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https://www.readbyqxmd.com/read/29222670/venetoclax-for-treating-chronic-lymphocytic-leukaemia-an-evidence-review-group-perspective-of-a-nice-single-technology-appraisal
#1
REVIEW
Hema Mistry, Chidozie Nduka, Martin Connock, Jill Colquitt, Theodoros Mantopoulos, Emma Loveman, Renata Walewska, James Mason
Venetoclax is licensed to treat relapsed or refractory (R/R) chronic lymphocytic leukaemia (CLL). As part of the Single Technology Appraisal (STA) ID944, the National Institute for Health and Care Excellence (NICE) invited AbbVie, the manufacturer, to submit evidence on the use of venetoclax, within its licensed indication. The Evidence Review Group (ERG), Warwick Evidence, was asked to provide an independent and critical review of the submitted evidence. Evidence came from three single-arm trials in CLL patients with or without 17p deletion [del(17p])/TP53 chromosomal abnormalities...
December 8, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/29221885/-design-of-a-questionnaire-on-the-knowledge-and-attitudes-of-the-population-of-madrid-spain-facing-the-end-of-life
#2
Belén Ortiz-Gonçalves, Andrés Santiago-Sáez, Elena Albarrán Juan, Elena Labajo González, Bernardo Perea-Pérez
OBJECTIVE: To create and validate a questionnaire about knowledge and attitudes of the general population in Madrid (Spain) about life's end stage. METHOD: A descriptive study designed as a structured self-administered questionnaire, validated by seven Madrid Health Service professional experts and assessed through a pilot study. RESULTS: The questionnaire consisted of 42 questions, divided into six modules: 1) decisions and psychological-physical care at life's end; 2) palliative care; 3) euthanasia and assisted suicide; 4) advance directives document; 5) spiritual factors; and 6) socio-demographic data...
December 5, 2017: Gaceta Sanitaria
https://www.readbyqxmd.com/read/29221846/prevailing-ethical-dilemmas-encountered-by-physicians-in-terminal-cancer-care-changed-after-the-enactment-of-the-natural-death-act-fifteen-years-follow-up-survey
#3
Hsien-Liang Huang, Chien-An Yao, Wen-Yu Hu, Shao-Yi Cheng, Shinn-Jang Huang, Chih-Dao Chen, Wen-Yuan Lin, Yen-Chun Lin, Tai-Yuan Chiu
CONTEXT: Advance directive laws have influences on ethical dilemmas encountered by physicians caring for terminal cancer patients. OBJECTIVES: To identify the prevailing ethical dilemmas among terminal care physicians fifteen years after the Natural Death Act was enacted in Taiwan. METHODS: This study is a cross-sectional survey from April 2014 to February 2015 using the clustering sampling method and a well-structured questionnaire. Targeted participants included physicians at oncology and related wards or palliative care units where terminal cancer care may be provided in Taiwan...
December 5, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29221845/characterizing-the-role-of-u-s-surgeons-in-the-provision-of-palliative-care-a-systematic-review-and-mixed-methods-meta-synthesis
#4
REVIEW
Pasithorn A Suwanabol, Arielle E Kanters, Ari C Reichstein, Lauren M Wancata, Lesly A Dossett, Emily B Rivet, Maria J Silveira, Arden M Morris
CONTEXT: The provision of palliative care varies appropriately by clinical factors such as patient age and severity of disease, but also varies by provider practice and specialty. Surgical patients are persistently less likely to receive palliative care than their medical counterparts for reasons that aren't clear. OBJECTIVES: We sought to characterize surgeon-specific determinants of palliative care in seriously-ill and dying patients. METHODS: We performed a systematic review of the literature focused on surgery and palliative care within PubMed, CINHAL, EMBASE, Scopus, and Ovid Medline databases from January 1, 2000 through December 31, 2016 according to PRISMA guidelines...
