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advance life support

Barbara Fischer, Harry Telser, Peter Zweifel
Healthcare expenditure (HCE) spent during an individual's last year of life accounts for a high share of lifetime HCE. This finding is puzzling because an investment in health is unlikely to have a sufficiently long payback period. However, Becker et al. (2007) and Philipson et al. (2010) have advanced a theory designed to explain high willingness to pay (WTP) for an extension of life close to its end. Their testable implications are complemented by the concept of 'pain of risk bearing' introduced by Eeckhoudt and Schlesinger (2006)...
June 7, 2018: Journal of Health Economics
Larry D Cripe, Kevin L Rand, Susan M Perkins, Yan Tong, Karen Krall Schmidt, David G Hedrick, Susan M Rawl
BACKGROUND: Patients with advanced cancer often face distressing decisions about chemotherapy. There are conflicting data on the relationships among perceived prognosis, psychological characteristics, and chemotherapy use, which impair the refinement of decision support interventions. OBJECTIVE: Clarify the relationships among patient and oncologist estimates of life expectancy for 6 and 12 months, chemotherapy use, and patient psychological characteristics. DESIGN: Secondary analysis of data from two cross-sectional studies...
June 15, 2018: Journal of Palliative Medicine
Anne-Hélène Clair, William Haynes, Luc Mallet
Deep brain stimulation (DBS) has been offered to patients suffering of severe and resistant neuropsychiatric disorders like Obsessive Compulsive Disorder (OCD), Gilles de la Tourette Syndrome (TS) and Major Depression (MDD). Modulation of several targets within the cortico-striato-thalamo-cortical circuits can lead to a decrease of symptom severity in those patients. This review focuses on the recent clinical outcomes in DBS in psychiatric disorders. Studies on OCD and TS are now focusing on the long-term effects of DBS, with encouraging results regarding not only the decrease of symptoms, but also quality of life...
2018: F1000Research
Viktor Grünwald, Berit Eberhardt, Axel Bex, Anne Flörcken, Thomas Gauler, Thorsten Derlin, Martin Panzica, Hans Roland Dürr, Knut Achim Grötz, Rachel H Giles, Christian von Falck, Anno Graser, Alexander Muacevic, Michael Staehler
Bone is a major site of haematogenous tumour cell spread in renal cell carcinoma (RCC), and most patients with RCC will develop painful and functionally disabling bone metastases at advanced disease stages. The prognosis of these patients is generally poor and the treatment is, therefore, aimed at palliation. However, RCC-associated bone metastases can be curable in select patients. Current data support a multimodal management strategy that includes wide resection of lesions, radiotherapy, systemic therapy, and other local treatment options, which can improve quality of life and survival...
June 14, 2018: Nature Reviews. Urology
Alison E Turnbull, Sarina K Sahetya, Elizabeth Colantuoni, Josephine Kweku, Roozbeh Nikooie, J Randall Curtis
CONTEXT: Goal-concordant care has been identified as an important outcome of advance care planning and shared decision-making initiatives. However validated methods for measuring goal-concordance are needed. OBJECTIVES: To estimate the inter-rater reliability of senior critical care fellows rating the goal-concordance of preference-sensitive interventions performed in intensive care units (ICUs) while considering patient-specific circumstances as described in a previously-proposed methodology...
June 11, 2018: Journal of Pain and Symptom Management
Andrew Lockey, Yiqun Lin, Adam Cheng
OBJECTIVES: The objective of this study was to evaluate the impact of the prior participation of one or more members of the adult resuscitation team in an accredited advanced life support course on patient outcomes (return of spontaneous circulation, survival to discharge, survival to 30 days, and survival to 1 year). METHODS: A systematic search of Medline, CINAHL, Embase, ERIC, and Cochrane databases was conducted through 6 March 2018. We included randomised and observational studies in any language...
June 11, 2018: Resuscitation
Arthur R H van Zanten
PURPOSE OF REVIEW: To summarize the most recent advances in acute metabolic care and critical care nutrition. RECENT FINDINGS: Recent research has demonstrated unknown consequences of high protein and amino acid administration in the early phase of ICU stay associated with dysregulated glucagon release leading to hepatic amino acid breakdown and suggested adverse effects on autophagy and long-term outcome. Progress has been made to measure body composition in the ICU...
