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https://www.readbyqxmd.com/read/28079553/end-of-life-decisions-in-heart-failure-to-turn-off-the-intracardiac-device-or-not
#1
Bilal Ayach, Amrit Malik, Colette Seifer, Shelley Zieroth
PURPOSE OF REVIEW: Heart failure is a significant public health concern around the world. Implantable cardioverter defibrillators with or without cardiac resynchronization therapy (CRT-D) have proven survival benefit. As patients progress to end-stage disease, management shifts to palliative care, and cardiologists are often confronted with how to best manage these devices. RECENT FINDINGS: Studies suggest that up to one-third of patients with an implantable cardioverter defibrillator receive painful shocks in the last 24 h of life...
January 11, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28078828/biomarkers-upon-discontinuation-of-renal-replacement-therapy-predict-60-day-survival-and-renal-recovery-in-critically-ill-patients-with-acute-kidney-injury
#2
Tingting Yang, Si Sun, Yuliang Zhao, Qiang Liu, Mei Han, Liping Lin, Baihai Su, Songmin Huang, Lichuan Yang
Introduction There is no consensus on the specific indications for weaning critically ill patients with acute kidney injury (AKI) off renal replacement therapy (RRT). This study aimed to explore the prognostic value of several biomarkers measured upon discontinuation of RRT for their value in predicting 60-day survival and renal recovery in an effort to add knowledge to the decision-making process regarding RRT withdrawal. Methods We prospectively enrolled 102 patients with AKI who required RRT from the intensive care unit...
January 11, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28078168/concurrent-validity-of-caffeine-problems-and-diagnostic-criteria-for-substance-use-disorders
#3
Elizabeth Harstad, Georgios Sideridis, Lon Sherritt, Lydia A Shrier, Rosemary Ziemnik, Sharon Levy
Background: The DSM-5 proposes caffeine use disorder (CUD) as a condition for further study. The objective of this study was to report on the prevalence of CUD and rates of endorsement for each substance use disorder (SUD) criterion in relation to caffeine compared to alcohol and marijuana in a sample of adolescents presenting for medical care in the primary, adolescent, and substance use clinics at an academic medical center. Methods: A convenience sample of patients (N = 213; 66.7% female) aged 12-17 presenting for medical care completed the Composite Diagnostic Interview-Substance Abuse Module questionnaire, with questions regarding use of caffeine, alcohol, and marijuana...
December 1, 2016: Journal of Caffeine Research
https://www.readbyqxmd.com/read/28073819/the-opioid-epidemic-and-neonatal-abstinence-syndrome-in-the-usa-a-review-of-the-continuum-of-care
#4
Jason R Pryor, Faouzi I Maalouf, Elizabeth E Krans, Robert E Schumacher, William O Cooper, Stephen W Patrick
As the prescription opioid epidemic grew in the USA, its impact extended to pregnant women and their infants. This review summarises how increasing rates of neonatal abstinence syndrome resulted in a need to improve care to pregnant women and opioid-exposed infants. We discuss the variations in care delivery with particular emphasis on screening at-risk mothers, scoring systems for neonatal drug withdrawal, type and duration of pharmacotherapy, and discharge safety.
