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https://www.readbyqxmd.com/read/29783184/postoperative-outcomes-in-patients-with-a-do-not-resuscitate-dnr-order-undergoing-elective-procedures
#1
Ethan Y Brovman, Elisa C Walsh, Brittany N Burton, Christine E Kuo, Charlotta Lindvall, Rodney A Gabriel, Richard D Urman
STUDY OBJECTIVE: Do-not-resuscitate (DNR) status has been shown to be an independent risk factor for mortality in the post-operative period. Patients with DNR orders often undergo elective surgeries to alleviate symptoms and improve quality of life, but there are limited data on outcomes for informed decision making. DESIGN: Retrospective cohort study. SETTING: A multi-institutional setting including operating room, postoperative recovery area, inpatient wards, and the intensive care unit...
May 18, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29778506/quality-of-life-symptoms-and-care-needs-in-patients-with-persistent-or-recurrent-platinum-resistant-ovarian-cancer-an-nrg-oncology-gynecologic-oncology-group-study
#2
Vivian E von Gruenigen, Helen Q Huang, David Cella, MichaelA Zevon, Jason A LaChance, Joan L Walker, Ritu Salani, Susan C Modesitt, Robert T Morris, William H Bradley, Matthew P Boente, Lari Wenzel
OBJECTIVES: The goals of treating recurrent platinum-resistant ovarian cancer are palliative, aimed at reducing symptoms and improving progression free survival. A prospective trial was conducted to determine the prevalence and severity of symptoms, and associated care needs. METHODS: Eligible women included those with persistent or recurrent platinum-resistant ovarian cancer with an estimated life expectancy of at least 6 months. The Needs at the End-of-Life Screening Tool (NEST), FACIT-Fatigue (FACIT-F), NCCN-FACT Ovarian Symptom Index [NFOSI-18]; Disease Related Symptoms (DRS), Treatment Side Effects (TSE), and Function/Well Being (F/WB) were collected at study entry, 3 and 6 months...
May 17, 2018: Gynecologic Oncology
https://www.readbyqxmd.com/read/29743759/knowledge-and-attitude-of-er-and-intensive-care-unit-physicians-toward-do-not-resuscitate-in-a-tertiary-care-center-in-saudi-arabia-a-survey-study
#3
Alaa Gouda, Norah Alrasheed, Alaa Ali, Ahmad Allaf, Najd Almudaiheem, Youssuf Ali, Ahmad Alghabban, Sami Alsalolami
Introduction: Only a few studies from Arab Muslim countries address do-not-resuscitate (DNR) practice. The knowledge of physicians about the existing policy and the attitude towards DNR were surveyed. Objective: The objective of this study is to identify the knowledge of the participants of the local DNR policy and barriers of addressing DNR including religious background. Methods: A questionnaire has been distributed to Emergency Room (ER) and Intensive Care Unit (ICU) physicians...
April 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29731386/characteristics-and-outcomes-of-do-not-resuscitate-patients-admitted-to-the-emergency-department-intensive-care-unit
#4
An-Yi Wang, Hon-Ping Ma, Wei-Fong Kao, Shin-Han Tsai, Cheng-Kuei Chang
BACKGROUND: Appropriate utilization of intensive care unit (ICU) beds are essential. Patients with critical illness who have do not resuscitate (DNR) have a reduced priority of intensive care. However, the possibility of recovery/survival is ambiguous and multifactorial. OBJECTIVE: To deliberate the characteristics and outcomes of critical illness in patients with prior DNR who were admitted to the emergency department (ED)-ICU. METHOD: This was a retrospective cohort study conducted between April 2015 and November 2015 in a university-based hospital...
May 3, 2018: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/29729816/wasp-write-a-scientific-paper-special-cases-of-selective-non-treatment-and-or-dnr
#5
Pierre Mallia
Fetuses at low gestational age limit of viability, neonates with life threatening or life limiting congenital anomalies and deteriorating acutely ill newborn babies in intensive care, pose taxing ethical questions on whether to forego or stop treatment and allow them to die naturally. Although there is essentially no ethical difference between end of life decision between neonates and other children and adults, in the former, the fact that we are dealing with a new life, may pose greater problems to staff and parents...
