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https://www.readbyqxmd.com/read/27902530/cardiac-troponin-release-is-associated-with-biomarkers-of-inflammation-and-ventricular-dilatation-during-critical-illness
#1
Marlies Ostermann, Salma Ayis, Emma Tuddenham, Jessica Lo, Katie Lei, John Smith, Barnaby Sanderson, Carl Moran, Paul Collinson, Janet Peacock, Andrew Rhodes, David Treacher
INTRODUCTION: Troponin release is common during critical illness. We hypothesized that there was an association between cardiac troponin T (cTnT) and biomarkers of systemic inflammation and ventricular dilatation. METHODS: In an observational prospective cohort study, we enrolled consecutive adult patients admitted for non-cardiac reasons to the Intensive Care Unit (ICU) in 2 tertiary care centers. We measured cTnT, C-reactive protein (CRP), Interleukin-6 (IL-6), procalcitonin (PCT) and N-terminal pro brain natriuretic peptide (NT-proBNP) daily in the first week, and on alternate days in the second week...
November 29, 2016: Shock
https://www.readbyqxmd.com/read/27898294/longitudinal-changes-in-and-modifiable-predictors-of-the-prevalence-of-severe-depressive-symptoms-for-family-caregivers-of-terminally-ill-cancer-patients-over-the-first-two-years-of-bereavement
#2
Su-Ching Kuo, Wen-Chi Chou, Jen-Shi Chen, Wen-Cheng Chang, Ming-Chu Chiang, Ming-Mo Hou, Siew Tzuh Tang
BACKGROUND: Bereaved families endure tremendous grief. However, few studies have longitudinally investigated caregivers' bereavement grief for more than one year postloss and none is from family-oriented Asian countries. OBJECTIVES: We explored longitudinal changes in and modifiable predictors of severe depressive symptoms for Taiwanese family caregivers of terminally ill cancer patients over the first two years postloss. DESIGN: For this descriptive, longitudinal study, severe depressive symptoms (Center for Epidemiological Studies Depression Scale score ≥16) were measured 1, 3, 6, 13, 18, and 24 months postloss...
November 29, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27893033/effect-of-a-decision-aid-on-access-to-total-knee-replacement-for-black-patients-with-osteoarthritis-of-the-knee-a-randomized-clinical-trial
#3
Said A Ibrahim, Marissa Blum, Gwo-Chin Lee, Pekka Mooar, Elina Medvedeva, Aliya Collier, Diane Richardson
Importance: Black patients with advanced osteoarthritis (OA) of the knee are significantly less likely than white patients to undergo surgery. No strategies have been proved to improve access to surgery for black patients with end-stage OA of the knee. Objective: To assess whether a decision aid improves access to total knee replacement (TKR) surgery for black patients with OA of the knee. Design, Setting, and Participants: In a randomized clinical trial, 336 eligible participants who self-identified as black and 50 years or older with chronic and frequent knee pain, a Western Ontario McMaster Universities Osteoarthritis Index score of at least 39, and radiographic evidence of OA of the knee were recruited from December 1, 2010, to May 31, 2014, at 3 medical centers...
November 23, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27882391/-palliative-care-for-patients-with-turkish-or-arabic-migration-background-in-lower-saxony-a%C3%A2-survey-from-palliative-care-professionals-perspective
#4
Maximiliane Jansky, Sonja Owusu-Boakye, Friedemann Nauck
BACKGROUND AND OBJECTIVES: People with a migration background (MB) are an important part of German society. If and how they use specialised palliative care (SPC) has not been studied. We aimed to assess the current SPC for patients with Turkish or Arabic MB (the largest group of immigrants in Germany with a shared ascribed culture) from the point of view of healthcare professionals (HCP) in Lower Saxony. METHOD: All HCPs in institutions providing SPC (n = 90) were invited to participate in an anonymous online survey which contained closed and open questions about care for this patient group, characteristics of the last patient with Turkish or Arabic MB they cared for, and resources and strategies to care for these patients...
