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ascites and palliative care

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https://www.readbyqxmd.com/read/29762074/use-of-artificial-hydration-at-the-end-of-life-a-survey-of-australian-and-new-zealand-palliative-medicine-doctors
#1
Jacqueline Oehme, Caitlin Sheehan
BACKGROUND: Dying is ubiquitous, yet the optimal management of hydration in the terminal phase is undetermined. Palliative care (PC) doctors' practices may act as a de facto measure of the benefits and burdens of artificial hydration (AH) use. OBJECTIVE: To identify PC doctors' AH prescribing practices for imminently dying patients and possible influencing factors. METHODS: An online survey of doctors belonging to the Australian and New Zealand Society of Palliative Medicine...
May 15, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29689120/acute-on-chronic-liver-failure-getting-ready-for-prime-time
#2
Jasmohan S Bajaj, Richard Moreau, Patrick S Kamath, Hugo E Vargas, Vicente Arroyo, K Rajender Reddy, Gyongyi Szabo, Puneeta Tandon, Jody Olson, Constantine Karvellas, Thierry Gustot, Jennifer C Lai, Florence Wong
Acute on chronic liver failure (ACLF) is a culmination of chronic liver disease and extra-hepatic organ failures, which is associated with a high short-term mortality and immense healthcare expenditure. There are varying definitions for organ failures and ACLF in Europe, North America and Asia. These differing definitions need to be reconciled to enhance progress in the field. The pathogenesis of ACLF is multi-factorial and related to interactions between the immuno-inflammatory system, microbiota and the precipitating factors...
April 24, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29650840/-a-case-of-effective-palliative-care-with-cart-for-refractory-ascites-associated-with-cancerous-peritonitis-of-gastric-cancer
#3
Junji Kawada, Masaya Nishino, Tomoki Hata, Takayuki Ogino, Hiromitsu Hoshino, Miho Okano, Kenichi Nagai, Yongkook Kim, Masaki Okuyama, Toshimasa Tsujinaka
Refractory ascites associated with cancerous peritonitis causes abdominal tension and reduced oral intake. Frequent ascites drainage can cause rapid worsening ofa patient's general condition. Cell-free and concentrated ascites reinfusion therapy (CART)for refractory ascites was first covered in 1981, and the general conditions ofpatients and their symptoms could be improved after undergoing CART. Herein, we report a case of effective palliative care with CART for refractory ascites associated with cancerous peritonitis...
April 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29510685/case-report-8-years-after-liver-transplantation-de-novo-hepatocellular-carcinoma-8-months-after-hcv-clearance-through-ifn-free-antiviral-therapy
#4
Giuliano Ramadori, Patrizia Bosio, Federico Moriconi, Ihtzaz A Malik
BACKGROUND: After orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC), recurrent HCC mostly develops within 2 years. All cases of de novo HCC described so far occurred later than 2 years after OLT. Prevention of post-transplantation HCC has usually been tried to achieve by curing or controlling recurrent liver disease. This has been rationale for treatment with interferon (IFN)/ribavirin of HCV-recurrence in patients after OLT, transplanted for advanced HCV-induced liver disease and/or HCC...
March 6, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29489450/therapeutic-procedures-for-malignant-ascites-in-a-palliative-care-outpatient-clinic
#5
Säde Korpi, Veera V Salminen, Reetta P Piili, Niina Paunu, Tiina Luukkaala, Juho T Lehto
BACKGROUND: The optimal treatment of malignant ascites (MA) and feasibility of the management with free drainage remain unclear. OBJECTIVE: To study the success of drainage, complications, and survival after paracentesis or insertion of an indwelling tunneled catheter (TC) for the MA performed on a day-case basis. DESIGN AND SETTING: We evaluated 118 paracenteses and 48 insertions of TCs performed in 104 patients with MA at the Palliative Care Outpatient Unit of Tampere University Hospital...
