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https://www.readbyqxmd.com/read/29052656/initial-efficacy-testing-of-an-autobiographical-memory-intervention-on-advance-care-planning-for-patients-with-terminal-cancer
#1
Cheryl Brohard
PURPOSE/OBJECTIVES: To test the efficacy of a novel intervention to facilitate advance care planning.
. DESIGN: Exploratory, quasiexperimental pilot study with two independent groups.
. SETTING: A large hospice located in the southwestern United States. 
. SAMPLE: A convenience sample of 50 participants with terminal cancer enrolled in hospice.
. METHODS: An autobiographical memory (ABM) intervention used the participants' experiences with cancer and end of life for the purpose of directing advance care planning...
November 1, 2017: Oncology Nursing Forum
https://www.readbyqxmd.com/read/29049111/risk-management-for-opioid-prescribing-in-the-treatment-of-patients-with-pain-from-cancer-or-terminal-illness-inadvertent-oversight-or-taboo
#2
David J Copenhaver, Nicolas B Karvelas, Scott M Fishman
As the United States experiences an epidemic of prescription drug abuse, and guidelines on safe practices in prescribing opioids in chronic pain have subsequently emerged from professional organizations and governmental agencies, limited guidance exists for prescribers of opioids to treat pain in patients with cancer or terminal illness. Patients with active cancer or terminal illness often have pain and are frequently prescribed opioids and other controlled substances. Current studies suggest that patients with cancer have similar rates of risk for misuse, abuse, and addiction as the general public...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29032021/clinical-characteristics-and-survival-outcomes-of-terminally-ill-patients-undergoing-withdrawal-of-mechanical-ventilation
#3
Yu-Shin Hung, Shu-Hui Lee, Chia-Yen Hung, Chao-Hui Wang, Chen-Yi Kao, Hung-Ming Wang, Wen-Chi Chou
BACKGROUND: Withdrawal of mechanical ventilation is an important, but rarely explored issue in Asia during end-of-life care. This study aimed to describe the clinical characteristics and survival outcomes of terminally ill patients undergoing withdrawal of mechanical ventilation in Taiwan. METHODS: One-hundred-thirty-five terminally ill patients who had mechanical ventilation withdrawn between 2013 and 2016, from a medical center in Taiwan, were enrolled. Patients' clinical characteristics and survival outcomes after withdrawal of mechanical ventilation were analyzed...
October 11, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/29030255/molecular-cloning-and-characterization-of-secretory-carbonic-anhydrase-vi-in-pufferfish-takifugu-rubripes
#4
Kanij Rukshana Sumi, Soo Cheol Kim, Sathishkumar Natarajan, Kap Seong Choi, Myeong Rak Choi, Hoy-Teak Kim, Jong-In Park, Ill-Sup Nou, Kathleen M Gilmour, Kang Hee Kho
Carbonic anhydrase VI (CA VI) has been characterized as a secretory isozyme in mammals. Our present study confirmed the occurrence of CA VI in pufferfish (Takifugu rubripes). In this study, genomic sequence information for the CA VI of pufferfish was used for molecular cloning. We cloned a 1821-bp cDNA sequence, which consisted of a complete coding sequence of 1623bp and a deduced amino acid sequence of 540 amino acids from the open reading frame. A BLAST search indicated that this protein exhibits 53%, 79%, and 67% identity with human, tilapia, and gar CA VI, respectively...
October 10, 2017: Gene
https://www.readbyqxmd.com/read/29029985/clinical-and-pathological-outcomes-after-irreversible-electroporation-of-the-pancreas-using-two-parallel-plate-electrodes-a-porcine-model
#5
Steffi J E Rombouts, Willemijn P M van Dijck, Maarten W Nijkamp, Tyche C Derksen, Lodewijk A A Brosens, Frederik J H Hoogwater, Maarten S van Leeuwen, Inne H M Borel Rinkes, Richard van Hillegersberg, Fred H Wittkampf, Izaak Q Molenaar
BACKGROUND: Irreversible electroporation (IRE) by inserting needles around the tumor as treatment for locally advanced pancreatic cancer entails several disadvantages, such as incomplete ablation due to field inhomogeneity, technical difficulties in needle placement and a risk of pancreatic fistula development. This experimental study evaluates outcomes of IRE using paddles in a porcine model. METHODS: Six healthy pigs underwent laparotomy and were treated with 2 separate ablations (in head and tail of the pancreas)...
