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Therapy: Palliative

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Total 139 results found since Jan 2013.

Aggressiveness of care following intracerebral hemorrhage in women and men
Conclusions: After ICH, women do not receive less aggressive care than men after controlling for the substantial comorbidity differences. Future studies on sex bias should include the presence of comorbidities, prestroke disability, and other factors that may influence management.
Source: Neurology - July 24, 2017 Category: Neurology Authors: Guha, R., Boehme, A., Demel, S. L., Li, J. J., Cai, X., James, M. L., Koch, S., Langefeld, C. D., Moomaw, C. J., Osborne, J., Sekar, P., Sheth, K. N., Woodrich, E., Worrall, B. B., Woo, D., Chaturvedi, S. Tags: All Cerebrovascular disease/Stroke, Intracerebral hemorrhage ARTICLE Source Type: research

Palliative Care Needs Assessment in the Neuro-ICU: Effect on Family
ConclusionsAmong families of patients discharged from the neuro-ICU, the daily use of a palliative care needs checklist had no measurable effect on family satisfaction scores or long-term psychological outcomes. Further research is needed to identify optimal interventions to meet the palliative care needs specific to family members of patients treated in the neuro-ICU.
Source: Neurocritical Care - July 11, 2017 Category: Neurology Source Type: research

Brain Injury and Neurodevelopmental Outcome in Congenital Heart Disease: A Systematic Review
CONCLUSIONS: Prenatal and postnatal preoperative abnormal cerebral findings might play an important role in neurodevelopmental impairment in infants with CHD. Increased awareness of the vulnerability of the young developing brain of an infant with CHD among caregivers is essential.
Source: PEDIATRICS - June 30, 2017 Category: Pediatrics Authors: Mebius, M. J., Kooi, E. M. W., Bilardo, C. M., Bos, A. F. Tags: Fetus/Newborn Infant, Cardiology, Cardiovascular Disorders Review Article Source Type: research

Early transition to comfort measures only in acute stroke patients: Analysis from the Get With The Guidelines-Stroke registry
Conclusions: Early CMO was utilized in about 5% of stroke patients, being more common in ICH and SAH than IS. Early CMO use varies widely between hospitals and is influenced by patient and hospital characteristics.
Source: Neurology Clinical Practice - June 12, 2017 Category: Neurology Authors: Prabhakaran, S., Cox, M., Lytle, B., Schulte, P. J., Xian, Y., Zahuranec, D., Smith, E. E., Reeves, M., Fonarow, G. C., Schwamm, L. H. Tags: All Cerebrovascular disease/Stroke, Palliative care Research Source Type: research

Which patients die in their preferred place? A secondary analysis of questionnaire data from bereaved relatives.
CONCLUSION: Positive associations were found between continuity of care between healthcare professionals and contact with the general practitioner and the chance of people dying in their preferred place. Moreover, special attention for people who have had a stroke and for people with dementia who want to die at home seems indicated as their diagnosis is negatively associated with dying in their preferred place. PMID: 28590159 [PubMed - as supplied by publisher]
Source: Palliative Medicine - June 1, 2017 Category: Palliative Care Authors: Raijmakers NJ, de Veer AJ, Zwaan R, Hofstede JM, Francke AL Tags: Palliat Med Source Type: research

Survival, Functional Status, and Eating Ability After Percutaneous Endoscopic Gastrostomy Tube Placement for Acute Stroke
ConclusionIn this community‐based sample, individuals who had had a stroke and a PEG tube placed had high mortality, and survivors were unlikely to be functional or mobile or to recover eating ability after hospitalization. A palliative care discussion including goals of care should occur before PEG tube placement is considered.
Source: Journal of the American Geriatrics Society - April 27, 2017 Category: Geriatrics Authors: Karl Meisel, Robert M. Arnold, Irena Stijacic Cenzer, John Boscardin, Alexander K. Smith Tags: Brief Report Source Type: research

Increase in Rate of Utilization of Withdrawal of Care in Acute Ischemic Stroke in USA (P1.209)
Conclusions:We found a considerable increase in rate of withdrawal of care with aggressive treatment, which may be due to disease severity and/or patient/family preference. Prognostic models and clinical experience for severe stroke patients may be biased by frequent withdrawal of care, leading to errors in prognostication with significant consequences including premature withdrawal of care, suboptimal outcomes and higher risk of short-term mortalityStudy Supported by: NADisclosure: Dr. Adil has nothing to disclose. Dr. Zweifler has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Adil, M., Zweifler, R. Tags: Pain and Palliative Care Source Type: research

Early Palliative Care Consultation Decreases Length of Stay in Severe Stroke Patients (P1.211)
Conclusions:Early PCC in severe stroke patients decreased hospital LOS by 3 days. This may be due to prompt clarification of goals of care and hastened discharge to hospice. Advanced age, poor pre-stroke functional status, and severe post-stroke deficits and disability warrant early PCC. In addition to decreasing LOS, further study is needed to determine whether early PCC also limits futile tests, procedures, and iatrogenic complications. Ultimately, timely identification of PCC candidates may produce higher satisfaction and decreased hospital costs.Disclosure: Dr. Schloss has nothing to disclose. Dr. Tversky has nothing t...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Schloss, E. R., Tversky, S., Katz, J. M., Wright, P. Tags: Pain and Palliative Care Source Type: research

