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https://www.readbyqxmd.com/read/29466977/the-rotterdam-elderly-pain-observation-scale-repos-is-reliable-and-valid-for-non-communicative-end-of-life-patients
#1
Anniek D Masman, Monique van Dijk, Joost van Rosmalen, Frans P M Baar, Dick Tibboel, Anneke A Boerlage
BACKGROUND: In palliative care, administration of opioids is often indispensable for pain treatment. Pain assessment may help recognize pain and guide treatment in non-communicative patients. In the Netherlands the Rotterdam Elderly Pain Observation Scale (REPOS) is recommended to this aim, but not yet validated. Therefore the objective of this study was to validate the REPOS in non-communicative or unconscious end-of-life patients. METHODS: In this observational study, the primary researcher applied the REPOS, while both the researcher and a nurse applied the Numeric Rating Scale (NRS)...
February 21, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29463090/assessment-and-treatment-considerations-for-post-traumatic-stress-disorder-at-end-of-life
#2
Debra M Glick, Joan M Cook, Jennifer Moye, Anica Pless Kaiser
Post traumatic stress disorder (PTSD) may first emerge, reemerge, or worsen as individuals approach end of life and may complicate the dying process. Unfortunately, lack of awareness of the occurrence and/or manifestation of PTSD at end of life can lead to PTSD going unaddressed. Even if PTSD is properly diagnosed, traditional evidence-based trauma-focused treatments may not be feasible or advisable with this group as many patients at end of life often lack the physical and mental stamina to participate in traditional psychotherapy...
January 1, 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29461908/improving-early-palliative-care-with-a-scalable-stepped-peer-navigator-and-social-work-intervention-a-single-arm-clinical-trial
#3
David B Bekelman, Rachel Johnson-Koenke, Daniel W Bowles, Stacy M Fischer
BACKGROUND: Patients with cancer could benefit from early primary (i.e., basic) palliative care. Scalable models of care delivery are needed. OBJECTIVE: Examine the feasibility of a stepped peer navigator and social work intervention developed to improve palliative care outcomes. DESIGN: Single-arm prospective clinical trial. The peer navigator educated patients to advocate for pain and symptom management with their healthcare providers, motivated patients to pursue advance care planning, and discussed the role of hospice...
February 20, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29458429/advance-directives-as-a-tool-to-respect-patients-values-and-preferences-discussion-on-the-case-of-alzheimer-s-disease
#4
Corinna Porteri
BACKGROUND: The proposal of the new criteria for the diagnosis of Alzheimer's disease (AD) based on biomarker data is making possible a diagnosis of AD at the mild cognitive impairment (MCI) or predementia/prodromal- stage. Given the present lack of effective treatments for AD, the opportunity for the individuals to personally take relevant decisions and plan for their future before and if cognitive deterioration occurs is one the main advantages of an early diagnosis. MAIN BODY: Advance directives are largely seen as an effective tool for planning medical care in the event the subject becomes incompetent...
February 20, 2018: BMC Medical Ethics
https://www.readbyqxmd.com/read/29456895/calibration-adjustments-to-address-bias-in-mortality-analyses-due-to-informative-sampling-a-census-linked-survey-analysis-in-switzerland
#5
André Moser, Matthias Bopp, Marcel Zwahlen
Background: Sampling bias, like survey participants' nonresponse, needs to be adequately addressed in the analysis of sampling designs. Often survey weights will be calibrated on specific covariates related to the probability of selection and nonresponse to get representative population estimates. However, such calibrated survey (CS) weights are usually constructed for cross-sectional results, but not for longitudinal analyses. For example, when the outcome of interest is time to death, and sampling selection is related to time to death and censoring, sampling is informative...
