
#3
P Uusalo, D Al-Ramahi, I Tilli, R A Aantaa, M Scheinin, T I Saari
PURPOSE: Palliative care patients often need sedation to alleviate intractable anxiety, stress, and pain. Dexmedetomidine is used for sedation of intensive care patients, but there is no prior information on its subcutaneous (SC) administration, a route that would be favored in palliative care. We compared the pharmacokinetics and cardiovascular, sympatholytic, and sedative effects of SC and intravenously (IV) administered dexmedetomidine in healthy volunteers. METHODS: An open two-period, cross-over design with balanced randomization was used...
April 17, 2018: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29666139/last-year-of-life-study-cologne-lyol-c-protocol-for-a-cross-sectional-mixed-methods-study-to-examine-care-trajectories-and-transitions-in-the-last-year-of-life-until-death
#4
Julia Strupp, Gloria Hanke, Nicolas Schippel, Holger Pfaff, Ute Karbach, Christian Rietz, Raymond Voltz
INTRODUCTION: The last year of life constitutes a particularly vulnerable phase for patients, involving nearly all health and social care structures. Yet, little scientific evidence is available that provides insight into the trajectories including the number and types of care setting transitions, transitions into palliative care and the dying phase. Only few studies have focused on difficulties associated with having to move between health and social care settings in the last year of life, although patients face a significant risk of adverse events...
April 17, 2018: BMJ Open
https://www.readbyqxmd.com/read/29666009/in-vitro-validation-of-a-self-driving-aortic-turbine-venous-assist-device-for-fontan-patients
#5
Kerem Pekkan, Ibrahim Basar Aka, Ece Tutsak, Erhan Ermek, Haldun Balim, Ismail Lazoglu, Riza Turkoz
BACKGROUND: Palliative repair of single ventricle defects involve a series of open-heart surgeries where a single-ventricle (Fontan) circulation is established. As the patient ages, this paradoxical circulation gradually fails, because of its high venous pressure levels. Reversal of the Fontan paradox requires an extra subpulmonic energy that can be provided through mechanical assist devices. The objective of this study was to evaluate the hemodynamic performance of a totally implantable integrated aortic-turbine venous-assist (iATVA) system, which does not need an external drive power and maintains low venous pressure chronically, for the Fontan circulation...
March 11, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29665807/palliative-care-for-patients-with-cancer-do-patients-receive-the-care-they-consider-important-a-survey-study
#6
Marianne Heins, Jolien Hofstede, Mieke Rijken, Joke Korevaar, Gé Donker, Anneke Francke
BACKGROUND: In many countries, GPs and home care nurses are involved in care for patients with advanced cancer. Given the varied and complex needs of these patients, providing satisfactory care is a major challenge for them. We therefore aimed to study which aspects of care patients, GPs and home care nurses consider important and whether patients receive these aspects. METHODS: Seventy-two Dutch patients with advanced cancer, 87 GPs and 26 home care nurses rated the importance of support when experiencing symptoms, respect for patients' autonomy and information provision...
April 17, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29665588/current-technique-and-application-of-percutaneous-cryotherapy
#7
Andreas H Mahnken, Alexander Marc König, Jens Holger Figiel
PURPOSE:  Local ablative therapies have become an established treatment option in interventional oncology. Radiofrequency ablation (RFA) and microwave ablation (MWA) are a standard of care in the treatment of hepatocellular carcinoma (HCC). Currently, there is an increasing interest in cryotherapy, one of the oldest ablation techniques. It has some unique characteristics with regard to technology and mechanism of action. MATERIALS AND METHODS:  A systematic literature search using the terms cryotherapy, cryosurgery and cryoablation was performed...
April 17, 2018: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
https://www.readbyqxmd.com/read/29664725/expectations-for-tinnitus-treatment-and-outcomes-a-survey-study-of-audiologists-and-patients
#8
Fatima T Husain, Phillip E Gander, Jaclyn N Jansen, Sa Shen
BACKGROUND: Roughly 10-15% of the general population is affected by tinnitus and this percentage is estimated to rise in future. Because there is currently no cure for tinnitus, treatment is limited and is primarily achieved through management of symptoms and counseling. PURPOSE: This study compared audiologists' and patients' responses to related survey questions about their expectations regarding tinnitus treatment. Two separate surveys were created, one for patients with tinnitus, and one for practicing audiologists who may treat such patients...
