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Advance care directives

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https://www.readbyqxmd.com/read/29353516/magnetic-hyperthermia-therapy-for-the-treatment-of-glioblastoma-a-review-of-the-therapy-s-history-efficacy-and-application-in-humans
#1
Keon Mahmoudi, Alexandros Bouras, Dominique Bozec, Robert Ivkov, Constantinos Hadjipanayis
Hyperthermia therapy (HT) is the exposure of a region of the body to elevated temperatures to achieve a therapeutic effect. HT anticancer properties and its potential as a cancer treatment have been studied for decades. Techniques used to achieve a localized hyperthermic effect include radiofrequency, ultrasound, microwave, laser, and magnetic nanoparticles (MNPs). The use of MNPs for therapeutic hyperthermia generation is known as magnetic hyperthermia therapy (MHT) and was first attempted as a cancer therapy in 1957...
January 21, 2018: International Journal of Hyperthermia
https://www.readbyqxmd.com/read/29351769/protocol-to-disseminate-a-hospital-site-controlled-intervention-using-audit-and-feedback-to-implement-guidelines-concerning-inappropriate-treatment-of-asymptomatic-bacteriuria
#2
Barbara W Trautner, Pooja Prasad, Larissa Grigoryan, Sylvia J Hysong, Jennifer R Kramer, Suja Rajan, Nancy J Petersen, Tracey Rosen, Dimitri M Drekonja, Christopher Graber, Payal Patel, Paola Lichtenberger, Timothy P Gauthier, Steve Wiseman, Makoto Jones, Anne Sales, Sarah Krein, Aanand Dinkar Naik
BACKGROUND: Antimicrobial stewardship to combat the spread of antibiotic-resistant bacteria has become a national priority. This project focuses on reducing inappropriate use of antimicrobials for asymptomatic bacteriuria (ASB), a very common condition that leads to antimicrobial overuse in acute and long-term care. We previously conducted a successful intervention, entitled "Kicking Catheter Associated Urinary Tract Infection (CAUTI): the No Knee-Jerk Antibiotics Campaign," to decrease guideline-discordant ordering of urine cultures and antibiotics for ASB...
January 19, 2018: Implementation Science: IS
https://www.readbyqxmd.com/read/29349812/drug-promotion-practices-a-review
#3
Nilan T Jacob
Over the years, the pharmaceutical industry has been at the forefront of research and innovation in drug discovery and development. The process of drug discovery extending from pre-clinical studies to multi-centric clinical trials and post-marketing phase is a costly affair running into billions of dollars. On the flip side, not all investigational molecules clear the trial phases and get approved; which puts pressure on the manufacturers to maximise the profit from approved drugs. It is in this key area, the practice of drug promotion plays its role...
January 18, 2018: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29349760/advancements-and-personalization-of-breast-cancer-treatment-strategies-in-radiation-therapy
#4
Meena S Moran
Significant technologic advances in radiation treatment delivery now allow for more personalized delivery considerations which incorporate individual patient characteristics (such as tumor location and patient anatomy) and more precise delivery in the breast conservation or post-mastectomy setting. The combined advancements with other treatment modalities (i.e., systemic therapy, surgical management) have had direct effects on local-regional management and outcomes such that currently, local-regional relapses after definitive treatment for localized disease are now rarely experienced...
2018: Cancer Treatment and Research
https://www.readbyqxmd.com/read/29349518/checkpoint-inhibitors-palliative-care-or-hospice
#5
REVIEW
Mellar P Davis, Rajiv Panikkar
PURPOSE: Checkpoint (CTLA-4, PD-1, and PD-L1) inhibitors have changed the face of oncology. A subset of patients enjoys long, gratifying treatment responses. Unfortunately, most patients do not respond even when expressing favorably markers such as PD-L1. Checkpoint inhibitors are largely palliative (though a subset have long-term cancer responses) and as such patient-related outcome measures should be included when evaluating benefits. The purpose of this review is to place checkpoint inhibitor trials within a palliation context...
