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Poor end-of-life care

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https://www.readbyqxmd.com/read/28528421/end-of-life-care-for-glioblastoma-patients-at-a-large-academic-cancer-center
#1
Kamini E Kuchinad, Roy Strowd, Anne Evans, W Anthony Riley, Thomas J Smith
Glioblastoma (GBM) is a universally fatal disease, complicated by significant cognitive and physical disabilities, inherent to the disease course. The purpose of this study was to retrospectively analyze end-of-life care for GBM patients at an academic center and compare utilization of these services to national quality of care guidelines, with the goal of identifying opportunities to improve end-of-life care. Single center retrospective cohort study of GBM patients at Johns Hopkins Hospital (JHH) between 2009 and 2014, using electronic medical records and hospice records...
May 20, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28507910/penile-calciphylaxis-the-use-of-radiological-investigations-in-the-management-of-a-rare-and-challenging-condition
#2
Rebecca A Campbell, Laith M Alzweri, Nikolai A Sopko, Katarzyna J Macura, Arthur L Burnett
Penile calciphylaxis is a rare phenomenon of penile necrosis observed in patients with hemodialysis-dependent end-stage renal failure. Multiple treatments have been proposed including conservative management, surgical debridement and penectomy; yet, the prognosis remains extremely poor. Here, we describe a patient with protracted resolution of dry gangrene of the glans, which failed conservative management of wound care and pain management. Radiological studies revealed extensive calcification of abdominal aorta and branching vessels including the penile arteries...
July 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28506865/protocol-driven-neurological-prognostication-and-withdrawal-of-life-sustaining-therapy-after-cardiac-arrest-and-targeted-temperature-management
#3
Irina Dragancea, Matthew P Wise, Nawaf Al-Subaie, Julius Cranshaw, Hans Friberg, Guy Glover, Tommaso Pellis, Rebecca Rylance, Andrew Walden, Niklas Nielsen, Tobias Cronberg
BACKGROUND: Brain injury is reportedly the main cause of death for patients resuscitated after out-of-hospital cardiac arrest (OHCA). However, the majority may actually die following withdrawal of life-sustaining therapy (WLST) with a presumption of poor neurological recovery. We investigated how the protocol for neurological prognostication was used and how related treatment recommendations might have affected WLST decision-making and outcome after OHCA in the Targeted Temperature Management (TTM) trial...
May 12, 2017: Resuscitation
https://www.readbyqxmd.com/read/28506309/social-isolation-and-cancer-management-advanced-rectal-cancer-with-patient-delay-following-the-2011-triple-disaster-in-fukushima-japan-a-case-report
#4
Akihiko Ozaki, Claire Leppold, Toyoaki Sawano, Masaharu Tsubokura, Manabu Tsukada, Tetsuya Tanimoto, Masahiro Kami, Hiromichi Ohira
BACKGROUND: Little is known about the effects of social isolation in the elderly on their process of gaining health information and seeking health care. CASE PRESENTATION: In March 2011, Fukushima, Japan experienced an earthquake, tsunami, and nuclear disaster, also known as Japan's triple disaster. In June 2016, an 80-year-old Japanese man, who lived alone after divorce at the age of 42, presented to our hospital with bloody stools and dizziness. Although his bloody stools initially occurred in May 2015, a year earlier, he did not pursue the possibility of malignancy...
May 16, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28502866/what-is-inappropriate-hospital-use-for-elderly-people-near-the-end-of-life-a-systematic-review
#5
REVIEW
Magnolia Cardona-Morrell, James C H Kim, Mikkel Brabrand, Blanca Gallego-Luxan, Ken Hillman
BACKGROUND: Older people with advance chronic illness use hospital services repeatedly near the end of life. Some of these hospitalizations are considered inappropriate. AIM: To investigate extent and causes of inappropriate hospital admission among older patients near the end of life. METHODS: English language publications in Medline, EMBASE, PubMed, Cochrane library, and the grey literature (January 1995-December 2016) covering community and nursing home residents aged ≥60years admitted to hospital...
May 11, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28502266/refining-the-frommelt-attitude-toward-the-care-of-the-dying-scale-fatcod-b-for-medical-students-a-confirmatory-factor-analysis-and-rasch-validation-study
#6
Barbara Loera, Giorgia Molinengo, Marco Miniotti, Paolo Leombruni
OBJECTIVE: Given the increasing number of patients requiring palliative care and the need for more professionals who are able to provide care for the dying comfortably, assessment of medical attitudes toward end-of-life care is becoming a key aspect of medical education. The present study aimed to establish whether the Frommelt Attitude Toward the Care Of the Dying, Form B (FATCOD-B) meets current psychometric standards of validity for an assessment tool in medical education. METHOD: The participants were 200 undergraduate medical students...
