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https://www.readbyqxmd.com/read/28063860/could-objective-tests-be-used-to-measure-fatigue-in-patients-with-advanced-cancer
#1
Gustavo Schvartsman, Minjeong Park, Diane D Liu, Sriram Yennu, Eduardo Bruera, David Hui
CONTEXT: Assessment of cancer-related fatigue is currently based on patient-reported outcomes. We asked whether objective assessments such as muscle strength and nutritional markers can be used as surrogate measures of cancer-related fatigue. OBJECTIVE: We examined the association among three fatigue scales, muscle strength, and nutritional markers in patients with advanced cancer. METHODS: In this prospective study, we enrolled hospitalized cancer patients who had been seen in palliative care consultation at MD Anderson Cancer Center...
January 4, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28041869/-palliative-care-after-neonatal-intensive-care-contributions-of-leonetti-law-and-remaining-challenges
#2
P Kuhn, L Dillenseger, N Cojean, B Escande, C Zores, D Astruc
The 2005 enactment of the "Patients' rights and end-of-life care" act, known as the Leonetti law, has been accompanied by practical changes in the processes of withdrawal and withholding of active life-sustaining treatments. This law has also promoted the implementation of palliative care in perinatal medicine to avoid unreasonable therapeutic interventions and to preserve the dying patient's quality of life and human dignity. Recently, a new law has been voted by the French National Assembly and new reflections on the ethical aspects of the end of life in neonatal medicine should resume again within the French Society of Neonatology in the working group on ethical issues in neonatology...
December 29, 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28038676/health-care-professionals-experience-understanding-and-perception-of-need-of-advanced-cancer-patients-with-cachexia-and-their-families-the-benefits-of-a-dedicated-clinic
#3
David Scott, Joanne Reid, Peter Hudson, Peter Martin, Sam Porter
BACKGROUND: Cachexia is defined as the on-going loss of skeletal muscle mass that cannot be fully reversed by conventional nutritional support. It is found in up to 80% of patients with advanced cancer and has profound psycho-social consequences for patients and their families. Previous studies demonstrate that many healthcare professionals receive little formal education in cachexia management leading them to feel that they have limited understanding of the syndrome and cannot intervene effectively...
December 30, 2016: BMC Palliative Care
https://www.readbyqxmd.com/read/28034356/improving-cancer-care-for-children-in-the-developing-world-challenges-and-strategies
#4
Zakiya Al Lamki
Cancer is a global health problem particularly in developing countries where the burden of cancer is ever increasing and claiming the lives of about 100,000 children under the age of 15 years every year. Majority of these occur in the Low and Middle Income Countries (LMICs) where 90% of world children live. Contributing factors to this trend is the reduction of communicable diseases and emergence of new infections, improvement of nutrition and socio-economic conditions, industrialization and urbanization. However, due to its complexity, childhood cancer is given the least priority by the governments' funding...
December 30, 2016: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28032354/end-of-life-treatment-decisions-in-nursing-home-residents-dying-with-dementia-in-the-netherlands
#5
Simone A Hendriks, Martin Smalbrugge, Luc Deliens, Raymond T C M Koopmans, Bregje D Onwuteaka-Philipsen, Cees M P M Hertogh, Jenny T van der Steen
OBJECTIVE: The objective was to describe end-of-life treatment decisions for patients dying with dementia in various stages of dementia in long-term care facilities in the Netherlands with elderly care physicians responsible for treatment and care. METHODS: We present data collected in the nationally representative Dutch End of Life in Dementia study (2007-2011). Within 2 weeks after death, 103 physicians completed questionnaires about the last phase of life in 330 residents with dementia who resided in 1 of 34 participating long-term care facilities...
