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Palliative care Brain tumors

Aurélie Duruflé, Claire Le-Meur, Marie-Pierre Reillon, Claire Lozach, Benoit Nicolas
Many mobile teams were created over the past decade in various medical specialties including physical medicine and rehabilitation (MPR). The Pôle Saint-Helier has created a mobile team of rehabilitation-reintegration (EM2R) in December 2012 with support from the Regional Health Agency of Brittany. It operates on the health territory No. 5 of Brittany near people experiencing neurological disability. Its main mission is to implement the necessary devices to facilitate the home return of people hospitalized after a neurological event or maintaining to home people with neurological disorders...
September 2016: Annals of Physical and Rehabilitation Medicine
Véronique Bourg, Anne Descotes, Anne Pagnier, Jacques Griffet, Dominique Plantaz
The Child and Family Hospital of Grenoble is one of the rare university hospitals in France to benefit from the presence of a physician specializing in rehabilitation medicine. This hospital includes both inpatient and outpatient units. During the temporary closure of one department, certain members of the rehabilitation unit were reassigned to the acute care wards of the pediatric department, including physical therapists, occupational therapists, and speech therapists. Over the course of one year, these therapists completed more than 150 interventions in this department, more than half of which were in the hematology and oncology ward...
September 2016: Annals of Physical and Rehabilitation Medicine
B Dasch, K Blum, H Vogelsang, C Bausewein
Background | In Germany, place of death is recorded on death certificates, but is not analyzed further. In consequence, only little is known about the place of death among cancer patients at the population level. The aim of the study was to describe the changes of places of death in cancer patients over a time period of 10 years. Material and methods | This study examined death certificates from 2001 and 2011 of selected regions of Westphalia-Lippe (Germany). Cancer patients were identified on the basis of cause of death...
August 2016: Deutsche Medizinische Wochenschrift
Belinda N Mandrell, Justin Baker, Deena Levine, Jami Gattuso, Nancy West, April Sykes, Amar Gajjar, Alberto Broniscer
To assess health-related quality of life (HRQOL) from the time of diagnosis until disease progression in a cohort of children with diffuse intrinsic pontine glioma (DIPG). The assessment was collected from the perspectives of the child and their parents and evaluated the effect of the child's HRQOL on their parents' physical and mental well-being, thus providing insight into the optimal timing of palliative consultation, including anticipatory grief and bereavement services. This longitudinal study assessed 25 parents and their children, ages 2-17 years of age with DIPG across five time-points, baseline and weeks 2, 4, 6, 16, 24...
September 2016: Journal of Neuro-oncology
Amandeep Taggar, Joanna MacKenzie, Haocheng Li, Harold Lau, Gerald Lim, Robert Nordal, Alana Hudson, Rao Khan, David Spencer, Jon-Paul Voroney
PURPOSE: To audit outcomes after introducing frameless stereotactic radiosurgery (SRS) for brain metastases, including co-interventions: neurosurgery, systemic therapy, and whole brain radiotherapy (WBRT). We report median overall survival (MS), local failure, and distant brain failure. We hypothesized patients treated with SRS would have clinically meaningful improved MS compared with historic institutional values. We further hypothesized that patients treated with co-interventions would have clinically meaningful improved MS compared with patients treated with SRS alone...
2016: Curēus
Michael C Burger, Pia S Zeiner, Kolja Jahnke, Marlies Wagner, Michel Mittelbronn, Joachim P Steinbach
Leptomeningeal dissemination of a primary brain tumor is a condition which is challenging to treat, as it often occurs in rather late disease stages in highly pretreated patients. Its prognosis is dismal and there is still no accepted standard of care. We report here a good clinical effect with a partial response in three out of nine patients and a stable disease with improvement on symptoms in two more patients following systemic anti-angiogenic treatment with bevacizumab (BEV) alone or in combination with chemo- and/or radiotherapy in a series of patients with leptomeningeal dissemination from primary brain tumors (diffuse astrocytoma WHO°II, anaplastic astrocytoma WHO°III, anaplastic oligodendroglioma WHO°III, primitive neuroectodermal tumor and glioblastoma, both WHO°IV)...
