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https://www.readbyqxmd.com/read/28210861/the-effects-of-alcoholism-and-smoking-on-advanced-cancer-patients-admitted-to-an-acute-supportive-palliative-care-unit
#1
Sebastiano Mercadante, Claudio Adile, Patrizia Ferrera, Alessandra Casuccio
AIM: The aim of this prospective study was to determine the characteristics and symptom burden of advanced cancer patients with alcoholism problems and smoking, who were referred to an acute palliative/supportive care unit (ASPCU) of a comprehensive cancer center. METHODS: Patients' characteristics, indications for admission, kind of admission, awareness of prognosis, and anticancer treatments were recorded. The Edmonton Symptom Assessment Scale (ESAS) was used to assess physical and psychological symptoms, and the CAGE questionnaire for the diagnosis of alcoholism...
February 16, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28209400/multidrug-resistant-enterococcal-infections-new-compounds-novel-antimicrobial-therapies
#2
REVIEW
Roel M van Harten, Rob J L Willems, Nathaniel I Martin, Antoni P A Hendrickx
Over the past two decades infections due to antibiotic-resistant bacteria have escalated world-wide, affecting patient morbidity, mortality, and health care costs. Among these bacteria, Enterococcus faecium and Enterococcus faecalis represent opportunistic nosocomial pathogens that cause difficult-to-treat infections because of intrinsic and acquired resistance to a plethora of antibiotics. In recent years, a number of novel antimicrobial compound classes have been discovered and developed that target Gram-positive bacteria, including E...
February 13, 2017: Trends in Microbiology
https://www.readbyqxmd.com/read/28203581/long-term-response-and-possible-cure-of-patients-with-b-cell-malignancies-with-dose-escalated-rituximab
#3
Lauren M Jacobs, Peter H Wiernik, Janice P Dutcher, Pablo Muxi
Rituximab (R), a chimeric monoclonal antibody targeting CD20 antigen on B-cells, has become a standard of care in the treatment of B-cell malignancies, most often in conjunction with cytotoxic chemotherapy. Activity has been demonstrated in many subtypes of B-cell lymphoma, including diffuse large cell lymphoma, follicular lymphoma (FL), mantle cell lymphoma (MCL), chronic lymphocytic leukemia (CLL), lymphocyte-predominant Hodgkin lymphoma, and Waldenström macroglobulinemia (WM). Additionally, dose escalation of R as a single agent has demonstrated improved activity in previously treated/poor prognosis CLL...
January 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28203387/an-overview-of-available-drugs-for-management-of-opioid-abuse-during-pregnancy
#4
REVIEW
Jillian Laslo, Jon-Michael Brunner, Daniel Burns, Emily Butler, Autumn Cunningham, Ryan Killpack, Courtney Pyeritz, Kimberly Rinard, Jennifer Childers, Joseph Horzempa
The prevalence of opioid abuse in the United States has been steadily increasing over the last several years among many major demographics, including pregnant women. Rise in prenatal opioid abuse has resulted in subsequent escalation of neonatal abstinence syndrome incidence, prompting the US Congress to pass the Protecting Our Infants Act of 2015. This act specifically calls for a critical review of current treatment options for prenatal opioid abuse which may ultimately lead to the development of better therapies and a decreased incidence of neonatal abstinence syndrome...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28198726/community-acquired-pneumonia-requiring-hospitalization-rational-decision-making-and-interpretation-of-guidelines
#5
Douwe F Postma, Cornelis H van Werkhoven, Jan Jelrik Oosterheert
PURPOSE OF REVIEW: This review focuses on the evidence base for guideline recommendations on the diagnosis, the optimal choice, timing and duration of empirical antibiotic therapy, and the use of microbiological tests for patients hospitalized with community-acquired pneumonia (CAP): issues for which guidelines are frequently used as a quick reference. Furthermore, we will discuss possibilities for future research in these topics. RECENT FINDINGS: Many national and international guideline recommendations, even on critical elements of CAP management, are based on low-to-moderate quality evidence...
February 13, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28196680/trajectories-of-substance-use-frequency-among-adolescents-seen-in-primary-care-implications-for-screening
#6
Scott E Hadland, Sarah H Copelas, Sion K Harris
OBJECTIVE: To identify trajectories of substance use in a prospective cohort of adolescent primary care patients one year after a clinic visit. STUDY DESIGN: We recruited 12- to 18-year-olds from 9 New England practices between 2005 and 2008 and identified 5 trajectories of substance use. We first distinguished adolescents with no past-year use at a baseline clinic visit and at 12-month follow-up (trajectory A). For adolescents who used substances, we assessed past 90-day use at both timepoints, and identified the remaining 4 trajectories based on frequency of use...
