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Paula Jimenez-Fonseca, Sebastian Krug, Gianluca Tamagno, F Fierro Maya, A Monleon Getino, C I Rodriguez Casado, Frederico Costa, Wouter W de Herder, Henning Jann
<br>Pancreatic neuroendocrine tumours (pNETs) represent rare neoplasms of all NETs often presenting without functional activity. Many sporadic non-functioning pNET patients are already metastatic at the time of diagnosis, and the therapeutic approach to such patients is mostly palliative. In this international, multicenter, retrospective cohort study we assessed the prognostic value of a set of anthropometric, clinical, biochemical, radiological, and pathological parameters at baseline and the impact of the therapeutic strategies on the survival of patients with sporadic grade 1/2, stage IV, non-functioning pNETs...
July 19, 2018: Neuroendocrinology
Maia Thrift-Perry, Anna Cabanes, Fatima Cardoso, Katherine Moose Hunt, Tauane Araújo Cruz, Kyra Faircloth
Metastatic breast cancer (mBC) is an area with high unmet need across the world. Despite significant progress to meet patient need, current breast cancer (BC) policies fail to recognize the unique challenges of patients who are further along the cancer patient journey. This analysis aims to understand BC/mBC policy development at a global level and identify opportunities for further development. A comprehensive analysis of National Cancer Control Plans (NCCPs) policies and programs was conducted across 16 countries, which represent a diverse range of healthcare systems, economies and geographic regions...
June 18, 2018: Breast: Official Journal of the European Society of Mastology
Shuzhong Liu, Xi Zhou, An Song, Xiangyi Kong, Yipeng Wang, Yong Liu
RATIONALE: Gorham-Stout syndrome in the spine is extremely rare, and there is no standard curative management thus far. The objective of this article is to report a very rare case of Gorham-Stout syndrome of the lumbar and sacral spine with chylothorax and chyloperitoneum successfully treated by combination of vertebroplasty with cement augmentation and medication treatment. We described the clinical characteristics and postoperative therapy of the patient, and reviewed all of the published cases of Gorham-Stout syndrome of the lumbar and sacral spine...
July 2018: Medicine (Baltimore)
Kyung-Ah Kang, Suk-Jung Han, Young-Sook Lim, Shin-Jeong Kim
BACKGROUND: For patients with advanced or terminal cancer undergoing hospice or palliative care, spiritual care based on meaning-centered intervention (MCI) has become an essential form of support. OBJECTIVE: The aim of this study was to characterize MCI systematically and the effectiveness of hospice and palliative care for patients with advanced or terminal cancer. METHODS: MEDLINE via PubMed, Cochrane Library CENTRAL, EMBASE, CINAHL, and several Korean electronic databases were searched from inception to May 2017...
July 17, 2018: Cancer Nursing
Gail Wan Ying Chua, Eu Tiong Chua
Distant metastases in nasopharyngeal carcinoma are fairly common. While the mainstay of treatment for metastatic nasopharyngeal carcinoma remains chemotherapy, it is now increasingly recognised that metastatic cases are a heterogenous group and can be stratified into oligometastatic cases versus those with widespread metastases, the former potentially benefiting more from local therapy. In this report, we describe a case of nasopharyngeal carcinoma with a solitary vertebral metastasis successfully treated with high-dose palliative radiotherapy alone, resulting in a long-term disease-free interval of more than 8 years at the time of writing...
May 2018: Case Reports in Oncology
Shinya Munakata, Yuta Murai, Akihiro Koizumi, Hisaki Kato, Riku Yamamoto, Shuhei Ueda, Satoshi Tokuda, Shunsuke Sakuraba, Tomoyuki Kushida, Hajime Orita, Mutsumi Sakurada, Hiroshi Maekawa, Koichi Sato
Neuroendocrine carcinoma (NEC) of the colon is very rare, and squamous cell carcinoma (SCC) of colon cancer is rare. We recently treated a patient with both NEC and SCC that initially presented as multiple unresectable liver and lung metastases. A 68-year-old Japanese man was referred to our hospital because of diarrhea with descending colon cancer obstruction. He underwent a left colectomy. Based on immunohistochemistry results, we diagnosed mixed NEC and SCC, the primary lesion location of which was probably the lung in the final pathologic examination...