December 29, 2016: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/27958619/evaluation-of-urgent-multivisceral-resections-due-to-complications-resulting-from-an-advanced-ovarian-cancer
#6
Tomasz Miłek, Witold Woźniak, Piotr Porzycki, Alkalayla Habib, Agnieszka Timorek, Piotr Ciostek, Włodzimierz Sawicki, Krzysztof Cendrowski
BACKGROUND: Unlike other solid tumors (i.e. pancreas, gallbladder, stomach), an ovarian cancer is responsive to a systemic treatment with platinum derivates in 80% of patients. This apparent chemosensitivity justifies a broader surgical approach. A cytoreductive, "tumor-debulking" surgery is defined as an attempt to remove in a maximum degree all visible and detect-able lesions. Despite treatment, the advancement of the disease very often leads to complications defined as "surgical" and life-threatening...
2016: Ginekologia Polska
https://www.readbyqxmd.com/read/27940700/acceptability-of-family-centered-advanced-care-planning-for-adolescents-with-hiv
#7
Ronald H Dallas, Allison Kimmel, Megan L Wilkins, Sohail Rana, Ana Garcia, Yao I Cheng, Jichuan Wang, Maureen E Lyon
BACKGROUND AND OBJECTIVE: Small pilot studies support the appropriateness of engaging adolescents with chronic or life-limiting illnesses in pediatric advance care planning (pACP). We do not yet know if pACP is acceptable, feasible, and worthwhile, even if emotionally intense, in a fully powered randomized controlled trial. METHODS: We conducted a prospective 2-arm randomized controlled trial at 6 US urban hospitals. Adolescent/family member dyads were randomized to receive the 1-session-a-week 3-session FAmily-CEntered Advance Care Planning (FACE) pACP intervention (1, ACP Survey; 2, Goals of Care Conversation/Treatment Preferences; 3, Completion of Advance Directive) or active comparator (1, Developmental History; 2, Safety Tips; 3, Nutrition/Exercise)...
December 2016: Pediatrics
https://www.readbyqxmd.com/read/27920476/self-expanding-metal-stents-for-the-palliation-of-malignant-gastric-outlet-obstruction-in-patients-with-peritoneal-carcinomatosis
#8
Christoph Rademacher, Matthias Bechtler, Steffen Schneider, Bettina Hartmann, Johannes Striegel, Ralf Jakobs
AIM: To evaluate the efficacy of self-expanding metal stents (SEMS) for the palliation of malignant gastric outlet obstruction in patients with and without peritoneal carcinomatosis (PC). METHODS: We performed a retrospective analysis of 62 patients who underwent SEMS placement for treatment of malignant gastroduodenal obstruction at our hospital over a six-year period. Stents were deployed through the scope under combined fluoroscopic and endoscopic guidance. Technical success was defined as successful stent placement and expansion...
November 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27900726/survey-on-german-palliative-care-specialists-experiences-with-advance-directives
#9
Julia Zenz, Michael Zenz
INTRODUCTION: Advance directives (AD) play a central role in end-of-life treatments, intensive care, and palliative care. However, little is known about the experiences of healthcare professionals with ADs. This study reports on palliative care professionals' views on advance directives (AD). METHODS: A questionnaire was handed out to attendants of a palliative care symposium. RESULTS: Complete answers were obtained from 126 physicians and 276 nurses...
November 29, 2016: Pain and Therapy
https://www.readbyqxmd.com/read/27867410/closed-gastroschisis-vanishing-midgut-and-extreme-short-bowel-syndrome-case-report-and-review-of-the-literature
#10
F A Dennison
Gastroschisis alone has excellent survival rates. Occasionally reported is closed gastroschisis, leading to vanishing small bowel and extreme short bowel syndrome. It is believed that the abdominal wall defect can contract or close in utero, which leads to strangulation of the eviscerated bowel and the rare "vanishing gut syndrome." This has a very poor prognosis with mortality as high as 70%. An 18-year-old primigravid patient's 13 week scan diagnosed a large gastroschisis affecting the fetus. After counselling, she decided to continue with the pregnancy...
