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Medically assisted death

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https://www.readbyqxmd.com/read/29792168/trends-in-the-incidence-and-associated-factors-of-late-onset-sepsis-associated-with-improved-survival-in-extremely-preterm-infants-born-at-23-26-weeks-gestation-a-retrospective-study
#1
Jin Kyu Kim, Yun Sil Chang, Sein Sung, So Yoon Ahn, Won Soon Park
BACKGROUND: To investigate the trends in the incidence and associated factors of late-onset sepsis (LOS) associated with improved survival in extremely preterm infants. METHODS: Medical records of 364 infants who were born at 23-26 weeks' gestation from 2000 to 2005 (period I, n = 124) and from 2006 to 2011 (period II, n = 240) were retrospectively reviewed. The infants were stratified into subgroups of 23-24 and 25-26 weeks' gestation within each period, and survival, LOS rate, and clinical characteristics were analyzed...
May 23, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29788007/knowledge-about-stroke-in-belo-horizonte-brazil-a-community-based-study-using-an-innovative-video-approach
#2
Fidel Meira, Daiane Magalhães, Luiz Sérgio da Silva, Ana Clara Mendonça E Silva, Gisele Sampaio Silva
BACKGROUND AND PURPOSE: Stroke is a leading cause of death in Brazil. Knowledge about the clinical manifestations of stroke as well as its risk factors and its management is still poor in the country. We intended to assess the stroke knowledge of an urban population in Belo Ho-rizonte, Brazil. METHODS: Individuals assisted by a basic health unit were interviewed between February and August 2014. After demographic data collection, the participants were asked to watch a video that consisted of a person presenting stroke signals and they were asked to answer questions about the condition shown on the video...
May 22, 2018: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/29775973/safety-model-for-the-introduction-of-robotic-surgery-in-gynecology
#3
Mariano Tamura Vieira Gomes, Beatriz Taliberti da Costa Porto, Jose Pedro Parise Filho, Ana Luiz Vasconcelos, Bruna Fernanda Bottura, Renato Moretti Marques
OBJECTIVE:  To analyze the perioperative results and safety of performing gynecological surgeries using robot-assisted laparoscopy during implementation of the technique in a community hospital over a 6-year period. METHODS:  This was a retrospective observational study in which the medical records of 274 patients who underwent robotic surgery from September 2008 to December 2014 were analyzed. We evaluated age, body mass index (BMI), diagnosis, procedures performed, American Society of Anesthesiologists (ASA) classification, the presence of a proctor (experienced surgeon with at least 20 robotic cases), operative time, transfusion rate, perioperative complications, conversion rate, length of stay, referral to the intensive care unit (ICU), and mortality...
May 18, 2018: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/29775692/exploring-canadian-physicians-experiences-providing-medical-assistance-in-dying-a-qualitative-study
#4
Narges Khoshnood, Marie-Clare Hopwood, Bhadra Lokuge, Allison Kurahashi, Anastasia Tobin, Sarina Isenberg, Amna Husain
CONTEXT: MAiD allows a practitioner to administer or prescribe medication for the purpose of ending a patient's life. In 2016, Canada was the latest country, following several European countries and American states, to legalize physician-assisted death. Although some studies report on physician attitudes towards MAiD or describe patient characteristics, there are few that explore the professional challenges faced by physicians who provide MAiD. OBJECTIVES: To explore the professional challenges faced by Canadian physicians who provide MAiD...
May 15, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29773431/preoperative-frailty-assessment-predicts-loss-of-independence-after-vascular-surgery
#5
Graham W Donald, Amir A Ghaffarian, Farid Isaac, Larry W Kraiss, Claire L Griffin, Brigitte K Smith, Mark R Sarfati, Julie L Beckstrom, Benjamin S Brooke
OBJECTIVE: Frailty, a clinical syndrome associated with loss of metabolic reserves, is prevalent among patients who present to vascular surgery clinics for evaluation. The Clinical Frailty Scale (CFS) is a rapid assessment method shown to be highly specific for identifying frail patients. In this study, we sought to evaluate whether the preoperative CFS score could be used to predict loss of independence after major vascular procedures. METHODS: We identified all patients living independently at home who were prospectively assessed using the CFS before undergoing an elective major vascular surgery procedure (admitted for >24 hours) at an academic medical center between December 2015 and December 2017...
