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Primary palliative care

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https://www.readbyqxmd.com/read/28435644/immunohistochemical-diagnosis-of-primary-cardiac-leiomyosarcoma-in-a-latin-american-patient
#1
Ruben Blachman-Braun, Carlos Manuel Aboitiz-Rivera, Alberto Aranda-Fraustro, Adrián Ransom-Rodríguez, Mario Enrique Baltazares-Lipp, Jorge Manuel Catrip-Torres, Jesús Octavio Martínez-Reding
Primary cardiac malignancies are rare entities. Although sarcomas enclosed the main group of malignant heart neoplasms, primary cardiac leiomyosarcomas are extremely rare and constitutes less than 8% of cardiac tumors. Leiomyosarcoma usually originates from the pulmonary veins and have a worm-like shaped structure. In this article, we present a case of a 40-year-old Hispanic man diagnosed with a cardiac tumor who underwent surgical resection, during pathological examination the tissue samples were consistent with a malignancy of mesenchymal origin that contained irregular bundles of spindle cells...
March 24, 2017: Rare Tumors
https://www.readbyqxmd.com/read/28428012/-retrospective-study-of-children-referred-from-paediatric-intensive-care-to-palliative-care-why-and-for-what
#2
Alberto García-Salido, Paula Santos-Herranz, Verónica Puertas-Martín, María Ángeles García-Teresa, Ricardo Martino-Alba, Ana Serrano-González
INTRODUCTION: The creation of paediatric palliative care units (PPCU) could optimise the management of children with palliative focus after admission to a paediatric intensive care unit (PICU). This study describes the clinical and epidemiological characteristics of children referred from PICU to the UCPP of the Autonomous Community of Madrid (CAM). The overall treatment, relapses, re-admissions, and deaths, if occurred, are described. PATIENTS AND METHOD: A retrospective review was performed using the medical records from children transferred from the CAM paediatric intensive care units to the paediatric palliative care unit (1 March 2008-31 January 2015)...
April 17, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28427740/a-study-of-the-incidence-and-management-of-admissions-for-cancer-related-symptoms-in-a-district-general-hospital-the-potential-role-of-an-acute-oncology-service
#3
C M Bruce, J Smith, A Price
AIMS: The non-specialist management of cancer patients is becoming increasingly complex. Acute oncology services (AOS), aiming to provide rapid access to specialist advice, have been shown to improve patient experience and reduce length of inpatient stay. The present study aimed to inform service provision in a district general hospital (DGH) by investigating cancer patients, not on active anti-cancer treatment, where the disease itself precipitated admission. This is a vulnerable group who are potentially disenfranchised of focused oncological input due to having less robust care pathways established to date...
April 17, 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/28424194/common-care-practices-among-effective-community-based-specialist-palliative-care-teams-a-qualitative-study
#4
Hsien Seow, Daryl Bainbridge, Melissa Brouwers, Deanna Bryant, Sue Tan Toyofuku, Mary Lou Kelley
OBJECTIVE: Evidence has shown that, despite wide variation in models of care, community-based specialist palliative care teams can improve outcomes and reduce acute care use at end of life. The goal of this study was to explore similarities in care practices among effective and diverse specialist teams to inform the development of other community-based teams. METHODS: Interviews with 78 providers and administrators from 11 distinct community-based specialist palliative care teams from Ontario, Canada were conducted...
April 19, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28413928/the-oncology-specialist-s-role-in-polst-form-completion
#5
Austin J Lammers, Dana M Zive, Susan W Tolle, Erik K Fromme
INTRODUCTION: Patients with cancer and oncology professional societies believe that advance care planning is important, but we know little of who actually has this conversation. Physician Orders for Life-Sustaining Treatment (POLST) forms can help to document these important conversations to ensure patients receive the level of treatment they want. We therefore sought to determine the specialty of those signing POLST forms for patients who died of cancer to better understand who is having this discussion with patients...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28409374/self-expandable-metal-stent-placement-versus-emergency-resection-for-malignant-proximal-colon-obstructions
#6
Femke Julie Amelung, Werner Adriaan Draaisma, Esther Catharina Josephina Consten, Peter Derk Siersema, Frank Ter Borg
BACKGROUND: Traditionally, all patients with a malignant obstruction of the proximal colon (MOPC) are treated with emergency resection. However, recent data suggest that Self-expandable metallic stent (SEMS) placement could lower mortality and morbidity rates. This study therefore aimed to compare SEMS placement with emergency resection as treatment options for MOPC. METHODS: All consecutive patients that underwent SEMS placement for MOPC in the period 2004-2015 at our institution were identified...
