Practices and Attitudes of Canadian Cardiologists Caring for Patients With Trisomy 18

Publication date: April 2017 Source:Canadian Journal of Cardiology, Volume 33, Issue 4 Author(s): Aisling A. Young, Christy Simpson, Andrew E. Warren Trisomy 18 (T18) is a genetic disorder with cardiac lesions in up to 90% of patients. Cardiac surgery is not frequently offered because of the overall poor prognosis, although this has recently been challenged. Our study aimed to explore the practices and attitudes of Canadian pediatric cardiologists managing T18 patients. We administered a survey to pediatric cardiologists attending the Canadian Cardiovascular Congress, Canadian Pediatric Cardiology Association Business Meeting. There were 30 respondents. Most (67%) supported comfort care for affected patients with a heart lesion. None supported palliative surgery for those with complex heart lesions. Of 30 respondents, 16 (53%) counsel families prenatally, and none would present the option of a single ventricle surgical track for complex heart disease. In a hypothetical situation in which their own child was born with T18, 67% would choose comfort care with medical treatment of heart failure, and none would choose palliative surgery. Being a parent was associated with a higher likelihood of choosing termination (14 of 20 vs 6 of 9; P = 0.046) or comfort care (14 of 20 vs 6 of 9; P = 0.036). Qualitative data suggest support for comfort care, while recognizing the need for individualization and shared decision-making, within the context of institution-specific policie...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research

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Publication date: November–December 2019Source: Journal of Minimally Invasive Gynecology, Volume 26, Issue 7, SupplementAuthor(s): SR Pena, J Brown, M Wally, R Seymour, JR Hsu, RW NaumannStudy ObjectiveTo determine opioid and benzodiazepine prescribing practices in the gynecologic oncology population and determine if this patient population is at risk for narcotic abuse.DesignThis was an IRB-approved, retrospective study of opioid and benzodiazepine prescriptions for cervical, ovarian (including fallopian tube and primary peritoneal), and uterine cancer patients within a single healthcare system from January 2016 to ...
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
No abstract available
Source: Journal of Cardiovascular Nursing - Category: Nursing Tags: DEPARTMENTS: Editorial Source Type: research
Background: Inadequate self-care is linked to poor health outcomes in heart failure (HF). Self-care depends on decision-making abilities, but links between self-care and brain injury to executive decision-making regulatory areas (prefrontal cortices) are unclear. Objective: We investigated the relationships between HF self-care and status of prefrontal cortices. Methods: Magnetic resonance imaging–based diffusion tensor imaging was performed in 21 patients with HF (age, 53.8 ± 7.9 years; 15 men; left ventricular ejection fraction, 25.1% ± 6.1%), and self-care and executive function were measured...
Source: Journal of Cardiovascular Nursing - Category: Nursing Tags: ARTICLES: Heart Failure Source Type: research
Conclusion We found that social support and executive function were associated with self-care in HF patients with MCI, whereas perceived control was associated with self-care in HF patients with intact cognition. Clinicians should develop tailored interventions to enhance self-care by considering the distinct factors associated with self-care based on the presence or absence of MCI.
Source: Journal of Cardiovascular Nursing - Category: Nursing Tags: ARTICLES: Heart Failure Source Type: research
Conclusions: The findings confirmed that “the situation-specific theory of heart failure self-care” could be applied in this context.
Source: Journal of Cardiovascular Nursing - Category: Nursing Tags: ARTICLES: Heart Failure Source Type: research
Conclusions Frequent adverse events and hospitalizations are of ongoing concern for LVAD recipients. More data are necessary to understand why urban LVAD recipients may experience shorter survival time compared with rural counterparts. Hospitalization may serve as a protective factor for rural LVAD recipients.
Source: Journal of Cardiovascular Nursing - Category: Nursing Tags: ARTICLES: Heart Failure Source Type: research
Conclusions The assessment of MS in HF patient-caregiver dyads is important to formulate interventions aimed at improving anxiety and depression in patients and caregivers.
Source: Journal of Cardiovascular Nursing - Category: Nursing Tags: ARTICLES: Heart Failure Source Type: research
We present a challenging case of recurrent acute coronary syndrome, in the context of very high thrombotic risk due to concomitant inflammatory disease. Although no general guidelines exist for the switch between antiplatelet agents, particularly in the acute setting, in specific cases, the availability of different orally- and i.v.-acting agents and platelet function tests may allow to discriminate among multiple possible mechanisms of drug failure or side effects in the individual patient. PMID: 31607192 [PubMed - as supplied by publisher]
Source: Platelets - Category: Hematology Tags: Platelets Source Type: research
We examined whether combined assessment of pulmonary vascular resistance and right ventricular function by echocardiography is useful for classifying risks in PAH. In 41 consecutive patients with PAH (mean age of 48.9  ± 17.3 years, 31 females), a 6-min walk test, pulmonary function test, and echocardiography were performed at baseline and during PAH-specific therapies. The study endpoint was defined as a composite of cardiovascular death and hospitalization for PAH and/or right ventricular failure. During a follow-up period of 9.2 ± 8.7 months, 18 patients reached the en...
Source: Heart and Vessels - Category: Cardiology Source Type: research
Conclusion: Patients with LEP had significant differences and disparities in end-of-life decision-making. Interventions to facilitate informed decision-making for those with LEP is a crucial component of care for this group. THU 1:30 pm:  “But She’ll Die if You Don’t!”: Understanding and Communicating Risks at the End of Life (Janet Malek) Clinicians sometimes decline to offer interventions even if their refusal will result in an earlier death for their patients. For example, a nephrologist may decide against initiating hemodialysis despite a patient’s rising creatinine levels if dea...
Source: blog.bioethics.net - Category: Medical Ethics Authors: Tags: Health Care syndicated Source Type: blogs
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