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Palliative medicine

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https://www.readbyqxmd.com/read/28086792/irish-general-practitioner-attitudes-toward-decriminalisation-and-medical-use-of-cannabis-results-from-a-national-survey
#1
Des Crowley, Claire Collins, Ide Delargy, Eamon Laird, Marie Claire Van Hout
BACKGROUND: Governmental debate in Ireland on the de facto decriminalisation of cannabis and legalisation for medical use is ongoing. A cannabis-based medicinal product (Sativex®) has recently been granted market authorisation in Ireland. This unique study aimed to investigate Irish general practitioner (GP) attitudes toward decriminalisation of cannabis and assess levels of support for use of cannabis for therapeutic purposes (CTP). METHODS: General practitioners in the Irish College of General Practitioner (ICGP) database were invited to complete an online survey...
January 13, 2017: Harm Reduction Journal
https://www.readbyqxmd.com/read/28065700/integrating-supportive-care-principles-into-dialysis-decision-making-a-primer-for-palliative-medicine-providers
#2
Alvin H Moss
Despite advances in pre-dialysis care and dialysis technology, patients with advanced chronic kidney disease and end-stage renal disease continue to experience multiple comorbidities, a high symptom burden, a shortened life expectancy and substantial physical, emotional, and spiritual suffering. Patients with acute kidney injury and end-stage renal disease, especially if they are older, often undergo prolonged hospitalizations, greater use of intensive medical treatment, and limited survival. Unfortunately, most nephrologists are not trained to conduct shared decision-making conversations to elicit patients' values, preferences, and goals for treatment and address their patients' multifactorial suffering...
January 5, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28062333/electronic-goals-of-care-alerts-an-innovative-strategy-to-promote-primary-palliative-care
#3
Erin M Haley, Deborah Meisel, Yevgeniy Gitelman, Laura Dingfield, David J Casarett, Nina R O'Connor
CONTEXT: Given the shortage of palliative care specialists, strategies are needed to promote primary palliative care by non-palliative care providers. Electronic reminders are frequently used in medicine to standardize practice, but their effectiveness in encouraging goals of care discussions is not well understood. OBJECTIVES: To determine whether brief education and electronic alerts increase the frequency of goals of care discussions. METHODS: All general medicine services at a large academic medical center were included...
January 3, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28056512/palliative-care-exposure-in-internal-medicine-residency-education
#4
Asher Edwards, Samuel Nam
As the baby boomer generation ages, the need for palliative care services will be paramount and yet training for palliative care physicians is currently inadequate to meet the current palliative care needs. Nonspecialty-trained physicians will need to supplement the gap between supply and demand. Yet, no uniform guidelines exist for the training of internal medicine residents in palliative care. To our knowledge, no systematic study has been performed to evaluate how internal medicine residencies currently integrate palliative care into their training...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28054241/characteristic-x-ray-imaging-for-palliative-therapy-using-strontium-89-chloride-understanding-the-mechanism-of-nuclear-medicine-imaging-of-strontium-89-chloride
#5
Yoshiki Owaki, Kazumasa Inoue, Hiroto Narita, Keisuke Tsuda, Masahiro Fukushi
Strontium-89 (Sr-89) chloride is a targeted palliative therapy used for painful bone metastasis in which repeated doses can be administered, and its usefulness has been reported in the case of bone metastasis of various primary tumors. However, the effectiveness of the pain relief treatment is only described using a subjective index such as the visual analog scale, which lacks objectivity. Although various attempts at quantifying the effectiveness of Sr-89 chloride therapy have been reported using nuclear medicine imaging for energy peaks around 70-80 keV, the principle of Sr-89 chloride imaging has not been explained...
