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Medically assisted death

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https://www.readbyqxmd.com/read/29345508/response-by-twin-italian-hub-hospitals-in-a-double-seismic-event-a-retrospective-observational-investigation
#1
Alberto Barbieri, Gabriele Melegari, Valentina Lob, Lorenzo Mazzali, Luca D'Amelio, Andrea Giovannoni, Enrico Giuliani
INTRODUCTION: The objectives of this study were to compare prevalence rates of different pathologies, ambulance system and emergency department management times, and patient survival and hazard ratios for codes 2 and 3 in two hub hospitals in Modena in the 36-month period across the stages of two major earthquakes in short sequence in Northern Italy in 2012. METHODS: Clinical records pertaining to the emergency care of patients were analyzed and only those assigned status codes 2 and 3 by ambulance professionals were included (if the assessment was confirmed by emergency department triage)...
January 18, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29334446/pediatric-community-acquired-pneumonia
#2
Stephanie Posten, Jennifer Reed
Pediatric community acquired pneumonia (CAP) is frequently encountered by medical providers and is one of the most common reasons for hospital admission. CAP is known to cause significant morbidity and mortality, causing greater than 2 million deaths annually worldwide in children younger than five years old. The Infectious Disease Society of America (IDSA) released guidelines in 2011 with recommendations regarding appropriate diagnosis and management of community acquired pneumonia for children greater than 3 months age, with the goal of assisting providers in clinical decision making...
December 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/29282231/involuntary-treatment-of-patients-with-life-threatening-anorexia-nervosa
#3
Patricia Westmoreland, Craig Johnson, Michael Stafford, Richard Martinez, Philip S Mehler
Anorexia nervosa has the highest mortality rate of any psychiatric illness. Predictors of mortality include chronicity of the illness, critically low body weight, and binging and purging behavior. Delusional beliefs body image, coupled with impaired judgment and cognition caused by starvation, often result in these patients adamantly resisting efforts to treat them. Guardianship, although useful in assisting with medical treatment decisions for patients with anorexia nervosa who are critically medically ill, is usually an inadequate intervention with respect to psychiatric treatment for these patients...
December 2017: Journal of the American Academy of Psychiatry and the Law
https://www.readbyqxmd.com/read/29279002/the-paradox-of-choice-and-the-illusion-of-autonomy-the-construction-of-ethical-subjects-in-right-to-die-activism
#4
Ari Gandsman
The right to die is an issue is predicated on larger cultural understandings of autonomy. Autonomy, in turn, is centered around assumptions of choice, that individuals are able to make health-related decisions based on a rational calculation. In such a way, a medically assisted death is differentiated from suicide. Through an ethnographic study of right to die activists in North America and Australia and how they understand ideals of "good deaths," this article will complicate this view by examining the ethical subject constructed by such activism that reveals autonomy to be a useful guiding fiction that mask larger ethical relationships...
December 26, 2017: Death Studies
https://www.readbyqxmd.com/read/29272998/risk-factors-and-outcome-of-patients-with-eclampsia-at-a-tertiary-hospital-in-egypt
#5
Ahmad Mahran, Hashem Fares, Reham Elkhateeb, Mahmoud Ibrahim, Haitham Bahaa, Ahmad Sanad, Alaa Gamal, Mohamed Zeeneldin, Eissa Khalifa, Ahmed Abdelghany
BACKGROUND: Eclampsia is a major cause of maternal and neonatal morbidity and mortality in low and middle income countries. The aim of this study was to assess the risk factors and maternal and perinatal outcome in patients with eclampsia in order to get reliable data that helps in reducing the incidence and improving the outcome in an area with high incidence of eclampsia. METHODS: Retrospective study including 250 patients diagnosed with eclampsia at Minia Maternity University Hopsital, Minia, Egypt in the period between January 2013 and December 2014...