January 10, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28072812/is-kratom-the-new-legal-high-on-the-block-the-case-of-an-emerging-opioid-receptor-agonist-with-substance-abuse-potential
#5
George C Chang-Chien, Charles A Odonkor, Prin Amorapanth
Kratom is an unscheduled opioid receptor agonist that comes in the form of dietary supplements currently being abused by chronic pain patients on prescription opioids. Active alkaloids isolated from kratom such as mitragynine and 7-hydroxymitragynine are thought to act on mu- and delta-opioid receptors as well as alpha-2 adrenergic and 5-HT2A receptors. Animal studies suggest that kratom may be more potent than morphine. Consequently, kratom consumption produces analgesic and euphoric feelings among users. In particular, some chronic pain patients on opioids take kratom to counteract the effects of opioid withdrawal...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28067594/nicotine-withdrawal-relapse-of-mental-illness-or-medication-side-effect-implementing-a-monitoring-tool-for-people-with-mental-illness-into-quitline-counseling
#6
Catherine J Segan, Amanda L Baker, Alyna Turner, Jill M Williams
BACKGROUND: Smokers with mental illness and their health care providers are often concerned that smoking cessation will worsen mental health. Smokers with mental illness tend to be more nicotine dependent and experience more severe symptoms of nicotine withdrawal, some of which are difficult to distinguish from psychiatric symptoms. In addition, smoking cessation can increase the blood levels and hence side-effects of some psychotropic medications. Improved monitoring of nicotine withdrawal and medication side-effects may help distinguish temporary withdrawal symptoms from psychiatric symptoms and facilitate targeted treatment to help smokers with mental illness manage the acute phase of nicotine withdrawal...
January 9, 2017: Journal of Dual Diagnosis
https://www.readbyqxmd.com/read/28065391/-cancer-prevention-in-france-implication-of-health-professionals
#7
REVIEW
Andrea Lasserre, Julie Gaillot, Antoine Deutsch, Claire Chauvet, Dominique Bessette, Raphaëlle Ancellin
Almost 40% of cancers are attributable to preventable cancer risk factors related to behavior. Health professionals must take into account the respective weight of the different causes of cancer to enforce effective cancer prevention. Their involvement is needed on several levels. In primary prevention, not only for vaccinations, detection and support the withdrawal of addiction, but also by a greater consideration in their patients of all cancer risk behavioral factors. This involvement is essential in the care and monitoring of patients with cancer...
January 5, 2017: Bulletin du Cancer
https://www.readbyqxmd.com/read/28063864/the-end-of-life-experience-of-pediatric-heart-transplant-recipients
#8
Seth A Hollander, John Dykes, Sharon Chen, Lynsey Barkoff, Barbara Sourkes, Harvey Cohen, David N Rosenthal, Daniel Bernstein, Beth D Kaufman
CONTEXT: Despite advances in therapies, many pediatric heart transplant (Htx) recipients will die prematurely. We characterized the circumstances surrounding death in this cohort, including location of death and interventions performed in the final 24 hours. METHODS: We reviewed all patients who underwent Htx at Lucile Packard Children's Hospital, Stanford, survived hospital discharge, and subsequently died between 7/19/2007-9/13/2015. The primary outcome studied was location of death, characterized as inpatient, outpatient, or emergency department (ED)...
January 4, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28063660/deprescribing-a-narrative-review-of-the-evidence-and-practical-recommendations-for-recognizing-opportunities-and-taking-action
#9
REVIEW
Emily Reeve, Wade Thompson, Barbara Farrell
Deprescribing can be defined as the process of withdrawal or dose reduction of medications which are considered inappropriate in an individual. The aim of this narrative review is to provide an overview of "deprescribing"; firstly discussing the potential benefits and harms followed by the barriers to and enablers of deprescribing. We also provide practical recommendations to recognise opportunities and strategies for deprescribing in practice. Studies focused on minimizing polypharmacy indicate that deprescribing may be associated with potential benefits including resolution of adverse drug reactions, improved quality of life and medication adherence and a reduction in drug costs...
January 4, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28061017/feasibility-and-safety-of-extended-release-naltrexone-treatment-of-opioid-and-alcohol-use-disorder-in-hiv-clinics-a-pilot-feasibility-randomized-trial
#10
P Todd Korthuis, Paula J Lum, Pamela Vergara-Rodriguez, Keith Ahamad, Evan Wood, Lynn E Kunkel, Neal L Oden, Robert Lindblad, James L Sorensen, Virgilio Arenas, Doan Ha, Raul N Mandler, Dennis Mccarty
BACKGROUND AND AIMS: HIV-infected persons with substance use disorders are least likely to benefit from advances in HIV treatment. Integration of extended-release naltrexone (XR-NTX) into HIV clinics may increase engagement in the HIV care continuum by decreasing substance use. We aimed to compare 1) XR-NTX treatment initiation, 2) retention, and 3) safety of XR-NTX versus treatment as usual (TAU) for treating opioid use disorder (OUD) and/or alcohol use disorder (AUD) in HIV clinics...