January 4, 2017: Radiological Physics and Technology
https://www.readbyqxmd.com/read/28052721/the-practice-of-terminal-discharge
#6
Lalit Kumar Radha Krishna, Vengadasalam Murugam, Daniel Song Chiek Quah
'Terminal discharges' are carried out in Singapore for patients who wish to die at home. However, if due diligence is not exercised, parallels may be drawn with euthanasia. We present a theoretical discussion beginning with the definition of terminal discharges and the reasons why they are carried out in Singapore. By considering the intention behind terminal discharges and utilising a multidisciplinary team to deliberate on the clinical, social and ethical intricacies with a patient- and context-specific approach, euthanasia is avoided...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28043897/natural-products-against-alzheimer-s-disease-pharmaco-therapeutics-and-biotechnological-interventions
#7
REVIEW
Abhijit Dey, Raktim Bhattacharya, Anuradha Mukherjee, Devendra Kumar Pandey
Alzheimer's disease (AD) is a severe, chronic and progressive neurodegenerative disease associated with memory and cognition impairment ultimately leading to death. It is the commonest reason of dementia in elderly populations mostly affecting beyond the age of 65. The pathogenesis is indicated by accumulation of the amyloid-beta (Aβ) plaques and neurofibrillary tangles (NFT) in brain tissues and hyperphosphorylation of tau protein in neurons. The main cause is considered to be the formation of reactive oxygen species (ROS) due to oxidative stress...
December 30, 2016: Biotechnology Advances
https://www.readbyqxmd.com/read/28043807/on-the-ground-floor-looking-up-managing-trainees-uncertainty-at-the-end-of-life
#8
Ravi B Parikh, Dhruv Khullar
Recent US healthcare policy changes set the stage for integrating palliative and end-of-life care into routine medicine. However, these changes may not affect the daily practice of medical trainees-fellows, residents, and medical students-who as front-line care providers are not always equipped with the skills needed to treat terminally ill patients. We review evidence on trainees' discomfort with end-of-life care and highlight limitations of recent policy changes. Key barriers to proficiency include inadequate conversational training, prognostic uncertainty, and unfamiliarity with hospice and palliative care...
December 30, 2016: Healthcare
https://www.readbyqxmd.com/read/28042068/empowering-bereaved-parents-through-the-development-of-a-comprehensive-bereavement-program
#9
Jennifer M Snaman, Erica C Kaye, Deena R Levine, Brittany Cochran, Robin Wilcox, Charlene K Sparrow, Nancy Noyes, Lisa Clark, Wendy Avery, Justin N Baker
Parents who experience the loss of a child have unique and valuable insights into the grief journey and can help healthcare providers identify key components intrinsic to the development, implementation, and maintenance of a comprehensive bereavement program. The bereavement program at St. Jude Children's Research Hospital was developed by pediatric palliative care experts in collaboration with bereaved parents to standardize and improve the institutional support provided to families around and after the death of a child...
December 29, 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28042066/repurposing-medications-for-hospice-palliative-care-symptom-control-is-no-longer-sufficient-a-manifesto-for-change
#10
David C Currow, Amy P Abernethy, Marie Fallon, Russell K Portenoy
The World Health Organisation (WHO) essential medications list for hospice / palliative care reflects that, with the judicious use of currently available medications, the majority of symptoms can be lessened, and some controlled completely. Even with optimal use of current medications, symptom control is still unacceptable for many people. Currently available medications offer great benefit to a minority of patients, some benefit to an additional group, and no benefit or harms to others. In symptom control, development of new drugs is advancing at a glacial pace, contrasting to the rapid advances seen in many other disciplines...
December 29, 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28041869/-palliative-care-after-neonatal-intensive-care-contributions-of-leonetti-law-and-remaining-challenges
#11
P Kuhn, L Dillenseger, N Cojean, B Escande, C Zores, D Astruc
The 2005 enactment of the "Patients' rights and end-of-life care" act, known as the Leonetti law, has been accompanied by practical changes in the processes of withdrawal and withholding of active life-sustaining treatments. This law has also promoted the implementation of palliative care in perinatal medicine to avoid unreasonable therapeutic interventions and to preserve the dying patient's quality of life and human dignity. Recently, a new law has been voted by the French National Assembly and new reflections on the ethical aspects of the end of life in neonatal medicine should resume again within the French Society of Neonatology in the working group on ethical issues in neonatology...
