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https://www.readbyqxmd.com/read/29682693/costs-of-cancer-care-for-elderly-patients-with-neuroendocrine-tumors
#1
Chan Shen, Arvind Dasari, Dian Gu, Yiyi Chu, Shouhao Zhou, Ying Xu, Daniel Halperin, Shuangshuang Fu, James C Yao, Ya-Chen Tina Shih
BACKGROUND: The incidence and prevalence of neuroendocrine tumors (NETs) have been steadily rising. NETs can arise in various parts of the body and have distinct pathogenesis, clinical manifestations, treatment, and survival compared to other neoplasms. The magnitude of the economic burden of NETs is largely unknown. This study aimed to estimate the cost of illness for NETs among elderly patients based on a large amount of observational data. METHODS: We estimated the direct medical costs by phase of care using the Surveillance, Epidemiology, and End Results-Medicare data, including claims from January 1, 2002 through to December 31, 2012...
April 23, 2018: PharmacoEconomics
https://www.readbyqxmd.com/read/29682162/metabolic-alterations-in-a-slow-paced-model-of-pancreatic-cancer-induced-wasting
#2
Elisabeth Wyart, Simone Reano, Myriam Y Hsu, Dario Livio Longo, Mingchuan Li, Emilio Hirsch, Nicoletta Filigheddu, Alessandra Ghigo, Chiara Riganti, Paolo Ettore Porporato
Cancer cachexia is a devastating syndrome occurring in the majority of terminally ill cancer patients. Notably, skeletal muscle atrophy is a consistent feature affecting the quality of life and prognosis. To date, limited therapeutic options are available, and research in the field is hampered by the lack of satisfactory models to study the complexity of wasting in cachexia-inducing tumors, such as pancreatic cancer. Moreover, currently used in vivo models are characterized by an explosive cachexia with a lethal wasting within few days, while pancreatic cancer patients might experience alterations long before the onset of overt wasting...
2018: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/29679597/management-of-dyspnea-in-the-terminally-ill
#3
REVIEW
Lara Pisani, Nicholas S Hill, Angela Maria Grazia Pacilli, Massimiliano Polastri, Stefano Nava
The genesis of dyspnea involves the activation of several mechanisms that are mediated and perceived depending on previous experiences, values, emotions and beliefs. Breathlessness may become unbearable, especially in terminally ill patients, whether afflicted by respiratory, cardiac or cancer-related disorders, due to a final stage of a chronic process, an acute event or both. Compared to pain, palliation of dyspnea has received relatively little attention in clinical practice and the medical literature. This is particularly true when the breathlessness is associated with acute respiratory failure since most of the studies on pharmacological and non-pharmacological treatments of respiratory distress have excluded such patients...
April 18, 2018: Chest
https://www.readbyqxmd.com/read/29678989/prescribing-and-deprescribing-antihypertensive-medication-in-older-people-by-dutch-general-practitioners-a-qualitative-study
#4
Tessa van Middelaar, Sophie D Ivens, Petra G van Peet, Rosalinde K E Poortvliet, Edo Richard, A Jeannette Pols, Eric P Moll van Charante
OBJECTIVES: To explore general practitioners' (GPs) routines and considerations on (de)prescribing antihypertensive medication (AHM) in older patients, their judgement on usability of the current guideline and needs for future support. DESIGN: Semistructured interviews. SETTING: Dutch general practice. PARTICIPANTS: Fifteen GPs were purposively sampled based on level of experience and practice characteristics until saturation was reached...
April 20, 2018: BMJ Open
https://www.readbyqxmd.com/read/29678735/recent-developments-of-nanotherapeutics-for-targeted-and-long-acting-combination-hiv-chemotherapy
#5
REVIEW
Yu Gao, John C Kraft, Danni Yu, Rodney J Y Ho
Combination antiretroviral therapy (cART) given orally has transformed HIV from a terminal illness to a manageable chronic disease. Yet despite the recent development of newer and more potent drugs for cART and suppression of virus in blood to undetectable levels, residual virus remains in tissues. Upon stopping cART, virus rebounds and progresses to AIDS. Current oral cART regimens have several drawbacks including (1) challenges in patient adherence due to pill fatigue or side-effects, (2) the requirement of life-long daily drug intake, and (3) limited penetration and retention in cells within lymph nodes...