October 10, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/29024708/nationwide-quality-of-hospice-care-findings-from-the-centers-for-medicare-medicaid-services-cms-hospice-quality-reporting-program-hqrp
#6
Nan Tracy Zheng, Qinghua Li, Laura C Hanson, Kathryn L Wessell, Natalie Chong, Noha Sherif, Ila H Broyles, Jennifer Frank, M Alexis Kirk, Carol R Schwartz, Alan F Levitt, Franziska Rokoske
BACKGROUND: With increasing use of the Medicare hospice benefit, policymakers recognize the need for quality measurement to assure that terminally ill patients receive high quality care and have the information they need when selecting a hospice. Towards these goals, CMS has been collecting standardized patient-level quality data via the Hospice Item Set (HIS) since July 1, 2014. OBJECTIVES: This article presents a first look at the national hospice HIS quality data...
October 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29017462/vitamin-d-deficiency-was-common-among-nursing-home-residents-and-associated-with-dementia-a-cross-sectional-study-of-545-swedish-nursing-home-residents
#7
Rebeka Arnljots, Jörgen Thorn, Marie Elm, Michael Moore, Pär-Daniel Sundvall
BACKGROUND: Residents of nursing homes may have low 25-hydroxyvitamin D (25OHD) concentrations. Associations between vitamin D and cognitive performance, dementia and susceptibility to infections are not clearly established. The aim of this study was to investigate the prevalence of vitamin D deficiency and to identify associated factors among residents of nursing homes for elderly. METHODS: In this cross-sectional study blood samples for analysis of 25OHD were collected from all participating residents of Swedish nursing homes for the elderly from January to March 2012...
October 10, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/29016462/the-medical-futility-experience-of-nurses-in-caring-for-critically-ill-patients
#8
Ming-Yi Hsu, Shu-Fen Su, Lien-Ying Chiang, Sou-Jen Shih, Yu-Chen Chen
BACKGROUND: Medical futility is a key bioethical concern. In Taiwan, policymakers tend to provide care standards and evaluation guidelines for critically ill and terminal patients whose treatment is medically futile. However, the current status of medical futility for critically ill patients is inadequate, and no consensus currently exists on the definition of medical futility. PURPOSE: The aim of this study was to understand the medical futility experiences of intensive care nurses...
October 10, 2017: Journal of Nursing Research: JNR
https://www.readbyqxmd.com/read/28984172/analysis-of-mortality-in-the-emergency-department-at-a-university-hospital-in-pleven
#9
Petko Hristov Stefanovski, Radev Vladimir Radkov, Tsankov Lyubomir Ilkov, Tonchev Pencho Tonchev, Todorova Yoana Mladenova, Kovachev Vihar Manchev, Radev Radko Nikolov
Objective To identify the demographic patterns of mortality, the time spent before death in the emergency department (ED), and the causes of fatal outcomes. Methods We performed a 5-year (01/01/2011 to 01/01/2016) retrospective analysis of all non-traumatic deaths in the ED of the UMHAT - Pleven. To extract the necessary information, we used the registers in the ED until the patients' death. Results Among 156,848 patients in the study period, 381 died and the mortality rate was 2.4/100000. The male:female ratio was 1...
October 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28977651/trajectories-of-end-of-life-a-systematic-review
#10
Jiska Cohen-Mansfield, Michal Skornick-Bouchbinder, Shai Brill
Objectives: Because End of life (EOL) is becoming an increasingly long life stage, this paper aims to describe the delineation of EOL by reviewing studies which examine (a) terminal decline (TD), the timing of change in slope of decline in specific abilities; and (b) trajectories of decline in areas such as function, health care expenditures, and well-being according to cause of death. Methods: Studies were identified through Google Scholar, PsycNET, and PubMed...
