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Advanced life support

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https://www.readbyqxmd.com/read/29150491/hypothermia-modulates-arrhythmia-substrates-during-different-phases-of-resuscitation-from-ischemic-cardiac-arrest
#1
Joseph S Piktel, Aurelia Cheng, Matthew McCauley, Zack Dale, Michelle Nassal, Danielle Maleski, Gary Pawlowski, Kenneth R Laurita, Lance D Wilson
BACKGROUND: We designed an innovative porcine model of ischemia-induced arrest to determine dynamic arrhythmia substrates during focal infarct, global ischemia from ventricular tachycardia or fibrillation (VT/VF) and then reperfusion to determine the effect of therapeutic hypothermia (TH) on dynamic arrhythmia substrates and resuscitation outcomes. METHODS AND RESULTS: Anesthetized adult pigs underwent thoracotomy and regional plunge electrode placement in the left ventricle...
November 17, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29147847/r-hyper-cvad-versus-r-chop-cytarabine-with-high-dose-therapy-and-autologous-haematopoietic-stem-cell-support-in-fit-patients-with-mantle-cell-lymphoma-20%C3%A2-years-of-single-center-experience
#2
Fabienne Widmer, Stefan Balabanov, Davide Soldini, Panagiotis Samaras, Bernhard Gerber, Markus G Manz, Jeroen S Goede
Standard of care for untreated mantle cell lymphoma (MCL) is still debated. At the University Hospital Zurich, advanced MCL in physically fit patients is treated either with rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisone induction followed by consolidating high-dose chemotherapy and autologous stem cell support (R-CHOP/HD-ASCT), or with rituximab plus fractionated cyclophosphamide, vincristine, doxorubicin and dexamethasone alternating with high-dose methotrexate-cytarabine (R-hyper-CVAD/MTX-AraC) without consolidating HD-ASCT upon physicians' and patients' choice...
November 16, 2017: Annals of Hematology
https://www.readbyqxmd.com/read/29145928/note-of-clarification-potential-risks-to-offspring-of-intrauterine-exposure-to-maternal-age-related-obstetric-complications
#3
Juan J Tarín, Miguel A García-Pérez, Antonio Cano
Several hypotheses have been proposed to explain the negative effects of delayed motherhood on an offspring's morbidity later in life. However, these hypotheses are not supported by clinical and epidemiological evidence. Because advanced maternal age is associated with increased risk of obstetric complications, the aim of the present study was to ascertain whether the negative effects on offspring of intrauterine exposure to maternal age-related obstetric complications may explain the reported negative effects of delayed motherhood on offspring...
August 2017: Reproduction, Fertility, and Development
https://www.readbyqxmd.com/read/29145869/a-mixed-methods-analysis-of-quality-of-life-among-late-life-patients-diagnosed-with-chronic-illnesses
#4
Monica S Frazer, Patrick Mobley
BACKGROUND: Quality of life (QOL) is an important consideration for people living with advancing chronic conditions. Palliative care providers speak about how, despite physical decline in late life, many patients report growth and meaning in other domains. This mixed methods study uses QOL survey responses to explore domain trajectories and interview data to explore how patients with advancing chronic conditions experience distinct QOL domains. METHODS: The study sample includes 156 now-deceased participants who completed the FACIT-Pal quarterly, and 40 (10 now-deceased) participants who discussed QOL in an interview...
