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Palliative medicine

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https://www.readbyqxmd.com/read/28440125/palliative-care-education-for-medical-students-differences-in-course-evolution-organisation-evaluation-and-funding-a-survey-of-all-uk-medical-schools
#1
Steven Walker, Jane Gibbins, Paul Paes, Astrid Adams, Madawa Chandratilake, Faye Gishen, Philip Lodge, Bee Wee, Stephen Barclay
BACKGROUND: A proportion of newly qualified doctors report feeling unprepared to manage patients with palliative care and end-of-life needs. This may be related to barriers within their institution during undergraduate training. Information is limited regarding the current organisation of palliative care teaching across UK medical schools. AIMS: To investigate the evolution and structure of palliative care teaching at UK medical schools. DESIGN: Anonymised, web-based questionnaire...
June 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28434845/abr-subspecialty-certifications-in-hospice-and-palliative-medicine-and-pain-medicine
#2
Paul E Wallner, Kay H Vydareny, Anne C Roberts
The ACGME currently approves fellowship training in 11 subspecialties of radiology, and the ABR currently offers six subspecialty certificates (vascular interventional radiology will be phased out in 2017) to its primary certificate holders. Four of the ABR-sponsored or co-sponsored subspecialties have been available to ABR diplomates for more than 18 years, but two-hospice and palliative medicine and pain medicine-are relatively new. The nature of specialty and subspecialty certificate development and details related to these two specific programs will be considered...
April 20, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28426520/nursing-practice-research-and-education-in-the-west-the-best-is-yet-to-come
#3
Heather M Young, Susan Bakewell-Sachs, Linda Sarna
PURPOSE: This paper celebrates the 60th anniversary of the Western Institute of Nursing, the nursing organization representing 13 states in the Western United States, and envisions a preferred future for nursing practice, research, and education. BACKGROUND: Three landmark calls to action contribute to transforming nursing and healthcare: the Patient Protection and Affordable Care Act of 2010; the Institute of Medicine report Future of Nursing: Leading Change, Advancing Health; and the report Advancing Healthcare Transformation: A New Era for Academic Nursing...
April 20, 2017: Nursing Research
https://www.readbyqxmd.com/read/28426492/clinical-practice-guidelines-for-pancreatic-cancer-2016-from-the-japan-pancreas-society-a-synopsis
#4
Koji Yamaguchi, Takuji Okusaka, Kyoko Shimizu, Junji Furuse, Yoshinori Ito, Keiji Hanada, Tooru Shimosegawa, Kazuichi Okazaki
OBJECTIVES: Clinical Practice Guidelines for Pancreatic Cancer based on Evidence-Based Medicine 2006 were first published by the Japan Pancreas Society, and they were revised to Clinical Practice Guidelines for Pancreatic Cancer 2009 in July 2009 and were further revised to Clinical Practice Guidelines for Pancreatic Cancer 2013 in October 2013. These guidelines were established according to evidence-based medicine. In October 2016, the Clinical Practice Guidelines for Pancreatic Cancer were newly revised in Japanese...
May 2017: Pancreas
https://www.readbyqxmd.com/read/28424084/durable-complete-remission-with-aromatase-inhibitor-therapy-in-a-patient-with-metastatic-uterine-carcinosarcoma-with-poor-performance-status-and-coagulation-disorders-a-case-report
#5
P Martin-Romano, M Jurado, M A Idoate, L Arbea, J L Hernandez-Lizoain, D Cano, J A Paramo, S Martin-Algarra
BACKGROUND: Chemotherapy is considered the most appropriate treatment for metastatic uterine sarcoma, despite its limited efficacy. No other treatment has been conclusively proved to be a real alternative, but some reports suggest that anti-hormonal therapy could be active in a small subset of patients. We report the case of a patient with metastatic uterine carcinosarcoma with positive hormonal receptors and a complete pathological response. CASE PRESENTATION: A 54-year-old white woman presented to our emergency room with hypovolemic shock and serious vaginal bleeding...
April 19, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28423478/a-qualitative-study-of-community-nurses-decision-making-around-the-anticipatory-prescribing-of-end-of-life-medications
#6
Ben Bowers, Sarah Redsell
AIMS: To explore community nurses' decision-making processes around the prescribing of anticipatory medications for people who are dying. BACKGROUND: Community nurses frequently initiate the prescribing of anticipatory medications to help control symptoms in those who are dying. However, little is known about their decision-making processes in relation to when they instigate anticipatory prescribing and their discussions with families and General Practitioners. DESIGN: A qualitative interpretive descriptive enquiry...
April 19, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28401622/predicting-mortality-in-the-emergency-department-external-validation-and-derivation-of-a-clinical-prediction-tool
#7
Rajat N Moman, Caitlin Loprinzi Brauer, Katherine M Kelsey, Rachel D Havyer, Christine M Lohse, M Fernanda Bellolio
BACKGROUND: he Choosing Wisely campaign has called for better engagement of palliative and hospice care services for patients in the emergency department (ED). PREDICT is a clinical prediction tool that was derived in an Australian ED cohort. It assesses a patient's risk of mortality at one year to select those who would benefit from advanced care planning. Such goals of care discussion can improve patients' ability to communicate what they want out of their healthcare and, in cases of end-of-life, potentially reduce the number of futile interventions...