February 10, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28191917/newborn-birth-weight-of-pregnant-women-on-methadone-or-buprenorphine-maintenance-treatment-a-national-contingency-management-approach-trial
#7
Einat Peles, Anat Sason, Shaul Schreiber, Miriam Adelson
BACKGROUND AND OBJECTIVES: Methadone maintenance treatment (MMT) is the gold standard for pregnant women with opioid use disorders. Still, low birth-weights were reported, in particular of mothers who became pregnant before admission to MMT. We studied whether an escalating incentive contingency-management approach may contribute to better newborn birth-weights. METHODS: A nationwide controlled randomized trial among all Israeli methadone/buprenorphine maintenance treatment (MBMT), newly or already in treatment pregnant women was performed...
February 13, 2017: American Journal on Addictions
https://www.readbyqxmd.com/read/28190433/seizures-in-the-critically-ill
#8
J Ch'ang, J Claassen
Critically ill patients with seizures are either admitted to the intensive care unit because of uncontrolled seizures requiring aggressive treatment or are admitted for other reasons and develop seizures secondarily. These patients may have multiorgan failure and severe metabolic and electrolyte disarrangements, and may require complex medication regimens and interventions. Seizures can be seen as a result of an acute systemic illness, a primary neurologic pathology, or a medication side-effect and can present in a wide array of symptoms from convulsive activity, subtle twitching, to lethargy...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28188596/treatment-adherence-intervention-studies-in-dermatology-and-guidance-on-how-to-support-adherence
#9
REVIEW
Steven R Feldman, Bernard Vrijens, Uwe Gieler, Stefano Piaserico, Lluís Puig, Peter van de Kerkhof
Adequate adherence to prescribed treatment regimens can help to break the cycle of treatment failure, disease progression and subsequent treatment escalation. Unfortunately, adherence in the treatment of skin disorders such as acne, atopic dermatitis/eczema and psoriasis is often inadequate. A review of the literature identified a number of studies that tested an intervention to improve adherence in dermatology, including the following: electronic messages and/or reminders; more frequent or 'extra' clinic visits; audio-visual and internet-based interventions; and patient support programmes and/or self-management, educational training programmes...
February 10, 2017: American Journal of Clinical Dermatology
https://www.readbyqxmd.com/read/28187812/family-discussions-on-life-sustaining-interventions-in-neurocritical-care
#10
M M Adil, D Larriviere
Approximately 20% of all deaths in the USA occur in the intensive care unit (ICU) and the majority of ICU deaths involves decision of de-escalation of life-sustaining interventions. Life-sustaining interventions may include intubation and mechanical ventilation, artificial nutrition and hydration, antibiotic treatment, brain surgery, or vasoactive support. Decision making about goals of care can be defined as an end-of-life communication and the decision-making process between a clinician and a patient (or a surrogate decision maker if the patient is incapable) in an institutional setting to establish a plan of care...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28182774/benefits-and-unintended-consequences-of-antimicrobial-de-escalation-implications-for-stewardship-programs
#11
Josie Hughes, Xi Huo, Lindsey Falk, Amy Hurford, Kunquan Lan, Bryan Coburn, Andrew Morris, Jianhong Wu
Sequential antimicrobial de-escalation aims to minimize resistance to high-value broad-spectrum empiric antimicrobials by switching to alternative drugs when testing confirms susceptibility. Though widely practiced, the effects de-escalation are not well understood. Definitions of interventions and outcomes differ among studies. We use mathematical models of the transmission and evolution of Pseudomonas aeruginosa in an intensive care unit to assess the effect of de-escalation on a broad range of outcomes, and clarify expectations...
2017: PloS One
https://www.readbyqxmd.com/read/28181702/cerebrovascular-burden-and-depressive-symptomatology-interrelate-over-18%C3%A2-years-support-for-the-vascular-depression-hypothesis
#12
Rosanna Scott, Daniel Paulson
OBJECTIVE: Potentially incongruent research literatures suggest three divergent hypotheses about depressive symptomatology: (1) symptoms are recurrent; (2) later-life depression results from high cerebrovascular burden (CVB); and (3) depressive symptoms contribute to comorbidities causing vascular burden. Past vascular depression research assumes that later-life depressive symptoms relate uniquely to high CVB and not to prior, recurrent depression. This study examines these divergent hypotheses...