December 29, 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28040092/global-access-to-radiotherapy-in-low-and-middle-income-countries
#12
M Abdel-Wahab, E Fidarova, A Polo
Over the last 60 years, the International Atomic Energy Agency (IAEA) has been working to introduce, expand and improve radiotherapy services, working with partners such as the World Health Organization (WHO) to improve cancer diagnosis, treatment, care and control through collective action in low- and middle-income countries (LMICs). The Lancet Oncology Commission on radiotherapy published a report that defined five calls for action to expand global access to radiotherapy, drawing on the previous work of the Global Taskforce on Radiotherapy for Cancer Control...
February 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/28034291/radiopharmaceuticals-for-diagnosis-and-therapy-of-neuroendocrine-differentiated-prostate-cancer
#13
Giampiero Giovacchini, Elisabetta Giovannini, Mattia Riondato, Andrea Ciarmiello
Neuroendocrine differentiation of prostate cancer (PCa) is a relatively frequent event, generally understudied, that carries important prognostic information. It is most frequently observed during the advanced stages of disease, when PCa has lost its sensitivity to androgen deprivation therapy or to chemotherapy, moderate to diffuse bone metastatic spread dominates the imaging scenario and it is responsible for painful clinical symptomatology. However, evidences indicate that neuroendocrine differentiation is a progressive phenomenon that starts at the very early part of the pathogenesis of cancer transformation contributing to it...
December 29, 2016: Current Radiopharmaceuticals
https://www.readbyqxmd.com/read/28029300/hospice-utilization-and-its-effect-on-acute-care-needs-at-the-end-of-life-in-medicare-beneficiaries-with-hepatocellular-carcinoma
#14
Hanna K Sanoff, YunKyung Chang, Melissa Reimers, Jennifer L Lund
INTRODUCTION: Hepatocellular carcinoma (HCC) is a poor-prognosis cancer with a high symptom burden. Multidisciplinary HCC care is complex and unique in cancer medicine. We sought to determine whether the distinct process affects hospice use and how hospice affects end-of-life acute care utilization. PATIENTS AND METHODS: Patients dying after HCC diagnosed from 2004 to 2011 were identified within SEER-Medicare. Hospice use and associated factors were described using logistic regression...
December 28, 2016: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28025426/life-and-medical-ethics-in-pediatric-neurosurgery
#15
Mami Yamasaki
Ethical issues in the field of pediatric neurosurgery, including prenatal diagnosis, palliative care for children with an intractable serious disease, and medical neglect, are discussed. An important role of medicine is to offer every possible treatment to a patient. However, it also is the responsibility of medicine to be conscious of its limitations, and to help parents love and respect a child who suffers from an incurable disease. When dealing with cases of medical neglect and palliative care for an incurable disease, it is critical to diagnose the child's condition accurately and evaluate the outcome...
December 26, 2016: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28024994/teaching-the-art-of-difficult-family-conversations
#16
Rita Dadiz, Michael L Spear, Erin Denney-Koelsch
CONTEXT: Difficult family conversations are a challenge for even the most seasoned clinicians. Teaching the skills of successful communication between providers, family members, and patients are a vital component of medical education. However, traditional teaching methods using didactics and expert role modeling are often inadequate. OBJECTIVES: The train-the-educator workshop aimed to teach educators how to create and conduct workshops on facilitating difficult family conversations that target their own learners' needs...
