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Medical aid in dying

Michael J Boivin, Horacio Ruiseñor-Escudero, Itziar Familiar-Lopez
There is growing concern that although the more severe forms of HIV-associated neurologic deficits are reduced following highly active anti-retroviral therapy (HAART), mild to moderate cognitive disorders may persist for years after HAART initiation and this may occur despite complete plasma viral suppression. According to the UNAIDS 2014 report, there were 3.2 million children living with HIV around the world at the end of 2013 and 91 % of these resided in sub-Saharan Africa. In the same year, only 24 % of children who needed antiretroviral treatment (ART) received it and 190,000 children died of AIDS-related illnesses...
October 25, 2016: Current HIV/AIDS Reports
Sadikalmahdi Hussen, Tefera Belachew, Nezif Hussien
PURPOSES: The aim of this study was to determine the effects of nutritional status at the start of highly active anti-retroviral therapy on treatment outcomes among HIV/AIDS patients taking HAART at Jimma University Specialized Hospital. METHODS: We performed a retrospective cohort study involving 340 adults who started highly active anti-retroviral therapy. The patients have been clinically followed for 2 years. Data were extracted from paper based medical charts by trained data collectors from January 30 to February 28, 2014 using data collection format...
2016: AIDS Research and Therapy
Phillipa J Malpas, Anneka Anderson, Pio Jacobs, Takawai Jacobs, Danielle Luinstra, Dolly Paul, Jim Rauwhero, Julie Wade, David Wharemate
AIM: To explore kaumātua attitudes towards physician aid-in dying, to gain a clear understanding of how such attitudes may influence and shape their expectations of medical care at the end of life and to assist health professionals in Aotearoa/New Zealand to address the healthcare needs of older Māori near the end of life. DESIGN: A kaupapa Māori consistent approach was undertaken. A systematic narrative technique was employed for the qualitative data analysis...
September 26, 2016: Palliative Medicine
Annette Hanson
Due to the growing number of ageing prisoners in the American correctional system, penal institutions are increasingly caring for patients with chronic and potentially terminal medical conditions. To address this problem states have attempted sentencing reform initiatives and adopted compassionate release programmes; however, these efforts have failed to significantly reduce the number of elderly or seriously ill inmates. Correctional mental health services are now called upon to aid in the care of prisoners at the end of life...
September 26, 2016: International Review of Psychiatry
Shaza O H Kanan, Mohammed Osman Swar
This is a retrospective observational hospital-based study aimed to determine the prevalence and outcome of severe acute malnutrition in children less than five years admitted to Omdurman Paediatric Hospital during the period January 2014 to December 2014. Data was collected from patient's hospital records during the study period. Ethical approval and permission to access patients' record were obtained. A total of 593 children with severe malnutrition were identified; 305 of cases were male (51.4%) with a male: female ratio of 1:0...
2016: Sudan J Paediatr
Thomas H McCoy, Victor M Castro, Ashlee M Roberson, Leslie A Snapper, Roy H Perlis
Importance: Suicide represents the 10th leading cause of death across age groups in the United States (12.6 cases per 100 000) and remains challenging to predict. While many individuals who die by suicide are seen by physicians before their attempt, they may not seek psychiatric care. Objective: To determine the extent to which incorporating natural language processing of narrative discharge notes improves stratification of risk for death by suicide after medical or surgical hospital discharge...
October 1, 2016: JAMA Psychiatry
Lori L Boland, Jonathan S Hokanson, Karl M Fernstrom, Tyler G Kinzy, Charles J Lick, Paul A Satterlee, Brian K LaCroix
INTRODUCTION: We aimed to pilot test the delivery of sepsis education to emergency medical services (EMS) providers and the feasibility of equipping them with temporal artery thermometers (TATs) and handheld lactate meters to aid in the prehospital recognition of sepsis. METHODS: This study used a convenience sample of prehospital patients meeting established criteria for sepsis. Paramedics received education on systemic inflammatory response syndrome (SIRS) criteria, were trained in the use of TATs and hand-held lactate meters, and enrolled patients who had a recent history of infection, met ≥ 2 SIRS criteria, and were being transported to a participating hospital...
September 2016: Western Journal of Emergency Medicine
Nikki Johnston, Clare Lovell, Wai-Man Liu, Michael Chapman, Liz Forbat
BACKGROUND: Improving access to palliative care for older adults living in residential care is recognised internationally as a pressing clinical need. The integration of specialist palliative care in residential care for older adults is not yet standard practice. OBJECTIVE: This study aimed to understand the experience and impact of integrating a specialist palliative care model on residents, relatives and staff. METHODS: Focus groups were held with staff (n=40) and relatives (n=17)...
