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https://www.readbyqxmd.com/read/29161396/demands-and-requests-for-inappropriate-or-inadvisable-treatments-at-the-end-of-life-what-do-you-do-at-2-o-clock-in-the-morning-when-%C3%A2
#1
L McCrossan, R Siegmeth
In an era when healthcare has become increasingly complex and patient expectations are higher than ever before, we can find the decision-making process for patients, potentially at the end of their lives, increasingly difficult. In the shift from paternalism to patient choice, we can struggle to know what to do when faced with a patient, their family, or both requesting or demanding inadvisable, inappropriate, or futile treatments. It can feel as if we are being asked to subject patients to intrusions and interventions that 'just feel wrong'...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29161262/the-value-of-confirmatory-testing-in-early-infant-hiv-diagnosis-programmes-in-south-africa-a-cost-effectiveness-analysis
#2
Lorna Dunning, Jordan A Francke, Divya Mallampati, Rachel L MacLean, Martina Penazzato, Taige Hou, Landon Myer, Elaine J Abrams, Rochelle P Walensky, Valériane Leroy, Kenneth A Freedberg, Andrea Ciaranello
BACKGROUND: The specificity of nucleic acid amplification tests (NAATs) used for early infant diagnosis (EID) of HIV infection is <100%, leading some HIV-uninfected infants to be incorrectly identified as HIV-infected. The World Health Organization recommends that infants undergo a second NAAT to confirm any positive test result, but implementation is limited. Our objective was to determine the impact and cost-effectiveness of confirmatory HIV testing for EID programmes in South Africa...
November 2017: PLoS Medicine
https://www.readbyqxmd.com/read/29161064/meeting-the-institute-of-medicine-s-2030-life-expectancy-target
#3
David Kindig, Jenna Nobles, Moheb Zidan
OBJECTIVES: To quantify the improvement in US life expectancy required to reach parity with high-resource nations by 2030, to document historical precedent of this rate, and to discuss the plausibility of achieving this rate in the United States. METHODS: We performed a demographic analysis of secondary data in 5-year periods from 1985 to 2015. RESULTS: To achieve the United Nations projected mortality estimates for Western Europe in 2030, the US life expectancy must grow at 0...
November 21, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/29160489/cross-cultural-adaptation-of-the-filial-responsibility-protocol-for-use-in-brazil
#4
Marines Aires, Fernanda Laís Fengler Dal Pizzol, Duane Mocellin, Idiane Rosset, Eliane Pinheiro de Morais, Lisiane Manganelli Girardi Paskulin
OBJECTIVE: To carry out a cross-cultural adaptation of the Filial Responsibility protocol for use in Brazil with adult child caregivers for elderly parents. METHOD: A methodological study that included the steps of initial translation, synthesis of translations, back-translation, committee of experts, pre-test, evaluation of psychometric measures and submission to authors. The protocol comprises a qualitative step, closed questions and seven scales: Filial Expectation, Subsidiary Compassion, Caregiver burden, Life Satisfaction, Personal Well-being and Quality of Relationships...
November 2017: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/29160185/temperature-modulates-the-interaction-between-fungicide-pollution-and-disease-evidence-from-a-daphnia-microparasitic-yeast-model
#5
Ana P Cuco, Bruno B Castro, Fernando Gonçalves, Justyna Wolinska, Nelson Abrantes
Temperature is expected to modulate the responses of organisms to stress. Here, we aimed to assess the influence of temperature on the interaction between parasitism and fungicide contamination. Specifically, using the cladoceran Daphnia as a model system, we explored the isolated and interactive effects of parasite challenge (yeast Metschnikowia bicuspidata) and exposure to fungicides (copper sulphate and tebuconazole) at two temperatures (17 and 20 °C), in a fully factorial design. Confirming a previous study, M...