April 2018: Journal of the American Academy of Audiology
https://www.readbyqxmd.com/read/29664697/best-practices-for-reducing-unplanned-acute-care-for-patients-with-cancer
#9
Nathan R Handley, Lynn M Schuchter, Justin E Bekelman
Variation and cost in oncology care represent a large and growing burden for the US health care system, and acute hospital care is one of the single largest drivers. Reduction of unplanned acute care is a major priority for clinical transformation in oncology; proposed changes to Medicare reimbursement for patients with cancer who suffer unplanned admissions while receiving chemotherapy heighten the need. We conducted a review of best practices to reduce unplanned acute care for patients with cancer. We searched PubMed for articles published between 2000 and 2017 and reviewed guidelines published by professional organizations...
April 17, 2018: Journal of Oncology Practice
https://www.readbyqxmd.com/read/29663828/effect-of-participation-in-a-randomised-controlled-trial-of-an-integrated-palliative-care-intervention-on-hiv-associated-stigma
#10
Keira Lowther, Richard Harding, Victoria Simms, Nancy Gikaara, Aabid Ahmed, Zipporah Ali, Hellen Kariuki, Lorraine Sherr, Irene J Higginson, Lucy Selman
We conducted in Kenya a mixed-methods randomised controlled trial (RCT) of a nurse-led palliative care intervention integrated with anti-retroviral therapy (ART) provision for the management of HIV. Here we report qualitative findings showing increased resistance to HIV-associated stigma among trial participants. A mixed method design was chosen to enable identification of the active ingredients of the intervention and exploration of participants' experiences of receiving the intervention. The RCT was conducted from July 2011 to November 2012 in a community hospital in the city of Mombasa, Kenya, with a sample of 120 adults with HIV on ART...
April 17, 2018: AIDS Care
https://www.readbyqxmd.com/read/29663697/testing-a-new-form-to-document-goals-of-care-discussions-regarding-plans-for-end-of-life-care-for-patients-in-an-australian-emergency-department
#11
Amber C Mills, Michele Levinson, William A Dunlop, Edward Cheong, Timothy Cowan, Jennifer Hanning, Erin O'Callaghan, Katherine J Walker
OBJECTIVE: There is limited literature to inform the content and format of Goals-of-Care forms, for use by doctors when they are undertaking these important conversations. METHODS: This was a prospective, qualitative and quantitative study evaluating the utility of a new 'Goals-of-Care' form to doctors in a private, tertiary ED, used from December 2016 to February 2017 at Cabrini, Melbourne. A Goals-of-Care form was designed, incorporating medical aims of therapy and patient values and preferences...
April 16, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29663123/creation-of-a-restrictive-atrial-communication-in-heart-failure-with-preserved-and-mid-range-ejection-fraction-effective-palliation-of-left-atrial-hypertension-and-pulmonary-congestion
#12
Anna Bauer, Markus Khalil, Monika Lüdemann, Jürgen Bauer, Anoosh Esmaeili, Roberta De-Rosa, Norbert F Voelkel, Hakan Akintuerk, Dietmar Schranz
BACKGROUND: Left atrial decompression is considered in patients with symptomatic heart failure with preserved ejection fraction (HFpEF). We aimed to evaluate the feasibility and efficacy of transcatheter generation of a restrictive atrial septum communication to manage HFpEF from infancy to adulthood with cardiomyopathy and congenital heart defect. METHODS AND RESULTS: From June 2009 to December 2016, 24 patients (50% with an age less than 16 years) with HFpEF were palliated; NYHA-/Ross class IV (n = 10); median systemic ventricular ejection fraction 64 (range 35-78) %...
April 16, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29663062/-follow-up-of-bladder-cancer-the-right-examinations-at-the-right-time
#13
REVIEW
P Olbert, P J Goebell, A Hegele
Schedules for the follow-up (FU) of bladder cancer patients are predominantly based on studies with low level of evidence and the resulting guidelines' recommendations that are often founded on expert consensus. FU of non-muscle invasive bladder cancer (NMIBC) includes cystoscopy and cytology as standard, and imaging modalities to a lower extent. FU of muscle-invasive bladder cancer (MIBC) depends primarily on the therapeutic modality chosen and on the stage of disease. In this scenario, FU is complemented by functional and quality of life related aspects...
April 16, 2018: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/29663037/polyfunctionality-of-cd4-t-lymphocytes-is-increased-after-chemoradiotherapy-of-head-and-neck-squamous-cell-carcinoma
#14
J Doescher, S Jeske, S E Weissinger, C Brunner, S Laban, E Bölke, T K Hoffmann, T L Whiteside, P J Schuler
BACKGROUND: For head and neck squamous cell cancer (HNSCC), standard therapy consists of surgery, radiation, and/or chemotherapy. Antineoplastic immunotherapy could be an option in an adjuvant setting and is already in palliation. A functional immune system is a prerequisite for successful immunotherapy. However, effects of the standard-of-care therapy on the patients' immune system are not fully understood. METHODS: Peripheral blood mononuclear cells (PBMC) were collected from patients with HNSCC (n = 37) and healthy controls (n = 10)...
