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Pre-admission functional status impacts the performance of the APACHE IV model of mortality prediction in critically ill patients.

BackgroundFunctional status (FS) before intensive care unit (ICU) admission is associated with short-term and long-term outcomes among critically ill patients. However, measures of FS are generally not integrated into ICU-specific mortality prediction models.MethodsThis retrospective cohort study used prospectively collected data from 9638 consecutive patients admitted to a single ICU between 1 October 2005 and 30 September 2015. For each ICU admission, FS was prospectively determined and classified into three discrete categories based on performance of basic daily living activities (FS1 - ful

Receipt of specialized palliative care and health care utilization at the end of life in hematological cancer patients - the Stockholm experience.

BackgroundThe treatments of hematological malignancies tend to be intense, and compared with solid tumors, less is known about the health care consumption during end of life (EOL). Therefore, the aim was to study the receipt of specialized palliative care (SPC) and how it affects health care utilization, in relation to sex, age, socioeconomics, and frailty risk (Hospital Frailty Risk Score [HFRS]).MethodsIn a retrospective, observational registry study, all patients who died of a hematological malignancy during the years 2015-2021 in the Stockholm County were included and analyzed with descrip

Healthcare professionals' perspectives of the management of people with palliative care needs in the emergency department of a UK hospital.

BackgroundThe Emergency Department (ED) is not always the optimal place for people with palliative care needs but is the most common route for treatment when urgent care is sought. The aim of this study,''REasons for PalLIative Care Admissions (REPLICA)' was to explore the perspectives of ED healthcare professionals of hospital admission or discharge via ED for palliative care patients.MethodsThis is a sequential mixed methods study comprising (i) quantitative descriptive analysis of Hospital Episode Statistics (HES) of palliative care patients (code Z51.5) who were admitted through ED in a We

Move more, age well: prescribing physical activity for older adults.

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Assessment of Psychiatric Disorders in Consultation-Liaison Setting.

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Последние новости и достижения в области диагностики и управления клетками Плазмы.

Плазменные клеточные дискразии (ПХД) охватывают разнородную группу расстройств, начиная от асимптоматических свойств-прекурсоров, таких, как моноклональная гаммопатия неопределенного значения (MGUS) и заморозка множественной миеломы (SMM) и кончая открытой множественной миеломой (MM), первичной плазменной лейкемией и системным амилоидозом. Этот обзор основан на структурированном поиске литературы, опубликованной между PubMed, Scopus, Cochrane Bibrary и Web of Science. 2015 и 2025, дополненные референцной проверкой и основными международными руководящими принципами в отношении миэломы для обесп

Social support and care burden in family caregivers of patients with hematologic malignancies: a parallel mediation model of coping strategies.

ObjectiveWith the rising incidence of hematologic malignancies (HMs) in recent years, caregivers of HMs patients have increasingly emerged as a significant factor affecting the treatment of these conditions. This study aimed to explore the association of coping strategies on the relationship between care burden and social support among family caregivers of HMs patients.MethodologyA questionnaire survey was conducted involving 207 family caregivers of hospitalized HMs patients in a tertiary hospital in Dalian from October 2023 to May 2024 and 200 valid responses were collected. We used hierarch

Identifying High-Cost, High-Risk Patients Using Administrative Databases in Tuscany, Italy.

Objective(1) Assessing the performance of the algorithm in terms of sensitivity and positive predictive value, considering General Practitioners' (GPs) judgement as benchmark, and (2) describing adverse events (hospitalisation, death, and health services' consumption) of complex patients compared to the general population.Data sources(i) Tuscany administrative database containing health data (2013-5); (ii) lists of complex patients indicated by GPs; and (iii) annual health registry of Tuscany.Study designThe present study is a validation study. It compares a list of complex patients extracted

Palliative care utilization in oncology and hemato-oncology: a systematic review of cognitive barriers and facilitators from the perspective of healthcare professionals, adult patients, and their families.

BackgroundDespite the high potential to improve the quality of life of patients and families, palliative care services face significant obstacles to their use. In countries with high-resource health systems, the nonfinancial and nonstructural obstacles to palliative care services are particularly prominent. These are the cognitive barriers -knowledge and communication barriers- to the use of palliative care. To date no systematic review has given the deserved attention to the cognitive barriers and facilitators to palliative care services utilization. This study aims to synthesize knowledge on

The concept of multidimensional frailty in geriatric oncology: a systematic scoping review.

BACKGROUND: One of the major challenges in geriatric oncology is to estimate the risk-benefit balance of any therapeutic proposal for each patient and frailty is one of the key components of Comprehensive Geriatric Assessment (CGA)and can also be assessed using stand-alone screening tools that predicts functional decline, treatment-related complications and mortality. This study aimed to provide an overview of the existing literature on the concept of multidimensional frailty in older adults with cancer, to clarify the dimensions included in multidimensional frailty, and the components of frai

Current management of cancer pain in Italy: Expert opinion paper.

IntroductionChronic pain and breakthrough cancer pain (BTcP) have a high prevalence in all cancer types and cancer stages, combined with a significant physical, psychological, and economic burden. Despite efforts to improve appropriate management of cancer pain, a poor assessment and guilty undertreatment are still reported in many countries. The purpose of this expert opinion paper is to contribute to reduce and clarify these issues with a multidisciplinary perspective in order to share virtuous paths of care.MethodsCommon questions about cancer pain assessment and treatment were submitted to

Delirium in cancer patients admitted to the intensive care unit: a retrospective study.

