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Survival of Stage IV Lung Cancer Patients with Diabetes Treated with Metformin.
Conclusions: Metformin is associated with improved survival among diabetic patients with stage IV NSCLC suggesting a potential anticancer effect. Further research should evaluate plausible biological mechanisms as well as test the effect of metformin in prospective clinical trials.
PMID: 25522257 [PubMed - as supplied by publisher]
Source: American Journal of Respiratory and Critical Care Medicine - December 18, 2014 Category: Respiratory Medicine Authors: Lin JJ, Gallagher EJ, Sigel K, Mhango G, Galsky MD, Smith CB, LeRoith D, Wisnivesky JP Tags: Am J Respir Crit Care Med Source Type: research
Admission to the Intensive Care Unit and Well-being in Patients With Advanced Chronic Illness.
Conclusions Well-being trajectories declined sharply after admission to the intensive care unit, with recovery in the subsequent 6 months, and may be characterized by common patterns. These results help to better describe intensive care as a marker for advancing illness in patients with advanced chronic illness.
PMID: 23635931 [PubMed - as supplied by publisher]
Source: American Journal of Critical Care - May 1, 2013 Category: Nursing Authors: Chiarchiaro J, Olsen MK, Steinhauser KE, Tulsky JA Tags: Am J Crit Care Source Type: research
Physician Payments Sunshine Act: Organizations Respond to CMS
September 2nd marked the last day for comments on CMS’ proposed rule to eliminate the accredited continuing medical education (CME) exemption from Sunshine Act reporting. In an overwhelming display of support for the exemption, over 800 comments were submitted encouraging the agency to either maintain or expand the current exclusion.
-Total comments supporting maintenance or expansion of the CME exemption: 820
-Total comments supporting elimination of the CME exemption: approximately 20
-Percentage of comments supporting the CME exemption: 98%
We have followed this issue closely, and recentl...
Source: Policy and Medicine - September 8, 2014 Category: American Health Authors: Thomas Sullivan Source Type: blogs
Dismiss Simulation for Palliative Medicine Communication Training? Not So Fast
Conclusion While the results of this trial are disappointing, the negative results may reflect how challenging it is to study patient centered outcomes of educational interventions. This study also gives us an opportunity to reflect on how to define the patients who benefit most from communication training interventions, when the benefit is most likely to occur, and which trainees/practitioners might be in the best position to receive the intervention. No doubt, there are other interventions which may improve clinician communication in pivotal conversations, and we should also reflect on ways to improve the stu...
Source: Pallimed: A Hospice and Palliative Medicine Blog - December 23, 2013 Category: Palliative Carer Workers Authors: Lyle Fettig, MD Source Type: blogs
The man with the fedora in the ICU
I visit him in the ICU day in and day out. It’s the man with the fedora. I see him every day because he is not going anywhere. The metastatic cancer has ravaged his colon, bones, liver, and lungs. His oncologist is willing to try more chemo — but not now — maybe someday “when he is stronger.” The man has already failed several other regimens. The oncologist hasn’t seen him in a while. He’ll see the patient in clinic when he is discharged. He thanks us for keeping him updated.
Every day as I log on to the electronic health record in the top left corner, I see the man’s picture. Taken at an outpatient vis...
Source: Kevin, M.D. - Medical Weblog - June 7, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/daniel-z-uslan" rel="tag" > Daniel Z. Uslan, MD < /a > Tags: Physician Critical Care Hospital-Based Medicine Infectious Disease Source Type: blogs
Morbidity, mortality, and risk factors of emergency colorectal surgery among older patients in the Acute Care Surgery service: A retrospective study
CONCLUSION: Clinical perforation leads to sepsis and septic shock in older patients, this may be modifiable to improve mortality by developing an early, rapid, protocol-driven surgical sepsis fast-track process. Ventilator dependency is potentially modifiable with postoperative advanced surgical critical care. The non-modifiable risk factor of co-morbid heart disease might be improved by postoperative advanced critical care for close monitoring.PMID:33680448 | PMC:PMC7917398 | DOI:10.1016/j.amsu.2020.11.001
Source: Annals of Medicine - March 8, 2021 Category: Internal Medicine Authors: Chonlada Krutsri Preeda Sumpritpradit Pongsasit Singhatas Tharin Thampongsa Samart Phuwapraisirisan Goragoch Gesprasert Jakrapan Jirasiritham Pattawia Choikrua Source Type: research
Use of Inpatient Palliative Care Services in Patients With Advanced Cancer Receiving Critical Care Therapies.
