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https://www.readbyqxmd.com/read/29151044/mortality-among-referrals-to-a-community-based-intermediate-care-team
#1
Bharath Lakkappa, Sanjay Shah, Stephen Rogers, Leanne Helen Holman
OBJECTIVES: Intermediate care services have been introduced to help mitigate unnecessary hospital demand and premature placement in long-term residential care. Many patients are elderly and/or with complex comorbidities, but little consideration has been given to the palliative care needs of patients referred to intermediate care services. The objective of this study is to determine the proportion of patients referred to a community-based intermediate care team who died during care and up to 24 months after discharge and so to help inform the development of supportive and palliative care in this setting...
November 18, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/29150549/psychometric-validation-of-the-needs-assessment-tool-progressive-disease-in-interstitial-lung-disease
#2
Miriam J Johnson, Armita Jamali, Joy Ross, Caroline Fairhurst, Jason Boland, Carla Reigada, Simon Paul Hart, Gunn Grande, David C Currow, Athol U Wells, Sabrina Bajwah, Thanos Papadopoulos, J Martin Bland, Janelle Yorke
The inter-rater/test-retest reliability and construct validity of a palliative care needs assessment tool in interstitial lung disease (NAT:PD-ILD) were tested using NAT:PD-ILD-guided video-recorded consultations, and NAT:PD-ILD-guided consultations, and patient and carer-report outcomes (St George's Respiratory Questionnaire (SGRQ)-ILD, Carer Strain Index (CSI)/Carer Support Needs Assessment Tool (CSNAT)). 11/16 items reached at least fair inter-rater agreement; 5 items reached at least moderate test-retest agreement...
November 17, 2017: Thorax
https://www.readbyqxmd.com/read/29150163/the-management-of-diagnosed-heart-failure-in-older-people-in-primary-care
#3
REVIEW
Nicholas R Jones, F D Richard Hobbs, Clare J Taylor
Heart failure (HF) is a common condition affecting predominantly older people. Symptoms include breathlessness and fatigue, and can significantly reduce quality of life. HF rarely occurs in isolation, with most patients having several co-existing diseases requiring multiple medications. There is a large evidence base for treatment of HF with reduced ejection fraction, or HFrEF; however, many of the trials did not include older people with multimorbidity so their findings should be applied to this group with some caution...
December 2017: Maturitas
https://www.readbyqxmd.com/read/29150038/thoracic-surgery-considerations-in-the-mentally-ill-or-handicapped-patient
#4
REVIEW
Anthony B Mozer, James E Speicher, Carlos J Anciano
Increasing prevalence of mentally ill and handicapped populations requiring surgical thoracic interventions has brought to light their worse associated morbidity and mortality. Baseline functional status, caretaker environment, and mental limitations in day to day life have an impact in the short and long term from these interventions. Aggressive perioperative care, multispecialty approach, technical aspects, palliative procedures, and ethical considerations all play a part in improving outcomes. In this article real cases are presented illustrating points of care and situations for discussion...
February 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/29149150/the-hopeless-case-palliative-cryoablation-and-cementoplasty-procedures-for-palliation-of-large-pelvic-bone-metastases
#5
Tyler M Coupal, Kevin Pennycooke, Paul I Mallinson, Hugue A Ouellette, Paul W Clarkson, Pippa Hawley, Peter L Munk
BACKGROUND: Metastases to the bone are common in cancer patients, and it has been estimated that up to 50% of patients with pelvic bone metastases will not achieve adequate pain control with medications alone. This has led to a paradigm shift over recent years towards the use and development of minimally invasive image-guided treatment options for palliation of bony metastases. Despite these developments, large metastatic lesions are still often considered to be "hopeless cases" that would garner little to no benefit from image-guided intervention...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29148298/understanding-patient-requirements-for-technology-systems-that-support-pain-management-in-palliative-care-services-a-qualitative-study
#6
Matthew J Allsop, Sally Taylor, Michael I Bennett, Bridgette M Bewick
Approaches to pain management using electronic systems are being developed for use in palliative care. This article explores palliative care patients' perspectives on managing and talking about pain, the role of technology in their lives and how technology could support pain management. Face-to-face interviews were used to understand patient needs and concerns to inform how electronic systems are developed. A total of 13 interviews took place with a convenience sample of community-based patients with advanced cancer receiving palliative care through a hospice...
November 1, 2017: Health Informatics Journal
https://www.readbyqxmd.com/read/29147444/visceral-crisis-means-short-survival-among-patients-with-luminal-a-metastatic-breast-cancer-a-retrospective-cohort-study
#7
Yassir Sbitti, Khaoula Slimani, Adil Debbagh, Anouar Mokhlis, Habiba Kadiri, Abdelilah Laraqui, Hassan Errihani, Mohamed Ichou
Background: Patients with visceral crisis from luminal metastatic breast cancer (mBC) are often treated with palliative chemotherapy. No studies have analyzed the aggressiveness of the care in visceral crisis from luminal mBC patients. The objective of this study was to assess practices in this setting in a university medical oncology department. Methods: This retrospective study included all patients who were managed for luminal mBC between January 2013 and April 2016...
