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Medically assisted death

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https://www.readbyqxmd.com/read/27905492/high-fidelity-computational-simulation-of-thrombus-formation-in-thoratec-heartmate-ii-continuous-flow-ventricular-assist-device
#1
Wei-Tao Wu, Fang Yang, Jingchun Wu, Nadine Aubry, Mehrdad Massoudi, James F Antaki
Continuous flow ventricular assist devices (cfVADs) provide a life-saving therapy for severe heart failure. However, in recent years, the incidence of device-related thrombosis (resulting in stroke, device-exchange surgery or premature death) has been increasing dramatically, which has alarmed both the medical community and the FDA. The objective of this study was to gain improved understanding of the initiation and progression of thrombosis in one of the most commonly used cfVADs, the Thoratec HeartMate II...
December 1, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27898287/international-association-for-hospice-and-palliative-care-position-statement-euthanasia-and-physician-assisted-suicide
#2
Liliana De Lima, Roger Woodruff, Katherine Pettus, Julia Downing, Rosa Buitrago, Esther Munyoro, Chitra Venkateswaran, Sushma Bhatnagar, Lukas Radbruch
BACKGROUND: Reports about regulations and laws on Euthanasia and Physician Assisted Suicide (PAS) are becoming increasingly common in the media. Many groups have expressed opposition to euthanasia and PAS while those in favor argue that severely chronically ill and debilitated patients have a right to control the timing and manner of their death. Others argue that both PAS and euthanasia are ethically legitimate in rare and exceptional cases. Given that these discussions as well as the new and proposed laws and regulations may have a powerful impact on patients, caregivers, and health care providers, the International Association for Hospice and Palliative Care (IAHPC) has prepared this statement...
November 29, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27882838/a-pragmatic-randomized-trial-comparing-telephone-based-enhanced-pharmacy-care-and-usual-care-to-support-smoking-cessation
#3
Jason Gong, Christine L Baker, Kelly H Zou, Marianna Bruno, Zhanna Jumadilova, David Lawrence, Beth Wilson, Cynthia Ewel
BACKGROUND: Smoking is the leading preventable cause of death, and tobacco control professionals continue to make progress in cessation efforts. Pharmacists can assist smokers seeking to quit by offering counseling on smoking cessation pharmacotherapies. Pragmatic randomized trials are useful for investigating practical questions about an intervention's risks, benefits, and costs in routine clinical practice. OBJECTIVE: To evaluate an enhanced pharmacy care (EPC) program involving personalized pharmacist-provided telephone counseling for supporting prescription smoking cessation medications compared with usual care (UC)...
December 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27881360/an-observational-registry-of-carotid-endarterectomy-and-carotid-artery-stenting-in-brazil-study-protocol
#4
Edwaldo Edner Joviliano, Winston Bonetti Yoshida, Marcone Lima Sobreira, Regina Moura, Ana Terezinha Guillaumon, Selma Regina De Oliveira Raymundo, Daniel Gustavo Miquelin, Ludvig Hafner, Marcelo Jose Almeida
BACKGROUND: Carotid artery stenting (CAS) and carotid endarterectomy (CEA) are alternative strategies for stroke prevention in patients with atherosclerotic carotid disease. CEA has been considered the first-line treatment for carotid stenosis worldwide, and the safety and efficacy of CAS compared to CEA remains in question. OBJECTIVE: The purpose of this study is to compare the practice and outcomes of CAS and CEA in a real-world setting within public university hospitals in Brazil...
November 23, 2016: JMIR Research Protocols
https://www.readbyqxmd.com/read/27875738/heart-rate-response-to-exercise-in-heart-failure-patients-the-prognostic-role-of-metabolic-chronotropic-relation-and-heart-rate-recovery
#5
Pavel Hajdusek, Martin Kotrc, Josef Kautzner, Vojtech Melenovsky, Eva Benesova, Petr Jarolim, Jan Benes
BACKGROUND: The dynamics of the sinus node response to exercise is linked to functional capacity and outcome in heart failure (HF). The goal of the work was to analyze determinants and impacts of cardio-acceleration, described by the concept of metabolic-chronotropic relation (MCR) and of cardio-deceleration, described by heart rate recovery (HRR). METHODS: A cohort of 25 healthy controls and 78 patients with advanced systolic HF and optimized medical and/or device therapy (97% receiving beta-blockers, 54% ICD) underwent maximal cardiopulmonary exercise test and were prospectively followed...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27872871/microscopic-medical-image-classification-framework-via-deep-learning-and-shearlet-transform
#6
Hadi Rezaeilouyeh, Ali Mollahosseini, Mohammad H Mahoor
Cancer is the second leading cause of death in US after cardiovascular disease. Image-based computer-aided diagnosis can assist physicians to efficiently diagnose cancers in early stages. Existing computer-aided algorithms use hand-crafted features such as wavelet coefficients, co-occurrence matrix features, and recently, histogram of shearlet coefficients for classification of cancerous tissues and cells in images. These hand-crafted features often lack generalizability since every cancerous tissue and cell has a specific texture, structure, and shape...
