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palliative care, evidence-based medicine

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https://www.readbyqxmd.com/read/29729119/palliative-care-in-end-stage-liver-disease-time-to-do-better
#1
REVIEW
Chiara Mazzarelli, Wendy M Prentice, Michael A Heneghan, Luca S Belli, Kosh Agarwal, Mary D Cannon
Optimal involvement of palliative care services in the management of patients with decompensated cirrhosis and end-stage liver disease is limited. This may result from both ignorance and the failure to recognize the spectrum and unpredictability of the underlying liver condition. Palliative care is a branch of medicine that focuses on quality of life by optimizing symptom management and providing psychosocial, spiritual, and practical support for both patients and their caregivers. Historically, palliative care has been underutilized for patients with decompensated liver disease...
May 5, 2018: Liver Transplantation
https://www.readbyqxmd.com/read/29671078/palliative-care-in-heart-failure
#2
REVIEW
Abhinav Sood, Krista Dobbie, W H Wilson Tang
PURPOSE OF REVIEW: This review illustrates the dynamic role of palliative care in heart failure management and encapsulates the commonly utilized pharmacologic and non-pharmacologic therapeutic strategies for symptom palliation in heart failure. In addition, we provide our experience regarding patient care issues common to the domain of heart failure and palliative medicine which are commonly encountered by heart failure teams. RECENT FINDINGS: Addition of palliative care to conventional heart failure management plan results in improvement in quality of life, anxiety, depression, and spiritual well-being among patients...
April 19, 2018: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29669454/palliative-nursing-and-sacred-medicine-a-holistic-stance-on-entheogens-healing-and-spiritual-care
#3
William E Rosa, Stephanie Hope, Marianne Matzo
The fields of palliative and holistic nursing both maintain a commitment to the care of the whole person, including a focus on spiritual care. Advanced serious illness may pose a plethora of challenges to patients seeking to create meaning and purpose in their lives. The purpose of this article is to introduce scholarly dialogue on the integration of entheogens, medicines that engender an experience of the sacred, into the spiritual and holistic care of patients experiencing advanced serious illness. A brief history of the global use of entheogens as well as a case study are provided...
April 1, 2018: Journal of Holistic Nursing: Official Journal of the American Holistic Nurses' Association
https://www.readbyqxmd.com/read/29596296/increasing-access-to-palliative-care-services-in-the-intensive-care-unit
#4
Caitlin Marie McCarroll
BACKGROUND: The Institute of Medicine's report, Dying in America, highlights the critical need for the widespread implementation of palliative care to improve end-of-life care. Approximately 20% of all deaths in America occur during or shortly after an intensive care unit (ICU) admission; therefore, it is important for critical care units to have systems in place to facilitate patient access to palliative care services. OBJECTIVES: The aim of this quality improvement (QI) project was to develop and implement a palliative care screening tool using evidence-based triggers to help increase the proportion of palliative care consultations in the ICU setting...
May 2018: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/29574425/blood-transfusion-practice-in-the-uk-and-ireland-a-survey-of-palliative-care-physicians
#5
Karen Neoh, Simon Stanworth, Michael I Bennett
OBJECTIVES: Red cell (blood) transfusions are used in palliative care to manage patients with symptomatic anaemia or when patients have lost blood. We aimed to understand current blood transfusion practice among palliative medicine doctors and compare this with National Institute for Health and Care Excellence (NICE) guidance. NICE guidance advocates more restrictive transfusion practice but is based on clinical trials in non-palliative care contexts; the extent to which these findings should be applied to palliative care remains unclear...
March 23, 2018: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/29567281/-multidisciplinary-oncopalliative-meeting-aims-and-pratical-recommendations
#6
François Goldwasser, Nathalie Nisenbaum, Pascale Vinant, Elisabeth Balladur, Sarah Dauchy, Idriss Farota-Romejko, Isabelle Colombet, Marie-Laure Alby, Julie Giroux, Anne Larrouy, Elisabeth Destaintot, Luc Garcon, Danièle Legrand, Isabelle Marin
Progress leads to increase life duration at the metastatic stage but metastatic disease is most often lethal. Decision-making is necessary for an increasing period of care, beyond evidence-based medicine, dealing with complexity and uncertain benefit/risk ratio. This requires to inform the patient realistically, to discuss prognostication, to develop anticipated written preferences. These changes mean to pass from a medicine based on informed consent to medicine based on respect of the patient wishes even if it can be complex to determine...
March 19, 2018: Bulletin du Cancer
https://www.readbyqxmd.com/read/29472258/compassionate-care-intervention-for-hospital-nursing-teams-caring-for-older-people-a-pilot-cluster-randomised-controlled-trial
#7
Lisa Jane Gould, Peter Griffiths, Hannah Ruth Barker, Paula Libberton, Ines Mesa-Eguiagaray, Ruth M Pickering, Lisa Jane Shipway, Jackie Bridges
OBJECTIVE: Compassionate care continues to be a focus for national and international attention, but the existing evidence base lacks the experimental methodology necessary to guide the selection of effective interventions for practice. This study aimed to evaluate the Creating Learning Environments for Compassionate Care (CLECC) intervention in improving compassionate care. SETTING: Ward nursing teams (clusters) in two English National Health Service hospitals randomised to intervention (n=4) or control (n=2)...