ObjectiveTo describe the occurrence of delirium in cancer patients admitted to the intensive care unit according to clinical and demographic characteristics.MethodsA retrospective study was conducted with 135 adults admitted to the intensive care unit of a public cancer hospital in the city of Rio de Janeiro, Brazil, between January and March 2016. Fisher's exact test and the linear association test were used to identify statistically significant associations between the occurrence of delirium and categorical and ordinal variables, respectively, considering a p-value ResultsThe overall occurre

Associations of Age and Sex with the Efficacy of Inpatient Cancer Rehabilitation: Results from a Longitudinal Observational Study Using Electronic Patient-Reported Outcomes.

Cancer rehabilitation is thought to increase the quality of life (QOL) and functioning of cancer survivors. It remains, however, uncertain whether subgroups benefit equally from rehabilitation. We wished to investigate the outcomes of multimodal rehabilitation according to age, sex and functioning. Patients of an Austrian rehabilitation center routinely completed the EORTC QLQ-C30 and the hospital anxiety and depression scale (HADS) questionnaires prior to (T1), and after rehabilitation (T2). To compare the outcomes between age groups (i.e., p p d. In conclusion, QOL is improved by rehabilitat

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… An Investigation of Geriatric Nursing Problems in Hospital. Volume 69 Churchill Livingstone; London, UK: 1962. 16. González-Expósito J., García-Román J.C., Prado-Amores M., Pardo-Fernández L., Pariente-Rodrigo E. …

A survey to determine usual care after cancer treatment within the United Kingdom national health service.

BackgroundApproximately one third of cancer survivors in the United Kingdom face ongoing and debilitating psychological and physical symptoms related to poor quality of life. Very little is known about current post-cancer treatment services.MethodsOncology healthcare professionals (HCPs) were invited to take part in a survey, which gathered both quantitative and free text data about the content and delivery of cancer aftercare and patient needs. Analysis involved descriptive statistics and content analysis.ResultsThere were 163 complete responses from 278 survey participants; 70% of NHS acute

Treatment Considerations for Severe Osteoporosis in Older Adults.

Osteoporosis, a chronic metabolic bone disease, increases the predisposition to fragility fractures and is associated with considerable morbidity, high health care cost as well as mortality. An elevation in the rate of incident fragility fractures will be observed proportional with the increase in the number of older people worldwide. Severe osteoporosis is currently defined as having a bone density determined by dual-energy X-ray absorptiometry that is more than 2.5 standard deviations (SD) below the young adult mean with one or more past fractures due to osteoporosis. Nutrition, physical act

Exploring the ethical decision-making experience of caregivers of end stage cancer patients in Iran: a phenomenological study.

BackgroundEthical decision making is a complex issue because it strongly depends on the religion, beliefs, traditional laws and moral views of each society. The purpose of this study was to explore the experience of Iranian family caregivers of end stage cancer patients about ethical decision making.MethodsThis qualitative study is based on van Manen's method of hermeneutic phenomenology. In-depth interviews were carried out to collect data. Participants were 12 caregiver. Audiotapes were transcribed and analyzed for common themes that represented the participants' experiences. Trustworthiness

Older cancer patients' information and support needs surrounding treatment: An evaluation through the eyes of patients, relatives and professionals.

BackgroundProviding cancer patients with adequate treatment information is important for patients' health, well-being and satisfaction. Nurses play an important role in patient education. So far, few studies focused on the specific information needs of older cancer patients surrounding chemotherapy treatment. Given the growing incidence of cancer among older individuals, insight in these needs is crucial. This article describes the views of older cancer patients, their relatives and professionals on older patients' specific communication needs regarding chemotherapy treatment.MethodsA qualitat

Venous thromboembolism in China: epidemiology, management strategies, and future directions.

Venous thromboembolism (VTE) is one of the leading causes of unexpected death among hospitalized patients. It is also a preventable condition, and its incidence can be substantially reduced through active and effective prophylaxis. In recent years, the burden of VTE in China has continued to increase, driven by population aging, a rising prevalence of malignancy, a growing volume of complex surgery, and advances in imaging and laboratory testing. At present, the clinical management paradigm for VTE in China has gradually evolved from the traditional acute event-centered 'diagnosis-treatment' p

Pathophysiology and treatment of osteoporosis: challenges for clinical practice in older people.

Osteoporosis, a common chronic metabolic bone disease is associated with considerable morbidity and mortality. As the prevalence of osteoporosis increases with age, a paralleled elevation in the rate of incident fragility fractures will be observed. This narrative review explores the origins of bone and considers physiological mechanisms involved in bone homeostasis relevant to management and treatment. Secondary causes of osteoporosis, as well as osteosarcopenia are discussed followed by an overview of the commonly used pharmacological treatments for osteoporosis in older people.

Improved functional assessment in cancer patients using home-based digital technologies.

Accurate assessment of performance status (PS) in oncology care is crucial for improving clinical decisions, therapy selection and anticipated risks of treatment toxicity. While physical function is traditionally assessed in the clinic, in-clinic instruments do not capture the full spectrum of daily functioning. Digital health technologies (DHTs) can address this limitation by passively monitoring patients in their daily environment. Our study showed at-home physical activity and gait metrics from DHTs were associated with self-reported PS in participants with cancer, and these metrics had gre