Conclusions: Use of IPC was low in the cohort who received CCTs with poor outcomes, although data on outpatient palliative care services is lacking. Predictors of IPC use may be used to identify patients who may benefit from these services.
PMID: 30181417 [PubMed - in process]
Source: Journal of the National Comprehensive Cancer Network : JNCCN - September 6, 2018 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research
Gastrointestinal and Hepatobiliary Disease in Cystic Fibrosis
Semin Respir Crit Care Med DOI: 10.1055/s-0039-1697591Cystic fibrosis (CF) is a multiorgan disease, and gastrointestinal (GI) manifestations can contribute to significant morbidity and mortality for individuals with CF. Up to 85% of patients with CF experience GI symptoms, thus addressing the GI aspects of this disease is paramount. With the advent of highly effective CF transmembrane conductance regulator modulators that are increasingly available, many individuals with CF now have significantly improved life expectancy. With these advances, GI manifestations that can be a detriment to quality of life such as gastroesopha...
Source: Seminars in Respiratory and Critical Care Medicine - October 27, 2019 Category: Respiratory Medicine Authors: Gabel, Megan E. Galante, Gary J. Freedman, Steven D. Tags: Review Article Source Type: research
Trends and Social Barriers for Inpatient Palliative Care in Patients With Metastatic Bladder Cancer Receiving Critical Care Therapies.
CONCLUSIONS: The rate of IPC use in patients with mUCB receiving CCTs sharply increased between 2004 and 2015. The presence of liver metastases, infections, or cardiopulmonary disorders as admission diagnoses represented independent predictors of higher IPC use. Conversely, Hispanic race, nonteaching hospital status, and hospitalization in the Midwest were identified as independent predictors of lower IPC use and represent targets for efforts to improve IPC delivery in patients with mUCB receiving CCT.
PMID: 31693981 [PubMed - in process]
Source: Journal of the National Comprehensive Cancer Network : JNCCN - November 8, 2019 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research
The Dangers of Big Corporate Health Care: Deceptive Marketing of Cancer Treatments
A series of articles over the last few months, culminating in an investigative report by Reuters, provided the newest example of what can go wrong when corporations provide direct care to vulnerable patients. In this case, the vulnerable patients had cancer, and the corporation that provided them care was the Cancer Treatment Centers of America (CTCA). I will try to go through the case chronologically.As Rueters reported, CTCA "was founded in 1988 by Richard J. Stephenson, who has been chairman ever since."The Founder's Checkered PastA Misdemeanor As Reuters noted,A graduate of Northwestern University Law Schoo...
Source: Health Care Renewal - March 11, 2013 Category: Health Medicine and Bioethics Commentators Tags: deception crime marketing Cancer Treatment Centers of America hospital systems complementary/ alternative medicine Source Type: blogs
Colorectal carcinoma in pediatric patients: A comparison with adult tumors, treatment and outcomes from the National Cancer Database
Pediatric colorectal cancer (CRC) is rare. Comparison with adult CRC tumors, management, and outcomes may identify opportunities for improvement in pediatric CRC care.
Source: Journal of Pediatric Surgery - December 16, 2015 Category: Surgery Authors: Gabriela C. Poles, David E. Clark, Sara W. Mayo, Elizabeth A. Beierle, Melanie Goldfarb, Kenneth W. Gow, Adam Goldin, John J. Doski, Jed G. Nuchtern, Sanjeev A. Vasudevan, Monica Langer Source Type: research
How I Use P4 Medicine to Maximize Patient Engagement
By MOLLY MALOOF, MD SPONSORED CONTENT
The healthcare industry is changing as new models of care and reimbursement emerge. One of these approaches is P4 Medicine. P4 Medicine stands for predictive, preventive, personalized, and participatory. This approach deeply resonates with me because the philosophy is aligned with how I have been developing my medical practice, which is focused on optimizing health and avoiding disease. In my opinion, P4 Medicine is one of the best models for maximizing patient engagement.
The earliest manifestation of P4 Medicine began eight years ago at the Instit...
Source: The Health Care Blog - September 23, 2015 Category: Consumer Health News Authors: John Irvine Tags: THCB Institute of Systems Biology Kareo Molly Maloof P4 Medicine Source Type: blogs
Inequalities in end-of-life care for colorectal cancer patients in Nova Scotia, Canada.
This study demonstrates that although access to, and quality of, EOL care appears to have improved, there remain significant inequalities throughout the population. Of primary concern is the variation in access to, and quality of, EOL care based on geographic location of residence and patient age.
PMID: 22860381 [PubMed - indexed for MEDLINE]
Source: Journal of Palliative Care - June 3, 2015 Category: Palliative Care Tags: J Palliat Care Source Type: research