2016: PloS One
Sophie E M Veldhuijzen van Zanten, Ofelia Cruz, Gertjan J L Kaspers, Darren R Hargrave, Dannis G van Vuurden
Children diagnosed with diffuse intrinsic pontine glioma (DIPG) face a dismal prognosis, with severe neurologic deterioration and inevitable death at a median of 9 months from diagnosis. Steroids are widely prescribed as supportive or palliative treatment although they are known to cause severe side effects that may reduce the quality of life. This study aims to review the current knowledge on, and use of, steroids in DIPG patients. A global questionnaire-study among health care professionals was performed to ascertain information on the current (multi-)institutional and (multi-)national use of steroids, the availability of clinical guidelines, and the need for improvements in prescribing steroids to DIPG patients...
July 2016: Journal of Neuro-oncology
Tiffany A Glazer, Andrew G Shuman
Salivary gland neoplasms are rare and diverse tumors with variable disease courses, making it difficult to concisely summarize the management of distant metastases (DM). Nonetheless, there are trends of DM in salivary gland cancer that can be contextualized and reviewed. In general, the primary tumor characteristics that predict DM include the primary tumor site, tumor stage and grade, perineural spread, cervical nodal status, and genomic signatures. The most common site of DM is the lung, followed by the bone, liver, and brain...
2016: Advances in Oto-rhino-laryngology
Allen Perkins, Gerald Liu
Primary intracranial tumors of the brain structures, including meninges, are rare with an overall five-year survival rate of 33.4%; they are collectively called primary brain tumors. Proven risk factors for these tumors include certain genetic syndromes and exposure to high-dose ionizing radiation. Primary brain tumors are classified by histopathologic criteria and immunohistochemical data. The most common symptoms of these tumors are headache and seizures. Diagnosis of a suspected brain tumor is dependent on appropriate brain imaging and histopathology...
February 1, 2016: American Family Physician
Mihaela Dana Turliuc, Anca Sava, Gabriela FlorenŢa Dumitrescu, Andrei Cucu, Anda Eşanu, Cornelia Tudorache, Irina Iuliana Costache, Claudia Florida Costea
The symptomatic choroidal metastasis is a rare manifestation of lung cancer. The aim of this study was to present a clinical case of choroidal metastasis associated with multiple intracerebral metastases from a papillary adenocarcinoma of the lung diagnosed simultaneously with its metastases. We present the case of a 40-year-old male patient, smoker, admitted to the Neurosurgery Clinic II, "Prof. Dr. Nicolae Oblu" Emergency Hospital, Iassy, Romania, for right hemiparesis, headache, right visual loss, dysphonia and swallowing disorders occurring six days earlier...
2015: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
M Renovanz, N Keric, C Richter, A Gutenberg, A Giese
INTRODUCTION: Communication between university medical centers and general practitioners (GP) is becoming increasingly more important in supportive patient care. A survey among GPs was performed with the primary objective to assess their opinion on current workflow and communication between GPs and the university medical center. METHODS: The GPs were asked to score (grades 1-6) their opinion on the current interdisciplinary workflow in the care of patients with brain tumors, thereby rating communication between a university medical center in general and the neuro-oncology outpatient center in particular...
December 2015: Der Nervenarzt
Kaifan Zhao, Thomas W Barkley
BACKGROUND: Von Hippel-Lindau (VHL) is a rare autosomal dominant hereditary disorder that predisposes individuals to benign and malignant tumors in the brain, eyes, kidneys, pancreas, genital tract, or other body parts. The VHL gene, which is located on the short arm of chromosome 3, prevents cells from dividing too rapidly. Mutations in the VHL gene result in uncontrollable cell growth and tumor formation. OBJECTIVES: The purpose of this article is to summarize the current research literature describing diagnosis, treatment, and nursing implications of VHL...
December 2015: Clinical Journal of Oncology Nursing
Katharine E Brock, Angela Steineck, Clare J Twist
BACKGROUND: Decisions about end-of-life care may be influenced by cultural and disease-specific features. We evaluated associations of demographic variables (race, ethnicity, language, religion, and diagnosis) with end-of-life characteristics (Phase I enrollment, do-not-resuscitate (DNR) orders, hospice utilization, location of death), and trends in palliative care services delivered to pediatric hematology, oncology, and stem cell transplant (SCT) patients. PROCEDURE: In this single-center retrospective cohort study, inclusion criteria were as follows: patients aged 0-35 who died between January 1, 2002 and March 1, 2014, and had been cared for in the pediatric hematology, oncology, and SCT divisions...