May 15, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/28501134/factors-associated-with-palliative-care-use-in-patients-undergoing-cytoreductive-surgery-and-hyperthermic-intraperitoneal-chemotherapy
#7
Rachel S Morris, Faiz Gani, Abdulrahman Y Hammad, Wendy Peltier, T Clark Gamblin, Kiran K Turaga, Fabian M Johnston
BACKGROUND: Peritoneal carcinomatosis represents widespread metastatic disease throughout the abdomen and/or pelvis. Cytoreductive surgery/hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) improves the overall survival compared to standard therapy alone. The role palliative care (PC) plays however, remains poorly studied among these patients. METHODS: Patients who had previously undergone HIPEC and who underwent an inpatient admission from 7/1/2013 to 6/30/2014 were identified to determine which patients were referred for inpatient or outpatient palliative consultation...
May 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28499512/the-organ-transplant-imperative
#8
REVIEW
Wil L Santivasi, Jacob J Strand, Paul S Mueller, Thomas J Beckman
More than 120,000 US patients were listed for solid organ transplants in 2016. Although data are scarce, we suspect that many of these patients will die while awaiting transplant and without engaging in goals-of-care discussions with their physicians. The challenges of addressing goals of care in patients with malignancy, end-stage renal disease, and heart failure have been studied. However, there is sparse literature on addressing goals of care throughout the dynamic process of transplant assessment and listing...
May 10, 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28493926/obesity-and-access-to-kidney-transplantation-in-patients-starting-dialysis-a-prospective-cohort-study
#9
Mathilde Lassalle, Léopold K Fezeu, Cécile Couchoud, Thierry Hannedouche, Ziad A Massy, Sébastien Czernichow
BACKGROUND: Obesity has been linked to poor access to medical care. Although scientific evidence suggest that kidney transplantation improves survival and quality of life in obese patients with end-stage renal disease (ESRD), few data exist on the impact of obesity on access to kidney transplantation in this population. OBJECTIVES: We aimed to characterize the relationships between body mass index (BMI) at the start of dialysis, changes in BMI after the start of dialysis, and either access to kidney transplantation or overall mortality in dialysis or transplantation among ESRD patients...
2017: PloS One
https://www.readbyqxmd.com/read/28486892/cardiopulmonary-resuscitation-from-the-patient-s-perspective
#10
S Wee, Z Y Chang, Y H Lau, Yky Wong, Cym Ong
With increasing emphasis on patient autonomy, patients are encouraged to be more involved in end-of-life issues, including the use of extraordinary efforts to prolong their lives. Being able to make anticipatory decisions is seen to promote autonomy, empower patients and optimise patient care. To facilitate shared decision-making, patients need to have a clear and accurate understanding of cardiopulmonary resuscitation (CPR). This study aims to understand the knowledge and perspectives of the local community regarding resuscitation options and end-of-life decision-making and to explore ways to improve the quality of end-of-life discussions...
May 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28476296/rural-emergency-nurses-suggestions-for-improving-end-of-life-care
#11
Renea L Beckstrand, Kelly E Smith, Karlen E Beth Luthy, Janelle L B Macintosh
Many patient visits to emergency departments result in the patient dying or being pronounced dead on arrival. The numbers of deaths in emergency departments are likely to increase as a significant portion of the U.S. population ages. Consequently, emergency nurses face many obstacles to providing quality end-of-life (EOL) care when death occurs. The purpose of this study was to identify suggestions that emergency nurses have to improve EOL care, specifically in rural emergency departments. METHODS: A 57-item questionnaire was sent to 53 rural hospitals in 4 states in the Intermountain West, plus Alaska...
May 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28472598/supportive-cardiology-moving-palliative-care-upstream-for-patients-living-with-advanced-heart-failure
#12
Warren Harris Lewin, Wendy Cheung, A Nina Horvath, Shana Haberman, Archna Patel, Dorothy Sullivan
Heart failure (HF) affects ∼600,000 Canadians and is a chronic, life-limiting illness marked by exacerbations of distressing symptoms requiring acute medical management, typically sought in Canada's emergency departments. HF often has an unpredictable illness trajectory and is a chronic terminal illness with a poor prognosis. Patients living with advanced HF have difficulty in accessing palliative care (PC) supports, which can result in unnecessary suffering as their HF progresses and they near end of life (EOL)...
May 4, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28471764/palliative-care-in-surgery-defining-the-research-priorities
#13
Elizabeth J Lilley, Zara Cooper, Margaret L Schwarze, Anne C Mosenthal
OBJECTIVE: To describe the existing science of palliative care in surgery within three priority areas and expose specific gaps within the field. BACKGROUND: Given the acute and often life-limiting nature of surgical illness, as well as the potential for treatment to induce further suffering, surgical patients have considerable palliative care needs. Yet these patients are less likely to receive palliative care than their medical counterparts and palliative care consultations often occur when death is imminent, reflecting poor quality end-of-life care...
May 3, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28462236/palliative-and-end-of-life-care-conversations-in-copd-a-systematic-literature-review
#14
REVIEW
Nuno Tavares, Nikki Jarrett, Katherine Hunt, Tom Wilkinson
Chronic obstructive pulmonary disease (COPD) is a chronic life-limiting disorder characterised by persistent airflow obstruction and progressive breathlessness. Discussions/conversations between patients and clinicians ensure palliative care plans are grounded in patients' preferences. This systematic review aimed to explore what is known about palliative care conversations between clinicians and COPD patients. A comprehensive search of all major healthcare-related databases and websites was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines...