February 28, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29415840/palliative-home-parenteral-nutrition-clinical-service-evaluation-and-identifying-potential-prognostic-factors-to-assist-with-patient-selection
#6
B Drinkwater, B K Clarke, J Jones, J Ratcliffe, P Deel-Smith, S C Cooper
BACKGROUND AND AIMS: Home parenteral nutrition (HPN) for palliation has little evidence supporting existing guidance. Patient selection remains challenging. We aimed to evaluate use of palliative HPN in our service against ESPEN guidance, and to identify potential prognostic indicators. METHODS: Palliative care patients commenced on HPN were identified. Medical notes, computer records and HPN database were accessed to identify patient demographics, primary diagnosis and aetiology of intestinal failure, blood test results potentially associated with prognosis (eGFR, albumin, CRP, Hb), presence of ascites, and PN duration...
December 2017: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29400065/the-role-of-ultrasound-guided-therapeutic-paracentesis-in-an-outpatient-transitional-care-program-a-case-series
#7
Jeffrey Wang, Shahida Khan, Paige Wyer, Jessica Vanderwilp, Justin Reynolds, Bruce Bethancourt, Ken S Ota
BACKGROUND: Patients with ascites suffer from distressing symptoms and are at high risk for readmission after hospitalization. Timely paracentesis is an important palliative tool in managing this vulnerable population. At our institution, we have developed a multidisciplinary transitional care program for patients discharged from the hospital with a wide range of complex conditions including refractory ascites. METHODS: We present a case series of 10 patients with symptomatic ascites who were enrolled in our transitional care program and treated with ultrasound-guided therapeutic paracentesis in our clinic...
January 1, 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29360690/predicting-6-and-12-month-risk-of-mortality-in-patients-with-platinum-resistant-advanced-stage-ovarian-cancer-prognostic-model-to-guide-palliative-care-referrals
#8
Jonathan Foote, Micael Lopez-Acevedo, Gregory Samsa, Paula S Lee, Arif H Kamal, Angeles Alvarez Secord, Laura J Havrilesky
OBJECTIVE: Predictive models are increasingly being used in clinical practice. The aim of the study was to develop a predictive model to identify patients with platinum-resistant ovarian cancer with a prognosis of less than 6 to 12 months who may benefit from immediate referral to hospice care. METHODS: A retrospective chart review identified patients with platinum-resistant epithelial ovarian cancer who were treated at our institution between 2000 and 2011. A predictive model for survival was constructed based on the time from development of platinum resistance to death...
February 2018: International Journal of Gynecological Cancer
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
#9
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/29057245/a-case-report-of-congenital-glycogen-storage-liver-cirrhosis-treated-with-bone-marrow-derived-stem-cells
#10
Terek W Wehbe, Nassim H Abi Chahine, Abdul-Rahman A Annous, Mohammad A Ferri, Robert C Boulous, Majid F El-Mestrah
Liver cirrhosis represents a state of end-stage failure that is usually fatal. The condition results in liver dysfunction, recurrent ascites, encephalopathy, renal failure, splenomegaly, bleeding, and a poor quality of life in general. With the current severe shortage of donated organs, the only available treatment in the developing countries remains palliative care. We report a case of congenital metabolic liver cirrhosis due to glycogen storage disease diagnosed at age eight. The patient, a male, received bone marrow derived mononuclear cells (BMMC) at age 16 and again at age 17 with significant improvement of his biochemical liver function tests, ascites build-up, asthenia, splenomegaly and quality of life...
2017: Stem Cell Investigation
https://www.readbyqxmd.com/read/29027398/nutritional-status-cachexia-and-anorexia-in-women-with-peritoneal-metastasis-and-intraperitoneal-chemotherapy-a-longitudinal-analysis
#11
Ziad Hilal, Günther A Rezniczek, Robert Klenke, Askin Dogan, Clemens B Tempfer
OBJECTIVE: To describe the nutritional status of women with peritoneal metastasis (PM) from recurrent ovarian, fallopian, or peritoneal cancer and to assess longitudinal variations of the cachexia-anorexia syndrome (CAS) during palliative pressurized intraperitoneal aerosol chemotherapy (PIPAC). METHODS: Nutritional assessment included body mass index (BMI), bioelectrical impedance analysis (BIA), and blood chemistry. CAS presence/absence was recorded before and during repeated cycles (1-11) of PIPAC...