December 23, 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28009422/position-paper-of-the-italian-association-of-medical-oncology-on-early-palliative-care-in-oncology-practice-simultaneous-care
#17
Vittorina Zagonel, Vittorio Franciosi, Antonella Brunello, Guido Biasco, Chiara Broglia, Daniela Cattaneo, Luigi Cavanna, Domenico Corsi, Gabriella Farina, Luisa Fioretto, Teresa Gamucci, Gaetano Lanzetta, Roberto Magarotto, Marco Maltoni, Paolo Marchetti, Elena Massa, Cataldo Mastromauro, Barbara Melotti, Fausto Meriggi, Angelo Nacci, Ida Pavese, Erico Piva, Michela Quirino, Mario Roselli, Cosimo Sacco, Giuseppe Tonini, Leonardo Trentin, Giovanni Ucci, Roberto Labianca, Stefania Gori, Carmine Pinto, Stefano Cascinu
One of the priorities of personalized medicine regards the role of early integration of palliative care with cancer-directed treatments, called simultaneous care. This article, written by the Italian Association of Medical Oncology (AIOM) Simultaneous and Continuous Care Task Force, represents the position of Italian medical oncologists about simultaneous care, and is the result of a 2-step project: a Web-based survey among medical oncologists and a consensus conference. We present the opinion of more than 600 oncologists who helped formulate these recommendations...
December 19, 2016: Tumori
https://www.readbyqxmd.com/read/28001457/illustrating-and-analyzing-the-processes-of-interprofessional-collaboration-a-lesson-learned-from-palliative-care-in-deconstructing-the-concept
#18
Deborah Witt Sherman, Kinsuk Maitra, Yhovana Gordon, Sharon Simon, Maria Olenick, Salvatore Barbara, Jennifer Doherty-Restrepo, Monica Hough, Marilys Randolph, Arvindar Singh
BACKGROUND: A basic tenet of palliative care is interprofessional collaboration. Palliative care educators and practitioners lead the way in responding to the Institute of Medicine's (2003) challenge to transform educational and health care systems through interprofessional collaboration. Through exemplary commitment to interprofessional collaboration, a college's academic and palliative care leader, in collaboration with Department Chairs and Directors of nursing and allied health professions, can illustrate and analyze the processes of interprofessional collaboration through the development of a simulated case study of a combat veteran with traumatic brain injury...
December 21, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27993826/minimal-change-disease-associated-with-malignant-pleural-mesothelioma-case-report-and-review-of-the-literature
#19
Halil Yildiz, Stoian Ioana Andreea, Delphine Hoton, Jean Cyr Yombi
A 77-year-old man with a history of asbestos exposure was admitted to our internal medicine division for generalised weakness, fatigue, loss of weight, night sweats and difficulty for breathing since 3 months. Clinical examination revealed left fine crackles and bilateral leg oedema. Blood test showed elevated C reactive protein level at 142 mg/L, lactate dehydrogenase level at 421 UI, creatinine level at 5.75 mg/dL. Serum albumin level at 30 g/L, urinalysis showed significant proteinuria at 6.4 g/L...
December 19, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27976538/cryopreservation-and-hypothermic-storage-of-lacrimal-gland-towards-enabling-delivery-of-regenerative-medicine-therapies-for-treatment-of-dry-eye-syndrome
#20
I Massie, K Spaniol, G Geerling, S Schrader
Severe dry eye syndrome (DES) can cause painful loss of vision and may result from lacrimal gland dysfunction. Current treatments are palliative, so a causative therapy is desirable. The ability to (cryo)preserve lacrimal gland tissue or epithelial cells would simplify this. Here, lacrimal gland tissue was cryopreserved in 10% dimethylsulphoxide in liquid nitrogen, or stored at 4 °C in culture medium for up to 7 days, and compared with fresh tissue using immunohistochemistry. Cultures were initiated from fresh and stored tissue, and cells characterised in P1 for proliferation (WST-1), colony-forming efficiency (CFE) and secretory capacity (immunocytochemistry and β-hexosaminidase activity assay)...
December 14, 2016: Journal of Tissue Engineering and Regenerative Medicine
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