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https://www.readbyqxmd.com/read/28731945/the-changing-paradigm-of-radiotherapy-in-the-elderly-population
#1
Myer Raphael Pfeffer, Philip Blumenfeld
There is increasing awareness of the special needs for care of the elderly cancer patient. Newer precise conformal radiotherapy techniques allow the safe delivery of higher doses of radiotherapy to the target tumor while reducing the dose to surrounding critical organs. This has led to a shortening of radiotherapy protocols for both curative and palliative indications. We review these novel techniques and protocols and the published clinical studies that include elderly patients treated with these techniques...
July 2017: Cancer Journal
https://www.readbyqxmd.com/read/28731893/validity-of-administrative-data-in-identifying-cancer-related-events-in-adolescents-and-young-adults-a-population-based-study-using-the-impact-cohort
#2
Sumit Gupta, Paul C Nathan, Nancy N Baxter, Cindy Lau, Corinne Daly, Jason D Pole
BACKGROUND: Despite the importance of estimating population level cancer outcomes, most registries do not collect critical events such as relapse. Attempts to use health administrative data to identify these events have focused on older adults and have been mostly unsuccessful. We developed and tested administrative data-based algorithms in a population-based cohort of adolescents and young adults with cancer. METHODS: We identified all Ontario adolescents and young adults 15-21 years old diagnosed with leukemia, lymphoma, sarcoma, or testicular cancer between 1992-2012...
July 20, 2017: Medical Care
https://www.readbyqxmd.com/read/28731379/quasi-experimental-evaluation-of-a-multifaceted-intervention-to-improve-quality-of-end-of-life-care-and-quality-of-dying-for-patients-with-advanced-dementia-in-long-term-care-institutions
#3
René Verreault, Marcel Arcand, Lucie Misson, Pierre J Durand, Edeltraut Kroger, Michèle Aubin, Maryse Savoie, Thomas Hadjistavropoulos, Sharon Kaasalainen, Annick Bédard, Annie Grégoire, Pierre-Hughes Carmichael
BACKGROUND: Improvement in the quality of end-of-life care for advanced dementia is increasingly recognized as a priority in palliative care. AIM: To evaluate the impact of a multidimensional intervention to improve quality of care and quality of dying in advanced dementia in long-term care facilities. DESIGN: Quasi-experimental study with the intervention taking place in two long-term care facilities versus usual care in two others over a 1-year period...
July 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28731361/the-impact-of-teaching-prognostication-at-the-end-of-life-a-pre-post-interventional-study
#4
Alexandria Bear, Tucker Keuter, Jayshil J Patel
BACKGROUND: Providing accurate and valid prognostic information significantly influences end-of-life care. Disclosing a poor prognosis can be among the most difficult of physician responsibilities, thus having appropriate knowledge during training is crucial for appropriate prognostication. OBJECTIVE: To provide internal medicine (IM) house staff with a pre- and posteducational survey to determine their ability to accurately prognosticate 5 common end-stage diseases...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28730773/thermal-ablation-may-improve-outcomes-in-patients-with-colorectal-liver-metastasis-a-case-control-study
#5
Loukia S Poulou, Loukas Thanos, Panayiotis D Ziakas, Emmanouel Merikas, Apostolos Achimastos, Constantine Gennatas, Konstantinos N Syrigos
PURPOSE: Local thermal ablation may extend the scope of palliative therapy in patients with colorectal liver metastasis. We performed a retrospective, case-controlled study to compare patients with colorectal liver metastases that were treated with percutaneous radiofrequency (RF) or microwave (MW) thermal ablation, against the control group of chemotherapy alone. METHODS: We described baseline demographics, ablation sessions, procedure duration and related complications...
May 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/28730759/surgical-treatment-for-colorectal-cancer-in-octogenarians-and-nonagenarians
#6
Young Wan Kim
Advances in surgical techniques and perioperative care have improved cancer-related outcomes. However, there are still concerns regarding the safety of octogenarian and nonagenarian patients during surgery. Clinicians may be reluctant to perform a radical resection for colorectal cancer and administer adjuvant or palliative cytotoxic chemotherapy to octogenarian and nonagenarian patients. In the elderly, setting a primary goal based on multidisciplinary team discussions prior to treatment is important. The overall treatment scheme, risks, and potential benefits should be discussed with elderly patients and their families...
May 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/28730266/-malignant-melanoma-current-status
#7
REVIEW
J K Winkler, K Buder-Bakhaya, A Dimitrakopoulou-Strauss, A Enk, J C Hassel
CLINICAL ISSUE: The incidence of malignant melanoma is continuously increasing. The prognosis of metastatic disease is still limited. STANDARD TREATMENT: Until a few years ago palliative chemotherapy with a limited response rate was the standard treatment for metastatic melanoma. TREATMENT INNOVATIONS: Immunotherapy and targeted therapy provide new treatment options. Immune checkpoint inhibitors have significantly improved the prognosis. DIAGNOSTIC WORK-UP: Regional lymph node sonography, computed tomography (CT) of the neck, chest and abdomen and brain magnetic resonance imaging (MRI) are routinely used...
