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https://www.readbyqxmd.com/read/28214748/electrochemical-monitoring-of-biointeraction-by-graphene-based-material-modified-pencil-graphite-electrode
#1
Ece Eksin, Erhan Zor, Arzum Erdem, Haluk Bingol
Recently, the low-cost effective biosensing systems based on advanced nanomaterials have received a key attention for development of novel assays for rapid and sequence-specific nucleic acid detection. The electrochemical biosensor based on reduced graphene oxide (rGO) modified disposable pencil graphite electrodes (PGEs) were developed herein for electrochemical monitoring of DNA, and also for monitoring of biointeraction occurred between anticancer drug, Daunorubicin (DNR), and DNA. First, rGO was synthesized chemically and characterized by using UV-Vis, TGA, FT-IR, Raman Spectroscopy and SEM techniques...
February 11, 2017: Biosensors & Bioelectronics
https://www.readbyqxmd.com/read/28209392/transfer-of-do-not-resuscitate-orders-to-the-emergency-department-from-extended-care-facilities
#2
Colleen M McQuown, Jennifer A Frey, Ahmad Amireh, Ali Chaudhary
PURPOSE/OBJECTIVE: With an elderly and chronically ill patient population visiting the emergency department, it is important to know patients' wishes regarding care preferences and advanced directives. Ohio law states DNR orders must be transported with the patient when they leave an extended care facility (ECF). We reviewed the charts of ECF patients to evaluate which patients presenting to the ED had their DNR status recognized by the physician and DNR orders that were made during their hospital stay...
February 4, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28198722/triad-viii-nationwide-multicenter-evaluation-to-determine-whether-patient-video-testimonials-can-safely-help-ensure-appropriate-critical-versus-end-of-life-care
#3
Ferdinando L Mirarchi, Timothy E Cooney, Arvind Venkat, David Wang, Thaddeus M Pope, Abra L Fant, Stanley A Terman, Kevin M Klauer, Monica Williams-Murphy, Michael A Gisondi, Brian Clemency, Ankur A Doshi, Mari Siegel, Mary S Kraemer, Kate Aberger, Stephanie Harman, Neera Ahuja, Jestin N Carlson, Melody L Milliron, Kristopher K Hart, Chelsey D Gilbertson, Jason W Wilson, Larissa Mueller, Lori Brown, Bradley D Gordon
OBJECTIVE: End-of-life interventions should be predicated on consensus understanding of patient wishes. Written documents are not always understood; adding a video testimonial/message (VM) might improve clarity. Goals of this study were to (1) determine baseline rates of consensus in assigning code status and resuscitation decisions in critically ill scenarios and (2) determine whether adding a VM increases consensus. METHODS: We randomly assigned 2 web-based survey links to 1366 faculty and resident physicians at institutions with graduate medical education programs in emergency medicine, family practice, and internal medicine...
February 14, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28158232/the-effects-of-hospice-shared-care-for-gastric-cancer-patients
#4
Kun-Siang Huang, Shih-Ho Wang, Seng-Kee Chuah, Kun-Ming Rau, Yu-Hung Lin, Meng-Che Hsieh, Li-Hsueh Shih, Yen-Hao Chen
BACKGROUND: Hospice care has been proved to result in changes to the medical behaviors of terminally ill patients. The aim of this study was to evaluate the effects and medical behavior changes of hospice-shared care intervention among terminally ill gastric cancer patients. METHODS: A total of 174 patients who died of gastric cancer between 2012 and 2014 were identified. These patients were divided into two groups: a hospice-shared care group (n = 93) and a control group (n = 81)...