August 2017: World Journal of Oncology
https://www.readbyqxmd.com/read/29145869/a-mixed-methods-analysis-of-quality-of-life-among-late-life-patients-diagnosed-with-chronic-illnesses
#8
Monica S Frazer, Patrick Mobley
BACKGROUND: Quality of life (QOL) is an important consideration for people living with advancing chronic conditions. Palliative care providers speak about how, despite physical decline in late life, many patients report growth and meaning in other domains. This mixed methods study uses QOL survey responses to explore domain trajectories and interview data to explore how patients with advancing chronic conditions experience distinct QOL domains. METHODS: The study sample includes 156 now-deceased participants who completed the FACIT-Pal quarterly, and 40 (10 now-deceased) participants who discussed QOL in an interview...
November 16, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/29145675/-implementing-the-cross-disciplinary-subject-palliative-care-lecture-s-perspective
#9
Leonie Isermeyer, Benjamin Ilse, Gabriella Marx, Stephanie Seidemann, Jana Jünger, Friedemann Nauck, Bernd Alt-Epping
Introduction In 2009, palliative care was introduced as a mandatory subject in the undergraduate medical curriculum in Germany. Despite all efforts to integrate this subject into the curriculum, research suggests substantial differences and deficits in the quality of education between the medical schools. The aim of this research was to find out promoting as well as impedimental aspects of implementing palliative care in the medical training program. By this, a suitable framework in terms of content and structure for palliative care teaching should be extracted...
November 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29145584/critical-lessons-from-high-value-oncology-practices
#10
Douglas W Blayney, Melora K Simon, Beatrice Podtschaske, Scott Ramsey, Margaret Shyu, Craig Lindquist, Arnold Milstein
Importance: Cancer care is expensive. Cancer care provided by practice organizations varies in total spending incurred by patients and payers during treatment episodes and in quality of care, and this unnecessary variation contributes to the high cost. Objective: To use the variation in total spending and quality of care to assess oncology practice attributes distinguishing "high value" that may be tested and adopted by others to produce similar results. Design, Setting, and Participants: "Positive deviance" was used in this exploratory mixed-methods (quantitative and qualitative) analysis of interview results...
November 16, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/29145313/the-importance-of-family-caregiving-to-achieving-palliative-care-at-home-a-case-report-of-end-of-life-breast-cancer-in-an-area-struck-by-the-2011-fukushima-nuclear-crisis-a-case-report
#11
Akihiko Ozaki, Masaharu Tsubokura, Claire Leppold, Toyoaki Sawano, Manabu Tsukada, Tsuyoshi Nemoto, Kazuhiro Kosugi, Yoshitaka Nishikawa, Shigeaki Kato, Hiromichi Ohira
RATIONALE: The primary setting of palliative care has shifted from inpatient care to patients' residences. Family caregiving is essential for patients with life-limiting illnesses to receive palliative care at home, however little information is available regarding potential interventions to achieve palliative homecare for those without sufficient support from family members in various settings, including disasters. PATIENT CONCERNS: In March 2011, Fukushima, Japan experienced an earthquake, tsunami and nuclear disaster...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29144543/primary-thromboprophylaxis-in-individuals-without-cancer-admitted-to-a-geriatric-palliative-care-unit
#12
Adam J Gurau, Anna Berall, Jurgis Karuza, Giulia-Anna Perri
BACKGROUND/OBJECTIVES: The prevalence of individuals with advanced noncancer disease is increasing on palliative care units (PCUs), but there are no current guidelines to direct venous thromboembolism (VTE) prophylaxis decisions in these individuals. The aim of this study was to compare primary VTE prophylaxis in elderly adults with advanced noncancer diagnoses with that of those with advanced cancer on a dedicated geriatric PCU. DESIGN: Single-center retrospective chart review...
November 16, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29144172/disruptions-in-sleep-wake-cycles-in-community-dwelling-cancer-patients-receiving-palliative-care-and-their-correlates
#13
Marie Solange Bernatchez, Josée Savard, Hans Ivers
Significant disruptions in sleep-wake cycles have been found in advanced cancer patients in prior research. However, much remains to be known about specific sleep-wake cycle variables that are impaired in patients with a significantly altered performance status. More studies are also needed to explore the extent to which disrupted sleep-wake cycles are related to physical and psychological symptoms, time to death, maladaptive sleep behaviors, quality of life and 24-h light exposure. This study conducted in palliative cancer patients was aimed at characterizing patients' sleep-wake cycles using various circadian parameters (i...
November 16, 2017: Chronobiology International
https://www.readbyqxmd.com/read/29143495/palliative-care-in-residential-aged-care-an-overview
#14
Juliet Butler
OBJECTIVE: To measure how care needs, health and length of stay in permanent residential aged care differs by assessed need for palliative care. METHODS: On entry into permanent residential aged care, people's care needs and health conditions are assessed on the Aged Care Funding Instrument. Data for the period 2008-2009 and 2015-2016 were analysed for trends in care needs, health conditions, length of stay and separation reason across assessed need for palliative care...
