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https://www.readbyqxmd.com/read/29221885/-design-of-a-questionnaire-on-the-knowledge-and-attitudes-of-the-population-of-madrid-spain-facing-the-end-of-life
#1
Belén Ortiz-Gonçalves, Andrés Santiago-Sáez, Elena Albarrán Juan, Elena Labajo González, Bernardo Perea-Pérez
OBJECTIVE: To create and validate a questionnaire about knowledge and attitudes of the general population in Madrid (Spain) about life's end stage. METHOD: A descriptive study designed as a structured self-administered questionnaire, validated by seven Madrid Health Service professional experts and assessed through a pilot study. RESULTS: The questionnaire consisted of 42 questions, divided into six modules: 1) decisions and psychological-physical care at life's end; 2) palliative care; 3) euthanasia and assisted suicide; 4) advance directives document; 5) spiritual factors; and 6) socio-demographic data...
December 5, 2017: Gaceta Sanitaria
https://www.readbyqxmd.com/read/29221534/on-becoming-a-global-citizen-transformative-learning-through-global-health-experiences
#2
Debra K Litzelman, Adrian Gardner, Robert M Einterz, Philip Owiti, Charity Wambui, Jordan C Huskins, Kathleen M Schmitt-Wendholt, Geren S Stone, Paul O Ayuo, Thomas S Inui, Rachel A Umoren
BACKGROUND: Globalization has increased the demand for international experiences in medical education. International experiences improve medical knowledge, clinical skills, and self-development; influence career objectives; and provide insights on ethical and societal issues. However, global health rotations can end up being no more than tourism if not structured to foster personal transformation and global citizenship. OBJECTIVE: We conducted a qualitative assessment of trainee-reported critical incidents to more deeply understand the impact of our global health experience on trainees...
May 2017: Annals of Global Health
https://www.readbyqxmd.com/read/29211857/pulmonary-vein-isolation-with-vs-without-continued-antiarrhythmic-drug-treatment-in-subjects-with-recurrent-atrial-fibrillation-powder-af-results-from-a-multicentre-randomized-trial
#3
Mattias Duytschaever, Anthony Demolder, Thomas Phlips, Andrea Sarkozy, Milad El Haddad, Philippe Taghji, Sebastien Knecht, Rene Tavernier, Yves Vandekerckhove, Tom De Potter
Aims: Catheter ablation is indicated in patients with symptomatic paroxysmal atrial fibrillation (AF) resistant to antiarrhythmic drug therapy (ADT). We investigated whether continued use of previously ineffective ADT beyond the post-ablation blanking period reduces recurrence of atrial tachyarrhythmia within the 1st year after ablation. Methods and results: This was a multicentre, randomized controlled study in patients undergoing contact force-guided pulmonary vein isolation (PVI) for paroxysmal AF in whom previously ineffective ADT was continued during a blanking period of 3 months...
December 2, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29207679/italian-real-life-experience-with-brentuximab-vedotin-results-of-a-large-observational-study-on-234-relapsed-refractory-hodgkin-s-lymphoma
#4
Cinzia Pellegrini, Alessandro Broccoli, Alessandro Pulsoni, Luigi Rigacci, Caterina Patti, Guido Gini, Donato Mannina, Monica Tani, Chiara Rusconi, Alessandra Romano, Anna Vanazzi, Barbara Botto, Armando Santoro, Stefan Hoaus, Gian Matteo Rigolin, Pellegrino Musto, Patrizio Mazza, Stefano Molica, Paolo Corradini, Angelo Fama, Francesco Gaudio, Michele Merli, Fioravante Ronconi, Giuseppe Gritti, Daniele Vallisa, Patrizia Tosi, Anna Marina Liberati, Antonello Pinto, Vincenzo Pavone, Filippo Gherlinzoni, Maria Paola Bianchi, Stefano Volpetti, Livio Trentin, Maria Cecilia Goldaniga, Maurizio Bonfichi, Amalia De Renzo, Corrado Schiavotto, Michele Spina, Angelo Michele Carella, Vittorio Stefoni, Lisa Argnani, Pier Luigi Zinzani
A large Italian multicenter observational retrospective study was conducted on the use of brentuximab vedotin (BV) for patients with relapsed Hodgkin's lymphoma (HL) to check if clinical trial results are confirmed even in a real life context. 234 CD30+ HL patients were enrolled. Best response was observed after a median of 4 cycles in 140 patients (59.8%): 74 (31.6%) patients obtained a complete response (CR) and 66 (28.2%) achieved a partial response (PR); overall response rate at the end of the treatment was 48...
