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Medically assisted death

Daniel S Budnitz, Maribeth C Lovegrove, Mathew R P Sapiano, Justin Mathew, Scott R Kegler, Andrew I Geller, Christian Hampp
Expanding access to office-based medication-assisted treatment with buprenorphine/naloxone for opioid dependence is a key part of the national strategy to address the opioid abuse epidemic (1). However, as buprenorphine/naloxone prescribing increased, emergency department (ED) visits and hospitalizations for unsupervised ingestions by young children began to increase, with buprenorphine/naloxone ingestions becoming the most common cause of hospitalization for medication ingestions by young children during 2010-2011 (2)...
October 21, 2016: MMWR. Morbidity and Mortality Weekly Report
Shannon M Dunlay, Jacob J Strand, Sara E Wordingham, John M Stulak, Angela J Luckhardt, Keith M Swetz
BACKGROUND: Despite the ability of left ventricular assist device as destination therapy (DT-LVAD) to prolong survival for many patients with advanced heart failure, little is known about the eventual end-of-life care that patients with DT-LVAD receive. METHODS AND RESULTS: All patients undergoing DT-LVAD at the Mayo Clinic in Rochester, Minnesota, from January 1, 2007, to September 30, 2014, who subsequently died before July 1, 2015, were included. Information about end-of-life care was obtained from documentation in the electronic medical record...
October 2016: Circulation. Heart Failure
Youcef Azeli, Eneko Barbería, María Jiménez-Herrera, Gil Bonet, Eva Valero-Mora, Alfonso Lopez-Gomariz, Isaac Lucas-Guarque, Alex Guillen-Lopez, Carlos Alonso-Villaverde, Inés Landín, Pilar Torralba, Ali Jammoul, Jordi Bladé-Creixenti, Christer Axelsson, Alfredo Bardají
BACKGROUND: Cardiovascular diseases are one of the leading causes of death in the industrialized world. Sudden cardiac death is very often the first manifestation of the disease and it occurs in the prehospital setting. The determination of the sudden cardiac death phenotype is challenging. It requires prospective studies in the community including multiple sources of case ascertainment that help to identify the cause and circumstances of death. The aim of the Clinical and Pathological Registry of Tarragona (ReCaPTa) is to study incidence and etiology of Sudden Cardiac Death in the Tarragona region (Catalonia, Spain)...
October 19, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Corey Butler, Suzanne Marsh, Joseph W Domitrovich, Jim Helmkamp
BACKGROUND: Wildland fire fighting is a high-risk occupation requiring considerable physical and psychological demands. Multiple agencies publish fatality summaries for wildland fire fighters; however, the reported number and types vary. At least five different surveillance systems capture deaths, each with varying case definitions and case inclusion/exclusion criteria. Four are population-level systems and one is case-based. System differences create challenges to accurately characterize fatalities...
October 18, 2016: Journal of Occupational and Environmental Hygiene
Axel C Mühlbacher, Susanne Bethge, Anika Kaczynski
BACKGROUND: Cardiovascular disease is one of the most common causes of death worldwide, with many individuals having experienced acute coronary syndrome (ACS). How patients with a history of ACS value aspects of their medical treatment have been evaluated rarely. The aim of this study was to determine patient priorities for long-term drug therapy after experiencing ACS. METHODS: To identify patient-relevant treatment characteristics, a systematic literature review and qualitative patient interviews were conducted...
October 18, 2016: International Journal of Technology Assessment in Health Care
Jens Henrichs, Viki Verfaille, Laura Viester, Myrte Westerneng, Bert Molewijk, Arie Franx, Henriette van der Horst, Judith E Bosmans, Ank de Jonge, Petra Jellema
BACKGROUND: Intrauterine growth retardation (IUGR) is a major risk factor for perinatal mortality and morbidity. Thus, there is a compelling need to introduce sensitive measures to detect IUGR fetuses. Routine third trimester ultrasonography is increasingly used to detect IUGR. However, we lack evidence for its clinical effectiveness and cost-effectiveness and information on ethical considerations of additional third trimester ultrasonography. This nationwide stepped wedge cluster-randomized trial examines the (cost-)effectiveness of routine third trimester ultrasonography in reducing severe adverse perinatal outcome through subsequent protocolized management...