March 2016: Pediatric Blood & Cancer
Tushar B Patil, Maneesh Kumar Singh, Rakesh Lalla
Type 1 neurofibromatosis (NF1), which mainly involves ectodermal tissue arising from the neural crest, can increase the risk of developing malignant peripheral nerve sheath tumors (MPNSTs), soft tissue sarcomas and subarachnoid hemorrhage. We describe a patient with neurofibromatosis type 1 who developed soft tissue sarcoma, MPNST, and subarachnoid hemorrhage. A 22-year-old male reported right focal seizures consequence to severe headache. He had a weakness in both legs, could walk only with the support of a stick for the last 3 months and suffered from constipation and intermittent urinary retention for the past 1 week...
July 2015: Journal of Natural Science, Biology, and Medicine
Suguru Tarui, Shuta Ishigami, Daiki Ousaka, Shingo Kasahara, Shinichi Ohtsuki, Shunji Sano, Hidemasa Oh
OBJECTIVES: Our aim was to assess midterm safety and clinical outcomes of intracoronary infusion of cardiosphere-derived cells (CDCs) after staged palliation in patients with hypoplastic left heart syndrome (HLHS). METHODS: In this prospective, controlled study, 14 consecutive patients with HLHS who were undergoing 2- or 3-stage surgical palliations were assigned to receive intracoronary CDC infusion 1 month after cardiac surgery (n = 7), followed by 7 patients allocated to a control group with standard care alone...
November 2015: Journal of Thoracic and Cardiovascular Surgery
Christine E Hill-Kayser, Peter Gabriel, Edna Volz, Robert A Lustig, Zelig Tochner, Stephen M Hahn, Amit Maity
PURPOSE: Pediatric patients may receive complex treatment. In our department, an electronic incident reporting system (condition reporting system [CRS]) was developed and made available to all members. METHODS AND MATERIALS: The CRS system is available on all departmental computers. Entered events are evaluated and graded by a supervisor as follows: "A"(dose deviation or patient harm), "B" (near miss), "C" (interruption in care process), or "D" (inconvenience). Data for pediatric patients for whom events were entered were reviewed retrospectively and compared to the entire treated pediatric population...
September 2015: Practical Radiation Oncology
Arun Z Thomas, Mehrad Adibi, Leonardo D Borregales, Christopher G Wood, Jose A Karam
PURPOSE OF REVIEW: Management of patients with metastatic renal cell carcinoma is challenging and continues to be delivered in a multidisciplinary context. Even with the advent of systemic targeted therapy, complete remission with these new agents is rare using systemic therapy alone. Surgical resection of the primary tumor and metastatic deposits continues to play an important role in managing patients with metastatic renal cell carcinoma when aiming for complete remissions. To date, despite the lack of level 1 evidence, metastasectomy appears to prolong survival and achieve long-term cure in carefully selected patients...
September 2015: Current Opinion in Urology
Vincy Chan, Chen Xiong, Angela Colantonio
Data on the utilization of occupational therapy among patients with brain tumors have been limited to those with malignant tumors and small samples of patients outside North America in specialized palliative care settings. We built on this research by examining the characteristics of patients with brain tumors who received postacute occupational therapy services in Ontario, Canada, using health care administrative data. Between fiscal years 2004-2005 and 2008-2009, 3,199 patients with brain tumors received occupational therapy services in the home care setting after hospital discharge; 12...
March 2015: American Journal of Occupational Therapy: Official Publication of the American Occupational Therapy Association
Richard Partl, Gerd Fastner, Julia Kaiser, Elisabeth Kronhuber, Klaudia Cetin-Strohmer, Claudia Steffal, Barbara Böhmer-Breitfelder, Johannes Mayer, Alexander Avian, Andrea Berghold
PURPOSE: Low Karnofsky performance status (KPS) and elevated lactate dehydrogenases (LDHs) as a surrogate marker for tumor load and cell turnover may depict patients with a very short life expectancy. To validate this finding and compare it to other indices, namely, the recursive partitioning analysis (RPA) and diagnosis-specific graded prognostic assessment (DS-GPA), a multicenter analysis was undertaken. METHODS: A retrospective analysis of 234 metastatic melanoma patients uniformly treated with palliative whole brain radiotherapy (WBRT) was done...
February 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Michael H Chan, Frederick Boop, Ibrahim Qaddoumi
PURPOSE: As the morbidity and mortality associated with communicable diseases continue to decrease in the developing world, the medical burden of childhood cancer continues to expand. Although international aid and relief groups such as the World Health Organization recognize the importance of childhood cancer, their main emphasis is on the more easily treated malignancies, such as leukemias and lymphomas, and not pediatric brain tumors, which are the second most common malignancy in children and the leading cause of cancer-related deaths in the pediatric population...
August 2015: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
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