January 19, 2018: Current Oncology Reports
https://www.readbyqxmd.com/read/29343871/-ulysses-contract-in-psychiatry
#6
Andrea Daverio, Gioia Piazzi, Anna Saya
Over the last twenty years we have witnessed a growing focus on the rights of the ill people. The debate on informed consent and a new redefinition of the therapeutic relationship is constantly evolving. With this article, we propose a critical literature review of the so-called "Ulysses contract" or "psychiatric advance directives". It refers to the will that a subject expresses in writing, or orally, about the treatments he or she wishes or does not wish to be subject to if the time comes when it may be impossible to express his/her consent...
November 2017: Rivista di Psichiatria
https://www.readbyqxmd.com/read/29341962/withdrawal-of-life-sustaining-therapy
#7
Barbara G Jericho
PURPOSE OF REVIEW: The aim of this review is to examine literature relating to the withdrawal of life-sustaining therapy (WLST). RECENT FINDINGS: Discussions regarding end-of-life issues in adults and children are not occurring comprehensively. Discussions relating to the WLST in the pediatric population varies by institution and may vary by race, age, health insurance, diagnosis, and severity of illness. Completing advance directives prior to placement of life-sustaining treatments is not consistent practice...
January 15, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29340632/developing-a-set-of-indicators-to-monitor-quality-in-ambulatory-diabetes-care-using-a-modified-delphi-panel-process
#8
Geetha Mukerji, Ilana Halperin, Katie Hunter, Phillip Segal, Maria Wolfs, Lindsay Bevan, Lianne Jeffs, Jeannette Goguen
Objective: There is a large evidence to practice gap in diabetes care with limited performance assessments that capture the full spectrum of care delivery. Our study aimed to develop a set of ambulatory diabetes quality indicators across six domains (effectiveness, safety, patient-centered, timely, equitable and efficient) to provide a broad view of quality. Design: A modified Delphi panel process was conducted. Phase I involved compiling a list of indicators through literature review and generation of patient and healthcare provider-derived indicators through interviews and surveys, respectively...
January 11, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29334569/assessment-of-prehospital-hemorrhage-and-airway-care-using-a-simulation-model
#9
Mariya E Skube, Seth Witthuhn, Kristine Mulier, Bonnie Boucher, Elizabeth Lusczek, Greg J Beilman
BACKGROUND: The quality of prehospital care impacts patient outcomes. Military efforts have focused on training revision and the creation of high fidelity simulation models to address potentially survivable injuries. We sought to investigate the applicability of models emphasizing hemorrhage control and airway management to a civilian population. METHODS: Prehospital healthcare providers (PHPs) undergoing their annual training were enrolled. A trauma scenario was simulated with two modules: hemorrhage control and airway management...
January 12, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29332973/metabologenomics-of-phaeochromocytoma-and-paraganglioma-an-integrated-approach-for-personalised-biochemical-and-genetic-testing
#10
REVIEW
Graeme Eisenhofer, Barbara Klink, Susan Richter, Jacques Wm Lenders, Mercedes Robledo
The tremendous advances over the past two decades in both clinical genetics and biochemical testing of chromaffin cell tumours have led to new considerations about how these aspects of laboratory medicine can be integrated to improve diagnosis and management of affected patients. With germline mutations in 15 genes now identified to be responsible for over a third of all cases of phaeochromocytomas and paragangliomas, these tumours are recognised to have one of the richest hereditary backgrounds among all neoplasms...
