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Primary palliative care

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https://www.readbyqxmd.com/read/28547207/role-of-out-of-hours-primary-care-service-in-limiting-inappropriate-access-to-emergency-department
#1
Andrea Posocco, Maria Paola Scapinello, Irene De Ronch, Francesco Castrogiovanni, Gianluca Lollo, Guglielmo Sergi, Iginio Tomaselli, Loris Tonon, Marco Solmi, Daniele Pescador, Elena Battistuz, Stefano Traversa, Vincenzo Zambianco, Nicola Veronese
Out of hours (OOH) doctors can have an important gate-keeping role over the access to the emergency department (ED), but the outcome and the quality of their ED referrals have been poorly studied. We aimed to investigate the outcome of patients referred to ED from OOH service and the determinants of admission or short-stay dispositions. We collected retrospectively data about referrals to ED from a local OOH service in the north-east of Italy using the OOH paper register and the ED electronic database, over the period of 01/10/2012 to 31/03/2013...
May 25, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28544780/spinal-metastatic-disease-a-review-of-the-role-of-the-multidisciplinary-team
#2
REVIEW
Mark Curtin, Robert P Piggott, Evelyn P Murphy, Sudarshan Munigangaiah, Joseph F Baker, John P McCabe, Aiden Devitt
Historically, a simple approach centered on palliation was applicable to the majority of patients with metastatic spinal disease. With advances in diagnosis and treatment, a more complicated algorithm has devolved requiring a multidisciplinary approach with institutional commitment and support. We performed a database review including pertinent articles exploring the multidisciplinary management of spinal metastatic disease. The wide variation in clinical presentation and tumor response to treatment necessitates a multidisciplinary approach that integrates the diagnosis and treatment of the cancer, symptom management, and rehabilitation for optimal care of patients with spinal metastases...
May 24, 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28537777/palliative-care-office-hours-for-patients-with-hematologic-malignancies-an-innovative-model-for-symptom-management-and-education
#3
Anessa M Foxwell, Mary E Moyer, David J Casarett, Nina R O'Connor
BACKGROUND: Palliative care programs are experiencing rapid growth, with demand for consults surpassing staffing. Innovative models are needed to equip nonpalliative care providers to manage basic palliative care issues. OBJECTIVES: To develop a novel program of palliative care office hours for hematologic oncology advanced practice providers, and to evaluate its impact on palliative care consult volume and composition. METHODS: A palliative care nurse practitioner or pharmacist was available for weekday office hours to all inpatient hematologic oncology advanced practice providers at an academic medical center to offer advice on pain, nonpain symptoms, and psychosocial distress...
May 24, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28533106/trans-sectoral-care-of-geriatric-cancer-patients-based-on-comprehensive-geriatric-assessment-and-patient-reported-quality-of-life-results-of-a-multicenter-study-to-develop-and-pilot-test-a-patient-centered-interdisciplinary-care-concept-for-geriatric-oncology
#4
Heike Schmidt, Stephanie Boese, Katharina Lampe, Karin Jordan, Eckhard Fiedler, Ursula Müller-Werdan, Andreas Wienke, Dirk Vordermark
OBJECTIVES: For older patients with cancer the maintenance of independence, functionality and health-related quality of life (HRQOL) is of great importance. Aiming to maintain HRQOL of older patients with cancer we developed an interdisciplinary care program based on comprehensive geriatric assessment (CGA) and patient-reported HRQOL comprising tailored supportive measures and telephone-based counseling during 6month aftercare. MATERIALS AND METHODS: Pilot-testing of the intervention took place in three centers at the University Hospital Halle to examine feasibility, acceptance and potential benefit...