November 23, 2016: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/27880621/the-dying-role-its-relevance-to-improved-patient-care
#5
Russell Noyes, John Clancy
SOCIETY is failing to meet the obligation it has to its dying members. Persons with terminal illnesses suffer isolation and neglect in hospitals, receive overzealous treatment by physicians, and are kept in ignorance of their situation by families and medical personnel. Evidence for these statements has come from observers of the medical care system and from dying patients themselves (Kübler-Ross, 1969; Reynolds and Kalish, 1974; Sudnow, 1967). In the nineteenth century it was common for persons to die in the familiar environs of their homes, surrounded by grieving families from whom they parted in a meaningful manner (Blauner, 1966)...
2016: Psychiatry
https://www.readbyqxmd.com/read/27875642/international-perspectives-on-physician-assistance-in-dying
#6
David Orentlicher
When the Supreme Court of Canada recognized a constitutional right to "medical assistance in dying" last year-and the nation's Parliament enacted legislation to implement the right earlier this year-Canadian lawmakers could look to two different models for guidance. The Netherlands and Belgium recognize a broad right to assistance in dying, while Oregon and elsewhere in the United States have a narrow right. In some ways, assistance in dying in Canada follows the Dutch-Belgian approach, while, in other ways, it seems more American...
November 2016: Hastings Center Report
https://www.readbyqxmd.com/read/27871287/perspectives-on-death-and-dying-a-study-of-resident-comfort-with-end-of-life-care
#7
Jessica M Schmit, Lynne E Meyer, Jennifer M Duff, Yunfeng Dai, Fei Zou, Julia L Close
BACKGROUND: Despite the benefits to early palliative care in the treatment of terminal illness, barriers to timely hospice referrals exist. Physicians who are more comfortable having end-of-life (EOL) conversations are more likely to refer to hospice. However, very little is known about what factors influence comfort with EOL care. METHODS: An anonymous survey was sent to all the residents and fellows at a single institution. Self-reported education, experience and comfort with EOL care was assessed...
November 21, 2016: BMC Medical Education
https://www.readbyqxmd.com/read/27861375/trends-of-do-not-resuscitate-consent-and-hospice-care-utilization-among-noncancer-decedents-in-a-tertiary-hospital-in-taiwan-between-2010-and-2014-a-hospital-based-observational-study
#8
Hsiao-Ting Chang, Ming-Hwai Lin, Chun-Ku Chen, Pesus Chou, Tzeng-Ji Chen, Shinn-Jang Hwang
Do-Not-Resuscitate (DNR) and hospice care are not only applied to cancer patients but also to patients with noncancer progressive illness. However, the trends of DNR consent and hospice utilization are not well explored for noncancer patients. This study aimed to explore the trends of DNR consent and hospice care utilization among noncancer decedents in a tertiary hospital in Taiwan. We analyzed the Death and Hospice Palliative Care Database from the Taipei Veterans General Hospital in Taiwan. The Death and Hospice Palliative Care Database contains information including patient sex, major diagnosis, admission date, date of death, age at death, department at discharge, status of DNR consent, and status of hospice care of patients who died in the Taipei Veterans General Hospital...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27858496/inverse-association-between-platelet-lymphocyte-ratio-and-prognosis-in-terminally-ill-cancer-patients-a-preliminary-study
#9
Yoonjoo Lee, Ye Won Kim, Dong Kyun Park, In Cheol Hwang
BACKGROUND: An elevated platelet-lymphocyte ratio (PLR) is an indicator for worse outcomes in cancer, but its significance at the end of life remains unclear. OBJECTIVE: This study aimed to investigate the value of PLR as an independent prognostic factor in terminally ill cancer patients. METHODS: This retrospective cohort study included 312 terminal cancer patients and was conducted in a palliative care unit of a tertiary cancer center. Patient demographic data, clinical information, and laboratory values, including complete blood cell count, were obtained...
November 18, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27831972/the-role-of-thioredoxin-1-in-suppression-sepsis-through-inhibiting-mitochonrial-induced-apoptosis-in-spleen
#10
Guobing Chen, Xiang Li, Mengbing Huang, Xiaoshuang Zhou, Ye Li, Xiaoqin Mao, Jie Bai
Sepsis is a serious public health issue and the leading cause of death in critically ill patients in intensive care units. Thioredoxin-1 (Trx-1) is a protein of regulating redox, as well as a modulator of inflammation and apoptosis. Our previous study reported that Trx-1 decreased endoplasmic reticulum mediated inflammation involved in lung in a model of experimental sepsis. However, its effect on mitochondrial -mediated apoptosis in spleen has not been reported. We studied whether Trx-1 could prevent spleen cells apoptosis in sepsis...