2018: PeerJ
https://www.readbyqxmd.com/read/29454380/quality-of-life-satisfaction-and-outcomes-after-ministernotomy-versus-full-sternotomy-isolated-aortic-valve-replacement-quality-avr-study-protocol-for-a-randomised-controlled-trial
#6
Emiliano A Rodríguez-Caulo, Ana Guijarro-Contreras, Juan Otero-Forero, María José Mataró, Gemma Sánchez-Espín, Arantza Guzón, Carlos Porras, Miguel Such, Antonio Ordóñez, José María Melero-Tejedor, Manuel Jiménez-Navarro
BACKGROUND: During the last decade, the use of ministernotomy in cardiac surgery has increased. Quality of life and patient satisfaction after ministernotomy have never been compared to conventional full sternotomy in randomised trials. The aim of the study is to determine if this minimally invasive approach improves quality of life, satisfaction and clinical morbimortality outcomes. METHODS/DESIGN: The QUALITY-AVR trial is a single-blind, single-centre, independent, and pragmatic randomised clinical trial comparing ministernotomy ("J" shaped upper hemisternotomy toward right 4th intercostal space) to full sternotomy in patients with isolated severe aortic stenosis scheduled for elective aortic valve replacement...
February 17, 2018: Trials
https://www.readbyqxmd.com/read/29451946/first-experience-in-switzerland-in-phe508del-homozygous-cystic-fibrosis-patients-with-end-stage-pulmonary-disease-enrolled-in-a-lumacaftor-ivacaftor-therapy-trial-preliminary-results
#7
Christian Murer, Lars Christian Huber, Thomas Kurowski, Astrid Hirt, Cécile A Robinson, Urs Bürgi, Christian Benden
AIMS OF THE STUDY: Cystic fibrosis is the most common genetic disorder in Caucasians. The combination of the cystic fibrosis transmembrane conductance regulator (CFTR) corrector lumacaftor / potentiator ivacaftor (LUM/IVA) has been shown to increase forced expiratory volume in 1 second (FEV1) moderately, but predominantly reduce acute exacerbation rate (AER) in Phe508del homozygous cystic fibrosis patients; however, patients with FEV1 <40% predicted were excluded from studies. We used LUM/IVA on a "compassionate use" basis in cystic fibrosis patients with end-stage pulmonary disease...
February 16, 2018: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29450402/modeling-the-consumer-s-perception-of-experiential-marketing-in-the-romanian-private-ophthalmologic-services
#8
Consuela-Mădălina Gheorghe, Iuliana-Raluca Gheorghe, Victor Lorin Purcărea
Introduction. The importance of experience in marketing grew, as the concept itself is very personal and difficult to measure. Experience turns out to be complicated but once placed in a context it gets significant features. As the health care competitive environment increases, marketers are looking for new and effective methods of engaging consumers by using experiential marketing strategies. Moreover, little is known about the consumers' perceptions related to ophthalmologic services. Aim. The objective of this paper was to measure the consumer's perception of experiential marketing in the Romanian private ophthalmologic services by using structural equation modeling...
July 2017: Romanian Journal of Ophthalmology
https://www.readbyqxmd.com/read/29449113/characterization-of-the-non-metal-fraction-of-the-processed-waste-printed-circuit-boards
#9
Amit Kumar, Maria E Holuszko, Travis Janke
Electronic waste is one the fastest growing waste streams in the world and waste printed circuit boards (PCB) are the most valuable part of this stream due to the presence of gold, silver, copper, and palladium. The metal present in PCBs is mostly recovered for the market value whereas the nonmetal fractions are often ignored. This research explored the characteristics of the non-metal fraction (NMF) obtained after the processing of milled waste PCBs with a focus on responsible end-of-life solutions, in the form of non-hazardous landfilling or incineration...
February 12, 2018: Waste Management
https://www.readbyqxmd.com/read/29448148/large-inter-rater-variability-on-eeg-reactivity-is-improved-by-a-novel-quantitative-method
#10
Christophe Henri Valdemar Duez, Mads Qvist Ebbesen, Krisztina Benedek, Martin Fabricius, Mary Doreen Atkins, Sandor Beniczky, Troels W Kjaer, Hans Kirkegaard, Birger Johnsen
OBJECTIVE: To assess inter-rater agreement on EEG-reactivity (EEG-R) in comatose patients and compare it with a quantitative method (QEEG-R). METHODS: Six 30-s stimulation epochs (noxious, visual and auditory) were performed during EEG on 19 neurosurgical and 11 cardiac arrest patients. Six experts analysed EEGs for reactivity using their habitual methods. QEEG-R was defined as present if ≥2/6 epochs were reactive (stimulation/rest power ratio exceeding noise level)...