"I believe in miracles": Implications for the Neuro-ICU (P3.181)
Conclusions:Preliminary data lack robustness to make definitive conclusions, however suggest possibility of shorter hospital LOS in those who don’t believe in miracles. Involvement of spiritual care early in the ICU may assist in important decision making with patients and family members.Disclosure: Dr. Ramineni has nothing to disclose. Dr. Dangayach has nothing to disclose. Dr. Griffiths has nothing to disclose. Dr. Keogh has nothing to disclose. Dr. Wheelwright has nothing to disclose. Dr. Sharma has nothing to disclose. Dr. Gidwani has nothing to disclose. Dr. Ahmad has nothing to disclose. Dr. Bederson has nothin...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Ramineni, A., Dangayach, N., Griffiths, S., Keogh, M., Wheelwright, D., Sharma, V., Gidwani, U., Ahmad, J., Bederson, J., Mocco, J., Mayer, S. Tags: Neurocritical Care: NICU Issues Source Type: research

Can we Improve on Neuro-prognostication for Patients with Severe Ischemic Stroke? (P6.272)
Conclusions:The outcomes of patients presenting with severe ischemic stroke (NIHSS 16–20, 21+) is poor overall; although there were significant differences in early mortality, these are no longer significant at 90 days. A good recovery was predicted by early rapid improvement in NIHSS. More data is needed to improve neuro-prognostication to inform patients and families on expected outcomes and when to incorporate palliative care.Disclosure: Dr. Bu has nothing to disclose. Dr. Beilman has nothing to disclose. Dr. Sila has received personal compensation for activities with Axio Research, Hoffman La Roche, Medtronic, Ja...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Bu, J., Beilman, C., Sila, C. Tags: Cerebrovascular Disease Health Services Research Source Type: research

Intensive treatment of hypertension to a SBP
Commentary on: Williamson JD, Supiano MA, Applegate WB, et al.. Intensive vs standard blood pressure control and cardiovascular disease outcomes in adults aged ≥75 years. A randomized clinical trial. JAMA 2016;315:2673–82 . Context There is uncertainty regarding optimal blood pressure (BP) targets in treating hypertension. Most recent guidelines have recommended a systolic target of <140 mm Hg. The Systolic Blood Pressure Intervention Trial (SPRINT) compared cardiovascular (CV) outcomes in non-diabetic hypertensive patients randomised to standard (systolic blood pressure (SBP) <140 mm&nbs...
Source: Evidence-Based Medicine - January 23, 2017 Category: Internal Medicine Authors: Weber, M. A. Tags: Palliative care, Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Stroke, Hypertension, Ischaemic heart disease, Renal medicine, Ethics Therapeutics/Prevention Source Type: research

Post-Acute Care Facility as a Discharge Destination for Patients in Need of Palliative Care in Brazil.
Abstract Patients with complex palliative care needs can experience delayed discharge, which causes an inappropriate occupancy of hospital beds. Post-acute care facilities (PACFs) have emerged as an alternative discharge destination for some of these patients. The aim of this study was to investigate the frequency of admissions and characteristics of palliative care patients discharged from hospitals to a PACF. We conducted a retrospective analysis of PACF admissions between 2014 and 2016 that were linked to hospital discharge reports and electronic health records, to gather information about hospital-to-PACF tran...
Source: The American Journal of Hospice and Palliative Care - December 31, 2016 Category: Palliative Care Authors: Soares LG, Japiassu AM, Gomes LC, Pereira R Tags: Am J Hosp Palliat Care Source Type: research

Race/Ethnicity as a Predictor for Location of Death in Patients With Acute Neurovascular Events.
CONCLUSION: This study did not show a difference in site of death in our institution by race or ethnicity, which is considered an important quality end-of-life care metric. PMID: 28056515 [PubMed - as supplied by publisher]
Source: The American Journal of Hospice and Palliative Care - December 31, 2016 Category: Palliative Care Authors: Salomon S, Chuang E, Bhupali D, Labovitz D Tags: Am J Hosp Palliat Care Source Type: research

Morphine exposure in preterm infants correlates with impaired cerebellar growth and poorer neurodevelopmental outcome
This study included 136 infants born at 24–32 weeks gestational age who underwent magnetic resonance imaging of the brain near birth and...
Source: Evidence-Based Medicine - November 22, 2016 Category: Internal Medicine Authors: McPherson, C. Tags: Clinical trials (epidemiology), Epidemiologic studies, Pain (neurology), Stroke, Pain (palliative care), Radiology, Drugs: musculoskeletal and joint diseases, Clinical diagnostic tests, Radiology (diagnostics) Aetiology/Harm Source Type: research

Predicting Performance Status 1 Year After Critical Illness in Patients 80 Years or Older: Development of a Multivariable Clinical Prediction Model
Conclusion: Approximately one-quarter of very old ICU patients achieve a reasonable level of function 1 year after admission. This prediction model applied to individual patients may be helpful in decision making about the utility of life support for very elderly patients who are admitted to the ICU.
Source: Critical Care Medicine - August 16, 2016 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research