May 3, 2018: Early Human Development
https://www.readbyqxmd.com/read/29723128/factors-influencing-family-surrogates-intention-with-regard-to-do-not-resuscitate-directive-for-patients-with-dementia
#6
Yu-Chiung Fang, Ming-Chyi Pai, Liang-Chao Wang, Ya-Ping Yang, Chung-Yi Li, Feng-Ping Lee, Jing-Jy Wang
OBJECTIVE: To investigate the prevalence of family surrogates' do-not-resuscitate (DNR) intention for patients with dementia (PwD), and factors influencing family surrogates' decisions. METHODS: This is a descriptive and cross-sectional study. Patients with dementia and their family surrogates from Dementia Outpatient Clinic of a teaching hospital in southern Taiwan were included. Data were collected using chart review and questionnaire survey. Influential factors were analyzed using multiple logistic regression...
April 10, 2018: Clinical Gerontologist
https://www.readbyqxmd.com/read/29718859/the-do-not-resuscitate-order-for-terminal-cancer-patients-in-mainland-china-a-retrospective-study
#7
Bo-Yan Huang, Hui-Ping Chen, Ying Wang, Yao-Tiao Deng, Ting-Wu Yi, Yu Jiang
With the development of palliative care, a signed do-not-resuscitate (DNR) order has become increasingly popular worldwide. However, there is no legal guarantee of a signed DNR order for patients with cancer in mainland China. This study aimed to estimate the status of DNR order signing before patient death in the cancer center of a large tertiary affiliated teaching hospital in western China. Patient demographics and disease-related characteristics were also analyzed.This was a retrospective chart analysis...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29715098/the-combination-of-flavokawain-b-and-daunorubicin-induces-apoptosis-in-human-myeloid-leukemic-cells-by-modifying-nf-%C3%AE%C2%BAb
#8
Jae Jin Lee, Kyung-Nam Koh, Chan-Jeoung Park, Seongsoo Jang, Ho Joon Im, Nayoung Kim
BACKGROUND/AIM: Flavokawain B (FKB), is a natural chalcone isolated from kava root that induces apoptosis in cancer cells. Herein we investigated the effects of combination of FKB and daunorubicin (DNR) on human leukemic cells. MATERIALS AND METHODS: Cell viability and death were assessed by the MTS assay and flow cytometry. NK-κB was detected by western blotting. RESULTS: FKB alone and in combination with DNR reduced the viable cell numbers of four leukemic cell lines...
May 2018: Anticancer Research
https://www.readbyqxmd.com/read/29676952/associations-between-patient-characteristics-and-a-new-early-do-not-attempt-resuscitation-order-after-intracerebral-hemorrhage
#9
Jessica McFarlin, Claire E Hailey, Wenjing Qi, Peter G Kranz, Weiping Sun, Wei Sun, Marisa Gray, Nicolas King, Daniel T Laskowitz, Michael L James
BACKGROUND: Decisions to limit care, including use of a do-not-resuscitate (DNR) order, are associated with increased risk of death after intracerebral hemorrhage (ICH). Given the value that patient surrogates place on the physician's perception of prognosis, understanding prognostic indicators that influence clinical judgment of outcomes is critical. OBJECTIVE: The purpose of this study was to understand the patient variables and comorbid illnesses associated with DNR orders placed on patients within 72 hours after ICH...
April 20, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29676777/do-not-resuscitate-orders-in-older-adults-during-hospitalization-a-propensity-score-matched-analysis
#10
Karishma Patel, Liron Sinvani, Vidhi Patel, Andrzej Kozikowski, Christopher Smilios, Meredith Akerman, Kinga Kiszko, Sutapa Maiti, Negin Hajizadeh, Gisele Wolf-Klein, Renee Pekmezaris
OBJECTIVES: To explore the effect of the presence and timing of a do-not-resuscitate (DNR) order on short-term clinical outcomes, including mortality. DESIGN: Retrospective cohort study with propensity score matching to enable direct comparison of DNR and no-DNR groups. SETTING: Large, academic tertiary-care center. PARTICIPANTS: Hospitalized medical patients aged 65 and older. MEASUREMENTS: Primary outcome was in-hospital mortality...
