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https://www.readbyqxmd.com/read/28437202/low-dose-morphine-for-dyspnea-in-terminally-ill-patients-with-idiopathic-interstitial-pneumonias
#1
Yoshinobu Matsuda, Isseki Maeda, Kazunobu Tachibana, Keiko Nakao, Yumiko Sasaki, Chikatoshi Sugimoto, Toru Arai, Akihiro Tokoro, Masanori Akira, Yoshikazu Inoue
BACKGROUND: Dyspnea is highly prevalent in patients with idiopathic interstitial pneumonias (IIPs). OBJECTIVE: The objective of this study is to examine the effectiveness and safety of continuous subcutaneous morphine for dyspnea in terminally ill IIP patients. SETTING/SUBJECTS: We retrospectively reviewed cases of terminally ill IIP patients who received continuous subcutaneous morphine for dyspnea. MEASUREMENTS: We reviewed dyspnea severity measured using numerical rating scale (NRS) and respiratory rate (RR) before and two and four hours after morphine initiation...
February 16, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28435571/outcome-of-skeletal-reconstructive-surgery-for-metastatic-bone-tumours-in-the-femur
#2
N H Mohamed-Haflah, Y Kassim, I Zuchri, W Zulmi
INTRODUCTION: The role of surgery in skeletal metastasis is to reduce morbidity and improve the quality of life in terminally ill patients. We report our experience with patients who underwent skeletal reconstructive surgery for metastatic bone tumour of the femur. MATERIALS AND METHODS: Twenty nine operations for skeletal metastasis of the femur performed in our centre between 2009 and 2015 were included in this study. We evaluated the choice of implant, complications, survival rate and functional outcome...
March 2017: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/28432854/quality-of-death-rumination-and-posttraumatic-growth-among-bereaved-family-members-of-cancer-patients-in-home-palliative-care
#3
Kayo Hirooka, Hiroki Fukahori, Kanako Taku, Taisuke Togari, Asao Ogawa
OBJECTIVE: The current study was designed to test the hypothesis that quality of death (QOD) and intrusive and deliberate rumination are associated with posttraumatic growth (PTG) among bereaved family members of cancer patients in home palliative care. METHODS: Data were collected from 805 bereaved family members of cancer patients who died at home in Japan. We used a cross-sectional design and participants completed Good Death Inventory, Event-Related Rumination Inventory and PTG Inventory...
April 22, 2017: Psycho-oncology
https://www.readbyqxmd.com/read/28428172/how-are-non-numerical-prognostic-statements-interpreted-and-are-they-subject-to-positive-bias
#4
Anne Moyer, Samantha Siess, Sumeet Bhinder
OBJECTIVES: Frank, clear communication with family members of terminally ill or incapacitated patients has important implications for well-being, satisfaction with care and sound decision-making. However, numerical prognostic statements, particularly more negative ones, have been found to be interpreted in a positively biased manner. Less precise non-numerical statements, preferred by physicians, and particularly statements using threatening terms (dying vs surviving) may be even more subject to such biases...
April 20, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28426540/family-functioning-predicts-end-of-life-care-quality-in-patients-with-cancer-multicenter-prospective-cohort-study
#5
Myung Kyung Lee, Young Ho Yun
BACKGROUND: Treating patients with cancer within a family setting is the accepted standard of care and a hallmark of end-of-life (EoL) quality of care (QoC). OBJECTIVE: The aim of this study was to determine whether family caregiver functioning predicts EoL QoC received by terminally ill patients with cancer. METHODS: Family caregivers of terminally ill patients with cancer (n = 264) were enrolled from oncology inpatient and outpatient units of 12 large hospitals located in different regions throughout South Korea...
April 20, 2017: Cancer Nursing
https://www.readbyqxmd.com/read/28420191/designing-effective-interactions-for-concordance-around-end-of-life-care-decisions-lessons-from-hospice-admission-nurses
#6
Carey Candrian, Channing Tate, Kirsten Broadfoot, Alexandra Tsantes, Daniel Matlock, Jean Kutner
Near the end of life, hospice care reduces symptom-related distress and hospitalizations while improving caregiving outcomes. However, it takes time for a person to gain a sufficient understanding of hospice and decide to enroll. This decision is influenced by knowledge of hospice and its services, emotion and fear, cultural and religious beliefs, and an individual's acceptance of diagnosis. Hospice admission interactions, a key influence in shaping decisions regarding hospice care, happen particularly late in the illness trajectory and are often complex, unpredictable, and highly variable...