November 15, 2017: Australasian Journal on Ageing
https://www.readbyqxmd.com/read/29143390/chemotherapy-and-healthcare-utilisation-near-the-end-of-life-in-patients-with-cancer
#15
K J G Schulkes, I C van Walree, L J R van Elden, F van den Bos, L van Huis-Tanja, J-W J Lammers, D Ten Bokkel Huinink, M E Hamaker
The quality of medical care delivered to patients with cancer near the end of life is a significant issue. Previous studies have defined several areas suggestive of aggressive cancer treatment as potentially representing poor quality care. The primary objective of current analysis was to examine chemotherapy and healthcare utilisation in the last 3 months of life among patients with cancer that received palliative chemotherapy. Patients were selected from the hospital administration database of the Diakonessenhuis Utrecht, the Netherlands...
November 16, 2017: European Journal of Cancer Care
https://www.readbyqxmd.com/read/29143282/hypomethylating-agents-for-treatment-and-prevention-of-relapse-after-allogeneic-blood-stem-cell-transplantation
#16
REVIEW
Thomas Schroeder, Christina Rautenberg, Rainer Haas, Ulrich Germing, Guido Kobbe
Despite the curative potential of allogeneic stem cell transplantation (allo-SCT) in patients with acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS), many patients will relapse. Until recently therapeutic options mainly consisted of palliative care, chemotherapy, donor lymphocyte infusions and second transplantation in selected cases. Still many patients either do not tolerate intensive therapies or do not achieve durable remissions and will finally succumb. Given this unmet medical need the hypomethylating agents (HMA), Azacitidine (Aza) and Decitabine (DAC) have been tested as salvage therapy in patients with myeloid malignancies relapsing after allo-SCT...
November 15, 2017: International Journal of Hematology
https://www.readbyqxmd.com/read/29142376/intensive-care-nurses-attitude-on-palliative-and-end-of-life-care
#17
Swagata Tripathy, Pragyan K Routray, Jagdish C Mishra
Background: Intensive Care Unit (ICU) nurses have a vital role in the implementation of end of life (EOL) care. There is limited data on the attitude of ICU nurses toward EOL and palliation. Aim: This study aimed to investigate knowledge, attitude, and beliefs of intensive care nurses in eastern India toward EOL. Materials and Methods: A self-administered questionnaire was distributed to delegates in two regional critical care nurses' training programs...
October 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29142358/transitional-cell-carcinoma-of-urinary-bladder-manifesting-as-extensive-retroperitoneal-and-axillary-lymph-node-metastasis-an-extremely-rare-case-scenario-detected-by-18-f-fluorodeoxyglucose-positron-emission-tomography-scan
#18
Abhishek Purkayastha, Neelam Sharma, Rekha Vashisth, Braj Kishore
Transitional cell carcinoma (TCC) urinary bladder is known to metastasize to regional lymph nodes (LNs), liver, lung, bone, adrenal glands, and intestine. However, an asymptomatic TCC bladder manifesting as metastatic axillary LN mass and extensive retroperitoneal lymphadenopathy is rarely heard of. A 46-year-old male, smoker, presented with 8 cm × 6 cm right axillary swelling of 1-month duration. Aspiration cytology revealed metastatic deposits of poorly differentiated carcinoma favoring TCC. Metastatic evaluation with (18)F-fluorodeoxyglucose positron emission tomography ((18)FDG-PET) scan showed mass lesion urinary bladder, conglomerate right axillary mass and extensive retroperitoneal LNs with significant metabolic activity, biopsy from which revealed deposits of TCC...
October 2017: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
https://www.readbyqxmd.com/read/29142184/efficacy-of-cell-free-and-concentrated-ascites-reinfusion-therapy-for-palliative-care-in-a-patient-with-malignant-pleural-mesothelioma-a-case-report
#19
Kakeru Hisakane, Hironobu Ohmatsu, Shigeki Umemura, Keisuke Kirita, Shingo Matsumoto, Kiyotaka Yoh, Seiji Niho, Koichi Goto
Cell-free and concentrated ascites reinfusion therapy (CART) is recognized as a useful treatment to improve the symptoms caused by refractory ascites. Recently, a few clinical studies have reported the effects of CART for malignant ascites, especially in gynecological and gastrointestinal cancers. We report the case of malignant ascites in a patient with malignant pleural mesothelioma (MPM) whose symptoms were relieved by CART. A 59-year-old Japanese male with MPM who had undergone pleural decortication had pleural and peritoneal recurrence...
2017: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
https://www.readbyqxmd.com/read/29141770/outcomes-following-changing-from-a-two-tiered-to-a-three-tiered-hospital-rapid-response-system
#20
Winston Cheung
Objectives The aim of the present study was to determine whether changing a hospital rapid response system (RRS) from a two-tiered to a three-tiered model can reduce disruption to normal hospital routines while maintaining the same overall patient outcomes.Methods Staff at an Australian teaching hospital attending medical emergency team and cardiac arrest (MET/CA) calls were interviewed after the RRS was changed from a two-tiered to three-tiered model, and the results were compared with a study using the same methods conducted before the change...
November 16, 2017: Australian Health Review: a Publication of the Australian Hospital Association
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