November 21, 2017: Parasitology
https://www.readbyqxmd.com/read/29160158/-i-think-he-will-have-it-throughout-his-whole-life-parent-and-youth-perspectives-about-childhood-mental-health-problems
#6
Kyleigh E Schraeder, Graham J Reid, Judith Belle Brown
Children's mental health (CMH) problems can be long-lasting. Even among children and youth who receive specialized CMH treatment, recurrence of problems is common. It is unknown whether youth and their parents view the possibility of future mental health problems. This has important implications for how CMH services should be delivered. This grounded theory study gained perspectives from youth (aged 12-15 years) who received CMH treatment ( n = 10) and their parents ( n = 10) about the expected course of CMH problems...
November 1, 2017: Qualitative Health Research
https://www.readbyqxmd.com/read/29160139/high-and-rising-burden-of-hip-and-knee-osteoarthritis-in-the-nordic-region-1990-2015
#7
Aliasghar A Kiadaliri, L Stefan Lohmander, Maziar Moradi-Lakeh, Ingemar F Petersson, Martin Englund
Background and purpose - Osteoarthritis (OA) imposes a substantial burden on individuals and societies. We report on the burden of knee and hip OA in the Nordic region. Patients and methods - We used the findings from the 2015 Global Burden of Diseases Study to explore prevalence, years lived with disability (YLDs), and disability-adjusted life-years (DALYs) of OA in the 6 Nordic countries during 1990-2015 (population of about 27 million in 2015). Results - During 1990-2015, the number of prevalent OA cases increased by 43% to 1,507,587 (95% uncertainty interval [UI] 1,454,338-1,564,778) in the region...
November 21, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/29159904/growing-into-teen-fatherhood-a-grounded-theory-study
#8
C Uengwongsapat, K Kantaruksa, A Klunklin, N Sansiriphun
BACKGROUND: Becoming an adolescent father is a significant and critical life event. Expectant fathers are faced with a concurrent dual developmental crisis: being an adolescent and becoming a father. This transition has a tremendous impact on these adolescents, their families and society. The impact on these individuals and society does not, at this point, seem to be clearly understood. PURPOSE: To explore the process of Thai adolescents becoming first-time fathers with an unplanned pregnancy during their girlfriend's pregnancy...
November 21, 2017: International Nursing Review
https://www.readbyqxmd.com/read/29159791/determining-personalized-treatment-by-gene-expression-profiling-in-metastatic-breast-carcinoma-patients-a-pilot-study
#9
M Sureda, J Rebollo, E Mª Martínez-Navarro, F J Fernández-Morejón, J Farré, V Muñoz, P Bretcha-Boix, M Duarte, R G Manzano, A Crespo, M Del Carmen Redal, B Valenzuela, A Brugarolas
PURPOSE: The present study evaluates the massive study of gene expression in metastatic breast carcinoma (MBC) patients using microarray gene expression profiling (MAGE) complemented with conventional sequencing, immunohistochemistry (IHC) and fluorescent "in situ" hybridization (FISH), seeking to optimize the treatment in a subset of heavily pretreated patients and with limited life expectancy. PATIENTS, MATERIAL AND METHODS: MBC patients in hormone therapy progression with survival expectancy of at least 3 months (m) have been included...
November 20, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/29159733/management-of-hemophilia-in-older-patients
#10
REVIEW
Massimo Franchini, Pier Mannuccio Mannucci
In recent decades, several improvements in hemophilia care have resulted in increased quality of life and life expectancy for those affected by this inherited hemorrhagic condition. Nowadays, individuals with hemophilia enjoy a life expectancy at birth close to that of males in the general population. As a consequence of the increasing age of the hemophilia population, a growing number of these patients develop age-related co-morbidities, such as cardiovascular disease and cancer, the management of which represents a new challenge for caregivers at hemophilia treatment centers...
