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Palliative medicine

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https://www.readbyqxmd.com/read/28632194/a-mind-body-approach-to-pediatric-pain-management
#1
REVIEW
Melanie L Brown, Enrique Rojas, Suzanne Gouda
Pain is a significant public health problem that affects all populations and has significant financial, physical and psychological impact. Opioid medications, once the mainstay of pain therapy across the spectrum, can be associated with significant morbidity and mortality. Centers for Disease and Control (CDC) guidelines recommend that non-opioid pain medications are preferred for chronic pain outside of certain indications (cancer, palliative and end of life care). Mindfulness, hypnosis, acupuncture and yoga are four examples of mind-body techniques that are often used in the adult population for pain and symptom management...
June 20, 2017: Children
https://www.readbyqxmd.com/read/28629916/a-medical-student-perspective-on-physician-assisted-suicide
#2
John Y Rhee, Katharine A Callaghan, Philip Allen, Amanda Stahl, Martin T Brown, Alexandra Tsoi, Grace McInerney, Ana-Maria G Dumitru
Physician assisted suicide and euthanasia (PAS/E) has been increasingly discussed and debated in the public square, including in professional medical organizations. However, the medical student perspective on the debate has been essentially absent. We present a medical student perspective on the PAS/E debate as future doctors and those about to enter the profession. We argue that PAS/E is not in line with the core principles of medicine, and the focus should rather be on providing high-quality end-of-life and palliative care...
June 16, 2017: Chest
https://www.readbyqxmd.com/read/28614082/pharmacology-of-cough-in-palliative-care
#3
Alyn H Morice, Gabriella Shanks
PURPOSE OF REVIEW: Cough is a common and distressing symptom. It has a marked decrement on quality-of-life particularly in the arena of palliative care where coexisting symptoms such as pain may be exacerbated. Whilst local definitive treatment may alleviate coughing it usually requires general measures. The purpose of the review is to assess the current evidence relating to the pharmacological management of cough. RECENT FINDINGS: Key to understanding cough is the realization that most cough is because of a hypersensitivity of the afferent vagus nerve...
June 12, 2017: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/28595441/healing-spirituality-and-integrative-medicine
#4
David M Steinhorn, Jana Din, Angela Johnson
Spirituality plays a prominent role in the lives of most palliative patients whether or not they formally adhere to a specific religion and belief. As a result, the palliative care team is frequently called upon to support families who are experiencing their "dark night of the soul" and struggling to make sense of their lives during a healthcare crisis. While conventional religious practices provide a source of comfort and guidance for many of our patients, a significant number of our patients do not have a strong religious community to which to turn...
May 22, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28595440/on-the-way-of-liberation-from-suffering-and-pain-role-of-hypnosis-in-palliative-care
#5
Enrico Facco, Edoardo Casiglia, Gastone Zanette, Ines Testoni
The huge problems related to chronic, ultimately fatal diseases involve disability, pain, suffering and the perception of one's doom; this calls for reappraising the conventional concepts of health and disease, life and death, encompassing spirituality and the mystery of death beyond any limited perspective. The management of suffering and pain to enhance resilience plays a central role in palliative care (PC) and is the core of the patient-centered approach, focused on the "to care" instead of the "to cure" of the illness-centered medicine...
May 25, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28594725/pelvic-exenteration-surgery-the-evolution-of-radical-surgical-techniques-for-advanced-and-recurrent-pelvic-malignancy
#6
Kilian G M Brown, Michael J Solomon, Cherry E Koh
Pelvic exenteration was first described by Alexander Brunschwig in 1948 in New York as a palliative procedure for recurrent carcinoma of the cervix. Because of initially high rates of morbidity and mortality, the practice of this ultraradical operation was largely confined to a small number of American centers for most of the 20 century. The post-World War II era saw advances in anaesthesia, blood transfusion, and intensive care medicine that would facilitate the evolution of more radical and heroic abdominal and pelvic surgery...
July 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28594585/impact-of-palliative-medicine-involvement-on-end-of-life-services-for-patients-with-cancer-with-in-hospital-deaths
#7
Alison Wiesenthal, Debra A Goldman, Deborah Korenstein
PURPOSE: Palliative care (PC) has been shown to improve the quality of care and resource utilization for inpatients. We examined the relationship between PC consultation before and during final admission and patterns of care for dying patients at our tertiary cancer center. METHODS: We retrospectively reviewed adult patients with solid tumor cancer with a length of stay ≥ 3 days who died in hospital between December 2012 and November 2014. We recorded services, including laboratory testing, imaging, blood products, medications, diet orders, do not resuscitate orders, and consultations, delivered within 3 days of death...