May 19, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28532739/quality-of-missing-data-reporting-and-handling-in-palliative-care-trials-demonstrates-that-further-development-of-the-consort-missing-data-reporting-guidance-is-required-a-systematic-review
#5
Jamilla A Hussain, Martin Bland, Dean Langan, Miriam J Johnson, David C Currow, Ian R White
OBJECTIVES: Assess (i) the quality of reporting and handling missing data in palliative care trials against current guidance, (ii) whether there are differences in the reporting of criteria specified by the CONSORT 2010 statement compared to those not specified, (iii) the association of the reporting of missing data with journal impact factor and CONSORT endorsement status. STUDY DESIGN AND SETTING: Systematic review of palliative care randomised controlled trials...
May 19, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28524892/palliative-radiation-therapy-knowledge-and-referrals-among-primary-care-providers
#6
Sydney Schone
Cancer is a leading cause of death worldwide. Many individuals have significant symptoms related to this disease. Palliative radiation therapy (PRT) can relieve symptoms at the end of life for those with metastatic cancer. PRT is underused in treating patients with symptomatic cancer at the end of life, particularly in rural and remote settings, despite the evidence that supports it. The purpose of this evidence-based practice study is to (a) assess the knowledge of rural primary care providers about PRT, (b) disseminate evidence on the indications for PRT, and...
June 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28521070/drug-therapy-for-symptoms-associated-with-anxiety-in-adult-palliative-care-patients
#7
REVIEW
Susan Salt, Caroline A Mulvaney, Nancy J Preston
BACKGROUND: This is an update of a Cochrane Review first published in 2004 (Issue 1) and previously updated in 2012 (Issue 10). Anxiety is common in palliative care patients. It can be a natural response to the complex uncertainty of having a life-limiting illness or impending death, but it may represent a clinically significant issue in its own right. OBJECTIVES: To assess the effectiveness of drug therapy for treating symptoms of anxiety in adults with a progressive life-limiting illness who are thought to be in their last year of life...
May 18, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28521020/mid-term-outcomes-in-unbalanced-complete-atrioventricular-septal-defect-role-of-biventricular-conversion-from-single-ventricle-palliation%C3%A2
#8
Meena Nathan, Sitaram Emani, Rinske IJsselhof, Hua Liu, Kimberlee Gauvreau, Pedro Del Nido
OBJECTIVES: Management strategy for unbalanced complete atrioventricular septal defects (CASVSDs) includes single-ventricle (SV) palliation and primary or staged biventricular (BiV) repair. More recently, BiV conversion (BiVC) from SV palliation and staged BiV recruitment (BiVR) have also been advocated. This study assesses mid-term outcomes in patients with unbalanced CASVSDs according to management strategy. METHODS: Consecutive patients with unbalanced CASVSDs who underwent surgery at a tertiary care centre from January 2000 to February 2016 with institutional review board approval...
May 18, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28515919/programmed-death-ligand-1-expression-is-associated-with-fibrosarcomatous-transformation-of-dermatofibrosarcoma-protuberans
#9
Kenji Tsuchihashi, Hitoshi Kusaba, Yuichi Yamada, Yuta Okumura, Hozumi Shimokawa, Masato Komoda, Keita Uchino, Tomoyasu Yoshihiro, Nobuhiro Tsuruta, Fumiyasu Hanamura, Kyoko Inadomi, Mamoru Ito, Kosuke Sagara, Michitaka Nakano, Kenta Nio, Shuji Arita, Hiroshi Ariyama, Kenichi Kohashi, Ryuji Tominaga, Yoshinao Oda, Koichi Akashi, Eishi Baba
Dermatofibrosarcoma protuberans (DFSP) is a locally invading tumor, characterized by the presence of the collagen type I α 1 (COL1A1)-platelet-derived growth factor (PDGF) β fusion gene. We herein report the case of a 31-year-old man with a history of resection of an abdominal wall DFSP. The patient presented with chest pain and a computed tomography scan revealed a large mass in the posterior mediastinum and another mass in the right lung. The mediastinal mass was a sarcomatous lesion expressing the COL1A1-PDGFβ fusion gene, suggesting that it represented a metastasis of the DFSP following fibrosarcomatous (FS) transformation...
