Integration of a palliative care specialist in an amyotrophic lateral sclerosis clinic: Observations from one center

Palliative care specialists can aid in the care of patients with amyotrophic lateral sclerosis (ALS). In this article, we describe our 1-year experience incorporating a palliative care specialist into the ALS multidisciplinary team. We describe our integration model, patient selection, and visit content. Of 500 total clinic patients, 74 (14.8%) were seen by the palliative care specialist in 1 year. Referral was most often triggered by advance care planning needs (91%). In the initial visit with the palliative care specialist, topics most frequently covered included goals of care (84%), anxiety/depression (35%), and medical decision-making about feeding tubes (27%) or tracheostomy (31%). Symptom management comprised a relatively small number of the visits, and duration of visits was limited by patient fatigue. Patients with complex goals of care may benefit from the input of a palliative care specialist, and unique integration models may help to facilitate care delivery. Muscle Nerve 60: 137-140, 2019

Integration of a palliative care specialist in an amyotrophic lateral sclerosis clinic: Observations from one center

Palliative care specialists can aid in the care of patients with amyotrophic lateral sclerosis (ALS). In this article, we describe our 1-year experience incorporating a palliative care specialist into the ALS multidisciplinary team. We describe our integration model, patient selection, and visit content. Of 500 total clinic patients, 74 (14.8%) were seen by the palliative care specialist in 1 year. Referral was most often triggered by advance care planning needs (91%). In the initial visit with the palliative care specialist, topics most frequently covered included goals of care (84%), anxiety/depression (35%), and medical decision-making about feeding tubes (27%) or tracheostomy (31%). Symptom management comprised a relatively small number of the visits, and duration of visits was limited by patient fatigue. Patients with complex goals of care may benefit from the input of a palliative care specialist, and unique integration models may help to facilitate care delivery. Muscle Nerve 60: 137-140, 2019

Neurocysticercosis in Bhutan: a cross-sectional study in people with epilepsy

Background: We sought to provide an assessment of the burden of neurocysticercosis among people with epilepsy (PWE) in Bhutan and evaluate the yield of various tests for Taenia solium. Methods: PWE were enrolled at the National Referral Hospital in Thimphu (2014-2015). Serum was tested for anti-Taenia solium IgG using ELISA (Ab-ELISA), enzyme-linked immunoelectrotransfer blot (EITB), and parasite antigen. Results were compared to brain MRI. Participants were categorized as definite neurocysticercosis (MRI and EITB positive), probable neurocysticercosis (MRI or EITB positive), or without neurocysticercosis. Logistic regression models were constructed to explore clinicodemographic associations. Results: There were 12/205 (6%, 95% CI 2%, 9%) definite and 40/205 (20%, 95% CI 14%, 25%) probable neurocysticercosis cases. 25/205 (12%) with positive EITB did not have neurocysticercosis on MRI, and 15/205 (7%) participants with positive MRI had negative EITB. Participants with neurocysticercosis-suggestive lesions on MRI had an average of 1.2 cysts (parenchymal 26/27; nodular/calcified stage 21/27). In a multivariable analysis, present age (OR 1.05, 95% CI 1.01,1.09, p=0.025) was positively associated with (combined probable or definite) neurocysticercosis while mesial temporal sclerosis on MRI (OR 0.294, 95% CI 0.144, 0.598, p=0.001) was negatively associated. Conclusions: Neurocysticercosis was associated with 6-25% of epilepsy in a Bhutanese cohort. Combining EITB and MRI would aid the diagnosis of neurocysticercosis among PWE since no test identified all cases.Fil: Brizzi, Kate. Massachusetts General Hospital; Estados UnidosFil: Pelden, Sonam. Jigme Dorji Wangchuck National Referral Hospital; ButánFil: Tshokey, Tshokey. Jigme Dorji Wangchuck National Referral Hospital; ButánFil: Nirola, Damber K.. Jigme Dorji Wangchuck National Referral Hospital; ButánFil: Diamond, Megan B.. Massachusetts General Hospital; Estados UnidosFil: Klein, Joshua P.. Harvard Medical School; Estados UnidosFil: Tshering, Lhab. Jigme Dorji Wangchuck National Referral Hospital; ButánFil: Deki, Sonam. Jigme Dorji Wangchuck National Referral Hospital; ButánFil: Nidup, Dechen. Jigme Dorji Wangchuck National Referral Hospital; ButánFil: Bruno, Veronica Andrea. Massachusetts General Hospital; Estados Unidos. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Dorny, Pierre. Institute of Tropical Medicine; BélgicaFil: Garcia, Hector Hugo. Instituto Nacional de Ciencias Neurologicas Lima; PerúFil: Mateen, Farrah J.. Massachusetts General Hospital; Estados Unidos. Harvard Medical School; Estados Unido

St. John's Daily Star, 1920-02-24

The St. John's Daily Star was published daily except Sunday between 17 April 1915 - 23 July 1921

Phylogenetic and epidemiologic data relating to age-specific HIV incidence and transmission in Rakai, Uganda, 2003-2018

This repository contains the data for the analyses presented in the paper Growing gender inequity in HIV infection in Africa: sources and policy implications by M. Monod, A. Brizzi, R. Galiwango, R. Ssekubugu, Y. Chen, X. Xi et al