July 20, 2017: Der Radiologe
https://www.readbyqxmd.com/read/28730250/metastatic-high-grade-myxofibrosarcoma-review-of-a-clinical-case
#8
Tiberiu Paul Neagu, Ruxandra Diana Sinescu, Valentin Enache, Sanda Claudia Achim, Mirela Ţigliş, Liliana Elena Mirea
We present the particular clinical and histological features of a metastatic high-grade myxofibrosarcoma (MFS) of the left buttock in a 77-year-old male patient. The tumor was biopsied and surgically removed in order to increase the patient's comfort, due to its increased size and aggressive clinical behavior. Computed tomography (CT) revealed metastases in the pleura and mediastinal lymph nodes, so limb-sparing tumor excision followed by palliative care was the best practice for the patient until the fatal outcome...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28729130/information-needs-about-palliative-care-and-euthanasia-a-survey-of-patients-in-different-phases-of-their-cancer-trajectory
#9
Kim Beernaert, Chloë Haverbeke, Simon Van Belle, Luc Deliens, Joachim Cohen
OBJECTIVE: We assessed information provision and information needs about illness course, treatments, palliative care and euthanasia in cancer patients. METHODS: Cancer patients consulting a university hospital (N=620) filled out a questionnaire. Their cancer related data were collected through the treating oncologist. This study is performed in Belgium, where "palliative care for all" is a patient's right embedded in the law and euthanasia is possible under certain conditions...
July 1, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28729009/development-of-entrustable-professional-activities-for-hospice-and-palliative-medicine-fellowship-training-in-the-united-states
#10
Lindy H Landzaat, Michael D Barnett, Gary T Buckholz, Jillian L Gustin, Jennifer M Hwang, Stacie K Levine, Tomasz Okon, Steven M Radwany, Holly B Yang, John Encandela, Laura J Morrison
CONTEXT: Entrustable Professional Activities (EPAs) represent the key physician tasks of a specialty. Once a trainee demonstrates competence in an activity, they can then be 'entrusted' to practice without supervision(1). A physician workgroup of the American Academy of Hospice and Palliative Medicine (AAHPM) sought to define Hospice and Palliative Medicine (HPM) EPAs. OBJECTIVE: To describe the development of a set of consensus EPAs for HPM fellowship training in the United States...
July 17, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28728935/transcatheter-arterial-chemoembolization-with-spherical-embolic-agent-in-patients-with-pulmonary-or-mediastinal-metastases-from-breast-cancer
#11
Norifumi Kennoki, Shinichi Hori, Takeo Yuki, Atsushi Hori
PURPOSE: To evaluate safety and feasibility of transcatheter arterial chemoembolization with superabsorbent polymer microspheres (SAP-MS) for patients with pulmonary or mediastinal metastasis from breast cancer. METHODS: Between November 2002 and January 2015, 14 patients with 29 unresectable pulmonary or mediastinal breast cancer metastases underwent transcatheter arterial chemoembolization using SAP-MS (50-100 μm) after injection of a combination of 2-4 types of anticancer drugs (eg, cisplatin [30 mg] + fluorouracil [500 mg], or epirubicin [40 mg] + mitomycin C [4 mg] + fluorouracil [500 mg])...
July 18, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28728799/-mental-health-determines-the-quality-of-life-in-patients-with-cancer-related-neuropathic-pain-in-quito-ecuador
#12
Fernando Gordillo Altamirano, María José Fierro Torres, Nelson Cevallos Salas, María Cristina Cervantes Vélez
OBJECTIVE: To identify the main factors determining the health related quality of life (HRQL) in patients with cancer-related neuropathic pain in a tertiary care hospital. METHODS: A cross-sectional analytical study was performed on a sample of 237 patients meeting criteria for cancer-related neuropathic pain. Clinical and demographic variables were recorded including, cancer type, stage, time since diagnosis, pain intensity, physical functionality with the Palliative Performance Scale (PPS), and anxiety and depression with the Hospital Anxiety and Depression Scale (HADS)...
July 2017: Revista Colombiana de Psiquiatría
https://www.readbyqxmd.com/read/28728768/maintaining-integrity-how-nurses-navigate-boundaries-in-pediatric-palliative-care
#13
Alyssa Erikson, Betty Davies
PURPOSE: To explore how nurses manage personal and professional boundaries in caring for seriously ill children and their families. DESIGN AND METHODS: Using a constructivist grounded theory approach, a convenience sample of 18 registered nurses from four practice sites was interviewed using a semi-structured interview guide. RESULTS: Nurses across the sites engaged in a process of maintaining integrity whereby they integrated two competing, yet essential, aspects of their nursing role - behaving professionally and connecting personally...
