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https://www.readbyqxmd.com/read/28432090/international-variations-in-clinical-practice-guidelines-for-palliative-sedation-a-systematic-review
#1
REVIEW
Ebun Abarshi, Judith Rietjens, Lenzo Robijn, Augusto Caraceni, Sheila Payne, Luc Deliens, Lieve Van den Block
OBJECTIVES: Palliative sedation is a highly debated medical practice, particularly regarding its proper use in end-of-life care. Worldwide, guidelines are used to standardise care and regulate this practice. In this review, we identify and compare national/regional clinical practice guidelines on palliative sedation against the European Association for Palliative Care (EAPC) palliative sedation Framework and assess the developmental quality of these guidelines using the Appraisal Guideline Research and Evaluation (AGREE II) instrument...
April 20, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28428012/-retrospective-study-of-children-referred-from-paediatric-intensive-care-to-palliative-care-why-and-for-what
#2
Alberto García-Salido, Paula Santos-Herranz, Verónica Puertas-Martín, María Ángeles García-Teresa, Ricardo Martino-Alba, Ana Serrano-González
INTRODUCTION: The creation of paediatric palliative care units (PPCU) could optimise the management of children with palliative focus after admission to a paediatric intensive care unit (PICU). This study describes the clinical and epidemiological characteristics of children referred from PICU to the UCPP of the Autonomous Community of Madrid (CAM). The overall treatment, relapses, re-admissions, and deaths, if occurred, are described. PATIENTS AND METHOD: A retrospective review was performed using the medical records from children transferred from the CAM paediatric intensive care units to the paediatric palliative care unit (1 March 2008-31 January 2015)...
April 17, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28393785/modifying-risks-to-improve-outcome-in-cardiac-surgery-an-anesthesiologist-s-perspective
#3
REVIEW
Murali Chakravarthy
Challenging times are here for cardiac surgical and anesthesia team. The interventional cardiologist seem to have closed the flow of 'good cases' coming up for any of the surgery,; successful percutaneous interventions seem to be offering reasonable results in these patients, who therefore do not knock on the doors of the surgeons any more . It is a common experience among the cardiac anesthesiologists and surgeons that the type of the cases that come by now are high risk. That may be presence of comorbidities, ongoing medical therapies, unstable angina, uncontrolled heart failure and rhythm disturbances; and in patients with ischemic heart disease, the target coronaries are far from ideal...
April 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28386787/prospective-evaluation-of-systematic-use-of-peripherally-inserted-central-catheters-picc-lines-for-the-home-care-after-allogeneic-hematopoietic-stem-cells-transplantation
#4
J Cornillon, J A Martignoles, E Tavernier-Tardy, M Gire, P Martinez, C Tranchan, A Vallard, K Augeul-Meunier, B Hacquard, D Guyotat
PURPOSE: Long-term catheters are often necessary for outpatient care after an allogeneic hematopoietic stem cell transplantation (HSCT), However, there is paucity of data on the use of peripherally inserted central catheter (PICC) in post-HSCT setting. METHODS: We prospectively evaluated the systematic use of PICC in 37 consecutive patients returning home after HSCT. RESULTS: In 6 out of 37 patients, the PICC was exclusively used for weekly blood controls...
April 6, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28365652/interstage-home-monitoring-after-newborn-first-stage-palliation-for-hypoplastic-left-heart-syndrome-family-education-strategies
#5
Jo Ann Nieves, Karen Uzark, Nancy A Rudd, Jennifer Strawn, Anne Schmelzer, Nancy Dobrolet
Children born with hypoplastic left heart syndrome are at high risk for serious morbidity, growth failure, and mortality during the interstage period, which is the time from discharge home after first-stage hypoplastic left heart syndrome palliation until the second-stage surgical intervention. The single-ventricle circulatory physiology is complex, fragile, and potentially unstable. Multicenter initiatives have been successfully implemented to improve outcomes and optimize growth and survival during the interstage period...