February 9, 2017: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28180127/impact-of-fecal-calprotectin-measurement-on-decision-making-in-children-with-inflammatory-bowel-disease
#13
Wael El-Matary, Esmail Abej, Vini Deora, Harminder Singh, Charles N Bernstein
BACKGROUND: The use of fecal calprotectin (FCal) as a marker of intestinal inflammation, in the management of inflammatory bowel disease (IBD) is increasing. The aim of this study was to examine the impact of FCal measurements on decision-making and clinical care of children with IBD. MATERIALS AND METHODS: In a retrospective cohort study, FCal, clinical activity indices, and blood markers were measured in children with established diagnoses of IBD. Pearson correlation coefficient analysis was performed to examine association between FCal and other markers...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28168186/the-impact-of-central-venous-catheters-on-pediatric-venous-thromboembolism
#14
REVIEW
Julie Jaffray, Mary Bauman, Patti Massicotte
The use of central venous catheters (CVCs) in children is escalating, which is likely linked to the increased incidence of pediatric venous thromboembolism (VTE). In order to better understand the specific risk factors associated with CVC-VTE in children, as well as available prevention methods, a literature review was performed. The overall incidence of CVC-VTE was found to range from 0 to 74%, depending on the patient population, CVC type, imaging modality, and study design. Throughout the available literature, there was not a consistent determination regarding whether a particular type of central line (tunneled vs...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28165691/de-escalate-tense-talk-five-simple-strategies-to-help-keep-things-cool
#15
Ann M Garrido
The tensions of the wider world all too frequently erupt in our nation's emergency rooms in the form of gunshot wounds and domestic battery, gang brawls and road rage accidents. As health care professionals, you generally are called into action after things have taken a turn toward violence. Even as you suture and bandage and console frightened family members, I imagine you sigh: "Why did things have to go this far?"
July 2016: Health Progress
https://www.readbyqxmd.com/read/28164820/medical-care-of-the-homeless-an-american-and-international-issue
#16
REVIEW
Sheryl B Fleisch, Robertson Nash
Homeless persons die significantly younger than their housed counterparts. In many cases, relatively straightforward primary care issues escalate into life-threatening, expensive emergencies. Poor health outcomes driven by negative interactions between comorbid symptoms meet the definition of a health syndemic in this population. Successful primary care of patients struggling with homelessness may result in long-term lifesaving measures along with decreased expenditure to hospital systems. This primary prevention requires patience, creativity, and acknowledgment that the source of many confounders may lay outside the control of these patients...
March 2017: Primary Care
https://www.readbyqxmd.com/read/28163937/a-narrowing-diagnosis-a-rare-cause-of-adult-croup-and-literature-review
#17
Jayshil J Patel, Emily Kitchin, Kurt Pfeifer
Croup or laryngotracheitis is rare in adults. We present a case of an otherwise healthy young woman that presented in the winter with 3 days of increasing dyspnea, cough, and fever. She was hemodynamically stable but was found to have a barking cough, paradoxical abdominal breathing, and stridor. Chest radiograph revealed subglottic narrowing. Respiratory viral nucleic acid amplification testing was positive for respiratory syncytial virus. The patient was treated with nebulized epinephrine, dexamethasone, and a helium-oxygen mixture...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28159553/brachytherapy-boost-for-prostate-cancer-trends-in-care-and-survival-outcomes
#18
S M Glaser, M J Dohopolski, G K Balasubramani, R M Benoit, R P Smith, S Beriwal
PURPOSE: Androgen suppression combined with elective nodal and dose-escalated radiation therapy recently demonstrated an improved biochemical failure-free survival in men who received external beam radiation therapy (EBRT) plus a brachytherapy boost (BB) compared with dose-escalated external beam radiotherapy (DE-EBRT). We sought to analyze the factors predictive for use of EBRT + BB as compared with DE-EBRT and report resulting survival outcomes on a national level using a hospital-based registry...
February 1, 2017: Brachytherapy
https://www.readbyqxmd.com/read/28156629/a-whole-greater-than-the-sum-of-the-parts-close-collaboration-between-palliative-care-and-clinical-ethics
#19
(no author information available yet)
: 53 Background: The disciplines of palliative care (PC) and clinical ethics (CE) share common content but also important distinctions in method, skill set, and clinical role in a given patient encounter. Particularly in cases of advance care planning, complex decision-making, and clarifying goals oncology teams may be challenged to know which consultation service to involve. METHODS: Case report and commentary. RESULTS: A 60 year-old man with a 3-year history of glioblastoma multiforme presented with sudden onset right-sided weakness and altered mental status...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152780/changing-patterns-of-care-for-locally-advanced-non-small-cell-lung-cancer-nsclc-implications-for-quality-initiatives
#20
Peter Edward Gabriel, Wensheng Guo, Sandhya Upasani, Marjorie van der Pas, Timothy E Schultheiss, Joel W Goldwein, John Paul Christodouleas
: 302 Background: Our purpose was to assess the utilization of dose escalated radiotherapy (RT) in Stage III NSCLC patients in the United States from 2004-2013, a period when no Level 1 evidence on dose escalation was published. METHODS: Data on all NSCLC patients treated with RT were extracted from the National Oncology Data Alliance (NODA), a pooled database of cancer registries from >150 US hospitals. The NODA contains the same data submitted to state cancer registries and SEER, but also contains RT dose fields that are manually verified by trained staff...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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