August 3, 2016: BMJ Supportive & Palliative Care
Susanna L Lamers, Rebecca Rose, Ekaterina Maidji, Melissa Agsalda-Garcia, David J Nolan, Gary B Fogel, Marco Salemi, Debra L Garcia, Paige Bracci, William Yong, Deborah Commins, Jonathan Said, Negar Khanlou, Charles H Hinkin, Miguel Valdes Sueiras, Glenn Mathisen, Suzanne Donovan, Bruce Shiramizu, Cheryl A Stoddart, Michael S McGrath, Elyse J Singer
UNLABELLED: HIV infection treatment strategies have historically defined effectiveness through measuring patient plasma HIV RNA. While combined antiretroviral therapy (cART) can reduce plasma viral load (pVL) to undetectable levels, the degree that HIV is eliminated from other anatomical sites remains unclear. We investigated the HIV DNA levels in 229 varied autopsy tissues from 20 HIV-positive (HIV(+)) cART-treated study participants with low or undetectable plasma VL and cerebrospinal fluid (CSF) VL prior to death who were enrolled in the National Neurological AIDS Bank (NNAB) longitudinal study and autopsy cohort...
October 15, 2016: Journal of Virology
Rafael Garcia Torres, Renata Margarida Etchebehere, Sheila Jorge Adad, Adilha Rua Micheletti, Barbara de Melo Ribeiro, Leonardo Eurípedes Andrade Silva, Delio Jose Mora, Kennio Ferreira Paim, Mario León Silva-Vergara
Cryptococcosis occurs in acquired immunodeficiency syndrome (AIDS) patients with poor compliance to antiretroviral therapy or unaware of their human immunodeficiency virus status who present severe immunosuppression at admission. Consequently, high mortality rates are observed due to disseminated fungal infection. This report presents clinical and postmortem data of AIDS patients with cryptococcosis in a teaching hospital in Brazil. Retrospectively, medical and necropsy records of AIDS patients with cryptococcosis clinically confirmed and/or postmortem verified were reviewed...
October 5, 2016: American Journal of Tropical Medicine and Hygiene
Cindy L Cain
In late 2015, California passed the End of Life Option Act (AB 15), which allows residents at the terminal stage of an illness to request a prescription for medications meant to hasten death. As California seeks to implement the law in June 2016, findings from other states that practice aid in dying (AID) may guide implementation. This policy brief provides an overview of the use of AID, outlines outstanding questions about practice and ethics, and recommends steps for improving California's implementation of AB 15...
May 2016: Policy Brief
I Cornelis, H A Volk, L Van Ham, S De Decker
Although long-term outcomes of meningoencephalitis of unknown aetiology (MUA) in dogs have been evaluated, little is known about short-term survival and initial response to therapy. The aim of this study was to evaluate possible prognostic factors for 7-day survival after diagnosis of MUA in dogs. Medical records were reviewed for dogs diagnosed with MUA between 2006 and 2015. Previously described inclusion criteria were used, as well as 7-day survival data for all dogs. A poor outcome was defined as death within 1 week...
August 2016: Veterinary Journal
Natsuyo Yoshida-Hata, Naomichi Katai, Toshiyuki Oshitari
Purpose. To report the ocular findings in patients with hematopoietic malignancy with optic nerve involvement and abducens nerve palsy. Methods. The medical records of all cases of hematopoietic cancer with ophthalmic involvements seen in the Department of Ophthalmology of the National Center for Global Health and Medicine between 2009 and 2014 were reviewed. Results. Eight patients with hematopoietic cancer with optic nerve invasion or abducens nerve palsy were studied. The primary diseases were 3 cases of multiple myeloma, 1 case of acute lymphocytic leukemia, 1 case of follicular lymphoma, and 3 cases of AIDS-related lymphoma...
2016: Case Reports in Ophthalmological Medicine
Alister Browne, J S Russell
The Criminal Code of Canada prohibits persons from aiding or abetting suicide and consenting to have death inflicted on them. Together, these provisions have prohibited physicians from assisting patients to die. On February 6, 2015, the Supreme Court of Canada declared void these provisions insofar as they "prohibit physician-assisted death for a competent adult person who (1) clearly consents to the termination of life and (2) has a grievous and irremediable medical condition (including an illness, disease or disability) that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition...