April 12, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28399846/palliative-sedation-challenging-the-professional-competency-of-health-care-providers-and-staff-a-qualitative-focus-group-and-personal-written-narrative-study
#8
Danièle Leboul, Régis Aubry, Jean-Michel Peter, Victor Royer, Jean-François Richard, Frédéric Guirimand
BACKGROUND: Despite recent advances in palliative medicine, sedating a terminally ill patient is regarded as an indispensable treatment to manage unbearable suffering. With the prospect of widespread use of palliative sedation, the feelings and representations of health care providers and staff (carers) regarding sedation must be carefully explored if we are to gain a better understanding of its impact and potential pitfalls. The objective of the study was to provide a comprehensive description of the opinions of carers about the use of sedation practices in palliative care units (PCU), which have become a focus of public attention following changes in legislation...
April 11, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28386785/assessing-the-prognostic-features-of-a-pain-classification-system-in-advanced-cancer-patients
#9
Joseph Arthur, Kimberson Tanco, Ali Haider, Courtney Maligi, Minjeong Park, Diane Liu, Eduardo Bruera
PURPOSE: The Edmonton Classification System for Cancer Pain (ECS-CP) has been shown to predict pain management complexity based on five features: pain mechanism, incident pain, psychological distress, addictive behavior, and cognitive function. The main objective of our study was to explore the association between ECS-CP features and pain treatment outcomes among outpatients managed by a palliative care specialist-led interdisciplinary team. METHODS: Initial and follow-up clinical information of 386 eligible supportive care outpatients were retrospectively reviewed and analyzed...
April 6, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28384684/an-international-collaborative-standardizing-a-comprehensive-patient-centered-outcomes-measurement-set-for-colorectal-cancer
#10
Jessica A Zerillo, Maartje G Schouwenburg, Annelotte C M van Bommel, Caleb Stowell, Jacob Lippa, Donna Bauer, Ann M Berger, Gilles Boland, Josep M Borras, Mary K Buss, Robert Cima, Eric Van Cutsem, Eino B van Duyn, Samuel R G Finlayson, Skye Hung-Chun Cheng, Corinna Langelotz, John Lloyd, Andrew C Lynch, Harvey J Mamon, Pamela K McAllister, Bruce D Minsky, Joanne Ngeow, Muhammad R Abu Hassan, Kim Ryan, Veena Shankaran, Melissa P Upton, John Zalcberg, Cornelis J van de Velde, Rob Tollenaar
Importance: Global health systems are shifting toward value-based care in an effort to drive better outcomes in the setting of rising health care costs. This shift requires a common definition of value, starting with the outcomes that matter most to patients. Objective: The International Consortium for Health Outcomes Measurement (ICHOM), a nonprofit initiative, was formed to define standard sets of outcomes by medical condition. In this article, we report the efforts of ICHOM's working group in colorectal cancer...
April 6, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/28379833/provision-of-palliative-care-services-by-family-physicians-is-common
#11
Claire K Ankuda, Anuradha Jetty, Andrew Bazemore, Stephen Petterson
OBJECTIVE: Provision of palliative care services by primary care physicians is increasingly important with an aging population, but it is unknown whether US primary care physicians see themselves as palliative practitioners. METHODS: This study used cross-sectional analysis of data from the 2013 American Board of Family Medicine Maintenance of Certification Demographic Survey. RESULTS: Of 10,894 family physicians, 33.1% (n = 3609) report providing palliative care...
March 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28379816/improving-family-medicine-with-thoughtful-research
#12
EDITORIAL
Anne Victoria Neale, Marjorie A Bowman, Dean A Seehusen
This issue is about improving primary health care outcomes, from behavioral health to opioid issues to diagnosing hypertension to providing hope for childhood obesity. It includes hints for integrating behavioral health and care managers into family medicine practices. Opiate prescribing practices vary considerably between Japan and the United States, with helpful insights for our opiate abuse epidemic. Suicidality is high among patients taking opiates. Diagnosing hypertension the recommended way is not easily accomplished...
March 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28378133/-palliative-therapy-concepts-in-intensive-care-medicine
#13
M Schuster, M Ferner, M Bodenstein, R Laufenberg-Feldmann
Involvement of palliative care is so far not common practice for critically ill patients on surgical intensive care units (ICUs) in Germany. The objectives of palliative care concepts are improvement of patient quality of life by relief of disease-related symptoms using an interdisciplinary approach and support of patients and their relatives considering their current physical, psychological, social and spiritual needs. The need for palliative care can be identified via defined screening criteria. Integration of palliative care can either be realized using a consultative model which focusses on involvement of palliative care consultants or an integrative model which embeds palliative care principles into the routine daily practice by the ICU team...
