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https://www.readbyqxmd.com/read/28533998/ipilimumab-as-a-cause-of-severe-pan-colitis-and-colonic-perforation
#1
Raj Shah, Danielle Witt, Talal Asif, Fahad F Mir
Ipilimumab is a human monoclonal antibody that functions as a cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) inhibitor that is used to treat malignant melanoma. Due to ipilimumab's removal of immune regulation, specifically through the inactivation of CTLA-4, it is commonly associated with inflammatory and autoimmune events. Gastrointestinal (GI) related immune-related adverse events such as diarrhea occur in 29% of patients with 7.6% of patients specifically suffering from colitis. We describe a case of colonic perforation with ipilimumab use...
April 20, 2017: Curēus
https://www.readbyqxmd.com/read/28508460/treatment-patterns-and-outcomes-of-stage-iiib-iiic-melanoma-in-france-germany-and-the-uk-a-retrospective-and-prospective-observational-study-melabis
#2
Mark Harries, Peter Mohr, Florent Grange, Rainer Ehness, Laure Benjamin, Obukohwo Siakpere, Janina Barth, Ceilidh Stapelkamp, Sylvie Pfersch, Lori McLeod, Sorrel Wolowacz, James A Kaye, Ilias Kontoudis
AIM: Real-world data on treatment patterns/outcomes in patients with advanced melanoma, while scarce, are useful for health technology assessments that govern patient access in many countries. We collected retrospective data on treatment patterns among patients in France, Germany and the UK with Stage IIIB/IIIC melanoma with macroscopic lymph node involvement, whose primary melanoma and regional lymph node metastases had been completely resected. METHODS: Patients ≥18 years were diagnosed between 1 January 2009 and 31 December 2011...
May 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28507429/factors-associated-with-the-attitudes-of-oncology-nurses-toward-hospice-care-in-china
#3
Fei-Min Yang, Zhi-Hong Ye, Lei-Wen Tang, Wei-Lan Xiang, Lin-Juan Yan, Min-Li Xiang
OBJECTIVE: To examine factors that are associated with the apprehension levels of oncology nurses toward hospice care. Factors examined in this study included demographics, nursing experience, education levels, title and post, personal experiences, and attitudes toward end-of-life care. METHODS: Questionnaires were provided to nurses (n=201) from three first-tier hospitals in China. A quantitative scale, Professional End-of-life Care Attitude Scale (PEAS), was used to assess personal and professional apprehension levels toward hospice care...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28506127/living-into-death-a-case-for-an-iterative-fortified-and-cross-sector-approach-to-advance-care-planning
#4
Rebecca Llewellyn, Chrystal Jaye, Richard Egan, Wayne Cunningham, Jessica Young, Peter Radue
Advance care planning (ACP) has been framed as best practice for quality palliative care, yet a growing body of literature affirms the need for an early iterative ACP process to begin when people are young and healthy. A significant gap appears to exist in the literature regarding the utility of death conversations outside the end-of-life context. Could 'death conversations' early in life be an effective tool by which doctor and patient can co-construct a more healthful way of life, and realistic relationship with death? And what variables must be taken into account for these conversations to proceed successfully? This paper provides a narrative exploration of the value of death conversations in the clinical context in New Zealand...
May 16, 2017: Anthropology & Medicine
https://www.readbyqxmd.com/read/28506099/propofol-based-palliative-sedation-to-treat-antipsychotic-resistant-agitated-delirium
#5
Alfredo Covarrubias-Gómez, Maria López Collada-Estrada
Delirium is a common problem in terminally ill patients that is associated with significant distress and, hence, considered a palliative care emergency. The three subtypes of delirium are hyperactive, hypoactive, and mixed, depending on the level of psychomotor activity and arousal disturbance. When agitated delirium becomes refractory in the setting of imminent dying, the agitation may be so severe that palliative sedation (PS) is required. Palliative sedation involves the administration of sedative medications with the purpose of reducing level of consciousness for patients with refractory suffering in the setting of a terminal illness...
May 16, 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28505020/the-role-of-thioredoxin-1-in-suppression-sepsis-through-inhibiting-mitochondrial-induced-apoptosis-in-spleen
#6
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...
June 2017: Shock
https://www.readbyqxmd.com/read/28503542/role-of-physical-activity-in-mortality-prediction-in-elderly-hospice-patients
#7
Hye-Sang Park, Kyu-Tae Lee, Tae-Woon Kim
The prediction of life-expectancy in terminally ill patients is important both for medical and social reasons but it is widely recognized as being inaccurate. The aim of this study was to investigate the mortality predictors and indicators of life extension among elderly patients in a hospice service center. In order to determine the mortality predictors, we investigated the relationship between patients' cognitive status using the Korean-Mini Mental State Examination & Global Deterioration Scale (K-MMSE & GDS), the patient's physical function using the instrumental Activities of Daily Living (ADL) score, and the patient's blood component values...