February 2, 2018: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/29443647/system-level-health-care-integration-and-the-costs-of-cancer-care-across-the-disease-continuum
#11
Deborah R Kaye, Hye Sung Min, Edward C Norton, Zaojun Ye, Jonathan Li, James M Dupree, Chad Ellimoottil, David C Miller, Lindsey A Herrel
PURPOSE: Policy reforms in the Affordable Care Act encourage health care integration to improve quality and lower costs. We examined the association between system-level integration and longitudinal costs of cancer care. METHODS: We used linked SEER-Medicare data to identify patients age 66 to 99 years diagnosed with prostate, bladder, esophageal, pancreatic, lung, liver, kidney, colorectal, breast, or ovarian cancer from 2007 to 2012. We attributed each patient to one or more phases of care (ie, initial, continuing, and end of life) according to time from diagnosis until death or end of study interval...
February 13, 2018: Journal of Oncology Practice
https://www.readbyqxmd.com/read/29442351/milk-alkali-syndrome-mas-as-a-complication-of-the-treatment-of-hypoparathyroidism
#12
Agata Skwarek, Janusz Pachucki, Tomasz Bednarczuk, Zuzanna Żurecka, Michał Popow
Milk-alkali syndrome (MAS), characterized by renal failure, metabolic alkalosis and hypercalcemia, is a severe and life-threatening complication of the treatment of hypoparathyroidism. The clinical course is often sudden and is not preceded by any prodromal symptoms. Occurrence does not depend on the duration of hypoparathyroidism treatment, although it is closely related to the applied therapy, especially the dose of calcium carbonate and active vitamin D preparations. Drugs influencing the glomerular filtration rate (angiotensin receptor blockers, sartans, aldosterone receptor antagonists, thiazide diuretics), lack of adequate routine control, changing the calcium carbonate supplementation, dehydration, a diet rich in pH-basic foods (i...
February 14, 2018: Endokrynologia Polska
https://www.readbyqxmd.com/read/29440148/interventions-in-hospitalised-patients-with-cancer-the-importance-of-impending-death-awareness
#13
Eric Cornelis Theodorus Geijteman, Marcella van der Graaf, Frederika E Witkamp, Sanne van Norden, Bruno H Stricker, Carin C D van der Rijt, Agnes van der Heide, Lia van Zuylen
OBJECTIVES: Burdensome and futile interventions with the aim of prolonging life should be avoided in dying patients. However, current clinical practice has hardly been investigated.We examined the number and type of diagnostic and therapeutic medical interventions in hospitalised patients with cancer in their last days of life. In addition, we investigated if physician awareness of impending death affected the use of these interventions. METHODS: Questionnaire study and medical record study...
February 9, 2018: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/29439674/establishing-a-clinical-phenotype-for-cachexia-in-end-stage-kidney-disease-study-protocol
#14
Joanne Reid, Helen R Noble, Gary Adamson, Andrew Davenport, Ken Farrington, Denis Fouque, Kamyar Kalantar-Zadeh, John Mallett, C McKeaveney, S Porter, David S Seres, Joanne Shields, Adrian Slee, Miles D Witham, Alexander P Maxwell
BACKGROUND: Surveys using traditional measures of nutritional status indicate that muscle wasting is common among persons with end-stage kidney disease (ESKD). Up to 75% of adults undergoing maintenance dialysis show some evidence of muscle wasting. ESKD is associated with an increase in inflammatory cytokines and can result in cachexia, with the loss of muscle and fat stores. At present, only limited data are available on the classification of wasting experienced by persons with ESKD...
February 13, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29436003/is-hospitalisation-necessary-a-survey-of-frail-older-persons-with-cognitive-impairment-transferred-from-nursing-homes-to-the-emergency-department
#15
Maria Björck, Helle Wijk
BACKGROUND: Providing care for frail older persons is complex and demanding, and the transfer of older persons with cognitive impairment to the emergency department is associated with a high risk of them developing complications. AIM: To survey the most ill and frail older persons with cognitive impairment who were transferred from nursing homes to the emergency department, considering reasons for referral, symptoms and actions taken at the hospital. METHOD: A retrospective descriptive survey, conducting a review of 588 referral notes and medical records, analysed and presented with descriptive statistics and visualised with typical case narratives...