May 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28511720/identifying-models-of-delivery-care-domains-and-quality-indicators-relevant-to-palliative-day-services-a-scoping-review-protocol
#10
Seán R O'Connor, Martin Dempster, Noleen K McCorry
BACKGROUND: With an ageing population and increasing numbers of people with life-limiting illness, there is a growing demand for palliative day services. There is a need to measure and demonstrate the quality of these services, but there is currently little agreement on which aspects of care should be used to do this. The aim of the scoping review will be to map the extent, range and nature of the evidence around models of delivery, care domains and existing quality indicators used to evaluate palliative day services...
May 16, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28505689/-pain-management-in-palliative-care
#11
Martin B Steins, Corinna Eschbach, Matthias Villalobos, Michael Thomas
A consistent pain management together with treatment of dyspnoea belongs to the main issues in symptom control in particular in palliative thoracic oncology. Together with the medicamentous therapy the psychologic and social circumstances of the affected patients have to be considered as factors influencing the experience of pain. The therapeutic fundament according to the WHO guideline for cancer pain is the opiate based medicamentous adjustment combined with non-opioids. In principle, this should be performed preferably orally, as simply as possible, according to a fix drug schedule and individually adjusted to the needed dosage...
May 2017: Pneumologie
https://www.readbyqxmd.com/read/28502684/metastatic-neuroendocrine-carcinoma-of-unknown-origin-arising-in-the-femoral-nerve-sheath
#12
Nicholas Candy, Adam Young, Kieren Allinson, Oliver Carr, Jason McMillen, Rikin Trivedi
Metastatic neuroendocrine carcinoma of unknown origin is a rare condition, usually presenting with lesions in the liver and/or lung. We present the first reported case of a metastatic neuroendocrine carcinoma of unknown origin arising in the femoral nerve sheath. MRI demonstrated what was thought to be a schwannoma in the left femoral nerve sheath in the proximal femoral triangle, immediately inferior to the anterior inferior iliac spine. At the time of operation, the tumour capsule was invading surrounding tissue as well as three trunks of the femoral nerve...
May 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28501253/resection-of-the-primary-tumor-in-stage-iv-colorectal-cancer-when-is-it-necessary
#13
REVIEW
Leandro Feo, Michael Polcino, Garrett M Nash
Management of metastatic colorectal cancer requires accurate staging and multidisciplinary evaluation, leading to a consensus treatment plan with the ultimate goal of increasing survival and improving the quality of life, while taking into consideration the patient's performance status, disease burden, and goals of care. Since the introduction of multidrug chemotherapeutic regimens, survival of patients with metastatic colorectal cancer has improved. Many patients with unresectable disease are undergoing surgery for asymptomatic primary tumors despite evidence that it is usually a futile intervention...
June 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28499512/the-organ-transplant-imperative
#14
REVIEW
Wil L Santivasi, Jacob J Strand, Paul S Mueller, Thomas J Beckman
More than 120,000 US patients were listed for solid organ transplants in 2016. Although data are scarce, we suspect that many of these patients will die while awaiting transplant and without engaging in goals-of-care discussions with their physicians. The challenges of addressing goals of care in patients with malignancy, end-stage renal disease, and heart failure have been studied. However, there is sparse literature on addressing goals of care throughout the dynamic process of transplant assessment and listing...
May 10, 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28497194/treatment-and-outcomes-of-recurrent-hepatocellular-carcinomas
#15
Gaëtan-Romain Joliat, Pierre Allemann, Ismail Labgaa, Nicolas Demartines, Nermin Halkic
PURPOSE: Surgery is one of the best options for curative treatment of hepatocellular carcinomas (HCC). Recurrences are nevertheless common (45-75%). This study aimed to compare overall survival (OS) of patients with recurrent HCC after primary resection to OS of patients without recurrence. METHODS: A retrospective review of all HCC patients operated between 1993 and 2015 was performed. Median and 5-year OS were calculated. RESULTS: This study included 147 HCC patients...
