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Palliative medicine

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https://www.readbyqxmd.com/read/29775550/palliative-sedation-with-oral-medicines-in-an-infant-with-generalized-severe-junctional-epidermolysis-bullosa
#1
Keith P Pasichow, Meg Frizzola, Elissa G Miller
Generalized severe junctional epidermolysis bullosa is a rare mechanobullous skin disorder that is uniformly fatal. We present the case of an infant who received palliative pain management and ultimately proportionate palliative sedation. However, because of the extent of the patient's skin disease, we were unable to provide palliative medication through parenteral routes. We discuss the provision of enteral palliative sedation, including the pharmacology, and creative use of medications to achieve sufficient palliation in this difficult and unique situation...
May 18, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29772280/an-analysis-of-palliative-care-development-in-africa-a-ranking-based-on-region-specific-macro-indicators
#2
John Y Rhee, Eduardo Garralda, Eve Namisango, Emmanuel Luyirika, Liliana de Lima, Richard A Powell, Jesús López-Fidalgo, Carlos Centeno
CONTEXT: To date, there is no study comparing palliative care (PC) development among African countries. OBJECTIVE: To analyze comparatively PC development in African countries based on region-specific indicators. METHODS: Data were obtained from the APCA Atlas of PC in Africa and a comparative analysis conducted. Nineteen indicators were developed and defined through qualitative interviews with African PC experts and a two-round modified Delphi consensus process with international experts on global PC indicators...
May 14, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29771351/burn-surgeon-and-palliative-care-physician-attitudes-regarding-goals-of-care-delineation-for-burned-geriatric-patients
#3
Holly B Cunningham, Shannon A Scielzo, Paul A Nakonezny, Brandon R Bruns, Karen J Brasel, Kenji Inaba, Scott C Brakenridge, Jeffrey D Kerby, Bellal A Joseph, M J Mohler, Joseph Cuschieri, Mary E Paulk, Akpofure P Ekeh, Tarik D Madni, Luis R Taveras, Jonathan B Imran, Steven E Wolf, Herb A Phelan
Objective: Palliative care specialists and burn surgeons were surveyed regarding: 1) importance of goals of care conversations for burned seniors; 2) confidence in their own specialty's ability to conduct these conversations; and 3) confidence in the ability of the other specialty to do so. Methods: A 13-item survey was developed by the steering committee of a multi-center consortium dedicated to palliative care in the injured geriatric patient and beta-tested by burn surgeons and palliative care specialists unaffiliated with the consortium...
May 16, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/29770299/regenerative-medicine-therapy-for-single-ventricle-congenital-heart-disease
#4
REVIEW
Chetan Ambastha, Gregory J Bittle, David Morales, Nathaniel Parchment, Progyaparamita Saha, Rachana Mishra, Sudhish Sharma, Alexander Vasilenko, Muthukumar Gunasekaran, Manal T Al-Suqi, Deqiang Li, Peixin Yang, Sunjay Kaushal
One of the most complex forms of congenital heart disease (CHD) involving single ventricle physiology is hypoplastic left heart syndrome (HLHS), characterized by underdevelopment of the left ventricle (LV), mitral and aortic valves, and narrowing of the ascending aorta. The underdeveloped LV is incapable of providing long-term systemic flow, and if left untreated, the condition is fatal. Current treatment for this condition consists of three consecutive staged palliative operations: the first is conducted within the first few weeks of birth, the second between 4 to 6 months, and the third and final surgery within the first 4 years...
April 2018: Translational Pediatrics
https://www.readbyqxmd.com/read/29764177/solidarity-and-compassion-prisoners-as-hospice-volunteers-in-poland
#5
Piotr Krakowiak, Renata Deka, Anna Janowicz
Democracy in Eastern Europe arrived after a long fight with a communist regime, and the activities of medical volunteers have been developing in opposition to the existing then in Poland mentality called Homo Sovieticus. From 1981 onwards the Polish Hospice Movement there was inspired by practitioners and international experiences brought by visits of Dr. Cicely Saunders. The history of modern end-of-life care in Poland was connected to caring communities, which could be called compassionate, because of the volunteering of all hospice team members...
April 2018: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29762074/use-of-artificial-hydration-at-the-end-of-life-a-survey-of-australian-and-new-zealand-palliative-medicine-doctors
#6
Jacqueline Oehme, Caitlin Sheehan
BACKGROUND: Dying is ubiquitous, yet the optimal management of hydration in the terminal phase is undetermined. Palliative care (PC) doctors' practices may act as a de facto measure of the benefits and burdens of artificial hydration (AH) use. OBJECTIVE: To identify PC doctors' AH prescribing practices for imminently dying patients and possible influencing factors. METHODS: An online survey of doctors belonging to the Australian and New Zealand Society of Palliative Medicine...