February 22, 2018: BMJ Open
https://www.readbyqxmd.com/read/29455777/palliative-treatment-of-coronary-atherosclerotic-cancer-by-drug-eluting-or-bare-metal-stents-from-oculo-stenotic-reflex-period-to-age-of-precision-medicine
#8
Elif Hande Ozcan Cetin, Ozcan Ozeke, Erdogan Ilkay, Dursun Aras, Serkan Topaloglu, Zehra Golbasi, Sinan Aydogdu, Can Ozer
Medications and treatments are said to have a palliative effect if they relieve symptoms without having a curative effect on the underlying disease such as atherosclerosis or cancer. Some authors speculated that atherosclerotic coronary artery disease (CAD) could be considered a "cancer of the coronary arterial wall". Although the percutaneous coronary intervention (PCI) has proven to be effective in decreasing mortality rates among patients with acute coronary syndromes, the previous meta-analyses of PCI versus optimal medical therapy for stable CAD have not been able to demonstrate a reduction in major adverse cardiac outcomes...
January 2018: Indian Heart Journal
https://www.readbyqxmd.com/read/29414846/pediatric-palliative-care-in-infants-and-neonates
#9
REVIEW
Brian S Carter
The application of palliative and hospice care to newborns in the neonatal intensive care unit (NICU) has been evident for over 30 years. This article addresses the history, current considerations, and anticipated future needs for palliative and hospice care in the NICU, and is based on recent literature review. Neonatologists have long managed the entirety of many newborns' short lives, given the relatively high mortality rates associated with prematurity and birth defects, but their ability or willingness to comprehensively address of the continuum of interdisciplinary palliative, end of life, and bereavement care has varied widely...
February 7, 2018: Children
https://www.readbyqxmd.com/read/29397121/management-of-perceived-devastating-brain-injury-after-hospital-admission-a-consensus-statement-from-stakeholder-professional-organizations
#10
D Harvey, J Butler, J Groves, A Manara, D Menon, E Thomas, M Wilson
Patients with severe grades of life-threatening brain injury are commonly characterized as having devastating brain injury (DBI), which we have defined as: 'any neurological condition that is assessed at the time of hospital admission as an immediate threat to life or incompatible with good functional recovery AND where early limitation or withdrawal of therapy is being considered'. The outcome in patients with DBI is often death or severe disability, and as a consequence rapid withdrawal of life sustaining therapies is commonly contemplated or undertaken...
January 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29392483/crossing-the-death-threshold-experiencing-multi-disciplinary-end-of-life-integrative-oncology-training
#11
Eran Ben-Arye, Yael Keshet, Maria Livas, Thomas Breitkreuz
OBJECTIVE: Complementary and integrative medicine (CIM) is acknowledged in more and more oncology-care centers as part of supportive and palliative cancer care. However, only limited research is available on medical training of CIM practitioners regarding end-of-life (EOL) care. In this study, we assess the impact of multi-disciplinary EOL training on cultural-diverse groups of CIM-trained healthcare practitioners (HCPs) working in integrative oncology care settings in Germany and Israel...
February 1, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29307208/implementation-issues-relevant-to-outpatient-neurology-palliative-care
#12
Benzi M Kluger, Michael J Persenaire, Samantha K Holden, Laura T Palmer, Hannah Redwine, Julie Berk, C Alan Anderson, Christopher M Filley, Jean Kutner, Janis Miyasaki, Julie Carter
BACKGROUND: There is growing interest in the application of palliative care principles to improve care for patients and families affected by neurologic diseases. We developed an interdisciplinary outpatient clinic for patients and families affected by neurologic disorders to better address the problems faced by our highest need patients. We have developed and improved this program over the past three years and share several of our most important lessons as well as ongoing challenges and areas where we see our clinic evolving in the future...
November 29, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29305720/barriers-for-the-implementation-of-guidelines-in-palliative-care-results-from-a-national-survey-of-professionals
#13
Helen Kalies, Rieke Schöttmer, Steffen T Simon, Raymond Voltz, Alexander Crispin, Claudia Bausewein
BACKGROUND: In 2015, an evidence- and consensus-based palliative care guideline in adults with incurable cancer was published by the German Guideline Program. Barriers and enablers for the guideline implementation of members of the German Association for Palliative Medicine (DGP) were unknown. Therefore, the aims of this study were (1) to evaluate professionals' knowledge, motivation, and outcome expectancy towards already existing recommendations for palliative care and (2) to evaluate the self-experienced competence in five medical key topics presented in the new guideline...