May 14, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29767218/management-of-emotionally-challenging-responses-of-hospitalized-patients-with-cancer
#6
Yelena Burklin, Daniel P Hunt
Cancer is the second leading cause of death in the United States, and the majority of hospital admissions of patients with cancer occur because of uncontrolled, urgent symptoms. In addition to complex physical presentations, these patients often manifest a number of complex emotional and psychological responses resulting in a unique set of healthcare needs and expectations. Inpatient generalists or hospitalists frequently serve as the primary providers of medical care for these patients. Formal training for nononcologists on effective communication strategies in managing patients with cancer in a hospital setting may not fully prepare generalists for challenging patient encounters, however...
May 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29766728/-euthanasia-legal-comparison-in-selected-european-countries
#7
Adam Doležal
This article deals with the subject of euthanasia (all its forms) and other end-of-life decisions, such as assisted suicide, withdrawing and whithholding life-sustaining treatments. Among other things, the article will also deal with the issue of the offense of Homicide by the Victims Request. Based on an empirical historical method, the article compares the various selected legal orders. From this analysis, it draws some conclusions that have an impact on ethical discourse. First of all, the terminology is defined in the article, which is very important in this area...
2018: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29766726/-euthanasia-and-the-good-life-why-euthanasia-is-sometimes-ethical
#8
David Černý
In this paper I present the strongest argument, in my opinion, in favour of moral admissibility of euthanasia. In the introduction I briefly mention two important arguments in support of euthanasia - out of respect for autonomy and as a last act of grace, however I refuse them as insufficient. I propose a definition of both forms of assisted death: euthanasia and assisted suicide. I present the basic ideas underlying the theory of the good life and deal with hedonism in greater depth. I define a deprivation concept of the badness of death and, employing hedonism, I specifically describe when death is bad and when it is good...
2018: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29754123/psychiatry-trainees-attitudes-towards-euthanasia-and-physician-assisted-suicide
#9
M-I Kontaxaki, K Paplos, M Dasopoulou, V Kontaxakis
We investigated the attitudes towards Euthanasia (EUT) and Physician-Assisted Suicide (PAS) in a sample of Greek Psychiatry trainees (PT), (n=120, mean age 32.01±0.21, male 60.0%) and compared these to those of medical trainees of other specialties (OMT), i.e. internal medicine, surgery, intensive care (n=154, mean age 32.97±1.17, male 57.1%). Most of the responders were for the acceptance of EUT and PAS under some circumstances. More often PT answer "never" in the question regarding the permission to withdraw life-sustaining medical treatment to hasten death, if that requested by a terminally ill patient (p<0...
January 2018: Psychiatrikē, Psychiatriki
https://www.readbyqxmd.com/read/29745361/a-window-beneath-the-skin-how-computed-tomography-assessment-of-body-composition-can-assist-in-the-identification-of-hidden-wasting-conditions-in-oncology-that-profoundly-impact-outcomes
#10
L E Daly, C M Prado, A M Ryan
Advancements in image-based technologies and body composition research over the past decade has led to increased understanding of the importance of muscle abnormalities, such as low muscle mass (sarcopenia), and more recently low muscle attenuation (MA), as important prognostic indicators of unfavourable outcomes in patients with cancer. Muscle abnormalities can be highly prevalent in patients with cancer (ranging between 10 and 90 %), depending on the cohort under investigation and diagnostic criteria used...