April 4, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28375816/confidence-with-and-barriers-to-serious-illness-communication-a-national-survey-of-hospitalists
#14
Leah B Rosenberg, Jeff Greenwald, Bartho Caponi, Ami Doshi, Howard Epstein, Jeff Frank, Elizabeth Lindenberger, Nick Marzano, Lynnea M Mills, Rab Razzak, James Risser, Wendy G Anderson
OBJECTIVE: To describe the concerns, confidence, and barriers of practicing hospitalists around serious illness communication. BACKGROUND: Hospitalist physicians are optimally positioned to provide primary palliative care, yet their experiences in serious illness communication are not well described. METHODS: Web-based survey, conducted in May 2016. The survey link was distributed via email to 4000 members of the Society of Hospital Medicine...
April 4, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28375640/coriolus-versicolor-yunzhi-use-as-therapy-in-advanced-hepatocellular-carcinoma-patients-with-poor-liver-function-or-who-are-unfit-for-standard-therapy
#15
Wen Yee Chay, Chee Kian Tham, Han Chong Toh, Hwee Yong Lim, Chee Kiat Tan, Cindy Lim, Who-Whong Wang, Su-Pin Choo
BACKGROUND: The majority of patients with hepatocellular carcinoma (HCC) are inoperable and results with conventional chemotherapy are dismal. Many end up with no treatment options and resort to alternative medicine. The authors report the use of Coriolus versicolor (CV) in advanced HCC patients with poor liver function or who were unfit to receive standard therapy. METHODS: Fifteen eligible cases were randomized 2:1 to either CV or placebo. The primary endpoint was the median time to progression (TTP) between both arms...
April 4, 2017: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/28349415/pharmacotherapeutic-management-of-pancreatic-ductal-adenocarcinoma-current-and-emerging-concepts
#16
REVIEW
Dietrich A Ruess, Kivanc Görgülü, Sonja M Wörmann, Hana Algül
Pancreatic ductal adenocarcinoma is a devastating malignancy, which is the result of late diagnosis, aggressive disease, and a lack of effective treatment options. Thus, pancreatic ductal adenocarcinoma is projected to become the second leading cause of cancer-related death by 2030. This review summarizes recent developments of oncological therapy in the palliative setting of metastatic pancreatic ductal adenocarcinoma. It further compiles novel targets and therapeutic approaches as well as promising treatment combinations, which are presently in preclinical evaluation, covering several aspects of the hallmarks of cancer...
March 27, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28347144/compassion-fatigue-among-palliative-care-clinicians
#17
Sean O'Mahony, Maisa Ziadni, Michael Hoerger, Stacie Levine, Aliza Baron, James Gerhart
OBJECTIVES: Palliative medicine is a rewarding field, but providers encounter patient trauma on a routine basis. Compassion fatigue, marked by burnout, secondary traumatic stress, and low satisfaction may result. However, professionals differ markedly in how they respond to patient trauma. The objective of the current study was to determine whether personality traits of neuroticism and agreeableness relate to aspects of compassion fatigue, after accounting for time spent working in the field...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28346387/oprm1-c-118a-g-polymorphism-and-duration-of-morphine-treatment-associated-with-morphine-doses-and-quality-of-life-in-palliative-cancer-pain-settings
#18
Aline Hajj, Lucine Halepian, Nada El Osta, Georges Chahine, Joseph Kattan, Lydia Rabbaa Khabbaz
Despite increased attention on assessment and management, pain remains the most persistent symptom in patients with cancer, in particular in end-of-life settings, with detrimental impact on their quality-of-life (QOL). We conducted this study to evaluate the added value of determining some genetic and non-genetic factors to optimize cancer pain treatment. Eighty-nine patients were included in the study for the evaluation of palliative cancer pain management. The regression analysis showed that age, OPRM1 single nucleotide polymorphism (SNP), as well as the duration of morphine treatment were significantly associated with morphine doses at 24 h (given by infusion pump; p = 0...
March 27, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28345115/counseling-practices-for-fetal-hypoplastic-left-heart-syndrome
#19
Michael J Walsh, George R Verghese, M Eric Ferguson, Nora F Fino, David J Goldberg, Sonal T Owens, Nelangi Pinto, Sinai C Zyblewski, Michael D Quartermain
While counseling parents of a fetus diagnosed with hypoplastic left heart syndrome (HLHS), pediatric cardiologists play a critical role in shaping a family's expectations for the months and years to come. However, techniques for the most effective counseling practices have not been studied, and significant variation among physicians is likely present. Web-based survey of pediatric cardiologists that perform fetal echocardiography using snowball sampling. 201 physicians responded (61% male, 81% from academic centers, and 95% from the U...
March 27, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28342432/-ethical-dilemmas-in-practice-of-medicine-child
#20
Justo Ruiz López, Javier Navarro Zaragoza, Francisco Carrillo Navarro, Aurelio Luna Maldonado
After reviewing the existing bibliography in the last 20 years, we concluded that there is a lack of information regarding the ethical conflicts that affect to pediatrics in their daily practice. It produces certain degree of uncertainty in these professionals at the time of solving these problems. We made a systematic search in the main data bases, finding more than 150 articles related, of which 80 were considered outstanding. After studying them, we have found 40 ethical dilemmas, related to some principle of solution and that we described in this article...
January 2017: Cuadernos de Bioética: Revista Oficial de la Asociación Española de Bioética y Ética Médica
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