April 2017: ERJ Open Research
https://www.readbyqxmd.com/read/28450219/terminally-ill-taiwanese-cancer-patients-and-family-caregivers-agreement-on-patterns-of-life-sustaining-treatment-preferences-is-poor-to-fair-and-declines-over-a-decade-results-from-two-independent-cross-sectional-studies
#15
Tsang-Wu Liu, Fur-Hsing Wen, Cheng-Hsu Wang, Ruey-Long Hong, Jyh-Ming Chow, Jen-Shi Chen, Chang-Fang Chiu, Siew Tzuh Tang
CONTEXT/OBJECTIVE: Temporal changes have not been examined in patient-caregiver agreement on life-sustaining treatment (LST) preferences at end of life (EOL). We explored the extent of and changes in patient-caregiver agreement on LST-preference patterns for two independent cohorts of Taiwanese cancer patient-family caregiver dyads recruited a decade apart. METHODS: We surveyed preferences for cardiopulmonary resuscitation, intensive care unit care, cardiac massage, intubation with mechanical ventilation, intravenous nutritional support, tube feeding, and dialysis among 1049 and 1901 dyads in 2003-2004 and 2011-2012, respectively...
April 24, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28437385/before-or-after-transplantation-a-review-of-the-cost-effectiveness-of-treating-waitlisted-patients-with-hepatitis-c
#16
Elliot B Tapper, Nezam H Afdhal, Michael P Curry
All patients with chronic hepatitis C virus (HCV) infections can and should be treated. Though highly effective direct-acting antiviral therapies are costly, the price of a cure is a 1-time investment that is outweighed by future benefits. For clinicians caring for patients requiring liver transplant, the key question relates to the timing of treatment: before or after liver transplantation? On 1 hand, treating HCV often improves our patients' model for end-stage liver disease (MELD) score, decreasing costs, and potentially improving longevity by reducing our patients' risk of death and transplantation...
May 2017: Transplantation
https://www.readbyqxmd.com/read/28432089/preparing-future-doctors-for-palliative-care-views-of-course-organisers
#17
Steven Walker, Jane Gibbins, Paul Paes, Stephen Barclay, Astrid Adams, Madawa Chandratilake, Faye Gishen, Philip Lodge, Bee Wee
BACKGROUND: Effective training at medical school is essential to prepare new doctors to safely manage patients with palliative care (PC) and end of life care (EOLC) needs. The contribution of undergraduate PC course organisers is central but their collective views regarding role are unknown. OBJECTIVE: To survey attitudes of PC course organisers regarding their course, organisation, the adequacy of training provided and level of personal satisfaction. METHODS: An anonymised, multifactorial, web-based questionnaire was devised, tested, modified and then sent to lead PC course organisers at all UK medical schools...
April 21, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28387570/seeking-and-accepting-u-s-clergy-theological-and-moral-perspectives-informing-decision-making-at-the-end-of-life
#18
Justin J Sanders, Vinca Chow, Andrea C Enzinger, Tai-Chung Lam, Patrick T Smith, Rebecca Quiñones, Andrew Baccari, Sarah Philbrick, Gloria White-Hammond, John Peteet, Tracy A Balboni, Michael J Balboni
BACKGROUND: People with serious illness frequently rely on religion/spirituality to cope with their diagnosis, with potentially positive and negative consequences. Clergy are uniquely positioned to help patients consider medical decisions at or near the end of life within a religious/spiritual framework. OBJECTIVE: We aimed to examine clergy knowledge of end-of-life (EOL) care and beliefs about the role of faith in EOL decision making for patients with serious illness...
April 7, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28361048/screening-for-hypertension-in-children-and-adolescents-methodology-and-current-practice-recommendations
#19
REVIEW
Michaela N Lewis, Ibrahim F Shatat, Shannon M Phillips
Hypertension (HTN) requires urgent, uniform, and consistent attention across all frontiers of pediatric health care not only because of established links between the onset of HTN during one's youth and its sustenance throughout adulthood but also because of the sequelae associated with the disease's trajectory, such as cardiovascular disease, end organ damage, and decreased quality of life. Although national guidelines for the diagnosis and management of pediatric HTN have been available for nearly 40 years, knowledge and recognition of the problem by clinicians remain poor due to a host of influencing factors...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28358269/gaps-in-understanding-the-experiences-of-homecare-workers-providing-care-for-people-with-dementia-up-to-the-end-of-life-a-systematic-review
#20
Valerie D'Astous, Ruth Abrams, Tushna Vandrevala, Kritika Samsi, Jill Manthorpe
This systematic review of the literature explores the perspectives and experiences of homecare workers providing care for people with dementia living at home up to the end of life. A search of major English language databases in 2016 identified 378 studies on the topic, of which 12 met the inclusion criteria. No empirical research was identified that specifically addressed the research question. However, synthesis of the findings from the broader literature revealed three overarching themes: value of job role, emotional labour and poor information and communication...
January 1, 2017: Dementia
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