December 5, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29221534/on-becoming-a-global-citizen-transformative-learning-through-global-health-experiences
#5
Debra K Litzelman, Adrian Gardner, Robert M Einterz, Philip Owiti, Charity Wambui, Jordan C Huskins, Kathleen M Schmitt-Wendholt, Geren S Stone, Paul O Ayuo, Thomas S Inui, Rachel A Umoren
BACKGROUND: Globalization has increased the demand for international experiences in medical education. International experiences improve medical knowledge, clinical skills, and self-development; influence career objectives; and provide insights on ethical and societal issues. However, global health rotations can end up being no more than tourism if not structured to foster personal transformation and global citizenship. OBJECTIVE: We conducted a qualitative assessment of trainee-reported critical incidents to more deeply understand the impact of our global health experience on trainees...
May 2017: Annals of Global Health
https://www.readbyqxmd.com/read/29221484/the-impacts-of-baseline-ventilator-parameters-on-hospital-mortality-in-acute-respiratory-distress-syndrome-treated-with-venovenous-extracorporeal-membrane-oxygenation-a-retrospective-cohort-study
#6
Meng-Yu Wu, Yu-Sheng Chang, Chung-Chi Huang, Tzu-I Wu, Pyng-Jing Lin
BACKGROUND: Venovenous extracorporeal membrane oxygenation (VV-ECMO) is a valuable life support in acute respiratory distress syndrome (ARDS) in adult patients. However, the success of VV-ECMO is known to be influenced by the baseline settings of mechanical ventilation (MV) before its institution. This study was aimed at identifying the baseline ventilator parameters which were independently associated with hospital mortality in non-trauma patients receiving VV-ECMO for severe ARDS. METHODS: This retrospective study included 106 non-trauma patients (mean age: 53 years) who received VV-ECMO for ARDS in a single medical center from 2007 to 2016...
December 8, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29220878/a-qualitative-study-of-the-experience-of-lower-extremity-wounds-and-amputations-among-people-with-diabetes-in-philadelphia
#7
Frances K Barg, Peter F Cronholm, Ebony E Easley, Trocon Davis, Michelle Hampton, D Scot Malay, Cornelius Donohue, Jinsup Song, Stephen R Thom, David J Margolis
The purpose of this study was to explore perceptions among people with type 2 diabetes about foot ulcers and lower extremity amputations. This was a qualitative observational study utilizing open-ended, semistructured interviews of 39 people with diabetes who were purposively selected because they had either a foot ulcer (n = 19) or a lower extremity amputation (n = 20). Interviews were audio-recorded, deidentified, and entered into NVivo 10.0 for coding and analysis. Our integrated analytic approach combined inductively and deductively derived codes that were applied to all transcripts...
December 8, 2017: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/29220589/first-year-internal-medicine-residents-reflections-on-nonmedical-home-visits-to-high-risk-patients
#8
Stephanie K Nothelle, Colleen Christmas, Laura A Hanyok
PROBLEM: Patients who are high utilizers of care often experience health-related challenges that are not readily visible in an office setting but paramount for residents to learn. A nonmedical home visit performed at the beginning of residency training may help residents better understand social underpinnings related to their patient's health and place subsequent care within the context of the patient's life. INTERVENTION: First-year internal medicine residents completed a nonmedical home visit to an at-risk patient prior to seeing the patient in the office for his or her first medical visit...
December 8, 2017: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/29220303/locally-aggressive-connective-tissue-tumors
#9
Mrinal M Gounder, David M Thomas, William D Tap
In this review, we highlight the complexities of the natural history, biology, and clinical management of three intermediate connective tissue tumors: desmoid tumor (DT) or aggressive fibromatosis, tenosynovial giant cell tumor (TGCT) or diffuse-type pigmented villonodular synovitis (dtPVNS), and giant cell tumor of bone (GCTB). Intermediate histologies include tumors of both soft tissue and bone origin and are locally aggressive and rarely metastatic. Some common aspects to these tumors are that they can be locally infiltrative and/or impinge on critical organs, which leads to disfigurement, pain, loss of function and mobility, neurovascular compromise, and occasionally life-threatening consequences, such as mesenteric, bowel, ureteral, and/or bladder obstruction...
December 8, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29219936/end-of-life-care-discussion-for-residents-with-dementia-in-long-term-care-facilities
#10
Hsiu-Li Huang, Li-Chueh Weng, WeWen-Yu Hu, Yea-Ing Lotus Shyu, Wen-Pin Yu, Kang-Hua Chen
BACKGROUND: Healthcare professionals play an important role in end-of-life care decisions. Although the factors affecting end-of-life care in long-term care facilities have been well studied in Western contexts, few studies have examined factors affecting end-of-life care discussions for residents with dementia among multidisciplinary professionals in Asian or Taiwanese contexts. PURPOSE: The aim of this study was to explore the factors related to the end-of-life care discussions of registered nurses, social workers, and physicians with residents with dementia and their families...