October 2016: Journal of Medical Imaging
https://www.readbyqxmd.com/read/27870068/systematic-review-of-the-prevalence-of-medication-errors-resulting-in-hospitalization-and-death-of-nursing-home-residents
#7
Noha Ferrah, Janaka J Lovell, Joseph E Ibrahim
Medication errors (MEs) result in preventable harm to nursing home (NH) residents and pose a significant financial burden. Institutionalized older people are particularly vulnerable because of various organizational and individual factors. This systematic review reports the prevalence of MEs leading to hospitalization and death in NH residents and the factors associated with risk of death and hospitalization. A systematic search was conducted of the relevant peer-reviewed research published between January 1, 2000, and October 1, 2015, in English, French, German, or Spanish examining serious outcomes of MEs in NHs residents...
November 21, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27858590/turning-the-tide-or-riptide-the-changing-opioid-epidemic
#8
Stefan G Kertesz
The US opioid epidemic has changed profoundly in the last 3 years, in ways that require substantial recalibration of the US policy response. This report summarizes the changing nature of overdose deaths in Jefferson County (home to Birmingham, Alabama) using data updated through June 30, 2016. Heroin and fentanyl have come to dominate an escalating epidemic of lethal opioid overdose, while opioids commonly obtained by prescription play a minor role, accounting for no more than 15% of reported deaths in 2015...
November 18, 2016: Substance Abuse
https://www.readbyqxmd.com/read/27852723/regional-versus-general-anesthesia-for-promoting-independence-after-hip-fracture-regain-protocol-for-a-pragmatic-international-multicentre-trial
#9
Mark D Neuman, Susan S Ellenberg, Frederick E Sieber, Jay S Magaziner, Rui Feng, Jeffrey L Carson
INTRODUCTION: Hip fractures occur 1.6 million times each year worldwide, with substantial associated mortality and losses of independence. At present, anaesthesia care for hip fracture surgery varies widely within and between countries, with general anaesthesia and spinal anaesthesia representing the 2 most common approaches. Limited randomised evidence exists regarding potential short-term or long-term differences in outcomes between patients receiving spinal or general anaesthesia for hip fracture surgery...
November 15, 2016: BMJ Open
https://www.readbyqxmd.com/read/27849287/effects-of-comprehensive-cardiac-rehabilitation-on-functional-capacity-and-cardiovascular-risk-factors-in-brazilians-assisted-by-public-health-care-protocol-for-a-randomized-controlled-trial
#10
Gabriela S S Chaves, Gabriela L M Ghisi, Sherry L Grace, Paul Oh, Antonio L Ribeiro, Raquel R Britto
Background: Cardiovascular Disease (CVD) is the leading burden of disease worldwide. Moreover, CVD-related death rates are considered an epidemic in low- and middle-income countries (LMICs). Research shows that cardiac rehabilitation (CR) participation reduces death and improves disability and quality of life. Given the growing epidemic of CVD in LMICs and the insufficient evidence about CR programs in these countries, a Randomized Control Trial (RCT) in Latin America is warranted. Objective: To investigate the effects of comprehensive CR on functional capacity and cardiovascular risk factors...
October 27, 2016: Brazilian Journal of Physical Therapy
https://www.readbyqxmd.com/read/27845576/assisted-suicide-as-a-remedy-for-suffering-the-end-of-life-preferences-of-british-suicide-tourists
#11
Naomi Richards
The highly charged debate about the moral status of assisted suicide features regularly in the news media in medically advanced countries. In the UK, the debate has been dominated in recent years by a new mode of death: assisted suicide in Switzerland, so-called 'suicide tourism'. Drawing on in-depth interviews with people who were actively planning on 'going to Switzerland', alongside participant-observation at a do-it-yourself self-deliverance workshop, I discuss how participants arrived at their decision to seek professionalized assistance...