November 9, 2016: Shock
https://www.readbyqxmd.com/read/27828774/ethical-analysis-for-physicians-considering-the-provision-of-life-ending-medication-in-compliance-with-the-california-end-of-life-option-act
#11
D Malcolm Shaner
The End of Life Option Act in California, effective June 9, 2016, permits physicians to prescribe lethal medication to patients confirmed to be terminally ill and capable of independently making and carrying out a decision to ingest deadly medication. Medicine has traditionally excluded the provision of deadly medication from proper practice. Physicians reasonably may hold to that limit. However, honoring a repeated request from a capable, terminally ill patient to receive life-ending medication still can be considered to be a moral and permissible approach to relieve suffering...
2016: Permanente Journal
https://www.readbyqxmd.com/read/27828697/aripiprazole-induced-hyperlipidemia-an-update
#12
Caroline Tarraf, Wadih J Naja
OBJECTIVE: To review the literature on the metabolic side effects of aripiprazole. Three cases of aripiprazole-induced hypertriglyceridemia are also presented. DATA SOURCES: A search was conducted of English-language articles and abstracts (meta-analyses, randomized controlled trials, clinical trials, naturalistic open-label trials, reviews, and case reports) published up to August 31, 2014, in electronic databases (PubMed, MEDLINE). STUDY SELECTION: Free-text and MeSH search keywords included aripiprazole, cholesterol, triglyceride, lipid profile, hyperlipidemia, and hypercholesterolemia and their differing terminations and combinations...
August 25, 2016: Primary Care Companion to CNS Disorders
https://www.readbyqxmd.com/read/27826454/pregabalin-prescription-for-terminally-ill-cancer-patients-receiving-specialist-palliative-care-in-an-acute-hospital
#13
Ryo Yajima, Kazuaki Matsumoto, Yuya Ise, Norihito Suzuki, Yuta Yokoyama, Junko Kizu, Shiro Katayama
BACKGROUND: Pregabalin is recommended as an adjuvant analgesic for neuropathic cancer-related pain, and may be taken at all steps of the World Health Organization analgesic ladder. However, unlike opioids, pregabalin treatments are limited to an oral administration route. If patients have oral feeding difficulties, it is not possible to administer any drug as an adjuvant analgesic for neuropathic cancer-related pain. Therefore, the aim of the present study was to clarify the problems of pain control after pregabalin discontinuation in terminally ill cancer patients...
2016: Journal of Pharmaceutical Health Care and Sciences
https://www.readbyqxmd.com/read/27824794/balloon-kyphoplasty-for-managing-intractable-pain-in-pediatric-pathologic-vertebral-fractures
#14
Jane S Hoashi, Stefanie M Thomas, Ryan C Goodwin, David P Gurd, Rabi Hanna, Thomas E Kuivila
BACKGROUND: Vertebral compression fractures are a common result of osteoporosis and osteopenia secondary to steroid use and chemotherapy treatment. Balloon kyphoplasty is a treatment option with good to excellent results well described in adults. Although a few recent studies have been published regarding the use of kyphoplasty in children, no formal indication exists for the pediatric population. The purpose of this study is to describe the outcomes of 3 chronically ill children with intractable pain from vertebral compression fractures, managed with kyphoplasty...
November 7, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27821895/health-care-utilization-of-mexican-patients-with-medically-unexplained-physical-symptoms
#15
Azucena Maribel Rodriguez González, José Manuel Ramírez Aranda, Homero de Los Santos Reséndiz, María Yolanda Lara Duarte, Santiago Oscar Pazaran Zanella, Jafet Felipe Méndez López, Issa Gil Alfaro, Félix Gilberto Islas Ruz, Gloria Navarrete Floriano, Edith Guillen Salomón, Obdulia Texon Fernández, Silvia Cruz Duarte, Juan Carlos Romo Salazar, Claudia Elsa Pérez Ruiz, Sara de Jesús López Salas, Lizbeth Benítez Amaya, Javier Nahum Zapata Gallardo
OBJECTIVE: To determine the prevalence of medically unexplained physical symptoms and the characteristics and use of health services in a group of patients with medically unexplained physical symptoms and a group of patients with other illnesses. METHODS: This was a cross-sectional, retrospective and multicenter study. We included 1,043 patients over 18 years of age from 30 primary care units of a government health institution, in 11 states of Mexico, attended by 39 family physicians...