August 2016: Ultrasound: Journal of the British Medical Ultrasound Society
https://www.readbyqxmd.com/read/27853740/utility-of-endoscopic-therapy-in-the-management-of-boerhaave-syndrome
#11
K J Dickinson, N Buttar, L M Wong Kee Song, C J Gostout, S D Cassivi, M S Allen, F C Nichols, K R Shen, D A Wigle, S H Blackmon
Background/aims: The optimal intervention for Boerhaave perforation has not been determined. Options include surgical repair with/without a pedicled muscle flap, T tube placement, esophageal resection or diversion, or an endoscopic approach. All management strategies require adequate drainage and nutritional support. Our aim was to evaluate outcomes following Boerhaave perforation treated with surgery, endoscopic therapy, or both. Patients and methods: We performed a 10-year review of our prospectively maintained databases of adult patients with Boerhaave perforations...
November 2016: Endoscopy International Open
https://www.readbyqxmd.com/read/27798016/supporting-the-provision-of-palliative-care-in-the-home-environment-a-proof-of-concept-single-arm-trial-of-a-palliative-carers-education-package-precept
#12
Liz Forbat, Erna Haraldsdottir, Marsha Lewis, Ken Hepburn
INTRODUCTION: Practical educational interventions for palliative carers are needed. Current supports frequently rely on carers travelling to a central venue to receive education. A substantial gap therefore exists around determining how high-quality relevant information can be delivered nationally, with limited cost implications, using educational methods that are acceptable to carers in palliative care. This study seeks to design and assess feasibility and acceptability of a distance-learning approach to educating carers...
October 25, 2016: BMJ Open
https://www.readbyqxmd.com/read/27751743/nutriscore-a-new-nutritional-screening-tool-for-oncological-outpatients
#13
Lorena Arribas, Laura Hurtós, Maria José Sendrós, Inmaculada Peiró, Neus Salleras, Eduard Fort, Jose Manuel Sánchez-Migallón
OBJECTIVES: The aim of this study was to design a new nutritional screening tool (NUTRISCORE) to detect nutritional risk in outpatients with cancer. METHODS: A multicenter, cross-sectional study was conducted. We randomly selected outpatients receiving onco-specific, palliative, or symptomatic treatment for malignant neoplasms (including solid tumors and hematologic malignancies). These patients were assessed using the NUTRISCORE tool, the Malnutrition Screening Tool (MST), and the Patient-Generated Subjective Global Assessment (PG-SGA) to detect risk for malnutrition...
January 2017: Nutrition
https://www.readbyqxmd.com/read/27750261/does-nutrition-support-have-a-role-in-managing-cancer-cachexia
#14
Alessandro Laviano, Gianluca Di Lazzaro Giraldi, Angela Koverech
PURPOSE OF REVIEW: Cachexia is a negative prognostic factor in cancer patients. The pathogenesis is related to a variable combination of reduced food intake and metabolic changes. However, whether nutritional support may contribute to effectively prevent and treat cachexia remains a debated issue. RECENT FINDINGS: Consistent evidence demonstrates that anabolic windows of opportunity occur during the clinical trajectory of cancer patients. Also, the use of specific nutrients, namely omega-3 fatty acids, may enhance the efficacy of nutritional support when tumor-driven inflammatory response is high...
December 2016: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/27729480/baby-o-and-the-withdrawal-of-life-sustaining-medical-treatment-in-the-devastated-neonate-a-review-of-clinical-ethical-and-legal-issues
#15
Joseph Sacco, Rebecca Virata
The discontinuation of life sustaining medical treatment (LSMT) in severely and permanently impaired neonates, especially artificial nutrition and hydration (ANH) is subject to uncertainty and controversy. Definitive clinical guidelines are lacking, clinical research is limited, ethical disagreement is commonplace, and while case and statutory law provide legal underpinning for the practice in defined circumstances, uncertainty in this realm likely influences clinical practice. We use the case of a neurologically devastated neonate to highlight and review these arenas, and show how, using available legal, ethical, and clinical standards and practice, the case of Baby O was resolved, and to underline the need for further research in neonatal palliative care...