October 31, 2017: Oncotarget
https://www.readbyqxmd.com/read/29206578/wellness-in-sickness-and-health-the-w-i-s-h-project-advance-care-planning-preferences-and-experiences-among-elderly-latino-patients
#5
Lauren Y Maldonado, Ruth B Goodson, Matthew C Mulroy, Emily M Johnson, Jo M Reilly, Diana C Homeier
OBJECTIVE: To assess advance care planning (ACP) preferences, experiences, and comfort in discussing end-of-life (EOL) care among elderly Latinos. METHODS: Patients aged 60 and older from the Los Angeles County and University of Southern California (LAC+USC) Medical Center Geriatrics Clinic (n = 41) participated in this intervention. Trained staff conducted ACP counseling with participants in their preferred language, which included: (a) pre-counseling survey about demographics and EOL care attitudes, (b) discussion of ACP and optional completion of an advance directive (AD), and (c) post-session survey...
October 25, 2017: Clinical Gerontologist
https://www.readbyqxmd.com/read/29191183/an-economic-model-of-advance-care-planning-in-australia-a-cost-effective-way-to-respect-patient-choice
#6
Kim-Huong Nguyen, Marcus Sellars, Meera Agar, Sue Kurrle, Adele Kelly, Tracy Comans
BACKGROUND: Advance care planning (ACP) is a process of planning for future health and personal care. A person's values and preferences are made known so that they can guide decision making at a future time when that person cannot make or communicate his or her decisions. This is particularly relevant for people with dementia because their ability to make decisions progressively deteriorates over time. This study aims to evaluate the cost-effectiveness of delivering a nationwide ACP program within the Australian primary care setting...
December 1, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29189943/relieving-one-s-relatives-from-the-burdens-of-care
#7
Govert den Hartogh
It has been proposed that an old and ill person may have a 'duty to die', i.e. to refuse life-saving treatment or to end her own life, when she is dependent on the care of intimates and the burdens of care are becoming too heavy for them. In this paper I argue for three contentions: (1) You cannot have a strict duty to die, correlating to a claim-right of your relatives, because if they reach the point at which the burdens of care are larger than you can reasonably expect them to take, the natural conclusion is that their duty ends...
November 30, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/29189854/-effects-of-a-high-intensity-interval-training-on-the-aerobic-capacity-of-adolescents
#8
Álvaro Huerta Ojeda, Sergio Galdames Maliqueo, Marianela Cataldo Guerra, Guillermo Barahona Fuentes, Tania Rozas Villanueva, Pablo Cáceres Serrano
BACKGROUND: If aerobic capacity is stimulated early in life, maximal oxygen consumption during adulthood is assured. AIM: To analyze the effects of a high intensity interval training (HIIT) in adolescents on the maximal oxygen consumption (VO2max) measured using the 20-m shuttle run test (20mSRT). MATERIAL AND METHODS: Twenty eight teenagers aged 13 ± 0.6 years were divided in two groups of 14 subjects each. One group was to a 16 sessions of HIIT interval training based on their individual maximal aerobic speed and the other continued with their usual exercise done at school...
August 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/29182726/the-association-between-income-and-life-expectancy-revisited-deindustrialization-incarceration-and-the-widening-health-gap
#9
Elias Nosrati, Michael Ash, Michael Marmot, Martin McKee, Lawrence P King
Background: The health gap between the top and the bottom of the income distribution is widening rapidly in the USA, but the lifespan of America's poor depends substantially on where they live. We ask whether two major developments in American society, deindustrialization and incarceration, can explain variation among states in life expectancy of those in the lowest income quartile. Methods: Life expectancy estimates at age 40 of those in the bottom income quartile were used to fit panel data models examining the relationship with deindustrialization and incarceration between 2001 and 2014 for all US states...