November 20, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29159544/-yeah-that-made-a-big-difference-the-importance-of-the-relationship-between-health-professionals-and-fathers-who-have-a-child-with-down-syndrome
#11
Freyja Docherty, Rebecca Dimond
Evidence suggests that medical services do not reflect the increased involvement of fathers in childcare, a discrepancy that can often lead to feelings of exclusion and inequality. Fathers who have a child with Down syndrome may encounter many different health professionals during their child's life, therefore it is important to consider this relationship, and investigate the factors that influence their experiences. This is particularly important because the limited research focusing on fathers suggest that those who have a child with Down syndrome can experience increased stress levels and lasting feelings of loss and grief...
November 20, 2017: Journal of Genetic Counseling
https://www.readbyqxmd.com/read/29159488/inter-rater-reliability-of-stoppfrail-screening-tool-of-older-persons-prescriptions-in-frail-adults-with-limited-life-expectancy-criteria-amongst-12-physicians
#12
Amanda Hanora Lavan, Paul Gallagher, Denis O'Mahony
PURPOSE: STOPPFrail is an explicit tool, developed by Delphi consensus, to assist physicians with deprescribing medications in frail older adults with poor survival prognosis. This study aimed to determine the inter-rater reliability (IRR), amongst physicians, of STOPPFrail application. METHODS: Twenty clinical cases were collated to represent frail older patients. Eighteen cases met STOPPFrail inclusion criteria. They had a mean age of 79.5 (SD6) years and a median of 7 (IQR6-8...
November 20, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29158981/fitness-implications-of-sex-specific-catch-up-growth-in-nephila-senegalensis-a-spider-with-extreme-reversed-ssd
#13
Rainer Neumann, Nicole Ruppel, Jutta M Schneider
Background: Animal growth is often constrained by unfavourable conditions and divergences from optimal body size can be detrimental to an individual's fitness, particularly in species with determinate growth and a narrow time-frame for life-time reproduction. Growth restriction in early juvenile stages can later be compensated by means of plastic developmental responses, such as adaptive catch-up growth (the compensation of growth deficits through delayed development). Although sex differences regarding the mode and degree of growth compensation have been coherently predicted from sex-specific fitness payoffs, inconsistent results imply a need for further research...
2017: PeerJ
https://www.readbyqxmd.com/read/29158649/life-expectancy-of-osteoarthritic-patients-after-primary-total-knee-arthroplasty
#14
Yoshinori Ishii, Hideo Noguchi, Junko Sato, Hana Ishii, Satoshi Takayama, Shin-Ichi Toyabe
Background: Although an increased life expectancy has been previously reported in patients with osteoarthritis (OA) after undergoing total knee arthroplasty (TKA), the long-living Japanese population may provide a more accurate cohort for determining 10- and 15-year survival rates. The aims of the present study were to (1) determine the survival of patients after TKA, (2) identify the factors important for survival, and (3) compare the survival rate of the OA patients with that of the standardized general population...
November 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29158206/pulmonary-rehabilitation-with-balance-training-for-fall-reduction-in-chronic-obstructive-pulmonary-disease-protocol-for-a-randomized-controlled-trial
#15
Marla K Beauchamp, Dina Brooks, Cindy Ellerton, Annemarie Lee, Jennifer Alison, Pat G Camp, Gail Dechman, Kimberley Haines, Samantha L Harrison, Anne E Holland, Alda Marques, Rahim Moineddin, Elizabeth H Skinner, Lissa Spencer, Michael K Stickland, Feng Xie, Roger S Goldstein
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. A growing body of evidence shows that individuals with COPD have important deficits in balance control that may be associated with an increased risk of falls. Pulmonary rehabilitation (PR) is a key therapeutic intervention for individuals with COPD; however, current international guidelines do not include balance training and fall prevention strategies. OBJECTIVE: The primary aim of this trial is to determine the effects of PR with balance training compared to PR with no balance training on the 12-month rate of falls in individuals with COPD...
