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Medically assisted death

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https://www.readbyqxmd.com/read/28716621/healthcare-professionals-attitudes-about-physician-assisted-death-an-analysis-of-their-justifications-and-the-roles-of-terminology-and-patient-competency
#1
Derek W Braverman, Brian S Marcus, Paul G Wakim, Mark R Mercurio, Gary S Kopf
CONTEXT: Healthcare professionals (HCPs) are crucial to physician-assisted death (PAD) provision. OBJECTIVES: To quantitatively assess the favorability of justifications for or against PAD legalization among HCPs, the effect of the terms "suicide" and "euthanasia" on their views, and their support for three forms of PAD. METHODS: Our questionnaire presented three cases: physician-assisted suicide, euthanasia for a competent patient, and euthanasia for an incompetent patient with an advance directive for euthanasia...
July 14, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28705229/brugada-syndrome-in-a-patient-with-amyotrophic-lateral-sclerosis-a-case-report
#2
Anusha Battineni, Rohit Gummi, Naresh Mullaguri, Raghav Govindarajan
BACKGROUND: Amyotrophic lateral sclerosis is a fatal neuromuscular disorder characterized by progressive death of the upper and lower motor neurons in the central nervous system. Patients with this disease die mostly as a result of respiratory failure; however, owing to prolonged survival through assisted ventilation, cardiovascular causes are increasingly responsible for mortality. We report what is to the best of our knowledge the first case of type 2 Brugada syndrome causing ventricular tachyarrhythmia and cardiac arrest in a patient with upper limb onset amyotrophic lateral sclerosis...
July 14, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28692616/development-of-a-falls-registry-a-pilot-study
#3
Gina M Berg, Tara Carlson, Joanne Fairchild, Courtney Edwards, Ryan Sorell
Each year approximately 1 in 4 healthy older adults aged 65+ years and 1 in 2 aged 80+ years living in the community will fall. Fall-related injuries are the leading cause of death and disability and cost the United States approximately $31 billion annually. Currently, no repository of scene data exists that informs prevention programs regarding circumstances that contribute to older adult falls. This was a multicenter (4 sites: Kansas, Maryland, Oregon, and Texas) pilot study consisting of interviews of older (55+ years) patients who had been admitted to a trauma center with fall-related injuries...
July 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28692459/comparative-determinants-of-5-year-cardiovascular-event-rates-in-patients-with-unprotected-left-main-coronary-artery-disease
#4
Cheol Hyun Lee, Jung-Min Ahn, Pil Hyung Lee, Minkyu Han, Se Hun Kang, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Duk-Woo Park, Seung-Jung Park
BACKGROUND: Diabetes mellitus (DM), low ejection fraction (EF), and the extent of coronary artery disease (CAD) have all been identified as predictors of cardiovascular events in multivessel disease, but their comparative contributions to future risk remain unclear in patients with unprotected left main coronary artery (ULMCA) disease. Through this study we aimed to categorize the risk for cardiovascular events in patients with ULMCA disease using simple clinical descriptors. PATIENTS AND METHODS: Our study included a total of 5975 patients with ULMCA disease from the Interventional Research Incorporation Society-Left MAIN Revascularization registry who were treated with percutaneous coronary intervention (n=2850), coronary artery bypass grafting (n=2337), or medical therapy alone (n=608)...
August 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28678808/validation-of-accuracy-of-svm-based-fall-detection-system-using-real-world-fall-and-non-fall-datasets
#5
Omar Aziz, Jochen Klenk, Lars Schwickert, Lorenzo Chiari, Clemens Becker, Edward J Park, Greg Mori, Stephen N Robinovitch
Falls are a major cause of injuries and deaths in older adults. Even when no injury occurs, about half of all older adults who fall are unable to get up without assistance. The extended period of lying on the floor often leads to medical complications, including muscle damage, dehydration, anxiety and fear of falling. Wearable sensor systems incorporating accelerometers and/or gyroscopes are designed to prevent long lies by automatically detecting and alerting care providers to the occurrence of a fall. Research groups have reported up to 100% accuracy in detecting falls in experimental settings...
2017: PloS One
https://www.readbyqxmd.com/read/28676211/cost-effectiveness-analysis-of-additional-bevacizumab-to-pemetrexed-plus-cisplatin-for-malignant-pleural-mesothelioma-based-on-the-maps-trial
#6
Mei Zhan, Hanrui Zheng, Ting Xu, Yu Yang, Qiu Li
PURPOSE: Malignant pleural mesothelioma (MPM) is a rare malignancy, and pemetrexed/cisplatin (PC) is the gold standard first-line regime. This study evaluated the cost-effectiveness of the addition of bevacizumab to PC (with maintenance bevacizumab) for unresectable MPM based on a phase III trial that showed a survival benefit compared with chemotherapy alone. METHODS: To estimate the incremental cost-effectiveness ratio (ICER) of the incorporation of bevacizumab, a Markov model based on the MAPS trial, including the disease states of progression-free survival, progressive disease and death, was used...