December 22, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29260013/popular-stroke-knowledge-in-brazil-a-multicenter-survey-during-world-stroke-day
#6
Ana Beatriz Ayroza Galvão Ribeiro Gomes, Mauro Henrique, Vinicius Andreoli Schoeps, Mariana Monteiro Saldanha Altenfelder Santos, Ada Pellegrinelli, Bárbara Pessoa de Matos, Gabriel Taricani Kubota, Haniel Alves Araújo, Letícia Sant' Ana Cardoso da Silva, Fabrício de Paula Leite Battisti, Bruno Yukio Kubota, Areta Cavalcanti Ferreira, Mateus Paquesse Pellegrino, Renata de Andrade Prado, Ronaldo Abrahm, Vivian Dias Baptista Gagliardi, Marcel Simis, Rubens José Gagliardi
Context and objective: Cerebrovascular disease is one of the most important causes of death and disability worldwide. The patient's inability to identify the warning signs of stroke substantially delays the search for emergency services, which is related directly to a worse outcome. Thus, during the 2011 Stroke Campaign in Brazil, a survey was conducted to identify the lay population's knowledge with regard to the recognition, treatment, and prevention of stroke. Design and setting: This retrospective, cross-sectional, multicenter study was held in cities throughout southeastern Brazil...
March 2017: ENeurologicalSci
https://www.readbyqxmd.com/read/29250473/trauma-resuscitation-in-a-left-ventricular-assist-device-patient-an-emergency-medicine-simulation-scenario
#7
William E Kenyhercz, Jorge L Pérez, Adrienne N Wolfe, Morgan R Starkey, Dominic J Bagnoli Iii, Ahmed F Ozgur, Anna Ciullo, Rami Ahmed
Heart failure is a leading cause of death worldwide. While heart transplantation is the most successful treatment for end-stage heart failure, the scarcity in donor hearts has ushered in the use of alternative therapies, such as the left ventricular assist device (LVAD). This patient population may present with low frequency, but they require disease-specific management. Learners may fine-tune these principles in a safe learning environment, such as a medical simulation lab. Here, we present a case in which a patient with a LVAD sustained serious traumatic injuries...
October 13, 2017: Curēus
https://www.readbyqxmd.com/read/29244986/breast-cancer-in-ghana-demonstrating-the-need-for-population-based-cancer-registries-in-low-and-middle-income-countries
#8
Abigail S Thomas, Kelley M Kidwell, Joseph K Oppong, Ernest K Adjei, Ernest Osei-Bonsu, Angela Boahene, Evelyn Jiggae, Kofi Gyan, Sofia D Merajver
Purpose Breast cancer, the most common cancer worldwide, is the leading cause of cancer mortality in Ghanaian women. Previous studies find Ghanaian women are diagnosed at a younger age and at more advanced stages (III and IV), and have tumors with characteristics similar to African American women. We sought to remedy gaps in knowledge about breast cancer survival in Ghana and its relation to demographic and biologic factors of the tumors at diagnosis to assist in cancer control and registration planning. Methods Individuals with a breast cancer diagnosis who sought care at Komfo Anokye Teaching Hospital from 2009 to 2014 were identified via medical records...
December 2017: Journal of Global Oncology
https://www.readbyqxmd.com/read/29237604/stormy-weather-a-retrospective-analysis-of-demand-for-emergency-medical-services-during-epidemic-thunderstorm-asthma
#9
Emily Andrew, Ziad Nehme, Stephen Bernard, Michael J Abramson, Ed Newbigin, Ben Piper, Justin Dunlop, Paul Holman, Karen Smith
OBJECTIVES: To describe the demand for emergency medical assistance during the largest outbreak of thunderstorm asthma reported globally, which occurred on 21 November 2016. DESIGN: A time series analysis was conducted of emergency medical service caseload between 1 January 2015 and 31 December 2016. Demand during the thunderstorm asthma event was compared to historical trends for the overall population and across specific subgroups. SETTING: Victoria, Australia...
December 13, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29236658/how-using-generative-learning-strategies-improved-medical-student-self-competency-in-end-of-life-care
#10
Sandra Marquez Hall, Janet Lieto, Roy Martin
During a mandatory fourth-year core geriatric medicine rotation at our medical school, we discovered that our medical students were struggling with end-of-life (EOL) issues both personally and professionally. We implemented curriculum changes to assist them in developing emotional awareness about death and dying, and to help develop their ability to respond personally and professionally to patients and their families during EOL experiences.In our new curriculum, a seasoned ethicist at our university conducts 2 educational sessions addressing EOL issues...