September 30, 2016: Colombia Médica: CM
https://www.readbyqxmd.com/read/27821105/interventions-and-decision-making-at-the-end-of-life-the-effect-of-establishing-the-terminal-illness-situation
#16
C Campos-Calderón, R Montoya-Juárez, C Hueso-Montoro, E Hernández-López, F Ojeda-Virto, M P García-Caro
BACKGROUND: Many 'routine' interventions performed in hospital rooms have repercussions for the comfort of the patient, and the decision to perform them should depend on whether the patient is identified as in a terminal phase. The aim of this study is to analyse the health interventions performed and decisions made in the last days of life in patients with advanced oncological and non-oncological illness to ascertain whether identifying the patient's terminal illness situation has any effect on these decisions...
November 7, 2016: BMC Palliative Care
https://www.readbyqxmd.com/read/27820789/health-professions-students-attitudes-toward-death-and-caring-for-dying-patients
#17
Kristine A Prazak, Melissa Fazzari
PURPOSE: To assess the attitudes of students pursuing health professions about death and caring for the terminally ill. METHODS: Students currently enrolled in a health profession academic program were invited to complete the Frommelt Attitudes Toward Care of the Dying Scale, Form B. RESULTS: Participants who had been exposed to material or had taken a previous course on death and dying obtained higher scores than participants who had no previous education...
November 3, 2016: Journal of Physician Assistant Education
https://www.readbyqxmd.com/read/27813724/patterns-of-cost-for-patients-dying-in-the-intensive-care-unit-and-implications-for-cost-savings-of-palliative-care-interventions
#18
Nita Khandelwal, David Benkeser, Norma B Coe, Ruth A Engelberg, Joan M Teno, J Randall Curtis
BACKGROUND: Terminal intensive care unit (ICU) stays represent an important target to increase value of care. OBJECTIVE: To characterize patterns of daily costs of ICU care at the end of life and, based on these patterns, examine the role for palliative care interventions in enhancing value. DESIGN: Secondary analysis of an intervention study to improve quality of care for critically ill patients. SETTING/PATIENTS: 572 patients who died in the ICU between 2003 and 2005 at a Level-1 trauma center...
November 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27809949/psychometric-testing-of-the-spiritual-well-being-scale-mandarin-version-in-taiwanese-cancer-patients
#19
Woung-Ru Tang, Chen-Yi Kao
OBJECTIVE: The spiritual well-being of terminally ill cancer patients is an important indicator of the quality of their lives and of the quality of hospice care, but no validated tools are available for assessing this indicator in Taiwan. METHOD: The present cross-sectional study validated the Spiritual Well-Being Scale-Mandarin version (SWBS-M) by testing its psychometric properties in 243 cancer patients from five teaching hospitals throughout Taiwan. Construct validity was tested by factor analysis and hypothesis testing...
November 4, 2016: Palliative & Supportive Care
https://www.readbyqxmd.com/read/27809822/primary-psychosis-and-borna-disease-virus-infection-in-lithuania-a-case-control-study
#20
Violeta Zaliunaite, Vesta Steibliene, Liv Bode, Aurelija Podlipskyte, Robertas Bunevicius, Hanns Ludwig
BACKGROUND: The hypothesis that microbial infections may be linked to mental disorders has long been addressed for Borna disease virus (BDV), but clinical and epidemiological evidence remained inconsistent due to non-conformities in detection methods. BDV circulating immune complexes (CIC) were shown to exceed the prevalence of serum antibodies alone and to comparably screen for infection in Europe (DE, CZ, IT), the Middle East (IR) and Asia (CN), still seeking general acceptance. METHODS: We used CIC and antigen (Ag) tests to investigate BDV infection in Lithuania through a case-control study design comparing in-patients suffering of primary psychosis with blood donors...
November 3, 2016: BMC Psychiatry
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