May 2018: Proceedings of the Nutrition Society
https://www.readbyqxmd.com/read/29743764/definition-of-terms-used-in-limitation-of-treatment-and-providing-palliative-care-at-the-end-of-life-the-indian-council-of-medical-research-commission-report
#11
Naveen Salins, Roop Gursahani, Roli Mathur, Shivakumar Iyer, Stanley Macaden, Nagesh Simha, Raj Kumar Mani, M R Rajagopal
Background: Indian hospitals, in general, lack policies on the limitation of inappropriate life-sustaining interventions at the end of life. To facilitate discussion, preparation of guidelines and framing of laws, terminologies relating to the treatment limitation, and providing palliative care at the end-of-life care (EOLC) need to be defined and brought up to date. Methodology: This consensus document on terminologies and definitions of terminologies was prepared under the aegis of the Indian Council of Medical Research...
April 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29726698/on-the-use-of-wearable-physiological-monitors-to-assess-heat-strain-during-occupational-heat-stress
#12
Sean R Notley, Andreas D Flouris, Glen P Kenny
Workers in many industries are required to perform arduous work in high heat stress conditions, which can lead to rapid increases in body temperature that elevate the risk of heat-related illness or even death. Traditionally, effort to mitigate work-related heat injury has been directed to the assessment of environmental heat stress (e.g., wet-bulb globe temperature), rather than the associated physiological strain responses (e.g., heart rate, skin and core temperatures). However, since a workers physiological response to a given heat stress is modified independently by inter-individual factors (e...
May 4, 2018: Applied Physiology, Nutrition, and Metabolism, Physiologie Appliquée, Nutrition et Métabolisme
https://www.readbyqxmd.com/read/29723168/malaria-surveillance-united-states-2015
#13
Kimberly E Mace, Paul M Arguin, Kathrine R Tan
PROBLEM/CONDITION: Malaria in humans is caused by intraerythrocytic protozoa of the genus Plasmodium. These parasites are transmitted by the bite of an infective female Anopheles species mosquito. The majority of malaria infections in the United States occur among persons who have traveled to regions with ongoing malaria transmission. However, malaria is occasionally acquired by persons who have not traveled out of the country through exposure to infected blood products, congenital transmission, laboratory exposure, or local mosquitoborne transmission...
May 4, 2018: MMWR. Surveillance Summaries: Morbidity and Mortality Weekly Report. Surveillance Summaries
https://www.readbyqxmd.com/read/29716636/video-assisted-thoracoscopic-surgery-vats-with-mini-thoracotomy-for-the-management-of-pulmonary-hydatid-cysts
#14
Nizar Abbas, Sarah Zaher Addeen, Fatima Abbas, Tareq Al Saadi, Ibrahem Hanafi, Mahmoud Alkhatib, Tarek Turk, Ahmad Al Khaddour
BACKGROUND: Hydatid cyst is an endemic infectious disease. Various modalities have been provided to approach hydatosis. This article reports a 20-years-experience of a new minimally invasive technique for the management of solitary pulmonary hydatid cysts using video-assisted thoracoscopic surgery (VATS) with mini-thoracotomy. METHODS: We reviewed the medical records of patients who underwent unilateral or bilateral single pulmonary hydatid cyst excision using VATS with mini-thoracotomy...
May 2, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29710352/laboratory-tests-and-x-ray-imaging-in-a-surgical-intensive-care-unit-checking-the-checklist
#15
Brian K Yorkgitis, Jesse W Loughlin, Zachary Gandee, Halla H Bates, Gerald Weinhouse
Context: Patients in the surgical intensive care unit (ICU) frequently undergo laboratory and imaging testing. These tests can lead to iatrogenic anemia and radiation exposure. Many of these tests may be unnecessary for the management of a patient's illness in the surgical ICU, and their ordering may be a reflex rather than in response to a clinical question. Checklists have been used in critical care to identify and address patient care strategies. Objective: To examine whether adding a "diagnostic testing" section to a daily checklist used for patient rounds in a surgical ICU would decrease the amount of laboratory tests and chest x-ray imaging ordered...