May 11, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28494643/randomised-clinical-trial-of-early-specialist-palliative-care-plus-standard-care-versus-standard-care-alone-in-patients-with-advanced-cancer-the-danish-palliative-care-trial
#16
Mogens Groenvold, Morten Aagaard Petersen, Anette Damkier, Mette Asbjoern Neergaard, Jan Bjoern Nielsen, Lise Pedersen, Per Sjøgren, Annette Sand Strömgren, Tove Bahn Vejlgaard, Christian Gluud, Jane Lindschou, Peter Fayers, Irene J Higginson, Anna Thit Johnsen
BACKGROUND: Beneficial effects of early palliative care have been found in advanced cancer, but the evidence is not unequivocal. AIM: To investigate the effect of early specialist palliative care among advanced cancer patients identified in oncology departments. SETTING/PARTICIPANTS: The Danish Palliative Care Trial (DanPaCT) (ClinicalTrials.gov NCT01348048) is a multicentre randomised clinical trial comparing early referral to a specialist palliative care team plus standard care versus standard care alone...
May 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28485714/portugal-health-system-review
#17
Jorge de Almeida Simoes, Goncalo Figueiredo Augusto, Ines Fronteira, Cristina Hernandez-Quevedo
This analysis of the Portuguese health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. Overall health indicators such as life expectancy at birth and at age 65 years have shown a notable improvement over the last decades. However, these improvements have not been followed at the same pace by other important dimensions of health: child poverty and its consequences, mental health and quality of life after 65...
March 2017: Health Systems in Transition
https://www.readbyqxmd.com/read/28480719/stereotactic-body-radiation-therapy-for-metastases-to-the-kidney-in-patients-with-non-small-cell-lung-cancer-a-new-treatment-paradigm-for-durable-palliation
#18
Vivek Verma, Charles B Simone
BACKGROUND: Cancer metastasis to the kidney is a rare event; treatment must take into account the associated and unique anatomic and physiological challenges of treating the kidney. Stereotactic body radiation therapy (SBRT) is a widely emerging modality of radiotherapy touted for its ability to minimize irradiation to surrounding tissues and to provide a vastly shortened treatment course that is highly biologically potent. However, the use of SBRT to treat kidney neoplasms has been described in only a few case reports generally for primary renal malignancies...
April 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28479774/renal-medullary-carcinoma-with-an-ophthalmic-metastasis
#19
Christine Ibilibor, Allen Medway, Thomas Nelius
Renal medullary carcinoma (RMC) is a rare, aggressive primary renal malignancy that classically occurs in adolescent males with sickle cell trait and universally presents with metastatic disease at presentation. We report a case of medullary carcinoma in a young man with likely ophthalmic metastasis. We also review relevant literature available to date. The patient is a 20-year-old African-American male with a past medical history significant to for sickle cell trait who presented to the University Medical Center with cough and the right eye pain for 1 month as well as painless gross hematuria for 1 week...
April 2017: Urology Annals
https://www.readbyqxmd.com/read/28476546/infantile-gangliosidoses-mapping-a-timeline-of-clinical-changes
#20
Jeanine R Jarnes Utz, Sarah Kim, Kelly King, Richard Ziegler, Lynn Schema, Evelyn S Redtree, Chester B Whitley
BACKGROUND: Infantile gangliosidoses include GM1 gangliosidosis and GM2 gangliosidosis (Tay-Sachs disease, Sandhoff disease). To date, natural history studies in infantile GM2 (iGM2) have been retrospective and conducted through surveys. Compared to iGM2, there is even less natural history information available on infantile GM1 disease (iGM1). There are no approved treatments for infantile gangliosidoses. Substrate reduction therapy using miglustat has been tried, but is limited by gastrointestinal side effects...
April 29, 2017: Molecular Genetics and Metabolism
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