July 8, 2017: Journals of Gerontology. Series B, Psychological Sciences and Social Sciences
https://www.readbyqxmd.com/read/28977262/new-concepts-in-palliative-care-in-the-intensive-care-unit
#11
Cristina Bueno Terzi Coelho, James R Yankaskas
Some patients admitted to an intensive care unit may face a terminal illness situation, which usually leads to death. Knowledge of palliative care is strongly recommended for the health care providers who are taking care of these patients. In many situations, the patients should be evaluated daily as the introduction of further treatments may not be beneficial to them. The discussions among health team members that are related to prognosis and the goals of care should be carefully evaluated in collaboration with the patients and their families...
April 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28977013/bereavement-support-for-family-caregivers-the-gap-between-guidelines-and-practice-in-palliative-care
#12
Samar M Aoun, Bruce Rumbold, Denise Howting, Amanda Bolleter, Lauren J Breen
BACKGROUND: Standards for bereavement care propose that support should be matched to risk and need. However, studies in many countries demonstrate that palliative care services continue to adopt a generic approach in offering support to bereaved families. OBJECTIVE: To identify patterns of bereavement support in palliative care services based upon the experience of bereaved people from a population based survey and in relation to clinical practice guidelines. DESIGN: An anonymous postal survey collected information from clients of six funeral providers in four Australian states (2014-15), 6 to 24 months after the death of their family member or friend, with 1,139 responding...
2017: PloS One
https://www.readbyqxmd.com/read/28975413/the-influence-of-family-adaptability-and-cohesion-on-anxiety-and-depression-of-terminally-ill-cancer-patients
#13
Young-Yoon Park, Young-Jin Jeong, Junyong Lee, Nayun Moon, Inho Bang, Hyunju Kim, Kyung-Sook Yun, Yong-I Kim, Tae-Hee Jeon
PURPOSE: This study investigated the effect of family members on terminally ill cancer patients by measuring the relationship of the presence of the family caregivers, visiting time by family and friends, and family adaptability and cohesion with patient's anxiety and depression. METHODS: From June, 2016 to March, 2017, 100 terminally ill cancer patients who were admitted to a palliative care unit in Seoul, South Korea, were surveyed, and their medical records were reviewed...
October 4, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28975232/oregon-s-death-with-dignity-act-20-years-of-experience-to-inform-the-debate
#14
Katrina Hedberg, Craig New
Twenty years ago, Oregon voters approved the Death With Dignity Act, making Oregon the first state in the United States to allow physicians to prescribe medications to be self-administered by terminally ill patients to hasten their death. This report summarizes the experience in Oregon, including the numbers and types of participating patients and providers. These data should inform the ongoing policy debate as additional jurisdictions consider such legislation.
September 19, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28974585/routine-screening-in-the-general-hospital-what-happens-after-discharge-to-those-identified-as-at-risk-of-dementia
#15
Ana Phelps, Bethany Kingston, Rose M Wharton, Sarah T Pendlebury
Cognitive screening is recommended for older patients with unplanned hospital admission. We determined rates of reassessment/specialist memory referral after routine inclusion of at risk of dementia status in discharge documentation to primary care. Questionnaires were sent to relevant GP practices on consecutive patients aged ≥75 years identified as at risk and discharged 6 months earlier. Among 53 patients (mean age ±SD = 87.3±6.0 years, mean±SD Abbreviated Mental Test Score = 4.4±2.7), 49 (92%) patients had been reviewed since discharge, and 12/43 (28%) without previously known cognitive problem had had a cognitive reassessment...
October 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28972697/feasibility-of-sustained-low-efficiency-dialysis-in-critically-sick-pediatric-patients-a-multicentric-retrospective-study
#16
Sidharth K Sethi, Rajiv Sinha, Pranaw Jha, Nikita Wadhwani, Veena Raghunathan, Maninder Dhaliwal, Shyam B Bansal, Vijay Kher, Valentine Lobo, Jyoti Sharma, Rupesh Raina
INTRODUCTION: Sustained low-efficiency dialysis (SLED) has emerged as a cost effective alternative to Continuous Renal Replacement Therapy in the management of hemodynamically unstable adult patients with acute kidney injury. The objective of the study was to document the SLED practices in these centers, and to look at the feasibility, and tolerability of SLED in critically sick pediatric patients. METHODS: It was a retrospective record review from January 2010 to June 2016 done in four tertiary pediatric nephrology centers in India...