November 22, 2017: International Journal of Epidemiology
https://www.readbyqxmd.com/read/29181841/epidural-therapy-for-the-treatment-of-severe-pre-eclampsia-in-non-labouring-women
#10
REVIEW
Amita Ray, Sujoy Ray
BACKGROUND: Pre-eclampsia is a pregnancy-specific multi-organ disorder, which is characterised by hypertension and multisystem organ involvement and which has significant maternal and fetal morbidity and mortality. Failure of the placental vascular remodelling and reduced uteroplacental flow form the etiopathological basis of pre-eclampsia. There are several established therapies for pre-eclampsia including antihypertensives and anticonvulsants. Most of these therapies aim at controlling the blood pressure or preventing complications of elevated blood pressure, or both...
November 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29178866/a-scoping-review-of-palliative-care-for-children-in-low-and-middle-income-countries
#11
Hatoko Sasaki, Marie-Charlotte Bouesseau, Joan Marston, Rintaro Mori
BACKGROUND: Ninety-eight percent of children needing palliative care live in low- and middle-income countries (LMICs), and almost half of them live in Africa. In contrast to the abundance of data on populations in high income countries, the current data on populations in LMICs is woefully inadequate. This study aims to identify and summarize the published literature on the need, accessibility, quality, and models for palliative care for children in LMICs. METHODS: A scoping review was performed following the method of Arksey and O'Malley...
November 25, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/29168934/challenging-a-dogma-five-year-survival-does-not-equal-cure-in-all-colorectal-cancer-patients
#12
Omar Abdel-Rahman
BACKGROUND: The current study tried to evaluate the factors affecting 10- to 20- years' survival among long term survivors (>5 years) of colorectal cancer (CRC). METHODS: Surveillance, Epidemiology and End Results (SEER) database (1988-2008) was queried through SEER*Stat program.Univariate probability of overall and cancer-specific survival was determined and the difference between groups was examined. Multivariate analysis for factors affecting overall and cancer-specific survival was also conducted...
November 26, 2017: Expert Review of Anticancer Therapy
https://www.readbyqxmd.com/read/29168475/chronic-kidney-disease
#13
REVIEW
Paola Romagnani, Giuseppe Remuzzi, Richard Glassock, Adeera Levin, Kitty J Jager, Marcello Tonelli, Ziad Massy, Christoph Wanner, Hans-Joachim Anders
Chronic kidney disease (CKD) is defined by persistent urine abnormalities, structural abnormalities or impaired excretory renal function suggestive of a loss of functional nephrons. The majority of patients with CKD are at risk of accelerated cardiovascular disease and death. For those who progress to end-stage renal disease, the limited accessibility to renal replacement therapy is a problem in many parts of the world. Risk factors for the development and progression of CKD include low nephron number at birth, nephron loss due to increasing age and acute or chronic kidney injuries caused by toxic exposures or diseases (for example, obesity and type 2 diabetes mellitus)...
November 23, 2017: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/29166306/the-surgical-management-of-nerve-gaps-present-and-future
#14
Samer Bassilios Habre, Grant Bond, Xi Lin Jing, Epameinondas Kostopoulos, Robert D Wallace, Petros Konofaos
Peripheral nerve injuries can result in significant morbidity, including motor and/or sensory loss, which can affect significantly the life of the patient. Nowadays, the gold standard for the treatment of nerve section is end-to-end neurorrhaphy. Unfortunately, in some cases, there is segmental loss of the nerve trunk. Nerve mobilization allows primary repair of the sectioned nerve by end-to-end neurorrhaphy if the gap is less than 1 cm. When the nerve gap exceeds 1 cm, autologous nerve grafting is the gold standard of treatment...