July 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/28728515/the-prevalence-of-constipation-at-admission-and-after-one-week-of-palliative-care-a-multicenter-study
#14
Sebastiano Mercadante, Francesco Masedu, Marco Maltoni, Daniela De Giovanni, Luigi Montanari, Cristina Pittureri, Raffaella Bertè, Laura Ursini, Franco Marinangeli, Federica Aielli
AIM: To assess the prevalence and intensity of constipation in advanced-cancer patients referred to palliative care, and to assess changes after one week of specialist palliative care. METHODS: Prospective multicenter study in advanced patients for a period of one year. At admission (T0), age, gender, primary tumor, concomitant diseases, Karnofsky status, Palliative prognostic score (PaP) Edmonton Symptom Assessment scale (ESAS), MDAS (Memorial Delirium Assessment Scale), and bowel function index (BFI) were collected...
July 20, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28728429/palliative-care-for-respiratory-disease-an-education-model-of-care
#15
Brynn Bowman, Diane E Meier
That palliative care improves quality of life for seriously ill patients and their families is well known - but how can healthcare providers ensure that the palliative needs of all patients are being assessed and addressed? A growing number of curricula in core palliative care practices have been developed to ensure that clinicians from all specialties and disciplines have the necessary training to manage pain and symptoms and discuss care goals with patients and families. Through broad-based training in core palliative care skills, combined with referral to specialty palliative care for high-need patients, providers can improve quality of life for their patients with respiratory disease...
January 1, 2017: Chronic Respiratory Disease
https://www.readbyqxmd.com/read/28727692/short-term-outcomes-following-cytoreductive-surgery-and-heated-intra-peritoneal-chemotherapy-at-waikato
#16
Ngov Jasen Ly, Linus Wu, Ralph Van Dalen, Simione Lolohea
AIM: Pseudomyxoma peritonei is a rare disease that affects 1-2 per million population per year. Treatment with cytoreductive surgery with heated intraperitoneal chemotherapy (CRS with IPC) has been well described. The purpose of this study was to look at the short-term outcomes following CRS with IPC for all such patients treated in Waikato. METHOD: Records for all patients presenting to surgery for CRS with IPC were retrospectively reviewed. CRS with IPC was performed in accordance with the techniques described by Sugarbaker...
July 21, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28727277/high-dose-palliative-radiotherapy-for-malignant-pleural-mesothelioma
#17
Farshad Foroudi, Jennifer G Smith, Faye Putt, Morikatsu Wada
INTRODUCTION: High-dose radiotherapy to the hemithorax for patients with malignant pleural mesothelioma is a controversial treatment. Between 2003 and 2013 our institution had a policy of giving hemithoracic radiotherapy to at least 45 Gy. This retrospective study reports survival, progression and toxicity associated with this policy. METHODS: Seventy-one patients with pleural mesothelioma were irradiated with doses of 45-60 Gy. Conformal radiotherapy (3D-CRT) to the lower hemithorax was used for 17 and intensity-modulated radiotherapy (IMRT) to the whole hemithorax for 54 patients...
July 20, 2017: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/28727242/examining-trust-in-health-professionals-among-family-caregivers-of-nursing-home-residents-with-advanced-dementia
#18
Jannie A Boogaard, Perla Werner, Anna Zisberg, Jenny T van der Steen
AIM: In a context of increasing emphasis on shared decision-making and palliative care in dementia, research on family caregivers' trust in health professionals in advanced dementia is surprisingly scant. The aim of the present study was to assess trust in nursing home health professionals of family caregivers of nursing home residents with advanced dementia, and possible correlates, such as family caregivers' satisfaction, involvement in care, care burden and patients' symptom burden...
July 20, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28727207/palliative-care-physicians-experiences-of-end-of-life-communication-a-focus-group-study
#19
C Udo, M Lövgren, G Lundquist, B Axelsson
The aim of this study was to explore palliative home care physicians' experiences regarding end-of-life breakpoint communication (BPC). This is a qualitative study where focus group interviews were conducted and analysed using qualitative content analysis. The results show that the participants saw themselves as being responsible for accomplishing BPC, and they were convinced that it should be regarded as a process of communication initiated at an early stage, i.e. proactively. However, BPC was often conducted as a reaction to the patient's sudden deterioration or sometimes not at all...
July 20, 2017: European Journal of Cancer Care
https://www.readbyqxmd.com/read/28726679/accuracy-of-rhenium-188-spect-ct-activity-quantification-for-applications-in-radionuclide-therapy-using-clinical-reconstruction-methods
#20
Pedro L Esquinas, Carlos F Uribe, M Gonzalez, Cristina Rodríguez-Rodríguez, Urs O Häfeli, Anna Celler
The main applications of (188)Re in radionuclide therapies include trans-arterial liver radioembolization and palliation of painful bone-metastases. In order to optimize (188)Re therapies, the accurate determination of radiation dose delivered to tumors and organs at risk is required. Single photon emission computed tomography (SPECT) can be used to perform such dosimetry calculations. However, the accuracy of dosimetry estimates strongly depends on the accuracy of activity quantification in (188)Re images...
July 20, 2017: Physics in Medicine and Biology
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