October 13, 2016: BMC Pregnancy and Childbirth
Helena Boene, Marianne Vidler, Orvalho Augusto, Mohsin Sidat, Eusébio Macete, Clara Menéndez, Diane Sawchuck, Rahat Qureshi, Peter von Dadelszen, Khátia Munguambe, Esperança Sevene
BACKGROUND: Mozambique has drastically improved an array of health indicators in recent years, including maternal mortality rates which decreased 63 % from 1990-2013 but the rates still high. Pre-eclampsia and eclampsia constitute the third major cause of maternal death in the country. Women in rural areas, with limited access to health facilities are at greatest risk. This study aimed to assess the current state of knowledge and the regular practices regarding pre-eclampsia and eclampsia by community health workers in southern Mozambique...
September 30, 2016: Reproductive Health
F Hénon, J Le Nobin, A Ouzzane, A Villers, G Strecker, S Bouyé
OBJECTIVES: Report the reasons that lead families to refuse organ donation during their close solicitation by hospital coordination. MATERIAL AND METHODS: A retrospective study was conducted between 2012 and 2015, including 148 (34%) refusal of organ donation among 426 patients identified in a state of brain death. A questionnaire of the family was completed for each interview. Collected data concerned patient characteristics, cause of death, description of the interview and reasons for refusal...
October 4, 2016: Progrès en Urologie
O Vallès-Fructuoso, B Ruiz-de Pablo, M Fernández-Plaza, V Fuentes-Milà, O Vallès-Fructuoso, G Martínez-Estalella
OBJECTIVE: To determine the perspective of intensive care nursing staff on the limitation of life support treatment (LLST) in the Intensive Care Units. METHOD: An exploratory qualitative study was carried out by applying the theory of Strauss and Corbin as the analysis tool. Constructivist paradigm. POPULATION: Nursing staff from three Intensive Care Units of Hospital Universitari de Bellvitge. Convenience sampling to reach theoretical saturation of data...
October 1, 2016: Enfermería Intensiva
Christopher L Bowlus, James T Kenney, Gary Rice, Robert Navarro
BACKGROUND: Chronic liver disease and cirrhosis are a leading cause of morbidity and mortality in the United States. Primary biliary cholangitis (PBC), previously known as primary biliary cirrhosis and which has been designated an orphan condition, is a chronic autoimmune disease resulting in the destruction of the small bile ducts in the liver. Without effective treatment, disease progression frequently leads to liver failure and death. Until May 2016, the only FDA-approved treatment for PBC was ursodiol (UDCA), an oral hydrophilic bile acid, which can slow progression of liver damage due to PBC...
October 2016: Journal of Managed Care & Specialty Pharmacy
Mehrbakhsh Nilashi, Othman Ibrahim, Ali Ahani
Parkinson's disease (PD) is a member of a larger group of neuromotor diseases marked by the progressive death of dopamineproducing cells in the brain. Providing computational tools for Parkinson disease using a set of data that contains medical information is very desirable for alleviating the symptoms that can help the amount of people who want to discover the risk of disease at an early stage. This paper proposes a new hybrid intelligent system for the prediction of PD progression using noise removal, clustering and prediction methods...
September 30, 2016: Scientific Reports
Keele E Wurst, Barbara K Zedler, Andrew R Joyce, Maciek Sasinowski, E Lenn Murrelle
BACKGROUND: Untreated opioid dependence in pregnant women is associated with adverse birth outcomes. Buprenorphine and methadone are options for opioid agonist medication-assisted treatment during pregnancy. OBJECTIVE: The aim of this study was to describe adverse birth outcomes observed with buprenorphine or methadone treatment compared to the general population in Sweden. METHODS: Pregnant women and their corresponding births during 2005-2011 were identified in the Swedish Medical Birth Register...
2016: Substance Abuse: Research and Treatment
C E Canan, B Lau, M E McCaul, J Keruly, R D Moore, G Chander
OBJECTIVES: The aim of the study was to examine the association between levels of past and current alcohol consumption and all-cause and liver-related mortality among people living with HIV (PLWH). METHODS: A prospective cohort study of 1855 PLWH in Baltimore, MD was carried out from 2000 to 2013. We ascertained alcohol use by (1) self-report (SR) through a computer-assisted self interview, and (2) medical record abstraction of provider-documented (PD) alcohol use...
September 28, 2016: HIV Medicine
Braghadheeswar Thyagarajan, Monisha Priyadarshini Kumar, Rutuja R Sikachi, Abhinav Agrawal
Heart failure is one of the leading causes of death in developed nations. End stage heart failure often requires cardiac transplantation for survival. The left ventricular assist device (LVAD) has been one of the biggest evolvements in heart failure management often serving as bridge to transplant or destination therapy in advanced heart failure. Like any other medical device, LVAD is associated with complications with infections being reported in many patients. Endocarditis developing secondary to the placement of LVAD is not a frequent, serious and difficult to treat condition with high morbidity and mortality...
