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https://www.readbyqxmd.com/read/29742715/liver-abscess-caused-by-clostridium-haemolyticum-infection-after-transarterial-chemoembolization-for-hepatocellular-carcinoma-a-case-report
#1
Dong-Jun Son, Ji-Yun Hong, Ki-Hyun Kim, Young-Hoon Jeong, Dae-Seong Myung, Sung-Bum Cho, Wan-Sik Lee, Yang-Jun Kang, Jin-Woong Kim, Young-Eun Joo
RATIONALE: Liver abscesses caused by Clostridium species infection are extremely rare. PATIENT CONCERNS: The authors report the first case of a liver abscess due to Clostridium haemolyticum, which occurred after transarterial chemoembolization (TACE) for hepatocellular carcinoma, in a 76-year-old woman who presented with right upper quadrant pain and fever. DIAGNOSES: Computed tomography of the abdomen after the second TACE showed an air-filled abscess around a compact, lipiodolized lesion in the right hepatic lobe...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29741672/limit-lean-or-listen-a-typology-of-low-value-care-that-gives-direction-in-de-implementation
#2
Eva W Verkerk, Marit A C Tanke, Rudolf B Kool, Simone A van Dulmen, Gert P Westert
Background: Overuse of unnecessary care is widespread around the world. This so-called low-value care provides no benefit for the patient, wastes resources and can cause harm. The concept of low-value care is broad and there are different reasons for care to be of low-value. Hence, different strategies might be necessary to reduce it and awareness of this may help in designing a de-implementation strategy. Based on a literature scan and discussions with experts, we identified three types of low-value care...
May 7, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29719873/ward-round-template-enhancing-patient-safety-on-ward-rounds
#3
Niall Gilliland, Natalie Catherwood, Shaouyn Chen, Peter Browne, Jacob Wilson, Helena Burden
Introduction and aims: Concerns had been raised at clinical governance regarding the safety of our inpatient ward rounds with particular reference to: documentation of clinical observations and National Early Warning Score (NEWS), compliance with Trust guidance for venous thromboembolism (VTE) risk assessment, antibiotic stewardship, palliative care and treatment escalation plans (TEP). This quality improvement project was conceived to ensure these parameters were considered and documented during the ward round, thereby improving patient care and safety...
2018: BMJ Open Quality
https://www.readbyqxmd.com/read/29500237/antibiotics-in-palliative-care-less-can-be-more-recognising-overuse-is-easy-the-real-challenge-is-judicious-prescribing
#4
EDITORIAL
Shing Fung Lee
No abstract text is available yet for this article.
March 2, 2018: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/29454083/incidence-of-acute-suppurative-sialadenitis-in-end-stage-cancer-patients-a-retrospective-observational-study
#5
Hiroaki Watanabe, Takuya Odagiri, Yasuyuki Asai
CONTEXT: Acute suppurative sialadenitis (hereafter referred to as sialadenitis) is accompanied by pain and fever and can diminish the quality of life in end-stage cancer patients; however, its incidence is not clear. OBJECTIVES: We conducted this study to elucidate the incidence of sialadenitis in end-stage cancer patients. METHODS: Retrospective review and observational study based on patients' medical records. SUBJECTS: About 726 consecutive cancer patients who died on the palliative care unit of our hospital between April 2012 and November 2016 were included...
February 14, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29423164/cutaneous-metastasis-of-a-primary-oesophageal-adenocarcinoma-to-the-right-cheek
#6
Emily Higgins, Liam Monaghan, Raghu R Mani
This case report details of a case of cutaneous metastasis from a primary adenocarcinoma of the oesophagus to the right cheek. A 67-year-old male was referred to the maxillofacial department with a 2-3 week history of non-painful swelling of the cheek. A diagnosis of infected sebaceous cyst was made and drainage was attempted with adjunctive antibiotic therapy. Follow up appointments showed no improvement a biopsy was taken. Histology reported presence of metastatic adenocarcinoma, suggesting the gastrointestinal tract as the primary site...
September 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29345756/clinical-intentions-of-antibiotics-prescribed-upon-discharge-to-hospice-care
#7
Sarah A Servid, Brie N Noble, Erik K Fromme, Jon P Furuno
OBJECTIVES: To better understand the clinical intentions for antibiotic prescribing upon discharge from acute care to hospice care. DESIGN: Retrospective cohort study. SETTING: Five hundred forty-four-bed academic, acute-care, tertiary referral hospital in Portland, Oregon. PARTICIPANTS: Adults (≥18) who received an outpatient prescription for antibiotics on discharge from an acute care hospital to hospice care between January 1, 2009 and December 31, 2011 (N = 149)...
January 18, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29344766/patient-reported-symptoms-before-palliative-radiotherapy-predict-survival-differences
#8
Carsten Nieder, Thomas A Kämpe, Adam Pawinski, Astrid Dalhaug
BACKGROUND: Widely used prognostic scores, e. g., for brain or bone metastases, are based on disease- and patient-related factors such as extent of metastases, age and performance status, which were available in the databases used to develop the scores. Few groups were able to include patient-reported symptoms. In our department, all patients were assessed with the Edmonton Symptom Assessment System (ESAS, a one-sheet questionnaire addressing 11 major symptoms and wellbeing on a numeric scale of 0-10) at the time of treatment planning since 2012...
