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https://www.readbyqxmd.com/read/29455168/experiences-of-australian-men-diagnosed-with-advanced-prostate-cancer-a-qualitative-study
#1
Suzanne K Chambers, Melissa K Hyde, Kirstyn Laurie, Melissa Legg, Mark Frydenberg, Ian D Davis, Anthony Lowe, Jeff Dunn
OBJECTIVE: To explore men's lived experience of advanced prostate cancer (PCa) and preferences for support. DESIGN: Cross-sectional qualitative study applying open-ended surveys and interviews conducted between June and November 2016. Interviews audio-recorded and transcribed verbatim and analysed from an interpretive phenomenological perspective. SETTING: Australia, nation-wide. PARTICIPANTS: 39 men diagnosed with advanced PCa (metastatic or castration-resistant biochemical regression) were surveyed with 28 men subsequently completing a semistructured in depth telephone interview...
February 17, 2018: BMJ Open
https://www.readbyqxmd.com/read/29454590/understanding-how-prostate-cancer-patients-value-the-current-treatment-options-for-metastatic-castration-resistant-prostate-cancer
#2
Tarik Benidir, Karen Hersey, Antonio Finelli, Rob Hamilton, Anthony M Joshua, Girish Kulkarni, Alexandre Zlotta, Neil Fleshner
Several new compounds are now available for castration resistant prostate cancer (CRPC). Individual costs range between $40,000 and $93,000 with mean survival extensions from 2.4 to 4.8 months. Currently, it remains unclear how patients with prostate cancer (PCa) value the effect of these therapies in the setting of CRPC. OBJECTIVE: To assess patient understanding of core cancer concepts, opinions on the cost and overall benefit of CRPC drugs, whether out-of-pocket costs would change opinions and whether patients would ultimately opt out of CRPC drug treatment for an end-of-life (EOL) premium...
February 14, 2018: Urologic Oncology
https://www.readbyqxmd.com/read/29454337/the-second-patient-family-members-of-cancer-patients-and-their-role-in-end-of-life-decision-making
#3
Katsiaryna Laryionava, Timo A Pfeil, Mareike Dietrich, Stella Reiter-Theil, Wolfgang Hiddemann, Eva C Winkler
BACKGROUND: Family members are important companions of severely ill patients with cancer. However, studies about the desirability and difficulties of integrating relatives in the decision-making process are rare in oncology. This qualitative study explores the family role in decisions to limit treatment near the end of life from the professionals' point of view. METHODS: Qualitative in-depth interviews were conducted with oncologists (n = 12) and nurses (n = 6) working at the Department of Hematology/Oncology at the University Hospital in Munich, Germany...
February 17, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29453695/temporary-assist-device-support-for-the-right-ventricle-pre-implant-and-post-implant-challenges
#4
REVIEW
Michael Dandel, Roland Hetzer
Severe right ventricular (RV) failure is more likely reversible than similar magnitudes of left ventricular (LV) failure and, because reversal of both adaptive remodeling and impaired contractility require most often only short periods of support, the use of temporary RV assist devices (t-RVADs) can be a life-saving therapy option for many patients. Although increased experience with t-RVADs and progresses made in the development of safer devices with lower risk for complications has improved both recovery rate of RV function and patient survival, the mortality of t-RVAD recipients can still be high but it depends mainly on the primary cause of RV failure (RVF), the severity of end-organ dysfunction, and the timing of RVAD implantation, and much less on adverse events and complications related to RVAD implantation, support, or removal...
February 17, 2018: Heart Failure Reviews
https://www.readbyqxmd.com/read/29449241/simplified-guideline-for-prescribing-medical-cannabinoids-in-primary-care
#5
G Michael Allan, Jamil Ramji, Danielle Perry, Joey Ton, Nathan P Beahm, Nicole Crisp, Beverly Dockrill, Ruth E Dubin, Ted Findlay, Jessica Kirkwood, Michael Fleming, Ken Makus, Xiaofu Zhu, Christina Korownyk, Michael R Kolber, James McCormack, Sharon Nickel, Guillermina Noël, Adrienne J Lindblad
OBJECTIVE: To develop a clinical practice guideline for a simplified approach to medical cannabinoid use in primary care; the focus was on primary care application, with a strong emphasis on best available evidence and a promotion of shared, informed decision making. METHODS: The Evidence Review Group performed a detailed systematic review of 4 clinical areas with the best evidence around cannabinoids: pain, nausea and vomiting, spasticity, and adverse events. Nine health professionals (2 generalist family physicians, 2 pain management-focused family physicians, 1 inner-city family physician, 1 neurologist, 1 oncologist, 1 nurse practitioner, and 1 pharmacist) and a patient representative comprised the Prescribing Guideline Committee (PGC), along with 2 nonvoting members (pharmacist project managers)...