April 18, 2017: Behavioral Sciences
https://www.readbyqxmd.com/read/28419483/pharmacokinetic-study-of-intravenous-acetaminophen-administered-to-critically-ill-multiple-trauma-patients-at-the-usual-dosage-and-a-new-proposal-for-administration
#7
Oscar Fuster-Lluch, Pedro Zapater-Hernández, Manuel Gerónimo-Pardo
The pharmacokinetic profile of intravenous acetaminophen administered to critically ill multiple-trauma patients was studied after 4 consecutive doses of 1 g every 6 hours. Eleven blood samples were taken (predose and 15, 30, 45, 60, 90, 120, 180, 240, 300, and 360 minutes postdose), and urine was collected (during 6-hour intervals between doses) to determine serum and urine acetaminophen concentrations. These were used to calculate the following pharmacokinetic parameters: maximum and minimum concentrations, terminal half-life, area under serum concentration-time curve from 0 to 6 hours, mean residence time, volume of distribution, and serum and renal clearance of acetaminophen...
April 17, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28412933/beyond-quality-of-life-a-cross-sectional-study-on-the-mental-health-of-patients-with-chronic-kidney-disease-undergoing-dialysis-and-their-caregivers
#8
Beatriz Dos Santos Pereira, Neimar da Silva Fernandes, Nayara Pires de Melo, Renata Abrita, Fabiane Rossi Dos Santos Grincenkov, Natália Maria da Silva Fernandes
BACKGROUND: Patients with terminal chronic kidney disease (CKDT) requiring renal replacement therapies (RRT) undergo important changes in living habits and frequently need caregiving. These patients and their caregivers are risk groups for the development of physical and psychological symptoms. This study aimed to evaluate the prevalence of anxiety, depression, stress, fatigue, social support, and quality of life in patients with CKD and their caregivers. METHOD: This cross sectional study was conducted with 21 patients and their caregivers, from January to September 2015...
April 17, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/28406430/palliative-care-and-the-family-caregiver-trading-mutual-pretense-empathy-for-a-sustained-gaze-compassion
#9
Joy Goldsmith, Sandra L Ragan
In this conceptual piece, we survey the progress of palliative care communication and reflect back on a chapter we wrote a decade ago, which featured the communication concept of mutual pretense, first described by Glaser and Strauss (1965). This work will include an update on family caregivers and their role in cancer caregiving as well as a review of current palliative care communication curriculum available for providers. And finally, we will spotlight the conversation and research going forward on the subject of health literacy for all stakeholders; patients, families, providers, and systems...
April 13, 2017: Behavioral Sciences
https://www.readbyqxmd.com/read/28405065/practical-and-ethical-considerations-in-the-management-of-pacemaker-and-implantable-cardiac-defibrillator-devices-in-terminally-ill-patients
#10
REVIEW
Mina M Benjamin, Christine A Sorkness
More than 4.5 million people worldwide live with an implanted pacemaker, including >3 million in the USA alone. Also, >0.8 million people in the USA have an implantable cardioverter defibrillator (ICD). Knowing the principles of managing these devices towards the end of life is important, as the interruption of their function may have serious consequences. This article provides health care providers who are not specialized in cardiac electrophysiology with an introduction to the general principles of management of pacemakers or ICD devices towards the end of life, with a suggested algorithm for approaching this process...
April 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28399905/cardiac-biomarkers-are-associated-with-maximum-stage-of-acute-kidney-injury-in-critically-ill-patients-a-prospective-analysis
#11
Ryan Haines, Siobhan Crichton, Jessica Wilson, David Treacher, Marlies Ostermann
BACKGROUND: This study aimed to investigate whether cardiac troponin T (cTnT), cardiac troponin I (cTnI) and serum N-terminal pro-brain natriuretic peptide (NT-proBNP) are associated with acute kidney injury (AKI) and need for acute renal replacement therapy (RRT) in adult patients admitted to the intensive care unit (ICU). METHODS: We analysed prospectively collected data for patients admitted to the ICU between June and December 2010 for non-cardiac reasons. The Kidney Disease Improving Global Outcomes creatinine criteria were applied to identify patients with AKI including those who received acute RRT...
April 12, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28399846/palliative-sedation-challenging-the-professional-competency-of-health-care-providers-and-staff-a-qualitative-focus-group-and-personal-written-narrative-study
#12
Danièle Leboul, Régis Aubry, Jean-Michel Peter, Victor Royer, Jean-François Richard, Frédéric Guirimand
BACKGROUND: Despite recent advances in palliative medicine, sedating a terminally ill patient is regarded as an indispensable treatment to manage unbearable suffering. With the prospect of widespread use of palliative sedation, the feelings and representations of health care providers and staff (carers) regarding sedation must be carefully explored if we are to gain a better understanding of its impact and potential pitfalls. The objective of the study was to provide a comprehensive description of the opinions of carers about the use of sedation practices in palliative care units (PCU), which have become a focus of public attention following changes in legislation...
April 11, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28395664/the-future-of-critical-care-renal-support-in-2027
#13
REVIEW
William R Clark, Mauro Neri, Francesco Garzotto, Zaccaria Ricci, Stuart L Goldstein, Xiaoqiang Ding, Jiarui Xu, Claudio Ronco
Since its inception four decades ago, both the clinical and technologic aspects of continuous renal replacement therapy (CRRT) have evolved substantially. Devices now specifically designed for critically ill patients with acute kidney injury are widely available and the clinical challenges associated with treating this complex patient population continue to be addressed. However, several important questions remain unanswered, leaving doubts in the minds of many clinicians about therapy prescription/delivery and patient management...
