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Poor end-of-life care

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https://www.readbyqxmd.com/read/28631517/what-factors-influence-emergency-department-visits-by-patients-with-cancer-at-the-end-of-life-analysis-of-a-124-030-patient-cohort
#1
Lesley A Henson, Irene J Higginson, Wei Gao
BACKGROUND: Emergency department visits towards the end of life by patients with cancer are increasing over time. This is despite evidence of an association with poor patient and caregiver outcomes and most patients preferring home-based care. AIM: To identify socio-demographic and clinical factors associated with end-of-life emergency department visits and determine the relationship between patients' prior emergency department use and risk of multiple (⩾2) visits in the last month of life...
June 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28629338/a-phase-2-randomized-trial-to-evaluate-the-impact-of-a-supervised-exercise-program-on-cardiotoxicity-at-3%C3%A2-months-in-patients-with-her2-overexpressing-breast-cancer-undergoing-adjuvant-treatment-by-trastuzumab-design-of-the-cardapac-study
#2
Quentin Jacquinot, Nathalie Meneveau, Marion Chatot, Franck Bonnetain, Bruno Degano, Malika Bouhaddi, Gilles Dumoulin, Dewi Vernerey, Xavier Pivot, Fabienne Mougin
BACKGROUND: The overexpression of human epidermal growth factor receptor-2 (HER2) in breast cancer is a poor prognosis. Trastuzumab improves overall survival but is associated with cardiotoxicity, especially a decline in left ventricular ejection fraction (LVEF). In addition, chemotherapy and radiotherapy increase fatigue and pain, decrease physical capacity and health-related quality of life. To date, no study has evaluated the benefits of physical activity on the side effects of treatment in patients with HER2 positive breast cancer...
June 19, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28623155/care-toward-the-end-of-life-in-older-populations-and-its-implementation-facilitators-and-barriers-a-scoping-review
#3
REVIEW
Diane Erin Threapleton, Roger Y Chung, Samuel Y S Wong, Eliza L Y Wong, Nicole Kiang, Patsy Y K Chau, Jean Woo, Vincent C H Chung, Eng Kiong Yeoh
PURPOSE: To inform health system improvements for care of elderly populations approaching the end of life (EOL) by identifying important elements of care and implementation barriers and facilitators. DESIGN: A scoping review was carried out to identify key themes in EOL care. Articles were identified from MEDLINE, the Cochrane Library, organizational websites, and internet searches. Eligible publications included reviews, reports, and policy documents published between 2005 and 2016...
June 13, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28619775/retrospective-cohort-study-of-all-deaths-among-infants-born-between-22-and-27-completed-weeks-of-gestation-in-switzerland-over-a-3-year-period
#4
T M Berger, M A Steurer, H U Bucher, J C Fauchère, M Adams, R E Pfister, R Baumann-Hölzle, D Bassler
OBJECTIVES: The aim of this research is to assess causes and circumstances of deaths in extremely low gestational age neonates (ELGANs) born in Switzerland over a 3-year period. DESIGN: Population-based, retrospective cohort study. SETTING: All nine level III perinatal centres (neonatal intensive care units (NICUs) and affiliated obstetrical services) in Switzerland. PATIENTS: ELGANs with a gestational age (GA) <28 weeks who died between 1 July 2012 and 30 June 2015...
June 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28617167/patient-reported-barriers-to-the-prekidney-transplant-evaluation-in-an-at-risk-population-in-the-united-states
#5
Mark B Lockwood, Milda R Saunders, Rachel Nass, Claire L McGivern, Patrick N Cunningham, W James Chon, Michelle A Josephson, Yolanda T Becker, Christopher S Lee
BACKGROUND: Despite our knowledge of barriers to the early stages of the transplant process, we have limited insight into patient-reported barriers to the prekidney transplant medical evaluation in populations largely at-risk for evaluation failure. METHODS: One-hundred consecutive adults were enrolled at an urban, Midwestern transplant center. Demographic, clinical, and quality of life data were collected prior to patients visit with a transplant surgeon/nephrologist (evaluation begins)...
June 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/28596151/survey-on-advance-care-planning-of-italian-outpatients-on-chronic-haemodialysis
#6
Nicola Panocchia, Giuseppe Tonnara, Roberta Minacori, Dario Sacchini, Maurizio Bossola, Luigi Tazza, Giovanni Gambaro, Antonio Gioacchino Spagnolo
OBJECTIVES: The clinical practice guidelines published by the Renal Physicians Association (USA) recommend instituting advance care planning (ACP) for patients with end-stage renal disease. Studies on this issue are lacking in Italy. Our aim was to determine the attitudes of patients on ACP in our dialysis centre. METHODS: We performed a cross-sectional survey. We recruited patients on maintenance haemodialysis (HD) at Hemodialysis Center of Università Cattolica del Sacro Cuore, from 1 March 2014 to 31 March 2015...
June 8, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28554221/a-review-of-prognostic-tools-in-heart-failure
#7
Jennifer Treece, Hrak Chemchirian, Neil Hamilton, Manar Jbara, Venkataramanan Gangadharan, Timir Paul, Steven J Baumrucker
A minority of patients with end-stage disease are referred to palliative medicine for consultation in advanced heart failure. Educating stakeholders, including primary care, cardiology, and critical care of the benefits of hospice and palliative medicine for patients with poor prognosis, may increase appropriately timed referrals and improve quality of life for these patients. This article reviews multiple tools useful in prognostication in the setting of advanced heart failure.
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28552003/-i-m-only-dealing-with-the-acute-issues-how-medical-ward-busyness-constrains-care-of-the-dying
#8
Lisa S Chan, Mary Ellen Macdonald, Franco A Carnevale, S Robin Cohen
Acute hospital units are a common location of death. Curative characteristics of the acute medical setting make it difficult to provide adequate palliative care; these characteristics include an orientation to life-prolonging treatment, an emphasis on routine or task-oriented care and a lack of priority on emotional engagement with patients. Indeed, research shows that dying patients in acute medical units often experience unmet needs at the end of life, including uncontrolled symptoms (e.g. pain, breathlessness), inadequate emotional support and poor communication...
May 1, 2017: Health (London)
https://www.readbyqxmd.com/read/28528421/end-of-life-care-for-glioblastoma-patients-at-a-large-academic-cancer-center
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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