Chlorpromazine in Delirium FTW!

by Drew Rosielle (@drosielle)David Hui, Eduardo Bruera, and colleagues havepublished another important delirium trial out of MD Anderson which I thought was worth blogging about in detail.In some ways it's related to thesame group's RCT a few years ago of lorazepam added to haloperidol for agitation in hospitalized advanced cancer patients with delirium (showing the lorazepam quite effectively reduced agitation via presumably a sedating effect). As I pointed out in the Palllimed post about that trial, while they labeled their patient group as'agitated delirium in advanced cancer', in essence it was really a sedation for terminal delirium trial as most patients only lived a few days, but a casual reader of the study might not realize that and think they were finding that lorazepam is a disease-modifying therapy for delirium. Which it is not, discrete exception aside (alcohol withdrawal?).This is an important distinction, as I think there's been a sort of confusion over the years in our discussions about delirium and even research about it between disease-modifying therapy for delirium and essentially palliative-focused therapies to reduce distressing aspects of delirium (primarily agitation). Eg, a drug or drug combo or other intervention that reverses delirium / shortens delirium / returns normal cognition vs a therapy that reduces agitation (because while you could reduce agitation by'fixing'the delirium you could also do it by sedating the patient). When and whom to just se...
Source: Pallimed: A Hospice and Palliative Medicine Blog - Category: Palliative Care Source Type: blogs

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Asian Pac J Cancer Prev. 2021 Aug 1;22(8):2421-2428. doi: 10.31557/APJCP.2021.22.8.2421.ABSTRACTOBJECTIVE: To estimate the awareness level of Saudi adults about the risk factors and warning signs of cancer and observe the association of different determinants with cancer Knowledge in Riyadh city.METHODS: A cross-sectional study carried out on 390 Saudis in the outpatient clinics of King Khalid University Hospital (KKUH), Riyadh. Data was collected using a validated Arabic questionnaire. Data was analyzed using SPSS software.RESULTS: The overall awareness of the participants was limited, as the mean score of the overall can...
Source: Asian Pacific Journal of Cancer Prevention - Category: Cancer & Oncology Authors: Source Type: research
CONCLUSIONS: Given the high risk of bias and insufficient power of the included trials and the very low certainty of the available evidence, vitamin D supplementation versus placebo or no intervention may increase or reduce all-cause mortality, liver-related mortality, serious adverse events, or non-serious adverse events in adults with chronic liver diseases. There is a lack of data on liver-related morbidity and health-related quality of life. Further evidence on clinically important outcomes analysed in this review is needed.PMID:34431511 | DOI:10.1002/14651858.CD011564.pub3
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Source Type: research
Evid Based Complement Alternat Med. 2021 May 30;2021:7539037. doi: 10.1155/2021/7539037. eCollection 2021.ABSTRACTAcanthus ilicifolius Linn. (Acanthaceae) is a popular mangrove ethnomedicinal plant that cures several ailments, including asthma, diabetes, cancer, and many others. Our experiment was aimed at evaluating the anti-atherogenic effect of A. ilicifolius (leaf and stem) on a high-fat diet-induced atherogenic rat model. Atherosclerosis was developed in 12 weeks. Treatment with the standard drug (3 mg/kg b.w./day, p.o. of Simvastatin), separate doses of methanolic and ethanolic extracts of A. ilicifolius leaf (250 an...
Source: Evidence-based Complementary and Alternative Medicine - Category: Complementary Medicine Authors: Source Type: research
ConclusionDOACs as a class do not increase the risk of major gastrointestinal bleeding compared to VKAs, which supports their continued use for different anticoagulant indications.
Source: Cardiovascular Drugs and Therapy - Category: Cardiology Source Type: research
June 1, 2021 (RARITAN, N.J.) – The Janssen Pharmaceutical Companies of Johnson &Johnson announced today that more than 30 company-sponsored studies, including six oral presentations, will be featured during the 2021 American Society of Clinical Oncology (ASCO) Annual Meeting, June 4-8. Janssen presentations will include new data and updates for both approved and investigational therapeutics that are being studied for the treatment of various solid tumors and blood cancers. Immediately following ASCO, additional data will be featured during the European Hematology Association (EHA) Virtual Congress, June 9-17. A c...
Source: Johnson and Johnson - Category: Pharmaceuticals Tags: Innovation Source Type: news
Author's Note:  The lawyers have a saying, " Res Ipsa Loquitur " " .  Translated from Latin, it means, " The thing speaks for itself " .  This is the text of the letter I sent to theNC Local Government Commission (embellished with a few links and additional comments in red) . . .in support of the state of North Carolina granting a loan to Randolph County (via the NC Rural Healthcare Stabilization Act) . . . for purposes of assisting in the " rescue " of Asheboro's Randolph Health - in a bankruptcy Court-approved buy-out of Randolph's assets by American Healthcare ...
Source: Dr.J's HouseCalls - Category: American Health Tags: Asheboro Atrium Health Bankruptcy Cone Health Duke Lifepoint LGC Medical Whistle-blower Mother-Baby Care NC Rural Heatlh NCDHHS Non-profit Randolph Health UNC Health Wake Forest Baptist Source Type: blogs
Conclusion: OSTs are very common in Zambia and are strongly associated with HIV coinfection. Patients with OSSN were more likely to be HIV positive than those with pterygia. Despite the commonality of OSTs in sub-Saharan Africa, these cancers have historically been poorly characterized.Ocul Oncol Pathol
Source: Ocular Oncology and Pathology - Category: Opthalmology Source Type: research
Colorectal cancer (CRC) is the second leading cause of cancer death in the United States. There is compelling evidence that screening to detect CRC early to find and remove precancerous polyps can reduce CRC mortality. However, screening has associated harms, including procedural complications, and inherent limitations. For example, colonoscopy, the most common screening tool in the US, is less effective in preventing cancers of the right, or ascending side, of the colon compared with cancers of the left, or descending, side of the colon. Moreover, only 60% of US adults recommended for screening actually follow through. Ev...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Cancer Prevention Screening Source Type: blogs
ConclusionTransgastric EUS-guided ethanol injection in the treatment of giant intra-abdominal cavernous hemangioma can provide good outcomes without major complications and can be repeated if necessary.
Source: Journal of Gastrointestinal Cancer - Category: Cancer & Oncology Source Type: research
Basel, 2 November 2020 - Roche (SIX: RO, ROG; OTCQX: RHHBY) today announced that the European Commission has approved Tecentriq ® (atezolizumab) in combination with Avastin® (bevacizumab) for the treatment of adult patients with advanced or unresectable hepatocellular carcinoma (HCC) who have not received prior systemic therapy.“Tecentriq in combination with Avastin is the first treatment to be approved in over a decade that has improved overall survival for people with previously untreated advanced or unresectable hepatocellular carcinoma,” said Levi Garraway, M.D., Ph.D., Roche’s Chief Medical O...
Source: Roche Media News - Category: Pharmaceuticals Source Type: news
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