2017: PloS One
https://www.readbyqxmd.com/read/28156564/advance-care-planning-and-specialty-palliative-care-utilization-for-patients-with-hematologic-malignancies-who-undergo-allogeneic-hematopoietic-cell-transplant
#5
Lisa M McNey, Erik Eckhert, Derek Galligan, Gabriel N Mannis
: 18 Background: Unlike most metastatic solid tumors, many advanced hematologic malignancies are treated with curative intent. Accordingly, aggressive interventions often continue until late in the disease course because it can be difficult to discern when cure is no longer possible. This is particularly true for recipients of allogeneic hematopoietic cell transplant (alloHCT). We hypothesized that alloHCT recipients and their providers would be less likely to utilize specialty Palliative Care (PC) services or to engage in early communication regarding advance care planning...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156550/advance-care-planning-and-palliative-care-consultation-for-stem-cell-transplant-patients
#6
Joseph D Ma, Sandahl H Nelson, Carolyn Revta, Gary T Buckholz, Carolyn M Mulroney, Eric Roeland
: 113 Background: Advance care planning (ACP) in stem cell transplantation (SCT) is particularly challenging given the potential for cure for patients with blood cancers despite an increased risk of suffering and even death. Data regarding ACP and palliative care (PC) integration in SCT is limited. METHODS: A retrospective chart review was conducted of patients with hematologic malignancies who underwent SCT at UCSD from January 2011 to December 2015. The primary objective was to determine the medical discipline of the initial and last code status documentation...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156485/palliative-care-interventions-and-end-of-life-care-outcomes-for-hepatocellular-patients-pts-at-two-veterans-affairs-va-medical-centers
#7
Sarah Lee, Sejal Kothadia, Yucai Wang, Victor Tsu-Shih Chang, Yeun-Hee Anna Park, Ellen Olson, David Klein, Fengming Zhong
: 164 Background: Palliative care interventions and their effect on EOL outcomes for liver cancer pts have not been described. We investigated the association between palliative care intervention and EOL care outcomes. METHODS: We reviewed the charts of pts with hepatocellular carcinoma and who were seen by palliative care at 2 VA medical centers from 2006 to 2012. We investigated the association between EOL outcomes (number of ER visits, ICU visits, chemotherapy, place of death, number of hospitalizations during their last 30 days), and interventions such as early referral (within 30 days of diagnosis), defined goals of care, holding a family meeting, and symptom assessment and management...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156477/a-comparison-of-patients-with-liver-cancer-receiving-palliative-care-at-two-veterans-affairs-va-medical-centers
#8
Zhen Wang, Sejal Kothadia, Yucai Wang, Ellen Olson, Yeun-Hee Anna Park, David Klein, Fengming Zhong, Victor Tsu-Shih Chang
: 75 Background: Liver cancer is a leading cause of death. Lack of data exists on palliative care in this group, and care varies by location. We aim to determine if there are differences in palliative care for patients (pts) with liver cancer by VA site. METHODS: In an IRB approved protocol, we reviewed medical records of pts at 2 VA medical centers (S1, S2) with liver cancer, who were seen by Palliative Care between 2006 and 2012. Veterans were compared by 1) demographics: Karnofsky performance status > 50 (KPS), marital status, DNR/DNI, 2) palliative intervention: goals of care discussion, referrals to psychology and PT/OT, and 3) outcomes: ED visit within 1 month (mo) of death, ED visit within 6 mo of death, ICU within 30 days of death, and hospice as site of death, time from diagnosis to palliative care, and time from DNR to death...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156462/patterns-of-palliative-care-utilization-and-end-of-life-care-in-adult-patients-with-cancer-who-died-as-inpatients-at-mayo-clinic
#9
Shivani S Shinde, Pashtoon Murtaza Kasi, Mark Robert Litzow, Jeanne M Huddleston
: 60 Background: A significant number of patients with advanced cancer die in the hospital. Examination of patterns of care and palliative care (PC) involvement may identify opportunities for process of care improvements for this vulnerable population. METHODS: Patients were identified using the institutional mortality review system registry (Mayo Clinic hospitals from July, 2013-June, 2014). Within this group, patients with a diagnosis of terminal malignancy were identified by chart review and ICD-9 codes...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156439/are-patients-with-cancer-concerned-about-burdening-their-families
#10