August 2017: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
https://www.readbyqxmd.com/read/28666682/family-led-rehabilitation-after-stroke-in-india-attend-a-randomised-controlled-trial
#7
(no author information available yet)
BACKGROUND: Most people with stroke in India have no access to organised rehabilitation services. The effectiveness of training family members to provide stroke rehabilitation is uncertain. Our primary objective was to determine whether family-led stroke rehabilitation, initiated in hospital and continued at home, would be superior to usual care in a low-resource setting. METHODS: The Family-led Rehabilitation after Stroke in India (ATTEND) trial was a prospectively randomised open trial with blinded endpoint done across 14 hospitals in India...
June 27, 2017: Lancet
https://www.readbyqxmd.com/read/28664689/fatal-cardiovascular-risk-in-poland-as-determined-via-internet
#8
Bartosz Trzeciak, Piotr Gutknecht, Andrzej Molisz, Janusz Siebert
[b]Abstract Introduction.[/b] Web information systems can serve as a diagnostic tool for Internet users and to support the epidemiological work of doctors and health care providers. As part of this work, a system for detecting and calculating cardiovascular risk has been created. [b]Objectives[/b]. 1) Application of web-based risk assessment of cardiovascular death; 2) an attempt to evaluate the distribution of selected risk factors among the population of Polish Internet users; 3) implementation of the epidemiological imaging system of cardiovascular risk factors...
May 11, 2017: Annals of Agricultural and Environmental Medicine: AAEM
https://www.readbyqxmd.com/read/28646524/risk-factors-for-severe-respiratory-depression-from-prescription-opioid-overdose
#9
Lindsay M Fox, Robert S Hoffman, David Vlahov, Alex F Manini
BACKGROUND AND AIMS: Prescription opioid overdose is a leading cause of injury-related morbidity and mortality in the US. We aimed to identify characteristics associated with clinical severity in emergency department patients with prescription opioid overdose. DESIGN: This was a secondary data analysis of adult prescription opioid overdoses from a large prospective cohort of acute overdoses. We examined elements of a typical emergency department evaluation using a multivariable model to determine which characteristics were associated with clinical severity, specifically severe respiratory depression (SRD)...
June 23, 2017: Addiction
https://www.readbyqxmd.com/read/28644057/the-implementation-of-medical-monitoring-programs-following-potentially-hazardous-exposures-a-medico-legal-perspective
#10
David Vearrier, Michael I Greenberg
CONTEXT: Clinical toxicologists may be called upon to determine the appropriateness of medical monitoring following documented or purported exposures to toxicants in the occupational, environmental, and medical settings. METHODS: We searched the MEDLINE database using the Ovid(®) search engine for the following terms cross-referenced to the MeSH database: ("occupational exposures" OR "environmental exposures") AND ("physiologic monitoring" OR "population surveillance")...
June 23, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28633314/qualitative-identification-of-fentanyl-analogs-and-other-opioids-in-postmortem-cases-by-uhplc-ion-trap-msn
#11
Elisa N Shoff, M Elizabeth Zaney, Joseph H Kahl, George W Hime, Diane M Boland
Since 2013, the Miami-Dade County Medical Examiner Department has experienced an increase in the number of opioid-related deaths. The majority of cases coincided with the introduction of fentanyl into the local heroin supply. From 2014 to 2015, Miami-Dade County experienced a near 600% increase in fentanyl-related deaths, followed by an additional 200% increase in 2016. In 2015, two novel fentanyl analogs were identified in medical examiner cases: beta-hydroxythiofentanyl and acetyl fentanyl. In 2016, four additional fentanyl analogs emerged: para-fluoroisobutyryl fentanyl, butyryl fentanyl, furanyl fentanyl and carfentanil, as well as the synthetic opioid U-47700...
June 13, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/28604832/insects-and-associated-arthropods-analyzed-during-medicolegal-death-investigations-in-harris-county-texas-usa-january-2013-april-2016
#12
Michelle R Sanford
The application of insect and arthropod information to medicolegal death investigations is one of the more exacting applications of entomology. Historically limited to homicide investigations, the integration of full time forensic entomology services to the medical examiner's office in Harris County has opened up the opportunity to apply entomology to a wide variety of manner of death classifications and types of scenes to make observations on a number of different geographical and species-level trends in Harris County, Texas, USA...