June 8, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28592238/a-survey-of-palliative-medicine-education-in-japan-s-undergraduate-medical-curriculum
#8
Yoichi Nakamura, Yusuke Takamiya, Mari Saito, Koichi Kuroko, Tatsuko Shiratsuchi, Kenzaburo Oshima, Yuko Ito, Satoshi Miyake
BACKGROUND: This study aimed to examine the status of undergraduate palliative care education among Japanese medical students using data from a survey conducted in 2015. METHODS: A questionnaire was originally developed, and the survey forms were sent to universities. The study's objectives, methods, disclosure of results, and anonymity were explained to participating universities in writing. Responses returned by the universities were considered to indicate consent to participate...
June 7, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28591907/-ultrasound-in-palliative-care-medicine-part-ii
#9
Dieter Nuernberg, Christian Jenssen, Eckhart Fröhlich, Andre Ignee, Gebhard Mathis, Christoph F Dietrich
Complementary to part 1, this review summarizes indications, opportunities and applications of ultrasounds in palliative care medicine. In particular, the following topics are discussed: · Ultrasound as a non-invasive, low-threshold, bedside technique, which uniquely combines diagnostic efficacy and empathy.. · Sonographic surveillance of patients with malignant disease.. · Point-of-care application of ultrasound in palliative care services.. · Ultrasound-guided palliative interventions (drainage of effusions and other therapeutic procedures)...
June 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28590164/care-of-the-critically-ill-burn-patient-an-overview-from-the-perspective-of-optimizing-palliative-care
#10
Daniel E Ray, Mohana B Karlekar, Donnelle L Crouse, Margaret Campbell, J Randall Curtis, Jeffrey Edwards, Dana R Lustbader, Anne C Mosenthal, Colleen Mulkerin, Kathleen A Puntillo, David E Weissman, Renee D Boss, Karen J Brasel, Judith E Nelson
Burn specialists have long recognized the need for and role modeled a comprehensive approach incorporating relief of distress as part of care during critical illness. More recently, palliative care specialists have become part of the healthcare team in many US hospitals, especially larger academic institutions that are more likely to have designated burn centers. No current literature describes the intersection of palliative care and burn care or integration of primary and specialist palliative care in this unique context...
June 7, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28590153/is-it-acceptable-to-video-record-palliative-care-consultations-for-research-and-training-purposes-a-qualitative-interview-study-exploring-the-views-of-hospice-patients-carers-and-clinical-staff
#11
Marco Pino, Ruth Parry, Luke Feathers, Christina Faull
BACKGROUND: Research using video recordings can advance understanding of healthcare communication and improve care, but making and using video recordings carries risks. AIM: To explore views of hospice patients, carers and clinical staff about whether videoing patient-doctor consultations is acceptable for research and training purposes. DESIGN: We used semi-structured group and individual interviews to gather hospice patients, carers and clinical staff views...
February 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28587264/being-in-the-chemotherapy-suite-versus-being-in-the-oncology-ward-an-analytical-view-of-two-hospital-sites-occupied-by-people-experiencing-cancer
#12
Catherine Hughes, Kate van Heugten, Sally Keeling, Francisc Szekely
How do people with cancer occupy places within the health system during their journey through palliative care? The answer to this question was explored by the authors as part of a wider ethnographic study of eight people's journeys from referral to palliative care services to the end of life. This article reports on findings that have emerged from ongoing analysis that has been completed in the years proceeding data collection. An ethnographic research design was used to collect data about the participants and their family members over a three-year period...
June 5, 2017: Cancers
https://www.readbyqxmd.com/read/28585274/junior-doctors-attitudes-to-opioids-for-refractory-breathlessness-in-patients-with-advanced-chronic-obstructive-pulmonary-disease
#13
Natasha Smallwood, Nicole Gaffney, Alexandra Gorelik, Louis Irving, Brian Le, Jennifer Philip
Refractory breathlessness is a common, distressing symptom in patients with advanced chronic obstructive pulmonary disease (COPD). The judicious, off-licence prescription of opioids, together with other management strategies, can improve breathlessness, however, internationally there is profound reluctance to prescribe opioids for breathlessness in COPD. AIMS: To understand Australian junior doctors' knowledge and attitudes regarding the management of refractory breathlessness and the role of opioids in COPD...