November 2017: Journal of Gynecologic Oncology
https://www.readbyqxmd.com/read/28803353/palliative-care-in-ovarian-carcinoma-patients-a-personalized-approach-of-a-team-work-a-review
#12
REVIEW
Yakir Segev, Lior Segev, Meirav Schmidt, Ron Auslender, Ofer Lavie
Most ovarian cancer patients are diagnosed in an advanced stage; and after the initial treatment experience disease recurrence, which eventually becomes palliative. Many questions arise in this setting including how to address patients in the palliative setting, how to discuss end-of-life issues, and how to manage symptoms. In this review, we discuss the timing and setting of end-of-life discussion in the context of end-stage ovarian cancer. We review the approach to relieving disease burden by improving and decreasing symptoms...
October 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28734721/factors-influencing-survival-of-patients-with-pancreatic-adenocarcinoma-and-synchronous-liver-metastases-receiving-palliative-care
#13
Huaqiang Ouyang, Weidong Ma, Fang Liu, Zhensong Yue, Minghui Fang, Manman Quan, Zhanyu Pan
BACKGROUND AND AIMS: Patients with pancreatic ductal adenocarcinoma and synchronous liver metastases (PACLM) have an extremely limited life expectancy. We performed a single-center analysis to explore the clinical results and prognostic factors of patients with PACLM receiving palliative care. METHODS: We retrospectively reviewed 189 patients undergoing palliative care at Tianjin Medical University Cancer Hospital over a 15-year period. Clinical characteristics, survival condition, and factors associated with survival were analyzed...
September 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28469345/primary-t-cell-lymphoblastic-lymphoma-of-the-ovary-a-case-report
#14
Sweta Singh, Susama Patra, Narbadyswari Deep Bag, Monalisha Naik
Primary ovarian lymphoma is extremely rare. We report a case of primary T-cell lymphoblastic lymphoma of the ovary in a 31-year-old multiparous woman, who presented with abdominal pain. Her menstrual cycles were regular. There was no generalized lymphadenopathy or fever. On per abdominal examination, there was a firm, tender, solid, mobile mass with well-defined borders, corresponding to 20 weeks gestation, whose lower pole was easily reached. Per vaginum examination revealed a large adnexal mass in the right and anterior fornix...
January 2017: Indian Journal of Medical and Paediatric Oncology
https://www.readbyqxmd.com/read/28464346/review-article-maximising-quality-of-life-while-aspiring-for-quantity-of-life-in-end-stage-liver-disease
#15
REVIEW
R A Bhanji, E J Carey, K D Watt
BACKGROUND: With recent advances in the management of chronic liver disease and its complications, the long-term survival in cirrhosis has improved. Therefore, the number of individuals who will spend a significant proportion of their life with end-stage liver disease (ESLD) may continue to rise. Thus, more attention to quality of life (QOL) and its integration with traditional clinical endpoints is needed. AIMS: Recently, there have been many studies looking at treatment outcomes and their impact on the QOL in patients with ESLD...
July 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27900548/predictors-of-response-to-corticosteroids-for-dyspnea-in-advanced-cancer-patients-a-preliminary-multicenter-prospective-observational-study
#16
MULTICENTER STUDY
Masanori Mori, Akemi Naito Shirado, Tatsuya Morita, Kenichiro Okamoto, Yoshinobu Matsuda, Yoshihisa Matsumoto, Hirohide Yamada, Hiroki Sakurai, Etsuko Aruga, Keisuke Kaneishi, Hiroaki Watanabe, Takashi Yamaguchi, Takuya Odagiri, Shuji Hiramoto, Hiroyuki Kohara, Naoki Matsuo, Hideki Katayama, Tomohiro Nishi, Takashi Matsui, Satoru Iwase
PURPOSE: Although corticosteroids can relieve dyspnea in advanced cancer patients, factors predicting the response remain unknown. We aimed to explore potential factors predicting the response to corticosteroids for dyspnea in advanced cancer patients. METHODS: In this preliminary multicenter prospective observational study, we included patients who had metastatic or locally advanced cancer, were receiving specialized palliative care services, and had a dyspnea intensity of ≥3 on a 0-10 Numerical Rating Scale (NRS) (worst during the last 24 h)...