December 6, 2017: Journal of Nursing Research: JNR
https://www.readbyqxmd.com/read/29218968/the-psychiatry-integrated-nurse-practitioner-role-in-hemodialysis-an-opportunity-to-provide-nurse-practitioner-care-between-the-interface-of-psychiatry-and-hemodialysis
#11
Brock Cooper, Kien Dang, Ann Jones, Alison Thomas
The mental health of patients living with end-stage kidney disease (ESKD) is an important aspect of their care. According to national survey data, depressive disorders affect about 9% of the North American population (Kessler, Chiu, Demler, Merikangas, & Walters, 2005). A review of psychological distress and depression across the spectrum of chronic kidney disease indicates that the prevalence of depression in ESKD is reported to be about four times that of the general population and it is associated with adverse outcomes including low quality-of-life ratings, graft failure, and death after renal transplantation (Zalai, Szeifert, & Novak, 2012)...
January 2017: CANNT Journal, Journal ACITN
https://www.readbyqxmd.com/read/29218773/illness-and-end-of-life-experiences-of-children-with-cancer-who-receive-palliative-care
#12
Erica C Kaye, Courtney A Gushue, Samantha DeMarsh, Jonathan Jerkins, April Sykes, Zhaohua Lu, Jennifer M Snaman, Lindsay Blazin, Liza-Marie Johnson, Deena R Levine, R Ray Morrison, Justin N Baker
BACKGROUND: The field of pediatric palliative oncology is newly emerging. Little is known about the characteristics and illness experiences of children with cancer who receive palliative care (PC). METHODS: A retrospective cohort study of 321 pediatric oncology patients enrolled in PC who died between 2011 and 2015 was conducted at a large academic pediatric cancer center using a comprehensive standardized data extraction tool. RESULTS: The majority of pediatric palliative oncology patients received experimental therapy (79...
December 8, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29217720/likelihood-of-death-among-hospital-inpatients-in-new-zealand-prevalent-cohort-study
#13
Merryn Gott, Joanna Broad, Xian Zhang, Lene Jarlbaek, David Clark
OBJECTIVES: (1) To establish the likelihood of dying within 12 months for a cohort of hospital inpatients in New Zealand (NZ) on a fixed census date; (2) to identify associations between likelihood of death and key sociodemographic, diagnostic and service-related factors and (3) to compare results with, and extend findings of, a Scottish study undertaken for the same time period and census date. National databases of hospitalisations and death registrations were used, linked by unique health identifier...
December 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/29216857/images-of-god-and-attitudes-towards-death-in-relation-to-spiritual-wellbeing-an-exploratory-side-study-of-the-eortc-qlq-swb32-validation-study-in-palliative-cancer-patients
#14
Renske Kruizinga, Michael Scherer-Rath, Johannes B A M Schilderman, Mariëtte Weterman, Teresa Young, Hanneke W M van Laarhoven
BACKGROUND: When patients are facing the ends of their lives, spiritual concerns often become more important. It is argued that effective, integrated palliative care should include addressing patients' spiritual wellbeing. In 2002 the EORTC Quality of Life Group began an international study to develop an spiritual wellbeing measure for palliative patients (SWB). Spiritual wellbeing is a complex construct, which comprises multiple contributory components. While conducting the EORTC SWB validation study with Dutch palliative cancer patients we also conducted an exploratory side study to examine the relationship between their spiritual wellbeing, images of God, and attitudes towards death...
December 8, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/29215810/pediatric-deaths-attributed-to-complex-chronic-conditions-over-10-years-in-korea-evidence-for-the-need-to-provide-pediatric-palliative-care
#15
Min Sun Kim, Nam Gu Lim, Hyun Joo Kim, Chohee Kim, Jin Yong Lee
BACKGROUND: Pediatric palliative care (PPC) is the active total care of children suffering from life-threatening illnesses. Palliative care includes symptom management, psychosocial support, and end-of-life care. Despite significant advances in disease diagnosis and treatment, resources for PPC of children with serious illnesses are limited in Korea. This study aimed to investigate the scale, time trends, disease composition, regional distribution, and unmet needs of children dying from complex chronic conditions (CCCs)...