November 21, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29165139/analysis-of-the-evidence-practice-gap-to-facilitate-proper-medical-care-for-the-elderly-investigation-using-databases-of-utilization-measures-for-national-database-of-health-insurance-claims-and-specific-health-checkups-of-japan-ndb
#15
Takeo Nakayama, Yuichi Imanaka, Yasushi Okuno, Genta Kato, Tomohiro Kuroda, Rei Goto, Shiro Tanaka, Hiroshi Tamura, Shunichi Fukuhara, Shingo Fukuma, Manabu Muto, Motoko Yanagita, Yosuke Yamamoto
As Japan becomes a super-aging society, presentation of the best ways to provide medical care for the elderly, and the direction of that care, are important national issues. Elderly people have multi-morbidity with numerous medical conditions and use many medical resources for complex treatment patterns. This increases the likelihood of inappropriate medical practices and an evidence-practice gap. The present study aimed to: derive findings that are applicable to policy from an elucidation of the actual state of medical care for the elderly; establish a foundation for the utilization of National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB), and present measures for the utilization of existing databases in parallel with NDB validation...
June 6, 2017: Environmental Health and Preventive Medicine
https://www.readbyqxmd.com/read/29163086/adolescent-exposure-to-methylphenidate-increases-impulsive-choice-later-in-life
#16
Zarish Abbas, Arwen Sweet, Giovanni Hernandez, Andreas Arvanitogiannis
Background: The psychostimulant methylphenidate (MPH) is known to temporarily reduce impulsive choice and promote self-control. What is not sufficiently understood is how repeated treatment with MPH affects impulsive choice in the long run, and whether any such effect is contingent on exposure at certain developmental stages. Methods: Using an animal model for impulsive choice, we examined first whether giving MPH through early adolescence alters delay discounting, an operational measure of impulsive choice, later in adulthood...
2017: Frontiers in Behavioral Neuroscience
https://www.readbyqxmd.com/read/29161396/demands-and-requests-for-inappropriate-or-inadvisable-treatments-at-the-end-of-life-what-do-you-do-at-2-o-clock-in-the-morning-when-%C3%A2
#17
L McCrossan, R Siegmeth
In an era when healthcare has become increasingly complex and patient expectations are higher than ever before, we can find the decision-making process for patients, potentially at the end of their lives, increasingly difficult. In the shift from paternalism to patient choice, we can struggle to know what to do when faced with a patient, their family, or both requesting or demanding inadvisable, inappropriate, or futile treatments. It can feel as if we are being asked to subject patients to intrusions and interventions that 'just feel wrong'...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29159708/mainstreaming-genetics-in-palliative-care-barriers-and-suggestions-for-clinical-genetic-services
#18
A Dearing, N Taverner
Palliative healthcare professionals (PHCPs) frequently do not refer their eligible patients for genetic testing. After the death of the affected individual, clinically relevant information for family members is lost. In previous research, PHCPs stated that the end-of-life setting is not appropriate to discuss genetic issues. It is unclear if this has changed due to increasing awareness of genetics in the media and efforts to mainstream genetic testing. Semi-structured interviews of PHCPs were analysed by thematic analysis...
November 20, 2017: Journal of Community Genetics
https://www.readbyqxmd.com/read/29156917/advance-care-planning-for-patients-with-advanced-neurology-diseases
#19
Ka-Chi Cheung, Vikki Wai-Kee Lau, Ka-Chun Un, Man-Sheung Wong, Kwok-Ying Chan
BACKGROUND: Advanced neurology diseases including motor neuron disease (MND) are usually progressive life-limiting illness and could be devastating for patients, families and caregivers. Although medical technologies, such as enteral feeding and non-invasive ventilation, may prolong life expectancy of the patients, their utilization prompts important ethical questions in regard to their quality of life (QoL). Little attention had been paid on how ACP practice would practically help with patients suffering from different neurology diseases...
October 13, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29153752/hospice-care-for-patients-with-dementia-in-the-united-states-a-longitudinal-cohort-study
#20
Aline De Vleminck, R Sean Morrison, Diane E Meier, Melissa D Aldridge
BACKGROUND: Patients with dementia form an increasing proportion of those entering hospice care. Little is known about the types of hospices serving patients with dementia and the patterns of hospice use, including timing of hospice disenrollment between patients with and without dementia. OBJECTIVES: To characterize the hospices that serve patients with dementia, to compare patterns of hospice disenrollment for patients with dementia and without dementia, and to evaluate patient-level and hospice-level characteristics associated with hospice disenrollment...
November 16, 2017: Journal of the American Medical Directors Association
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