April 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28353374/prediction-of-poor-short-term-prognosis-and-unmet-needs-in-advanced-chronic-obstructive-pulmonary-disease-use-of-the-two-minute-walking-distance-extracted-from-a-six-minute-walk-test
#6
Han-Yee Neo, Hui-Ying Xu, Huei-Yaw Wu, Allyn Hum
OBJECTIVES: Prognostic challenges hinder the identification of patients with advanced chronic obstructive pulmonary disease (COPD) for timely palliative interventions. We postulate that a two-minute derivative (two-minute walking distance [2MWD]) of a standard six-minute walk test (6MWT) can identify frail subjects with poorer survival for early palliative intervention. The primary outcome of interest is mortality at 18 months. Secondary objectives include evaluation of the relationship between the 2MWD and ability to self-care, dyspnea-related disabilities, nutrition, forced expiratory volume in first second (FEV1), quality of life (QoL), and comorbidity burden...
March 29, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28320382/laparoscopic-t-tube-feeding-jejunostomy-as-an-adjunct-to-staging-laparoscopy-for-upper-gastrointestinal-malignancies-the-technique-and-review-of-outcomes
#7
Sze Li Siow, Hans Alexander Mahendran, Chee Ming Wong, Nirumal Kumar Milaksh, Myo Nyunt
BACKGROUND: In recent years, staging laparoscopy has gained acceptance as part of the assessment of resectability of upper gastrointestinal (UGI) malignancies. Not infrequently, we encounter tumours that are either locally advanced; requiring neoadjuvant therapy or occult peritoneal disease that requires palliation. In all these cases, the establishment of enteral feeding during staging laparoscopy is important for patients' nutrition. This review describes our technique of performing laparoscopic feeding jejunostomy and the clinical outcomes...
March 20, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28301959/utility-of-clinico-biological-data-for-long-term-prognosis-of-head-and-neck-terminal-cancer
#8
Taiji Kawasaki, Koichiro Wasano, Sayuri Yamamoto, Shuta Tomisato, Kaoru Ogawa
OBJECTIVE: The prognosis of terminal head and neck cancer is traditionally determined using indices such as the palliative prognosis index. We aimed to develop an alternative prognosis index using clinico-biological data. METHODS: This retrospective case-series study included 33 head and neck cancer patients whose cancer recurred despite receiving radiation therapy between April 2010 and April 2014. Clinico-biological data were collected the day patients were diagnosed as terminal...
March 16, 2017: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/28289851/withdrawal-of-artificial-nutrition-and-hydration-in-neonatal-intensive-care-parents-and-healthcare-practitioners-views
#9
Véronique Fournier, Elisabeth Belghiti, Laurence Brunet, Marta Spranzi
Withdrawing Artificial Nutrition and Hydration (WANH) in the neonatal intensive care units (NICUs) has long been controversial. In France, the practice has become a legal option since 2005. But even though, the question remains as to what the stakeholders' experience is, and whether they consider it ethically appropriate. In order to contribute to the debate, we initiated a study in 2009 to evaluate parental and health care professionals (HCP) perspectives, after they experienced WAHN for a newborn. The study included 25 cases from 5 different clinical neonatology departments...
March 13, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28288593/palliative-gastrectomy-is-beneficial-in-selected-cases-of-metastatic-gastric-cancer
#10
Jun-Te Hsu, Jian-Ann Liao, Huei-Chieh Chuang, Tai-Di Chen, Tsung-Hsing Chen, Chia-Jung Kuo, Chun-Jung Lin, Wen-Chi Chou, Ta-Sen Yeh, Yi-Yin Jan
BACKGROUND: Salvage chemotherapy is the mainstay of treatment for metastatic gastric cancer (mGC). This study aimed to clarify the effects of palliative gastrectomy (PG) and identify prognostic factors in mGC patients undergoing PG. METHODS: This was a retrospective review of 333 mGC patients receiving PG or a non-resection procedure (NR) between 2000 and 2010. Clinicopathological factors affecting the prognosis of these patients were collected prospectively and analyzed...
