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Renal palliative care

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https://www.readbyqxmd.com/read/29767579/healthcare-use-costs-and-quality-of-life-in-patients-with-end-stage-kidney-disease-receiving-conservative-management-results-from-a-multi-centre-observational-study-packs
#1
Glenn Phair, Ashley Agus, Charles Normand, Kevin Brazil, Aine Burns, Paul Roderick, Alexander P Maxwell, Colin Thompson, Magdi Yaqoob, Helen Noble
BACKGROUND: Previous research has explored the cost of providing renal replacement therapies in patients with end-stage kidney disease and their quality of life. This is the first study to examine the healthcare costs of patients receiving conservative care without dialysis for end-stage kidney disease. This alternative to dialysis is an option for patients who prefer a supportive and palliative care approach. AIM: Descriptive cost and quality of life analyses alongside a UK-based multi-centre observational study in patients receiving conservative management for end-stage kidney disease...
May 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29743022/predictors-of-major-complications-after-elective-abdominal-surgery-in-cancer-patients
#2
Claudia M Simões, Maria J C Carmona, Ludhmila A Hajjar, Jean-Louis Vincent, Giovanni Landoni, Alessandro Belletti, Joaquim E Vieira, Juliano P de Almeida, Elisangela P de Almeida, Ulysses Ribeiro, Ana L Kauling, Celso Tutyia, Lie Tamaoki, Julia T Fukushima, José O C Auler
BACKGROUND: Patients undergoing abdominal surgery for solid tumours frequently develop major postoperative complications, which negatively affect quality of life, costs of care and survival. Few studies have identified the determinants of perioperative complications in this group. METHODS: We performed a prospective observational study including all patients (age > 18) undergoing abdominal surgery for cancer at a single institution between June 2011 and August 2013...
May 9, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29739453/spontaneous-renal-hemorrhage-secondary-to-choriocarcinoma-in-a-man-with-congenital-hypospadias-and-cryptorchidism-a-case-report-and-literature-review
#3
Yi Li, Gang Chen, Han Chen, Shuang Wen, Chao-Yu Xiong, Zi-Yi Yang, Yun-Xiao Zhu, Nathan Jeffreys
BACKGROUND: Choriocarcinoma is a rare malignant germ-cell tumour, most commonly found in adult women. It infrequently presents as spontaneous renal haemorrhage (SRH). Genital malformation and SRH secondary to choriocarcinoma has previously been only reported in females. We present what we believe to be the first case of a male patient with genital malformation (hypospadias and cryptorchidism) and SRH at presentation of choriocarcinoma. CASE PRESENTATION: A 25-year-old man presented to the department with intense pain in the right flank region and lower back...
May 8, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29729346/validation-of-the-ipos-renal-symptom-survey-in-advanced-kidney-disease-a-cross-sectional-study
#4
Rajesh Raj, Kiran Ahuja, Mai Frandsen, Fliss E M Murtagh, Matthew Jose
CONTEXT: The significant symptom burden in advanced renal disease is often poorly recognized by clinicians. Recently, the Integrated Palliative Outcome Score (IPOS) - Renal survey was developed from pre-existing tools to capture these symptoms and other common concerns. OBJECTIVES: We studied the validity and reliability of the IPOS-Renal survey (patient and staff versions) in an Australian population. METHODS: Adult patients with advanced renal disease and nurses caring for them participated...
May 2, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29694607/clinical-and-laboratory-characteristics-associated-with-referral-of-hospitalized-elderly-to-palliative-care
#5
Suelen Pereira Arcanjo, Luis Alberto Saporetti, José Antonio Esper Curiati, Wilson Jacob-Filho, Thiago Junqueira Avelino-Silva
Objective To investigate clinical and laboratory characteristics associated with referral of acutely ill older adults to exclusive palliative care. Methods A retrospective cohort study based on 572 admissions of acutely ill patients aged 60 years or over to a university hospital located in São Paulo, Brazil, from 2009 to 2013. The primary outcome was the clinical indication for exclusive palliative care. Comprehensive geriatric assessments were used to measure target predictors, such as sociodemographic, clinical, cognitive, functional and laboratory data...
2018: Einstein
https://www.readbyqxmd.com/read/29665588/current-technique-and-application-of-percutaneous-cryotherapy
#6
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/29650821/-continuation-of-axitinib-for-advanced-renal-cell-carcinoma-by-the-application-of-homecare-urology-a-case-report-and-literature-review
#7
Satoshi Yazawa, Yuji Kato, Jin Nakahara, Toshio Miyata, Mototsugu Oya
A 56-year-old man with advanced RCC and a past medical history of type 2 diabetes underwent a radical left nephrectomy following a histological diagnosis of papillary RCC, G2, INF b, pT3, V1 in 1999. In 2008, sorafenib was started to treat multiple pulmonary metastases of RCC. In 2011, sorafenib was switched to sunitinib when radiologic progression was observed. In 2014, sunitinib was switched to axitinib when further radiologic progression was observed. In 2015, the patient was referred to Yazawa clinic for homecare urology when hospital visits became difficult due to cancer pain and bilateral lower-extremity muscle weakness...