November 15, 2016: Medical Anthropology
https://www.readbyqxmd.com/read/27834198/intermacs-interagency-registry-for-mechanically-assisted-circulatory-support-profiling-identifies-ambulatory-patients-at-high-risk-on-medical-therapy-after-hospitalizations-for-heart-failure
#12
Garrick C Stewart, Michelle M Kittleson, Parag C Patel, Jennifer A Cowger, Chetan B Patel, Maria M Mountis, Frances L Johnson, Maya E Guglin, J Eduardo Rame, Jeffrey J Teuteberg, Lynne W Stevenson
BACKGROUND: INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support) profiles provide important prognostic information for patients with advanced heart failure (HF) receiving mechanical support. The value of INTERMACS profiling has not been shown for patients followed on medical therapy for advanced HF at centers that also offer mechanical circulatory support. METHODS AND RESULTS: This prospective, observational study enrolled 166 patients with chronic New York Heart Association class III-IV HF, ejection fraction ≤30%, and ≥1 HF hospitalization in the previous year, excluding patients listed for transplant or receiving chronic intravenous inotropic therapy...
November 2016: Circulation. Heart Failure
https://www.readbyqxmd.com/read/27822349/implementation-of-laparoscopic-surgery-for-endometrial-cancer-work-in-progress
#13
REVIEW
H N Sallam, N H Sallam
Human response to new developments regarding birth, death, marriage and divorce is largely shaped by religious beliefs. When assisted reproduction was introduced into medical practice in the last quarter of the twentieth century, it was fiercely attacked by some religious groups and highly welcomed by others. Today, assisted reproduction is accepted in nearly all its forms by Judaism, Hinduism and Buddhism, although most Orthodox Jews refuse third party involvement. On the contrary assisted reproduction is totally unacceptable to Roman Catholicism, while Protestants, Anglicans, Coptic Christians and Sunni Muslims accept most of its forms, which do not involve gamete or embryo donation...
March 28, 2016: Facts, Views & Vision in ObGyn
https://www.readbyqxmd.com/read/27821302/suffering-and-medicalization-at-the-end-of-life-the-case-of-physician-assisted-dying
#14
Hadi Karsoho, Jennifer R Fishman, David Kenneth Wright, Mary Ellen Macdonald
'Suffering' is a central discursive trope for the right-to-die movement. In this article, we ask how proponents of physician-assisted dying (PAD) articulate suffering with the role of medicine at the end of life within the context of a decriminalization and legalization debate. We draw upon empirical data from our study of Carter v. Canada, the landmark court case that decriminalized PAD in Canada in 2015. We conducted in-depth interviews with 42 key participants of the case and collected over 4000 pages of legal documents generated by the case...
December 2016: Social Science & Medicine
https://www.readbyqxmd.com/read/27805796/implementation-of-a-multicenter-performance-improvement-program-for-early-detection-and-treatment-of-severe-sepsis-in-general-medical-surgical-wards
#15
Christa Schorr, Andrew Odden, Laura Evans, Gabriel J Escobar, Snehal Gandhi, Sean Townsend, Mitchell Levy
Sepsis is a leading cause of in-hospital death, and evidence suggests a higher mortality in patients presenting with sepsis on the ward compared to those presenting to the emergency department. Ward patients who develop severe sepsis may have poor outcomes for a variety of reasons, including delayed diagnosis, lack of readily available staffing, and delayed treatment. We report on a multihospital quality improvement program for early detection and treatment of sepsis on general medical-surgical wards. We describe a multipronged approach to improve severe sepsis outcomes using the Institute for Healthcare Improvement's Plan-Do-Study-Act model...
November 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/27799316/longitudinal-strain-combined-with-delayed-enhancement-magnetic-resonance-improves-risk-stratification-in-patients-with-dilated-cardiomyopathy
#16
Misato Chimura, Tetsuari Onishi, Yasue Tsukishiro, Takahiro Sawada, Kunihiko Kiuchi, Akira Shimane, Katsunori Okajima, Shinichiro Yamada, Yasuyo Taniguchi, Yoshinori Yasaka, Hiroya Kawai
OBJECTIVE: Late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) imaging has been reported to be associated with unfavourable outcomes; however, few studies have addressed the prognostic value of left ventricular (LV) deformation parameter indicated by global longitudinal strain (GLS) in two-dimensional speckle-tracking (2DST) echocardiography in patients with non-ischaemic dilated cardiomyopathy (DCM). This study aims to investigate whether the combination of GLS and LGE is useful in stratifying the risk in patients with DCM...