January 17, 2018: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
https://www.readbyqxmd.com/read/29273073/pulmonary-tumor-thrombotic-microangiopathy-successfully-treated-with-corticosteroids-a-case-report
#9
Shinichi Miyazaki, Takuya Ikeda, Genshi Ito, Masahide Inoue, Keiji Nara, Yuko Nishinaga, Yoshinori Hasegawa
BACKGROUND: Pulmonary tumor thrombotic microangiopathy is a special type of tumor thromboembolism. We report the case of a patient who developed pulmonary tumor thrombotic microangiopathy with alveolar hemorrhage. Almost all patients with pulmonary tumor thrombotic microangiopathy die within 1 week of the onset of dyspnea; however, the prognosis in this case was better, with 10 weeks of survival from presentation. CASE PRESENTATION: A 62-year-old Japanese man was referred to our hospital with a 4-week history of dyspnea on exertion and severe pulmonary hypertension...
December 23, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29129177/copd-x-australian-and-new-zealand-guidelines-for-the-diagnosis-and-management-of-chronic-obstructive-pulmonary-disease-2017-update
#10
Ian A Yang, Juliet L Brown, Johnson George, Sue Jenkins, Christine F McDonald, Vanessa M McDonald, Kirsten Phillips, Brian J Smith, Nicholas A Zwar, Eli Dabscheck
Chronic obstructive pulmonary disease (COPD) is characterised by persistent respiratory symptoms and chronic airflow limitation, and is associated with exacerbations and comorbidities. Advances in the management of COPD are updated quarterly in the national COPD guidelines, the COPD-X plan, published by Lung Foundation Australia in conjunction with the Thoracic Society of Australia and New Zealand and available at http://copdx.org.au. Main recommendations: Spirometry detects persistent airflow limitation (post-bronchodilator FEV1/FVC < 0...
November 20, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/29104029/nasolabial-flap-improves-healing-in-medication-related-osteonecrosis-of-the-jaw
#11
Juliana Lemound, Thomas Muecke, Alexander-Nicolai Zeller, Jürgen Lichtenstein, André Eckardt, Nils-Claudius Gellrich
PURPOSE: Medication-related osteonecrosis of the jaw (MRONJ) is an adverse side effect of antiresorptive and antiangiogenic therapeutic agents that is difficult to treat owing to its high relapse rate. The aim of the present study was to determine whether patients with MRONJ treated using decortication and a nasolabial flap compared with those who underwent decortication with mucoperiosteal flaps have better outcomes regarding stable wound closure. MATERIALS AND METHODS: Two groups of patients with MRONJ and intraoral exposed bone were evaluated in a cohort clinical study retrospectively...
April 2018: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28958968/a-major-procalcitonin-elevation-without-sepsis-in-a-metastatic-small-cell-lung-carcinoma
#12
Pierre-Alain Billy, Laurence Parmeland, Sylvie Brunette, Sophie Lecordier, Matthieu Pecquet
We report the case of a 54-year-old man with metastatic pulmonary neuroendocrine tumor associated with major procalcitonin (PCT) elevation without sepsis. Three lines of antibiotic therapies were successively introduced but had no positive effect on PCT kinetic and disease progression. Under palliative care, increasing of PCT level was constant during the hospitalization, along with major asthenia and pain and metastatic progression. PCT is an excellent biological marker of bacterial infection, both sensitive and specific...
October 1, 2017: Annales de Biologie Clinique
https://www.readbyqxmd.com/read/28946806/palliation-of-malignant-biliary-obstruction-adverse-events-are-common-after-percutaneous-transhepatic-biliary-drainage
#13
P A Heedman, E Åstradsson, K Blomquist, R Sjödahl
BACKGROUND AND AIM: Endoscopic stents in the common bile duct is the first treatment choice to alleviate symptoms of biliary obstruction due to malignant disease. When endoscopic stenting fails in palliative patients, one option is to use a percutaneous transhepatic biliary drainage, but it is not clear whether and how it can reduce the symptom load. The aim of this study was to evaluate benefits and disadvantages of percutaneous transhepatic biliary drainage in palliative care. MATERIAL AND METHODS: Inclusion criteria were malignant disease and bilirubin ≥26 µmol/L in plasma...
March 2018: Scandinavian Journal of Surgery: SJS
https://www.readbyqxmd.com/read/28905328/lessons-learned-from-protein-aggregation-toward-technological-and-biomedical-applications
#14
REVIEW
César L Avila, Silvina Chaves, Sergio B Socias, Esteban Vera-Pingitore, Florencia González-Lizárraga, Cecilia Vera, Diego Ploper, Rosana Chehín
The close relationship between protein aggregation and neurodegenerative diseases has been the driving force behind the renewed interest in a field where biophysics, neurobiology and nanotechnology converge in the study of the aggregate state. On one hand, knowledge of the molecular principles that govern the processes of protein aggregation has a direct impact on the design of new drugs for high-incidence pathologies that currently can only be treated palliatively. On the other hand, exploiting the benefits of protein aggregation in the design of new nanomaterials could have a strong impact on biotechnology...