April 2017: Clinical Biochemist. Reviews
https://www.readbyqxmd.com/read/29331943/modern-management-of-perianal-fistulas-in-crohn-s-disease-future-directions
#11
REVIEW
Paulo Gustavo Kotze, Bo Shen, Amy Lightner, Takayuki Yamamoto, Antonino Spinelli, Subrata Ghosh, Remo Panaccione
Perianal fistulae in patients with Crohn's disease (CD) can be associated with significant morbidity resulting in negative impact on quality of life. The last two decades have seen significant advancements in the management of perianal fistulas in CD, which has evolved into a multidisciplinary approach that includes gastroenterologists, colorectal surgeons, endoscopists and radiologists. Despite the introduction of new medical therapies such as antitumour necrosis factor and novel models of care delivery, the best fistula healing rates reported with combined medical and surgical approaches are approximately 50%...
January 13, 2018: Gut
https://www.readbyqxmd.com/read/29331524/strategies-and-technical-challenges-for-imaging-oligometastatic-disease-recommendations-from-the-european-organisation-for-research-and-treatment-of-cancer-imaging-group
#12
REVIEW
Nandita M deSouza, Yan Liu, Arturo Chiti, Daniela Oprea-Lager, Géraldine Gebhart, Bernard E Van Beers, Ken Herrmann, Frederic E Lecouvet
Patients with oligometastatic disease (OMD) often have controllable symptoms, and cures are possible. Technical improvements in surgery and radiotherapy have introduced the option of metastasis-directed ablative therapies as an adjunct or alternative to standard-of-care systemic therapies. Several clinical trials and registries are investigating the benefit of these therapeutic approaches across several cancer sites. This requires that patients are correctly included and followed with appropriate imaging. This article discusses the evidence and offers recommendations for the implementation of standard-of-care (Response Evaluation Criteria in Solid Tumours measurements on computed tomography [CT], magnetic resonance imaging [MRI] and bone scintigraphy) and advanced imaging modalities (functional, metabolic and radionuclide targeted) for identifying and following up patients with OMD...
January 10, 2018: European Journal of Cancer
https://www.readbyqxmd.com/read/29331262/can-interrogation-of-tumour-characteristics-lead-us-to-safely-omit-adjuvant-radiotherapy-in-patients-with-early-breast-cancer
#13
I S Bhattacharya, A M Kirby, J M Bliss, C E Coles
Adjuvant radiotherapy after breast-conserving surgery has been an important component of the standard of care for early breast cancer. Improvements in breast cancer care have resulted in a substantial reduction in local relapse rates over recent decades. Although the proportional benefits of adjuvant radiotherapy are similar for different prognostic risk groups of patients, the absolute benefits depend on the risk of relapse and therefore vary considerably between prognostic groups. Radiotherapy is not without risk and for some patients at very low risk of relapse the risks of radiotherapy may outweigh the benefit, leading to potential overtreatment...
January 10, 2018: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/29329960/the-future-of-lgbt-cancer-care-practice-and-research-implications
#14
REVIEW
David Rice, Matthew B Schabath
OBJECTIVES: To synthesize state of the knowledge collected in this volume and propose future directions for lesbian, gay, bisexual and transgender (LGBT) cancer practice, education, research, and advocacy. DATA SOURCES: Current and extant literature. CONCLUSION: Health care disparities that are known but not yet fully elucidated in the LGBT population carry into the cancer arena. Substantially more effort is required in the domains of patient care, nursing practice, nursing and patient-facing services provider education, patient education, nursing and interprofessional research, governmental commitment, professional organization action, and patient advocacy...
January 9, 2018: Seminars in Oncology Nursing
https://www.readbyqxmd.com/read/29328354/end-of-life-conversations-as-a-legacy
#15
Jeanne M Sorrell
Advance directives such as living wills and health care powers of attorney are important documents that offer patients ways to avoid unwanted care when they are unable to express their wishes. Although health care professionals have increased focus on advance care planning in recent years, approximately two thirds of American adults do not have advance medical directives. In addition, 90% of individuals believe that talking to loved ones about end-of-life wishes is important, but only 27% have done so. It is important for nurses to understand the complex factors that influence how individuals make health care decisions and identify ways to encourage conversations with family, friends, and health care providers to help clarify patients' wishes for endof-life care...