April 13, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28400632/management-strategies-for-mycosis-fungoides-in-india
#7
Tanumay Raychaudhury
Mycosis fungoides is the most common primary cutaneous T-cell lymphoma. The approach to diagnosis and further follow-up is outlined. Evidence for interventions is based classically on a Tumor Node Metastasis Blood TNMB "stage-based" approach. The treatment options in India are limited. The options as per risk stratification and prognostic index are discussed. Early stages and low-risk patients can be managed with expectant policy or skin-directed therapies including topical steroids and phototherapy; intermediate-risk patients can be opted for interferons or retinoids or low dose methotrexate along with radiotherapy including total skin electron beam therapy while high-risk patients are managed most often with single agent or multiagent palliative chemotherapy...
March 2017: Indian Journal of Dermatology
https://www.readbyqxmd.com/read/28387129/integrating-palliative-care-to-promote-earlier-conversations-and-to-increase-the-skill-and-comfort-of-nonpalliative-care-clinicians-lessons-learned-from-an-interventional-field-trial
#8
Marilyn K Szekendi, Jocelyn Vaughn, Beth McLaughlin, Carol Mulvenon, Karin Porter-Williamson, Chris Sydenstricker, Mary Williamson
While the uptake of palliative care in the United States is steadily improving, there continues to be a gap in which many patients are not offered care that explicitly elicits and respects their personal wishes. This is due in part to a mismatch of supply and demand; the number of seriously ill individuals far exceeds the workload capacities of palliative care specialty providers. We conducted a field trial of an intervention designed to promote the identification of seriously ill patients appropriate for a discussion of their goals of care and to advance the role of nonpalliative care clinicians by enhancing their knowledge of and comfort with primary palliative care skills...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28381133/randomized-controlled-trial-of-a-home-based-palliative-approach-for-people-with-severe-multiple-sclerosis
#9
Alessandra Solari, Andrea Giordano, Francesco Patti, Maria Grazia Grasso, Paolo Confalonieri, Lucia Palmisano, Michela Ponzio, Claudia Borreani, Rosalba Rosato, Simone Veronese, Paola Zaratin, Mario Alberto Battaglia
BACKGROUND: Evidence on the efficacy of palliative care in persons with severe multiple sclerosis (MS) is scarce. OBJECTIVE: To assess the efficacy of a home-based palliative approach (HPA) for adults with severe MS and their carers. METHODS: Adults with severe MS-carer dyads were assigned (2:1 ratio) to either HPA or usual care (UC). At each center, a multi-professional team delivered the 6-month intervention. A blind examiner assessed dyads at baseline, 3 months, and 6 months...
April 1, 2017: Multiple Sclerosis: Clinical and Laboratory Research
https://www.readbyqxmd.com/read/28379833/provision-of-palliative-care-services-by-family-physicians-is-common
#10
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
#11
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/28375816/confidence-with-and-barriers-to-serious-illness-communication-a-national-survey-of-hospitalists
#12
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/28375046/delirium-assessed-by-memorial-delirium-assessment-scale-in-advanced-cancer-patients-admitted-to-an-acute-palliative-supportive-care-unit
#13
Sebastiano Mercadante, Claudio Adile, Patrizia Ferrera, Andrea Cortegiani, Alessandra Casuccio
BACKGROUND: Delirium is often unrecognized in cancer patients. The aim of this study was to investigate the prevalence of delirium assessed by Memorial Delirium Assessment Scale (MDAS), and possible associated factors associated on admission to an acute palliative/supportive care unit (ASPCU). The secondary outcome was to assess changes in MDAS and symptom burden at time of discharge. METHODS: A consecutive sample of advanced cancer patients who were admitted to an ASPCU was prospectively assessed for a period of 10 months...
April 4, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28373421/self-efficacy-for-coping-moderates-the-effects-of-distress-on-quality-of-life-in-palliative-cancer-care
#14
Andrea Chirico, Samantha Serpentini, Thomas Merluzzi, Luca Mallia, Paola Del Bianco, Rosalba Martino, Leonardo Trentin, Enrico Bucci, Michelino DE Laurentiis, Eleonora Capovilla, Fabio Lucidi, Gerardo Botti, Antonio Giordano
Recent aggressive chemotherapeutic and combined treatments have resulted in increased survivorship for advanced stage breast cancer. In some patients, treatment produces an actual abatement of their cancer, while in others treatment mitigates the progression of cancer bringing those patients into palliative care where their chronic disease requires continuous management. There is also evidence that the majority of palliative-care cancer patients have a deteriorating quality of life that only precipitously declines in the final few weeks of life...