April 17, 2018: European Journal of Pharmaceutics and Biopharmaceutics
https://www.readbyqxmd.com/read/29676687/christopher-hitchens-public-dying-toward-a-secular-humanist-ars-moriendi
#6
Michael Brennan
This article explores the public dying of journalist, writer, provocateur, public intellectual, and renowned atheist, Christopher Hitchens. It does so primarily through an analysis of television interviews given by Hitchens following his diagnosis with esophageal cancer in June 2010. Four key themes are identified as emerging from analysis of the interviews: (a) Hitchens' explicit sense of mission in challenging myths and superstitions surrounding cancer, dying, and death; (b) the personal experience of terminal illness and dying and the particular way (or style of dying) by which it is approached; (c) issues of regret and a life well lived; and (d) questions surrounding religion, the afterlife, and possibility of deathbed conversion...
June 2018: Omega
https://www.readbyqxmd.com/read/29672149/access-to-aid-in-dying-in-the-united-states-shifting-the-debate-from-rights-to-justice
#7
Mara Buchbinder
Much of the literature on aid-in-dying (AID) has drawn heavily on rights-based ethical and legal frameworks that emphasize patients' rights of self-determination in end-of-life decision-making. Less attention has focused on how terminally ill people actually experience such putative rights once they are legally authorized. This analytic essay draws on findings from the Vermont Study on Aid-in-Dying, an ethnographic study of the implementation of AID in Vermont (2015-2017). First, I show that terminally ill people can face a range of barriers to accessing AID in permissive jurisdictions, and that access to AID is mediated by various inequalities endemic to US health care, as well as some that are unique to AID...
April 19, 2018: American Journal of Public Health
https://www.readbyqxmd.com/read/29666477/single-cell-analysis-of-pyroptosis-dynamics-reveals-conserved-gsdmd-mediated-subcellular-events-that-precede-plasma-membrane-rupture
#8
Nathalia M de Vasconcelos, Nina Van Opdenbosch, Hanne Van Gorp, Eef Parthoens, Mohamed Lamkanfi
Pyroptosis is rapidly emerging as a mechanism of anti-microbial host defense, and of extracellular release of the inflammasome-dependent cytokines interleukin (IL)-1β and IL-18, which contributes to autoinflammatory pathology. Caspases 1, 4, 5 and 11 trigger this regulated form of necrosis by cleaving the pyroptosis effector gasdermin D (GSDMD), causing its pore-forming amino-terminal domain to oligomerize and perforate the plasma membrane. However, the subcellular events that precede pyroptotic cell lysis are ill defined...
April 17, 2018: Cell Death and Differentiation
https://www.readbyqxmd.com/read/29660991/palliative-performance-scale-score-at-1-week-after-palliative-care-unit-admission-is-more-useful-for-survival-prediction-in-patients-with-advanced-cancer-in-south-korea
#9
Seok-Joon Yoon, Sung-Eun Choi, Thomas W LeBlanc, Sang-Yeon Suh
BACKGROUND: The Palliative Performance Scale (PPS) is a useful prognostic index in palliative care. Changes in PPS score over time may add useful prognostic information beyond a single measurement. OBJECTIVE: To investigate the usefulness of repeated PPS measurement to predict survival time of inpatients with advanced cancer admitted to a palliative care unit (PCU) in South Korea. DESIGN: Prospective observational cohort study. SETTING/PATIENTS: 138 patients with advanced cancer admitted to a PCU in a university hospital in South Korea from June 2015 to May 2016...
January 1, 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29657083/the-course-of-awake-breathing-disturbances-across-the-lifespan-in-rett-syndrome
#10
Daniel C Tarquinio, Wei Hou, Jeffrey L Neul, Gamze Kilic Berkmen, Jana Drummond, Elizabeth Aronoff, Jennifer Harris, Jane B Lane, Walter E Kaufmann, Kathleen J Motil, Daniel G Glaze, Steven A Skinner, Alan K Percy
Rett syndrome (RTT), an X-linked dominant neurodevelopmental disorder caused by mutations in MECP2, is associated with a peculiar breathing disturbance exclusively during wakefulness that is distressing, and can even prompt emergency resuscitation. Through the RTT Natural History Study, we characterized cross sectional and longitudinal characteristics of awake breathing abnormalities in RTT and identified associated clinical features. Participants were recruited from 2006 to 2015, and cumulative lifetime prevalence of breathing dysfunction was determined using the Kaplan-Meier estimator...