October 2017: Biophysical Reviews
https://www.readbyqxmd.com/read/28904010/vitamin-d-supplementation-to-palliative-cancer-patients-protocol-of-a-double-blind-randomised-controlled-trial-palliative-d
#15
Maria Helde-Frankling, Jenny Bergqvist, Caritha Klasson, Marie Nordström, Jonas Höijer, Peter Bergman, Linda Björkhem-Bergman
BACKGROUND: According to a small pilot study on palliative cancer patients at our ward, vitamin D supplementation had beneficial effects on pain (measured as opioid consumption), infections and quality of life (QoL) without having any significant side effects. OBJECTIVE: The primary objective of the 'Palliative-D' study is to test the hypothesis that vitamin D supplementation for 12 weeks reduces opioid consumption. The secondary objectives are to study if reduction of antibiotic consumption and fatigue as well as improvement in QoL assessments can be observed...
December 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28859173/vitamin-d-supplementation-to-palliative-cancer-patients-shows-positive-effects-on-pain-and-infections-results-from-a-matched-case-control-study
#16
Maria Helde-Frankling, Jonas Höijer, Jenny Bergqvist, Linda Björkhem-Bergman
BACKGROUND: We previously showed an association between low vitamin D levels and high opioid doses to alleviate pain in palliative cancer patients. The aim of this case-controlled study was to investigate if vitamin D supplementation could improve pain management, quality of life (QoL) and decrease infections in palliative cancer patients. METHODS: Thirty-nine palliative cancer patients with levels of 25-hydroxyvitamin D < 75 nmol/L were supplemented with vitamin D 4000 IE/day, and were compared to 39 untreated, matched "control"-patients from a previous study at the same ward...
2017: PloS One
https://www.readbyqxmd.com/read/28837757/systemic-antibiotics-for-treating-malignant-wounds
#17
REVIEW
Darshini A Ramasubbu, Valerie Smith, Fiona Hayden, Patricia Cronin
BACKGROUND: Malignant wounds are a devastating complication of cancer. They usually develop in the last six months of life, in the breast, chest wall or head and neck regions. They are very difficult to treat successfully, and the commonly associated symptoms of pain, exudate, malodour, and the risk of haemorrhage are extremely distressing for those with advanced cancer. Treatment and care of malignant wounds is primarily palliative, and focuses on alleviating pain, controlling infection and odour from the wound, managing exudate and protecting the surrounding skin from further deterioration...
August 24, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28832178/-radiotherapy-of-lung-tumours-in-idiopathic-pulmonary-fibrosis
#18
V Kolek, M Vašáková, M Šterclová, K Cwiertka, D Vrána, A Kudláček, J Skřičková, M Pešek, J Petera
BACKGROUND: This article is a joint statement of the Czech Pneumological and Physiological Society and the Czech Society for Radiation Oncology, Biology and Physics, and reviews current opinions on radiotherapy in patients with idiopathic pulmonary fibrosis (IPF). In general, radiotherapy of lung tumours is associated with risk of radiation pneumonitis (RP); moreover, IPF may be complicated by acute exacerbations (AE-IPF). Both complications may immediately threaten patients lives. MATERIAL AND METHODS: Assessment of individual radiotherapy modalities has shown that conventional radiotherapy is not appropriate, especially in large tumours...
2017: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
https://www.readbyqxmd.com/read/28771478/patients-in-palliative-care-development-of-a-predictive-model-for-anxiety-using-routine-data
#19
Sonja Hofmann, Stephanie Hess, Carsten Klein, Gabriele Lindena, Lukas Radbruch, Christoph Ostgathe
INTRODUCTION: Anxiety is one of the most common psychological symptoms in patients in a palliative care situation. This study aims to develop a predictive model for anxiety using data from the standard documentation routine. METHODS: Data sets of palliative care patients collected by the German quality management benchmarking system called Hospice and Palliative Care Evaluation (HOPE) from 2007 to 2011 were randomly divided into a training set containing two-thirds of the data and a test set with the remaining one-third...
2017: PloS One
https://www.readbyqxmd.com/read/28663352/a-high-value-care-curriculum-for-interns-a-description-of-curricular-design-implementation-and-housestaff-feedback
#20
Jason Hom, Andre Kumar, Kambria H Evans, David Svec, Ilana Richman, Daniel Fang, Andrea Smeraglio, Marisa Holubar, Tyler Johnson, Neil Shah, Cybele Renault, Neera Ahuja, Ronald Witteles, Stephanie Harman, Lisa Shieh
PURPOSE: Most residency programmes do not have a formal high value care curriculum. Our goal was to design and implement a multidisciplinary high value care curriculum specifically targeted at interns. DESIGN: Our curriculum was designed with multidisciplinary input from attendings, fellows and residents at Stanford. Curricular topics were inspired by the American Board of Internal Medicine's Choosing Wisely campaign, Alliance for Academic Internal Medicine, American College of Physicians and Society of Hospital Medicine...
December 2017: Postgraduate Medical Journal
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