May 2018: Case Reports in Gastroenterology
Eva Bergsträsser
Paediatric Palliative Care: What is different in children compared to adults? Abstract. The number of children and adolescents (0 - 18 years) with life-limiting conditions and needs for paediatric palliative care (PPC) is rising. In Switzerland, the awareness for these needs lags largely behind other developed countries. In the United Kingdom, the prevalence for children with life-limiting conditions and PPC needs was estimated at 32 children per 10'000 population (0 - 19 years). In Switzerland, this would correspond to an absolute number of 5'000 children living with a life-limiting condition and potentially in need of PPC...
July 2018: Therapeutische Umschau. Revue Thérapeutique
Ralf J Jox, Francesca Bosisio, Eve Rubli Truchard
Dementia from a palliative care perspective: why a disease-specific advance care planning is necessary Abstract. Palliative Care has to transform profoundly in the context of population aging in many countries around the globe. It has to collaborate increasingly with geriatric medicine and incorporate geriatric expertise. One of the pivotal challenges of geriatric palliative care is ethically appropriate decision making for patients who have lost decision-making capacity. While the traditional approach to advance directives (living wills) has demonstrably proven ineffective, the new approach that is currently being embraced, including in German-speaking countries, is the systemic process of advance care planning (ACP)...
July 2018: Therapeutische Umschau. Revue Thérapeutique
Johanna Anneser
Palliative Sedation: Comments on a controversial topic Abstract. Palliative sedation (PS) is an accepted medical practice for terminally ill patients. It intends the alleviation of unbearable suffering by intentionally lowering the level of consciousness. In contrast to physician assisted suicide and euthanasia, palliative sedation aims to relieve burdensome symptoms with no intention of hastening death. PC can be applied as "intermittent palliative sedation" or "continuous (deep) sedation until death"...
July 2018: Therapeutische Umschau. Revue Thérapeutique
Jan Gärtner, Daniel Büche, Cristian Camartin
Delirium in Palliative Care: Evidence and Practice Abstract. Delirium is a frequent condition in Palliative Care. For patients, their families and the formal caregivers it is associated with substantial burden, fears and challenges. It is also associated with increased morbidity and mortality and often irreversible. Of utmost importance is the identification of patients and threat for delirium and prophylactic measures to avoid delirium whenever possible. For this, risk factors should be identified and eliminated whenever possible...
July 2018: Therapeutische Umschau. Revue Thérapeutique
Jan Gärtner, Bernd Alt-Epping, Marion Daun
Palliative Care - not just for the final phase. A rewiev of evidence Abstract. Already in early stages of their disease, patients with incurable, advanced cancer and non-cancer disease suffer from a range of limitations of their quality of life due to symptoms (i. e. pain, dyspnoea) or psychical, social or spiritual problems. Palliative Care aims to maintain the patients' quality of life and is applicable already early in the disease trajectory and not only at the end of life. As providers of general (basic) palliative care, all health care providers from all disciplines should therefore hold basic expertise in symptom control and communication...
July 2018: Therapeutische Umschau. Revue Thérapeutique
Heike Gudat
Give the due value to the end of life: the systematic underfunding of specialised palliative care in the Swiss DRG system Abstract. Palliative care is an integral part of modern medicine, improving quality of life, treatment satisfaction, and reducing the costs of care in severe disease. Patients' access should be early, regardless of age, diagnosis and setting, when incurable or advanced disease has been diagnosed. The public expenditure for specialised palliative care units in hospitals can be seen as yardstick for an appropriate palliative care supply, but in Switzerland only a mere fraction of revenues is dedicated to the palliative care units...
July 2018: Therapeutische Umschau. Revue Thérapeutique
Friedemann Nauck
Role of the influence of cultural and religious beliefs on medical end-of-life decision-making Abstract. Decision-making at the end of life must encompass medical indication, therapeutic offer, patient autonomy and consent. Furthermore, physicians must reflect on whether their own cultural and religious beliefs have an influence on their decision-making process. Basic knowledge in palliative care or integration of experts in palliative care may be useful when dealing with patients at the end of life, particularly when shifting treatment goals to palliative or comfort care measures is considered or necessary...