June 8, 2018: Current Opinion in Critical Care
Anoop Mayya, Joana D'Souza, Ann Mary George, Kamalakanth Shenoy, Praveen Jodalli, Shreemathi S Mayya
Context: Implant-supported prosthesis improves the self-confidence and quality of life of the patient by giving them masticatory comfort and a high level of satisfaction. For any professional community, it is essential to know whether patients feel well informed and whether what they know reflects on the current advances in dental health care. The aim of this study was to assess the knowledge and awareness of dental implants as a treatment choice in patients visiting a dental college situated in Mangalore, Karnataka, India...
May 2018: Indian Journal of Dental Research: Official Publication of Indian Society for Dental Research
Julie W Dreier, Liselotte Petersen, Carsten B Pedersen, Jakob Christensen
OBJECTIVE: This study aims to examine the association between maternal age, paternal age, and parental age difference at the time of birth and the risk of epilepsy in the offspring. METHODS: We carried out a prospective population-based register study of all singletons born in Denmark between 1981 and 2012. Cox regression was used to estimate hazard ratios (HRs) of epilepsy and their corresponding 95% confidence intervals (CIs), adjusted for relevant confounders...
June 13, 2018: Epilepsia
Jacqueline Gahagan, Montse Subirana-Malaret
BACKGROUND: This study explores the perceived barriers to primary health care as identified among a sample of Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) identified individuals and health care providers in Nova Scotia, Canada. These findings, based on a province-wide anonymous online survey, suggest that additional efforts are needed to improve pathways to primary health among LGBTQ populations and in deepening our understanding of how to advance the unique primary health needs of these populations...
June 13, 2018: International Journal for Equity in Health
Gai-Ling Chen, Ye-Ru Qiao, Jin-Hui Ma, Jian-Xin Wang, Fei-Long Hei, Jie Yu
Background: Recent advances in extracorporeal membrane oxygenation (ECMO) have led to increasing interest in its use during cardiopulmonary resuscitation (CPR). However, decisions regarding extracorporeal CPR (ECPR) in children are difficult as a result of limited studies, especially in Asia Pacific. The objective of this study was to investigate trends in survival and demographic details for children with ECPR in Asia Pacific recorded in the Extracorporeal Life Support Organization (ELSO) registry from 1999 to 2016 and identify the risk factors associated with in-hospital mortality...
June 20, 2018: Chinese Medical Journal
Leila Etemad, Mohammad Moshiri, Mahdi Balali-Mood
The present study aimed to review and discuss the recommended and recently suggested protocols by Iranian researchers for a long-term treatment of delayed complications of sulfur mustard (DCSM) in veterans. As indicated clinically, patients who suffer from delayed ocular complications of sulfur mustard (DOCS) benefit from treatments for dry eyes, therapeutic contact lenses, amniotic membrane transplantation; blepharorrhaphy, tarsorrhaphy, limbal stem cell transplantation; corneal transplantation, topical steroids, and immunosuppressive...
May 2018: Iranian Journal of Medical Sciences
Laura F Bech, Mette Line Donneborg, Allan M Lund, Finn Ebbesen
BACKGROUND: Galactosemia has not been recognized as a cause of extreme neonatal hyperbilirubinemia, although growing evidence supports this association. METHODS: In a retrospective cohort study, we identified children with galactosemia due to GALT deficiency using the Danish Metabolic Laboratory Database. Among these, we identified children with extreme neonatal hyperbilirubinemia or symptoms of ABE. Extreme neonatal hyperbilirubinemia was defined as maximum total serum bilirubin (TSBmax) ) level ≥450 µmol/L and a ratio of conjugated serum bilirubin/TSB <0...