2017: Permanente Journal
https://www.readbyqxmd.com/read/29219080/health-practitioners-emotional-reactions-to-caring-for-hospitalized-children-in-lom%C3%A3-togo-a-qualitative-study
#11
Bassantéa Lodegaèna Kpassagou, Kokou Messanh Agbémélé Soedje
BACKGROUND: Health practitioners frequently encounter dying, death and suffering. While providing health care can be stressful, the literature on how different health practitioners cope with the emotional challenges associated with their work is sparse. Further, much of this literature is based on studies conducted in high-income countries. In this study, we explored emotional distress and associated coping strategies among health practitioners working in a pediatric oncology department in a large teaching hospital in Lomé, Togo...
December 4, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29214967/fear-of-life-fear-of-death-and-fear-of-causing-death-how-legislative-changes-on-assisted-dying-are-doomed-to-fail
#12
Matti Häyry
Fear of life, fear of death, and fear of causing death form a combination that prevents reasoned changes in laws concerning end-of-life situations. This is shown systematically in this article using the methods of conceptual analysis. Prevalent fears are explicated and interpreted to see how their meanings differ depending on the chosen normative stance. When the meanings have been clarified, the impact of the fears on the motivations and justifications of potential legislative reforms are assessed. Two main normative stances are evoked...
January 2018: Cambridge Quarterly of Healthcare Ethics: CQ: the International Journal of Healthcare Ethics Committees
https://www.readbyqxmd.com/read/29206080/understanding-forensic-psychiatry-in-healthcare-practices-and-collaboration-between-legal-nurse-consultants-and-physicians
#13
Daphne K Sharpe, Jasmine K Hall, Sochima Ochije, Rahn K Bailey
In 2000, the Institute of Medicine stunned many professionals with their published report that noted the vast number of deaths that occur each year in hospitals across the United States which reach as many as 98,000. Therefore, it comes as no surprise that the healthcare arena faces litigious issues regularly, with some specialties budgets being significantly impacted by the cost of maintaining liability insurance. Legal Nurse Consultants and forensic physicians working in tandem but who work independently from treating clinicians can carry out forensic independent medical examinations (IME)...
January 1, 2017: Medico-legal Journal
https://www.readbyqxmd.com/read/29205960/what-do-medical-students-learn-from-dissection
#14
Natasha A M S Flack, Helen D Nicholson
Dissection has long been the accepted method for teaching anatomy to medical students. More recently, some educators have suggested that easier, cheaper, alternative methods are just as effective. But what do the students think? This paper aimed to identify what undergraduate medical students learn, how they cope, and what effects participating in dissection has on them as individuals. A cohort of 267 second year medical students at Otago Medical School were invited to complete three online surveys; before their first dissection laboratory class, after their first musculoskeletal system dissection and following the last semester of studying anatomy...
December 4, 2017: Anatomical Sciences Education
https://www.readbyqxmd.com/read/29198634/intraoperative-administration-of-4-factor-prothrombin-complex-concentrate-reduces-blood-requirements-in-cardiac-transplantation
#15
Gina H Sun, Visal Patel, Ingrid Moreno-Duarte, Farhad Zahedi, Eric Ursprung, Greg Couper, Fred Y Chen, Ian J Welsby, Raymond Comenzo, Grace Kao, Frederick C Cobey
OBJECTIVE: Assessing the efficacy of intraoperative 4-factor prothrombin complex concentrate (4F-PCC) use in blood product utilization, time to chest closure, intensive care unit (ICU) and hospital length of stay (LOS), thromboembolic complications, renal injury and mortality in left ventricular assist device (LVAD) patients on home anticoagulation therapy with warfarin, undergoing orthotopic heart transplantation (OHT). DESIGN: Retrospective analysis of OHT patients at Tufts Medical Center from May 2013 to October 2016...