August 2016: Intractable & Rare Diseases Research
Phillipa J Malpas, Anneka Anderson, Pio Jacobs, Takawai Jacobs, Danielle Luinstra, Dolly Paul, Jim Rauwhero, Julie Wade, David Wharemate
AIM: To explore kaumātua attitudes towards physician aid-in dying, to gain a clear understanding of how such attitudes may influence and shape their expectations of medical care at the end of life and to assist health professionals in Aotearoa/New Zealand to address the healthcare needs of older Māori near the end of life. DESIGN: A kaupapa Māori consistent approach was undertaken. A systematic narrative technique was employed for the qualitative data analysis...
September 26, 2016: Palliative Medicine
G Chen, W W Zhai, Z Q Yu
Objective: To explore experience and methods in the microsurgical treatment of midline deep brain lesions. Methods: The clinical data of patients with midline deep brain lesions were retrospectively analyzed. The clinical manifestation, imaging findings, lesion locations, surgical procedures, pathological diagnosis and follow-up results were summarized and analyzed. All the lesions were located deeply in the brain midline: corpus callosum (n=1), thalamus and basal ganglia (n=6), lateral ventricle (n=4), the third ventricle (n=2), pineal region (n=8), brainstem and fourth ventricle region (n=4)...
September 13, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Jonathan A Drezner, Francis G O'Connor, Kimberly G Harmon, Karl B Fields, Chad A Asplund, Irfan M Asif, David E Price, Robert J Dimeff, David T Bernhardt, William O Roberts
Cardiovascular screening in young athletes is widely recommended and routinely performed prior to participation in competitive sports. While there is general agreement that early detection of cardiac conditions at risk for sudden cardiac arrest and death (SCA/D) is an important objective, the optimal strategy for cardiovascular screening in athletes remains an issue of considerable debate. At the centre of the controversy is the addition of a resting ECG to the standard preparticipation evaluation using history and physical examination...
September 22, 2016: British Journal of Sports Medicine
Joseph K Eibl, Kristen A Morin-Taus, David C Marsh
Prescription opioid (PO) misuse is a major health concern across North America, and it is the primary cause of preventable death for the 18-35 year old demographic. Medication assisted therapy including methadone and buprenorphine, is the standard of care for patients with opioid-dependence. Moreover, both of these medications are recognized as essential medicines by World Health Organization. In Ontario Canada, the availability of medication assisted therapy has expanded substantially, with almost a ten-fold increase number of patients accessing methadone in Ontario in the past decade...
2016: Substance Abuse Treatment, Prevention, and Policy
Sunil K Sinha, Barbara Crain, Katie Flickinger, Hugh Calkins, John Rickard, Alan Cheng, Ronald Berger, Gordon Tomaselli, Joseph E Marine
BACKGROUND: Cardiovascular implantable electronic device (CIED) removal and interrogation are recommended at autopsy in suspected cases of sudden cardiac death, but data on the role of nonselective post-mortem CIED (pacemaker or defibrillator) analysis in this setting are lacking. OBJECTIVES: This study undertook an institutional registry analysis to determine the utility of systematic routine CIED removal, interrogation, and analysis at autopsy. METHODS: From May 19, 2009, to May 18, 2015, autopsy subjects with a CIED at a Johns Hopkins University medical institution (Baltimore, Maryland) underwent CIED removal and interrogation by an electrophysiologist for clinical alerts...
September 20, 2016: Journal of the American College of Cardiology
Heng-Chih Pan, Ying-Jen Chen, Jhe-Ping Lin, Ming-Jung Tsai, Chang-Chyi Jenq, Wei-Chen Lee, Ming-Hung Tsai, Pei-Chun Fan, Chih-Hsiang Chang, Ming-Yang Chang, Ya-Chung Tian, Cheng-Chieh Hung, Ji-Tseng Fang, Chih-Wei Yang, Yung-Chang Chen
BACKGROUND: Proteinuria is a manifestation of renal dysfunction and it has been demonstrated to be a significant prognostic factor in various clinical situations. The study was designed to analyze prognosis of patients receiving liver transplantation as well as to determine predictive performance of perioperative proteinuria. METHODS: We retrospectively reviewed data of patients who had received a liver transplant in a medical center between 2002 and 2010. Demographic information and clinical characteristic parameters were recorded on the day of intensive care unit admission before operation and on postoperative days 1, 7, and 14...
2016: BMC Surgery
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