April 20, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29675055/shifting-paradigm-from-no-code-and-do-not-resuscitate-to-goals-of-care-policies
#11
Yaseen M Arabi, Abdulla A Al-Sayyari, Mohamed S Al Moamary
Policies addressing limitations of medical therapy in patients with advanced medical conditions are typically referred to as Code Status (No Code) policies or Do-Not-Resuscitate (DNR) status polices. Inconsistencies in implementation, understanding, decision-making, communication and management of No Code or DNR orders have led to delivery of poorer care to some patients. Several experts have called for a change in the current approach. The new approach, Goals of Care paradigm, aims to contextualize the decisions about resuscitation and advanced life support within the overall plan of care, focusing on choices of treatments to be given rather than specifically on treatments not to be given...
April 2018: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/29658530/the-comparative-study-of-influence-of-lactic-and-glycolic-acids-copolymers-type-on-properties-of-daunorubicin-loaded-nanoparticles-and-drug-release
#12
Elena Nikolskaya, Mariya Sokol, Mariya Faustova, Olga Zhunina, Murad Mollaev, Nikita Yabbarov, Oksana Tereshchenko, Roman Popov, Eugen Severin
PURPOSE: The aim of this study was to compare the physico-chemical and biological properties of polymeric nanoparticles obtained from poly(DL-lactide-co-glycolide) (PLGA) with different ratios of monomers loaded with daunorubicin (DNR). METHODS: DNR-loaded nanoparticles (NPs) were prepared with use of modified simultaneous double-emulsion solvent evaporation/diffusion technique. NPs were characterized using dynamic light scattering, atomic force microscopy, transmission electron microscopy, scanning electron microscopy, and differential scanning calorimetry and Fourier transform infrared spectroscopy...
2018: Acta of Bioengineering and Biomechanics
https://www.readbyqxmd.com/read/29657160/dnr-for-a-survivor
#13
Bonnie Salomon
No abstract text is available yet for this article.
2018: Narrative Inquiry in Bioethics
https://www.readbyqxmd.com/read/29651270/disparities-in-functional-outcome-after-intracerebral-hemorrhage-among-asians-and-pacific-islanders
#14
Kazuma Nakagawa, Sage L King, Todd B Seto, Marjorie K L M Mau
Background: Disparities in outcome after intracerebral hemorrhage (ICH) among Asians, Native Hawaiians, and other Pacific Islanders (NHOPI) have been inadequately studied. We sought to assess differences in functional outcome between Asians and NHOPI after ICH. Methods: A multiracial prospective cohort study of ICH patients was conducted from 2011 to 2016 at a tertiary center in Honolulu, HI, USA to assess racial disparities in outcome after ICH. Favorable outcome was defined as 3-month modified Rankin Scale (mRS) score ≤2...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29615003/role-of-cytarabine-in-paediatric-acute-promyelocytic-leukemia-treated-with-the-combination-of-all-trans-retinoic-acid-and-arsenic-trioxide-a-randomized-controlled-trial
#15
Li Zhang, Yao Zou, Yumei Chen, Ye Guo, Wenyu Yang, Xiaojuan Chen, Shuchun Wang, Xiaoming Liu, Min Ruan, Jiayuan Zhang, Tianfeng Liu, Fang Liu, Benquan Qi, Wenbin An, Yuanyuan Ren, Lixian Chang, Xiaofan Zhu
BACKGROUND: The combination of all-trans-retinoic acid (ATRA) and arsenic trioxide (ATO) has been suggested to be safe and effective for adult acute promyelocytic leukaemia (APL). As of 2010, the role of cytarabine (Ara-C) in APL was controversial. The aim of this study was to test the efficacy and safety of ATRA and ATO in paediatric APL patients. Also, we assessed whether Ara-C could be omitted in ATO and ATRA- based trials in children. METHODS: We performed a randomized controlled trial in paediatric APL patients (≤14 years of age) in our hospital from May 2010 to December 2016...