November 16, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/29145313/the-importance-of-family-caregiving-to-achieving-palliative-care-at-home-a-case-report-of-end-of-life-breast-cancer-in-an-area-struck-by-the-2011-fukushima-nuclear-crisis-a-case-report
#5
Akihiko Ozaki, Masaharu Tsubokura, Claire Leppold, Toyoaki Sawano, Manabu Tsukada, Tsuyoshi Nemoto, Kazuhiro Kosugi, Yoshitaka Nishikawa, Shigeaki Kato, Hiromichi Ohira
RATIONALE: The primary setting of palliative care has shifted from inpatient care to patients' residences. Family caregiving is essential for patients with life-limiting illnesses to receive palliative care at home, however little information is available regarding potential interventions to achieve palliative homecare for those without sufficient support from family members in various settings, including disasters. PATIENT CONCERNS: In March 2011, Fukushima, Japan experienced an earthquake, tsunami and nuclear disaster...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29144241/shifting-risks-and-conflicting-outcomes-ecmo-for-neonates-with-congenital-diaphragmatic-hernia-in-the-modern-era
#6
Joseph W Turek, Joseph R Nellis, Brenton G Sherwood, Meera Kotagal, Andrew L Mesher, Ravi R Thiagarajan, Sonali S Patel, Jeffrey R Avansino, Peter T Rycus, D Michael McMullan, Thomas V Brogan
OBJECTIVES: To update previously described trends for neonates with congenital diaphragmatic hernia (CDH) receiving ECMO with changes in recommendations for care, and to determine how recent advancements in respiratory care have affected this patient population. STUDY DESIGN: This study is a retrospective review of more than 2500 neonates with CDH who received ECMO listed in the Extracorporeal Life Support Organization (ELSO) registry. Cochran-Armitage and multivariate regression analyses were used to analyze changes in the patient population over time and in mortality-related risk factors...
November 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29138367/-the-framework-of-the-amended-cancer-control-act
#7
Shinsuke Amano
The Cancer Control Act approved in 2006 was amended in December 2016 by the nonpartisan federation of the National Assembly, while meeting the requests from cancer patient groups. In the chapter on the basic ideas, it is said that cancer control needs to advance the development ofthe social environment that enables cancer patients to run a smooth social life and employment support for cancer patients and promotion of cancer education are newly stated. In the chapter on the basic measures, palliative care, rehabilitation, the research on rare cancer and intractable cancer, the treatment ofchildhood cancer patients and the improvement of educational environment for those patients, and the support for private organizations and cancer patient groups are newly stated...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29138206/monitor-ic-study-a-mixed-methods-prospective-multicentre-controlled-cohort-study-assessing-5-year-outcomes-of-icu-survivors-and-related-healthcare-costs-a-study-protocol
#8
Wytske Geense, Marieke Zegers, Hester Vermeulen, Mark van den Boogaard, Johannes van der Hoeven
INTRODUCTION: Due to advances in critical care medicine, more patients survive their critical illness. However, intensive care unit (ICU) survivors often experience long-term physical, cognitive and mental problems, summarised as post-intensive care syndrome (PICS), impacting their health-related quality of life (HRQoL). In what frequency PICS occurs, and to what extent this influences ICU survivors' HRQoL, is mostly unknown. The aims of this study are therefore to study the: (1) 5-year patient outcomes, (2) predictors for PICS, (3) ratio between HRQoL of ICU survivors and healthcare-related costs, and (4) care and support needs...
November 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/29138131/reducing-symptom-distress-in-patients-with-advanced-cancer-using-an-e-alert-system-for-caregivers-pooled-analysis-of-two-randomized-clinical-trials
#9
David H Gustafson, Lori L DuBenske, Amy K Atwood, Ming-Yuan Chih, Roberta A Johnson, Fiona McTavish, Andrew Quanbeck, Roger L Brown, James F Cleary, Dhavan Shah
BACKGROUND: Symptom distress in patients toward the end of life can change rapidly. Family caregivers have the potential to help patients manage those symptoms, as well as their own stress, if they are equipped with the proper resources. Electronic health (eHealth) systems may be able to provide those resources. Very sick patients may not be able to use such systems themselves to report their symptoms but family caregivers could. OBJECTIVE: The aim of this paper was to assess the effects on cancer patient symptom distress of an eHealth system that alerts clinicians to significant changes in the patient's symptoms, as reported by a family caregiver...
November 14, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29137701/the-correlation-between-atls-and-junior-doctors-anatomical-knowledge-of-central-venous-catheter-insertion-at-a-major-trauma-service-in-south-africa
#10
V Y Kong, J J Odendaal, R Weale, M Liu, C M Keene, B Sartorius, D L Clarke
OBJECTIVE: To review the ability of junior doctors (JDs) in identifying the correct anatomical site for central venous catheterization (CVC) and whether prior Advanced Trauma Life Support (ATLS) training influences this. DESIGN: We performed a prospective, observational study using a structured survey and asked a group of JDs (postgraduate year 1 [PGY1] or year 2 [PGY2]) to indicate on a photograph the exact site for CVC insertion via the internal jugular (IJV) and the subclavian (SCV) approach...
