Journal of palliative medicine
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Bleeding stomal varices (BSV) is a common problem in patients undergoing an ileostomy or colostomy. The diagnosis is often delayed as blood loss occurs in small amounts over a period of time, usually from minor anastamosing blood vessels at the ostomy site making it hard to diagnose. Treatment options can be limited in terms of modalities and efficacy. ⋯ Embolization of a recurrent bleeding stomal varix with a liquid copolymer may be an effective therapeutic option.
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Consumerism in health care defines patients as self-determined, rational customers. Yet, it is questionable whether vulnerable patients, such as the terminally ill, also fulfill these criteria. Vulnerable contexts and the patient's perspective on being a customer remain relatively unexplored. The present study addresses this research gap by analyzing terminally ill patients' views on being customers. ⋯ The idealized customer role cannot be arbitrarily applied to all medical fields. Palliative patients are dependent on the physician, regardless of whether the customer or patient role is preferred. Hence, self-determination must be understood in relational terms, and physicians must recognize their crucial role in promoting patients' self-determination in the context of shared decision-making.
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8,600 children are eligible for palliative care services each day in the US, yet many pediatric residents and pediatricians do not feel comfortable providing palliative/end of life care. ⋯ Reported presence of a PCT may be associated with greater resident comfort in providing PPC and a more accurate understanding of PPC. There remains ample opportunity to educate pediatric and IM/Peds residents in PPC.