April 12, 2018: Brain & Development
https://www.readbyqxmd.com/read/29644989/the-palliative-care-in-dementia-context-health-professionals-point-of-view-about-advantages-and-resistances
#11
Sabina Zapponi, Maria Chiara Ascari, Erjona Feracaku, Silvia Masin, Paola Paglia, Roberta Petroccione, Ana Pinzaru, Chiara Foà, Giovanna Artioli, Leopoldo Sarli
BACKGROUND AND AIM: The 38/2010 law has expanded the provision of palliative care to patients with chronic-degenerative diseases. The ISTAT data show that 60% of the dying population is suffering from these diseases and could, according to the literature review, benefit particularly from such treatments. This study investigates the point of view of healthcare professionals, working in the context of dementia, regarding the knowledge and application of palliative care in the field of dementia...
March 26, 2018: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/29644908/life-course-stage-and-social-support-mobilization-for-end-of-life-caregivers
#12
Susan A LaValley, Elizabeth A Gage-Bouchard
Caregivers of terminally ill patients are at risk for anxiety, depression, and social isolation. Social support from friends, family members, neighbors, and health care professionals can potentially prevent or mitigate caregiver strain. While previous research documents the importance of social support in helping end-of-life caregivers cope with caregiving demands, little is known about differences in social support experiences among caregivers at different life course stages. Using life course theory, this study analyzes data from in-depth interviews with 50 caregivers of patients enrolled in hospice services to compare barriers to mobilizing social support among caregivers at two life course stages: midlife caregivers caring for parents and older adult caregivers caring for spouses/partners...
April 1, 2018: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
https://www.readbyqxmd.com/read/29643886/an-examination-of-anxiety-levels-of-nursing-students-caring-for-patients-in-terminal-period
#13
Behire Sancar, Ayse Saba Yalcin, Inci Acikgoz
Objective: To investigate the anxiety levels of the nursing students who are caring for the patients in the terminal period and to determine whether there is a difference between 3rd , 4th grade in this direction. Methods: A 40-item "State and Trait Anxiety Scale" was used together with the questionnaire on "Determining the Level of Anxiety Levels of Nursing Students Caring for the Patient at the Terminal Period" for determining the data. Results: The mean scores and standard deviations of all students from the state and trait anxiety scales were respectively 41...
January 2018: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29629982/end-of-life-care-in-icus-in-east-asia-a-comparison-among-china-korea-and-japan
#14
So Young Park, Jason Phua, Masaji Nishimura, Yiyun Deng, Yan Kang, Keiichi Tada, Younsuck Koh
OBJECTIVES: To compare physicians' perceptions and practice of end-of-life care in the ICU in three East Asian countries cultures similarly rooted in Confucianism. DESIGN: A structured and scenario-based survey of physicians who managed ICU patients from May 2012 to December 2012. SETTING: ICUs in China, Korea, and Japan. SUBJECTS: Specialists who are either intensivists or nonintensivist primary attending physicians in charge of patients (195 in China, 186 in Korea, 224 in Japan)...
April 6, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29629400/long-term-evaluation-of-the-effects-of-aclidinium-bromide-on-major-adverse-cardiovascular-events-and-copd-exacerbations-in-patients-with-moderate-to-very-severe-copd-rationale-and-design-of-the-ascent-copd-study
#15
Robert A Wise, Kenneth R Chapman, Benjamin M Scirica, David A Schoenfeld, Deepak L Bhatt, Sami Z Daoud, Beatriz Seoane, Colin Reisner, Esther Garcia Gil
Introduction: Chronic obstructive pulmonary disease (COPD) is a heterogeneous illness characterized by persistent airflow obstruction and exacerbations. Patients typically experience a decline in lung function, increasingly impaired health-related quality of life, and high mortality. Poor lung function and exacerbations are associated with an increased risk of cardiovascular (CV) and cerebrovascular events, and approximately 30% of patients with COPD die from CV‑related disease. Treatment with inhaled long-acting bronchodilators, such as long-acting muscarinic antagonists (LAMAs), is recommended; however, some studies have suggested that LAMAs may increase the risk of CV events...