June 6, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28579682/the-intersection-of-palliative-care-and-interventional-radiology-enhancing-understanding-and-collaboration
#14
REVIEW
Mary K Buss
In the treatment of cancer patients, many interventional radiologic procedures are palliative in nature. The goal for these therapies is often something other than cure, such as prolonged survival or improved quality of life. The goals of therapy should be matched with the patient's wishes, and must include open communication between the health care provider and the patient. Hospice and palliative medicine is its own specialty, and a multidisciplinary approach to the care of cancer patients should include discussions with these health care specialists...
June 2017: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/28575866/catalpol-protects-synaptic-proteins-from-beta-amyloid-induced-neuron-injury-and-improves-cognitive-functions-in-aged-rats
#15
Zhiming Xia, Fengfei Wang, Shuang Zhou, Rui Zhang, Fushun Wang, Jason H Huang, Erxi Wu, Yongfang Zhang, Yaer Hu
Synapse loss is one of the common factors contributing to cognitive disorders, such as Alzheimer's disease (AD), which is manifested by the impairment of basic cognitive functions including memory processing, perception, problem solving, and language. The current therapies for patients with cognitive disorders are mainly palliative; thus, regimens preventing and/or delaying dementia progression are urgently needed. In this study, we evaluated the effects of catalpol, isolated from traditional Chinese medicine Rehmannia glutinosa, on synaptic plasticity in aged rat models...
May 17, 2017: Oncotarget
https://www.readbyqxmd.com/read/28574529/prospective-cohort-study-of-hospitalized-adults-with-advanced-cancer-associations-between-complications-comorbidity-and-utilization
#16
Peter May, Melissa M Garrido, Melissa D Aldridge, J Brian Cassel, Amy S Kelley, Diane E Meier, Charles Normand, Joan D Penrod, Thomas J Smith, R Sean Morrison
BACKGROUND: Inpatient hospital stays account for more than a third of direct medical cancer care costs. Evidence on factors driving these costs can inform planning of services, as well as consideration of equity in access. OBJECTIVE: To measure the association between hospital costs, and demographic, clinical, and system factors, for a cohort of adults with advanced cancer. DESIGN: Prospective multisite cohort study. SETTING: Four medical and cancer centers...
June 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28569616/doctor-related-medication-safety-incidents-on-a-specialist-palliative-medicine-inpatient-unit-a-retrospective-analysis-of-three-years-of-voluntary-reporting
#17
Hannah O'Brien, Fiona Kiely, Ann Carmichael
Patients receiving palliative care and those at the end of life are known to be susceptible to medical errors. Errors related to medications are the most avoidable cause of patient harm. This retrospective study examined reported anonymized medication safety incidents, related to physician errors, assessed by the risk committee in a specialist palliative care unit over a 3-year time period. The aim of the study was to describe medication errors, with specific attention paid to what type of errors occurred and when these errors happened...
June 1, 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28562301/pain-assessment-and-treatment-in-children-with-significant-impairment-of-the-central-nervous-system
#18
Julie Hauer, Amy J Houtrow
Pain is a frequent and significant problem for children with impairment of the central nervous system, with the highest frequency and severity occurring in children with the greatest impairment. Despite the significance of the problem, this population remains vulnerable to underrecognition and undertreatment of pain. Barriers to treatment may include uncertainty in identifying pain along with limited experience and fear with the use of medications for pain treatment. Behavioral pain-assessment tools are reviewed in this clinical report, along with other strategies for monitoring pain after an intervention...
May 22, 2017: Pediatrics
https://www.readbyqxmd.com/read/28554221/a-review-of-prognostic-tools-in-heart-failure
#19
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/28552630/protective-effects-of-melatonin-on-long-term-administration-of-fluoxetine-in-rats
#20
Majid Khaksar, Ahmad Oryan, Mansour Sayyari, Aysa Rezabakhsh, Reza Rahbarghazi
The degree and consequence of tissue injury are highly regarded during long-term exposure to selective antidepressant fluoxetine. Melatonin has been shown to palliate different lesions by scavenging free radicals, but its role in the reduction of the fluoxetine-induced injuries has been little known. Thirty-six mature male Wistar rats were randomly assigned into control and experimental groups. The experimental rats were included as following; 24mg/kg/bw fluoxetine for 4 weeks; 1mg/kg/bw melatonin for 4 weeks; fluoxetine+1-week melatonin, fluoxetine+2-week melatonin and fluoxetine+4-week melatonin...
May 25, 2017: Experimental and Toxicologic Pathology: Official Journal of the Gesellschaft Für Toxikologische Pathologie
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