November 7, 2017: Injury
https://www.readbyqxmd.com/read/29136683/why-is-meaning-centered-group-psychotherapy-mcgp-effective-enhanced-sense-of-meaning-as-the-mechanism-of-change-for-advanced-cancer-patients
#11
Barry Rosenfeld, Heining Cham, Hayley Pessin, William Breitbart
OBJECTIVES: Meaning-Centered Group Psychotherapy (MCGP) has been demonstrated to be an effective method for improving advanced cancer patients' quality of life and reducing their depression, hopelessness, and desire for hastened death. To further understand MCGP, this study examined the mechanisms of change in MCGP on these outcomes via advanced cancer patients' changes of sense of meaning and peace in life. METHODS: The sample data were from two randomized control trials that compared MCGP (n = 124) to supportive group psychotherapy (n = 94)...
November 14, 2017: Psycho-oncology
https://www.readbyqxmd.com/read/29135530/should-percussion-pacing-have-a-role-in-perioperative-advanced-cardiac-life-support-a-case-report
#12
Chris Giordano, Jordan Miller, Ilan Keidan
Percussion pacing involves using one's fist to repeatedly strike a patient's left sternal border in a rhythmic manner. The resulting increase in ventricular pressure can trigger myocardial depolarization and subsequent contraction. We describe the successful treatment of acute preoperative symptomatic sinus bradycardia with percussion pacing in a 63-year-old patient scheduled for placement of a gastric feeding tube after trauma involving spinal cord injury. Although no longer included in current advanced cardiovascular life support guidelines, percussion pacing may be a suitable alternative to chest compressions in multitrauma cases where the force of compressions could cause further complications...
November 9, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29135524/a-palliative-approach-for-heart-failure-end-of-life-care
#13
Jane Maciver, Heather J Ross
PURPOSE OF REVIEW: The current review discusses the integration of guideline and evidence-based palliative care into heart failure end-of-life (EOL) care. RECENT FINDINGS: North American and European heart failure societies recommend the integration of palliative care into heart failure programs. Advance care planning, shared decision-making, routine measurement of symptoms and quality of life and specialist palliative care at heart failure EOL are identified as key components to an effective heart failure palliative care program...
November 10, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29132946/an-interview-study-of-patient-and-caregiver-perspectives-on-advance-care-planning-in-esrd
#14
Marcus Sellars, Josephine M Clayton, Rachael L Morton, Tim Luckett, William Silvester, Lucy Spencer, Carol A Pollock, Rowan G Walker, Peter G Kerr, Allison Tong
BACKGROUND: Advance care planning (ACP) empowers patients to consider and communicate their current and future treatment goals. However, it can be an emotionally charged process for patients with kidney disease and their caregivers. This study aimed to describe the perspectives and attitudes of patients with end-stage renal disease (ESRD) and their caregivers toward ACP. STUDY DESIGN: Qualitative study. SETTING & PARTICIPANTS: Patients with ESRD (n=24) and their caregivers (n=15) aged 36 to 91 years at various stages of ACP ("not commenced," "in progress," or "completed") from 3 renal services...
November 10, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29132595/remote-ecls-implantation-and-transport-for-retrieval-of-cardiogenic-shock-patients
#15
Sabina P W Guenther, Stefan Buchholz, Frank Born, Stefan Brunner, René Schramm, Dominik J Hoechter, Vera von Dossow, Maximilian Pichlmaier, Christian Hagl, Nawid Khaladj
OBJECTIVE: Extracorporeal life support (ECLS) emerges as a salvage option in therapy refractory cardiogenic shock but is limited to highly specialized tertiary care centers. Critically ill patients are often too unstable for conventional transport. Mobile ECLS programs for remote implantation and subsequent air or ground-based transport for patient retrieval could solve this dilemma and make full-spectrum advanced cardiac care available to patients in remote hospitals in whom shock otherwise might be fatal...