January 6, 2017: Addiction
https://www.readbyqxmd.com/read/28060160/withdrawal-of-life-sustaining-therapy-at-home-broadening-the-view-of-end-of-life-care-in-the-picu%C3%A2-even-in-children-s-homes
#11
Amy Sanderson, Jeffrey P Burns
No abstract text is available yet for this article.
January 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28058228/corticosteroid-minimization-in-renal-transplantation-careful-patient-selection-enables-feasibility
#12
Georgios Vlachopanos, Julie M Bridson, Ajay Sharma, Ahmed Halawa
AIM: To explore the benefits and harms of corticosteroid (CS) minimization following renal transplantation. METHODS: CS minimization attempts to improve cardiovascular risk factors (hypertension, diabetes, dyslipidemia), to enhance growth in children, to ameliorate bone disease and to lead to better compliance with immunosuppressive agents. Nevertheless, any benefit must be carefully weighed against the reduction in net immunosuppression and the potential harm to renal allograft function and survival...
December 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/28057111/-health-economic-evaluation-of-a-23-value-pneumococcal-polysaccharide-vaccination-pilot-programme-among-elderly-chronic-obstructive-pulmonary-disease-patients-in-china
#13
Y P Qiu, K Zhao, X Li, L W Shi, W D Guo, X R Qi, B Y Sui, R M Zhou
Objective: From the perspective of health economics, to evaluate 23 pneumococcal polysaccharide vaccination programme among chronic obstructive pulmonary disease (COPD) patient. Methods: In the pilot counties of the project of integrated care pathway for COPD patient (Hanbin district of Hanzhong city in Shanxi Province, Qianjian district of Qingqing city, Huandao district of Qindao city in Shangdong Province, Wen county of Jiaozuo city in Henan Province), information of insurance participants of New Rural Cooperative Medical System (NRCS) was collected by local NRCM information system, which included general information as well as records of medical care and medical fee...
December 6, 2016: Zhonghua Yu Fang Yi Xue za Zhi [Chinese Journal of Preventive Medicine]
https://www.readbyqxmd.com/read/28051842/the-use-of-auricular-acupuncture-in-opioid-use-disorder-a-systematic-literature-review
#14
REVIEW
Tanya E Baker, Grace Chang
BACKGROUND AND OBJECTIVES: Opioid use disorder (OUD) is a chronic disease with significant personal, societal, and public health consequences. Even for the minority who receive the most effective evidence-based treatments, morbidity, and mortality remain significant. These facts, along with the recovery movement calling for individualized, holistic, culturally sensitive care, have led to the exploration of adjunctive interventions including acupuncture. Despite hundreds of international trials, however, there is a lack of consensus regarding its efficacy in OUD due in large part to methodological issues of trials to date...
December 2016: American Journal on Addictions
https://www.readbyqxmd.com/read/28045861/pharmacokinetics-and-pharmacogenetics-of-ssris-during-pregnancy-an-observational-study
#15
Laura Pogliani, Felicia Stefania Falvella, Dario Cattaneo, Paola Pileri, Anna Flora Moscatiello, Stefania Cheli, Sara Baldelli, Valentina Fabiano, Irene Cetin, Emilio Clementi, Gianvincenzo Zuccotti
BACKGROUND: An involvement of selective serotonin reuptake inhibitors (SSRIs) in increasing the risk of malformations, neonatal withdrawal syndrome, has been suggested recently. Here, we aimed to investigate the contribution of individual pharmacogenetics of SSRI on infants' outcome. We also estimated the umbilical/maternal plasma SSRI concentration ratio in the pregnant women still on SSRI therapy at the time of delivery. METHODS: Thirty-four pregnant women, referred to our hospital from January 2011 to July 2015, who were given SSRIs in the third trimester, and related children, were considered...