January 24, 2018: Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation
https://www.readbyqxmd.com/read/29626051/access-to-palliative-care-by-disease-trajectory-a-population-based-cohort-of-ontario-decedents
#16
Hsien Seow, Erin O'Leary, Richard Perez, Peter Tanuseputro
OBJECTIVES: To examine access to palliative care between different disease trajectories and compare to other geographic areas. DESIGN: A retrospective population-based decedent cohort study using linked administrative data. SETTING: Ontario, Canada. PARTICIPANTS: Ontario decedents between 1 April 2010 and 31 December 2012. Patients were categorised into disease trajectories: terminal illness (eg, cancer), organ failure (eg, chronic heart failure), frailty (eg, dementia), sudden death or other...
April 5, 2018: BMJ Open
https://www.readbyqxmd.com/read/29623288/the-association-between-assisted-living-direct-care-worker-end-of-life-training-and-hospice-use-patterns
#17
Debra Dobbs, Sharon Kaufman, Hongdao Meng
As resident acuity levels increase for those who reside in assisted living (AL), states allow for hospice care provision in AL. End-of-life care training for staff can potentially increase the awareness of benefits of hospice care for AL residents. This study examined the association between AL staff trained in end-of-life care and hospice utilization in a sample of ALs ( n = 45) in Florida. The sample included ALs ( n = 21) with a low percentage (≤59%) and ALs ( n = 24) with a high percentage (≥60%) of staff trained in end-of-life care as reported by AL directors...
January 2018: Gerontology & Geriatric Medicine
https://www.readbyqxmd.com/read/29622389/dying-in-hospital-qualitative-study-among-caregivers-of-terminally-ill-patients-who-are-transferred-to-the-emergency-department
#18
Martin Pillet, Aline Chassagne, Régis Aubry
INTRODUCTION: Most people in France die in the hospital, even though a majority would like to die at home. These end-of-life hospital admissions sometimes occur in the emergency setting, in the hours preceding death. OBJECTIVE: To understand the motives that incite main natural caregivers to transfer terminally ill patients at the end of life to the emergency department. METHODS: A qualitative study was performed among caregivers of terminally ill patients receiving palliative care and living at home, and who died within 72hours of being admitted to the emergency department of the University Hospital of Besançon, France...
April 2, 2018: La Presse Médicale
https://www.readbyqxmd.com/read/29621007/disseminated-intravascular-coagulation-is-it-fact-or-fancy
#19
Jae C Chang
: 'Disseminated intravascular coagulation (DIC)' occurs commonly in critical illnesses such as sepsis, trauma, cancer, and complications of surgery and pregnancy. Mortality is very high. The pathogenesis has been ascribed to tissue factor-initiated coagulation disorder, resulting in disseminated microblood clots that are made of platelets, plasma factors, fibrins, and blood cells. True DIC depletes coagulation factors and consumes platelets, and activates fibrinolysis. 'DIC' is assumed to orchestrate thrombocytopenia, microangiopathic hemolytic anemia and hypoxic multiorgan dysfunction syndrome, and causes hemorrhagic disorder due to depleted coagulation factors...
April 4, 2018: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/29618364/exploring-attitudes-toward-physician-assisted-death-in-patients-with-life-limiting-illnesses-with-varying-experiences-of-palliative-care-a-pilot-study
#20
Patricia Hizo-Abes, Lauren Siegel, Gil Schreier
BACKGROUND: On February 6th, 2015, the Supreme Court of Canada ruled that competent adults suffering intolerably from a grievous and irremediable medical condition have the right to the assistance of a physician in ending their own lives, an act known as physician-assisted death, and later defined as medical assistance in dying, allowing for provision by a physician or a nurse practitioner. As of June 6th, 2016, this is no longer illegal across Canada. There is strong support amongst the general population for physician-assisted death, however there is no recent data on the attitudes of terminally ill patients...
April 4, 2018: BMC Palliative Care
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