Journal of palliative medicine
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Retraction Of Publication
Retraction of: Dayer et al., J Palliat Med 2016;19(5):538-541; DOI: 10.1089/jpm.2015.0230.
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To provide a guide to researchers selecting a dataset pertinent to the study of palliative care for people with dementia and to aid readers who seek to critically evaluate a secondary analysis study in this domain. ⋯ While secondary analysis of existing datasets requires consideration of key limitations, it can be a powerful tool for efficiently enhancing knowledge of palliative care needs among people with dementia.
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Case Reports
It is Electric! Electroconvulsive Therapy for Refractory Central Pain and Comorbid Psychiatric Disease.
Central pain syndromes are a complex, diverse group of clinical conditions that are poorly understood. We present a patient with progressive, debilitating central pain and co-existing mood disorders that was refractory to multimodal pharmacologic and nonpharmacologic therapies, but that ultimately responded to electroconvulsive therapy (ECT). ⋯ She began maintenance ECT, and a rate of roughly one treatment a month provided persistent pain suppression. Despite this lack of evidence, ECT has a favorable safety profile and can be considered in the therapeutic armamentarium for patients who have exhausted standard treatment regimens who continue to have suffering in the setting of central pain syndromes and coexisting mood disorders.
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Access to Palliative Care Consultation and Advance Care Planning for Adults with High-Risk Leukemia.
Although strong evidence supports early palliative care (PC) and consistent advance care planning (ACP) for patients with poor-prognosis Stage IV solid tumors, best practice standards have not been established for hematologic malignancies. Our primary objective was to describe current access to specialty PC consultation and ACP for inpatients with high-risk leukemia. Secondary objectives were to describe components of ACP and PC practices. ⋯ In this descriptive study of inpatients with high-risk leukemia, we found that despite a poor prognosis and high symptom burden, the frequency of PC consultation and ACP documentation was low. Findings suggest missed opportunities to provide PC to a high-risk subset of hematologic malignancies, and may help to target future interventions.
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Little is known about nursing home (NH) residents who receive palliative care (PC) consults in the United States. ⋯ The high rates of SNF care and six-month survival among NH recipients of PC consults demonstrate the utility of these consults before Medicare hospice eligibility or use.