January 5, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29284761/refugees-in-conflict-creating-a-bridge-between-traditional-and-conventional-health-belief-models
#14
Eran Ben-Arye, Massimo Bonucci, Michel Daher, Rejin Kebudi, Bashar Saad, Thomas Breitkreuz, Maryam Rassouli, Elio Rossi, Nahla Gafer, Omar Nimri, Mohamed Hablas, Gunver Sophia Kienle, Noah Samuels, Michael Silbermann
The recent wave of migration from Middle Eastern countries to Europe presents significant challenges to the European health profession. These include the inevitable communication gap created by differences in health care beliefs between European oncologists, health care practitioners, and refugee patients. This article presents the conclusions of a workshop attended by a group of clinicians and researchers affiliated with the Middle East Cancer Consortium, as well as four European-based health-related organizations...
December 28, 2017: Oncologist
https://www.readbyqxmd.com/read/29224571/-worried-to-death-the-assessment-and-management-of-anxiety-in-patients-with-advanced-life-limiting-disease-a-national-survey-of-palliative-medicine-physicians
#15
N Atkin, V Vickerstaff, B Candy
BACKGROUND: Anxiety adversely affects quality of life and is common in adults with advanced life-limiting disease. There are no UK-wide guidelines on the assessment and management of anxiety in this specific population and there is little evidence regarding drug treatments. This study aimed to explore how palliative care physicians assess and manage anxiety in their patients, and to identify barriers encountered. METHODS: A cross-sectional survey was undertaken of all physicians working in specialist palliative care in the UK who were members of the Association for Palliative Medicine...
December 11, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/29162047/treatment-recommendations-within-the-leeway-of-clinical-guidelines-a-qualitative-interview-study-on-oncologists-clinical-deliberation
#16
I Otte, S Salloch, A Reinacher-Schick, J Vollmann
BACKGROUND: Recommending the optimal treatment for an individual patient requires a well-balanced consideration of various medical, social and ethical factors. The interplay of these factors, interpretation of the patient's situation and understanding of the existing clinical guidelines can lead to divergent therapy recommendations, depending on the attending physician. Gaining a better understanding of the individual process of medical decision-making and the differences occurring will support the delivery of optimal individualized care within the clinical setting...
November 21, 2017: BMC Cancer
https://www.readbyqxmd.com/read/29134767/availability-and-approval-of-cannabis-based-medicines-for-chronic-pain-management-and-palliative-supportive-care-in-europe-a-survey-of-the-status-in-the-chapters-of-the-european-pain-federation
#17
N Krcevski-Skvarc, C Wells, W Häuser
BACKGROUND: There is considerable public and political interest in the use of cannabis products for medical purposes. METHODS: The task force of the European Pain Federation (EFIC) conducted a survey with its national chapters representatives on the status of approval of all types of cannabis-based medicines, the covering of costs and the availability of a position paper of a national medical association on the use of medical cannabis for chronic pain and for symptom control in palliative/supportive care...
March 2018: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/29123350/evaluation-of-community-based-palliative-care-services-perspectives-from-various-stakeholders
#18
Venugopal Vinayagamoorthy, Elayaperumal Suguna, Amol R Dongre
Background: As a part of Memorandum of Understanding with Tamil Nadu Institute of Palliative Medicine, community-based palliative care services have been initiated 2 years back in our urban field practice areas. Aim: The aim of this study was to evaluate the home care service, a major component of our community-based palliative care, with a view to identify the unmet needs of the services rendered for decision-making about the program. Materials and Methods: It was a descriptive qualitative design carried out by the authors trained in qualitative research methods...
October 2017: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/29078648/video-assisted-thoracoscopic-and-open-chest-surgery-in-diagnosis-and-treatment-of-malignant-pleural-diseases
#19
REVIEW
Periklis Perikleous, David A Waller
Parenchymal cancers of lung, breast, gastrointestinal tract and ovaries as well as lymphomas and mesotheliomas are among the most common cancer types causing malignant effusions, though almost all tumour types have been reported to cause a malignant effusion. The prognosis heavily depends on patients' response to systemic therapy however, regardless of the causing pathology and histopathologic form, malignant pleural disease is normally associated with a poor prognosis. To date, there are not sufficient data to allow accurate predictions of survival that would facilitate decision making for managing patients with malignant pleural diseases...
2017: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/28975242/ethics-and-the-legalization-of-physician-assisted-suicide-an-american-college-of-physicians-position-paper
#20
Lois Snyder Sulmasy, Paul S Mueller
Calls to legalize physician-assisted suicide have increased and public interest in the subject has grown in recent years despite ethical prohibitions. Many people have concerns about how they will die and the emphasis by medicine and society on intervention and cure has sometimes come at the expense of good end-of-life care. Some have advocated strongly, on the basis of autonomy, that physician-assisted suicide should be a legal option at the end of life. As a proponent of patient-centered care, the American College of Physicians (ACP) is attentive to all voices, including those who speak of the desire to control when and how life will end...
October 17, 2017: Annals of Internal Medicine
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