April 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29622009/health-service-utilisation-during-the-last-year-of-life-a-prospective-longitudinal-study-of-the-pathways-of-patients-with-chronic-kidney-disease-stages-3-5
#8
Shirley Chambers, Helen Healy, Wendy E Hoy, Adrian Kark, Sharad Ratanjee, Geoffrey Mitchell, Carol Douglas, Patsy Yates, Ann Bonner
BACKGROUND: Chronic kidney disease (CKD) is a growing global problem affecting around 10% of many countries' populations. Providing appropriate palliative care services (PCS) to those with advanced kidney disease is becoming paramount. Palliative/supportive care alongside usual CKD clinical treatment is gaining acceptance in nephrology services although the collaboration with and use of PCS is not consistent. METHODS: The goal of this study was to track and quantify the health service utilisation of people with CKD stages 3-5 over the last 12 months of life...
April 5, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29596042/ten-tips-nephrologists-wish-the-palliative-care-team-knew-about-caring-for-patients-with-kidney-disease
#9
Amar D Bansal, Amanda Leonberg-Yoo, Jane O Schell, Jennifer S Scherer, Christopher A Jones
Many patients with chronic kidney disease (CKD) and end-stage renal disease have unmet palliative care (PC) needs. Physical and emotional symptoms are common. Some, like uremia and fluid overload, improve with dialysis, but the increasing age of patients initiating renal replacement therapy leaves many untreatable comorbidities like dementia and frailty to negatively impact quality of life. Written by nephrologists and PC clinicians, this article will help PC providers to have a richer understanding of kidney disease-related symptom burden, disease trajectory, prognosis, and barriers to hospice enrollment for patients with CKD and end-stage renal disease...
April 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29596025/palliative-care-consultation-in-advanced-chronic-kidney-disease-with-pain
#10
Kwok Ying Chan, Desmond Y H Yap, Terence Yip, Mau Kwong Sham, Sing Leung Lui, Tak Mao Chan
BACKGROUND: There is little data on pain management in patients with advanced chronic kidney disease (CKD) who have opted for palliative care. OBJECTIVE: We investigated the prevalence, severity and management of pain in advanced CKD patients attending Renal Palliative Care out-patient clinics under our Division. METHODS: Consecutive patients referred to the Renal Palliative Care Clinics at two hospitals under our Division from July 2012 to June 2016 were included...
March 12, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29523558/drug-associated-risk-tool-development-and-validation-of-a-self-assessment-questionnaire-to-screen-for-hospitalised-patients-at-risk-for-drug-related-problems
#11
Carole P Kaufmann, Dominik Stämpfli, Nadine Mory, Kurt E Hersberger, Markus L Lampert
INTRODUCTION: Identifying patients with a high risk for drug-related problems (DRPs) might optimise the allocation of targeted pharmaceutical care during the hospital stay and on discharge. OBJECTIVE: To develop a self-assessment screening tool to identify patients at risk for DRPs and validate the tool regarding feasibility, acceptability and the reliability of the patients' answers. DESIGN: Prospective validation study. SETTING: Two mid-sized hospitals (300-400 beds)...
March 9, 2018: BMJ Open
https://www.readbyqxmd.com/read/29521074/thromboprophylaxis-in-cancer-patients-in-hospice
#12
REVIEW
Ewa Zabrocka, Marek Z Wojtukiewicz, Ewa Sierko
Advanced cancer patients in hospice are at notably increased risk of venous thromboembolism (VTE) due to age, local and distal advancement of the malignancy and bed confinement, among other factors. Asymptomatic VTE prevalence among palliative care patients has been found to reach 50%, whereas the clinically overt form occurs in 10%. Hospice patients are frequently given medications increasing VTE risk, for instance megestrol which is a drug commonly used in cancer cachexia. Many of the available guidelines encourage the implementation of thromboprophylaxis (TPX) in cancer patients, e...
February 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/29510920/palliative-care-disincentives-in-ckd-changing-policy-to-improve-ckd-care
#13
Manjula Kurella Tamura, Ann M O'Hare, Eugene Lin, Laura M Holdsworth, Elizabeth Malcolm, Alvin H Moss
The dominant health delivery model for advanced chronic kidney disease (CKD) and end-stage renal disease (ESRD) in the United States, which focuses on provision of dialysis, is ill-equipped to address many of the needs of seriously ill patients. Although palliative care may address some of these gaps in care, its integration into advanced CKD care has been suboptimal due to several health system barriers. These barriers include uneven access to specialty palliative care services, underdeveloped models of care for seriously ill patients with advanced CKD, and misaligned policy incentives...