April 3, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29614148/clinical-inquiries-how-well-do-polst-forms-assure-that-patients-get-the-end-of-life-care-they-requested
#16
Jordan Collier, Gary Kelsberg, Sarah Safranek
Quite well, for cardiopulmonary resuscitation (CPR). Most patients (91%-100%) who select "do not resuscitate" (DNR) on their physician's orders for life-sustaining treatment (POLST) forms are allowed a natural death without attempted CPR across a variety of settings (community, skilled nursing facilities, emergency medical services, and hospice). Few patients (6%) who select "comfort measures only" die in the hospital, whereas more (22%) who choose "limited interventions," and still more (34%) without a POLST form, die in the hospital (strength of recommendation [SOR]: B, large, consistent cross-sectional and cohort studies)...
April 2018: Journal of Family Practice
https://www.readbyqxmd.com/read/29611241/the-interactive-effect-of-advanced-cancer-patient-and-caregiver-prognostic-understanding-on-patients-completion-of-do-not-resuscitate-orders
#17
Megan Johnson Shen, Kelly M Trevino, Holly G Prigerson
OBJECTIVE: Advanced cancer patients' prognostic understanding is associated with completion of Do Not Resuscitate (DNR) orders, which often represent engagement in advance care planning (ACP). Given caregivers' critical roles in patient decision-making about ACP and end-of-life care, caregivers' prognostic understanding may have a large additive effect. The present study examined the association between the main and interactive effects of advanced cancer patient and caregiver prognostic understanding on DNR order completion...
April 2, 2018: Psycho-oncology
https://www.readbyqxmd.com/read/29602983/genome-guided-exploration-of-metabolic-features-of-streptomyces-peucetius-atcc-27952-past-current-and-prospect
#18
REVIEW
Nguyen Huy Thuan, Dipesh Dhakal, Anaya Raj Pokhrel, Luan Luong Chu, Thi Thuy Van Pham, Anil Shrestha, Jae Kyung Sohng
Streptomyces peucetius ATCC 27952 produces two major anthracyclines, doxorubicin (DXR) and daunorubicin (DNR), which are potent chemotherapeutic agents for the treatment of several cancers. In order to gain detailed insight on genetics and biochemistry of the strain, the complete genome was determined and analyzed. The result showed that its complete sequence contains 7187 protein coding genes in a total of 8,023,114 bp, whereas 87% of the genome contributed to the protein coding region. The genomic sequence included 18 rRNA, 66 tRNAs, and 3 non-coding RNAs...
March 30, 2018: Applied Microbiology and Biotechnology
https://www.readbyqxmd.com/read/29601114/analysis-and-improvement-of-motion-encoding-in-magnetic-resonance-elastography
#19
Christian Guenthner, Jurgen Henk Runge, Ralph Sinkus, Sebastian Kozerke
Magnetic resonance elastography (MRE) utilizes phase contrast magnetic resonance imaging (MRI), which is phase locked to externally generated mechanical vibrations, to measure the three-dimensional wave displacement field. At least four measurements with linear-independent encoding directions are necessary to correct for spurious phase contributions if effects from imaging gradients are non-negligible. In MRE, three encoding schemes have been used: unbalanced four- and six-point and balanced four-point ('tetrahedral') encoding...
March 30, 2018: NMR in Biomedicine
https://www.readbyqxmd.com/read/29596827/structural-and-biochemical-characterization-of-the-type-ii-log-protein-from-streptomyces-coelicolor-a3
#20
Hogyun Seo, Kyung-Jin Kim
Streptomyces coelicolor A3 contains Sc5140, a gene coding for poorly understood bacterial LOG-like protein. In this study, we determined the crystal structure of Sc5140 and found it resembles the overall structure of other type-II LOGs. In addition, Sc5140 exhibited phosphoribohydrolase activity against adenosine monophosphate (AMP), indicating that it had the same function as known type-II LOGs. Based on these results, we designated Sc5140 as ScLOGII. We performed docking calculations of AMP into the ScLOGII structure, which suggested the mode of binding for type-II LOG with their AMP substrate...
March 26, 2018: Biochemical and Biophysical Research Communications
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