November 2017: Air Medical Journal
https://www.readbyqxmd.com/read/29132581/resuscitation-resequenced-a-rational-approach-to-patients-with-trauma-in-shock
#16
REVIEW
Andrew Petrosoniak, Christopher Hicks
Trauma resuscitation is a complex and dynamic process that requires a high-performing team to optimize patient outcomes. More than 30 years ago, Advanced Trauma Life Support was developed to formalize and standardize trauma care; however, the sequential nature of the algorithm that is used can lead to ineffective prioritization. An improved understanding of shock mandates an updated approach to trauma resuscitation. This article proposes a resequenced approach that (1) addresses immediate threats to life and (2) targets strategies for the diagnosis and management of shock causes...
February 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29130418/caregiver-quality-of-life-in-advanced-cancer-qualitative-results-from-a-trial-of-early-palliative-care
#17
Julie McDonald, Nadia Swami, Ashley Pope, Sarah Hales, Rinat Nissim, Gary Rodin, Breffni Hannon, Camilla Zimmermann
BACKGROUND: Early involvement of palliative care improves patient quality of life; however, quantitative studies have not yet demonstrated a similar effect for caregivers, for whom the construct of quality of life is less well developed. AIM: To conceptualise quality of life of caregivers from their own perspective and to explore differences in themes between those who did or did not receive an early palliative care intervention. DESIGN: Qualitative grounded theory study...
November 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/29130405/what-is-the-role-of-community-at-the-end-of-life-for-people-dying-in-advanced-age-a-qualitative-study-with-bereaved-family-carers
#18
Merryn Gott, Janine Wiles, Tess Moeke-Maxwell, Stella Black, Lisa Williams, Ngaire Kerse, Gabriella Trussardi
BACKGROUND: New public health approaches to palliative care prioritise the role of community at end of life. However, little is known about community support for the increasing numbers of people dying in advanced age. AIM: To explore the role of community at end of life for people dying in advanced age from the perspective of their bereaved family caregivers. DESIGN: A constructionist framework underpinned a qualitative research design. Data were analysed using critical thematic analysis...
October 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/29129758/impact-of-nivolumab-versus-docetaxel-on-health-related-quality-of-life-and-symptoms-in-patients-with-advanced-squamous-non-small-cell-lung-cancer-results-from-the-checkmate-017-study
#19
Martin Reck, Fiona Taylor, John R Penrod, Michael DeRosa, Laura Morrissey, Homa Dastani, Lucinda Orsini, Richard J Gralla
INTRODUCTION: In the phase III CheckMate 017 study, nivolumab prolonged overall survival versus docetaxel in previously treated patients with advanced squamous non-small cell lung cancer (NSCLC). Study objectives included health-related quality of life (HRQoL) and symptom assessments. METHODS: Patients serially completed Lung Cancer Symptom Scale (LCSS) and European Quality of Life Five Dimensions (EQ-5D) questionnaires. The LCSS average symptom burden index (ASBI; mean score for six lung cancer-specific symptoms; range, 0-100), LCSS 3-item global index, EQ-5D utility index, and EQ-5D visual analog scale scores were analyzed...
November 9, 2017: Journal of Thoracic Oncology
https://www.readbyqxmd.com/read/29129177/copd-x-australian-and-new-zealand-guidelines-for-the-diagnosis-and-management-of-chronic-obstructive-pulmonary-disease-2017-update
#20
Ian A Yang, Juliet L Brown, Johnson George, Sue Jenkins, Christine F McDonald, Vanessa M McDonald, Kirsten Phillips, Brian J Smith, Nicholas A Zwar, Eli Dabscheck
Chronic obstructive pulmonary disease (COPD) is characterised by persistent respiratory symptoms and chronic airflow limitation, and is associated with exacerbations and comorbidities. Advances in the management of COPD are updated quarterly in the national COPD guidelines, the COPD-X plan, published by Lung Foundation Australia in conjunction with the Thoracic Society of Australia and New Zealand and available at http://copdx.org.au. Main recommendations: Spirometry detects persistent airflow limitation (post-bronchodilator FEV1/FVC < 0...
November 20, 2017: Medical Journal of Australia
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