February 2018: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29448148/large-inter-rater-variability-on-eeg-reactivity-is-improved-by-a-novel-quantitative-method
#6
Christophe Henri Valdemar Duez, Mads Qvist Ebbesen, Krisztina Benedek, Martin Fabricius, Mary Doreen Atkins, Sandor Beniczky, Troels W Kjaer, Hans Kirkegaard, Birger Johnsen
OBJECTIVE: To assess inter-rater agreement on EEG-reactivity (EEG-R) in comatose patients and compare it with a quantitative method (QEEG-R). METHODS: Six 30-s stimulation epochs (noxious, visual and auditory) were performed during EEG on 19 neurosurgical and 11 cardiac arrest patients. Six experts analysed EEGs for reactivity using their habitual methods. QEEG-R was defined as present if ≥2/6 epochs were reactive (stimulation/rest power ratio exceeding noise level)...
February 2, 2018: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/29440801/a-retrospective-study-of-end-of-life-care-decisions-in-the-critically-ill-in-a-surgical-intensive-care-unit
#7
Yi Lin Lee, Yee Yian Ong, Sze Ying Thong, Shin Yi Ng
Aim: Progress in medical care and technology has led to patients with more advanced illnesses being admitted to the Intensive Care Unit (ICU). The practice of approaching end-of-life (EOL) care decisions and limiting care is well documented in Western literature but unknown in Singapore. We performed a retrospective cohort study to describe the practice of EOL care in patients dying in a Singapore surgical ICU (SICU). The surgical critical care population was chosen as it is unique because surgeons are frequently involved in the EOL process...
January 2018: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/29440799/is-every-life-worth-saving-does-religion-and-religious-beliefs-influence-paramedic-s-end-of-life-decision-making-a-prospective-questionnaire-based-investigation
#8
Alexander Leibold, Christoph L Lassen, Nicole Lindenberg, Bernhard M Graf, Christoph Hr Wiese
Background: Paramedics, arriving on emergency cases first, have to make end-of-life decisions almost on a daily basis. Faith shapes attitudes toward the meaning and worth of life itself and therefore influences decision-making. Objective: The objective of this study was to detect whether or not religious and spiritual beliefs influence paramedics in their workday life concerning end-of-life decisions, and whether it is legally possible for them to act according to their conscience...
January 2018: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/29439650/a-model-to-predict-disease-progression-in-patients-with-autosomal-dominant-polycystic-kidney-disease-adpkd-the-adpkd-outcomes-model
#9
Phil McEwan, Hayley Bennett Wilton, Albert C M Ong, Bjarne Ørskov, Richard Sandford, Francesco Scolari, Maria-Cristina V Cabrera, Gerd Walz, Karl O'Reilly, Paul Robinson
BACKGROUND: Autosomal dominant polycystic kidney disease (ADPKD) is the leading inheritable cause of end-stage renal disease (ESRD); however, the natural course of disease progression is heterogeneous between patients. This study aimed to develop a natural history model of ADPKD that predicted progression rates and long-term outcomes in patients with differing baseline characteristics. METHODS: The ADPKD Outcomes Model (ADPKD-OM) was developed using available patient-level data from the placebo arm of the Tolvaptan Efficacy and Safety in Management of ADPKD and its Outcomes Study (TEMPO 3:4; ClinicalTrials...