April 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/27707955/palliative-long-term-abdominal-drains-in-refractory-ascites-due-to-end-stage-liver-disease-a-case-series
#17
Lucia Macken, Deepak Joshi, Jenny Messenger, Mark Austin, Jeremy Tibble, Louise Mason, Sumita Verma
BACKGROUND: Ascites, the commonest complication of cirrhosis, leads to frequent hospitalisations. Refractory ascites confers a median survival of 6 months without liver transplantation. In many, the management remains palliative (large-volume paracentesis). Despite calls for improvement, palliative and end-of-life care is not yet integrated into end-stage liver disease. Long-term abdominal drains are a palliative strategy in malignant ascites, but not end-stage liver disease. CASE PRESENTATION: A retrospective, single centre, case series review was performed of patients undergoing long-term abdominal drain placement for refractory ascites secondary to end-stage liver disease at a large teaching hospital between August 2011 and March 2013...
July 2017: Palliative Medicine
https://www.readbyqxmd.com/read/27682610/hyperthermic-intraperitoneal-chemotherapy-as-palliative-treatment-for-malignant-ascites-a-single-center-experience-and-a-review-of-the-literature
#18
Luigina Graziosi, Elisabetta Marino, Verena De Angelis, Alberto Rebonato, Annibale Donini
Malignant ascites is an abnormal accumulation of fluid in the peritoneal cavity of patients with intraperitoneal cancer dissemination. This clinical condition could represent the terminal evolution of a lethal disease and could influence the prognosis, severely impairing the patients' quality of life. Treatment options include a multitude of different procedures with limited efficacy and some degree of risk; diuretics, paracentesis, peritoneo-venous shunts and intraperitoneal biologic agents like anti-VEGF molecules, metalloproteinase inhibitors and immunomodulators are included...
2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/27598949/experience-from-a-real-life-cohort-outcome-of-606-patients-with-hepatocellular-carcinoma-following-transarterial-chemoembolization
#19
Martha M Kirstein, Nora Schweitzer, Nazli Ay, Christina Boeck, Katerina Lappas, Jan B Hinrichs, Torsten Voigtländer, Frank Wacker, Michael P Manns, Thomas Rodt, Arndt Vogel
BACKGROUND: Hepatocellular carcinoma (HCC) is one of the most lethal cancers. Transarterial chemoembolization (TACE) has been accepted as the standard care for intermediate stage disease. METHODS: In this study, we characterized 606 with HCC patients from Hannover Medical School treated with TACE. RESULTS: 606 with HCC patients treated with TACE were identified between 2000 and 2015. Most patients (59.8%) were at intermediate stage. Following TACE, most patients subsequently received systemic therapy or best supportive care (BSC), whereas 227 (37...
January 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/27473538/sertoli-leydig-cell-tumor-with-retiform-areas-and-overgrowth-of-rhabdomyosarcomatous-elements-case-report-and-literature-review
#20
REVIEW
T Burnik Papler, S Frković Grazio, B Kobal
BACKGROUND: Sertoli - Leydig cell tumors (SLCTs) are sex-cord stromal tumors that account less than 0.5 % of primary ovarian neoplasms. They are mostly benign and occur in reproductive age women. Variants with heterologous mesenchymal elements are exceptionaly rare. The usual presentation of SLCTs is with signs of androgen excess as majority of them produce androgens. CASE PRESENTATION: We present a case of a SLCT occurring in a 70 year old woman. Her presenting complaint was abdominal distension and pain...
July 30, 2016: Journal of Ovarian Research
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