Geriatric Palliative Care.

Geriatric Palliative Care. Prim Care. 2019 Sep;46(3):447-459 Authors: Lazris A Abstract In the geriatric age group, few studies demonstrate the efficacy of aggressive treatment. Often, a more palliative approach is wanted; such an approach can lead to better quality of life and even a longer life. The author discusses the limits of medical interventions in the elderly, the paucity of data, and the benefits of palliation in certain medical conditions, including dementia, Parkinson, depression, arthritis, congestive heart failure, and pneumonia. The role of frailty is addressed; specific goals of palliative care are delineated, such as reduction of polypharmacy, fall prevention, pain reduction, and the central role of a primary care provider. PMID: 31375192 [PubMed - in process]
Source: Pain Physician - Category: Anesthesiology Authors: Tags: Prim Care Source Type: research

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Conclusions: Similar to previous studies, our results suggest that patients suffering from CLBP differ with regard to the magnitude of mental burden and the presence of physical impairment. These differences ascertain the need for precise targeting of treatment for CLBP. Inpatient pain centers therefore should offer different multimodal therapy pathways and integrate a meaningful triage, taking into account the multifaceted nature of CLBP based on sophisticated knowledge about forms, differences, and relationships among the biopsychosocial components of CLBP. PMID: 31728134 [PubMed - in process]
Source: GMS German Medical Science - Category: General Medicine Tags: Ger Med Sci Source Type: research
Authors: Tosoni A, Paratore M, Piscitelli P, Addolorato G, De Cosmo S, Mirijello A, Internal Medicine Sepsis Study Group Abstract Procalcitonin (PCT) is a circulating polypeptide produced in response to bacterial infections. Studies conducted in the Intensive Care Unit (ICU) setting have demonstrated its utility as a biomarker of bacterial infection and sepsis. Thus, PCT is widely used to distinguish between sepsis and SIRS, and to guide antibiotic therapy. At present sepsis represents a frequent diagnosis among patients admitted to Internal Medicine (IM) departments. Basing on the knowledge derived from ICU studie...
Source: Panminerva Medica - Category: General Medicine Tags: Panminerva Med Source Type: research
CONCLUSION: technical success, treatment success, procedure duration, and overall adverse event rate were comparable between ERCP-BD and EUS-BD in decompressing malignant distal biliary obstruction. Nevertheless, EUS-BD had a significantly lower rate of PEP and a lower tendency toward stent reintervention than ERCP-BD. Therefore, EUS-BD might be a suitable alternative to ERCP-BD when performed by experts. PMID: 31729233 [PubMed - as supplied by publisher]
Source: Revista Espanola de Enfermedades Digestivas - Category: Gastroenterology Tags: Rev Esp Enferm Dig Source Type: research
Alright, probably a horrible and simple question, but I want other opinions: We just took an OSCE, and I was given some interesting advice/directions. The pt had c/c of RUQ pain. Fair. Hx was no problem. Then, I got to the PE. Per our guidelines, I performed soft palpation, deep palpation, painful quadrant rebound tenderness, then for this at least, Murphy's sign. But, on soft palpation, barely touching the pt in RUQ, he flinched w/ pain. Then, I barely hooked my hand into his... Bear with me here – OCSEs
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Medical Students - MD Source Type: forums
Is a stent always the answer for people with chest pain? Maybe not. But they do need to do some work, new research finds, including sticking to medication and changing behaviors. www.nbcnews.com Study Finds Limited Benefits of Stent Use for Millions With Heart Disease Stents and coronary artery bypass surgery are no more effective than intensive drug treatment and better health habits in preventing millions of Americans from heart attacks and death, a large study fou...
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Topics in Healthcare Source Type: forums
Should PainSpecialists strive to cultivate a humble and modest professional demeanor like pediatricians or family practice docs or should we be more “in your face” specialty like plastics, deem, or spine surgery? Imagine if no one Pain dressed up in fancy suits at conference ms and drove fast, expensive cars and instead just cane “as you are” in comfortable Dad jeans and JCPenny shirts and ties? Would purposely presenting ourselves this improve the specialty’s reputation and would... Cultivating a humble and modest professional demeanor
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Pain Medicine Source Type: forums
Publication date: Available online 15 November 2019Source: European Journal of Obstetrics &Gynecology and Reproductive BiologyAuthor(s): Keisuke Tanaka, Leah Mayne, Akram Khalil, David Baartz, Lars Eriksson, Sally-Anne Mortlock, Grant Montgomery, Brett McKinnon, Akwasi A AmoakoAbstractEndometriosis affects a large proportion of women during their reproductive years and is associated with pain and infertility, also affecting psychological wellbeing and quality of life. The pathogenesis of the disease remains unclear, although it is believed to be multifactorial. The endocannabinoid system (ECS) consists of a number of l...
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - Category: OBGYN Source Type: research
Publication date: Available online 15 November 2019Source: SeizureAuthor(s): Hyo Jae Kim, Ji-Ye Jeon, Hyun-Woo Kim, Sang-Ahm LeeAbstractPurposeWe compared the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) with the Patient Health Questionnaire-9 (PHQ-9) according to different antiepileptic drug (AED) loads in people with epilepsy (PWE).MethodsDepression and suicidality were assessed with the Mini International Neuropsychiatric Interview (MINI), the NDDI-E, and the PHQ-9. A receiver operating characteristic (ROC) curve analysis was used. Sensitivity and specificity of the NDDI-E and PHQ-9 were compared between an AED load
Source: Seizure - Category: Neurology Source Type: research
Publication date: Available online 16 November 2019Source: Journal of Critical CareAuthor(s): Marie-José Roos-Blom, Dave Dongelmans, Willemke Stilma, Jan Jaap Spijkstra, Evert de Jonge, Nicolette de KeizerAbstractPurposeHalf of the patients experience pain during their ICU stay which is known to influence their outcomes. Nurses and physicians encounter organizational barriers towards pain assessment and treatment. We aimed to evaluate the association between adequate pain management and nurse to patient ratio, bed occupancy rate, and fulltime presence of an intensivist.Materials and methodsWe performed unadjusted an...
Source: Journal of Critical Care - Category: Gastroenterology Source Type: research
ConclusionsLack of ALX/FPR2 induced obesity, reduced the lifespan, amplified leukocyte dysfunction, and facilitated profound inter-organ non-resolving inflammation. Our study shows the integrative and indispensable role of ALX/FPR2 in lipid metabolism, cardiac inflammation-resolution processes, obesogenic aging, and renal homeostasis.
Source: Molecular Metabolism - Category: Endocrinology Source Type: research
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