2017: PloS One
https://www.readbyqxmd.com/read/28599052/tccc-updates-two-decades-of-saving-lives-on-the-battlefield-tactical-combat-casualty-care-turns-20
#13
Frank K Butler
BACKGROUND: Twenty years ago, the original Tactical Combat Casualty Care (TCCC) article was published in this journal. Since TCCC is essentially a set of bestpractice prehospital trauma care guidelines customized for use on the battlefield, the presence of a journal with a specific focus on military medicine was a profound benefit to the initial presentation of TCCC to the US Military. METHODS: In the two ensuing decades, which included the longest continuous period of armed conflict in our nation's history, TCCC steadily evolved as the prehospital trauma care evidence base was augmented and as feedback from user medics, corpsmen, and pararescuemen was obtained...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28598715/responding-to-a-suicide-death-the-role-of-first-responders
#14
Kenneth Norton
Effective response by first responders in the immediate aftermath of a suicide death can play a critical role in reducing risk and promoting healing for family, friends, and the larger community by helping people who are newly bereaved to cope with the immediate crisis, created by the death. They also can lay the foundation for the difficult journey of mourning and healing that must follow. Stressing the importance of a comprehensive and coordinated community response to suicide, this article addresses the principles and practices that are called for in the Guidelines by highlighting four distinct first responder communities: law enforcement and emergency medical services; medical examiners; funeral professionals; and clergy and faith leaders...
June 9, 2017: Death Studies
https://www.readbyqxmd.com/read/28594767/the-case-for-a-national-maternal-mortality-review-committee
#15
Steven L Clark, Michael A Belfort
The United States has the highest maternal mortality ratio of any high-resource country; the 2014 ratio of 22 per 100,000 live births is in fact four to five times higher than that of the best-performing nations, and recent data suggest that this ratio may be increasing. The causes of this disparity are unknown and may be related to social, economic, cultural, or medical issues or a combination of factors. Repeated counts of categories of maternal death are of little assistance in determining the actual cause of death or in identifying preventive measures...
July 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28590391/misuse-of-novel-synthetic-opioids-a-deadly-new-trend
#16
Matthew P Prekupec, Peter A Mansky, Michael H Baumann
: Novel synthetic opioids (NSOs) include various analogs of fentanyl and newly emerging non-fentanyl compounds. Together with illicitly manufactured fentanyl (IMF), these drugs have caused a recent spike in overdose deaths, whereas deaths from prescription opioids have stabilized. NSOs are used as stand-alone products, as adulterants in heroin, or as constituents of counterfeit prescription medications. During 2015 alone, there were 9580 deaths from synthetic opioids other than methadone. Most of these fatalities were associated with IMF rather than diverted pharmaceutical fentanyl...
June 5, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28588967/who-multi-country-survey-on-abortion-related-morbidity-and-mortality-in-health-facilities-study-protocol
#17
Caron R Kim, Özge Tunçalp, Bela Ganatra, Ahmet Metin Gülmezoglu
INTRODUCTION: According to the WHO, abortion accounts for about 8% (4.7-13.2) of maternal mortality worldwide. In 2010, the WHO Multi-Country Survey (MCS) on Maternal and Newborn Health collected data on over 300 000 women who were admitted in health facilities to receive pregnancy-related care. Abortion data were partially captured by centring on severe maternal outcomes (ie, near-miss or maternal deaths). Building on the experiences of the prior MCS as well as current WHO reproductive health projects, we are undertaking a multi-country survey to better capture the burden and severity of abortion-related complications and management among women presenting to the health facilities...
November 2016: BMJ Global Health
https://www.readbyqxmd.com/read/28587644/current-and-future-perspectives-on-the-management-of-polypharmacy
#18
Mariam Molokhia, Azeem Majeed
BACKGROUND: Because of ageing populations, the growth in the number of people with multi-morbidity and greater compliance with disease-specific guidelines, polypharmacy is becoming increasingly common. Although the correct drug treatment in patients with complex medical problems can improve clinical outcomes, quality of life and life expectancy, polypharmacy is also associated with an increased risk of adverse drug events, some severe enough to result in hospital admission and even death...
June 6, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28578941/mortality-among-twins-and-singletons-in-sub-saharan-africa-between-1995-and-2014-a-pooled-analysis-of-data-from-90-demographic-and-health-surveys-in-30-countries
#19
Christiaan W S Monden, Jeroen Smits
BACKGROUND: Sub-Saharan Africa has the world's highest under-5 and neonatal mortality rates as well as the highest naturally occurring twin rates. Twin pregnancies carry high risk for children and mothers. Under-5 mortality has declined in sub-Saharan Africa over the last decades. It is unknown whether twins have shared in this reduction. METHODS: We pooled data from 90 Demographic and Health Surveys for 30 sub-Saharan Africa countries on births reported between 1995 and 2014...
May 31, 2017: Lancet Global Health
https://www.readbyqxmd.com/read/28577725/postoperative-liver-volume-was-accurately-predicted-by-a-medical-image-three-dimensional-visualization-system-in-hepatectomy-for-liver-cancer
#20
Wei Cai, Yingfang Fan, Haoyu Hu, Nan Xiang, Chihua Fang, Fucang Jia
BACKGROUND: Liver cancer is the second most common cause of cancer death worldwide. The hepatectomy is the most effective and the only potentially curative treatment for patients with resectable neoplasm. Precisely preoperative assessment of remnant liver volume is essential in preventing postoperative liver failure. The aim of our study is to report our experience of using a medical image three dimensional (3D) visualization system (MI-3DVS), which was developed by our team, in assisting hepatectomy for patients with liver cancer...
June 2017: Surgical Oncology
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