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César Gutiérrez Samperio, Raúl Ruiz Canizales, Salvador Arellano Rodríguez, Hilda Romero Zepeda, Robert T Hall, Bernardo García Camino
The concepts and background of palliative medicine, the patient-health team relationship and the right of the patients to receive palliative care, its application in surgery, the criterion defining the terminally ill, proportionate and disproportionate measures, where it is applied and what this consists of, drugs and procedures used, who should administrate them and for how long, the requirements for advanc directives and avoidance of therapeutic obstinacy, were reviewed. It describes and reflects their ethical and legal bases...
March 2017: Cirugia y Cirujanos
Bengt Sallerfors, Maria Sandberg, Carl-Johan Fürst
Systematic improvement of quality of care at the end of life is still scarce. The regional palliative care service in Skåne, which has eight units covering a population of almost 1.3 million inhabitants, has systematically used the Swedish Register of Palliative Care (SRPC, ) for care development. 9 out of 12 of the indicators improved significantly in 2014 compared to 2013. Through transparency of registered data and regular feedback to the department's units we have been able to encourage the exchange of experiences between the units, provide opportunities for internal and external benchmarking and also prioritize topics for teaching and training...
March 8, 2016: Läkartidningen
P Engeser, K Hermann, J Szecsenyi, F Peters-Klimm
BACKGROUND: The care of patients at the end of life focuses on preservation of the quality of life, symptom control and fulfillment of the preferred place of death. Only few care and outcome-related data for primary palliative care in Germany are available; therefore, the objective was to examine the quality of life, symptom control and place of death of patients with palliative treatment by general practitioners (GP). MATERIAL AND METHODS: The study is part of the PAMINO project, a non-randomized, controlled trial evaluating the effectiveness of continuing medical education for GPs (≥ 40 h) in palliative care (ISRCTN78021852)...
December 2014: Der Schmerz
I-U Grom, D A Vagts, U Kampa, G Pfeiffer, L Schreiber-Winzig, C H R Wiese
The accompaniment of people in the face of death offers insights into dimensions which are mostly not seen in ordinary life. These insights also exist in intensive care in German hospitals and are highly relevant in medical decision making. End-of-life decisions in particular often determine medical, cultural and spiritual aspects concerning medical treatment and therapeutic targets and if necessary new therapy targets. The following article especially illuminates cultural aspects and their characteristics in patients at the end of life in the intensive care unit...
June 2013: Der Anaesthesist
C H R Wiese, D A Vagts, U Kampa, G Pfeiffer, I U Grom, M A Gerth, L Schreiber-Winzig, M von Berswordt-Wallrabe
BACKGROUND: Since 2011 palliative care has been a compulsory part of the German medical study course (so-called Q13 palliative and pain medicine). Palliative care content does not, however, as often taught, have to focus only on patients in the so-called palliative stages of disease. The aim of this investigation was to encourage a discussion concerning the integration of palliative care aspects into general medical treatment. METHODS: For data collection an open discussion of the main topics by experts in palliative medical care was used...
June 2012: Der Anaesthesist
C H R Wiese, D A Vagts, U Kampa, G Pfeiffer, I-U Grom, M A Gerth, B M Graf, Y A Zausig
BACKGROUND: At the end of life acute exacerbations of medical symptoms (e.g. dyspnea) in palliative care patients often result in emergency medical services being alerted. The goals of this study were to discuss cooperation between emergency medical and palliative care structures to optimize the quality of care in emergencies involving palliative care patients. METHODS: For data collection an open discussion of the main topics by experts in palliative and emergency medical care was employed...
February 2011: Der Anaesthesist
W Steger, H Amthauer, T J Vogl, B Wiedenmann, S Steger, H Eichstädt
INTRODUCTION: In patients with neuroendocrine gastrointestinal tumors and liver metastases, but without known extrahepatic manifestations, liver transplantation may be indicated as curativ or "long-term-palliativ" therapy. For these patients the absence of bone lesions is mandatory. METHODS: 4 patients with a histologically proven neuroendocrine tumor were examined in order to exclude further metastases. We compared the diagnostic value of somatostatin-receptor-scintigraphy (SRS), X-ray, 99mTc-DPD-scintigraphy, CT and MRI...
March 1999: Der Radiologe
P E Jönsson, M Malmberg, L Bergljung, C Ingvar, M Ericsson, S Ryden, I Nilsson, I J Terje
Thirty-five (34 evaluable) consecutive postmenopausal women with estrogen receptor positive (greater than or equal to 10 fmol/mg) or unknown advanced breast cancer were treated with high dose toremifene in a phase II study. All patients had progressed during prior adjuvant or palliativ antiestrogen treatment. The dose of toremifene was 240 mg per day. No complete or partial responders were registered. Nine patients (26%) were considered to have stable disease (NC). The time to progression for these patients was 5-27+ months with a mean time of twelve months and median time of eight months...
March 1991: Anticancer Research
K Keminger, R Roka
This report concerns our experience in the treatment of 125 patients with carcinoma of the esophagus during 17 years (excluding the cardiac region of the stomach). In our material predisponsing factors had no effect upon the age of the patients. The symptomatology is described, the causes of postoperative complications and mortality are discussed. The principal indications are mentioned and technical considerations are summariced. Radical tumor resection resulted in a 2 year survival rate of 23 percent. Palliativ resections in cases of advanced carcinoma are refused because of the high mortality rate and the small expectation of life...
September 23, 1976: Langenbecks Archiv Für Chirurgie
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