Updates in Hospital Palliative Care

Background: This review critiques recent palliative care (PC) literature with likelihood of impacting general hospital practice in order to help address the PC needs of patients. Methods: Articles published between January and December 2018 were identified through hand-search of leading PC journals and MEDLINE search. The final ten selected articles were determined by consensus based on scientific rigor, relevance to general hospital medicine, and impact to practice. Results: Key findings include: Early PC interventions reduced healthcare costs; Prognostic awareness of surrogates of patients with advanced dementia was associated with reduced burdensome interventions; Care transitions, especially in the last 3 days of life, can be detrimental to caregivers' well-being and perceptions of care; Haloperidol was effective for treatment of nausea and vomiting without untoward effects; Antipsychotics did not improve delirium symptoms in hospitalized patients; A fan directed to the face improved dyspnea; Disparities in advance directive completion disappeared when equal opportunities were given; Improving communication with families of critically ill patients improved perceptions of patient-centered care; Communication-priming tools improved the quality and documentation of goals of care conversations; Discussing prognosis did not harm the patient-provider relationship. Conclusion: Recent PC research affirmed the importance of PC delivery to patients with life-limiting illness and provided important guidance to hospitalists on symptom management, advance care planning, and communication.Rachel D. Havyer (1*), Nauzley Abedini (2), Robert L. Jayes (3), Brenda Matti-Orozco (4), Daniel H. Pomerantz (5), Aziz A. Ansari (6); 1. Division of Community Internal Medicine, Mayo Clinic. 2. Division of Palliative Medicine, University of California San Francisco. 3. Division of Geriatrics and Palliative Medicine, George Washington University Medical Faculty Associates. 4. Division of General Internal Medicine and Palliative Medicine, Morristown Medical Center, Atlantic Health System. 5. Department of Medicine, Montefiore New Rochelle Hospital. 6. Division of Hospital Medicine, Loyola University Medical CenterIncludes bibliographical reference

Gain of MYC underlies recurrent trisomy of the MYC chromosome in acute promyelocytic leukemia

The leukemogenic effects of Myc drive recurrent trisomy in a mouse model of acute myeloid leukemia

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Tres mundos, una novela

Thesis (B.A.)--University of Illinois at Urbana-Champaign, 1999.Includes bibliographical reference (leaves 25-26)U of I OnlyTheses restricted to UIUC community onl

Satiation effects in the perception of single letters

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/148508/1/1969_PandP_Pomerantz1et_al_SatiationEffects.pd

Palliative care: An update for internists

All clinicians should maintain basic skills in general palliative care to help address the needs of patients and families. Because keeping up with the information provided by the growing palliative care literature can be challenging, we conducted a detailed search via Medline for palliative care articles published in 2020 in top peer-reviewed medical journals. Using a consensus-driven process of selection, we reviewed and summarized 11 articles to enhance knowledge of the practice-changing palliative care literature for general internists