July 2018: Therapeutische Umschau. Revue Thérapeutique
Janet M Simsic, Christina Phelps, Kristin Kirchner, Kirby-Rose Carpenito, Robin Allen, Holly Miller-Tate, Karen Texter, Mark Galantowicz
OBJECTIVE: Interstage readmissions are common in infants with single ventricle congenital heart disease undergoing staged surgical palliation. We retrospectively examined readmissions during the interstage period. DESIGN: Retrospective analysis. SETTING: The Heart Center at Nationwide Children's Hospital, Columbus, Ohio. PATIENTS: Newborns undergoing hybrid stage 1 palliation from January 2012 to December 2016 who survived to hospital discharge and were followed at our institution...
July 18, 2018: Congenital Heart Disease
Richard Fitzgerald, Jennifer Gallagher
INTRODUCTION: Maintaining oral health is vital for every individual's quality of life. Little consideration, however, has been given to the oral health of patients approaching end-of-life, perhaps due to sensitivities over research ethics. The aim of this rapid review is to synthesize existing evidence on oral health in this population. METHODS AND RESULTS: A rapid review of the literature was conducted using the key words: "Oral/Dental Health" in "End-of-life" or "Palliative care" patients...
July 19, 2018: Special Care in Dentistry
Handan Sevim, Yusuf Çetin Kocaefe, Mehmet Ali Onur, Duygu Uçkan-Çetinkaya, Özer Aylin Gürpınar
BACKGROUND: Familial hemophagocytic lymphohistiocytosis 2 (FHL2) is the most common familial type of hemophagocytic lymphohistiocytosis with immune dysregulation. FHL2 patients have mutations in the perforin gene which cause overactivation and proliferation of cytotoxic T lymphocytes and natural killer cells. Perforin is the key component of the cytolytic granule response function of cytotoxic T lymphocytes and natural killer cells. Perforin dysfunction causes a cytotoxic immune deficiency with a clinical outcome of uncontrolled and continuous immune stimulation response...
July 18, 2018: Stem Cell Research & Therapy
Reetta P Piili, Juho T Lehto, Tiina Luukkaala, Heikki Hinkka, Pirkko-Liisa I Kellokumpu-Lehtinen
BACKGROUND: Characteristics of the physician influence the essential decision-making in end-of-life care. However, the effect of special education in palliative medicine on different aspects of decision-making in end-of-life care remains unknown. The aim of this study was to explore the decision-making in end-of-life care among physicians with or without special competency in palliative medicine (cPM). METHODS: A questionnaire including an advanced lung cancer patient-scenario with multiple decision options in end-of-life care situation was sent to 1327 Finnish physicians...
July 18, 2018: BMC Palliative Care
Britt Viola Danielsen, Anne Marit Sand, Jan Henrik Rosland, Oddvar Førland
BACKGROUND: Norway has one of the lowest home death rates in Europe. However, it is the health authorities´ ambition to increase this by facilitating palliative care at home. The aim of this study was to achieve more insight, through home care nurses and general practitioners, of conditions that facilitate or hamper more time at home and more home deaths for patients with terminal disease and short life expectancy. METHODS: We used a qualitative research design with four focus groups with a total of 19 participants, of either home care nurses or general practitioners, using semi-structured question guides...
July 18, 2018: BMC Palliative Care
Amy D Proal, Trevor G Marshall
The theory of autoimmunity was developed at a time when the human body was regarded as largely sterile. Antibodies in patients with chronic inflammatory disease could consequently not be tied to persistent human pathogens. The concept of the "autoantibody" was created to reconcile this phenomenon. Today, however, the discovery of the human microbiome has revolutionized our understanding of human biology. Humans are superorganisms that harbor trillions of persistent microbial cells. Indeed, vast human microbiomes have been detected in human tissue and blood...
June 2018: Discovery Medicine
Sanjay Bhandari, Mubeen Khan Mohammed Abdul, Will Hollabaugh, Kanav Sharma, Douglas B Evans, Nalini Guda
BACKGROUND AND AIM: Pancreatic cancer is one of the common cancers in US and is associated with high mortality and morbidity. The objectives of our study were to look at the recent trends in the number of hospitalizations with pancreatic cancer. METHODS: We identified patients with a discharge diagnosis of pancreatic cancer in the National Inpatient Sample from 2007 to 2011 using International Classification of Diseases-Clinical Modification, 9th revision (ICD-9-CM) codes...
2018: PloS One
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