March 14, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28268054/the-nature-of-conflict-in-palliative-care-a-qualitative-exploration-of-the-experiences-of-staff-and-family-members
#11
Karemah François, Elizabeth Lobb, Sarah Barclay, Liz Forbat
OBJECTIVES: Conflict is a significant and recurring problem in healthcare. This study aimed to understand staff and relatives' perspectives on the characteristics of conflict and serious disagreement in adult palliative care, including triggers, risk factors and the impact on themselves and clinical care. METHODS: Qualitative study of 25 staff and seven bereaved relatives using individual interviews, recruited from a multidisciplinary specialist palliative care setting in Australia...
February 24, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28266126/the-outcomes-of-31-cases-of-trisomy-13-diagnosed-in-utero-with-various-management-options
#12
Ken Takahashi, Aiko Sasaki, Seiji Wada, Yuka Wada, Keiko Tsukamoto, Rika Kosaki, Yushi Ito, Haruhiko Sago
There are few reports on the prognosis of prenatally diagnosed trisomy 13 in relation to postnatal management. The aim of this study was to report on the prenatal and postnatal outcomes and postnatal management of trisomy 13 fetuses that were prenatally diagnosed at our center between 2003 and 2015. The data were retrospectively reviewed from medical records. Of the 31 cases of trisomy 13, 12 patients were diagnosed before 22 weeks of gestation, and 19 were diagnosed at or after 22 weeks of gestation. Nine families opted for termination of the pregnancy, 14 fetuses died, and 8 were born alive...
March 7, 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28250751/traumatic-brain-injury-and-palliative-care-a-retrospective-analysis-of-49-patients-receiving-palliative-care-during-2013-2016-in-turkey
#13
Kadriye Kahveci, Metin Dinçer, Cihan Doger, Ayse Karhan Yaricı
Traumatic brain injury (TBI), which is seen more in young adults, affects both patients and their families. The need for palliative care in TBI and the limits of the care requirement are not clear. The aim of this study was to investigate the length of stay in the palliative care center (PCC), Turkey, the status of patients at discharge, and the need for palliative care in patients with TBI. The medical records of 49 patients with TBI receiving palliative care in PCC during 2013-2016 were retrospectively collected, including age and gender of patients, the length of stay in PCC, the cause of TBI, diagnosis, Glasgow Coma Scale score, Glasgow Outcome Scale score, Karnofsky Performance Status score, mobilization status, nutrition route (oral, percutaneous endoscopic gastrostomy), pressure ulcers, and discharge status...
January 2017: Neural Regeneration Research
https://www.readbyqxmd.com/read/28244680/dysphagia-in-infants-with-single-ventricle-anatomy-following-stage-1-palliation-physiologic-correlates-and-response-to-treatment
#14
Katlyn Elizabeth McGrattan, Heather McGhee, Allan DeToma, Elizabeth G Hill, Sinai C Zyblewski, Maureen Lefton-Greif, Lucinda Halstead, Scott M Bradley, Bonnie Martin-Harris
BACKGROUND: Deficits in swallowing physiology are a leading morbidity for infants with functional single ventricles and systemic outflow tract obstruction following stage 1 palliation. Despite the high prevalence of this condition, the underlying deficits that cause this post-operative impairment remain poorly understood. OBJECTIVE: Identify the physiologic correlates of dysphagia in infants with functional single ventricles and systemic outflow tract obstruction following stage 1 palliative surgery...
February 28, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28226414/methylene-blue-for-the-treatment-of-intractable-pain-associated-with-oral-mucositis
#15
Carlos J Roldan, Kent Nouri, Thomas Chai, Billy Huh
Oral mucositis is a common and often debilitating complication among cancer patients receiving radiation therapy to the head and neck or chemotherapy agents, or undergoing hematopoietic stem cell transplantation. Pain and decreased oral function associated with oral mucositis may persist long after the conclusion of therapy. Although most patients respond to conservative management, a subset of patients develop intractable pain with severe consequences. For some, the use of total parenteral nutrition with insertion of percutaneous endoscopic gastrostomy feeding tubes is the only alternative...