April 11, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28379179/final-conversations-overview-and-practical-implications-for-patients-families-and-healthcare-workers
#14
Maureen P Keeley, Mark A Generous
The current paper presents a summary of a 12-year body of research on final conversations, which will be useful for healthcare providers who work with patients and family nearing the end-of-life, as well as for patients and their family members. Final conversations encompass any and all conversations that occur between individuals with a terminal diagnosis and their family members (all participants are aware that their loved one is in the midst of the death journey). Final conversations take the family member's perspective and highlights what are their memorable messages with the terminally ill loved one...
April 5, 2017: Behavioral Sciences
https://www.readbyqxmd.com/read/28378724/-a-personalized-approach-to-the-pulmonary-rehabilitation-of-patients-with-chronic-obstructive-pulmonary-disease
#15
S I Ovcharenko, B A Volel', Ya K Galetskaite
AIM: To elaborate and introduce personalized pulmonary rehabilitation (PR) programs adapted in terms of the types of disease response in patients with chronic obstructive pulmonary disease (COPD) and to evaluate the effectiveness of the programs. SUBJECTS AND METHODS: A total of 85 patients with COPD of more than 2 years' duration (the shortest time frame that was valid to assess the type of disease response) were examined. All the patients underwent adequate physical, instrumental, laboratory, and psychiatric examinations, during which the type of COPD response was determined...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28367463/fourth-year-medical-students-reflective-writing-on-death-of-ivan-ilych-a-qualitative-study
#16
Mahshid Zohouri, Mitra Amini, Mohammad Mehdi Sagheb
INTRODUCTION: Medical students should be familiar with the end of life ethical issues and its considerations. For teaching end of life care to medical students, literature is a source of excellent narratives of patients with experiences of terminally ill condition in their journey through suffering and one of the most favourite bioethics literature readings has been the death of Ivan Ilych by Tolstoy. We used this novel to show medical students end of life events and suffering and asked them to write a reflective essay on it...
April 2017: Journal of Advances in Medical Education & Professionalism
https://www.readbyqxmd.com/read/28365971/is-preoperative-smoking-abstinence-needed-for-terminally-ill-cancer-patients
#17
Anto Domić
No abstract text is available yet for this article.
January 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/28365206/prevalence-and-incidence-density-of-unavoidable-pressure-ulcers-in-elderly-patients-admitted-to-medical-units
#18
Alvisa Palese, Barbara Trevisani, Annamaria Guarnier, Paolo Barelli, Paola Zambiasi, Elisabetta Allegrini, Letizia Bazoli, Paola Casson, Meri Marin, Marisa Padovan, Michele Picogna, Patrizia Taddia, Daniele Salmaso, Paolo Chiari, Oliva Marognolli, Canzan Federica, Luisa Saiani, Elisa Ambrosi
To describe the prevalence and incidence density of hospital-acquired unavoidable pressure sores among patients aged ≥65 years admitted to acute medical units. A secondary analysis of longitudinal study data collected in 2012 and 2013 from 12 acute medical units located in 12 Italian hospitals was performed. Unavoidable pressure ulcers were defined as those that occurred in haemodynamically unstable patients, suffering from cachexia and/or terminally ill and were acquired after hospital admission. Data at patient and at pressure ulcer levels were collected on a daily basis at the bedside by trained researchers...
March 23, 2017: Journal of Tissue Viability
https://www.readbyqxmd.com/read/28364172/mapping-french-people-and-health-professionals-positions-regarding-the-circumstances-of-morphine-use-to-relieve-cancer-pain
#19
Julie Mazoyer, Maria Teresa Muñoz Sastre, Paul Clay Sorum, Etienne Mullet
BACKGROUND: Cancer patients suffer in part because some health professionals prescribe or administer amounts of analgesics, namely opioids, which are too small or too widely spaced to be fully effective. Patients' reluctance to use opioids for pain treatment is often mentioned as a reason not to apply the official guidelines, but very few studies have been conducted on people's attitudes about opioid use to relieve cancer pain. METHODS: One hundred twenty lay participants and 30 health professionals (7 physicians and 23 nurses) were presented with a set of vignettes describing a terminally ill woman with cancer who is in pain...
March 31, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28356489/how-shared-is-shared-decision-making-a-care-ethical-view-on-the-role-of-partner-and-family
#20
Inge van Nistelrooij, Merel Visse, Ankana Spekkink, Jasmijn de Lange
The aim of shared decision-making (SDM) is to provide information to patients in order to enable them to decide autonomously and freely about treatment together with the doctor, without interference, force or coercion by others. Relatives may be considered as hindering or impeding a patient's own decision. Qualitative-empirical research into lived experience of SDM of patients with cancer, however, problematises the patient's autonomy when facing terminal illness and the need to make decisions regarding treatment...
March 29, 2017: Journal of Medical Ethics
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