February 12, 2018: Scandinavian Journal of Caring Sciences
https://www.readbyqxmd.com/read/29434083/survey-of-awareness-about-hazardous-chemicals-of-residents-living-near-chemical-plants-in-south-korea
#16
Don-Hee Han, Min Soo Park
With economic growth, the use of chemicals has continually increased, resulting in an increase of chemical accidents. Chemical accidents pose a life threat and can lead to many health problems among the residents living in close proximity to chemical plants. This study aimed to investigate the awareness of the residents living near chemical plants about hazardous chemicals, as well as to survey the awareness of workers who do not directly handle chemicals at chemical plants (WNHCs). To this end, a questionnaire survey was conducted among a total of 600 residents and 160 WNHCs...
February 10, 2018: Industrial Health
https://www.readbyqxmd.com/read/29433525/assessment-of-clinical-effect-and-treatment-quality-of-immediate-release-carvedilol-ir-versus-slow-release-carvedilol-sr-in-heart-failure-patients-slow-hf-study-protocol-for-a-randomized-controlled-trial
#17
Dong-Ju Choi, Chan Soon Park, Jin Joo Park, Hae-Young Lee, Seok-Min Kang, Byung-Su Yoo, Eun-Seok Jeon, Seok Keun Hong, Joon-Han Shin, Myung-A Kim, Dae-Gyun Park, Eung-Ju Kim, Soon-Jun Hong, Seok Yeon Kim, Jae-Joong Kim
BACKGROUND: Carvedilol is a non-selective, third-generation beta-blocker and is one of the cornerstones for treatment for patients with heart failure and reduced ejection fraction (HFrEF). However, due to its short half-life, immediate-release carvedilol (IR) needs to be prescribed twice a day. Recently, slow-release carvedilol (SR) has been developed. The aim of this study is to evaluate whether carvedilol-SR is non-inferior to standard carvedilol-IR in terms of its clinical efficacy in patients with HFrEF...
February 13, 2018: Trials
https://www.readbyqxmd.com/read/29431532/a-29-year-analysis-of-acute-peak-salicylate-concentrations-in-fatalities-reported-to-united-states-poison-centers
#18
Brandon J Warrick, Andrew King, Susan Smolinske, Ronald Thomas, Cynthia Aaron
BACKGROUND/OBJECTIVES: The threshold salicylate concentration commonly recommended to initiate extracorporeal elimination, in the absence of significant end-organ toxicity, is 100 mg/dL. Unfortunately, the grade of evidence to support this decision is low. Our primary aim is to describe highest reported salicylate concentrations in patients who died from acute salicylate ingestions. Our secondary aim is to determine if age or coingestants varied with highest reported salicylate concentration...
February 12, 2018: Clinical Toxicology
https://www.readbyqxmd.com/read/29425828/outcomes-of-renal-transplant-from-donors-with-polycystic-kidney-disease
#19
REVIEW
Awad Shamali, Sarah Milsom-Mcquillan, Paul Gibbs
INTRODUCTION: Kidneys from donors affected by autosomal-dominant polycystic kidney disease (ADPKD) are, in general, considered unsuitable for transplantation. However, some authors report cases of patients who received kidneys from a deceased ADPKD donor showing encouraging outcomes. Our aim is to provide our experience of a patient with end stage renal failure who received a deceased donor kidney from a 29-year-old who themselves had been diagnosed with ADPKD but well maintained renal function, and to provide a comprehensive review of all the published literature...
February 6, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29423912/implementing-and-assessing-a-standardized-protocol-for-weaning-children-successfully-from-extracorporeal-life-support
#20
Rouven Kubicki, René Höhn, Jochen Grohmann, Thilo Fleck, Katja Reineker, Johannes Kroll, Matthias Siepe, Christoph Benk, Rolf Klemm, Frank Humburger, Brigitte Stiller
Extracorporeal life support (ECLS) weaning is a complex interdisciplinary process with no clear guidelines. To assess ventricular and pulmonary function as well as hemodynamics including end-organ recovery during ECLS weaning, we developed a standardized weaning protocol. We reviewed our experience 2 years later to assess its feasibility and efficacy. In 2015 we established an inter-professional, standardized, stepwise protocol for weaning from ECLS. If the patient did not require further surgery, weaning was conducted bedside in the intensive care unit (ICU)...
February 8, 2018: Artificial Organs
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