Kelly Choi, Ruth Pe Benito, Victoria DeVincenzo, Emily Sassano, Brooke Gruman, Katherine DeMarco, Jose Contreras, Kathryn Tanenbaum, Jennifer Covington, Dhakshila Paramanathan, Stuart L Goldberg
: 86 Background: A diagnosis of advanced cancer frequently thrusts family members into the role of caregiver. Although caregiver burdens have been well documented, less is known about the level of concern borne by the patient (pt) with cancer in placing a family member in this role, known as self-perceived burden (SPB). METHODS: As part of the larger "Living with Cancer" project we prospectively surveyed 1307 pts with advanced malignancies receiving treatment with non-curative intent at 17 New Jersey cancer programs within the Regional Cancer Care Associates network between Sept 2015 and Apr 2016...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152940/code-status-documentation-in-the-electronic-medical-record-for-patients-with-stage-iv-pancreatic-cancer
#11
Janet M Armstrong, Joseph D Ma, Carolyn Revta, Eric Roeland
: 125 Background: Improving incidence of code status documentation in the electronic medical record (EMR) has been suggested a better guidance for clinical care compared with a traditional advance directive. We have previously reported that in the absence of a template in the EMR, code status documentation was 36% and inconsistent in patients with advanced cancer. Utilizing a different cohort of patients with metastatic pancreatic cancer, we examined the prevalence of EMR code status documentation...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28130945/a-snapshot-of-advance-directives-in-long-term-care-how-often-is-do-not-done
#12
Sheril Perry, Christina Lawand
Advance directives allow individuals and their families or legal guardians to communicate preferences for interventions and treatments in the event that these individuals are no longer able to make decisions for themselves. This study examines how often do-not-hospitalize (DNH) and do-not-resuscitate (DNR) directives were recorded for residents in 982 reporting Canadian long-term care facilities between 2009-2010 and 2011-2012 and, to the extent possible, whether these directives were followed in acute care settings...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/28112576/atp-binding-casette-transporter-expression-in-acute-myeloid-leukemia-association-with-in-vitro-cytotoxicity-and-prognostic-markers
#13
Savitha Varatharajan, Ajay Abraham, Sreeja Karathedath, Sukanya Ganesan, Kavitha M Lakshmi, Nancy Arthur, Vivi M Srivastava, Biju George, Alok Srivastava, Vikram Mathews, Poonkuzhali Balasubramanian
INTRODUCTION: Drug resistance and relapse are considered to be the major reasons for treatment failure in acute myeloid leukemia (AML). There is limited data on the role of ABC transporter expression on in vitro sensitivity to cytarabine (Ara-C) and daunorubicin (Dnr) in primary AML cells. PATIENTS & METHODS: RNA expression levels of 12 ABC transporters were analyzed by real-time quantitative PCR in 233 de novo adult acute myeloid leukemia patients. Based on cytarabine or Dnr IC50, the samples were categorized as sensitive, intermediate and resistant...
February 2017: Pharmacogenomics
https://www.readbyqxmd.com/read/28108837/can-mechanical-imaging-increase-the-specificity-of-mammography-screening
#14
Magnus Dustler, Daniel Förnvik, Pontus Timberg, Ingvar Andersson, Hannie Petersson, Håkan Brorson, Anders Tingberg, Sophia Zackrisson
OBJECTIVES: This study aimed to investigate the effects of adding adjunct mechanical imaging to mammography breast screening. We hypothesized that mechanical imaging could detect increased local pressure caused by both malignant and benign breast lesions and that a pressure threshold for malignancy could be established. The impact of this on breast screening was investigated with regard to reductions in recall and biopsy rates. METHODS: 155 women recalled from breast screening were included in the study, which was approved by the regional ethical review board (dnr 2013/620)...
January 20, 2017: European Radiology
https://www.readbyqxmd.com/read/28099054/association-between-do-not-resuscitate-do-not-intubate-status-and-resident-physician-decision-making-a-national-survey
#15
Elizabeth K Stevenson, Hashim M Mehter, Allan J Walkey, Renda Soylemez Wiener
RATIONALE: Compared to their Full Code counterparts, patients with Do Not Resuscitate/Do Not Intubate (DNR/DNI) status receive fewer interventions and have higher mortality than predicted by clinical characteristics. OBJECTIVES: To assess whether internal medicine residents, the front-line providers for many hospitalized patients, would manage hypothetical patients differently based on code status. We hypothesized respondents would be less likely to provide a variety of interventions to DNR/DNI patients than Full Code patients...