May 1, 2018: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/29701352/two-years-of-experience-in-the-implantation-of-heartmate-iii
#16
Vítor Mendes, Candido Cerca, Monique Crosset, Matthias Kirsh
INTRODUCTION: Left ventricular assist devices as long-term mechanical circulatory support are increasingly used as an option for medically refractory advanced heart failure. Heartmate III is one of the alternative devices for circulatory support in those patients. OBJECTIVES: Analyze a two years Heartmate III implantation Program. METHODS: From November 2015 to August 2017, Heartmate III was implanted in 16 patients with chronic end-stage heart failure, in 81% (n = 13) as a bridge to transplant and 19% (n = 3) as destination therapy...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29697666/-the-clinical-and-anatomical-aspects-of-preeclampsia-current-features-of-its-course
#17
L M Mikhaleva, N A Gracheva, A E Biryukov
Preeclampsia is the most menacing complication of pregnancy and childbirth worldwide and remains one of the leading causes of maternal and perinatal morbidity and mortality. It is characterized by a complex etiopathogenesis with specific clinical and laboratory changes (hypertension, proteinuria and edema), as well as by the morphological pattern of target organ damage and uteroplacental blood vascular lesions. However, the triad of clinical signs of preeclampsia is not encountered in all cases now. OBJECTIVE: to study the clinical and anatomical aspects of preeclampsia at the present stage...
2018: Arkhiv Patologii
https://www.readbyqxmd.com/read/29696214/mat%C3%A3-o-controlling-hypertension-match-project-rationale-and-design
#18
Cesar Minelli, Norberto Cabral, Ariany de Souza Leite, Paulo Cicogna Neto, Maria Silvia Vichi, João Luiz Carmo, Fumiu Iwachima, Antônio Durval Martins Peres, Arthur Augusto Ribeiro Ferreira, Flavio Borsetti Neto, Liliana Tiene Ujikawa, Lucileni Aparecida Borin, Geraldo Cassio Dos Reis, Denise Paolinetti Camara Minelli, Esther Langhi Chiozzini
Background: Hypertension is the main risk factor for most cardiovascular diseases. A coordinated and organized system from the Brazilian Ministry of Healthy involving Family Health Strategy (FHS), a program for the prevention of chronic disease, and the Popular Pharmacy Program (PPP), which subsidizes medications for the population, could allow an earlier identification and better blood pressure (BP) control. Matão Controlling Hypertension (MatCH) is a community-based population project that aims to apply an organized, integrated and coordinated program in the city of Matão, Brazil, involving FHS and PPP in order to actively search, treat and follow-up hypertensive subjects...
December 2017: Contemporary Clinical Trials Communications
https://www.readbyqxmd.com/read/29686550/evidence-based-pain-medicine-for-primary-care-physicians
#19
REVIEW
Graves T Owen, Brian M Bruel, C M Schade, Maxim S Eckmann, Erik C Hustak, Mitchell P Engle
The last several decades have seen a marked increase in both the recognition and treatment of chronic pain. Unfortunately, patients frequently misunderstand both the nature of pain and the best practices for its treatment. Because primary care physicians treat the majority of chronic pain, they are ideally situated to provide evidence-based pain care. The majority of the medical evidence supports a biopsychosocial model of pain that integrates physical, emotional, social, and cultural variables. The goal of this primer is to assist primary care physicians in their understanding of pain, evaluation of the chronic pain patient, and ability to direct evidence-based care...
January 2018: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/29673714/discovery-and-evaluation-of-nna-v-1-5-sodium-channel-blockers-with-potent-cell-invasion-inhibitory-activity-in-breast-cancer-cells
#20
Shilpa Dutta, Osbaldo Lopez Charcas, Samuel Tanner, Frédéric Gradek, Virginie Driffort, Sébastien Roger, Katri Selander, Sadanandan E Velu, Wayne Brouillette
Voltage-gated sodium channels (VGSC) are a well-established drug target for anti-epileptic, anti-arrhythmic and pain medications due to their presence and the important roles that they play in excitable cells. Recently, their presence has been recognized in non-excitable cells such as cancer cells and their overexpression has been shown to be associated with metastatic behavior in a variety of human cancers. The neonatal isoform of the VGSC subtype, Nav 1.5 (nNav 1.5) is overexpressed in the highly aggressive human breast cancer cell line, MDA-MB-231...
April 3, 2018: Bioorganic & Medicinal Chemistry
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