November 20, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/29158145/intratumoural-leukocyte-infiltration-is-a-prognostic-indicator-among-pancreatic-cancer-patients-with-type-2-diabetes
#16
Emelie Karnevi, Agata Sasor, Katarzyna Said Hilmersson, Daniel Ansari, Jonas S Erjefält, Ann H Rosendahl, Roland Andersson
BACKGROUND: The life expectancy of pancreatic cancer patients remains minimal. The disease progression may be influenced by type 2 diabetes (T2D) and inflammatory status, although important gaps persist around their joint effects on disease outcome. The aim of this study was to investigate the clinical significance of the tumour immune microenvironment on pancreatic cancer prognosis in relation to T2D status. METHOD: Tumour-infiltrating macrophages, neutrophils and eosinophils were studied in primary pancreatic tumours and paired lymph node metastases in relation to patient and tumour characteristics, T2D status and overall survival in a retrospective cohort of patients with resectable pancreatic cancer in Sweden...
November 11, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/29158016/genetic-hemochromatosis-pathophysiology-diagnostic-and-therapeutic-management
#17
Pierre Brissot, Thibault Cavey, Martine Ropert, Pascal Guggenbuhl, Olivier Loréal
The term hemochromatosis (HC) corresponds to several diseases characterized by systemic iron overload of genetic origin and affecting both the quality of life and life expectancy. Major improvement in the knowledge of iron metabolism permits to divide these diseases into two main pathophysiological categories. For most HC forms (types 1, 2, 3 and 4B HC) iron overload is related to cellular hepcidin deprivation which causes an increase of plasma iron concentration and the appearance of plasma non-transferrin bound iron...
November 17, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/29157839/lifestyles-guide-and-glaucoma-i-sports-and-activities
#18
J Moreno-Montañés, A Antón-López, S Duch-Tuesta, P Corsino Fernández-Vila, J García-Feijoó, E Millá-Griñó, F J Muñoz-Negrete, L Pablo-Júlvez, I Rodríguez-Agirretxe, J L Urcelay-Segura, F Ussa-Herrera, M P Villegas-Pérez
PURPOSES: The increase in quality and life expectancy, often leads to many patients asking the glaucoma specialist whether some sports, activities or hobbies would affect their illness. The aim of this article is to establish guidelines for patients, based on the scientific evidence of published papers. METHODS: Review of all published articles on glaucoma and sports or other activities. The papers were classified according to the level of scientific evidence based on the Oxford Centre for Evidence-Based Medicine classification...
November 17, 2017: Archivos de la Sociedad Española de Oftalmología
https://www.readbyqxmd.com/read/29157828/immune-related-and-adverse-drug-reactions-to-low-versus-high-initial-doses-of-viscum-album-l-in-cancer-patients
#19
Friedemann Schad, Anja Thronicke, Antje Merkle, Harald Matthes, Megan L Steele
BACKGROUND: Immune-related adverse drug reactions (ADRs) to immunotherapy agents have been associated with beneficial clinical outcomes in oncology. Viscum album L. (VA, European mistletoe) is frequently used as an immunomodulatory agent alongside conventional cancer treatment in Europe. VA has been associated with improved quality of life and a reduction in chemotherapy-related ADRs. Beneficial effects of VA are believed to be related to its immunomodulatory properties. Current guidelines recommend commencing with a low dose and increasing slowly overtime, however, off-label prescribing of high initial doses is common...
December 1, 2017: Phytomedicine: International Journal of Phytotherapy and Phytopharmacology
https://www.readbyqxmd.com/read/29157400/advanced-symptom-management-in-multiple-sclerosis
#20
REVIEW
Elizabeth Crabtree-Hartman
Meaningful symptom management can have a profound impact on quality of life. It can challenge time parameters during clinic, and therefore thought should be given to strategies that can improve efficiency and thereby make the undertaking more tenable. For any given symptom, the building blocks of care, such as vitamin D status, exercise/physical therapy, nutrition, and stress management, and ensuring disease-modifying therapy coverage, should be maximized. For each symptom, there are pharmacologic and nonpharmacologic interventions...
February 2018: Neurologic Clinics
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