May 15, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29755917/sharing-is-caring-minimizing-the-disruption-with-palliative-care
#7
EDITORIAL
Abd Moain Abu Dabrh, Robert P Shannon, Richard J Presutti
There is an upward trend incidence of multiple chronic life-limiting conditions with a well-documented associated impact on patients and their caregivers. When patients approach the end of life, they are often faced with a challenging multidimensional burden while navigating a complex health care system. Patients and families/caregivers are faced with daily decisions, often with little or no frame of reference or medical knowledge. The "what, how, when, and where" puzzle during this challenging time can be overwhelming for patients and their families, and when clinicians do not contemplate this associated workload's impact on patients and caregivers' capacity for self-care, patients and caregivers scramble to find compensatory solutions, often putting their health care at lower priority...
March 13, 2018: Curēus
https://www.readbyqxmd.com/read/29744546/-supportive-therapy-best-supportive-care-and-palliative-medicine
#8
EDITORIAL
M Retz, H J Bardenheuer
No abstract text is available yet for this article.
May 2018: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/29742049/a-new-frontier-in-palliative-medicine-research-is-needed
#9
Charles F von Gunten
No abstract text is available yet for this article.
May 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29737962/perceived-barriers-and-facilitators-to-goals-of-care-discussions-in-the-emergency-department-a-descriptive-analysis-of-the-views-of-emergency-medicine-physicians-and-residents
#10
Niran Argintaru, Kieran L Quinn, Lucas B Chartier, Jacques Lee, Paul Hannam, Erin O'Connor, Leah Steinberg, Howard Ovens, Melissa McGowan, Samuel Vaillancourt
CLINICIAN'S CAPSULE What is known about the topic? Goals of care discussions (GOC) are critical to reflecting patients' preferences in the provision of acute care, yet these discussions can be challenging to have in the emergency department (ED) setting. What did this study ask? What are emergency physicians' perspectives on barriers and facilitators to GOC discussions? What did this study find? In this survey of emergency medicine attending and resident physicians, the majority reported feeling comfortable and adequately trained to conduct GOC discussions...
May 8, 2018: CJEM
https://www.readbyqxmd.com/read/29736929/determinants-of-regret-in-elderly-dialysis-patients
#11
Edlyn Gui Fang Tan, Irene Teo, Eric A Finkelstein, Choong Meng Chan
BACKGROUND: In Singapore, most elderly end stage renal disease (ESRD) patients choose dialysis over palliative management. However, dialysis may not be the optimal treatment option given only moderate survival benefits and high costs and treatment burden compared to non-dialysis management. Elderly patients may therefore come to regret this decision. This study investigated (1) extent of patients' decision regret after starting dialysis, and (2) potentially modifiable predictors of regret: satisfaction with chronic kidney disease education, decisional conflict, and decision-making involvement...
May 7, 2018: Nephrology
https://www.readbyqxmd.com/read/29736868/a-pragmatic-comparative-study-of-palliative-care-clinician-s-reports-of-the-degree-of-shadowing-visible-on-plain-abdominal-radiographs
#12
Katherine Clark, L Lam, N J Talley, G Watts, J L Phillips, N J Byfieldt, D C Currow
The assessment of constipation symptoms is based on history and physical examination. However, the experience is highly subjective perhaps explaining why palliative medicine doctors continue to use plain abdominal radiographs as part of routine assessment of constipation. Previous studies have demonstrated poor agreement between clinicians with this work in palliative care, limited further by disparity of clinicians' experience and training. The aim of this work was to explore whether there was less variation in the assessments of faecal shadowing made by more experienced clinicians compared to their less experienced colleagues...
May 7, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29732904/characterization-categorization-and-5-year-mortality-of-medicine-high-utilizer-inpatients
#13
Joyeeta G Dastidar, Min Jiang
BACKGROUND: Patients who are frequently admitted to Medicine inpatient services comprise a distinct subset of readmitted patients about whom not much is known. OBJECTIVE: We sought to characterize this group including mortality rates, with the goal of better understanding this population. DESIGN: Observational study of frequently hospitalized patients defined as 4 or more admissions over a 6-month period, with hospitalization defined as nonelective admission to the hospital...