April 2017: Anticancer Research
https://www.readbyqxmd.com/read/28357099/spontaneous-regression-of-hepatocellular-carcinoma-in-a-caucasian-male-patient-a-case-report-and-review-of-the-literature
#15
Daniel P Noij, Petrus W G van Der Linden
Hepatocellular carcinoma (HCC) is the most common primary hepatic cancer. As it often presents at an advanced stage, it generally has a poor prognosis. Spontaneous regression is a rare finding in HCC, and is often associated with tumour ischemia or a systemic inflammatory response. We herein present the case of a Caucasian patient with spontaneous regression of advanced HCC, not associated with either mechanism. Our patient was a 74-year old Caucasian male who presented with advanced biopsy-proven HCC, with α-fetoprotein levels of >16,600 kU/l...
February 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28353374/prediction-of-poor-short-term-prognosis-and-unmet-needs-in-advanced-chronic-obstructive-pulmonary-disease-use-of-the-two-minute-walking-distance-extracted-from-a-six-minute-walk-test
#16
Han-Yee Neo, Hui-Ying Xu, Huei-Yaw Wu, Allyn Hum
OBJECTIVES: Prognostic challenges hinder the identification of patients with advanced chronic obstructive pulmonary disease (COPD) for timely palliative interventions. We postulate that a two-minute derivative (two-minute walking distance [2MWD]) of a standard six-minute walk test (6MWT) can identify frail subjects with poorer survival for early palliative intervention. The primary outcome of interest is mortality at 18 months. Secondary objectives include evaluation of the relationship between the 2MWD and ability to self-care, dyspnea-related disabilities, nutrition, forced expiratory volume in first second (FEV1), quality of life (QoL), and comorbidity burden...
March 29, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28341469/long-term-survival-after-the-fontan-operation-twenty-years-of-experience-at-a-single-center
#17
Tacy E Downing, Kiona Y Allen, Andrew C Glatz, Lindsay S Rogers, Chitra Ravishankar, Jack Rychik, Jennifer A Faerber, Stephanie Fuller, Lisa M Montenegro, James M Steven, Thomas L Spray, Susan C Nicolson, J William Gaynor, David J Goldberg
OBJECTIVE: Existing studies of patients palliated with the Fontan operation are limited by heterogeneous patient populations and incomplete follow-up. This study aimed to describe long-term post-Fontan survival in a modern patient cohort. METHODS: All 773 patients who underwent a first Fontan operation at our institution between 1992 and 2009 were reviewed. The primary outcome was the composite endpoint of Fontan takedown, heart transplantation, or death before 2013...
March 6, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28333571/screening-and-assessment-of-substance-use-in-hospice-care-examining-content-from-a-national-sample-of-psychosocial-assessments
#18
Paul Sacco, John G Cagle, Melissa L Moreland, Elizabeth A S Camlin
BACKGROUND: Quality of care provided by hospice and palliative care agencies depends on a thorough understanding of the patient, the family, their history, and current risk factors. It is therefore imperative for social workers and other providers in these settings to assess patients and caregivers for substance use disorders and potential for substance misuse. OBJECTIVE: We aimed to examine how hospice social workers in the United States screen and assess for alcohol and substance use and risk of medication diversion among patients and family caregivers...
March 23, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28331844/a-single-institution-report-of-19-hepatocellular-carcinoma-patients-with-bile-duct-tumor-thrombus
#19
Anon Chotirosniramit, Akkaphod Liwattanakun, Worakitti Lapisatepun, Wasana Ko-Iam, Trichak Sandhu, Sunhawit Junrungsee
BACKGROUND: Obstructive jaundice caused due to bile duct tumor thrombus (BDTT) in a hepatocellular carcinoma (HCC) patient is an uncommon event. This study reports our clinical experiences and evaluates the outcomes of HCC patients with BDTT in a single institution. METHODS: A retrospective review of 19 HCC patients with secondary obstructive jaundice caused due to BDTT during a 15-year period was conducted. RESULTS: At the time of diagnosis, 14 (73...
2017: Journal of Hepatocellular Carcinoma
https://www.readbyqxmd.com/read/28315478/improving-palliative-care-through-teamwork-impactt-in-nursing-homes-study-design-and-baseline-findings
#20
Helena Temkin-Greener, Susan Ladwig, Zhiqiu Ye, Sally A Norton, Dana B Mukamel
BACKGROUND: The 2014 Institute of Medicine report recommended that healthcare providers caring for individuals with advanced illness have basic palliative care competencies in communication, inter-professional collaboration, and symptom management. Nursing homes, where one in three American decedents live and die, have fallen short of these competency goals. We implemented an intervention study to examine the efficacy of nursing home-based integrated palliative care teams in improving the quality of care processes and outcomes for residents at the end of life...
March 14, 2017: Contemporary Clinical Trials
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