August 3, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29189549/outcome-of-guillain-barr%C3%A3-syndrome-in-tertiary-care-centers-in-thailand
#16
Kongkiat Kulkantrakorn, Puchit Sukphulloprat
BACKGROUND: Guillain-Barré syndrome (GBS), a common acute polyneuropathy, is seen worldwide with significant morbidity and mortality. GBS consists of a number of subtypes. OBJECTIVE: The aim of this study is to identify clinical characteristics, electrophysiologic changes, clinical course, treatment, and outcome of GBS in Thailand. MATERIAL AND METHODS: Retrospective study of GBS patients aged 15 years or older, admitted to Thammasat University Hospital and Bangkok Hospital Medical Center between January 1, 2009 and November 30, 2014...
December 2017: Journal of Clinical Neuromuscular Disease
https://www.readbyqxmd.com/read/29185616/incremental-prognostic-value-of-conventional-echocardiography-in-patients-with-acutely-decompensated-heart-failure
#17
Fabio Luis de Jesus Soares, Janine Magalhães Garcia de Oliveira, Gabriel Neimann da Cunha Freire, Lucas Carvalho Andrade, Marcia Maria Noya-Rabelo, Luis Claudio Lemos Correia
BACKGROUND: Acutely decompensated heart failure (ADHF) presents high morbidity and mortality in spite of therapeutic advance. Identifying factors of worst prognosis is important to improve assistance during the hospital phase and follow-up after discharge. The use of echocardiography for diagnosis and therapeutic guidance has been of great utility in clinical practice. However, it is not clear if it could also be useful for risk determination and classification in patients with ADHF and if it is capable of adding prognostic value to a clinical score (OPTIMIZE-HF)...
November 27, 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/29157510/euthanasia-requests-in-a-canadian-psychiatric-emergency-room-a-case-series-part-1-of-the-mcgill-university-euthanasia-in-psychiatry-case-series
#18
David Benrimoh, Antoine Perreault, Frederique Van Den Eynde
Euthanasia was decriminalized in Quebec in December 2015, and Canada-wide in June 2016. Both the Provincial and Federal legislation have limited the right to medical assistance in dying (MAID) to end-of-life cases; which makes MAID inaccessible to most patients solely suffering from psychiatric illness. While some end-stage anorexia nervosa or elderly patients may meet the end-of-life criterion because of their medical comorbidities or their age (Kelly et al., 2003), repeated suicide attempts or psychotic disorganization would not qualify since they would not be seen as elements of an illness leading to a foreseeable "natural death" (Canada, 2016)...
November 2017: International Journal of Law and Psychiatry
https://www.readbyqxmd.com/read/29155988/opioid-prescribing-patterns-and-patient-outcomes-by-prescriber-type-in-the-oregon-prescription-drug-monitoring-program
#19
Patrick B Fink, Richard A Deyo, Sara E Hallvik, Christi Hildebran
Objective: Prescription drug monitoring programs (PDMPs) were created to facilitate responsible use of controlled substances. In Oregon, physicians, physician's assistants (MDs/DOs/PAs), dentists, nurse practitioners (NPs), and naturopathic physicians (NDs) may prescribe opioids, but differences in prescribing practices, patient mix, and patient outcomes among prescriber types have not been characterized. Methods: De-identified Oregon PDMP data from October 2011 through October 2014 were linked with vital records and a statewide hospital discharge registry...
November 16, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29153636/early-intervention-for-lactate-dehydrogenase-elevation-improves-clinical-outcomes-in-patients-with-the-heartmate-ii-left-ventricular-assist-device-insights-from-the-prevent-study
#20
Thenappan Thenappan, John M Stulak, Richa Agarwal, Simon Maltais, Palak Shah, Peter Eckman, Sitaramesh Emani, Jason N Katz, Igor Gregoric, Mary E Keebler, Nir Uriel, Eric Adler, Joyce Chuang, David J Farrar, Kartik S Sundareswaran, Ranjit John
BACKGROUND: Hemolysis, assessed by elevated serum lactate dehydrogenase (LDH), is strongly associated with HeartMate II pump thrombosis (PT). However, it is unknown whether early intervention for elevated LDH circumvents the risk of serious PT requiring pump exchange. We sought to evaluate the relationship between elevated LDH and clinical outcomes, the effectiveness of early medical intervention, and risk factors for elevated LDH. METHODS: We studied 268 patients in the prospective, multicenter PREVENT study who had 2 or more LDH measurements at ≥30 days post-implant...
October 24, 2017: Journal of Heart and Lung Transplantation
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