April 16, 2018: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
https://www.readbyqxmd.com/read/29663015/-palliative-care-challenges-in-the-intensive-care-unit
#15
REVIEW
H Lemm, J Hoeger-Schäfer, M Buerke
Intensive care unit (ICU) stays often result due to an acute, potentially life-threatening illness or aggravation of a chronic life-threatening illness. In many cases, ICU patients die after life-sustaining treatments are withdrawn or withheld. When patients are asked, they prefer to die at home, although logistic and medical problems often prevent this. Therefore, attention focuses on care at the end of life in the ICU. Despite many efforts to improve the quality of care, evidence suggests that the quality in hospitals varies significantly and that palliative care in the ICU has not significantly improved over time...
April 16, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29662888/prognostic-value-of-immunoscore-and-pd-l1-expression-in-metastatic-colorectal-cancer-patients-with-different-ras-status-after-palliative-operation
#16
Ruiqi Liu, Ke Peng, Yiyi Yu, Li Liang, Xiaojing Xu, Wei Li, Shan Yu, Tianshu Liu
Colorectal cancer (CRC) is the fifth leading cause of cancer death and the fifth most commonly diagnosed cancer in China. Approximately, 25% of CRC was in the advanced stage as diagnosed, and 40% of patients with CRC progress to metastatic colorectal cancer (mCRC). RAS mutation status is now routinely used to select their therapy. But it is still a question whether RAS mutation status is a prognostic marker. In our study, we detected RAS mutation, immunoscore (IS), and PD-L1 expression in 60 Chinese mCRC patients who received palliative operation...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29662656/stereotactic-body-radiation-therapy-for-palliative-management-of-pancreatic-adenocarcinoma-in-elderly-and-medically-inoperable-patients
#17
John F Ryan, Lauren M Rosati, Vincent P Groot, Dung T Le, Lei Zheng, Daniel A Laheru, Eun J Shin, Juan Jackson, Joseph Moore, Amol K Narang, Joseph M Herman
Stereotactic body radiation therapy (SBRT) represents a promising treatment option for patients with localized pancreatic ductal adenocarcinoma (PDAC) who cannot tolerate surgical therapy. We retrospectively reviewed the records of patients with localized PDAC treated with SBRT at our institution between 2010 and 2016 to identify patients deemed medically inoperable due to poor performance status, advanced age, and/or comorbid conditions. Overall survival (OS), progression-free survival (PFS), and local progression-free survival (LPFS) were estimated using Kaplan-Meier curves...
March 27, 2018: Oncotarget
https://www.readbyqxmd.com/read/29662598/-clinical-epidemiological-and-therapeutic-features-of-biliary-tract-cancers-about-20-cases
#18
Ibrahima Ka, Magatte Faye, Papa Saloum Diop, Amadou Bocar Niang Aliou Coly Faye, Jean Marc Ndoye, Babacar Fall
Biliary tract cancers mainly occur in two sites: gallbladder cancer which are adenocarcinomas and intra- and extrahepatic cholangiocarcinomas. We conducted a retrospective study of 20 cases with biliary tract cancer in the Department of Surgery at the General Hospital in Grand-Yoff between January 2006 and October 2014. 40% of patients had gallbladder cancer, 60% of patients had common bile duct cancer. Sex ratio was 1. The average age of patients was 58.1 years. The average time to diagnosis was 3.77 months...
2018: Pan African Medical Journal
https://www.readbyqxmd.com/read/29662536/attrition-as-one-of-the-challenges-of-developing-a-palliative-care-centre-experience-of-the-indian-institute-of-head-and-neck-oncology-indore-india
#19
EDITORIAL
Digpal Dharkar
Palliative care is an essential component of health care delivery. With respect to India, currently, despite rapid socio economic development, there are tremendous challenges in offering institutional palliative care due to several factors. A major factor has been an acute shortage of trained palliative care professionals. Another has been the fact that the majority of India's population is not covered by any health insurance. We describe the problems, including attrition faced by the Indian Institute of Head and Neck Oncology, in the central Indian state of Madhya Pradesh...
2018: Ecancermedicalscience
https://www.readbyqxmd.com/read/29661851/the-bmj-awards-2018-palliative-and-hospice-care-team-of-the-year
#20
Nigel Hawkes
No abstract text is available yet for this article.
April 16, 2018: BMJ: British Medical Journal
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