March 3, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29490907/parents-refusing-dialysis-for-a-3-month-old-with-renal-failure
#14
Laurel Willig, Erin Paquette, D Micah Hester, Bradley A Warady, John D Lantos
A 3-month-old boy with failure to thrive was referred to a nephrology clinic after a diagnostic workup for failure to thrive revealed a serum urea nitrogen level of 95 mg/dL and creatinine level of 3.6 mg/dL. A renal ultrasound revealed marked bilateral hydronephrosis with little remaining renal cortex in either kidney. A voiding cystourethrogram revealed evidence of posterior urethral valves. The child had no evident comorbidities. Fulguration of the valves was successfully performed but did not lead to improvement in kidney function...
February 28, 2018: Pediatrics
https://www.readbyqxmd.com/read/29482355/the-role-of-palliative-care-in-addressing-the-health-needs-of-syrian-refugees-in-jordan
#15
Isabel Pinheiro, Dilshad Jaff
Refugees are often afflicted with health conditions that require long-term, specialized and continuous care services that are costly and difficult to secure in host countries and camp settings. This study interviewed 21 Syrian refugees in Jordan with life-limiting conditions such as cancer, diabetes, chronic disability and renal failure, and 4 caregivers caring for refugee children with similar conditions. This study found that patients in refugee camps and communities would benefit from receiving palliative care services that are often either unavailable or inaccessible...
February 27, 2018: Medicine, Conflict, and Survival
https://www.readbyqxmd.com/read/29465875/-calcific-uremic-arteriolopathy-calciphylaxis-update-in-2018
#16
Cyrielle Alves, Thomas Ernandez, Catherine Stoermann Chopard
Calciphylaxis is a rare disease with a poor prognostic that mostly occurs in patients with renal failure. Diagnosis is difficult and skin biopsy is the gold standard diagnostic procedure, although it may aggravate skin lesions. Identification of the typical cutaneous signs is important to initiate adequate medical care. Several differential diagnoses must be excluded. Treatments should include appropriate pain management, local wound pain, daily dialysis, intravenous sodium thiosulfate treatment, hyperbaric oxygenotherapy, thigh control of calcium-phosphate metabolism and interruption of medications that could contribute to calciphylaxis...
February 21, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29366912/change-in-physiological-variables-in-the-last-two-weeks-of-life-an-observational-study-of-hospitalized-adults-with-heart-failure
#17
Paul Taylor, Simon Crouch, Debra A Howell, Dawn W Dowding, Miriam J Johnson
CONTEXT: Recognition of dying is a difficult task in end-stage heart failure, yet it remains an important clinical skill in providing good palliative care to these patients. OBJECTIVES: To use routinely collected data to explore evidence for physiological change in the final two weeks of life in end-stage heart failure. METHODS: This was a retrospective cohort study of routinely collected data from hospital inpatients dying as a result of heart failure during a one-year period in a U...
May 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29361829/barriers-to-hospice-care-in-trauma-patients-the-disparities-in-end-of-life-care
#18
Krista L Haines, Hee Soo Jung, Tiffany Zens, Scott Turner, Charles Warner-Hillard, Suresh Agarwal
INTRODUCTION: End-of-life and palliative care are important aspects of trauma care and are not well defined. This analysis evaluates the racial and socioeconomic disparities in terms of utilization of hospice services for critically ill trauma patients. METHODS: Trauma patients ≥15 years old from 2012 to 2015 were queried from the National Trauma Databank. Chi-square and multivariate logistic regression analyses for disposition to hospice were performed after controlling for age, gender, comorbidities, injury severity, insurance, race, and ethnicity...
January 1, 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29314264/a-practical-guide-for-the-care-of-patients-with-end-stage-renal-disease-near-the-end-of-life
#19
Amar D Bansal, Jane O Schell
Most patients who rely on dialysis for treatment of end-stage renal disease (ESRD) never receive a kidney transplant. Therefore, it is important for nephrology providers to feel comfortable discussing the role of dialysis near the end of life (EOL). Advance care planning (ACP) is an ongoing process of learning patient values and goals in an effort to outline preferences for current and future care. This review presents a framework for how to incorporate ACP in the care of dialysis patients throughout the kidney disease course and at the EOL...
March 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29297082/enhancing-recovery-from-sepsis-a-review
#20
REVIEW
Hallie C Prescott, Derek C Angus
Importance: Survival from sepsis has improved in recent years, resulting in an increasing number of patients who have survived sepsis treatment. Current sepsis guidelines do not provide guidance on posthospital care or recovery. Observations: Each year, more than 19 million individuals develop sepsis, defined as a life-threatening acute organ dysfunction secondary to infection. Approximately 14 million survive to hospital discharge and their prognosis varies. Half of patients recover, one-third die during the following year, and one-sixth have severe persistent impairments...
January 2, 2018: JAMA: the Journal of the American Medical Association
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