January 1, 2018: Journal of Psychosocial Nursing and Mental Health Services
https://www.readbyqxmd.com/read/29323668/professional-responsibilities-regarding-the-provision-publication-and-dissemination-of-patient-phenotypes-in-the-context-of-clinical-genetic-and-genomic-testing-points-to-consider-a-statement-of-the-american-college-of-medical-genetics-and-genomics-acmg
#16
Lynn W Bush, Anita E Beck, Leslie G Biesecker, James P Evans, Ada Hamosh, Ingrid A Holm, Christa L Martin, C Sue Richards, Heidi L Rehm
Disclaimer: This Points to Consider document is designed as an educational resource to provide best practices for medical genetic clinicians, laboratories, and journals regarding the provision, publication, and dissemination of patient phenotypes in the context of genomic testing, clinical genetic practice, and research. While the goal of the document is the improvement of patient care, the considerations and practices described should not be considered inclusive of all proper considerations and practices or exclusive of others that are reasonably directed to obtaining the same goal...
January 11, 2018: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/29322613/forward-view-advancing-health-library-and-knowledge-services-in-england
#17
Sue Lacey Bryant, Helen Bingham, Ruth Carlyle, Alison Day, Linda Ferguson, David Stewart
This article is the fourth in a series on New Directions. The National Health Service is under pressure, challenged to meet the needs of an ageing population, whilst striving to improve standards and ensure decision making is underpinned by evidence. Health Education England is steering a new course for NHS library and knowledge services in England to ensure access to knowledge and evidence for all decision makers. Knowledge for Healthcare calls for service transformation, role redesign, greater coordination and collaboration...
January 10, 2018: Health Information and Libraries Journal
https://www.readbyqxmd.com/read/29322243/humanistic-burden-of-disease-for-patients-with-advanced-melanoma-in-canada
#18
Winson Y Cheung, Martha S Bayliss, Michelle K White, Angela Stroupe, Andrew Lovley, Bellinda L King-Kallimanis, Kathryn Lasch
BACKGROUND: Metastatic melanoma is a highly aggressive cancer, often striking in the prime of life. This study provides new information directly from advanced melanoma (stage III and IV) patients on how their disease impacts their health-related quality of life (HRQL). METHODS: Twenty-nine in-depth, qualitative interviews were conducted with adult patients with advanced melanoma in Canada. A semi-structured interview guide was used. Interviews were transcribed verbatim and key concepts were identified using a grounded theory analytic approach...
January 10, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29320792/-advanced-care-planning-and-its-relevance-for-emergency-and-intensive-care-medicine
#19
Friedemann Nauck, Georg Marckmann, Jürgen In der Schmitten
Like in other countries, advance care planning (ACP) is currently being implemented in Germany as a new concept to realise valid and effective advance directives. This concept comprises processes to explore and document individual preferences for future treatment, and to honour them at a time when the person is incapacitated. ACP aims to ensure that patients will be treated according to their preferences when they are no longer capable due to acute health crises or chronic diseases. This paper gives an overview of the concept of ACP with a focus on relevant issues for emergency and intensive care medicine...
January 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29317381/using-social-media-for-the-promotion-of-education-and-consultation-in-adolescents-who-have-undergone-kidney-transplant-protocol-for-a-randomized-control-trial
#20
Claudiana Pase, Andréia Dias Mathias, Clotilde Druck Garcia, Clarissa Garcia Rodrigues
BACKGROUND: Falling ill represents a traumatic experience especially in adolescence, since in addition to the moments of ambiguity and contradictions that this period brings, there is coping with the disease. Renal transplantation provides a better quality of life but the dependence on dialysis is replaced by the greater responsibility of self-care. With advances in technology, contemporary communication methods are a strategic mechanism for the approximation of the adolescent and the multiprofessional team...
January 9, 2018: JMIR Research Protocols
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