October 11, 2016: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/27703567/the-association-between-malnutrition-and-pressure-ulcers-in-elderly-in-long-term-care-facility
#16
Lenche Neloska, Katerina Damevska, Andjelka Nikolchev, Lidija Pavleska, Biljana Petreska-Zovic, Milenko Kostov
BACKGROUND: Malnutrition is common in elderly and is a risk factor for pressure ulcers. AIM: The aim of the present study was to determine the prevalence of malnutrition in geriatric and palliative patients hospitalised in long-term care facility, and to examine the influence of nutritional status on the prevalence of pressure ulcers (PU). MATERIAL AND METHODS: Descriptive, observational and cross-sectional study including 2099 patients admitted to the Hospital during a 24 month period (January 2013 to December 2014)...
September 15, 2016: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/27645556/identifying-patients-with-advanced-chronic-conditions-for-a-progressive-palliative-care-approach-a-cross-sectional-study-of-prognostic-indicators-related-to-end-of-life-trajectories
#17
J Amblàs-Novellas, S A Murray, J Espaulella, J C Martori, R Oller, M Martinez-Muñoz, N Molist, C Blay, X Gómez-Batiste
OBJECTIVES: 2 innovative concepts have lately been developed to radically improve the care of patients with advanced chronic conditions (PACC): early identification of palliative care (PC) needs and the 3 end-of-life trajectories in chronic illnesses (acute, intermittent and gradual dwindling). It is not clear (1) what indicators work best for this early identification and (2) if specific clinical indicators exist for each of these trajectories. The objectives of this study are to explore these 2 issues...
September 19, 2016: BMJ Open
https://www.readbyqxmd.com/read/27640365/estimating-the-palliative-effect-of-percutaneous-endoscopic-gastrostomy-in-an-observational-registry-using-principal-stratification-and-generalized-propensity-scores
#18
Pallavi S Mishra-Kalyani, Brent A Johnson, Jonathan D Glass, Qi Long
Clinical disease registries offer a rich collection of valuable patient information but also pose challenges that require special care and attention in statistical analyses. The goal of this paper is to propose a statistical framework that allows for estimating the effect of surgical insertion of a percutaneous endogastrostomy (PEG) tube for patients living with amyotrophic lateral sclerosis (ALS) using data from a clinical registry. Although all ALS patients are informed about PEG, only some patients agree to the procedure which, leads to the potential for selection bias...
September 19, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27635765/practical-multimodal-care-for-cancer-cachexia
#19
Matthew Maddocks, Jane Hopkinson, John Conibear, Annie Reeves, Clare Shaw, Ken C H Fearon
PURPOSE OF REVIEW: Cancer cachexia is common and reduces function, treatment tolerability and quality of life. Given its multifaceted pathophysiology a multimodal approach to cachexia management is advocated for, but can be difficult to realise in practice. We use a case-based approach to highlight practical approaches to the multimodal management of cachexia for patients across the cancer trajectory. RECENT FINDINGS: Four cases with lung cancer spanning surgical resection, radical chemoradiotherapy, palliative chemotherapy and no anticancer treatment are presented...
December 2016: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/27626318/esophageal-stenting-for-benign-and-malignant-disease-european-society-of-gastrointestinal-endoscopy-esge-clinical-guideline
#20
Manon C W Spaander, Todd H Baron, Peter D Siersema, Lorenzo Fuccio, Brigitte Schumacher, Àngels Escorsell, Juan-Carlos Garcia-Pagán, Jean-Marc Dumonceau, Massimo Conio, Antonella de Ceglie, Janusz Skowronek, Marianne Nordsmark, Thomas Seufferlein, André Van Gossum, Cesare Hassan, Alessandro Repici, Marco J Bruno
This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE), endorsed by the European Society for Radiotherapy and Oncology (ESTRO), the European Society of Digestive Endoscopy (ESDO), and the European Society for Clinical Nutrition and Metabolism (ESPEN). The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was adopted to define the strength of recommendations and the quality of evidence. Main recommendations for malignant disease 1 ESGE recommends placement of partially or fully covered self-expandable metal stents (SEMSs) for palliative treatment of malignant dysphagia over laser therapy, photodynamic therapy, and esophageal bypass (strong recommendation, high quality evidence)...
October 2016: Endoscopy
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