December 29, 2016: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28042369/oral-baclofen-withdrawal-resulting-in-progressive-weakness-and-sedation-requiring-intensive-care-admission
#16
Bret D Alvis, Christopher M Sobey
Baclofen is a common medication used as a muscle relaxant and antispasmodic. Baclofen-withdrawal syndrome has many symptoms such as sedation, somnolence, and weakness but can include psychological symptoms. We present a 62-year-old female whose oral baclofen was not continued at a skilled nursing facility after discharge following inpatient surgery that led to the development of altered mental status and respiratory insufficiency necessitating intensive care unit admission. Abrupt cessation of baclofen, no matter the mode of administration to the patient, can lead to baclofen-withdrawal syndrome...
January 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28041869/-palliative-care-after-neonatal-intensive-care-contributions-of-leonetti-law-and-remaining-challenges
#17
P Kuhn, L Dillenseger, N Cojean, B Escande, C Zores, D Astruc
The 2005 enactment of the "Patients' rights and end-of-life care" act, known as the Leonetti law, has been accompanied by practical changes in the processes of withdrawal and withholding of active life-sustaining treatments. This law has also promoted the implementation of palliative care in perinatal medicine to avoid unreasonable therapeutic interventions and to preserve the dying patient's quality of life and human dignity. Recently, a new law has been voted by the French National Assembly and new reflections on the ethical aspects of the end of life in neonatal medicine should resume again within the French Society of Neonatology in the working group on ethical issues in neonatology...
December 29, 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28035993/brain-monitoring-in-critically-neurologically-impaired-patients
#18
REVIEW
Salazar Jones, Gary Schwartzbauer, Xiaofeng Jia
Assessment of neurologic injury and the evolution of severe neurologic injury is limited in comatose or critically ill patients that lack a reliable neurologic examination. For common yet severe pathologies such as the comatose state after cardiac arrest, aneurysmal subarachnoid hemorrhage (aSAH), and severe traumatic brain injury (TBI), critical medical decisions are made on the basis of the neurologic injury. Decisions regarding active intensive care management, need for neurosurgical intervention, and withdrawal of care, depend on a reliable, high-quality assessment of the true state of neurologic injury, and have traditionally relied on limited assessments such as intracranial pressure monitoring and electroencephalogram...
December 27, 2016: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28032354/end-of-life-treatment-decisions-in-nursing-home-residents-dying-with-dementia-in-the-netherlands
#19
Simone A Hendriks, Martin Smalbrugge, Luc Deliens, Raymond T C M Koopmans, Bregje D Onwuteaka-Philipsen, Cees M P M Hertogh, Jenny T van der Steen
OBJECTIVE: The objective was to describe end-of-life treatment decisions for patients dying with dementia in various stages of dementia in long-term care facilities in the Netherlands with elderly care physicians responsible for treatment and care. METHODS: We present data collected in the nationally representative Dutch End of Life in Dementia study (2007-2011). Within 2 weeks after death, 103 physicians completed questionnaires about the last phase of life in 330 residents with dementia who resided in 1 of 34 participating long-term care facilities...
December 29, 2016: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28031934/stories-of-experiences-of-care-for-growth-hormone-deficiency-the-crescere-project
#20
Maria G Marini, Paola Chesi, Laura Mazzanti, Laura Guazzarotti, Teresa D Toni, Maria C Salerno, Annunziata Officioso, Maria Parpagnoli, Cristina Angeletti, Maria F Faienza, Maria L Iezzi, Tommaso Aversa, Cinzia Sacchetti
AIMS: Growth hormone deficiency therapy is demanding for patients and caregivers. Teams engaged in the clinical management of growth hormone deficiency therapy need to know how families live with this condition, to provide an adequate support and prevent the risk of withdrawal from therapy. METHODS: Using Narrative Medicine, testimonies from patients, their parents and providers of care were collected from 11 Italian centers. Narrations were analyzed throughout an elaboration of recurring words and expressions...
March 2016: Future Science OA
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