Extremis Documentary Falls Short at Oscars, Wins Over Palliative Care

by Christian SinclairLast night at the Oscars, there sure was a lot of excitement for many of my friends and colleagues, and I'm not just talking about the surprise ending with La La Land winning Best Picture, then losing it in a tragic mistake of envelopes, to another well-deserving film Moonlight. That is because many of my friends and colleagues are strong advocates and wonderful clinicians who are vocal about excellent care at the end of life.The filmExtremis, which was released in April 2016 at the Tribeca Film Festival, was nominated for An Academy Award for Best Documentary Short Subject, but up against top competition did not end up taking home the Oscar. The winner last night was a film about the Syrian Civil Defense volunteer rescue workers calledThe White Helmets. The nomination forExtremis should really be considered a win, because now many more people are aware of it, and palliative care providers can use it as a discussion tool.Extremis offers a glimpse into the hectic and fragmented world of the Intensive Care Unit and the decisions doctors, patients and families make when the chances of survival reach the limits. The clinician who we follow isDr. Jessica Zitter, a Critical Care Specialist and board-certified palliative care physician.We see glimpses of her conversations with a diverse group of patients and families, never lingering on one discussion too long. Many phrases will feel familiar to palliative care and ICU staff as hope, miracles, uncertainty, and s...
Source: Pallimed: A Hospice and Palliative Medicine Blog - Category: Palliative Care Tags: extremis film sinclair zitter Source Type: blogs

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An 85-year-old patient with a history of oxygen-dependent chronic obstructive pulmonary disease and coronary artery bypass grafting (LIMA-LAD, free vein-circumflex) presented to the emergency department with chest and back pain. Computed tomography angiography (CTA) confirmed acute type a thoracic aortic dissection limited to the ascending thoracic aorta. Aneurysm size is 10 cm. This patient was evaluated by cardiovascular surgeons who offered the patient palliative care secondary to perioperative risk and sent home.
Source: Journal of Vascular Surgery - Category: Surgery Authors: Tags: Abstract from the 2018 Eastern Vascular Society Annual Meeting Source Type: research
Endovascular interventions for aortic aneurysmal disease in the elective, urgent, and emergent settings have accelerated in the last decade, with multiple groups reporting improved outcomes compared with the historical standard of open intervention. This has benefited patients and their families. Starnes et  al1 also pointed out the need to stratify emergent patients into survivable and nonsurvivable and advocated for the employment of a third arm, that of palliative care for the patient presenting with a ruptured aortic aneurysm and meeting nonsurvivable criteria.
Source: Journal of Vascular Surgery - Category: Surgery Authors: Tags: Clinical research study Source Type: research
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. Three hundre...
Source: Neuroendocrinology - Category: Endocrinology Source Type: research
We present a case example and discussion of these issues in the Head and Neck cancer clinic. PMID: 30016909 [PubMed - as supplied by publisher]
Source: Journal of Palliative Care - Category: Palliative Care Tags: J Palliat Care Source Type: research
The objective of our study was to review our experience of PE in terms of surgical characteristics, complications, and overall survival. All patients who had PE surgery between January 1999 and December 2015 were identified. Patients with verified distant metastatic disease were excluded. Patients with advanced pelvic tumors experiencing incapacitating postradiation severe damages were included. The following parameters were recorded: age, sex, indication for surgery, tumor histology, type of exenteration, urinary tract and colon reconstruction methods, operative time, blood transfusion, intensive care unit admissions, len...
Source: Indian Journal of Surgical Oncology - Category: Cancer & Oncology Source Type: research
Different amounts of opioid are required for the relief of cancer pain in different individuals, raising the possibility that genetic factors play a role. We tested the hypothesis that genetic variations in the TAOK3 (TAO kinase 3, encoding serine/threonine-protein kinase) explain some of the inter-individual variations related to the morphine equivalent daily dose (MEDD) in cancer patients.
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Source Type: research
I sincerely appreciate all your support for my boutique speakers bureau, Physician Speaking by KevinMD. These speakers are both practicing physicians and award-winning speakers that shine on stage. This Fall, we will highlight the following events: 2018 Ohio Dermatological Association Annual Meeting, Columbus OH Richmond Academy of Medicine, Annual Meeting, Richmond VA Maricopa County Medical Society, Annual Meeting, Phoenix AZ Kaiser Permanente San Francisco, private event, San Francisco CA MGMA18, Featured Speaker, Boston MA Pri-Med Midwest, Keynote, Rosemont IL College of American Pathologists, CAP18, Keynote, Chicago ...
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: KevinMD Practice Management Source Type: blogs
Some recent things you might need to know about.StatisticsBirth summary tables in England and Wales.Includes annual births and mean age of mothers.Scientific Advisory Committee on NutritionFeeding in the first year of lifeCovers infant feeding from birth up to 12 months of age, looking at evidence of the impact of infant feeding on short and longer term health outcomes for infants and mothers. Also considers factors that influence eating behaviour and diversification of the diet and makes recommendations on feeding in the first year of life.World Health OrganisationWHO Recommendations on Antenatal Care for a Positive Pregn...
Source: Browsing - Category: Databases & Libraries Tags: midwifery Source Type: blogs
Publication date: Available online 17 July 2018Source: The Lancet HIVAuthor(s): Richard HardingSummaryAlthough antiretroviral therapy has reduced mortality among people with HIV, inadequate treatment coverage, ageing, and the increasing incidence of organ failure and malignancies mean that high-quality care should include care at the end of life. This Review summarises the epidemiology of HIV in relation to mortality, and the symptoms and concerns of people with AIDS and those living with HIV who have either related or unrelated advanced comorbidities. In response to the evidence of a need for palliative care, the principl...
Source: The Lancet HIV - Category: Infectious Diseases Source Type: research
Publication date: Available online 17 July 2018Source: Journal of Geriatric OncologyAuthor(s): Karis Kin-fong Cheng, Caroline Nicholson
Source: Journal of Geriatric Oncology - Category: Cancer & Oncology Source Type: research
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