February 22, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28220314/supportive-care-organization-in-france-a-national-in-depth-survey-among-patients-and-oncologists
#16
Florian Scotté, Christian Hervé, Pauline Leroy, Jean-Marc Tourani, René-Jean Bensadoun, Marie-Eve Bugat, Fadila Farsi, Nicolas Jovenin, Moïse Namer, Christophe Tournigand, Sophie Morin, Cloé Brami, Stéphane Oudard, Alexandre Saadi, Ivan Krakowski
PURPOSE: Medical doctors' (MDs), but not patients', perception of supportive care in cancer (SCC) in France has been previously assessed in a national survey. This study evaluated MDs and patients' perceptions of the SCC organization and implementation in France. METHODS: The French SCC Association conducted two observational studies: study 1 (S1), containing a 30-point questionnaire sent to 2263 MDs, and study 2 (S2), containing a 40-point questionnaire sent to 2000 patients...
February 20, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28216856/feasibility-and-acceptability-of-implementing-the-integrated-care-plan-for-the-dying-in-the-indian-setting-survey-of-perspectives-of-indian-palliative-care-providers
#17
Naveen Salins, Jeremy Johnson, Stanley Macaden
INTRODUCTION: Capacity to provide end-of-life care in India is scored as 0.6/100, and very few people in India have access to palliative and end-of-life care. Lack of end-of-life care provision in India has led to a significant number of people receiving inappropriate medical treatment at the end of life, with no access to pain and symptom control and high treatment costs. The International Collaborative for the Best Care for the Dying Person is an initiative that offers the opportunity to apply international evidence on the key factors required to provide best care for the dying in the Indian context...
January 2017: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/28184974/-causes-of-death-in-amyotrophic-lateral-sclerosis-results-from-the-rhineland-palatinate-als-registry
#18
J Wolf, A Safer, J C Wöhrle, F Palm, W A Nix, M Maschke, A J Grau
BACKGROUND: Amyotrophic lateral sclerosis (ALS) is associated with an increased mortality. Knowledge of possible causes of death could lead to an individualization of the palliative treatment concept and result in a differentiated palliative treatment pathway. Currently, only few systematic data are available on the heterogeneity of causes of death associated with ALS. OBJECTIVE: Analysis of the various causes of death in a prospective population-based German cohort of ALS patients...
February 9, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28174485/prognostic-nutritional-index-is-an-independent-prognostic-factor-for-gastric-cancer-patients-with-peritoneal-dissemination
#19
Runcong Nie, Shuqiang Yuan, Shi Chen, Xiaojiang Chen, Yongming Chen, Baoyan Zhu, Haibo Qiu, Zhiwei Zhou, Junsheng Peng, Yingbo Chen
OBJECTIVE: The predictive and prognostic role of prognostic nutritional index (PNI) in gastric cancer patients with peritoneal dissemination remains unclear. This study aims to explore the role of the PNI in predicting outcomes of gastric cancer patients with peritoneal dissemination. METHODS: A total of 660 patients diagnosed with gastric adenocarcinoma with peritoneal metastasis between January 2000 and April 2014 at Sun Yat-sen University Cancer Center and the Sixth Affiliated Hospital of Sun Yat-sen University were retrospectively analyzed...
December 2016: Chinese Journal of Cancer Research, Chung-kuo Yen Cheng Yen Chiu
https://www.readbyqxmd.com/read/28166798/identifying-and-characterising-health-policy-and-system-relevant-documents-in-uganda-a-scoping-review-to-develop-a-framework-for-the-development-of-a-one-stop-shop
#20
Boniface Mutatina, Robert Basaza, Ekwaro Obuku, John N Lavis, Nelson Sewankambo
BACKGROUND: Health policymakers in low- and middle-income countries continue to face difficulties in accessing and using research evidence for decision-making. This study aimed to identify and provide a refined categorisation of the policy documents necessary for building the content of a one-stop shop for documents relevant to health policy and systems in Uganda. The on-line resource is to facilitate timely access to well-packaged evidence for decision-making. METHODS: We conducted a scoping review of Uganda-specific, health policy, and systems-relevant documents produced between 2000 and 2014...
February 6, 2017: Health Research Policy and Systems
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