April 2017: Journal of Exercise Rehabilitation
https://www.readbyqxmd.com/read/28503041/pediatric-end-of-life-care-barriers-and-facilitators-perception-of-nursing-professionals-in-jordan
#8
Omar Mohammad Khraisat, Nemeh Ahmad Alakour, Teresa M O'Neill
INTRODUCTION: End-of-life care is a critical issue for pediatric population with terminal illness to ensure the best possible quality of care for them and their families. A survey was conducted to identify the barriers and facilitators to provide pediatric end-of-life care. METHODS: A descriptive cross-sectional study was conducted at three tertiary centers providing end-of-life care in Jordan. Two hundred critical care nurses were surveyed (response rate 93%). RESULTS: Nurses reported moderate level of experience in all areas of delivering pediatric end-of-life care...
April 2017: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/28502866/what-is-inappropriate-hospital-use-for-elderly-people-near-the-end-of-life-a-systematic-review
#9
REVIEW
Magnolia Cardona-Morrell, James C H Kim, Mikkel Brabrand, Blanca Gallego-Luxan, Ken Hillman
BACKGROUND: Older people with advance chronic illness use hospital services repeatedly near the end of life. Some of these hospitalizations are considered inappropriate. AIM: To investigate extent and causes of inappropriate hospital admission among older patients near the end of life. METHODS: English language publications in Medline, EMBASE, PubMed, Cochrane library, and the grey literature (January 1995-December 2016) covering community and nursing home residents aged ≥60years admitted to hospital...
May 11, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28501792/healing-ministry-and-palliative-care-in-christianity
#10
S Stephen Jayard, Nishant A Irudayadason, J Charles Davis
Death is inevitable, but that does not mean it can be planned or imposed. It is an ethical imperative that we attend to the unbearable pain and suffering of patients with incurable and terminal illnesses. This is where palliative care plays a vital role. Palliative care has been growing faster in the world of medicine since its emergence as a specialty in the last decade. Palliative care helps to reduce physical pain while affirming the aspect of human suffering and dying as a normal process. The goal of palliative care is to improve the quality of life both of the patient and the family...
May 3, 2017: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/28501706/upward-counterfactual-thinking-and-depression-a-meta-analysis
#11
REVIEW
Anne Gene Broomhall, Wendy J Phillips, Donald W Hine, Natasha M Loi
This meta-analysis examined the strength of association between upward counterfactual thinking and depressive symptoms. Forty-two effect sizes from a pooled sample of 13,168 respondents produced a weighted average effect size of r=.26, p<.001. Moderator analyses using an expanded set of 96 effect sizes indicated that upward counterfactuals and regret produced significant positive effects that were similar in strength. Effects also did not vary as a function of the theme of the counterfactual-inducing situation or study design (cross-sectional versus longitudinal)...
April 27, 2017: Clinical Psychology Review
https://www.readbyqxmd.com/read/28494680/end-of-life-care-in-emergency-departments-a-review-of-the-literature
#12
Kayla Gloss
Providing end of life care (EOLC) in emergency departments (EDs) is challenging because of minimal resources, lack of staff education and outdated models of care. Dynamic, chaotic environments like EDs require systematic, clear and concise principles and goals for patient care. Death in EDs is inevitable, therefore staff should be equipped to provide optimal care to this vulnerable patient group. This article reviews the literature on the barriers to providing EOLC in EDs, and makes recommendations for clinical practice and further research...
May 12, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/28480602/nursing-students-death-anxiety-and-fear-towards-dementia-patients
#13
Ellen L McKenzie, Patricia M Brown
OBJECTIVE: This study investigated the relationship between death anxiety (DA) and fear towards patients according to the age and illness of the patient. METHODS: A sample of 94 undergraduate nursing students from an Australian university were presented with a hypothetical patient, who varied by age (29 years or 71 years) and illness (arthritis, cancer or dementia). They then completed measures of DA and fear towards the patient. RESULTS: Older patients with dementia were associated with higher DA compared to all other conditions...
May 8, 2017: Australasian Journal on Ageing
https://www.readbyqxmd.com/read/28479409/-i-just-felt-like-i-was-stuck-in-the-middle-physician-assistants-experiences-communicating-with-terminally-ill-patients-and-their-families-in-the-acute-care-setting
#14
Elizabeth Chuang, Richard Lamkin, Aluko A Hope, Gina Kim, Jean Burg, Michelle Ng Gong
CONTEXT: Terminally ill hospitalized patients and their families consistently rank effective communication and shared decision-making among their top priorities. Advance Practice Providers such as Physician Assistants (PAs) are increasingly providing care in the hospital setting and are often called to communicate with patients and families. A first step to improving PA communication is to better understand PAs' current experiences in their daily practices. OBJECTIVES: This study aimed to explore: 1) roles PAs serve in communicating with terminally ill patients/families; 2) PAs' attitudes and opinions about communication roles and 3) perceived barriers and facilitators of communication with patients/families in the hospital setting...