October 31, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27799295/the-m1-muscarinic-receptor-antagonist-vu0255035-delays-the-development-of-status-epilepticus-after-organophosphate-exposure-and-prevents-hyperexcitability-in-the-basolateral-amygdala
#17
Steven L Miller, Vassiliki Aroniadou-Anderjaska, Volodymyr I Pidoplichko, Taiza H Figueiredo, James P Apland, Jishnu K S Krishnan, Maria F M Braga
Exposure to organophosphorus toxins induces seizures that progress to status epilepticus (SE), which can cause brain damage or death. Seizures are generated by hyperstimulation of muscarinic receptors, subsequent to inhibition of acetylcholinesterase; this is followed by glutamatergic hyperactivity, which sustains and reinforces seizure activity. It has been unclear which muscarinic receptor subtypes are involved in seizure initiation and the development of SE in the early phases after exposure. Here, we show that pretreatment of rats with the selective M1 receptor antagonist, VU0255035 [N-(3-oxo-3-(4-(pyridine-4-yl)piperazin-1-yl)propyl)-benzo[c][1,2,5]thiadiazole-4 sulfonamide], significantly suppressed seizure severity and prevented the development of SE for about 40 minutes after exposure to paraoxon or soman, suggesting an important role of the M1 receptor in the early phases of seizure generation...
January 2017: Journal of Pharmacology and Experimental Therapeutics
https://www.readbyqxmd.com/read/27795486/correlation-of-pre-and-in-hospital-systolic-blood-pressure-in-acute-heart-failure-patients-and-the-prognostic-implications%C3%A3-report-from-the-tokyo-cardiac-care-unit-network-emergency-medical-service-database
#18
Yasuyuki Shiraishi, Shun Kohsaka, Kazumasa Harada, Takamichi Miyamoto, Shuzou Tanimoto, Kiyoshi Iida, Tetsuro Sakai, Tetsuro Miyazaki, Mayuko Yagawa, Kenichi Matsushita, Shuta Furihata, Naoki Sato, Keiichi Fukuda, Takeshi Yamamoto, Ken Nagao, Morimasa Takayama
BACKGROUND: Systolic blood pressure (SBP) is an important prognostic indicator for patients with acute heart failure (AHF). However, its changes and the effects in the different phases of the acute management process are not well known.Methods and Results:The Tokyo CCU Network prospectively collects on-site information about AHF from emergency medical services (EMS) and the emergency room (ER). The association between in-hospital death and SBP at 2 different time points (on-site SBP [measured by EMS] and in-hospital SBP [measured at the ER; ER-SBP]) was analyzed...
October 28, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/27788808/comparison-of-upper-midline-incision-with-and-without-laparoscopic-assistance-for-living-donor-right-hepatectomy
#19
S Shen, W Zhang, L Jiang, L Yan, J Yang
BACKGROUND: Since minimally invasive procedures for living-donor right hepatectomy (LDRH) became popular in recent years, several studies comparing the outcomes of donors undergoing an upper midline incision (UMI) under laparoscopic assistance for LDRH with those undergoing the traditional open LDRH have been published. However, there are very few comparative studies of outcomes for a UMI for LDRH with and without laparoscopic-assistance. We designed the present study to compare the benefits and shortcomings of a UMI for LDRH with and without laparoscopic assistance...
October 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27788784/assessment-of-attitude-and-knowledge-of-personnel-in-the-intensive-care-unit-of-tabriz-university-of-medical-sciences-hospitals-toward-organ-donation
#20
K S Nia, A Tagizadieh, M Pouraghaei, H Soleimanpour, F Kakaie, S Sanaie, A Mahmoodpoor
BACKGROUND: The increasing gap between organ supply and demand remains a worldwide problem and can be attributed to several reasons. Because health care workers play an important role in management of brain dead patients, we performed a survey to evaluate the attitude and knowledge of personnel in the intensive care unit (ICU) at Tabriz University of Medical Sciences hospitals toward organ donation. MATERIALS AND METHODS: This cross-sectional study was included personnel from 8 university affiliated ICUs in Northwest of Iran from May to July 2014...
October 2016: Transplantation Proceedings
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