February 13, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29436432/passing-the-baton-of-trust
#10
Catherine Millington-Sanders
Proactive, shared decision making between key professionals and sensitive communication with patients, and those important to them, can never be overestimated. Projected annual deaths in England and Wales are set to rise, highlighting the increasing need for high quality palliative and end-of-life care. The Royal College of General Practitioners and Marie Curie have worked in partnership to develop the Daffodil Standards, an evidenced-based, structured approach for practices using quality improvement methodology to help improve care for patients at an advanced stage of serious illness or approaching end of life...
February 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29432705/lay-patient-navigators-perspectives-of-barriers-facilitators-and-training-needs-in-initiating-advance-care-planning-conversations-with-older-patients-with-cancer
#11
Soumya J Niranjan, Chao-Hui S Huang, J Nicholas Dionne-Odom, Karina I Halilova, Maria Pisu, Patricia Drentea, Elizabeth A Kvale, Kerri S Bevis, Thomas W Butler, Edward E Partridge, Gabrielle B Rocque
CONTEXT: Respecting Choices is an evidence-based model of facilitating advance care planning (ACP) conversations between health-care professionals and patients. However, the effectiveness of whether lay patient navigators can successfully initiate Respecting Choices ACP conversations is unknown. As part of a large demonstration project (Patient Care Connect [PCC]), a cohort of lay patient navigators underwent Respecting Choices training and were tasked to initiate ACP conversations with Medicare beneficiaries diagnosed with cancer...
January 1, 2018: Journal of Palliative Care
https://www.readbyqxmd.com/read/29431532/a-29-year-analysis-of-acute-peak-salicylate-concentrations-in-fatalities-reported-to-united-states-poison-centers
#12
Brandon J Warrick, Andrew King, Susan Smolinske, Ronald Thomas, Cynthia Aaron
BACKGROUND/OBJECTIVES: The threshold salicylate concentration commonly recommended to initiate extracorporeal elimination, in the absence of significant end-organ toxicity, is 100 mg/dL. Unfortunately, the grade of evidence to support this decision is low. Our primary aim is to describe highest reported salicylate concentrations in patients who died from acute salicylate ingestions. Our secondary aim is to determine if age or coingestants varied with highest reported salicylate concentration...
February 12, 2018: Clinical Toxicology
https://www.readbyqxmd.com/read/29428002/physician-perceptions-regarding-antimicrobial-use-in-end-of-life-care
#13
Christopher E Gaw, Keith W Hamilton, Jeffrey S Gerber, Julia E Szymczak
BACKGROUND The decision to utilize antimicrobials in end-of-life situations is complex. Understanding the reasons why physicians prescribe antimicrobials in this patient population is important for informing the design of antimicrobial stewardship interventions. METHODS A 51-item survey containing both closed and open-ended questions on end-of-life antimicrobial use was administered to physicians affiliated with the University of Pennsylvania and Children's Hospital of Philadelphia from January through April 2017...
February 12, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29426965/decisional-control-preferences-in-the-hispanic-population-in-the-bronx
#14
Jhosselini Cardenas, Pamela Infante, Abel Infante, Elizabeth Chuang, Peter Selwyn
Hispanic Americans are among the fastest growing minority groups in the USA, and understanding their preferences for medical decision-making and information sharing is imperative to provide high quality end of life care. Studies exploring these decision control preferences (DCPs) are limited and found inconsistent results. (1) To measure DCPs of Hispanic patients in the Bronx. (2) To measure disclosure of information preferences of Hispanic patients in the Bronx. This is a cross-sectional survey. One hundred nineteen cancer patients who self-identified as Hispanic and were waiting at the oncology clinic at Montefiore Medical Center Cancer Center...
February 9, 2018: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
https://www.readbyqxmd.com/read/29425521/identifiable-risk-factors-and-miscalculations-during-listing-for-pediatric-heart-transplantation
#15
REVIEW
Hugo R Martinez, Samuel Wittekind, Roosevelt Bryant, James S Tweddell, Clifford Chin
The objective of this study is to describe identifiable risk factors, complications, and pitfalls while listing pediatric patients for heart transplantation, which is the standard of care for end-stage heart disease in children. Since the introduction of cyclosporine in the 1980s, the management in pediatric heart transplantation has shown consistent improvement, mainly because of technological advances and the integration of multidisciplinary teams in the field. However, the complexity of this patient population makes medical providers vulnerable to complications as a result of undesirable mistakes...