May 31, 2018: Pediatric Research
Péter Osváth, Attila Kovács, Adrienn Boda-Jörg, Tamás Tényi, Sándor Fekete, Viktor Vörös
Modern information and communication tools have increasingly become an indispensable part of our everyday life. Research data demonstrate that it can be used effectively to preserve and restore health, not just among young people but also among the elderly, as for nowadays the use of the internet is widespread among the elderly, but healthcare applications are less well-known. This supports the significance of our project since it is important to develop and introduce disease-specific healthcare applications...
June 2018: Orvosi Hetilap
Luis Miguel Rondón García, Jose Manuel Ramírez Navarrro
Background: This research analyzes the impact of quality of life as a metavariable that conditions the health and social welfare of the elderly. The sample of this study is composed of 500 people, randomly selected from the major day centers for the elderly in the province of Granada (Spain). Method: For the inferential analysis, we used the CUBRECAVI questionnaire, which is a multidimensional scale of health and quality of life, along with the Katz and García measure questionnaires, which are also applied to quality of life...
2018: Journal of Aging Research
Laurence Jee Peng Leong, Gregory Brian Crawford
BACKGROUND: With ageing of Australians, the numbers of residential aged care (RAC) residents is rising. This places a spotlight on decisions about appropriate care for this population, including hospitalisation and end-of-life (EOL) care. The aim was to study a sample of RAC residents who attended and died in hospital, to quantify measurable components of EOL care so as to describe the extent of palliative care required. METHODS: A retrospective case-note review of hospital records was conducted in Adelaide, Australia...
June 9, 2018: BMC Palliative Care
Kimia Honarmand, Chantal Mepham, Craig Ainsworth, Zahira Khalid
AIM OF THE STUDY: Identifying modifiable factors associated with survival following in-hospital cardiac arrest is crucial. The purpose of this study was to determine the extent to which adherence to the 2010 American Heart Association (AHA) Advanced Cardiac Life Support (ACLS) guidelines in their entirety affects patient outcomes. In addition, we explored the role of code leader training level on patient outcomes. METHODS: We conducted a retrospective review of records for cardiac arrests that occurred on hospital wards and were run by the hospital code team, at three tertiary care centres over 2 to 4 years...
June 6, 2018: Resuscitation
Kevin K C Hung, Colin A Graham, Lok-Kwan Chan, Wai K Poon, Timothy H Rainer, Robert A Cocks
INTRODUCTION: Modern automated external defibrillators (AEDs) are designed to prevent shock delivery when excessive motion produces rhythm disturbances mimicking ventricular fibrillation (VF). This has been reported as a safety issue in airline operations, where turbulent motion is commonplace. We aimed to evaluate whether all seven AEDs can deliver shock appropriately in a flight simulator under turbulent conditions. METHODS: The study was performed in a Boeing 747-400 full motion flight simulator in Hong Kong...
June 5, 2018: Resuscitation
Kelly N Sawyer, Michael Mooney, Gregory Norris, Thomas Devlin, Justin Lundbye, Pratik B Doshi, Jonathan Kyle Hewett, Alan T Kono, Jesse P Jorgensen, Brian J O'Neil
Targeted temperature management (TTM) is recommended postcardiac arrest. The cooling method with the highest safety and efficacy is unknown. The COOL-ARREST pilot trial aimed to evaluate the safety and efficacy of the most contemporary ZOLL Thermogard XP Intravascular Temperature Management (IVTM) system for providing mild TTM postcardiac arrest. This multicenter, prospective, single-arm, observational pilot trial enrolled patients at eight U.S. hospitals between July 28, 2014, and July 24, 2015. Adult (≥18 years old), out-of-hospital cardiac arrest subjects of presumed cardiac etiology who achieved return of spontaneous circulation (ROSC) were considered for inclusion...
June 8, 2018: Therapeutic Hypothermia and Temperature Management
W Ennis James, Robert Baughman
Treatment of sarcoidosis recommendations are often based on clinical experience and expert opinion. However, there are an increasing number of studies which are providing evidence to support decisions regarding treatment. Areas Covered: Several studies have identified factors associated with increased risk for organ failure or death ("danger"). There have been several studies focused on the role of treatment to improve quality of life for the patient. Sarcoidosis treatment often follows a progression, based on response...
June 8, 2018: Expert Review of Clinical Pharmacology
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