January 18, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28097649/hospital-variation-in-utilization-of-life-sustaining-treatments-among-patients-with-do-not-resuscitate-orders
#16
Allan J Walkey, Janice Weinberg, Renda Soylemez Wiener, Colin R Cooke, Peter K Lindenauer
OBJECTIVE: To determine between-hospital variation in interventions provided to patients with do not resuscitate (DNR) orders. DATA SOURCES/SETTING: United States Agency of Healthcare Research and Quality, Healthcare Cost and Utilization Project, California State Inpatient Database. STUDY DESIGN: Retrospective cohort study including hospitalized patients aged 40 and older with potential indications for invasive treatments: in-hospital cardiac arrest (indication for CPR), acute respiratory failure (mechanical ventilation), acute renal failure (hemodialysis), septic shock (central venous catheterization), and palliative care...
January 18, 2017: Health Services Research
https://www.readbyqxmd.com/read/28094898/polyelectrolyte-oil-core-nanocarriers-for-localized-and-sustained-delivery-of-daunorubicin-to-colon-carcinoma-mc38-cells-the-case-of-polysaccharide-multilayer-film-in-relation-to-peg-ylated-shell
#17
Urszula Bazylińska, Jadwiga Pietkiewicz, Joanna Rossowska, Grzegorz Chodaczek, Andrzej Gamian, Kazimiera A Wilk
The authors examine properties of daunorubicin (DNR)-loaded oil-core multilayer nanocapsules prepared via layer-by-layer approach with different polyelectrolyte (PE) coatings such as a standard one (containing polysodium 4-styrenesulphonate/poly(diallyldimethyl-ammonium) chloride) and a polysaccharide-based shell (dextran/chitosan), in regard to the outer layer of poly-l-glutamic acid (PGA) grafted with polyethylene glycol (PGA-g-PEG). The nanocarriers are obtained on a cationic nanoemulsion template (stabilized by dicephalic-type surfactant, N,N-bis[3,30-(trimethylammonio)propyl]-dodecanamide dimethylsulfate) and layered with the PE shell of different thicknesses resulting in average size of 150 nm in diameter (as shown by dynamic light scattering, scanning electron microscopy and cryogenic-transmission electron microscopy, and atomic force microscopy)...
January 17, 2017: Macromolecular Bioscience
https://www.readbyqxmd.com/read/28074589/on-patient-well-being-and-professional-authority
#18
Mildred Z Solomon
Two papers in this issue address the limits of surrogates' authority when making life-and-death decisions for dying family members or friends. Using palliative sedation as an example, Jeffrey Berger offers a conceptual argument for bounding surrogate authority. Since freedom from pain is an essential interest, when imminently dying, cognitively incapacitated patients are in duress and their symptoms are not manageable in any other way, clinicians should be free to offer palliative sedation without surrogate consent, although assent should be sought and every effort made to work with surrogates as harmoniously as possible...
January 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28074587/after-the-dnr-surrogates-who-persist-in-requesting-cardiopulmonary-resuscitation
#19
Ellen M Robinson, Wendy Cadge, Angelika A Zollfrank, M Cornelia Cremens, Andrew M Courtwright
Some health care organizations allow physicians to withhold cardiopulmonary resuscitation from a patient, despite patient or surrogate requests that it be provided, when they believe it will be more harmful than beneficial. Such cases usually involve patients with terminal diagnoses whose medical teams argue that aggressive treatments are medically inappropriate or likely to be harmful. Although there is state-to-state variability and a considerable judicial gray area about the conditions and mechanisms for refusals to perform CPR, medical teams typically follow a set of clearly defined procedures for these decisions...
January 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28074578/managing-conflicts-between-physicians-and-surrogates
#20
Carol Bayley
Two articles in this issue of the Hastings Center Report explore two sides of the same problematic coin. In "The Limits of Surrogates' Moral Authority and Physician Professionalism," Jeffrey Berger discusses the moral problem of a surrogate refusing a treatment, palliative sedation, on behalf of a patient whose suffering is refractory to intensive palliative efforts provided by a multidisciplinary team. In "After the DNR: Surrogates Who Persist in Requesting Cardiopulmonary Resuscitation," Ellen Robinson and her colleagues analyze data from a study of cases in which physicians wished not to perform cardiopulmonary resuscitation on patients whom they thought it would harm...
January 2017: Hastings Center Report
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