July 2016: Cambridge Quarterly of Healthcare Ethics: CQ: the International Journal of Healthcare Ethics Committees
Emily C Bendel, Michael A McKusick, Chad J Fleming, Jeremy L Friese, David A Woodrum, Andrew H Stockland, Sanjay Misra
PURPOSE: The purpose of this study is to evaluate the short-term safety and efficacy of a co-axial angioplasty balloon technique for percutaneous radiologic gastrostomy catheter placement (PRG). METHODS: A total of 65 percutaneous radiologic gastrostomy tube placements were performed with the co-axial angioplasty balloon technique from 10/1999 to 1/2014. This included 19 females and 46 males between the ages of 20-83. Without the use of T-fasteners for gastropexy, the gastrostomy tube was placed over a catheter-shaft angioplasty balloon as a co-axial system...
June 25, 2016: Abdominal Radiology
Murat Nihat Arslan, Deniz Oguzhan Melez, Arzu Akcay, Adem Gur, Bulent Sam, Suheyla Guven Apaydın
Nicolau syndrome (NS) is a dermatological adverse reaction of intramuscular injections and is caused by several mechanisms. The etiopathogenesis remains unclear, and several hypotheses have suggested a vascular origin. Rhabdomyolysis (RM) is the destruction of striated muscle, with the subsequent release of muscle cell contents into circulation. NS and RM diagnoses may overlap. Herein, we present the autopsy findings of a 40-year-old female with NS complicated with RM. On clinical follow-up, creatine kinase (CK) was 7146 IU/L, and urea and creatinine levels were elevated on the third day after intramuscular diclofenac injection...
September 2016: Journal of Forensic Sciences
Sheryl Reimer-Kirkham, Richard Sawatzky, Della Roberts, Marie Cochrane, Kelli Stajduhar
AIMS AND OBJECTIVES: The purpose of the study was to examine nurses' and nursing assistants' perspectives of a palliative approach in a variety of nursing care settings that do not specialise in palliative care. BACKGROUND: Ageing populations worldwide are drawing increasing attention to palliative care. In particular, people with advancing chronic life-limiting conditions often have unmet needs and may die in acute medical, residential care and home health settings without access to palliative care...
August 2016: Journal of Clinical Nursing
Wasna Sirirungsi, Woottichai Khamduang, Intira Jeannie Collins, Artit Pusamang, Pranee Leechanachai, Suchada Chaivooth, Nicole Ngo-Giang-Huong, Tanawan Samleerat
BACKGROUND: Early infant diagnosis of HIV is crucial for timely initiation of antiretroviral therapy (ART) in infected children who are at high risk of mortality. Early infant diagnosis with dried blood spot testing was provided by the National AIDS Programme in Thailand from 2007. We report ART initiation and vital status in children with HIV after 7 years of rollout in Thailand. METHODS: Dried blood spot samples were collected from HIV-exposed children in hospitals in Thailand and mailed to the Faculty of Associated Medical Sciences, Chiang Mai University, where HIV DNA was assessed with real-time PCR to establish HIV infection...
June 2016: Lancet HIV
Daniel Boivin, Julie Barrette
Soon, physicians across Canada will be permitted to assist patients in dying, provided certain conditions are met. Physicians in the province of Quebec can already provide this service since December 10, 2015. While Quebec has been studying the question of legislating medical aid in dying since 2009, the rest of the country must come up with legislation on this issue within the next few months. This article suggests that other Canadian jurisdictions, federally and provincially/territorially, may find inspiration in the extensive work done in Quebec leading to its end-of-life legislation, including on the issues of identifying proper safeguards to protect vulnerable people and eligibility criteria that could be put in place in these jurisdictions...
February 2016: Health Law in Canada
Tom Koch
In February 2016, the Canadian Supreme Court argued in a unanimous decision that criminal statutes prohibiting physician-assisted or -directed termination violated the Charter of Rights and Freedoms. In the unanimous judgment, they argued that the promise of "life, liberty, and sanctity of person" in s. 7 enshrined patient choice as a principal Canadian virtue. But for choice to be real, that requires a set of predicate conditions assuring fragile Canadians have free and ready access to a range of medical services including, in a partial list, expert counseling, home care aides, palliative treatment, rehabilitative services, and social support for themselves and familial carers...
February 2016: Health Law in Canada
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