May 4, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28472598/supportive-cardiology-moving-palliative-care-upstream-for-patients-living-with-advanced-heart-failure
#15
Warren Harris Lewin, Wendy Cheung, A Nina Horvath, Shana Haberman, Archna Patel, Dorothy Sullivan
Heart failure (HF) affects ∼600,000 Canadians and is a chronic, life-limiting illness marked by exacerbations of distressing symptoms requiring acute medical management, typically sought in Canada's emergency departments. HF often has an unpredictable illness trajectory and is a chronic terminal illness with a poor prognosis. Patients living with advanced HF have difficulty in accessing palliative care (PC) supports, which can result in unnecessary suffering as their HF progresses and they near end of life (EOL)...
May 4, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28469984/do-not-resuscitate-brain-death-and-organ-transplantation-islamic-perspective
#16
REVIEW
Hassan Chamsi-Pasha, Mohammed Ali Albar
Muslim patients and families are often reluctant to discuss and accept fatal diagnoses and prognoses. In many instances, aggressive therapy is requested by a patient's family, prolonging the life of the patient at all costs. Islamic law permits the withdrawal of futile treatment, including life support, from terminally ill patients allowing death to take its natural course. "Do not resuscitate" is permitted in Islamic law in certain situations. Debate continues about the certainty of brain death criteria within Islamic scholars...
April 2017: Avicenna Journal of Medicine
https://www.readbyqxmd.com/read/28469440/the-exercise-of-autonomy-by-older-cancer-patients-in-palliative-care-the-biotechnoscientific-and-biopolitical-paradigms-and-the-bioethics-of-protection
#17
REVIEW
Márcio Niemeyer-Guimarães, Fermin Roland Schramm
Toward the end of life, older cancer patients with terminal illness often prefer palliative over life-extending care and also prefer to die at home. However, care planning is not always consistent with patients' preferences. In this article, discussions will be centered on patients' autonomy of exercising control over their bodies within the current biotechnoscientific paradigm and in the context of population aging. More specifically, the biopolitical strategy of medicine in the context of hospital-centered health care control and of the frail condition of cancer patients in the intensive care unit will be considered in terms of the bioethics of protection...
2017: Palliative Care
https://www.readbyqxmd.com/read/28466293/-renal-replacement-therapy-in-acute-kidney-injury
#18
REVIEW
S J Klein, M Joannidis
Acute kidney injury is still a common complication in intensive care units and is associated with a significantly increased risk for morbidity and mortality. Various treatment concepts, like continuous renal replacement therapy (RRT) or (modified) intermittent procedures, as well as different methods of anticoagulation and the general decision of when and if to initiate RRT have to be considered by the treating physician. While giving vital input on when to initiate RRT, the German ELAIN (Early versus late initiation of renal replacement therapy in critically ill patients) trial and the French AKIKI (The artificial kidney initiation in kidney injury) trial raised many more questions...
May 2, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28465969/study-of-vitamin-d-status-in-patients-with-dilated-cardiomyopathy-at-a-teaching-hospital-in-north-india
#19
S Priya, Zeba Siddiqi, Ritu Karoli, Jalees Fatima, Saumya Gupta, Ritu Mishra
BACKGROUND/INTRODUCTION: Recent studies have indicated a much broader role to Vitamin D than simply the regulation of calcium metabolism alone. Vitamin D likely confers physiologically relevant pleiotropic functions that include cardioprotective and immunomodulatory effect, and its deficiency could lead to increased risk of cardiovascular disease and heart failure. AIM: The aim of our work was to evaluate the presence of hypovitaminosis D in patients with dilated cardiomyopathy (DCMP) and to study any correlation of echocardiographic parameters with Vitamin D deficiency...
July 2016: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/28463935/admission-n-terminal-pro-brain-natriuretic-peptide-nt-probnp-level-predicts-the-development-of-atrial-fibrillation-in-general-surgical-intensive-care-unit-patients
#20
Nalin Chokengarmwong, Daniel Dante Yeh, Yuchiao Chang, Luis Alfonso Ortiz, Haytham M A Kaafarani, Peter Fagenholz, David R King, Marc DeMoya, Kathryn Butler, Jarone Lee, George Velmahos, James Louis Januzzi, Elizabeth Lee-Lewandrowski, Kent Lewandrowski
BACKGROUND: New onset atrial fibrillation (AF) in critically ill surgical patients is associated with significant morbidity and increased mortality. N-terminal pro-B type natriuretic peptide (NT-proBNP) is released by cardiomyocytes in response to stress and may predict AF development after surgery. We hypothesized that elevated NT-proBNP level at surgical ICU admission predicts AF development in a general surgical and trauma population. METHODS: From July to October 2015, NT-proBNP concentrations were measured at ICU admission...
May 1, 2017: Journal of Trauma and Acute Care Surgery
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