January 1, 2018: Journal of Palliative Care
https://www.readbyqxmd.com/read/29729119/palliative-care-in-end-stage-liver-disease-time-to-do-better
#14
REVIEW
Chiara Mazzarelli, Wendy M Prentice, Michael A Heneghan, Luca S Belli, Kosh Agarwal, Mary D Cannon
Optimal involvement of palliative care services in the management of patients with decompensated cirrhosis and end-stage liver disease is limited. This may result from both ignorance and the failure to recognize the spectrum and unpredictability of the underlying liver condition. Palliative care is a branch of medicine that focuses on quality of life by optimizing symptom management and providing psychosocial, spiritual, and practical support for both patients and their caregivers. Historically, palliative care has been underutilized for patients with decompensated liver disease...
May 5, 2018: Liver Transplantation
https://www.readbyqxmd.com/read/29727264/palliative-medicine-family-conferences-reduce-spokesperson-distress-and-enhance-communication-in-advanced-cancer
#15
Ruth D Powazki, Declan Walsh, Aynur Aktas, Katherine Hauser
INTRODUCTION: Family conferences (FCs) may be important in communication. There is limited evidence about their value in palliative medicine. We examined specific information needs of patient-identified spokespersons (SP) and if the needs were met by a subsequent FC. Further data were collected on FC attendee characteristics, changes in SP distress, and SP assessment of FC value. METHODS: We conducted a prospective observational study of the family SP perspective of consecutive first time palliative medicine FCs for cancer patients...
May 4, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29720039/palliative-medicine-advance-care-planning-virtual-issue
#16
Sarah Russell
Since the latter part of the twentith century, international research, education and practice of advance care planning has experienced a diversity of developments and defintions. Whilst this variety may seem bewildering, a continued commitment to accurate, focussed research enables better care through better understanding and better evidence.
May 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29717986/aortic-dissecting-aneurysm-associated-with-systemic-arterial-hypertension-in-a-cat
#17
V Gouni, S Papageorgiou, J Debeaupuits, C Damoiseaux, J Pouchelon, V Chetboul
Aortic dissection is characterized by a tear in the aortic wall resulting in blood from the aortic lumen penetrating into the media, which causes dissection. When aortic dissection does not cause rupture, it provokes localized dilation of the aorta or aneurism, also called dissecting aortic aneurism (DAA). This case report describes a DAA in a cat associated with systemic arterial hypertension (SAHT). A 10-year-old male Domestic shorthair cat was presented for cardiac evaluation. Anamnestic clinical complaints were a syncope associated with paraparesis and weak femoral pules...
May 2018: Schweizer Archiv Für Tierheilkunde
https://www.readbyqxmd.com/read/29673712/update-on-systemic-prostate-cancer-therapies-management-of-metastatic-castration-resistant-prostate-cancer-in-the-era-of-precision-oncology
#18
REVIEW
Philipp Nuhn, Johann S De Bono, Karim Fizazi, Stephen J Freedland, Maurizio Grilli, Philip W Kantoff, Guru Sonpavde, Cora N Sternberg, Srinivasan Yegnasubramanian, Emmanuel S Antonarakis
CONTEXT: Introduction of novel agents for the management of advanced prostate cancer provides a range of treatment options with notable benefits for men with metastatic castration-resistant prostate cancer (mCRPC). At the same time, understanding of optimal patient selection, effective sequential use, and development of resistance patterns remains incomplete. OBJECTIVE: To review current systemic therapies and recent advances in drug development for mCRPC and strategies to aid in patient selection and optimal sequencing...
April 16, 2018: European Urology
https://www.readbyqxmd.com/read/29671078/palliative-care-in-heart-failure
#19
REVIEW
Abhinav Sood, Krista Dobbie, W H Wilson Tang
PURPOSE OF REVIEW: This review illustrates the dynamic role of palliative care in heart failure management and encapsulates the commonly utilized pharmacologic and non-pharmacologic therapeutic strategies for symptom palliation in heart failure. In addition, we provide our experience regarding patient care issues common to the domain of heart failure and palliative medicine which are commonly encountered by heart failure teams. RECENT FINDINGS: Addition of palliative care to conventional heart failure management plan results in improvement in quality of life, anxiety, depression, and spiritual well-being among patients...
April 19, 2018: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29669454/palliative-nursing-and-sacred-medicine-a-holistic-stance-on-entheogens-healing-and-spiritual-care
#20
William E Rosa, Stephanie Hope, Marianne Matzo
The fields of palliative and holistic nursing both maintain a commitment to the care of the whole person, including a focus on spiritual care. Advanced serious illness may pose a plethora of challenges to patients seeking to create meaning and purpose in their lives. The purpose of this article is to introduce scholarly dialogue on the integration of entheogens, medicines that engender an experience of the sacred, into the spiritual and holistic care of patients experiencing advanced serious illness. A brief history of the global use of entheogens as well as a case study are provided...
April 1, 2018: Journal of Holistic Nursing: Official Journal of the American Holistic Nurses' Association
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