January 1, 2018: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29215646/follow-up-status-during-the-first-5-years-of-life-for-metabolic-disorders-on-the-federal-recommended-uniform-screening-panel
#16
Lisa Feuchtbaum, Juan Yang, Robert Currier
PurposeTo investigate the 5-year follow-up status for newborns diagnosed with metabolic disorders designated as "primary disorders" on the federal Recommended Uniform Screening Panel (RUSP).MethodsFollow-up status and demographic characteristics are described for 426 newborns diagnosed with one of 20 primary metabolic disorders on the RUSP between 2005 and 2009. Newborn screening program data were linked to birth certificate data. Follow-up status is described for each year through age 5 and by disorder type...
December 7, 2017: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/29215421/educating-emergency-department-nurses-about-miscarriage
#17
Joyce L Merrigan
Miscarriage is the unwanted ending of a pregnancy before 20 weeks gestation. Women experiencing miscarriage require specialized care from nurses and other healthcare professionals. Many women are dissatisfied with emergency care related to miscarriage and desire honest communication, validation of urgency, and more robust information at discharge. Perinatal bereavement education offers an opportunity for emergency department nurses to acquire specific knowledge and communication skills that assist with understanding the individualized experience of early pregnancy loss...
January 2018: MCN. the American Journal of Maternal Child Nursing
https://www.readbyqxmd.com/read/29215098/proxies-of-quality-of-life-in-metastatic-colorectal-cancer-analyses-in-the-recourse-trial
#18
COMMENT
Eric Van Cutsem, Alfredo Falcone, Rocio Garcia-Carbonero, Yoshito Komatsu, Alessandro Pastorino, Marc Peeters, Yasuhiro Shimada, Kentaro Yamazaki, Takayuki Yoshino, Alberto Zaniboni, Nadia Amellal, Akira Kanehisa, Robert Winkler, Lukas Makris, Robert J Mayer, Atsushi Ohtsu, Josep Tabernero
Background: In the pivotal phase III, randomised, double-blind, placebo-controlled RECOURSE study, treatment with trifluridine/tipiracil was well tolerated and associated with prolonged progression-free and overall survival in patients with metastatic colorectal cancer (mCRC). There was no formal analysis of quality of life (QoL) in RECOURSE. The aim of the present analysis was to assess proxies of QoL during the RECOURSE treatment period, in terms of adverse events (AEs) likely to affect QoL and Eastern Cooperative Oncology Group performance status (ECOG PS)...
2017: ESMO Open
https://www.readbyqxmd.com/read/29214963/ideology-and-palliative-care-moral-hazards-at-the-bedside
#19
Rosamond Rhodes, James J Strain
Palliative care has had a long-standing commitment to teaching medical students and other medical professionals about pain management, communication, supporting patients in their decisions, and providing compassionate end-of-life care. Palliative care programs also have a critical role in helping patients understand medical conditions, and in supporting them in dealing with pain, fear of dying, and the experiences of the terminal phase of their lives. We applaud their efforts to provide that critical training and fully support their continued important work in meeting the needs of patients and families...
January 2018: Cambridge Quarterly of Healthcare Ethics: CQ: the International Journal of Healthcare Ethics Committees
https://www.readbyqxmd.com/read/29212870/pathological-ecg-that-seemed-normal-following-electrode-misplacement
#20
Clement Derkenne, Daniel Jost, Hugues Lefort, Jean-Pierre Tourtier
We report the case of a 57-year-old woman found at home who received an ECG after having recovered from a seizure, without any clinical cardiac anomaly. The ECG revealed an elevation of the ST segment from the V1 to V5 leads and negative T waves from V1 to V5 leads. At her hospital admission, the emergency care unit (ECU) nurse performed another ECG. It no longer showed any repolarisation anomaly. However, the ECU nurse had put the precordial electrodes 3 cm too low, probably due to the patient's voluminous breasts...
December 5, 2017: BMJ Case Reports
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