Stents in the Gastrointestinal Tract in Palliative Care

2011 ◽  
pp. 159-169
Author(s):  
Iruru Maetani
Keyword(s):  
Palliative Care ◽  
Gastrointestinal Tract

Determinants of Palliative Care Utilization Among Patients Hospitalized With Metastatic Gastrointestinal Malignancies

2016 ◽  
Vol 34 (3) ◽  
pp. 269-274 ◽  
Author(s):  
Philip N. Okafor ◽  
Derrick J. Stobaugh ◽  
Augustine K. Nnadi ◽  
Jayant A. Talwalkar
Keyword(s):  
Palliative Care ◽  
Gastrointestinal Tract ◽  
African Americans ◽  
Native Americans ◽  
Length Of Stay ◽  
Regression Model ◽  
Care Utilization ◽  
To Receive ◽  
Total Charges ◽  
White Patients

Background: Gastrointestinal tract cancers account for a significant proportion of the national cancer burden. Aim: We sought to explore patient- and hospital-level determinants of palliative care utilization among patients hospitalized with metastatic gastrointestinal tract cancers using a national database. Methods: An analysis of the 2012 National Inpatient Sample was performed. International Classification of Diseases, Ninth Revision codes were used to identify hospital discharges associated with metastatic digestive tract cancers and patient/hospital covariates for inclusion in a logistic regression model. Total charges and length of stay were analyzed in a linear regression model. Results: Compared to males, females were more likely to receive inpatient palliative care (adjusted odds ratio [OR] 1.12, P = .002). No difference was seen between white and Asian patients (adjusted OR 1.2, P = .11) or Native Americans patients (adjusted OR 1.4, P = .22). However, relative to white patients, African Americans (adjusted OR 1.13, P = .02) and Hispanics (adjusted OR 1.25, P = .001) had significantly higher odds of inpatient palliative care. Medicare patients were least likely to receive palliative care compared to those with Medicaid or commercial payers. Length of stay during these hospitalizations was longer in African Americans ( P = .0001), Asians ( P = .0001), and Native Americans ( P = .03) compared to white patients. No difference was seen when total charges were compared between white and African American patients ( P = .08). Conversely, total charges were higher in Hispanics ( P = .005) and Asians ( P = .001) relative to white patients. Conclusion: Gender and racial differences exist in utilization of inpatient palliative care among patients hospitalized with metastatic gastrointestinal tract cancers.

Nausea and vomiting

2021 ◽  
pp. 534-544
Author(s):  
Saskie Dorman
Keyword(s):  
Palliative Care ◽  
Social Interaction ◽  
Gastrointestinal Tract ◽  
Area Postrema ◽  
Nausea And Vomiting ◽  
Psychological State ◽  
Solitary Tract ◽  
Hyoscine Hydrobromide ◽  
Neurokinin Antagonists ◽  
Metabolic Treatment

Nausea and vomiting are common, distressing symptoms, with significant impacts on physical functioning, psychological state, and social interaction. There are numerous causes including gastrointestinal, metabolic, treatment-related, vestibular, cranial, and psychological causes. Vomiting is mediated through pathways involving the nucleus of the solitary tract in the brainstem, with inputs from the gastrointestinal tract, viscera, vestibular system, area postrema, and higher centres. Nausea involves more complex connections between gut and brain. The roles of non-pharmacological strategies and medications (including levomepromazine, olanzapine, haloperidol, metoclopramide, domperidone, hyoscine hydrobromide, serotonin (5-HT3) antagonists, neurokinin antagonists, and others) are discussed. Emerging evidence in palliative care will facilitate optimum treatment.

Habitat Association of Klebsiella Species

1985 ◽  
Vol 6 (2) ◽  
pp. 52-58 ◽  
Author(s):  
Susan T. Bagley
Keyword(s):  
Drinking Water ◽  
Gastrointestinal Tract ◽  
Surface Waters ◽  
Industrial Effluents ◽  
Opportunistic Pathogen ◽  
Habitat Associations ◽  
Habitat Association ◽  
Klebsiella Species ◽  
Almost All ◽  
Polluted Waters

AbstractThe genus Klebsiella is seemingly ubiquitous in terms of its habitat associations. Klebsiella is a common opportunistic pathogen for humans and other animals, as well as being resident or transient flora (particularly in the gastrointestinal tract). Other habitats include sewage, drinking water, soils, surface waters, industrial effluents, and vegetation. Until recently, almost all these Klebsiella have been identified as one species, ie, K. pneumoniae. However, phenotypic and genotypic studies have shown that “K. pneumoniae” actually consists of at least four species, all with distinct characteristics and habitats. General habitat associations of Klebsiella species are as follows: K. pneumoniae—humans, animals, sewage, and polluted waters and soils; K. oxytoca—frequent association with most habitats; K. terrigena— unpolluted surface waters and soils, drinking water, and vegetation; K. planticola—sewage, polluted surface waters, soils, and vegetation; and K. ozaenae/K. rhinoscleromatis—infrequently detected (primarily with humans).

Much Ado About Fried Chicken: Abetting Aspiration or Respecting Autonomy?

2019 ◽  
Vol 28 (3) ◽  
pp. 1356-1362
Author(s):  
Laurence Tan Lean Chin ◽  
Yu Jun Lim ◽  
Wan Ling Choo
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Multidisciplinary Team ◽  
Biopsychosocial Model ◽  
Family Members ◽  
Clinical Decisions ◽  
Goals Of Care ◽  
Complex Needs ◽  
Aspiration Risk ◽  
Patient Centric

Purpose Palliative care is a philosophy of care that encompasses holistic, patient-centric care involving patients and their family members and loved ones. Palliative care patients often have complex needs. A common challenge in managing patients near their end of life is the complexity of navigating clinical decisions and finding achievable and realistic goals of care that are in line with the values and wishes of patients. This often results in differing opinions and conflicts within the multidisciplinary team. Conclusion This article describes a tool derived from the biopsychosocial model and the 4-quadrant ethical model. The authors describe the use of this tool in managing a patient who wishes to have fried chicken despite aspiration risk and how this tool was used to encourage discussions and reduce conflict and distress within the multidisciplinary team.

Swallowing Management in Palliative Care

ASHA Leader ◽  
2017 ◽  
Vol 22 (9) ◽  
Author(s):  
Brenda Arend ◽  
Kate Krival
Keyword(s):  
Palliative Care
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