March 2018: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
https://www.readbyqxmd.com/read/29421457/political-economy-of-hope-as-a-cultural-facet-of-biomedicalization-a-qualitative-examination-of-constraints-to-hospice-utilization-among-u-s-end-stage-cancer-patients
#16
Emily Hammad Mrig, Karen Lutfey Spencer
A growing body of social science literature is devoted to describing processes of biomedicalization. The issue of biomedicalization is especially relevant for individuals suffering from end-stage cancer and hoping that aggressive end-of-life interventions, which are riddled with uncertainty around quantity or quality of life, will produce a 'cure'. To examine hospice underutilization among end-stage cancer patients, we apply the anthropological concept 'political economy of hope,' which describes how personal and collective 'hope' is associated with the political and economic structures that produce biomedicalization processes...
January 27, 2018: Social Science & Medicine
https://www.readbyqxmd.com/read/29421166/defining-the-scope-of-prognosis-primary-care-clinicians-perspectives-on-predicting-the-future-health-of-older-adults
#17
John M Thomas, Terri R Fried
CONTEXT: Studies examining the attitudes of clinicians towards prognostication for older adults have focused on life expectancy prediction. Little is known about whether clinicians approach prognostication in other ways. OBJECTIVES: To describe how clinicians approach prognostication for older adults, defined broadly as making projections about patients' future health METHODS: In five focus groups, thirty primary care clinicians from community-based, academic-affiliated, and Veterans Affairs primary care practices were given open-ended questions about how they make projections about their patients' future health, and how this informs the approach to care...
February 5, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29419564/patient-factors-and-outcomes-associated-with-the-withdrawal-or-withholding-of-life-sustaining-therapies-in-mechanically-ventilated-brain-injured-patients-an-observational-multicentre-study
#18
Nicolas Nesseler, Antoine Roquilly, Sigismond Lasocki, Claire Dahyot-Fizelier, Yoann Launey, Cinotti Raphaël, Marine Hubert, Sonia Isslame, Pierre-François Perrigault, Thomas Geeraerts, Olivier Mimoz, Fouad Marhar, Yannick Mallédant, Fanny Feuillet, Karim Asehnoune, Philippe Seguin
BACKGROUND: Knowledge of the factors associated with the decision to withdraw or withhold life support (WWLS) in brain-injured patients is limited. However, most deaths in these patients may involve such a decision. OBJECTIVES: To identify factors associated with the decision to WWLS in brain-injured patients requiring mechanical ventilation who survive the first 24 h in the ICU, and to analyse the outcomes and time to death. DESIGN: A retrospective observational multicentre study...
February 3, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29417395/islamic-considerations-on-the-application-of-patient-s-autonomy-in-end-of-life-decision
#19
Mohammad Mustaqim Malek, Noor Naemah Abdul Rahman, Mohd Shahnaz Hasan, Luqman Haji Abdullah
In end-of-life situation, the need for patient's preference comes into the picture with the intention of guiding physicians in the direction of patient care. Preference in medical directive is made by a person with full mental capacity outlining what actions should be taken for his health should he loses his competency. This is based on the reality of universal paradigm in medical practice that emphasises patient's autonomy. A specific directive is produced according to a patient's wish that might include some ethically and religiously controversial directives such as mercy killing, physician-assisted suicide, forgoing life-supporting treatments and do-not-resuscitate...
February 7, 2018: Journal of Religion and Health
https://www.readbyqxmd.com/read/29417291/management-and-survival-analysis-of-elderly-patients-with-a-cancer-in-the-digestive-system-who-refused-to-receive-anticancer-treatments
#20
Jun Wan, Shiping Xu, Yinqiao Wu, Benyan Wu, Dezhong Joshua Liao, Ningzhi Xu, Gangshi Wang
Treatment and management of cancers in elderly patients require some special considerations. A better understanding of how cancers progress in those elderly patients who have not received any anticancer treatments could better help us in treating these patients and in making end-of-life decisions. Over the past years, we had encountered 57 elderly patients, aged 75 to 94 years (87.6 on average), with a cancer in the digestive system, who refused to accept anticancer treatment but who did receive the best available supportive and palliative care...
February 7, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
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