October 3, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28960387/population-pharmacodynamic-modelling-of-midazolam-induced-sedation-in-terminally-ill-adult-patients
#17
L G Franken, B C M de Winter, A D Masman, M van Dijk, F P M Baar, D Tibboel, B C P Koch, T van Gelder, R A A Mathot
INTRODUCTION: Midazolam is the drug of choice for palliative sedation and is titrated to achieve the desired level of sedation. A previous pharmacokinetic (PK) study showed that variability between patients could be partly explained by renal function and inflammatory status. The goal of this study was to combine this PK information with pharmacodynamic (PD) data, to evaluate the variability in response to midazolam and to find clinically relevant covariates that may predict PD response...
September 27, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28946853/modifiable-risk-factors-for-typhoid-intestinal-perforations-during-a-large-outbreak-of-typhoid-fever-kampala-uganda-2015
#18
Lilian Bulage, Ben Masiira, Alex R Ario, Joseph K B Matovu, Peter Nsubuga, Frank Kaharuza, Victoria Nankabirwa, Janell Routh, Bao-Ping Zhu
BACKGROUND: Between January and June, 2015, a large typhoid fever outbreak occurred in Kampala, Uganda, with 10,230 suspected cases. During the outbreak, area surgeons reported a surge in cases of typhoid intestinal perforation (TIP), a complication of typhoid fever. We conducted an investigation to characterize TIP cases and identify modifiable risk factors for TIP. METHODS: We defined a TIP case as a physician-diagnosed typhoid patient with non-traumatic terminal ileum perforation...
September 25, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28940342/physician-assisted-death-and-severe-treatment-resistant-depression
#19
Bonnie Steinbock
Should people suffering from untreatable psychiatric conditions be eligible for physician-assisted death? This is possible in Belgium and the Netherlands, where PAD for psychiatric conditions is permitted, though rare, so long as the criteria of due care are met. Those opposed to all instances of PAD point to Belgium and the Netherlands as a dark warning that once PAD is legalized, restricting it will prove impossible because safeguards, such as the requirement that a patient be terminally ill, will inevitably be eroded or discarded...
September 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28936597/terminal-weaning-or-immediate-extubation-for-withdrawing-mechanical-ventilation-in-critically-ill-patients-the-arreve-observational-study
#20
René Robert, Amélie Le Gouge, Nancy Kentish-Barnes, Alice Cottereau, Bruno Giraudeau, Mélanie Adda, Djillali Annane, Juliette Audibert, François Barbier, Patrick Bardou, Simon Bourcier, Jeremy Bourenne, Alexandre Boyer, François Brenas, Vincent Das, Arnaud Desachy, Jérôme Devaquet, Marc Feissel, Frédérique Ganster, Maïté Garrouste-Orgeas, Guillaume Grillet, Olivier Guisset, Rebecca Hamidfar-Roy, Anne-Claire Hyacinthe, Sebastien Jochmans, Mercé Jourdain, Alexandre Lautrette, Nicolas Lerolle, Olivier Lesieur, Fabien Lion, Philippe Mateu, Bruno Megarbane, Sybille Merceron, Emmanuelle Mercier, Jonathan Messika, Paul Morin-Longuet, Bénédicte Philippon-Jouve, Jean-Pierre Quenot, Anne Renault, Xavier Repesse, Jean-Philippe Rigaud, Ségolène Robin, Antoine Roquilly, Amélie Seguin, Didier Thevenin, Patrice Tirot, Isabelle Vinatier, Elie Azoulay, Jean Reignier
PURPOSE: The relative merits of immediate extubation versus terminal weaning for mechanical ventilation withdrawal are controversial, particularly regarding the experience of patients and relatives. METHODS: This prospective observational multicentre study (ARREVE) was done in 43 French ICUs to compare terminal weaning and immediate extubation, as chosen by the ICU team. Terminal weaning was a gradual decrease in the amount of ventilatory assistance and immediate extubation was extubation without any previous decrease in ventilatory assistance...
September 22, 2017: Intensive Care Medicine
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